NUR 3678 - Exam 1 Review
Place the steps of communication in the correct order according to Berlo's communication model. 1) Stimulus 2) Message 3) Feedback 4) Sender 5) Receiver
1, 4, 2, 5, 3
In which order does the process of neurotransmission events occur? 1) Removal and destruction of neurotransmitters 2) Electrical impulse reaching the presynaptic neuron 3) Excitation of the postsynaptic neuron 4) Release of neurotransmitters from the presynaptic neuron 5) Diffusion of neurotransmitters in the postsynaptic neuron 6) Binding of neurotransmitters to receptors
2, 4, 5, 6, 3, 1
Place these brainstem structures in order according to their anatomic position beginning with the most superior. 1) Pons 2) Medulla oblongata 3) Midbrain
3, 1, 2
Which neuroimaging technique demonstrates structural rather than functional problems? Select all that apply. A. Computed tomography (CT) B. Electroencephalograpy (EEG) C. Magnetic resonance imaging (MRI) D. Positron emission tomography (PET) E. Single-photon emission computed tomography (SPECT)
A and C
A patient is having difficulty managing the relationship with a spouse. Which statement made during the patient interview indicates transference is taking place? A. The patient tells the nurse, "You do not listen to me, just like my spouse doesn't listen." B. The nurse tells the patient, "You seem to have difficulty talking to me, just like your spouse." C. The nurse informs the patient, "You are acting like my children when they do not get their way." D. The patient informs the nurse, "When you say that, it reminds me of something my spouse said."
A.
About which type of medication would the nurse teach a patient who is diagnosed with somatic symptom disorder? A. Anxiolytics B. Antidiabetics C. Cardiac medications D. Anticoagulants
A.
Which action does the nurse perform before obtaining evidence from a victim after being sexually assaulted? A. Get a consent form signed. B. Contact the hospital chaplain. C. Document the emotional status. D. Perform a mental-status exam. E. Notify family of the patient's arrival.
A.
Which anticipated functional problems would the nurse focus initial interventions on when caring for an adult with a frontal lobe brain tumor? A. Motor function and judgment B. Sensory and calculation abilities C. Interpretation of visual stimuli D. Hearing and emotional expression
A.
Which brain structure responds to stimuli, conducts electrical impulses, and releases neurotransmitters? A. Neuron B. Synapse C. Cerebellum D. Receptor
A.
Which communication technique would be therapeutic for the nurse to use when a patient begins crying and opens up to the nurse about the pain of losing a child to a drug overdose? A. Providing silence B. Asking why the patient feels it is their fault C. Offering information about support groups D. Stating the nurse understands how the patient feels
A.
Which condition is likely the cause of fatigue in a nurse who is otherwise healthy? A. Secondary stress trauma B. Acute stress disorder C. Posttraumatic stress disorder D. Traumatic brain injury
A.
Which date rape drug is used legally to treat narcolepsy? A. γ-Hydroxybutyric acid (GHB) B. Flunitrazepam C. Ketamine E. Phencyclidine (PCP)
A.
Which defense mechanism would the nurse recognize that a patient is using who reports increased anxiety in uncomfortable situations and cracking jokes when under a lot of stress? A. Humor B. Undoing C. Sublimation D. Suppression
A.
Which description most accurately applies to the term rape? A. An act of violence using sex as the weapon B. Assault by a stranger on an unsuspecting victim C. Sexual desire satisfied inappropriately D. An act prompted by early childhood neglect
A.
Which disorder is rape-trauma syndrome usually a variant of? A. Posttraumatic stress disorder B. Maturational crisis disorder C. A dissociative disorder D. Generalized anxiety disorder
A.
Which drug is most commonly used to facilitate the crime of rape? A. Alcohol B. Ketamine C. Flunitrazepam D. γ-Hydroxybutyric acid
A.
Which emotional reaction is most often displayed during the initial assessment and treatment period of a patient who is a victim of rape? A. Fear B. Eagerness C. Suspicion D. Disinterest
A.
Which finding would be expected when a patient presents to the emergency department after being sexually assaulted within the last 2 hours? A. Hysteria B. Flashbacks C. Depression D. Suicidal thoughts
A.
Which intervention by the nurse would not be appropriate in a therapeutic relationship? A. Giving advice B. Actively listening C. Clarifying feelings D. Giving respect
A.
Which patient is experiencing disenfranchised grief? A. A man whose wife had a miscarriage B. A young man whose mother is in hospice care C. A man who lost his wife 2 years ago and is having suicidal thoughts D. A woman who lost her husband to a sudden death from a motor vehicle collision
A.
Which phrase is the definition of obsession? A. A recurrent, persistent thought or impulse B. An intense irrational fear of an object or situation C. A recurrent behavior performed in the same manner D. Thinking of an action and immediately taking the action
A.
Which reaction to a loss does the Jewish ritual of a sitting shiva after a family death represent? A. Mourning B. Acute grief C. Bereavement D. Anticipatory grief
A.
Which response would the nurse make when the patient asks, "What exactly are neurotransmitters"? A. "Neurotransmitters are chemical messengers in the brain that help regulate specific functions." B. "Neurotransmitters are too complicated to explain easily. Just know that the medication will help your mood." C. "Neurotransmitters are the reason you are depressed." D. "I will ask your health care provider to give you a more in-depth explanation on neurotransmitters and their effects."
A.
Which statement describes the nurse's objective when using strategies that will induce a slight degree of anxiety for patients attending a teaching session? A. The patients will be more focused during the session. B. The patients will be more expressive during the session. C. The patients will be more comfortable during the session. D. The patients will be more willing to participate in the session.
A.
Which symptom would the nurse assess in a patient with posttraumatic stress disorder (PTSD)? A. Mood alterations B. Undisturbed sleep C. Talking about memories D. Unchanged concentration levels
A.
Which term describes the basic functional unit of the nervous system? A. Neuron B. Synapse C. Receptor D. Neurotransmitter
A.
In which instance would the nurse-patient relationship be blurred? Select all that apply. A. Meeting a patient at a restaurant for dinner B. Connecting with a patient on social media C. Giving a patient a private cell phone number D. Attending family gatherings at a patient's home E. Refusing to allow another nurse to care for a patient
A., B., C., D., and E.
Which emotion is common for a person to experience during the grieving process? Select all that apply. A. Guilt B. Panic C. Anger D. Shock E. Denial
A., B., C., D., and E.
Which medication is used to treat anxiety disorders? Select all that apply. A. Clonidine B. Paroxetine C. Alprazolam D. Venlafaxine E. Propranolol
A., B., C., D., and E.
Which phase of communication included in the Four Gifts of resolving relationships can the nurse use in helping families and caregivers say goodbye to their loved ones? Select all that apply. A. Love B. Farewell C. Gratitude D. Forgiveness E. Bereavement
A., B., C., and D.
Which factor can affect both people involved in the communication process? Select all that apply. A. Personal bias B. Value system C. Past experience D. Education level E. Relevance of input
A., B., and C.
Which phrase describes a component of an effective short-term psychotherapy session for patients who are at risk for complicated grief? Select all that apply. A. An educational component B. Full expression of emotions C. Admission to a psychiatric inpatient unit D. An attempt to help the bereaved take on new roles and responsibilities E. An attempt to help the bereaved come to peace with a new relationship to the deceased
A., B., and E.
In which instance would a patient benefit from telehealth services? Select all that apply. A. Bedridden patient B. Annual physical examination C. Patient with suicidal ideations D. Health care needs during a pandemic E. Closest health care provider 50+ miles away
A., D., and E.
A patient who was sexually abused is demonstrating euphoria, nausea and vomiting, hypotonia, and respiratory depression. Which "date rape" drug would the nurse expect to find in the patient's blood sample report? A. Ketamine B. γ-Hydroxybutyric acid (GHB) C. Flunitrazepam D. Super C
B.
At which location does a specialized chemical transported between two neurons occur during the process of conduction? A. Transmitter B. Synpase C. Receptor D. Postsynaptic cell
B.
During the assessment process, which patient cue would reflect conflicting verbal and nonverbal communication? A. Admitted for bipolar disorder and is laughing and joking with nursing staff B. Reported no difficulty with sexual activity but looks away when answering C. Maintained eye contact when discussing noncompliance with diabetic regimen D. Stated pain level 8/10 with an increase in heart rate, blood pressure, and respirations
B.
First-generation antipsychotics have which mechanism of action and therapeutic effect? A. Increase levels of dopamine to decrease positive symptoms in schizophrenia B. Decrease levels of dopamine to decrease positive symptoms in schizophrenia C. Increase levels of domaine to increase positive symptoms in schizophrenia D. Decrease levels of dopamine to increase positive symptoms in schizophrenia
B.
Which brain structure is responsible for basic vital life functions? A. Cerebrum B. Brainstem C. Cerebellum D. Hippocampus
B.
Which defense mechanism is evident when an adult diagnosed with type 2 diabetes makes an excuse for not joining a strenuous group activity because of fear of difficulty with blood glucose management? A. Displacement B. Rationalization C. Passive aggression D. Reaction formation
B.
Which imaging study would show the health care provider the parts of the brain that are particularly active in a patient suspected of having obsessive compulsive disorder? A. Computed tomography (CT) B. Positron emission tomography (PET) C. Ventriculography D. Electroencephalography (EEG)
B.
Which level of anxiety is experienced when selective inattention is first noted? A. Mild B. Moderate C. Severe D. Panic
B.
Which lobe of the cerebral cortex is injured when a patient with a traumatic brain injury is demonstrating abnormally fluctuating emotions? A. Frontal B. Temporal C. Occipital D. Parietal
B.
Which medication would it be most important to perform systematic measurement of body weight, body mass index (BMI), waist circumference, and glucose levels for a patient beginning a new prescription? A. Aripiprazole B. Olanzapine C. Ziprasidone D. Cariprazine
B.
Which neurotransmitter is selectively blocked by the antidepressant effect of citalopram? A. Gamma-aminobutyric acid (GABA) B. Serotonin C. Glutamate D. Dopamine
B.
Which phrase is the definition of burnout? A. The ability to be with someone who is suffering B. A decreased work performance caused by negative behaviors and thoughts C. The individualized response to a loss that is perceived, real, or anticipated D. The emotional pain or cost of working with traumatized persons that may result in stress
B.
Which seating arrangement appropriately supports communication during the nurse-patient interview? A. The nurse behind a desk and the patient in a chair in front of the desk B. The nurse and patient sitting at a 90-degree angle to each other C. The patient sitting in a chair and the nurse standing a few feet away D. The nurse and patient sitting in chairs while facing each other
B.
Which statement accurately describes a patient experiencing uncomplicated grief? A. A caregiver at the bedside of a patient who is terminally ill in hospice care B. A young male complaining of insomnia after losing his mother 2 weeks ago C. A young female who has thoughts of harming herself after losing her father 3 months ago D. A fan mourning the death of a country music singer who passed away suddenly in a car accident
B.
Which statement explains the mechanism by which a tricyclic antidepressant helps relieve depression? A. It prevents the destruction of monoamine oxidase. B. It prevents the destruction of norepinephrine. C. It stimulates the production of monoamine oxidase. D. It stimulates the production of norepinephrine.
B.
Which symptom would the nurse expect a patient with depersonalization disorder to exhibit? A. Aimless wandering with confusion and disorientation B. A feeling of detachment from one's own body or mental processes C. Existence of two or more personalities that take control of behavior D. Anxiety about having a serious disease based on symptom misinterpretation
B.
Which system is responsible for a patient's sensation of their heart racing when experiencing stress? A. Central nervous system B. Sympathetic nervous system C. Parasympathetic system D. Limbic system
B.
Which type of stressor is a patient exhibiting when feeling anxious while at work as a result of an overwhelming assignment? A. Physical B. Psychological C. Existential D. Psychosocial
B.
Who determines the content and direction of the clinical interview? A. Nurse B. Patient C. Health care provider D. Health care team
B.
Which action would the nurse document in the health record as passive-aggressive behavior by a patient who is using immature defense mechanisms? Select all that apply. A. Justifying having an affair as a result of spousal infidelity B. Being hostile after agreeing to follow unit rules C. Yelling at the nurse after complimenting the nurse D. Avoiding completing tasks when asked by the boss at work E. Blaming family members for losing their job
B. and D.
Which neurotransmitter is destroyed by being taken back into the presynaptic cell during the reuptake process? Select all that apply. A. Acetylcholine B. Dopamine C. Norepinephrine D. Serotonin
B., C., and D.
Which statement is a myth about grief and mourning in US culture? Select all that apply. A. Tears are not an expression of weakness. B. It is best to move away from grief rather than toward it. C. There is a predictable and orderly stage-like progression to grieving. D. Following the death of someone important to you, the goal is to "get over it." E. Grief and mourning are not the same experience and not the same for everyone.
B., C., and D.
Which statement about panic attacks is true? Select all that apply. A. A stressful situation is generally the trigger for a panic attack. B. They are characterized by a sudden onset of extreme apprehension. C. The symptomology of panic attacks is primarily psychological in nature. D. The fear is so intense that it interferes with a person's ability to function normally. E. People with a history of panic attacks develop a deep-seated fear of having an attack.
B., D., and E.
A patient may experience which short-term reaction in response to a traffic accident involving death on the scene? A. Heart attack B. Diabetes C. Psychological stress D. Gastric ulcers
C.
A rape victim is in a dreamlike state and is not responding to painful stimuli. Which drug would the nurse suspect to have been used to facilitate the violence? A. γ-Hydroxybutyric acid (GHB) B. Flunitrazepam C. Ketamine D. Diazepam
C.
Which additional problem is most important for the nurse to assess in a new patient diagnosed with generalized anxiety disorder? A. Conduct disorder B. Alcohol use disorder C. Major depressive disorder D. Obsessive-compulsive disorder
C.
Which behavior by the nurse demonstrates promoting a social relationship rather than a therapeutic nurse-patient relationship? A. Sharing stories about their children B. Talking about favorite television shows with the patient C. Confiding in the patient about a frustrating day at work D. Talking about a patient with another nurse outside the workplace
C.
Which communication technique involves the nurse repeating what the patient said using different words? A. Focusing B. Exploring C. Restating D. Reflecting
C.
Which condition is a short-term effect of stress controlled by the hypothalamus-pituitary-adrenal (HPA) cortex? A. Fluid gain B. Hypoglycemia C. Reduced inflammation D. Muscular tension
C.
Which condition may the nurse experience while caring for a seriously ill patient over an extended time? A. Posttraumatic stress disorder (PTSD) B. Mental illness C. Compassion fatigue D. Flight or fight
C.
Which defense mechanism is being used by a patient after an argument in which the patient blamed the spouse for a new diagnosis of heart failure? A. Repression B. Somatization C. Displacement D. Rationalization E. Reaction formation
C.
Which instruction would the nurse provide to a patient diagnosed with anxiety and prescribed buspirone? A. "Take this medication on an empty stomach." B. "Take this medication only when you feel anxious." C. "It will take 3 or more weeks for you to feel the full benefit." D. "Avoid consuming aged cheese products while you are taking this medication."
C.
Which is the most likely diagnosis the nurse would expect the health care provider to make for a patient who compulsively looks at their reflection in the mirror? A. The patient has panic disorder. B. The patient has hoarding disorder. C. The patient has body dysmorphic disorder. D. The patient has obsessive-compulsive disorder.
C.
Which nursing action implemented while working with a patient demonstrates the use of active listening? A. Reviewing the health record B. Asking introductory questions C. Providing observable feedback D. Informing the patient about the nurse-patient relationship
C.
Which phrase is an accurate definition of grief work? A. A process that aims at recreating a new life B. A process that deals with recognizing the loss C. The manner in which a person adjusts to the loss D. When a griever constructs and reconstructs the world around themself through the experience as a survivor of loss
C.
Which psychosocial characteristic would the nurse utilize to help a patient develop adaptive coping mechanisms? A. Inflexibility to change B. Resistance to treatment C. Patient strengths D. Rigidness of thought
C.
Which situation is most likely to produce fear when encountered by a healthy adult? A. A large spider crawls along the kitchen wall. B. An elevator stops between floors because of a power outage. C. A gunman begins firing an assault weapon in a crowded mall. D. A storm accompanied by heavy thunder and lightning lasts for over an hour.
C.
Which statement by the nurse would be considered nontherapeutic when caring for a patient who is readmitted for alcohol withdrawal? A. "Did you try the 12-step program of Alcoholics Anonymous?" B. "Tell me what things are like for you at home with your family." C. "Why do you keep drinking when you know what it does to you?" D. "Was there any specific trigger to lead you to start drinking again?"
C.
Which statement by the nurse would be helpful to a family grieving the loss of a loved one and follows the guidelines for dealing with loss? A. "Try and do things out of the ordinary to help you cope with the loss and move on." B. "I know that it is painful to relive the story of your loss. You only need to tell it once. C. "It is okay not to get back into all of your daily routines right away. Give yourself time." D. "If you are still experiencing depression after 6 months, be sure to seek professional assistance."
C.
Which statement is true regarding obsessive-compulsive disorder (OCD)? A. Behaviors suggestive of OCD usually begin in infancy. B. Hospitalization is often necessary for persons diagnosed with OCD. C. Patients diagnosed with OCD should be assessed regularly for risk for suicide. D. Compulsions are repetitive thoughts, whereas obsessions are ritualistic behaviors.
C.
Which statement made by the psychiatric mental health nurse to a colleague breaches patient confidentiality? A. "It seems like my workload is very heavy right now." B. "My supervisor announced plans for renovations to our offices." C. "I am taking care of a prominent political person from our community." D. "We have a new psychiatrist with expertise in working with troubled veterans."
C.
Which statement would indicate to the nurse that the patient who lost a spouse is experiencing persistent complex bereavement disorder? A. "I have had several dreams in the past week, and my spouse has been in all of them." B. "I haven't been able to get a full night's sleep since my spouse passed away 2 weeks ago." C. "It's been over a year. There are days when I want to die so we can be together again. I can't do this anymore. D. "I know it's only been a week, but I should have made them go to the doctor and maybe this wouldn't have happened."
C.
Which substance is potentiated as a result of the therapeutic effect of the drug ramelteon? A. Gamma-aminobutyric acid (GABA) B. Serotonin C. Melatonin D. Norepinephrine
C.
A patient states, "That nurse never seems comfortable being with me." How might the nurse be described? A. Controlling B. Unfriendly and aloof C. Transmitting fear of patients D. Not seeming genuine to the patient
D.
A patient tells the nurse they are hearing voices telling them to hurt themself. Which response by the nurse would be presenting reality? A. "Give an example of what the voices are saying to you." B. "When did you first begin hearing the voices talk to you?" C. "Can you tell me why you think the voices are talking to you?" D. "I know you think the voices are real, but I do not hear them."
D.
Which assessment finding is a risk factor that could complicate successful completion of mourning? A. The bereaved denies a history of psychiatric illness. B. The bereaved has not had any past significant losses. C. The bereaved has a strong support system of family and friends. D. The bereaved depended on the deceased to provide financial stability.
D.
Which behavior is characteristic of an individual who is displaying passive aggression? A. Lying B. Stealing C. Slapping D. Procrastinating
D.
Which interaction would be considered countertransference? A. The nurse provides community resources for alcohol abstinence. B. The patient admits to drinking several beers with friends every night. C. The patient informs the nurse that the urge to drink alcohol is too powerful. D. The nurse admonishes the patient for getting drunk again like their father did.
D.
Which method of treatment would the nurse used when treating a war veteran who comes to the clinic demonstrating signs of posttraumatic stress disorder (PTSD)? A. Low carbohydrate diet B. Herbal supplements C. Manipulative practices D. Cognitive behavioral therapy
D.
Which part of the nervous system is related to staying awake? A. Amygdala B. Hippocampus C. Temporal lobe D. Reticular activating system (RAS)
D.
Which percentage of diseases is related to stress? A. 60% B. 70% C. 80% D. 90%
D.
Which phenomena experienced during bereavement does the nurse recognize in a family member who has symptoms of shortness of breath and throat tightness? A. Guilt B. Anger C. Depression D. Sensations of somatic distress
D.
Which phrase describes an example of a physical stressor in the workplace? A. Staff cliques B. Guilt C. Low pay D. Loud noises
D.
Which physiological response is caused by tricyclic antidepressants such as amitriptyline? A. Inhibiting monamine oxidase inhibitors that break down norepinephrine B. Inhibiting nerve activity, which prevents overexcitability or stimulation C. Blocking the reuptake of serotonin, which increases norepinephrine levels D. Inhibiting the reuptake of norepinephrine and serotonin
D.
Which question would the nurse ask when assessing spiritual history using the Federal Insurance Contribution Act (FICA) tool for a patient who has just been placed in hospice care? A. "Do you have an advance directive?" B. "Are you having any thoughts of hurting yourself?" C. "Have you experienced a significant loss in the past?" D. "Do you have spiritual beliefs that help you cope with stress?"
D.
Which response by the nurse is appropriate for effective nurse-patient interaction when a patient diagnosed with breast cancer says, "I will discuss my illness, but you should not share the information with anyone"? A. "It is a part of the assessment, and you are required to inform me of your concerns." B. "I assure you that I will not share the information provided by you with anyone." C. "I cannot maintain your secrets because I have to follow and abide by professional ethics." D. "I will be sharing the information provided by you with other health care professionals involved in your care, but no one else."
D.
Which scenario presents the most accurate example of altruism? A. After recovering from a gunshot wound, a police officer attends a local support group. B. After recovering from open-heart surgery, an individual plays tennis 3 times a week. C. An individual with a long-standing fear of animals volunteers at a community animal shelter. D. An individual who received a liver transplant volunteers at a local organ procurement agency.
D.
Which statement by the nurse demonstrates the best understanding of the goals of hospice care? A. "The goal of hospice care is to optimize quality of life through the illness." B. "The goal of hospice care is to use recommendations by the primary health care provider to deliver care." C. "The goal of hospice care is for nurses to deliver compassionate, holistic end-of-life care." D. "The goal of hospice care is to use an interdisciplinary team to provide end-of-life services.
D.
Which symptom is commonly associated with panic attacks? A. Fever B. Apathy C. Obsessions D. Fear of impending doom
D.
Which term is used for the emotional pain or cost of working with traumatized persons that may result in a stress response for a nurse? A. Grief B. Burnout C. Compassion D. Compassion fatigue
D.
Which therapeutic modality helps a patient view a disturbing occurrence in a more positive light? A. Exposure B. Desensitization C. Response prevention D. Cognitive restructuring
D.
Which type of anxiety may be associated with delusional thinking? A. Acute B. Severe C. Chronic D. Panic
D.
Which imaging technique requires an injection of a substance that is then traced to gather data regarding brain function? Select all that apply. A. Electroencephalography (EEG) B. Computed tomography (CT) C. Magnetic resonance imaging (MRI) D. Positron emission tomography (PET) E. Single-photon emission computed tomography (SPECT)
D. and E.