Psych Exam 1

A 25-year-old man barely avoids a motor vehicle accident. His heart is pounding, his palms are sweaty, and his respirations are increased. This is an example of which stage of the general adaptation syndrome? a)Alarm reaction stage b)Stage of resistance c)Stage of exhaustion d)Stage of biological stress

A

A client with depression has just been prescribed the antidepressant phenelzine (Nardil). She says to the nurse, "The doctor says I will need to watch my diet while I'm on the medication. What foods should I avoid?" a. Bleu cheese, red wine, raisins b. Black beans, garlic, pears c. Pork, shellfish, egg yolks d. Milk, peanuts, tomatoes

A

A nursing student is learning about the human limbic system. Which student statement demonstrates that teaching about the function of the limbic system has been effective? a)"The limbic system helps stabilize emotional behavior." b)"The limbic system functions to assist with symbolic thinking." c)"The limbic system aids in analytical thinking." d)"The limbic system helps modulate motor coordination."

A

Anna, who is 72 years old, is of the age when she may have experienced many losses coming close together. What is this called? a. Bereavement overload b. Normal mourning c. Isolation d. Cultural relativity

A

Anti-anxiety medications, such as benzodiazepines, produce a calming effect by which of the following actions? a. depressing the CNS b. decreasing levels of norepinephrine and serotonin in the brain c. decreasing levels of dopamine in the brain d. inhibiting the production of the enzyme MAO

A

The goal of cognitive therapy with depressed clients is to: a. Identify and change dysfunctional patterns of thinking b. resolve the symptoms and initiate or restore adaptive family functioning c. Alter the neurotransmitters that are creating the depressed mood d. Provide feedback from peers who are having similar experiences

A

The nurse is using nursing process to care for a suicidal client. Which of the following nursing actions is a part of the planning step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the client b. Determines if nursing interventions have been appropriate to achieve desired results c. Obtains a short-term contract from the client to seek out staff if feeling suicidal d. Establishes goal of care: client will not harm self during hospitalization

A

The nurse is using nursing process to care for a suicidal client. Which of the following nursing actions is part of the diagnosis step of the nursing process? a. Identifies nursing diagnosis: Risk for suicide b. Notes that client's family reports recent suicide attempt c. Prioritizes the necessity for maintaining a safe environment for the client d. Obtains a short-term contract from the client to seek out staff if feeling suicidal

A

Which of the following is a concern with children on long-term therapy with CNS stimulants for ADHD? a. addiction b. weight gain c. substance abuse d. growth suppression

A

which of the following parts of the brain is associated with voluntary body movement, thinking and judgment, and expression of feeling? a. forntal b. parietal c. temporal d. occipital

A

According to the American Nurses Association standards of practice for psychiatric/mental health nurses, which specific intervention can be implemented by any psychiatric/mental health nurse generalist? a)Milieu therapy b)Psychotherapy c)Consultation d)Prescriptive authority

A Milieu therapy, which is the scientific structuring of the environment in order to affect behavioral change, is a nursing intervention that can be implemented by any psychiatric/mental health nurse generalist.

Anna has been a widow for 20 years. Her maladaptive grief response to the loss of her dog may be attributed to which of the following? Select all that apply. a. Unresolved grief over loss of her husband b. Loss of several relatives and friends over the last few years c. Repressed feelings of guilt over the way in which Lucky died d. Inability to prepare in advance for the loss

A B C D

S.T. is a 15 year old girl who has just been admitted to the adolescent psychiatric unit with a diagnosis of Anorexia Nervosa. she is 5'5'' tall and weighs 82 lbs. She was elected to the cheerleading for the fall but states that she is not as good as the others on the squad. The treatment team has identified the following problems: refusal to eat, occasional purging, refusing to interact with staff and peers, and fear of failure. Which of the following nursing diagnoses would be appropriate diagnosis for S.T.? Select all that apply. a. social isolation b. disturbed body image c. low self-esteem d. imbalanced nutrition: less than body requirements

A, B, C, D

A client has just been admitted tothe psychiatric unit with a diagnosis of Major Depressive Disorder. Which of the following behavioral manifestations might the nurse expect to assess? (Select all that apply) a. Slumped posture b. Delusional thinking c. Feelings of despair d. Feels best early in the morning and worse as the day progresses e. Anorexia

A, B, C, E

Sally is admitted to the hospital with Major Depressive Disorder and repeatedly makes negative statements about herself. Which of the following interventions is identified as an approach that promotes positive self-esteem in the patient? Select all that apply. a. Teach assertive communication skills. b. Make observations to Sally when she completes a goal or task. c. Instruct Sally that you will not talk with her unless she stops talking negatively about herself. d. Offer to spend time with Sally using a nonjudgmental, accepting approach.

A, B, D

Which of the following describes advantages to electronic health records (EHRs)? Select all that apply. a. EHRs reduce redundancy of information b. EHRs reduce issues regarding privacy c. EHRs decrease charting time d. EHRs facilitate communication between disciplines

A, C, D

A client is brought to the emergency department and diagnosed with a panic level of anxiety. What biological system domination would be responsible for this diagnosis? a) Parasympathetic division of the autonomic nervous system b) Sympathetic division of the autonomic nervous system c) The cerebral cortex d) The cerebellum

B

A newly admitted depressed client isolates herself in her room and just sits and stares into space. How best might the nurse begin a therapeutic relationship with this client? a. Say, "come with me. I will go with you to group therapy." b. Make frequent short visits to her room and sit with her c. Offer to introduce her to the other clients d. Help her to identify stressors in her life that precipitate crises

B

Anna's daughter notices anna appears to be listening to another voice when just the two of them are in a room together. when questioned anna admits that she hears someone telling her that she was a horrible caretaker for lucky and did not deserve to ever have a pet. which of the following best describes what anna is experiencing? a. neurosis b. psychosis c. depression d. bereavement

B

Anna, age 72, has been grieving the death of her dog, Lucky, for 3 years. She is not able to take care of her activities of daily living and wants only to make daily visits to Lucky's grave. Her daughter has likely put off seeking help for Anna because a. Women are less likely than men to seek help for emotional problems. b. Relatives often try to "normalize" the behavior rather than label it mental illness. c. She knows that all older people are expected to be a little depressed. d. She is afraid that the neighbors "will think her mother is crazy."

B

Antipsychotic medications are thought to decrease psychotic symptoms by which of the following actions? a. Blocking reuptake of norepinephrine and serotonin b. Blocking the action of dopamine in the brain c. Inhibiting production of the enzyme MAO d. Depressing the CNS

B

If the foregoing extrapyramidal symptoms should occur, which of the following would be a priority nursing intervention? a. Notify the physician immediately. b. Administer prn trihexyphenidyl (Artane). c. Withhold the next dose of antipsychotic medication. d. Explain to the client that these symptoms are only temporary and will disappear shortly.

B

Part of the nurse's continual assessment of the client taking antipsychotic medications is to observe for extrapyramidal symptoms. Examples include which of the following? a. Muscular weakness, rigidity, tremors, facial spasms b. Dry mouth, blurred vision, urinary retention, orthostatic hypotension c. Amenorrhea, gynecomastia, retrograde ejaculation d. Elevated blood pressure, severe occipital headache, stiff neck

B

The nurse is using nursing process to care for a suicidal client. Which of the following nursing actions is a part of the evaluation step of the nursing process? a. prioritizes the necessity for maintaining a safe environment for the client b. Determines if nursing interventions have been appropriate to achieve desired results c. Obtains a short term contract from the client to seek out staff if feeling suicidal d. Establishes goal of care: client will not harm self during hospitalization

B

The nurse is using nursing process to care for a suicidal patient. Which of the following nursing actions is a part of the assessment step of the nursing process? a. Identifies nursing diagnosis: Risk for suicide b. Notes that client's family reports recent suicide attempt c. prioritizes the necessity for maintaining a safe environmental for the client d. obtains a short term contract from the client to seek out staff if feeling suicidal

B

The physician orders sertraline (Zoloft) 50mg bid for margaret, a 68-year old woman with Major Depressive Disorder. After 3 days taking the medication, Margaret says tot he nurse, "I don't think this medicine is doing any good. I don't feel a bit better." What is the most appropriate response by the nurse? a. Cheer up, Margaret. You have so much to be happy about. b. Sometimes it takes a few weeks for the medicine to bring about an improvement in symptoms. c. I'll report that to the physician, Margaret. Maybe he will order something different. d. Try not to dwell on your symptoms, margaret. Why don't you join the others down in the dayroom?

B

There is a very narrow margin between the therapeutic and toxic levels of lithium carbonate. Symptoms of toxicity are most likely to appear if the serum levels exceed which of the following levels? a. 0.15 mEq/L b. 1.5 mEq/L c. 15.0 mEq/L d. 150 mEq/L

B

What is the reason that doses of bupropion should be administered at least 4 to 6 hours apart and never doubled when a dose is missed? a. To prevent orthostatic hypotension b. To prevent seizures c. To prevent hypertensive crisis d. To prevent extrapyramidal symptoms

B

Which of the following statements by Anna might suggest that she is achieving resolution of her grief over Lucky's death? a. "I don't cry anymore when I think about Lucky." b. "It's true. Lucky didn't always mind me. Sometimes he ignored my commands." c. "I remember how it happened now. I should have held tighter to his leash!" d. "I won't ever have another dog. It's just too painful to lose them."

B

A widow of 23 years has not removed any of her husband's possessions, including the slippers beside their bed. Which pathological grief response is being exhibited by this client?a)Inhibited grief response b)Prolonged grief response c)Delayed grief response d)Distorted grief response

B - The prolonged grief response is characterized by intense preoccupation with memories of the lost person years after the loss has occurred. This is how this client has responded to her husband's death.

In teaching a client about his antidepressant medication, fluoxetine, which of the following would the nurse include? (select all that apply) a. Don't eat chocolate while taking this medication b. Keep taking this medication, even if you don't feel it is helping. It sometimes takes a while to take effect c. Don't take this medication with the migraine drugs "triptans" d. Go to the lab each week to have your blood drawn for therapeutic level of this drug e. This drug causes a high degree of sedation, so take it just before bedtime

B, C

A client whose husband died 6 months ago is diagnosed with major Depressive Disorder. She says to the nurse, "I start feeling angry that Harold died and left me all along; he should have stopped smoking years ago! But then I start feeling guilty for feeling that way." What is an appropriate response by the nurse? a. Yes, he should have stopped smoking. Then he probably wouldn't have gotten lung cancer b. I can understand how you must feel c. Those feelings are a normal part of the grief response d. Just think about the good times that you had while he was alive

C

Initial symptoms of lithium toxicity include which of the following? a. Constipation, dry mouth b. Dizziness, thirst c. Vomiting, diarrhea d. Anuria, arrhythmias

C

Lucky sometimes refused to obey Anna and indeed did not come back to her when she called to him on the day he was killed. But Anna continues to insist, "He was the very best dog. He always minded me. He always did everything I told him to do." This represents the defense mechanism: a. sublimation. b. compensation. c. reaction formation. d. undoing.

C

Margaret, age 68, is a widow of 6 months. Since her husband died, her sister reports that margaret has become socially withdrawn, has lost weight, and does little more each day than visit the cemetery where her husband was buried. She told her sister today that she "didn't have anything more to live for." She has been hospitalized with major Depressive Disorder. The priority nursing diagnosis for Margaret would be: a. Imbalance nutrition: less than body requirements b. Complicated grieving c. Risk for suicide d. Social isolation

C

Nancy has a new diagnosis of panic disorder. Dr. S has written a prn order for alprazolam (Xanax) for when Nancy is feeling anxious. She says to the nurse, "Dr. S prescribed Buspirone for my friend's anxiety. Why did he order something different for me?" The nurse's answer is based on which of the following? a. Buspirone is not an antianxiety medication. b. Alprazolam and buspirone are essentially the same medication, so either one is appropriate. c. Buspirone has delayed onset of action and cannot be used on a prn basis. d. Alprazolam is the only medication that really works for panic disorder.

C

Nursing diagnosis are prioritized according to which of the following? a. degree of potential for resolution b. legal implications associated with nursing intervention c. life-threatening potential d. client and family requirements

C

The nurse is using nursing process to care for a suicidal client. which of the following nursing actions is a part of the implementation step of then nursing process? a. Prioritizes the necessity for maintaining a safe environment for the client b. Determines if nursing interventions have been appropriate to achieve desired results c. Obtains a short-term contract from the client to seek out staff if feeling suicidal d. Establishes goal of care: client will not harm self during hospitalization

C

Three years ago, Anna's dog Lucky, whom she had had for 16 years, was run over by a car and killed. Anna's daughter reports that since that time, Anna has lost weight, rarely leaves her home, and just sits and talks about Lucky. Anna's behavior would be considered maladaptive because: a. it has been more than 3 years since Lucky died. b. her grief is too intense over just the loss of a dog. c. her grief is interfering with her functioning. d. people in this culture would not comprehend such behavior over the loss of a pet.

C

When anna's daughter expresses concern about her mother's behavior and recommends she see a counselor, anna declares, "I'm fine. There is nothing wrong with me!" which of the following best describes anna's response? a. grief resolution b. somatic disorder c. anosognosia d. intellectualization

C

Which nursing diagnosis is written correctly? a)Risk for social isolation related to low self-esteem evidenced by staying in room during the day b)Low self-esteem related to major depressive disorder evidenced by childhood abuse c)Imbalanced nutrition: less than body requirements related to suspiciousness evidenced by 20-lb weight loss d)Conduct disorder related to childhood sexual abuse evidenced by hostile and aggressive behaviors

C Imbalanced nutrition: less than body requirements related to suspiciousness evidenced by 20 lbs. weight loss is a correctly written nursing diagnosis. Evidence of a nutritional problem is documented and the cause of the problem, suspiciousness, is identified. "Imbalanced nutrition: less than body requirements" is an approved NANDA diagnostic stem.

A client hates her mother because of childhood neglect. The nurse determines which client statement represents the use of the defense mechanism of reaction formation? a)"I don't like to talk about my relationship with my mother." b)"My mother hates me." c)"I have a very wonderful mother whom I love very much." d)"My mom always loved my sister more than she loved me."

C - The client hides her negative unacceptable feelings by the exaggerated expression of positive feelings. This is an example of the defense mechanism of reaction formation

Anna states that Lucky was her closest friend, and since his death, there is no one who could ever replace the relationship they had. According to Maslow's hierarchy of needs, which level of need is not being met? a. physiological b. self-esteem c. safety and security d. love and belonging

D

Anna's dog Lucky got away from her while they were taking a walk. He ran into the street and was hit by a car. Anna cannot remember any of these circumstances of his death. This is an example of what defense mechanism? a. Rationalization b. Suppression c. Denial d. Repression

D

Education for the client who is taking MAOIs should include which of the following? a. Fluid and sodium replacement when appropriate, frequent drug blood levels, signs, and symptoms of toxicity b. Lifetime of continuous use, possible tardive dyskinesia, advantages of an injection every 2 to 4 weeks c. Short-term use, possible tolerance to beneficial effects, careful tapering of the drug at end of treatment d. Tyramine-restricted diet, prohibitive concurrent use of over-the-counter medications without physician notification

D

Education for the client who is taking MAOIs should include which of the following? a. Fluid and sodium replacement when appropriate, frequent drug blood levels, signs and symptoms of toxicity. b. Lifetime of continuous use, possible tardive dyskinesia, advantages of an injection every 2 to 4 weeks. c. Short-term use, possible tolerance to beneficial effects, careful tapering of the drug at end of treatment. d. tyramine-restricted diet, prohibitive concurrent use of over the counter medications without physician notification.

D

John is a client at the mental health clinic. He is depressed, has been expressing suicidal ideations, and has been seeing the psychiatric nurse every 3 days. He has been taking 100 mg of sertraline daily for about a month, receiving small amounts of the medication from his nurse at each visit. Today he comes tot he clinic in a cheerful mood, much different than he seemed just 3 days ago. How might the nurse assess this behavioral change? a. The sertraline is finally taking effect b. He is no longer in need of antidepressant medication c. He has completed the grief response over loss of his wife d. He may have decided to carry out his suicide plan

D

S.T. is a 15 year old girl who has just been admitted to the adolescent psychiatric unit with a diagnosis of Anorexia Nervosa. she is 5'5'' tall and weighs 82 lbs. She was elected to the cheerleading for the fall but states that she is not as good as the others on the squad. The treatment team has identified the following problems: refusal to eat, occasional purging, refusing to interact with staff and peers, and fear of failure. Which of the following nursing diagnoses would be the priority diagnosis for S.T.? a. social isolation b. disturbed body image c. low self-esteem d. imbalanced nutrition: less than body requirements

D

The nurse is using nursing process to care for a suicidal client. which of the following nursing actions is a part of the outcome identification step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the client b. Determines if nursing interventions have been appropriate to achieve desired results c. Obtains a short-term contract from the client to seek out staff if feeling suicidal d. Establishes goal of care: client will not harm self during hospitalization

D

Which of the following parts of the brain is associated with the multiple feelings and behaviors and is sometimes referred to as the emotional brain? a. frontal lobe b. thalamus c. hypothalamus d. limbic system

D

which of the following parts of the brain is concerned with the visual reception and interpretation? a. frontal lobe b. parietal lobe c. temporal lobe d. occipital lobe

D

Mental Illness

maladaptive responses to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are incongruent with the local and cultural norms and interfere with the individual's social, occupational, or physical functioning

Mental Health

the successful adaptation to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are age-appropriate and congruent with local and cultural norms