Leadership in Psychiatric Nursing Solved Exam Questions
Course Introduction
Leadership in Psychiatric Nursing explores the essential principles and practices of leadership within mental health care settings, focusing on effective management, advocacy, and interdisciplinary collaboration. The course covers theories of leadership, communication strategies, ethical considerations, and decision-making processes unique to psychiatric nursing. Students analyze real-world scenarios, develop critical thinking and problem-solving skills, and learn to foster supportive environments for both clients and staff. Emphasis is placed on promoting recovery-oriented care, cultural competence, and innovation in policy and practice to improve patient outcomes and advance the role of psychiatric nurse leaders.
Recommended Textbook
Psychiatric Advanced Practice Nursing 1st Edition by Perese
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19 Chapters
203 Verified Questions
203 Flashcards
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Chapter 1: Theoretical Framework of Practice
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11 Verified Questions
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Sample Questions
Q1) In a cantilevered model of needs such as Hansell's model,
A) Basic needs must be met first
B) There is a hierarchy of needs
C) Each need supports all other needs
D) Self-actualization is the last need to be met
Answer: C
Q2) Which attachment pattern is more likely to be found among children who have been abused?
A) Secure
B) Inhibited
C) Disorganized
D) Avoidant
Answer: C
Q3) It is believed that recovery can be promoted in children by all of the following except
A) Teaching problem-solving skills
B) Providing social support
C) Limiting challenging experiences
D) Providing structure to daily life
Answer: C
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Page 3
Brain Functioning, Brain Development and Prenatal and
Perinatal Factors Disrupting Brain Development
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Sample Questions
Q1) This area of the brain is called a system and is made up of the rim of the medial (innermost) portions of the frontal, parietal, and temporal lobes and overlies the brainstem. It is involved with emotions and is referred to as the
A) Ventricular system
B) Limbic system
C) Reticular activating system
D) Blood-brain barrier system
Answer: B
Q2) Which of the lobes of the brain is primarily involved in auditory hallucinations?
A) Occipital lobe
B) Parietal lobe
C) Frontal lobe
D) Temporal lobe
Answer: D
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4
Chapter 3: Postnatal Influences on Development of
Psychopathology
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Sample Questions
Q1) Premature birth disrupts brain development in specific areas. Disruption of brain development in the sensorimotor area is thought to be associated with later development of
A) Cerebral palsy
B) Language impairment
C) Hearing impairment
D) Depression
Answer: A
Q2) In considering fetal exposure to prenatal risk factors, it is known that A) Damage due to maternal stress is greatest during the third trimester.
B) Nutritional deficits can damage the brain as well as the spinal cord.
C) Radiation exposure has no effect on brain development during the first trimester.
D) There are safe periods of time for maternal consumption of alcohol.
Answer: B
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Chapter 4: Communicating, Interviewing and Assessing
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Sample Questions
Q1) In using the communication technique of reflection, the clinician
A) Interprets the difference between a patient's thoughts and his or her behaviors
B) Repeats something that the patient has said to encourage the patient to give more information
C) Provides prompts such as "tell me more"
D) Seeks more information in order to have a more clear understanding
Q2) In a biopsychosocial assessment, which of the following questions might be used to assess the social domain?
A) Did any medical conditions precipitate the psychiatric symptoms?
B) Did the patient have any childhood attentional problems or school phobia?
C) Has the patient ever attempted suicide or harmed himself?
D) Have the symptoms affected the patient's social and work functioning?
Q3) Patients' perceptual difficulties may have an adverse effect on the therapeutic alliance. Which of the following is likely to have the greatest negative effect?
A) The patient perceives the office seating arrangement as belittling.
B) The patient perceives the clinician as being part of her delusional system.
C) The patient perceives the sound in the hall as messages for the patient.
D) The patient perceives the clinician's glancing at his watch as nonvalidating.
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Chapter 5: Case Formulation and Diagnosis, Differential
Diagnoses and Developing a Biopsychosocial Plan of Care
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Sample Questions
Q1) Mechanisms that maintain a problem are biopsychosocial causes or sources of the problem. Psychological causes might include
A) Poverty and social isolation
B) Impaired neural circuitry
C) Impaired ability to regulation emotions
D) Abnormalities of neurotransmission
Q2) In developing a biopsychosocial plan of treatment, focus in the biological domain is on
A) Identification and treatment of comorbid medical illnesses
B) Social skills training and social support enhancement
C) Vocational rehabilitation and supported employment
D) Interpersonal therapy or cognitive behavioral therapy
Q3) In the problem-oriented method of case formulation, the patient's problems are defined as a solvable target of treatment. Which of the following is an example of a problem-oriented case formulation description?
A) "Lack of interpersonal communication skills"
B) "Due to early childhood conflicts"
C) "Due to use of immature defense mechanisms"
D) "Caused by stigma and discrimination"
Page 7
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Chapter 6: Psychopharmacotherapy
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Sample Questions
Q1) A patient with bipolar disorder who has been on lithium for 3 months has a blood lithium level of 0.3 mEq/L when tested. You anticipate
A) Improvement of manic symptoms
B) No improvement of manic symptoms
C) Improvement of depressive symptoms
D) Symptoms of moderate lithium toxicity
Q2) The tricyclic antidepressant class of medications can be characterized by all of the following properties except
A) Long half-life
B) Inexpensive cost
C) Safety in overdose
D) High rate of side effects
Q3) In treating a patient with depression for whom you want to increase norepinephrine, which of the following antidepressants would you choose because it specifically increases levels of norepinephrine?
A) Reboxetine (Vestra)
B) Fluoxetine (Prozac)
C) Phenelzine (Nardil)
D) Venlafaxine (Effexor)
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Chapter 7: Psychotherapies
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Sample Questions
Q1) Brief psychotherapy refers to a category of psychotherapies that brings about changes in patients through
A) Therapist-initiated, focused, emotionally corrective interventions
B) Helping patients to develop an understanding of childhood conflicts
C) Participation of family members in treatment sessions
D) Helping patients to develop insight through self-exploration
Q2) The core principle of relational therapies that include psychodynamic psychotherapy and interpersonal psychotherapy is that current problems reflect
A) Learned behavioral responses
B) Failure to integrate life experiences
C) Problems with relationships with others
D) Distorted perceptions of ability to cope
Q3) Among factors believed to be involved in the development of psychopathology, which of the following factors is most amenable to psychotherapy?
A) Temperament
B) Genetic influenced brain development
C) Adverse circumstances of birth
D) Mastery of psychosocial tasks at different ages
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9
Chapter 8: Psychosocial Interventions
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Sample Questions
Q1) The primary goal of compensatory interventions is to help patients improve coping through the use of all of the following except
A) Brief dynamic therapy
B) Social skills training
C) Stress management
D) Problem-solving therapy
Q2) Research has found that sleep therapy is effective in reducing symptoms of which of the following disorders?
A) Social anxiety disorder (nongeneralized)
B) Agoraphobia
C) Depression
D) Obsessive-compulsive disorder
Q3) It can be said of social rhythms therapy that
A) It is involved in establishing regular patterns of sleep.
B) It has been found to be effective for major depressive disorder but not for bipolar disorder.
C) It is involved in establishing regular patterns of sleeping, eating, exercising, and engaging in other daily activities.
D) It has not been found to be effective as adjunctive treatment in obesity.
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Page 10
Chapter 9: Response to Stressors: Bridging Normal
Responses and Psychiatric Disorders
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Sample Questions
Q1) The response of exposure to stressors
A) Is the same response in all humans
B) Is the same for males and females
C) Is followed by homeostasis
D) Is buffered by the presence of three or more social contacts
Q2) Complicated grief differs from normal grief by the presence of
A) Emotions of anger and regret
B) Persistent longing and yearning for the deceased
C) Physical symptoms of headaches and indigestion
D) Problems with concentration and planning
Q3) The process of allostasis includes
A) Mobilization of energy, activation of cognition, and behavioral changes
B) Reduction of production of cortisol
C) Decreased levels of norepinephrine
D) Development of a state of exhaustion
Q4) In general, the treatment of choice for adjustment disorder is
A) Pharmacotherapy
B) Light therapy
C) Psychotherapy
D) Electroconvulsive therapy
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Chapter 10: Phobias, Generalized Anxiety Disorder, Social Anxiety
Disorder and Panic Disorder
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Sample Questions
Q1) Regarding generalized anxiety disorder (GAD), which of the following is true?
A) GAD is rare in older adults.
B) Comorbidity for major depression and other anxiety disorders is not common.
C) GAD is considered to be a chronic condition.
D) GAD is characterized by seasonal cycles.
Q2) Types of specific phobias include all of the following except
A) Blood, injury, or injection
B) Public speaking
C) Situational phobias-elevators, bridges
D) Environmental phobias-storms, water
Q3) It can be said that in the fear system, the amygdala
A) Serves as a response center for danger and fear
B) Imprints the time and place of an event
C) Evaluates the event in relation to memories of previous experiences
D) Releases hormones that start a cascade of neurohormones and neurotransmitters that prepare the body to respond to a threat
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Chapter 11: Acute Stress Disorder and Posttraumatic Stress Disorder
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Sample Questions
Q1) The brain structure that is involved with encoding the time and place of a trauma is the
A) Amygdala
B) Thalamus
C) Hippocampus
D) Hypothalamus
Q2) The current frontline treatment for acute stress disorder is
A) Mood stabilizer medications
B) Interpersonal psychotherapy
C) Antianxiety medications
D) Trauma-focused cognitive behavioral therapy
Q3) Which mental status variation are you most likely to expect for a client diagnosed as having post-traumatic stress disorder?
A) Thought: delusions of grandeur
B) Perceptual: derealization and depersonalization
C) Memory: impaired recent memory
D) Mood: inappropriate, silly
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Page 13
Chapter 12: Obsessive-Compulsive Disorder and
Obsessive-Compulsive Spectrum Disorders
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Sample Questions
Q1) Nonpharmacological treatment of obsessive-compulsive disorder (OCD) would most likely include which of the following?
A) Electroconvulsive therapy
B) Cognitive behavioral therapy
C) Milieu therapy
D) Dialectical behavioral therapy
Q2) In obsessive-compulsive disorder, patients are likely to experience
A) Obsessions as ego-syntonic
B) Extreme worrying about everyday concerns such as being late
C) Specific worries about the sight of blood
D) Obsessions of symmetry and need to have things just right
Q3) Which of the following tricyclic antidepressants is most effective in the treatment of OCD?
A) Imipramine
B) Amitriptyline
C) Desipramine
D) Clomipramine
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Page 14
Chapter 13: Depressive Disorders
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Sample Questions
Q1) A patient who has been taking venlafaxine (Effexor) for major depressive disorder with melancholic features says that suddenly he can't sleep and spends hours writing to his congressman with his ideas of how to reduce the national debt. The psychiatric advanced practice nurse considers all of the following but selects which one as the most likely explanation for the change in his clinical presentation:
A) Nonadherence with venlafaxine
B) Emergence of symptoms of hypomania
C) Emergence of symptoms of a personality disorder
D) Increasing severity of symptoms of depression
Q2) Compared with unipolar depression, the depressed phase of bipolar disorder
A) Has a later onset
B) Has a more gradual onset
C) Carries a greater risk for suicide
D) Is less frequently accompanied by psychotic symptoms in younger patients
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15
Chapter 14: Bipolar Disorder
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Sample Questions
Q1) The course of bipolar disorder is characterized by
A) Difficulty achieving good vocational functioning
B) Patient adherence to treatment
C) Infrequent recurrences
D) Good interpersonal and social functioning
Q2) In treatment of the acute phase of mania, the focus is on
A) Protecting the patient's biopsychosocial safety
B) Educating the patient about social rhythms theory
C) Interventions that address impairment of vocational functioning
D) Interventions for self-management of finances
Q3) Manic episodes of bipolar disorder are thought be related to
A) Changes in diet
B) Disruption of sleep-wake cycles
C) Female gender
D) Advanced age, over 60 years
Q4) Disruptions of social rhythms
A) Are related to changes of zeitgerbers (time givers)
B) Occur after the onset of bipolar disorder
C) Are related to anticipation
D) Occur rarely in the general population
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Chapter 15: Schizophrenia and Schizoaffective Disorder
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Sample Questions
Q1) When used for treatment of a patient with schizophrenia, typical antipsychotics could be expected to be most effective for which of the following symptoms?
A) Social isolation
B) Ineffective individual coping
C) Hallucinations
D) Lack of ability to make decisions
Q2) A patient who is being evaluated in the emergency room says that she is a mother deity, the earth mother god who is all-powerful. The psychiatric advanced practice nurse states that the patient is
A) Experiencing a delusion
B) Experiencing a hallucination
C) Experiencing impaired impulse control
D) Experiencing an acute stress reaction
Q3) Brain imaging techniques have revealed which one of the following anatomic changes in some people with schizophrenia?
A) Increased blood flow in the prefrontal area
B) Increased ventricular size
C) Increased brain activity in the frontal area
D) Enlargement of the thalamus
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Chapter 16: Delirium and Dementia
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Sample Questions
Q1) Which of the following is known to be a risk for cognitive decline?
A) Being a widow or widower
B) Retirement or relocation
C) Reduced income or increased expenses
D) Loneliness and social isolation
Q2) Regarding alcohol withdrawal delirium or delirium tremens, which of the following is true?
A) Symptoms may include hypersomnia and lack of energy.
B) Symptoms may include agitation and abnormal perceptions.
C) Symptom onset often begins with elevated mood.
D) Symptoms often begin within 12 hours of cessation of drinking.
Q3) The neurotransmitters most widely accepted to be dysregulated in delirium are
A) Norepinephrine and acetylcholine
B) Norepinephrine and serotonin
C) Serotonin and acetylcholine
D) Dopamine and acetylcholine
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Chapter 17: Dual Diagnosis
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Sample Questions
Q1) Symptoms of alcohol withdrawal
A) Are most severe 8 to 10 hours after last drink
B) Are most severe 24 to 28 hours after last drink
C) Include hallucinations among 50% of individuals
D) Are evidenced as delirium tremens 2 weeks after the last drink
Q2) It is known that high levels of alcohol consumption
A) Exacerbate psychiatric symptoms
B) Improve circulation
C) Reduce the risk for developing dementia
D) Reduce the risk of suicide among older adults
Q3) The areas of the brain considered to be most involved in the development of substance abuse are the
A) Brainstem and reticular activating system
B) Thalamus and hypothalamus
C) Ventral tegmental area and nucleus accumbens
D) Cerebellum and olfactory bulb
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Chapter 18: Personality Disorders
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Sample Questions
Q1) Temperament, which is one component of personality,
A) Has a 50% heritability
B) Achieves stability by age 16 years
C) Includes the trait of spirituality
D) Is associated with insight learning
Q2) Conrad, a 26-year-old male, is being treated for cuts after being arrested for breaking the windows in the home of his girlfriend, who has just told him that they are through. He has a history of having been physically abused by his father, setting fires as a child, treatment for substance abuse, and arrest for stealing a car. Which of the following personality disorders might the clinician consider?
A) Narcissistic
B) Paranoid
C) Antisocial
D) Histrionic
Q3) Patients with schizoid personality disorder are likely to
A) Desire relationships but avoid them because of fear of rejection
B) Have perceptual and cognitive distortions
C) Be suspicious, be jealous, and hold a grudge
D) Appear to be cold, aloof, and a loner
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Page 20
Chapter 19: Prevention of Psychiatric Disorders
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Sample Questions
Q1) Evidence suggests that prevention of psychiatric disorders should focus on which of the following stages of life?
A) Middle age (ages 35 to 45 years)
B) Young adulthood (ages 20 to 30 years)
C) Adolescence
D) Early childhood
Q2) Some childhood disorders persist in the same form into adulthood, but some may increase the risk for other psychiatric disorders. Which of the following childhood disorders increases risk for other psychiatric disorders?
A) Anxiety disorder
B) Depression
C) Oppositional-defiant disorder
D) Specific phobias
Q3) Among adults, promoting daily reward experiences that create positive emotions has been found to be associated with
A) Reexperiencing of traumatic memories
B) Reduction of symptoms of depression
C) Improvement of cognition
D) Reduction of sleep disturbances
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Page 21