Psych Midterm

Which statement by the nurse reflects the application of deontology to the care of patients admitted to the mental health unit? Select all that apply. 1. "I need to report this error because it is the right thing to do." 2. "I think patients have a right to refuse certain psychotropic medications." 3. "All patients need flu shots so that we can all be healthy during flu season." 4. "All patients should be treated equally whether they have insurance or not." 5. "The doctor needs to obtain informed consent so the patient can make a good decision."

1. "I need to report this error because it is the right thing to do." 2. "I think patients have a right to refuse certain psychotropic medications." 4. "All patients should be treated equally whether they have insurance or not." 5. "The doctor needs to obtain informed consent so the patient can make a good decision."

The nurse is caring for a patient who has been diagnosed with postpartum depression. The patient tells the nurse, "I can't seem to get out of bed and take care of my baby." Which responses by the nurse best demonstrate therapeutic communication? Select all that apply. 1. "It sounds like you are having a hard time." 2. "The baby blues are normal for every woman after birth." 3. "Have you felt like this before, after the birth of your oldest child?" 4. "Would I be correct in saying that you are sleeping more than usual?" 5. "I had this condition after my son's birth. It is best to seek help from family members."

1. "It sounds like you are having a hard time." 3. "Have you felt like this before, after the birth of your oldest child?" 4. "Would I be correct in saying that you are sleeping more than usual?"

The nurse is caring for a patient who is experiencing dysfunctional grieving following the traumatic death of spouse due to an automobile accident. The nurse also experienced the death of a loved one in the same manner. What statement made by the nurse best exemplifies the nurse using empathy toward the patient? 1. "Many people may feel angry when faced in this situation. How do you feel?" 2. "Many people may feel angry when faced in this situation. I know I felt very angry." 3. "I am so sorry you feel angry about this situation. How do you diffuse your anger?" 4. "I am so sorry you feel angry about this situation. I feel bad you have to experience this."

1. "Many people may feel angry when faced in this situation. How do you feel?"

While reviewing therapeutic communication techniques, a nursing student reviews statements and actions that are nontherapeutic. Which statement best represents nontherapeutic communication? 1. "Why do you think you will never get well?" 2. "How do you feel about being discharged today?" 3. "What are your concerns about your living situation?" 4. "What happened when you quit taking your medications?"

1. "Why do you think you will never get well?"

A patient has lost his home and family as a result of an addiction to alcohol. What does the nurse understand about the patient's condition? 1. Addictive behavior involves the limbic system. 2. Addictive behavior is indicative of character flaws. 3. Addictive behavior has a variety of neurological patterns. 4. Addictive behavior is related to dysfunctional parent-child relationships.

1. Addictive behavior involves the limbic system.

The nurse is planning care for a newly admitted patient. Which concepts are considered essential in establishing a therapeutic nurse-patient relationship? Select all that apply. 1. An emphasis on patient-centered care 2. The nurse's view of health and mental health 3. The nurse's ability to sympathize with the patient 4. Unconditional positive regard for the patient and family 5. The nurse's ability to make judgments regarding the patient's condition

1. An emphasis on patient-centered care 2. The nurse's view of health and mental health 4. Unconditional positive regard for the patient and family

The novice nurse is applying the ANA Code of Ethics to the care of individuals with mental illness. Which reflects its appropriate use? Select all that apply. 1. As a framework to help nurses solve ethical dilemmas. 2. As an affirmation of nursing's nonnegotiable ethical standards. 3. As an answer to specific ethical challenges which nurses face in clinical practice. 4. As a reference for how the nursing profession sees itself in terms of its obligation to society. 5. As a brief description of the ethical obligations and duties of all persons who enter the nursing profession.

1. As a framework to help nurses solve ethical dilemmas. 2. As an affirmation of nursing's nonnegotiable ethical standards. 4. As a reference for how the nursing profession sees itself in terms of its obligation to society. 5. As a brief description of the ethical obligations and duties of all persons who enter the nursing profession.

Which actions made by the nurse best exemplify the orientation phase of the nurse-patient therapeutic relationship? Select all that apply. 1. Assessing the patient's limitations 2. Clarifying the patient's expectations for care 3. Educating the patient about the patient's health problem 4. Identifying resources that will be used in the first interaction 5. Reviewing the patient's history in the patient's medical record

1. Assessing the patient's limitations 3. Educating the patient about the patient's health problem

A 16-year-old patient is brought into the emergency department (ED) after being attacked in an alley. The patient states that she "can't see," but that she is otherwise "okay." The initial assessment reveals no physiological reason for the blindness, but several bruises, cuts, and abrasions are noted. After a thorough assessment, the patient is diagnosed with posttraumatic stress disorder (PTSD). The nurse knows that the patient is employing which defense mechanisms? Select all that apply. 1. Denial 2. Projection 3. Conversion 4. Suppression 5. Displacement

1. Denial 3. Conversion 4. Suppression

A nurse is conducting an intake interview for a patient newly admitted to the hospital. The patient reports that the only medication she is currently taking is an SSRI. The nurse suspects the patient is most likely to have which condition? 1. Depression 2. Bipolar disorder 3. Schizophrenia 4. Sexual dysfunction

1. Depression

A patient with a history of an anxiety disorder presents at the community health clinic complaining of headache and dizziness. Which additional symptoms would suggest to the nurse that the patient might be experiencing a recurrence of the anxiety disorder? Select all that apply. 1. Dilated pupils 2. Decreased blood pressure 3. Dry skin 4. Tachycardia 5. Diarrhea

1. Dilated pupils 4. Tachycardia 5. Diarrhea

What is the purpose of the nurse using nonverbal communication in a therapeutic relationship with a patient? 1. Enhance verbal messages. 2. Detract from verbal messages 3. Avoid the use of verbal messages. 4. Terminate the therapeutic relationship.

1. Enhance verbal messages.

A nurse fails to check on her suicidal patient every 15 minutes per hospital policy. When she checks on him next, he has jumped off the bed and broken his ankle. Why could she be charged with negligence? Select all that apply. 1. Failure to properly monitor 2. Failure to communicate risk 3. Failure to assess the risk of suicide 4. Failure to maintain proper boundaries 5. Failure to provide sufficient documentation

1. Failure to properly monitor 3. Failure to assess the risk of suicide

The charge nurse is caring for a patient recently diagnosed with an anxiety disorder. The patient has an identical twin. The nurse knows that which condition increases the likelihood that the undiagnosed twin will suffer from the same disorder? Select all that apply. 1. Genetics 2. Environment 3. Shared trauma 4. Psychological influences 5. Developmental influences

1. Genetics 2. Environment 4. Psychological influences 5. Developmental influences

The novice nurse is learning about the barriers to communication within the therapeutic nurse-patient relationship and the various types of communication that block the therapeutic relationship. What will the nurse recognize as a barrier to the therapeutic relationship? 1. Giving advice 2. Voicing doubt 3. Giving information 4. Seeking clarification

1. Giving advice

A patient in the clinic is diagnosed with General Adaptation Syndrome (GAS). Which physiological symptoms would indicate that the patient is in the last stage of this syndrome if the patient is unable to find resolution of the stressor? 1. Infection, migraines, stroke 2. Increased cortisol, stroke, high cholesterol levels 3. Hallucinations, fatigue, decreased immune response 4. Decreased albumin, increased adrenaline, decreased blood pressure

1. Infection, migraines, stroke

What is the key concept that allows the nurse to maintain professional boundaries when first developing the nurse-patient relationship? 1. Intentional development of the relationship 2. Use of caring in the relationship 3. Shared goals of the relationship 4. Shared knowledge occurring in the relationship

1. Intentional development of the relationship

What process is used as a tool in developing a therapeutic relationship but is not used in developing a social relationship? 1. Interaction 2. Equal sharing 3. Mutual knowledge 4. The process of intimate disclosures

1. Interaction

The nurse will expect to observe which responses in behavior in the patient who is experiencing an episode of anxiety? Select all that apply. 1. Irritability 2. Indulgence 3. Withdrawal 4. Perspiration 5. Constricted pupils

1. Irritability 3. Withdrawal 4. Perspiration

Which aspect of nonverbal communication conveys the nurse's positive attitude toward the patient? Select all that apply. 1. Leaning slightly forward 2. Orienting to face the patient 3. Maintaining physical proximity 4. Formulating a reply while the patient is speaking 5. Maintaining good eye contact while the patient is speaking

1. Leaning slightly forward 2. Orienting to face the patient 3. Maintaining physical proximity 5. Maintaining good eye contact while the patient is speaking

Which intervention demonstrates the nurse's sensitivity toward the teen who is admitted with a diagnosis of depression? 1. Listening to the patient's feelings 2. Using closed-ended questions with the patient 3. Asking for details to demonstrate interest in the patient 4. Avoiding the use of silence with the patient to decrease anxiety

1. Listening to the patient's feelings

A patient asks a nurse to explain why morphine is used for significant pain. What is the most appropriate response the nurse might make? 1. Morphine is an opioid drug. It affects a pain modulation circuit that contains certain cell structures that bind with morphine and have a significant pain modulating and relief effect. 2. Morphine is a serotonin-stimulating drug. It affects a pain modulation circuit that contains certain cell structures that bind with morphine and have a significant pain modulating and relief effect. 3. Morphine is a norepinephrine-stimulating drug. It affects a pain modulation circuit that contains certain cell structures that bind with morphine and have a significant pain modulating and relief effect. 4. Morphine is a dopamine medication. It affects a pain modulation circuit that contains certain cell structures that bind with morphine and have a significant pain modulating and relief effect.

1. Morphine is an opioid drug. It affects a pain modulation circuit that contains certain cell structures that bind with morphine and have a significant pain modulating and relief effect.

During the first interaction with a client, the nurse makes an introduction and identifies the purpose of the interaction. This serves to accomplish which stage of the nurse-patient relationship? 1. Orienting 2. Evaluating 3. Identifying 4. Implementing

1. Orienting

A patient tells visiting family that a test was done to examine how the patient's brain is functioning. Which type of test does the nurse recognize as the test the patient is describing? 1. Positron emission test (PET) 2. Computerized tomography (CT) 3. Magnetic resonance imaging (MRI) 4. Single photon-emission computed tomography (SPECT)

1. Positron emission test (PET)

The novice nurse is learning about the use of boundaries in the therapeutic nurse-patient relationship. What examples will the nurse recognize as boundary violations? Select all that apply. 1. Sexual misconduct 2. Last-minute appointment changes 3. Inappropriate self-disclosure 4. Giving or receiving small gifts 5. Disclosing bits of personal information

1. Sexual misconduct 3. Inappropriate self-disclosure

A patient is on life support and unresponsive to stimuli. One of her daughters talks to the nurse about withdrawing life support. The other daughter asks the nurse when the patient is likely to wake up and be able to eat. The nurse talks with her charge nurse and manager about this patient situation. This action demonstrates which ethical skills outlined in the PILLAR mnemonic? Select all that apply. 1. The ability to IDENTIFY ethical issues 2. The ability to find needed RESOURCES 3. The ability to ANTICIPATE ethical issues 4. The ability to work within defined professional LIMITATIONS 5. The ability to understand how PERSONAL experiences impact care

1. The ability to IDENTIFY ethical issues 2. The ability to find needed RESOURCES 3. The ability to ANTICIPATE ethical issues

The psychiatric-mental health novice nurse asks "What is mental health?" Which qualities will her superior include when describing mental health? Select all that apply. 1. The ability to give and receive love 2. Having a sense of purpose in life 3. The ability to make important decisions 4. The ability to experience emotions 5. The ability to give and receive criticism

1. The ability to give and receive love 2. Having a sense of purpose in life 3. The ability to make important decisions

A patient has been court-ordered to take his antipsychotic medications due to concerns that he will be a danger to himself. The nurse recognizes such action may be justified in which situations? Select all that apply. 1. To alleviate suffering 2. In an emergency situation 3. When in the patient's best interest 4. To foster the therapeutic relationship 5. To care a patient who cannot care for himself

1. To alleviate suffering 2. In an emergency situation 3. When in the patient's best interest 5. To care a patient who cannot care for himself

When assessing a patient with chronic anxiety, the nurse notes that the patient also suffers from frequent infections. Which is most likely the reason for the patient's frequent infections? 1. Trait anxiety leads to immune system compromise. 2. Trait anxiety is a defense mechanism for psychological illness. 3. Proteins released by immune cells indirectly influence brain activity. 4. Psychological illness occurs due to a lack of interpersonal relationships, resulting in manifestations of physiological illness.

1. Trait anxiety leads to immune system compromise.

The patient with a history of schizophrenia presents in the emergency department with delusions, hallucinations, and unsafe behavior. The nurse learns the patient has completed an advance directive agreeing to hospitalization should decompensation occur. How would the current admission be categorized? 1. Voluntary admission 2. Involuntary commitment 3. Temporary involuntary admission 4. Emergency involuntary admission

1. Voluntary admission

The nurse is establishing a therapeutic environment with a newly admitted patient with a severe mental illness. Which statement best demonstrates empathetic communication? 1. "I feel really bad that you have this disorder." 2. "You appear upset. Do you want to talk about it?" 3. "You appear upset. Why do you feel this way?" 4. "Many people have this disorder. You will feel better in no time."

2. "You appear upset. Do you want to talk about it?"

The psychiatric nurse faces a patient care ethical dilemma and uses the ANA's Code of Ethics for Nurses as a reference. What will the ANA's Code of Ethics provide to the nurse's situation? 1. The answer to the ethical dilemma 2. A framework for addressing the ethical dilemma 3. A choice for various decisions regarding the ethical dilemma 4. The evaluation of the decision made regarding the ethical dilemma

2. A framework for addressing the ethical dilemma

The psychiatric-mental health nurse is learning about various tools that can be used to help the nurse establish a therapeutic nurse-patient relationship. The nurse learns that taping offers what advantage to establishing a therapeutic relationship? 1. Assists the nurse in memorizing useful habits and mannerisms. 2. Assists the nurse in identifying communication habits and mannerisms. 3. Offers a way for feedback on communication skills and dynamics to be provided when direct observation is not an option. 4. Offers a way for feedback on communication skills and dynamics to be provided when indirect observation is not an option.

2. Assists the nurse in identifying communication habits and mannerisms.

A patient is hospitalized for symptoms that include auditory hallucinations and paranoid delusions. Based on the nurse's understanding of neurobiology, which neurotransmitter alteration causes these manifestations? 1. Serotonin 2. Dopamine 3. Acetylcholine 4. Norepinephrine

2. Dopamine

A teenage patient was recently in a motorcycle accident and suffered a closed head injury. Although the patient's family said the patient has always been even-tempered and reasonable, now the patient is frequently angry and is demonstrating poor impulse control. Which area of the patient's brain does the nurse suspect may have been injured in the accident? 1. Temporal lobe 2. Frontal lobe 3. Occipital lobe 4. Parietal lobe

2. Frontal lobe

A nurse is caring for an older adult with a mental illness who will be going to surgery for placement of a non-emergent pacemaker in the morning. The patient has been deemed incompetent by a court of law. The nurse understands that which individual will need to sign the patient's surgical consent? 1. Spouse 2. Guardian 3. Oldest child 4. Hospital administrator

2. Guardian

A nurse is caring for a patient who is experiencing visual hallucinations. Which neuroanatomical structure does the nurse recognize as the source of the patient's manifestations? 1. Parietal lobe 2. Occipital lobe 3. Temporal lobe 4. Right frontal lobe

2. Occipital lobe

The nurse is caring for a patient with schizophrenia who is admitted to the hospital after being found incoherent and combative at a local grocery store. The patient tells the nurse that he has not taken his medications for over two weeks. The nurse is assessing the patient's needs, symptoms, and strengths. What stage of the nurse-patient relationship is being demonstrated? 1. Working 2. Orientation 3. Identification 4. Pre-orientation

2. Orientation

A patient who was admitted voluntarily to the hospital verbally refuses his medication. The nurse proceeds to give the medication over the patient's objections. What is the legal significance of the nurse's actions? 1. The nurse cannot be held liable. 2. The nurse could be charged with battery. 3. The nurse could be charged with negligence. 4. The nurse could be charged with malpractice.

2. The nurse could be charged with battery.

The nurse who is caring for an Asian patient who is newly diagnosed with an anxiety disorder considers what factors when developing the plan of care? Select all that apply. 1. Adherence to treatment 2. The patient's cultural beliefs 3. The spiritual component of treatment 4. Clarification of stressors and resources 5. Medical history

2. The patient's cultural beliefs 3. The spiritual component of treatment 4. Clarification of stressors and resources 5. Medical history

Which intervention promotes mindful listening in any health care setting? 1. Telling the patient to get off the phone 2. Turning off the television before interviewing the patient 3. Encouraging family to step outside before assessing the patient 4. Offering the patient a choice of drink when taking a medication

2. Turning off the television before interviewing the patient

A nurse in the emergency department is working triage. Although a patient with hypomania has been waiting for 2 hours, the nurse sends a suicidal patient to be evaluated immediately. This decision is most likely based upon which ethical principle? 1. Deontology 2. Utilitarianism 3. Ethics of care 4. Virtue ethics

2. Utilitarianism

The nurse is caring for the patient complaining of acute pain. The physician tells the nurse that the patient is not really in pain and orders a placebo instead. The nurse disagrees with this idea and tells the physician he will not administer a placebo, even though he does not know whether the patient is experiencing pain or not. He suggests to the physician that they have an honest discussion with the patient rather than administering a placebo. This is an example of which element of ethical decision- making? 1. Utilitarianism 2. Virtue ethics 3. Paternalism 4. Rule-based ethics

2. Virtue ethics

The nurse is working with a patient who has revealed to the nurse that she hits her toddler with a wooden paddle when she is angry. When the child visits, the nurse sees bruises and welts on the child's legs. The patient asks the nurse not to tell anyone because she is ashamed and afraid the child will be taken away from her. What is the most appropriate response by the nurse? 1. "I won't tell anyone. HIPAA protects this information." 2. "I will not report this if you sign a contract stating that you won't hit the child again." 3. "I will have to report this because it is my legal obligation to do so as a nurse." 4. "I will refer you to social services so they can discuss it with you."

3. "I will have to report this because it is my legal obligation to do so as a nurse."

The nurse notes cigarette burns on the back of an adolescent patient while providing routine care. After initial hesitation, the patient tells the nurse that her mother burns her when she is "bad." The patient then begs the nurse not to tell anyone. What is the appropriate statement by the nurse? 1. "Don't worry, I won't break your confidence." 2. "I have to tell or I'll get in big trouble myself." 3. "I'm sorry, but it is my responsibility to report that your mother is burning you with a cigarette." 4. "OK, but can I get your permission to tell your doctor this is happening?"

3. "I'm sorry, but it is my responsibility to report that your mother is burning you with a cigarette."

A patient tells the nurse, "I don't think I can deal with feeling so sad much longer." What is the nurse's best response? 1. "We all have times of sadness." 2. "Are you saying you feel sad?" 3. "Tell me about your feelings of sadness." 4. "Is there a history of depression in your family?"

3. "Tell me about your feelings of sadness."

The nurse is caring for the patient with a history of addiction. The nurse notes that although the patient is in severe pain, the patient's requests for pain medication have been ignored. Which ethical principle is the nurse exercising when advocating for appropriate pain relief? 1. Justice 2. Autonomy 3. Beneficence 4. Nonmaleficence

3. Beneficence

A staff nurse notices that her co-worker has been checking the mirror constantly and asking several times during their shift if her uniform "looks okay." The co-worker has become increasingly preoccupied with any perceived flaws in her personal appearance. The staff nurse is concerned and suspects which disorder?v 1. Obsessive-compulsive disorder 2. Posttraumatic stress disorder 3. Body dysmorphic disorder 4. Reactive attachment disorder

3. Body dysmorphic disorder

The psychiatric-mental health nurse wishes to build upon the professional skill of using therapeutic communication during the nurse-patient relationship. Using the acronym RULE, which action by the nurse will best demonstrate active listening? 1. Conveying sympathy 2. Accepting the patient 3. Conveying empathy 4. Validating the patient

3. Conveying empathy

A patient tells the nurse, "My therapist touched my face and asked me to come to his house for a romantic evening." The nurse recognizes that the therapist has engaged in which unethical behavior? 1. Invasion of privacy 2. Inappropriate self-disclosure 3. Failure to maintain boundaries 4. False imprisonment

3. Failure to maintain boundaries

The nurse is participating in a team meeting to determine the disposition of a patient with severe mental illness. The nurse speaks up to ensure that the placement is appropriate to the patient's needs and interests. Which ethical principle is the nurse demonstrating? 1. Justice 2. Veracity 3. Fidelity 4. Beneficence

3. Fidelity

A nurse tells the patient that meeting new people sometimes makes the nurse feel anxious. What is the nurse demonstrating by acknowledging feelings to the patient? 1. Empathy 2. Sympathy 3. Genuineness 4. Superficiality

3. Genuineness

The nurse is researching the pathophysiology and etiology of major depressive disorder. What will the nurse learn is true regarding neurological structure alterations and the development of major depressive disorder? Select all that apply. 1. An increase in the central nervous system (CNS) volume is associated with major depressive disorder. 2. Excessive levels of serotonin and norepinephrine have been associated with major depressive disorder. 3. Impairments to cerebral structural plasticity and neuronal cellular resilience have been noted with major depressive disorder. 4. An increase in the numbers and sizes of glia and neurons in some areas of the brain have been noted with major depressive disorder. 5. Dysfunction of cerebral blood flow and glucose metabolism in some areas of the brain has been noted with major depressive disorder.

3. Impairments to cerebral structural plasticity and neuronal cellular resilience have been noted with major depressive disorder. 5. Dysfunction of cerebral blood flow and glucose metabolism in some areas of the brain has been noted with major depressive disorder.

During a group session, a patient expresses anger at the nurse. The nurse sits tensely with arms and legs crossed while verbally agreeing that the patient's point of view is correct. What message is being sent by the nurse? 1. Tolerance 2. Empathy 3. Incongruence 4. Compassion

3. Incongruence

The nurse is meeting with a patient and says, "I would love to hear how you are feeling today." While the patient speaks, the nurse yawns, looks at her watch, and folds her arms over her chest. What do the nurse's words and actions best indicate? 1. Disinterest in the patient's answers 2. Boredom with the therapy session 3. Incongruence of verbal and nonverbal communication 4. Incongruence of nonverbal communication and meta-communication

3. Incongruence of verbal and nonverbal communication

The nurse is learning about active listening techniques that will improve nurse-patient relationships. What is active listening's influence on communication? 1. It acknowledges the nurse's interest in a nonjudgmental attitude. 2. It facilitates spontaneous responses and interactive conversation. 3. It offers a way to hear, observe, and understand what patients communicate. 4. It offers a way to seek information or clarification of the patient's thoughts or ideas.

3. It offers a way to hear, observe, and understand what patients communicate.

What concepts create the framework for the American Nurses Association's Code of Ethics for Nurses? 1. Patient care and a commitment to learning 2. Patient rights and a commitment to compassion 3. Patient advocacy and a commitment to society 4. Patient education and a commitment to professionalism

3. Patient advocacy and a commitment to society

A nurse is making an initial psychiatric assessment. What does she realize is the most important part of this process? 1. Providing the DSM-5 diagnosis 2. Gathering information from the family 3. Ruling out a medical causation of symptoms 4. Evaluating the need for psychotropic medication

3. Ruling out a medical causation of symptoms

A patient presents to the clinic with an exacerbation of eczema. During the assessment phase, the nurse determines that the 18-year-old was recently diagnosed with panic disorder after being thrown out of her parent's house. The nurse knows that which domain is an important factor in this patient's condition? 1. Cultural 2. Biological 3. Sociological 4. Psychological

3. Sociological

A patient tells his nurse during the initial assessment that he is angry with his girlfriend and plans to kill her with a gun as soon as he is released from the hospital. The nurse confirms that he does have a gun and ammunition. Which statement best describes the nurse's legal and ethical obligation? 1. The nurse may not break confidentiality because of HIPAA. 2. The nurse cannot disclose the information because it is considered privileged. 3. The nurse has a duty to warn the girlfriend and law enforcement of the patient's plans. 4. The nurse may not discuss the assessment with anyone except those caring for the patient.

3. The nurse has a duty to warn the girlfriend and law enforcement of the patient's plans.

The nurse manager is meeting with a staff nurse on the inpatient mental health unit for an annual employee review. When discussing the nurse's current concerns, the nurse tells the manager, "I am having trouble sleeping at night thinking about that patient we had who was hospitalized for several weeks. I got so close to that patient and I wonder how she is doing." What is the manager most concerned about regarding the nurse's statement? 1. The nurse is experiencing burnout. 2. The nurse is experiencing insomnia. 3. The nurse has crossed professional boundaries. 4. The nurse has compromised his or her professional license.

3. The nurse has crossed professional boundaries.

The relative of a woman with severe mental illness requests that the woman be involuntarily committed because of her history of numerous hospitalizations and because she is refusing to get dressed. Based on which factor does the nurse recognize that the woman likely does not qualify for involuntary commitment? 1. The woman has used up her hospital coverage. 2. The woman has not voluntarily requested hospitalization. 3. There is no evidence that woman is a danger to self or others. 4. It is less than two weeks since the woman's most recent hospital discharge.

3. There is no evidence that woman is a danger to self or others.

Which patient situation does the mental health nurse recognize may support the need for involuntary commitment? 1. History of incarceration 2. Self-medication with marijuana 3. Threats made against family members 4. Presence of auditory hallucinations

3. Threats made against family members

The novice nurse is attempting to incorporate both verbal and nonverbal communication to her practice. What does the nurse recognize as the best definition of the purpose of verbal communication? 1. To establish and maintain relationships 2. To establish and maintain interactions 3. To communicate information about external events 4. To communicate information about internal events

3. To communicate information about external events

A nurse makes a medication error and, even though it does not cause any adverse reaction, she tells the patient about this error and apologizes. This is an example of which ethical principle? 1. Justice 2. Fidelity 3. Veracity 4. Beneficence

3. Veracity

Which statement would indicate that a novice nurse understands the concept of autonomy? 1. "All patients should be given their due." 2. "We must always be honest with patients." 3. "Part of our profession is doing good things for others." 4. "After I provide information, I will respect my patient's right to make a decision."

4. "After I provide information, I will respect my patient's right to make a decision."

A psychiatric-mental health nurse is learning about effective ways to clarify patient's responses. What is the best example of clarifying a patient's verbal response? 1. "See, the medicine does work." 2. "Everything seems to work out eventually." 3. "I knew it would work for you; it just takes time." 4. "Are you saying you feel the medicine is helping you?"

4. "Are you saying you feel the medicine is helping you?"

A patient experiencing psychosis tells the nurse, "I am in charge. Who are you and why are you here?" What is the most therapeutic response by the nurse? 1. "You know who I am." 2. "You don't know who I am?" 3. "You are not in charge; you are a patient in the hospital." 4. "I am your nurse and I will be here to help you until dinner."

4. "I am your nurse and I will be here to help you until dinner."

The patient admitted to the mental health unit is concerned that health information given to the nurse remains confidential. What is the nurse's best response? 1. "We can keep the information just between the two of us if you prefer." 2. "I will share the information with staff members only with your approval." 3. "You can choose whether your physician needs this information for your care." 4. "If the information is important to your care, I will need to share it with the staff."

4. "If the information is important to your care, I will need to share it with the staff."

A psychiatric nurse is preparing nursing staff education on the role of neurotransmitters in neurobiology. Which statement will the nurse include in the teaching presentation? 1. "There are two classes of neurotransmitters." 2. "Each neurotransmitter functions in the same manner." 3. "Neurotransmitters and receptors do not vary in their affinity for each other." 4. "Neurotransmitters consistently act in either an excitatory or inhibitory manner."

4. "Neurotransmitters consistently act in either an excitatory or inhibitory manner"

Several nurses are discussing whether or not there is a single universally accepted hypothesis that provides an explanation about the pathophysiology and etiology of depression. Which statement by the nurse is accurate? 1. "Cerebral structure is responsible for depression." 2. "We know that heredity is the single cause of depression." 3. "Because all patients respond the same to SSRIs, we have a thorough understanding of the neurochemistry of depression." 4. "There is no unified hypothesis regarding pathophysiology and etiology of depression, in part because patients demonstrate individualized responses to treatments."

4. "There is no unified hypothesis regarding pathophysiology and etiology of depression, in part because patients demonstrate individualized responses to treatments."

The nurse who is operating with the ethics of care in mind believes which statement? 1. "We should always tell the truth." 2. "We are expected to always do the right thing." 3. "We should do whatever provides the best benefit." 4. "We are all interconnected and part of the same global family."

4. "We are all interconnected and part of the same global family."

The nurse is subpoenaed to provide information about a patient's injuries sustained in a criminal case. The hospital's attorney tells her she must comply. Which statement best describes how the nurse should respond? 1. Plead the Fifth Amendment in this case. 2. Refuse to give any information about the patient. 3. Disclose any information she knows about the patient. 4. Answer questions with the minimum information needed.

4. Answer questions with the minimum information needed.

The nurse is taking care of a patient newly diagnosed with an anxiety disorder. Which process is most important in providing care to patients with anxiety disorders? 1. Review of the health care professional's orders for the patient 2. Acquisition of information from the patient's high school counselor 3. Assessment of the patient's response during the initial phase of treatment 4. Awareness of the nurse's own anxiety and how it may affect the patient's treatment

4. Awareness of the nurse's own anxiety and how it may affect the patient's treatment

The psychiatric-mental health nurse is receiving a report on a patient who is being transferred to the hospital from a local emergency department (ED) after expressing suicidal ideations. The ED nurse tells the psychiatric-mental health nurse that the patient is "crazy, just like my aunt!" Which quality that commonly occurs in the pre-interaction stage of the nurse-patient relationship does the ED nurse's statement demonstrate? 1. Transference 2. Ethnocentrism 3. Cultural relativism 4. Countertransference

4. Countertransference

A patient holds a knife to his throat and tells a family member that voices in his head are telling him to kill himself. The patient may be admitted to the psychiatric unit under which type of admission? 1. Commitment 2. Temporary admission 3. Observational admission 4. Emergency involuntary admission

4. Emergency involuntary admission

The novice nurse is reviewing the ANA's Code of Ethics for Nurses and its influence on providing patient care. What concept is correct regarding ethical and legal standards? 1. Ethical standards outweigh legal standards. 2. Legal standards outweigh ethical standards. 3. Ethical and legal standards are separate, yet similar. 4. Ethical and legal standards are intertwined, yet distinct.

4. Ethical and legal standards are intertwined, yet distinct.

A novice nurse is learning how to effectively communicate within a therapeutic nurse-patient relationship. What struggle is most harmful when the nurse is new to therapeutic relationships? 1. Feeling uncomfortable with the relationship 2. Feeling anxious about developing the relationship 3. Falling back on knowledge learned from nursing school and not accounting for practical knowledge 4. Falling back on relationship skills learned in friendships, family relationships, or other personal relationships

4. Falling back on relationship skills learned in friendships, family relationships, or other personal relationships

The nurse caring for a patient recently diagnosed with an anxiety disorder knows that which physiological disturbance is thought to result in pathologic anxiety? 1. Increased pituitary response 2. Increased cortisol production 3. Decreased epinephrine response 4. Increased limbic system response

4. Increased limbic system response

A patient becomes upset when touched by a staff member who is attempting to obtain the patient's blood pressure. What has the staff member overlooked? 1. Privacy 2. Confidentiality 3. Duty to protect 4. Informed consent

4. Informed consent

A physician orders a nurse to give a patient a placebo instead of her scheduled opiate medication because he doesn't believe that the patient is really experiencing pain. The nurse refuses to do so but tells the physician he is happy to talk with the patient about her pain and whether they could try decreasing the dosage of her pain medication. This is an example of which element of ethical decision making? 1. Values clarification 2. Stakeholder identification 3. Moral hierarchy exploration 4. Integrity-preserving compromise

4. Integrity-preserving compromise

The nurse understands that health is typically defined as the state of being without illness. What is wrong with this definition? 1. It suggests that being healthy is difficult to achieve. 2. It suggests that all who are without illness are healthy. 3. It suggests that health and illness correlate with one another. 4. It suggests that individuals diagnosed with illness cannot possibly be healthy.

4. It suggests that individuals diagnosed with illness cannot possibly be healthy.

A nurse is a member of an ethics committee. The committee has been asked to help make a decision regarding end-of-life care for an unresponsive patient who has no advanced directives or next of kin. The nurse asks the committee to meet with the patient's friends to learn more about his life. This action corresponds with which guideline from the DILEMMA mnemonic? 1. Moral hierarchy 2. Make decisions 3. Describe the conflict 4. Learn background information

4. Learn background information

The nurses on a medical-surgical floor disagree with the care being provided to a patient by a particular physician. They contact the ethics committee at the hospital. Which action should they expect the committee to take? 1. Assume primary care of the patient. 2. Censure the physician for inappropriate care. 3. Turn the information over to a judge. 4. Make recommendations to resolve conflict.

4. Make recommendations to resolve conflict.

A nurse is reviewing the stress response. What does she identify as the most important neurotransmitter involved? 1. GABA 2. Serotonin 3. Dopamine 4. Norepinephrine

4. Norepinephrine

The patient reports to her nurse that she has experienced a significant reduction in her energy level. What neurotransmitter might the nurse suspect is involved in this change? 1. GABA 2. Dopamine 3. Serotonin 4. Norepinephrine

4. Norepinephrine

The nurse is caring for a patient diagnosed with posttraumatic stress disorder (PTSD). In this disorder, which element of the nervous system does the nurse identify as malfunctioning? 1. Central 2. Peripheral 3. Sympathetic 4. Parasympathetic

4. Parasympathetic

The nurse is developing a plan of care for a patient. Which intervention must the nurse be careful to avoid? 1. Discussing expectations with the patient 2. Identifying the patient's perception of the problem 3. Addressing issues related to the patient's past experiences 4. Performing actions that conflict with the patient's value system

4. Performing actions that conflict with the patient's value system

The nurse caring for a 5-year-old diagnosed with posttraumatic stress disorder (PTSD) knows that which coping mechanisms and/or symptoms may manifest during treatment? 1. Crying and pacing 2. Hoarding and migraines 3. Nausea and separation anxiety 4. Repetitive play and temper tantrums

4. Repetitive play and temper tantrums

A patient with bipolar disorder is being treated with lithium. What laboratory test will provide the nurse with information on the effectiveness and toxicity of the patient's lithium levels? 1. Complete blood count 2. Basic metabolic panel 3. Urinalysis 4. Serum level test

4. Serum level test

A patient who is agitated and aggressive has threatened two staff members. After other less invasive interventions fail, the nurse calls the physician and obtains an order to physically restrain the patient. Which statement regarding restraint use is correct? 1. The patient must be assessed every 6 hours. 2. The order must be written as "PRN confusion." 3. The doctor must assess the patient every other day. 4. The patient must be educated about the use of restraints.

4. The patient must be educated about the use of restraints.

The nurse validates the patient's response to an intervention prior to documenting in the progress note. What does validation ensure? 1. The patient's request is clarified. 2. The patient's affect is appropriate to the situation. 3. The patient's need for further intervention is understood. 4. The patient's perception of the response is communicated.

4. The patient's perception of the response is communicated.

The novice nurse is learning about the various types of relationships and how these affect the role of the nurse when providing care to patients with mental illness. What tool do therapeutic relationships use that is not used in social relationships? 1. Shared interest 2. Shared power 3. The process of communication 4. The process of interaction

4. The process of interaction

A novice nurse is learning about various tools that nurses may use to aid in therapeutic communication in the nurse-patient relationship. What does the nurse recognize as true regarding the concept of process recording? 1. The purpose is to record the nurse-patient interaction and provide a guideline for therapeutic care. 2. The purpose is to allow the patient to actually hear what the nurse stated in the nurse-patient interaction. 3. The purpose is to allow the nurse to actually hear what the patient heard in the nurse-patient interaction. 4. The purpose is to reflect on and evaluate the dynamics of a specific interaction and to provide a sample of interaction for consideration in supervision or consultation with others.

4. The purpose is to reflect on and evaluate the dynamics of a specific interaction and to provide a sample of interaction for consideration in supervision or consultation with others.

A patient with bipolar disorder asks the nurse what caused the illness. What will the nurse tell the patient regarding the genetic transmission of bipolar disorder? 1. Bipolar disorder is caused by environmental factors. 2. There is one single gene responsible for bipolar disorder. 3. There is no known cause for the development of bipolar disorder. 4. There appears to be a genetic link in the transmission of bipolar disease.

4. There appears to be a genetic link in the transmission of bipolar disease.

A novice nurse caring for patients with mental illness wants to use empathy as a therapeutic tool. How is empathy used as a therapeutic tool for nurses? 1. To validate the nurse's expertise 2. To validate the nurse's perceptions 3. To validate the nurse-patient relationship 4. To validate the experiences of the patient

4. To validate the experiences of the patient

During assessment, the nurse determines that the patient is having trouble learning from the past, difficulty dressing self, and cannot recognize written words. The nurse suspects that the patient's symptoms are a manifestation of dysfunction in which brain structure? A. Frontal lobe B. Temporal lobe C. Parietal lobe D. Occipital lobe

D. Occipital Lobe

A novice nurse is learning the difference between pain and suffering. What kind of experience does the nurse associate with suffering? Select all that apply. 1. Mental 2. Spiritual 3. Emotional 4. Physiological 5. Psychological

Mental, Spiritual, Emotional, Psychological

A nurse is assessing a patient who presented to the emergency department after a public fight. The patient is crying and claiming that he does not remember how the fight started. What sensory functions should the nurse check as part of the patient's initial psychiatric assessment? Select all that apply. 1. Pain 2. Smell 3. Pressure 4. Temperature 5. Proprioception

Pain, Pressure, Temp, Proprioception

A patient with paraplegia tells the nurse that paraplegia has some advantages. What are some secondary gains to which the patient may be referring? Select all that apply. 1. Attention 2. Sympathy 3. Personal services 4. Disability benefits 5. Escape from some responsibilities

Personal services, Disability benefits, Escape from some responsibilities