Mental health nursing final exam
A student says, "Before taking a test, I feel a heightened sense of awareness and restlessness." What nursing intervention is most helpful for assisting the student? A) advising the student to discuss this experience with a health care provider B) encouraging the student to begin antioxidant vitamin supplements C) explaining that the symptoms are the result of mild anxiety and discussing the helpful aspects D) listening without comment
C) explaining that the symptoms are the result of mild anxiety and discussing the helpful aspects
A patient who fears serious heart disease was referred to the mental health center by a cardiologist after diagnostic evaluation showed no physical illness. The patient says, "My heart misses beats. I'm frequently absent from work. I don't go out much because I need to rest." Which health problem is most likely? A) depersonalization disorder B) persistent depressive disorder C) illness anxiety disorder D) antisocial personality disorder
C) illness anxiety disorder
A nurse wishes to teach alternative coping strategies to a patient experiencing severe anxiety. The nurse will first need to: A) verify the patients learning style B) assess how the patient uses defense mechanisms C) lower the patients current anxiety level D) create outcomes and a teaching plan
C) lower the patients current anxiety level
A nurse administering psychotropic medications should be prepared to intervene when giving a drug that blocks the attachment of norepinephrine to α1-receptors because the patient may experience what effect? A) severe appetite disturbance B) hypertensive crisis C) orthostatic hypotension D) increased psychotic symptoms
C) orthostatic hypotension
A nurse wants to enhance the growth of a patient by showing positive regard. What nursing action is consistent with this wish? A) administering daily medication as prescribed B) making patient rounds daily C) staying with a tearful patient D) examining personal feelings about a patient
C) staying with a tearful patient
Why should the nurse introduce the matter of a contract during the first session with a new patient? A) to prevent either party from prematurely ending the relationship B) to indicate the feeling tone established between the participants C) to explain the participation and responsibilities of each party D) to specify what the nurse will do for the patient
C) to explain the participation and responsibilities of each party
An adolescent hospitalized after a violent physical outburst tells the nurse, "I'm going to kill my father, but I know you can't tell anyone." What is the nurse's best response? A) "Those kinds of thoughts will make your hospitalization even longer." B) "You really should share these kinds of thoughts with your psychiatrist." C) "You're right. Federal law requires me to keep that information private." D) "I am required to share information like this with your treatment team."
D) "I am required to share information like this with your treatment team."
Which patient statement best supports the diagnosis of somatic disorders? A) "I feel as if different parts of my body are at war" B) "I feel as if I'm living in a fuzzy dream state" C) "I feel very anxious and worried about my problems" D) "I can't do much because of the severe pain"
D) "I can't do much because of the severe pain"
Which remark by a patient indicates passage from the orientation phase to the working phase of a nurse-patient relationship? A) "I don't have any problems" B) "I don't know how talking about things twice a week can help" C) "It is so difficult for me to talk about my problems." D) "I want to find a way to deal with my anger without becoming violent"
D) "I want to find a way to deal with my anger without becoming violent"
A nurse's neighbor asks, "Why aren't people with mental illness kept in state institutions anymore?" What is the nurse's best response? A) "Many people are still in psychiatric institutions. Inpatient care is needed because many people who are mentally ill are violent." B) "Our nation has fewer persons with mental illness; therefore, fewer hospital beds are needed." C) "Psychiatric institutions are no longer popular as a consequence of negative stories in the press." D) "Less restrictive settings are now available to care for individuals with mental illness"
D) "Less restrictive settings are now available to care for individuals with mental illness"
A soldier returned home last year after deployment to a war zone. The soldier's spouse reports, "We were going to start a family but now he won't talk about it. He will not look at children. I wonder if we're going to make it as a couple." What response best addresses the spouse's concerns? A) "Have you talked with your spouse about these reactions? Sometimes we just need to confront behavior." B) "Posttraumatic stress disorder often changes a person's sexual functioning." C) "I encourage you to continue to participate in social activities where children are present." D) "Posttraumatic stress disorder often strains relationships. I will suggest some community resources for help and support."
D) "Posttraumatic stress disorder often strains relationships. I will suggest some community resources for help and support."
A nurse assesses a patient diagnosed with functional neurological (conversion) disorder. Which comment best supports this diagnosis? A) "Sexual intercourse is painful. I pretend as if I'm asleep so I can avoid it. I think it's starting to cause problems with my marriage." B) "I have daily problems with nausea, vomiting, and diarrhea. My skin is very dry and I think I'm getting seriously dehydrated." C) "I get choked very easily and have trouble swallowing when I eat. I think I might have cancer of the esophagus." D) "Since my father died, I've been short of breath and had sharp pains that go down my left arm, but I think it's just indigestion."
D) "Since my father died, I've been short of breath and had sharp pains that go down my left arm, but I think it's just indigestion."
Which assessment question would be most appropriate for the nurse to ask a patient who is at risk for developing generalized anxiety disorder (GAD)? A) "do you repeatedly do certain things over and over again?" B) "do you feel especially uncomfortable in social situations involving people?" C) "have you been a victim of a crime or seen someone badly injured or killed?" D) "do you find it difficult to control your worrying?"
D) "do you find it difficult to control your worrying?"
A patient tells the nurse, "I don't think I will ever get out of here." Select the nurse's most therapeutic response. A) "don't talk that way. of course you will leave here" B) "everyone feels that way sometimes" C) "you don't think you're making progress?" D) "keep up the good work and you certainly will"
"you don't think you're making progress?"
For a patient diagnosed with somatic symptom disorder, what statement would effectively complete the long-term outcome of "Within 4 weeks, the patient will demonstrate an ability to? A) Identifying personal coping patterns that are proving to be ineffective. B) Functioning independently on a basic level. C) Verbalizing feelings of physical and emotional safety. D) Regularly attending prescribed diversional activity groups.
A) Identifying personal coping patterns that are proving to be ineffective.
A nurse assesses an inpatient psychiatric unit, noting that exits are free from obstruction, no one is smoking, the janitor's closet is locked, and all sharp objects are being used under staff supervision. These observations relate to what nursing responsibility? A) management of milieu safety B) use of therapeutic intervention strategies C) management of interpersonal climate D) coordinating care of patients
A) management of milieu safety
A student says, "Before taking a test, I feel a heightened sense of awareness and restlessness." The nurse can correctly assess that the student's response is a result of what? A) mild anxiety B) displacement C) cultural influence D) trait anxiety
A) mild anxiety
A supervisor assigns a worker a new project. The worker initially agrees but feels resentful. The next day, when asked about the project, the worker says, "I've been working on other things." When asked 4 hours later, the worker says, "Someone else was using the copier, so I couldn't finish it." The worker's behavior demonstrates the use of what mechanism? A) passive aggression B) acting out C) projection D) suppression
A) passive aggression
An adult diagnosed with conversion (functional neurobiological symptom) disorder says, "Our family has gotten along over the years by working together. My partner cooks and the children clean house." Understanding of this disorder will provide what rationalization for this statement? A) patient is receiving secondary gains from the symptoms B) patient will benefit from the confrontation about physical complaints C) patient has problems with sexual identity and satisfaction D) patient will be resistant to developing a trusting relationship
A) patient is receiving secondary gains from the symptoms
Which assessment finding for a patient living in the community requires priority intervention by the nurse? A) purchases and uses marijuana on a frequent basis B) lives in an apartment with two patients who attend day hospital programs C) receives social security disability income plus a small check from a trust fund D) has a sibling who is interested and active in care planning
A) purchases and uses marijuana on a frequent basis
A person who is speaking about a contender for a significant other's affection says in a gushy, syrupy voice, "What a lovely person. That's someone I simply adore." The individual is demonstrating what defense mechanism? A) reaction formation B) projection C) denial D) repression
A) reaction formation
A patient with a high level of motor activity runs from chair to chair and cries, "They're coming! They're coming!" The patient is unable to follow instructions or respond to verbal interventions from staff. Which nursing diagnosis has the highest priority? A) risk for injury B) disturbed thought processes C) self-care deficit D) disturbed energy field
A) risk for injury
The goal for a patient is to increase resiliency. Which outcome should the nurse add to the plan of care to be achieved within three days? A) patient will describe feelings associated with loss and stress B) patient will identify healthy coping behaviors in response to stressful events C) patient will allow others to assume responsibility for major areas of own life D) patient will meet own needs before considering the rights of others
B) patient will identify healthy coping behaviors in response to stressful events
A patient demonstrates disorganized thinking associated related to a diagnosis of schizophrenia. Neuroimaging would most likely show dysfunction in which part of the brain? A) brainstem B) prefrontal cortex C) temporal lobe D) cerebellum
B) prefrontal cortex
A patient tells the nurse, "I don't go to restaurants because people might laugh at the way I eat, or I could spill food and be laughed at." The nurse assesses this behavior as consistent with which mental health diagnosis? A) acrophobia B) social anxiety disorder C) agoraphobia D) posttraumatic stress disorder (PTSD)
B) social anxiety disorder
An individual has been diagnosed with a dissociative disorder. Which comorbid psychiatric disorders are most likely to accompany this type of mental illness? (Select all that apply.) A) schizophrenia B) substance use disorders C) depression D) personality disorders E) eating disorders
B) substance use disorders C) depression D) personality disorders E) eating disorders
A Puerto Rican-American patient uses dramatic body language when describing emotional discomfort. Which analysis most likely explains the patient's behavior? A) a belief that dramatic body language is sexually appealing B) a histrionic personality disorder is likely C) belongs to a culture in which dramatic body language is the norm D) wishes to impress staff with the degree of emotional pain
C) belongs to a culture in which dramatic body language is the norm`
A nurse says, "I am the only one who truly understands this patient. Other staff members are too critical." What does the nurse's statement indicate? A) sexual harassment B) advocacy C) boundary blurring D) positive regard
C) boundary blurring
A patient approaches the nurse and impatiently blurts out, "You've got to help me! Something terrible is happening. My heart is pounding." The nurse responds, "It's almost time for visiting hours. Let's get your hair combed." Which approach has the nurse used? A) focusing B) responding to physical needs C) bringing up an irrelevant topic D) addressing false cognitions
C) bringing up an irrelevant topic
Which action by a psychiatric nurse best supports a patients rights to be treated with dignity and respect? A) informing a treatment team that a patient is too drowsy to participate in care planning B) strongly encouraging a patient to participate in the unit milieu C) consistently addressing a patient by title and surname D) discussing a patient's condition with another health care provider in the elevator
C) consistently addressing a patient by title and surname
A nurse assesses that a patient is suspicious and frequently manipulates others. Using the Freudian theory, these traits are related to which psychosexual stage? A) anal B) oral C) genital D) phallic
B) oral
A soldier returns to the United States from active duty in a combat zone. The soldier is diagnosed with posttraumatic stress disorder (PTSD). The nurse's highest priority is to screen this soldier for which problem? A) major depressive disorder B) dementia C) bipolar disorder D) schizophrenia
A) major depressive disorder
A veteran of military combat tells the nurse, "I saw a child get blown up over a year ago, and now I keep seeing bits of flesh everywhere. I see something red and the visions race back to my mind." Which phenomenon associated with posttraumatic stress disorder (PTSD) is this veteran describing? A) psychosis B) hyperarousal C) avoidance D) re-experiencing
D) re-experiencing
A patient's partner, who is a chemist, asks a nurse how serotonin reuptake inhibitors (SSRIs) lift depression. What response will the nurse provide? A) makes more serotonin available at the synaptic gap B) blocks muscarinic and alpha1-norepinephrine receptors C) increases production of acetylcholine and dopamine D) destroys increased amounts of neurotransmitters
A) makes more serotonin available at the synaptic gap
A nurse encourages an anxious patient to talk about feelings and concerns. What is the rationale for this intervention? A) Encouraging patients to explore alternatives increases the sense of control and lessens anxiety B) Concerns stated aloud become less overwhelming and help decrease feelings of isolation C) Offering hope allays and defuses the patient's anxiety D) Anxiety is reduced by focusing on and validating what is occurring in the environment
A) Encouraging patients to explore alternatives increases the sense of control and lessens anxiety
A 26-month-old child displays negative behaviors. The parent says, "My child refuses toilet training and shouts, 'No!' when given direction. What do you think is wrong?" Select the nurse's best reply. A) "this is normal for your child's age. the child is striving for independence." B) "some undesirable attitudes are developing. a child psychologist can help you develop a remedial plan." C) "the child needs firmer control. punish the child for disobedience and say "no"." D) "there may be developmental problems. most children are toilet trained by age 2 years."
A) "this is normal for you child's age. the child is striving for independence"
A patient prescribed a muscarinic-receptor blocker, will require assess for what side effect? A) pseudo-parkinsonism B) dry mouth C) orthostatic hypotension D) gynecomastia
B) dry mouth
A nurse is talking with a patient, and 5 minutes remain in the session. The patient has been silent for most of the session. Another patient comes to the door of the room, interrupts, and says to the nurse, "I really need to talk to you right now." What action is most appropriate? A) Telling the patient who interrupted, "This session will end in 5 minutes; then, I will talk with you." B) Ending the unproductive session with the current patient and spend time with the patient who has just interrupted. C) Saying to the interrupting patient, "I am not available to talk with you at the present time." D) Inviting the interrupting patient to join in the session with the current patient.
A) Telling the patient who interrupted, "This session will end in 5 minutes; then, I will talk with you."
Which situations qualify as abandonment on the part of a nurse? (Select all that apply.) A) The nurse terminates employment without referring a seriously mentally ill patient for aftercare. B) The nurse asks another nurse to provide a patient's care because of concerns about countertransference. C) The nurse calls police to bring a suicidal patient to the hospital after a suicide attempt. D) The nurse refers a patient with persistent paranoid schizophrenia to community treatment. E) The nurse allows a patient with acute mania to refuse hospitalization without taking further action.
A) The nurse terminates employment without referring a seriously mentally ill patient for aftercare. E) The nurse allows a patient with acute mania to refuse hospitalization without taking further action.
Which medication would the nurse expect to be prescribed for a patient diagnosed with a somatic symptom disorder? A) Antidepressant medications to treat underlying depression B) Conventional antipsychotic medications to correct cognitive distortions C) Narcotic analgesics for use as needed for acute pain D) Long-term use of benzodiazepines to support coping with anxiety
A) antidepressant medications to treat underlying depression
A patient is hospitalized for a reaction to a psychotropic medication and then is closely monitored for 24 hours. During a pre-discharge visit, the case manager learns the patient received a notice of eviction on the day of admission. What is the most appropriate intervention for the case manager to implement? A) arrange for a temporary place for the patient to stay until new housing can be secured B) document that the patient's recovery will be hampered because of homelessness C) contact the landlord who evicted the patient to discuss the situation D) cancel the patient's discharge from the hospital
A) arrange for a temporary place for the patient to stay until new housing can be secured
A patient hurriedly tells the community mental health nurse, "Everything's a disaster! I can't concentrate. My disability check didn't come. My roommate moved out, and I can't afford the rent. My therapist is moving away. I feel like I'm coming apart." What should be the immediate focus of nursing care? A) assisting with the management of anxiety that may lead to psychosocial disequilibrium B) facilitating the clarification of the patient's misperceptions of the environment C) helping the patient cope with feelings of abandonment D) assisting with the clarification of personal values
A) assisting with the management of anxiety that may lead to psychological disequilibrium
A patient with blindness related to a functional neurological (conversion) disorder states, "All the doctors and nurses in this hospital stop by often to check on me. Too bad people outside the hospital don't find me interesting." Which nursing diagnosis is most relevant? A) chronic low self esteem B) ineffective health maintenance C) interrupted family processes D) social isolation
A) chronic low self-esteem
Termination of a therapeutic nurse-patient relationship with a patient has been successful when nurse engages in what action? A) Discusses with the patient changes that have happened during the relationship and evaluates the outcomes. B) avoids upsetting the patient by shifting focus to other patients before the discharge C) gives the patient a personal telephone number and permission to call after discharge D) offers to meet the patient for coffee and conversation three times a week after discharge
A) discusses with the patient changes that have happened during the relationship and evaluates the outcomes
A patient's blindness is related to a functional neurological (conversion) disorder. To help the patient eat, the nurse should implement what intervention? A) Expecting the patient to self-feed after explaining the arrangement of the food on the tray B) Establishing a "buddy" system with other patients who can feed the patient at each meal C) Directing the patient to locate items on the tray independently with feeding being unassisted D) Addressing the needs of other patients in the dining room, and then feeding this patient
A) expecting the patient to self-feed after explaining the arrangement of the food on the tray
A soldier returned 1 year ago from Afghanistan and was diagnosed with posttraumatic stress disorder (PTSD). Which social event would most likely be disturbing for this soldier? A) fireworks display on July 4th B) singing carols around a Christmas tree C) family outing to the seashore D) Halloween festival with neighborhood children
A) fireworks display on July 4th
A nurse can anticipate anticholinergic side effects are likely to occur when a patient is prescribed what medication? A) fluphenazine B) buspirone C) risperidone D) lithium
A) fluphenazine
A nurse psychotherapist works with an anxious, dependent patient. What therapeutic strategy is most consistent with the framework of psychoanalytic psychotherapy? A) focusing on feelings developed by the patient toward the nurse B) offering psychoeducational materials and groups C) emphasizing medication compliance D) identifying patients strengths and assets
A) focusing on feelings developed by the patient toward the nurse
A person with a fear of heights drives across a high bridge. Which structure will stimulate a response from the autonomic nervous system? A) hypothalamus B) pituitary gland C) thalamus D) parietal lobe
A) hypothalamus
A 4-year-old child grabs toys from siblings, saying, "I want that toy now!" The siblings cry, and the child's parent becomes upset with the behavior. Using the Freudian theory, a nurse can interpret the child's behavior as a product of impulses originating in the: A) id B) superego C) ego D) preconscious
A) id
A patient's history shows intense and unstable relationships with others. The patient initially idealizes an individual and then devalues the person when the patient's needs are not met. Which aspect of mental health is a problem for this patient? A) maintaining relationships B) communication skills C) effectiveness in work D) productive activities
A) maintaining relationships
What cognitive strategy should a nurse use to assist a very dependent patient achieve independence? A) reveal dream content B) examine thoughts about being autonomous C) take prescribed medications D) role model ways to ask for help from others
B) examine thoughts about being autonomous
A nurse cares for an older adult patient admitted for treatment of depression. The health care provider prescribes an antidepressant medication, but the dose is more than the usual adult dose. The nurse is obligated to take what action? A) give the usual geriatric dosage at the scheduled times B) hold the medication and then notify the health care provider C) Implement the order as written but document the concern D) consult a drug reference if a pharmacist is not available
B) hold the medication and then notify the provider
A patient in the emergency department has no physical injuries but exhibits disorganized behavior and incoherence after a minor traffic accident. In which room should the nurse place the patient? A) small, empty storage room with no windows or furniture B) interview room furnished with a desk and two chairs C) Nurse's office, furnished with chairs, files, magazines, and bookcases D) room with an examining table, instrument cabinets, desk, and chair
B) interview room furnished with a desk and two chairs
Which comment by a person experiencing severe anxiety indicates the possibility of obsessive-compulsive disorder? A) "my legs often feel weak and spastic" B) "I check where my car keys are eight times" C) "I'm embarrassed to go out in public" D) "I keep reliving the car accident"
B) "I check where my car keys are eight times"
A school-age child tells the school nurse, "Other kids call me mean names and will not sit with me at lunch. Nobody likes me." Select the nurse's most therapeutic response. A) "you should make friends with other children." B) "tell me more about how you feel" C) "just ignore them and they will leave you alone." D) "call them names if they do that to you"
B) "tell me more about how you feel"
Which benefits are most associated with the use of telehealth? (Select all that apply.) A) rapid development of trusting relationships with patients B) maximization of care management C) access to services for patients in rural areas D) prompt reimbursement by third-party payers E) cost savings for patients
B) maximization of care management C) assess to services for patients in rural areas E) cost savings for patients
A critical care nurse asks a psychiatric nurse about the difference between a diagnosis in the Diagnostic and Statistical manual of Mental disorders (DSM-5) and a nursing diagnosis. What is the psychiatric nurse's best response? A) "the DSM-5 diagnosis disregards culture, whereas the nursing diagnosis includes cultural variables" B) " the DSM-5 diagnosis influences the medical treatment, the nursing diagnosis offers a framework to identify interventions for problems a patient may experience." C) "no functional difference exists between the two diagnoses. both serve to identify a human deviance" D) "the DSM-5 diagnosis profiles present distress or disability, whereas a nursing diagnosis considers past and present responses to actual mental health problems"
B) "the DSM-5 diagnosis influences the medical treatment; the nursing diagnosis offers a framework to identify interventions for problems a patient has or may experience"
A patient with severe depression states, "God is punishing me for my past sins." What is the nurse's best response? A) "why do you think that?" B) "you sound very upset about this" C) "if you feel this way, you should talk to a member of your clergy" D) "you believe god is punishing you for your sins?"
B) "you sound very upset about this"
A patient has been diagnosed with a somatic symptoms disorder after various testing has failed to confirm a physiological cause for the patient's reports of back pain. What intervention by the nurse demonstrates the appropriate response when the patient continues to monopolize the group discussion with about back pain? A) In a matter-of-fact manner tell the patient that their pain is somatic in nature. B) Acknowledge the presence of pain but then redirect to another topic. C) Offer to discuss the back pain with the patient after the group session is over. D) Offer to discuss additional pain medication with the patient's health care provider.
B) Acknowledge the presence of pain but then redirect to another topic
A new psychiatric nurse is providing care to a parent diagnosed with bipolar disorder. This nurse angrily recalls embarrassing events concerning the parent's behavior in the community. Select the best ways for this nurse to cope with these feelings. (Select all that apply.) A) Beginning new patient relationships by saying, "My own parent had mental illness, so I accept it without stigma" B) Seeking ways to use the understanding gained from childhood to help patients cope with their own illnesses C) Recognizing that the feelings may add sensitivity to the nurse's practice, but supervision is important D) Recognizing that these feelings are unhealthy and try to suppress them when working with patients E) Recognizing that psychiatric nursing is not an appropriate career choice and explore other nursing specialties
B) Seeking ways to use the understanding gained from childhood to help patients cope with their own illnesses C) Recognizing that the feelings may add sensitivity to the nurse's practice, but supervision is important
Several nurses are concerned that agency policies related to restraint and seclusion are inadequate. Which statement about the relationship of substandard institutional policies and individual nursing practice should guide nursing practice? A) In an institution with substandard policies, the nurse has a responsibility to inform the supervisor and leave the premises. B) The policies do not absolve an individual nurse of the responsibility to practice according to the professional standards of nursing care. C) Interpretation of policies by the judicial system is rendered on an individual basis and therefore cannot be predicted. D) Agency policies are the legal standard by which a professional nurse must act and therefore override other standards of care.
B) The policies do not absolve an individual nurse of the responsibility to practice according to the professional standards of nursing care.
Which documentation of a patient's behavior best demonstrates a nurse's observations? A) Appeared to hallucinate. Patient frequently increased volume on television, causing conflict with others B) Wears four layers of clothing. States, "I need protection from dangerous bacteria trying to penetrate my skin." C) Isolates self from others. Frequently fell asleep during group. Vital signs stable. D) Calmer and more cooperative. Participated actively in group. No evidence of psychotic thinking.
B) Wears four layers of clothing. States, "I need protection from dangerous bacteria trying to penetrate my skin."
A student nurse prepares to administer oral medication to a patient diagnosed with major depressive disorder. What should the student nurse do when the patient refuses the medication? A) tell the patient "refusing your medication is not permitted. you are required to take it" B) Attempt to discuss the patients concerns about the medication and report to the staff nurse C) document the patients refusal of the medication without further comment D) share with the patient. "I'll get an unsatisfactory grade if i don't give you the medication"
B) attempt to discuss the patients concerns about the medication and report to the staff nurse
A 26-month-old child displays negative behavior, refuses toilet training, and often shouts, "No!" when given direction. The nurse's counseling with the parent should be based on the premise that the child is engaged in which of Erikson's psychosocial crises? A) trust versus mistrust B) autonomy versus shame and doubt C) initiative versus guilt D) industry versus inferiority
B) autonomy versus shame and doubt
A soldier who served in a combat zone returned to the United States. The soldier's spouse complains to the nurse, "We had planned to start a family, but now he won't talk about it. He won't even look at children." The spouse is describing which symptom associated with posttraumatic stress disorder (PTSD)? A) re-experiencing B) avoidance C) psychosis D) hyperarousal
B) avoidance
A patient is demonstrating signs of dementia. The health care provider wants to make a differential diagnosis between Alzheimer's disease and multiple infarctions. Which diagnostic procedure should a nurse expect to prepare the patient for first? A) functional magnetic resonance imaging (fMRI) B) computed tomography (CT) scan C) single-photon emission computed tomography (SPECT) scan D)positron emission tomography (PET) scan
B) computed tomography (CT) scan
A patient has delusions and hallucinations. Before beginning treatment with a psychotropic medication, the health care provider wants to rule out the presence of a brain tumor. For which test will a nurse need to prepare the patient? A) positron emission tomography (PET) or single photon emission computed tomography (SPECT) B) computed tomography (CT) scan or magnetic resonance imaging (MRI) C) functional magnetic resonance imaging (fMRI) D) cerebral arteriogram
B) computed tomography (CT) scan or magnetic resonance imaging (MRI)
When a female Mexican-American patient and a female nurse sit together, the patient often holds the nurse's hand. The patient also links arms with the nurse when they walk. The nurse is uncomfortable with this behavior and thinks the patient is misunderstanding the nurse-patient relationship. Which alternative is a more accurate assessment? A) The patient understands that touch makes the nurse uncomfortable and controls the relationship based on that factor. B) The patient is accustomed to touch during conversations, as are members of many Hispanic subcultures. C) The patient is afraid of being alone. When touching the nurse, the patient is reassured and comforted. D) the nurse is quick to make assumptions
B) the patient is accustomed to touch during conversations, as are members of many Hispanic subcultures
A patient should be considered for involuntary commitment for psychiatric care when demonstrating what behavior? A) nonadherent with the treatment regimen B) threatens to harm self and others C) sells and distributes illegal drugs D) fraudulently files for bankruptcy
B) threatens to harm self and others
The parent of an adolescent diagnosed with schizophrenia asks a nurse, "My child's doctor ordered a positron-emission tomography (PET) scan. What is that?" What is the nurse's best response? A) 'its a special type of x-ray image that shows structures of the brain and whether a brain injury has ever occurred." B) "PET is a scan that passes an electrical current through the brain and shows brainwave activity. PET can help diagnose seizures." C) "PET is a special scan that shows blood flow and activity in the brain" D) "PET uses a magnetic field and gamma waves to identify problem areas in the brain. does your teenager have any metal implants?"
C) "PET is a special scan that shows blood flow and activity in the brain."
What client statement most supports a diagnosis of agoraphobia? A) "I'm sure I'll get over not wanting to leave home soon. it takes time" B) "my family says they like it now that I stay at home." C) "being afraid to go out seems ridiculous, but I can't go out the door" D) "when I have a good incentive to go out, I can do it"
C) "being afraid to go out seems ridiculous, but I can't go out the door
Which patient would a nurse refer to partial hospitalization? A) One who spent yesterday in the 24-hour supervised crisis care center and continues to be actively suicidal. B) One who has a therapeutic lithium level and reports regularly for blood tests and clinic follow-up. C) One who states, "I'm not sure I can avoid using alcohol when my spouse goes to work every morning." D) One who is experiencing agoraphobia and panic episodes and who would benefit from psychoeducation for relaxation therapy.
C) One who states, "I'm not sure I can avoid using alcohol when my spouse goes to work every morning."
Which scenario best demonstrates an example of eustress? A) a couple receives a bank notice there were insufficient funds in their account for a recent rent payment B) a child loses a beloved family pet C) a single male prepares to take a 1-week vacation to a tropical island with a group of close friends D) a married female receives notification that their current employer is experiencing financial problems and some workers will be terminated
C) a single male prepares to take a 1-week vacation to a tropical island with a group of close friends
To provide comprehensive care to patients, which competency is more important for a nurse who works in a community mental health center than a psychiatric nurse who works in an inpatient unit? A) knowledge of psychopharmacology B) problem solving skills C) ability to cross service systems D) calm and caring manner
C) ability to cross service systems
A suspicious and socially isolated patient lives alone, eats one meal a day at a nearby shelter, and spends the remaining daily food allowance on cigarettes. Select the community psychiatric nurse's best initial action. A) tell the patient "you must stop smoking to save money" B) report the situation to the manager of the shelter C) assess the patients weight; determine the foods and amounts eaten D) seek hospitalization for the patient while a new plan is being formulated
C) assess the patients weight; determine the foods and amounts eaten
The parent of a child diagnosed with schizophrenia tearfully asks a nurse, "What could I have done differently to prevent this illness?" Select the nurse's most caring response. A) "although schizophrenia is caused by impaired family relationships, try not to feel guilty. no one can predict how a child will respond to parental guidance" B) "most of the damage is done, but there is still hope. changing your parenting style can help your child learn to cope more effectively with the environment" C) "most mental illnesses result from genetic inheritance. your genes are more at fault than your parenting" D) "schizophrenia is a biological illness with similarities to diabetes and heart disease. you are not to blame for your child's illness"
D) "schizophrenia is a biological illness with similarities to diabetes and heart disease. you are not to blame for your child's illness."
Which statement shows a nurse has empathy for a patient who made a suicide attempt? A) "suicide is a drastic solution to a problem that may not be such a serious matter." B) "if you tell me what is troubling you, i can help you solve your problems" C) "it makes me sad to see you going through such a difficult experience." D) "you must have been very upset when you tried to harm yourself."
D) "you must have been very upset when you tried to harm yourself"
As a nurse discharges a patient, the patient gives the nurse a card of appreciation made in an arts and crafts group. What is the nurse's best action? A) Inform the patient that accepting gifts violates the policies of the facility. Decline the card regretfully. B) Acknowledge the patient's transition through the termination phase but decline the card. C) Accept the card and invite the patient to return to participate in other arts and crafts groups. D) Accept the card while recognizing the effectiveness of the relationship and the patient's thoughtfulness.
D) Accept the card while recognizing the effectiveness of the relationship and the patient's thoughtfulness.
A multidisciplinary health care team meets 12 hours after an adolescent is hospitalized after a suicide attempt. Members of the team report their assessments. What outcome can be expected from this meeting? A) the healthcare team will order neuroimaging studies B) the team will request a court appointed advocate for the patient C) assessment of the patients need for placement outside the home will be undertaken D) a treatment plan will be formulated
D) a treatment plan will be formulated
A patient tells a nurse, "I have psychiatric problems and am in and out of hospitals all the time. Not one of my friends or relatives has these problems." What is the nurse's best response? A) "comparing yourself with others has no real advantages." B) "mental illness affects 50% of the adult population in any given year" C) "why do you blame yourself for having a psychiatric illness?" D) "are you concerned that others don't experience the same challenges as you?"
D) are you concerned others don't experience the same challenges as you
A patient diagnosed with a somatic symptom disorder has the nursing diagnosis: Interrupted family processes, related to patient's disabling symptoms as evidenced by the spouse and children assuming roles and tasks that previously belonged to patient. What is an appropriate outcome for this patient? A) relies on family members to meet personal needs B) focuses energy on problems occurring in the family C) assumes roles and functions of the other family members D) demonstrate a resumption of former roles and tasks
D) demonstrate a resumption of former roles and tasks
A nurse listens to a group of recent retirees. One says, "I volunteer with Meals on Wheels, coach teen sports, and do church visitation." Another laughs and says, "I'm too busy taking care of myself to volunteer. I don't have time to help others." These comments contrast which developmental tasks? A) trust vs mistrust B) industry vs inferiority C) intimacy vs isolation D) generativity vs self-absorption
D) generativity vs self-absorption
As part of the stress response, the HPA axis is stimulated. Which structures make up this system? A) Hind brain, pyramidal nervous system, and anterior cerebrum B) hepatic artery, parasympathetic nervous system, and acoustic nerve C) hippocampus, parietal lobe, and amygdala D) hypothalamus, pituitary gland, and adrenal glands
D) hypothalamus, pituitary gland, and adrenal glands
In a team meeting, a nurse says, "I'm concerned whether we are behaving ethically by using restraint to prevent one patient from self-mutilation while the care plan for another patient who has also self-mutilated calls for one-on-one supervision." Which ethical principle most clearly applies to this situation? A) fidelity B) beneficence C) autonomy D) justice
D) justice
A college student reports that, "My vision is too blurry to read effectively, especially when it's time to be studying for a test." Which health problem should be considered initially? A) functional neurological disorder B) factitious disorder C) illness anxiety D) malingering
D) malingering
The patient says, "My marriage is just great. My spouse and I usually agree on everything." The nurse observes the patient's foot moving continuously as the patient twirls a shirt button. What type of communication is the patient presenting? A) clear B) inadequate C) precise D) mixed
D) mixed
A patient diagnosed with schizophrenia has been stable in the community. Today, the spouse reports the patient is expressing delusional thoughts. The patient says, "I'm willing to take my medicine, but I forgot to get my prescription refilled." Which outcome should the nurse add to the plan of care? A) nurse will obtain prescription refills every 90 days and deliver them to the patient B) patient will call the nurse weekly to discuss medication-related issues C) patient will report to hospital for medication follow-up every week D) patient's spouse will mark dates for prescription refills on the family calendar
D) patient's spouse will mark dates for prescription refills on the family calendar
What is an example of a lack of parity in health care delivery today? A) Medicare is provided for only those 65 years of age and older B) most psychiatric care is provided on an outpatient basis C) there is sufficient need for mental health care providers D) payment for psychiatric health care is not equal to that of physical health care
D) payment for psychiatric healthcare is not equal to that of physical healthcare
On the basis of current knowledge of neurotransmitter effects, a nurse anticipates that the treatment plan for a patient with memory difficulties may include medications designed to do what? A) increase dopamine sensitivity B) inhibit GABA production C) decrease dopamine at receptor sites D) prevent destruction of acetylcholine
D) prevent destruction of acetylcholine
After leaving work, a staff nurse realizes that documentation of the administration of a medication to a patient was omitted. This off-duty nurse telephones the unit and tells the nurse, "Please document the administration of the medication I forgot to do. My password is alpha1." What action should the on-duty nurse take? A) access the record and document the information B) report the request to the patients health care provider C) suggest the nurse return and document D) refer the matter to the charge nurse to resolve
D) refer the matter to the charge nurse to resolve
A nurse uses Maslow's hierarchy of needs to plan care for a psychotic patient. Which problem will receive priority? A) is reluctant to participate in unit social activities B) reports feelings of alienation from family C) needs to be taught about medication action and side effects D) refuses to eat or bathe
D) refuses to eat or bathe
A soldier served in combat zones in Iraq in 2010 and was deployed to Afghanistan in 2014. When is it most important for the nurse to screen for signs and symptoms of posttraumatic stress disorder (PTSD)? A) immediately upon return to the United States from Afghanistan B) before departing Afghanistan to return to the United States C) two years after returning from Afghanistan D) screening should be ongoing
D) screening should be ongoing
The parent of a 4 year old rewards and praises the child for helping a younger sibling, being polite, and using good manners. A nurse supports the use of praise because, according to the Freudian theory, these qualities will likely be internalized and become what part of the child's personality? A) preconscious B) id C) ego D) superego
D) superego
A person who has been unable to leave home for more than a week because of severe anxiety says, "I know it does not make sense, but I just can't bring myself to leave my apartment alone." Which nursing intervention is appropriate when implementing cognitive restructuring? A) assist the person to apply for disability benefits B) ask the person to explain why the fear is so disabling C) advise the person to accept the situation and use a companion D) teach the person to use positive self-talk
D) teach the person to use positive self talk
During the first interview with a parent whose child died in a car accident, the nurse feels empathic and reaches out to take the patient's hand. Select the correct analysis of the nurse's behavior. A) It shows empathy and compassion. It will encourage the patient to continue to express feelings. B) the patient will perceive the gesture as intrusive and overstepping boundaries C) the action is inappropriate. patients in a psychiatric setting should not be touched D) the gesture is premature. the patients cultural and individual interpretation of touch is unknown.
D) the gesture is premature. the patients cultural and individual interpretation of touch is unknown.
As a patient diagnosed with mental illness is being discharged from a facility, a nurse invites the patient to the annual staff picnic. What is the best analysis of this scenario? A) the nurses action assists the patient's integration into community living B) the invitation facilitates dependency on the nurse C) the invitation is therapeutic for the patient's diversional activity deficit D) the nurse's action blurs the boundaries of the therapeutic relationship
D) the nurse's action blurs the boundaries of the therapeutic relationship
A patient diagnosed with mental illness asks a psychiatric technician, "What's the matter with me?" The technician replies, "Your wing nuts need tightening." The nurse who overheard the exchange should take action based on what principle? A) the nurse's obligation to report caregiver negligence B) supervisory liability C) preventing defamation of the patients character D) violation of the patients right to be treated with dignity and respect
D) violation of the patients right to be treated with dignity and respect
