NURS 661 Exam 1
A client asks the nurse about the doctors comment that he may have problems due to delayed synaptic transmission in his brain. The nurse explains that the best way to describe a synaptic transmission is which of the following? 1. An electrochemical process called neurotransmission 2. Where the axon is released 3. When the receptors bind to neurons 4. The space where neurotransmitters match up with receptors
Answer: 1
A client is admitted to the psychiatric unit exhibiting behaviors indicating a high level of anxiety following a personal crisis. Which of the following communication skills should the nurse utilize when interacting with this client? 1. Closed-ended questions 2. Providing reassurance 3. Open-ended questions 4. Providing the client with advice
Answer: 1
A delusional client walks up to the nurse and says, I am the appointed overseer. Who are you and why are you here? The most therapeutic response is which of the following? 1. I am your nurse and I will be here to help you until suppertime. 2. You dont know who I am? 3. You know who I am. 4. You are not the overseer; you are a client in the hospital.
Answer: 1
A family member reports that his mother has started hiding valuables around the house, then cant remember where she put them. He asks the nurse to explain what is happening. Which of the following assessment tools might the nurse utilize to screen the mother for signs of cognitive dysfunction? 1. Benton Visual Retention Test 2. Thematic Apperception Test 3. Ravens Progressive Matrices Test 4. Sentence Completion Test
Answer: 1
A female client disclosed to the nurse that she is in an abusive situation. This information will be used to contribute to: 1. Axis IV. 2. Axis III. 3. Nothing, since this is confidential information and should not be shared. 4. Axis I.
Answer: 1
A working goal for the nurseclient relationship is to achieve: 1. Facilitative intimacy. 2. Self-disclosure. 3. Interdependence. 4. Social superficiality
Answer: 1
Due to a staff members absence, the nurse is reviewing staff assignments for the day. Which task can the nurse delegate to the psychosocial rehabilitation worker? 1. Conflict resolution teaching to a small group of clients 2. Comparison of physicians orders with the medication records 3. Routine medication administration to a stable client 4. Assessment of a long-term client
Answer: 1
The nurse engaged in a therapeutic relationship with a client uses nonverbal communication to: 1. Enhance verbal messages. 2. Avoid the use of verbal messages. 3. Detract from verbal messages. 4. Terminate the therapeutic relationship.
Answer: 1
The nurse is documenting observations of client interactions during a group session. The nurse strives to document the behaviors of the client interactions with: 1. Objectivity. 2. Serendipity. 3. Sympathy. 4. Empathy.
Answer: 1
The nurse on the inpatient unit is reviewing the record of a client admitted the previous day, and notes the client has an Axis I diagnosis. What inferences can the nurse make about the client? 1. The client has a clinical psychiatric disorder. 2. The client is in need of immediate medical attention. 3. The client has a chronic condition. 4. The client lacks a support system.
Answer: 1
The unit manager is consistently advocating for self-awareness among the psychiatric mental health nursing staff in order to promote quality care. From which theoretical base is the unit manager operating? 1. Jean Watsons theory of human caring 2. Dorothea Orems theory of self-care 3. Martha Rogerss principles of homeodynamics 4. Sister Callista Roys adaptation theory
Answer: 1
Which of the following is an example of clarifying a clients verbal response? 1. Are you saying you feel the medicine is helping you? 2. See, the medicine does work. 3. I knew it would work; it just takes time. 4. Everything seems to work out eventually.
Answer: 1
A client makes the following statement during a mental status assessment: I cant use the phones; the CIA has bugged all the wires. Which of the following categories will the nurse use to document the clients response? 1. Orientation 2. Content of thought 3. Emotional state 4. General behavior
Answer: 2
A depressed client asks why a physical exam is necessary before being admitted for outpatient treatment. The nurse explains to the client that a physical exam will: 1. Provide information about medications the client will need. 2. Make sure the client gets all necessary treatment. 3. Complete the admission process. 4. Ensure the client has not ingested any caustic material or inhaled noxious vapors
Answer: 2
A nurse acknowledges feeling anxious about meeting new people. By acknowledging feelings to the client, the nurse is demonstrating: 1. Sympathy. 2. Genuineness. 3. Empathy. 4. Superficiality.
Answer: 2
After interviewing a client for admission, the nurse gives the client a score of 50 on the Global Assessment of Functioning Scale (GAF). The nurse selected this score based on the clients level of functioning: 1. Since being given a psychiatric diagnosis. 2. Within the past week. 3. Since beginning the psychotropic medication. 4. Within the past year.
Answer: 2
As part of the comprehensive admission assessment, the nurse talks with family and friends who may contribute additional data to a clients psychiatric history. When reviewing the data obtained from these sources, the nurse keeps in mind which of the following perspectives of the data? The information provided: 1. Will vary according to the sources relationship to the client. 2. Comes from each individuals perspective. 3. Is considered false. 4. Is considered accurate.
Answer: 2
During a mental status assessment, the examiner asks the client to repeat these words: motorcar, teacup, and lilies. Five minutes later the client is asked to repeat the words again. The purpose of this exercise is to test the clients: 1. Insight. 2. Retention and recall. 3. Recall of recent past experiences. 4. Abstract thinking.
Answer: 2
In planning care for a client who is gaining mental stability, the nurse develops measures to confirm the clients view of self. Which of the following responses made by the nurse would be categorized as disturbed communication? 1. I do not understand what you are telling me. 2. You are wrong. 3. How might you go about that differently? 4. Do you want to try that again?
Answer: 2
Select the priority nursing diagnosis for a client with a Global Assessment of Functioning (GAF) score of 10. 1. Risk for Impaired Social Interaction 2. Risk for Injury 3. Knowledge Deficit 4. Risk for Communication Deficit
Answer: 2
The client asks the nurse if certain changes can be made in the unit milieu. Which action by the nurse indicates understanding of the nursing role in the therapeutic milieu? 1. The nurse refers the clients requests to the psychiatric social worker. 2. The nurse discusses the desired changes with the client. 3. The nurse refers the clients requests to the psychosocial rehabilitation worker. 4. The nurse instructs the client that no changes can be made.
Answer: 2
The client on the psychiatric unit is asking questions about prevention of sexually transmitted diseases. Given the PsychiatricMental Health Nursing Standards of Practice, which action would be most appropriate for the nurse to take at this time? 1. Consult with the mental health care team. 2. Teach safer sexual practices. 3. Investigate the questions in individual psychotherapy. 4. Notify the attending psychiatrist.
Answer: 2
The nurse gathering data from a client admitted to labor and delivery is overheard making the comment, You are lying. You need to tell me the truth so we can do what is best for your baby. The nurses communication is: 1. A perception check. 2. Nontherapeutic. 3. Necessary. 4. Therapeutic.
Answer: 2
The nurse in the community mental health clinic assesses a client and determines the presence of an Axis II diagnosis. What conclusions can the nurse draw? 1. The client is in need of further evaluation. 2. The client has a personality disorder. 3. The client will need a special diet. 4. The client is a candidate for the least restrictive environment.
Answer: 2
The nurse is developing a plan of care for a client. Which of the following interventions must the nurse be careful to avoid? 1. Discussing expectations with the client 2. Selecting interventions that conflict with the clients value system 3. Identifying the clients perception of the problem 4. Addressing issues related to the clients past experiences
Answer: 2
The nurse is validating what was observed before documenting in the progress note. Validation is used as a mechanism to ensure which of the following? 1. The clients affect is appropriate to the situation 2. The clients perception of the response is communicated 3. The clients request is clarified 4. The clients need for further intervention is understood
Answer: 2
The nurse observed that during a teaching session, the overall emotional tone of a client remained unchanged. The nurse documents this as: 1. Affect that has range. 2. Flat affect. 3. Incongruent verbal and nonverbal responses. 4. Muted behavior.
Answer: 2
The nurse reviews the data family and friends provided in the comprehensive assessment of a clients situation. The nurse knows to treat the data as: 1. Invalid until confirmed with the client. 2. Subjective data. 3. Primary data. 4. Peripheral to the assessment.
Answer: 2
The psychiatric mental health nurse is asked to develop an intervention for the nursing unit based on Watsons theory of caring. Given this assignment, which intervention is most appropriate for the nurse to implement? 1. One-to-one debriefing sessions each week with individual unit nurses and the unit manager 2. Clarification of values and cultural beliefs that might pose barriers to caring for clients 3. Identification of additional coping skills for new nurses on the unit 4. Discussion of the impact of recent changes in hospital policy on the nursing staff
Answer: 2
The school nurse, who must be familiar with mental health issues, will find child clinical disorders classified under: 1. Axis II. 2. Axis I. 3. Axis X. 4. Axis VII.
Answer: 2
When considering communication skills, the nurse caring for an older client anticipates that the client will: 1. Interrupt frequently. 2. Take longer to respond. 3. Answer questions with one-word responses. 4. Remain silent.
Answer: 2
During a group session, the clients are asked to make one positive statement about their home life. The nurse notices that one of the clients begins to fidget in the chair and interprets this behavior as: 1. A form of nonlanguage vocalization. 2. A therapeutic use of space. 3. An expression of discomfort. 4. An excuse to avoid answering the question.
Answer: 3
During the first interaction with a client, the nurse makes an introduction and identifies the purpose of the interaction. This serves to accomplish which of the following in developing a trusting relationship? 1. Setting goals 2. Building 3. Initiating 4. Maintaining
Answer: 3
If psychiatric nurses used Orems theory for structuring much of their nursing practice, a major focus area for assessment would be the clients ability to do which of the following? 1. Adapt and function to meet various role expectations. 2. Care about self and participate in self-healing. 3. Implement self-care to meet psychosocial needs. 4. Enter into a therapeutic one-to-one relationship with the nurse.
Answer: 3
If the nurse is using the nursing theory that has shaped psychiatric mental health most directly, which nursing action is priority? 1. Assessing the clients abilities in areas of self-care 2. Teaching effective coping skills 3. Establishing a therapeutic nurseclient relationship 4. Encouraging the clients sensitivity and caring for self
Answer: 3
Psychiatricmental health nursing interventions occur at which of the following levels of communication? 1. Public 2. Intrapersonal 3. Interpersonal 4. International
Answer: 3
The nurse is admitting a client from the emergency room. Which of the following would be used to clarify the nurses understanding of the clients chief complaint? 1. If you are bleeding, where is the blood? 2. I feel your pain when I see you hold your side. 3. Are you saying you feel that you are bleeding inside? 4. Dont worry; we have the technology to take care of you.
Answer: 3
The nurse is talking with the family of a mentally ill client who lives with them. The client is being admitted to the inpatient psychiatric unit. What is the priority information to gather from the family? 1. Whether the client had a flu shot recently 2. The number of medications prescribed for the client 3. How the clients symptoms are expressed at home 4. The type of soap the client prefers to use
Answer: 3
The psychiatric mental health nurse is working with the new graduate nurse who is orienting to the psychiatric unit. Which comment by the new graduate indicates further clarification of the generalist-nursing role is needed? 1. I would feel better if you would look at my documentation that addresses progress toward treatment goals. 2. I will spend time each day evaluating the effectiveness of the therapeutic milieu. 3. I am a little nervous about conducting psychotherapy with clients. 4. I am doing some reading on how to incorporate complementary interventions into treatment plans.
Answer: 3
The student nurse asks why the nurse is documenting the clients nonverbal responses in addition to verbal responses during the initial assessment. Which of the following statements made by the nurse reflects the rationale for documenting both verbal and nonverbal responses? 1. It is the hospital policy to document both. 2. It is important to be thorough when documenting. 3. Documenting both permits the reader to compare the behaviors for congruence. 4. Charting verbal and nonverbal helps me remain objective.
Answer: 3
Which of the following best describes the information the nurse will use to construct a nursing care plan? 1. A mental status examination 2. An intake assessment and reason for admission 3. A psychiatric history and mental status examination 4. A detailed psychiatric history
Answer: 3
Which of the following interventions promotes mindful listening in any health care setting? 1. Telling the client to get off the phone 2. Encouraging the family to step outside before assessing the client 3. Turning off the television before interviewing a client 4. Asking clients what they would like to drink when taking medication
Answer: 3
Which of the following is not related to the theory of successful versus disturbed communication patterns during an admission assessment? 1. The appropriateness of the content of the message. 2. The quality of the feedback provided. 3. The language level of the assessment nurse. 4. How efficiently the client delivers a message
Answer: 3
A client is admitted with the following diagnosis: Axis I: 300.01 Panic disorder without agoraphobia Axis II: 301.83 Borderline personality disorder Axis III: No diagnosis Axis IV: Unemployment What conclusions can the nurse make relative to the clients Axis III information? 1. This client has problems with environment, but they are not related to mental disorder. 2. The clients environment has not been evaluated. 3. The clients health status has not been evaluated. 4. The client has no diagnosed physiological health problems relevant to mental disorder at the time of admission.
Answer: 4
A client states, I just know my brother will not come back from the war. Which of the following examples would be used to encourage the client to explore this concern? 1. Maybe he will be one of the lucky ones. 2. How do you know this? 3. Where is your brother going? 4. What do you feel will happen to him?
Answer: 4
An anxious client is to complete the Minnesota Multiphasic Personality Inventory-2 as part of the psychological testing. The client is worried about not having enough time to prepare for the test. To decrease anxiety, the nurse reviews the purpose of the test and explains that the client will: 1. Just need to complete a series of sentences. 2. Interpret ink blots. 3. Only have to copy geometric designs. 4. Be answering true or false questions.
Answer: 4
During a group session, a client expresses anger at the nurse. The nurse sits tensely with arms and legs crossed while verbally agreeing that the clients point of view is correct. Which of the following messages is being sent by the nurse? 1. The nurse is expressing warmth toward the client 2. The nurse is being patient 3. The nurse is demonstrating empathy 4. The nurse is sending a mixed message
Answer: 4
During a nurseclient interaction, the client tells the nurse, I dont think I can deal with feeling so sad much longer. The nurses best response is which of the following? 1. Is there a history of depression in your family? 2. We all have times of sadness. 3. Are you saying you feel sad? 4. Tell me about your feelings of sadness.
Answer: 4
In the immunization clinic, the nurse notices a client displaying tense body posture. Which of the following is the most therapeutic response for the nurse to make? 1. This wont hurt a bit. 2. You need to relax. 3. I can tell youve had a bad experience before. 4. I notice you are clenching your fists.
Answer: 4
The nurse is serving on a committee charged with reviewing the roles and responsibilities of the nurses on the psychiatric unit. Which publication should the nurse bring to the first meeting? 1. Diagnostic and Statistical Manual of Mental Disorders 2. American Nurses Credentialing Center certification requirements 3. American Nurses Association, Code of Ethics 4. Psychiatric Mental Health Nursing Standards of Practice
Answer: 4
The nurse is working with a teen admitted with a diagnosis of depression. Which of the following interventions demonstrates that the nurse is sensitive to the clients needs? 1. Avoiding the use of silence to decrease anxiety 2. Asking for details to demonstrate interest in the client 3. Using closed-ended questions 4. Listening to the clients feelings
Answer: 4
The psychiatric home health nurse is evaluating whether a clients level of functioning has improved since starting the prescribed psychotropic medication. What evidence does the nurse look for? 1. There is no change in the GAF score. 2. There is a significant decrease (by 10 or more points) in the clients GAF score. 3. The client no longer qualifies for a GAF score. 4. There is an increase in the clients GAF score.
Answer: 4
The psychiatric mental health nurse reflecting on professional role activities is referred to the standards of professional performance by a colleague. To which organization should the nurse look for guidance? 1. North American Nursing Diagnosis Association 2. American Nurses Credentialing Center 3. National League for Nursing 4. American Nurses Association
Answer: 4
Upon the clients arrival on the patient care unit, the nurse begins implementation of the nursing process. Of which nursing theorist should the nurses practice be most reflective? 1. Ida Jean Orlando 2. Jean Watson 3. Dorothea Orem 4. Hildegard Peplau
Answer: 4
Which of the following communication theories provides the most appropriate rationale for a nursing intervention to utilize the perceived strengths of the client in promoting effective communication? 1. Behavioral Effects and Human Communication Theory 2. Neurolinguistic Programming Theory 3. Theory of Communication Levels 4. Therapeutic Communication Theory
Answer: 4
While reviewing therapeutic communication techniques, a nursing student made a list of things not to do or say to a client. Which of the following comments should be on the students list? 1. How do you feel about being discharged today? 2. What happened when you quit taking your medications? 3. What are your concerns about your living situation? 4. Why do you think you will never get well?
Answer: 4
A drug causes muscarinic receptor blockade. The nurse will assess the patient for: a. dry mouth b. gynecomastia c. psedoparkinsonism d. orthostatic hypotension
Answer: A
A nurse cares for four patients who are receiving clozapine, lithium, fluoxetine, and venlafaxine, respectively. With which patient should the nurse be most alert for problems associated with fluid and electrolyte imbalance? The patient receiving: a. lithium b. clozapine c. fluoxetine d. venlafaxine
Answer: A
A patient tells the nurse, My doctor prescribed Paxil (paroxetine) for my depression. I assume Ill have side effects like I had when I was taking Tofranil (imipramine). The nurses reply should be based on the knowledge that paroxetine is a(n): a. selective norepinephrine reuptake inhibitor. b. tricyclic antidepressant. c. MAO inhibitor. d. SSRI
Answer: A
An obese patient has a diagnosis of schizophrenia. Medications that block which receptors would contribute to further weight gain? a. H1 b. 5HT2 c. Acetylcholine d. Gamma-aminobutyric acid (GABA)
Answer: A
The laboratory report for a patient taking clozapine (Clozaril) shows a white blood cell count of 3000 mm . Select the nurses best action. a. Report the results to the health care provider immediately. b. Administer the next dose as prescribed. c. Give aspirin and force fluids. d. Repeat the laboratory test.
Answer: A
The nurse administers a medication that potentiates the action of gamma-aminobutyric acid (GABA). Which effect would be expected? a. reduced anxiety b. improved memory c. more organized thinking d. fewer sensory perceptual alterations
Answer: A
The nurse should assess a patient taking a drug with anticholinergic properties for inhibited function of the: a. parasympathetic nervous system b. sympathetic nervous system c. reticular activating system d. medulla oblongata
Answer: A
Which technique will best communicate to a patient that the nurse is interested in listening? a. Restating a feeling or thought the patient has expressed. b. Asking a direct question, such as Did you feel angry? c. Making a judgment about the patients problem. d. Saying, I understand what you're saying
Answer: A
While talking with a patient diagnosed with major depression, a nurse notices the patient is unable to maintain eye contact. The patients chin lowers to the chest, while the patient looks at the floor. Which aspect of communication has the nurse assessed? A. nonverbal communication b. A message filter c. A cultural barrier d. social skills
Answer: A
8. A patient has disorganized thinking associated with schizophrenia. Neuroimaging would likely show dysfunction in which part of the brain? a. Hippocampus b. Frontal lobe c. Cerebellum d. Brainstem
Answer: B
A drug blocks the attachment of norepinephrine to 1 receptors. The patient may experience: a. hypertensive crisis. b. orthostatic hypotension. c. severe appetite disturbance. d. an increase in psychotic symptoms.
Answer: B
A nurse caring for a patient taking a selective serotonin reuptake inhibitor (SSRI) will develop outcome criteria related to: a. coherent thought processes b. improvement in depression c. reduced levels of motor activity d. decreased extrapyramidal symptoms
Answer: B
A nurse would anticipate that treatment for a patient with memory difficulties might include medications designed to: A. inhibit gamma-aminobutyric acid (GABA). B. prevent destruction of acetylcholine. C. reduce serotonin metabolism. D. increase dopamine activity.
Answer: B
A patient diagnosed with bipolar disorder has an unstable mood, aggressiveness, agitation, talkativeness, and irritability. The nurse expects the health care provider to prescribe a medication from which group? a. psychostimulants b. mood stabilizers c. anticholinergics d. antidepressants
Answer: B
A patient diagnosed with schizophrenia tells the nurse, The CIA is monitoring us through the fluorescent lights in this room. Be careful what you say. Which response by the nurse would be most therapeutic? a. Let's talk about something other than the CIA. b. It sounds like you're concerned about your privacy. c. The CIA is prohibited from operating in health care facilities. d. You have lost touch with reality, which is a symptom of your illness
Answer: B
A patient has fear as well as increased heart rate and blood pressure. The nurse suspects increased activity of which neurotransmitter? a. Gamma-aminobutyric acid (GABA) b. Norepinephrine c. Acetylcholine d. Histamine
Answer: B
A patient taking medication for mental illness develops restlessness and an uncontrollable need to be in motion. Which drug action causes these symptoms to develop? a. Anticholinergic effects b. Dopamine-blocking effects c. Endocrine-stimulating effects d. ability to stimulate spinal nerves
Answer: B
A patient with a long history of hypertension and diabetes now develops confusion. The health care provider wants to make a differential diagnosis between Alzheimers disease and multiple infarcts. Which diagnostic procedure should the nurse expect to prepare the patient for first? a. Skull x-rays b. Computed tomography (CT) scan c. Positron-emission tomography (PET) d. Single-photon emission computed tomography (SPECT)
Answer: B
By which mechanism do selective serotonin reuptake inhibitors (SSRI) improve depression? a. Destroying increased amounts of serotonin b. Making more serotonin available at the synaptic gap c. Increasing production of acetylcholine and dopamine d. Blocking muscarinic and 1 norepinephrine receptors
Answer: B
During the first interview with a parent whose child died in a car accident, the nurse feels empathic and reaches out to take the patients hand. Select the correct analysis of the nurses behavior. a. It shows empathy and compassion. It will encourage the patient to continue to express feelings. b. The gesture is premature. The patients cultural and individual interpretation of touch is unknown. c. The patient will perceive the gesture as intrusive and overstepping boundaries. d. The action is inappropriate. Psychiatric patients should not be touched.
Answer: B
The nurse prepares to assess a patient diagnosed with major depression for disturbances in circadian rhythms. Which question should the nurse ask this patient? a. Have you ever seen or heard things that others do not? b. What are your worst and best times of the day? c. How would you describe your thinking? d. Do you think your memory is failing?
Answer: B
The parent of an adolescent diagnosed with schizophrenia asks the nurse, My childs doctor ordered a PET. What kind of test is that? Select the nurses best reply. A. This test uses a magnetic field and gamma waves to identify problem areas in the brain. Does your teenager have any metal implants? B. PET means positron-emission tomography. It is a special type of scan that shows blood flow and activity in the brain. C. A PET scan passes an electrical current through the brain and shows brain-wave activity. It can help diagnose seizures. D. Its a special x-ray that shows structures of the brain and whether there has ever been a brain injury
Answer: B
The patient says, My marriage is just great. My spouse and I always agree. The nurse observes the patients foot moving continuously as the patient twirls a shirt button. The conclusion the nurse can draw is that the patients communication is: a. clear. b. mixed c. recise d. inadequate
Answer: B
The therapeutic action of neurotransmitter inhibitors that block reuptake cause: a. decreased concentration of the blocked neurotransmitter in the central nervous system. b. increased concentration of the blocked neurotransmitter in the synaptic gap. c. destruction of receptor sites specific to the blocked neurotransmitter. d. limbic system stimulation.
Answer: B
Which instruction has priority when teaching a patient about clozapine (Clozaril)? a. Avoid unprotected sex. b. Report sore throat and fever immediately. c. Reduce foods high in polyunsaturated fats. d. Use over-the-counter preparations for rashes.
Answer: B
A nurse can anticipate anticholinergic side effects are likely when a patient takes: a. lithium (Lithobid) b. buspirone (BuSpar) c. imipramine (Tofranil) d. risperidone (Risperdal)
Answer: C
A nurse cares for a group of patients receiving various medications, including haloperidol (Haldol), carbamazepine (Tegretol), trazodone (Desyrel), and phenelzine (Nardil). The nurse will order a special diet for the patient who takes: a. carbamazepine b. haloperidol c. phenelzine d. trazodone
Answer: C
A nurse instructs a patient taking a drug that inhibits monoamine oxidase (MAO) to avoid certain foods and drugs because of the risk of: a. cardiac dysrhythmia b. hypotensive shock c. hypertensive crisis d. hypoglycemia
Answer: C
A patient discloses several concerns and associated feelings. If the nurse wants to seek clarification, which comment would be appropriate? a. What are the common elements here? b. Tell me again about your experiences. c. Am I correct in understanding that . . . d. Tell me everything from the beginning
Answer: C
A patient is hospitalized for severe depression. Of the medications listed below, the nurse can expect to provide the patient with teaching about: a. chlordiazepoxide (Librium) b. clozapine (Clozaril) c. sertraline (Zoloft) d. tacrine (Cognex)
Answer: C
A patient tells the nurse, I dont think Ill ever get out of here. Select the nurses most therapeutic response. a. Dont talk that way. Of course you will leave here! b. Keep up the good work, and you certainly will. d. You dont think youre making progress? e. Everyone feels that way sometimes.
Answer: C
Documentation in a patients chart shows, Throughout a 5-minute interaction, patient fidgeted and tapped left foot, periodically covered face with hands, and looked under chair while stating, I enjoy spending time with you. Which analysis is most accurate? a. The patient is giving positive feedback about the nurses communication techniques. b. The nurse is viewing the patients behavior through a cultural filter. c. The patients verbal and nonverbal messages are incongruent. d. The patient is demonstrating psychotic behaviors.
Answer: C
1. A patient says to the nurse, I dreamed I was stoned. When I woke up, I felt emotionally drained, as though I hadn't rested well. Which response should the nurse use to clarify the patient's comment? a. It sounds as though you were uncomfortable with the content of your dream. b. I understand what you're saying. Bad dreams leave me feeling tired, too. c. So you feel as though you did not get enough quality sleep last night? d. Can you give me an example of what you mean by stoned?
Answer: D
A nurse interacts with a newly hospitalized patient. Select the nurses comment that applies the communication technique of offering self. a. Ive also had traumatic life experiences. Maybe it would help if I told you about them. b. Why do you think you had so much difficulty adjusting to this change in your life? c. I hope you will feel better after getting accustomed to how this unit operates. d. Id like to sit with you for a while to help you get comfortable talking to me.
Answer: D
A patient asks, What are neurotransmitters? The doctor said mine are imbalanced. Select the nurses best response. A) How do you feel about having imbalanced neurotransmitters? B)Neurotransmitters protect us from harmful effects of free radicals. C)Neurotransmitters are substances we consume that influence memory and mood. D)Neurotransmitters are natural chemicals that pass messages between brain cells.
Answer: D
A patient begins therapy with a phenothiazine medication. What teaching should the nurse provide related to the drugs strong dopaminergic effect? a. chew sugarless gum b. increase dietary fiber c. arise slowly from bed d. report changes in muscle movement
Answer: D
A patient has acute anxiety related to an automobile accident 2 hours ago. The nurse should teach the patient about medication from which group? a. Tricyclic antidepressants b. Antipsychotic drugs c. Antimanic drugs d. Benzodiazepines
Answer: D
A patients history shows drinking 4 to 6 liters of fluid and eating more than 6,000 calories per day. Which part of the central nervous system is most likely dysfunctional for this patient? a. Amydala c. Hippocampus b. Parietal lobe d. Hypothalamus
Answer: D
An individual hiking in the forest encounters a large poisonous snake on the path. Which change in this individuals vital signs is most likely? a. Pulse rate changes from 90 to 72. b. Respiratory rate changes from 22 to 18. c. Complaints of intestinal cramping begin. d. blood pressure changes from 114/62 to 136/78
Answer: D
Who can benefit from EMDR?
Anyone who has ever experienced an upset that they have not recovered from. Often these people have one or more of the following symptoms in varying degrees: feeling "stuck", excess stress/tension, depression, anxiety, restlessness, sleep trouble, fatigue, appetite disturbances, and ongoing physical health concerns despite treatment. In the more severe cases: panic attacks, flashbacks, nightmares, obsessions, compulsions, eating disorder, and suicidal tendencies.
How does the overall treatment with EMDR look?
EMDR focuses first on the past, second on the present and third on the future. The past is focused on first because it is the past unresolved pain (whether it is childhood or the more recent past) which is causing pain in the present. Dealing with the past is therefore going to the root of the problem. For example, if a client comes in with depression and she has a history of being depressed since a death in her family, we would focus on the time around the death first because it is the root of the depression. To only focus on the symptoms of the depression in the present would be like taking an aspirin for a headache caused by a brain tumor rather than working with the brain tumor.
What is the history of EMDR?
EMDR has created by Francine Shapiro PhD, discovered that moving her eyes in certain directions reduced emotional tension. Francine did further investigation into this phenomenon making EMDR the subject of her doctoral thesis in 1987. Integrating her clinical experience, Francine has formulated a unique method which she calls EMDR.
How does EMDR treatment work?
When an upset is experienced, it can become locked in the nervous system with the original picture, sounds, thoughts, feelings, and body sensations. This upset is stored in the brain (and also the body) in an isolated memory network preventing learning from taking place. Old material just keeps getting triggered over & over again and you end up feeling "stuck" emotionally. In another part of your brain, in a separate network, is most of the information you need to resolve the upset. It's just prevented from linking up to the old stuff. Once processing starts with EMDR, the 2 networks can link up. New information can then come to mind to resolve the old problems.
How effective is EMDR?
When compared to other methods of therapy (psychoanalysis, cognitive, behavioral, etc), EMDR has been rated as far more effective by mental health professionals. Clients experience emotional healing at an accelerated rate. If we use the metaphor of a driving a car through a tunnel to get to the other side, (where the tunnel represents the journey of healing and the other side of the tunnel represents the healed state), EMDR is like driving your car through the tunnel at very high speeds. Because of this accelerated processing, you should notice improvement within each session.
