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Course Introduction
Clinical Psychiatric Nursing explores the foundational principles and practices of nursing care for individuals experiencing mental health disorders across the lifespan. The course emphasizes the development of therapeutic communication skills, psychiatric assessment techniques, and evidence-based interventions within a multidisciplinary care framework. Students gain a thorough understanding of the biological, psychological, and social factors affecting mental health, as well as legal and ethical considerations in psychiatric care. Through case studies, clinical simulations, and hands-on practica, students develop competency in planning, implementing, and evaluating individualized care for patients with acute and chronic psychiatric conditions in a variety of clinical settings.
Recommended Textbook
Essentials of Psychiatric Mental Health Nursing 2nd Edition by Elizabeth M. Varcarolis
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28 Chapters
809 Verified Questions
809 Flashcards
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15 Verified Questions
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Sample Questions
Q1) A patient who immigrated to the United States from Honduras was diagnosed with schizophrenia.The patient took an antipsychotic medication for 3 weeks but showed no improvement.Which resource should the treatment team consult for information on more effective medications for this patient?
A)Clinical algorithm
B)Clinical pathway
C)Clinical practice guideline
D)International Statistical Classification of Diseases and Related Health Problems (ICD)
Answer: A
Q2) Which historical nursing leader helped focus practice to recognize the importance of science in psychiatric nursing?
A)Abraham Maslow
B)Hildegard Peplau
C)Kris Martinsen
D)Harriet Bailey
Answer: B
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22 Flashcards
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Sample Questions
Q1) The goal for a patient is to increase resiliency.Which outcome should a nurse add to the plan of care? Within 3 days,the patient will:
A)describe feelings associated with loss and stress.
B)meet own needs without considering the rights of others.
C)identify healthy coping behaviors in response to stressful events.
D)allow others to assume responsibility for major areas of own life.
Answer: C
Q2) A nurse at a behavioral health clinic sees an unfamiliar psychiatric diagnosis on a patient's insurance form.Which resource should the nurse consult to discern the criteria used to establish this diagnosis?
A)DSM-IV-TR
B)Nursing Diagnosis Manual
C)A psychiatric nursing textbook
D)A behavioral health reference manual
Answer: A
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Sample Questions
Q1) A patient states,"I'm starting cognitive behavioral therapy.What can I expect from the sessions?" Which responses by the nurse are appropriate? Select all that apply.
A)"The therapist will be active and questioning."
B)"You may be given homework assignments."
C)"The therapist will ask you to describe your dreams."
D)"The therapist will help you look at ideas and beliefs you have about yourself."
E)"The goal is to increase your subjectivity about thoughts that govern your behavior."
Answer: A,B,D
Q2) A patient underwent psychotherapy weekly for 3 years.The therapist used free association,dream analysis,and facilitated transference to help the patient understand unconscious processes and foster personality changes.Which type of therapy was used?
A)Short-term dynamic psychotherapy
B)Transactional analysis
C)Cognitive therapy
D)Psychoanalysis
Answer: D
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Sample Questions
Q1) A patient has disorganized thinking associated with schizophrenia.Neuroimaging would most likely show dysfunction in which part of the brain?
A)Brainstem
B)Cerebellum
C)Temporal lobe
D)Prefrontal cortex
Q2) A nurse administering psychotropic medications should be prepared to intervene when giving a drug that blocks the attachment of norepinephrine to alpha? receptors because the patient may experience:
A)increased psychotic symptoms
B)severe appetite disturbance
C)orthostatic hypotension
D)hypertensive crisis
Q3) A patient is hospitalized for major depression.Of the medications listed,a nurse can expect to provide the patient with teaching about:
A)chlordiazepoxide (Librium)
B)fluoxetine (Prozac)
C)clozapine (Clozaril)
D)tacrine (Cognex)

6
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Q1) A community psychiatric nurse assesses that a patient 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.
Q2) Which employer's health plan is required to include parity provisions related to mental illnesses?
A)Employer with more than 50 employees
B)Cancer thrift shop staffed by volunteers
C)Daycare center that employs 7 teachers
D)Church that employs 15 people
Q3) 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.
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Sample Questions
Q1) A nurse cares for an older adult patient admitted for the treatment of depression.The health care provider prescribes an antidepressant medication,but the dose is more than the usual adult dose.The nurse should:
A)implement the order.
B)consult a drug reference.
C)give the usual geriatric dosage.
D)hold the medication and consult the health care provider.
Q2) A voluntarily hospitalized patient tells the nurse,"Get me the forms for discharge against medical advice so I can leave now." What is the nurse's best initial response?
A)"I can't give you those forms without your health care provider's knowledge."
B)"I will get them for you,but let's talk about your decision to leave treatment."
C)"Since you signed your consent for treatment,you may leave if you desire."
D)"I'll get the forms for you right now and bring them to your room."
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Sample Questions
Q1) An adolescent asks a nurse conducting an assessment interview,"Why should I tell you anything? You'll just tell my parents whatever you find out." Select the nurse's best reply.
A)"That isn't true.What you tell us is private and held in strict confidence.Your parents have no right to know."
B)"Yes,your parents may find out what you say,but it is important that they know about your problems."
C)"What you say about feelings is private,but some things,like suicidal thinking,must be reported to the treatment team."
D)"It sounds as though you are not really ready to work on your problems and make changes."
Q2) At what point in an assessment interview would a nurse ask,"How does your faith help you in stressful situations?" During the assessment of:
A)childhood growth and development.
B)substance use and abuse.
C)educational background.
D)coping strategies.
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22 Flashcards
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Sample Questions
Q1) The relationship between a nurse and patient as it relates to status and power is best described by which term?
A)Symmetric
B)Complementary
C)Incongruent
D)Paralinguistic
Q2) 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."
Q3) An African-American patient says to a Caucasian nurse,"There's no sense talking.You wouldn't understand because you live in a white world." The nurse's best action would be to:
A)explain,"Yes,I do understand.Everyone goes through the same experiences."
B)say,"Please give an example of something you think I wouldn't understand."
C)reassure the patient that nurses are in contact with people from all cultures.
D)change the subject to one that is less emotionally disturbing.
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Sample Questions
Q1) A nurse wants to enhance the growth of a patient by showing positive regard.The action consistent with this wish is:
A)making rounds daily.
B)staying with a tearful patient.
C)administering daily medication as prescribed.
D)examining personal feelings about a patient.
Q2) A nurse wants to demonstrate genuineness with a patient diagnosed with schizophrenia.The nurse should:
A)restate what the patient says.
B)use congruent communication strategies.
C)use self-revelation in patient interactions.
D)consistently interpret the patient's behaviors.
Q3) As a patient with mental illness is being discharged from a facility,a nurse invites the patient to the annual staff picnic.What is the best analysis of this scenario?
A)The invitation facilitates dependency on the nurse.
B)The nurse's action blurs the boundaries of the therapeutic relationship.
C)The invitation is therapeutic for the patient's diversional activity deficit.
D)The nurse's action assists the patient's integration into community living.
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Sample Questions
Q1) Which scenario best demonstrates an example of eustress? An individual:
A)loses a beloved family pet.
B)prepares to take a 1 week vacation to a tropical island with a group of close friends.
C)receives a bank notice there were insufficient funds in their account for a recent rent payment.
D)receives notification that their current employer is experiencing financial problems and some workers will be terminated.
Q2) Which experiences are most likely to precipitate post-traumatic stress disorder (PTSD)? Select all that apply.
A)A young adult jumps from a bridge with a bungee cord with a best friend.
B)An 8-year-old child watches an R-rated movie with both parents.
C)An adolescent is kidnapped and held for 2 years in the home of a sexual predator.
D)A passenger is in a bus that overturns on a sharp curve in the road,tumbling down an embankment.
E)An adult is trapped for 3 hours at an angle in an elevator after a portion of the supporting cable breaks.
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39 Verified Questions
39 Flashcards
Source URL: https://quizplus.com/quiz/42981
Sample Questions
Q1) A patient performs ritualistic hand washing.What should the nurse do to help the patient develop more effective coping strategies?
A)Allow the patient to set a hand-washing schedule.
B)Encourage the patient to participate in social activities.
C)Encourage the patient to discuss hand-washing routines.
D)Focus on the patient's symptoms rather than on the patient.
Q2) A patient tells the nurse,"I don't go to restaurants because people might laugh at the way I eat or I could spill food and be laughed at." The nurse assesses this behavior as consistent with:
A)Acrophobia
B)Agoraphobia
C)Social phobia
D)Posttraumatic stress disorder
Q3) A student says,"Before taking a test,I feel a heightened sense of awareness and restlessness." The nurse can correctly assess the student's experience as:
A)Culturally influenced
B)Displacement
C)Trait anxiety
D)Mild anxiety

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Q1) A patient with depersonalization disorder tells the nurse,"It's starting again.I feel as though I'm going to float away." The nurse should help the patient by:
A)encouraging meditation.
B)administering an anxiolytic medication.
C)helping the patient visualize a pleasant scene.
D)helping the patient focus on the here and now.
Q2) To assist a patient with a somatic system disorder,a nursing intervention of high priority is to:
A)imply that somatic symptoms are not real.
B)help the patient suppress feelings of anger.
C)shift the focus from somatic symptoms to feelings.
D)investigate each physical symptom as it is offered.
Q3) Which assessment finding best supports dissociative fugue? The patient states:
A)"I cannot recall why I'm living in this town."
B)"I feel as if I'm living in a fuzzy dream state."
C)"I feel like different parts of my body are at war."
D)"I feel very anxious and worried about my problems."
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Sample Questions
Q1) Which commonality would be most applicable to the patient with a personality disorder? The patient:
A)demonstrates behaviors that cause distress to self rather than to others.
B)has self-esteem issues,despite his or her outward presentation.
C)usually becomes psychotic when exposed to stress.
D)does not experience real distress from symptoms.
Q2) The most challenging nursing intervention with patients with personality disorders who use manipulation to get their needs met is:
A)supporting behavioral change.
B)monitoring suicide attempts.
C)maintaining consistent limits.
D)using aversive therapy.
Q3) The history shows that a newly admitted patient has impulsivity.The nurse would expect behavior characterized by:
A)adherence to a strict moral code.
B)manipulative,controlling strategies.
C)postponing gratification to an appropriate time.
D)little time elapsed between thought and action.
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Q1) What behavior by a nurse caring for a patient with an eating disorder indicates the nurse needs supervision?
A)The nurse's comments are nonjudgmental.
B)The nurse uses an authoritarian manner when interacting with the patient.
C)The nurse teaches the patient to recognize signs of increasing anxiety and ways to intervene.
D)The nurse refers the patient to a self-help group for individuals with eating disorders.
Q2) A nursing care plan for a patient with anorexia nervosa includes the intervention "monitor for complications of refeeding." Which system should a nurse closely monitor for dysfunction?
A)Renal
B)Endocrine
C)Central nervous
D)Cardiovascular
Q3) Physical assessment of a patient with bulimia often reveals:
A)prominent parotid glands.
B)peripheral edema.
C)thin,brittle hair.
D)amenorrhea.
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33 Verified Questions
33 Flashcards
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Sample Questions
Q1) A priority intervention for a patient with major depression is:
A)distracting the patient from self-absorption.
B)carefully and unobtrusively observing the patient around the clock.
C)allowing the patient to spend long periods alone in meditation.
D)offering opportunities for the patient to assume a leadership role in the therapeutic milieu.
Q2) A nurse is caring for a patient with low self-esteem.Which nonverbal communication should the nurse anticipate?
A)Arms crossed
B)Staring at the nurse
C)Smiling inappropriately
D)Eyes pointed downward
Q3) Which beverage should the nurse offer to a patient with depression who refuses solid food?
A)Tomato juice
B)Orange juice
C)Hot tea
D)Milk
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Sample Questions
Q1) The cause of bipolar disorder has not been determined,but:
A)several factors,including genetics,are implicated.
B)brain structures were altered by stresses early in life.
C)excess norepinephrine is probably a major factor.
D)excess sensitivity in dopamine receptors may exist.
Q2) Which nursing diagnosis would most likely apply to both a patient with depression and one with acute mania?
A)Deficient diversional activity
B)Disturbed sleep pattern
C)Fluid volume excess
D)Defensive coping
Q3) A patient with acute mania is dancing atop the pool table in the recreation room.The patient waves a cue in one hand and says,"I'll throw the pool balls if anyone comes near me." The nurse's first intervention is to:
A)tell the patient,"You need to be secluded."
B)clear the room of all other patients.
C)help the patient down from the table.
D)assemble a show of force.
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Sample Questions
Q1) A nurse sits with a patient diagnosed with disorganized schizophrenia.The patient starts to laugh uncontrollably,although the nurse has not said anything funny.Select the nurse's best response.
A)"Why are you laughing?"
B)"Please share the joke with me."
C)"I don't think I said anything funny."
D)"You're laughing.Tell me what's happening."
Q2) A patient with delusions of persecution about being poisoned has refused all hospital meals for 3 days.Which intervention is most likely to be acceptable to the patient?
A)Allowing the patient to have supervised access to food vending machines
B)Allowing the patient to telephone a local restaurant to deliver meals
C)Offering to taste each portion on the tray for the patient
D)Providing tube feedings or total parenteral nutrition
Q3) Which patient with schizophrenia would be expected to have the lowest score in global assessment of functioning?
A)39 years old;paranoid ideation since age 35 years
B)32 years old;diagnosed as catatonic at age 24 years;stable for 3 years
C)19 years old;diagnosed with undifferentiated schizophrenia at age 17
D)40 years old;disorganized schizophrenia since age 18;frequent relapses
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Q1) A hospitalized patient with delirium misinterprets reality and a patient with dementia wanders about the home.Which outcome is the priority in both scenarios? Each patient will:
A)remain safe in the present environment.
B)participate actively in self-care.
C)communicate verbally.
D)acknowledge reality.
Q2) An older adult patient takes digoxin and hydrochlorothiazide daily,as well as lorazepam (Ativan)as needed for anxiety.Over 2 days,the patient developed confusion,slurred speech,an unsteady gait,and fluctuating levels of orientation.These findings are most characteristic of:
A)delirium
B)dementia
C)amnestic syndrome
D)Alzheimer's disease
Q3) What is the priority need for a patient with late-stage dementia?
A)Promotion of self-care activities
B)Meaningful verbal communication
C)Maintenance of nutrition and hydration
D)Prevention of the patient from wandering
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Sample Questions
Q1) Which assessment findings support a nurse's suspicion that a patient has been using inhalants?
A)Perforated nasal septum and hypertension
B)Drowsiness,euphoria,and constipation
C)Pinpoint pupils and respiratory rate of 12 breaths per minute
D)Confusion,mouth ulcers,and ataxia
Q2) A woman in the last trimester of pregnancy drinks 8 to 12 ounces of alcohol daily.The nurse plans for the delivery of an infant who is:
A)jaundiced
B)dependent on alcohol
C)healthy but underweight
D)microcephalic and cognitively impaired
Q3) A patient in an alcohol rehabilitation program says,"I have been a loser all my life.I'm so ashamed of what I have put my family through.Now,I'm not even sure I can succeed at staying sober." Which nursing diagnosis applies?
A)Chronic low self-esteem
B)Situational low self-esteem
C)Disturbed personal identity
D)Ineffective health maintenance
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Sample Questions
Q1) Which health care worker should be referred to critical incident stress debriefing?
A)Nurse who works at an oncology clinic where patients receive chemotherapy
B)Case manager whose patients are seriously mentally ill and are being cared for at home
C)Health care employee who worked 8 hours at the information desk of an intensive care unit
D)Emergency medical technician (EMT)who treated victims of a car bombing at a department store
Q2) While conducting the initial interview with a patient in crisis,the nurse should:
A)speak in short,concise sentences.
B)convey a sense of urgency to the patient.
C)be forthright about time limits of the interview.
D)let the patient know the nurse controls the interview.
Q3) 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)Riot at a rock concert
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Sample Questions
Q1) A nurse assists a victim of spousal abuse to create a plan for escape if it becomes necessary.The plan should include which components? Select all that apply.
A)Keep a cell phone fully charged.
B)Hide money with which to buy new clothes.
C)Have the telephone number for the nearest shelter.
D)Take enough toys to amuse the children for 2 days.
E)Secure a supply of current medications for self and children.
F)Determine a code word to signal children that it is time to leave.
G)Assemble birth certificates,Social Security cards,and licenses.
Q2) An adult has recently been absent from work on several occasions.Each time,the adult returns wearing dark glasses.Facial and body bruises are apparent.During the occupational health nurse's interview,the adult says,"My partner beat me,but it was because there are problems at work." What should the nurse's next action be?
A)Call the police.
B)Arrange for hospitalization.
C)Call the adult protective agency.
D)Document injuries with a body map.
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Q1) When working with rape victims,immediate care focuses first on:
A)collecting evidence.
B)notifying law enforcement.
C)helping the victim feel safe.
D)documenting the victim's comments.
Q2) A rape victim asks an emergency department nurse,"Maybe I did something to cause this attack.Was it my fault?" Which response by the nurse is the most therapeutic?
A)Pose questions about the rape,helping the patient explore why it happened.
B)Reassure the victim that the outcome of the situation will be positive.
C)Make decisions for the victim because of the temporary confusion.
D)Support the victim to separate issues of vulnerability from blame.
Q3) A victim of a sexual assault that occurred approximately 1 hour earlier sits in the emergency department rocking back and forth and repeatedly saying,"I can't believe I've been raped." This behavior is characteristic of which phase of the rape trauma syndrome?
A)Acute phase
B)Outward adjustment phase
C)Long-term reorganization phase
D)Anger phase
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Q1) A nurse and patient construct a no-suicide contract.Select the preferable wording.
A)"I will not try to harm myself during the next 24 hours."
B)"I will not make a suicide attempt while I am hospitalized."
C)"For the next 24 hours,I will not kill or harm myself in any way."
D)"I will not kill myself until I call my primary nurse or a member of the staff."
Q2) Which statement by a patient during an assessment interview should alert the nurse to the patient's need for immediate,active intervention?
A)"I am mixed up,but I know I need help."
B)"I have no one to turn to for help or support."
C)"It is worse when you are a person of color."
D)"I tried to get attention before I shot myself."
Q3) Select the most helpful response for a nurse to make when a patient being treated as an outpatient states,"I am considering committing suicide."
A)"I'm glad you shared this.Please do not worry.We will handle it together."
B)"I think you should admit yourself to the hospital to get help."
C)"We need to talk about the good things you have to live for."
D)"Bringing this up is a very positive action on your part."
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Q1) Which medication should a nurse administer to provide immediate intervention for a psychotic patient whose aggressive behavior continues to escalate despite verbal intervention?
A)lithium (Eskalith)
B)trazodone (Desyrel)
C)olanzapine (Zyprexa)
D)valproic acid (Depakene)
Q2) A patient being admitted suddenly pulls a knife from a coat pocket and threatens,"I will kill anyone who tries to get near me." An emergency code is called.The patient is safely disarmed and placed in seclusion.Justification for the use of seclusion is that the patient:
A)evidences a thought disorder,rendering rational discussion ineffective.
B)presents a clear and present danger to others.
C)presents a clear escape risk.
D)is psychotic.
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Q1) After the death of his wife,a man tells the nurse,"I can't live without her.She was my whole life." Which is the nurse's most therapeutic reply?
A)"Each day will get a little better."
B)"Her death is a terrible loss for you."
C)"Remember,she's no longer suffering."
D)"Your friends will help you cope with this."
Q2) After the death of a spouse,an adult repeatedly says,"I should have made him go to the doctor when he said he didn't feel well." This individual is experiencing:
A)preoccupation with the image of the deceased.
B)sensations of somatic distress.
C)anger.
D)guilt.
Q3) A nurse talks with a person whose spouse died while jogging.Which is the appropriate statement for the nurse?
A)"At least your spouse did not suffer."
B)"It's better to go quickly as your spouse did."
C)"The loss of your spouse must be very painful for you."
D)"You'll begin to feel better after you get over the shock."
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Q1) Which assessment finding would cause the nurse to consider an 8-year-old child to be most at risk for the development of a psychiatric disorder?
A)Being raised by a parent with chronic major depression
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) A 5-year-old child moves and talks constantly,is easily distracted,and does not listen to the parents.The child awakens before the parents every morning.The child attended kindergarten,but the teacher could not handle the behavior.What is this child's most likely problem?
A)Mental retardation
B)Oppositional defiant disorder (ODD)
C)Pervasive developmental disorder
D)Attention deficit hyperactivity disorder (ADHD)
Q3) Which child shows behaviors indicative of mental illness?
A)4-year-old who stuttered for 3 weeks after the birth of a sibling
B)9-month-old who does not eat vegetables and likes to be rocked
C)3-month-old who cries after feeding until burped and sucks a thumb
D)3-year-old who is mute,passive toward adults,and twirls while walking
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Questions
Q1) Which nursing action should occur first when preparing to work with a patient who has a problem of sexual functioning?
A)Acquiring knowledge of the patient's sexual roles and preferences
B)Developing an understanding of human sexual responses
C)Assessing the patient's sexual functioning
D)Clarifying the nurse's own personal values
Q2) Which economic factors are most critical to the success of discharge planning for a patient with severe and persistent mental illness? Select all that apply.
A)Access to housing
B)Individual psychotherapy
C)Income to meet basic needs
D)Availability of health insurance
E)Ongoing interdisciplinary evaluation
Q3) 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
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Available Study Resources on Quizplus for this Chatper
31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/42998
Sample Questions
Q1) An older patient drinks a six-pack of beer daily.The patient tells the community health nurse,"I've been having trouble with my arthritis lately,so I take acetaminophen four times a day for pain." What are the nurse's priority interventions? Select all that apply.
A)Inquiring about sleep disturbances caused by mixing alcohol and analgesic medications
B)Determining the safety of the daily acetaminophen dose the patient is ingesting
C)Advising the patient of the harmful effects of alcohol and acetaminophen on the liver
D)Suggesting an increase in the acetaminophen dose because alcohol causes faster excretion
E)Assessing the patient for declining functional status associated with medication-induced dementia
Q2) An advance directive gives valid direction to health care providers when a patient is:
A)aggressive
B)dehydrated
C)unable to verbally communicate
D)unable to make decisions for him- or herself
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