Clinical Practice in Psychiatric Nursing Exam Preparation Guide
Course Introduction
Clinical Practice in Psychiatric Nursing provides students with hands-on experience in delivering care to individuals with mental health disorders across various clinical settings. This course emphasizes the development of therapeutic communication skills, comprehensive mental health assessments, and the implementation of evidence-based nursing interventions. Students collaborate with multidisciplinary teams to plan, implement, and evaluate care, while exploring ethical, legal, and cultural considerations unique to psychiatric nursing. Through direct patient interactions and reflective practice, students gain confidence and competence in promoting mental health, facilitating recovery, and supporting patients and their families throughout the treatment process.
Recommended Textbook
Principles and Practice of Psychiatric Nursing 10th Edition by Gail Wiscarz Stuart
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40 Chapters
943 Verified Questions
943 Flashcards
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Chapter 1: Roles and Functions of Psychiatric-Mental Health
Nurses: Competent Caring
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) Hildegard Peplau's classic article "Interpersonal Techniques: The Crux of Psychiatric Nursing" directed psychiatric nursing's future growth by stating that the primary role of the psychiatric nurse was that of:
A) leader.
B) teacher.
C) counselor.
D) surrogate parent.
Answer: C
Q2) The major determinants of the roles in which a psychiatric nurse engages are:
A) personal preference and age.
B) local custom and physician support.
C) state law and personal qualifications.
D) work setting and personal preference.
Answer: C
Q3) A psychiatric nurse uses leadership skills to strengthen the profession by:
A) working as a change agent advocating for patients, families, and communities.
B) volunteering time each week to outpatient clinics in poor neighborhoods.
C) voting for candidates in local elections who will advocate for nurses.
D) working for state government representatives at local voting sites.
Answer: A
Page 3
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Chapter 2: Therapeutic Nurse-Patient Relationship
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28 Verified Questions
28 Flashcards
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Sample Questions
Q1) When the nurse suggests the patient communicate to her employer how overwhelmed she is by the workload,the patient responds,"Yes but I'll get fired if I do that."
According to transactional analysis theory,this is an example of a(n) _____ transaction.
A) ulterior
B) crossed
C) congruous
D) complementary
Answer: A
Q2) A psychiatric nurse will recognize which action as demonstration of resistance behavior?
A) Regularly referring to himself as a "loser"
B) Becoming tearful during every therapy session about abuse
C) Asking to postpone a therapy session until after visiting hours
D) Consistently describing his drug use as starting "a little while ago"
Answer: D
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4
Chapter 3: The Stuart Stress Adaptation Model of Psychiatric Nursing Care
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31 Verified Questions
31 Flashcards
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Sample Questions
Q1) A patient states,"Sometimes I hear voices when no one else is in the room telling me that people are plotting to hurt me." This patient is experiencing impairment of which criterion of mental health?
A) Autonomy
B) Integration
C) Reality perception
D) Environmental mastery
Answer: C
Q2) A comparison of the nursing and medical models of care shows that:
A) nurses assess disease states and causes.
B) physicians assess risk factors and vulnerability.
C) nursing intervention focuses on curative treatments.
D) nursing diagnoses focus on the effectiveness of coping responses.
Answer: D
Q3) Precipitating stressors are stimuli that:
A) society views as being deviant or troublesome.
B) the family views as disruptive or burdensome.
C) the patient views as challenging, threatening, or demanding.
D) the nurse views as noxious, overwhelming, or culturally unacceptable.
Answer: C
Page 5
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Chapter 4: Evidence-Based Psychiatric Nursing Practice
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22 Verified Questions
22 Flashcards
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Sample Questions
Q1) Which activity will be most useful to a nurse wishing to provide evidence-based psychiatric nursing care?
A) Relying on findings of one properly designed, randomized, controlled trial
B) Using a protocol from several well-designed, cohort, quasiexperimental studies
C) Seeking sound, opinion-based processes and maintaining self-directed practice
D) Applying findings from a meta-analysis of relevant randomized, controlled trials
Q2) To what extent is outcome measurement important to the delivery of psychiatric nursing care?
A) It is more "nice" than it is necessary.
B) It will support the legitimacy of psychiatric nursing.
C) It will promote descriptive and correlational nursing research.
D) It gives information about the appropriate settings for treatment.
Q3) To substantiate clinical practice the psychiatric nurse should place the greatest reliance on the _____ basis.
A) traditional
B) regulatory
C) evidence
D) philosophical/conceptual
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Chapter 5: Biological Context of Psychiatric Nursing Care
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23 Verified Questions
23 Flashcards
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Sample Questions
Q1) A couple tells a nurse that they are concerned about having children because there is bipolar disorder in first-degree relatives of each of them.What advice should the nurse give?
A) "Do not have children."
B) "Seek genetic counseling."
C) "Do as your conscience dictates."
D) "Bipolar disorder is not hereditary."
Q2) A patient demonstrates disoriented thinking and irrational ideas.A nurse can anticipate that a PET scan would most likely show dysfunction in the brain's _____ lobe.
A) frontal
B) parietal
C) occipital
D) temporal
Q3) Pharmacogenetics will eventually allow researchers to do which of the following?
A) Remove the genes that cause illness.
B) Allow the design of custom drugs.
C) Develop foods that fight disease.
D) Splice genes to improve health.
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Chapter 6: Psychological Context of Psychiatric Nursing Care
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28 Verified Questions
28 Flashcards
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Sample Questions
Q1) Success in obtaining sufficient data in the initial psychiatric interview depends largely on the:
A) patient's ability to communicate effectively.
B) interviewer's ability to establish good rapport.
C) number of psychiatric interviews the nurse has performed.
D) interviewer's ability to organize and systematically record data.
Q2) Which clinical skills used to conduct a mental status examination are most relevant to establishing rapport?
A) Clarification and restatement
B) Information giving and feedback
C) Systematic inquiry and organization of data
D) Attentive listening, observation, and focused questions
Q3) During a mental status evaluation,a nurse's intuition may indicate:
A) clues about the patient's physical well-being.
B) subtle emotions being expressed by the patient.
C) areas to be explored in the predischarge interview.
D) potential nursing diagnoses that relate to a patient knowledge deficit.
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Page 8
Chapter 7: Social, Cultural, and Spiritual Context of Psychiatric Nursing Care
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18 Verified Questions
18 Flashcards
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Sample Questions
Q1) Sociocultural risk factors are identified by assessing which patient characteristic?
A) Belief system
B) Daily health habits
C) Stress management habits
D) Restfulness of the home environment
Q2) One task of an administrator of a culturally sensitive mental health system would be to:
A) eliminate all staff bias related to cultural diversity.
B) hire significant numbers of minority health care providers.
C) incorporate the values of culture competency into all levels of care.
D) keep access to care open for the dominant ethnic, social, and religious groups.
Q3) A culturally competent nurse possesses which characteristics? (Select all that apply.)
A) Flexibility
B) An unbiased nature
C) Sensitivity to diversity
D) Willingness to learn
E) Mastery of nursing skills
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Chapter 8: Legal and Ethical Context of Psychiatric Nursing Care
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24 Verified Questions
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Sample Questions
Q1) A patient signed a sales contract to purchase a new home and 1 week later was voluntarily hospitalized for treatment of depression.The sales contract is now most likely:
A) invalid.
B) still valid.
C) postponed.
D) in litigation.
Q2) Which action by a nurse violates the rights of a psychiatric patient?
A) Arranging for a patient to work in the hospital kitchen for minimum wage
B) Refusing to mail letters to the local newspaper written by a committed patient
C) Placing the wristwatch of a patient with delusions in the hospital's main safe
D) Discouraging a patient with paranoid delusions to sign a contract to sell a home
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Chapter 9: Policy and Advocacy in Mental Health Care
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23 Verified Questions
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Sample Questions
Q1) A nurse works in an organization that provides an integrated behavioral continuum of care.The goal of treatment in the crisis clinic is:
A) remission.
B) recovery.
C) stabilization.
D) optimal level of wellness.
Q2) In many rural communities the ratio of consumers to doctors is higher than it is in cities.This is an example of:
A) a health access problem in rural areas.
B) a lack of compassion among physicians.
C) reimbursement barriers in rural states.
D) appropriate distribution of health care providers.
Q3) Which type of managed care plan allows the most flexibility in choosing health services and providers?
A) Health maintenance organization (HMO)
B) Independent practice organization (IPO)
C) Preferred provider organization (PPO)
D) Point of service plan (POS)
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11
Chapter 10: Families as Resources, Caregivers, and Collaborators
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23 Verified Questions
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Sample Questions
Q1) A psychiatric nurse working within a competence paradigm would emphasize which of the following when working with a patient with an anxiety disorder?
A) Use of natural family support networks
B) Prevention of negative patient outcomes
C) The view of anxiety disorder as a disease
D) Treatment of dysfunctional characteristics
Q2) During a mental health assessment,a patient reports living with two children from a previous relationship,a sibling,and a sibling's three children.To use the most precise documentation,the nurse documents that the patient is part of a(n):
A) household.
B) nuclear family.
C) extended family.
D) traditional family.
Q3) The symbolic interactionism theoretical model helps explain the:
A) hypotheses explaining why patients with schizophrenia hear voices.
B) basis for social difficulties experienced by patients with bipolar disorder.
C) impact that living with a mentally ill person has on their family structure.
D) relative lack of support for mentally ill patients of certain U.S. subcultures.
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Chapter 11: Implementing the Nursing Process: Standards of Practice
and Professional Performance
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) A nurse teaching a patient about the effects and side effects of the prescribed medication bases the plan on the knowledge that learning is more effective when:
A) patients are actively included in the process.
B) topics are introduced only when the patient expresses an interest.
C) nurses establish realistic goals for learning on behalf of the patient.
D) patients have responsibility for directing the teaching-learning process.
Q2) A staff nurse is told in orientation to expect to receive performance appraisals in various forms.The nurse can expect that these will be: (Select all that apply.)
A) collaborative practice.
B) interdisciplinary.
C) administrative.
D) professional.
E) clinical.
Q3) Which goal should be given the highest priority?
A) Reduction of anxiety
B) Alleviation of depression
C) Enhancement of self-esteem
D) Protection from self-destructive impulses
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Chapter 12: Prevention and Mental Health Promotion
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) In the event that a vaccine is developed to prevent schizophrenia,which population group would be selected to receive it first?
A) The universal population
B) The indicated population
C) The developmental population
D) The epidemiological population
Q2) A nurse who works in community mental health identifies a minority neighborhood group as having low self-efficacy and being particularly susceptible to a number of stressors.In which phase of the nursing process did this activity take place?
A) Assessment
B) Analysis
C) Planning
D) Implementation
E) Evaluation
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Chapter 13: Crisis Intervention
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) When a patient in crisis intervention therapy alludes to the possibility of self-harm,the nurse should:
A) arrange for someone to check in on the patient.
B) take all steps necessary to ensure the patient's safety.
C) advise the patient that such thoughts are common in crisis.
D) tell the patient that he or she is too intelligent to consider that as a solution.
Q2) A patient who undergoes a hostage experience begins crisis intervention therapy.The patient asks,"How long before I will feel like myself again?" The reply that shows the best understanding of the parameters of crisis intervention therapy would be:
A) "No one can really say."
B) "It usually takes about 6 weeks."
C) "My best guess would be 6 months."
D) "The experience usually results in permanent changes."
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15
Chapter 14: Recovery and Psychiatric Rehabilitation
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23 Verified Questions
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Sample Questions
Q1) The family burden associated with having a mentally ill family member is evidenced by:
A) decreased family stress and conflict.
B) family members blaming each other for the illness.
C) increased understanding and acceptance of the illness.
D) too little time, energy, and money given to the ill member.
Q2) The most effective way for a nurse working in psychiatric rehabilitation to gain firsthand knowledge about a community agency is to:
A) query patients who have used the services of the agency.
B) go to the agency with someone who is requesting services.
C) read the description in a community social services directory.
D) go to the agency pretending to be someone who needs services.
Q3) Effective programs are essential for families of patients with severe mental illness.Which components should be included to enhance a program's effectiveness?
A) Education and empowerment
B) Political support and education
C) Financial support and a large membership
D) Empowerment and the participation of political figures
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Chapter 15: Anxiety Responses and Anxiety Disorders
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) A patient tends to use the defense mechanism of displacement.When the patient's spouse accuses the patient of being disorganized and flighty,the patient is most likely to react by:
A) burning the spouse's dinner.
B) scolding the paperboy for being late.
C) telling the spouse, "I'm so angry with you."
D) promising the spouse to try be more organized and calm.
Q2) A nurse who has spent an hour with a highly anxious patient shares with a peer,"I'm really feeling uptight! I need a quiet place to be alone." This can be attributed to:
A) hypersensitivity on the nurse's part.
B) anxiety resulting from the patient contact.
C) fatigue from the effort of establishing a relationship.
D) a threat to the nurse's self-esteem created by a difficult patient.
Q3) In the cognitive realm,which assessment finding most indicates depression?
A) Uncertainty in negative evaluations
B) Selective and specific negative appraisals
C) Global view that nothing will turn out right
D) Tentatively regards defects or mistakes as revocable
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Chapter 16: Psychophysiological Responses and Somatoform
and Sleep
Disorders
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Sample Questions
Q1) A patient with a history of insomnia has been taking 15 mg of chlordiazepoxide (Librium) at bedtime for the past year.The patient reports having difficulty falling asleep and wakes up frequently during the night.The most appropriate nursing diagnosis to consider is:
A) disturbed sleep pattern related to anxiety.
B) moderate anxiety related to disturbed sleep pattern.
C) insomnia related to tolerance to chlordiazepoxide (Librium).
D) thought disorder related to intolerance of chlordiazepoxide (Librium).
Q2) A patient says,"Although numerous assessments and diagnostic tests over the past year have shown no evidence of organic disease I'm still anxious and sure something is wrong." The nurse should suspect the presence of: A) hypochondriasis.
B) chronic pain disorder.
C) chronic major depression.
D) body dysmorphic disorder.
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18
Chapter 17: Self-Concept Responses and Dissociative Disorders
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Sample Questions
Q1) A patient is acutely psychotic,withdrawn,claims to be a robot,and cannot think of how to take a shower.Which response by the nurse is best?
A) "If you can't shower independently, the staff will give you a bed bath."
B) "I will turn on the water for you and provide you with step-by-step directions."
C) "You must shower, or you'll risk having people actively avoid being around you."
D) "We can put off the shower for another day because you don't have any body odor."
Q2) A patient states,"Ever since I was a kid,I knew I should study,get good grades,and go to medical school.I wanted to be helpful and do good for others." From this statement,the nurse obtains information to assess this patient's:
A) self-ideal.
B) self-esteem.
C) self-concept.
D) self-actualization.
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Chapter 18: Emotional Responses and Mood Disorders
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27 Verified Questions
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Sample Questions
Q1) A patient displaying symptoms of mania has spent the entire morning pacing in the dayroom and now has begun verbally intimidating other patients.The nurse manages the milieu by:
A) obtaining a telephone order to seclude the patient.
B) stating, "You can't frighten the other patients."
C) escorting the patient out of the dayroom.
D) distracting the patient with the television.
Q2) The emergency department calls to say a patient experiencing symptoms of mania is being admitted.Which room placement should a nurse choose for the patient?
A) A single room near the unit entrance
B) A single room near the nurse's station
C) A double room shared with a patient with depression
D) A double room shared with a patient with schizophrenia
Q3) Based on current sociocultural risk factors for mental illness,a nurse assesses that which patient is at highest risk for depression?
A) A 26-year-old female
B) A 33-year-old male
C) A 57-year-old male
D) A 72-year-old female
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Page 20
Chapter 19: Self-Protective Responses and Suicidal Behavior
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Sample Questions
Q1) An assessment has been made that a patient is highly suicidal.One-to-one constant supervision with unit restriction has been ordered.How will this order be implemented?
A) By observing the patient while awake, both on and off the unit
B) By observing the patient at all times while revoking any off-unit privileges
C) By obtaining a no-suicide contract while removing all harmful objects from the environment
D) By observing the patient every 15 minutes around the clock while documenting whereabouts and activity level
Q2) A patient who _____ should be assessed as using indirect self-destructive behavior.
A) scratches both wrists with safety pins
B) drinks nearly 1 quart of whiskey per day
C) took an overdose of sedative-hypnotic drugs
D) calls a friend when contemplating suicide
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21
Chapter 20: Neurobiological Responses and Schizophrenia and Psychotic Disorders
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Sample Questions
Q1) Which teaching point will have the most positive effect on patients diagnosed with schizophrenia and their families concerning the risk of relapses?
A) Patients who take their medications will not relapse.
B) Caffeine and nicotine can reduce the effectiveness of antipsychotic drugs.
C) With support, education, and adherence to treatment, patients will not relapse.
D) Schizophrenia is a chronic disorder that is characterized by repeated relapses.
Q2) A patient diagnosed with schizophrenia has difficulty completing tasks and seems forgetful and disinterested in activities.A nurse can best select successful strategies by understanding that these behaviors are due to:
A) a lack of self-esteem.
B) manipulative tendencies.
C) shyness and embarrassment.
D) problems in cognitive functioning.
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22
Chapter 21: Social Responses and Personality Disorders
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Sample Questions
Q1) The care plan for a patient with a personality disorder contains the following interventions: demonstrate accessibility,maintain confidentiality,and maintain consistent behavior by all nursing staff.The goal of these interventions is the:
A) patient's serotonin levels will stabilize.
B) patient will not engage in self-mutilation.
C) patient will participate in therapeutic nurse-patient relationships.
D) patient will not use manipulation as a way of relating to staff and family.
Q2) A nurse has become the focus of projective identification by the patient.The greatest risk to the nurse-patient relationship is that the nurse will become:
A) afraid to be alone with the patient.
B) prejudicial and biased against the patient.
C) overly strict and inflexible regarding patient expectations.
D) unable to effectively place limits on the patient's behaviors.
Q3) Milieu work with patients with personality disorders is most effective when it:
A) focuses on interactional behaviors in the here and now.
B) facilitates a process of delving into the patient's early childhood.
C) provides strict structure to compensate for a lack of personal boundaries.
D) promotes regression to help the patient work through earlier conflicts.
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23
Chapter 22: Cognitive Responses and Organic Mental Disorders
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Sample Questions
Q1) Which nursing diagnosis would be appropriate for a patient with Alzheimer disease?
A) Disorientation related to hyperthermia
B) Anxiety (moderate) related to dementia
C) Disturbed sensory perception (visual) related to normal aging
D) Disturbed thought processes related to irreversible brain disorder
Q2) The goal for a patient with disturbed thought processes is,"The patient will:
A) be safe from injury."
B) meet basic biological needs."
C) achieve optimum cognitive functioning."
D) maintain positive interpersonal relationships."
Q3) A patient experiencing delirium secondary to drug toxicity is manifesting paranoid thinking and noisy,assaultive behavior and is currently pacing the room.The nurse's initial intervention is to:
A) prepare to apply supervised restraints.
B) request an intravenous sedative.
C) calmly attempt to quiet the patient.
D) attempt to divert the patient's attention.
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Page 24
Chapter 23: Chemically Mediated Responses and
Substance-Related Disorders
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Q1) The following are goals for a patient being treated for alcoholism.Select the order in which these goals should be approached.
A.Developing alternative coping skills
B.Attaining physiological stabilization
C.Learning about dependence and recovery
D.Abstinence and development of a support system
A) A,B,C,D
B) B,D,C,A
C) C,D,B,A
D) D,C,B,A
Q2) The spouse of a patient with alcoholism asks,"How do I respond in a helpful way even though this abuse is so harmful to my family?" The nurse's best response would be:
A) "Search the house regularly for hidden alcohol."
B) "Include your spouse in family activities whether or not drinking has occurred."
C) "Make your spouse responsible for the consequences of the disruptive behavior."
D) "Refuse to be supportive when your spouse is under the influence of alcohol."
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Chapter 24: Eating Regulation Responses and Eating Disorders
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Q1) What is the central concept around which a family education plan for preventing childhood eating problems is constructed?
A) Promoting self-demand feeding for the child
B) Distinguishing between physical and psychological hunger
C) Scheduling meals because children do not recognize physical hunger
D) Parental expectations of ideal intake as determinants of healthy eating habits
Q2) A patient with an eating disorder states,"Now that I've gained 4 pounds,I can't wear shorts until I lose it again." The patient is exhibiting which cognitive distortion related to maladaptive eating regulation responses?
A) Magnification
B) Personalization
C) Superstitious thinking
D) Dichotomous thinking
Q3) When undertaking care for patients with eating disorders,a nurse should first:
A) perform a complete patient assessment.
B) obtain a history from the patient's family.
C) examine personal feelings about weight.
D) question the patient as to when he or she last ate a meal.
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Chapter 25: Sexual Responses and Sexual Disorders
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Q1) A nurse consults with local elementary and secondary school teachers about implementing strategies to reinforce the concept of "say no to unwanted sexual advances." The most helpful method the nurse can suggest is:
A) pretesting for accurate sexual knowledge.
B) explaining why saying "no" is appropriate for teens.
C) role playing assertive behavior in potentially difficult sexual situations.
D) brainstorming examples of behaviors that will promote good sexual health.
Q2) When a patient tells a nurse,"I think I'm impotent," which response by the nurse would be most therapeutic?
A) "That must be very scary for you."
B) "How is your overall health?"
C) "What medications are you currently taking?"
D) "Please tell me what you mean by 'impotent.'"
Q3) A couple reports having rare-to-occasional variations in their sexual response patterns.The nurse should conclude that this couple has:
A) no medically diagnosed health problem.
B) behaviors in accordance with sexual dysfunction.
C) engaged in sexual perversion or deviations regularly.
D) at least one partner who experiences a gender identity disorder.
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Page 27
Chapter 26: Psychopharmacology
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Q1) A patient who is taking lithium shares with the nurse,"I'm planning to breast-feed my baby who is due to be born in 2 months." Which statement shows the best understanding of the effect of lithium on breast-feeding?
A) "Your medication would be excreted in your breast milk, so let's discuss a safer option for your baby."
B) "Your medication will cause the breast milk to have an unpleasant taste and will likely cause your infant to be gassy."
C) "This medication will likely affect your ability to lactate, resulting in a marked decrease in breast milk production."
D) "This medication can cause extreme mood fluctuations, which can have a negative effect on your ability to produce breast milk."
Q2) A nurse who administers an antipsychotic medication explains to the client patient how the medication helps manage the symptoms by affecting:
A) dopamine and GABA.
B) serotonin and dopamine.
C) synaptic neurovesicles and neurodendrites.
D) monoamine oxidase inhibitors and serotonin.
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Page 28
Chapter 27: Behavior Change and Cognitive Interventions
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Sample Questions
Q1) A patient says,"There aren't many things in life that I'm really afraid of,but I'm so afraid that I'll have another panic attack when I least expect it." Which question indicates the nurse is using decatastrophizing?
A) "Okay, let's talk about the worst case scenario. What if you're driving in a snow storm with your children in the car and you have an attack?"
B) "I can understand your concern. But keep telling yourself not to worry because panic attacks go away as quickly as they appear."
C) "I can understand that your anxiety over the possibility of experiencing another panic attack could paralyze you with fear."
D) "Let me understand this. You're not afraid of much, but these attacks cause you to be fearful?"
Q2) A nurse determines that a patient with a fear of insects has mastered the first step in a systematic desensitization process when the patient is able to:
A) relax the muscles of the body.
B) look at a picture of an insect in a book.
C) rate anxiety produced by various insects.
D) touch a clear glass bottle containing an insect.
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Page 29
Chapter 28: Preventing and Managing Aggressive Behavior
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Q1) A newly licensed nurse tells a nurse manager,"I'd like you to stop referring to me as 'the smart new degree nurse.'" The nurse manager replies,"I was only teasing.You are being overly sensitive." Which statement accurately evaluates the newly licensed nurse's comment to the nurse manager?
A) The nurse is appropriately assertive, but now the nurse manager will likely belittle the nurse even more.
B) The nurse is behaving aggressively because of the newness of being a graduate licensed nurse and owes the nurse manager an apology.
C) The nurse is assertive, and responding that the nurse does not regard the nurse manager's comments as "teasing" would be an effective follow-up communication.
D) The nurse is overly sensitive and ought to have ignored the nurse manager's teasing until it was extinguished. Now the nurse manager will be more sarcastic than ever.
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Chapter 29: Somatic Therapies
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Q1) The spouse of a patient who is scheduled for ECT (electroconvulsive therapy) asks,"Isn't this a risky treatment? I know pills haven't worked,but this seems barbaric to me." Which response to the question is of greatest therapeutic communication value?
A) "Although no treatment is perfect, research has proven that this therapy has the same risk as minor surgery and actually presents a lower risk than medication."
B) "The psychiatrist would not order a treatment that would place your spouse in any real danger. I've seen many patients respond well to this treatment."
C) "That's an understandable concern. However, you've been misled by outdated information that stigmatizes ECT treatment."
D) "You appear to be very concerned about consenting to the treatment. I'd suggest you discuss this with your spouse's health care provider."
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Chapter 30: Complementary and Alternative Therapies
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Q1) A nurse knows that the patient has an understanding of complementary and alternative medicine (CAM) therapies when the patient states: (Select all that apply.)
A) "I'm going to begin meditating since I've read that it may help my chronic depression."
B) "I want to use reflexology because I want to improve my focus and ability to concentrate."
C) "I want to try working with a chiropractor to see if I can experience better flexibility in my lower back."
D) "I think I will try the herbal medication that the clinic nurse is recommending for the management of mild depression."
E) "Massage therapy appears to have a similar long-term affect on chronic anxiety Disorders as does medication therapy."
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Chapter 31: Therapeutic Groups
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Q1) Which example best describes an unresolved issue that should be further discussed at a future group meeting?
A) The seating of the two new members to the group
B) The identification of the goals successfully accomplished
C) An individual termination that was not anticipated by group members
D) The group leader's role now that the group has been meeting for 4 weeks
Q2) A nurse who facilitates a group for parents of children diagnosed with schizophrenia joins a peer support group for advanced practice psychiatric nurses.Which comment indicates that the nurse is using this group appropriately?
A) "I love my work, but if you measure your success by the money you earn, nursing is not the profession for you."
B) "Are any of you married or have young children? Working as a nurse is certainly challenging if you have children at home."
C) "I am feeling so ineffective since a member's child was found dead after having spent the night sleeping outside in the cold."
D) "Do any of you have a family member or friend who has been diagnosed with schizophrenia? We can talk about your concerns after the meeting."
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Chapter 32: Family Interventions
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Q1) A family participating in family therapy has identified the middle child as being the source of the family's conflict.What will the family therapist most likely suggest?
A) The parents should provide extra time and support to the middle child in order to facilitate necessary changes in behavior.
B) All members should participate in therapy sessions by identifying the daily difficulties that the individual member is experiencing.
C) The middle child should attend an educational group especially designed to address the special needs of this birth order position.
D) All members should be active participants in suggested activities between therapy sessions that focus on improving their coping skills.
Q2) One of the primary goals identified in marital therapy is:
A) support from families of origin.
B) consensus in all decisions related to the marriage.
C) the preservation of good interpersonal communication skills.
D) the maintenance of a support system comprised of mutual friends.
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Chapter 33: Hospital-Based Psychiatric Nursing Care
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Q1) A patient has just received information regarding the goals of a partial-hospitalization program.Which statement best indicates patient understanding?
A) "I think that the partial-hospitalization program will provide a good interim rest for me."
B) "The partial-hospitalization program will be a good support to me as I adjust to the stress of being back home."
C) "I know that partial hospitalization seems like a small step, but it will prevent readmission to the hospital."
D) "I'm looking forward to the partial-hospitalization program, because I can gather my thoughts there and think about what I want to do."
Q2) A patient with a history of chronic alcohol abuse and impaired cognitive function has been successfully taught to interpret a community bus schedule.The nurse should now be confident that the patient would benefit from attending:
A) a community resource group in the day hospital.
B) a substance abuse group on an outpatient basis.
C) a life skills group at the outpatient clinic.
D) Alcoholics Anonymous at the YMCA.
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Chapter 34: Community-Based Psychiatric Nursing Care
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Q1) An example of the primary responsibility of a nurse case manager for psychiatric patients in a residential home is to:
A) assure each patient is bathed and clothed appropriately.
B) conduct the unit's socialization group session daily.
C) participate in the feeding of a severely depressed patient.
D) arrange for a patient to move into a private apartment.
Q2) Which interventions would be provided by an employee assistance program (EAP) when an employee is suspected of having an alcohol abuse problem? (Select all that apply.)
A) A consultation with their immediate supervisor
B) Referral to an alcohol abuse treatment program
C) Financial help while at an alcohol treatment center
D) Guarantee that one's job will be held until treatment is successful
E) Evaluation of the employee's need for a leave of absence from their job
Q3) Which intervention demonstrates effective management of two contradictory goals of case management?
A) Arranging for outpatient patients to car pool to group meetings
B) Assessing patients to determine who is able to shower independently
C) Scheduling a patient to have in-home help with cooking and cleaning
D) Helping a patient appropriately fill a personal 5-day medication container
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Chapter 35: Child Psychiatric Nursing
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Q1) Which medication would the nurse expect to include in a care plan for an adolescent with a history of conduct disorder and violent behaviors?
A) Antianxiety agents
B) Antipsychotic medications
C) Antihistamine medications
D) Antidepressant medications
Q2) Nursing care for a child with attention-deficit/hyperactivity disorder (ADHD) usually includes which therapeutic component?
A) Foster care
B) Institutionalization
C) Stimulant drug therapy
D) Cognitive processing games
Q3) A nurse is working with primary school-age children diagnosed with psychiatric disorders.To most therapeutically address low self-esteem issues the nurse should:
A) give positive feedback for small goal accomplishment.
B) reward all acceptable behavior with positive feedback.
C) set major goals so that they can strive for accomplishments.
D) encourage active participation in a peer self-esteem self-help group.
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Chapter 36: Adolescent Psychiatric Nursing
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Q1) A nurse would be most concerned about the risk of suicide in which adolescent?
A) A 13-year-old girl with poor school performance
B) A 14-year-old male exhibiting hostile behavior
C) A 17-year-old female with alcohol abuse issues
D) An 18-year-old male with relationship problems
Q2) Since the divorce of parents 6 months ago,an adolescent has been absent from school nearly every Friday and gives vague complaints of various illnesses.Which nursing intervention would be most therapeutic in this situation?
A) Ask the student to discuss what is happening on Fridays.
B) Call the student's parents to determine their view concerning the behavior.
C) Request that the school counselor invite the student's parents for a family meeting.
D) Arrange for an examination including diagnostic testing to rule out any medical illnesses.
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Chapter 37: Geropsychiatric Nursing
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Q1) An older adult reports that "I know that I'm not the cheerful person I used to be but that's just a part of growing old." Using a psychological theoretical framework,the nurse might respond:
A) "When your life focuses on positive experiences from your adolescence, aging is reduced by that youthful mental status."
B) "There may be many causes for what you are feeling. I'd suggest seeing your health care provider to rule out any physical causes."
C) "The best way to prepare for a 'good death' is to systematically review your life and change any behaviors you feel might interfere with this process."
D) "You are in the last stage of development in your life, and it's important that you attempt to correct anything about your life that dissatisfies or saddens you."
Q2) Which older adult patient profile presents the highest risk for falls?
A) A widowed older adult who takes an antidepressant at bedtime
B) An older adult with diabetes who bicycles regularly as exercise
C) An older retired adult who provides in-home care for a spouse
D) An older single adult who wears corrective eyeglasses for myopia
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Chapter 38: Care of Survivors of Abuse and Violence
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Q1) Which behavior would the nurse expect in a person who commits psychic rape? The perpetrator:
A) gives money to the victim after the rape.
B) seduces the victim by providing wine, flowers, and music.
C) threatens the victim to submit or else be severely beaten.
D) always mentions including violent bondage in sexual activities.
Q2) Which assessment finding most clearly indicates that a rape victim is exhibiting behavior typically seen in the acute stage of sexual assault? The victim:
A) is demanding and controlling when dealing with staff.
B) appears to be confused, restless, and fearful when left alone.
C) uses profanity to describe events surrounding the attack.
D) experiences a panic attack on the anniversary of the attack.
Q3) Which patient is at greatest risk for physical abuse by a family member?
A) A 15-year-old who lives with a single parent in an inner city apartment complex
B) An 8-year-old who is mentally challenged and living with a foster family
C) A 30-year-old adult who shares a home with a homosexual partner
D) A 79-year-old with chronic depression who lives with a grandchild
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Chapter 39: The Military and Their Families
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Q1) Which assessment question is particularly important to ask of a veteran of the Iraq conflict?
A) "Have you ever experienced a migraine headache?"
B) "Could you ever see yourself considering suicide?"
C) "Do you feel anxious when you find yourself in a confined space like an elevator?"
D) "Would you say that your sleep patterns provide you with sufficient amounts of recuperative rest?"
Q2) Female military personnel who have recently returned from deployment in a war zone are being assessed for potential physical and sexual assault as well as for an increased risk for developing posttraumatic stress disorder (PTSD).During the assessment,the nurse would ask: (Select all that apply.)
A) "How safe did you feel while you were deployed?"
B) "Did you have much contact with potential enemy soldiers?"
C) "Have you ever experienced physical abuse as either a child or an adult?
D) "Do you feel the military is prepared to help you reenter a noncombat environment?"
E) "What is your greatest fear regarding your personal safety as a member of the military community?"
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Chapter 40: Psychological Care of Patients with Life-Threatening Illness
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Q1) A nurse enters the room of a patient newly diagnosed with multiple sclerosis and notes that the patient is crying quietly while lying in bed.Which communication by the nurse would be most appropriate?
A) "You are crying. What are you feeling that's making you so sad?"
B) "Do you want me to call the health care provider to order some antidepressant medication for you?"
C) "I can understand why you would cry. I imagine most people would feel sad after being given your diagnosis."
D) "Crying is a normal response to a diagnosis such as yours. You'll feel better after your plan of care has been fully developed."
Q2) A patient with end-stage renal disease does not want further aggressive treatment but is reluctant to withdraw life-sustaining treatment.The nurse would help the patient to understand that life-sustaining treatment includes maintaining:
A) full code status.
B) comfort measures only.
C) nutrition, hydration, and dialysis.
D) nutrition and hydration but removal of dialysis.
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