Mental Health Exam 3 :)

The critical factor to assess with a suicidal client is: A) Reasons to go on living B) Whether or not there is a plan C) Presence of family members D) Reasons for wanting to commit suicide

B

The nurse is leading a support group for women who have experiences interpersonal violence. When a patient asks about the characteristics of the perpetrators of interpersonal violence, the nurse accurately responds that they are: A) Usually under the influence of alcohol B) Most often someone the victim knows C) A stranger to the victim in most cases D) Often in a psychotic state during the act.

B

When asked how tricyclic antidepressants affect the neurotransmitter activity, the nurse should respond that they: A) Decrease available dopamine B) Increase availability of norepinephrine and serotonin. C) Make available increased amounts of monoamine oxidase. D) Increase availability of histamine

B

When discussing depression and suicide with parents of male teenagers, the nurse is accurate in reporting that the most common method used by those 18-19 years of age is: A) Hanging B) Firearms C) Oral poisoning D) Drug overdose

B

When symptom related to thought-flow disturbances is the nurse most likely to assess in a newly admitted patient who is diagnosed with bipolar disorder, manic episode? A) Slow, halting speech B) Flight of ideas C) Schemata D) Anhedonia

B

Which behavior is supportive of a diagnosis of dependent personality disorder? A) Perceives personal behavior to be embarrassing B) Believes they are incapable of functioning independently C) Tends to exaggerate the potential dangers of ordinary situations D) Demands excessive attention from other whenever in a group situation

B

A nurse planning a group to help batterers learn more effective ways to cope would teach participants that the key component in wife battering is: A) The need of the batterer to control B) The role of alcohol in the pattern of abuse C) History of psychotic or paranoid behavior. D) Failure of the woman involved to assert herself.

A

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

A

A patient who has a history of bipolar disorder recently underwent orthopedic surgery and was discharged to return home. When at home, the nurse documented the following: slow and soft speech; sad facial expression; patient crying when describing extreme fatigue, low mood, and the feeling that he will never get well. He has refused to bathe or perform ADLs for several days. Which nursing diagnosis would be appropriate? A) Self-care deficit secondary to possible depression. B) Situational low self-esteem related to immobility. C) Deficient knowledge related to depression and surgery. D) Disturbed though processes related to bipolar disorder.

A

A patient who is a policewoman tells the nurse she is depressed and can no longer deal with the stress of her job. She mentions that employee assistance counseling failed to change her hopeless attitude. She states that she will use her police revolver to shoot herself in the head during the day when no one is at home and the home is locked. Which formulation by the triage nurse is correct? A) Plan explicit. Imminence high. Method highly lethal and accessible. rescue potential low B) Plan vague. Imminence moderate. Method somewhat lethal and accessible. Rescue potential moderate. C) Plan complete. Imminence low. Method low lethality but accessible. Rescue potential high D) Plan vague. Immense low. Method low lethality but accessible. Rescue potential high.

A

A substance use disorder (SUD) is likely comorbid mental illness in which patient? A) The soldier diagnosed with posttraumatic stress disorder B) The teenager demonstrating symptoms of poor impulse control. C) The older adult diagnosed with early stage Alzheimer's disease. D) The new mother exhibiting symptoms of postpartum depression.

A

An inappropriately dressed patient has not slept for 3 days while making excessive, expensive long-distance phone calls. When the patient can be heard singing loudly in the examining room, the nurse makes initial plans to focus on: A) Assessing needs for food, liquids, and rest B) Setting strict limits on dress and behavior C) Conducting an in-depth suicide assessment D) Obtaining a complete psychosocial assessment

A

Mr. Roberts is admitted to the ER with symptoms of confusion, rambling illogical speech and disorientation. In assessing this patient, which question has priority? A) When did Mr. Robert's symptoms begin? B) What kind of care has Mr. Roberts been receiving at home? C) What medications is Mr. Roberts receiving? D) What kind of diet is Mr. Roberts able to tolerate?

A

The individual who displays the history and symptoms most consistent with a medical diagnosis of seasonal affective disorder (SAD) is: A) 26 years of age and complains of 3 consecutive years of depressed mood beginning in November and remitting in April B) 64 year of age and complains of anhedonia, early morning awakening, psychomotor retardation, weight loss, and excessive feeling of guilt. C) 46 years of age and complains of dysphoric mood for 3 years, poor concentration, loss of interest in social activities, indecision, low energy, and low self-esteem. D) 38 years of age and complains of sadness, loss of ability to react to positive stimuli, weight gain, hypertension, leaden paralysis of limbs, and sensitivity to interpersonal rejection

A

The nurse is discussing causes of Alzheimer's disease with a patient's family. The nurse bases his response on the knowledge that which of the following factors is not associated with increased incidence of Alzheimer's disease? A) Multiple small strokes. B) Family history of Alzheimer's disease. C) Head trauma D) Advanced age

A

Which of the following behavior patterns is consistent with an individual with narcissistic personality disorder? A) Overly self-centered and exploitive of others B)Suspicious and distrustful of others C) Rule conscious and disapproving of change D) Anxious and socially isolated

A

From which of the following symptoms might the nurse identify chronic cocaine abuser? A) Clear constricted pupils B) Red, irritated nostrils C) Muscle aches D) Conjunctival redness

B

A patient who has been taking lithium carbonate 3000 mg tid comes to the Outpatient Department with a list of medications he is taking. Which of the medications on the list would require re-evaluation of lithium dosage? (best answer) A) A diuretic B) A benzodiazepine C) An antidepressant D) An antibiotic

A`

"Splitting" by the client with borderline personality disorder denotes: A) Evidence of precocious development B) A primitive defense mechanism in which the client sees objects as all good or all bad C) A brief psychotic episode in which the client loses content with reality D) Two distinct personalities within the client

B

A suicidal patient tells the nurse, "There's no other way out for me. I have so many problems that there's nothing to do but cash it in." Which statements by the nurse would be a helpful approach? A) "I can see that things are bad. It's good you recognize your limitations." B) "Let's look at the problem you consider most urgent to see about a solution." C) "We'll begin problem-solving together as soon as you stop feeling suicidal." D) "Your thinking is flawed. I'll teach you to think differently and be less depressed."

B

A young child is being evaluated in the Emergency Department for injuries her mother reports resulted from a fall down the stairs. Which of these finding indicates that physical abuse may be chronic problem for the child? A) The mother's description of the child as being "clumsy" B) Several fractures revealed on x-ray in varying degree of healing C) Clinging to her mother as she attempted to leave the examining room D) Struggling with the staff when attempts to obtain a blood specimen were made.

B

An appropriate expected outcome to family therapy regarding the perpetrator of abuse would be: A) A decrease in family interactions so there are fewer opportunities for abuse to occur B) The perpetrator will recognize destructive patterns of behavior and learn alternative responses C) The perpetrator will no longer live with the family but have supervised visits while in intensive inpatient therapy D) A variety of treatment modalities, including medication and counseling

B

In working in a crisis center with a woman with two children, who has been abused by her husband, the nurse is aware that the most common reason that this woman will return to her husband is: A) The children have a close emotional bond with their father. B) The woman is financially dependent on her husband. C) The woman really loves her husband D) She is afraid pf societal criticism

B

Mrs. Jones is diagnosed with Alzheimer's disease and is prescribed donepezil (Aricept). In teaching the family about this medication, which of the following statements is most accurate? A) This medication will help decrease the patient's anxiety. B) In some patients, this medication will delay the progression of the disease for 18 months. C) This medication decreases the amount of available acetylcholine, which increases cognitive function. D) This purpose of this medication is to decrease hallucinations.

B

A 75 year old patient, who lives with her son, is admitted to the hospital for pneumonia. The nurse observe that the patient's clothes are old and dirty. The patient also has a small decubitus on her sacrum. The best question to assess for the possibility of abuse would be which of the following? A) "How long have you lived with your son?" B) "How much money do you have in your bank account?" C) "Describe a typical day at home. What do you have to eat, what do you do during the day, and what time do you bathe?" D) "Who buys your clothes for you?"

C

A patient recently discharged from an alcohol rehabilitation program is brought to the hospital in a state of prostration with severe throbbing headache, tachycardia, a beet-red face, dyspnea, and continuous vomiting. The patient's significant other states the patient got sick about 15 minutes after drinking a glass of wine. The nurse should be guided in assessment by the suspicion that the patient: A) Is having a stroke B) Has alcohol intoxication C) Is reaching to disulfiram (Antabuse) D) Is exhibiting symptoms of cross-dependence.

C

If an individual is admitted with a diagnosis of Wernicke-Korsakoff's syndrome the nurse would expect assess: A) Peptic ulcer B) Vivid illusions C) Cognitive deficits D) Auditory hallucinations

C

Mrs. Jamison, a 72 year-old who seldom attends the adult day center where you work, begins telling you her life story, with many references to her deceased husband and sisters. She states she misses each of them terribly and that she can't keep on going, that there is nothing to live for any more. What is you most therapeutic response? A) "Now Mrs. Jamison, you you know that isn't true." B) "In your situation, I might feel the same way." C) "It sounds like you are feeling pretty hopeless." D) "Things will look better tomorrow."

C

Mrs. Jones is diagnosed with Alzheimer's disease and is taking donepezil (Aricept). In reviewing her medications, which of the following medications would prompt the nurse to question the order? A) Trazodone (Desyrel) for sleep B) Acetaminophen (Tylenol) prn for pain C) Amitriptyline (Elavil) for depression D) Olanzapine (Zprexa) for thought disturbances

C

Symptoms of alcohol withdrawal include: A) Euphoria, hyperactivity and insomnia B) Depression, suicidal ideation, and hypersomnia C) Diaphoresis, nausea and vomiting, and tremors D) Unsteady gait, nystagmus and profound disorientation

C

The night nurse finds Mrs. Brown, a client with Alzheimer's disease, wandering the hallway at 4 A.M. and trying to open the door to the side yard. Which statement by the nurse probably reflects the most accurate assessment of the situation? A) "That door leads to the patio, Mrs. Brown. You don't want to go outside now." B) "You look confused, Mrs. Brown. What is bothering you?" C) "This is the patio door Mrs. Brown. Are you looking for the bathroom?" D) "Are you lonely? Perhaps you'd like to go back to your room and talk for a while."

C

The nurse notes that a patient has been receiving paroxetine (Paxil) for symptoms of major depression begins to behave in a confused and elated manner with the presence of restlessness, muscle jerking, and diaphoresis. The nurse should assess these symptoms as probable: A) Neuroleptic malignant syndrome B) Anticholinergic blockade C) Serotonin syndrome D) Dystonia

C

There are several suicidal patients on the psychiatric unit. When meal trays are returned to the kitchen, a serrated-edge knife is missing. The nurse to whom the aide reports this should: A) Acknowledge the information and be watchful for the remainder of the shift. B) Ask each of the patients on suicide precautions where the knife is hidden. C) Report the information tot he charge nurse and suggest a unit search. D) Report the information to security and let them handle the matter.

C

When analyzing the behaviors of a 23 year old who meets the criteria for antisocial personality disorder, the nurse recognizes that which nursing diagnosis would be pertinent to his care? A) Risk for self-mutilation B) Disturbed personal identity C) Impaired social interaction D) Social Isolation

C

Which observation is supportive of a diagnosis of avoidant personality disorder? A) Talks about "my three failed marriages" B) Cries loudly whenever requests are denied. C) Fears criticism from others, including staff. D) Shows no remorse when accidentally breaking patient's bracelet.

C

Which patient statement should receive priority from a patient who is taking MAOI isocarboxazide (Marplan?) A) "I haven't had a bowel movement in 2 days." B) "Will you take my temperature? I feel too warm/" C) "I had cheese breakfast." D) "My legs get still when I sit in the chair for any length of time."

C

You are assessing Linda, a 25 year old woman who came to the ED with a broken arm. She says she slipped on the ice on the steps outside her home. She has numerous other bruises in various stages of healing. Her boyfriend, with whom she lives accompanied her to the ED and aggressively responds to questions posed to the patient, while Linda remains silent. What is your response to boyfriend? A) "It sounds as if you love Linda a lot. She is lucky to have such support ." B) "By answering the questions for her, it seems as if you don't want her to answer. What are you afraid of?" C) "I now need to examine Linda in private. Please wait outside the room. I will come get you when we are finished." D) I am calling security to have you escorted out because you are interfering with Linda's care."

C

You are discharging Vanessa, a 30 year old victim of domestic violence from the emergency department. She has sustained bruises and abrasions but not more serious trauma. She is afraid she will lose custody of her daughter, who has not been harmed and who is currently staying with Vanessa's mother. Which intervention on your part is indicated? A) Probe Vanessa for information to use as evidence in prosecuting the perpetrator B) Advise Vanessa to leave her partner and move in with her mother C) Assist Vanessa to develop a safety plan for rapid escape in case abuse happens again D) Schedule Vanessa for interpersonal counseling

C

A confused and disoriented patient, newly admitted to the gerontology unit, is diagnosed with delirium. Which of the following statements support this diagnosis? A) Patient has a history of increasing forgetfulness B) Patient recently fell while in the bathroom C) Patients temperature is 101.8 degrees D) Patient is 78 years old

D

A patient states he has "given up on life. His wife left him, he was fired from his job, and he is four payments behind on his mortgage. What nursing diagnosis is appropriate? A) Anxiety related to multiple losses B) Defensive coping related to multiple loses C) Ineffective denial related to multiple losses D) Hopelessness related to multiple losses

D

High risk factors for childhood sexual abuse include which of the following? A) Undereducated parents B) Low-income families C) Multiple siblings D) Parents who were sexually abused as children

D

Kim has a diagnosis of borderline personality disorder. She exhibits alternating clinging and distancing behaviors. The most appropriate nursing intervention would be to: A) Encourage Kim to establish trust in one staff person with who, all therapeutic interactions should take place. B) Secure a verbal contract from Kim that she will discontinue these behaviors. C) Withdraw attention if these behaviors continue. D) Rotate staff members assigned to Kim so she will learn to relate to more than one person.

D

The nurse caring for an extremely withdrawn patient with depression wants to assist her to become more interactive. The best approach would be to say: A) "I know you'll feel better if you leave your room." B) "You look so gloomy sitting here all by yourself." C) "Let's explore how it feels to sit alone here all day and feel sad." D) "I need another person for a card game and I'd like you to be my partner."

D

Wen planning care for a patient with antisocial personality disorder, which consideration has the greatest importance? A) Addressing the demand for constant attention. B) Teaching coping skills related to frustration tolerance. C) Identifying behaviors related to well-developed ego. D) Manage manipulative behaviors of socially irresponsible, exploitive, and without remorse.

D

When following up on SSRI medication side effects, the nurse will need to make specific inquires about: A) Anticholinergic symptoms B) Alpha-adrenergic blockade C) GI tract symptoms D) Sexual dysfunction

D

Which assessment observation is the best support for a patient's diagnosis of alcoholism? A) Reporting, "I messed up three marriages." B) Testing positive for hepatitis B virus (HBV) C) Admission that, "I drink more than I should." D) A positive response to three items on the CAGE test.

D

Which intervention will the nurse plane for when managing the detoxication of a patient diagnosed with chronic alcoholism? A) Low-protein diet to minimize risk of kidney failure B) Seclusion to help manage aggression towards others C) Transporting patient to scheduled 12-step support group meetings D) Administering Ativan (lorazepam) to manage alcohol withdrawal symptoms

D

Which interventions has priority when a nurse suspects a staff member of providing patient care while being impaired by alcohol or drugs? A) Asking the staff member to explain their suspicious behavior B) Adjust the staff member's assignment to minimize patient contact C) Providing the staff member with material regarding alcohol abuse and treatment D) Reporting the staff member's suspicious behavior to the nursing supervisor on duty

D

Which of these statements made by a patient taking the MAOI tanylcypromine (Parnate) would warrant further instruction? A) "I often forget to wear sunscreen" B) "I need to restrict the amount of sodium in my diet" C) "I should not use over-the counter cold medications" D) "I usually order liver and onions when my wife and I eat out"

D