Clinical Psychiatric Nursing
Midterm Exam
Course Introduction
Clinical Psychiatric Nursing focuses on the principles and practices involved in the mental health care of individuals, families, and communities across the lifespan. This course covers the assessment, diagnosis, and management of psychiatric disorders, emphasizing the development of therapeutic communication, crisis intervention, and evidence-based interventions. Students learn to collaborate with interdisciplinary teams and apply ethical and legal frameworks in diverse clinical settings. The course also addresses the promotion of mental health, the reduction of stigma, and the advocacy for patients rights and holistic well-being.
Recommended Textbook
Psychiatric Nursing 7th Edition by Keltner
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36 Chapters
819 Verified Questions
819 Flashcards
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Page 2
Chapter 1: Me, Meds, Milieu
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26 Verified Questions
26 Flashcards
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Sample Questions
Q1) The primary element required to match individual patient needs with appropriate services is proper:
A) planning.
B) evaluation.
C) assessment.
D) implementation.
Answer: C
Q2) What explanation about the unit milieu would be most important for the nurse to give to a newly admitted patient?
A) "Your behavior will be carefully monitored during your hospital stay."
B) "Unit activities will help you cope with immediate needs and stressors."
C) "You will be given enough medication to bring your symptoms under control."
D) "I will be gathering information about you to plan your care and your discharge."
Answer: B
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Chapter 2: Historical Issues
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Sample Questions
Q1) An adult with serious mental illness is being admitted to a community behavioral health inpatient unit. Recognizing current trends in hospitalization, this patient is likely to:
A) comply readily with the prescribed treatment.
B) have a clear understanding of the illness.
C) display aggressive behavior.
D) stabilize within 24 hours.
Answer: C
Q2) Put these services in order from least to most intensive.
A) Day treatment
B) Hospitalization
C) Scheduled visits at a community mental health center
Answer: A, B, C
Q3) Select the most accurate characterization of treatment of the mentally ill prior to the Period of Enlightenment.
A) Large asylums provided custodial care.
B) Care for the mentally ill was more compassionate.
C) Care focused on reducing stress and meeting basic human needs.
D) Patients were banished from communities or displayed for public amusement.
Answer: D
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Page 4
Chapter 3: Legal Issues
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27 Flashcards
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Sample Questions
Q1) An involuntarily admitted inpatient with paranoid schizophrenia repeatedly calls the local mayor. The patient verbally abuses the person who reply the phone as well as the mayor. Select the most appropriate initial nursing intervention.
A) Allow the patient to continue to use the phone.
B) Include the patient in a social skills building group.
C) Suspend the patient's phone privileges temporarily, and document the reason.
D) Ask the patient advocate to review the limits of the patient's rights with the patient.
Answer: C
Q2) An adolescent is hospitalized after a violent physical outburst and tells the nurse, "I'm going to kill my parents, but you can't tell them." Select the nurse's initial response.
A) "You're right. Federal law requires me to keep information private."
B) "Those kinds of threats will make your hospitalization longer."
C) "You really should share this thought with your psychiatrist."
D) "I am required to talk to the treatment team about your threats."
Answer: D
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5
Chapter 4: Psychobiologic Bases of Behavior
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Sample Questions
Q1) An individual is experiencing problems associated with speech and communication. Which cerebral structures are most likely to be involved in this deficit? Select all that apply.
A) Frontal lobe
B) Parietal lobe
C) Occipital lobe
D) Temporal lobe
E) Basal ganglia
Q2) A patient diagnosed with split-brain syndrome has damage to which structure of the brain?
A) Amygdala
B) Hippocampus
C) Pyramidal tract
D) Corpus callosum
Q3) A patient demonstrates visual aphasia. The nurse can project that there is dysfunction in which cerebral lobe?
A) Temporal
B) Parietal
C) Occipital
D) Frontal
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Chapter 5: Cultural Issues
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Sample Questions
Q1) A patient of Cuban descent is hospitalized with depression. Which factor is most applicable to care planning?
A) The nurse should confer with the family's oldest woman, who will serve as the primary decision maker.
B) With the patient's permission, the nurse should consult with family and religious advisors to plan care.
C) The plan of care should incorporate use of meditation and contemplation techniques.
D) Western medical treatment will be readily accepted by the patient.
Q2) A nurse cares for patients who recently immigrated to the United States. The nurse would expect patients from which countries to hold relational worldviews? Select all that apply.
A) Germany
B) Panama
C) Mexico
D) Ghana
E) France
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Chapter 6: Spiritual Issues
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19 Verified Questions
19 Flashcards
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Sample Questions
Q1) A patient says, "I am a Christian." The nurse understands that Christianity includes which groups? Select all that apply.
A) Judaism
B) Mormonism
C) Buddhism
D) Catholicism
E) Greek Orthodox
Q2) A depressed patient expresses feelings of hopelessness, helplessness, and powerlessness. The patient's spiritual distress is related to an inability to:
A) find meaning and hope through choices.
B) develop wisdom in the face of adversity.
C) draw strength from a higher power.
D) live by higher principles.
Q3) Which statement by a mentally ill patient best exemplifies sick religiosity?
A) "Suicide will result in eternal damnation for your soul."
B) "Your illness has nothing to do with insufficient faith."
C) "Questioning God is a common reaction to illness."
D) "Your illness is not related to sin."
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8
Chapter 7: Models for Working with Psychiatric Patients
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25 Flashcards
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Sample Questions
Q1) A patient says, "It's my fault because I always make bad decisions. I should never have taken that job." Using a rational-emotive approach, how would the nurse respond?
A) "What can you do to solve your problems at work?"
B) "You're experiencing a great deal of stress right now. How can you manage it more effectively?"
C) "Can you describe a time in your childhood when your parents blamed you for things you didn't do?"
D) "Consider the words you are using to talk about yourself. Let's try to change those words to more positive ones."
Q2) An individual diagnosed with alcohol dependence will begin motivational enhancement therapy. The nurse will explain this therapy to significant others as a way of:
A) altering the patient's irrational thoughts.
B) enhancing the patient's willingness to change behavior.
C) managing anxiety through satisfying interpersonal interactions.
D) mastering critical developmental tasks not attained earlier in life.
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Chapter 8: Learning to Communicate Professionally
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Sample Questions
Q1) A patient cries as the nurse explores the patient's feelings about the death of a close friend. The patient sobs, "I shouldn't be crying like this. It happened a long time ago." Which responses by the nurse facilitate communication? Select all that apply.
A) "Why do you think you are so upset?"
B) "I can see that you feel sad about this situation."
C) "The loss of your friend is very painful for you."
D) "Crying is a way of expressing the hurt you're experiencing."
E) "Let's talk about something else, since this subject is upsetting you."
Q2) A patient's plan of care includes this nursing diagnosis: Impaired verbal communication related to lack of assertiveness skills. To include the patient in prioritizing this problem, the nurse should say:
A) "Who are the people with whom you are most passive?"
B) "How important is it for you to become more assertive?"
C) "Let's look at how we can address this problem together."
D) "Are you interested in attending the assertiveness class?"
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Chapter 9: Working with an Individual Patient
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Sample Questions
Q1) A patient shouts at a nurse who just entered the room, "You're an incompetent fool. Leave me alone." The nurse's response should be based on which rationale?
A) The anger was created by a situation or significant person, not the nurse.
B) The reaction probably results from transference and countertransference.
C) The patient is probably reacting to fear of loss of emotional control.
D) The patient has a right to openly express negative feelings.
Q2) Complete this goal statement for a newly admitted patient in the orientation stage. "By the end of the orientation stage of the therapeutic relationship, the patient will demonstrate:
A) greater independence."
B) increased self-responsibility."
C) trust and rapport with two staff members."
D) ability to problem-solve one issue."
Q3) When the nurse formulates nursing diagnoses, it is necessary to be specific in describing dysfunctional behaviors so as to:
A) select appropriate desirable behaviors for outcome criteria.
B) analyze how the patient was feeling at the time of assessment.
C) explore the context that precipitated the exacerbation of the illness.
D) determine how the illness relates to the patient's total life experience.
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Page 11
Chapter 10: Working with Groups of Patients
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Sample Questions
Q1) A patient says, "I wish I could express my depressed feelings rather than keeping them inside." The nurse should schedule the patient to attend which type of group?
A) Social skills
B) Special problems
C) Reality orientation
D) Relapse prevention
Q2) Which type of group is a staff nurse with 2 months' psychiatric experience best qualified to conduct?
A) Social skills group
B) Family therapy group
C) Medication education group
D) Insight-oriented psychotherapy group
Q3) After attending a group, which statement by a patient shows evidence of benefits associated with universality?
A) "I've learned to identify my anxious feelings."
B) "The group really gave me the support to change."
C) "I've learned that I can be helpful to others."
D) "My problems are not unique. I'm not alone."
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12
Chapter 11: Working with the Family
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Sample Questions
Q1) Which information is the nurse most likely to find when assessing the family of a patient with a serious and persistent mental illness?
A) The family exhibits many characteristics of dysfunctional families.
B) Several family members have serious problems with their physical health.
C) Power in the family is maintained in the parental dyad and rarely delegated.
D) The stress of living with a mentally ill individual has negatively affected family function.
Q2) A family expresses helplessness related to dealing with a mentally ill member's odd behaviors, mood swings, and argumentativeness. An appropriate nursing intervention for the family would be to:
A) express sympathy.
B) involve local social services.
C) explain symptoms of relapse.
D) role-play problem situations.
Q3) Select the best question to assess a family's ability to cope.
A) "What strengths does your family have?"
B) "Do you think your family copes effectively?"
C) "Describe how you successfully handled one family problem."
D) "How do you think the current family problem should be resolved?"
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Page 13
Chapter 12: Introduction to Psychotropic Drugs
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Sample Questions
Q1) Studies about psychiatric patients' understanding of psychopharmacology suggest that the nursing diagnosis most applicable is:
A) deficient knowledge related to drug therapy.
B) impaired memory related to drug side effects.
C) impaired decision making related to drug dependency.
D) disturbed thought processes related to anticipation of side effects.
Q2) The parent of a teen diagnosed with schizophrenia asks, "Why does schizophrenia usually appear in adolescence?" The nurse's reply would be based on which premise?
A) Stimulation of neurotransmitters is unstable.
B) Neuronal system complexity stabilizes.
C) Dendrite branching becomes complete in adolescence.
D) Amino acid production increases.
Q3) A realistic outcome of patient teaching about psychotropic medication is that the patient will:
A) understand physiologic responses to drug therapy.
B) assess effectiveness of prescribed drugs in controlling symptoms.
C) describe onset, peak, and duration of action of each drug prescribed.
D) state the purpose, dose, and significant side effects of each drug prescribed.
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Chapter 13: Antiparkinsonian Drugs
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) A psychiatric nurse should base care of patients diagnosed with Parkinson's disease and patients demonstrating extrapyramidal side effects (EPSEs) caused by antipsychotic drug therapy on the premise that symptoms:
A) are the same for both problems.
B) result from deficits in dopamine synthesis.
C) result from acetylcholine and dopamine imbalance.
D) are produced by neurodegeneration of the substantia nigra.
Q2) A patient began trihexyphenidyl (Artane) for treatment of drug-induced parkinsonism. Which finding demonstrates a positive response to the medication?
A) Blood pressure returns to patient's normal range.
B) Gait is steady with decreased rigidity.
C) Patient reports fewer feelings of depression.
D) Patient has tremors with voluntary movement.
Q3) Patient teaching for a patient beginning an anticholinergic drug should include:
A) limiting fluid intake to 1000 ml/day.
B) limiting strenuous activity on hot days.
C) eating small, frequent meals to decrease nausea.
D) wearing adequate clothing to prevent hypothermia.
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Page 15
Chapter 14: Antipsychotic Drugs
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28 Verified Questions
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Sample Questions
Q1) Thioridazine (Mellaril) is prescribed for a 72-year-old patient with a psychiatric disorder. It is most critical for the nurse to obtain information about preexisting:
A) cataracts.
B) heart disease.
C) diabetes mellitus.
D) chronic bronchitis.
Q2) Which drug would a nurse expect to produce a favorable response for both positive and negative symptoms?
A) Haloperidol (Haldol)
B) Risperidone (Risperdal)
C) Fluphenazine (Prolixin)
D) Trifluoperazine (Stelazine)
Q3) A nurse cares for four patients diagnosed with schizophrenia who are receiving antipsychotic medication. Which patient will receive the nurse's priority attention? The patient:
A) with diaphoresis and a temperature of 104° F
B) who reports feelings of neck and shoulder stiffness
C) who reports auditory hallucinations of church bells clanging loudly
D) who chants, "I am the messiah, delivered to earth from the heavens above"
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Page 16
Chapter 15: Antidepressant Drugs
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Sample Questions
Q1) A patient prescribed fluoxetine ( Prozac ) is being changed to tranylcypromine ( Parnate ). The nurse schedules a time lapse between the last dose of fluoxetine and the first dose of tranylcypromine of at least:
A) 7 days.
B) 14 days.
C) 3 weeks.
D) 6 weeks.
Q2) The nurse's priority assessment for a patient taking an antidepressant medication is for the presence of:
A) suicidal ideation.
B) antiadrenergic side effects.
C) anticholinergic side effects.
D) symptoms of sexual dysfunction.
Q3) A secondary amine tricyclic antidepressant is prescribed for a patient. The medication will significantly increase the availability of which neurotransmitter?
A) GABA
B) Glutamate
C) Serotonin
D) Norepinephrine
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Page 17
Chapter 16: Antimanic Drugs
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Sample Questions
Q1) A nurse prepares to lead a psychoeducational group for patients who take anticonvulsants to manage bipolar disorder. The nurse should invite patients who take which drugs? Select all that apply.
A) Lithium
B) Aripiprazole (Abilify)
C) Lamotrigine (Lamictal)
D) Gabapentin (Neurontin)
E) Carbamazepine (Tegretol)
Q2) Select the accurate information about the pharmacokinetics of lithium.
A) Wide therapeutic index
B) Excreted by the kidneys
C) Poorly absorbed in the gastrointestinal (GI) tract
D) Provides immediate relief of symptoms
Q3) A patient has mild lithium toxicity with a serum level of 1.6 mEq/L. Which assessment findings are most likely?
A) Coarse hand tremor, coordination problems, and dizziness
B) Elevated white blood cell count, temperature, and blood pressure
C) Orthostatic hypotension, fainting, and nystagmus
D) Restlessness, shuffling gait, and tics
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Page 18
Chapter 17: Antianxiety Drugs
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Sample Questions
Q1) A patient has taken diazepam (Valium) for 1 week for back spasms. The patient complains of "feeling sleepy all the time." The nurse should tell the patient:
A) "The dosage probably needs to be decreased."
B) "Drowsiness indicates a paradoxical reaction to the drug."
C) "Tolerance to the sedative effect of the drug will develop quickly."
D) "Sleepiness is an unavoidable side effect of non-benzodiazepine drugs."
Q2) Lorazepam ( Ativan ) reduces anxiety by:
A) increasing serotonin levels.
B) blocking dopamine receptors.
C) depressing norepinephrine levels.
D) potentiating gamma-aminobutyric acid ( GABA ).
Q3) An emergency room patient was very anxious after a serious car accident. Lorazepam (Ativan) 2 mg intramuscularly was administered. One hour later, which finding indicates to the nurse that the medication was effective?
A) Impaired problem-solving skills
B) Increased alertness and attention
C) Increased verbalization and activity
D) Reduced agitation and environmental scanning
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Chapter 18: Antidementia Drugs
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Sample Questions
Q1) An adult tells the nurse, "I'm taking large doses of vitamin B. I read that it prevents AD, but I don't understand how it works." Which statements would be applicable as the nurse responds to the individual? Select all that apply.
A) "Research has not proven the effectiveness of B vitamins in Alzheimer's prevention."
B) "B vitamins lower the amino acid homocysteine, which is associated with a lower incidence of AD."
C) "A favorable response occurs when these vitamins block NMDA."
D) "B vitamins may reduce risk of AD by lowering cholesterol levels."
E) "B vitamins reduce the body's inflammatory response."
Q2) Most drugs used to treat AD affect:
A) monoamine oxidase reuptake systems.
B) serotonin and norepinephrine production.
C) cholinergic pathways, enzymes, and receptors.
D) the Krebs cycle and GABA neuronal inhibition.
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Chapter 19: Over-the-Counter Drugs
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Sample Questions
Q1) Alternative therapy refers to:
A) any natural therapy without a research basis.
B) evidence-based pharmacologic use of plant products.
C) therapies used in conjunction with Western medicine.
D) therapies not generally accepted by Western medicine.
Q2) Which intervention is an example of a complementary and alternative medicine therapy?
A) Acupuncture
B) Bright-light therapy
C) Electroconvulsive therapy
D) Repetitive transcranial magnetic stimulation
Q3) Select the desired outcome for a patient who uses valerian. The patient will report:
A) a lower stress level.
B) undisturbed sleep throughout the night.
C) an increased interest in recreational activities.
D) awakening without an alarm clock in the morning.
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21
Chapter 20: Introduction to Milieu Management
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Sample Questions
Q1) A nurse plans ways to promote patient safety and security. A proactive approach would include:
A) restricting psychotic patients' rights.
B) enforcing consequences of limit-setting.
C) setting limits when a patient acts out aggressively.
D) clearly communicating expectations for patients' behavior.
Q2) Which statements indicate that a patient understands the unit norms? Select all that apply.
A) "I need quiet time after art therapy today."
B) "I will not yell during the community meeting."
C) "I realize that I need help with my problems."
D) "I will show up on time to take my medication."
E) "I will talk to staff if I get angry instead of punching somebody."
Q3) A psychiatric facility is "accredited by JCAHO." Which asset would be expected?
A) A 4:1 patient-to-staff ratio
B) Private rooms for all patients
C) Use of a therapeutic milieu treatment model
D) Telephones for private patient conversations
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Chapter 21: Variables Affecting the Therapeutic
Environment: Violence and Suicide
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Sample Questions
Q1) Which emotion experienced by a patient should be assessed by the nurse as most predictive of an increased suicide risk?
A) Anger
B) Elation
C) Sadness
D) Hopelessness
Q2) A patient is increasingly tense, pacing the hall and glaring angrily at others. Select the nurse's best comment to this patient.
A) "It looks as though you are feeling upset. Please tell me what's concerning you."
B) "I can see you are on the verge of losing control. What can I do to help you?"
C) "You must maintain control of your feelings even if you are feeling angry."
D) "I'm going to give you an injection of your medication to prevent loss of control."
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Chapter 22: Therapeutic Environment in Various Treatment Settings
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Q1) Which treatment setting would necessitate the most restrictive environment?
A) Partial hospitalization
B) Geropsychiatric unit
C) Forensic hospital
D) Group home
Q2) A patient says, "I'm like a wind-tossed leaf. My goal is to find meaning in life." The nurse should consider referring the patient to which group?
A) Self-help
B) Spirituality
C) Reality orientation
D) Psychoeducational
Q3) A patient asks, "Who will be at the community meeting?" The nurse responds:
A) "Patient representatives and staff"
B) "Members of the mental health team"
C) "All patients and the nurse manager"
D) "All patients, nursing staff, and students"
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24
Chapter 23: Introduction to Psychopathology
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Sample Questions
Q1) Which argument effectively supports the importance of funding services for persons with mental illness in the United States?
A) During any given year 25% of Americans are affected by mental disorders.
B) Increasing toxins in the environment are increasing the incidence of mental illness.
C) The high prevalence of mental illness is directly linked to increasing violence in the media.
D) The incidence of mental illness is increasing because of deterioration of the American family.
Q2) The nurse reads this information in a patient's record: history of agranulocytosis from antipsychotic medication; victim of childhood sexual abuse; weight loss of 27 lb in 3 months; parent diagnosed with bipolar disorder. Which item would be classified as a psychodynamic factor associated with the patient's mental illness?
A) History of agranulocytosis from antipsychotic medication
B) Parent diagnosed with bipolar disorder
C) Weight loss of 27 lb in 3 months
D) Victim of childhood sexual abuse
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Chapter 24: Schizophrenia Spectrum and Other Psychotic Disorders
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Q1) The family of a patient with type I schizophrenia asks, "Did this illness occur because of all the chaos in our family?" Select the nurse's best response.
A) "It is likely that the chaos in your family caused the disorder. It is very important for every family member to keep calm."
B) "Stress in your family may make the disorder more difficult to manage, but it is not the cause."
C) "Too little is known about the cause of this illness for anyone to speculate."
D) "That question would be best solveed by the psychiatrist."
Q2) Genetic evidence regarding twins and the risk for schizophrenia supports which fact?
A) Identical and fraternal twins are equal in concordancy for schizophrenia.
B) Monozygotic twins have a lower concordancy rate for schizophrenia than the general population.
C) Fraternal twins have a higher concordancy rate for schizophrenia than monozygotic twins.
D) Monozygotic twins are significantly more likely than the general population to be concordant for schizophrenia.
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Page 26
Chapter 25: Depressive Disorders
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Sample Questions
Q1) Which entry in the medical record best indicates that the treatment plan for a depressed patient was successful?
A) Gained 2 lb; sleeping 8 hours nightly; states, "I'm feeling better about my life situation"
B) Weight stable; sleeping 6 hours nightly; complains of frequent abdominal pain and headache
C) Gained 6 lb; sleeping 10 hours nightly; sensitive to interpersonal conflicts
D) Lost 2 lb; sleeping 5 hours nightly; shows minimal interest in activities
Q2) The nurse sees a depressed patient who has psychomotor retardation leaving the dining room. The patient's shirt is soiled from spilled food. The nurse should:
A) foster independence by suggesting changing shirts.
B) ignore the spill to avoid embarrassing the patient.
C) assist the patient to change into a clean shirt.
D) notify the patient of the soiled shirt.
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Chapter 26: Bipolar Disorders
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Sample Questions
Q1) A patient is hospitalized with new onset of manic behavior. It would be important for the nurse to inspect and report results of which laboratory tests? Select all that apply.
A) Calcium
B) Creatinine
C) Potassium
D) Drug screens
E) Thyroid function
Q2) During community lunch, a manic patient tells another patient, "Push yourself away from the table. You're too fat for your own good!" How should the nurse intervene?
A) Say to the patient, "You may remain at lunch only if you apologize."
B) Tell the patient, "You must leave lunch and go to your room now."
C) Calmly tell the patient that insulting others is not permitted.
D) Extinguish the behavior by ignoring it.
Q3) A medication teaching plan for a patient receiving lithium should include:
A) directions to eat one or two bananas daily.
B) dietary teaching to limit daily sodium intake.
C) the need to restrict daily fluid intake to 1000 ml.
D) the importance of laboratory testing to monitor the lithium level.
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28
Chapter 27: Anxiety-Related, Obsessive-Compulsive,
Trauma- and Stressor-Related, Somatic, and Dissociative
Disorders
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Q1) A priority focus of milieu management for a patient diagnosed with dissociative identity disorder ( DID ) should be:
A) ensuring safety.
B) stimulating memory return.
C) insight-oriented group therapy.
D) gathering data about family relationships.
Q2) A driver was trapped in a car for several hours after an earthquake caused a bridge to collapse. A year later this person still has nightmares and reexperiences feelings of fear associated with being trapped in the car. The assessment findings are consistent with symptoms of:
A) agoraphobia.
B) panic attacks.
C) generalized anxiety disorder.
D) posttraumatic stress disorder ( PTSD ).
Q3) Which term describes the final stage in the normal process of anxiety?
A) Panic
B) Crisis
C) Disorganization
D) Coping
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Chapter 28: Cognitive Disorders
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Sample Questions
Q1) Which aspects of assessment are most important for a patient with diffuse Lewy body disease who is agitated? Select all that apply.
A) Medications recently administered
B) Objective signs of pain
C) Sleep disturbances
D) Urinary output
E) Heart sounds
Q2) The family of a patient diagnosed with AD is concerned about the patient's occasional urinary incontinence. The nurse should give which suggestion?
A) Use adult diapers.
B) Put a sign on the bathroom door.
C) Limit fluid intake to 1,000 ml daily.
D) Take the patient to the bathroom every 2 hours.
Q3) Donepezil ( Aricept ) reduces symptoms for patients diagnosed with mild to moderate Alzheimer's disease ( AD ) by:
A) enhancing acetylcholine ( Ach ) function.
B) inhibiting serotonin reuptake.
C) anti-oxidizing free radicals.
D) reducing GABA action.
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Chapter 29: Personality Disorders
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Sample Questions
Q1) A patient diagnosed with borderline personality disorder impulsively self-mutilates and has severe mood lability with explosive outbursts, poor interpersonal relations, and inability to sustain employment. Which referrals should the nurse consider for the patient? Select all that apply.
A) Dialectic behavior therapy
B) Alcoholics Anonymous
C) Vocational rehabilitation
D) Desensitization therapy
E) Anger management
Q2) Which behaviors are expected in patients diagnosed with avoidant personality disorders?
A) Social aptitude; risk taking
B) Promiscuity; impulsiveness
C) Shyness; poor self-confidence
D) Attention seeking; helplessness
Q3) Which statement accurately applies to personality disorders?
A) One aspect of personality is usually involved.
B) Personality traits are dysfunctional and inflexible.
C) Patients have subjective distress, but not impaired functioning.
D) Symptoms have a short duration and are responsive to treatment.
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Chapter 30: Sexual Disorders
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Sample Questions
Q1) The clinic nurse sees a patient with a long-standing diagnosis of pedophilia who was recently arrested and released on bail. Which perspective about pedophilia would the nurse expect from this patient?
A) Extreme remorse for traumatizing a child to meet his/her own needs.
B) Desire to be placed in jail to prevent acting on the sexual impulses.
C) The belief that the child was given valuable knowledge and pleasure.
D) A feeling of victimization related to genetic and environmental factors.
Q2) A nurse cares for a patient demonstrating paraphilia. The nurse expects the health care provider may prescribe which type of medication to reduce paraphilic behaviors?
A) Selective serotonin reuptake inhibitor (SSRI)
B) Erectile dysfunction medication
C) Atypical antipsychotic
D) Mood stabilizer
Q3) Contemporary cultural rejection of certain sexual behaviors is determined primarily based on sexual acts:
A) involving coercion rather than consent.
B) associated with homosexual contacts.
C) using artificial devices.
D) resulting in orgasm.
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Page 32
Chapter 31: Substance Abuse Disorders
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Sample Questions
Q1) The nurse assesses a patient who abuses large quantities of amphetamines. Assessment findings are likely to be similar to which psychiatric disorder?
A) Wernicke-Korsakoff syndrome
B) Bipolar disorder, manic phase
C) Generalized anxiety disorder
D) Paranoid schizophrenia
Q2) When caring for patients withdrawing from cocaine and amphetamines, the nurse should plan measures recognizing that:
A) physical withdrawal is severe and often fatal.
B) psychologic withdrawal is more severe than physical.
C) physical and psychologic withdrawal are equally severe.
D) physical withdrawal is a problem only if the individual used injection.
Q3) Which assessment findings would prompt the nurse to suspect a disulfiram (Antabuse) reaction?
A) Skin rash, itching, and urticaria
B) Pallor, hypotension, and muscle cramping
C) Dry skin, bradycardia, fatigue, and headache
D) Headache, dyspnea, nausea, vomiting, and flushing
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33
Chapter 32: Eating Disorders
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Sample Questions
Q1) A nurse assesses a 25-year-old man with a suspected eating disorder. Which comment is most likely from this patient when the nurse asks about the patient's sexuality?
A) "Sometimes I feel attracted to other men."
B) "I'm here because my girlfriend is worried about how much I exercise."
C) "I am sexually active, but I sometimes have trouble maintaining an erection."
D) "I've been involved in a satisfying relationship with my girlfriend for 3 years."
Q2) To meet DSM-V criteria for bulimia nervosa, the patient's history must reveal episodes of binge eating and compensatory behaviors occurring at least:
A) once a week for 6 months.
B) once weekly for 3 months.
C) three times weekly for a year.
D) four times weekly for 6 months.
Q3) School nurses should be particularly vigilant for signs of eating disorders:
A) in fourth-graders.
B) in rebellious, aggressive girls.
C) during summer breaks and around holidays.
D) at transitions between elementary, middle, and high school.
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34
Chapter 33: Survivors of Violence and Trauma
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Sample Questions
Q1) A patient says, "I was raped 2 hours ago." The patient coherently, quietly, and calmly states the facts in a monotone voice. The nurse should assess this behavior as:
A) a delayed reaction to the trauma.
B) indicative of ego integrity.
C) evidence of denial.
D) sublimation.
Q2) Which comment by the nurse would best support relationship building with a victim of partner abuse?
A) "You are feeling violated, because you thought you could trust your partner."
B) "I'm here for you. I want you to tell me about the bad things that happened to you."
C) "I was very worried about you. I knew you were living in a potentially violent situation."
D) "Abusers often target people who are passive. I will refer you to an assertiveness class."
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Chapter 34: Children and Adolescents
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Q1) Which finding necessitates immediate nursing action for a child being treated for depression with a selective serotonin reuptake inhibitor (SSRI)?
A) Oversedation
B) Behavioral activation
C) Anticholinergic effects
D) Extrapyramidal symptoms
Q2) A child diagnosed with ADHD will begin medication therapy. The nurse should prepare a plan to teach the family about which classification of medications?
A) Central nervous system stimulants
B) Tricyclic antidepressants
C) Antipsychotics
D) Anxiolytics
Q3) Which behaviors are indicative of bullying by a child? Select all that apply.
A) Recruits other children to avoid a child who wears glasses
B) Consistently calls another child "fat" and "stupid"
C) Accidentally trips another child, resulting in a fall
D) Repeatedly steals another child's lunch money
E) Plays a practical joke on another child
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Chapter 35: Mental Disorders of Older Adults
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Sample Questions
Q1) Which information is most important to obtain during assessment of an older adult with a mental disorder?
A) Functional ability and emotional status
B) Chronologic age and sexual functioning
C) Economic status and sources of income
D) Developmental history, interests, and activities
Q2) A nurse plans a staff education program for employees of a senior living community. Which topic has priority?
A) Late-onset schizophrenia
B) Depression and suicide
C) Dementia
D) Delirium
Q3) A patient living in community housing for older adults says, "I don't go to the senior citizens club. They play cards and talk about the past, because that's all they can do."
The nurse analyzes that these remarks represent:
A) failure to achieve developmental tasks.
B) thinking associated with ageism.
C) hypercritical behavior.
D) paranoid thinking.
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Page 37
Chapter 36: Soldiers and Veterans
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Sample Questions
Q1) A combat veteran diagnosed with moderate traumatic brain injuries is agitated and aggressive. Which pharmacologic intervention would the nurse expect to be effective?
A) Bupropion (Wellbutrin)
B) Benztropine (Cogentin)
C) Propranolol (Inderal)
D) Buspirone (BuSpar)
Q2) A soldier in a combat zone tells the nurse, "I saw a child get blown up over a year ago, but I keep seeing bits of flesh everywhere. I see something red and the visions race back to my mind." The soldier is describing which phenomenon associated with PTSD?
A) Reexperiencing
B) Hyperarousal
C) Avoidance
D) Psychosis
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