Mental Health Nursing Final Exam
Course Introduction
Mental Health Nursing focuses on the principles and practices essential for providing effective care to individuals experiencing mental health conditions across the lifespan. The course covers the theoretical foundations of mental health, the assessment and management of psychiatric disorders, therapeutic communication, crisis intervention, and the promotion of mental well-being. Students will explore the roles of mental health nurses as advocates, educators, and caregivers, while emphasizing ethical considerations, cultural competence, interprofessional collaboration, and the importance of evidence-based practice in the holistic care of service users and their families.
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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Page 2
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) It is essential that psychiatric nurses become aware of their ability in the area of positive political action.The nurse can best achieve this goal by:
A) raising donations for a local community health center.
B) becoming involved in an election campaign for a local sheriff.
C) becoming an active volunteer working regularly at a crisis center.
D) working on a city committee to help register local voters.
Answer: D
Q2) The contribution of Linda Richards that remains a part of contemporary psychiatric nursing practice is the idea that:
A) psychiatric nurses should have advanced preparation.
B) nurses should assess both the physical and the emotional needs of patients.
C) psychotic behavior must be controlled before serious psychotherapy begins.
D) basic physical needs must always be met before emotional needs are addressed.
Answer: B
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3
Chapter 2: Therapeutic Nurse-Patient Relationship
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28 Verified Questions
28 Flashcards
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Sample Questions
Q1) A nurse makes observations that a depressed patient is more energetic and is smiling much more.Still,the nurse shares with the unit manager that when thinking about the patient a sense of hopelessness surfaces.The nurse manager replies:
A) "Sometimes it's best to disregard subjective perceptions like that and focus on the objective signs."
B) "Pay attention to your feelings. They can provide valuable clues about the patient's feelings."
C) "You should share your perceptions with the patient and seek an explanation."
D) "Confrontation can be a useful tool in situations like this."
Answer: B
Q2) A novice nurse states,"Psychiatric nursing can't be very difficult.After all,I believe in showing care and in mutual exchange with my friends." The experienced nurse's understanding of the difference between a social and a therapeutic relationship is primarily based on the:
A) kind of information given.
B) amount of emotion invested.
C) degree of satisfaction obtained.
D) type of responsibility involved.
Answer: A
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Page 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 nurse caring for a patient suspects that the patient has a personality disorder in addition to presenting with maladaptive stress response.To confirm this,the nurse would look in the patient's medical record on the DSM-IV-TR Axis:
A) I.
B) II.
C) IV.
D) V.
Answer: B
Q2) A patient became acutely anxious and hysterical in response to the stress of the patient's home being destroyed by fire the previous evening.A nurse assesses the patient's treatment stage as:
A) crisis.
B) acute.
C) maintenance.
D) health promotion.
Answer: A
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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) A nurse is developing a set of practice guidelines for a clinical unit and is conducting a literature review to search for examples of criteria that will be relevant to achieving patient-care goals.The search criteria that will be most relevant are those that:
A) explain their complexity in detail.
B) include reduced costs as a major criterion for use.
C) document preferred practices among other mental health professionals.
D) provide methods and procedures that ensure safe and effective treatment.
Q2) For a theory to be useful in practice,nurses need to validate the theory by:
A) learning the theory.
B) performing research.
C) formulating a theoretical paradigm.
D) informing other clinicians of theoretical frameworks.
Q3) For psychiatric nurses,an essential part of outcome measurement is the:
A) development of practice guidelines.
B) systematic review of research literature.
C) systematic use of reliable patient-rating scales.
D) identification of the core knowledge and skills of psychiatric nurses.
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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) What part of the brain is responsible for regulating pituitary hormones and is known to regulate the body's temperature?
A) Thalamus
B) Cerebellum
C) Limbic system
D) Hypothalamus
Q2) A family member asks a mental health nurse,"I am reading a lot of information about gene therapy in the news lately.Will gene therapy be able to help my spouse,who has schizophrenia?" Which response by the nurse is best?
A) "Gene therapy for schizophrenia is common in Europe but has not yet become popular in the United States."
B) "Gene therapy for schizophrenia is available, but the high cost prohibits most people from taking advantage of it."
C) "Gene therapy is still an experimental field and is not likely to be used to treat mental health disorders in the near future."
D) "Gene therapy has already shown promise in treating schizophrenia, but not enough large-scale studies have been carried out to date."
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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) While being interviewed,a patient expresses the belief that other people can place beliefs in her mind.This statement can be assessed as evidence of:
A) thought insertion.
B) nihilistic delusions.
C) somatic delusions.
D) ideas of reference.
Q2) During a mental status examination,a patient shouts angrily at the nurse,"You are too nosy for your own good!" Then,almost immediately,happily says,"Well,let's let bygones be bygones and be buddies." The nurse assesses this emotional display as:
A) labile affect.
B) hallucinations.
C) magical thinking.
D) ideas of reference.
Q3) Which question would best assess a patient's ability to make judgments?
A) "Who is the president of the USA?"
B) "How long have you been here?"
C) "What is the name of the building we're in?"
D) "If you won $10,000, what would you do with it?"
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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) When conducting an admission interview,a mental health nurse asks a patient a series of questions related to personal beliefs.When the patient asks why these questions are being asked,how should the nurse respond?
A) "These questions are routine and are a mandatory part of the admission process."
B) "The prime reason is that these questions help the staff to identify any specific health care practices that would conflict with your religious beliefs."
C) "Mental health can be affected by personal belief systems, so it is important that your treatment plan be developed to be compatible with your beliefs."
D) "These questions are asked of every patient and are confidential, but if you are not comfortable answering them I will simply note that in your chart."
Q2) 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
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Page 9
Chapter 8: Legal and Ethical Context of Psychiatric Nursing Care
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24 Verified Questions
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Sample Questions
Q1) Two nurses are discussing the rights of hospitalized psychiatric patients.Which of their beliefs requires follow-up by the nurse manager?
A) The hospital is responsible for the patient's safety.
B) If a committed patient is judged to be incompetent, he or she retains the right of habeas corpus.
C) Privileged communication does not apply to hospital charts, so they can be used in court.
D) Disclosure of patient information to law enforcement agencies is permitted without patient consent.
Q2) While making a home visit,a community health nurse sees evidence that the child of a patient has been abused.What rationale should be the basis for the nurse's nursing action?
A) Privileged patient communication prevents the nurse from reporting the abuse.
B) Documenting the evidence in the medical record supports the observation.
C) A federal ruling requires that the nurse report the suspected abuse.
D) A signed patient release is needed before action can be taken.
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Chapter 9: Policy and Advocacy in Mental Health Care
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23 Flashcards
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Sample Questions
Q1) Access to care refers to the:
A) availability of health care.
B) degree to which services are comprehensive.
C) overall use of mental health services in a community.
D) convenience and ease of obtaining service and information.
Q2) 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)
Q3) A patient asks a nurse,"How do managed care systems control costs?" The nurse should reply that the HMO's cost saving strategies include using: (Select all that apply.)
A) utilization reviews.
B) case management.
C) easy repayment plans.
D) preadmission certifications.
E) inexpensive health care plans.
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Chapter 10: Families as Resources, Caregivers, and Collaborators
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23 Verified Questions
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Sample Questions
Q1) Which interview information could indicate the need for further assessment of a potential problem with a patient's family functioning?
A) The patient spends time away from the family, taking both a weekly art and dance class.
B) Every other week, the patient visits aging parents who live 1 hour away.
C) The patient and spouse resolve problems on their own, although it often takes several hours.
D) The patient often grounds the children for misbehavior in an attempt to raise them "the right way."
Q2) To plan and budget for preventive services,a nurse in charge of a community mental health center has reviewed the records to discern how many families received services in the current year.To estimate the need for the coming year,the nurse should:
A) increase the allocation, because most eligible families are underserved.
B) decrease the allocation, because most eligible families are overserved.
C) interview the families currently being supported to determine valid needs.
D) ask for a consultant to ascertain community interest in preventive services.
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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 is working with a patient with depression.To best help the patient translate insight into action,a major nursing challenge will be to:
A) promote self-care activities.
B) consult appropriate resources.
C) build adequate incentives to change.
D) identify ineffective behavior patterns.
Q2) A psychiatric nurse clinician is heard calling nurse educators "the experts" and frequently refers to nurse administrators and researchers as "those who know it all." This nurse can be assessed as having a problem with:
A) ethics.
B) education.
C) collegiality.
D) resource use.
Q3) Which action best demonstrates a nurse displaying accountability?
A) Volunteering to serve on a hospital committee
B) Notifying the nurse manager when a medication error occurs
C) Planning patient care strategies for a newly admitted adult patient
D) Coordinating a patient-centered conference for the health care team
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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) The identification of intervention strategies designed to increase self-efficacy among members of a minority neighborhood group would occur in which phase of the nursing process?
A) Assessment
B) Analysis
C) Planning
D) Implementation
E) Evaluation
Q2) An individual considering a self-help group says to a nurse,"I might go to the bereavement group meeting,but what if I'm required to make changes I don't like?" The nurse's most therapeutic response would be:
A) "Perhaps you're not quite ready to join a group. Give yourself a few more weeks."
B) "These are natural concerns. Trying something new activates all our insecurities."
C) "Most group members will feel just like you do. They will help you hold your own against aggressive group members."
D) "Self-help groups are designed so that each member has sole responsibility for making changes in his or her own life."
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14
Chapter 13: Crisis Intervention
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) While working with a patient in crisis,a nurse attempts to help the patient identify the relationship between the event precipitating the crisis and the patient's subsequent feelings and behaviors.This is an example of:
A) clarification.
B) support of defenses.
C) reinforcement of behavior.
D) raising the patient's self-esteem.
Q2) A teenaged new mother reports she has felt apathetic,fatigued,and helpless since giving birth.She states,"I don't know what's expected of me." The nurse believes the patient will benefit from:
A) crisis intervention.
B) short hospitalization.
C) neuroleptic medication.
D) antidepressant medication.
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Chapter 14: Recovery and Psychiatric Rehabilitation
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23 Verified Questions
23 Flashcards
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Sample Questions
Q1) At a community meeting,a homeowner states,"I don't want mentally ill people in the neighborhood.They're dangerous!" The community mental health nurse should respond:
A) "Former patients need care and concern, not stigmatization."
B) "I sincerely believe your fears and concerns are really unfounded."
C) "The way you act toward former patients will determine how they act toward you."
D) "Our residents are more apt to be withdrawn and timid than aggressive or violent."
Q2) In addition to the psychiatric nurse,which professional would be considered a multidisciplinary rehabilitative treatment team member in a community mental health center? (Select all that apply.)
A) Psychologist
B) Pharmacist
C) Social worker
D) Psychiatrist
E) Employment specialist
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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) If a penny-pinching patient rationalizes personal behavior,a nurse will expect that the patient is most likely to:
A) call other people wasteful.
B) start spending money liberally.
C) claim to exemplify the virtue of thrift.
D) give vast amounts of money to charity on death.
Q2) A patient diagnosed with obsessive-compulsive disorder (OCD) tells a nurse,"I'm such a stupid person for behaving this way." The most therapeutic nursing response would be to:
A) change the subject.
B) agree that the behavior is problematic.
C) ask about the feelings experienced before using the behavior.
D) support the insight by asking for immediate behavioral change.
Q3) Physiological responses associated with anxiety are modulated by the brain through which system?
A) Autonomic nervous
B) Cardiovascular
C) Neuromuscular
D) Endocrine
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Chapter 16: Psychophysiological Responses and Somatoform and Sleep Disorders
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Sample Questions
Q1) Which type of treatment is likely to be effective for a patient diagnosed with body dysmorphic disorder whose nose is the focus of concern?
A) Short-term benzodiazepine use to reduce anxiety
B) Biofeedback to control physical responses to anxiety
C) Antidepressant therapy to increase self-esteem, self-confidence, and outlook
D) Cognitive behavioral therapy to challenge distorted thinking and interrupt self-critical thoughts
Q2) A patient diagnosed with essential hypertension reports feeling pressured by the demands made by family,friends,and an employer.Which role-play situation,as part of a patient education plan for coping with stress,would most likely help the patient develop effective stress-reduction skills?
A) Patient offering to help a friend organize a church group activity
B) Patient saying "no" to a request made by the employer to work overtime
C) Patient accepting a verbal demonstration of caring and concern from spouse
D) Patient asking a work subordinate to be prepared to come to work on time
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Page 18
Chapter 17: Self-Concept Responses and Dissociative Disorders
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Sample Questions
Q1) Which individual is most in need of measures to reduce the risk for self-concept disturbance associated with health-illness transition?
A) A 15-year-old with Crohn disease who states, "An ileostomy will mean I won't be able to do stuff with my friends."
B) An 18-year-old with an above-the-knee double amputation who states, "I guess I'll be a wheelchair athlete instead of a marathon runner."
C) A 30-year-old with blindness caused by glaucoma who states, "My spouse will help me learn Braille."
D) A 52-year-old with breast cancer who states, "My life is more valuable than any body part."
Q2) When working with a patient with self-concept disturbance,which type of communication would initially be most useful?
A) Probing
B) Empathic
C) Confrontational
D) Sympathetic
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Chapter 18: Emotional Responses and Mood Disorders
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Sample Questions
Q1) A patient is extremely hyperactive,distractible,and rarely sleeps.The patient eats little,resulting in a loss of 6 pounds since admission 3 days ago.Which measure is a priority when developing a plan for the patient's care?
A) Require that the patient remain in the dining room for at least 15 minutes per meal.
B) Offer high-calorie "portable" finger foods and nutritionally fortified fluids hourly.
C) Document all food and fluid intake.
D) Weigh the patient daily.
Q2) A patient hospitalized 3 weeks ago with major depressive disorder presented with suicidal ideations but no suicide plan.Sertraline (Zoloft) was prescribed,and the patient now reports that the feelings of depression have somewhat lessened.The guiding factor the nurse considers when planning care is that there is:
A) little risk for injury if the patient has no plan.
B) an increased risk for suicide as the depression lifts.
C) little suicide risk after 3 weeks on an antidepressant.
D) an increase in patient compliance with sertraline (Zoloft).
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Chapter 19: Self-Protective Responses and Suicidal Behavior
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23 Verified Questions
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Sample Questions
Q1) A psychiatric technician states,"This patient has frequently threatened suicide but has never attempted it.The patient should be sent home instead of encouraging the threats." The nurse supports admitting the patient by responding:
A) "There is no family to provide the social support that is vital to safety."
B) "Any suicide threat deserves serious attention and concern for safety."
C) "You seem to have a real problem when patients lose emotional control."
D) "Nursing staff are encouraged to share their concerns with the physician."
Q2) When evaluating the effectiveness of the care provided for a self-destructive patient,the best approach is to:
A) identify maladaptive coping behaviors.
B) involve the patient in the process of evaluation.
C) make sure the staff has followed the original care plan.
D) modify the plan as little as possible to avoid confusing the patient.
Q3) Which remark by a nurse best represents an attempt to assess the patient's current ability to organize and enact a suicide wish?
A) "What is your educational background?"
B) "What plan do you have for committing suicide?"
C) "Have you ever thought about or tried to hurt yourself?"
D) "Are your self-destructive thoughts constant or intermittent?"
Page 21
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Chapter 20: Neurobiological Responses and Schizophrenia and Psychotic Disorders
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Sample Questions
Q1) Which neurological deficits would the nurse be most likely to encounter when assessing a patient diagnosed with schizophrenia?
A) Weakness and loss of function
B) Paralysis and diminished reflexes
C) Droopy eyelids and reddened cornea
D) Increased blinking and impaired fine motor skills
Q2) A nurse observes a patient who is sitting alone in a room muttering,"You don't know what you're talking about! Leave me alone." The nurse attempts to validate whether the patient is:
A) seeking the attention of staff.
B) inappropriately expressing emotion.
C) experiencing auditory hallucinations.
D) displaying negative symptoms of schizophrenia.
Q3) A patient diagnosed with schizophrenia was rehospitalized after a relapse.A priority intervention in designing a discharge plan to prevent relapses will be:
A) helping the patient's family develop tolerance for the cognitive symptoms.
B) mobilizing the family to provide structure to reduce social dysfunction.
C) working on self-concept to reduce avolition, anhedonia, and dysphoria.
D) early identification of signs of impending relapse and coping strategies.
Page 22
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Chapter 21: Social Responses and Personality Disorders
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Sample Questions
Q1) A nurse working with a patient diagnosed with borderline personality disorder will need to consider therapeutic strategies for which likely patient characteristics? (Select all that apply.)
A) Unpredictable mood shifts
B) A strong sense of interdependence
C) Impulsivity that leads to extreme risk taking
D) Tendency to overreact to even minor criticism
E) Hallucinations that may be either visual or auditory
Q2) 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.
Q3) A patient with a personality disorder tells a nurse,"What do you say we cancel the therapy today and watch a good movie?" Which reply by the nurse is most therapeutic?
A) "Don't be manipulative."
B) "This isn't a social occasion."
C) "You'd rather not work on your problems today?"
D) "You know our time together has to be spent problem solving."
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Page 23
Chapter 22: Cognitive Responses and Organic Mental Disorders
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Sample Questions
Q1) A nurse is working with a family with an elderly member who is in the prediagnostic phase of Alzheimer disease.The most important nursing intervention at this time would be to provide:
A) family consultation to facilitate communication.
B) information about support groups and counseling.
C) options directed toward the reduction of caregiver stress.
D) education that helps them understand their situation.
Q2) Family members of a delirious elderly patient are very anxious and express their concerns about placing the patient in a nursing home.What information should serve as a basis for the nurse's reply?
A) Delirium is reversible, and the patient will likely recover.
B) The symptoms are related to depression, which can be treated.
C) Delirium usually progresses to dementia, which is usually permanent.
D) Home care should be attempted; a nursing home should be the last resort.
Q3) 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."
Page 24
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Chapter 23: Chemically Mediated Responses and
Substance-Related Disorders
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Sample Questions
Q1) A patient has been admitted in an acute psychotic state after ingesting PCP.The nurse has not been able to administer the prescribed dose of benzodiazepine because of the patient's aggressive behavior.The most appropriate intervention under these circumstances would be to:
A) provide an alternative activity to channel energy.
B) move the patient to a quiet room to minimize stimulation.
C) perform a lavage to prevent continuing absorption of drug.
D) assign a nurse to stay with the patient to reassure and calm the patient.
Q2) In assessing risks and planning interventions,a nurse should recognize that the longer the half-life of a drug of abuse,the:
A) shorter the withdrawal.
B) less intense the withdrawal symptoms.
C) sooner the patient will begin to crave the drug.
D) shorter the withdrawal and the more intense the symptoms.
Q3) A nurse should specifically assess a patient opiate withdrawal for:
A) lacrimation, rhinorrhea, dilated pupils, and muscle pain.
B) somnolence, constipation, normal pupils, and hypothermia.
C) tremors, hypertension, constricted pupils, and deep sleep.
D) visual and tactile hallucinations, agitation, and generalized seizures.
Page 25
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Chapter 24: Eating Regulation Responses and Eating Disorders
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Q1) Which information would be most important to a nurse assessing a patient's motivation to change behavior associated with maladaptive eating regulation responses?
A) The number, on a scale of 1 to 10, that reflects the patient's desire for treatment
B) The name of a support person the patient identifies for emotional support
C) The disadvantages the patient identifies as resulting from the maladaptive behavior
D) The reasons the patient identifies as the factors that originally caused the maladaptive behavior
Q2) The coping mechanism patients with anorexia nervosa use maladaptively is:
A) denial.
B) projection.
C) introjection.
D) rationalization.
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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Sample Questions
Q1) A patient being treated for cellulitis tells a nurse,"I feel like you and I should get romantic tonight.What do you say to closing the door and crawling into bed with me?" The nurse should respond by saying:
A) "Stop joking around. You've got to be kidding."
B) "Now that you've gotten my attention, tell me what you really need."
C) "Sex is not part of our relationship. Your comment makes me uncomfortable."
D) "I wonder what I did to make you think I would be willing to have sex with you."
Q2) Which classification of drugs has the greatest potential for causing sexual dysfunction?
A) Diuretics
B) Antihypertensives
C) Appetite suppressants
D) Gastrointestinal (GI) antiinflammatory agents
Q3) Which statement made by a patient shows a correct understanding of human sexuality?
A) "Oral intercourse is dangerous."
B) "Sex during menstruation should be avoided."
C) "Advanced age is not by itself a deterrent to sexual function."
D) "Alcohol ingestion enhances sexual pleasure and performance."
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Page 27
Chapter 26: Psychopharmacology
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Sample Questions
Q1) A patient being treated for depression reports experiencing nausea,palpitations,and "a terrible headache." When the physical examination determines the patient is diaphoresic and hypertensive,the nurse should ask:
A) "When did you last take your phenelzine (Nardil)?"
B) "Did you take your amitriptyline (Elavil) on schedule?"
C) "What natural foods have you had in the last 24 hours?"
D) "Have you had any alcohol to drink within the last 24 hours?"
Q2) Which medication would the nurse expect to administer when observing that a patient being treated for schizophrenia is fidgety,demonstrates motor restlessness,and jiggles both legs when asked to sit down?
A) Olanzapine (Zyprexa)
B) Molindone (Moban)
C) Biperiden (Akineton)
D) Thioridazine (Mellaril)
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Chapter 27: Behavior Change and Cognitive Interventions
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Q1) A patient says,"When I lost weight,everyone was so nice to me.Now that I've regained the weight,people don't want anything to do with me.They think I'm just a fat pig." The nurse's initial response should be:
A) "It sounds as if your interpersonal relationships improved when you lost weight and now that you have regained the weight, you feel people don't want to be with you."
B) "Yes, there is a stigma about obesity. People are judged harshly for their weight."
C) "So, if you lose all the weight again do you think your relationships will improve?"
D) "Do you really believe that your friends think that you are a 'fat pig'?"
Q2) Which relaxation technique will a nurse implement for a patient who reports panic attacks that "come over me for no apparent reason" but denies being agoraphobic?
A) Implosion therapy
B) Relaxation technique
C) Interoceptive exposure
D) Progressive muscle relaxation
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Chapter 28: Preventing and Managing Aggressive Behavior
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Q1) Which statement by a nurse new to the unit best reflects an understanding that staff attitudes and actions have a powerful effect on both patient behavior and milieu management?
A) "I understand that there are going to be days where the unit will be short-staffed or really busy. As new members of the team, how can we contribute to keeping the stress level on the unit from escalating?"
B) "What are the administration's expectations of us as new employees related to the management of the milieu in general and of individual patient behavior?"
C) "I'm new, so I will learn best by observing while one of the more experienced staff members manages control over the patients."
D) "How do I best involve the health care providers in the management of the milieu when a patient begins to escalate?"
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Chapter 29: Somatic Therapies
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Q1) A patient who has received three ECT (electroconvulsive therapy) treatments with no ill effects displays confusion and memory loss after the fourth treatment.Which nursing intervention would be most therapeutic based on a nurse's knowledge of ECT effects?
A) Administer a benzodiazepine by IM injection immediately.
B) Call the health care provider and report this sudden alteration immediately.
C) Inform the family that the short-term memory loss may be permanent.
D) Orient the patient periodically, emphasizing that the memory loss is temporary.
Q2) A nurse is discussing ECT (electroconvulsive therapy) treatments with a patient with chronic depression and the patient's parents.Which is the first therapeutic comment appropriate for this situation?
A) "What do you know about ECT treatment?"
B) "ECT treatment is used very successfully in treating your disorder."
C) "The risks most often associated with ECT treatment are both minor and rare."
D) "Do you have any questions about ECT treatment that I can answer for you now?"
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Chapter 30: Complementary and Alternative Therapies
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Q1) Which patient statement is the best indication that a nurse's teaching concerning the use of complementary and alternative medicine (CAM) therapies has been effective?
A) "I don't think these non-traditional treatments can help me at all."
B) "The latest studies show that kava-kava is as effective as some antidepressants."
C) "CAM therapies are often more expensive than traditional medical therapies."
D) "I'm going to discuss adding acupuncture to my depression treatment plan with my health care provider."
Q2) When counseling a patient diagnosed with depression who is prescribed St.John's wort,which information would a nurse include in the patient's education plan?
A) No research-based findings of drug interactions have been reported.
B) The introduction of the herb should be postponed for 24 hours after starting an antidepressant.
C) The herbal tea made with this herb can be taken along with a prescribed antidepressant.
D) Side effects such as dry mouth, photosensitivity, gastrointestinal symptoms, and dizziness can occur.
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Chapter 31: Therapeutic Groups
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Q1) Which documentation by a nurse leader best indicates that the group was demonstrating an appropriate pattern of interaction during the group process?
A) Not all group members chose to communicate equally on the topics discussed.
B) Members removed unused chairs because they felt the chairs were a distraction.
C) Group members shared today while the group was in session.
D) The absence of one member was noted by the group.
Q2) Which question should a nurse pose initially to a patient being considered for inclusion into a therapeutic group that focuses on the management of bipolar disorder?
A) "Do you find it difficult to talk to people about your manic periods?"
B) "Can you share with me what it is you hope to gain from this group?"
C) "Can you tell me how this diagnosis has affected your daily life?"
D) "What is your opinion about joining a therapeutic group?"
Q3) Which is an appropriate nurse-led educational group?
A) Smoking cessation group
B) Parents without partners
C) A medication group
D) Grieving a loss
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Chapter 32: Family Interventions
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Q1) A fundamental component of family therapy is: (Select all that apply.)
A) attendance at all sessions by all family members.
B) agreement on when the therapeutic sessions will terminate.
C) consensus among all parties regarding the amount of needed therapy.
D) understanding related to the target behaviors identified for therapeutic change.
E) willingness on the part of all family members to actively participate in sessions.
Q2) A nurse suspects that an adolescent patient is at risk for psychiatric problems according to the risk and protective factors model.Which information gathered during the intake assessment supports this suspicion?
A) The patient lives with a parent and a half-sibling whom the patient "hates."
B) The patient readily admits to regularly "having a few beers to loosen up."
C) The patient repeatedly says, "I want to play drums for a rock band for a living."
D) The patient's parents are divorced and "both of them date a lot of different people."
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Chapter 33: Hospital-Based Psychiatric Nursing Care
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Q1) When a partial-hospitalization patient is assessed as possibly having suicidal ideations,the treatment plan will focus on:
A) stabilization.
B) institutionalization.
C) symptom remission.
D) diagnostic evaluation.
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) A community mental health center is adjusting to severe budget cuts.Which service is most likely to be considered for elimination?
A) Toll-free suicide prevention telephone hotline services
B) Community education regarding the risk factors of depression
C) Transitional housing for a parent diagnosed with chronic depression
D) Follow-up laboratory testing regarding therapeutic medication levels
Q2) Which patient meets the criteria for psychiatric homebound care? (Select all that apply.)
A) A 68-year-old whose moderate Alzheimer disease (AD) symptoms are progressing
B) A 19-year-old who refuses to leave his room because of paranoid delusions
C) A 45-year-old who is so persistently depressed she rarely gets out of bed
D) A 50-year-old alcoholic who has developed cirrhosis of the liver
E) A 35-year-old who washes his hands 25 to 35 times a day
Q3) 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.
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Page 36
Chapter 35: Child Psychiatric Nursing
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Q1) 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
Q2) When attempting to modify unacceptable behaviors exhibited by an aggressive and self-destructive child,which nursing intervention would be most therapeutic while being the least restrictive?
A) Informing the child that physical restraints will be used to remodel behavior
B) Requiring the child to interact only with staff when unable to behave
C) Encouraging the child to engage in only low-stimulation activities
D) Secluding the patient with a time-out for inappropriate behavior
Q3) When planning immediate care for a child based on a biopsychosocial assessment,the nurse initially addresses any dysfunction in the:
A) biological development of the child.
B) effect of medical illness on the child.
C) social support systems available to the child.
D) child's mastery of specific ego competency skills.
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Page 37
Chapter 36: Adolescent Psychiatric Nursing
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Q1) A father drags his adolescent to the nurse's office at school and says,"I caught him trying to run away from school again." The nurse should initially:
A) ask the child why he feels a need to keep running away.
B) inform the parent that these actions could be considered physical abuse.
C) refer both the adolescent and the parent to the local juvenile justice authorities. D) encourage the parent and child to talk with the nurse about the current problems.
Q2) Which response by an adolescent during the termination of outpatient substance abuse therapy indicates the need to reevaluate the treatment plan? The adolescent:
A) says, "I'm ready to get started, but I'm just a little worried."
B) becomes tearful, and the voice quivers while saying, "goodbye."
C) says, "I never thought I'd be sorry to stop coming here!"
D) writes a note sharing fears of relapsing once independent.
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Chapter 37: Geropsychiatric Nursing
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Q1) An older adult who recently learned that his last surviving sibling has died refuses to take medication and is fearful of allowing anyone other than a specific staff member to assist with bathing and dressing.The patient is exhibiting signs of:
A) paranoia.
B) confusion.
C) depression.
D) disorientation.
Q2) Based on a biological programming framework,which statement about aging is accurate?
A) "So you see, it's a matter of adding free radicals to your system through diet and supplements in order to stop the aging process."
B) "Although DNA programming isn't reversible, a healthy lifestyle and preventive health care can maximize cell function."
C) "Collagen delays aging. By increasing the collagen levels in the body, you improve flexibility and delay aging."
D) "The key is in the immune system, and once we solve the problem by gradually eliminating error cells, we extend youth."
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Chapter 38: Care of Survivors of Abuse and Violence
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Q1) A person currently in an abusive relationship tells a nurse,"My partner is really sorry for hitting me and wants to come back and be part of the family again." The nurse should provide which intervention?
A) Share with the patient that abusers seldom voluntarily stop abusing.
B) Encourage the patient to demand the abuser seek psychiatric help.
C) Advise the patient to focus on minimizing the abuse if the relationship continues.
D) Inform the partner that any physical abuse will certainly be reported to the police.
Q2) 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.
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Chapter 39: The Military and Their Families
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Q1) Which statement made by a female military personnel currently deployed in a war zone provides the best evidence that the soldier is not feeling any unhealthy guilt over being separated from family?
A) "My family back home realizes I miss and love them but leaving them was a part of my job."
B) "When I get back, I will make up for the time I've been away from my family, especially my children."
C) "The guilt I feel for leaving my family is offset by the pride they have for me serving my country like this."
D) "Being away from my children and spouse is too hard to do again; when my enlistment is finished, I'm leaving the military."
Q2) A military veteran is diagnosed with tinnitus.The educational material provided by the nurse related to the condition should include: (Select all that apply.)
A) exposure to repeated loud noises is often the cause of the disorder.
B) the primary characteristic is a persistent ringing in the ears.
C) tinnitus may be either temporary or chronic.
D) the symptoms can be expected to worsen over time.
E) surgery on the eardrum is usually recommended.
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Chapter 40: Psychological Care of Patients with Life-Threatening Illness
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Source URL: https://quizplus.com/quiz/6414
Sample Questions
Q1) A nurse explained hospice services to a patient with metastatic cancer.In evaluating the teaching,the nurse determines the need for further information when the patient states that one of the services provided in hospice care is:
A) experimental chemotherapy.
B) symptom management.
C) psychosocial support.
D) nutritional counseling.
Q2) A patient with liver failure rings the call bell and tells the nurse,"The lunch is cold,and my sheets are wrinkled.You never seem to have enough help to give me the care I need." Which intervention should the nurse implement initially?
A) Listen quietly but attentively until the patient has finished speaking.
B) Attempt to correct each problem the patient has identified immediately.
C) Say to the patient, "I'm sorry but please know that the staff is really doing the best they can."
D) Promise the patient to share all of the concerns with the unit's nurse manager on day shift.
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