Nursing Concepts Chapter Questions

Your patient is Jewish and refuses to eat non-kosher food. You say: A. "I will ask the dietitian to come and talk with you." B. "The dietitian will come to see you." C. "It's the best we can do. You need to eat." D. "You're right. The hospital food does leave much to be desired!"

A - "I will ask the dietitian to come and talk with you."

Your patient has refused all your attempts to care for him. You say: A. "I'd like to help you; what can I do?" B. "Why don't you like me?" C. "What is the matter with you?" D. "You must do this; physician's orders!"

A - "I'd like to help you; what can I do?"

Your patient, who is usually very talkative, does not respond to you when you enter the room. You say: A. "Ms. Smith, you are so quiet this afternoon. Is something bothering you?" B. "Ms. Smith, is something bothering you?" C. "Can I help you?" D. "Why are you so quiet this afternoon?"

A - "Ms. Smith, you are so quiet this afternoon. Is something bothering you?"

Ms. S is admitted to your medical unit with a diagnosis of dehydration and a history of depression. She tells you, "I just can't eat. I'm not hungry." Your best therapeutic response would be: A. "You aren't hungry?" B. "If you can't eat, what is that candy bar wrapper doing in your bed?" C. "Why aren't you hungry?" D. "You really should try to eat some real food."

A. "You aren't hungry?"

The most current thinking on the cause of schizophrenia is that it is: A. A brain disorder B. Primarily related to a disturbed mother/child relationship C. Brain damage caused by the mother's use of tranquilizers during pregnancy D. An alteration in opioid receptors

A. A brain disorder

The mental status examination takes place in what part of the nursing process? A. Assessment B. Plan C. Implementation D. Evaluation

A. Assessment

Effective coping skills are described as: A. Being able to make choices that are healthy and individualized B. The excessive usage of any defense mechanism C. Imitating the coping behavior of others D. Working on the problem until totally exhausted

A. Being able to make choices that are healthy and individualized

Which of the following is/are part of the principles of teaching? (select all that apply) A. Being flexible B. Evaluate the learning C. Teach without a teaching plan D. Know the patient

A. Being flexible B. Evaluate the learning D. Know the patient

Shawna is a 22-year-old woman who has episodes of extreme muscle rigidity and hyperexcitability. She sometimes repeats a word or a phrase over and over. Attempts to move her are met with even more muscle resistance. What is she exhibiting? A. Catatonia B. Disorganized schizophrenia C. Brief psychotic disorder D. Schizotypal personality

A. Catatonia

An individual stands on the train track with the train coming nearer. The person exclaims, "I am invincible! The train will not hurt me." This is an example of: A. Delusions of grandeur B. Echolalia C. Sensory hallucinations D. Extrapyramidal symptoms

A. Delusions of grandeur

The alcoholic who says, "I don't have a problem. I can quit any time I want to; I just don't want to" is displaying: A. Denial B. Fantasy C. Dissociation D. Transference

A. Denial

A patient who repeats a word or part of a word over and over might be said to have which of the following symptoms? A. Echolalia B. Echopraxia C. Illusion D. Word salad

A. Echolalia

The most common reasons for homelessness include: (select all that apply) A. Economic setbacks B. Lack of ambition and laziness C. Major health expenses D. Desire to live independently E. Mental health

A. Economic setbacks C. Major health expenses E. Mental health

Mr. G is calling out, "Nurse!" When you arrive in his room, he tells you to be careful of the snake in the corner. You do not see anything in the corner. Mr. G is experiencing a (an): A. Hallucination B. Attention-getting behavior C. Illusion D. Delusion

A. Hallucination

Which of the following is not true about depression? A. It is more common in men than in women. B. It is common after myocardial infarction. C. Grief after a major loss can mimic depression. D. Children and adolescents can suffer from depression.

A. It is more common in men than in women.

A primary mechanism used by people with personality disorders is: A. Manipulation B. Depression C. Projection D. Euphoria

A. Manipulation

The Mental Health Status Examination includes: (select all that apply) A. Memory B. Judgment C. Mood and tone D. Mood and affect E. Level of awareness and orientation

A. Memory B. Judgment D. Mood and affect E. Level of awareness and orientation

According to ANA, the RN is the primary person for developing this part of the care plan: A. Nursing diagnosis B. Implementation/interventions C. Evaluation D. Assessment

A. Nursing diagnosis

Shirley, a 70-year-old woman, went to a photo shoot for a portrait. As soon as the photographer began to photograph Shirley, she started to display signs of regression by: (select all that apply) A. Posing as a young adolescent B. Posing as her mother C. Pouting when poses were suggested by the photographer D. Stopping the session to make two ponytails, one on each side of her head E. Posing as a 70-year-old woman

A. Posing as a young adolescent C. Pouting when poses were suggested by the photographer D. Stopping the session to make two ponytails, one on each side of her head

You overhear someone jokingly repeating the social cliché, "Stop smoking, lose weight, exercise; die anyway" as he orders a big burger and super-sized fries. That cliché is an example of: A. Rationalization B. Repression C. Regression D. Rebellion

A. Rationalization

The fact that Susan is telling you she has another plan for suicide indicates what? A. She is reaching out for help and is ambivalent about wanting to die. B. She is committed to her suicide plan. C. She is psychotic. D. She needs antidepressants started right away.

A. She is reaching out for help and is ambivalent about wanting to die.

Which of the following are components of the planning part of the nursing process? (select all that apply) A. Short-term goals B. Long-term goals C. Subjective D. Objective E. Evaluation

A. Short-term goals B. Long-term goals

The nursing process is a method for: A. Systematic organization and implementation of patient care B. Documenting patient needs C. Differentiating the RN role from the LPN/LVN role D. Data collection

A. Systematic organization and implementation of patient care

Which of the following is an example of a therapeutic, open-ended question? A. "Why did you do that, Mrs. Jones?" B. "How can I help you, Mr. Thompson?" C. "Can I help you, Ms. Greene?" D. "Please, can I ask you a question, Mark?"

B - "How can I help you, Mr. Thompson?"

In the past, facilities that housed patients who were needy, sick, or insane were known as A. Detox centers B. Asylums C. Outpatient clinics D. Hospitals

B - Asylums

Which of the following nursing organizations specifically represent minority nurses? (Select all that apply.) A. NACE B. AAPINA C. NAPNES D. PNAA E. NANAINA

B,D,E - AAPINA, NAPNES, NANAINA

The next day, Susan tells you that she has another plan to "finish the job when I get out of here. Please don't tell anyone." What would be your best response? A. "You are safe here." B. "What are you planning to do?" C. "I won't tell anyone if you promise not to do anything to yourself." D. "I was hoping you were feeling better."

B. "What are you planning to do?"

For the patient with antisocial personality disorder, which of the following behaviors would be the most difficult for the patient to comply with? A. Listening to music B. Abiding by the rules in the hospital C. Playing volleyball D. Asking to organize a patient committee

B. Abiding by the rules in the hospital

The phenomenon of homelessness can be blamed, in part, on: A. Deinstitutionalization B. Access to community services C. Mental illness D. All of the above

B. Access to community services

Nurses who care for patients who are homeless understand that in the United States: A. Homelessness is classified as a mental illness. B. Approximately one-third of the homeless are mentally ill. C. All the homeless have some form of mental illness. D. People must be mentally ill to choose to be homeless.

B. Approximately one-third of the homeless are mentally ill.

Your charge nurse tells you that Mr. P must be placed on suicide precautions. The first intervention you begin is: A. Place Mr. P in a locked unit. B. Begin one-on-one observation at least every 15 minutes. C. Call the security code over the public-address system. D. Allow Mr. P to shave and carry out his bedtime care.

B. Begin one-on-one observation at least every 15 minutes.

The concepts of space, time, and waiting are: A. Religious B. Cultural C. Economic D. Ethnic

B. Cultural

When collecting data during an intake interview, the nurse understands: (select all that apply) A. Most homeless people are unemployed. B. Culture is a shared belief system. C. Prejudice exists within the health-care delivery system. D. There is no correlation between mental illness and the condition of homelessness.

B. Culture is a shared belief system. C. Prejudice exists within the health-care delivery system. D. There is no correlation between mental illness and the condition of homelessness.

Which of the following is not an anxiety disorder? (Select all that apply.) A. Panic disorder B. Depressive Disorders C. Multiple personality disorder D. Agoraphobia E. Selective Mutism

B. Depressive Disorders C. Multiple personality disorder E. Selective Mutism

The use of defense mechanisms is related to what part(s) of Freud's personality theory? (select all that apply) A. Id B. Ego C. Superego D. Response E. Superid

B. Ego

Which of the following are nursing interventions for people with anxiety disorders? (Select all that apply.) A. Maximize stimuli to create diversion from the anxiety. B. Encourage the patient to verbalize all thoughts and feelings. C. Observe the patient's nonverbal communication for data on the patient's thoughts and feelings. D. Observe for signs of suicidal thoughts. E. Document only positive changes in behavior. F. Discourage activities; activities might only increase a patient's anxiety level.

B. Encourage the patient to verbalize all thoughts and feelings. C. Observe the patient's nonverbal communication for data on the patient's thoughts and feelings. D. Observe for signs of suicidal thoughts.

Agoraphobia is: A. Fear of speaking B. Fear of shopping in a large mall C. Fear of heights D. Fear of blood

B. Fear of shopping in a large mall

Angela is a veteran who served in Iraq. It is very difficult for her to drive through a parking ramp because "There are people hiding behind the pillars! They have guns! Be careful!" Angela is most likely experiencing: A. Auditory hallucinations B. Flashbacks C. Delusions of grandeur D. Free-floating anxiety

B. Flashbacks

A person is more likely to commit suicide when he or she: A. Is in deepest depression B. Has a sudden lift from previous depressed mood C. Is confused D. Is feeling loved and appreciated

B. Has a sudden lift from previous depressed mood

Mr. S states, "Look at the snakes on the ceiling." You see some cracks in the plaster. Mr. S is experiencing a (an): A. Hallucination B. Illusion C. Delusion D. Flashback

B. Illusion

Statistically, which of the following people is at highest risk for suicide based on the information provided? A. Nancy is a 33-year-old mother of two who just lost her mother in a motor vehicle accident. B. Jim is a 68-year-old recent widower with a long history of alcohol abuse. C. Carol, age 18, has a long history of sickle cell disease and is depressed over chronic pain and the inability to attend her prom. D. Hans is a 55-year-old man with end-stage pancreatic cancer who is entering a hospice program.

B. Jim is a 68-year-old recent widower with a long history of alcohol abuse.

A nursing intervention for a person with schizophrenia is to: A. Reinforce the hallucinations. B. Keep the person oriented to reality and to the present. C. Encourage the patient to begin psychoanalysis. D. Encourage competitive activities.

B. Keep the person oriented to reality and to the present.

The main goal of deinstitutionalization was to A. Let all mentally ill people care for themselves. B. Return as many people as possible to a "normal" life. C. Keep all mentally ill people in locked wards. D. Close all community hospitals.

B. Return as many people as possible to a "normal" life.

When conducting patient teaching, the best method to evaluate the success of the patient is: A. Lecture B. Return demonstration C. Implementation D. Assessment

B. Return demonstration

Patients who display very bizarre behavior most likely have which of the following types of personality disorder? A. Narcissistic B. Schizotypal C. Antisocial D. Borderline

B. Schizotypal

You observe a patient in the family lounge. She appears to be talking to herself. You want to find out what is wrong. Your best approach to her might be: A. "Who are you talking to?" B. "Please stop talking. You are disturbing the other people." C. "I saw your lips moving. Can you tell me what you are talking about?" D. "Why are you talking to yourself?"

C - "I saw your lips moving. Can you tell me what you are talking about?"

Your patient is a single parent who has just been diagnosed with terminal cancer. She is concerned about returning to work and asks many questions. Finally, the patient says, "What do you think I should do?" You say: A. "I think you should just stay busy." B. "I wouldn't worry about it." C. "What are your thoughts about returning to work?" D. "Oh, you'll be just fine. There are lots of people worse off than you."

C - "What are your thoughts about returning to work?"

The purpose of therapeutic communication is to: A. Develop a friendly, social relationship with the patient. B. Develop a parental, authoritarian relationship with the patient. C. Develop a helping, purposeful relationship with the patient. D. Develop a cool, businesslike relationship with the patient.

C - Develop a helping, purposeful relationship with the patient.

A major breakthrough of the 1950s that assisted in the deinstitutionalization movement was A. The Community Mental Health Centers Act B. The Nurse Practice Act C. The development of psychotropic medications D. Electroshock therapy

C - The development of psychotropic medications

You are assisting in collecting data on a new patient in your unit. The health-care provider suspects alcohol abuse. You want to learn the patient's history and frequency of alcohol use. Your best choice for collecting these data might be to ask: A. "Do you use alcohol?" B. "How often do you get drunk?" C. "How many times a week would you say you drink alcohol?" D. "Why do you use alcohol? It's bad for you."

C. "How many times a week would you say you drink alcohol?"

Of the following responses, which would be your best response to Mr. G regarding the snake that he sees? A. "Don't worry; I'll get rid of it." (You pretend to remove the snake.) B. "I don't see a snake; what else do you see that isn't there?" C. "I don't see a snake. It is time for your group meeting. I'll walk with you to the meeting room." D. "Where is it? I hate snakes. Let's get out of here."

C. "I don't see a snake. It is time for your group meeting. I'll walk with you to the meeting room."

Your best response to Mr. S might be: A. "How many snakes do you see, Mr. S?" B. "Yes, I see them, too. Let's go to the dayroom." C. "I see some cracks in the plaster, but I do not see snakes. Let's go to the day room." D. "I don't think your medication is working. I'll call the doctor."

C. "I see some cracks in the plaster, but I do not see snakes. Let's go to the day room."

Your patient, Mr. A, had a recent myocardial infarction and open heart surgery with an uncomplicated recovery. His wife tells you that Mr. A has changed and is now uncommunicative, sad, and discouraged about the future. How would you respond to Mrs. A? A. "I'll let the doctor know." B. "This is normal. I would just ignore it for now." C. "Tell me more about the changes in his behavior." D. "We should get a psychiatric consult."

C. "Tell me more about the changes in his behavior."

The three subcategories of phobia include all of the following EXCEPT: A. Agoraphobia B. Social phobia C. Acrophobia D. Specific phobia

C. Acrophobia

Patient Y is 20 years old. Y is a perfectionist and very routine-oriented. Freudian theorists would say that Patient Y did not successfully complete which of the following stages of development? A. Genital B. Oral C. Anal D. Phallic

C. Anal

A patient who has committed multiple crimes would probably have which of the following personality disorders? A. Narcissistic B. Schizoid C. Antisocial D. Borderline

C. Antisocial

David, 30 years old, comes to your unit for treatment of multiple broken bones following a car accident. He is friendly and flirtatious, but very demanding. As you gather data from him, you learn that the police have been looking for him for petty theft. He laughs and says, "Like they don't have better things to do!" He states he has changed jobs three times in the past year and has just broken off his second engagement. His former fiancée is visiting and privately tells you that you need to be careful because "He doesn't always tell the truth." You suspect which of the following personality disorders? A. Paranoid B. Dependent C. Antisocial D. Schizoid

C. Antisocial

Your patient appears withdrawn and depressed. Which of the following would not be an effective intervention? A. Develop trust B. Show acceptance C. Be judgmental D. Be honest

C. Be judgmental

The primary goal in working with an actively psychotic, suspicious patient is to: A. Improve her relationship with her parents B. Encourage participation in individual psychotherapy C. Decrease her anxiety and increase trust D. Promote healthy living habits

C. Decrease her anxiety and increase trust

Further discussion with Mr. P reveals he is of a religious sect that believes there is honor in dying for one's religion. He does not understand why everyone is so afraid to die in this country. As his nurse, you: A. Document the discussion and remove the suicide precautions, citing religious freedom. B. Encourage him to present his beliefs at group tomorrow. C. Document the discussion but tell him that the suicide precautions remain in effect. D. Thank him for his explanation and bring him his next dose of medication.

C. Document the discussion but tell him that the suicide precautions remain in effect.

The nurse who is assessing a patient with major depression would expect to observe which of the following symptoms? A. Euphoria B. Fear C. Extreme sadness D. Compulsions

C. Extreme sadness

Which of the following is not a sign of untreated schizophrenia? A. Loss of reality B. Living in one's own world C. Maintaining satisfactory performance on the job D. Delusions, hallucinations

C. Maintaining satisfactory performance on the job

Your patient has been admitted with a diagnosis of bilateral pneumonia. You have trouble communicating with this patient, who is pouty and is demanding of your constant attention. She talks for long periods about the smallest details of her life. Besides the pneumonia, you ask the physician if the patient has a history of which of the following personality disorders? A. Schizoid B. Antisocial C. Narcissistic D. Borderline

C. Narcissistic

The condition of judging a person or situation before all the facts are known is called: A. Hatred B. Abuse C. Prejudice D. Stereotype

C. Prejudice

After receiving disappointing news about a job promotion, John stated, "I didn't get the promotion because I write with my left hand." This is an example of: A. Avoidance B. Regression C. Projection D. Denial

C. Projection

A person who always sounds as though he or she is making excuses is displaying: A. Denial B. Fantasy C. Rationalization D. Transference

C. Rationalization

Which intervention describes an important component in treatment of personality disorders? A. Antidepressants are most effective with most personality disorders. B. Inpatient psychiatric hospitalization is particularly effective. C. Self-awareness by the nurse is necessary to ensure a therapeutic relationship. D. Long-term psychoanalysis is the treatment of choice.

C. Self-awareness by the nurse is necessary to ensure a therapeutic relationship.

Your patient tells you, "I am just a burden. Everyone would be better off if I was dead." Nurses are aware that: A. Suicide talk is just an attention-getting device. B. Suicide is an impulsive act; it is not thought out. C. Suicidal talk or ideation can lead to suicidal behavior. D. Suicidal people seldom really attempt suicide.

C. Suicidal talk or ideation can lead to suicidal behavior.

Your patient asks you the results of his blood tests. You respond: A. "They are all negative." B. "Why do you want to know?" C. "I think you should wait until your physician comes in." D. "I am not able to tell you right now, but I will call your physician and have her stop in to explain them to you."

D - "I am not able to tell you right now, but I will call your physician and have her stop in to explain them to you."

Your patient is commenting that the physician has not been in to visit for 2 days. You say: A. "I hate it when that happens!" B. "What do you need to know?" C. "Well, he is very busy!" D. "You feel ignored by your physician?"

D - "You feel ignored by your physician?"

As a result of deinstitutionalization and changes in the health-care delivery system, nurses can expect to care for people with mental health issues in which of the following settings? A. Psychiatric hospitals only B. Outpatient settings only C. Medical-surgical hospital settings D. All of the above

D - All of the above

The set of regulations that dictates the scope of a nurse's professional duties is called A. National League for Nursing B. American Nurses Association C. Patient Bill of Rights D. Nurse Practice Act

D - Nurse Practice Act

Mr. L, who has a severe fear of needles, is hospitalized on your medical unit. The laboratory technician enters to draw blood for the routine CBC, and Mr. L begins to cry out, "Get away from me! I can't breathe! I'm having a heart attack!" Your first response to Mr. L would be: A. "I'll take your vital signs and call my supervisor." B. "Why do you think you're having a heart attack, Mr. L?" C. "Don't worry. She's done this many times before." D. "Mr. L, relax. Take a few deep breaths. I'll stay with you."

D. "Mr. L, relax. Take a few deep breaths. I'll stay with you."

Susan is 27 years old and has been admitted from the ED with an overdose of an antidepressant. She tells you, "My boyfriend broke up with me, and I can't live without him." What is your best response? A. "You are young. You will find someone else." B. "Forget him. You can do better than him. He isn't worth losing your life for." C. "Why did he break up with you?" D. "You must have been feeling very sad when he told you."

D. "You must have been feeling very sad when he told you."

Parents accompany their ill 8-year-old child to the clinic. The child was diagnosed last month with type 1 diabetes and is insulin dependent. The parents admit they are not administering the insulin, as their religious beliefs do not allow foreign substances in any form for any reason. A check of the patient's chart clearly indicates that diabetes teaching had been done with this family unit at last month's visit. Your initial nursing action is: A. Report the parents for child endangerment, as nurses are mandatory reporters. B. Inform the parents that this child could die without the required insulin. C. Leave the room and call a doctor or RN to the room stat. D. Collect information pertaining to what the religion would allow and facilitate discussion with the doctor.

D. Collect information pertaining to what the religion would allow and facilitate discussion with the doctor.

Your young male patient who tells you that he may not be big enough for the basketball team, but says "That's no problem because I'm a 4.0 student and on the principal's list" is displaying: A. Denial B. Transference C. Dissociation D. Compensation

D. Compensation

A patient is admitted with the diagnosis of paranoid behavior. The patient claims to be of a religion requiring the wearing of very heavy necklaces. You research the religion and determine this to be true, but the patient has been seen violently flinging a necklace at his or her roommate. Your best nursing action is: A. Call an assistance code. B. Remove all religious items. C. Do nothing: it is his or her religious right. D. Enlist the assistance of a religious representative to negotiate removal of the item(s) in question.

D. Enlist the assistance of a religious representative to negotiate removal of the item(s) in question.

Language, country of origin, and skin color define: A. Religion B. Culture C. Ethnocentrism D. Ethnicity

D. Ethnicity

Dianne is sitting in her hospital bed holding the orange given to her to practice her insulin injections. When the nurse enters the room, Dianne asks when she is going to inject herself instead of the orange. This statement indicates that Dianne is ready for: A. Discharge to home B. More time injecting the orange C. Informal teaching D. Formal teaching

D. Formal teaching

Brian, an 18-year-old with schizophrenia, has a negative attitude, is delusional, hears voices, and is withdrawing from others. A nursing intervention that is appropriate for promoting activity for Brian is: A. Tell him "the voices" told you he should participate in the weekly party. B. Remind him that he does not want to get worse by sitting alone. C. Tell him he must join the party; it is part of his care plan. D. Invite him to join in the party.

D. Invite him to join in the party.

Which of the following is true regarding a phobic disorder? A. It involves repetitive actions. B. It involves a loss of identity. C. It results in sociopathic behavior. D. It is an irrational fear that is not changed by logic.

D. It is an irrational fear that is not changed by logic.

A patient with post-traumatic stress disorder is: A. Suspicious and hostile B. Flexible and adaptable to change C. Extremely frightened of something D. Likely to avoid any stimuli associated with the traumatic event

D. Likely to avoid any stimuli associated with the traumatic event

A nursing intervention that is appropriate for a patient who is suicidal is: A. Report the patient to the police. B. Ignore the patient's suicidal comments, considering them "attention getting." C. Tell the patient that he or she "has so much to live for!" D. Listen to the patient's concerns and worries.

D. Listen to the patient's concerns and worries.

Your patient with major depressive disorder isolates herself in her room for the whole day. You find her sitting and staring out the window. What is the best therapeutic response when you walk in the room? A. "Come with me. It's time for group therapy." B. "I'd like to introduce you to other patients." C. "What are you thinking about?" D. Make frequent short visits to her room and just sit there.

D. Make frequent short visits to her room and just sit there.

NANDA is responsible for: A. Interventions B. Implementation C. Appearance D. Nursing diagnoses

D. Nursing diagnoses

A 4-year-old patient comes into the clinic with her father. She is being checked for a recurring ear infection. As you prepare her to see the physician, she says to you, "I love my Daddy. I'm going to marry him like Mommy someday!" Which one of Freud's stages of development is she most likely demonstrating? A. Genital B. Oral C. Anal D. Phallic

D. Phallic

Mr. P is brought to the hospital by his wife. She states that he has been treated for depression recently, but that tonight he said, "You and the kids don't need me messing up your lives." Mr. P tells you he has been thinking about suicide for some time now. A nursing diagnosis for Mr. P would be: A. Knowledge deficit related to family needs B. Ineffective individual coping as evidenced by manipulation of wife's feelings C. Anxiety related to hospitalization D. Potential for violence, self-directed, as evidenced by stating suicidal thoughts

D. Potential for violence, self-directed, as evidenced by stating suicidal thoughts

Mr. V becomes angry that Mrs. V spent the whole day shopping with her friends. Upon her return home, he hits her and tells her, "It's your own fault. Stay home once in a while!" Mr. V is displaying: A. Repression B. Regression C. Dissociation D. Projection

D. Projection

The nursing interventions for a patient with major depression would include all of the following except: A. Active listening skills B. Maintaining safe milieu C. Encouraging adequate nutrition D. Reassuring the patient everything will be "just fine"

D. Reassuring the patient everything will be "just fine"

When setting limits with patients with personality disorders, the consequences of violating those limits should be set: A. When the behavior is done B. Just before the nurse anticipates the behavior C. When the staff or family complains about the behavior D. When the limit is set

D. When the limit is set