Psych Exam 3

After teaching a group of nursing students about the neurobiologic theories of depression, the instructor determines the need for additional teaching when the students identify which neurotransmitter as playing a role? A) Gamma-amino butyric acid (GABA) B) Norepinephrine C) Serotonin D) Dopamine

A) Gamma-amino butyric acid (GABA)

A client with schizoaffective disorder is having difficulty adhering to the medication regimen that requires the use of several agents. The client also is experiencing several side effects contributing to this nonadherence. The physician plans to change the clients medication. Which agent would the nurse anticipate that the physician would prescribe? A) Lithium B) Aripiprazole C) Clozapine D) Olanzapine

B) Aripiprazole

The history of a child newly diagnosed with ADHD reveals that the child is experiencing sleeping difficulties. Which agent would the nurse most likely use? A) Methylphenidate B) Atomoxetine C) Bupropion D) Clonidine

B) Atomoxetine

A nurse is assessing an 8-year-old girl with a mood disorder. Which of the following would the nurse most likely expect to assess? A) Statement from the child that she feels sad B) Behavioral problems C) Recurrent obsessions D) Ritualistic behavior

B) Behavioral problems

The nurse is preparing to initiate a behavioral treatment program for a child with encopresis. Which of the following would the nurse most likely implement first? A) Administration of mineral oil B) Bowel cleansing C) Low-fiber diet D) Toilet sitting after each meal

B) Bowel cleansing

After teaching a class about factors that enhance the risk of suicide, the instructor determines the need for additional teaching when the class identifies which of the following? A) Family member committing suicide B) Cautiousness C) Delusions D) Loss

B) Cautiousness

A 34-year-old client with depression is admitted to an inpatient psychiatric unit. The nurse enters her room and initiates interaction with the client. When talking with the client, which approach would be least appropriate? A) Quiet and empathetic manner B) Animated and cheerful manner C) Matter-of-fact manner D) Respectful, direct manner

B) Animated and cheerful manner

A client with a history of substance abuse is involved in a skills training group. Which of the following would the client be involved with to enhance intrapersonal coping skills? Select all that apply. A) Substance refusal skills B) Problem solving C) Anger awareness D) Emergency planning E) Social support networking

B) Problem solving C) Anger awareness D) Emergency planning

The nurse is reviewing the medical record of a client diagnosed with depression and notes that the client has been prescribed mirtazapine. The nurse interprets this information, identifying this agent as which type? A) Selective serotonin reuptake inhibitor B) Cyclic antidepressant C) Norepinephrine dopamine reuptake inhibitor D) Alpha-2 antagonist

D) Alpha-2 antagonist

The nurse is caring for a client diagnosed with a delusional disorder. While assessing this client, which of the following would the nurse expect to find? A) History of chronic major depression B) Consistently disrupting behavior patterns C) Verbalization of bizarre delusions D) Living with one or more delusions for a period of time

D) Living with one or more delusions for a period of time

An older patient tells the nurse that she is becoming more forgetful. The nurse explains to the patient that this is most likely related to which of the following? A) Anxiety B) Organic brain syndrome C) Plaques in the brain tissue D) Medications

D) Medications

The nurse determines that a patient is at imminent risk for suicide. Which of the following would be least appropriate to include in the patients plan of care? A) Listening intently and nonjudgmentally B) Validating the patients feelings and experience C) Instituting strict restriction on the patients activity D) Using cognitive interventions to foster hope

C) Instituting strict restriction on the patients activity

A client with depression is prescribed fluoxetine. On a return visit to the clinic, the client tells the nurse that he also just started taking St. Johns wort to feel better. The nurse assesses the client for which of the following? A) Water intoxication B) Increased depressive symptoms C) Serotonin syndrome D) Hypertensive crisis

C) Serotonin syndrome

A nurse has used the Geriatric Depression Scale (short form) to assess an older adult client for depression. Which score would lead the nurse to suspect that the client is mildly depressed? A) 3 B) 5 C) 8 D) 13

C) 8

A nurse is using the Neuropsychiatric Inventory to assess an older adult client who is exhibiting behavior problems related to dementia. When using this tool, which of the following would the nurse assess? Select all that apply. A) Dysphoria B) Inhibition C) Apathy D) Level of orientation E) Memory F) Anxiety

A) Dysphoria B) Inhibition C) Apathy F) Anxiety

The nurse is planning to assess a clients anxiety level using the Rating Anxiety in Dementia Scale because the client also has dementia. When using this scale which of the following areas would the nurse assess? Select all that apply. A) Apprehension B) Motor tension C) Life satisfaction D) Boredom E) Autonomic hyperactivity F) Worry

A) Apprehension B) Motor tension E) Autonomic hyperactivity F) Worry

Assessment of an older adult client reveals that the client is receiving psychiatric medications. The client states, I get dizzy periodically and have trouble walking. Which of the following should the nurse do first? A) Compare the clients baseline blood pressure with the clients current blood pressure. B) Instruct the client to stop taking the psychiatric medications. C) Interview the clients family about the clients coping skills and current stress level. D) Suggest the client periodically use an alcohol-based mouthwash several times a day.

A) Compare the clients baseline blood pressure with the clients current blood pressure.

A 12-year-old child is brought to the mental health clinic by his parents because of a court-ordered evaluation. When assessing the child, which of the following would lead the nurse to suspect that the child has a conduct disorder? Select all that apply. A) Destruction of neighbors car on two separate occasions B) Arrests for petty larceny several times C) Repetitive disobedience of parents D) Blaming of others for problems E) Evidence of overt lying

A) Destruction of neighbors car on two separate occasions B) Arrests for petty larceny several times E) Evidence of overt lying

A client is brought into the emergency department because he was involved in an automobile accident. His blood alcohol level (BAL) is 0.10 mg %. Based on this finding, the nurse would expect to assess which of the following? A) Difficulty with coordination B) Stupor C) Emotional lability D) Ataxia

A) Difficulty with coordination

A nurse is obtaining a history from a client who drinks about 6 cups of coffee and several diet cola drinks per day. The client states, I just cut down my coffee and soda intake to one per day. Which of the following would the nurse most likely expect to assess? Select all that apply. A) Headache B) Fatigue C) Yawning D) Flushing E) Diuresis

A) Headache B) Fatigue C) Yawning

An 80-year-old client visits the mental health clinic with her daughter. During the assessment process, the client tells the nurse that she is taking an antidepressant, an antibiotic, and an occasional aspirin. Which question would be most important for the nurse to ask? A) How much grapefruit juice do you drink on a daily basis? B) How much orange juice do you drink on a daily basis? C) How much tomato juice do you drink on a daily basis? D) How much grape juice do you drink on a daily basis?

A) How much grapefruit juice do you drink on a daily basis?

As part of an interdisciplinary team, a nurse is assisting in developing the plan of care for a client with a delusional disorder. Which of the following would the team be least likely to include in the plan? A) Insight-oriented therapy B) Psychoeducation C) Cognitive therapy D) Support therapy

A) Insight-oriented therapy

A nursing instructor is developing a class lecture that compares and contrasts schizoaffective disorder with schizophrenia. When describing one of the differences between these two diagnoses, which of the following would the instructor include as reflecting schizoaffective disorder? A) It is episodic in nature. B) It involves difficulties with self-care. C) It has less severe hallucinations. D) It is associated with a lower suicide risk.

A) It is episodic in nature.

A patient comes to the clinic for an evaluation of headache, fatigue, and an overall feelings of being down. When assessing the patient, which statement by the patient would alert the nurse to suspect possible suicide? Select all that apply. A) Ive been drinking about three or four more beers every night. B) Ive been going out with my friends about once or twice a week. C) Im so tired that all I ever want to do is sleep all the time. D) Most times, I feel like Im trapped with no way out. E) Im looking for a new job because my job is so stressful

A) Ive been drinking about three or four more beers every night. C) Im so tired that all I ever want to do is sleep all the time. D) Most times, I feel like Im trapped with no way out.

The nurse makes a home visit to a client who has dysthymic disorder. Which of the following would the nurse expect to assess? A) Low energy B) Intense concentration C) Agitation D) Normal appetite

A) Low energy

A nurse is preparing an inservice program about substance abuse and its etiology. Which of the following would the nurse most likely include in the presentation when discussing possible psychologic etiologies? A) Low self-esteem B) Genetic predisposition C) Dysfunctional family D) Peer influence

A) Low self-esteem

A 20-year-old man arrives at the emergency department by ambulance. He is unconscious, with slow respirations and pinpoint pupils. There are tracks visible on his arms. The friend who came with him reports that the client had just shot up heroin when he became unconscious. Which medication would the nurse most likely expect to administer? A) Naloxone B) Naltrexone C) Bupropion D) Varenicline

A) Naloxone

A patient who has attempted suicide has an underlying diagnosis of depression. Which of the following would the nurse anticipate being ordered for the patient? A) Selective serotonin reuptake inhibitor B) Mood stabilizer C) Tricyclic antidepressant D) Atypical antipsychotic

A) Selective serotonin reuptake inhibitor

The nurse is working with a patient who will be signing a commitment to treatment statement. After teaching the patient about this statement, the nurse determines the need for additional instruction when the patient states which of the following? A) Signing this statement means that I will not commit suicide. B) I am agreeing to get emergency treatment if I have suicidal thoughts. C) I will be open and honest about my feelings about treatment. D) I am agreeing to participate in the necessary treatment for my condition

A) Signing this statement means that I will not commit suicide

The nurse is completing the admission of a client who is seeking treatment for alcoholism. He tells the nurse that the last time he had any alcohol to drink was at 10:00 AM before he left for the hospital. The nurse closely monitors the client. Which of the following would lead the nurse to suspect that the client is experiencing stage 1 of alcohol withdrawal syndrome? Select all that apply. A) Slight diaphoresis B) Hand tremors C) Intermittent confusion D) Heart rate of 135 beats/min E) Normal blood pressure

A) Slight diaphoresis B) Hand tremors E) Normal blood pressure

When assessing a client with delusional disorder, the nurse would most likely expect to find impairment in which of the following? Select all that apply. A) Social functioning B) Marital functioning C) Intellectual functioning D) Occupational functioning E) Mental status functioning

A) Social functioning B) Marital functioning

A 10-year-old child with Tourettes disorder is receiving haloperidol as part of his treatment plan. When assessing the child at a follow up visit, which statement by the child would lead the nurse to suspect that he is experiencing a side effect of the drug? A) Sometimes I feel like Im so sleepy. B) Im eating about the same amount as before. C) My muscles seem pretty flexible lately. D) I think Im much more alert with this drug.

A) Sometimes I feel like Im so sleepy

The nurse is providing a presentation for a group of health professionals about suicide. Which of the following would the nurse address as a major contributing factor to the rising suicide rate among men? A) Substance abuse B) Media influences C) Lack of conflict resolution skills D) Parenting practices

A) Substance abuse

A client tells the nurse that he is committed to trying to quit smoking. When teaching the client about smoking cessation, which of the following would the nurse include? A) Success usually involves more than one type of intervention. B) Relapse is fairly rare within the first year of quitting. C) Ear acupressure is a highly proven method for quitting. D) Education is key for smoking cessation.

A) Success usually involves more than one type of intervention.

The nurse is caring for a client in the outpatient setting who has been diagnosed with a depressive disorder. Before the client is given a prescription for a tricyclic antidepressant, assessment for which of the following would be most important? A) Suicide B) Hypersomnia C) Cardiac arrhythmia D) Erectile dysfunction

A) Suicide

The nurse is caring for a client who was diagnosed with schizoaffective disorder. Based on the nurses understanding of this disorder, the nurse develops a plan of care to address which issue as the top priority? A) Suicide B) Aggression C) Substance abuse D) Eating disorder

A) Suicide

A nurse has just completed a suicide risk assessment of a 76-year-old widowed man. In addition to documenting the presence or absence of suicidal thoughts, plan, and means, the nurse would also document which of the following? A) Use of substances 6 hours before the assessment B) Speech patterns C) Availability of support resources D) Amount of sleep in past 24 hours

A) Use of substances 6 hours before the assessment

A nurse is working with a client who is addicted to heroin. The nurse engages in harm reduction by teaching the client about which of the following? A) Using bleach solution to disinfect dirty needles B) Problem solving C) Healthy coping skills D) Proper use of naltrexone (Trexan)

A) Using bleach solution to disinfect dirty needles

After teaching the parents of a child diagnosed with ADHD about the disorder and its treatment, the nurse determines that the teaching has been effective when the parents state which of the following? A) We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention. B) We need to be careful so he doesnt develop a substance abuse problem as he grows older. C) We should stop the medication after 2 months to see how effective it is in really controlling his symptoms. D) We should set up regular routines for him but not worry if he violates the limits once in a while.

A) We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention

The nurse is developing a teaching plan for a client who is prescribed escitalopram. Which of the following side effects would the nurse include in this plan? Select all that apply. A) Weight gain B) Decreased sexual interest C) Sedation D) Blurred vision E) Urinary retention F) Dry mouth

A) Weight gain B) Decreased sexual interest

A client is prescribed phenelzine (Nardil) to treat her depression. She is at a local caf for lunch with a friend. Which of the following items on the menu would be least appropriate for the client to order? A) Roast beef, mashed potatoes, and gravy B) A Cobb salad with blue cheese and Roquefort salad dressing C) Scrambled eggs, toast, and grape jelly D) Medium-well steak, French fries, and broccoli

B) A Cobb salad with blue cheese and Roquefort salad dressing

When assessing a client with depression, the client states, I just feel so sad and hopeless. I just dont care anymore. I dont even enjoy doing the crossword puzzles like I used to. The nurse documents this finding as indicative of which of the following? A) Dysthymic disorder B) Anhedonia C) Delusion D) Psychosis

B) Anhedonia

A nurse is providing parent training for parents of a child diagnosed with a disruptive behavior disorder involving the use of time out. When describing how to implement this, which of the following would the nurse identify as the first step? A) Having the child recount the reason for the time out B) Clearly identifying what is required for the child C) Informing the child what will happen because of the behavior D) Placing the child in a designated area removed from others

B) Clearly identifying what is required for the child

A nurse is reviewing the medical record of a patient who has attempted suicide. Which of the following would the nurse identify as relating to a psychological cause? A) History of childhood trauma B) Cluster B personality disorder C) Social isolation D) Suicide contagion

B) Cluster B personality disorder

A group of nursing students is reviewing information about substances that are abused. The students demonstrate understanding of the information when they identify which of the following as stimulants? Select all that apply. A) Alcohol B) Cocaine C) Heroin D) Nicotine E) Phencyclidine

B) Cocaine D) Nicotine

A nurse is preparing a presentation for family members of clients who have been diagnosed with depression. When describing the family response to depression, which of the following would the nurse include? A) Family members typically can understand how disabling depression can be. B) Depression in one family member affects the entire family. C) Abuse of the depressed person is a rare occurrence in families. D) Families of women older than 55 years of age with depression experience the majority of problems.

B) Depression in one family member affects the entire family.

A patient was admitted to the psychiatric unit 3 days ago because of suicidal ideation. His suicidal risk has lessened considerably, and he currently denies having any desire to kill himself. In addition, he is able to identify reasons why he wants to be alive. Which nursing intervention would be most appropriate at this time? A) Assigning nursing staff to stay with him during his suicidal crisis B) Developing a personal plan for managing suicidal thoughts when they occur C) Advising the patient that he should consider electroconvulsive therapy treatments D) Administering psychotropic drugs that decrease the patients serotonin levels

B) Developing a personal plan for managing suicidal thoughts when they occur

A nurse is providing an in-service educational program for beginning nurses regarding mental health assessment needs of the older adult. One of the topics addressed is the importance of interviewing family members in addition to the older adult client. The nurse tells the audience that family members are sometimes able to give a more accurate history if the client has memory impairment. The nurse also emphasizes that interviewing family members provides which of the following? A) A more accurate picture of the social support resources available B) Evaluation of the familys ability to effectively care for the older client C) Determination of the extent of the clients memory impairment D) A much needed period of respite and support for the family members

B) Evaluation of the familys ability to effectively care for the older client

The nurse is caring for a client with major depression. The client tells the nurse that she just isnt sure that life is worth living. The nurse documents which nursing diagnosis as the priority? A) Self-esteem, Low, related to depressive episode B) Hopelessness related to symptoms of depression C) Anxiety related to lack of energy for self-care activities D) Thought Processes, Disturbed, related to memory loss and depression

B) Hopelessness related to symptoms of depression

A client with a history of alcohol abuse is participating in a 12-step Alcoholics Anonymous (AA) program. The nurse determines that the client is at step two when he states which of the following? A) Ive admitted to myself and others the wrongdoings Ive done. B) I realize that there is a higher power that can help me. C) I know now that I am powerless over alcohol. D) I am making amends to all those that Ive harmed.

B) I realize that there is a higher power that can help me.

A client is receiving methadone maintenance therapy. After teaching the client about this treatment, the nurse determines that the teaching was successful when the client states which of the following? A) I can have a glass of wine with dinner if I choose. B) I should eat small frequent meals if I get nauseated. C) I should take the drug on an empty stomach. D) I might experience diarrhea with this drug.

B) I should eat small frequent meals if I get nauseated.

The nurse is counseling a parent whose child has a communication disorder. Which of the following would the nurse emphasize when teaching the parent about this disorder? A) Providing the child with nonverbal activities B) Initiating conversations with the child frequently C) Stopping the childs conversation if stuttering begins D) Asking the physician for medication to improve the childs speech

B) Initiating conversations with the child frequently

A nurse is assessing an older adult client. Which of the following would the nurse interpret as most indicative of mental health and wellness? A) Keeping social contacts to a minimum B) Interacting with others in the environment C) Relying solely on family for assistance D) Experiencing bereavement

B) Interacting with others in the environment

The nurse is assessing a client who has a history of heavy drinking and who lost his wife to cancer during the previous year. He reports that he isnt getting as much sleep as he used to when he was younger. Which question would be most appropriate to ask the client to determine if the change in his sleep pattern is related to normal aging or depression? A) How much did you sleep when you were younger? B) Is it hard for you to fall asleep or remain asleep during the night? C) Why do you think you continue to ingest so much alcohol? D) What used to help you go to sleep?

B) Is it hard for you to fall asleep or remain asleep during the night?

A client is prescribed disulfiram as part of his alcohol treatment program to prevent relapse. The client asks the nurse, How will this drug help me? Which response by the nurse would be most appropriate? A) It will help to cure your alcoholism. B) It can help to prevent you from drinking. C) It makes the withdrawal symptoms less troublesome. D) It helps to clear the alcohol out of your body.

B) It can help to prevent you from drinking.

After teaching a group of students about the epidemiology of schizoaffective disorder, the instructor determines that the teaching was successful when the students state which of the following? A) The disorder occurs often in children. B) It is more likely to occur in women. C) Most persons are African Americans. D) The disorder is rare in family relatives.

B) It is more likely to occur in women.

A group of nursing students is reviewing information about the epidemiology of depressive disorders. The students demonstrate understanding of the information when they identify which of the following as possible risk factors? Select all that apply. A) History of substance abuse as a teenager B) Little social support C) Inadequate coping skills D) Prior episode of anxiety disorder E) Concomitant medical illnesses

B) Little social support C) Inadequate coping skills E) Concomitant medical illnesses

A nurse is implementing a brief intervention with a client who is abusing alcohol. The nurse most likely would be involved with which of the following? A) Asking the client questions about alcohol use B) Negotiating a conversation with the client to reduce use C) Pointing out the inconsistencies in thoughts, feelings, and action D) Helping the client change the way he thinks about a situation

B) Negotiating a conversation with the client to reduce use

The nurse is preparing to interview a client who has a delusional disorder. Which of the following would the nurse expect? A) Cognitive impairment B) Normal behavior C) Labile affect D) Evidence of motor symptoms

B) Normal behavior

A child diagnosed with autism is hospitalized in an inpatient mental health unit. When developing the plan of care for this child, which of the following would the nurse most likely include? A) Ensuring that a variety of caregivers are available for the child B) Providing a consistent, structured environment with predictable routines C) Allowing the child frequent visits off the unit to provide stimulation D) Sending the child to the time out area if the child repeats phrases continually

B) Providing a consistent, structured environment with predictable routines

A group of nurses is reviewing medications used to treat attention deficit hyperactivity disorder. The students demonstrate understanding of the information when they identify methylphenidate as which of the following? A) Selective serotonin reuptake inhibitor B) Psychostimulant C) Noradrenergic reuptake inhibitor D) Alpha agonist

B) Psychostimulant

A family member of a client diagnosed with schizoaffective disorder asks a nurse what causes the disorder. Which response by the nurse would be most appropriate? A) Dysfunctional family dynamics has been identified as a strong link. B) Research has suggested that the cause is predominately genetic. C) Dopamine, a substance in the brain, appears to be underactive. D) Studies have indicated that birth order is strongly associated with this disorder.

B) Research has suggested that the cause is predominately genetic.

The nurse is caring for a 78-year-old client who is taking an anticholinergic medication and complains of dry mouth. Which of the following would be most appropriate for the nurse to suggest? A) Chew hard candies. B) Rinse the mouth with a mouthwash. C) Use more seasonings on food. D) Drink decaffeinated beverages often.

B) Rinse the mouth with a mouthwash.

A 52-year-old male client who has a history of alcohol dependence is admitted to a detoxification unit. He has tremors, he is anxious, his pulse has risen from 98 to 110 beats/min, his blood pressure has risen from 140/88 to 152/100 mm Hg, and his temperature is six tenths of a degree above normal. He is slightly diaphoretic. Which nursing diagnosis would be the priority? A) Disturbed Thought Processes B) Risk for Injury C) Ineffective Coping D) Ineffective Denial

B) Risk for Injury

A client is brought to the emergency department after having overdosed on cocaine. When assessing the client, which of the following would the nurse expect to find? Select all that apply. A) Euphoria B) Seizures C) Cardiac arrhythmia D) Paranoia E) Dilated pupils

B) Seizures C) Cardiac arrhythmia

A group of nursing students is reviewing information about age-related changes occurring in cognition and intellectual performance. The students demonstrate understanding of the information when they identify which of the following as a normal cognitive change? A) Disorientation to time B) Slowed information processing C) Diminished executive functioning D) Restricted judgment

B) Slowed information processing

A nurse is with an adolescent who tells the nurse that she has nothing to live for and she just wishes she was dead. Which nursing action would be the priority? A) Going to the patients psychiatrist to tell him of the girls suicidal ideation B) Staying with the patient to explore more of her thoughts about suicide C) Putting the patient in seclusion with a staff assigned to watch her at all times D) Ascertaining the clients beliefs about what happens when you die

B) Staying with the patient to explore more of her thoughts about suicide

The parents of a child with ADHD bring the child for a follow-up visit. During the visit, they tell the nurse that the child receives his first dose of methylphenidate (Ritalin) at about 7:30 AM every morning before leaving for school. The teacher and school nurse have noticed a return in the childs overactivity and distractibility just before lunch. The childs second dose is scheduled for about 12 noon. Which of the following might the nurse suggest as a possible solution to control the childs symptoms a bit more effectively? A) Giving the second dose at 1 PM or later. B) Switching to a longer acting preparation. C) Splitting the early morning dose in half. D) Switching to another class of medication.

B) Switching to a longer acting preparation.

A nursing instructor is preparing a class discussion about major depression. Which of the following would the instructor expect to include? A) Depression in children is manifested in the same manner as in adults. B) The risk for suicide is especially high during the mid-adolescent years. C) Response to treatment in older adults is slower than that for younger adults. D) People older than age 65 years have the lowest suicide rates of any age group. E) Episodes of depression tend to occur more frequently over time. F) Depressive disorders are most often treated in the primary care setting

B) The risk for suicide is especially high during the mid-adolescent years. C) Response to treatment in older adults is slower than that for younger adults E) Episodes of depression tend to occur more frequently over time. F) Depressive disorders are most often treated in the primary care setting

The nurse is giving a presentation comparing and contrasting autism disorder and Asperger syndrome. Which of the following would the nurse include as differentiating Asperger syndrome from autism disorder? A) Children typically do not engage in stereotypic behavior. B) They display age-appropriate intelligence. C) The children often reverse pronouns when speaking. D) They appear aloof and indifferent to others.

B) They display age-appropriate intelligence.

A nurse is preparing to assess a middle-aged male client who was brought to the emergency department by his wife. She reports that the client has been extremely depressed lately. When assessing this client, which of the following would be a priority assessment? A) Changes in sleeping patterns B) Thoughts of self-harm C) Appetite changes D) Level of fatigue

B) Thoughts of self-harm

A client comes to the emergency department complaining of a severe pounding headache in the temples and a stiff neck. The client is flushed and diaphoretic, and his pulse is racing. The client states that he is being treated for depression with selegiline. Which question by the nurse would be most important to ask at this time? A) When did you last have blood drawn to check your drug level? B) What have you had to eat or drink today? C) Are you having any chest pain? D) Do you use any herbal remedies?

B) What have you had to eat or drink today?

The nurse is preparing a client for treatment with repetitive transcranial magnetic stimulation. When teaching the client about this procedure, which of the following would the nurse include? Select all that apply. A) You will receive a short-acting anesthetic to relax you. B) You will be awake and alert during the procedure. C) You can resume your normal activities right after the treatment. D) We will need to shave your scalp at the area where the magnet is placed. E) You might feel a moderate amount of stinging at the site.

B) You will be awake and alert during the procedure. C) You can resume your normal activities right after the treatment.

The nurse is counseling a family whose 4-year-old child has mild mental retardation. The nurse is working with the family on realistic long-term goals. Which of the following would be most appropriate? A) Locating suitable residential placement for the child B) Finding a foster home for the child C) Achieving independent functioning of the child as an adult D) Preventing the onset of psychiatric disorders in the child

C) Achieving independent functioning of the child as an adult

A nurse is performing an assessment of a patient with suicidal ideation. Which question would the nurse most likely ask to determine the degree of planning? A) How seriously do you want to die? B) Have you attempted suicide before? C) Could you stop yourself from killing yourself? D) How much do the thoughts distress you?

C) Could you stop yourself from killing yourself?

A nurse is preparing a presentation for a group of colleagues about suicide and the older adult population. Which of the following would the nurse include in this presentation? Select all that apply. A) Suicide is less of a risk in this population as compared with middle-aged adults. B) Married African American men are at the greatest risk for suicide in this group. C) Depression is the greatest risk factor for suicide in this population group. D) White women account for the highest number of suicide deaths in this age group. E) Recent behavior changes and loss of support are important assessment areas for suicide risk.

C) Depression is the greatest risk factor for suicide in this population group. E) Recent behavior changes and loss of support are important assessment areas for suicide risk.

A client with a history of opioid abuse is exhibiting manifestations of moderate withdrawal. Which of the following would the nurse expect to assess? A) Rhinorrhea B) Lacrimation C) Dilated pupils D) Dysphoria

C) Dilated pupils

An elderly client tells the nurse that she had been constipated for the last few days and decided to use an over-the-counter fiber laxative that is dissolved in water. When reviewing the use of this laxative with the client, which of the following would the nurse include as a possible side effect? A) Diarrhea B) Nausea C) Flatus D) Stomach pain

C) Flatus

A client is hospitalized on a psychiatric unit secondary to a suicide attempt. He has been diagnosed with depression. He has been consistently depressed. When assessing the client, which of the following would alert the nurse that the clients suicidal risk has worsened? A) He tells the nurse that he feels more depressed than ever. B) He is lethargic, remaining isolated from other clients. C) He says he feels better as he interacts more with other clients. D) His energy level and degree of depression remain the same.

C) He says he feels better as he interacts more with other clients.

The nurse is caring for a 3-year-old child with autism who has been hospitalized. The child rocks continuously without any danger present to the childs safety. Which intervention by the nurse would be most appropriate? A) Continue to monitor the childs behaviors. B) Hold the child until the child stops rocking. C) Ignore the childs rocking behavior. D) Place the child in a time out area until the rocking stops.

C) Ignore the childs rocking behavior.

A couple is concerned that the husbands father may be developing depression. In questioning the couple, which of the following statements would support their concern? A) Dad has been crying off and on now for over 2 weeks since Mom died. Hes also still having trouble sleeping. B) Dad is agitated and anxious; hes been that way for a month now since Mom died. C) Its been over 2 months now since Mom died, and Dad keeps crying; he cant eat or sleep. D) Moms funeral was last week, and Dad hasnt been able to eat or sleep since then.

C) Its been over 2 months now since Mom died, and Dad keeps crying; he cant eat or sleep

A client with schizoaffective disorder is prescribed clozapine to treat her symptoms. Which of the following instructions would the nurse provide? A) Keep a record of how often and how long you experience the side effect of dry mouth. B) Monitor your urinary output and notify your doctor if your urine changes color. C) Keep an eye on your weight, and if you gain weight rapidly, notify your doctor. D) If you experience any drowsiness, discontinue taking this medication.

C) Keep an eye on your weight, and if you gain weight rapidly, notify your doctor.

A nurse is talking with a 57-year-old client who has been a heavy drinker for many years. The client is being treated for alcoholism, and this is her second week as an inpatient on the psychiatric unit. It is 5:00 AM, and the client has been having difficulty sleeping. The client is an orthopedic nurse, and although she is clothed in a hospital-issued gown and robe, she is wearing a stethoscope around her neck that the nurse recognizes as belonging to one of the staff nurses. When the nurse asks her why she is wearing the stethoscope and where she got it, the client gives her a long and involved reply that basically describes how her nursing supervisor came to visit and gave it to her to wear so shed remember to get well. The nurse suspects that the client may be experiencing which of the following? A) Wernickes syndrome B) Delirium tremens C) Korsakoffs psychosis D) Malignant hyperthermia

C) Korsakoffs psychosis

A nurse determines that a patient has poor social skills that have interfered with his ability to engage others, which has contributed to his feelings of purposelessness, hopelessness, and withdrawal. Which of the following would be most important to assist the patient in beginning to social skills? A) Self-help group B) Recovery group C) Nursepatient relationship D) Limit setting

C) Nursepatient relationship

The nurse is counseling a family whose child has autism. When describing this condition, which of the following would the nurse most likely include? A) Connection to ineffective parental practices B) Detection after the child enters school C) Onset before child is 2.5 years old D) Girls are more frequently affected than boys

C) Onset before child is 2.5 years old

A client has been prescribed naltrexone (Trexan) for treatment of alcohol dependence. The nurse has explained the drugs purpose to the client. The nurse determines that the client has understood the instructions when the client identifies which of the following about the drug? A) Causes itching if alcohol is consumed B) Produces the euphoria of alcohol C) Reduces the appeal of alcohol D) Improves appetite and nutritional status

C) Reduces the appeal of alcohol

A group of nursing students is reviewing information about other psychotic disorders. The students demonstrate understanding of this information when they identify which disorder as involving an inducer? A) Brief psychotic disorder B) Schizophreniform disorder C) Shared psychotic disorder D) Psychotic disorder attributable to a substance

C) Shared psychotic disorder

While interviewing a client diagnosed with a delusional disorder, the client states, I have this really strange odor coming out of my mouth. I stop to brush my teeth almost every hour and then rinse with mouthwash every half hour to get rid of this smell. Ive seen so many doctors, and they cant tell me whats wrong. The nurse interprets the clients statement as reflecting which type of delusion? A) Erotomanic B) Grandiose C) Somatic D) Jealous

C) Somatic

A nurse is presenting a discussion for a local community group about suicide. Which comment from an audience member indicates the need to clarify the information? A) Warning signs about the persons intention often occur. B) People who are suicidal are undecided about living or dying. C) Suicides more often occur during the holiday seasons. D) People who talk about suicide need to taken seriously.

C) Suicides more often occur during the holiday seasons.

The plan of care for a client diagnosed with depression includes cognitive interventions. The nurse would expect to assist with which of the following? A) Social skills training B) Activity scheduling C) Thought stopping D) Interpersonal therapy

C) Thought stopping

The nurse is assessing a newly admitted client diagnosed with schizoaffective disorder. The nurse assesses the clients level of anxiety and reactions to stressful situations, obtaining this information for which reason? A) To help determine the clients outcomes after treatment B) To help identify whether or not the clients mental competency is intact C) To act as a predictor of the clients risk for a suicide attempt D) To provide a basis for evaluating the clients social skills

C) To act as a predictor of the clients risk for a suicide attempt

A client diagnosed with major depression was prescribed imipramine (Tofranil) and has been taking this medication for 1 week. The client took his last dose of imipramine (Tofranil) at 9:00 PM. The client is scheduled to have blood drawn to monitor the medication level the next morning. The nurse should instruct the client to have his blood drawn as close as possible to which time? A) 6:00 AM B) 7:00 AM C) 8:00 AM D) 9:00 AM

D) 9:00 AM

The nurse is caring for a family with a 3-year-old child who has autism disorders. When developing the teaching plan for the parents, which of the following would the nurse most likely include? A) The child is at higher risk for seizure disorders as well. B) The childs IQ will typically be higher than that of other children. C) Dyslexia also may be a comorbid condition. D) A structured physical environment is an important aspect.

D) A structured physical environment is an important aspect.

The nurse is caring for a 30-year-old white man whose wife has recently died. The patient has been diagnosed with clinical depression and is demonstrating insufficient coping skills. Which action by the nurse would be most important? A) Refer the patient for long-term psychotherapy. B) Determine the patients risk of psychosis. C) Determine if anyone in the patients family has had depression. D) Ask the patient if he is thinking about killing himself.

D) Ask the patient if he is thinking about killing himself.

The nurse is preparing to document information obtained from a client diagnosed with a delusional disorder who is experiencing somatic delusions. Which of the following would the nurse most likely document? A) Disorientation B) Reduced attention span C) Above average intelligence D) Body complaints

D) Body complaints

An adolescent client tells the nurse that he or she occasionally sniffs airplane glue. When discussing the effects of long-term use of inhalants, which of the following would the nurse most likely include? A) Tremors and CNS arousal B) Enhanced normal heart rhythms C) Enhanced attention focus and memory D) Brain damage and cognitive abnormalities

D) Brain damage and cognitive abnormalities

The nurse is caring for a client who was just admitted with a diagnosis of schizoaffective disorder with depression. Which agent would the nurse anticipate as being prescribed for this client? A) Lithium B) Haloperidol C) Chlorpromazine D) Clozapine

D) Clozapine

A group of nursing students is reviewing information about disruptive behavior disorders. The students demonstrate understanding of the topic when they identify which of the following as an externalizing disorder? A) Anxiety B) Depression C) Schizophrenia D) Conduct disorder

D) Conduct disorder

The school nurse is caring for a 7-year-old child who has demonstrated a significantly lower-than-average score for mental age on standardized tests in reading. However, the childs IQ scores were within the average range. The nurse interprets this information as suggesting which of the following? A) Communication disorder B) Attention deficit hyperactivity disorder C) Asperger syndrome D) Dyslexia

D) Dyslexia

The nurse is assessing a 78-year-old client who lives alone in his own home. To assess the clients instrumental activities of daily living, which question would be most appropriate to ask? A) How often do you bathe or shower? B) How many times do you change clothes during the day? C) How often do you cook meals for yourself? D) How often do you go to the store to buy groceries?

D) How often do you go to the store to buy groceries?

A group of nursing students is reviewing information about suicide and associated concepts. The group demonstrates understanding of the information when they identify which of the following as the probability that a person will successfully complete suicide? A) Parasuicide B) Suicidal ideation C) Suicidality D) Lethality

D) Lethality

A client has been diagnosed with major depression. The client reports that he often wakes up during the night and has trouble returning to sleep. The nurse interprets this finding as suggesting which of the following? A) Initial insomnia B) Terminal insomnia C) Hypersomnia D) Middle insomnia

D) Middle insomnia

While caring for an 88-year-old client suspected of having dementia, the nurse assesses the client for a common delusional thought. Which of the following would the nurse interpret as a common delusion? A) I am the king of the universe. B) Creatures are living in my closet. C) The government has people following me. D) My roommate keeps stealing my clothes.

D) My roommate keeps stealing my clothes.

The mother of a child with Asperger disorder tells the nurse that her child has few playmates. She states, He has such poor social skills with other children, and he strongly rejects any change in his routine by throwing a tantrum. Based on this information, the nurse identifies which nursing diagnosis as the priority? A) Self-Care Deficits related to repeated tantrums B) Risk for Injury related to Asperger disorder C) Ineffective Family Coping related to having a child with Asperger disorder D) Risk for Social Isolation related to poor social skills of the child

D) Risk for Social Isolation related to poor social skills of the child

A nurse is assessing a child who is suspected of having attention deficit hyperactivity disorder. Which of the following would the nurse identify as reflecting impulsiveness in the child? A) Inability to wait his turn B) Restlessness C) Difficulty completing a task D) Risk-taking behavior

D) Risk-taking behavior

A client who has a major depressive episode tells the nurse that for the past 2 weeks, he has been hearing voices and at times thinks that someone is following him. History reveals that he had these alternating symptoms before along with times when he has experienced neither of these symptoms and has been able to function adequately. The nurse interprets these findings as suggesting which of the following? A) Paranoid schizophrenia B) Undifferentiated schizophrenia C) Brief psychotic disorder D) Schizoaffective disorder

D) Schizoaffective disorder

When obtaining a clients history, the nurse determines that the client has been experiencing delusions and hallucinations for the past 3 months, which has caused some problems in his ability to function on a daily basis at work. He also is exhibiting catatonic excitement, echopraxia, loose associations, and pressured speech. The nurse suspects which of the following? A) Schizophrenia B) Schizoaffective disorder C) Brief Psychotic disorder D) Schizophreniform disorder

D) Schizophreniform disorder

A nurse is caring for a 76-year-old patient with a hearing deficit caused by presbycusis. Which of the following would be most appropriate for the nurse to do when communicating with the patient? A) Use a higher volume of speech. B) Address the clients family members. C) Ask if the client can use sign language. D) Use lower pitched tones.

D) Use lower pitched tones.

After teaching a group of students about the various concepts involving suicide, the instructor determines that the teaching was successful when the students describe parasuicide as which of the following? A) Voluntary act of killing oneself B) All suicide related behaviors and suicidal thoughts C) Nonfatal act with the intent to die D) Voluntary attempt without death as the aim

D) Voluntary attempt without death as the aim

A nurse is using motivational therapy with a female client with alcoholism. The client, who is unwilling to consider changing her drinking behavior, emphatically states, I am not an alcoholic; you cant make me stop drinking. Which response by the nurse would be most appropriate? A) You have to stop drinking and driving; you could kill someone. B) Youre right; youre not an alcoholic. C) You should consider what you are doing to your marital relationship. D) Youre the only one who can make yourself stop drinking.

D) Youre the only one who can make yourself stop drinking.

A nurse is teaching a medication class to a group of psychiatric patients. One of them asks the nurse why he has so much more trouble learning now when hes in his 60s than he did when he was younger. Which of the following concepts would the nurse integrate into the response? A) The extrapyramidal motor system B) The amygdala C) Neuroplasticity D) Psychoneuroimmunology

Neuroplasticity

A group of nursing students are reviewing the various neurotransmitters. The students demonstrate understanding when they identify which of the following as a neuropeptide? A) Melatonin B) Serotonin C) Glutamate D) Gamma-aminobutyric acid

A) Melatonin

A nurse is participating in a neighborhood health fair and is screening participants for depression. Which individual would the nurse anticipate as being at increased risk for depression? A) A middle-aged man who is providing care for his disabled mother who has paraplegia B) A middle-aged man who is a single parent of a teenage boy who is still living at home C) A woman who is single and has no children of her own D) A young adult who is living at home with his parents and is unable to find work

A) A middle-aged man who is providing care for his disabled mother who has paraplegia

The nurse is counseling a family with a child who has been abused by adult family friend in the past. When explaining about the childs needs, which of the following would be most important for the nurse to stress? A) A supportive relationship with an adult B) Long-term psychotherapy C) Antidepressant medications D) Short-term separation from the parents

A) A supportive relationship with an adult

While assessing an older adult, the nurse allows ample time for the patient to respond based on the understanding of which of the following? A) Ample time ensures that the correct answer is given. B) The patient is most likely experiencing irreversible memory impairment. C) The patient is experiencing decreased cerebral oxygen flow from reduced activity. D) Ample time is needed to weigh the pros and cons of the perceived risk for answering.

A) Ample time ensures that the correct answer is given.

A nurse is assessing a middle-aged adult for possible biologic risk factor associated with mental illness. Which of the following would the nurse identify as placing this patient at increased risk? Select all that apply. A) Changes in skin tone and moisture leading to the development of wrinkles B) Enhanced respiratory efficiency leading to preference for less activity C) Loss of lens elasticity leading which can affect a persons self-esteem D) Changes in brain structure leading to changes in cognition E) Decreased basal metabolic rate leading to weight gain and low activity

A) Changes in skin tone and moisture leading to the development of wrinkles C) Loss of lens elasticity leading which can affect a persons self-esteem

After teaching a class about childhood and adolescent mental health, the instructor determines that additional teaching is needed when the class identifies which of the following as promoting mental health in children? A) Difficult temperament B) Age-appropriate physical development C) Secure attachment D) Normal psychosocial development

A) Difficult temperament

A nurse is preparing to conduct an assessment of a 79-year-old woman who has come to the clinic for evaluation. When performing this assessment, which of the following would be most appropriate for the nurse to do? Select all that apply. A) Dim any lights that appear too bright. B) Face the patient from the side. C) Use short, simple sentences. D) Focus on one topic at a time. E) Speak slowly in a shouting tone.

A) Dim any lights that appear too bright. C) Use short, simple sentences. D) Focus on one topic at a time.

A nurse is preparing a patient for electroconvulsive therapy. Which of the following would the nurse include in the patients plan of care? Select all that apply. A) Ensuring that there is a signed informed consent on the patients chart B) Telling the patient he can have fluids but no food before the procedure C) Alerting the patient to the possibility of confusion after the treatment D) Informing the patient that he can leave his dentures in place for the treatment E) Ensuring that the patient is closely supervised for at least the first 12 hours afterward

A) Ensuring that there is a signed informed consent on the patients chart C) Alerting the patient to the possibility of confusion after the treatment E) Ensuring that the patient is closely supervised for at least the first 12 hours afterward

A nurse is providing an in service program for a group of nurses who are providing home care to middle-aged adults. When describing the typical caregiver, which characteristics would the nurse include? Select all that apply. A) Female gender B) Average age of 40 years C) Married D) Working within the home E) Median income of $20,000/year

A) Female gender C) Married

A nurse is preparing a continuing education presentation for a group of psychiatricmental health nurses about various psychopharmacologic agents. The nurse is planning to discuss selective serotonin reuptake inhibitors. Which agents would the nurse include in this group? Select all that apply. A) Fluoxetine B) Duloxetine C) Sertraline D) Venlafaxine E) Bupropion F) Amoxapine

A) Fluoxetine C) Sertraline

A nurse is caring for a psychiatric patient who is receiving an antacid that contains aluminum salts. Which action by the nurse would be most appropriate? A) Give the antacid 1 hour before the antipsychotic medication. B) Give the antacid at the same time as the antipsychotic medication. C) Administer the antacid 1 hour after the antipsychotic medication. D) Administer the antacid just before the patient goes to sleep.

A) Give the antacid 1 hour before the antipsychotic medication.

While caring for a family who lost a 10-year-old son in a car accident, the nurse should instruct the parents to tell the 4-year-old sister which of the following about her brother? A) He died and is not coming back. B) He passed on to the other side. C) He departed on a long journey. D) He has gone to see the Lord above.

A) He died and is not coming back.

After teaching a patient who is prescribed imipramine about the drug, the nurse determines that the teaching was effective when the patient states which of the following? A) I need to be careful because the drug can make me sleepy. B) I dont have to worry about getting dizzy when I get up from lying down. C) I might notice some excess saliva in my mouth at different times. D) I need to avoid foods with fiber because diarrhea can occur.

A) I need to be careful because the drug can make me sleepy

A patient is scheduled for a challenge test. Which of the following would the nurse include when explaining this test to the patient? A) Intravenous administration of a substance to induce symptoms B) Application of electrodes to the scalp for monitoring C) Evaluation electrical impulses recorded on graph paper D) Exposure to a flashing strobe light to elicit abnormal activity

A) Intravenous administration of a substance to induce symptoms

While engaging in a discussion with a group of teens about risk behaviors, one of the teens says, That will never happen to me. The nurse interprets this as which of the following? A) Invincibility fable B) Formal operations C) Egocentric thinking D) Relational aggression

A) Invincibility fable

A nurse is reading a journal article about psychoneuroimmunology. Which information would the nurse most likely find? Select all that apply. A) Neurotoxins role in receptor site damage B) Hypothalamicpituitarythyroid axis disruption C) Static activity of natural killer cells in response to stress D) Hypothalamic damage leading to immune dysfunction E) Interruption in the typical circadian rhythm cycle

A) Neurotoxins role in receptor site damage B) Hypothalamicpituitarythyroid axis disruption D) Hypothalamic damage leading to immune dysfunction

A nurse is participating as a speaker in a public workshop on the topic of promoting mental health in young and middle-aged adults. The nurse tells the audience that age, unemployment, and lower education are risk factors associated with mental illness. A woman raises her hand and asks, Does that mean because I only have a 10th grade education and am unemployed that I will develop a mental illness? Which response by the nurse would be most appropriate? A) No, not necessarily; it just means that there is an increased chance that you might. B) Of course not; we live in a rural area, and these statistics are based on large cities. C) Yes, I am afraid so, but with early detection, we can prevent the illness from worsening. D) It probably does, but we have developed advanced medications to treat mental illness.

A) No, not necessarily; it just means that there is an increased chance that you might.

The nurse is working as part of a team to help reduce the stigma attached to mental health treatment for the older adult population. Which of the following would be most appropriate to do to achieve this outcome? A) Provide education about mental health and mental disorders. B) Initiate screening programs for symptoms. C) Ensure older adults received integrated community care. D) Institute a wide range of social support services.

A) Provide education about mental health and mental disorders.

A group of nursing students is reviewing the physical changes that occur in older adults. The students demonstrate understanding of the information when they identify which of the following as contributing the patients risk for drug toxicity? A) Reduced liver function B) Reduce brain gray matter volume C) Lower metabolic rate at rest D) Decreased body water

A) Reduced liver function

A female patient, who is in her late 30s, is describing her home life to the nurse. The nurse determines that the patient is a member of the sandwich generation based on which of the following? A) She has a young adult child at home and an elderly parent to care for at the same time. B) She has a young adult child who is married and currently living away from home. C) She has a young adult child away at college and without any living parents. D) She has no responsibilities associated with her young adult children or her parents.

A) She has a young adult child at home and an elderly parent to care for at the same time.

The nurse is caring for a hospitalized patient who has a disorder of the hypothalamus. When developing the patients plan of care, in which of the following areas would the nurse anticipate a problem? A) Sleep B) Constipation C) Speech D) Motor activity

A) Sleep

A psychiatricmental health nurse is assessing a woman for possible factors related to suicide. Which of the following would the nurse be least likely to identify? A) Smoking B) Poor self-rated health C) Low education D) Drug use

A) Smoking

A nurse is developing a plan for establishing appropriate supportive community care services for older adults to promote independence. Which services would the nurse be most likely to include? Select all that apply. A) Transportation B) Homemakers C) Legal D) Housing E) Child care

A) Transportation B) Homemakers C) Legal D) Housing

The nurse is counseling a family with two parents and two children, ages 8 and 10 years. The mother complains that the children are constantly fighting and have intense sibling rivalry. When statement would be most appropriate when advising the parents about how to respond to the sibling rivalry? A) Try reacting to each as unique individuals with talents and interests distinctly their own. B) Be firm about telling the children they have to cooperate with one another. C) Slowly decrease the amount of attention and control shown to the older child. D) Make sure they have a quiet, subdued home environment to avoid stimulating conflict

A) Try reacting to each as unique individuals with talents and interests distinctly their own.

A nurse is working with a family in which the parents have just gotten divorced. After teaching the parents about measures to reduce the risk of emotional problems for the children, which statement by the parents indicates a need for additional teaching? A) We will try to alter their routines so they dont think about the past. B) We will make sure that they understand that they did not cause the divorce. C) We will develop a regular and consistent schedule for visitation. D) We will make sure that we are consistent in the limit that we set.

A) We will try to alter their routines so they dont think about the past.

The nurse is caring for an older adult who has experienced damage to the frontal lobe after an automobile accident. The nurse anticipates that the patient will have difficulty with which of the following? A) Smell B) Concept formation C) Receptive speech D) Hearing

B) Concept formation

A nurse is providing care to several chronically ill children. Which of the following would the nurse identify as having the greatest risk for developing a psychiatric problem? A) 12 year-old with diabetes mellitus B) 5 year-old with cerebral palsy C) 8 year-old who has chronic renal disease D) 10 year-old with a heart murmur

B) 5 year-old with cerebral palsy

A nurse is reviewing the medical records of several older adult patients. The nurse determines that which individual would have the least chance of developing mental health problems with aging? A) A man who is single, has an eighth grade education, and walks to the mailbox and back every day B) A woman who is married with graduate education, eats nutritionally balanced meals, and exercises for 20 minutes each day C) A man who is married, has a high school education, eats mostly fast food, and walks a mile each day D) A woman who is single, has a college degree and watches what she eats but really does not exercise

B) A woman who is married with graduate education, eats nutritionally balanced meals, and exercises for 20 minutes each day

When describing the various neurotransmitters, which of the following would the nurse identify as the primary cholinergic neurotransmitter? A) Dopamine B) Acetylcholine C) Norepinephrine D) Serotonin

B) Acetylcholine

A patient who is scheduled to undergo a sleep deprivation electroencephalogram (EEG) in the morning is experiencing moderate anxiety about the procedure. Based on an understanding of this test, which of the following would the nurse avoid? A) Explaining in depth what to expect during the upcoming procedure B) Administering a benzodiazepine medication prescribed for anxiety C) Taking a thorough history of her use of prescribed and illicit drugs D) Giving her a noncaffeinated beverage of her choice

B) Administering a benzodiazepine medication prescribed for anxiety

The nurse is presenting a community educational program focusing on older adults and mental health protective factors. One of the participants asks what the influence of co-parenting ones grandchild has on the mental health of the grandparent. Which response by the nurse would be most appropriate? A) The well-being of grandmothers is statistically more significant when they co-parent their grandchildren. B) Although there are stresses involved with grandparenting, the positive benefits appear to outweigh the negatives. C) White grandmothers experience less well-being when they co-parent their grandchildren. D) The perceived well-being of grandfathers who co-parent their grandchildren significantly changes in a positive direction.

B) Although there are stresses involved with grandparenting, the positive benefits appear to outweigh the negatives.

A patient is experiencing hallucinations and delusions. The nurse would expect the physician to order which class of drug? A) Mood stabilizer B) Antipsychotic C) Antianxiety agent D) Stimulant

B) Antipsychotic

A nurse is reviewing information about a psychiatric medication that describes the amount of the drug that actually reaches systemic circulation unchanged. The nurse identifies this as which of the following? A) First-pass effect B) Bioavailability C) Solubility D) Biotransformation

B) Bioavailability

A nurse is providing teaching to a group of parents with children and adolescents who have experienced losses. The nurse determines that the teaching was successful when the group states which of the following? A) Children grieve in similar ways regardless of their age. B) Children often use fantasy to fill in their gaps in understanding. C) Families tend to grieve at similar times after the loss. D) Children and adults grieve much in the same manner.

B) Children often use fantasy to fill in their gaps in understanding

The nurse is counseling a family with a 10-year-old child after the death of a favorite uncle. The nurse provides guidance to the parents, informing them that the child may exhibit which of the following as a response? A) Talk about scary, morbid novels all the time. B) Complain of aches and pains, stomachaches, that sort of thing. C) Suddenly become afraid of leaving home to go to school. D) Become obsessed with religious rituals, Bible verses, and prayer.

B) Complain of aches and pains, stomachaches, that sort of thing.

A nurse is developing a plan of care for a patient diagnosed with schizophrenia. The nurse integrates knowledge of this disorder, identifying which neurotransmitter as being primarily involved? A) Acetylcholine B) Dopamine C) Norepinephrine D) Serotonin

B) Dopamine

A group of nursing students is reviewing risk and protective factors associated for mental disorders in the older adult population. The students demonstrate understanding of the information when they identify which of the following as a protective factor? A) Poverty B) Education C) Loss D) Chronic illness

B) Education

When describing mental health to a community group ranging in age between 25 and 50 years, the nurse includes information about the developmental concepts that are often readdressed when life stresses occur. Which developmental concept would the nurse be least likely to address? A) Identity B) Ego integrity C) Generativity D) Intimacy

B) Ego integrity

A home-health nurse is working with a poverty-stricken family that has two small children, ages 2 and 3 years. The family lives in an isolated rural area. The familys home has a dirt floor, and there are chickens living in the house with the family. Because of a recent wind storm, there is a sizeable hole in the roof that lets rain and snow into the house. Which nursing intervention would be the highest priority in this situation? A) Make immunization appointments for the children in a nearby towns public health clinic. B) Help the family find funding and manpower to patch and repair the roof of their home. C) Determine the educational readiness of the two children. D) Report the family for child abuse because of neglect.

B) Help the family find funding and manpower to patch and repair the roof of their home.

A group of nursing students are reviewing information related to drug therapy for mood disorders. The students demonstrate understanding of the information when they identify which agent as the gold standard for treating bipolar disorder? A) Carbamazepine B) Lithium C) Valproate D) Lamotrigine

B) Lithium

A group of nursing students are reviewing the various drug classes used to treat psychiatric disorders. The students demonstrate understanding when they identify which of the following as examples of antianxiety medications? Select all that apply. A) Selegiline B) Lorazepam C) Buspirone D) Zolpidem E) Methylphenidate

B) Lorazepam C) Buspirone

A group of nursing students is reviewing information about the differences that occur with grieving in children, adolescents, and adults. The students demonstrate understanding of this information when they identify which of the following as characteristic of adolescents? A) View death as reversible B) Mourn by talking about the loss C) Need repeated explanations to understand the loss D) Express a time limit for socially acceptable grieving

B) Mourn by talking about the loss

The nurse is assessing a patient experiencing anxiety and observes increased sweating and gooseflesh. The nurse understands that these are the result of which substance? A) Acetylcholine B) Norepinephrine C) Serotonin D) Histamine

B) Norepinephrine

A nursing instructor is preparing for a class discussion on polypharmacy and older adults. Which of the following would the instructor expect to include? A) The risk for drug abuse, although present, is fairly rare in this population. B) Older adults often experience a greater risk for adverse reactions. C) Medications are usually prescribed in higher doses initially and then gradually reduced. D) Age-related pharmacokinetic changes enhance the drugs therapeutic effectiveness.

B) Older adults often experience a greater risk for adverse reactions.

A patient with depression tells the nurse that he is to have a test that involves the recording of an electroencephalogram (EEG) throughout the night. The nurse most likely identifies this testing as which of the following? A) Sleep deprivation EEG B) Polysomnography C) Evoked potentials D) Functional magnetic resonance imaging

B) Polysomnography

While assessing an older adult patient for mental health issues, the nurse pays special attention to the patients sensory function based on the understanding of which of the following? A) Most older adults follow a specific pattern of decline in functioning leading to gradual onset of problems. B) Sensory decline may affect the individuals ability to process information, possible influencing the findings of the mental status examination. C) Diminished sensory function can lead to changes in other body systems that may affect the individuals reaction to prescribed medications. D) Changes in the senses can result in changes in cognitive abilities that mimic the manifestations of mental disorders.

B) Sensory decline may affect the individuals ability to process information, possible influencing the findings of the mental status examination.

A patient with depression asks the nurse about possible herbal supplements. Which of the following would the nurse identify as being commonly used? A) Valerian B) St. Johns wort C) Kava D) Melatonin

B) St. Johns wort

When describing neuronal transmission, an instructor describes the area where the electrical intracellular signal becomes a chemical one. The instructor is describing which of the following? A) Soma B) Synaptic cleft C) Terminal D) Receptor site

B) Synaptic cleft

A nurse is performing an admission assessment. The patient complains that it has been taking larger and larger amounts of medication to get the desired effect. Based on this information, the nurse interprets this as suggesting which of the following? A) Desensitization B) Tolerance C) Therapeutic index D) Toxicity

B) Tolerance

A patient is prescribed medication for a psychiatric disorder. After 3 days, the patient tells the nurse that he or she has been constipated. Which instruction would the nurse give the patient? A) You need to eat more high-protein foods such as meat and peanut butter. B) You need to eat more fruits and vegetables and drink more water. C) Ask your psychiatrist to prescribe a stool softener for you. D) This side effect should disappear within a week or so.

B) You need to eat more fruits and vegetables and drink more water.

A 3-year-old child has been admitted to the hospital after an automobile accident. Which statement by the nurse would be most appropriate when discussing the type of behavior the parents can expect their child to display while hospitalized? A) Your child may not be able to accept how the injury has changed your childs appearance. B) Your child may seem unduly anxious in the presence of strangers. C) Your child may experience some guilt feelings associated with the accident. D) Your child will exhibit intermittent periodic mood swings, but these should be brief.

B) Your child may seem unduly anxious in the presence of strangers.

A nurse is developing a plan of care for a patient experiencing expressive aphasia. The nurse incorporates knowledge that the patient most likely has sustained damage to which of the following? A) The postcentral gyrus B) Brocas area C) Basal ganglia D) The hippocampus

B) Brocas area

The nurse is caring for a patient who has experienced damage to the parietal lobes of the brain. The nurse anticipates that the patient with have difficulty with which of the following? A) Perceiving sensory input B) Calculating a math problem C) Seeing objects in front of him D) Speaking fluently

B) Calculating a math problem

A nurse is reviewing the medical records of several older adult patients who have come to the clinic for evaluation. The nurse would classify a patient of which age as being in the middle-old stage? A) 66-year-old adult B) 70-year-old adult C) 78-year-old adult D) 86-year-old adult

C) 78-year-old adult

The nurse is caring for a 70-year-old psychiatric patient who has been prescribed a number of medications. When teaching the patient about the medications, which explanation would be most appropriate? A) Your stomach empties more quickly as you age; therefore, you may feel the effect of your medications almost immediately. B) Your entire GI system speeds up, so your medications are digested much more quickly. Therefore, it is important that you not drive after you take your medications. C) Because of your age and related changes in liver functioning, you may have medication levels in your system with the potential to be toxic. D) Because of age-related circulation changes, your body will be able to deliver therapeutic doses of your medication to select body sites more quickly.

C) Because of your age and related changes in liver functioning, you may have medication levels in your system with the potential to be toxic.

A nurse is developing a plan of care for a family who is experiencing problems related to their childs chronic illness. The nurse plans to have the family read a group of short stories written by parents of children with chronic illnesses. The nurse will be using which technique? A) Psychoeducation B) Social skills training C) Bibliotherapy D) Assertiveness training

C) Bibliotherapy

The nurse observes an older adult patient who has been taking antipsychotic medications for 8 months. The patient is smacking her lips and blinking her eyes rapidly. The nurse also observes a protruding tongue. Which action by the nurse would be most appropriate? A) Ask if the patient has been experiencing side effects. B) Contact the patients physician for a different medication order. C) Document the patients symptoms of tardive dyskinesia. D) Instruct the patient to begin tapering off the medication.

C) Document the patients symptoms of tardive dyskinesia.

The nurse is preparing to assess a 78-year-old patient who has been diagnosed with major depression. Which of the following would the nurse expect to assess as a normal finding? A) Decrease in body fat B) Increased muscle mass C) Dulled taste sensation D) Enhanced visual acuity

C) Dulled taste sensation

A school nurse is teaching a class of adolescents about healthy behaviors. Which of the following activities include as a means for preventing anxiety and depression when they are middle-aged adults? A) Restricting their sugar and fat intake B) Refraining from smoking or doing drugs C) Engaging in physical activity and exercise D) Becoming active in local church activities

C) Engaging in physical activity and exercise

The nurse is reviewing the medical records of several patients receiving antipsychotic agents. Which factors, if noted, would the nurse identify as placing a patient at greater risk for tardive dyskinesia? A) Male gender B) Age 30 to 45 years C) History of depression D) Short duration of treatment

C) History of depression

A nurse is providing teaching to a young adult about measures to promote mental health. Which statement by the patient would indicate a need for additional teaching? A) I will make sure that I eat foods that are nutritious. B) I need to allow some time for relaxation every day. C) I will make sure I have the support of two really good friends. D) I have to work to make sure that I get enough sleep every night

C) I will make sure I have the support of two really good friends

A nurse is developing a presentation for a local community group of young and middle-aged adults about common psychosocial problems. Which of the following would be least appropriate for the nurse need to integrate into the presentation? A) The age range for individuals in this category is from 18 to 65 years of age. B) These categories are specific to Western culture secondary to a lengthened lifespan. C) Longer periods of development for this group have become the norm throughout the world. D) These categories apply primarily in the United States because of superior technologic advances.

C) Longer periods of development for this group have become the norm throughout the world.

The nurse is planning an initial therapy session with a 20-year-old patient whose parents had alcoholism. The nurse anticipates that the patient would most likely exhibit symptoms of which of the following? A) Delusions B) Paranoid delusions C) Low self-concept D) Extroversion

C) Low self-concept

The nurse is caring for a group of hospitalized patients with various psychiatric diagnoses. The nurse identifies which patient as having the greatest risk for a suicide attempt? A) Man with bipolar I disorder B) Woman with acute stress disorder C) Man with major depressive disorder D) Woman with somatoform disorder

C) Man with major depressive disorder

A nurse is preparing a presentation for mental health promotion for young and middle-aged adults and is planning to address changes in family structure. Which of the following would the nurse include as reflecting marriage? A) The peak marriage age is between 28 to 32 years. B) Those marrying in their teens are more likely to get divorced. C) Middle-aged adults are most likely to be married. D) People who marry between the ages of 23 to 27 years are likely to get divorced.

C) Middle-aged adults are most likely to be married.

A nursing instructor is teaching a class on the pharmacodynamics of psychiatric medications. The instructor determines that additional teaching is needed when the students identify which of the following as a site of action? A) Receptor B) Ion channels C) Neurotransmitters D) Enzymes

C) Neurotransmitters

A nurse is working as part of a team involved with the testing of a new psychiatric medication. The drug is currently being used in multiple clinical trials at various different sites. The nurse is engaged in which phase of testing? A) Phase I B) Phase II C) Phase III D) Phase IV

C) Phase III

A family member of an adolescent who has expressed a desire to commit suicide asks the nurse, What might predict the possibility of future suicide attempts? Which of the following would the nurse include in the response? A) Unemployment B) Death of a spouse C) Previous suicide attempt D) Polydrug use

C) Previous suicide attempt

A nurse is working with a child for which an out-of-home placement has occurred. Which of the following would the nurse anticipate as the childs initial response? A) Despair B) Withdrawal C) Protest D) Detachment

C) Protest

A nursing student is reading an article about protective factors for mental illness with older adults. The article mentions the individuals ability to adapt successfully to stress, trauma, or chronic adversity. The student identifies this as which of the following? A) Functional status B) Gerotransendence C) Resilience D) Empty nest

C) Resilience

A nurse is involved in gathering information about the inheritance of mental disorders using population genetics. Which of the following would the nurse be least likely to be evaluating? A) Concordance rates B) Occurrence in first-degree relatives C) Risk factor analysis D) Adoptions studies

C) Risk factor analysis

A patient is brought to the emergency department by her brother, who reports that the patient became very agitated and started hallucinating. Further assessment reveals tachycardia, incoordination, vomiting, and diarrhea. The brother states that the patient is taking paroxetine for depression. Which of the following would the nurse most likely suspect? A) Neuroleptic malignant syndrome B) Acute dystonic reaction C) Serotonin syndrome D) Hypothyroidism

C) Serotonin syndrome

After teaching a patient who is receiving phenelzine, the nurse determines that the teaching was successful when the patient states the need to avoid which of the following? A) Fresh cottage cheese B) Cooked sliced ham C) Tap beers D) Soy milk

C) Tap beers

A patient receiving an antipsychotic agent develops acute extrapyramidal symptoms. Which response by the nurse would be most appropriate? A) These symptoms are not real; the medication makes your brain think they are real. B) You have developed an allergy to the medication, so we need to change it. C) These are the results of the drug that can be treated; your illness is not getting worse. D) The sunlight together with the medication has caused these symptoms; just stay indoors.

C) These are the results of the drug that can be treated; your illness is not getting worse.

After checking a patients blood pressure, he asks the nurse what changes he should expect in himself as he grows older. Which response by the nurse would be most appropriate? A) You dont have anything to worry about; you will basically stay the same. B) Your personality will stay the same, but your intelligence level will lessen somewhat. C) Usually, you can anticipate that you will begin to react to things more slowly. D) You will become increasingly childlike, and your personality will change

C) Usually, you can anticipate that you will begin to react to things more slowly.

A group of nursing students is reviewing the results of the Behavioral Risk Factor Surveillance System. The students demonstrate understanding of this information when they identify which group as experiencing the greatest number of sad, blue, or depressed days (SBDD)? A) Women B) Men C) Young adults D) Older adults

C) Young adults

A 72-year-old woman is participating in a health fair that is being held at a local community center. Basic psychiatric screening will be provided by mental health professionals. Which of the following problems would this screening most likely reveal? A) Anxiety Disorder B) Psychosocial Impairment C) Mood Disorder D) Cognitive Impairment

D) Cognitive Impairment

A nurse administers a prescribed dose of lithium at 8 PM. The nurse would schedule a specimen to be obtained for a blood level at which time? A) 10 PM B) 12 AM C) 4 AM D) 8 AM

D) 8 AM

A group of students are reviewing information about neurotransmitter subtypes. The group demonstrates understanding of the information when they identify which neurotransmitter as having muscarinic and nicotinic receptors? A) Serotonin B) Gamma-aminobutyric acid (GABA) C) Dopamine D) Acetylcholine

D) Acetylcholine

A patient who has been taking clozapine for 6 weeks visits the clinic complaining of fever, sore throat, and mouth sores. The nurse notifies the patients physician because the nurse suspects which of the following? A) Severe anemia B) Neuroleptic malignant syndrome C) Encephalitis D) Agranulocytosis

D) Agranulocytosis

A hospitalized patient who has been taking an antipsychotic medication for 2 weeks begins pacing and walking throughout the unit. He tells the nurse that he cannot sit still. The nurse documents this finding as which of the following? A) Akinesia B) Dystonia C) Pseudoparkinsonism D) Akathisia

D) Akathisia

During the stabilization phase of drug therapy for a patient who is hospitalized with a psychiatric disorder, which action would be most appropriate? A) Discussing the timing of tapering the medication B) Instructing the patient about relapse prevention C) Determining if the medication is losing its effect D) Assessing the patient for target symptoms and side effects

D) Assessing the patient for target symptoms and side effects

The nurse is working with a patient whose mobility is impaired secondary to a fall that resulted in a broken hip. In addition, the patient, who has diabetes, is developing problems with vision and hearing. The patient seems increasingly withdrawn and depressed. The nurse determines that the patient is at risk for spiritual distress. Which intervention would be most appropriate? A) Encourage the patient to talk about significant childhood religious experiences. B) Offer to take the patient to a revival the nurses church is holding in the community. C) Read to the patient Bible passages that seem particularly relevant to the patients case. D) Explore what the mobility, sight, and hearing changes mean to the patient.

D) Explore what the mobility, sight, and hearing changes mean to the patient

A nurse is teaching a class at a community health center on the topic of attributes that influence good health in the adult population. Which of the following would the nurse correlated with being married? A) Engaging in more health risking behaviors B) Having more serious psychological stress if a married middle-aged woman C) Consuming more alcohol and smoking more cigarettes D) Having a higher incidence of being overweight or obese if a middle-aged man

D) Having a higher incidence of being overweight or obese if a middle-aged man

A patient has been diagnosed with memory dysfunction associated with Alzheimers disease. The nurse determines that damage to the patients brain includes deterioration of temporal lobe structures and the nerves of which of the following? A) Basal ganglia B) Limbic system C) Frontal lobe D) Hippocampus

D) Hippocampus

A nursing instructor asks a student to explain the influence of chronobiology on depression. Which of the following would the student include when responding? A) The exact location of genes leads to identifying the gene responsible for causing depression. B) A break in the corpus coliseum blocks information exchange between the right and left hemispheres. C) Damage to the posterior areas of the parietal lobe leads to altered discriminative sensory function. D) Internal and external triggers can elicit biologic rhythm changes indicative of clinical depression.

D) Internal and external triggers can elicit biologic rhythm changes indicative of clinical depression.

The nurse is planning a counseling session with a group of at-risk adolescents on the topic of drug abuse. Which teaching strategy would be most effective? A) Handing out educational pamphlets and showing slides of car accidents related to teen drug use. B) Showing informational videotapes and providing Internet addresses on the topic of drug addiction. C) Giving information by lecturing and using pre- and posttest quizzing about the information. D) Involving peers in teaching the effective group problem-solving skills.

D) Involving peers in teaching the effective group problem-solving skills.

The nurse is reviewing the medical records of several patients diagnosed with major depression. The nurse identifies which patient as least likely to commit suicide? A) Divorced man B) Widowed woman C) Single woman D) Married man

D) Married man

The nurse is planning a presentation to a group of older adults on the topic of suicide in the population. One of the group participants asks who has the highest risk of suicide. Which response by the nurse would be most appropriate? A) Older adults who have multiple prescriptions from a variety of different pharmacies. B) Older adults who are experiencing a deep and profound depression. C) Older adult women who are divorced or widowed. D) Men over the age of 75 years who are divorced or widowed.

D) Men over the age of 75 years who are divorced or widowed

A group of nursing students is reviewing information about the course of aging in future older adults and qualities that contribute to successful aging. The students demonstrate understanding of this information when they identify which of the following as least important? A) Capacity to adapt to change B) Engagement in life C) Stability with reliable social support D) Physical health

D) Physical health

A group of nursing students are reviewing the role of serotonin in psychiatric disorders. The students demonstrate a need for additional study when they identify which disorder as being associated with its dysfunction? A) Depression B) Obsessive-compulsive disorder C) Panic disorder D) Schizophrenia

D) Schizophrenia

The nurse is working with a child who has engaged in bullying. Which of the following would be most effective for the nurse to implement? A) Psychoeducation B) Bibliotherapy C) Early intervention program D) Social skills training

D) Social skills training

After teaching a group of students about protective factors for mental illness, the instructor determines that the teaching was successful when the students identify which of the following? A) Unemployment B) Younger age C) Single status D) Social support

D) Social support

A psychiatricmental health nurse is responsible for performing admission assessments of a population that primarily involves young and middle-aged adults. When performing these assessments, which area would be a priority? A) Coping skills B) Cognition C) Self-esteem D) Suicide risk

D) Suicide risk

A nurse is completing an admission assessment of a young adult woman who has a history of depression and who was brought to the hospital by her boyfriend. In response to the nurses question regarding suicidal ideation, the patient discloses that the she is thinking about killing herself. Which question would be most appropriate for the nurse to ask next? A) What does your boyfriend think about your desire to kill yourself? B) What are your spiritual beliefs about suicide? C) What will killing yourself accomplish? D) What thoughts have you had about how you would kill yourself?

D) What thoughts have you had about how you would kill yourself?

A patient has been prescribed clozapine for treatment of schizophrenia. Which of the following would the nurse include in the teaching plan for this patient and family? A) You may experience hypertension while taking this medication. B) One of the side effects of this medication is breast engorgement. C) People taking this medication often experience dermatitis. D) You may experience noticeable weight gain while taking this medication.

D) You may experience noticeable weight gain while taking this medication.

An older adult is complaining of anxiety is prescribed diazepam (Valium) by a family physician. The physician asks the office nurse to explain the problematic side effects of this medication to the patient. Which instruction would be most important for the nurse to emphasize about this drug? A) You may experience minor urine incontinence from time to time. B) You may find that you have temporary memory disturbances. C) You need to use this medication cautiously because it can cause dependence. D) You may feel dizzy and be prone to falls after taking this medication.

D) You may feel dizzy and be prone to falls after taking this medication.

Which of the following would a nursing instructor identify when describing the area of the brain involved with verbal language function, including areas for both receptive and expressive speech? A) Right hemisphere B) Parietal lobe C) Occipital lobe D) Left hemisphere

D) Left hemisphere