Unm4445 final

Carlos is a nurse admitting Dean, a 13-year-old boy, to the inpatient behavioral health unit. Carlos assures Dean that his records are private and confidential. He realizes that he cannot keep such confidences when Dean divulges which of the following? Answers: "I dream of killing my sister." "I really enjoyed having sex with my 7-year-old cousin last year." "I had sex for the first time last year." "I hate my parents and wish they were dead."

"I really enjoyed having sex with my 7-year-old cousin last year."

Which of the following statements made by Emily or her patient reflects an ineffective nurse-patient relationship? Answers: "I wanted to let you know I don't think this medicine is helping my depression at all. I still hate it here." "I've given a lot of thought to what makes me so anxious. I think it's the staff here." "Will your partner be able to meet with you and Dr. Johnson tomorrow at 2 o'clock?" "Help me understand why you think it's okay to be so rude to other patients here."

"Help me understand why you think it's okay to be so rude to other patients here."

Christine is a 28 year old female patient with schizophrenia. She reports during your morning assessment "Last night I didn't sleep at all. Demons came in my room and tried to rape me." In report the night nurse stated that Christine slept 8 hours. Which response would be the most therapeutic? Answers: "You seem understandably upset. Please tell me more about what you experienced last night. "The night nurse reported that you slept 8 hours. How come you feel you didn't?" "That must have been really scary. We will make sure to protect you from the demons." "This is a safe hospital, Christine. We wouldn't let anything happen to you."

"You seem understandably upset. Please tell me more about what you experienced last night.

Erin is a nurse who wants to provide effective nursing care for her diverse group of patients. Which intervention would most likely accomplish her goal? Answers: Recognizing that race and ethnicity result in specific illness management views. Identifying the cultural norms of the population being served. Implementing care based on nursing evidence. Treating all patients the same to avoid prejudicial actions.

Identifying the cultural norms of the population being served.

Hector is a nurse who is reviewing prescriptions for a patient with major depressive disorder. The patient also has mild intellectual disability. Which of the following antidepressant classes would Hector question if ordered for this patient? Answers: Selective serotonin reuptake inhibitors Monoamine oxidase inhibitors Dopamine inhibitors Serotonin and norepinephrine reuptake inhibitors All of the above

Monoamine oxidase inhibitors

Jennifer is a 28-year-old female nurse working in an outpatient behavioral health practice. During the initial intake, Jennifer realizes that a new patient, Josephine, enjoys hiking, cooking, and painting as much as Jennifer does. They discuss going on a hike together in the next few weeks to enjoy the fall color. What does this situation reflect? Answers: Fostering therapeutic rapport Establishing a caring nurse-patient relationship Blurring boundaries Promoting interdependence

Blurring boundaries

Hannah lost her husband of 38 years to cancer 15 months ago. She reports feeling empty, angry at her husband, lost, and incapable of thinking into the future. From which of the following conditions is Hannah most likely suffering? Adjustment Disorder Post Traumatic Stress Disorder Major Depression Normal bereavement

Adjustment Disorder

In addition to anxiolytics, what classification of medication is commonly used to treat anxiety disorders? Answers: Beta blockers Antidepressants Novel antipsychotics Cholinesterase inhibitor

Antidepressants

Which of the following is a guiding principle of recovery? Select all that apply. Answers: Recovery is person driven. Recovery is supported by peers and allies Recovery is supported by addressing trauma. Recovery is holistic. Recovery is universal with little cultural influence. Recovery is driven by access to care.

Recovery is person driven. Recovery is supported by peers and allies Recovery is supported by addressing trauma. Recovery is holistic.

Robert is a nurse working in an inpatient behavioral health unit. During the initial intake, Robert realizes that a newly admitted patient, Claire, enjoys cooking, needlepoint, and the theater. Robert suggests to Claire that she join Robert's mother at a needlepoint club after Claire discharges. What does this situation reflect? Fostering therapeutic rapport Blurring boundaries Establishing a caring nurse-patient relationship Promoting interdependence

Blurring boundaries

Heather is a psychiatric nurse practitioner who uses a widely used, accepted, and empirically validated psychotherapy approach. Her approach focuses on helping her clients Identify, understand, and change their distorted thought patterns. Which therapy does this describe? Answers: Psychoanalytical therapy Cognitive therapy Interpersonal therapy Cognitive behavioral therapy

Cognitive behavioral therapy

Jonathan is a psychiatric nurse practitioner who uses a widely used, accepted, and empirically validated psychotherapy approach. His approach focuses on helping his clients identify, understand, and change their distorted thought patterns. Which therapy does this describe? Cognitive behavioral therapy Cognitive therapy Psychoanalytical therapy Interpersonal therapy

Cognitive behavioral therapy

Mrs. McShagnasty presents to the outpatient medical office where you are working as a nurse. During her intake, she reports that she has difficulty concentrating, has been forgetting things more than usual, and ran a stop sign on her drive here because she was not paying attention. She states she is tired likely from waking early every morning "for no reason". She says she's been snapping at her grandchildren and feels like someone might break into her house if she's away too long. She reports all of these symptoms slowly and in a low voice with little modulation. What is her likely diagnosis? Answers: Dementia Depression Urinary tract infection Delirium

Depression

Jonathan is diagnosed with Bipolar I Disorder. His psychiatric provider has ordered him to start taking lithium 600 mg PO BID. Which of the following information would you include in teaching Jonathan about his newly prescribed medication? Select all that apply Answers: Diarrhea, vomiting, and sweating are common on lithium; there is no need to contact your provider if these occur. Do not take any over the counter medications, including NSAIDs, without first checking with your provider. Take half the dose for the first three days as this is too high of a starting dose. A high sodium diet will decrease lithium levels and a low sodium diet will increase its level. The doctor will frequently monitor Jonathan's lithium levels to assure his levels are therapeutic. A high sodium diet will increase the levels of the lithium while a low sodium diet will decrease its level. In the first two weeks, many patients gain about five pounds in water weight.

Do not take any over the counter medications, including NSAIDs, without first checking with your provider. A high sodium diet will decrease lithium levels and a low sodium diet will increase its level. The doctor will frequently monitor Jonathan's lithium levels to assure his levels are therapeutic In the first two weeks, many patients gain about five pounds in water weight.

Roberto is diagnosed with schizoid personality disorder. His history includes significant turmoil as a child and adolescent, including placement in several foster homes and a history of physical and sexual abuse. What is the most likely outcome of these early childhood adverse events? Individuals with early trauma tend to have very good survival skills Early trauma increases the likelihood of psychiatric disorders in survivors Early trauma tends to improve resilience in survivors Individuals with early trauma tend to develop more empathetic, caring attitudes

Early trauma increases the likelihood of psychiatric disorders in survivors

Celeste is nervous about her exam and thus decides she must not be well prepared or she would not be anxious. Which cognitive distortion does this represent? Catstrophizing Emotional reasoning Fortune telling Mental filtering

Emotional reasoning

Joao is a nurse at Riverside Hospital. He is developing educational materials to provide patients on how to alleviate primary insomnia. What sort of information should he include? Select all that apply. Answers: Getting up at the same time daily Watching television until falling asleep Avoiding exercise at night Eating a hearty snack at bedtime Sleeping in on days off to catch up on missed sleep Avoiding napping during the day Moving the clock so it is not visible from the bed

Getting up at the same time daily Avoiding exercise at night Avoiding napping during the day Moving the clock so it is not visible from the bed

Ki is a nurse who is dismayed at the degree of stigma surrounding mental health. She wishes to mitigate stigma's adverse effects on care seeking behavior of those with mental illness. Which of the following is she likely to identify as ways to help accomplish her goal? SelSelect all that apply. Improve health literacy of those involved in mental health services Disciplining those she supervises who are biased against those with mental illness Aiming to engage family members of those with mental illness in their care Develop the cultural competence of those serving mentally ill clients

Improve health literacy of those involved in mental health services Aiming to engage family members of those with mental illness in their care Develop the cultural competence of those serving mentally ill clients

Diane is a 50-year-old female patient on your inpatient behavioral health unit. She presents at the nurses' station and reports "I feel like something bad is going to happen." She is visibly shaking, diaphoretic, and tachypnic. She reports she also feels chilled and nauseated. Which of the following is your best intervention? Answers: In a calm, low-pitched voice, offer Diane a PO dose of lorazepam. Inform Diane she is safe and, because it is reflection time, she should return to her room. Leave the nurses' station and alert security to the likelihood of restraining Diane. Put Diane on airborne precautions as she has developed the flu.

In a calm, low-pitched voice, offer Diane a PO dose of lorazepam.

Gwen is 25 and diagnosed with schizotypal personality disorder. Her history includes significant turmoil as a child and adolescent, including placement in several foster homes and a history of physical and sexual abuse. Her early traumatic history most likely: Answers: Developed her survival skills Increased her vulnerability to psychiatric disorders Shaped her caring attitude Made her more resilient to stressful situations

Increased her vulnerability to psychiatric disorders

Mrs. Jones brings in her 12 year old son Kyle to the Nurse Practitioner for evaluation. She reports that Kyle often yells at others, destroyed his stereo in a fit, and that "he just flies into a rage with no warning." What is Kyle's likely diagnosis? Answers: Conduct Disorder Conduct disorder Intermittent Explosive Disorder Pervasive Behavioral Discontrol Disorder

Intermittent Explosive Disorder

The activity of gama-aminobutyric acid (GABA) contributes to a slowing of neural activity. Which of the following drugs facilitates the action of GABA? Lorazepam Diphenhydramine Venlafaxine Phenytoin

Lorazepam

Which of the following disturbances would suggest that an individual has a neurocognitive disorder? Select all that apply. Answers: Christine sometimes enters a room and forgets why she did so. Marcus cannot recall three objects the nurse just told him. Eduardo wanders away from his home 3 - 4 times every week. Gladys is disoriented to date, place, and situation. Joan gets quite agitated each time the nurse enters her room without provocation.

Marcus cannot recall three objects the nurse just told him. Eduardo wanders away from his home 3 - 4 times every week. Gladys is disoriented to date, place, and situation. Joan gets quite agitated each time the nurse enters her room without provocation.

Maria stops by her mother's home every week to drop off groceries and to visit with her. At the start of one such visit, Maria notices that her mother's clothes are dirty and her hair is messy. She also notices that her mother is malodorous and speaking nonsensically. She convinces her mother to come to urgent care with her, afrald she may have had a stroke. What is the nurse caring for Maria's mother likely to explain? Answers: While upsetting, such presentations are common as individuals age and are nothing of real concern. Maria was right to bring her mother in as she likely did have a stroke. Maria's mother likely has dementia and will likely benefit from nursing home placement. Maria's mother will need to provide a urine sample for testing.

Maria's mother will need to provide a urine sample for testing

Sarah is a nurse who leads educational groups for parents of children diagnosed with Oppositional Defiant Disorder. What information would you expect her to include? Select all that apply. Answers: May become conduct disorder in later years. Children typically outgrow the behaviors without formal treatment. Argumentative and defiant are terms often used to describe the individual with ODD. Disorder is diagnosed equally in boys and girls. Classic symptoms include anger, irritation, and defiant behavior. Classic symptoms include periodic episodes of extreme anger and possible violence out of proportion to the trigger.

May become conduct disorder in later years. Children typically outgrow the behaviors without formal treatment. Argumentative and defiant are terms often used to describe the individual with ODD. Classic symptoms include anger, irritation, and defiant behavior.

Which of the following is an advanced practice level of nursing intervention? Select all that apply. Answers: Medication prescription and treatment Pharmacological, biological, and integrative therapies Psychotherapy Consultation

Medication prescription and treatment Psychotherapy Consultation

Jane, a 32-year-old female presents to the ED. Her pupils are dilated and she is reports feeling quite anxious. Her VS read 156/90, P = 128, T = 37.9, R = 24. She is complaining of pain to her abdomen and generalized pain systemically. She is sweating and states she cannot sleep. What would you expect her treatment to include? Answers: Ultrasound for ectopic pregnancy conformation and treatment Methadone to treat her symptoms of opiate withdrawal Clonidine to treat her withdrawal from hallucinogens Lorazepam to reduce the effects of her alcohol withdrawal symptoms

Methadone to treat her symptoms of opiate withdrawal

Sarah is orienting Jim, a new nurse, to the inpatient behavioral health unit. She explains that there are fundamental interventions in psychiatric-mental health nursing practice. Which of the following did she correctly include? Select all that apply. Answers: Milieu therapy Health promotion Coordination of care Pharmacological and integrative therapies if the nurse is an APRN Health teaching Psychotherapy

Milieu therapy Health promotion Coordination of care Pharmacological and integrative therapies if the nurse is an APRN Health teaching

As a nurse, you notice that the psychiatric provider has ordered Omega-3 and Omega-6 for your 16-year-old patient, Juan. Juan has primary diagnoses of Oppositional Defiant Disorder and Cannabis Use Disorder. Which of the following best explains the rationale for the orders? Answers: Omega-3 and Omega-6 can reduce the symptoms of ODD. Omega-3 and Omega-6 can reduce the risk of developing schizophrenia in at risk individuals. Omega-3 and Omega-6 can minimize the discomfort of sudden discontinuation of cannabis. Omega-3 and Omega-6 supplements are good for the developing adolescent brain.

Omega-3 and Omega-6 can reduce the risk of developing schizophrenia in at risk individuals.

Susan is a 34-year-old female patient recently admitted to the unit with Bipolar I Disorder. As her nurse, which of the following interventions should you implement when caring for her on your unit? Select all that apply Answers: Reduce the volume of the television and dim the lights on the unit. Monitor the patient's vital signs frequently. Encourage the patient to participate in as many group activities as possible in order to stay busy. Provide patient with full explanations for all procedures and interventions Provide the patient with frequent finger foods and protein shakes. Use a firm, calm voice in giving clear, concise directions

Reduce the volume of the television and dim the lights on the unit. Monitor the patient's vital signs frequently. Provide the patient with frequent finger foods and protein shakes. Use a firm, calm voice in giving clear, concise directions

During report, the night nurse uses dark humor when discussing her shift. You realize this most likely stems from an effort to: Answers: Alert others to the stress Reduce their own stress and anxiety Rectify their moral distress Relive the experience

Reduce their own stress and anxiety

Imelda is a 34-year-old female with schizophrenia treated with an antipsychotic medication whose name she cannot report. She arrives to the ED via ambulance after neighbors called EMS, reporting she was disoriented and yelling angrily at others they could not see. Upon assessment, her VS were difficult to obtain because she kept rocking. Eventually, you were able to obtain BP 148/92, P 110, T 103, R 18. As her nurse, your priority action is to: Answers: Request stat order of bromocriptine to treat her neuroleptic malignant syndrome. Request stat order of a benzodiazepine to help calm Imelda's agitation and stabilize her BP. Offer comfort medication and arrange transportation home as she Imelda has the flu. Orient Imelda to reality and assure her that she is safe in the ED.

Request stat order of a benzodiazepine to help calm Imelda's agitation and stabilize her BP.

In providing care to patients on an inpatient behavioral health unit, Alejandra recognizes the importance of adhering to standards of care. When Allejandra recognizes that her unit's policies fall short of the state licensing laws, which of the following best represent the standard of care pathway? Answers: Facility policy, professional association, federal hospital regulations Professional association, community standard of customary care, facility policy State board of nursing, professional association, facility policy Joint Commission standards, state board of nursing, facility policy

State board of nursing, professional association, facility policy

On what levels does stigma related to mental illness exist? Select all that apply. Answers: Federal Structural Institutional Systemic Interpersonal Intra-individual (self)

Structure Interpersonal Intra-individual (self)

Classical conditioning occurs under which of the following scenarios? Answers: Jonathan makes more sales call each week to earn his bonus. Susan stops going to see her primary care provider because he scolds her each time for her poor diet. Tommy gets ill every time he smells egg salad because he once got sick from eating it. Megan avoids the living room where she saw a scary movie last week.

Tommy gets ill every time he smells egg salad because he once got sick from eating it.

Johnny was admitted to the unit with a diagnosis of Major Depressive Disorder. He is sitting in the day room but not interacting with anyone. Which of the following approaches is the most therapeutic method in managing his silence? Answers: Meditate in the quiet environment with the patient. Inform Johnny that you are concerned about him and his safety. Let Johnny know that more fully engaging in the milieu will improve his mood. Use the technique of making observations

Use the technique of making observations

Psychotropic medications have been used for over 50 years. What statement regarding their current status is true? Answers: Chlormiprazine (Thorazine) continues to be the treatment of choice for patients experiencing hallucinations. Overall costs have dropped significantly as their use has become more common The Food and Drug Administration approves several new antidepressants annually. We do not know exactly how they work.

We do not know exactly how they work

In clinical supervision, Julie reports to her supervisor that she has firm grasp on nonverbal communication. Which of the following statements of hers best reflect her understanding? Answers: "When my patient responds to my questions, I check for congruence between verbal and nonverbal communication to help shape my response." "If a patient is pacing, I can be sure she is angry or anxious." "It's easier to understand verbal communication than nonverbal communication." "Nonverbal communication is often different from verbal communication."

When my patient responds to my questions, I check for congruence between verbal and nonverbal communication to help shape my response.

Pamela, a nurse educator, is educating staffs about seclusion and restraint. Place the following interventions from least (1) to most (5) restrictive Answers With the patient, identify the behaviors that are unacceptable and the related consequences for harmful behaviors Placing the patient in physical restraints Offering the patient a PRN medication to help calm the patient Placing the patient in a locked seclusion room Encouraging the patient to take a time out in her room

With the patient, identify the behaviors that are unacceptable and the related consequences for harmful behaviors Offering the patient a PRN medication to help calm the patient Encouraging the patient to take a time out in her room Placing the patient in a locked seclusion room Placing the patient in physical restraints

Pamela, a nurse educator, is educating staffs about seclusion and restraint. Place the following interventions from least (1) to most (5) restrictive. Answers With the patient, identify the behaviors that are unacceptable and the related consequences for harmful behaviors Encouraging the patient to take a time out in her room Placing the patient in physical restraints Placing the patient in a locked seclusion room Offering the patient a PRN medication to help calm the patient

With the patient, identify the behaviors that are unacceptable and the related consequences for harmful behaviors Offering the patient a PRN medication to help calm the patient Encouraging the patient to take a time out in her room Placing the patient in a locked seclusion room Placing the patient in physical restraints