Psych Exam 4

Is the following statement true or false? A patient with depression is at greatest risk for suicide when his or her mood is at the lowest point.

False

Is the following statement true or false? A person with a histrionic personality lacks empathy and demonstrates an air of superiority, specialness, and self-centeredness.

False

Is the following statement true or false? A person with obsessive-compulsive personality disorder experiences obsessions and compulsions just as a person with obsessive-compulsive disorder (OCD).

False

Is the following statement true or false? An expansive mood is characterized by euphoria.

False

Is the following statement true or false? An individual suspected of having a personality disorder recognizes he or she has a problem and seeks help.

False

Is the following statement true or false? Hallucinations are considered positive symptoms, but delusions are considered negative symptoms.

False

True or False? Everyone who experiences a traumatic event sustains an emotional injury.

False

True or false? A person with schizoaffective disorder experiences the symptoms of schizophrenia and an anxiety disorder.

False

Is the following statement true or false? A person with antisocial personality disorder typically must be older than the age of 18 years and have shown some evidence of a conduct disorder.

True

Is the following statement true or false? Poor family response to disorder can be a factor in the development of schizophrenia in children.

True

Is the following statement true or false? Protecting the patient from self-harm is crucial during a manic phase.

True

True or False? A patient diagnosed with hoarding has an increased risk for injury related to the associated clutter.

True

True or False? Children experiencing depression commonly exhibit an irritable mood.

True

True or False? The family member is the best individual for the nurse to question about any changes in a patient's compulsive actions.

True

Prior to the community meeting, a patient with antisocial personality disorder was overheard coaching other patients to strongly object to the unit's "no smoking" policy. Which response would be most characteristic of this patient when approached by staff members who wish to discuss the behavior? a. "Hey, it's not my fault. They object to you people running this place like a jail." b. "I knew they'd mess this up. I've learned to be my own spokesman in the future." c. "I think the clients and staff should talk about the rules and negotiate some changes." d. "I've learned something valuable from this. Can we talk about this in my therapy session?"

a. "Hey, it's not my fault. They object to you people running this place like a jail."

A patient with PTSD startles easily and reacts irritably to small annoyances. The nurse interprets this as which of the following? a. Hyperarousal b. Avoidance c. Numbing d. Intrusion

a. Hyperarousal

A patient is diagnosed with obsessive-compulsive disorder (OCD) and is to receive medication therapy. The nurse expects the patient to be prescribed one of the following medications except. a. Lithium b. Fluvoxamine c. Clomipramine d. Sertraline

a. Lithium

Which agent would most commonly be prescribed for a patient with bipolar I disorder? a. Lithium b. Carbamazepine c. Lamotrigine d. Divalproex

a. Lithium

A patient diagnosed with a dissociative disorder should also be assessed regularly for which of the following? Select all that apply. a. Mood disorders b. Substance abuse c. Personality disorders d. Social engagement disorder e. Posttraumatic stress disorder

a. Mood disorders b. Substance abuse c. Personality disorders e. Posttraumatic stress disorder

The psychiatric-mental health nurse is assessing a new client who was just admitted to the inpatient psychiatric unit in a manic episode. Which assessment should the nurse prioritize? a. Possible past history of antidepressant use b. Family history of psychiatric disorders c. Identify the possible trigger for this episode d. Dates of any prior hospitalizations

a. Possible past history of antidepressant use

The psychiatric mental-health nurse is preparing a care plan for a patient who is being discharged from the hospital after a bout of severe depression. Which individual should the nurse ensure is included in the interprofessional team for this individual? a. Primary care provider b. Psychiatrist on call c. The staff nurse d. Insurance representative

a. Primary care provider

A patient with obsessive-compulsive disorder reveals that he was late for his appointment "because of my dumb habit. I have to take off my socks and put them back on 41 times! I can't stop until I do it just right." The nurse interprets the patient's behavior as most likely representing which factor? a. relief from anxiety b. control of his thoughts c. attention from others d. safe expression of hostility

a. relief from anxiety

A patient is admitted with a recent history of severe anxiety following a home invasion and robbery. During the initial assessment interview, which statement by the patient should indicate to the nurse the possible diagnosis of posttraumatic stress disorder? Select all that apply. a. "I'm afraid of spiders." b. "I keep reliving the robbery." c. "I have to wash my hands over and over again many times." d. "I see his face everywhere I go" e. "I don't want anything to eat now."

b. "I keep reliving the robbery." d. "I see his face everywhere I go"

The patient diagnosed with a fear of eating in public places or in front of other people has finished eating lunch in the dining area in the nurse's presence. Which statement by the nurse should reinforce the patient's positive action? a. "It wasn't so hard, now was it?" b. "It's progress for you to eat in the dining room with me." c. "At supper, I hope to see you eat with a group of people." d. "You must have been hungry today."

b. "It's progress for you to eat in the dining room with me."

A patient arrives from the emergency department with a diagnosis of antisocial personality disorder. As the nurse explains the unit rules to him, the patient asks "Can I go to the snack shop just one time and then I will answer whatever you ask?" The nurse's most appropriate response is: a. "No, you can't go." b. "No, you can't go. The rules here apply to everyone." c. "Okay, but be back in five minutes." d. "Yes, but hurry, because I need to finish your assessment."

b. "No, you can't go. The rules here apply to everyone."

A 35-year-old patient, who is a veteran and has posttraumatic stress disorder, tells the nurse about the horror and mass destruction of war. He states, "I killed all of those people for nothing." Which response by the nurse is appropriate? a. "Maybe you didn't kill as many people as you think." b. "You did what you had to do at that time." c. "How many people did you kill?" d. "War is a terrible thing."

b. "You did what you had to do at that time."

A patient is admitted to the mental health unit with a diagnosis of depression. The nurse should develop a plan of care for the patient that includes which intervention? a. Encouraging quiet reading and writing for the first few days. b. A structured program of activities in which the patient can participate. c. No socializing activities until the patient asks to participate in milieu. d. Identification of physical activities that will provide exercise.

b. A structured program of activities in which the patient can participate.

The PMHRN is assessing a new patient. Which finding would cause the nurse to suspect the patient has OCD? a. Uses mega-doses of vitamin supplements b. Insists the house be clean and spotless before going to bed at night c. Spends 15 to 30 minutes each day reading a best-seller book d. Running every morning for at least 30 minutes

b. Insists the house be clean and spotless before going to bed at night

Which factor should the nurse prioritize when admitting a patient diagnosed with BPD to the in-patient psychiatric unit? a. Medication adherence b. Patient safety c. Therapeutic relationship d. Nutritional needs

b. Patient safety

An abused child has been placed in a loving foster home. The foster parents express concern when the child has not developed a positive attachment after living in their home for the past 9 months. The case manager concludes that the child has developed which condition? a. Acute stress disorder b. Reactive attachment disorder c. Adjustment disorder d. Disinhibited social engagement disorder

b. Reactive attachment disorder

Which food should the nurse tell the patient to avoid while taking phenelzine? a. roasted chicken b. salami c. fresh fish d. hamburger

b. salami

The patient with major depression and suicidal ideation has been taking bupropion 100 mg PO 3 times daily for 5 days. Assessment reveals the patient to be somewhat less withdrawn, able to perform activities of daily living with minimal assistance, and eating 50% of each meal. At this time, the nurse should monitor the patient specifically for which behavior? a. seizure activity b. suicide attempt c. visual disturbances d. increased libido

b. suicide attempt

The patient with a diagnosis of bipolar disorder, manic phase, states to the nurse, "I am the Queen of England. Bow before me." The nurse interprets this statement as important to document as which area of the mental status examination? a. psychomotor behavior b. thought content c. mood and affect d. attitude toward the nurse

b. thought content

A patient diagnosed with obsessive-compulsive disorder has been taking sertraline but would like to have more energy every day. At his monthly checkup, he reports that his massage therapist recommended he take St. John's wort to help his depression. What should the nurse tell the patient? a. St. John's wort is a harmless herb that might be helpful in this instance." "b. If you take St. John's wort, we will have to decrease the dose of your sertraline." c. "Combining St. John's wort with the sertraline can cause a serious reaction called serotonin syndrome." d. "St. John's wort is not very effective for depression, but we can increase your sertraline dose."

c. "Combining St. John's wort with the sertraline can cause a serious reaction called serotonin syndrome."

A newly admitted young adult patient, diagnosed with posttraumatic stress disorder (PTSD), reluctantly reveals that she was the victim of human trafficking 2 years ago. The patient says, "Nobody will ever believe the horrible things the men did to me, and no one never stopped them." Which response is appropriate for the nurse to make? a. "I'll believe anything you tell me. You can trust me." b. "I can't understand why society did not do more to protect you. It's not right." c. "It must be difficult to talk about what happened. I'm willing to listen." d. "Tell me what the men did to you. It's important that I understand the details."

c. "It must be difficult to talk about what happened. I'm willing to listen."

Which of the following would the nurse expect to assess in a patient experiencing akathisia? a. Shuffling gait b. Mask-like face c. Motor restlessness d. Resting tremor

c. Motor restlessness

A patient diagnosed with schizophrenia is prescribed ziprasidone (Geodon). When providing education to this patient, the nurse remembers to stress which of the following? a. The importance of taking this medication only at bedtime to improve its absorption. b. The importance of getting a blood work every week to prevent agranulocytosis. c. The importance of taking this medication with at least 350 calories of food for maximum absorption. d. The importance of taking this medication with grape juice to avoid the bad taste.

c. The importance of taking this medication with at least 350 calories of food for maximum absorption.

A male patient diagnosed with schizophrenia, who is experiencing delusional thinking, tells the nurse that he is working for the U.S. Government and was expecting a "very important phone call from the President today." The patient sat by the phone all day and refused to eat or go to his room. Which statement by the nurse is most appropriate? a. "Has the President called you before?" b. "Why do you think the President was going to call you today?" c. "The President has more important things to do than calling you; it is all in you mind." d. "Let's go to the dining room so you eat something; we will send for you when the phone rings."

d. "Let's go to the dining room so you eat something; we will send for you when the phone rings."

A patient with manic symptoms begins to make sexual advances toward visitors in the dayroom. When the nurse firmly states that this is inappropriate and will not be allowed, the patient becomes verbally abusive and threatens physical violence to the nurse. Based on the analysis of this situation, which intervention should the nurse implement? a. Place the patient in seclusion for 30 minutes. b. Tell the patient that the behavior is inappropriate. c. Tell the patient that their telephone privileges are revoked for 24 hours. d. Escort the patient to their room, with the assistance of other staff.

d. Escort the patient to their room, with the assistance of other staff.

A male patient diagnosed with a personality disorder boasts to the nurse that he has to fight off female attention and is the highest paid in his company. These statements are reflective of which personality disorder? a. Obsessive-compulsive personality disorder. b. Passive-agressive personality disorder c. Schizotypal personality disorder. d. Narcissistic personality disorder.

d. Narcissistic personality disorder.

Which of the following would the nurse be alert for in a patient receiving fluoxetine? a. Hypertensive crisis b. Weight gain c. Sedation d. Serotonin syndrome

d. Serotonin syndrome

Which of the following would the nurse be least likely to assess in a patient experiencing neuroleptic malignant syndrome? a. Diaphoresis b. Incontinence c. Muscle rigidity d. Unreactive dilated pupils

d. Unreactive dilated pupils