Clinical Nursing: Mental Health Practice Exam
Course Introduction
Clinical Nursing: Mental Health focuses on the integration of nursing science and evidence-based interventions in the care of individuals with mental health disorders across the lifespan. The course emphasizes assessment, diagnosis, planning, implementation, and evaluation of mental health nursing care within a variety of clinical settings. Students will develop therapeutic communication skills, apply psychiatric nursing theories, and collaborate within multidisciplinary teams to support the mental health and well-being of diverse patients. Key topics include common psychiatric disorders, crisis intervention, ethical and legal considerations, psychopharmacology, and strategies for patient and family education.
Recommended Textbook
Essentials of Psychiatric Mental Health Nursing 3rd Edition by Varcarolis
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28 Chapters
803 Verified Questions
803 Flashcards
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Chapter 1: Practicing the Science and Art of Psychiatric Nursing
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15 Verified Questions
15 Flashcards
Source URL: https://quizplus.com/quiz/2047
Sample Questions
Q1) In the shift-change report, an off-going nurse criticizes a patient who wears heavy makeup. Which comment by the nurse who receives the report best demonstrates advocacy?
A) "This is a psychiatric hospital, so we expect our patients to behave bizarrely."
B) "Let's all show acceptance of this patient by wearing lots of makeup too."
C) "Your comments are inconsiderate and inappropriate. Keep the report objective."
D) "Our patients need our help to learn behaviors that will help them get along in society."
Answer: D
Q2) Which research evidence would most influence a group of nurses to change their practice?
A) Expert committee report of recommendations for practice
B) Systematic review of randomized controlled trials
C) Non-experimental descriptive study
D) Critical pathway
Answer: B
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Chapter 2: Mental Health and Mental Illness
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17 Verified Questions
17 Flashcards
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Sample Questions
Q1) A patient tells a nurse, "I have psychiatric problems and am in and out of hospitals all the time. Not one of my friends or relatives has these problems." Select the nurse's best response.
A) "Comparing yourself with others has no real advantages."
B) "Why do you blame yourself for having a psychiatric illness?"
C) "Mental illness affects 50% of the adult population in any given year."
D) "It sounds like you are concerned that others don't experience the same challenges as you."
Answer: D
Q2) A nurse must assess several new patients at a community mental health center. Conclusions concerning current functioning should be made on the basis of:
A) the degree of conformity of the individual to society's norms.
B) the degree to which an individual is logical and rational.
C) a continuum from mentally healthy to unhealthy.
D) the rate of intellectual and emotional growth.
Answer: C
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Chapter 3: Theories and Therapies
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) An adult expresses the wish to be taken care of and often behaves in a helpless fashion. This adult has needs related to which of Freud's stages of psychosexual development?
A) Latency
B) Phallic
C) Anal
D) Oral
Answer: D
Q2) Cognitive behavioral therapy was provided for a patient who frequently said, "I'm stupid." Which statement by the patient indicates the therapy was effective?
A) "I'm disappointed in my lack of ability."
B) "I always fail when I try new things."
C) "Things always go wrong for me."
D) "Sometimes I do stupid things."
Answer: D
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Chapter 4: Biological Basis for Understanding
Psychopharmacology
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Sample Questions
Q1) A nurse prepares to administer an antipsychotic medication to a patient diagnosed with schizophrenia. Additional monitoring of the medication's effects and side effects will be most important if the patient is also diagnosed with which health problem? (Select all that apply.)
A) Parkinson disease
B) Graves disease
C) Osteoarthritis
D) Epilepsy
E) Diabetes
Q2) Priority teaching for a patient taking clozapine (Clozaril) should include which instruction?
A) Report sore throat and fever immediately.
B) Avoid foods high in polyunsaturated fat.
C) Use water-based lotions for rashes.
D) Avoid unprotected sex.
Q3) A drug causes muscarinic-receptor blockade. A nurse will assess the patient for:
A) dry mouth.
B) gynecomastia.
C) pseudoparkinsonism.
D) orthostatic hypotension.
Page 6
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Chapter 5: Settings for Psychiatric Care
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Sample Questions
Q1) A nurse surveys the medical records for violations of patients' rights. Which finding signals a violation?
A) No treatment plan is present in record.
B) Patient belongings are searched at admission.
C) Physical restraint is used to prevent harm to self.
D) Patient is placed on one-to-one continuous observation.
Q2) A community psychiatric nurse assesses that a patient diagnosed with a mood disorder is more depressed than on the previous visit a month ago; however, the patient says, "I feel the same." Which intervention supports the nurse's assessment while preserving the patient's autonomy?
A) Arrange for a short hospitalization.
B) Schedule weekly clinic appointments.
C) Refer the patient to the crisis intervention clinic.
D) Call the family and ask them to observe the patient closely.
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Chapter 6: Legal and Ethical Basis for Practice
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Sample Questions
Q1) Which documentation of a patient's behavior best demonstrates a nurse's observations?
A) Isolates self from others. Frequently fell asleep during group. Vital signs stable.
B) Calmer and more cooperative. Participated actively in group. No evidence of psychotic thinking.
C) Appeared to hallucinate. Patient frequently increased volume on television, causing conflict with others
D) Wears four layers of clothing. States, "I need protection from dangerous bacteria trying to penetrate my skin."
Q2) Which individual with a mental illness may need emergency or involuntary hospitalization for mental illness? The individual who:
A) resumes using heroin while still taking methadone.
B) reports hearing angels playing harps during thunderstorms.
C) throws a heavy plate at a waiter at the direction of command hallucinations.
D) does not show up for an outpatient appointment with the mental health nurse.
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Chapter
and Effective Care
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Sample Questions
Q1) At one point in an assessment interview a nurse asks, "How does your faith help you in stressful situations?" This question would be asked during the assessment of:
A) childhood growth and development.
B) substance use and abuse.
C) educational background.
D) coping strategies.
Q2) A nurse assesses an older adult patient brought to the emergency department by a family member. The patient was wandering outside, saying, "I can't find my way home." The patient is confused and unable to answer questions. Select the nurse's best action.
A) Document the patient's mental status. Obtain other assessment data from the family member.
B) Record the patient's answers to questions on the nursing assessment form.
C) Ask an advanced practice nurse to perform the assessment interview.
D) Call for a mental health advocate to maintain the patient's rights.
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Chapter 8: Communication Skills: Medium for All Nursing Practice
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Sample Questions
Q1) Which benefits are most associated with the use of telehealth? (Select all that apply.)
A) Cost savings for patients
B) Maximization of care management
C) Access to services for patients in rural areas
D) Prompt reimbursement by third-party payers
E) Rapid development of trusting relationships with patients
Q2) A patient says to the nurse, "I dreamed I was stoned. When I woke up, I felt emotionally drained, as though I hadn't rested well." Which comment would be appropriate if the nurse seeks clarification?
A) "It sounds as though you were uncomfortable with the content of your dream."
B) "I understand what you're saying. Bad dreams leave me feeling tired, too."
C) "So, all in all, you feel as though you had a rather poor night's sleep?"
D) "Can you give me an example of what you mean by 'stoned'?"
Q3) Which technique will best communicate to a patient that the nurse is interested in listening?
A) Restate a feeling or thought the patient has expressed.
B) Ask a direct question, such as, "Did you feel angry?"
C) Make a judgment about the patient's problem.
D) Say, "I understand what you're saying."
Page 10
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Chapter 9: Therapeutic Relationships and the Clinical
Interview
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Sample Questions
Q1) Termination of a therapeutic nurse-patient relationship with a patient has been successful when the nurse:
A) avoids upsetting the patient by shifting focus to other patients before the discharge.
B) gives the patient a personal telephone number and permission to call after discharge.
C) discusses with the patient changes that have happened during the relationship and evaluates the outcomes.
D) offers to meet the patient for coffee and conversation three times a week after discharge.
Q2) During which phase of the nurse-patient relationship can the nurse anticipate that identified patient issues will be explored and resolved?
A) Preorientation
B) Orientation
C) Working
D) Termination
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11
Chapter 10: Trauma and Stress-Related Disorders
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22 Verified Questions
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Sample Questions
Q1) Cortisol is released in response to a patient's prolonged stress. Which initial effect would the nurse expect to result from the increased cortisol level?
A) Diuresis and electrolyte imbalance
B) Focused and alert mental status
C) Drowsiness and lethargy
D) Restlessness and anxiety
Q2) A nurse designs a plan of exercise for a patient experiencing stress. The rationale the nurse should explain when presenting this plan to the treatment team is that exercise:
A) will stimulate endorphins and improve the patient's feelings of well-being.
B) prevents damage from overstimulation of the sympathetic nervous system.
C) detoxifies the body by removing metabolic wastes and other toxins.
D) will prevent exacerbation of the stress by the limbic system.
Q3) As part of the stress response, the HPA axis is stimulated. Which structures make up this system?
A) Hippocampus, parietal lobe, and amygdala
B) Hypothalamus, pituitary gland, and adrenal glands
C) Hind brain, pyramidal nervous system, and anterior cerebrum
D) Hepatic artery, parasympathetic nervous system, and acoustic nerve
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12
Chapter 11: Anxiety, Anxiety Disorders, and
Obsessive-Compulsive and Related Disorders
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39 Verified Questions
39 Flashcards
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Sample Questions
Q1) A supervisor assigns a worker a new project. The worker initially agrees but feels resentful. The next day, when asked about the project, the worker says, "I've been working on other things." When asked 4 hours later, the worker says, "Someone else was using the copier, so I couldn't finish it." The worker's behavior demonstrates:
A) acting out.
B) projection.
C) suppression.
D) passive aggression.
Q2) Two staff nurses applied for a charge nurse position. After the promotion was announced, the nurse who was not promoted said, "The nurse manager had a headache the day I was interviewed." Which defense mechanism is evident?
A) Introjection
B) Conversion
C) Projection
D) Splitting
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Chapter 12: Somatic Symptom Disorders and Dissociative Disorders
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Sample Questions
Q1) A patient diagnosed with somatic symptom disorder says, "I have pain from an undiagnosed injury. I can't take care of myself. I need pain medicine six or seven times a day. I feel like a baby because my family has to help me so much." It is important for the nurse to assess:
A) mood.
B) cognitive style.
C) secondary gains.
D) identity and memory.
Q2) A patient diagnosed with somatic symptom disorder says, "Why has God chosen me to be sick all the time and unable to provide for my family? The burden on my family is worse than the pain I bear." Which nursing diagnoses apply to this patient? (Select all that apply.)
A) Spiritual distress
B) Decisional conflict
C) Adult failure to thrive
D) Impaired social interaction
E) Ineffective role performance
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14
Chapter 13: Personality Disorders
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Sample Questions
Q1) A person's spouse filed charges of battery. The person has a long history of acting-out behaviors and several arrests. Which statement by the person suggests an antisocial personality disorder?
A) "I have a quick temper, but I can usually keep it under control."
B) "I've done some stupid things in my life, but I've learned a lesson."
C) "I'm feeling terrible about the way my behavior has hurt my family."
D) "I get tired of being nagged. My spouse deserved the beating."
Q2) A patient tells a nurse, "I sometimes get into trouble because I make quick decisions and act on them." A therapeutic response would be:
A) "Let's consider the advantages of being able to stop and think before acting."
B) "It sounds as though you've developed some insight into your situation."
C) "I'll bet you have some interesting stories to share about overreacting."
D) "It's good that you're showing readiness for behavioral change."
Q3) For which behavior would limit setting be most essential? The patient:
A) clings to the nurse and asks for advice about inconsequential matters.
B) is flirtatious and provocative with staff members of the opposite sex.
C) is hypervigilant and refuses to attend unit activities.
D) urges a suspicious patient to hit anyone who stares.
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Page 15
Chapter 14: Eating Disorders
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29 Verified Questions
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Sample Questions
Q1) Physical assessment of a patient diagnosed with bulimia nervosa often reveals:
A) prominent parotid glands.
B) peripheral edema.
C) thin, brittle hair.
D) amenorrhea.
Q2) One bed is available on the inpatient eating disorders unit. Which patient should be admitted? The patient whose weight dropped from:
A) 150 to 100 pounds over a 4-month period. Vital signs: temperature, 35.9° C; pulse, 38 beats/min; blood pressure, 60/40 mm Hg.
B) 120 to 90 pounds over a 3-month period. Vital signs: temperature, 36° C; pulse, 50 beats/min; blood pressure, 70/50 mm Hg.
C) 110 to 70 pounds over a 4-month period. Vital signs: temperature, 36.5° C; pulse, 60 beats/min; blood pressure, 80/66 mm Hg.
D) 90 to 78 pounds over a 5-month period. Vital signs: temperature, 36.7° C; pulse, 62 beats/min; blood pressure, 74/48 mm Hg.
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Chapter 15: Mood Disorders: Depression
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33 Verified Questions
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Sample Questions
Q1) An adult diagnosed with major depressive disorder was treated with medication and cognitive behavioral therapy. The patient now recognizes how passivity contributed to the depression. Which intervention should the nurse suggest?
A) Social skills training
B) Relaxation training classes
C) Use of complementary therapy
D) Learning desensitization techniques
Q2) A patient diagnosed with major depressive disorder shows vegetative signs of depression. Which nursing actions should be implemented? (Select all that apply.)
A) Offer laxatives, if needed.
B) Monitor food and fluid intake.
C) Provide a quiet sleep environment.
D) Eliminate all daily caffeine intake.
E) Restrict the intake of processed foods.
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17
Chapter 16: Bipolar Spectrum Disorders
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Sample Questions
Q1) A nurse receives this laboratory result for a patient diagnosed with bipolar disorder: lithium level 1 mEq/L. This result is:
A) within therapeutic limits.
B) below therapeutic limits.
C) above therapeutic limits.
D) likely to be inaccurate.
Q2) A patient experiencing mania dances around the unit, seldom sits, monopolizes conversations, interrupts, and intrudes. Which nursing intervention will best assist the patient with energy conservation?
A) Monitor physiologic functioning
B) Provide a subdued environment
C) Supervise personal hygiene
D) Observe for mood changes
Q3) Consider these three drugs: divalproex (Depakote), carbamazepine (Tegretol), and gabapentin (Neurontin). Which drug also belongs to this group?
A) Clonazepam (Klonopin)
B) Risperidone (Risperdal)
C) Lamotrigine (Lamictal)
D) Aripiprazole (Abilify)
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Page 18
Chapter 17: Schizophrenia Spectrum Disorders and Other
Psychotic Disorders
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Sample Questions
Q1) A community mental health nurse wants to establish a relationship with a very withdrawn patient diagnosed with schizophrenia. The patient lives at home with a supportive family. Select the nurse's best plan.
A) Visit daily for 4 days, then visit every other day for 1 week; stay with the patient for 20 minutes; accept silence; state when the nurse will return.
B) Arrange to spend 1 hour each day with the patient; focus on asking questions about what the patient is thinking or experiencing; avoid silences.
C) Visit twice daily; sit beside the patient with a hand on the patient's arm; leave if the patient does not respond within 10 minutes.
D) Visit every other day; remind the patient of the nurse's identity; encourage the patient to talk while the nurse works on reports.
Q2) Which symptoms are expected for a patient diagnosed with schizophrenia who has disorganization?
A) Extremes of motor activity, from excitement to stupor
B) Socially withdrawal and ineffective communication
C) Severe anxiety with ritualistic behavior
D) Highly suspicious, delusional behavior
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Page 19
Chapter 18: Neurocognitive Disorders
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Sample Questions
Q1) An older adult patient in an intensive care unit is experiencing visual and auditory illusions. Which nursing intervention will be most helpful?
A) Place large clocks and calendars on the wall.
B) Place personally meaningful objects in view.
C) Use the patient's glasses and hearing aids.
D) Keep the room brightly lit at all times.
Q2) An older adult was stopped by police for driving through a red light. When asked for a driver's license, the adult hands the police officer a pair of sunglasses. What sign of dementia is evident?
A) Aphasia
B) Apraxia
C) Agnosia
D) Memory impairment
Q3) Goals and desired outcomes for an older adult patient experiencing delirium caused by fever and dehydration will focus on:
A) returning to premorbid levels of function.
B) identifying stressors negatively affecting self.
C) demonstrating motor responses to noxious stimuli.
D) exerting control over responses to perceptual distortions.
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Page 20
Chapter 19: Substance-Related and Addictive Disorders
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Sample Questions
Q1) A patient admitted yesterday for injuries sustained in a fall while intoxicated believes snakes are crawling on the bed. The patient is anxious, agitated, and diaphoretic. What is the priority nursing diagnosis?
A) Disturbed sensory perception
B) Ineffective coping
C) Ineffective denial
D) Risk for injury
Q2) When a person first begins drinking alcohol, two drinks produce relaxation and drowsiness. After 1 year of drinking, four drinks are needed to achieve the same relaxed, drowsy state. Why does this change occur?
A) Tolerance develops
B) The alcohol is less potent
C) Antagonistic effects occur
D) Hypomagnesemia develops
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21
Chapter 20: Crisis and Mass Disaster
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Sample Questions
Q1) A woman says, "I can't take anymore! Last year my husband and I got a divorce. Three months ago, I found a lump in my breast. Yesterday my daughter said she's quitting college." If this person's immediate family is unable to provide sufficient situational support, the nurse should:
A) suggest hospitalization for a short period.
B) ask what other relatives or friends are available for support.
C) tell the patient, "You must be strong. Don't let this crisis overwhelm you."
D) foster insight by relating the present situation to earlier situations involving loss.
Q2) Which scenario is an example of an adventitious crisis?
A) Death of a child from sudden infant death syndrome
B) Being fired from a job because of company downsizing
C) Retirement of a 55-year-old
D) A riot at a rock concert
Q3) Which situation demonstrates the use of primary care related to crisis intervention?
A) Implementing suicide precautions for a patient with depression.
B) Teaching stress reduction techniques to a beginning student nurse.
C) Assessing coping strategies used by a patient who has attempted suicide.
D) Referring a patient with schizophrenia to a partial hospitalization program.
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22
Chapter 21: Child, Partner, and Elder Violence
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Sample Questions
Q1) A community health nurse visits a family with four children. The father behaves angrily, finds fault with a child, and asks twice, "Why are you such a stupid kid?" The wife says, "I have difficulty disciplining the children. It's so frustrating." Which comments by the nurse will facilitate the interview with these parents? (Select all that apply.)
A) "Tell me how you punish your children."
B) "How do you stop your baby from crying?"
C) "Caring for four small children must be difficult."
D) "Do you or your husband ever beat the children?"
E) "Calling children 'stupid' injures their self-esteem."
Q2) An older adult diagnosed with Alzheimer disease lives with family. During the week, the person attends a day care center while the family is at work. In the evenings, members of the family provide care. Which factor makes this patient most vulnerable to abuse?
A) Dementia
B) Living in a rural area
C) Being part of a busy family
D) Being home only in the evening
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Page 23
Chapter 22: Sexual Violence
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Sample Questions
Q1) Which activities are in the scope of practice of a sexual assault nurse examiner? (Select all that apply.)
A) Requiring HIV testing of a victim
B) Collecting and preserving evidence
C) Providing long-term counseling for rape victims
D) Obtaining signed consents for photographs and examinations
E) Providing pregnancy and sexually transmitted disease prophylaxis
Q2) The nurse cares for a victim of a violent sexual assault. What is the most therapeutic intervention?
A) Use accepting, nurturing, and empathetic communication techniques.
B) Educate the victim about strategies to avoid attacks in the future.
C) Discourage the expression of feelings until the victim stabilizes.
D) Maintain a matter-of-fact manner and objectivity.
Q3) A nurse working a rape telephone hotline should focus communication with callers to:
A) arrange long-term counseling.
B) serve as a sympathetic listener.
C) obtain information to relay to the local police.
D) explain immediate steps that a victim of rape should take.
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Page 24
Chapter 23: Suicidal Thoughts and Behavior
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Sample Questions
Q1) Which change in brain biochemical function is most associated with suicidal behavior?
A) Dopamine excess
B) Serotonin deficiency
C) Acetylcholine excess
D) Gamma-aminobutyric acid deficiency
Q2) Which individual in the emergency department should be considered at the highest risk for completing suicide?
A) An adolescent Asian-American girl with superior athletic and academic skills who has asthma
B) A 38-year-old single African-American female church member with fibrocystic breast disease
C) A 60-year-old married Hispanic man with 12 grandchildren who has type 2 diabetes
D) A 79-year-old single white man with cancer of the prostate gland
Q3) When assessing a patient's plan for suicide, what aspect has priority?
A) Patient's financial and educational status
B) Patient's insight into suicidal motivation
C) Availability of means and lethality of method
D) Quality and availability of patient's social support
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Page 25
Chapter 24: Anger, Aggression, and Violence
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Sample Questions
Q1) A patient diagnosed with pneumonia has been hospitalized for 4 days. Family members describe the patient as "a difficult person who finds fault with others." The patient verbally abuses nurses for providing poor care. The most likely explanation for this behavior lies in:
A) poor childrearing that did not teach respect for others.
B) automatic thinking, leading to cognitive distortion.
C) personality style that externalizes problems.
D) delusions that others wish to deliver harm.
Q2) An emergency department nurse realizes that the spouse of a patient is becoming increasingly irritable while waiting. Which intervention should the nurse use to prevent escalation of anger?
A) Explain that the patient's condition is not life threatening.
B) Periodically provide an update and progress report on the patient.
C) Explain that all patients are treated in order, based on their medical needs.
D) Suggest that the spouse return home until the patient's treatment is completed.
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Chapter 25: Care for the Dying and Those Who Grieve
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Q1) A woman whose husband is terminally ill says, "I don't want to cry in front of him. I don't want him to know how soon death will occur or how sad I am." Which response by the nurse would be most therapeutic?
A) "I'm glad you are protecting him at a time when he is so vulnerable."
B) "He might be more comforted than disturbed by your tears."
C) "It's important for you to know that time is running out."
D) "You definitely need to be honest about your feelings."
Q2) A grieving patient tells a nurse, "It's been eight months since my spouse died. I thought I would feel better by now, but lately I feel worse. I have no energy. I am lonely, but I don't want to be around people. What should I do?" What is the nurse's best counsel?
A) Seek psychotherapy.
B) Become active in a church.
C) Go to the spouse's grave every day.
D) Understand this is a normal response.
Q3) The mourning process is more difficult when the bereaved:
A) was relatively independent of the deceased.
B) has experienced many previous losses.
C) accepts that death is expected for everyone.
D) had resolved conflicts with the deceased.
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Chapter 26: Children and Adolescents
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Sample Questions
Q1) Which finding would prompt the nurse to carefully assess an 8-year-old child for development of a psychiatric disorder?
A) Being raised by a parent with chronic major depressive disorder
B) Moving to three new homes over a 2-year period
C) Not being promoted to the next grade
D) Having an imaginary friend
Q2) The parent of a child diagnosed with Tourette's disorder says to the nurse, "I think my child is faking the tics because they come and go." Which response by the nurse is accurate?
A) "Perhaps your child was misdiagnosed."
B) "Your observation indicates the medication is effective."
C) "Tics often change frequency or severity. That does not mean they aren't real."
D) "This finding is unexpected. How have you been administering your child's medication?"
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Chapter 27: Adults
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Q1) Before working with patients regarding sexual concerns, a prerequisite for providing nonjudgmental care is:
A) sympathy.
B) assertiveness training.
C) sexual self-awareness.
D) effective communication.
Q2) The manager of a health club put a hidden camera in the women's locker room and videotaped women as they showered and dressed. Which sexual dysfunction is evident?
A) Frotteurism
B) Exhibitionism
C) Pedophilia
D) Voyeurism
Q3) Health maintenance and promotion efforts for patients diagnosed with severe and persistent mental illness should include education about the importance of regular:
A) home safety inspections.
B) monitoring of self-care abilities.
C) screening for cancer, hypertension, and diabetes.
D) determination of adequacy of a patient's support system.
To view all questions and flashcards with answers, click on the resource link above.
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Chapter 28: Older Adults
Available Study Resources on Quizplus for this Chatper
31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/2074
Sample Questions
Q1) A student nurse visiting a senior center tells the instructor, "It's so depressing to see all these old people. They are so weak and frail. They are probably all confused." The student is expressing:
A) reality.
B) ageism.
C) empathy.
D) advocacy.
Q2) Which is the best comment for a nurse to use when beginning an interview with an older adult patient?
A) "Hello, [call patient by first name]. I am going to ask you some questions to get to know you better."
B) "Hello. My name is [nurse's name]. I am a nurse. Please tell me how you would like to be addressed by the staff."
C) "I am going to ask you some questions about yourself. I would like to call you by your first name if you don't mind."
D) "You look as though you are comfortable and ready to participate in an admission interview. Shall we get started?"
To view all questions and flashcards with answers, click on the resource link above. Page 30