Mental Health Exam 1
Antipsychotic medications are thought to decrease psychotic symptoms by which of the following actions? A. Blocking reuptake of norepinephrine and serotonin B. Blocking the action of dopamine in the brain C. Inhibiting production of the enzyme MAO D. Depressing the CNS
B. Blocking the action of dopamine in the brain
Nancy, a depressed client who has been unkempt and untidy for weeks, today comes to group therapy wearing makeup and a clean dress and having washed and combed her hair. Which of the following responses by the nurse is most appropriate? A. "Nancy, I see you have put on a clean dress and combed your hair" B. "Nancy, you look wonderful today!" C. "Nancy, I'm sure everyone will appreciate that you have cleaned up for the group today" D. "Now that you see how important it is, I hope you will do this everyday"
A. "Nancy, I see you have put on a clean dress and combed your hair"
Mrs.S asks the nurse, "Do you think I should tell my husband about my affair with my boss?" Which is the most appropriate response by the nurse? A. "What do you think would be best for you?" B. "Of course you should. Marriage has to be based on truth." C. "Of course not. That would only make things worse." D. "I can't tell you what to do. You have to decide for yourself."
A. "What do you think would be best for you?"
Chelsea says to the nurse, "I worked as a secretary to put my husband through college, and as soon as he graduated, he left me. I hate him! I hate all men!" Which is an empathetic response by the nurse? A. "You are very angry now. This is a normal response to your loss." B. "I know what you mean. Men can be very insensitive." C. "I understand completely. My husband is a jerk, too." D. "You are depressed now, but you will feel better in time."
A. "You are very angry now. This is a normal response to your loss."
An individual may be considered gravely disabled for which of the following reasons? (Select all that apply) A. A person, because of mental illness, cannot fulfill basic needs B. A mentally ill person is in danger of physical harm based on inability to care for self C. A mentally ill person lacks the resources to provide the necessities of life D. A mentally ill person is unable to make use of available resources to meet daily living requirements
A. A person, because of mental illness, cannot fulfill basic needs B. A mentally ill person is in danger of physical harm based on inability to care for self D. A mentally ill person is unable to make use of available resources to meet daily living requirements
Clozapine (Clozaril) is an antipsychotic required to have an approved risk evaluation and mitigation strategy (REMS) program. Which of the following actions are included in that program? (Select all that apply) A. Absolute neutrophil counts are assessed before initiation and treatment B. Initially only 1-week supply of clozapine is dispensed at a time C. Acceptable ANC levels for continuation of treatment are identified as 1,500 uL. D. Patients are not permitted to smoke cigarettes while on clozapine.
A. Absolute neutrophil counts are assessed before initiation and treatment B. Initially only 1-week supply of clozapine is dispensed at a time C. Acceptable ANC levels for continuation of treatment are identified as 1,500 uL.
Which of the following is a concern with children on long-term therapy with CNS stimulants for ADHD? A. Addiction B. Weight gain C. Substance abuse D. Growth suppression
A. Addiction
Sandra is the nurse leader of a supportive therapeutic group for individuals with anxiety disorders. Violet, who lacks self-confidence states to the group "Maybe if I became a blond, my boyfriend would love me more." Larry responds, "Listen, dummy, you need more than blond hair to keep the guy around. A bit more in the brains department would help!" What type of member role is Larry assuming in the group? A. Aggressor B. Monopolizer C. Blocker D. Seducer
A. Agressor
Anna, who is 72 years old, is of the age when she may have experienced many losses coming close together. What is this called? A. Bereavement overload B. Normal mourning C. Isolation D. Cultural relativity
A. Bereavement overload
How do antianxiety medications, such as benzodiazepines, produce a calming effect by which of the following actions? A. Depressing the CNS B. Decreasing levels of norepinephrine and serotonin in the brain C. Decreasing levels of dopamine in the brain D. Inhibiting production of the enzyme MAO
A. Depressing the CNS
Which of the following parts of the brain integrates all sensory input (except smell) on the way to the cortex? A. Temporal lobe B. Thalamus C. Limbic system D. Hypothalamus
B. Thalamus
Which of the following are basic assumptions of milieu therapy? (select all that apply) A. Each individual owns his or her own environment. B. Each individual owns his or her behavior. C. Peer pressure is a useful and powerful tool. D. Inappropriate behaviors are punished immediately.
A. Each individual owns his or her own environment. B. Each individual owns his or her behavior. C. Peer pressure is a useful and powerful tool.
Which of the following parts of the brain is associated with voluntary body movement, thinking and judgement, and expression of feeling? A. Frontal lobe B. Parietal lobe C. Temporal lobe D. Occipital lobe
A. Frontal lobe
The nurse is using the nursing process to care for a patient who is suicidal. Which of the following nursing actions is a part of the assessment step of the nursing process? A. Identifies the nursing diagnosis: Risk for suicide B. Notes that patient's family reports recent suicide attempt C. Prioritizes the necessity for maintaining a safe environment for the patient D. Obtains a commitment from the patient to work collaboratively to identify adaptive coping.mpt
A. Identifies the nursing diagnosis: Risk for suicide
Which of the following hormones has been implicated in the etiology of mood disorder with seasonal pattern? A. Increased levels of melatonin B. Decreased levels of oxytocin C. Decreased levels of prolactin D. Increased levels of thyrotropin
A. Increased levels of melatonin
One of the goals of therapeutic community is for patients to become more independent and accept self-responsibility. Which of the following approaches by staff best encourages fulfillment of this goal? A. Incuding patient input and decisions into the treatment plan B. Insisting that each patient take a turn as "president" of the community meeting C. Making decisions for the patient regarding plans for treatment D. Requiring that the patient be bathed and dressed and attend breakfast on time each morning
A. Incuding patient input and decisions into the treatment plan
Psychotropic medications may act at the neural synapse to accomplish which of the following? (Select all that apply) A. Inhibit the reuptake of certain neurotransmitters, creating more availability. B. Inhibit catabolic enzymes, promoting more availability of the neurotransmitter. C. Block receptors, resulting in less neurotransmitter activity. D. Add synthetic neurotransmitters found in the drug.
A. Inhibit the reuptake of certain neurotransmitters, creating more availability. B. Inhibit catabolic enzymes, promoting more availability of the neurotransmitter. C. Block receptors, resulting in less neurotransmitter activity.
On the milieu unit, duties of the staff psychiatric nurse include which of the following? (select all that apply) A. Medication administration B. Patient teaching C. Medical diagnosis D. Reality orientation E. Relationship development F. Group therapy
A. Medication administration B. Patient teaching D. Reality orientation E. Relationship development
Part of the nurse's continual assessment of the client taking antipsychotic medications is to observe for extrapyramidal symptoms. Examples include which of the following? A. Muscular weakness, rigidity, tremors, facial spasms B. Dry mouth, blurred vision, urinary retention, orthostatic hypotension C. Amenorrhea, gynecomastia, retrograde ejaculation D. Elevated blood pressure, severe occipital headache, stiff neck
A. Muscular weakness, rigidity, tremors, facial spasms
Sally was sexually abused as a child. She is a client on the milieu unit with a diagnosis of borderline personality disorder. She has refused to talk to anyone. Which of the following therapies might the IDT team recommend for Sally? (select all that apply) A. Music therapy B. Art Therapy C. Seclusion D. Electroconvulsive therapy
A. Music therapy B. Art Therapy
The nurse is using the nursing process to care for a patient who is suicidal. Which of the following nursing actions is a part of the planning step of the nursing process? A. Prioritizes the necessity for maintaining a safe environment for the patient. B. Determines if nursing interventions have been appropriate to achieve desired results. C. Obtains a commitment from the patient to work collaboratively to identify adaptive coping skills. D. Identifies that the "Patient will not harm self during hospitalization."
A. Prioritizes the necessity for maintaining a safe environment for the patient.
S.T. is a 15-year-old girl who has just been admitted to the adolescent psychiatric unit with a diagnosis of anorexia nervosa. She is 5ft 5in. tall and weighs 82 lb. She was elected to the cheerleading squad for the fall but states that she is not as good as the others on the squad. The treatment team has identified the following problems: refusal to eat, occasional purging, refusing to interact with staff and peers, and fear of failure. Which of the following nursing diagnoses would be appropriate for S.T.? (select all that apply) A. Social isolation B. Disturbed body image C. Low self-esteem D. Imbalanced nutrition: less than body requirements
A. Social isolation B. Disturbed body image C. Low self-esteem D. Imbalanced nutrition: less than body requirements
Eric is a staff nurse on a surgical unit. He has been selected as leader of a newly established group of staff nurses organized to determine ways to decrease the number of medication errors occurring on the unit. Eric has definite ideas about how to bring this about. He has also applied for the position of Head Nurse on the unit and believes that if he is successful in leading the group toward achievement of its goals, he can also facilitate his chances for promotion. At each meeting, he addresses the group in an effort to convince the members to adopt his ideas. Which type of group and style of leadership is described in this situation? A. Task; autocratic B. Teaching; autocratic C. Self-help; democratic D. Supportive-therapeutic; laissez-faire
A. Task; autocratic
Which of the following parts of the brain is concerned with hearing, short-term memory, and sense of smell? A. Temporal lobe B. Parietal lobe C. Cerebellum D. Hypothalamus
A. Temporal lobe
Which of the following behaviors suggests a possible breach of professional boundaries? (Select all that apply) A. The nurse repeatedly requests to be assigned to a specific patient. B. The nurse shares the details of her divorce with the patient. C. The nurse makes arrangements to meet the patient outside of the therapeutic environment. D. The nurse shares how she dealt with a similar difficult situation.
A. The nurse repeatedly requests to be assigned to a specific patient. B. The nurse shares the details of her divorce with the patient. C. The nurse makes arrangements to meet the patient outside of the therapeutic environment.
Which of the following describe advantages of electronic health records (EHRs)? (select all that apply) A. They reduce redundancy of information B. They reduce issues regarding privacy C. They decrease charting time. D. They facilitate communication between disciplines.
A. They reduce redundancy of information C. They decrease charting time. D. They facilitate communication between disciplines.
Guidelines relating to "duty to warn" state that a therapist should consider taking action to warn a third party when his or her client does which of the following? (Select all that apply) A. Threatens violence toward another individual B. Identifies a specific intended victim C. Is having command hallucinations D. Reveals paranoid delusions about another individual
A. Threatens violence toward another individual B. Identifies a specific intended victim
Anna has been a widow for 20 years. Her maladaptive grief response to the loss of her dog may be attributed to which of the following? Select all that apply. A. Unresolved grief over the loss of her husband B. Loss of several relatives and friends over the last few years C. Repressed feelings of guilt over the way in which Lucky died D. Inability to prepare in advance for the loss
A. Unresolved grief over the loss of her husband B. Loss of several relatives and friends over the last few years C. Repressed feelings of guilt over the way in which Lucky died D. Inability to prepare in advance for the loss
The nurse decides to respect family wishes and not tell the patient of his terminal status because that would bring the most happiness to the most people. Which of the following ethical theories is considered in this decision? A. Utilitarianism B. Kantianism C. Christian ethics D. Ethical egoism
A. Utilitarianism
A patient states, "I refuse to shower in this room. I must be very cautious. The FBI has placed a camera in here to monitor my every move." Which of the following is the most therapeutic response? A. "That's not true." B. "I have a hard time believing that is true." C. "Surely you don't really believe that." D. "Let's search the room together to see if we can find a camera."
B. "I have a hard time believing that is true."
Which of the following statements by Anna might suggest that she is achieving resolution of her grief over Lucky's death? A. "I never cry when I think about Lucky." B. "It's true. Lucky didn't always mind me. Sometimes he ignored my commands, but he was also a good companion." C. "I remember how it happened now. I should have held tighter to his leash! I didn't deserve to have a dog." D. "I won't ever have another dog. It's just too painful to lose them."
B. "It's true. Lucky didn't always mind me. Sometimes he ignored my commands, but he was also a good companion."
John tells the nurse, "I think lights out at ten o'clock on a weekend is stupid. We should be able to watch TV until midnight!" Which of the following is the most appropriate response from the nurse on the milieu unit? A. "John you were told the rules when you were admitted." B. "You may bring it up before the others at the community meeting C. "Some people want to go to bed early, John." D. "You are not the only person on this unit, John. You must think of others beside yourself."
B. "You may bring it up before the others at the community meeting
Abbey, an adolescent, just returned from group therapy and is crying. She says to the nurse, "All the other kids laughed at me! I try to fit in, but I always seem to say the wrong thing. I've never had a close friend. I guess I never will." Which is the most appropriate response by the nurse? A. "Why will you never have any friends?" B. "You're feeling pretty down on yourself right now." C. "I'm sure they didn't mean to hurt your feelings." D. "You don't need friends to be happy."
B. "You're feeling pretty down on yourself right now."
There is a very narrow margin between the therapeutic and toxic levels of lithium carbonate. Symptoms of toxicity are most likely to appear if the serum levels exceed which of the following levels? A. 0.15 mEq/L B. 1.5 mEq/L C. 15.0 mEq/L D. 150 mEq/L
B. 1.5 mEq/L
If extrapyramidal symptoms should occur, which of the following would be a priority nursing intervention? A. Notify the physician immediately. B. Administer prn trihexyphenidyl (Artane) as ordered. C. Withhold the next dose of antipsychotic medication. D. Explain to the patient that these symptoms are only temporary and will disappear shortly.
B. Administer prn trihexyphenidyl (Artane) as ordered.
The nurse assists the physician with electroconvulsive therapy on his patient who has refused to give consent. With which of the following legal actions might the nurse be charged because of this nursing action? A. Assault B. Battery C. False imprisonment D. Breach of confidentiality
B. Battery
The nurse decides to go against family wishes and tell the client of his terminal status because that is what she would want if she were the client. Which of the following ethical theories is considered in this decision? A. Kantianism B. Christian ethics C. Natural law theories D. Ethical egoism
B. Christian ethics
Which of the following activities would be a responsibility of the psychiatric clinical nurse specialist on the IDT team? A. Manages the therapeutic milieu on a 24-hour basis. B. Conducts group therapies and provides consultation and education to staff nurses C. Directs a group of patients in acting out a situation that is otherwise too painful for a patient to discuss openly D. Locates halfway house and arranges living conditions for patient being discharged from the hospital
B. Conducts group therapies and provides consultation and education to staff nurses
Which of the following tasks are associated with the orientation phase of relationship development? (Select all that apply) A. Promoting the patient's insight and perception of reality. B. Creating an environment for the establishment of trust and rapport. C. Using the problem-solving model toward goal fulfillment. D. Obtaining available information about the patient from various sources. E. Formulating nursing diagnoses and setting goals.
B. Creating an environment for the establishment of trust and rapport. E. Formulating nursing diagnoses and setting goals.
The nurse is using nursing process to care for a patient who is suicidal. Which of the following nursing actions is a part of the evaluation step of the nursing process? A. Prioritizes the necessity for maintaining a safe environment for the patient. B. Determines if nursing interventions have been appropriate to achieve desired results. C. Obtains a commitment from the patient to work collaboratively to identify adaptive coping skills. D. Identifies that the "Patient will not harm self during hospitalization."
B. Determines if nursing interventions have been appropriate to achieve desired results.
Sandra is the nurse leader of a supportive therapeutic group for individuals with anxiety disorders. In this group, Nancy talks incessantly. When someone else tries to make a comment, she refuses to allow him or her to speak. What type of member role is Nancy assuming in this group? A. Aggressor B. Monopolizer C. Blocker D. Seducer
B. Monopolizer
A decrease in which of the following neurotransmitters has been implicated in depression? A. GABA, acetylcholine, and aspartate B. Norepinephrine, serotonin, and dopamine C. Somatostatin, substance P, and glycine D. Glutamate, histamine, and opioid peptides
B. Norepinephrine, serotonin, and dopamine
The nurse is using nursing process to care for a patient who is suicidal. Which of the following nursing actions is a part of the diagnosis step of the nursing process? A. Identifies the nursing diagnosis: Risk for suicide B. Notes that patient's family reports recent suicide attempt C. Prioritizes the necessity for maintaining a safe environment for the patient D. Obtains a commitment from the patient to work collaboratively to identify adaptive coping.
B. Notes that patient's family reports recent suicide attempt
Which of the following statements is correct regarding the use of restraints? (Select all that apply) A. Restraints may never be initiated without a physician's order. B. Orders for restraints must be reissued by a physician every 2 hours for children and adolescents. C. Clients in restraints must be observed and assessed every hour for issues regarding circulation, nutrition, respiration, hydration, and elimination. D. An in-person evaluation must be conducted within 1 hour of initiating restraints.
B. Orders for restraints must be reissued by a physician every 2 hours for children and adolescents. D. An in-person evaluation must be conducted within 1 hour of initiating restraints.
Anna's daughter notices that Anna appears to be listening to another voice when just the two of them are in a room together. When questioned, Anna admits that she hears someone telling her that she was a horrible caretaker for Lucky and did not deserve to ever have a pet. Which of the following best describes what Anna is experiencing? A. Neurosis B. Psychosis C. Depression D. Bereavement
B. Psychosis
Anna, age 72, has been grieving the death of her dog, Lucky, for 3 years. She is not able to take care of her activities of daily living, and wants only to make daily visits to Lucky's grave. Her daughter has likely put off seeking help for Anna because: A. Women are less likely to seek help for emotional problems than men are B. Relatives often try to "normalize" the behavior, rather than label it mental illness C. She knows that all older people are expected to be a little depressed D. She is afraid that the neighbors "will think her mother is crazy"
B. Relatives often try to "normalize" the behavior, rather than label it mental illness
In the community meeting, which of the following actions is most important for reinforcing the democratic posture of the therapy setting? A. Allowing each person a specific and equal amount of time to talk B. Reviewing group rules and behavioral limits that apply to all patients C. Reading the minutes from yesterday's meeting D. Waiting until all patients are present before initiating the meeting
B. Reviewing group rules and behavioral limits that apply to all patients
The nurse has just admitted Hannah to the psychiatric unit. The psychiatrist has diagnosed Hannah with major depressive disorder. The nurse says to Hannah, "Some changes will have to be made in your behavior. I care about what happens to you." Which nursing role described by Peplau is the nurse fulfilling in this instance? a. Counselor b. Surrogate c. Technical expert d. Resource person
B. Surrogate
Nicole is the nurse leader of a childbirth preparation group. Each week, she shows various films and sets out various reading materials. She expects the participants to utilize their time on a topic of their choice or practice skills they have observed on the films. Two couples have dropped out of the group, stating, "This is a big waste of time." Which type of group and style of leadership is described in this situation? A. Task; democratic B. Teaching; laissez-faire C. Self-help; democratic D. Supportive-therapeutic; autocratic
B. Teaching; laissez-faire
Psychoneuroimmunology is a branch of science that involves which of the following? (Select all that apply) A. The impact of psychoactive medications at the neural synapse B. The relationship among the immune system, the nervous system, and psychological processes, including mental illness C. The correlation between psychosocial stress and the onset of illness D. The potential role of viruses in the onset of schizophrenia E. The genetic factors that influence prevention of mental illness
B. The relationship among the immune system, the nervous system, and psychological processes, including mental illness C. The correlation between psychosocial stress and the onset of illness D. The potential role of viruses in the onset of schizophrenia
What is the reason that doses of buproprion should be administered at least 4 to 6 hours apart and never doubled when a dose is missed? A. To prevent orthostatic hypotension B. To prevent seizures C. To prevent hypertensive crisis D. To prevent extrapyramidal symptoms
B. To prevent seizures
Initial symptoms of lithium toxicity include which of the following? A. Constipation, dry mouth B. Dizziness, thirst C. Vomiting, diarrhea D. Anuria, arrhythmias
C. Vomiting, diarrhea
Judy has been in the hospital for 3 weeks. She has used Valium "to settle my nerves" for the past 15 years. She was admitted by her psychiatrist for safe withdrawal from the drug. She has passed the physical symptoms of withdrawal at this time, but states to the nurse "I don't know if I will make it without Valium after I go home. I'm already starting to feel nervous. I have so many personal problems." Which of the following is the most appropriate response by the nurse? A. "Why do you think you have to have drugs to deal with your problems?" B. "Everybody has problems, but not everybody uses drugs to deal with them. You'll just have to do the best that you can." C. "Let's explore some things that you can do to decrease your anxiety without resorting to drugs" D. "Just hang in there. I'm sure everything is going to be okay."
C. "Let's explore some things that you can do to decrease your anxiety without resorting to drugs"
On Tom's day of discharge from the hospital, his wife brings a bouquet of flowers and box of chocolates to give to his primary care nurse. Tom presents these gifts to the nurse saying, "Thank you for taking care of me." What is a correct response by the nurse? A. "I don't want a gift from you!" B. "Thank you so much! I think you're really extra special, too!" C. "Thank you. I will share these with the rest of the staff." D. "I love chocolate but let me pay you for them!"
C. "Thank you. I will share these with the rest of the staff."
Which of the following activities would be a responsibility of the clinical psychologist member of the IDT team? A. Locates halfway house and arranges living conditions for patient being discharged from the hospital B. Manages the therapeutic milieu on a 24-hour basis C. Administers and evaluates psychological tests that assist in diagnosis D. Conducts psychotherapy and administers electroconvulsive therapy treatments
C. Administers and evaluates psychological tests that assist in diagnosis
When Anna's daughter expresses concern about her mother's behavior and recommends she see a counselor, Anna declares, "I'm fine. There is nothing wrong with me!" Which of the following best describes Anna's response? A. Grief resolution B. Somatic disorder C. Anosognosia D. Intellectualization
C. Anosognosia
In prioritizing care within the therapeutic environment, which of the following nursing interventions would receive the highest priority? A. Ensuring that the physical facilities are conducive to achievement of the goals of therapy. B. Scheduling a community meeting for 8:30 each morning C. Attending to patients' psychological and safety needs D. Establishing contacts with community resources
C. Attending to patients' psychological and safety needs
Tam has a new diagnosis of panic disorder. Dr. S has written a prn order for alprazolam (Xanax) for when Tam is feeling anxious. She says to the nurse, "Dr. S prescribed buspirone for my friend's anxiety. Why did he order something different for me?" The nurse's answer is based on which of the following? A. Buspirone is not an antianxiety medication. B. Alprazolam and buspirone are essentially the same medication, so either one is appropriate. C. Buspirone has delayed onset of action and cannot be used on a prn basis. D. Alprazolam is the only medication that really works for panic disorder.
C. Buspirone has delayed onset of action and cannot be used on a prn basis.
The nurse is using the nursing process to care for a patient who is suicidal. Which of the following nursing actions is a part of the implementation step of the nursing process? A. Prioritizes the necessity for maintaining a safe environment for the patient. B. Determines if nursing interventions have been appropriate to achieve desired results. C. Collaborates with the patient to develop a plan for ongoing safety and suicide prevention. D. Identifies that the "Patient will not harm self during hospitalization."
C. Collaborates with the patient to develop a plan for ongoing safety and suicide prevention.
The nurse has just admitted Hannah to the psychiatric unit. The psychiatrist has diagnosed Hannah with major depressive disorder. The nurse says to Hannah, "Please tell me what it was like when you were growing up." Which nursing role described by Peplau is the nurse fulfilling in this instance? a. Surrogate b. Resource person c. Counselor d. Technical expert
C. Counselor
A competent, voluntary client has stated he wants to leave the hospital. The nurse hides his clothes in an effort to keep him from leaving. With which of the following legal actions might the nurse be charged because of this nursing action? A. Assault B. Battery C. False imprisonment D. Breach of confidentiality
C. False imprisonment
Three years ago, Anna's dog Lucky, whom she had had for 16 years, was run over by a car and killed. Anna's daughter reports that since that time, Anna has lost weight, rarely leaves her home, and just sits and talks about Lucky. Anna's behavior would be considered maladaptive for which of the following reasons? A. It has been more than 3 years since Lucky died. B. Her grief is too intense over just the loss of a dog. C. Her grief is interfering with her functioning. D. Cultural norms typically don't comprehend grief over the loss of a pet.
C. Her grief is interfering with her functioning.
Benjamin is a member of an Alcoholics Anonymous group. He learned about the effects of alcohol on the body when a nurse from the chemical dependency unit spoke to the group. This is an example of which therapeutic factor? A. Catharsis B. Altruism C. Imparting of information D. Universality
C. Imparting of information
Carol is the nurse leader of a bereavement group for widows. Nancy is a new member. She listens to the group and learns that Jane has been a widow for 5 years. Jane has adjusted well, and Nancy thinks that maybe she can too. This is an example of which therapeutic factor? A. Universality B. Imitative behavior C. Installation of hope D. Imparting of information
C. Installation of hope
The nurse decides to tell the patient of his terminal status because she believes it is her duty to do so. Which of the following ethical theories is considered in this decision? A. Natural law theories B. Ethical egoism C. Kantianism D. Utilitarianism
C. Kantianism
Nursing diagnoses are prioritized according to which of the following? A. Degree of potential for resolution B. Legal implications associated with nursing intervention C. Life-threatening potential D. Client and family requests
C. Life-threatening potential
At a synapse, the determination of further impulse transmission is accomplished by means of which of the following? A. Potassium ions B. Interneurons C. Neurotransmitters D. The myelin sheath
C. Neurotransmitters
Which of the following parts of the brain deals with sensory perception and interpretation? A. Hypothalamus B. Cerebellum C. Parietal lobe D. Hippocampus
C. Parietal lobe
Lucky sometimes refused to obey Anna and, indeed, did not come back to her when she called to him on the day he was killed. But Anna continues to insist "he was the very best dog. He always minded me. He did everything I told him to do" This represents the defense mechanism of: A. Sublimation B. Compensation C. Reaction formation D. Undoing
C. Reaction formation
Attempting to calm an angry client by using "talk therapy" is an example which of the following clients rights? A. The right to privacy B. The right to refuse medication C. The right to the least restrictive treatment alternative D. The right to confidentiality
C. The right to the least restrictive treatment alternative
The nurse leader is explaining about group "therapeutic factors" to members of the group. She tells the members that group situations are beneficial because members can see that they are not alone in their experiences. This is an example of what therapeutic factor? A. Altruism B. Imitative behavior C. Universality D. Imparting of information
C. Universality
Dorothy was involved in an automobile accident while under the influence of alcohol. she swerved her car into a tree and narrowly missed hitting a child on a bicycle. She is in the hospital with multiple abrasions and contusions. She is talking about the accident with the nurse. Which of the following statements by the nurse is most appropriate? A. "Now that you know what can happen when you drink and drive, I'm sure you won't let it happen again" B. "You know that was a terrible thing you did. That child could have been killed" C. "I'm sure everything is going to be okay now that you understand the possible consequences of such behavior" D. "How are you feeling about what happened?"
D. "How are you feeling about what happened?"
Bill, who has been diagnosed with schizophrenia and has been on medication for several months states, "I'm not taking that stupid medication anymore!" Which of the following responses demonstrates a motivational interviewing style of communication? A. "Don't you know that if you don't take your medication you will never recover?" B. "Why won't you cooperate with the treatment your doctor prescribed?" C. "Bill, the medication is not stupid." D. "Tell me more about why you don't want to take the medication."
D. "Tell me more about why you don't want to take the medication."
Patient teaching is an important nursing function in milieu therapy. Which of the following statements by the patient indicates the need for knowledge and a readiness to learn? A. "Get away from me with that medicine! I'm not sick!" B. "I don't need psychiatric treatment. It's my migraine headaches that I need help with." C. "I've taken Valium every day of my life for the last 20 years. I'll stop when I'm good and ready!" D. "The doctor says I have bipolar disorder. What does that really mean?"
D. "The doctor says I have bipolar disorder. What does that really mean?"
Joe has been in rehabilitation for alcohol dependence. When he returns from a visit to his home, he tells the nurse, "We were having a celebration and I did have one drink, but it really wasn't a problem." The nurse notices that his breath smells of alcohol. Which of the following responses by the nurse demonstrates a motivational interviewing style of communication? A. "You are obviously not motivated to change so perhaps we should discuss your discharge from the treatment program." B. "You need to abstain from alcohol in order to recover, so let me talk to your doctor about the consequences of your behavior." C. "Why would you destroy everything you've worked so hard to achieve?" D. "What do you mean when you say, 'it really wasn't a problem'?"
D. "What do you mean when you say, 'it really wasn't a problem'?"
Joe is very restless and is pacing lot. The nurse says to Joe, "if you don't sit down in the chair and be still, I'm going to put you in restraints!" With which of the following legal actions might the nurse be charged because of this nursing action? A. Defamation of character B. Battery C. Breach of confidentiality D. Assault
D. Assault
Paul is a member of an anger management group. He knew that people did not want to be his friend because of his violent temper. In the group, he has learned to control his temper and form satisfactory interpersonal relationships with others. This is an example of which therapeutic factor? A. Catharsis B. Altruism C. Imparting of information D. Development of socializing techniques
D. Development of socializing techniques
Which of the following parts of the brain has control over the pituitary gland and autonomic nervous system as well as regulation of appetite and temperature? A. Temporal lobe B. Parietal lobe C. Cerebellum D. Hypothalamus
D. Hypothalamus
The nurse is using nursing process to care for a patient who is suicidal. Which of the following nursing actions is a part of the outcome identification step of the nursing process? A. Prioritizes the necessity for maintaining a safe environment for the patient. B. Determines if nursing interventions have been appropriate to achieve desired results. C. Obtains a commitment from the patient to work collaboratively to identify adaptive coping skills. D. Identifies that the "Patient will not harm self during hospitalization."
D. Identifies that the "Patient will not harm self during hospitalization."
S.T. is a 15-year-old girl who has just been admitted to the adolescent psychiatric unit with a diagnosis of anorexia nervosa. She is 5ft 5in. tall and weighs 82 lb. She was elected to the cheerleading squad for the fall but states that she is not as good as the others on the squad. The treatment team has identified the following problems: refusal to eat, occasional purging, refusing to interact with staff and peers, and fear of failure. Which of the following nursing diagnoses would be the highest priority diagnosis for S.T.? A. Social isolation B. Disturbed body image C. Low self-esteem D. Imbalanced nutrition: less than body requirements
D. Imbalanced nutrition: less than body requirements
Which of the following parts of the brain is associated with multiple feelings and behaviors and is sometimes referred to as the "emotional brain"? A. Frontal lobe B. Thalamus C. Hypothalamus D. Limbic system
D. Limbic system
Anna states that Lucky was her closest friend, and since his death, there is no one who could ever replace the relationship they had. According to Maslow's hierarchy of needs, which level of need is not being met? A. Physiological needs B. Self-esteem needs C. Safety and security needs D. Love and belonging needs
D. Love and belonging needs
Which of the following parts of the brain is concerned with visual reception and interpretation? A. Frontal lobe B. Parietal lobe C. Temporal lobe D. Occipital lobe
D. Occipital lobe
Anna's dog, Lucky got away from her while they were taking a walk. He ran into the street and was hit by a car. Anna cannot remember any of these circumstances of his death. This is an example of what defense mechanism? A. Rationalization B. Suppression C. Denial D. Repression
D. Repression
Sandra is the nurse leader of a supportive therapeutic group for individuals with anxiety disorders. On the first day the group meets, Valerie speaks first and begins sharing the intimate details of her incestuous relationship with her father. What type of member role is Valerie assuming in this group? A. Agressor B. Monopolizer C. Blocker D. Seducer
D. Seducer
When conducting a physical assessment, the nurse recognizes that biocultural variation is present in: a. Education level b. Oxygen saturation c. Socioeconomic status d. Skin color
D. Skin color
Aisha is a psychiatric nurse who has been selected to lead a group for women who desire to lose weight. The criterion for membership is that they must be at least 20 pounds overweight. All have tried to lose weight on their own many times in the past without success. At their first meeting, Aisha provides suggestions as the members determine what their goals will be and how they plan to achieve those goals. They decide how often they want to meet and what they plan to do at each meeting. Which type of group and style of leadership is described in this situation? A. Task; democratic B. Teaching; laissez-faire C. Self-help; democratic D. Supportive-therapeutic; autocratic
D. Supportive-therapeutic; autocratic
Education for the patient who is taking an MAOI should include which of the following? A. Fluid and sodium replacement when appropriate, frequent drug blood levels, signs and symptoms of toxicity. B. Lifetime of continuous use, possible tardive dyskinesia, advantages of an injection every 2 to 4 weeks C. Short-term use, possible tolerance to beneficial effects, careful tapering of the drug at end of treatment D. Tyramine-restricted diet, prohibitive concurrent use of over-the-counter medications without physician notification
D. Tyramine-restricted diet, prohibitive concurrent use of over-the-counter medications without physician notification
The nurse has just admitted Hannah to the psychiatric unit. The psychiatrist has diagnosed Hannah with major depressive disorder. The nurse says to Hannah, "What questions do you have about being here on the unit?" Which nursing role described by Peplau is the nurse fulfilling in this instance? a. Resource person b. Counselor c. Surrogate d. Technical expert
a. Resource person
During the assessment of a 35-year-old Asian American patient, the nurse asks the patient her preferences among different group treatment options. The patient indicates that she will need to discuss this with her parents because that's how decisions are made in her family. The most likely rationale is that: a. The patient ascribes to collectivist cultural values. b. The patient ascribes to individualistic cultural values. c. The patient has a passive dependent personality disorder. d. The patient comes from an emotionally abusive family.
a. The patient ascribes to collectivist cultural values.
Danny has been diagnosed with schizophrenia. On the unit he appears very anxious, paces back and forth, and darts his head from side to side in a continuous scanning of the area. He has refused to eat, making some barely audible comment related to "being poisoned." In planning care for Danny, which of the following would be the primary focus for nursing? a. To decrease anxiety and develop trust b. To set limits on his behavior c. To ensure that he gets to group therapy d. To attend to his hygiene needs
a. To decrease anxiety and develop trust
John is on the Alcohol Treatment Unit. He walks into the dayroom where other patients are watching a program on TV. He picks up the remote and changes the channel, saying, "That's a stupid program! I want to watch something else!" In what stage of development is John fixed according to Sullivan's interpersonal theory? a. Juvenile. He is learning to form satisfactory peer relationships. b. Childhood. He has not learned to delay gratification. c. Early adolescence. He is struggling to form an identity. d. Late adolescence. He is working to develop a lasting relationship.
b. Childhood. He has not learned to delay gratification.
Mr. J. is a new patient on the psychiatric unit. He is 35 years old. Theoretically, in which level of psychosocial development (according to Erikson) would you place Mr. J.? a. Intimacy vs. isolation b. Generativity vs. self-absorption c. Trust vs. mistrust d. Autonomy vs. shame and doubt
b. Generativity vs. self-absorption
Larry, who has antisocial personality disorder, feels no guilt about violating the rights of others. He does as he pleases without thought to possible consequences. In which of Peplau's stages of development would you place Larry? a. Learning to count on others b. Learning to delay gratification c. Identifying oneself d. Developing skills in participation
b. Learning to delay gratification
A culturally relevant health history considers all except which one of the following? a. Past and present modalities of self-care and self-treatments b. Presence or absence of health insurance c. Prevalence of disease conditions among family and relatives d. Past and present exposure to illnesses, hazardous conditions, and toxic substances
b. Presence or absence of health insurance
Adam has antisocial personality disorder. He says to the nurse, "I'm not crazy. I'm just fun-loving. I believe in looking out for myself. Who cares what anyone thinks? If it feels good, do it!" Which of the following describes the psychoanalytical structure of Adam's personality? a. Weak id, strong ego, weak superego b. Strong id, weak ego, weak superego c. Weak id, weak ego, punitive superego d. Strong id, weak ego, punitive superego
b. Strong id, weak ego, weak superego
CLAS standards apply to all of the following except: a. Healthcare organizations b. Individual clinicians and healthcare practitioners c. Manufacturers of pharmaceutical products d. Hospitals
c. Manufacturers of pharmaceutical products
Mr. J. has been diagnosed with schizophrenia. He refuses to eat and told the nurse he knew he was "being poisoned." According to Erikson's theory, in what developmental stage would you place Mr. J.? a. Intimacy vs. isolation b. Generativity vs. self-absorption c. Trust vs. mistrust d. Autonomy vs. shame and doubt
c. Trust vs. mistrust
In evaluating pharmacotherapy interventions, the nurse recognizes that: a. All patients respond to drug therapy in the same manner. b. Dosing and age-specific considerations are minor factors in evaluation. c. Patients from other cultures don't recognize the value of medication as a treatment modality. d. Environmental, cultural, and genetic factors affect pharmacokinetics.
d. Environmental, cultural, and genetic factors affect pharmacokinetics.
Janet, a psychiatric patient diagnosed with borderline personality disorder, has just been hospitalized for threatening suicide. According to Mahler's theory, Janet did not receive the critical "emotional refueling" required during the rapprochement phase of development. What are the consequences of this deficiency? a. She has not yet learned to delay gratification. b. She does not feel guilt about doing wrong to others. c. She is unable to trust others. d. She has internalized rage and fears of abandonment.
d. She has internalized rage and fears of abandonment.