Mental Health Test One (Chapters 56/57)

The nurse is completing a mental status examination for a newly admitted patient. In which part of the nursing process is the nurse functioning? A) Assessment B) Planning C) Implementation D) Evaluation

A) Assessment

A student feels anxious about being unprepared for an upcoming test. Which action is a positive response to this anxiety? A) Canceling nonessential activities for 3 days to study B) Staying up all night the night before the test to study C) Borrowing notes from another student who has had the class in the past D) Choosing not to worry about studying because grades have been good so far

A) Canceling nonessential activities for 3 days to study

The spouse of an older male patient is concerned because since retiring the patient sits around the house, avoids eating, naps, and refuses to participate in sporting activities. Which disorder should the nurse recognize as being associated with these manifestations? A) Depression B) Bipolar disorder C) Conversion disorder D) Post-traumatic stress disorder (PTSD)

A) Depression

After collecting data the nurse is concerned that a patient is at risk for developing a mental illness. What findings caused the nurse to come to this conclusion? (Select all that apply.) A) Difficulty thinking B) Discussed the use of daily exercise to deal with stress C) Made statements indicating being out of touch with reality D) Expressed remorse in having to leave a pet dog with a neighbor E) Explaining a lack of friends because everyone is jealous of the patient

A) Difficulty thinking C) Made statements indicating being out of touch with reality E) Explaining a lack of friends because everyone is jealous of the patient

A patient with schizophrenia is returning from a CT scan of the brain followed by an electroencephalogram. Which diagnostic test findings should the nurse identify as supporting this patient's diagnosis? (Select all that apply.) A) Enlarged ventricles B) Reduced amount of gray matter C) Areas of nerve de-myelinization D) Aneurysms of the cerebral vessels E) Diminished prefrontal cortex activity

A) Enlarged ventricles B) Reduced amount of gray matter E) Diminished prefrontal cortex activity

The nurse is assisting in planning care for a patient with extreme anxiety. Which interventions should the nurse include in this patient's plan of care? (Select all that apply.) A) Maintain a calm environment. B) Encourage verbalization of feelings. C) Model and encourage positive self-talk. D) Encourage participation in competitive activities. E) Permit the patient to have time alone during acute anxiety events.

A) Maintain a calm environment. B) Encourage verbalization of feelings. C) Model and encourage positive self-talk.

The nurse is reviewing potential patient teaching needs. For which prescribed medications should the nurse plan to instruct patients to follow a tyramine-free diet? (Select all that apply.) A) Phenelzine (Nardil) B) Buspirone (Buspar) C) Isocarboxazid (Marplan) D) Valproic acid (Depakote) E) Lithium carbonate (Eskalith)

A) Phenelzine (Nardil) C) Isocarboxazid (Marplan)

The nurse is assisting in the preparation of an educational seminar on anxiety disorders. Which anxiety disorders should the nurse make sure are included in this presentation? (Select all that apply.) A) Phobia B) Panic disorder C) Schizophrenia D) Unipolar depression E) Post-traumatic stress disorder F) Obsessive-compulsive disorder

A) Phobia B) Panic disorder E) Post-traumatic stress disorder F) Obsessive-compulsive disorder

After being admitted for a surgical procedure a patient with a history of schizophrenia becomes extremely agitated when other patients are around and believes that others want to cause the patient harm. Which intervention should the nurse use to provide a therapeutic milieu for the patient? A) Place the patient in a private room. B) Request an order for antipsychotic medications. C) Help the patient clarify the meaning of the feelings. D) Suggest the patient be scheduled for a psychotherapy session.

A) Place the patient in a private room.

A patient with extreme anxiety is arriving for out-patient chemotherapy. What should the nurse do to help reduce the patient's anxiety during this current treatment? A) Play a CD with nature sounds. B) Select a television station with a sporting event. C) Close the door to the room during the treatment. D) Remind the patient that anxiety is not going to make the treatment effective.

A) Play a CD with nature sounds.

After talking with a patient being evaluated for a mental health disorder, the nurse says, "It sounds as if you are feeling angry." Which therapeutic communication technique is the nurse employing? A) Restating B) Reflecting C) Giving recognition D) Offering a general lead

A) Restating

A young mother is angry with the mess her son has made in his room. She yells at him and tells him to stay in his room until it is cleaned up. About 20 minutes later, the mother enters the boy's room offering him milk and cookies. Which ego defense mechanism is the mother using? A) Restitution B) Regression C) Reaction formation D) Conversion reaction

A) Restitution

The nurse is caring for a patient experiencing depression. Which neurotransmitters should the nurse consider being decreased in this patient? (Select all that apply.) A) Serotonin B) Dopamine C) Substance P D) Acetylcholine E) Norepinephrine

A) Serotonin B) Dopamine E) Norepinephrine

A patient comes into the emergency department experiencing chest pain and feelings of impending doom. Which assessment findings should the nurse use to determine if this patient is experiencing a panic attack? (Select all that apply.) A) Shaking B) Neck pain C) Dissociation D) Vomiting brown emesis E) Occurs at 3 p.m. every day

A) Shaking C) Dissociation

The nurse is caring for a patient experiencing anxiety. Which techniques should the nurse use when instructing on progressive muscle relaxation therapy? (Select all that apply.) A) Start at the head and neck. B) End with the lower extremities. C) Play soft music to aid with relaxation. D) Systematically tense and relax muscle groups. E) Imaging a pleasurable experience from the past.

A) Start at the head and neck. B) End with the lower extremities. D) Systematically tense and relax muscle groups. E) Imaging a pleasurable experience from the past.

The nurse is visiting the home of a patient with a mental health disorder. What should the nurse ensure during this home visit? (Select all that apply.) A) Status of suicide ideation B) Ability to provide self-care safely C) Patient's risk of falling in the home D) Number of family members who visit E) Compliance with prescribed medications

A) Status of suicide ideation B) Ability to provide self-care safely C) Patient's risk of falling in the home E) Compliance with prescribed medications

The nurse is assisting a patient identify coping mechanisms. What general definition of "coping" is the nurse most likely using with this patient? A) The way one adapts to a stressor B) The adaptation to mental health problems C) The use of specific mechanisms to reduce anxiety D) The development of unconscious behaviors to reduce psychological distress

A) The way one adapts to a stressor

The nurse assists with admission of a patient to the hospital with pancreatitis and a history of alcohol abuse. Why should the nurse observe the patient for agitation, tremors, and hallucinations? A) These are symptoms of alcohol withdrawal. B) These symptoms indicate possible cirrhosis of the liver. C) The patient may be using alcohol in the hospital setting. D) Patients with a history of alcohol abuse are at risk for mental illness.

A) These are symptoms of alcohol withdrawal.

The nurse is providing care for a patient with symptoms of tardive dyskinesia from major tranquilizers. What treatment should the nurse anticipate? A) Use of anticholinergic agents B) Use of muscle relaxant agents C) Discontinuance of the tranquilizers D) Addition of rational emotive therapy to the treatment plan

A) Use of anticholinergic agents

A patient who has been diagnosed with a mental illness tells the nurse about plans to find a voodoo doctor. How should the nurse respond? A) "You know voodoo doctors can't really help you. Don't waste your money." B) "Be sure to mention your plan to your psychiatrist. It is important to follow up with that treatment plan also." C) "Research has shown that voodoo can effectively treat many mental health disorders. That decision is up to you." D) "I do not think using voodoo is safe. I would recommend you think about it carefully before contacting a voodoo doctor."

B) "Be sure to mention your plan to your psychiatrist. It is important to follow up with that treatment plan also."

A patient hospitalized for bipolar disorder is sitting in the corner of the room with the lights off, staring into space. Three hours later, the patient is in the same position. What should the nurse say to the patient? A) "Cheer up! Come on out and join us in a game!" B) "Come with me. I'd like you join our group for a while." C) "You won't make any progress if you stay in your room all the time." D) "What's the matter? Don't you know you should be in your group right now?"

B) "Come with me. I'd like you join our group for a while."

The nurse is caring for an older adult patient with a history of depression. Which comment by the patient indicates an immediate need for further assessment? A) "I am so old; all my friends have died." B) "I am useless now; there is no reason to be alive." C) "I retire in 6 months, and it will be all downhill from there." D) "I am looking forward to seeing my husband in heaven someday."

B) "I am useless now; there is no reason to be alive."

While providing care a teenage mother expresses ambivalence about her new role as a parent. Which response by the nurse is best? A) "I'll call the social worker so you can discuss adoption." B) "Tell me more about how you feel when you hold the baby." C) "Parenthood is certainly not for everyone, you shouldn't feel guilty about that." D) "I'm sure your own parents felt the same way when you were small, you should talk to your mom."

B) "Tell me more about how you feel when you hold the baby."

The nurse is cautiously avoiding the temptation to take unused or wasted doses of narcotic medications when providing patient care. What percentages of nurses in the United States are chemically impaired? A) 0% to 5% B) 6% to 15% C) 25% to 35% D) 49% to 50%

B) 6% to 15%

The nurse is caring for a patient who is verbalizing concerns related to a difficult relationship. Which responses by the nurse will block communication and should be avoided? (Select all that apply.) A) Using silence B) Asking "why" C) Changing the subject D) Agreeing or disagreeing E) Verbalizing the implied

B) Asking "why" C) Changing the subject D) Agreeing or disagreeing

A patient with depression is prescribed duloxetine (Cymbalta). What should the nurse instruct the patient about this medication? A) Take with fruit juice. B) Do not take with St. John's wort. C) Stop the medication if experiencing adverse effects. D) Expect blood pressure to drop with this medication.

B) Do not take with St. John's wort.

A patient is diagnosed as having a phobia. Which fear should the nurse expect to observe in this patient? A) Fear of poisonous spiders B) Fear of leaving the house during the day C) Fear of failing a test that one has not studied for D) Fear that a child playing in the street might get hurt

B) Fear of leaving the house during the day

A patient diagnosed with a mental illness is being considered for psychotherapy. What should the nurse realize are the goals for this treatment? (Select all that apply.) A) Relaxing the body B) Improve social interactions C) Clarify the meaning of events D) Reduce emotional discomfort E) Enhance performance in situations

B) Improve social interactions D) Reduce emotional discomfort E) Enhance performance in situations

The nurse is reviewing the causes of anxiety with a patient diagnosed with an anxiety disorder. Which neurotransmitter abnormalities should the nurse include as causing symptoms of anxiety? (Select all that apply.) A) Increased substance P B) Increased epinephrine C) Increased somatostatin D) Decreased norepinephrine E) Decreased gamma-aminobutyric acid (GABA)

B) Increased epinephrine E) Decreased gamma-aminobutyric acid (GABA)

During initial assessment of mental health status, the nurse asks a patient to interpret a familiar proverb and explain what it means. Which area/aspect of the patient's mental status is the nurse assessing? A) Memory B) Judgment C) Mood and affect D) Level of awareness and orientation

B) Judgment

During a mental status assessment a patient cannot remember the name of a childhood neighborhood. In which aspect of the assessment is the patient demonstrating an alteration? A) Speech B) Memory C) Orientation D) Mood and affect

B) Memory

The nurse is preparing to establish a relationship with a newly admitted patient. On which qualities should the nurse focus when creating this nurse-patient relationship? (Select all that apply.) A) Humor B) Respect C) Honesty D) Empathy E) Sympathy F) Friendship

B) Respect C) Honesty D) Empathy

The nurse notes that another nurse colleague has been acting differently lately. The nurse often has red watery eyes and a runny nose. Today, the nurse was unhappy with the patient assignment and screamed, "Someone is going to pay for this!" What should the nurse who has observed this behavior do? A) Nothing; all nurses have stressful days sometimes. B) Tell the clinical manager exactly what was observed. C) Tell the clinical manager that the nurse is abusing drugs. D) Confront the nurse with the behavior and provide information about counseling.

B) Tell the clinical manager exactly what was observed.

A patient who experienced injuries from a motor vehicle crash 6 months ago continues to request prescriptions for an opioid analgesic. When assessing this patient for opioid dependency which finding is the nurse least likely to observe? A) The patient drops out of a Saturday night Bingo group. B) The patient continues to manage to get to work each day. C) The patient tried to quit using the opioid but couldn't stop thinking about it. D) The patient has been to three or four physicians to obtain new prescriptions for the drug.

B) The patient continues to manage to get to work each day.

The nurse is assisting with teaching a patient who is to begin taking a monoamine oxidase inhibitor (MAOI). Which foods should the nurse teach the patient to avoid? (Select all that apply.) A) Fish B) Wine C) Bread D) Pastas E) Aged cheese

B) Wine E) Aged cheese

A patient has been prescribed fluoxetine (Prozac) to treat depression. What should be included in the nurse's teaching about the drug? (Select all that apply.) A) "You need to take this drug only once a week." B) "Take the prescribed dose in the early evening." C) "A decreased interest in sexual activity may occur with this medication." D) "You should not consume red wine, aged cheese, or other tyramine-rich foods." E) "Do not expect immediate results; it usually takes 6 to 8 weeks for therapeutic effects to be felt." F) "You may experience some nausea, vomiting, and anorexia, but these side effects will subside in time."

C) "A decreased interest in sexual activity may occur with this medication." F) "You may experience some nausea, vomiting, and anorexia, but these side effects will subside in time."

A patient with a suspected mental health disorder having blood drawn to check electrolyte levels asks what blood work have to do with mental health. Which response by the nurse is correct? A) "Electrolyte imbalances are the cause of certain mental health disorders." B) "Some mental health disorders cause the electrolytes to be out of balance." C) "The doctor wants to make sure your symptoms are not caused by a physical problem." D) "People with mental illnesses frequently take illicit drugs that can cause electrolyte imbalances."

C) "The doctor wants to make sure your symptoms are not caused by a physical problem."

The nurse is assisting with data collection on a patient newly diagnosed with schizophrenia. Which observations should the nurse consider as being positive symptoms of schizophrenia? (Select all that apply.) A) Alogia B) Apathy C) Delusions D) Hallucinations E) Social isolation F) Disorganized behavior

C) Delusions D) Hallucinations F) Disorganized behavior

A patient recovering from electroconvulsive therapy (ECT) for severe depression is confused and wants to know what has been done. What action by the nurse is best? A) Administer a sedative to help calm the patient. B) Call the physician and report the patient's response. C) Explain that the patient is in the hospital and has just had ECT. D) Encourage the patient to go back to sleep until the pre-procedure medication has worn off.

C) Explain that the patient is in the hospital and has just had ECT.

A patient who has schizophrenia has a dull facial expression and speaks in a monotone voice, even though a visitor is making an effort to be jovial. What terminology should the nurse use to document this observation? A) Bored B) Depressed C) Flat affect D) Ambivalent attitude

C) Flat affect

A patient with schizophrenia states, "I'm going to the fribity to see a megnat." What term should the nurse use to describe this language? A) Imagery B) Soliloquy C) Neologisms D) Conversions

C) Neologisms

The nurse is assisting with teaching a patient who has been started on fluphenazine (Prolixin). About which side effect should the nurse focus this teaching? A) Weight loss B) Hypoglycemia C) Photosensitivity D) Elevated blood pressure

C) Photosensitivity

A student is angry about failing a test at school and accuses the teacher of trying to fail everyone. What type of response is the student demonstrating? A) Anger B) Denial C) Projection D) Repression

C) Projection

A patient with schizophrenia calls the nurse into the room and says, "Help me! The books are on fire!" Which response by the nurse is best? A) "I'll get some water and put it out." B) "That's crazy; you know the books are not on fire!" C) "You don't have any books; how could they be on fire?" D) "I do not see any fire. Here is your supper; it's time to eat."

D) "I do not see any fire. Here is your supper; it's time to eat."

A patient with a mental illness says, "I have to go to the bank. The voices are telling me to go there." Which response by the nurse is best? A) "Do you need money?" B) "I will call you a cab later. Right now, it is time for therapy." C) "Why do you think the voices are telling you to go to the bank?" D) "I want to help you focus away from the voices. I am real, they are not."

D) "I want to help you focus away from the voices. I am real, they are not."

A patient who is withdrawing from alcohol is restless and reports seeing snakes on the ceiling. Vital signs are blood pressure 180/100 mm Hg, pulse 92 beats/min, and respirations 22 breaths/min. What should the nurse do first? A) Teach the patient a relaxation technique. B) Administer a dose of lorazepam (Ativan). C) Search the patient's room for hidden alcohol. D) Administer an antihypertensive agent as ordered.

D) Administer an antihypertensive agent as ordered

A patient is newly diagnosed with a trauma related disorder. Which medication should the nurse expect to be prescribed for this patient? A) Paroxetine (Paxil) B) Sertraline (Zoloft) C) Buspirone (Buspar) D) Alprazolam (Xanax)

D) Alprazolam (Xanax)

The nurse is assisting with medication teaching for a patient who is prescribed lithium carbonate (Eskalith) for bipolar disorder. Which instruction by the nurse is most important? A) Instruct the patient to discontinue other antidepressant agents. B) Teach the patient that the lithium will help stabilize mood swings. C) Teach the patient side effects to report, such as nausea or weight gain. D) Explain to the patient and significant other the importance of regular blood tests.

D) Explain to the patient and significant other the importance of regular blood tests.

Staff on a mental health unit routinely uses positive and negative reinforcement when caring for patients with mental health disorders. What needs to be done before the staff can implement these approaches? A) Have a health care provider order to use the approaches. B) Ensure all patients have medication orders for sedatives. C) Place a set of 4 point restraints within each patient's room. D) Have the patient sign a consent form agreeing to this approach.

D) Have the patient sign a consent form agreeing to this approach.

A patient cannot leave home without checking the coffee pot numerous times. This behavior makes the patient late to many functions. Which anxiety disorder should the nurse suspect the patient is experiencing? A) Phobia B) Generalized anxiety disorder (GAD) C) Post-traumatic stress disorder (PTSD) D) Obsessive-compulsive disorder (OCD)

D) Obsessive-compulsive disorder (OCD)

A patient with schizophrenia has not bathed recently and a family member states that the patient has not been out of the house for 10 days. The patient tells the nurse, "They are trying to hurt me; don't let them hurt me." Which symptom is this patient demonstrating? A) Paranoid delusions B) Grandiose delusions C) Auditory hallucinations D) Persecutory hallucinations

D) Persecutory hallucinations

A patient who is a war veteran states, "It should have been me that died. I'll never forgive myself for leaving my buddy when he needed me." The nurse recognizes this statement is most associated with which diagnosis? A) Bipolar depression B) Generalized anxiety C) Obsessive-compulsive disorder D) Post-traumatic stress disorder (PTSD)

D) Post-traumatic stress disorder (PTSD)