TEST 34 35
The nurse recognizes that researchers have identified that hereditary factors account for what percentage of mood disorders? 10% to 15% 20% to 30% 35% to 50% 60% to 80%
60% to 80%
When a patient is experiencing a panic attack, how should the nurse best assist the patient? -Assist with reality orientation. -Aid in decision making. -Assist with rational thought. -Coach in deep breathing.
-Coach in deep breathing.
The nurse alters the care plan for a patient with depression to include what type of activity? -Domino game with three other patients -Ping-Pong game with one other patient -Group outing to view wildflowers -Magazine to read alone
-Group outing to view wildflowers
A home health nurse has a patient who is taking lithium. What should be included in the teaching plan? -Examine her skin closely for eruptions. -Take her blood pressure twice a day to check for hypertension. -Have her drug blood level checked every month. -Avoid aged cheese and red wine.
-Have her drug blood level checked every month.
When the patient is told that his insurance will no longer pay for his physical therapy, the nurse is aware that this obstruction to his goal may result in which concept? a. Conflict b. Adaptation c. Frustration d. Anxiety
frustration
What is the prognosis for a schizophrenic patient who is exhibiting positive behaviors? a. Guarded b. Poor c. Good d. Repeatable
good
The nurse asks a patient with schizophrenia if he had any visitors on Sunday. Which response indicates loose association? - "No." - "Yes! I had 90 visitors who came from every state in the union." - "Sunday is the Sabbath. Do we have visitors on the Sabbath?" - "We visited Yellowstone Park last summer."
- "We visited Yellowstone Park last summer."
During the 17th and 18th centuries, care of patients with mental illness often was cruel. What type of care was used by Dr. Philippe Pinel to bring about change? - Personal care - Individual care - Behavior care - Humane care
- Humane care
Using Freud's personality theory, what action by a patient indicates a strong ego? - Laughs at himself for being foolish. - Continually boasts of his accomplishments. - Apologizes continually. - Insists that the TV channel stay tuned to CNN.
- Laughs at himself for being foolish.
When assisting the older adult who is despondent about the need to leave his home, what technique should the nurse use? - Ask him if he has a drinking problem. - Explore the option of his moving in with someone. - Reminisce with the patient and review his life. - Assess for hopelessness and helplessness.
- Reminisce with the patient and review his life.
The patient complains of recurrent, multiple physical ailments for which there is no organic cause. How should the nurse assess this? - Obsessive-compulsive disorder - Phobia anxiety disorder - Somatic symptom disorder - Delusional disorder
- Somatic symptom disorder
The nurse is caring for a patient with a diagnosis of catatonic schizophrenia. What behavior is consistent with this diagnosis? - Talks excitedly about going home. - Suspiciously watches the staff. - Stands on one foot for 15 minutes. - States he has a cat under his bed that talks to him.
- Stands on one foot for 15 minutes.
The patient is concerned about confidentiality and asks the nurse not to tell anyone what is said. What is the best response by the nurse? -"I am required to report any intent to hurt yourself or others." -"Conversations between patient and nurse are confidential." -"What we say can be secret. What I write in the chart is available to the health team." -"I can't help you unless you trust me."
-"I am required to report any intent to hurt yourself or others."
What action consistently done by a patient should indicate to a nurse that the patient has a poor self-concept? -Wears bright-colored clothing -Demands the attention of staff. -Apologizes to others repeatedly. -Becomes angry when frustrated.
-Apologizes to others repeatedly.
A nurse tearfully confides to the head nurse that being assigned to care for eight patients is stressful and overwhelming. What demonstrates the use of a healthy coping mechanism? -Writing down long lists of needed interventions before starting the day's work -Delegating appropriate care assignments to unlicensed assistive personnel -Asking a coworker to take one of her patients -Asking for the day off
-Delegating appropriate care assignments to unlicensed assistive personnel
The nurse cautions a patient to watch his step. What response indicates concrete thinking? -The patient fixedly begins to watch his feet. -The patient immediately examines his watch. -The patient begins to watch the nurse's feet. -The patient stands rigidly in one place without moving.
-The patient fixedly begins to watch his feet.
The nurse is discussing the differences between a patient with a neurosis and one with a psychosis. What is true of the patient experiencing a neurosis? -The patient experiences a flight from reality. -The patient usually needs hospitalization. -The patient has insight that there is an emotional problem. -The patient has severe personality deterioration.
-The patient has insight that there is an emotional problem
Which event in the mental health care movement occurred first? A. Establishment of Pennsylvania Hospital B. Deinstitutionalization movement C. Formation of Committee for Mental Health D. Passage of Omnibus Budget Reconciliation Act (OBRA) E. Dorothea Dix awakens public awareness of plight of mentally ill
A. Establishment of Pennsylvania Hospital
A profound, disabling mental illness is characterized by bizarre, nonreality thinking. What is the illness? Manic depressive Schizophrenia Paranoia Bipolar
Schizophrenia
. What disorder is a severe form of self-starvation that can lead to death? -Bulimia nervosa -Anorexia nervosa -Teenage nervosa - Obesity nervosa
Anorexia nervosa
The nurse is assessing a female patient who has become rapidly and exceedingly anxious because her fingernail polish is chipped. What type of anxiety should the nurse conclude that the patient is exhibiting? -Signal anxiety -General anxiety -Anxiety traits -Panic disorder
Anxiety traits
The patient talks with his dead brother and arranges furniture so that his brother will have a place to sit. How should the nurse document this behavior? Disordered thinking Anhedonia Hallucination Alogia
Hallucination
How many people in the United States will develop a mental disorder during their lifetime?
One in two
A 14-year-old survivor of a school shooting screams and dives under a table when firecrackers go off. What does this behavior represent? - Phobia - Posttraumatic stress disorder - Obsessive-compulsive disorder - Disordered thinking
PTSD
The majority of people function in a relatively healthy manner. What can diminish their functional capacity? - Lack of a support system - Periods of crisis - Nutritional deficits - A physical disease process
Periods of crisis
A variety of factors influence the level of anxiety experienced by the patient faced by a stressful situation. Which would the nurse outline? (Select all that apply.) -How others perceive the event -The number of stressors present at one time -Degree of change the stressors require -Present role assumption -Previous experience with a similar situation
b c d e
Why is it important for the nurse to be observant of patient behavior? Behavior is preformed. Behavior is important. Behavior is learned. Behavior is repeated.
behavior is learned
For the past 3 weeks, the nurse has observed a patient interacting with staff and other patients, helping decorate the dining room for a party, and leading the singing in the activity room. Today, the patient tearfully refuses to dress or get out of bed. The nurse recognizes these behaviors as evidence of which psychiatric disorder? Unipolar depression Dysthymic disorder Hypomanic episode Bipolar disorder
bipolar disorder
The nurse uses a diagram to show how the four parts of "self" fit together. What are the four parts? (Select all that apply.) Body image Ego Self-esteem Role Identity
body image self esteem role identity
A patient who is taking a monoamine oxidase inhibitor (MAOI) asks the nurse about the addition of St. John's wort to help with his depression. What would be the best response of the nurse? a. "That is a great idea. Alternative therapies can be very helpful." b. "You will feel better sooner if you include phenylalanine." c. "Did you know that St. John's wort can raise your blood pressure dramatically?" d. "You will need to drink lots of water."
c. "Did you know that St. John's wort can raise your blood pressure dramatically?"
What is the term for a long-term and intense form of psychotherapy developed by Sigmund Freud that allows a patient's unconscious thoughts to be brought to the surface? a. Adjunctive b. Behavior c. Psychoanalysis d. Cognitive
c. Psychoanalysis
Dementia is an organic mental disease secondary to what problem? Chemical imbalance Emotional problems Circulatory impairment Cerebral disease
cerebral disease
The situation in which a parent must choose between attending a daughter's ballet recital or a son's baseball game is an example of a __________.
conflict
The nurse is sensitive to the fact that patients lose control over their lives when admitted to the hospital. In what does this loss of control frequently result? a. Anger b. Depression c. Fear d. Anxiety
d anxiety
What should the nurse preparing a patient for a scheduled appointment for electroconvulsive therapy (ECT) remind the patient to do? a. Drink plenty of fluids before ECT to ensure adequate hydration. b. Bring a change of clothes in case of incontinence. c. Be prepared for visual disturbances after the treatment. d. Arrange for transportation to and from the appointment.
d. Arrange for transportation to and from the appointment.
A young man with malaria spikes a temperature of 105°F (40.5°C) and begins to hallucinate. How should the nurse assess this? Delirium Psychotic break Possible stroke Anxiety disorder
delirium
A family is informed that the brain damage to their daughter is irreversible. The father is later overheard making vacation plans and discussing what the family will do when his daughter leaves the hospital. The nurse recognizes the father is in which crisis stage? High anxiety Denial Reconciliation Adaptation
denial
After finding the patient with diabetes eating candy, the nurse reminds the patient that the candy will elevate blood sugar levels. The patient's response is: "It's only a little bit, and it won't do anything." Which defense mechanism is the patient using? Conversion Denial Repression Regression
denial
When developing a care plan for a mentally ill patient, what should the nurse assess first? Coping strategies Emotional status Medications taken Nutritional status
emotional status
When all five axes of the Diagnostic and Statistical Manual of Psychiatric Disorders, V, are used, it provides what type of assessment approach to comprehensive care? a. Personalized b. Individualized c. Holistic d. Organic
holistic
A patient is frequently late for appointments because he goes back to his room numerous times to assure himself that none of his belongings have been stolen. What does this behavior represent? -Senseless behavior -Controlled repetition -Obsessive-compulsive -Anxiety tension
obsessive compulsive
When a patient demonstrates accelerated heart rate, trembling, choking, and chest pain along with acute, intense, and overwhelming anxiety, the nurse should recognize that the patient is most likely experiencing what condition? a. Terror b. Fright c. Fear d. Panic
panic
What is a nursing intervention that helps to build trust, encourages the patient to have faith in the care being received, and meets psychosocial needs? Developing a care plan Implementing nurse orders Patient education Meeting patient goals
patient education
A patient believes himself to be the president of the United States and that terrorists are trying to kidnap him. The nurse records these observations as which type of behavior? Absent behavior Positive behavior Negative behavior False behavior
positive behavior
When the patient with a psychosis is thought to be a danger to self or others, by what method should the patient be admitted to the hospital? Probating B. Nurse's request d. Family request
probating
What is the term used for the beginning stage of schizophrenia, characterized by a lack of energy and complaints of multiple physical problems? a. Prepsychotic b. Residual c. Acute d. Prodromal
prodromal
In the movie Gone With the Wind, Scarlett O'Hara says, "I'll think about that tomorrow. Tomorrow is another day." The nurse recognizes the defense mechanism of __________.
repression
The nurse is assessing a nervous 18-year-old patient who has vital signs of P 120, R 30, and BP 160/90. The patient states that he feels something bad is about to happen. Based on this data alone, how should the nurse identify the patient's level of anxiety? a. MiLD b. Moderate c. Severe d. Panic
severe
Which role is an example of an ascribed role? -Sex -Occupation -Manner of dealing with stress - Attitude toward homosexuality
sex
The patient admitted to the hospital may adjust to illness by assuming a role in which everyday responsibilities are avoided. What is this role called? Patient role Illness role Sick role Dependent role
sick role
A patient admitted to the hospital after a motorcycle crash that has left him paralyzed from the waist down tells the nurse he has feelings of helplessness and hopelessness. What other feelings may the patient have that should be recognized? Isolation B. Suicidal ideation C. Fear D. Anger
suicidal ideation
A patient admitted for delirium demonstrates increased disorientation and agitation only during the evening and nighttime. What is the term applied to this type of delirium? Disordered thinking Schizophrenia Dementia Sundowning syndrome
sundrowning syndrome
What action by a student before taking a test should indicate to a nursing instructor that the student is demonstrating signs of moderate anxiety? -Studies for 6 hours -Sleeps 6 hours because of fatigue -Vomits -Argues about the scheduling of the test
vomits
The patient complains to the nurse that the health care provider does not like him and wants him to fail at following the diet prescribed. The nurse recognizes that the patient is using which defense mechanism? Conversion Projection Introjection Repression
Projection
When the patient who overeats insists that weight gain is related to retained fluids, the nurse recognizes the patient is using which defense mechanism? Compensation Rationalization Sublimation Regression
Rationalization
A 40-year-old patient cries and has a tantrum when the health care provider refuses to give her a prescription for diet pills. The nurse realizes that this is the use of which defense mechanism? Compensation Denial Regression Repression
Regression
Using Freud's personality theory, what action by a patient identifies the influence of the superego? - Eating an entire chocolate pie - Becoming anxious about having no visitors - Monopolizing the attention of the health care provider - Returning a $5 bill that another patient left on the table
Returning a $5 bill that another patient left on the table
The nurse is assessing a young woman who is a teacher, happily married, raising two children, taking care of her disabled mother, and going to school to get a master's degree. How should the behavior of the young woman be classified? -Ego-centered -Role integrated -High-level wellness -Unbounded energy
Role integrated
What does any event that requires change stimulate? -Anger -Depression -Stress -Anxiety
STRESS
The nurse is told that a patient believes he was born into the wrong body. What is the correct terminology for the desire to have the body of the opposite sex? a. Homosexuality b. Transsexualism c. Heterosexuality d. Bisexuality
Transsexualism
Adjunctive therapies are used for which reasons? (Select all that apply.) To increase self-esteem To promote positive interaction To enhance reality orientation To stimulate communication To increase energy
a b c
The home health nurse assesses a patient who creates elaborate excuses for not leaving home. Further questioning reveals the patient had not left home for 6 months. How should this be documented? a. Mania b. Depression c. Agoraphobia d. Anxiety
agroraphobia
A perceived threat to self causes what emotion? -Fear -Anger -Depression -Anxiety
anxiety
What is the most likely result when an attempt at adaptation fails? a. Depression b. Anger c. Frustration d. Anxiety
anxiety
What is the typical schedule for electroconvulsive therapy (ECT)? 3 treatments over 2 weeks 6 treatments over 2 months 8 treatments over several weeks 10 treatments over several weeks
10 treatments over several weeks
When was psychiatric training for nurses initially offered? 1852 1882 1865 1895
1882
What coping mechanism demonstrated by a patient should indicate to the nurse that the patient is seeking ways to deal with and resolve stress? - Projection - Adaptation - Reaction formation - Compensation
Adaptation
1. What is the mental health nurse referring to when using the term behavior? - An isolated incident - The manner in which a person performs - A product of a coping strategy - Failure to adapt
B. The manner in which a person performs
What is the basis for classifying a person as having a mental illness? - Behavior exhibited and the context - Response of society to the behavior - Ability of the patient to conform - Patient's history and previous behavior
Behavior exhibited and the context
How should the nurse document the behavior of a patient with mental illness? - Very disruptive to a person in society - Differing from socially acceptable behavior - Causing the person to be involved in problems - Resulting from an inability to exercise control
Differing from socially acceptable behavior
Which theorist believed that personality development was based on task mastery? -Sigmund Freud -Erik Erikson -Jean Piaget -Friedrich Nietzsche
Erik Erikson
Using the mental health continuum as a guide, the nurse observes behavior that usually places an individual on the illness end of the continuum. What is true of this behavior? a. It causes extreme concern about health. - It results in inability to function in society. - It demonstrates that the person is out of touch with reality. - It results in inability to interact with people.
It demonstrates that the person is out of touch with reality.
The Diagnostic and Statistical Manual of Psychiatric Disorders, V (DSM-V), is used by most hospitals and is the current tool used to examine mental health and illness. What approach does the DSM-V use to classify mental disorders? a. Holistic system b. Hierarchical system c. Multiaxial system d. Evaluation system
Multiaxial system
What definition should the nurse use to clarify the concept of "mental health"? - A wellness of attitude - A person's response to disease and dysfunction - The ability to cope and adjust to everyday stresses - How the person performs activities of daily living
The ability to cope and adjust to everyday stresses
