mental health exam final (33,31,30,29,28,24,23)

Holly is a 53-year-old female with a terminal breast cancer. Holly's nurse in the hospital brings up the subject of hospice care. Holly becomes upset and states, "I am not ready to give up and die." you respond that hospice is:

A model of health care that emphasizes quality of life for you and your family.

Which nurse would qualify as a fact witness in a case dealing with a physically abused young child?

A pediatric intensive care unit nurse

Nancy is a nurse. After talking with her mother, she became concerned enough to drive over and check on her. Her mother's appearance is disheveled, words are non-send cycle, smells strongly of urine, and there is a stain on her dressing gown. Nancy recognizes that her mother's condition is likely temporary due to:

A urinary tract infection

Markel, age 83, has dementia and difficulty feeding himself despite the fact that there is nothing wrong with his motor function. Which term should the nurse use to document this finding?

Apraxia

In the two months after his wife's death, Aaron, age 90 and in good health, has begun to pay less attention to his hygiene and seems less alert to his surroundings. He complains of difficulty concentrating and sleeping and reports that he lacks energy. His family sometimes has to remind and encourage him to shower, take his medications, and eat, all of which he then goes. Which response is most appropriate?

Arrange for an appointment with a therapist for evaluation and treatment of suspected depression.

A psychiatric forensic nurse (PFN) Has been asked to evaluate an incarcerated patient who has mental health problems for a competency hearing. As the patient is being considered for sentencing, what is the PF ends rule? Select all that apply

Assessing the patient for level of competency Completing a formal report to the court

A young woman named Carly was right behind the restaurant where she works after closing shift. Six months have passed and Carly has not been able to return to work, refuses to go out to eat, and feels that she has less value as a woman now that she has been raped. Carly's clinical presentation suggest:

Avoidance

Connor is a 28-year-old student, referred by his university for a psychiatric evaluation. He reports that he has no friends at the University and people call him a loaner. Recently, Connor has been giving lectures to pigeons at the University fountains. Com is diagnosed as schizotypal, which differs from schizophrenia in that person's diagnosis as schizotypal:

Can be made aware of their delusions

Which statement made by a nurse requires immediate correction by the supervisor?

Cognitive decline is normal in patients who are 65 and older

The dying patient with a neurocognitive disorder such as Alzheimer's disease is especially challenging to provide care for. They may have symptoms or pain that they are unable to adequately describe or define. Reversible conditions that respond to treatment that may affect level of consciousness, anxiety, or agitation include:

Distended bladder, constipation, or nausea

Perpetrators of social assault are often incarcerated but frequently do not undergo therapy. Samuel, convicted of rape and sentenced to 15 years in prison, has requested to see a therapist. The psychiatric nurse practitioner is surprised to learn of the request as many perpetrators:

Do not acknowledge the need for change

A forensic nurse examiner is interviewing an individual accused of a homicide. Which question should the nurse ask in preparation for a possible legal insanity defense?

Do you ever hear noise voices that no one else can hear?

Considering the guilt that women feel after being sexually assaulted, which nursing assessment question has priority?

Do you have any thoughts about harming yourself

Personality disorders often cooccur with mood and eating disorders. A young woman is undergoing treatment Ed and eating disorders clinic and her nurse suspects the patient may also have a cluster B personality disorder due to the young woman's:

Dramatic response to frustration

Ling works as a registered nurse in an Alzheimer's care home. Ling has a specialized rapport building technique she uses called reminiscence. She uses this technique by:

Encouraging the residents to talk about pleasurable past events

Secondary effects of abuse often manifest is arrested development in children due to the fact that:

Energy for development is diverted to coping

Do use of a patient centered interview technique works well for gathering information about abusive situations. It is a good use of clinical time to sit near the patient in colon:

Establish trust and rapport

The older patient is discussing chronic pain and ask the primary care provider for a prescription. Which medication should the nurse anticipate being ordered rather than an opioid?

Gabapentin

During an interview with a patient, which question asked of an older adult is associated with the patient self-determination act?

Have you discussed your end of life choices with your family or designated surrogate?

You are working at a telephone hotline center when Abby, a rib victim, Kohls. Happy state she is afraid to go to the hospital. What is your best response?

I am here to listen and we can talk about your feelings

Which statement made by the psychiatric nurse demonstrates an accurate understanding of the factors that affect an individual's personality?

I don't need to learn more about this patient's cultural beliefs

Which statement made by a new mother should be explored further by the nurse?

I think the baby cries just to make me angry

When assessing a patient diagnosed with a borderline personality disorder, which statement by the patient warrants immediate attention?

I'd really like to hurt her for hurting me

Garretts wife of eight years is divorcing him because the marriage never developed a warm or loving atmosphere. Garrett states in therapy, "I have always been a loner," and has never and was never concerned about what others think. The nurse practitioner suggest that Garrot try a trial of bupropion (Wellbutrin) to:

Increase the pleasure of living

What is the rationale for providing a patient diagnosed with dementia easily accessible finger foods through the day?

Increases input through out the day

What side effects should the nurse monitor for when caring for a patient prescribed donepezil (Aricept) select all that apply

Insomnia bradycardia signs of dizziness reports of headache

There is conflict surrounding the diet experience in modern medicine. The medical model of treatment in the United States has traditionally been focused on the prolongation of life. What in centric factor plays into the medical model?

Keeping people alive as long as possible is the ethical thing to do.

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 brother. John, the prison psychiatric nurse practitioner, recognizes that Larry's treatment will most likely:

Manifest as small incremental changes

In understanding the role of victim and perpetrator, the active evidence collection is in hands. What knowledge base assist in caring for the injured victim?

Medical surgical nursing skills

Well considering the pathophysiology responsible for both delirium and dementia, which intervention is appropriate for delirium specifically?

Monitor neurological status on an ongoing basis

Which statement is an accurate this depiction of sexual assault?

Most rapes occur in the home

Which racial identification places a woman at the greatest risk of being sexually assaulted in her lifetime?

Multiracial

Which statement by an older patient with a mild neurocognitive disorder demonstrates a safe response to beginning a new medication?

My daughter comes with me to appointments so that we get all the information we need

Fred is an older adult with spinal stenosis and who is being treated with a short term prescription of opioids for an acute episode of back pain. His nurse recognizes additional teaching is necessary when Fred states:

My wife and I share my Norco for our aches and pains

You are caring for Ellie, age 91, whose provider has written a "DNR-CCO" order. Which nursing action would be appropriate if Ellie were to go into cardiac arrest?

Notify the attending physician and family of the change in status

Guadalupe is the matriarch of a large family. She is terminally ill and none of her family members know her end of life wishes. the best action for the nurse is to?

Organize a family meeting with Guadalupe permission to discuss her goals and wishes.

Which signs and symptoms are associated with acute stress disorder and often observed in patients who have been sexually assaulted? Select all that apply

Outbursts of anger depression flashbacks amnesia for the event

Which personality disorders are generally associated with behaviors described as "odd or eccentric?" So I thought that apply

Paranoid schizoid

Which problem is observed in children who regularly witness acts of violence in their family? Select all that apply

Phobias low self-esteem major depressive disorder post traumatic stress disorder

The stress of being raped often results and suffering similar to people who have witnessed a murder or had a physiological reaction to trauma, resulting in:

Post traumatic stress disorder anxiety depression all of the above

You are caring for Naomi who has been arrested and is found to be at risk for alcohol and drug use. Which approach is thought to be most useful in treating Naomi?

Providing immediate drug/alcohol treatment plan

Which activity does a correctional nurse not fulfill within the corrections setting?

Psychotherapy

Which behaviors are examples of a primitive defense mechanism often relied upon by those diagnosed with a personality disorder? Select all that apply

Regularly attempts to split the staff attempts to undo feelings of anger by offering to do favors regresses to rocking and humming to soothe themselves when fearful

What safety related responsibility does the nurse have in any situation of suspected abuse?

Report a suspected abuse to the proper authorities

Ron is a victim of assault and has it revealed to his family and friends the fact that he was right. The family reacts with her and discuss, and the nurse caring for Ron recognizes:

Ron's family will also need support

Which statement made by a family member tends to support a diagnosis of delirium rather than dementia?

She was fine last night but this morning she was confused

Ophelia, a 69-year-old retired nurse, attends a reunion of her former coworkers. Ophelia is concerned because she usually knows everyone, and she cannot recognize faces today. A registered nurse colleague recognizes Ophelia's distress and "introduces" Ophelia to those attending. The nurse practitioner recognizes that Ophelia seems to have a deficit in:

Social cognition

What's the situation associated with the caregiver presents the greatest risk that an older adult will experience abuse by that carryover

The caregiver was neglected as a child

Which statement made by a sexually assaulted patient strongly suggest the drug gamma hydroxybutyrate acid GHB was involved in the attack?

The drink I was given had a salty taste to it

Which factor has the greatest influence on the hospice nurses ability to provide respectful professional care?

The existence of a healthy, well-balanced personal life

an appropriate expected outcome in individual therapy the perpetrator of abuse would be:

The perpetrator will recognize destructive patterns of behavior and learn alternative responses

The nurse is assisting a patient to identify safety issues that may occur now that she has left an abusive partner. What telephone numbers should be available to the patient? Select all that apply

The police department an abuse hotline a responsible friend or family member a domestic violence shelter

Considering psycho social role theory, which patient demonstrates healthy adjustments to aging?

The retiree who volunteers three days a week at the local library

A bereavement group run by a local hospice includes a woman who is distraught over her supervisor stuff. The woman appears severely distressed. She has trouble functioning with activities of daily living and making the simplest of decisions. The group facilitator recognizes that this woman is suffering from disenfranchised grief after learning:

The woman was in love with her married supervisor

What is the current excepted professional view of the effect of culture on the development of a personality disorder

There aren't sufficient studies to confirm the role that ethnicity and race have on the prevalence of personality disorders

Which statement made by a patient demonstrates acceptance of criteria required of hospice care?

There is no cure for my illness. I have excepted that.

The abused person is often in a dependent position, relying on the abuser for basic needs. At particular risk our children and the elderly due to:

There limited options

Forensic nursing to combine scientific knowledge and inquiry in an effort to serve:

Victims and perpetrators of crime

Which statement made by the primary caregiver of a patient diagnosed with dementia and demonstrates accurate understanding of providing the patient with environment?

We've installed locks on all the outside doors

Darnell is an 84-year-old widow war who has lived alone since his wife died six years ago. I never called Darnell son to tell him that Darnell was trying to start his car from the passenger side. He became angry and aggressive when the car would not start. After a medical assessment, Darnell was diagnosed with a major neurocognitive disorder. The nurse realized additional family teaching is necessary when Darnell son states:

With person centered care, my father will be able to remain in his home

Anxiety problems in older adults can manifest as a fear of fulfilling, greatly influencing an older adults personal freedom. A home health nurse checking on a patient with mild dementia and anxiety related to falling should question which new order?

Xanax

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

borderline

Nurse is caring for patients who have neurocognitive disorders are exposed to stress on many levels. Specialist skills training and continuing education are helpful to diffuse nursing stress, as well as: select all that apply

expressing emotions by journaling engage in exercise and relaxation activities having realistic patient expectations

To determine a patient's legal sanity or competency, the psychiatric forensic nurse must assess all of the following, except:

the patient's social network

The forensic nurse examiner is attempting to reconstruct the mental state of an individual accused of a hit and run automobile accident. Which question(s) would help achieve that goal? select all that apply

~ were you under the influence of illegal substances at the time of the accident? ~What were you feeling when you realized you hit someone crossing the street? ~Can you remember the events leading up to the accident? ~Had you and your friends been drinking before the accident?

Considering the subject of medically assisted death, which statements identify the pros and cons of the argument associated with the issue of nonmaleficence? Select all that apply

~From the patient's perspective, there is no difference between ending life by providing a lethal prescription and by stopping treatment that prolongs life. ~Assisted death violates the oath "do you no harm" and destroys trust between patient and nurse.

Traders of domestic violence tend to: select all that apply

~Have a relatively poor social skills and to have grown up with poor role models. ~Believe they, if male, should be dominant and in charge in relationships. ~Be controlling and willing to use force to maintain their power in relationships. ~Prevent their mates from having relationships and activities outside the family.

Which statement made by a widow demonstrates that her grief work has been effective? Select all that apply

~I can't remember how much my deceased husband love chocolate chip ice cream. ~Painting is my new passion, and I really enjoy learning the various strokes. ~Jim could be very stubborn when he thought he was right.

Which intervention focused on children supports the healthy people 2020 goals related to injury and violence prevention? Select all that apply

~Identify and risk-taking behaviors among high school students that often result in injury. ~Holding a focus group discussion regarding the reason students bring weapons onto school property. ~Holding a community forum to identify the main sources of violence children are exposed to.

Which statement made to the grieving patient demonstrates effective therapeutic communication? Select all that apply

~Your loss must be devastating. I can't imagine how you must be feeling right now. ~Your loved one was irreplaceably special. ~I would like to take the flowers from the funeral home to your house.

The psychiatric forensic nurse assesses all of the following to determine the patient's legal sanity and competency

~the patient's ability to distinguish right from wrong regarding the act ~the patient's capacity to understand the nature of the acts committed ~the evidence with respect to the defendant's mental state at the time of the act