Psych Midterm

Which of the following is not a symptom of major depressive disorder?

Sad mood that lifts in a few days

Based on Jean Piaget's developmental theory, which statement is true?

The client's development is related to experiential age more than cognitive age

Which statement can be applied to the early asylums?

The clients were heavily medicated

A major breakthrough of the 1950s that assisted in the deinstitutionalization movement was

The development of psychotropic medications

Which statement can be applied to cultural competency?

The nurse is able to adapt care to meet the needs of patients from different cultures/backgrounds.

Psychopharmacology (psychotropic drug therapy) is used:

To decrease symptoms and facilitate other therapies

What is considered a therapeutic lithium blood level in a stable patient?

0.5-1.2 milliequivalents per liter

Which information will the nurse use to describe the term "culture" to a group of nursing students?

Culture is the combination of traditions and beliefs that bind a group of people together.

A patient states, "I don't know what the pills are for or why I am taking them, so I don't want them." Which therapeutic communication technique will best help this patient?

Giving information (educating)

When traditional medicine is combined with less traditional methods, it is called:

Integrative medicine

All of the following are types of communication, except:

Intrusive communication

Which of the following nursing organizations specifically represent nurses who belong to racial or ethnic minorities? (select all that apply)

NANAINA, AAPINA, PNAA

What institute was established as a result of the National Mental Health Act of 1946?

NIMH

The nurse is preparing to assess a patient with a moderate level of anxiety. Which clinical finding will the nurse anticipate?

Nail biting.

Which response is the most accurate list of signs of lithium toxicity?

Nausea, tremors, confusion

Which style of parenting results in poor socializing ability?

Neglectful

The act of developing a clean environment (cleanliness) is a factor in providing effective health care as demonstrated by this Trailblazer:

Nightingale

Your new patient is taking an MAOI for severe depression. What would you tell the dietary department about her upcoming meals?

No processed lunch meat

Which statement can be applied to spirituality and religion?

Recuperation from illness may be tied to spirituality.

A patient asks the nurse to review the benefits of aromatherapy. Which statement will the nurse include in the education?

"Aromatherapy has direct pharmacological effects."

Which information will the nurse ask when assessing a client's orientation?

"Can you tell me where you are right now?"

The nurse is obtaining a history from a patient prescribed a stimulant to treat narcolepsy. Which assessment question is the most important to ask the patient?

"Do you have a history of heart disease?"

The nurse is preparing to conduct a cultural assessment. Which question will the nurse ask?

"Do you have any cultural considerations that I have to be aware of?"

One of the first comments a nurse might make to a person who has been abused might be:

"You're safe here. I would like to help you."

The nurse is preparing to explain the benefits of yoga to a patient. Which topic of information will the nurse include in the teaching?

Reduction of stress.

The nurse is providing patient education about the purpose of The Joint Commission (TJC). Which topic of information will the nurse include in the teaching?

Reduction of the risk of undesirable patient outcomes.

A parent expresses concern that their child who is toilet trained and recently started day care has started wetting themselves and chooses to crawl instead of walk. Which defense mechanism will the nurse plan to discuss with the parent?

Regression

During a recent clinical rotation, the nursing student used the patient's full name on the assigned care plan. Which is the instructor's priority intervention?

Remind the student of the importance of maintaining patient confidentiality.

A client states to the nurse, "I always feel angry towards one of my family members and I do not know why." Which defense mechanism is the client describing?

Repression

According to Hildegard Peplau, which stage of the nurse-client relationship focuses on the client developing self-responsibility and showing personal growth?

Resolution

The nurse who is assessing a patient with major depression would expect to observe which of the following symptoms?

Extreme sadness

A patient states "I think my marriage is over, my wife doesn't love me anymore." The nurse replies, "Don't worry, everything is going to be okay." What type of nontherapeutic communication is this?

False reassurance/social clichés

Which of the following is not a behavior noted in the crisis phase?

Feeling of well-being

Audrey is a veteran who served in Afghanistan. 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!" Audrey is most likely experiencing:

Flashbacks

Which intervention will the nurse implement for a patient expressing distress related to a phobia?

Focus on a nonthreatening topic.

A patient states to the nurse, "I just know something bad is going to happen to me." Which type of anxiety is the patient experiencing?

Free-floating

Which of the following best describes bipolar I disorder?

Full manic cycles with possibility of depression.

Mrs. J has been diagnosed with persistent depressive disorder and has been taking paroxetine for 3 years. On arrival in your mental health clinic, she presents very differently than on her last visit. She is cheerful, energetic, and talkative. Previously, she had been fatigued and negative. What should you do?

Get more information from the patient about how she is feeling.

Which of the following is an example of a therapeutic, open-ended question?

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

A client tells the nurse they drink a 12-pack of beer a night. Which additional statement made by the client reflects the defense mechanism of sublimation?

"I am a sponsor in Alcoholics Anonymous."

Your patient asks you the results of his blood tests. How would you respond?

"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."

A family member asks the nurse about a patient's diagnosis and treatment. Which response will the nurse provide the family member?

"I am unable to disclose information without the patient's permission."

The telephone rings at the nurses' station of an inpatient psychiatric facility. The caller asks to speak with Ms. Honey. Which nursing response protects the patient's rights and confidentiality?

"I cannot confirm or deny that Ms. Honey is admitted here."

Which statement made by the client reflects the defense mechanism of rationalization?

"I failed my driver's test because the instructor made me nervous."

Which statement by the patient correlates with the manic phase?

"I only needed two hours of sleep last night!"

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

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

Which question will the nurse ask a client when assessing their abstract thinking and judgment?

"What would you do if a small child was lost in the store?"

The main goal of deinstitutionalization was to

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

Your patient, who is usually very talkative, does not respond to you when you enter the room. You say:

"What's wrong, Ms. Smith?"

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:

"You aren't hungry?"

Your patient is commenting that the physician has not been in to visit for 2 days. You say:

"You feel ignored by your physician?"

Your patient has a diagnosis of major depressive disorder and has been started on sertraline (Zoloft) 50 mg daily. After taking the medication for 3 days the patient says, "I don't think this medicine is working. I don't want to take it any longer." What would be your best response?

"These medications usually take a few weeks to bring about an improvement in your symptoms."

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:

"What are your thoughts about returning to work?"

The nurse is providing education to a patient prescribed an antiparkinsonian agent. Which information will the nurse include in the teaching?

"Hard sugarless candy will help with the dry mouth."

Which question will the nurse ask to help identify a client's ethnicity?

"What is your primary language?"

Your patient is Jewish and refuses to eat nonkosher food. You say:

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

Your patient has refused all your attempts to care for him. You say:

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

Ms. Smith responds to your question with "I feel like nobody cares." You respond:

"Like nobody cares? Please tell me more about what you are feeling."

Which statement made by a parent reflects an authoritative parenting style?

"My son's bedtime is 8, but sometimes I let him stay up later if he chooses to."

A patient currently treated for schizophrenia calls the clinic stating, "I have had blurry vision and when I walk a shuffle over the past few days." Which response should the nurse provide the patient?

"Please go to the nearest emergency department."

Your patient, who is manic, says, "Everything I do is great." How should you respond?

"Tell me about a time in your life when things didn't go as planned."

Your patient, Mr. A, had a recent myocardial infarction (MI) 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?

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

The nurse is providing education to a patient about herbal and dietary supplements. Which statement will the nurse include in the teaching?

"The FDA does not regulate herbal and dietary supplements."

The nurse is explaining Skinner's theory of operant conditioning to a nursing student. Which statement will the nurse include when referring to the stimulus?

"The event that immediately precedes or follows the operant behavior."

Based on Sigmund Freud's model for the components of the personality, which statement can be applied to the "superego"?

"The superego is referred to as the conscious."

Which describes the long-term goal for inpatient mental health treatment?

Return the patient to the community to be productive members of society.

The health-care provider orders lithium carbonate 600 mg tid for a patient newly diagnosed with bipolar disorder. The therapeutic blood level of lithium for acute mania is:

1.0-1.5 mEq/L

The first psychotropic medications were introduced in the

1950s

Which information is true about abuse? (Select all that apply.)

Abuse is misuse of a person, substance, or situation. Violence is a learned behavior. A person gambling is displaying abusive behavior. The abuser was probably abused at some point in their life.

During an emergency situation, the nurse has performed care to the best of their ability within the boundaries of their scope of practice. Which term describes the nurse's behavior?

Accountable

Which theorist developed a "Hierarchy of Needs" pyramid?

Abraham Maslow

A newly admitted patient in an acute manic state has a nursing diagnosis of risk for injury related to hyperactivity. Which nursing intervention is most appropriate?

Administer antipsychotic medication as ordered prn by the physician

Which act recognized the needs of people with mental health challenges and established mental health care as an essential part of complete health coverage?

Affordable Care Act

A patient states "I don't think I am going to go tonight, it doesn't seem right." The nurse replies, "I agree with you, I think that is the right decision." What type of nontherapeutic communication is this?

Agreeing/disagreeing

Which organization will the nurse refer to for guidelines that provide a framework for taking ethical action?

American Nurses Association (ANA)

Which part of the brain is involved in the fight or flight response and processing of the memory of fear?

Amygdala

A therapeutic environment (milieu) is best defined as:

An environment that is structured to decrease stress and encourage learning new behavior

Your patient, Mrs. L, is on your unit for bowel resection. She is exhibiting signs of nervousness and anxiety, which she attributes to the upcoming surgery. You note from her record that she has a history of ethyl alcohol (ETOH) abuse. Which of the following classification of drugs would be potentially addictive for her?

Antianxiety drugs

James is a 13-year-old who has been transferred to your medical-surgical unit after being stabilized in the emergency department (ED). He slit both wrists and took an overdose of his bupropion (Wellbutrin). You know medications such as Wellbutrin:

Are antidepressants and may cause an increase in the suicidal ideation for children and adolescents

In the past, facilities that housed patients who were impoverished, sick, or insane were known as

Asylums

A 25-year-old client who lives with their parents explains to the nurse at the community clinic, "I really don't need to talk to anyone, even my parents." The client expresses that they are too busy and do not have the time to sit and talk. Which defense mechanism is the client using?

Avoidance

Identify which factor is not in the Mental Health Status Exam:

Awareness and delusion

The nurse is preparing to discuss the ethical principles in nursing with a nursing student. Which statement will the nurse include when discussing veracity?

Being honest with the patient

A mental health nurse has noticed that every day before going to work, they start off with headaches, loose stools, and episodes of feeling light-headed. Which defense mechanism is the nurse experiencing?

Conversion

A family member of a client actively dying of a terminal illness tells the nurse, "I told God that if He could allow my father to live a little longer, I would attend church every week." The nurse recognizes the family member is experiencing which stage of grief?

Bargaining

Your patient appears withdrawn and depressed. Which of the following would not be an effective intervention?

Be judgmental

Holistic treatments address:

Both the illness and the person

Which describes a component of the level 1 preconventional stage of Lawrence Kohlberg's theory of the development of moral reasoning?

Concerned with having needs met.

Which medical condition is associated with depression?

Cancer

A patient states "Do you think I will have to have bypass surgery? I'm so worried I will not get the results I have been hoping for." The nurse replies, "Did the doctor say anything about discharging you today?" What type of nontherapeutic communication is this?

Changing the subject

Which clinical finding will the nurse anticipate for a patient experiencing a panic attack?

Chest pain

Which describes the nurse's usual primary method of gathering data about a client?

Client interview

Karen Horney was a follower of Dr. Sigmund Freud. Dr. Horney believed that the abnormal behavior experienced by patients was the result of ineffective:

Mother-child bonding.

Marge is a 68-year-old woman with a long history of bipolar disorder I. She is brought to the ED by her sister, who reports that Marge has been increasingly agitated, is unable to sleep, and told her daughter that the mayor was calling her for advice on running the city. The behavior is an example of:

Delusions of grandeur

Which intervention will the nurse implement to demonstrate an effective practice in mental health?

Demonstrate therapeutic communication

Identify the five stages of "Death and Dying."

Denial/Anger/Bargaining/Depression/ Acceptance

The purpose of therapeutic communication is to:

Develop a helping, purposeful relationship with the patient

The purpose of therapeutic communication is to

Develop a helping, purposeful relationship with the patient.

Which factor contributed to deinstitutionalization?

Development of phenothiazines (psychotropic medication)

Which developmental psychologist classified the three types of parenting?

Diana Baumrind

Which of the following trailblazers in nursing was NOT a nurse?

Dorothea Dix

Which of the trailblazers in nursing was not a nurse?

Dorothea Dix

A patient states "My husband died two months ago, and I can't seem to move on." The nurse replies, "It must be lonely without him, I can only imagine how difficult that must be for you." What type of therapeutic communication is this?

Empathy

A patient has a nursing diagnosis of low self-esteem. Based on the nursing diagnosis, which is an appropriate nursing action to take with the patient?

Encourage group therapy.

In order for psychotherapy to be effective, it is necessary to do all of the following except:

Encourage the patient to repress feelings.

The nurse is preparing to transfer a patient to the procedure room for electric shock therapy. Which is a priority nursing intervention?

Ensure informed consent has been obtained.

Which is the nurse's priority action when a patient experiences a crisis?

Ensure safety.

Which of the following would be the most effective intervention for a depressed patient?

Establish small achievable goals

The code of behavior that reflects professional expectations based on fundamental moral principles is called:

Ethics

Which characteristic has prejudice resulted in?

Ethnocentrism

Which nursing theorist promoted the interpersonal theory/relationship between the nurse and the patient?

Hildegard Peplau

Which law protects people with mental illness who lack insurance coverage and live below the poverty line from being turned away for care?

Hill-Burton Act

The part of Freud's personality theory that relates to the gratification of oneself? (Me, Myself, I)

Id

The nurse is preparing to assess a client experiencing stress. Which physiological finding will the nurse anticipate?

Increased blood pressure

The goals of crisis intervention include all of the following except:

Increasing anxiety

Which of the following is not true about depression?

It is more common in men than in women.

Which of the following is false regarding ECT?

It is used to stop convulsive seizures.

Which describes a reaction associated with uncomplicated grief?

Labile.

Which statement describes a component of neurolinguistic programming?

Language cues are used to understand how an individual experiences their world.

Which of the following best describes what defense mechanisms are?

Learned response due to stress

Which laboratory information will the nurse anticipate monitoring a patient prescribed lithium carbonate?

Liver function

The nurse is preparing to provide information to a patient taking Sam-E, a dietary supplement. Which side effect will the nurse include in the teaching?

Loose stools

Avoiding such foods as bananas, cheese, and yogurt should be emphasized to patients who are taking:

MAOIs

Which is an important factor for the nurse to understand when caring for a client experiencing homelessness?

Maintain all of the client's rights.

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?

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

Identify which is not part of the "crisis phase."

Mid-crisis

A patient states "I feel overwhelmed, nothing I seem to do is right." The nurse replies, " We have all felt that way sometimes." What type of nontherapeutic communication is this?

Minimizing/belittling

The nurse is admitting a patient experiencing mania to the inpatient mental health unit. Which is the nurse's priority action?

Monitor the patient for self-injury.

What is the name of the publication written by Florence Nightingale?

Notes on Nursing

The set of regulations that dictates the scope of a nurse's professional duties is called

Nurse Practice Act

The following is true about the "Good Samaritan Law":

Nurses, physicians, and other medically-trained personnel may not always be protected by Good Samaritan laws.

Within the nursing process, the registered nurse (RN) is responsible for the:

Nursing Diagnosis

Mrs. A is admitted to the medical-surgical unit with a diagnosis of dehydration and pneumonia. She has a history of bipolar disorder and is controlled on lithium. As her nurse, you know you must:

Observe for signs of lithium toxicity from dehydration.

Which of the following drugs is NOT classified as a mood stabilizer?

Olanzapine

A patients states, "I am feeling helpless." The nurses replies, "What can I do to help, Mrs. Smith?" What type of therapeutic communication is this?

Open-ended question

Which intervention will the nurse implement in the care of a patient experiencing major depression?

Patience and promoting therapeutic communication

Which statement is most true about bipolar disorder?

Patients with bipolar II have major depression with hypomanic symptoms.

Which describes the component of the Mental Health Status Examination that focuses on the way a person experiences reality?

Perception

Which classification of medication was the first to revolutionize the treatment of clients with mental illness?

Phenothiazines

A patient asks the nurse what side effects St. John's wort can have. Which topic of information will the nurse include in the teaching?

Photosensitivity

During which phase of the nursing process should both short-term and long-term goals be utilized?

Planning

The nursing interventions for a patient with major depression would include all of the following except:

Reassuring the patient everything will be "just fine"

The condition of judging a person or situation before knowing all the facts is called:

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:

Projection

Which of the following is a priority when caring for a highly anxious patient?

Provide support and a therapeutic milieu.

The nurse reviews the different cultural preferences for personal space. Which term describes this concept?

Proxemics

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?

Psychiatric hospitals, Medical-surgical hospital settings, Outpatient settings

Which intervention will the nurse anticipate being included in the treatment of a patient with bipolar disorder to prevent relapse and promote medication compliance?

Psychotherapy.

A person who always sounds as though they are making excuses is displaying:

Rationalization

Mrs. D has an appointment with the doctor. She began taking lithium 1 month ago as prescribed. She now states that her mouth and lips are constantly dry and she sometimes feels confused. She says, "I stagger like I'm drunk sometimes when I walk." You suspect:

She is dehydrated.

Which therapeutic communication intervention will the nurse consider implementing when a patient needs time to collect their thoughts and doesn't know what to say next?

Sit with the patient in silence

Ms. T complains of headaches and body pains whenever her husband mentions that the house needs to be cleaned. This has been a reoccurring problem for more than 6 months. Ms. T probably is suffering from what kind of disorder?

Somatic Symptom Disorder (SSD)

Your patient, who is manic, has lost 5 pounds and is underweight. Which meal is most appropriate?

Spaghetti and meatballs

Which intervention will the nurse implement for a patient experiencing a panic attack?

Stay with the patient in the exam room.

Which category of medication would not be given to a patient with bipolar disorder?

Stimulant

The nursing process is a method for:

Systematically organizing and implementing patient care

Which characteristic is most accurate about antidepressants?

Takes several weeks to demonstrate effects

Which statement can be applied to the role of the LPN/LVN and the nursing process?

The LPN/LVN can assist with the planning of care along with the RN.

The nurse is using Erikson's framework to assess an early childhood client. Which finding indicates the client is unsuccessful in completing the task of development?

The client has a low self-esteem

The nurse is using Erikson's framework to assess a preschool-age client. Which finding indicates the client is unsuccessful in completing the task of development?

The client has a passive personality.

The nurse is preparing to request from a health-care provider a prescription for restraints for a patient after they attempted to hit a staff member. Which action will the nurse anticipate occurring?

The order for the restraints will be signed by the health-care provider within 24 hours

Which is an important factor for the nurse to understand about the involuntary commitment of a patient?

The patient has full ability to exercise their rights under the Civil Rights of Institutionalized Persons Act

A patient involuntarily committed to a mental health unit asks the nurse, "When can I have visitors?" Before responding to the patient, which information is important for the nurse to consider?

The patient has the right to visit anyone they choose

Which is an accurate planning goal?

The patient will lose 1 to 2 pounds a week until the goal of 20 pounds is reached.

Which statement can be applied to the process of communication?

The sender is only partially responsible for the message

The nurse is preparing to provide community education about bipolar disorder. Which information will the nurse include in the teaching?

There is a high risk of recurrence after the first episode.

Which information will the nurse include in the teaching to a nursing student about defense mechanisms?

They give the client the illusion they are alleviating their stress.

The patient is semiconscious and is in need of emergency surgery to relieve a subdural hematoma. The nurse knows that:

This is not a function of the LPN/LVN; the nurse should call his or her supervisor.