mental exam 3 practice questions
Nick a construction worker is on duty when a nearly completed wall suddenly falls, crushing a number of co workers. although badly shaken initially, he seemed to be coping well. About two weeks after the tragedy he begins to feel numb or detached from his environment. he finds himself frequently thinking about the tragedy and feeling guilty that he was spared while many others died. Which statement about this situation is most accurate?
Nick has acute stress and will benefit from antianxiety medications
The nurse is planning care for a patient with a binge eating disorder. Which outcomes are appropriate? Select all that apply
The pt. will identify stressors that lead to binge eating The pt. will identify four alternate coping skills
You are admitting Joel a 39 year old Patient with depression. Which assessment statements would be appropriate to ask Joel to assess suicide risk? select all that apply a. Do you ever think about suicide? b. Are you thinking about hurting yourself? c. Do you sometimes wish you were dead? d. Has it ever seemed as if life is not worth living? e. If you were to kill yourself, how would you do it? f. Does it seem as if others might be better off if you were dead?
a,b,c,d,e,f
Which of the following are correct regarding obsessive-compulsive disorder (OCD) Select all that apply a.Obsessions are repetitive thoughts where as compulsions are ritualistic behaviors b. OCDsymptoms can start as early as 3 years of age c. OCD patients often have difficulty sleeping d.Schizophrenia often occurs comorbidly with OCD e.There is a tool (scale) to measure compulsive behaviors f. Patients diagnosed with OCD are at higher risk for suicede than patients with depression
a,b,c,e
Michael seems to be angry when his family fails to visit him in the hospital as promised. However, he tells you that he is fine and that the visit wasnt important to him. When you suggest that perhaps he might be disappointed or even a little angry that the family has again let him down, the patient responds that it is his family that is angry, not him, or else they would have visited. What defense mechanism is this patient using to deal with his feelings? Select all apply a. Rationalization b.Projection c. Regression d. Denial
a,b,d
Which interventions maximize the safety of a patient who is activley suicidal on an inpatient mental health unit? select all apply: a. place the pt. on every 15-minute checks b. place the pt. in a room near the nurse's station. c. allow the pt. periods of time alone for reflection to promote self-awareness. d. Install breakaway curtain rods, coat hooks, and shower rods e. Allow the pt. to keep personal objects such as a razor and hairdryer in his room to demonstrate trust. f. assign the pt. to private room to facilitate monitoring
a,b,d
While on an inpatient unit you are caring for newly admitted Alyssa, a 16 year old diagnosed with anorexia nervosa. Number the following nursing interventions in order of priority a. ________ Initiate a therapeutic relationship b._________ Promote caloric consumption c._________ Asess for suicidal ideation d._________ Review accomplishments made during treatment e._________ Explore feelings of underlying anxiety and low self esteem
a. 1 b.3 c.2 d.5 e.4
Brittany is caring for a pt. with bulimia. She recognizes which of the following nursing interventions as being most appropriate? a. monitor the pt. on the bathroom trips after eating b. allow the pt. extensive private time with family members c. provide meals whenever the pt. request them. d. encourage the pt. to select foods that she likes
a. Monitor the pt. on the bathroom trips after eating
You are caring for Gabby a 12 year old patient diagnosed with oppositional defiant disorder. Gabbys other asks you what type of medication ia usually prescribed for this diagnosis. Your answer is based on the knowledge that
a. Treatment for this disorder does not usually involve and specific medication but focuses on adaptive coping mechanisms
A major principal the nurse should observe when communicating with a patient experiencing elated mood is to: a. Use a calm, firm approach b. Give expanded explanations c. Make use of abstract concepts d. Encourage lightheartedness and joking
a. Use a calm, firm approach
The nurse is preparing to assess a child who primarily speaks Spanish but is fluent in English. Which is the appropriate method for gathering information a. begin the assessment in English b. utilize a Spanish dictionary to ask questions of the child c. Ask the child if he understands English d. obtain an interpreter who is fluent in Spanish
a. begin the assessment in English
A medication teaching plan for a patient receiving lithium should include: a. Periodic monitoring of renal and thyroid function b. Dietary teaching to restrict daily sodium intake c. The importance of blood draws to monitor serum potassium level d. Discontinuing the drug if weight gain and fine hand tremors are noticed
a. periodic monitoring of renal and thyroid function
The nurse educator is teaching a new nurse about seclusion and restraint. Order the following interventions from least 1 to most restrictive 4. a. allow the pt. to sit in the sensory room b. Placing the pt. in physical restraints c. placing the pt. in a locked seclusion room d.offering PRN medication by mouth
a=1 b=4 c=3 d=2
The nurse is caring for a patient with attention deficit hyperactivity disorder. The child has been prescribed methylphenidate (ritalin) Which of the following symptoms are side effects the nurse will monitor for select all apply a. hypotension b. decreased appetitie c. sedation d. insomnia e. headache f. seizure
b,d,e
Kara is 23 year old patient admitted with depression and suicidal ideation. Which interventions would be therapeutic for Kara select all apply a. Focus primarily on developing solutions to the problem that are leading the patient to feel suicidal b. assess the pt. thoroughly and reassess the pt. at regular intervals as levels of risk fluctuate c. avoid talking about suicidal ideation as this may increase the patients risk for suicidal behavior d. meet regularly with the patient to provide opportunities for the pt. to express and explore feelings. e. administer antidepressant medications cautiously and conservatively because of their potential to increase the suicidal risk for Karas age group. f. Hep the pt. to identify positive self-attribute and to question negative self-perception that are unrealistic
b,d,e,f
A female patient tells the nurse that she would like to begin taking St.johns wort for depression. What teaching should the nurse provide? a."St. Johns wort should be taken several hours after your other antidepressant." b."St.johns wort has generally been shown to be effective in treating depression". c. "This supplement is safe to take if you are pregnant" d. "St.johns wort is regulated by the FDA, so you can be assured of its safety."
b. "St.john wort has been generally been shown to be effective to treating depression".
Marco age 83, has dementia and has dificulty feeding himself despite the fact that there is nothing wrong with his motor functions. Which term should the nurse use to document this finding ?
b. Apraxia
You are caring for susannah a 29 year old who has been diagnosed with dissociative identity disorder. she was recently hospitalized after coming to the ER with deep cuts on her arms with no memory of how this occurred. The priority nursing intervention is :
b. Maintain 1:1 observation
Lucas is a nurse on a medical floor caring for kelly a 48 year old pt. with newly dx. type two diabetes. He realizes his depression is complicating factor in the pt.s adjustment to her new diagnosis. What problem has the most potential to arise ?
b. Treatment non adherence
The nurse is reviewing orders given for a patient with depression which order should the nurse question? a. a low starting dose of a tricyclic antidepressant b. An SSRI given initially with an MAOI c. Electroconvulsive therapy to treat suicidal thoughts d. Elavil to address the patients agitation
b. an SSRI given initially with an MAOI
Griffin is an 19 year old student who volunteers for a depression screening at his college. He identifies himself as gay. Which of the following is true based on current knowledge of the gay, lesbian and bisexual community and suicide risk? a. griffins sexual preference has no bearing on suicide risk b. griffin has a higher suicide rate than heterosexual peers c. griffin has a lower suicide risk than his heterosexual peers d. griffin may experience a threefold risk for a mood disorder in his lifetime becuase of his sexual preference
b. griffin has a higher suicide risk than his heterosexual peers.
Nadia has been diagnosed with bipolar disorder. Which is an outcome for Nadia in the continuation of the treatment phase of bipolar disorder? a. patient will avoid involvement in self-help groups b. Patient will adhere to medication regimen c. Patient will demonstrate euphoric mood d. Patient will maintain normal weight
b. patient will adhere to medication regimen
Since learning he will have a trial pass to a new group home tomorrow , lukes usual behavior has changed. He has started to pace, has become distracted and is breathing rapidly. He has trouble focusing on anything other than the group home issue and complains that he suddenly feels nauseated. Which in
c. "Luke, slow down . Listen to me you are safe. Take a deep breath, and lets go to a quieter place."
You are caring for yolanda a 67-year-old pt. who has been receiving hemodialysis for 3 months, Yolanda reports she feels angry whenever it is time for dialysis, You attribute this is to :
c. A normal response to grief and loss
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 bi polar 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 gun he has hidden. d. An older Hispanic male who is catholic, is living with a debilitating chronic illness , is recently widowed, and states: "I wish that God would take me too."
c. A young single white male who is alcohol dependent, hopeless, impulsive, has just been rejected by his girlfriend and has ready access to gun he has hidden
You are caring for ellie , age 91, whos provider has written a "DNR-CCO" order. Which nursing action would be appropriate if ellie were to go into cardiac arrest?
c. Administer prescribed medication morphine for pain control
The nurse is developing a care plan for a teenage patient with attention deficit hyperactivity disorder, who is at high risk for self harm due to poor judgment, high risk taking behaviors and impulsivity. which of the following is the priority nursing intervention? a. schedule a regular nurse-patient session daily and encourage her to explore stressors that may worsen her depressed mood. b. Develop a "no self-harm" contract with the patient and encourage her to engage in all unit activities c. assign a staff member one to one close observation until the treatment team determines she is no longer a risk for self harm d. The patient is to wear hospital issue clothing (pajamas) and sit/sleep within view of the staff until the physician determines she is no longer a risk for self harm
c. Assign a staff member one to one close observation until the treatment team determines she is no longer a risk for self harm
Blake is a 15 year old patient admitted for emergency observation after stealing a car and being pulled over by the police for reckless driving. He also has a history of pyromania. Which of the following is the priority assessent
c. suicide risk
_________________ disorder is one of the most frequently diagnosed disorders in children and adolescents and is a problem in the adult population as well, with adults experiencing the same type of symptoms. It is characterized by disregard of the rights of others and disdain for societal rules.
conduct
A nurse is educating a patient about the causes of depression. Which statement lets the nurse know the patient understands the neurobiological theory of depression? a. "my depression is made worse because my marriage is stressful." b."Sometimes I believe that I cant help myself. Thats why I get so depressed." c."Im depressed becuase my parents were depressed"' d. "If i take these medications as prescribed, I should start to think clearly and feel energized".
d. :"If I take these medications as prescribed, I should start to think clearly and feel energized."
A 7 year old male without any other diagnosed problem engages in jaw clenching and rocking back and forth. Which conditions should the nurse anticipate a. attention deficit hyperactivity disorder b. Tourettes disorder c. Stereotypic movement disorder d. Autism spectrum disorder
d. Autism spectrum disorder
You are caring for Aaron a 38 year old pt. dx. 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 ?
d. Shift focus from Aarons somatic concerns to feelings and effective coping skills.
You are caring for maggie a 78 year old with Alzheimer's disease and stage III breat cancer who can no longer communicate verbally. What is the appropriate way to assess maggies pain ?
d. The pain assessment in advanced dementia scale
You are caring for connor an 8 year old boy who has been diagnosed with reactive attachment disorder. what would be an appropriate nursing outcome to achieve ?
d. Writes or draws feelings in a journal
When working on an inpatient adolescent mental health unit, staff maybe able to maintain saftey and calm environement when they interact with patients using
d. low expressed emotion- "please go to your room for quiet time now" - using a neutral, calm tone.
Carlton age 85, is brought to the clinic by his daughter. She states that carltons wife and brother both recently passed away, He has been sad and crying frequently, not attending to hygeine, eating less and sleeping much of the day. Your nursing assessment and intervention are guided by the knowledge that
d. older male patients have the highest rate of suicide
The info that is least relevant when assessing a pt. with a suspected somatization disorder is:
d. potential of violence
The nurse is caring for a patient who exhibits disorganized thinking and delusions. The patient repeatedly states "I hear voices of aliens trying to contact me". The nurse should recognize this presentation as which type of major depressive disorder (major depressive)? a. seasonal affective disorder b. dysthymic disorder c. premenstural dysphoric disorder d. psychotic
d. psychotic
A suitable outcome criterion for the nursing diagnosis Ineffective coping related to dependence on pain relievers to treat chronic pain of psychological origin is :
pt. will learn and practice effective coping skills
Jamie 24 dx with dissociative disorder following an traumatic event. The mother ask you does this mean she is now crazy. Your best response would be ?
"jamie is dealing with the anxiety associated with the trauma by seperating herself from it. With treatment she can go back to her previous level of functioning."
A disorder in which one experiences fear of being in place or situations from which escape might be difficult or embarrassing or in which help might not be available if in panic attack occurs is called
Agoraphobia
You are caring for Miguel, age 76 who is experiencing delirium. Which nursing response is appropriate when the pt.s daughter asks. " Will he ever stop acting like this?"
B. "Once we know the underlying medical cause of the delirium we can begin treatment to attempt to reverse the process."
Joshua a 17 year old outpatient has been diagnosed with intermitent explosive disorder. As you care for Joshua, you anticipate that the psychiatric care provider may prescribe which of the following ? a. Benzodiazepine b.An anticonvulsant c. A Psychostimulant d. An anticholinesterase inhibitor
B. An anticonvulsant
For assessment purposes, the nurse should identify the body system most at risk for decomposition during a severe manic episodes as: a. renal b. cardiac c.endocrine d.pulmonary
B. Cardiac
Which symptom related to communication is likely to be present in a patient experiencing mania a. mutism b.verbosity c. poverty of ideas d. confabulation
B. Verbosity
A variety of medication are used in the treatment of severe anxiety disorders. Which class or medication used to treat anxiety is potentially addictive?
Benzodiazepines
The nurse is planning care for a patient with depression who will be discharged to home soon. What aspect of teaching should be the priority on the nurse's discharge plan of care? a.Pharmacological teaching b. Saftey risk c. Awarness of symptoms that increase depression d. the need for interpersoanl contact
C. Awareness of symptoms that increase depression
Ashley is 21 year old college student who was sexually assaulted at a party. She was seen in the local ER and referred for counseling ...dx: with acute stress disorder. Which treatment modalities would you expect to see used in therapy with ashley ?
Cognitive - behavioral therapy
Which of the following are true regarding feeding disorders in children? select all apply
Feeding disorders are often manifested in children with developmental delays In many cases, toddler mealtime difficulties spontaneously resolve with no interventions Behavior modification has been found to be effective in treating feeding disorders
The nurse is admitting a pt. who weighs 100 pounds is 66 inches tall and is below the ideal body weight. The pt.s blood pressure is 130/80 mm hg, pulse is 72 bpm potassium is 2.5 and ecg is abnormal . Her teeth enamel is eroded, her hands are shaking and her parotid gland is enlarged. The pt. states" I am really nervouse about coming to this unit what is the priority nursing diagnosis ?
Imbalanced nutrition: less than body requirements
