Mental Test Chapter 1-3

The Substance Abuse and Mental Health Services Administration (SAMSHA) estimates that more than what percentage of Americans aged 18 years and older has a diagnosable mental disorder? 13% 18.6% 39.2% 52%

18.6%

What percentage of adults requiring mental health services get the care they need? 5% 15% 25% 35%

25%

When haloperidol is given as a depot injection, it has an effectiveness of which duration? 1 week 2 weeks 3 weeks 4 weeks

4 weeks

Approximately what percentage of homeless people suffer from a severe psychiatric illness of a chronic substance use disorder? 42% 60% 75% 85%

42%

The prescription of clozapine requires weekly blood samples for which time frame? 6 months 2 months 4 months 8 months

6 months

A nurse administers a prescribed dose of lithium at 8 p.m. The nurse would schedule a specimen to be obtained for a blood concentration at which time? 10 p.m. 12 p.m. 4 p.m. 8 a.m.

8 a.m.

Deinstitutionalization has reduced the number of public hospital beds by what percentage? 60% 70% 80% 90%

80%

A nurse is caring for a child with attention deficit hyperactivity disorder (ADHD). The nurse is teaching about effective administration of methylphenidate to the parents. What education given by the nurse is appropriate? "Monitor your child for nausea and vomiting." "Monitor the presence of dizziness in your child." "Administer the drug early in the morning." "Administer the drug before breakfast and lunch."

"Administer the drug early in the morning."

A Cuban American client has been prescribed an antipsychotic medication. Which response is most important for the nurse to make to this client? "Remember to take this medication at the times we've discussed." "Will your mother be available to help administer this medication for you?" "Call the doctor immediately if you experience any of the side effects we talked about." "Do you have any questions about why you are taking this medication?"

"Call the doctor immediately if you experience any of the side effects we talked about."

fter teaching a client who is prescribed imipramine about the drug, the nurse determines that the education was effective when the client states: "I need to be careful because the drug can make me sleepy." "I don't have to worry about getting dizzy when I get up from lying down." "I might notice some excess saliva in my mouth at different times." "I need to avoid foods with fiber because diarrhea can occur."

"I need to be careful because the drug can make me sleepy."

Individual psychotherapy consists of three phases. Which statement by the group therapist would reflect that the group is in the working phase of therapy? "We will be meeting once each week for 90 minutes here at this office." "Each of you has shared ideas and thoughts about your personal development. This has been a difficult process, and you have all grown tremendously." "Shane has asked the group if it is acceptable that he be 5 minutes late to each group session because of his job." "James, when Shane speaks, it seems you become angry and tend to withdraw."

"James, when Shane speaks, it seems you become angry and tend to withdraw."

An instructor is teaching a class about the use of cognitive therapies in psychiatric nursing. Which statement made by a student identifies a need for further instruction? "Solution-focused approaches have been effective with hospitalized people experiencing delusions." "Lengths of stay for clients in inpatient settings are becoming longer each year." "The context of practice has changed considerably over the years for psychiatric nurses." "Lengths of stay for clients in inpatient settings are becoming shorter each year."

"Lengths of stay for clients in inpatient settings are becoming longer each year."

A client has been discharged from the hospital with a prescription for lorazepam. Which instruction should the nurse provide to this client? "If you notice that you have tremors in your arms or hands, stop taking the medication and tell your doctor." "You might find that you have trouble falling asleep if you take this medication too late in the day." "Ask your pharmacist for a list of the foods you should avoid while you're taking this medication." "Make sure that you don't drink any alcohol when you're taking this medication."

"Make sure that you don't drink any alcohol when you're taking this medication."

A nurse is providing community education about the prevention of mental illness. In response to the question, "What does it mean to be mentally healthy?" which is the nurse's best response? "Mental health is difficult to define and depends on cultural norms." "Mental health is marked by productivity, fulfilling relationships, and adaptability." "Mental health is the absence of mental illness." "Mental health is defined as behavior accepted as normal by the major cultural group."

"Mental health is marked by productivity, fulfilling relationships, and adaptability."

A client with bipolar disorder has responded well to lithium therapy in the inpatient setting and is now being prepared for discharge. What should the nurse teach the client about outpatient lithium therapy? "Try to time your visit to the laboratory for the morning, around 12 hours after your most recent dose." "It's important that you take each dose of lithium on an empty stomach to achieve the best effect." "If you get a fever, seek help promptly because you might be experiencing lithium toxicity." "Try not to drink too many fluids in the 6 hours before you go the laboratory."

"Try to time your visit to the laboratory for the morning, around 12 hours after your most recent dose."

A client with a history of trauma has told the nurse that he is pursuing psychoanalysis with an independent therapist. What statement by the client would be most consistent with a Freudian approach to psychoanalysis? "We're spending quite a bit of time exploring the themes in my dreams." "We discuss the tension between my expectations for myself and the expectations of society." "I've learned a lot about how I've been conditioned to respond to situations in a certain way." "We talk a lot about how I've learned to model my behavior after other people in my life."

"We're spending quite a bit of time exploring the themes in my dreams."

Which is a result of deinstitutionalization? A "revolving door" of repetitive hospital admissions An increase in available community resources The improvement of the ability of people diagnosed with mental illness to achieve independence An improvement in community-based programs' ability to get funding

A "revolving door" of repetitive hospital admissions

Which client is most likely to benefit from treatment with an antiparkinsonism agent? A client who has a medication-induced movement disorder A client who is being treated with an atypical antidepressant A client who has been admitted to the hospital with a diagnosis of lithium toxicity A client who is scheduled to begin electroconvulsive therapy (ECT) for the treatment of major depression

A client who has a medication-induced movement disorder

Which client would not be able to undergo a magnetic resonance imaging scan (MRI)? A client with a pacemaker A client who is obese A client with a longstanding history of claustrophobia A client with a diagnosed anxiety disorder

A client with a pacemaker

A nurse is teaching family members about the brain's connection to behaviors commonly seen in mental illnesses. How can the nurse best explain the term "neurotransmitter" to the family? A hormone in the brain. A molecular substance released in the brain. A specific location in the brain. A nerve that transmits impulses in the brain.

A molecular substance released in the brain.

Which individual has experienced the consequences of deinstitutionalization? A man who was denied inpatient psychiatric treatment by his health maintenance organization (HMO) A woman who was transferred from a psychiatric hospital to the community because of the hospital's impending closure A man who has been unable to obtain health insurance but who receives Medicare benefits A woman who has been the frequent object of stigma due to her history of psychiatric illness

A woman who was transferred from a psychiatric hospital to the community because of the hospital's impending closure

Degree of agreement between the leader's norms and the group's norms, ability to deal with members' infractions, and conformity to group norms are characteristics of what kind of groups? Formal groups Secondary groups Primary groups All groups

All groups

In which phase of Freud's developmental stage does toilet training occur? Anal Oral Latency Genital

Anal

Which is not an action expected of a benzodiazepine? Antidepressant Anticonvulsant Muscle relaxant Antianxiety

Antidepressant

Chlorpromazine is a drug in which classification? Antipsychotic Antimanic Antianxiety Antidepressant

Antipsychotic

Benzodiazepines and buspirone are included in which therapeutic category? Antidepressants Antipsychotics Anxiolytics Mood stabilizers

Anxiolytics

Which culture is more comfortable at distances greater than 2 or 3 feet? Asian Middle Eastern Latin American American

Asian

During the stabilization phase of drug therapy for a client who is hospitalized with a psychiatric disorder, which action would be most appropriate? Discussing the timing of tapering the medication Instructing the client about relapse prevention Determining if the medication is losing its effect Assessing the client for target symptoms and side effects

Assessing the client for target symptoms and side effects

When engaged in rational emotive behavior therapy, which would be addressed during the activating event sequence? Teaching the connection between beliefs and consequences Assessing the consequences of the problem Facilitating the working-through process Preparing client to deepen conviction in rational beliefs

Assessing the consequences of the problem

Which is a major difference between the atypical antipsychotics (such as clozapine) and the typical antipsychotics (such as haloperidol)? Atypical antipsychotics block both serotonin and dopaminergic receptors. There are no side effects with the typical antipsychotics. Typical antipsychotics often lead to weight gain. Atypical antipsychotics can cause arrhythmias and kidney failure in rare cases.

Atypical antipsychotics block both serotonin and dopaminergic receptors.

What is the difference between traditional and atypical antipsychotics? Traditional antipsychotics work mostly as dopamine agonists, but antipsychotics work through antagonizing the dopamine receptor. Traditional antipsychotics have a more powerful effect on the negative symptoms of schizophrenia, whereas atypical antipsychotics exert stronger effects on the positive symptoms. Atypical antipsychotics work on dopamine-receptor and serotonin-receptor blockade, whereas traditional antipsychotics work on dopamine-receptor blockade. There are no major differences between these two classes of drugs; their advantages are that there is a wider spectrum of drugs from which to choose.

Atypical antipsychotics work on dopamine-receptor and serotonin-receptor blockade, whereas traditional antipsychotics work on dopamine-receptor blockade.

A nurse is leading a group. During the session, the nurse observes the members testing each other to see if they can trust each other. The nurse leader also notes that the members are testing the nurse, too. The nurse interprets this behavior as characteristic of which phase? Beginning Working Termination Intermittent

Beginning

The nurse is working with a family that has indicated a desire to learn better communication skills. The nurse role-plays assertive communication techniques with each family member. The role-play is an example of which type of family intervention? Cognitive Affective Behavioral Advocacy

Behavioral

The client's parents have begun a program of therapy that includes giving the client a token each time the client follows directions. Which theoretical framework provides the background for such a program? Psychodynamic theory Systems theory Behavioral theory Token economy theory

Behavioral theory

When assuming the responsibility for leading a couples therapy group, the nurse-therapist helps clients deal appropriately with their emotions, behaviors, and beliefs as well as which goal? Being aware of how they affect the relationship with their partner Changing these characteristics if they are the cause of problems with their partner Learning to negotiate for their wants fairly and effectively with their partner Understanding the importance of accepting the personality traits of their partner

Being aware of how they affect the relationship with their partner

When comparing the theories of mental illness popular in ancient Greece with those popular in the Middle Ages, which is more applicable to the Middle Ages? Emotional disorders were believed to be an organic dysfunction. Treatment included sedation, good nutrition and hygiene, and music and recreation. Mental illness was considered a disturbance of the four body fluids, or "humors." Belief in demonic possession and exorcism was common.

Belief in demonic possession and exorcism was common.

A nurse administers haloperidol to a client to promote deescalation. The nurse finds that after administering the drug, the client has started having jerky and involuntary movements of the head and arms. Which medication would be useful in treating this problem? Clozapine Risperidone Olanzapine Benztropine

Benztropine

The use of psychopharmacologic agents in the treatment of mental illness comes from which domain of the biopsychosocial model? Social Biologic Psychological Environmental

Biologic

he major goal of the Community Mental Health Act of 1963 was what? Develop centers in which biopsychiatric research could take place within the community. Build mental health centers that would provide mental health care within the local community. Attract more health care providers into local psychiatric clinics. Facilitate the integration of biology with the psychosocial components of treatment.

Build mental health centers that would provide mental health care within the local community.

A nurse is caring for a client who has experienced damage to the parietal lobes of the brain. The nurse anticipates that the client will have difficulty with what activity? Perceiving motor input Calculating a math problem Seeing objects in front of the client Speaking fluently

Calculating a math problem

A client taking lithium comes to the hospital for a 2-week follow-up. The client complains of a hand tremor that keeps from holding a coffee cup and states that the client feels confused, has stomach aches, and trips occasionally. Which would be the most therapeutic intervention of the psychiatric nurse? Explain to the client that these are common side effects and that they will subside soon Say that you and the client will monitor these side effects to be sure they do not increase in severity Ask the client to return 3 days later to see the psychiatrist, who will be in the clinic on that day Call the client's psychiatrist because her symptoms are indicative of moderate toxicity

Call the client's psychiatrist because her symptoms are indicative of moderate toxicity

A nurse demonstrates a sound understanding of the use of ego defense mechanisms by providing which explanation? Can be either a therapeutic or a pathological way to manage stress Are often symptomatic of moderate to severe mental illness Are substitutes for effective coping skills Should be used only when faced with severe stressors

Can be either a therapeutic or a pathological way to manage stress

What part of the brain would be responsible for activities such as walking and dancing? Cerebellum Cerebrum Midbrain Brain stem

Cerebellum

The nurse is working with a client seeking treatment for bulimia and determines that cognitive restructuring will help build the client's self-esteem. Which best describes the goals of cognitive restructuring? Avoid negative self-talk Find a sounding board for identifying and discussing feelings Change distorted thinking and the subsequent behaviors Use adaptive defense mechanisms

Change distorted thinking and the subsequent behaviors

A client with schizophrenia is erratic in adhering to the antipsychotic regimen. What action best addresses this client's lack of adherence? Changing the client's medication route to intramuscular depot Establishing a system of rewards and consequences for adherence and nonadherence Transitioning from oral to intravenous antipsychotics Administering a benzodiazepine 30 minutes prior to the antipsychotic

Changing the client's medication route to intramuscular depot

Neurotransmission is important in the function of the CNS. For neurotransmission to occur, how do neurons communicate with other cells? Selectively Chemically Excitably Accessibly

Chemically

A client is experiencing acute stress leading to the stimulation of increased gastric acid. In this situation, which body system uses acetylcholine as a neurotransmitter? Cholinergic Dopaminergic GABA-ergic Noradrenergic

Cholinergic

Which statement is inconsistent with the concept of milieu therapy, originally developed by Henry Stack Sullivan? Clients work independently to solve day-to-day problems. The therapy includes the practice of interpersonal relationship skills. The therapy incorporates a safe, therapeutic setting. The therapy enables clients to give one another feedback about behavior.

Clients work independently to solve day-to-day problems.

The psychiatric mental health nurse is planning the care of a client. What action best addresses the client's needs in the social domain? Collaborating with the client's family to organize support Teaching the client skills for identifying behavioral triggers Administering a scheduled dose of an atypical antipsychotic Dialoguing with a client about the client's feelings around a traumatic event

Collaborating with the client's family to organize support

The nursing instructor asks the student to perform an assessment of a mentally ill client. What should the student do when executing this task? Diagnose the problem Identify the outcome Collect comprehensive data Plan alternative interventions to attain the outcome

Collect comprehensive data

A client with mental illness has come to an outpatient mental health clinical for a counselling session with the community mental health nurse. Which areas should be the focus of counselling for this client? Select all that apply. Occupational skills Stress management Behavior modification Role modeling Communication skills

Communication skills Behavior modification Stress management

A nurse regularly volunteers to work double shifts in order to impress the nursing supervisor. This is an example of which defense mechanism? Compensation Displacement Regression Fixation

Compensation

The working stage of group therapy is marked by which characteristic? Conflict and cooperation among group members. Members' propensity to leave the group. Therapists' tendency to "back off" to allow the group to work. Group members' concern about confidentiality issues.

Conflict and cooperation among group members.

The nurse therapist is setting goals for a family in therapy. One goal is for the family to adopt a healthy family structure. Which would be an appropriate outcome criterion for this goal? Family conflict is avoided Family members are protected from external conflict Family appears to function in harmony Conflicts are resolved in a rational manner

Conflicts are resolved in a rational manner

A psychiatric nurse who was sexually assaulted by a tall, blonde man finds herself becoming severely anxious whenever a man with those characteristics is admitted to the unit. Which symptom is the nurse is exhibiting? Countertransference Transference Conscious resistance Unconscious resistance

Countertransference

The nurse has a client who reminds the nurse of the nurse's sister, with whom the nurse has a close and positive relationship. This phenomenon is best characterized by which term? Transference Free association Countertransference Reaction formation

Countertransference

Which is one common mistake that people working in the helping professions do when applying theory to the therapeutic process? Develop an overzealous commitment to one form of therapy, ignoring the benefits that other types of therapies may have for a given individual. Provide a biological approach to helping with psychiatric disorders by giving several medications at one time. Give medications along with psychotherapy. Deny access to care by restricting clients to only one form of therapy.

Develop an overzealous commitment to one form of therapy, ignoring the benefits that other types of therapies may have for a given individual.

The nurse recognizes that public education is needed to erode stigma to prevent what? Discrimination Labeling Stereotyping Devaluing

Discrimination

A psychiatric-mental health nurse is leading a group. The nurse identifies that the several group members are assuming individual roles within the group. The nurse understands that individual roles in group dynamics have which effect on group functioning? Disrupt group functioning Enhance group functioning Encourage the contributions of others Have no effect on group functioning

Disrupt group functioning

A nurse observes an older adult client who has been taking antipsychotic medications for 8 months. The nurse sees the client's lips smacking and eyes blinking rapidly. The nurse also observes a protruding tongue. Which action by the nurse would be most appropriate? Ask whether the client has been experiencing side effects. Contact the client's physician for a different medication order. Document the client's symptoms of tardive dyskinesia. Instruct the client to begin tapering the medication.

Document the client's symptoms of tardive dyskinesia

Increased activity in which neurotransmitter is implicated in increased impulsivity and violent behavior? Dopamine Serotonin Epinephrine Acetylcholine

Dopamine

Typical antipsychotics work by blocking which receptor? Serotonin Norepinephrine Dopamine and serotonin Dopamine

Dopamine

Who was responsible for much of the reform of the mental health care system in the 19th century? Florence Nightingale Hildegard Peplau Dorothea Dix Sigmund Freud

Dorothea Dix

Freud's personality theory was based on what? Drives Social attributes Symbols Impaired functioning

Drives

Extrapyramidal side effects are characterized by a triad of symptoms, including what? Sadness, flattened affect, and anxious behavior Dystonia, akathisia, and pseudoparkinsonism Dystonia, flat affect, and cogwheeling Shuffling gait, cogwheeling, and drooling

Dystonia, akathisia, and pseudoparkinsonism

When educating an African-American client regarding newly prescribed antipsychotic medication, it is vital that the nurse address which care issue? Choose the best answer. Early recognition of extrapyramidal symptoms Taking the medication exactly as prescribed Being aware of gastrointestinal side effects Keeping scheduled appointments with the primary healthcare provider

Early recognition of extrapyramidal symptoms

Which theorist's contribution led nurses to recognize that personality development begins at birth? Harry Stack Sullivan Erik Erikson Sigmund Freud B. F. Skinner

Erik Erikson

Which skill is in the psychiatric-mental health registered nurse's scope of practice? Prescribing psychiatric medications Conducting individual psychoanalysis Evaluating the effectiveness of psychiatric medications Diagnosing psychiatric-mental health conditions

Evaluating the effectiveness of psychiatric medications

The emergence of nursing theories has had a positive, direct impact on client care through which channels? Evidence-based nursing practice Client satisfaction Helping to contain client care costs Advancing nursing as a profession

Evidence-based nursing practice

Which is the most commonly seen adverse side effect of typical antipsychotics? Accidental overdosage as a result of the narrow therapeutic range Extrapyramidal symptoms and tardive dyskinesia Serotonin syndrome Auditory and visual hallucinations

Extrapyramidal symptoms and tardive dyskinesia

When the psychiatric nurse is aware of the cultural beliefs of a client diagnosed with bipolar disorder, the therapeutic process is most enhanced by what? Facilitating the nurse's understanding of how these beliefs affect the client's perception of the disorder Strengthening the therapeutic nature of the nurse-client relationship through mutual respect Facilitating the nurse's ability to effectively empathize with the client Showing the client that the nurse is truly interested in the client as a person

Facilitating the nurse's understanding of how these beliefs affect the client's perception of the disorder

In terms of causing disability among people aged 15 to 44 years of age in North America, where does mental illness rank? First Second Third Fourth

First

Which stage of cognitive development is being achieved when a child demonstrates the ability to think and reason in abstract terms? Formal operations Sensorimotor Concrete operations Preoperational

Formal operations

Abnormalities in which lobe is believed to be associated with schizophrenia? Frontal Occipital Temporal Parietal

Frontal

A decrease in which neurotransmitter has been implicated in seizure disorders? GABA serotonin dopamine epinephrine

GABA

Benzodiazepines increase which neurotransmitter function? GABA Serotonin Norepinephrine Acetylcholine

GABA

While discussing the CNS, the nursing instructor tells the students that the major inhibitory neurotransmitter in the CNS is what? Acetylcholine Dopamine GABA Serotonin

GABA

Which is a difference between counseling and psychotherapy? Psychotherapy is reserved for clients who have a documented history of failing to respond to counseling. Generalist psychiatric nurses may perform counseling interventions, but psychotherapy is an advanced practice role. Transference and countertransference are significant obstacles in psychotherapy that can be avoided in a counseling mode. Counseling may be used in the care of acutely psychotic clients, but psychotherapy is contraindicated.

Generalist psychiatric nurses may perform counseling interventions, but psychotherapy is an advanced practice role.

Which group role is best reflected by the client who consistently validates members' contributions, tries to be the "mediator" between members, and interprets the group's procedures? Individual Task Group cohesion Group building and maintenance

Group building and maintenance

In group, Client 1 talks about how stressful and important Client 1's job is. Client 2 comments that Client 1 seems to think Client 1 is "better than the rest of us." Client 3 supports Client 1's comment and says Client 3 doesn't understand why everyone wants Client 1 to "break down and cry." This dynamic illustrates what? Content communication Group process Transference Countertransference

Group process

Which is an advantage of group therapy over individual therapy for a client with a borderline personality disorder? Group therapy provides the client with relationship opportunities upon which to test behavior modifications Individual theory makes countertransference an extremely likely outcome when such a client is involved Group theory provides such clients with the personal attention they crave Individual therapy is too easily manipulated by such clients

Group therapy provides the client with relationship opportunities upon which to test behavior modifications

A nurse is assessing a child with a diagnosis of autism spectrum disorder. The child has severe uncontrollable temper outbursts and repeatedly bangs the head on the wall or door. When considering medication for treatment, the nurse knows which will be the most effective? Pemoline Haloperidol Methylphenidate Imipramine

Haloperidol

Which psychotherapy pioneer introduced the term parataxis? B. F. Skinner Harry Stack Sullivan Sigmund Freud Carl Rogers

Harry Stack Sullivan

Which theorist viewed interpersonal relations as a basis of human development and behavior? Harry Stack Sullivan B. F. Skinner Frederick Perls Abraham Maslow

Harry Stack Sullivan

When providing care to a client, the psychiatric-mental health nurse is implementing the therapeutic use of self. The nurse is applying the concepts based on the work of which individual? Hildegard Peplau Florence Nightingale Dorothea Dix Sigmund Freud

Hildegard Peplau

Who was the first to introduce the concept of interpersonal relations and the therapeutic relationship? Mary Nutting Florence Nightingale Hildegard Peplau Linda Richards

Hildegard Peplau

From the standpoint of cognitive therapy, the term cognition refers to what? Faulty thought patterns that result in abnormal behavior How clients think about themselves and their world An idea Dysfunctional ways of responding to situations

How clients think about themselves and their world

A nursing assessment of a client who has been diagnosed with neuroleptic malignant syndrome (NMS) would most likely reveal which signs? Chest pain, tachycardia, and cardiac dysrhythmias Respiratory distress, cyanosis, and pallor Nausea, vomiting, diarrhea, and gastric pain Hyperpyrexia, severe hypertension, and diaphoresis

Hyperpyrexia, severe hypertension, and diaphoresis

Excess tyramine caused by monoamine oxidase inhibitors (MAOIs) can result in what? Agitation Hypertensive crisis Serotonin syndrome Tardive dyskinesia

Hypertensive crisis

A client in the operating room goes into malignant hyperthermia due to an abnormal reaction to the anesthetic. The nurse knows that the area of the brain that regulates body temperature is what? Cerebellum Thalamus Hypothalamus Midbrain

Hypothalamus

client is returning from military service and has been diagnosed with post-traumatic stress disorder (PTSD). Dysfunction in which brain structure contributes to the rage and fear experienced in PTSD? Basal ganglia Pons Corpus callosum Hypothalamus

Hypothalamus

In recent years, the client has been experiencing increasing levels of anxiety when in large crowds. The client has recently begun behavioral therapy, which will emphasize which component? Hypnotherapy Identifying seminal childhood moments that may have contributed to the problem Identifying and promoting adaptive behaviors to reduce anxiety Uncovering trauma that may be the unconscious source of anxiety

Identifying and promoting adaptive behaviors to reduce anxiety

A nurse is planning an educational program for families with a mentally ill relative. Which goal is consistent with the current objectives of family education? Fewer hospital admissions Improved medication compliance Improved family quality of life Increased independence with activities of daily living

Improved family quality of life

The advanced practice registered nurse is planning interventions for clients in a mental health practice. Which are considered basic level? Select all that apply Consulting Conducting psychotherapy Ensuring a therapeutic environment Improving client function and health Prescribing medications

Improving client function and health Ensuring a therapeutic environment

Which provides the best definition for mental illness? Inability to function in a manner that manages both external and internal stressors effectively Existence of cognitive dysfunction resulting in a lack of autonomy Manifestation of altered sensory perceptions Result of genetic or environmental alterations resulting in mental dysfunction

Inability to function in a manner that manages both external and internal stressors effectively

Which is the most influencing factor that complicates the treatment of people with mental illness in the Unites States? Insurers' reimbursement decisions Increased responsibility for care by state mental hospitals Overuse of the well-coordinated mental health care system Lack of effective treatments

Insurers' reimbursement decisions

What are the standards of professional performance that a nurse should implement when caring for a mentally ill client? Select all that apply. Integration of research Evaluation of client progress Collegial interaction Consultation with clients and their families Collaboration with clients and their families

Integration of research Collegial interaction Collaboration with clients and their families

Interpersonal theorists, such as Harry Stack Sullivan, emphasize which tenet? The existence of the id, ego, and superego The importance of conditioning responses in working with people Interpersonal socialization of humans throughout their developmental stages Alleviating symptoms by utilizing biological tools, such as medicines

Interpersonal socialization of humans throughout their developmental stages

Which nursing theory focuses on the nurse-client relationship and development of problem-solving skills? Interpersonal theory Behavioral nursing theory Adaptation theory Theory of human becoming

Interpersonal theory

A client with a diagnosis of schizophrenia lacks insight into the illness. The client presents with significantly declined function and is consistently nonadherent with medications. Which medication administration route is best suited for optimal treatment of this client's condition? Intramuscularly Intravenously Orally Subcutaneously

Intramuscularly

Which phase of individual psychotherapy involves establishing mutual boundaries of the relationship between the client and the mental health nurse? Resolution Termination Working Introductory

Introductory

Which are examples of monoamine oxidase inhibitors (MAOIs)? Select all that apply. Isocarboxazid Phenelzine Fluoxetine Paroxetine Sertraline

Isocarboxazid Phenelzine

Which is a true statement regarding Medicaid? It covers individuals and families with low incomes. It covers people 65 years of age and older. It covers people with permanent kidney failure. It covers people with certain disabilities.

It covers individuals and families with low incomes.

Which is an inaccurate depiction of self-awareness? It involves changing one's values or beliefs. The nurse gains recognition of his or her feelings and beliefs. There is an understanding that a nurse's belief may conflict with the client's It involves self-reflection.

It involves changing one's values or beliefs.

A client diagnosed with schizophrenia has recently become divorced and is living in public housing. How would the DSM-5 best help in planning this client's care? It is used by all mental health professionals to identify and treat the mentally ill client. It provides information on all major mental health disorders and their effect on existing health issues. It provides the mental health team with links to the latest clinical research on schizophrenia. It is used by the mental health team to identify the psychosocial and environmental factors currently affecting the client.

It is used by the mental health team to identify the psychosocial and environmental factors currently affecting the client.

Several neuroimaging techniques are available for researchers and practitioners. What value does this technology have in diagnosing disorders of the brain? It provides data about the structures of the brain correlated with their activity. It provides data about the actual number of stimuli an individual can take in. It provides information about genetic reproduction of DNA at the time of transcription. It is moderately valuable because it is not accurate at this point in its development.

It provides data about the structures of the brain correlated with their activity.

Which correctly describes the primary effect of a selective serotonin reuptake inhibitor (SSRI) antidepressant drug? Its ability to block the reuptake of serotonin The management of the symptomology related to depression The inhibition of the hormonal cascade that affects the release of serotonin The increase in the number of serotonin receptor sites in the central nervous system

Its ability to block the reuptake of serotonin

Medical insurance coverage for medical illnesses is greater than for psychiatric illnesses. What term best describes this discrepancy? Stigmatism related to medical coverage. Lack of parity. Limited access to services. Medical noncompliance.

Lack of parity.

The structure of the brain associated with emotional control, memory, and learning is what? Basal ganglia Brainstem Limbic system Cerebellum

Limbic system

A nurse is reviewing the historical trends impacting the practice of psychiatric-mental health nursing practice. The nurse demonstrate understanding of the information by identifying which individual as being resonsible for opening the first training school for nurses in 1882? Dorothea Dix Hildegard Peplau Linda Richards Florence Nightingale

Linda Richards

Who was the first trained nurse in the United States? Linda Richards Florence Nightingale Hildegard Peplau Effie Taylor

Linda Richards

A client refuses to interact with a student nurse during a clinical session. Which would be the most helpful in the immediate situation? Select all that apply. Ask to be assigned to another client Listen to the client Ask another student for support Show genuine interest in the client's situation Share something personal with the client

Listen to the client Show genuine interest in the client's situation

A group of nurses is reviewing the various drug classes used to treat psychiatric disorders. The nurses demonstrate understanding when they identify which as examples of antianxiety medications? Select all that apply. Selegiline Lorazepam Buspirone Zolpidem Methylphenidate

Lorazepam Buspirone

One particular member of a medication group always seeks out the nurse for one-on-one conversation before each meeting and during scheduled breaks during meetings. What should be the nurse's initial response? Make a point of engaging with other group members before and after meetings and during breaks. Confront the member with the fact that this behavior is unfair to other members and inhibits cohesiveness. Explain to the member that the nurse is not participating in the group for social purposes. Arrive just in time for meetings and leave promptly after they conclude.

Make a point of engaging with other group members before and after meetings and during breaks.

A 46-year-old client sustained a closed-head injury 4 hours ago. The client now presents to the emergency department because the client is having difficulty breathing. This is a result of swelling surrounding which brain structure? Thalamus Cerebrum Pituitary Medulla oblongata

Medulla oblongata

A 46-year-old client sustained a closed-head injury 4 hours ago. The client now presents to the emergency department because the client is having difficulty breathing. This is a result of swelling surrounding which brain structure? Thalamus Cerebrum Pituitary Medulla oblongata

Medulla oblongata

A nurse is teaching a patient about how impulses are transmitted and describes the factors that can impact this transmission. Which factor would the nure most likely identify as increasing synaptic transmission? Reduction of chemicals Electrical impulse Calcium reaction Neurotransmitter

Neurotransmitter

What action by the psychiatric mental health nurse best demonstrates the behaviorist theories of B. F. Skinner? Offering to take a client for an outside smoke break if the client agrees to eat a nutritious meal at the scheduled meal time Dialoguing with a client about the client's perceptions of the negative consequences of the client's behavior Having a group of clients independently establish the behavior guidelines on the inpatient unit Removing the restrictions from clients' behavior in the belief that they will ultimately choose what is most beneficial

Offering to take a client for an outside smoke break if the client agrees to eat a nutritious meal at the scheduled meal time

Which is considered an atypical antipsychotic? Olanzapine Haloperidol Thioridazine Thiothixene

Olanzapine

Nursing students are learning about the stages of Freud's psychosexual model. Place the stages in the correct sequence, from first to last.

Oral stage Anal stage Phallic stage Latency stage Genital stage

A client has recently joined a group and presented a scenario in which the client ran out of funds to pay the rent this month. The therapist states, "Has anyone else in the group had this experience? Can you share any ideas about how you resolved this situation when it happened to you?" The therapist's intervention utilizes which theory to intervene? Psychoanalysis group Reeducational group Personality reconstruction group Problem-solving group

Problem-solving group

Which sets professional standards of care? States Provinces Professional nursing organizations Hospitals

Professional nursing organizations

Of the following, which is not typically applied to individual therapy? Developing interpersonal communication skills Promoting cohesion Identifying defense mechanisms Setting goals

Promoting cohesion

Which intervention is appropriate for a psychiatric-mental health nurse at the basic level of practice? Promoting symptom management Managing psychotropic medications Conducting family therapy Interpreting laboratory tests

Promoting symptom management

A client has been started on an antipsychotic medication and is exhibiting muscle stiffness of the arms, slowness of gait, and tremors. Which extrapyramidal syndrome (EPS) is the client displaying? Pseudoparkinsonism Akathisia Dystonia Neuroleptic malignant syndrome (NMS)

Pseudoparkinsonism

A client has been started on an antipsychotic medication and is exhibiting muscle stiffness of the arms, slowness of gait, and tremors. Which extrapyramidal syndrome (EPS) is the client displaying? Pseudoparkinsonism Akathisia Dystonia Neuroleptic malignant syndrome (NMS)

Pseudoparkinsonism

The psychiatrist states that repressed memories in the client's unconscious are causing depression. This reasoning implies that the psychiatrist uses which theory? Psychoanalytic theory Behavioral theory Cognitive-behavioral theory The humanistic perspective

Psychoanalytic theory

During the mid-20th century, the focus of treatment centered on treating neurotransmitter dysfunction in the brain. As a result hospital stays were shortened due to the introduction of which? Psychopharmacology Insulin shock therapy Psychosurgery Hydrotherapy

Psychopharmacology

Which is a clinical activity of only the advanced practice registered nurse? Milieu therapy Psychotherapy Crisis intervention Triage

Psychotherapy

Which mental health service is an advanced-level function? Psychotherapy Milieu therapy Counseling Self-care activities

Psychotherapy

The following events are important in the development of psychiatric-mental health nursing practice. Which event occurred first? Publication of Standards of Psychiatric-Mental Health Nursing by the ANA Publication of Standards of Child and Adolescent Psychiatric and Mental Health Nursing Practice Establishment of the first graduate program in psychiatric nursing at Rutgers University Publication of the first psychiatric nursing text, Nursing Mental Disease, by Harriet Bailey

Publication of the first psychiatric nursing text, Nursing Mental Disease, by Harriet Bailey

he concept that irrational beliefs lead to negative emotions underlies which psychotherapeutic approach? Gestalt therapy Choice therapy Solution-focused therapy Rational emotive behavior therapy

Rational emotive behavior therapy

The nurse is providing hygiene care for a 70-year-old client in a nursing home who states that the client does not like the physician. Later, when the physician enters the room, the nurse notes that the client is very friendly with the physician, complimenting the physician's care. Which defense mechanism is this client displaying? Rationalization Reaction-formation Displacement Projection

Reaction-formation

A nurse is aware that the likelihood a client will be in adherence with psychotropic medications is affected by what? Receiving education and information about the medication. A history of taking these types of medications. The number of other medications the client is taking. The support the client has at home for taking medications.

Receiving education and information about the medication.

A psychiatric-mental health nurse is asked to be a guest speaker at a community fund-raising event for mental health services. Which would the nurse emphasize as the primary focus of the current consumer movement and mental health services? Access to affordable mental health care Removal of exclusions because of preexisting conditions Recovery from mental illness as a realistic goal Effective treatment for mental health care needs

Recovery from mental illness as a realistic goal

Which is the most effective goal for clients who are learning about the adaptive use of the ego defense mechanism? Reduce fear and protect self-esteem Eliminate anxiety and apprehension Avoid conflict and unpleasant consequences Reduce workload and communicate better

Reduce fear and protect self-esteem

What nursing action demonstrates the intended impact of the American Nurses Association (ANA) standards of care on mental health nursing care? Using the standards to determine if a nurse's action is considered criminally negligent. Referring to the standards to determine if a particularly prescribed treatment falls within the scope of a nurse's practice. Using the standards as a guide to identify advanced level nursing functions. Citing the standards as a guide for determining the delegation of care.

Referring to the standards to determine if a particularly prescribed treatment falls within the scope of a nurse's practice.

A nurse has been working with a client who has a personality disorder and the nurse has recognized the potential for countertransference. How can the nurse best prevent this phenomenon? Reflecting on the nurse's own thinking to identify times where the nurse may project individual feelings on to the client Dialoguing with the client about the client's tendency to direct feelings about the client's father on to the nurse Teaching the client basic techniques for enhancing coping skills and managing stress Challenging the client when the nurse feels that the client is mimicking the nurse's ideas or demeanor

Reflecting on the nurse's own thinking to identify times where the nurse may project individual feelings on to the client

Two staff nurses in a psychiatric emergency department are being considered for a promotion that will be announced via memo on a unit bulletin board. They work in a collaborative team environment, have been colleagues for 15 years, and socialize outside of work. Nurse A hears from a third colleague that Nurse B was promoted. Nurse A leaves the room in tears. This behavior is an example of which ego defense mechanism? Conversion Regression Introjection Rationalization

Regression

All except which are therapeutic factors identified by Yalom? Universality Regulation Altruism Existentialism

Regulation

A client demonstrates sexually inappropriate behavior toward a student nurse. What is an effective way for the student to respond while protecting and respecting the client? Ignore the behavior at the time it occurs but report it to staff before leaving clinicals for the day. Immediately inform the client that the behavior is unacceptable and will be reported to staff. Report the incident to staff and the clinical instructor so boundaries can be reenforced with the client. React to the incident with a sense of humor at the time but minimize contact with the client in the future.

Report the incident to staff and the clinical instructor so boundaries can be reenforced with the client.

Based on the theory of transference, if a client's childhood experiences teach the client to mistrust authority figures, the client will do what as an adult? Resist advice given by the mental health care professionals Develop paranoid tendencies toward all of the unit's staff Strive to be a truthful authority figure to the client's family and friends. Freely discuss the client's experiences with people with power and authority

Resist advice given by the mental health care professionals

A psychiatric-mental health registered nurse is studying the impact of factors like safety, effectiveness, and cost on the practice and delivery of nursing services. What is this process called? Leadership Quality of practice Resource utilization Professional practice evaluation

Resource utilization

A nurse has completed an assessment of a family and has identified the family's strengths. Which would the nurse be least likely to identify as a strength? Rigid roles of family members Mutual support of members Intact support support systems Positive communication techniques

Rigid roles of family members

Which is a criterion for mental health? Satisfaction with personal relationships and self Absence of mental health disorders Absence of sadness or anger No observable demonstration of deviant behavior

Satisfaction with personal relationships and self

What are neuroleptic medications used to treat? Bipolar disorder Attention deficit/hyperactivity disorder Seizure disorders Schizophrenia

Schizophrenia

Which side effect is associated with selective serotonin reuptake inhibitors (SSRIs)? Exophthalmia Sexual dysfunction Liver failure Myopathy

Sexual dysfunction

An adult client has just been prescribed paroxetine by his primary care provider. When assessing the client prior to the beginning of drug therapy, the nurse should include what assessment? Sexual function Diet Body mass index Bowel pattern

Sexual function

Which theorist developed the psychoanalytic theory? Erik Erikson Harry Stack Sullivan Sigmund Freud B. F. Skinner

Sigmund Freud

A psychiatric-mental health nurse is working on a committee that is developing programs that integrate the objectives for mental health and mental disorders, as identified in Healthy People 2020. Which type of program would be least appropriate? Single substance abuse treatment programs Depression-screening programs for primary care providers Mental health programs for the homeless population Employment programs for those with serious mental illness

Single substance abuse treatment programs

Dorothea Dix's solution to gain humane treatment for the mentally ill population included what? Community centers Asylums State hospitals Locked wards

State hospitals

client has been recently diagnosed with schizophrenia and is just beginning treatment with olanzapine. What anticipatory guidance should the nurse provide to the client? Strategies for preventing and managing weight gain The importance of regular eye examinations The importance of blood level monitoring for the first several weeks Signs and symptoms of tardive dyskinesia

Strategies for preventing and managing weight gain

In the discharge instructions for a client who is taking alprazolam, the nurse should include what? Sedative hypnotics are effective analgesics. Sudden cessation of alprazolam can cause rebound insomnia and nightmares. Caffeine beverages can increase the effect of sedative hypnotics. The potential for addiction and abuse of anxiolytics is low.

Sudden cessation of alprazolam can cause rebound insomnia and nightmares.

According to psychoanalytic theory, matters of right and wrong are controlled by the conscious. What term does Freud use to identify the conscious? Id Superego Ego Latency

Superego

A student nurse does not want to think about the upcoming final exam. The student nurse will start studying for the exam tomorrow. The student nurse is exhibiting which type of defense mechanism? Denial Suppression Regression Conversion

Suppression

Which defense mechanism is being used when a student decides not to think about a parent's illness but to rather concentrate on studying for an upcoming test? Suppression Substitution Projection Introjection

Suppression

In terms of Maslow's hierarchy of need, families living in poverty may be focused more on which type of needs rather than self-actualization? Security Safety Esteem Survival

Survival

A client is seen in an outpatient mental health clinic for complaints of involuntary tongue movement, blinking, and facial grimacing. This syndrome would be identified correctly as what? Tardive dyskinesia Neuroleptic malignant syndrome Dystonia Akathisia

Tardive dyskinesia

The initiator-contributor, information seeker, information giver, and coordinator are examples of what? Task roles Group building roles Individual roles Group cohesion roles

Task roles

An older adult client has been taking diazepam on a daily basis for several years. On the advice of the client's daughter, the client now wants to stop taking it. Due to the possible effects of discontinuation, the nurse should perform what intervention? Teach the client nonpharmacologic strategies for promoting sleep Educate the client about the need to report any symptoms of depression to her primary care provider Encourage the client to have follow-up blood levels taken in 8 to 10 days Educate the client about the risks of respiratory depression

Teach the client nonpharmacologic strategies for promoting sleep

A mental health nurse is discussing the potential adverse effects of electroconvulsive therapy (ECT). According to Peplau's interpersonal theory, the nurse is functioning in which nursing role? Stranger Resource person Teacher Leader

Teacher

Health promotion and health maintenance interventions related to psychiatric-mental health nursing include what? Teaching stress-reduction techniques Instructing clients about medication side effects Ensuring clients are taking their medications Removing stress-inducing stimuli from the client's environment

Teaching stress-reduction techniques

A psychiatric mental health nurse is applying Erikson's theory of psychosocial development in the care of a young adult client. What outcome should the nurse identify to best address the developmental conflict that this client is experiencing at this age? The client demonstrates new interpersonal skills to promote the development of intimate relationships The client demonstrates increased autonomy and independence in the client's decision-making The client describes a greater appreciation for the value of hard work and prolonged effort The client shows an increased ability to delay gratification

The client demonstrates new interpersonal skills to promote the development of intimate relationships

When assessing a client from a Freudian developmental perspective, the nurse determines that the client is functioning in the latency stage based on which behavior? The client frequently bites the other children at preschool. The client has not yet developed adequate bowel control. The client is beginning to develop inner control over aggressive impulses. The client has developed the capacity for object relations.

The client is beginning to develop inner control over aggressive impulses.

While assessing a client, the nurse notes the client is functioning at the fourth level according to Maslow's hierarchy of needs. Which observation of the client led the nurse to conclude this? The client is extremely hungry. The client feels unsafe in the new city. The client longs to have validation for success and accomplishments. The client wants to be able to disclose the client's sexuality openly.

The client longs to have validation for success and accomplishments.

The client has a longstanding history of depression. A psychoanalytic theorist might say what about the client? The client has seen the client's mother being depressed and has learned that this is one way to receive attention. When the client exhibits depressive symptoms, the client has always been taken care of by a spouse until the client is less depressed. The client's depression is a result of a poor family upbringing, living in a hostile environment growing up, and frequently seeing violent fighting in the client's neighborhood. The client may be unconsciously repressing feelings of anger that arise due to early childhood abuse experiences, and these feelings emerge as depression.

The client may be unconsciously repressing feelings of anger that arise due to early childhood abuse experiences, and these feelings emerge as depression.

An older adult resident of a group home has been receiving treatment for schizophrenia for several decades. The nurse who oversees care at the facility believes that the resident may be developing tardive dyskinesia. What assessment findings would support this suspicion? Select all that apply. The client often smacks lips when at rest The client reports nightmares and frequent awakenings at night The client makes repetitive movements with the fingers The client recently fainted after getting up quickly from a chair The client exhibits delusional thinking that is uncharacteristic

The client often smacks lips when at rest The client makes repetitive movements with the fingers

A client is using cognitive therapy as an adjunct treatment for bipolar disorder. Which would be an overall goal for this client related to the use of cognitive therapy for this condition? The client will no longer have to take medication. The client will engage in self-care independent of professional assistance. The client will relinquish all control. The client will continue to have sessions with the therapist once a week for life.

The client will engage in self-care independent of professional assistance.

Among other problems, a client states the client is lonely and doesn't know how to interact with others. The nurse suggests that the client join an ongoing therapy group the nurse conducts. The client agrees reluctantly and, over the next several weeks, the group and therapist focus on the new client's issues. At this time, the nurse notes that the group is becoming less functional. Which statement best explains why? The nurse should not try to force group therapy on the client. The group should not be expected to help the client with social skills. The client is taking too much of the group's time. The nurse is not skilled in group techniques.

The nurse is not skilled in group techniques.

The nursing theorist Peplau identified which as the essence of psychiatric-mental health nursing? Nursing care independent of physicians The nurse's use of self The nurse-client relationship A neurobiologic approach

The nurse-client relationship

A 15-year-old client has been cutting the client's forearms in recent months, a pattern of behavior that has had far-reaching consequences for all the members of the client's family. The client and the client's family are scheduled to begin therapy with a nurse-therapist who utilizes a behaviorist approach. Which aspect of this situation will the nurse-therapist most likely emphasize? The underlying motives for the client's behavior The perceived benefits that the client receives from the behavior The disruption to family systems that the client's behavior causes Unconscious factors that may influence the family's response to the client

The perceived benefits that the client receives from the behavior

Which is the greatest barrier to an individual's ability to obtain the most effective and safest psychiatric medication? These medications are often not covered by the managed care system because they are expensive. These medications are not available because they are in such great demand. These medications are paid for by all insurance companies, but clients do not like to take psychotropics. The side effects of newer medications are often too severe for clients to consider taking them.

These medications are often not covered by the managed care system because they are expensive.

Benzodiazepines work by the following mechanism of action: They act directly on dopaminergic neurons in the medulla. They act directly on GABA receptors and are thought to increase the amount of GABA available. They act indirectly through a second messenger to affect levels of circulating GABA. The mechanism of action of this category of drugs is unknown at this time.

They act directly on GABA receptors and are thought to increase the amount of GABA available.

Why are the developmental theories important to nursing practice? They describe how parts work together as a system. They outline the process of human growth and development. They define human adaptation to others and to the environment. They explain the importance of legal and ethical care.

They outline the process of human growth and development.

Which antipsychotic drug can cause a lengthening of the QT interval? Thioridazine Clozapine Olanzapine Haloperidol

Thioridazine

Though the client does not exhibit any signs or symptoms of depression, a client's physician has prescribed a low dose of the antidepressant mirtazapine. What is the most likely rationale for the physician's action? To test for depression by inducing mild withdrawal symptoms after a few weeks To make use of an off-label application of the medication To potentiate the effects of one of the client's other, unrelated medications To induce euphoria and higher functioning by altering the client's neurotransmitter levels

To make use of an off-label application of the medication

A client is undergoing individual psychotherapy. The client is yelling at the therapist because of a fight with the client's spouse about their children several years ago. In this instance, the client is exhibiting which response? Transference Countertransference Resistance Parataxis

Transference

A client asks the nurse to help the client understand what a psychologist meant when the psychologist said that the client displaced anger. Which is the best definition for displacement the nurse can provide? Replacing consciously unacceptable emotions, drives, attitudes, or needs by those that are more acceptable Making up for a real or imagined inability or deficiency by engaging in a specific behavior to maintain self-respect or self-esteem Transferring feelings—such as frustration, hostility, or anxiety—from an idea, person, or object to one that is less threatening Negating a previous unconsciously tolerable action or experience to reduce or alleviate feelings of guilt

Transferring feelings—such as frustration, hostility, or anxiety—from an idea, person, or object to one that is less threatening

According to Maslow, mentally healthy people who achieve self-actualization are able to do what? Use varied approaches to solve problems Form distant relationships with others Be dependent in thought and action Make decisions based in fantasy

Use varied approaches to solve problems

A nurse is reading a journal article about anticonvulsant agents used in psychiatric-mental health commonly used to treat clients with bipolar disorder. Which medication would the nurse <b>most</b> likely find being discussed in the article? Select all that apply. Valproate Carbamazepine Lamotrigine Lithium Clozapine

Valproate Carbamazepine Lamotrigine

When describing the various neurotransmitters, which would a nurse identify as the primary cholinergic neurotransmitter? dopamine acetylcholine norepinephrine serotonin

acetylcholine

A client is receiving clozapine. For which life-threatening disorder should the nurse be alert when assessing this client? agranulocytosis hypotension hypertension diabetes

agranulocytosis

A client who has been taking clozapine for 6 weeks visits the clinic reporting fever, sore throat, and mouth sores. The nurse notifies the client's physician because the nurse suspects: severe anemia . neuroleptic malignant syndrome. encephalitis. agranulocytosis.

agranulocytosis

A hospitalized male client who has been taking an antipsychotic medication for 2 weeks begins pacing and walking throughout the unit. He tells the nurse that he "cannot sit still." The nurse documents this finding as: akinesia. dystonia. pseudoparkinsonism. akathisia.

akathisia

According to Yalom (2005), there are 11 therapeutic factors through which changes occur in group psychotherapy. Which factor correlates with learning to give to others? altruism universality catharsis group cohesiveness

altruism

A nurse is integrating Peplau's model when providing care to a client with a mental illness. Which would the nurse identify as a key component? suffering anxiety self-care nonverbal behaviors

anxiety

A mentally healthy individual exhibits Maslow's concept of self-actualization when: approaching a problem with more than one possible solution. regularly consulting with family when making major decisions. describing themselves as a totally independent person. deciding that nothing will interfere with achieving a goal.

approaching a problem with more than one possible solution.

A cognitive technique to identify automatic thoughts is to ... have the client view one's thoughts and feelings as facts and unshakable truths. ask the client to recount a very problematic situation. provide a direct approach throughout the course of treatment. create an environment in which clients feel free to disclose their anxieties and take risks.

ask the client to recount a very problematic situation.

During the moral treatment period, clients were routinely placed into which environment? asylums community mental health centers psychosocial rehabilitation centers group homes

asylums

Two nursing students are giving a presentation on the limbic system. Which can they accurately include as actions of this brain structure? intellect engorgement suppression behavior

behavior

Antidepressants are considered the treatment of choice for major depression; however, they should be used most cautiously in clients with a history of: asthma and respiratory diseases. smoking. liver disease. cardiac or seizure disorders.

cardiac or seizure disorders.

Ivan P. Pavlov is associated with the term ... principle of recency. classical conditioning. behaviorism. field theory.

classical conditioning.

Aaron T. Beck is associated with ... cognitive therapy. social learning theory. developmental stages. family development theory.

cognitive therapy.

According to Freud's theory, when a woman's id is attempting to cope with substantial stressors, including being a single mother of three, the resulting behavior might include: compulsive overeating. resisting the urge to abandon her children. seeking help for her depression. frequently sharing that her children are perfect because of her parenting skills.

compulsive overeating.

A nurse is caring for an older adult who has experienced damage to the frontal lobe after an automobile accident. The nurse anticipates that the client will have difficulty in what area? smell concept formation receptive speech hearing

concept formation

For Freud, the therapist's emotional reactions to the client based on personal unconscious needs and conflicts is termed ... countertransference. transference. situational conflict. interpersonal relations.

countertransference

A nurse is reviewing the process of neuronal transmission. The nurse demonstrates understanding of this concept by identifying which part of the neuron as carring information into the neuron from other neurons? axon dendrite nucleus soma

dendrite

Many families take years to understand that a member is mentally ill and identify the warning signs of relapse. During this period, they try to normalize puzzling behaviors. This is called ... denial. avoidance. ignorance. reaction formation.

denial

A client has been diagnosed with Parkinson's disease. Which neurotransmitter is decreased in those with Parkinson's disease? dopamine norepinephrine serotonin epinephrine

dopamine

A nurse is developing a plan of care for a client diagnosed with schizophrenia. The nurse integrates knowledge of this disorder, identifying which neurotransmitter as being primarily involved? acetylcholine dopamine norepinephrine serotonin

dopamine

Which are anticholinergic side effects that may occur with the use of antipsychotic drugs? Select all that apply. dry mouth constipation urinary retention diarrhea tunny nose

dry mouth constipation urinary retention

A group of nursing students is reviewing information about Freud's personality structure. The students demonstrate understanding of this information when they identify the ability to form mutually satisfying relationships as a function of: defense mechanisms. unconscious. id. ego.

ego

What is the primary factor that contributes to the high cost of providing mental health care? most mental illnesses are chronic in nature medications prescribed to treat mental illness are very expensive the large number of individuals currently diagnosed with treatable mental illnesses the amount of mental health trained staff needed to manage the aggressive behaviors associated with mental illness

most mental illnesses are chronic in nature

The nurse is beginning a group counseling session with an open group system. The nurse should explain to the group members that one advantage of an open group system is that ... it can offer the best treatment outcomes. the topics for the group can be controlled. relationships are more easily established in the group. new members can join the group at any time.

new members can join the group at any time.

The primary purpose for generalist nurses to develop skills with psychosocial interventions is: psychosocial interventions are included on the nursing licensure examinations. psychosocial interventions are needed in all nursing practice settings. nurses will be consulted to assist in the care of psychiatric clients in acute care settings. there are a growing number of nursing practice opportunities in mental health settings.

psychosocial interventions are needed in all nursing practice settings.

A psychiatric-mental health nurse is describing to a group of colleagues how information is gathered about the inheritance of mental disorders using population genetics. The nurse determines that additional discussion is needed when the group identifies which method as being used for evaluation? concordance rates of twins occurrence among first-degree relatives risk factor analysis adoption studies

risk factor analysis

A group of nurses is reviewing the role of serotonin in psychiatric disorders. The group demonstrates a need for additional study when they identify which disorder as being associated with its dysfunction? depression mania panic disorder schizophrenia

schizophrenia

A female client is brought to the emergency department by her sibling, who reports that the client became very agitated and "started hallucinating." Further assessment reveals tachycardia, incoordination, vomiting, and diarrhea. The sibling states that the client is taking paroxetine for depression. Which would the nurse most likely suspect? neuroleptic malignant syndrome acute dystonic reaction serotonin syndrome hypothyroidism

serotonin syndrome

A female client is brought to the emergency department by her sibling, who reports that the client became very agitated and "started hallucinating." Further assessment reveals tachycardia, incoordination, vomiting, and diarrhea. The sibling states that the client is taking paroxetine for depression. Which would the nurse most likely suspect? neuroleptic malignant syndrome acute dystonic reaction serotonin syndrome hypothyroidism

serotonin syndrome

It is evident that a client has entered Piaget's stage of formal operations when the client ... speaks about a recent ballad as being reflective of the client's life story. expresses sadness about the loss of the client's dog. can sleep through the night without having enuresis. talks about humans being homo sapiens.

speaks about a recent ballad as being reflective of the client's life story.

Which part of Freud's personality structure is associated with ethics, standards, and self-criticism? superego id ego libido

superego

After educating a client who is receiving phenelzine, the nurse determines that the education was successful when the client states the need to avoid: fresh cottage cheese . cooked sliced ham. tap beers . soy milk.

tap beers

Clients taking monoamine oxidase inhibitors (MAOIs) for depression must be placed on a diet that is low in: tyramine . sodium . fat. sugar.

tyramine

When caring for an older adult taking a psychotropic medication, the psychiatric nurse must be aware that older adults: usually require a lower dose of these medications than do younger counterparts. are often refractory to psychotropic medications. are always reluctant to take these medications because of stigma and stereotyping. are not as sensitive to the effects of the psychotropics, and so are usually given slightly higher doses than in younger people.

usually require a lower dose of these medications than do younger counterparts.

A group has formed and is going through the phases of group development. The nurse leading the group determines that the group is in which phase when the group realizes its purpose? working beginning pre-interaction termination

working

A group has formed and is going through the phases of group development. The nurse leading the group determines that the group is in which phase when the group realizes its purpose? working beginning pre-interaction termination

working

Calling the client by name and spending time with the client are examples of what? Positive regard Acceptance Empathy Values

Positive regard

A neuroimaging technique used to examine brain functioning, including glucose metabolism, blood flow, and neurotransmitter-receptor activity, is known as what? Magnetic resonance imaging (MRI) Electroencephalogram (EEG) Ultrasonography Positron emission tomography (PET) scan

Positron emission tomography (PET) scan

Which term is used to describe the amount of the drug needed to achieve the maximum effect? Potency Withdrawal Efficacy Rebound

Potency

A drug that is an antagonist functions to do what? Prevent natural or other substances from activating cell function Reduce synapses Accelerate reuptake of neurotransmitters Stabilize a receptor in an inactive state

Prevent natural or other substances from activating cell function

Within a group, facilitating verbal and nonverbal communication to meet treatment goals individually and with the entire group refers to the ... individual role. maintenance role. gatekeeper. group leader.

group leader.

A nurse is reviewing the medical records of several clients receiving antipsychotic agents. Which factors, if noted, would the nurse identify as placing a client at greater risk for tardive dyskinesia? male gender age 30 to 45 years history of depression short duration of treatment

history of depression

A 36-year-old client has been receiving a selective serotonin reuptake inhibitor for treatment of depression. The client is exhibiting manifestations of serotonin syndrome. The nurse should be aware of which symptom of this syndrome? hyperreflexia bradycardia hypothermia constipation

hyperreflexia

The function of the thalamus and the hypothalamus is to coordinate: internal and external responses. speech and communication. sensation. movement.

internal and external responses.

When describing the influence of Harry Stack Sullivan on psychiatric-mental health nursing, which would an instructor address as a major concept? interpersonal relations harmony between the individual and society collective unconscious unconditional positive regard

interpersonal relations

The most important reason that psychiatric nurses need to know about the brain is that ... it is the organ of the mind and governs all forms of human behavior. it is the center of all metabolic processes for drugs that are used for psychiatric disorders. it is responsible for the etiology of many mental disorders. it is the central location for transcription of genes related to behavior.

it is the organ of the mind and governs all forms of human behavior.

A client receiving an antipsychotic agent develops acute extrapyramidal symptoms. Which response by the nurse would be most appropriate? "These symptoms are not real; the medication makes your brain think they are real." "You have developed an allergy to the medication, so we need to change it." "These are the results of the drug and can be treated; your illness is not getting worse." "The sunlight together with the medication has caused these symptoms; just stay indoors."

"These are the results of the drug and can be treated; your illness is not getting worse."

A client has been prescribed clozapine for treatment of schizophrenia. Which would the nurse include in the education plan for this client and family? "You may experience hypertension while taking this medication." "One of the side effects of this medication is breast engorgement." "People taking this medication often experience dermatitis." "You may experience noticeable weight gain while taking this medication."

"You may experience noticeable weight gain while taking this medication."

An older adult reports anxiety and is prescribed diazepam by a family physician. The physician asks the office nurse to explain to the client the problematic side effects of this medication. Which instruction about this drug would be most important for the nurse to emphasize? "You may experience minor urine incontinence from time to time." "You may find that you have temporary memory disturbances." "You need to use this medication cautiously because it can cause dependence." "You may feel dizzy and be prone to falls after taking this medication."

"You may feel dizzy and be prone to falls after taking this medication."

In the 1970s, state mental hospitals came under increasing scrutiny and many were closed. What was the end result of this trend? A lack of suitable housing for persons with mental illness Higher employment rates among previously institutionalized people Increased numbers of for-profit institutions for the mentally ill Increased numbers of training programs for the mentally ill

A lack of suitable housing for persons with mental illness

A psychiatric-mental health nurse is preparing a presentation about the historical evolution of current psychiatric-mental health treatment. When describing the impact of Sigmund Freud's work on care, which information would the nurse most likely include? Select all that apply. Focus on the physiological aspects of mental illness A disturbance in personality development as an underlying issue Use of psychoanalysis to address the underlying injury Short-term use of medication therapy to correct the cause Application of conscious motivations for behavior

A disturbance in personality development as an underlying issue Use of psychoanalysis to address the underlying injury

What is a group that has structure and authority known as? An informal group A formal group A primary group A secondary group

A formal group

In the 1970s, state mental hospitals came under increasing scrutiny and many were closed. What was the end result of this trend? A lack of suitable housing for persons with mental illness Higher employment rates among previously institutionalized people Increased numbers of for-profit institutions for the mentally ill Increased numbers of training programs for the mentally ill

A lack of suitable housing for persons with mental illness

Cognitive interventions are based on the concept of cognition. Who developed cognitive behavioral therapy? Aaron Beck Albert Ellis Steven DeShazer Insoo Kim Berg

Aaron Beck

Cognitive interventions are based on the concept of cognition. Who developed cognitive behavioral therapy? Aaron Beck Albert Ellis Steven DeShazer Insoo Kim Berg

Aaron Beck

Who developed cognitive therapy for persons with depression? Aaron Beck Albert Ellis Sigmund Freud Jean Piaget

Aaron Beck

Clients diagnosed with myasthenia gravis have a decrease in which receptor? Acetylcholine Dopamine Serotonin Norepinephrine

Acetylcholine

The "ABCD" approach, used in rational-emotive therapy, includes the following four components: Assessment of behavior; behavior itself; conditioning new behavior; developing consistency. Activating stimulus; identify how to fill the 'blank' about an automatic thought; disproportionate response; disputation of maladaptive beliefs. Allowing new behaviors; brainstorming; counseling; deviation assessment. Anonymity; belief; confidentiality; dogma.

Activating stimulus; identify how to fill the 'blank' about an automatic thought; disproportionate response; disputation of maladaptive beliefs.

Which is the key common element in the various psychotherapeutic approaches? An effective client-therapist relationship The clients' history of therapeutic success in the past The therapist's ability to manage the clients' symptoms The underlying origin of the clients' issues

An effective client-therapist relationship

How can a nurse best assure the management of personal long-term self-reflection that is associated with professional interaction with clients? Engage in regular discussions with a formal clinical supervisor Keep a journal that focuses on personal feelings Communicate with peers working in similar client environments Regularly reflect from the client's point of view

Engage in regular discussions with a formal clinical supervisor

A nurse is attending a review class on the neurologic basis of psychiatric disorders. The class also includes a review of the anatomy and physiology of the neurological system. The nurse demonstrates understanding of the information by identifying which structures ascomponents of the brain stem? (Select all that apply.) midbrain pons medulla cerebellum occipital lobes

midbrain pons medulla

During the 1800s, Pinel believed that the cure for mental illness was ... arrest and confinement. placement outside of the community. moral treatment use of chains.

moral treatment

A client receives the first dose of fluphenazine. The next day, during the follow-up appointment, the nurse finds the client is confused and the client's temperature is 103°F, pulse rate is 116 beats per minute, respirations are 34 breaths per minute, and blood pressure is 100/50 mmHg. The nurse should investigate further for which condition? Heatstroke Serotonin syndrome Neuroleptic malignant syndrome Parkinsonism

Neuroleptic malignant syndrome

Which antidepressant is potentially lethal in overdose? Phenelzine Paroxetine Mirtazapine Buproprion

Phenelzine

According to Maslow, an individual who has developed to the individual's fullest potential has achieved what level of his hierarchy? Self-actualization Physiological Love and belonging Esteem

Physiological

A professional boxer has suffered several concussions while boxing. Since retirement, the client has experienced periods of depression and suffers from short-term memory loss. Which provides the best explanation for the neurological basis of the client's symptoms? Damage to the nucleus accumbeus Damage to the medulla Damage to the hippocampus Damage to the thalamus

Damage to the hippocampus

A nurse is studying the positron emission tomography (PET) report of a client with Alzheimer's disease. What findings should the nurse expect to find in the report? Select all that apply. Atrophy of the cerebral cortex Enlarged ventricles of the brain Decreased blood flow to the brain Presence of amyloid plaques and tangles Decreased glucose metabolism in the brain

Decreased blood flow to the brain Presence of amyloid plaques and tangles Decreased glucose metabolism in the brain

In early Christian times, what was thought to cause mental illness? Demonic control Personal failure Sin Contaminated environments

Demonic control

In a group therapy session, group members confront a 35-year-old client about the client's abuse of prescription pain medications. The client states, "The doctor prescribed me these pills, that doesn't make me a drug addict." The nurse identifies this as an example of which defense mechanism? Regression Projection Denial Sublimation

Denial

The nurse has been unsuccessful in the psychiatric clinical placement and will be obliged to repeat it next semester. The criteria for passing or failing were based on the Psychiatric-Mental Health Nursing Scope and Standards of Practice, which are? Future goals for the nursing profession as a whole The legal documents that allow a nurse to practice Descriptions of the responsibilities for which nurses are accountable Explanations of the ideal character of the psychiatric or mental health nurse

Descriptions of the responsibilities for which nurses are accountable

An 81-year-old resident of a long-term care facility has confided in the nurse that the client is profoundly fearful of death. Within Erikson's psychosocial theory, this statement may suggest a failure to resolve which developmental conflict? Resignation vs. acceptance Motivation vs. isolation Generativity vs. stagnation Ego integrity vs. despair

Ego integrity vs. despair

All but which are currently used neuroimaging techniques? Positron-emission tomography (PET) scan Computed tomography (CT) scan Electrocardiogram (ECG) Single-photon emission tomography (SPECT) scan

Electrocardiogram (ECG)

While a nurse is performing an admission assessment for a client in an inpatient mental health setting, the client states, "All of my problems are caused by my parents." The client statement reflects which factor that influences mental health? Neuroanatomy Emotional development Values and beliefs Religion

Emotional development

What is the primary benefit of the DSM-5 to the student nurse's practice with the mentally ill population? Encourages the building of a knowledge base about the nature of psychiatric illnesses. Facilitates communication with other mental health care providers through a standardized language Identifies medical conditions that could be contributing to decline of the client's mental health status Provides insight into the effects of environmental problems the client may be facing

Encourages the building of a knowledge base about the nature of psychiatric illnesses.

Which action by the group leader demonstrates effective leadership? Firmly disciplining negative behavior Using autocratic leadership strategies Encouraging participation by all members Conducting meetings based on personality attributes

Encouraging participation by all members

A nurse is applying principles of cognitive behavioral therapy (CBT) in the treatment of a client with depression. Which intervention is an example of CBT? Fostering hope by encouraging a focus on abilities rather than problems Rewarding the client with five tokens for attending group therapy Encouraging the client to identify destructive thoughts and practice mindfulness Encouraging the client to review the past and focus on strengths and accomplishments

Encouraging the client to identify destructive thoughts and practice mindfulness

A client with a history of schizophrenia is being treated with olanzapine. Which assessment should the nurse prioritize when planning care for this client? Systemic infections Seizures Depression Metabolic syndrome

Metabolic syndrome

The brain stem consists of which structure? Midbrain Cerebellum Hypothalamus Thalamus

Midbrain

Maintaining a therapeutic environment and promoting growth through role modeling are components of which basic level function? Milieu therapy Counseling Health teaching Case management

Milieu therapy

Dietary modifications are most likely necessary when a client is being treated with which antidepressant? Selective serotonin reuptake inhibitors(SSRIs) Monoamine oxidase inhibitors(MAOIs) Tricyclic antidepressants Atypical antidepressants

Monoamine oxidase inhibitors(MAOIs)

Lithium was one of the first psychotropic drugs developed. Lithium is in which medication classification? Mood stabilizer Antidepressants Antianxiety Antipsychotic

Mood stabilizer

The goal of the deinstitutionalization movement was to achieve which outcome? Move psychiatric clients out of the hospitals and into their families of origin because of the belief that families were the responsible parties. Move chronic, older psychiatric clients out of hospitals to make room for younger clients who had better prognoses and were amenable to long-term treatment. Empty out large psychiatric hospitals so they could be converted for military use. Move psychiatric clients out of the hospitals and into the community in an effort to provide a better quality of life for them.

Move psychiatric clients out of the hospitals and into the community in an effort to provide a better quality of life for them.

A new program has been launched with the goal of fostering the development of life skills for community-dwelling clients with mental illness, aiming to teach them how to shop, cook, and manage money more effectively. This program demonstrates what approach to practice? Eclectic approach Acute-care oriented approach Interaction-oriented approach Needs-oriented approach

Needs-oriented approach

A client with an anxiety disorder is exhibiting agitation after missing some doses of diazepam. The nurse interprets the aggression as relating to which cause? Habituation Paradoxical excitation Addiction Tolerance

Paradoxical excitation

The application of psychiatric mental health nursing theory to promote holistic client care in the therapeutic relationship is grounded in the work of which historical figure? Benner Peplau Freud Dix

Peplau

A nurse is part of a treatment team using cognitive behavior therapy (CBT). The nurse understands that this therapy operates on the premise that a person is disturbed by what? An event Perception of an event Nothing Both the event and perception of the event

Perception of an event

A client has completed treatment for an addiction to prescription pain medications. As part of the client's therapy, the family participates in a family therapy program. Which reason would best explain the need for a family system approach to therapy? The family needs to focus on helping the client until equilibrium is regained. The dynamics of the entire family have and will continue to shift to accommodate a change. The family has unresolved issues toward the client. The family needs to learn signs of relapse if the client begins taking pills again.

The dynamics of the entire family have and will continue to shift to accommodate a change.

The mental health nurse instructs a client prescribed phenelzine to avoid aged foods, such as wine and cheese. For which reasons are these instructions important for client safety? The foods cause gastrointestinal distress, which may provoke ulceration of the gastric mucosa. The foods contain tyramine, which may provoke hypertensive crisis. The foods interact with the drug to cause central nervous system depression, which could lead to coma and/or death. The foods contain amylase, an enzyme known to reduce liver perfusion.

The foods contain tyramine, which may provoke hypertensive crisis.

Which is necessary as a defining feature in mental illness? The individual must have difficulties in functioning that cause distress and/or impairment of some type. The individual must need medications in order for the diagnosis to be of psychiatric origin. The individual must acknowledge that he or she is having difficulties in functioning. The individual must have physiological symptoms that match with behaviors that are impaired.

The individual must have difficulties in functioning that cause distress and/or impairment of some type.

A client is being discharged from the psychiatric unit this afternoon, and a nurse needs to teach the client about discharge medications. The client is exhibiting signs of moderate anxiety about the upcoming discharge. Based on Peplau's views regarding anxiety, the nurse would expect to implement the education plan at which time? When the client's anxiety stabilizes at its current level When the client's anxiety decreases to a mild level When the client is completely free of anxiety When the client's anxiety escalates to the panic level

When the client's anxiety decreases to a mild level

The nurse leader of a group observes a group member attempting to stimulate the group to action or decision. The nurse interprets this member as fulfilling which role? energizer recorder orienter coordinator

energizer

One of the most common ways in which neurotransmitters are deactivated within the nervous system at the neuronal level is: RNA transferase breaks them down. killer cells scavenge the remains of the neurotransmitters. enzymatic degradation, primarily by monoamine oxidase (MAO). the blood-brain barrier ensures that they are deactivated.

enzymatic degradation, primarily by monoamine oxidase (MAO).

One of the primary reforms accomplished by Dorothea Lynde Dix was the ... establishment of "commitment" laws in state legislatures. establishment or enlargement of state hospitals. use of music to treat mentally ill clients. use of exercise therapy to treat mentally ill clients.

establishment or enlargement of state hospitals.

A nurse is preparing a continuing education presentation about various psychopharmacologic agents for a group of psychiatric-mental health nurses. The nurse is planning to discuss selective serotonin reuptake inhibitors. Which agents would the nurse include in this group? Select all that apply. fluoxetine duloxetine sertraline venlafaxine bupropion Amoxapine

fluoxetine sertraline

A nurse is watching a video that depicts a client and therapist interacting. The client is asked to say whatever comes to the client's mind. The nurse identifies this as: dream work. free association. gestalt therapy. classical conditioning.

free association.

Which therapeutic factor refers to the group members' relationships to the therapist and other group members? group cohesion catharsis altruism universality

group cohesion