Mental Unit 1

Which theorist is the nurse modeling when encouraging the patient to develop, strengthen, and use self-efficacy to maintain or regain mental health and wellness? 1. B. F. Skinner 2. Albert Bandura 3. Jean Piaget 4. Sigmund Freud

2

Which theory does the nurse recognize as the approach that explains how the patient's transformation of information is used? 1. Psychoanalytic theory 2. Cognitive theory 3. Psychosocial theory 4. Humanistic theory

2

A 20-year-old college student recently diagnosed with schizophrenia is taking antipsychotic medication to control his hallucinations. Which are appropriate activities for level 2 of wellness that could be included in this patient's treatment? Select all that apply. 1. Referral to a job training program 2. Medication management education 3. Group therapy 4. Inpatient admission 5. Family support group

2 3 5

According to Piaget's cognitive theory of development, which nursing considerations are most appropriate when caring for a 6-year-old child? Select all that apply. 1. Promote interaction with peers. 2. Offer explanations of assessments and procedures. 3. Provide consistency of caregiver; address stranger anxiety. 4. Provide clear and complete information, in both verbal and written form. 5. Provide opportunities to touch or play with medical equipment prior to assessments and procedures.

2 5

A nurse is making an initial psychiatric assessment. What does she realize is the most important part of this process? 1. Providing the DSM-5 diagnosis 2. Gathering information from the family 3. Ruling out a medical causation of symptoms 4. Evaluating the need for psychotropic medication

3

A patient with bipolar disorder is being treated with lithium. What laboratory test will provide the nurse with information on the effectiveness and toxicity of the patient's lithium levels? 1. Complete blood count 2. Basic metabolic panel 3. Urinalysis 4. Serum level test

4

A nurse is conducting an intake interview for a patient newly admitted to the hospital. The patient reports that the only medication she is currently taking is an SSRI. The nurse suspects the patient is most likely to have which condition? 1. Depression 2. Bipolar disorder 3. Schizophrenia 4. Sexual dysfunction

1

A patient with bipolar disorder asks the nurse what caused the illness. What will the nurse tell the patient regarding the genetic transmission of bipolar disorder? 1. Bipolar disorder is caused by environmental factors. 2. There is one single gene responsible for bipolar disorder. 3. There is no known cause for the development of bipolar disorder. 4. There appears to be a genetic link in the transmission of bipolar disease.

4

A nurse is preparing a paper for a conference on mental illness nursing throughout history. How does she present the concept of a curative point as a shift in the treatment of the mentally ill? 1. It envisioned the possibility of recovery in mental illness. 2. It incorporated herbal remedies in the treatment of mental illness. 3. It was the first treatment to provide specific treatment interventions. 4. It was the first treatment focused on the humane treatment of individuals with mental illness.

1

A 72-year-old patient tells the nurse that she is unable to take her antidepressant medication regularly because her granddaughter forgets to go to the drugstore for her. What perception of life events does this explanation demonstrate? 1. Resilience 2. External locus of control 3. Internal locus of control 4. Primary appraisal

2

What specific condition was considered an indication for bloodletting when patients were diagnosed with mental illness? 1. Melancholy 2. Excess excitability 3. Cerebral dysfunction 4. Hereditary weakness

2

) A nurse is making a presentation to her administration on the need for a room that is comfortable, light, and calming that a patient can use during times of stress. What is the best argument for encouraging implementation at this facility? 1. It has been proven effective. 2. It is required for accreditation. 3. It will be liked by the patients. 4. It presents a more up-to-date care image.

1

A 54-year-old patient tells the nurse that she is very upset that her son has become involved in demonstrations protesting corporate lobbying. Which of Kohlberg's stages of moral development does the nurse identify as her patient's current stage? 1. Adaptation 2. Assimilation 3. Conventional 4. Pre-conventional

1

A 74-year-old male patient is distressed that he has not accomplished all that he hoped to in his life. Based on Erikson's developmental stages, which conflict does the nurse consider this patient to be experiencing? 1. Integrity vs. despair 2. Generativity vs. stagnation 3. Identity vs. identity confusion 4. Autonomy vs. shame and doubt

1

A nurse is providing services at a shelter established for tornado survivors. The nurse is wondering what she is accomplishing just by listening to the disaster victims. Why is it important for the nurse to use active listening when caring for these patients? 1. It assists patients through suffering. 2. It assists patients to receive therapy. 3. It assists patients on focusing on the present issue. 4. It assists patients to recall events.

1

A nurse who is considering theories that guide the practice of psychiatric nursing wants to base her interactions with patients on the theory of interpersonal relations. Whose works might she consult in order to learn more? 1. Hilda Peplau 2. Karl Menninger 3. William Stokes 4. Florence Nightingale

1

A nursing assistant tells the psychiatric nurse that normal people do not have mental disorders. What action by the nurse is most appropriate? 1. Instruct the nursing assistant that anyone can have a mental health disorder. 2. Alert the nursing manager of the nursing assistant's remark. 3. Refer the nursing assistant back to the psychiatric orientation materials. 4. Disregard the comment because the nurse has no responsibility in this situation.

1

A patient asks a nurse to explain why morphine is used for significant pain. What is the most appropriate response the nurse might make? 1. Morphine is an opioid drug. It affects a pain modulation circuit that contains certain cell structures that bind with morphine and have a significant pain modulating and relief effect. 2. Morphine is a serotonin-stimulating drug. It affects a pain modulation circuit that contains certain cell structures that bind with morphine and have a significant pain modulating and relief effect. 3. Morphine is a norepinephrine-stimulating drug. It affects a pain modulation circuit that contains certain cell structures that bind with morphine and have a significant pain modulating and relief effect. 4. Morphine is a dopamine medication. It affects a pain modulation circuit that contains certain cell structures that bind with morphine and have a significant pain modulating and relief effect.

1

A patient has lost his home and family as a result of an addiction to alcohol. What does the nurse understand about the patient's condition? 1. Addictive behavior involves the limbic system. 2. Addictive behavior is indicative of character flaws. 3. Addictive behavior has a variety of neurological patterns. 4. Addictive behavior is related to dysfunctional parent-child relationships.

1

A patient tells her therapist that she is having an affair because she needs more attention and her husband won't give it to her. What component of personality functioning does the patient's statement indicate to the therapist? 1. Id 2. Ego 3. Sensorimotor 4. Self-esteem

1

A patient tells visiting family that a test was done to examine how the patient's brain is functioning. Which type of test does the nurse recognize as the test the patient is describing? 1. Positron emission test (PET) 2. Computerized tomography (CT) 3. Magnetic resonance imaging (MRI) 4. Single photon-emission computed tomography (SPECT)

1

A student nurse tells her mentor that adolescents are too young to be treated for depression. What information should her mentor provide to help the student understand the epidemiology and treatment of mental health disorders? 1. In 2012, more than two million individuals ages 12 to 17 had a major depressive episode (MDE). 2. Adolescents do not usually receive mental health treatment. 3. All depression in adolescents is connected to illicit drug use. 4. Men are the most likely group to experience depression.

1

Several nurses are discussing the effect of the medicalization of care on nursing patients with mental illness. What statement indicates that the nurses understand this historical trend? 1. "Medicalization tended to pull care away from its holistic tradition." 2. "Medicalization provided an essential basis for nursing education." 3. "Medicalization reflected a diminished interest in psychopathology." 4. "Medicalization provided a good understanding of the mind-body connection."

1

What was the treatment model used by Matilda Coskery? 1. Moral therapy 2. Biomedical treatment 3. Interpersonal therapy 4. Brief solution-focused therapy

1

When planning care for patients on the mental health unit, which statement will the nurse consider as using principles associated with the humanistic theory? 1. Emotional stress has a holistic relationship to physical symptoms. 2. Patients rely on providers to develop solutions for their problems. 3. The mind-body relationship focuses on biological explanations of illness. 4. Clinical interventions are most effective when they focus on the current actions, feelings, and concerns of clients.

1

Which action by the psychiatric-mental health nurse best indicates use of Hildegard Peplau's nursing theory when caring for a patient with mental illness? 1. Establishing a therapeutic nurse-patient relationship 2. Assessing patient interactions with the environment 3. Intervening to enhance the patient's abilities to perform self-care 4. Evaluating the effectiveness of the patient's coping and adaptation skills

1

Which nursing model was developed by Catherine McCauley in 19th century Ireland? 1. Careful nursing 2. Tidal model of care 3. Healing environment 4. Curative point nursing

1

) In the 19th century, what factors did practitioners who accepted the theory that mental illness was an excess or deficit in excitability see as contributing to mental illness? Select all that apply. 1. Education 2. Urban life 3. Intemperance 4. Cerebral hyperemia 5. Demonic possession

1 2

According to the Murphy-Moller wellness model, which elements occur within the sociological domain? Select all that apply. 1. Environment 2. Kinship 3. Religious faith 4. Moral development 5. Nutrition

1 2

A nurse is considering how the Sisters of Charity at Mt. Hope provided treatment for patients with mental illness. What elements of treatment at this facility does she see reflected in modern perspectives and practice? Select all that apply. 1. Conversation with the patient 2. Respectful and kind treatment 3. Provision of recreational activities 4. Control of treatment by the nursing staff 5. Removal from family and former associates

1 2 3

A group of student nurses were discussing how to promote resilience in their patients and realized that it is a concept they also want to promote in themselves. How might student nurses foster their own resilience? 1. By avoiding challenges 2. By using reflection 3. Through self-reliance 4. Through expecting the worst

2

The nurse is caring for a patient with anxiety and depression who tells the nurse, "I am always stressed out." Which factors inform the nurse's understanding of stress? Select all that apply. 1. It relates to an individual's perception of demands being made on him or her. 2. It relates to the individual's perception of his or her ability to meet the demands being made on him or her. 3. It is often a precipitant of anxiety. 4. It is often caused by anxiety. 5. It relates to an individual's perception of others.

1 2 3

Which components of Abraham Maslow's humanistic theory support the outcome of a person-centered motivation to grow and develop in a healthy way? Select all that apply. 1. Focus on health 2. Needs and self-actualization 3. Holistic, interactive approach 4. Human potential for goodness 5. Use of empathy and positive regard

1 2 3

Nursing theory provides guidance for a nurse who is expected to perform what activity? Select all that apply. 1. Generate goals 2. Plan interventions 3. Organize assessment data 4. Generate nursing actions 5. Diagnose patient conditions

1 2 3 4

A novice nurse is learning the difference between pain and suffering. What kind of experience does the nurse associate with suffering? Select all that apply. 1. Mental 2. Spiritual 3. Emotional 4. Physiological 5. Psychological

1 2 3 5

Several nurses were discussing methods of restraint used in the 19th century. What are some of the methods the nurses might have noted? Select all that apply. 1. Mitts 2. Seclusion 3. Strapping 4. Hydrotherapy 5. Straightjacket

1 2 3 5

A nurse is preparing a presentation on serious mental illness. Which conditions should be included? Select all that apply. 1. Major depression 2. Schizophrenia 3. Adjustment reaction 4. Bipolar disorder 5. Social phobia

1 2 4

What are some of the professional organizations that contribute to psychiatric-mental health nursing? Select all that apply. 1. The American Nurses Association (ANA) 2. The American Psychiatric Nurses Association (APNA) 3. The American Psychiatric Association (APA) 4. The North American Nursing Diagnosis Association International 5. The American Psychological Association (APA)

1 2 4

The nurse is teaching the patient about the concept of mental disorders. When instructing the patient, what areas should be covered when explaining what impacts the determination of a mental disorder? Select all that apply. 1. Social conditions 2. Biochemistry 3. Mother-child interactions 4. Brain structure 5. Culture

1 2 4 5

A nurse educator is teaching a group of students about the traits of a mentally healthy individual. Which concepts provide information regarding psychological, emotional, and social health? Select all that apply. 1. Behavior 2. Intrapersonal relationships 3. Gender 4. Age 5. Interpersonal relationships

1 2 5

A nursing student is doing a research paper on how to improve psychiatric nursing outcomes for serious mental illness. Which types of research would be most useful? Select all that apply. 1. Nursing 2. Psychosocial 3. Educational 4. Economic 5. Neurobiological

1 2 5

A nurse is working with a patient who needs to change unwanted or undesired behavior. The nurse recognizes that which patient response indicates that patient is at the pre-contemplation stage of the stages of change model? Select all that apply. 1. The patient denies having a problem. 2. The patient acknowledges the problem. 3. The patient has no desire to change the problem. 4. The patient begins to make plans to change the problem. 5. The patient begins to seriously consider changing the problem.

1 3

A nurse is working with a 9-year-old girl who has been diagnosed with leukemia. Using Piaget's cognitive theory of development, what are some specific ways in which the nurse should interact with the child? Select all that apply. 1. Give clear information regarding treatment. 2. Recognize and respect her need for increased privacy. 3. Show the child items or equipment that will be used in treatment. 4. Assess for and encourage the child to participate in favorite activities. 5. Provide opportunity to touch or play with medical equipment prior to assessments and procedures.

1 3 4

Which tools and guidelines are included in the DSM-5? Select all that apply. 1. Cultural formulation interview 2. Guidelines for forming a multi-axial diagnosis 3. Directions for use of the manual 4. Suggestions for future research 5. Global assessment functioning scale

1 3 4

A nurse is assessing a patient who presented to the emergency department after a public fight. The patient is crying and claiming that he does not remember how the fight started. What sensory functions should the nurse check as part of the patient's initial psychiatric assessment? Select all that apply. 1. Pain 2. Smell 3. Pressure 4. Temperature 5. Proprioception

1 3 4 5

In a research paper on moral therapy, a nurse wants to examine how the diagnoses in this method of treating mental illness differ from current diagnoses. What are some of the diagnoses she should consider related to the use of moral therapy? Select all that apply. 1. Ill health 2. Binge eating 3. Pecuniary losses 4. Family affliction 5. Jealousy and pride

1 3 4 5

What are some of the goals of trauma-informed care? Select all that apply. 1. Understand symptoms as attempts to cope. 2. Provide regular medication education and monitoring. 3. Collaborate between provider and consumer at all phases of service delivery. 4. Protect patients with a history of trauma from physical harm and re-traumatization. 5. Focus on what has happened to the person rather than what is wrong with the person.

1 3 4 5

The nurse obtains a new position as a psychiatric-mental health nurse at the generalist level of practice. Based on the Psychiatric-Mental Health Nursing Standards of Practice (ANA, APNA, ISPN), in which areas might the nurse plan programs and intervention to fulfill employment expectations? Select all that apply. 1. Stress management strategies 2. Early diagnosis of psychiatric disorders 3. Parenting classes for new parents 4. Family and group psychotherapy 5. Medication teaching for anti-anxiety medications

1 3 5

What essential treatment elements of moral therapy could be considered as components of some current treatments? Select all that apply. 1. Kindness 2. Medication 3. Nutrition 4. Bloodletting 5. Meaningful activity

1 5

A new nurse is discouraged because a patient with whom she has been working for four months recently refused to continue group therapy. The nurse tells her supervisor that she doubts the patient will ever have an effective recovery. What is an appropriate response from her supervisor? 1. "Recovery is probably unlikely for this patient." 2. "The patient is experiencing a setback, not an end to recovery." 3. "The patient should be told that group therapy is her only route to recovery." 4. "The patient should be punished for her refusal to participate."

2

A nurse is caring for a patient who is experiencing visual hallucinations. Which neuroanatomical structure does the nurse recognize as the source of the patient's manifestations? 1. Parietal lobe 2. Occipital lobe 3. Temporal lobe 4. Right frontal lobe

2

A nurse is providing mental health services to a 45-year-old homeless man who is diagnosed with bipolar disorder. Based on a wellness model, which services could broaden the patient's base of social supports? 1. Medication monitoring 2. Housing assistance 3. Nutritional counseling 4. Individual psychotherapy

2

A nurse was asked to identify the most preferred location for addressing mental illness during the 19th century. What is the nurse's best response? 1. Home 2. Asylums 3. Hospitals 4. Sanitariums

2

A nurse, newly assigned to a 55-year-old Native American patient diagnosed with major depression, is concerned about the patient's reliance on certain totemic objects for comfort. What should the nurse do in order to address her concern? 1. Tell the patient that he needs to learn to rely upon himself. 2. Ask the patient to explain the significance of these objects. 3. Inform the patient that superstitions will interfere with his recovery. 4. Request a psychiatric consult to help determine if the patient is delusional.

2

A patient is hospitalized for symptoms that include auditory hallucinations and paranoid delusions. Based on the nurse's understanding of neurobiology, which neurotransmitter alteration causes these manifestations? 1. Serotonin 2. Dopamine 3. Acetylcholine 4. Norepinephrine

2

A school nurse is explaining to a student that, as a result of an eye exam, it is likely that the student will need to get eyeglasses. The student says, "I guess even though I don't like glasses, I'll get them because they will help me see better." Which of Piaget's intellectual components of development does this statement indicate to the nurse? 1. Schemas 2. Equilibrium 3. Assimilation 4. Accommodation

2

A teenage patient was recently in a motorcycle accident and suffered a closed head injury. Although the patient's family said the patient has always been even-tempered and reasonable, now the patient is frequently angry and is demonstrating poor impulse control. Which area of the patient's brain does the nurse suspect may have been injured in the accident? 1. Temporal lobe 2. Frontal lobe 3. Occipital lobe 4. Parietal lobe

2

Based on the work of Florence Nightingale, what distinguishes nurses from nursing attendants? 1. Kindness 2. Training and education 3. Ability to use herbal remedies 4. Belief in the bio-medical model

2

How might a nurse describe the relationship between mental health treatment and humanism? 1. Science is the core consideration of humanistic philosophy. 2. Caring practices and compassion must be approached holistically. 3. Mental health clients must rely on clinicians for difficult decision-making and care. 4. Limitations of life in today's world have little effect on planning effective interventions.

2

The parents of a 22-year-old male who is hospitalized for depression ask the nurse what they should be doing to help. What is the most appropriate response the nurse can make? 1. Refuse to talk with family members because of confidentiality restrictions. 2. Provide the family with education, information, and referral resources. 3. Tell the family members that their son is too old for them to be involved in his care. 4. Inform the family that only the psychiatrist can discuss their son's care.

2

What documentation was required for hospital admission to the Maryland Hospital for the Insane? 1. No documentation 2. Certificate of Insanity 3. Order of the patient's physician 4. Written request of the patient's family

2

What evaluative tool is most important in assessing a patient's mental condition? 1. Beck Depression Inventory 2. Mental Status Exam 3. CAT scan 4. WAIS

2

What is the standardized source for classifying psychiatric diagnoses? 1. DSM-III 2. DSM-5 3. ICD-9 4. WHO Disability Schedule

2

What quality, emphasized by Vincent dePaul in the 17th century, would a psychiatric nurse find important in her practice today? 1. Spirituality 2. Humility 3. Practicality 4. Obedience

2

What was a common response during the eras when patients with mental illness were believed to be victims of demonic possession? 1. Punishment by stoning 2. Shackling in chains 3. Burning at the stake 4. Treatment with exorcism

2

Which dimension is not commonly affected by suffering experienced by cancer patients? 1. Physical 2. Geographical 3. Psychological 4. Social well-being

2

Which dimension would the nurse most likely focus on if assessing the patient from primarily a 19th century perspective? 1. Spiritual 2. Physical 3. Social 4. Emotional

2

Which is a fundamental principle of mental health recovery? 1. Recovery is culturally unrelated. 2. Recovery is holistic. 3. Recovery begins with despair. 4. Recovery is solitary.

2

Which nursing diagnosis does the nurse recognize as the most consistent with the focus of psychiatric nursing care during the 19th century? 1. Anxiety 2. Self-care deficit 3. Altered thought processes 4. Ineffective individual coping

2

Which religious group of women instituted asylum-based treatment in the United States in order to provide peaceful surroundings for those with mental illness? 1. Quakers 2. Sisters of Charity 3. Daughters of Charity 4. Little Sisters of the Sick Poor

2

A 14-year-old female patient tells the school nurse that she frequently cuts herself. The nurse is very upset by this information. What is the best action by the nurse? 1. Report the problem to the principal. 2. Call the girl's parents and suggest a psychiatric evaluation. 3. Reflect on her own reactions and focus on responding to the patient's needs. 4. Shift the conversation to the girl's academic performance.

3

A novice nurse is working with a preceptor on a medical-surgical unit. After assessment of a patient, the novice nurse states to the preceptor, "This patient has many odd ideas about several common health practices. He seems like a deviant to me." What concept will guide the preceptor's response? 1. A definition of deviance that covers all clinical situations. 2. The knowledge that beliefs and behaviors are only deviant if the patient thinks there is a problem. 3. The knowledge that beliefs and behaviors vary according to cultural and social considerations. 4. The need for further assessment to determine the duration of the beliefs and actions.

3

A nurse institutes an exercise program at an inpatient mental health facility. Which wellness domain does this type of program address? 1. Psychological 2. Sociological 3. Biological 4. Cultural

3

A nurse is providing counseling services to flood victims who are staying in a shelter. According to Maslow's hierarchy of needs, on what category should the nurse focus in order to provide effective assistance? 1. Physiological 2. Self-actualization 3. Safety and security 4. Love and belonging

3

A nurse is teaching a class on psychiatric-mental health nursing. She asks her class to identify the most challenging part of this practice. What response would let her know that a student understands the difficulties in providing psychiatric-mental health nursing? 1. "The most difficult part is making correct diagnoses." 2. "The most difficult part is providing advocacy." 3. "The most difficult part is development of the therapeutic relationship and the corresponding therapeutic use of self." 4. "The most difficult part is involving the patient in treatment planning."

3

A patient ready to leave a substance abuse rehabilitation facility tells the nurse that he understands that he must avoid his former associates and join Nar-Anon in order to find new connections. What stage of hope is this patient exhibiting? 1. Bracing for negative outcomes 2. Continuously evaluating signs to reinforce selected goals and the revision of these goals 3. Developing a realistic appraisal of personal resources and external conditions and resources 4. Making a realistic appraisal of an event and the threat to self

3

A patient tells the nurse that she is extremely unhappy at her job and she doesn't know what to do. Using Rogerian therapeutic techniques, how might the nurse respond? 1. "Let's make a plan for how you can handle this situation." 2. "This situation sounds really awful. I think you should quit." 3. "Tell me more about what is happening and how it makes you feel." 4. "You really need to think about whether you are contributing to the difficulties you are having."

3

A psychiatric nurse wants to comply with the recommendation of the Institute of Medicine (IOM) Future of Nursing report that nurses take part in expanded opportunities to lead and share in collaborative improvement efforts. What activity would accomplish this? 1. Taking a course on nursing diagnoses 2. Becoming a nurse-mentor 3. Leading an interdisciplinary team focused on improving patient outcomes 4. Volunteering for extra shifts

3

During the shift report, a nurse describes a patient as "crazy." Which approach by the charge nurse would be best? 1. Ask the staff what terminology they wish to use. 2. Disregard the staff member's comment. 3. Suggest that staff use the term "mentally ill." 4. Role model using the term "nervous breakdown."

3

The mental health nursing student is preparing to attend a meeting of the mental health care team to discuss possible updates to clients' diagnoses. When preparing for this meeting, the nursing student will consult which reference? 1. Standards of Psychiatric Nursing Practice 2. Psychiatric nursing care plan manual 3. Diagnostic and Statistical Manual of Mental Disorders 4. Dictionary of common mental disorders

3

The patient, who is in recovery for alcohol addiction and is a heavy smoker, tells his nurse that he can never stop smoking because it is the only way he can relieve stress. He thinks his other problems are much more serious than his smoking. Having assessed that the patient is at the pre-contemplation stage of change, what would be an appropriate action for the nurse to take? 1. Help the patient make a plan to stop smoking. 2. Offer information regarding therapies and treatment options. 3. Help the patient identify specific stressors and some alternative ways to manage them. 4. Tell the patient that he is risking his life by smoking and must find a way to stop soon.

3

Which nursing action is priority if the nurse is using the nursing theory that has shaped psychiatric-mental health most directly? 1. Teaching effective coping skills 2. Assessing the patient's abilities in areas of self-care 3. Establishing a therapeutic nurse-patient relationship 4. Encouraging the patient's sensitivity and caring for self

3

Which theory or concept does a psychiatric nurse consider to be most closely aligned with Erikson's developmental theory? 1. Freud's psychosexual stages 2. Freud's behaviorist concepts 3. Sullivan's stages of interpersonal development 4. Maslow's theory of self-actualization and hierarchy of needs

3

A patient with paraplegia tells the nurse that paraplegia has some advantages. What are some secondary gains to which the patient may be referring? Select all that apply. 1. Attention 2. Sympathy 3. Personal services 4. Disability benefits 5. Escape from some responsibilities

3 4 5

The nurse is researching the pathophysiology and etiology of major depressive disorder. What will the nurse learn is true regarding neurological structure alterations and the development of major depressive disorder? Select all that apply. 1. An increase in the central nervous system (CNS) volume is associated with major depressive disorder. 2. Excessive levels of serotonin and norepinephrine have been associated with major depressive disorder. 3. Impairments to cerebral structural plasticity and neuronal cellular resilience have been noted with major depressive disorder. 4. An increase in the numbers and sizes of glia and neurons in some areas of the brain have been noted with major depressive disorder. 5. Dysfunction of cerebral blood flow and glucose metabolism in some areas of the brain has been noted with major depressive disorder.

3 5

A nurse is a member of a committee assigned to review the roles and responsibilities of the nurses on the psychiatric unit. Which publication will the nurse bring to the first meeting? 1. Diagnostic and Statistical Manual of Mental Disorders 2. American Nurses Credentialing Center certification requirements 3. American Nurses Association, Code of Ethics 4. Psychiatric-Mental Health Nursing Standards of Practice

4

A nurse is caring for a patient who likely has obsessive-compulsive disorder. The nurse is not familiar with the assessment data and behaviors associated this disorder. What action would be most appropriate for the nurse to take? 1. Document all subjective and objective data provided by the client. 2. Ask the primary health provider to identify needed subjective and objective assessment data. 3. Research obsessive-compulsive disorder in the medical dictionary. 4. Consult the Diagnostic and Statistical Manual of Mental Disorders for diagnostic criteria.

4

A nurse is reviewing the stress response. What does she identify as the most important neurotransmitter involved? 1. GABA 2. Serotonin 3. Dopamine 4. Norepinephrine

4

A patient presents to the emergency department. Her husband, who drove her, explains that the patient has a history of depression and told him she intends to take sleeping pills and "just end it all." What stage in the Murphy-Moller wellness model is the patient demonstrating? 1. Recovery 2. Restoration 3. Rehabilitation 4. Relapse

4

A psychiatric nurse is preparing nursing staff education on the role of neurotransmitters in neurobiology. Which statement will the nurse include in the teaching presentation? 1. "There are two classes of neurotransmitters." 2. "Each neurotransmitter functions in the same manner." 3. "Neurotransmitters and receptors do not vary in their affinity for each other." 4. "Neurotransmitters consistently act in either an excitatory or inhibitory manner."

4

During assessment, the nurse determines that the patient is having trouble learning from the past, difficulty dressing self, and cannot recognize written words. The nurse suspects that the patient's symptoms are a manifestation of dysfunction in which brain structure? 1. Frontal lobe 2. Temporal lobe 3. Parietal lobe 4. Occipital lobe

4

Several nurses are discussing the medicalization of mental health treatment. Which historical figure do they identify as claiming that the physician should be the ultimate authority over moral as well as medical therapy, and that no one should be exempt from the physician's decision? 1. Tuke 2. Stokes 3. de Paul 4. Esquirol

4

Several nurses are discussing whether or not there is a single universally accepted hypothesis that provides an explanation about the pathophysiology and etiology of depression. Which statement by the nurse is accurate? 1. "Cerebral structure is responsible for depression." 2. "We know that heredity is the single cause of depression." 3. "Because all patients respond the same to SSRIs, we have a thorough understanding of the neurochemistry of depression." 4. "There is no unified hypothesis regarding pathophysiology and etiology of depression, in part because patients demonstrate individualized responses to treatments."

4

The nurse is caring for a patient diagnosed with posttraumatic stress disorder (PTSD). In this disorder, which element of the nervous system does the nurse identify as malfunctioning? 1. Central 2. Peripheral 3. Sympathetic 4. Parasympathetic

4

The patient reports to her nurse that she has experienced a significant reduction in her energy level. What neurotransmitter might the nurse suspect is involved in this change? 1. GABA 2. Dopamine 3. Serotonin 4. Norepinephrine

4

What does a nurse realize is the most important thing in order to become an effective psychiatric nurse? 1. Develop good diagnostic skills. 2. Understand how to use medications effectively. 3. Understand the history of mental health treatment. 4. Learn how to guide a patient through their illness towards recovery.

4

What important development in nursing is attributed to Effie Taylor? 1. Reforming the asylum system 2. Introducing the use of activity therapy 3. Pioneering the development of nursing training 4. Incorporating a reintegration of the mind and body in nursing training

4

What practice, implemented by the Sisters of Charity at Mount Hope, served as a resource providing historical information about the treatment provided there? 1. Daily notes 2. Patient charts 3. Treatment plans 4. Log of patient outcomes

4

What term was acceptable in the 19th century when talking about mental illness that a nurse would not find acceptable today? 1. The same terminology is still in use today. 2. The term "mentally ill" was used regularly. 3. The term "mentally disabled" was frequently used in the 19th century. 4. In the 19th century, using the term "insane" was considered acceptable.

4

What would the nurse recognize as the impact that Florence Nightingale has had on the role of the nurse in psychiatric-mental health nursing? 1. Nightingale emphasized the cultural environment for healing. 2. Nightingale developed the idea of the therapeutic relationship. 3. Nightingale focused her ideas on nursing education rather than direct patient care. 4. Nightingale was among the first to note the influence of nurses has psychological components.

4