Psych Unit 4 Book Questions

Which patient statement supports the diagnosis of anorexia nervosa? a. I'm terrified of gaining weight b. I wish I had a good friend to talk to c. I've been told I drink way too much alcohol d. I dont get much pleasure out of life anymore

a

Which personality disorders are generally associated with behaviors described as "odd or eccentric"? Select all a. Paranoid b. Schizoid c. Histronic d. Obsessive- COmpulsive e. Avoidant

a b

When considering an eating disorder, what is a physical criteria for hospital admission? a. a daytime heart rate of less than 50 bpm b. an oral temperature of 100F or more c. 90% of ideal body weight d. systolic bp greater than 130 mmHg

a

Which patient statement demonstrates a value held regarding children? a. nothing is more important to me than the safety of my children b. I believe my spouse wants to leave both me and my children c. I don't think my child's success depends on going to college d. I know my children help me through my hard times

a

Connor is a 28 year old student, referred by his university for a psych eval. He reports that he has no friends at the university and people call him a loner. Recently, Connor has been giving lectures to pigeons at the university fountain. Connor is diagnosed as schizotypal, which differs from schizophernia in that person's diagnosed as schizotypal: a. can be made aware fo their delusions b. are far more delusional than schizophrenics c. have a greater need for socialization d. do not usually respond to antipsychotic medications

a

In a parent teacher conference, the school nurse meets with the parents of a profoundly shy 8 year old girl. The parents hold hands, speak softly, respond briefly, and have poor eye contact. The nurse recognizes that the child is most likely exposed to parental modeling and: a. the inherited shyness trait b. a lack of affection in the home c. sever punishment in the home d. is afraid to say something foolish

a

Malika has been overweight all of her life. Now an adult, she has health problems related to her excessive weight. Seeking weight loss assistance at a primary care facility Malika is surprised when the nurse practitioner suggests: a. a trial of SSRI antidepressant therapy b. Mild exercise to start, increasing in intensity over time c. removing snack foods from the home d. medication treatment for hypertension

a

Mary is a 39 year old attending a psychiatric outpatient clinic. Mary believes that her husband, sister, and son cause her problems. Listening to Mary describe the problems the nurse displays therapeutic communication in which response? a. i understand you are in a difficult situation b. thinking about being wronged repeatedly does more harm than good c. I feel bad about your situation, and I am so sorry it is happening to you and your family d. It must be so difficult to live with such uncaring people

a

Melanie is a 38 year old female admitted to the hospital to rule out a neurological disorder. THe testing was negative, yet she is reluctant to be discharged. Today she has added lower back pain and a stabbing sensation in her abdomen. THe nurse suspects a factitious disorder in which melanie may: a. consciously be trying to maintain her role of a sick patient b. not recognize her unmet needs to be cared for c. protect her child from illness d. recognize physical symptoms as a coping mechanism

a

Taylor, a psych nurse, orients Regina, a patient with anorexia nervosa, to the room where she will be assigned during her stay. After getting Regina settles, the nurse informs Regina: a. I need to go through the belongings you have brought with you b. You can use the scale in the back room when you need to c. YOu will be eating five times a day here d. The daily structure is based around your desire to eat

a

The activity of gamma-aminobutyric acid (GABA) contributes to a slowing of neural activity. Which of the following drugs facilitates the action of GABA? a. Benzos b. antihistamines c. anticonvulsants d. noradrenergic

a

The patient expresses sadness at "being all alone with no one to share my life with." Which response by the nurse demonstrates the existence of a therapeutic relationship? a. loneliness can be a very painful and difficult emotion b. Lets talk and see if you and I have any interests in common c. I use Facebook to find people who share my love of cooking d. loneliness is managed by getting involved with people

a

What is the current accepted professional view of the effect of culture on the development of a personality disorder? a. there aren't sufficient studies to confirm the role that ethnicity and race have on the prevalence of personality disorders b. The North American and Australian cultures produce higher incidences of personality disorders among their populations c. Neither culture nor ethnic background is generally considered in the development of personality disorders d. personality disorders have been found to be primarily the products of genetic factors, not cultural factors

a

Which behaviors are examples of a primitive defense mechanism often relied upon by those diagnosed with a personality disorder? SELECT ALL a. regularly attempts to split the staff b. attempts to undo feelings of anger by offering to do favors c. regresses to rocking and humming to sooth themselves when fearful d. lashes out verbally when confronted with criticism e. destroys another person's belonging when angry

a b c

Safety measures are of concern in eating disorder treatments. Patients with anorexia nervosa are supervised closely to monitor: SELECT ALL a. foods that are eaten b. attempts at self-induced vomiting c. relationships wiht other patients d. weight

a b d

A patient with a history of alcohol use disorder has been prescribe disulfiram. Which physical effects support the suspicion that the patient has relapsed?SELECT ALL a. intense nausea b. diaphoresis c. acute paranoia d. confusion e. dyspnea

a b d e

Which patient has an increased risk for the development of anxiety and will require frequent assessment by the nurse? SELECT ALL a. exacerbation of asthma signs and symptoms b. history of peanut and strawberry allergies c. history of chronic obstructive pulmonary disease d. current treatment of angina pectoris e. history of a traumatic brain injury

a c d e

WHen considering the need for monitoring, which intervention should the nurse implement for a patient with anorexia nervosa? SELECT ALL a. provided scheduled portion-controlled meals and snacks b. congratulate patients for weight gian and behaviors that promote weight gain c. limit time spent in the bathroom during periods when not under direct supervision d. promote exercise as a method to increase appetite e. observe patient during and after meals/snack to ensure that adequate intake is achieved and maintained

a c e

Which assessment data confirm the suspicion that a patient is experiencing opioid withdrawal? SELECT ALL a. pupils dilated b. pulse rate is 62 bpm c. slow movements d. extreme anxiety e. sleepy

a d

A male patient frequently inquires about the female student nurse's boyfriend, social activities, and school experiences. WHich is the best initial response by the student? a. the student requests assignment to a patient of the same gender as the student b. she limits sharing personal information and stresses the patient-centered focus of the conversation c. the student shares information to make the therapeutic relationship more equal d. she explains that if he persists in focusing on her, she cannot work with him

b

A patient diagnosed with opioid use disorder has expressed a desire to enter into a rehab program. What initial nursing intervention during the early days after admission will help ensure the patient's success? a. restrict visitors to family members only b. manage the patient's withdrawal symptoms well c. provide the patient a low stimulus environment d. advocate for at least 3 months of treatment

b

Conversion disorder is described as an absence of a neurological diagnosis that manifests in neurological symptoms. Channeling of emotions, conflicts, and stressors into physical symptoms is thought to be the cause in conversion disorder. Which statement is true? a. people with conversion disorder are extremely upset about often dramatic symptoms b. abnormal patterns of cerebral activation have been found in individuals with conversion disorder c. an organic cause is usually found in most cases of conversion disorder d. symptoms can be turned off and on depending on the patient's choice

b

Josie, a 27 year old patient, complains that most of the staff do not like her or care what happens to her, but you are special and she can tell that you are a caring person. She talks with you about being unsure of what she wants to do with her life and her "mixed-up feelings" about relationships. When you tell her that you will be on vacation next week, she becomes very angry. Two hours later, she is found using a curling iron to burn her underarms and explains that it "makes the numbness stop." Given this presentation, which personality disorder would you suspect? a. obsessive-compulsive b. borderline c. antisocial d. schizotypal

b

Lester and Eileen have always enjoyed gambling. Lately, Eileen has discovered that their savings account is down by $50,000. Eileen insists that Lester undergo therapy for his gambling behavior. The nurse recognizes that LEster is making progress when he states: a. i understand that I am a bad person for depleating our savings b. Gambling activates the reward pathway in my brain c. Gambling is the only thing that makes me feel alive d. We have always enjoyed gaming. I do not know why Eileen is so upset

b

Lucas is a nurse on a medical floor caring for Kelly, a 48 year olf patient with newly diagnosed type 2 diabetes. He realizes that depression is a complicating disease factor in the patient's adjustment to her new diagnosis. What problem has the most potential to arise? a. development of agoraphobia b. treatment of nonadherence c. frequent hypoglycemic reactions d. sleeping rather than checking blood sugar

b

Maxwell is a 30-year-old male who arrives at the emergency department stating, "I feel like I am having a stroke." During the initial assessment, the nurse discovers that Maxwell has been working for 36 hours straight without eating and has consumed 8 double espresso drinks and 12 caffeinated sodas. THe nurse suspects: a. fluid overload b. dehydration and caffeine overdose c. benzo overdose d. sleep deprivation syndrome

b

Obesity can be the end result of a binge eating disorder. The nurse understands that the best treatment option in persons with a binge eating disorder promotes: a. Bariatric surgery b. coping strategies c. avoidance of public eating d. appetite suppression medications

b

Personality disorders often co-occur with mood and eating disorders. A young woman is undergoing treatment at an eating disorders clinic and her nurse suspects the patient may also have a Cluster B personality disorder due to the young woman's: a. desire to avoid eating b. dramatic response to frustration c. excessive exercise routine d. morose personality traits

b

Samantha is a new patient to the mental health clinic and is seeking assistance for what she describes as severe anxiety. In addition to daily self-medicating with alcohol, Samantha describes long term use of herbal kava. The nurse knows that kava is associated with inhibiting P450 and orders which of the following tests? a. ECG b. liver enzymes c. GFR d. complete blood count

b

The care plan of a patient diagnosed with a somatic disorder includes the nursing diagnosis ineffective coping. WHich patient behavior demonstrates a successful outcome for that nursing diagnosis? a. showers and dresses in clean clothes daily b. calls a friend to talk when feeling lonely c. spends more time talking about the pain in her abdomen d. maintains focus and attention

b

Which medication should the nurse be prepared to educate the patients on when they are prescribed as a selective serotonin reuptake inhibitor for panic attacks? a. Alprazolam b. Fluoxetine c. CLonazepam d. Cenlafaxine

b

Which patient outcome is directly associated with the goals of a therapeutic nurse-patient relationship? a. Patient will be respectful of other patients on the unit b. patient will identify suicidal feelings to staff whenever they occur c. patient will engage in at least one social interaction with the unit population daily d. patient will consume a daily diet to meet both nutritional and hydration needs

b

Which patient statement acknowledges the characteristic behavior associated with a diagnosis of pica? a. nothing could make me drink milk b. im ashamed of it, but i eat my hair c. i havent eaten a green vegetable since I was 3 d. I reguritate and re-chew my food after almost every meal

b

Which statement made by either the nurse or the patient demonstrates an ineffective patient-nurse relationship? a. Ive given a lot of thought about what triggers me to be so angry b. Why do you think it's acceptable for you to be so disrespectful to staff? c. will your spouse be available to attend tomorrow's family group session? d. I wanted you to know that the medication seems to be helping me feel less anxious

b

Which statement made by the psychiatric nurse demonstrates an accurate understanding of the factors that affect an individuals personality? a. Therapy will help her identify that her problems are personality related b. I'll need to learn more about this patient's cultural beliefs c. It's encouraging to know that personality disorders respond well to treatment d. a person's personality is fluid and adjusts to current social situations

b

The nursing diagnosis ineffective denial is especially useful when working with substance use disorders and gambling. Which statements describe this diagnosis? SELECT ALL a. reports inability to cope b. does not perceive danger of substance use or gambling c. minimizes symptoms d. refuses healthcare attention e. unable to admit impact of disease on life pattern

b c d e

Which statement(s) made by the nurse demonstrates an understanding of the effective use of relaxation therapy for anxiety managament? SELECT ALL a. relaxation therapys main goal is to prevent exhaustion by removing muscle tension b. muscle relaxation promotes the relaxation response c. show me how you learned to deep breathe in yesterdays therapy session d. you've said that going to group makes you nervous so let's start relaxing now e. i've given you written descriptions of the various relaxation exercises for you to review

b c d e

Opioid use disorder is characterized by: a. lack of withdrawal symptoms b. intoxication symptoms of pupillary dilation, agitation, addn insomia c. tolerance d, requiring smaller amounts of the drug to achieve a high over time

c

A homebound patient diagnosed with agoraphobia has been receiving therapy at home. The nurse evaluates patient teaching is effective when the patient states: a. I may never leave the house again b. having groceries delivered is very convenient c. my risk for agoraphobia is increased by my family history d. I will go out again, someday, just not today

c

A registered nurse is caring for an older adult male who reports depressive symptoms since his wife of 54 years died suddenly. He cries, maintains closed body posture, and avoids eye contact. Which nursing action describes attending behavior? a. reminding the patient gently that he will feel better over time b. using a soft tone of voice for questions c. sitting with the patient and taking cues for when to talk or when to remain silent d. offering medication and bereavement services

c

Diane, a 63-year-old mother of three, was brought to the community psychiatric clinic. Diane and her son had a bitter fight over finances. Ever since Diane has been complaining of "a severe pain in my neck." She has seen several doctors who cannot find a physical basis for the pain. The nurse knows that: a. Showing concern for Diane's pain will increase her obsessional thinking b. Diane's s/x are manipulative and under conscious control c. Diane believes there is a physical cause for pain and will resist a psychological explanation d. Diane is trying to make her son feel bad about the argument

c

Donald, a 49 year old male, is admitted for inpatient alcohol detoxification. He is cachexic, has multiple scabs on his arms and legs, and has lower extremity edema. An appropriate nursing diagnosis for Donald along with expected outcome is: a. Risk for injury/ remains free from injury b. ineffective denial/ accepts responsibility for behavior c. nutrition: less than body requirments/ maintains nutrient intake for metabolic needs d. risk for suicide/ expresses feelings, plans for the future

c

Emily is a 28 year old nurse who works on a psych unit. SHe is assigned to work with Jenna, a 27 year old admitted with major depressive disorder. Emily and Jenna realize they graduated from the same high school and each have a 2 year old daughter. Emily and Jenna discuss getting together for a play date with their daughters after Jenna is discharged. This situation reflects: a. successful termination b. promoting interdependence c. boundary blurring d. a strong therapeutic relationship

c

Garret's wife of 8 years is divorcing him because the marriage never developed a warm or loving atmosphere. Garret states in therapy, "I have always been a loner," and was never concerned about what other think. The nurse practitioner suggests that Garrett try a trial of buproprion (Wellbutrin) to: a. improve his flat emotions b. assist in getting a good night's sleep c. increase the please of living d. prepare Garret for group therapy

c

Isabel is a straight A student, yet she suffers from severe test anxiety and seeks medical attention. THe nurse interviews Isabel and develops a plan of care. THe nurse recognizes effective teaching about mild anxiety when Isabel states: a. I would like to try a benzo for my anxiety b. If I study harder, my anxiety will go down c. Mild anxiety is ok because it helps me to foucs d. I have fear that I will fail at college

c

Malika agrees to try losing weight according to the nurse practitioner's outlined plan. Additional teaching is warranted when Malika states: a. I am willing to admit I am depressed b. Psychotherapy will be part of my treatment c. I prefer to have gastric bypass rather than use this plan d. My comorbid conditions may improve with weight loss

c

Morgan is a third year nursing student in her psychiatric clinical rotation. She is assigned to an 80 year old widow admitted for major depressive disorder. The patient describes many losses and sadness. Morgan becomes teary and says meaningfully, I am so sorry for you. Morgan's instructor overhears the conversation and says I understand that getting tearful is a human response. Yet, sympathy isnt helpful in this field. The instructor urges Morgan to focus on: a. Adopting the patient's sorrow as your own b. maintaining pure objectivity c. using empathy to demonstrate respect and validation of the patients feelings d. using touch to let her know that everything is going to be alright

c

The nurse is providing care for a patient demonstrating behaviors associated with moderate levels of anxiety. What question should the nurse ask initially when attempting to help the patient deescalate their anxiety? a. do you know what will help you manage your anxiety b. do you need help managing your anxiety c. can you identify what was happening when your anxiety began to increase? d. are you feeling anxious right now?

c

You are caring for YOlanda, a 67 year old patient who has been receiving hemodialysis for 3 months. Yolanda reports that she feels angry whenever it is time for her dialysis treatment. You attribute this to: a. organic changes in Yolanda's brain b. a flaw in Yolanda's personality c. a normal response to loss and grief d. denial of the reality of a poor prognosis

c

Larry is from a small town and began displaying aggressive and manipulative traits while still a teenager. Now at 40 years old, Larry is serving a life sentence for the murders of his wife and her bother. John, the prison psych nurse practitioner, recognizes that Larry's treatment will most likely: a. transform Larry to a model prisoner b. Not improve Larry's coping skills c. reaffirm Larry's high risk behaviors d. Manifest as small incremental changes

d

Living comfortable and materialistic lives in Western societies seems to have altered the original hierarchy proposed by Maslow in that: a. Once lower level needs are satisfied, no further growth feels necessaary b. Self-actualization is easier to achieve with financial stabilty c. esteem is more highly valued that safety d. focusing on materialism reduces interests in love, belonging, and family

d

TO maximize the therapeutic effect, which lifestyle practice should the nurse discourage for a patient who has been recently prescribed an antianxiety medication? a. eating high protein foods b. using acetaminophen without first discussing it with a healthcare provider c. taking medications after eating dinner or while having a bedtime snack d. buying a large coffee with surgan and extra cream each morning on the way to work

d

Terry is a young male in a chemical dependency program. Recently he has become increasingly distracted and disengaged. The nurse concludes that Terry is: A. Bored B. Depressed C. Bipolar D. Not ready to change

d

WHich patient is at greatest risk for developing a stress induced MI? a. a patient who lost a child in an accidental shooting 24 hours ago b. a woman who has begun experiencing early signs of menopause c. a patient who has spent years trying to sustain a successful business d. a patient who was diagnosed with chronic depression 10 years ago

d

What action should you take when a female staff member is demonstrating behaviors associated with a substance use disorder? a. Accompany the staff member when she is giving patient care b. offer to attend rehab counseling with her c. refer her to a peer assistance program d. confront her about your concerns and/or report your concerns to a supervisor immediately

d

When assessing a patient diagnosed with a borderline personality disorder, which statement by the patient warrants immediate attention? a. My mother died ten years ago b. I haven't needed medication in weeks c. my dad never really loved me d. I'd really like to hurt her for hurting me

d

Which intervention will promote independence in a patient being treated for bulimia nervosa? a. have the patient monitor daily caloric intake and intake of I and O b. encourage the patient to use behavior modification techniques to promote weight gain behaviors c. ask the patient to use a daily log to record feelings and circumstances related to urges to purge d. allow the patient to make limited choices about eating and exercise as weight gain progresses

d

You are caring for Aaron, a 38 year old patient diagnosed with somatic symptom disorder. WHen interacting with you, Aaron continues to focus on his severe headaches. In planning care for Aaron, which of the following interactions would be appropriate? a. call for a family meeting with aaron in attendance to confront him regarding his diagnosis b. educate aaron on alternatives to deal with pain c. Improve reality testing by telling Aaron that you do not believe the headaches are real d. After a limit discussion of physical concerns, shift focus to feelings and effective coping skills

d

What precipitating emotional factor has been associated with an increased incidence of cancers? SELECT ALL a. anxiety b. job related stress c. acute grief d. feelings of hopelessness and despair from depression e. prolonged, intense stress

d e

WHat is the greatest trigger for the development of a patient's nurse focused transference? a. the similarity between the nurse and someone the patient already dislikes b. the nature of the patient's diagnosed mental illness c. the history the patient has with their parents d. the degree of authority the nurse has over the patient

d.