PYCH SOC (textbook questions)

A pregnant woman is in a relationship with a male who routinely abuses her. Her unborn child may engage in high-risk behavior as a teen as a result of: a. Maternal stress b. Parental nurturing c. Appropriate stress responses in the brain d. Memories of the abuse [trauma, stressor-related, and dissociative disorders]

a. Maternal stress

Which racial identification places a woman at the greatest risk of being sexually assaulted in her lifetime? a. Multiracial b. American Indian c. Black non-Hispanic d. Caucasian [sexual assault]

a. Multiracial

According to Maslow's hierarchy of needs, the most basic needs category for nurses to address is: a. physiological b. safety c. love and belonging d. self-actualization [theories and therapies]

a. physiological

The nurse is providing care for a patient demonstrating behaviors associated with moderate levels of anxiety. What question should the nurse ask initially when attempting to help the patient deescalate their anxiety? a. "Do you know what will help you manage your anxiety?" b. "Do you need help to manage your anxiety?" c. "Can you identify what was happening when your anxiety began to increase?" d. "Are you feeling anxious right now?" [anxiety and OCD]

c. "Can you identify what was happening when your anxiety began to increase?"

The patient you are assigned unexpectedly suffers a cardiac arrest. During this emergency situation, your body will produce a large amount of: a. carbon dioxide. b. growth hormone. c. epinephrine d. aldosterone [stress response]

c. epinephrine

Terry is a young male in a chemical dependency program. Recently he has become increasingly distracted and disengaged. The nurse concludes that Terry is: a. Bored b. Depressed c. Bipolar d. Not ready to change [substance related and addictive disorders]

d. Not ready to change

Which patient statement indicates the helpfulness of the nurse-patient relationship? a. "I appreciate the time you spent with me. I have a better understanding of what I can do to manage my problem." b. "I really need to talk with you. You always give me good advice about how to address my anger issues." c. "If it wasn't for you and the hours we've spent talking, I don't think I would be on my way to getting my anxiety under control." d. "You always showed me sympathy when I was at my lowest point after the sexual assault. Knowing you had been there too was such a help." [crisis]

a. "I appreciate the time you spent with me. I have a better understanding of what I can do to manage my problem."

Which statement made by the patient demonstrates an understanding of the treatment of choice for patients managing the effects of traumatic events? a. "I attend my therapy sessions regularly." b. "Those intrusive memories are hidden for a reason and should stay hidden." c. "Keeping busy is the key to getting mentally healthy." d. "I've agreed to move in with my parents so I'll get the support I need." [trauma, stressor-related, and dissociative disorders]

a. "I attend my therapy sessions regularly."

Which statement made by a widow demonstrates that her grief work has been effective? Select all that apply. a. "I can remember how much my deceased husband loved chocolate chip ice cream." b. "Painting is my new passion, and I really enjoy learning the various strokes." c. "Jim could be very stubborn when he thought he was right." d. "I don't know why he had to die." e. "I just can't believe he's gone." [death & dying]

a. "I can remember how much my deceased husband loved chocolate chip ice cream." b. "Painting is my new passion, and I really enjoy learning the various strokes." c. "Jim could be very stubborn when he thought he was right."

Which statement made by a patient demonstrates a healthy degree of resilience? Select all that apply. a. "I try to remember not to take other people's bad moods personally." b. "I know that if I get really mad I'll end up being depressed." c. "I really feel that sometimes bad things are meant to happen." d. "I've learned to calm down before trying to defend my opinions." e. "I know that discussing issues with my boss would help me get my point across." [mental health and illness]

a. "I try to remember not to take other people's bad moods personally." d. "I've learned to calm down before trying to defend my opinions." e. "I know that discussing issues with my boss would help me get my point across."

Mary is a 39-year-old attending a psychiatric outpatient clinic. Mary believes that her husband, sister, and son cause her problems. Listening to Mary describe the problems the nurse displays therapeutic communication in which response? a. "I understand you are in a difficult situation." b. "Thinking about being wronged repeatedly does more harm than good." c. "I feel bad about your situation, and I am so sorry it is happening to you and your family." d. "It must be so difficult to live with uncaring people." [therapeutic relationships]

a. "I understand you are in a difficult situation."

You are working at a telephone hotline center when Abby, a rape victim, calls. Abby states she is afraid to go to the hospital. What is your best response? a. "I'm here to listen, and we can talk about your feelings." b. "You don't need to go to the hospital if you don't want to." c. "If you don't go to the hospital, we can't collect evidence to help convict your rapist." d. "Why are you afraid to seek medical attention?" [sexual assault]

a. "I'm here to listen, and we can talk about your feelings."

The patient expresses sadness at "being all alone with no one to share my life with." Which response by the nurse demonstrates the existence of a therapeutic relationship? a. "Loneliness can be a very painful and difficult emotion." b. "Let's talk and see if you and I have any interests in common." c. "I use Facebook to find people who share my love of cooking." d. "Loneliness is managed by getting involved with people." [therapeutic relationships]

a. "Loneliness can be a very painful and difficult emotion."

Which statement made by the patient demonstrates an understanding of the foundational principle of integrative care? a. "My body has the ability to heal itself if we have the knowledge to give it the right tools." b. "The integrative care I'm getting is primarily a combination of complementary, alternative, and mainstream medicines." c. "Much of the knowledge that integrative care is based on comes from Western cultural traditions." d. "The most important focus of my integrative care is the cure of my cardiac illness." [integrative care]

a. "My body has the ability to heal itself if we have the knowledge to give it the right tools."

Which patient statement demonstrates a value held regarding children? a. "Nothing is more important to me than the safety of my children." b. "I believe my spouse wants to leave both me and our children." c. "I don't think my child's success depends on going to college." d. "I know my children will help me through my hard times." [therapeutic relationships]

a. "Nothing is more important to me than the safety of my children."

Which statement made by a family member tends to support a diagnosis of delirium rather than dementia? a. "She was fine last night but this morning she was confused." b. "Dad doesn't seem to recognize us anymore." c. "She's convinced that snakes come into her room at night." d. "He can't remember when to take his pills or whether he's bathed." [neurocognitive disorders]

a. "She was fine last night but this morning she was confused."

Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the patient states, "I don't need to come see you anymore. I have found a therapy app on my phone that I love." How should Carolina respond to this news? a. "That sounds exciting, would you be willing to visit and show me the app?" b. "At this time, there is no real evidence that the app can replace our therapy." c. "I am not sure that is a good idea right now, we are so close to progress." d. "Why would you think that is a better option than meeting with me?" [communication]

a. "That sounds exciting, would you be willing to visit and show me the app?"

Which statement made to the grieving patient demonstrates effective therapeutic communication? Select all that apply. a. "Your loved one was irreplaceably special." b. "It must be comforting to know they are with God now." c. "You can be very grateful for the time you had together." d. "I would like to take the flowers from the funeral home to your house." e. "Your loss must be devastating. I can't imagine how you must be feeling right now." [death & dying]

a. "Your loved one was irreplaceably special." d. "I would like to take the flowers from the funeral home to your house." e. "Your loss must be devastating. I can't imagine how you must be feeling right now."

When considering community suicide prevention programs, what population should the nurse plan to service with regular suicide screenings? Select all that apply. a. 10- to 34-year-olds b. Males c. College-educated adults d. Rural population e. Native American [suicide and nonsuicidal self-injury]

a. 10- to 34-year-olds b. Males e. Native American

Which statement about crisis theory will provide a basis for nursing intervention? a. A crisis is an acute time-limited phenomenon experienced as an overwhelming emotional reaction to a problem perceived as unsolvable. b. A person in crisis has always had adjustment problems and has coped inadequately in the usual life situations. c. Crisis is precipitated by an event that enhances a person's self-concept and self-esteem. d. Nursing intervention in crisis situations rarely has the effect of stopping the crisis. [crisis]

a. A crisis is an acute time-limited phenomenon experienced as an overwhelming emotional reaction to a problem perceived as unsolvable.

Which statement concerning a crisis experience is true and should be used as a guideline for crisis management care? Select all that apply. a. A crisis is self-limiting and usually resolves within 4 to 6 weeks. b. The earlier interventions are implemented, the better the expected prognosis. c. The nurse should maintain a nondirective role. d. The patient in crisis is assumed to be mentally unhealthy and in an extreme state of disequilibrium. e. The goal of crisis management is to return the patient to at least the precrisis level of functioning.[crisis]

a. A crisis is self-limiting and usually resolves within 4 to 6 weeks. b. The earlier interventions are implemented, the better the expected prognosis. e. The goal of crisis management is to return the patient to at least the precrisis level of functioning.

A young child is found wandering alone at a mall. A male store employee approaches and asks where her parents are. She responds, "I don't know. Maybe you will take me home with you?" This sort of response in children may be due to: a. A lack of bonding as an infant b. A healthy confidence in the child c. Adequate parental bonding d. Normal parenting [trauma, stressor-related, and dissociative disorders]

a. A lack of bonding as an infant

Holly is a 53-year-old female with terminal breast cancer. Holly's nurse in the hospital brings up the subject of hospice care. Holly becomes upset and states, "I am not ready to give up and die." You respond that hospice is: a. A model of healthcare that emphasizes quality of life for you and your family. b. The end of curative treatments and pain management. c. A multidisciplinary team providing curative and therapeutic treatment. d. An aggressive medical plan to end suffering and hasten death. [death & dying]

a. A model of healthcare that emphasizes quality of life for you and your family.

Which belief would be least helpful for a nurse working in crisis intervention? a. A person in crisis is incapable of responding to instruction. b. The crisis counseling relationship is one between partners. c. Crisis counseling helps the patient refocus to gain new perspectives on the situation. d. Anxiety-reduction techniques are used so the patient's inner resources can be accessed. [crisis]

a. A person in crisis is incapable of responding to instruction.

Which interventions will help make the environment on the unit safer for suicidal patients? Select all that apply. a. All windows are kept locked. b. Every shower has a breakaway shower rod. c. Eating utensils are counted when trays are collected. d. Patient doors are kept open. e. Staying within listening distance of the patient. [suicide and nonsuicidal self-injury]

a. All windows are kept locked. b. Every shower has a breakaway shower rod. c. Eating utensils are counted when trays are collected. d. Patient doors are kept open.

Which individuals are most at risk for displaying aggressive behavior? Select all that apply. a. An adolescent embarrassed in front of friends. b. A young male who feels rejected by the social group. c. A young adult depressed after the death of a friend. d. A middle-aged adult who feels that concerns are going unheard. e. A patient who was discovered telling a lie. [anger, aggression, violence]

a. An adolescent embarrassed in front of friends. b. A young male who feels rejected by the social group. d. A middle-aged adult who feels that concerns are going unheard. e. A patient who was discovered telling a lie.

Twenty-four-hour observation is a good choice for restraint in which of the following patients? a. An inmate with suicidal ideation on hospice care b. A sex offender in the psychiatric intensive care unit c. An aggressive female with antisocial personality disorder d. An inmate diagnosed with paranoid schizophrenia [anger, aggression, violence]

a. An inmate with suicidal ideation on hospice care

Which intervention(s) should the nurse implement when helping a patient expresses anger in an inappropriate manner? Select all that apply. a. Approach the patient in a calm, reassuring manner. b. Provide suggestions regarding acceptable ways of communicating anger. c. Warn the patient that being angry is not a healthy emotional state. d. Set limits on the angry behavior that will be tolerated. e. Allow any expression of anger as long as no one is hurt. [anger, aggression, violence]

a. Approach the patient in a calm, reassuring manner. b. Provide suggestions regarding acceptable ways of communicating anger. d. Set limits on the angry behavior that will be tolerated.

A nursing student in her last semester has increasing test anxiety. Her professor suggests the student try some integrative therapies. The student reported successful test anxiety reduction with which of the following therapies? a. Aromatherapy and breathing exercises b. Megavitamin therapy and yoga c. Naturopathy d. Reiki [integrative care]

a. Aromatherapy and breathing exercises

During an admission assessment and interview, which channels of information communication should the nurse be monitoring? Select all that apply. a. Auditory b. Visual c. Written d. Tactile e. Olfactory [communication]

a. Auditory b. Visual d. Tactile e. Olfactory

The activity of gamma-aminobutyric acid (GABA) contributes to a slowing of neural activity. Which of the following drugs facilitates the action of GABA? a. Benzodiazepines b. Antihistamines c. Anticonvulsants d. Noradrenergic [anxiety and OCD]

a. Benzodiazepines

Which nursing assessments are directed at monitoring a patient's fight-or-flight response? Select all that apply. a. Blood pressure b. Heart rate c. Respiratory rate d. Abdominal pain e. Dilated pupils [stress response]

a. Blood pressure b. Heart rate c. Respiratory rate e. Dilated pupils

When should a nurse be most alert to the possibility of communication errors resulting in harm to the patient? a. Change of shift report b. Admission interviews c. One-to-one conversations with patients d. Conversations with patient families [communication]

a. Change of shift report

The use of a patient-centered interview technique works well for gathering information about abusive situations. It is a good use of clinical time to sit near the patient and: a. Establish trust and rapport b. Ask lots of questions c. Interrupt the patients' story to allow for decompression d. Utilize closed-ended questions [abuse]

a. Establish trust and rapport

Which patient has an increased risk for the development of anxiety and will require frequent assessment by the nurse? Select all that apply. a. Exacerbation of asthma signs and symptoms b. History of peanut and strawberry allergies c. History of chronic obstructive pulmonary disease d. Current treatment for unstable angina pectoris e. History of a traumatic brain injury [anxiety and OCD]

a. Exacerbation of asthma signs and symptomsc. History of chronic obstructive pulmonary disease d. Current treatment for unstable angina pectoris e. History of a traumatic brain injury

Nurses caring for patients who have neurocognitive disorders are exposed to stress on many levels. Specialized skills training and continuing education are helpful to diffuse nursing stress, as well as: Select all that apply. a. Expressing emotions by journaling b. Describing stressful events on Facebook c. Engage in exercise and relaxation activities d. Having realistic patient expectations e. Happy hour after work to blow off steam [neurocognitive disorders]

a. Expressing emotions by journaling c. Engage in exercise and relaxation activities d. Having realistic patient expectations

Considering the subject of medically assisted death, which statements identify the pros and cons of the argument associated with the issue of nonmaleficence? Select all that apply. a. From the patient's perspective, there is no difference between ending life by providing a lethal prescription and by stopping treatment that prolongs life. b. Assisted death violates the oath to "do no harm" and destroys trust between patient and nurse. c. There is equal protection under the law that allows the right to refuse or withdraw treatment and to commit suicide. d. Every competent person has the right to make decisions based on personal convictions. e. Human beings are the stewards but not the absolute masters of the gift of life. [death & dying]

a. From the patient's perspective, there is no difference between ending life by providing a lethal prescription and by stopping treatment that prolongs life. b. Assisted death violates the oath to "do no harm" and destroys trust between patient and nurse.

The older patient is discussing chronic pain and asks the primary care provider for a prescription. Which medication should the nurse anticipate being ordered rather than an opioid? a. Gabapentin b. Acetaminophen c. Morphine d. Fentanyl [older adult]

a. Gabapentin

Perpetrators of domestic violence tend to: Select all that apply. a. Have relatively poor social skills and to have grown up with poor role models. b. Believe they, if male, should be dominant and in charge in relationships. c. Force their mates to work and expect them to handle the financial decisions. d. Be controlling and willing to use force to maintain their power in relationships. e. Prevent their mates from having relationships and activities outside the family. [abuse]

a. Have relatively poor social skills and to have grown up with poor role models. b. Believe they, if male, should be dominant and in charge in relationships. d. Be controlling and willing to use force to maintain their power in relationships. e. Prevent their mates from having relationships and activities outside the family.

What is the rationale for providing a patient diagnosed with dementia easily accessible finger foods thorough the day? a. Increases input throughout the day b. The person may be anorexic c. Assists with monitoring food intake d. Helps prevent constipation [neurocognitive disorders]

a. Increases input throughout the day

What side effects should the nurse monitor for when caring for a patient prescribed donepezil (Aricept)? Select all that apply. a. Insomnia b. Constipation c. Bradycardia d. Signs of dizziness e. Reports of headache [neurocognitive disorders]

a. Insomnia c. Bradycardia d. Signs of dizziness e. Reports of headache

What are the nursing responsibilities to a patient expressing suicidal thoughts? Select all that apply. a. Instituting one-to-one observation. b. Documenting the patient's whereabouts and mood every 15 to 30 minutes. c. Ensuring that the patient has no contact with glass or metal utensils. d. Ensuring that patient has swallowed each individual dose of medication. e. Discussing triggers of depression. [suicide and nonsuicidal self-injury]

a. Instituting one-to-one observation. b. Documenting the patient's whereabouts and mood every 15 to 30 minutes. c. Ensuring that the patient has no contact with glass or metal utensils. d. Ensuring that patient has swallowed each individual dose of medication.

A patient with a history of alcohol use disorder has been prescribed disulfiram (Antabuse). Which physical effects support the suspicion that the patient has relapsed? Select all that apply. a. Intense nausea b. Diaphoresis c. Acute paranoia d. Confusion e. Dyspnea [substance related and addictive disorders]

a. Intense nausea b. Diaphoresis d. Confusion e. Dyspnea

Which guidelines should direct nursing care when deescalating an angry patient? Select all that apply. a. Intervene as quickly as possible b. Identify the trigger for the anger c. Behave calmly and respectfully d. Recognize the patient's need for increased personal space e. Demands are agreed to as long as they won't result in harm to anyone [anger, aggression, violence]

a. Intervene as quickly as possible b. Identify the trigger for the anger c. Behave calmly and respectfully d. Recognize the patient's need for increased personal space

When considering the goals of complementary and alternative medicines, which patient would be of particular interest to researchers studying advances in symptom management? a. One who experiences chronic pain related to a neck injury b. A patient diagnosed with an acute gastrointestinal infection c. A pregnant woman diagnosed with gestational diabetes d. A child requiring surgery for a clubbed foot [integrative care]

a. One who experiences chronic pain related to a neck injury

Which signs and symptoms are associated with acute stress disorder and often observed in patients who have been sexually assaulted? Select all that apply. a. Outbursts of anger b. Depression c. Auditory hallucinations d. Flashbacks e. Amnesia for the event [sexual assault]

a. Outbursts of anger b. Depression d. Flashbacks e. Amnesia for the event

What principle about nurse-patient communication should guide a nurse's fear about "saying the wrong thing" to a patient? a. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation. b. The patient is more interested in talking to you than listening to what you have to say and so is not likely to be offended. c. Considering the patient's history, there is little chance that the comment will do any actual harm. d. Most people with a mentally illness have by necessity developed a high tolerance of forgiveness. [communication]

a. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.

Which problem is observed in children who regularly witness acts of violence in their family? Select all that apply. a. Phobias b. Low self-esteem c. Major depressive disorder d. Narcissistic personality disorder e. Posttraumatic stress disorder [abuse]

a. Phobias b. Low self-esteem c. Major depressive disorder e. Posttraumatic stress disorder

Which assessment data confirm the suspicion that a patient is experiencing opioid withdrawal? Select all that apply. a. Pupils are dilated b. Pulse rate is 62 beats/min c. Slow movements d. Extreme anxiety e. Sleepy [substance related and addictive disorders]

a. Pupils are dilated d. Extreme anxiety

When responding to the patient in question 7, the intervention that takes priority is to: a. Reduce anxiety. b. Arrange shelter. c. Contact out-of-area family. d. Hospitalize and place the patient on suicide precautions.[crisis]

a. Reduce anxiety.

First responders and emergency department healthcare providers often use dark humor in an effort to: a. Reduce stress and anxiety b. Relive the experience c. Rectify moral distress d. Alert others to the stress [stress response]

a. Reduce stress and anxiety

In a parent teacher conference, the school nurse meets with the parents of a profoundly shy 8- year-old girl. The parents hold hands, speak softly, respond briefly, and have poor eye contact. The nurse recognizes that the child is most likely exposed to parental modeling and: a. The inherited shyness trait b. A lack of affection in the home c. Severe punishment by the parents d. Is afraid to say something foolish [anxiety and OCD]

a. The inherited shyness trait

The nurse is assisting a patient to identify safety issues that may occur now that she has left an abusive partner. What telephone numbers should be available to the patient? Select all that apply. a. The police department b. An abuse hotline c. A responsible friend or family member d. A domestic violence shelter e. The hospital emergency department [abuse]

a. The police department b. An abuse hotline c. A responsible friend or family member d. A domestic violence shelter

When discussing therapy options, the nurse should provide information about interpersonal therapy to which patient? Select all that apply. a. The teenager who is the focus of bullying at school b. The older woman who has just lost her life partner to cancer c. The young adult who has begun demonstrating hoarding tendencies d. The adolescent demonstrating aggressive verbal and physical tendencies e. The middle-aged adult who recently discovered her partner has been unfaithful [theories and therapies]

a. The teenager who is the focus of bullying at school b. The older woman who has just lost her life partner to cancer e. The middle-aged adult who recently discovered her partner has been unfaithful

A bereavement group run by a local hospice includes a woman who is distraught over her supervisor's death. The woman appears severely distressed. She has trouble functioning with activities of daily living and making the simplest of decisions. The group facilitator recognizes that this woman is suffering from disenfranchised grief after learning: a. The woman was in love with her married supervisor. b. She has not taken enough time off work to grieve properly. c. The supervisor died over a year ago. d. Her family is not involved enough to support her. [death & dying]

a. The woman was in love with her married supervisor.

A male patient reports to the nurse, "I'm told I have memories of childhood abuse stored in my unconscious mind. I want to work on this." Based on this statement, what information should the nurse provide the patient? a. To seek the help of a trained therapist to help uncover and deal with the trauma associated with those memories. b. How to use a defense mechanism such as suppression so that the memories will be less threatening. c. Psychodynamic therapy will allow the surfacing of those unconscious memories to occur in just a few sessions. d. Group sessions are valuable to identify underlying themes of the memories being suppressed.[theories and therapies]

a. To seek the help of a trained therapist to help uncover and deal with the trauma associated with those memories.

In an outpatient psychiatric clinic, a nurse notices that a newly admitted young male patient smiles when he sees her. One day the young man tells the nurse, "You are pretty like my mother." The nurse recognizes that the male is exhibiting: a. Transference b. Id expression c. Countertransference d. A cognitive distortion [theories and therapies]

a. Transference

A nurse named Darryl has been hired to work in a psychiatric intensive care unit. He has undergone training on recognizing escalating anger. Which statement indicates that he understands danger signs in regard to aggression? a. "I need to be aware of patients who are withdrawn and sitting alone." b. "An obvious change in behavior is a risk factor for aggression." c. "Patients who seek constant attention are more likely to be violent." d. "Patients who talk to themselves are the most dangerous." [anger, aggression, violence]

b. "An obvious change in behavior is a risk factor for aggression."

Which assessment question regarding a patient's report of pain demonstrates the nurse's attention to the principles of holistic nursing care? a. "When did your pain begin?" b. "Are you taking any herbal supplements for the pain?" c. "Has anyone else in your family ever experienced this kind of pain?" d. "How has the pain affected your daily ability to care for yourself?" [integrative care]

b. "Are you taking any herbal supplements for the pain?"

Which question is focused on the assessment of an individual's personal ability to manage stress? Select all that apply. a. "Have you ever been diagnosed with cancer?" b. "Do you engage in any hobbies now that you have retired?" c. "Have you been taking your antihypertensive medication as it is prescribed?" d. "Who can you rely on if you need help after you're discharged from the hospital?" e. "What do you do to help manage the demands of parenting a 4-year-old and a newborn?" [stress response]

b. "Do you engage in any hobbies now that you have retired?" d. "Who can you rely on if you need help after you're discharged from the hospital?" e. "What do you do to help manage the demands of parenting a 4-year-old and a newborn?"

Which question should the nurse ask when assessing for what Sullivan's Interpersonal Theory identifies as the most painful human condition? a. "Is self-esteem important to you?" b. "Do you think of yourself as being lonely?" c. "What do you do to manage your anxiety?" d. "Have you ever been diagnosed with depression?" [theories and therapies]

b. "Do you think of yourself as being lonely?"

Lester and Eileen have always enjoyed gambling. Lately, Eileen has discovered that their savings account is down by $50,000. Eileen insists that Lester undergo therapy for his gambling behavior. The nurse recognizes that Lester is making progress when he states: a. "I understand that I am a bad person for depleting our savings." b. "Gambling activates the reward pathways in my brain." c. "Gambling is the only thing that makes me feel alive." d. "We have always enjoyed gaming. I do not know why Eileen is so upset." [substance related and addictive disorders]

b. "Gambling activates the reward pathways in my brain."

Which patient statement does not demonstrate an understanding of a suicide safety plan? a. "I know that when I start thinking about my dad, I'm going to start thinking about killing myself." b. "Going for a really long, hard run helps clear my mind and stops the suicidal thoughts." c. "My sister is always there for me when I start getting suicidal." d. "I keep the suicide prevention phone number in my wallet." [suicide and nonsuicidal self-injury]

b. "Going for a really long, hard run helps clear my mind and stops the suicidal thoughts."

During an interview with a patient, which question asked of an older adult is associated with the Patient Self-Determination Act? a. "Who besides yourself may have access to your medical information?" b. "Have you discussed your end-of-life choices with your family or designated surrogate?" c. "Do you have the information you need to make an informed decision about your treatment?" d. "How can I help you feel comfortable about this interview and any decisions you need to make?" [older adult]

b. "Have you discussed your end-of-life choices with your family or designated surrogate?"

What assessment question is focused on identifying a long-term consequence of chronic stress on physical health? a. "Do you have any problems with sleeping well?" b. "How many infections have you experienced in the past 6 months?" c. "How much moderate exercise do you engage in on a regular basis?" d. "What management techniques to you regularly use to manage your stress?" [stress response]

b. "How many infections have you experienced in the past 6 months?"

Hugo has a fraternal twin named Franco who is unaffected by mental illness even though they were raised in the same dysfunctional household. Franco asks the nurse, "Why Hugo and not me?" The nurse replies: a. "Your father was probably less abusive to you." b. "Hugo likely has a genetic vulnerability." c. "You probably ignored the situation." d. "Hugo responded to perceived threats by focusing on an internal world." [stress response]

b. "Hugo likely has a genetic vulnerability."

Which statement made by a new mother should be explored further by the nurse? a. "I have three children, that's enough." b. "I think the baby cries just to make me angry." c. "I wish my husband could help more with the baby." d. "Babies are a blessing, but they are a lot of work." [abuse]

b. "I think the baby cries just to make me angry."

A newly admitted male patient has a long history of aggressive behavior toward staff. Which statement by the nurse demonstrates the need for more information about the use of restraint? a. "If his behavior warrants restraints, someone will stay with him the entire time he's restrained." b. "I'll call the primary provider and get an as needed (prn) seclusion/restraint order." c. "If he is restrained, be sure he is offered food and fluids regularly." d. "Remember that physical restraints are our last resort." [anger, aggression, violence]

b. "I'll call the primary provider and get an as needed (prn) seclusion/restraint order."

Which statement(s) made by the nurse demonstrates an understanding of the effective use of relaxation therapy for anxiety management? Select all that apply. a. "Relaxation therapy's main goal is to prevent exhaustion by removing muscle tension." b. "Muscle relaxation promotes the relaxation response." c. "Show me how you learned to deep breathe in yesterday's therapy session." d. "You've said that going to group makes you nervous so let's start relaxing now." e. "I've given you written descriptions of the various relaxation exercises for you to review." [anxiety and OCD]

b. "Muscle relaxation promotes the relaxation response." c. "Show me how you learned to deep breathe in yesterday's therapy session." d. "You've said that going to group makes you nervous so let's start relaxing now." e. "I've given you written descriptions of the various relaxation exercises for you to review."

Which statement by an older patient with a mild neurocognitive disorder demonstrates a safe response to beginning a new medication? a. "I read the information the pharmacist gave me when I got the prescription filled." b. "My daughter comes with me to appointments so that we get all the information we need." c. "I know I can call my doctor if I think of any questions later." d. "I always follow the instructions on the medication bottle." [older adult]

b. "My daughter comes with me to appointments so that we get all the information we need."

When considering stigmatization, which statement made by the nurse demonstrates a need for immediate intervention by the nurse manager? a. "Depression seems to be a real problem among the teenage population." b. "Myterm-13 experience has been that the Irish have a problem with alcohol use." c. "Women are at greater risk for developing suicidal thoughts then acting on them." d. "We've admitted several military veterans with posttraumatic stress disorder this month." [mental health and illness]

b. "Myterm-13 experience has been that the Irish have a problem with alcohol use."

Martin is a 23-year-old male with a new diagnosis of schizophrenia, and his family is receiving information from a home health nurse. The topic of education is suicide prevention, and the nurse recognizes effective teaching when the mother says: a. "Persons with schizophrenia rarely commit suicide." b. "Suicide risk is greatest in the first few years after diagnosis." c. "Suicide is not common in schizophrenia due to confusion." d. "Most persons diagnosed with schizophrenia die of suicide." [suicide and nonsuicidal self-injury]

b. "Suicide risk is greatest in the first few years after diagnosis."

Which statement made by a sexually assaulted patient strongly suggests the drug gamma- hydroxybutyrate acid (GHB) was involved in the attack? a. "I remember everything that happened, but felt too tired to fight back." b. "The drink I was given had a salty taste to it." c. "They tell me I was unconscious for 24 hours." d. "I heard that I was fighting the nursing staff and saying that they were trying to kill me." [sexual assault]

b. "The drink I was given had a salty taste to it."

Which statement made by a patient demonstrates acceptance of criteria required of hospice care? a. "I want my family to be with me." b. "There is no cure for my illness. I've accepted that." c. "It's important to me that I die in my own home." d. "I don't want my family to bear the burden of caring for me." [death & dying]

b. "There is no cure for my illness. I've accepted that."

Which statement made by the nurse demonstrates the best understanding of nonverbal communication? a. "The patient's verbal and nonverbal communication is often different." b. "When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response." c. "If a patient is slumped in the chair, I can be sure he's angry or depressed." d. "It's easier to understand verbal communication that nonverbal communication." [communication]

b. "When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response."

Which statement made by either the nurse or the patient demonstrates an ineffective patient- nurse relationship? a. "I've given a lot of thought about what triggers me to be so angry." b. "Why do you think it's acceptable for you to be so disrespectful to staff?" c. "Will your spouse be available to attend tomorrow's family group session?" d. "I wanted you to know that the medication seems to be helping me fell less anxious." [therapeutic relationships]

b. "Why do you think it's acceptable for you to be so disrespectful to staff?"

You have been working closely with a patient for the past month. Today he tells you he is looking forward to meeting with his new psychiatrist but frowns and avoids eye contact while reporting this to you. Which of the following responses would most likely be therapeutic? a. "A new psychiatrist is a chance to start fresh; I'm sure it will go well for you." b. "You say you look forward to the meeting, but you appear anxious or unhappy." c. "I notice that you frowned and avoided eye contact just now. Don't you feel well?" d. "I get the impression you don't really want to see your psychiatrist—can you tell me why?" [communication]

b. "You say you look forward to the meeting, but you appear anxious or unhappy."

Which factor is likely to attract a patient to complementary and alternative medicine? Select all that apply. a. This nonmainstream approach is always less expensive than conventional medical treatment. b. A desire to choose personal healthcare practices. c. Using these approaches carries a lower risk than many pharmaceuticals. d. Traditional medicine has been unsuccessful in providing effective treatment. e. Integrative medication practices tend to produce desired results more quickly than conventional practices. [integrative care]

b. A desire to choose personal healthcare practices. c. Using these approaches carries a lower risk than many pharmaceuticals. d. Traditional medicine has been unsuccessful in providing effective treatment.

Conversion disorder is described as an absence of a neurological diagnosis that manifests in neurological symptoms. Channeling of emotions, conflicts, and stressors into physical symptoms is thought to be the cause in conversion disorder. Which statement is true? a. People with conversion disorder are extremely upset about often dramatic symptoms. b. Abnormal patterns of cerebral activation have been found in individuals with conversion disorder. c. An organic cause is usually found in most cases of conversion disorder. d. Symptoms can be turned off and on depending on the patient's choice. [somatic symptom disorder]

b. Abnormal patterns of cerebral activation have been found in individuals with conversion disorder.

Lilly, a single mother of four, comes to the crisis center 24 hours after a fire in which all the houses within a one-block area were wiped out. All of Lilly's household goods and clothing were lost. Lilly has no other family in the area. Her efforts to mobilize assistance have been disorganized, and she is still without shelter. She is distraught and confused. You assess the situation as: a. A maturational crisis. b. An adventitious crisis. c. A crisis of confidence. d. An existential crisis. [crisis]

b. An adventitious crisis.

Marco, age 83, has dementia and difficulty feeding himself despite the fact that there is nothing wrong with his motor functions. Which term should the nurse use to document this finding? a. Aphasia b. Apraxia c. Agnosia d. Disinhibition anergia [older adult]

b. Apraxia

. Kara is a 23-year-old patient admitted with depression and suicidal ideation. Which intervention(s) would be therapeutic for Kara? Select all that apply. a. Focus primarily on developing solutions to the problems leading the patient to feel suicidal. b. Assess the patient thoroughly and reassess the patient at regular intervals as levels of risk fluctuate. c. Avoid talking about the suicidal ideation as this may increase the patient's risk for suicidal behavior. d. Meet regularly with the patient to provide opportunities for the patient to express and explore feelings. e. Administer antidepressant medications cautiously and conservatively because of their potential to increase the suicide risk in Kara's age group. f. Help the patient to identify positive self-attributes and to question negative self-perceptions that are unrealistic.[suicide and nonsuicidal self-injury]

b. Assess the patient thoroughly and reassess the patient at regular intervals as levels of risk fluctuate. d. Meet regularly with the patient to provide opportunities for the patient to express and explore feelings. e. Administer antidepressant medications cautiously and conservatively because of their potential to increase the suicide risk in Kara's age group. f. Help the patient to identify positive self-attributes and to question negative self-perceptions that are unrealistic.

The care plan of a patient diagnosed with a somatic disorder includes the nursing diagnosis ineffective coping. Which patient behavior demonstrates a successful outcome for that nursing diagnosis? a. Showers and dresses in clean clothes daily b. Calls a friend to talk when feeling lonely c. Spends more time talking about pain in her abdomen d. Maintains focus and concentration [somatic symptom disorder]

b. Calls a friend to talk when feeling lonely

Maxwell is a 30-year-old male who arrives at the emergency department stating, "I feel like I am having a stroke." During the intake assessment, the nurse discovers that Maxwell has been working for 36 hours straight without eating and has consumed eight double espresso drinks and 12 caffeinated sodas. The nurse suspects: a. Fluid overload b. Dehydration and caffeine overdose c. Benzodiazepine overdose d. Sleep deprivation syndrome [substance related and addictive disorders]

b. Dehydration and caffeine overdose

The dying patient with a neurocognitive disorder such as Alzheimer's disease is especially challenging to provide care for. They may have symptoms or pain that they are unable to adequately describe or define. Reversible conditions that respond to treatment that may affect level of consciousness, anxiety, or agitation include: a. Inability to communicate b. Distended bladder, constipation, or nausea c. Reduced urinary output d. Weakness due to the dying process [death & dying]

b. Distended bladder, constipation, or nausea

The nursing diagnosis ineffective denial is especially useful when working with substance use disorders and gambling. Which statements describe this diagnosis? Select all that apply. a. Reports inability to cope b. Does not perceive danger of substance use or gambling c. Minimizes symptoms d. Refuses healthcare attention e. Unable to admit impact of disease on life pattern [substance related and addictive disorders]

b. Does not perceive danger of substance use or gambling c. Minimizes symptoms d. Refuses healthcare attention e. Unable to admit impact of disease on life pattern

Secondary effects of abuse often manifest as arrested development in children due to the fact that: a. Coping is easier than emotional growth b. Energy for development is diverted to coping c. Children cannot differentiate love from abuse d. Abuse fosters a sense of belonging, even if dysfunctional [abuse]

b. Energy for development is diverted to coping

Which medication should the nurse be prepared to educate patients on when they are prescribed a selective serotonin reuptake inhibitor (SSRI) for panic attacks? a. Alprazolam (Xanax) b. Fluoxetine (Prozac) c. Clonazepam (Klonopin) d. Venlafaxine (Effexor) [anxiety and OCD]

b. Fluoxetine (Prozac)

Epidemiological studies contribute to improvements in care for individuals with mental disorders by: a. Providing information about effective nursing techniques. b. Identifying risk factors that contribute to the development of a disorder. c. Identifying individuals in the general population who will develop a specific disorder. d. Identifying which individuals will respond favorably to a specific treatment. [mental health and illness]

b. Identifying risk factors that contribute to the development of a disorder. d. Identifying which individuals will respond favorably to a specific treatment.

Hugo is 21 and diagnosed with schizophrenia. His history includes significant turmoil as child and adolescent. Hugo reports his father was abusive and routinely beat him, all of his siblings, and his mother. Hugo's early exposure to stress most likely: a. Made him resilient to stressful situations b. Increased his future vulnerability to psychiatric disorders c. Developed strong survival skills d. Shaped his nurturing nature[stress response]

b. Increased his future vulnerability to psychiatric disorders

Samantha is a new patient to the mental health clinic and is seeking assistance for what she describes as "severe anxiety." In addition to daily self-medicating with alcohol, Samantha describes long-term use of herbal kava. The nurse knows that kava is associated with inhibiting P450 and orders which of the following tests? a. Electrocardiogram b. Liver enzymes c. Glomerular filtration rate d. Complete blood count [anxiety and OCD]

b. Liver enzymes

A patient diagnosed with opioid use disorder has expressed a desire to enter into a rehabilitation program. What initial nursing intervention during the early days after admission will help ensure the patient's success? a. Restrict visitors to family members only. b. Manage the patient's withdrawal symptoms well. c. Provide the patient a low stimulus environment. d. Advocate for at least 3 months of treatment. [substance related and addictive disorders]

b. Manage the patient's withdrawal symptoms well.

When considering the pathophysiology responsible for both delirium and dementia, which intervention is appropriate for delirium specifically? a. Assist with needs related to nutrition, elimination, hydration, and personal hygiene. b. Monitor neurological status on an ongoing basis. c. Place identification bracelet on patient. d. Give one simple direction at a time in a respectful tone of voice. [neurocognitive disorders]

b. Monitor neurological status on an ongoing basis.

Which statement is an accurate depiction of sexual assault? a. Rape is a sexual act. b. Most rapes occur in the home. c. Rape is usually an impulsive act. d. Women are usually raped by strangers. [sexual assault]

b. Most rapes occur in the home.

You are caring for Ellie, age 91, whose provider has written a "DNR-CCO" order. Which nursing action would be appropriate if Ellie were to go into cardiac arrest? a. Immediately call for the code team b. Notify the attending physician and family of the change in status c. Administer prescribed medication morphine for pain control d. Initiate cardiopulmonary resuscitation [older adult]

b. Notify the attending physician and family of the change in status

Guadalupe is the matriarch of a large family. She is terminally ill and none of her family members know her end-of-life wishes. The best action for the nurse is to: a. Discuss durable power of attorney. b. Organize a family meeting with Guadalupe's permission to discuss her goals and wishes. c. Have a family meeting without Guadalupe so as not to upset her. d. Ask the doctor to tell Guadalupe that she is dying. [death & dying]

b. Organize a family meeting with Guadalupe's permission to discuss her goals and wishes.

Which patient outcome is directly associated with the goals of a therapeutic nurse-patient relationship? a. Patient will be respectful of other patients on the unit. b. Patient will identify suicidal feelings to staff whenever they occur. c. Patient will engage in at least one social interaction with the unit population daily. d. Patient will consume a daily diet to meet both nutritional and hydration needs. [therapeutic relationships]

b. Patient will identify suicidal feelings to staff whenever they occur.

The World Health Organization describes health as "a state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity." Which statement is true in regards to overall health? Select all that apply. a. There is no relationship between physical and mental health. b. Poor physical health can lead to mental distress and disorders. c. Poor mental health does not lead to physical illness. d. There is a strong relationship between physical health and mental health. e. Mental health needs take precedence over physical health needs. [mental health and illness]

b. Poor physical health can lead to mental distress and disorders. d. There is a strong relationship between physical health and mental health.

2. Recognizing the frequency of depression among the American population, the nurse should advocate for which mental health promotion intervention? a. Including discussions on depression as part of school health classes b. Providing regular depression screening for adolescent and teenage students c. Increasing the number of community-based depression hotlines available to the public d. Encouraging senior centers to provide information on accessing community depression resources [mental health and illness]

b. Providing regular depression screening for adolescent and teenage students

Reviewing prescription medications in the discharge instructions for a patient with a diagnosis of major depression, the nurse would caution the patient about which over-the-counter supplement(s)? Select all that apply. a. Fish oil b. SAMe c. St. John's wort d. Melatonin [integrative care]

b. SAMe d. Melatonin

A male patient frequently inquires about the female student nurse's boyfriend, social activities, and school experiences. Which is the best initial response by the student? a. The student requests assignment to a patient of the same gender as the student. b. She limits sharing personal information and stresses the patient-centered focus of the conversation. c. The student shares information to make the therapeutic relationship more equal. d. She explains that if he persists in focusing on her, she cannot work with him. [therapeutic relationships]

b. She limits sharing personal information and stresses the patient-centered focus of the conversation.

Which student behavior is consistent with therapeutic communication? a. Offering your opinion when asked to convey support. b. Summarizing the essence of the patient's comments in your own words. c. Interrupting periods of silence before they become awkward for the patient. d. Telling the patient he did well when you approve of his statements or actions.[communication]

b. Summarizing the essence of the patient's comments in your own words.

Which of the following activities would be considered nursing care and appropriate to be performed by a basic level nurse for a patient suffering from mental illness? a. Treating major depression b. Teaching coping skills for a specific family dynamic c. Conducting psychotherapy d. Prescribing antidepressant medication [mental health and illness]

b. Teaching coping skills for a specific family dynamic

What situation associated with a caregiver presents the greatest risk that an older adult will experience abuse by that caregiver? a. The caregiver is a single male relative. b. The caregiver was neglected as a child. c. The caregiver is under the age of 30. d. The caregiver has little experience with the elderly. [abuse]

b. The caregiver was neglected as a child

Sigmund Freud, Karl Menninger, and Aaron Beck theorized that hopelessness was an integral part of why a person commits suicide. A more recent theory suggest suicide results from: a. Elevated serotonin levels b. The diathesis-stress model c. Outward aggression turned inward d. A lack of perfectionism [suicide and nonsuicidal self-injury]

b. The diathesis-stress model

An appropriate expected outcome in individual therapy regarding the perpetrator of abuse would be: a. A decrease in family interaction so that there are fewer opportunities for abuse to occur. b. The perpetrator will recognize destructive patterns of behavior and learn alternate responses. c. The perpetrator will no longer live with the family but have supervised contact while undergoing intensive inpatient therapy. d. A triad of treatment modalities, including medication, counseling, and role-playing opportunities. [abuse]

b. The perpetrator will recognize destructive patterns of behavior and learn alternate responses.

The abused person is often in a dependent position, relying on the abuser for basic needs. At particular risk are children and the elderly due to: a. The love they have for parents or children. b. Their limited options. c. The need to feel safe at home. d. Other relatives do not want them. [abuse]

b. Their limited options.

Lucas is a nurse on a medical floor caring for Kelly, a 48-year-old patient with newly diagnosed type 2 diabetes. He realizes that depression is a complicating factor in the patient's adjustment to her new diagnosis. What problem has the most potential to arise? a. Development of agoraphobia b. Treatment nonadherence c. Frequent hypoglycemic reactions d. Sleeping rather than checking blood sugar [somatic symptom disorder]

b. Treatment nonadherence

The care plan of a male patient diagnosed with a dissociative disorder includes the nursing diagnosis ineffective coping. Which behavior demonstrated by the patient supports this nursing diagnosis? a. Has no memory of the physical abuse he endured. b. Using both alcohol and marijuana. c. Often reports being unaware of surroundings. d. Reports feelings of "not really being here." [trauma, stressor-related, and dissociative disorders]

b. Using both alcohol and marijuana.

Anxiety problems in older adults can manifest as a fear of falling, greatly influencing an older adult's personal freedom. A home health nurse checking on a patient with mild dementia and anxiety related to falling should question which new order? a. Yoga and tai-chi b. Xanax c. Relaxation techniques d. Electric wheelchair [older adult]

b. Xanax

Which statement made by a nurse requires immediate correction by the supervisor? a. "Many older patients are depressed." b. "Retirement is a difficult time for older patients." c. "Cognitive decline is normal in patients who are 65 and older." d. "Sleep-related problems are often reported by older adults." [older adult]

c. "Cognitive decline is normal in patients who are 65 and older."

Gladys is seeing a therapist because her husband committed suicide 6 months ago. Gladys tells her therapist, "I know he was in pain, but why didn't he leave me a note?" The therapist's best response would be: a. "He probably acted quickly on his impulse to kill himself." b. "He did not want to think about the pain he would cause you." c. "He was not able to think clearly due to his emotional pain." d. "He thought you may think it was an accident if there was no note." [suicide and nonsuicidal self-injury]

c. "He was not able to think clearly due to his emotional pain."

Maggie, a child in protective custody, is found to have an imaginary friend, Holly. Her foster family shares this information with the nurse. The nurse teaches the family members about 653 children who have suffered trauma and knows her teaching was effective when the foster mother states: a. "I understand that imaginary friends are abnormal." b. "I understand that imaginary friends are a maladaptive behavior." c. "I understand that imaginary friends are a coping mechanism." d. "I understand that we should tell the child that imaginary friends are unacceptable." [trauma, stressor-related, and dissociative disorders]

c. "I understand that imaginary friends are a coping mechanism."

Which statement demonstrates the nurse's understanding of the effect of environmental factors on a patient's mental health? a. "I'll need to assess how the patient's family views mental illness." b. "There is a history of depression in the patient's extended family." c. "I'm not familiar with the patient's Japanese's cultural view on suicide." d. "The patient's ability to pay for mental health services needs to be assessed." [mental health and illness]

c. "I'm not familiar with the patient's Japanese's cultural view on suicide."

A patient is telling a tearful story. The nurse listens empathically and responds therapeutically with: a. "The next time you find yourself in a similar situation, please call me." b. "I am sorry this situation made you feel so badly. Would you like some tea?" c. "Let's devise a plan on how you will react next time in a similar situation." d. "I am sorry that your friend was so thoughtless. You should be treated better." [theories and therapies]

c. "Let's devise a plan on how you will react next time in a similar situation."

Isabel is a straight-A student, yet she suffers from severe test anxiety and seeks medical attention. The nurse interviews Isabel and develops a plan of care. The nurse recognizes effective teaching about mild anxiety when Isabel states: a. "I would like to try a benzodiazepine for my anxiety." b. "If I study harder, my anxiety level will go down." c. "Mild anxiety is okay because it helps me to focus." d. "I have fear that I will fail at college." [anxiety and OCD]

c. "Mild anxiety is okay because it helps me to focus."

A homebound patient diagnosed with agoraphobia has been receiving therapy in the home. The nurse evaluates patient teaching is effective when the patient states: a. "I may never leave the house again." b. "Having groceries delivered is very convenient." c. "My risk for agoraphobia is increased by my family history." d. "I will go out again, someday, just not today." [anxiety and OCD]

c. "My risk for agoraphobia is increased by my family history."

Morgan is a third-year nursing student in her psychiatric clinical rotation. She is assigned to an 80-year-old widow admitted for major depressive disorder. The patient describes many losses and sadness. Morgan becomes teary and says meaningfully, "I am so sorry for you." Morgan's instructor overhears the conversation and says, "I understand that getting tearful is a human response. Yet, sympathy isn't helpful in this field." The instructor urges Morgan to focus on: a. "Adopting the patient's sorrow as your own." b. "Maintaining pure objectivity." c. "Using empathy to demonstrate respect and validation of the patient's feelings." d. "Using touch to let her know that everything is going to be alright." [therapeutic relationships]

c. "Using empathy to demonstrate respect and validation of the patient's feelings."

Which statement made by the primary caregiver of a patient diagnosed with dementia demonstrates accurate understanding of providing the patient with a safe environment? a. "The local police know that he has wandered off before." b. "I keep the noise level low in the house." c. "We've installed locks on all the outside doors." d. "Our telephone number is always attached to the inside of his shirt pocket." [neurocognitive disorders]

c. "We've installed locks on all the outside doors."

James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for day shift and anxiously reports, "Last night, demons came to my room and tried to rape me." Which response would be most therapeutic? a. "There are no such things as demons. What you saw were hallucinations." b. "It is not possible for anyone to enter your room at night. You are safe here." c. "You seem very upset. Please tell me more about what you experienced last night." d. "That must have been very frightening, but we'll check on you at night and you'll be safe." [communication]

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

The nurse is caring for a patient who has a question about the safety of an herbal supplement. Which nursing response is best? a. "Herbal supplements are regulated by the FDA." b. "Natural ingredients in herbal supplements are harmless." c. "Your primary care provider needs to be aware of any supplements you take." d. "Marketing for herbal supplements demonstrates that all supplements are safe." [integrative care]

c. "Your primary care provider needs to be aware of any supplements you take."

You are caring for Yolanda, a 67-year-old patient who has been receiving hemodialysis for 3 months. Yolanda reports that she feels angry whenever it is time for her dialysis treatment. You attribute this to: a. Organic changes in Yolanda's brain b. A flaw in Yolanda's personality c. A normal response to grief and loss d. Denial of the reality of a poor prognosis [somatic symptom disorder]

c. A normal response to grief and loss

Nancy is a nurse. After talking with her mother, she became concerned enough to drive over and check on her. Her mother's appearance is disheveled, words are nonsensical, smells strongly of urine, and there is a stain on her dressing gown. Nancy recognizes that her mother's condition is likely temporary due to: a. Early onset dementia b. A mild cognitive disorder c. A urinary tract infection d. Skipping breakfast [neurocognitive disorders]

c. A urinary tract infection

In contrast to most Western medicine, integrative care takes into consideration: a. The physician's diagnosis and the patient's response b. The nurse's ideas about healing in addition to the physician c. A whole-person perspective: body, mind, and spirit d. The diagnosis before beginning spirit work [integrative care]

c. A whole-person perspective: body, mind, and spirit

Which person is at the highest risk for suicide? a. A 50-year-old married white male with depression who has a plan to overdose if circumstances at work do not improve. b. A 45-year-old married white female who recently lost her parents, suffers from bipolar disorder, and attempted suicide once as a teenager. c. A young single white male who is alcohol dependent, hopeless, impulsive, has just been rejected by his girlfriend, and has ready access to a gun he has hidden. d. An older Hispanic male who is Catholic, is living with a debilitating chronic illness, is recently widowed, and who states, "I wish that God would take me too." [suicide and nonsuicidal self-injury]

c. A young single white male who is alcohol dependent, hopeless, impulsive, has just been rejected by his girlfriend, and has ready access to a gun he has hidden.

During a routine health screening, a grieving widow whose husband died 15 months ago reports emptiness, a loss of self, difficulty thinking of the future, and anger at her dead husband. The nurse suggests bereavement counseling. The widow is most likely suffering from: a. Major depression b. Normal grieving c. Adjustment disorder d. Posttraumatic stress disorder [trauma, stressor-related, and dissociative disorders]

c. Adjustment disorder

The nurse is engaged in crisis intervention with a patient reporting, "I have no reason to keep on living." What is the nurse's initial intervention? a. Advise the patient about the services available to help them. b. Ask the patient, "Have you ever been this depressed before?" c. Ask the patient, "Do you have any plan to hurt yourself or anyone else?" d. Assure the patient that he or she is in a safe place and will be well cared for. [crisis]

c. Ask the patient, "Do you have any plan to hurt yourself or anyone else?"

A young woman named Carly was raped behind the restaurant where she works after closing shift. Six months have passed and Carly has not been able to return to work, refuses to go out to eat, and feels that she has less value as a woman now that she has been raped. Carly's clinical presentation suggests: a. Re-experiencing b. Hyperarousal c. Avoidance d. Physical effects [sexual assault]

c. Avoidance

Emily is a 28-year-old nurse who works on a psychiatric unit. She is assigned to work with Jenna, a 27-year-old who was admitted with major depressive disorder. Emily and Jenna realize that they graduated from the same high school and each has a 2-year-old daughter. Emily and Jenna discuss getting together for a play date with their daughters after Jenna is discharged. This situation reflects: a. Successful termination b. Promoting interdependence c. Boundary blurring d. A strong therapeutic relationship [therapeutic relationships]

c. Boundary blurring

An effective method of preventing escalation in an environment with violent offenders is to develop a level of trust through: a. A casual authoritative demeanor b. Keeping patients busy c. Brief, frequent, nonthreatening encounters d. Threats of seclusion or punishment [anger, aggression, violence]

c. Brief, frequent, nonthreatening encounters

Diane, a 63-year-old mother of three, was brought to the community psychiatric clinic. Diane and her son had a bitter fight over finances. Ever since Diane has been complaining of "a severe pain in my neck." She has seen several doctors who cannot find a physical basis for the pain. The nurse knows that: a. Showing concern for Diane's pain will increase her obsessional thinking. b. Diane's symptoms are manipulative and under conscious control. c. Diane believes there is a physical cause for the pain and will resist a psychological explanation. d. Diane is trying to make her son feel bad about the argument. [somatic symptom disorder]

c. Diane believes there is a physical cause for the pain and will resist a psychological explanation

A female nurse had been sexually assaulted as a teenager. She finds it difficult to work with patients who have undergone the same trauma. What is the most helpful response? a. Discussing these feelings with the nurse supervisor. b. Requesting that these patients not be a part of her patient assignment. c. Discussing these feelings with a mental health professional. d. Accepting her role in providing unbiased, respectful, and professional care to all patients. [crisis]

c. Discussing these feelings with a mental health professional.

Perpetrators of sexual assault are often incarcerated but frequently do not undergo therapy. Samuel, convicted of rape and sentenced to 15 years in prison, has requested to see a therapist. The psychiatric nurse practitioner is surprised to learn of the request as many perpetrators: a. Boast of their assault history b. Feel regret and remorse c. Do not acknowledge the need for change d. Are unable to recognize rape as a crime [sexual assault]

c. Do not acknowledge the need for change

Which statement accurately describes the effects of emotional trauma on the individual physically? a. Emotional trauma is a distinct category and unrelated to physical problems b. The physical manifestations of emotional trauma are usually temporary c. Emotional trauma is often manifested as physical symptoms d. Patients are more aware of the physical problems caused by trauma [trauma, stressor-related, and dissociative disorders]

c. Emotional trauma is often manifested as physical symptoms

John Patrick is a widower with four daughters. He has enjoyed a healthy relationship with all of them until they reached puberty. As each girl began to mature physically, he acted in an aggressive manner, beating her without provocation. John Patrick is most likely acting on: a. Self-protective measures b. Stress of raising four daughters c. Frustration of unhealthy desire d. Motivating his daughters to be chaste [anger, aggression, violence]

c. Frustration of unhealthy desire

Which goal should be addressed initially when providing care for 10-year-old Harper who is diagnosed with posttraumatic stress disorder (PTSD)? a. Harper will be able to identify feelings through the use of play therapy. b. Harper and her parents will have access to protective resources available through social services. c. Harper will demonstrate the effective use of relaxation techniques to restore a sense of control over disturbing thoughts. d. Harper and her parents will demonstrate an understanding of the personal human response to traumatic events. [trauma, stressor-related, and dissociative disorders]

c. Harper will demonstrate the effective use of relaxation techniques to restore a sense of control over disturbing thoughts.

When considering stress, what is the primary goal of making daily entries into a personal journal? a. Providing a distraction from the daily stress b. Expressing emotions to manage stress c. Identifying stress triggers d. Focusing on one's stress [stress response]

c. Identifying stress triggers

Which statement about mental illness is true? a. Mental illness is a matter of individual nonconformity with societal norms. b. Mental illness is present when irrational and illogical behavior occurs. c. Mental illness changes with culture, time in history, political systems, and the groups defining it. d. Mental illness is evaluated solely by considering individual control over behavior and appraisal of reality.[mental health and illness]

c. Mental illness changes with culture, time in history, political systems, and the groups defining it.

Your 39-year-old patient, Samantha, who was admitted with anxiety, asks you what the stress- relieving technique of mindfulness is. The best response is: a. Mindfulness is focusing on an object and repeating a word or phrase while deep breathing b. Mindfulness is progressively tensing, then relaxing, body muscles c. Mindfulness is focusing on the here and now, not the past or future, and paying attention to what is going on around you d. Mindfulness is a memory system to assist you in short-term memory recall [stress response]

c. Mindfulness is focusing on the here and now, not the past or future, and paying attention to what is going on around you

Donald, a 49-year-old male, is admitted for inpatient alcohol detoxification. He is cachexic, has multiple scabs on his arms and legs, and has lower extremity edema. An appropriate nursing diagnosis for Donald along with an expected outcome is: a. Risk for injury/Remains free from injury b. Ineffective denial/Accepts responsibility for behavior c. Nutrition: Less than body requirements/Maintains nutrient intake for metabolic needs d. Risk for suicide/Expresses feelings, plans for the future [substance related and addictive disorders]

c. Nutrition: Less than body requirements/Maintains nutrient intake for metabolic needs

When considering the suggestions of Hildegard Peplau, which activity should the nurse regularly engage in to ensure that the patient stays the focus of all therapeutic conversations? a. Assessing the patient for unexpressed concerns and fears b. Evaluating the possible need for additional training and education c. Reflecting on personal behaviors and personal needs d. Avoiding power struggles with the manipulative patient [theories and therapies]

c. Reflecting on personal behaviors and personal needs

A patient whose history includes experiences with abusive partners is being treated for major depressive disorder. The patient's care plan includes rape-trauma syndrome among its nursing diagnoses. What goal is directly associated with this diagnosis? a. Remains free from self-harm b. Wears appropriate clothing c. Reports feeling stronger and having a sense of hopefulness d. Demonstrates appropriate affect for both positive and negative emotions [crisis]

c. Reports feeling stronger and having a sense of hopefulness

Ron is a victim of assault and has revealed to his family and friends the fact that he was raped. The family reacts with horror and disgust, and the nurse caring for Ron recognizes: a. Ron's family is being judgmental. b. Ron's family should leave the hospital. c. Ron's family will also need support. d. Dysfunctional family dynamics. [sexual assault]

c. Ron's family will also need support.

A registered nurse is caring for an older male who reports depressive symptoms since his wife of 54 years died suddenly. He cries, maintains closed body posture, and avoids eye contact. Which nursing action describes attending behavior? a. Reminding the patient gently that he will "feel better over time" b. Using a soft tone of voice for questioning c. Sitting with the patient and taking cues for when to talk or when to remain silent d. Offering medication and bereavement services [therapeutic relationships]

c. Sitting with the patient and taking cues for when to talk or when to remain silent

What medication education should the nurse provide to a patient who has expressed an interest in taking St. John's wort? a. Allergic reactions to this herb are common. b. Due to liver toxicity, regular liver function test should be conducted while taking it. c. St. John's wort should not be taken in combination with antidepressants. d. This medication results in gastrointestinal symptoms including bleeding. [integrative care]

c. St. John's wort should not be taken in combination with antidepressants.

Which factor has the greatest influence on the hospice nurse's ability to provide respectful professional care? a. Acceptance that death is a natural part of life. b. Possession of excellent care giving nursing skills. c. The existence of a healthy, well-balanced personal life. d. The desire to work with both the patient and the family. [death & dying]

c. The existence of a healthy, well-balanced personal life.

Considering psychosocial role theory, which patient demonstrates healthy adjustment to aging? a. The 70-year-old who is training for a 5-mile running race b. The older adult who controls diabetes with diet and exercise c. The retiree who volunteers 3 days a week at the local library d. The 80-year-old who is upbeat and hopeful during chemotherapy for lung cancer [older adult]

c. The retiree who volunteers 3 days a week at the local library

Opioid use disorder is characterized by: a. Lack of withdrawal symptoms b. Intoxication symptoms of pupillary dilation, agitation, and insomnia c. Tolerance d. Requiring smaller amounts of the drug to achieve a high over time [substance related and addictive disorders]

c. Tolerance

Considering the guilt that women feel after being sexually assaulted, which nursing assessment question has priority? a. "Do you want the police to be called?" b. "Did you recognize the person who assaulted you?" c. "Do you have someone you trust that can stay with you?" d. "Do you have any thoughts about harming yourself?" [sexual assault]

d. "Do you have any thoughts about harming yourself?"

A patient asks the nurse if exercise and what she eats can impact her mood. The nurse's best response is which of the following? a. "There is no need to be concerned about exercise and nutrition if you take your antidepressant." b. "Limited studies are available on exercise and nutrition and mood." c. "Exercise is helpful, but you don't need to worry about nutrition." d. "Extensive research has shown that exercise and proper nutrition greatly improve mood symptoms." [integrative care]

d. "Extensive research has shown that exercise and proper nutrition greatly improve mood symptoms."

red is an older adult with spinal stenosis and who is being treated with a short-term prescription of opioids for an acute episode of back pain. His nurse recognizes additional teaching is necessary when Fred states: a. "Sitting up straight seems to reduce the pain." b. "Sometimes I use a heating pad on my back." c. "Once I get moving for the day my pain gets better." d. "My wife and I share my Norco for our aches and pains." [older adult]

d. "My wife and I share my Norco for our aches and pains."

Darnell is an 84-year-old widower who has lived alone since his wife died 6 years ago. A neighbor called Darnell's son to tell him that Darnell was trying to start his car from the passenger's side. He became angry and aggressive when the car would not start. After a medical assessment, Darnell was diagnosed with a major neurocognitive disorder. The nurse realized additional family teaching is necessary when Darnell's son states: a. "My father's diagnosis is interfering with his daily functioning." b. "This neurocognitive disorder will probably progress." c. "Advancing age is a risk factor in my father's diagnosis." d. "With person-centered care, my father will be able to remain in his home." [neurocognitive disorders]

d. "With person-centered care, my father will be able to remain in his home."

Which nursing statement is an example of reflection? a. "I think this feeling will pass." b. "So you are saying that life has no meaning." c. "I'm not sure I understand what you mean." d. "You look sad." [communication]

d. "You look sad."

An incest survivor undergoing treatment at the mental health clinic is relieved when she learns that her anxiety and depression are: a. Going to be eradicated with treatment b. Normal and will soon pass c. Abnormal but will pass d. A normal reaction to post traumatic events [trauma, stressor-related, and dissociative disorders]

d. A normal reaction to posttraumatic events

Which patient is at greatest risk for developing a stress- induced myocardial infarction? a. A patient who lost a child in an accidental shooting 24 hours ago b. A woman who has begun experiencing early signs of menopause c. A patient who has spent years trying to sustain a successful business d. A patient who was diagnosed with chronic depression 10 years ago [somatic symptom disorder]

d. A patient who was diagnosed with chronic depression 10 years ago

he school nurse has been alerted to the fact that an 8-year-old boy routinely playacts as a police officer "locking up" other children on the playground to the point where the children get scared. The nurse recognizes that this behavior is most likely an indication of: a. The need to dominate others b. Inventing traumatic events c. A need to develop close relationships d. A potential symptom of traumatization [trauma, stressor-related, and dissociative disorders]

d. A potential symptom of traumatization

Which action reflects therapeutic practices associated with operant conditioning? a. Encouraging a parent to read to their children to foster a love for learning b. Encouraging a patient to make daily journal entries describing their feelings c. Suggesting to a new mother that she spend time cuddling her newborn often during the day d. Acknowledging a patient who is often verbally aggressive for complimenting a picture another patient drew [theories and therapies]

d. Acknowledging a patient who is often verbally aggressive for complimenting a picture another patient drew

You are caring for Aaron, a 38-year-old patient diagnosed with somatic symptom disorder. When interacting with you, Aaron continues to focus on his severe headaches. In planning care for Aaron, which of the following interventions would be appropriate? a. Call for a family meeting with Aaron in attendance to confront Aaron regarding his diagnosis. b. Educate Aaron on alternative therapies to deal with pain. c. Improve reality testing by telling Aaron that you do not believe that the headaches are real. d. After a limited discussion of physical concerns, shift focus to feelings and effective coping skills. [somatic symptom disorder]

d. After a limited discussion of physical concerns, shift focus to feelings and effective coping skills.

The stress of being raped often results in suffering similar to people who have witnessed a murder or had a physiological reaction to trauma, resulting in: a. Posttraumatic stress disorder b. Anxiety c. Depression d. All of the above [sexual assault]

d. All of the above

In the 2 months after his wife's death, Aaron, aged 90 and in good health, has begun to pay less attention to his hygiene and seems less alert to his surroundings. He complains of difficulty concentrating and sleeping and reports that he lacks energy. His family sometimes has to remind and encourage him to shower, take his medications, and eat, all of which he then does. Which response is most appropriate? a. Reorient Mr. Smith by pointing out the day and date each time you have occasion to interact with him. b. Meet with family and support them to accept, anticipate, and prepare for the progression of his stage 2 dementia. c. Avoid touch and proximity; these are likely to be uncomfortable for Mr. Smith and may provoke aggression when he is disoriented. d. Arrange for an appointment with a therapist for evaluation and treatment of suspected depression. [neurocognitive disorders]

d. Arrange for an appointment with a therapist for evaluation and treatment of suspected depression.

Therapeutic communication is the foundation of a patient- centered interview. Which of the following techniques is not considered therapeutic? a. Restating b. Encouraging description of perception c. Summarizing d. Asking "why" questions [communication]

d. Asking "why" questions

Which comorbid condition would result in cautious use of a selective serotonin reuptake inhibitors for a patient with chronic aggression? a. Asthma b. Anxiety disorder c. Glaucoma d. Bipolar disorder [anger, aggression, violence]

d. Bipolar disorder

To maximize the therapeutic effect, which lifestyle practice should the nurse discourage for a patient who has been recently prescribed an antianxiety medication? a. Eating high protein foods. b. Using acetaminophen without first discussing it with a healthcare provider c. Taking medications after eating dinner or while having a bedtime snack d. Buying a large coffee with sugar and extra cream each morning on the way to work [anxiety and OCD]

d. Buying a large coffee with sugar and extra cream each morning on the way to work

A nurse is assessing a patient who graduated at the top of his class but now obsesses about being incompetent in his new job. The nurse recognizes that this patient may benefit from the following type of psychotherapy: a. Interpersonal b. Operant conditioning c. Behavioral d. Cognitive-behavioral [theories and therapies]

d. Cognitive-behavioral

What action should you take when a female staff member is demonstrating behaviors associated with a substance use disorder? a. Accompany the staff member when she is giving patient care. b. Offer to attend rehabilitation counseling with her. c. Refer her to a peer assistance program. d. Confront her about your concerns and/or report your concerns to a supervisor immediately. [substance related and addictive disorders]

d. Confront her about your concerns and/or report your concerns to a supervisor immediately.

Chronic obstructive pulmonary disease, spinal injury, seizure disorder, and pregnancy are conditions that: a. Frequently result in out of control behavior. b. Respond well to therapeutic holding. c. Necessitate the use of only two-point restraint. d. Contraindicate restraint and seclusion. [anger, aggression, violence]

d. Contraindicate restraint and seclusion.

A nursing student new to psychiatric-mental health nursing asks a peer what resources he can use to figure out which symptoms are present in a specific psychiatric disorder. The best answer would be: a. Nursing Interventions Classification (NIC) b. Nursing Outcomes Classification (NOC) c. NANDA-I nursing diagnoses d. DSM-5 [mental health and illness]

d. DSM-5

Ling works as a registered nurse in an Alzheimer's care home. Ling has a specialized rapport- building technique she uses called reminiscence. She uses this technique by: a. Telling the residents stories about her grandparents' lives. b. Playing music from the residents' formative years. c. Reviewing movies that the residents enjoy. d. Encouraging the residents to talk about pleasurable past events. [older adult]

d. Encouraging the residents to talk about pleasurable past events.

What precipitating emotional factor has been associated with an increased incidence of cancers? Select all that apply. a. Anxiety b. Job-related stress c. Acute grief d. Feelings of hopelessness and despair from depression e. Prolonged, intense stress [somatic symptom disorder]

d. Feelings of hopelessness and despair from depression e. Prolonged, intense stress

Living comfortable and materialistic lives in Western societies seems to have altered the original hierarchy proposed by Maslow in that: a. Once lower level needs are satisfied, no further growth feels necessary b. Self-actualization is easier to achieve with financial stability c. Esteem is more highly valued than safety d. Focusing on materialism reduces interests in love, belonging, and family [somatic symptom disorder]

d. Focusing on materialism reduces interests in love, belonging, and family

There is conflict surrounding the dying experience in modern medicine. The medical model of treatment in the United States has traditionally been focused on the prolongation of life. What intrinsic factor plays into this medical model? a. Healthcare works do not want their patients to die. b. Medicare is a fee-for-service model. c. Palliative care is expensive to administer. d. Keeping people alive as long as possible is the ethical thing to do. [death & dying]

d. Keeping people alive as long as possible is the ethical thing to do.

Research supports which intervention implemented on a long-term basis significantly reduces the incidence of suicide and suicide attempts in a patient diagnosed with bipolar disorder? a. A selective serotonin reuptake inhibitor (SSRI) b. Electroconvulsive therapy (ECT) c. One-on-one observation d. Lithium [suicide and nonsuicidal self-injury]

d. Lithium

The highest-priority goal of crisis intervention is: a. Anxiety reduction. b. Identification of situational supports. c. Teaching specific coping skills that are lacking. d. Patient safety. [crisis]

d. Patient safety.

Jackson has suffered from migraine headaches all of his life. Fatima, his nurse practitioner, suspects muscle tension as a trigger for his headaches. Fatima teaches him a technique that promotes relaxation by using: a. Biofeedback b. Guided imagery c. Deep breathing d. Progressive muscle relaxation [stress response]

d. Progressive muscle relaxation

What safety-related responsibility does the nurse have in any situation of suspected of abuse? a. Protect the patient from future abuse by the abuser. b. Inform the suspected abuser that the authorities have been notified. c. Arrange for counseling for all involved parties but especially the patient. d. Report suspected abuse to the proper authorities. [abuse]

d. Report suspected abuse to the proper authorities.

Ophelia, a 69-year-old retired nurse, attends a reunion of her former coworkers. Ophelia is concerned because she usually knows everyone, and she cannot recognize faces today. A registered nurse colleague recognizes Ophelia's distress and "introduces" Ophelia to those attending. The nurse practitioner recognizes that Ophelia seems to have a deficit in: a. Lower-level cognitive domain b. Delirium threshold c. Executive function d. Social cognition [neurocognitive disorders]

d. Social cognition

Linda is terrified of spiders and cannot explain why. Because she lives in a wooded area, she would like to overcome this overwhelming fear. Her nurse practitioner suggests which therapy? a. Behavioral b. Biofeedback c. Aversion d. Systematic desensitization [theories and therapies]

d. Systematic desensitization

What is the greatest trigger for the development of a patient's nurse focused transference? a. The similarity between the nurse and someone the patient already dislikes b. The nature of the patient's diagnosed mental illness c. The history the patient has with their parents d. The degree of authority the nurse has over the patient [therapeutic relationships]

d. The degree of authority the nurse has over the patient

When providing respectful, appropriate nursing care, how should the nurse identify the patient and his or her observable characteristics? a. The manic patient in room 234 b. The patient in room 234 is a manic c. The patient in room 234 is possibly a manic d. The patient in room 234 is displaying manic behavior [mental health and illness]

d. The patient in room 234 is displaying manic behavior