Mental Health Exam 1

. Which finding in a patient with Alzheimer's disease best describes the term agnosia? A. The patient uses a fork to eat a bowl of soup. B. The patient makes up a word to recall the name of an object. C. The patient can't recall their address. D. The patient is unable to perform the movements needed to use their hair brush.

A

Malou with schizophrenia tells Nurse Melinda, "My intestines are rotted from worms chewing on them." This statement indicates a: A. Jealous delusion B. Somatic delusion C. Delusion of grandeur D. Delusion of persecution

B

Ivy, who is in the psychiatric unit is copying and imitating the movements of her primary nurse. During recovery, she says, "I thought the nurse was my mirror. I felt connected only when I saw my nurse." This behavior is known by which of the following terms? A. Modeling B. Echopraxia C. Ego-syntonicity D. Ritualism

B

Katrina, a newly admitted is extremely hostile toward a staff member she has just met, without apparent reason. According to Freudian theory, the nurse should suspect that the client is experiencing which of the following phenomena? A. Intellectualization B. Transference C. Triangulation D. Splitting

B

Which ability should Nurse Rebecca expect from a client in the mild stage of dementia of the Alzheimer's type? A. Remembering the daily schedule. B. Recalling past events. C. Coping the anxiety. D. Solving problems of daily living.

B

Which information is most important for the nurse to include in a teaching plan for a schizophrenic client taking clozapine (Clozaril)? A. Monthly blood tests will be necessary. B. Report a sore throat or fever to the physician immediately. C. Blood pressure must be monitored for hypertension. D. Stop the medication when symptoms subside.

B

A client is about to be discharged with a prescription for the antipsychotic agent haloperidol (Haldol), 10 mg by mouth twice per day. During a discharge teaching session, the nurse should provide which instruction to the client? A. Take the medication 1 hour before a meal. B. Decrease the dosage if signs of illness decrease. C. Apply sunscreen before being exposed to the sun. D. Increase the dosage up to 50 mg twice per day if signs of illness don't decrease.

C

A student nurse was asked which of the following best describes dementia. Which of the following best describes the condition? A. Memory loss occurring as part of the natural consequence of aging. B. Difficulty coping with physical and psychological change. C. Severe cognitive impairment that occurs rapidly. D. Loss of cognitive abilities, impairing ability to perform activities of daily living.

D

Danny, who is diagnosed with bipolar disorder and acute mania, states the nurse, "Where is my daughter? I love Louis. Rain, rain go away. Dogs eat dirt." The nurse interprets these statements as indicating which of the following? A. Echolalia B. Neologism C. Clang associations D. Flight of ideas

D

Mrs. Mendoza is a 75-year-old client who has dementia of the Alzheimer's type and confabulates. The nurse understands that this client: A. Denies confusion by being jovial. B. Pretends to be someone else. C. Rationalizes various behaviors. D. Fills in memory gaps with fantasy.

D

A female client is admitted with a diagnosis of delusions of grandeur. This diagnosis reflects a belief that one is: A. Being Killed. B. Highly famous and important. C. Responsible for an evil world. D. Connected to the client unrelated to oneself.

b

Mrs. Jordan is an elderly client diagnosed with Alzheimer's disease. She becomes agitated and combative when a nurse approaches to help with morning care. The most appropriate nursing intervention in this situation would be to: A. Tell the client firmly that it is time to get dressed. B. Obtain assistance to restrain the client for safety. C. Remain calm and talk quietly to the client. D. Call the doctor and request an order for sedation.

c

A client with schizophrenia who receives fluphenazine (Prolixin) develops pseudoparkinsonism and akinesia. What drug would the nurse administer to minimize extrapyramidal symptoms? A. benztropine (Cogentin) B. dantrolene (Dantrium) C. clonazepam (Klonopin) D. diazepam (Valium)

A

Which neurotransmitter has been implicated in the development of Alzheimer's disease? A. Acetylcholine B. Dopamine C. Epinephrine D. Serotonin

A

A patient was recently diagnosed with Mild Alzheimer's (Early-stage Alzheimer's disease). What important educational topics should the nurse provide to this patient at this time? Select all that apply: A. Progression of the disease B. Future planning C. Surgical options D. Medications

A B D

The nurse is teaching a psychiatric client about her prescribed drugs, chlorpromazine, and benztropine. Why is benztropine administered? A. To reduce psychotic symptoms. B. To reduce extrapyramidal symptoms. C. To control nausea and vomiting. D. To relieve anxiety.

B

Which of the following is one of the advantages of the newer antipsychotic medication risperidone (Risperdal)? A. The absence of anticholinergic effects. B. A lower incidence of extrapyramidal effects. C. Photosensitivity and sedation. D. No incidence of neuroleptic malignant syndrome.

B

Nurse Arya assesses for evidence of positive symptoms of schizophrenia in a newly admitted client. Which of the following symptoms are considered positive evidence? Select all that apply. A. Anhedonia B. Delusions C. Flat affect D. Hallucinations E. Loose associations F. Social withdrawal

B, D, E

A client with persistent, severe schizophrenia has been treated with phenothiazines for the past 17 years. Now the client's speech is garbled as a result of drug-induced rhythmic tongue protrusion. What is another name for this extrapyramidal symptom? A. Dystonia B. Akathisia C. Pseudoparkinsonism D. Tardive dyskinesia

D

A patient taking a cholinesterase inhibitor is experiencing nausea and diarrhea. These side effects can be decreased by doing which of the following? A. Administering the medication on an empty stomach B. Administering the medication with meals C. Administering the medication two hours before a meal D. Administering the medication at bedtime

b

Nurse Monette recognizes that the focus of environmental (MILIEU) therapy is to: A. Manipulate the environment to bring about positive changes in behavior. B. Allow the client's freedom to determine whether or not they will be involved in activities. C. Role play life events to meet individual needs. D. Use natural remedies rather than drugs to control behavior.

A

The nurse collecting family assessment data asks. "Who is in your family and where do they live?" Which of the following is the nurse attempting to identify? A. Boundaries B. Ethnicity C. Relationships D. Triangles

A

The nurse is planning care for a client admitted to the psychiatric unit with a diagnosis of paranoid schizophrenia. Which nursing diagnosis should receive the highest priority? A. Risk for violence toward self or others B. Imbalanced nutrition: Less than body requirements C. Ineffective family coping D. Impaired verbal communication

A

The nurse understands that the therapeutic effects of typical antipsychotic medications are associated with which neurotransmitters change? A. Decreased dopamine level B. Increased acetylcholine level C. Stabilization of serotonin D. Stimulation of GABA

A

When establishing an initial nurse-client relationship, Nurse Hazel should explore with the client the: A. Client's perception of the presenting problem. B. Occurrence of fantasies the client may experience. C. Details of any ritualistic acts carried out by the client. D. Client's feelings when external; controls are instituted

A

Nurse Winona educates the family about symptom management for when the schizophrenic client becomes upset or anxious. Which of the following would Nurse Winona state be helpful? A. Call the therapist to request a medication change. B. Encourage the use of learned relaxation techniques. C. Request that the client be hospitalized until the crisis is over. D. Wait before the anxiety worsens before intervening.

B

Select the statement below that best describes how Galantamine works to treat a patient with Alzheimer's disease. A. "This medication decreases the amount of glutamate readily available at the receptor site." B. "Galantamine prevents the breakdown of acetylcholine." C. "This medication decreases the levels of acetylcholine in the brain." D. "Galantamine decrease beta-amyloid plaques in the brain."

B

Two nurses are co-leading group therapy for seven clients in the psychiatric unit. The leaders observe that the group members are anxious and look to the leaders for answers. Which phase of development is this group in? A. Conflict resolution phase B. Initiation phase C. Working phase D. Termination phase

B

A patient with Severe Alzheimer's Disease is prescribed to take Memantine. Which statement best describes how this medication works to treat this disease? A. "It increases acetylcholine levels in the brain." B. "It prevents the enzyme cholinesterase from working." C. "It limits how glutamate can engage the NMDA receptor in the brain." D. "It decreases beta amyloid plaques in the brain."

C

Nurse Isabelle enters the room of a client with a cognitive impairment disorder and asks what day of the week it is; what the date, month, and year are; and where the client is. The nurse is attempting to assess: A. Confabulation. B. Delirium. C. Orientation. D. Perseveration.

C

Ricky with chronic schizophrenia takes neuroleptic medication and is admitted to the psychiatric unit. Nursing assessment reveals rigidity, fever, hypertension, and diaphoresis. These findings suggest which life-threatening reaction: A. Tardive dyskinesia B. Dystonia C. Neuroleptic malignant syndrome D. Akathisia

C

Which nursing statement is a good example of the therapeutic communication technique of focusing? A. "Describe one of the best things that happened to you this week." B. "I'm having a difficult time understanding what you mean." C. "Your counseling session is in 30 minutes. I'll stay with you until then." D. "You mentioned your relationship with your father. Let's discuss that further."

D

Which of the following will Nurse Dory use when communicating with a client who has cognitive impairment? A. Complete explanations with multiple details. B. Pictures or gestures instead of words. C. Stimulating words and phrases to capture the client's attention. D. Short words and simple sentences.

D

Jaime has a diagnosis of schizophrenia with negative symptoms. In planning care for the client, Nurse Brienne would anticipate a problem with: A. Auditory hallucinations B. Bizarre behaviors C. Ideas of reference D. Motivation for activities

D.

Nurse Tony should first discuss terminating the nurse-client relationship with a client during the: A. Termination phase when discharge plans are being made. B. Working phase when the client shows some progress. C. Orientation phase when a contract is established. D. Working phase when the client brings it up.

c

Which client outcome is most appropriately achieved in a community approach setting in psychiatric nursing? A. The client performs activities of daily living and learns about crafts. B. The client is able to prevent aggressive behavior and monitors his use of medications. C. The client demonstrates self-reliance and social adaptation. D. The client experiences anxiety relief and learns about his symptom

c

You're providing education to a group of caregivers about wandering in Alzheimer's disease. You ask the participants to verbalize signs a family member with this disease may be experiencing wandering. Which sign verbalized by a participant requires re-education? A. The family member takes longer than expected to return from a place. B. The family member repeatedly requests to visit an old acquaintance. C. The family member refuses to leave their bedroom. D. The family member has trouble finding rooms within the house.

c