Mental Health - Quizzes 1-7 2017

Which documentation indicates that the treatment plan for a patient with acute mania was effective? A: "Converses without interrupting; clothing matched; participates in activities." B: "Attention span 1 to 3 minutes; journals frequently about unit activities." C: "Irritable; suggestible; distractible; napped for 10 minutes in afternoon." D: "Heavy makeup; seductive toward staff; pressured speech."

A - "Converses without interrupting; clothing matched; participates in activities."

A patient with bipolar disorder has taken lamotrigine (Lamictal) for 3 months with an excellent response. Which complaint from the patient necessitates the nurse's priority attention? A: "I have a rash on my chest and abdomen." B: "I experience occasional nausea." C: "My nose is stuffy." D: "I have a little hand tremor."

A - "I have a rash on my chest and abdomen."

A patient has acute anxiety related to an automobile accident 2 hours ago. The patient needs teaching about drugs from which group? A: Benzodiazepines B: Tricyclic antidepressants C: Antimanic drugs D: Antipsychotic drugs

A - Benzodiazepines

A patient with catatonic schizophrenia exhibits little spontaneous movement and demonstrates waxy flexibility. Which nursing intervention should receive the highest priority? A: Conducting passive range-of-motion exercises B: Exposing the patient to auditory and visual stimuli C: Interacting with the patient as if he is responding D:Including the patient in a variety of milieu activities

A - Conducting passive range-of-motion exercises

A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource would have the most complete information? A: Diagnostic and Statistical Manual of Mental Disorders B: The ICD-10 C: Nursing Outcomes Classification D: The ANA Psychiatric-Mental Health Nursing Scope and Standards of Practice

A - Diagnostic and Statistical Manual of Mental Disorders

A patient begins a new program to assist with building social skills. In which part of the plan of care should a nurse record this item? A: Implementation B: Assessment C: Planning D: Evaluation

A - Implementation

A patient with schizophrenia begins to talk about creatures called "volmers" hiding in the warehouse where he works and undoing his work each night. The term "volmers" most likely represents: A: neologism. B: clanging. C: anhedonia. D: alogia.

A - Neologism

During the first interview with a parent whose child died in a car accident, the nurse feels sorry for the patient and reaches out to take the parent's hand. Select the correct analysis of the nurse's behavior. A: The gesture is premature. The patient's cultural and individual interpretation of touch is unknown. B: The parent will perceive the gesture as intrusive and overstepping boundaries. C: The action is inappropriate. "No touch" rules are important in all psychiatric interactions. D: It shows empathy and compassion. It will encourage the parent to continue to express feelings.

A - The gesture is premature. The patient's cultural and individual interpretation of touch is unknown.

A patient with schizophrenia is admitted to the psychiatric unit in an acutely disturbed, violent state. He is given several doses of haloperidol (Haldol) and becomes calm and approachable. During rounds the nurse notices the patient has his head rotated to one side in a stiffly fixed position. His lower jaw is thrust forward and he appears severely anxious. The patient has _________ , and the nurse should _________. A: a dystonic reaction...administer PRN IM benztropine (Cogentin) B: tardive dyskinesia...seek a change in the drug or its dosage C: waxy flexibility...continue treatment with antipsychotic drugs D: akathisia...administer PRN diphenhydramine (Benadryl) PO

A - a dystonic reaction...administer PRN IM benztropine (Cogentin)

In the majority culture of the United States, which individual has the greatest risk to be labeled mentally ill? One who: A: describes hearing God's voice speaking. B: is usually pessimistic but strives to meet personal goals. C: is wealthy and gives away $20 bills to needy individuals. D: always has an optimistic viewpoint about life and having own needs met.

A - describes hearing God's voice speaking.

Which finding best indicates that a patient has a mental illness? The patient: A: reports mood is consistently sad, discouraged, and hopeless. B: responds to rules, routines, and customs of a group. C: performs tasks attempted within the limits set by own abilities. D: is able to see the difference between the "as if" and the "for real."

A - reports mood is consistently sad, discouraged, and hopeless.

A nurse can best communicate to a patient an interest in listening by: A: restating the feeling or thought the patient has expressed. B: saying "I understand what you're saying." C: expressing an opinion about the patient's problem. D: asking a direct question, such as "Do you feel guilty?"

A - restating the feeling or thought the patient has expressed.

A patient is hospitalized for severe depression. Of the medications listed below, the nurse can expect to provide the patient with teaching about: A: sertraline (Zoloft). B: chlordiazepoxide (Librium). C: tacrine (Cognex). D: clozapine (Clozaril).

A - sertraline (Zoloft).

The wife of a patient with schizophrenia is worried about her 17-year-old daughter and asks the nurse what symptoms mark the prodromal stage of schizophrenia. The nurse should respond by listing behaviors such as: A: withdrawal, poor concentration, phobic or obsessive behavior, oddities of speech. B: auditory hallucinations, ideas of reference, thought insertion, and broadcasting. C: stereotyped behavior, echopraxia, echolalia, waxy flexibility, thought-blocking. D: looseness of associations, concrete thinking, echolalia, paranoid delusions.

A - withdrawal, poor concentration, phobic or obsessive behavior, oddities of speech.

A patient with bipolar disorder is hyperactive and has not slept for 3 days. Mood and behavior are labile. The patient threatens to hit another patient. Which response by the nurse is appropriate? A: "If you try that again, you will be placed in seclusion immediately." B: "Do not hit anyone. If you are unable to control yourself, we will help you." C: "Stop that now. No one did anything to provoke an attack by you." You Answered D: "Do not hit anyone. If you are unable to control yourself, we will help you."

B - "Do not hit anyone. If you are unable to control yourself, we will help you."

A patient asks, "What are neurotransmitters? The doctor said mine are imbalanced." Select the nurse's best response. A: "You must feel relieved to know that your problem has a physical basis." B: "Neurotransmitters are natural chemicals that pass messages between brain cells." C: "How do you feel about having imbalanced neurotransmitters?" D: "Neurotransmitters are substances we eat daily that influence memory and mood."

B - "Neurotransmitters are natural chemicals that pass messages between brain cells."

A patient with the diagnosis of schizophrenia, disorganized type, approaches the nurse and says, "It's beat, it's eat. No room for doom." The nurse can correctly assess this verbalization as: A: neologisms. B: clanging. C: ideas of reference. D: associative looseness.

B - Clanging

A patient with acute mania approaches the nurse, waves a newspaper, and says, "I want the phone right now. I need to call this store while their sale is going on. I need ten dresses and four pairs of shoes." Select the nurse's best intervention. A: Ask whether the patient has enough money to pay for the purchases. B: Invite the patient to sit with the nurse and look at new fashion magazines. C: Suggest the patient ask a friend do the shopping and bring purchases to the unit. D: Tell the patient phone use is not allowed until self-control is improved.

B - Invite the patient to sit with the nurse and look at new fashion magazines.

A patient with mania dances around the unit, seldom sits or sleeps, and monopolizes conversations. Which nursing intervention will best assist the patient with energy conservation? A: Monitor physiological functioning. B: Provide a subdued environment. C: Supervise personal hygiene. D: Observe for mood changes.

B - Provide a subdued environment.

Which theory developed the idea of Transference and countertransference? A: Psychosocial Development B: Psychoanalytic Theory C: Human Motivation D: Interpersonal Theory

B - Psychoanalytic Theory

A serious side effect for Lamotrigine(Lamictal) and must be assessed immediately is? A: Blurred Vision B: Rash C: Nausea D: Difficult Sleeping

B - Rash

A patient with mania has not eaten or slept for 3 days. Which nursing diagnosis has priority? A: Ineffective coping B: Risk for injury C: Imbalanced nutrition, less than body requirements D: Ineffective management of therapeutic regime

B - Risk for injury

Which communication style would be most effective to use during an assessment interview with an adult Native American patient? A: Open and friendly; ask direct questions; touch the patient occasionally for reassurance. B: Soft voice; break eye contact occasionally; general leads and reflective techniques C: Frequent nonverbal behaviors such as gestures, smiles, and making a wry face to express negatives. D: Loud voice; unbroken eye contact; minimal gestures; direct questions.

B - Soft voice; break eye contact occasionally; general leads and reflective techniques

A catatonic patient admitted in a stuporous condition begins to demonstrate increased motor activity. During his assessment, the psychiatrist raises the patient's arm above his head and releases it. The patient maintains the position his arm was placed in, immobile in that position for 15 minutes, moving only when the nurse gently lowers his arm. What symptom is demonstrated by this A: Echopraxia B: Waxy flexibility C: Depersonalization D: Thought withdrawal

B - Waxy Flexibility

The nursing diagnosis for a patient with mania is Imbalanced nutrition: less than body requirements related to caloric intake insufficient to balance with hyperactivity as evidenced by 5 lb weight loss in 4 days. Select the most appropriate outcome. The patient will: A: display consistently nonviolent behavior toward others within 1 week. B: drink four high-calorie, high-protein supplements per day. C: consistently wear appropriate attire for age and sex within 1 week D: reduce hyperactivity within 1 week.

B - drink four high-calorie, high-protein supplements per day.

A patient is having difficulty making a decision. The nurse is conflicted about whether to provide advice. Which principle usually applies? Giving advice: A: lifts the burden of personal decision making. B: is rarely helpful. C: fosters independence. D: helps the patient develop feelings of personal adequacy.

B - is rarely helpful.

A outpatient with bipolar disorder takes lithium carbonate 600 mg BID. The patient complains of nausea. To lessen the nausea, the nurse can suggest taking the lithium with: A: an antacid. B: meals. C: a large glass of juice. D: an antiemetic.

B - meals

A patient with bipolar disorder has an unstable mood, aggressiveness, agitation, talkativeness, and irritability. The nurse begins care planning based on the expectation that the health care provider is most likely to prescribe a medication classified as a(n): A: anticholinergic. B: mood stabilizer. C: psychostimulant. D: antidepressant.

B - mood stabilizer

A patient discloses several concerns and associated feelings. If the nurse wishes to seek clarification, which comment would be appropriate? A: "Tell me everything from the beginning." B: "Tell me again about your experiences." C: "Am I correct in understanding that..." D: "What are the common elements here?"

C - "Am I correct in understanding that..."

An adolescent asks the nurse, "Why should I tell you anything? You'll just tell my parents whatever you find out." Select the nurse's best reply. A: "That isn't true. What you tell us is private and held in strictest confidence. Your parents have no right to know." B: "Yes, your parents may find out what you say, but it is important that they know about your problems." C: "Anything you say about feelings is private, but some things like suicidal thinking must be reported to the treatment team." D: "It sounds as though you are not really ready to work on your problems and make changes."

C - "Anything you say about feelings is private, but some things like suicidal thinking must be reported to the treatment team."

A salesman has had difficulty holding a job because he accuses co-workers of conspiring to take his sales. Today, he argued with several office mates and threatened to kill one of them. The police were called, and he was brought to the mental health center for evaluation. He has had previous admissions to the unit for stabilization of paranoid schizophrenia. When the nurse meets him, he points at staff in the nursing station and states loudly, "They're all plotting to destroy me. Isn't that true?" Which would be the most appropriate response? A: "No, that is not true. People here are trying to help you if you will let them." B: "Let's think about it: what reason would people have to want to destroy you?" C: "Thinking that people want to destroy you must be very frightening." D: "That doesn't make sense; staff are health care workers, not murderers."

C - "Thinking that people want to destroy you must be very frightening."

A category 5 hurricane is approaching. Which change in an individual's vital signs is most likely? A: Complaints of intestinal cramping begin B: Pulse rate changes from 90 to 72 C: Blood pressure changes from 114/62 to 136/78 D: Pupil size changes from 6 mm to 4 mm

C - Blood pressure changes from 114/62 to 136/78

A patient with acute mania undresses in the day room and dances about. Select the best intervention. A: Quietly ask the patient, "Are you embarrassed? Don't you think you should put your clothes on?" B: Let the patient stay in the day room. Move other patients to a different area. C: Cover the patient with a blanket and walk with the patient to a quiet room. D: Tell the patient firmly, "Stop dancing and put on your clothing."

C - Cover the patient with a blanket and walk with the patient to a quiet room.

Who developed the theory that identified each stage in development has a crisis and success or unsuccessful completion will affect the progression to the next stage? A: Freud B: Maslow C: Erickson D: Sullivan

C - Erickson

Police bring a patient to the mental health unit. The patient was directing traffic and shouting rhymes on a busy city street. The patient's spouse reports that the patient has not slept or eaten for 3 days. Which assessment findings have priority concern for this patient's plan of care? A: Insulting, provocative behavior directed at staff B: Poor concentration and decision making C: Hyperactivity; not eating and sleeping D: Pressured speech and grandiosity

C - Hyperactivity; not eating and sleeping

When communicating with a depressed patient, which of the following communication techniques would be helpful? A: Disregard covert suicidal messages B: Use complex ideas C: Make observation statements D: Provide limited time for patient to answer question

C - Make observation statements

The statement "I wished I were dead "is what kind of statement that is a clue for suicide? A: Non - Verbal B: Covert C: Overt D: Negative

C - Overt

A new staff nurse completes orientation to a psychiatric unit. This nurse may expect an advanced practice nurse to perform which additional interventions? A: Establish therapeutic relationships B: Individualize nursing care plans C: Prescribe psychotropic medication D: Conduct mental health assessments

C - Prescribe psychotropic medication

The nurse administers a medication that potentiates the action of GABA. Which effect would be expected? A: Improved memory B: Fewer sensory perceptual alterations C: Reduced anxiety D: More organized thinking

C - Reduce anxiety

Which technique communicates to a patient that a nurse is listening? A: Stating, "Your behavior was inappropriate." B: Commenting, "I understand what you're saying." C: Saying, "You said you were unsure how to handle your feelings." D: Asking, "Do you feel angry?"

C - Saying, "You said you were unsure how to handle your feelings."

A patient with schizophrenia refuses to take his medication because he believes he is not ill. What phenomenon most likely underlies this presentation? A: The patient is unable to face having an illness and is in denial. B: Stigma causes the patient to refuse to admit his mental illness. C: The illness itself is preventing the patient from realizing he is ill. D: Command hallucinations are instructing him to deny the illness.

C - The illness itself is preventing the patient from realizing he is ill.

Consider these medications: carbamazepine (Tegretol), lamotrigine (Lamictal), gabapentin (Neurontin). Which medication below also belongs with this group? A: Tacrine (Cognex) B: Buspirone (BuSpar) C: Valproate (Depakote) D: Galantamine (Reminyl)

C - Valproate (Depakote)

Nursing behaviors associated with the implementation phase of the nursing process are concerned with: A: gathering accurate and sufficient patient-centered data. B: comparing patient responses and expected outcomes. C: carrying out interventions and coordinating care. D: participating in mutual identification of patient outcomes.

C - carrying out interventions and coordinating care.

The therapeutic action of neurotransmitter inhibitors that block reuptake cause: A: destruction of receptor sites. B: decreased concentration of the neurotransmitter in the central nervous system. C: increased concentration of neurotransmitter in the synaptic gap. D: limbic system stimulation.

C - increased concentration of neurotransmitter in the synaptic gap.

A nurse cares for patients taking various medications, including buspirone (BuSpar), haloperidol (Haldol), carbamazepine (Tegretol), trazodone (Desyrel), and phenelzine (Nardil). The nurse will order a special diet for the patient who takes: A: buspirone. B: carbamazepine. C: phenelzine. D: trazodone

C - phenelzine

Which statement by a nurse may underrate a patient's feelings and belittle the patient's concerns? A: "I'm not sure I follow you." B: "I notice you are biting your lip." C: "You appear tense." D: "Everything will be all right.

D - "Everything will be all right."

A patient tells the nurse, "I don't think I'll ever get out of here." Select the nurse's most therapeutic response. A: "Why don't you feel like you're making progress." B: "Everyone feels that way sometimes." C: "Don't talk that way. Of course you will leave here!" D: "It sounds like You don't feel like you're making progress."

D - "It sounds like You don't feel like you're making progress."

Which comment most clearly shows a speaker views mental illness with stigma? A: "Some mental illnesses are inherited." B: "Severe environmental stress sometimes causes mental illness." C: "Some mental illnesses are brain disorders resulting from changes in how impulses are transmitted." D: "Most people with mental illness are unmotivated."

D - "Most people with mental illness are unmotivated."

Which instruction has priority when teaching a patient taking clozapine (Clozaril)? A: "Use over-the-counter preparations for rashes." B: "Avoid unprotected sex." C: "Reduce foods high in polyunsaturated fats." D: "Report sore throat and fever immediately."

D - "Report sore throat and fever immediately."

Which nursing documentation best meets the requirement for problem-oriented charting? A: "Pacing and muttering to self. Sensory perceptual alteration related to internal auditory stimulation. Given fluphenazine 2.5 mg PO at 0900 and went to room to lie down. Calmer by 0930. Returned to lounge to watch TV." B: "Agitated behavior. Patient muttering to self as though answering an unseen person. Given haloperidol 2 mg PO and went to room to lie down. Patient calmer within 30 minutes. Returned to lounge to watch TV." C: "Pacing hall and muttering to self as though answering an unseen person. Haloperidol 2 mg PO administered at 0900, with calming effect in 30 minutes. Stated 'I'm no longer bothered by the voices.'" D: "S: States 'I feel like I'm ready to blow up.' O: Pacing hall, mumbling to self. A: Auditory hallucinations. P: Offer haloperidol 2 mg PO. I: Haloperidol 2 mg PO given at 0900. E: Returned to lounge at 0930 and quietly watched TV."

D - "S: States 'I feel like I'm ready to blow up.' O: Pacing hall, mumbling to self. A: Auditory hallucinations. P: Offer haloperidol 2 mg PO. I: Haloperidol 2 mg PO given at 0900. E: Returned to lounge at 0930 and quietly watched TV."

A highly suspicious patient who has delusions of persecution about being poisoned has refused all hospital meals for 3 days. Which of the following interventions would be most appropriate under these circumstances? A: Feed the patient via tube, involuntarily via court order if needed. B: Offer to taste each food item on the tray yourself while he watches. C: Allow the patient to contact a local restaurant to deliver his meals. D: Allow him supervised access to use food vending machines in the hospital lobby.

D - Allow him supervised access to use food vending machines in the hospital lobby.

Symptoms of Mania / Hypomania include. A: Less talkative B: Increased need for sleep C: Magical thinking D: Inflated self-esteem or grandiosity

D - Inflated self-esteem or grandiosity

How is Seasonal Affective Disorder (SAD) treated? A: Anticonvulsant Drugs B: Trazodone(Desyrel) C: Talk therapy D: Light Therapy

D - Light Therapy

A Puerto Rican American patient uses dramatic body language when describing recent life events. Select the most accurate explanation of the patient's behavior. A: The patient has a histrionic personality disorder. B: The patient believes dramatic body language is sexually appealing. C: The nurse has misinterpreted the behavior. D: Members of this culture use dramatic body language as the norm.

D - Members of this culture use dramatic body language as the norm.

A depressed patient is unable to maintain eye contact with the nurse. The patient's chin drops, and the patient looks at the floor. Which aspect of communication has the nurse assessed? A: Social skills B: A message filter C: A cultural barrier D: Nonverbal communication

D - Nonverbal communication

Which Antidepressant medication requires dietary restrictions? A: Venlafaxine(Effexor) B: Trazadone(Desyrel) C: Amitriptyline(Elavil) D: Phenelzine(Nardil)

D - Phenelzine(Nardil)

A patient's nursing care plan includes assessment for auditory hallucinations. Indicators that suggest the patient may be hallucinating include: A: aloofness, increased distractibility, and suspicion. B: elevated mood, hypertalkativeness, and distractibility. C: performing rituals and avoiding open places. D: darting eyes, distracted, and mumbling to self.

D - darting eyes, distracted, and mumbling to self.

A patient says, "My marriage is great. My spouse and I usually agree on everything." The nurse observes the patient's foot moving continuously and fingers twirling a shirt button. What assessment can the nurse make? The patient's communication is: A: inadequate. B: explicit. C: clear. D: mixed.

D - mixed

True or False: A patients' Lithium lab values are not important?

False

True or False: Electroconvulsive Therapy is most commonly used to treat Major Depression with Psychosis.

True