Nursing Care of Patients with Mental Disorders Exam
Questions
Course Introduction
This course focuses on the principles and practices of nursing care for individuals experiencing mental health challenges across the lifespan. Students will explore the etiology, assessment, diagnosis, and management of common and complex mental disorders, including mood, anxiety, psychotic, and substance use disorders. Emphasis is placed on holistic and evidence-based nursing interventions, therapeutic communication, interdisciplinary collaboration, advocacy, and ethical considerations in mental health care. Through theoretical learning and practical application, students will develop skills to support recovery, promote mental well-being, and address the unique needs of patients and their families within diverse healthcare settings.
Recommended Textbook
Psychiatric Nursing 7th Edition by Keltner
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Chapter 1: Me, Meds, Milieu
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Q1) Which scenarios demonstrate that a nurse is functioning within the scope of psychotherapeutic management? The nurse (select all that apply)
A) structures meaningful unit activities.
B) administers electroconvulsive therapy.
C) encourages a patient to express feelings.
D) interprets the results of psychological testing.
E) assesses a patient for medication side effects.
Answer: A, C, E
Q2) The primary element required to match individual patient needs with appropriate services is proper:
A) planning.
B) evaluation.
C) assessment.
D) implementation.
Answer: C
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Chapter 2: Historical Issues
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Q1) A former pediatric nurse begins working in a clinic housed in a homeless shelter. The nurse asks the clinic director, "What topic should I review to improve my effectiveness as I begin my new job?" Which topic should the clinic director suggest?
A) Care of school-age children
B) Psychiatric and substance abuse assessment
C) Communicable disease prevention strategies
D) Sexually transmitted disease signs and symptoms
Answer: B
Q2) 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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4
Chapter 3: Legal Issues
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Sample Questions
Q1) To reduce the risk of a lawsuit based on false imprisonment, mental health nurses must give the highest priority to which intervention?
A) Educating patients about unit protocols
B) Providing adequate treatment during hospitalization
C) Selecting the least restrictive treatment environment that will be effective
D) Ensuring that patients have probable-cause hearings within 24 hours of admission
Answer: C
Q2) Considering that a state uses the M'Naghten Rule when an individual is on trial for a crime, what would be most important to document for a nurse caring for a patient who will soon be tried on murder charges?
A) The patient's participation in treatment planning
B) The patient's comments about commission of the crime
C) Examples of behaviors that support psychiatric diagnoses
D) The patient's perceptions of the need for hospitalization and treatment
Answer: B
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Chapter 4: Psychobiologic Bases of Behavior
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Sample Questions
Q1) A patient who experiences frequent panic attacks asks the nurse, "Why does this happen to me?" The nurse should explain that the problem might relate to a deficit of which brain chemical?
A) GABA
B) Serotonin
C) Dopamine
D) Glutamate
Q2) Although a patient appears to have recovered from a head injury resulting from an auto accident 3 months ago, the family reports changes in the patient's personality and behavior. The nurse should explain that these changes are probably associated with injury to which structure?
A) Pons
B) Parietal lobe
C) Prefrontal area
D) Caudate nucleus
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Chapter 5: Cultural Issues
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Q1) A Hispanic patient reports symptoms consistent with the cultural phenomena of susto. A physical examination reveals no pathology, and depression is diagnosed. The effectiveness of selective serotonin reuptake inhibitors (SSRIs) may be increased if combined with:
A) care from a traditional healer.
B) acupuncture.
C) skin scraping.
D) moxibustion.
Q2) A clinic patient comes to an appointment carrying a baby. The nurse notes abrasions on the baby's thighs and determines that skin scraping has been used. In an effort to use cultural negotiation, the nurse should:
A) encourage using less pressure during scraping to prevent abrasions and infections.
B) show the parent how to use moxibustion rather than skin scraping.
C) explain that skin scraping does not effectively treat illness.
D) caution that the scraped skin can become infected.
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Chapter 6: Spiritual Issues
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Q1) 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.
Q2) What is the predominant religious tradition in the United States?
A) Christian
B) Buddhist
C) Muslim
D) Jewish
Q3) The patient says, "I know I'm very sick right now, but I trust that God will make me better." Based on this statement, the nurse can assess the patient's spirituality as being based in:
A) theism.
B) humanism.
C) behaviorism.
D) existentialism.
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8
Chapter 7: Models for Working with Psychiatric Patients
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Q1) A student nurse says, "I don't need to interact with my patients. I learn by observing them." The instructor can best interpret the nursing implications of Sullivan's theory to this student by responding:
A) "Nurses cannot be isolated. We must interact to provide patients with opportunities to practice interpersonal skills."
B) "Observing patient interactions can help you formulate priority nursing diagnoses and appropriate interventions."
C) "I wonder how accurate your assessment of the patient's needs can be if you do not interact with the patient."
D) "It is important to note patient behavioral changes because these signify changes in personality."
Q2) A patient diagnosed with lung cancer continues to smoke and says, "I think my cancer is more the result of a bad gene than of smoking." The patient shows the use of which defense mechanism?
A) Denial
B) Compensation
C) Intellectualization
D) Reaction formation
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9
Chapter 8: Learning to Communicate Professionally
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Q1) A patient scheduled to attend various group sessions complains, "I'm really mad about having to attend all those groups. No one else spends all day in a circle in a little room." Select the nurse's best response.
A) "Why are you upset?"
B) "I can hear that you are upset. Let's talk about it."
C) "Just go along with the plan, even if you do not agree."
D) "The groups are carefully planned by staff to benefit patients."
Q2) What is the best analysis of this described nurse-patient interaction?
Patient: I get discouraged when I realize I've been struggling with my problems for over a year.
Nurse: Yes you have, but many people take even longer to resolve their issues. You shouldn't be so hard on yourself.
A) The nurse has responded ineffectively to the patient's concerns.
B) The patient is expressing lack of willingness to collaborate with the nurse.
C) The patient is offering the opportunity for the nurse to revise the plan of care.
D) The nurse is using techniques that are consistent with the evaluation step of the nursing process.
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Chapter 9: Working with an Individual Patient
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Sample Questions
Q1) As the nurse plans care for a newly admitted patient, identification of dysfunctional behaviors will provide the focus for:
A) evaluation.
B) nursing diagnosis.
C) nursing interventions.
D) outcome identification.
Q2) A patient says, "I went out drinking only one time last week. At least I'm trying to change." The nurse responds, "I appreciate your effort, but you agreed to abstain from alcohol completely." The nurse is:
A) using cognitive restructuring.
B) preventing manipulation.
C) showing empathy.
D) using flooding.
Q3) Assessment findings by the multidisciplinary team after a patient-intake interview are used primarily to:
A) confirm ongoing discharge planning.
B) expand and confirm the initial assessment.
C) verify the appropriateness of nursing diagnoses.
D) analyze the patient's feelings about hospitalization.
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Page 11
Chapter 10: Working with Groups of Patients
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Q1) A leader begins the discussion at the first meeting of a new group. Which comment would be most appropriate?
A) "Let's start by establishing some rules for our group."
B) "Let's begin with each person here defining his or her problem."
C) "I want each person to explain why he or she is attending this group."
D) "Talking to family about our group will help us achieve our goals."
Q2) A patient in a support group says, "I'm tired of being sick. Everyone always helps me, but I'll be glad when I can help someone else." This statement reflects:
A) altruism.
B) universality.
C) cohesiveness.
D) corrective recapitulation.
Q3) The nurse asks members of a group for recovering alcoholics how they handle the urge to drink. Which communication technique is the nurse using?
A) Summarizing
B) Presenting reality
C) Encouraging comparison
D) Seeking consensual validation
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Chapter 11: Working with the Family
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Q1) A parent is admitted to a chemical dependency treatment unit. The patient's spouse and adolescent children participate in a family session. What is the most important aspect of family assessment?
A) Spouse's co-dependent behaviors
B) Interactions among family members
C) Patient's reaction to the family's anger
D) Children's responses to the family sessions
Q2) The patient's parent asks the nurse, "Why do you want to do a family assessment? My child is the patient, not the rest of us." Select the nurse's best response.
A) "Family dysfunction might have caused the mental illness."
B) "Family members provide more accurate information than the patient."
C) "Family assessment is part of the protocol for care of all patients with mental illness."
D) "Every family member's perception of events is different and adds to the total picture."
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Chapter 12: Introduction to Psychotropic Drugs
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Sample Questions
Q1) The primary mechanisms of action of certain antidepressants result from neurotransmitter inactivation by enzyme-based metabolism and:
A) electrochemical stimulation.
B) stimulation of natural precursors.
C) extraction of precursors from the bloodstream.
D) reuptake into the presynaptic storage vesicles.
Q2) A nurse administers a highly protein-bound medication. Which patient would have the most immediate and powerful effect from this drug?
A) A healthy adolescent
B) A 76-year-old patient with malnutrition
C) A woman in the second trimester of pregnancy
D) An adult with a fractured femur from a sporting accident
Q3) 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.
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Chapter 13: Antiparkinsonian Drugs
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Sample Questions
Q1) 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.
Q2) 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.
Q3) Which neurotransmitter is most affected by an anticholinergic drug?
A) Acetylcholine
B) Dopamine
C) Serotonin
D) GABA
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Chapter 14: Antipsychotic Drugs
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Sample Questions
Q1) A patient receives a traditional low-potency antipsychotic medication. The nurse should assess closely for:
A) urinary frequency.
B) urinary retention.
C) hypertension.
D) diarrhea.
Q2) During a psychiatric emergency, a patient is given a traditional antipsychotic drug intramuscularly and placed in seclusion. Over the next 2 hours, concerns for safety and physiologic stability require that the patient be carefully monitored for:
A) tardive dyskinesia.
B) gastrointestinal hyperactivity.
C) drug-induced parkinsonian movements.
D) orthostatic hypotension and cardiac arrhythmias.
Q3) Which information should the nurse include in the teaching plan for a patient receiving clozapine (Clozaril)?
A) "Abstain from using tobacco products."
B) "Increase your daily carbohydrate intake."
C) "Notify your health care provider if you start drooling."
D) "You will need monthly electrocardiographic tracings done."
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Page 16
Chapter 15: Antidepressant Drugs
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Q1) Evaluation of a patient's response after 1 week of tricyclic antidepressant therapy would be expected to show:
A) no change in objective or subjective symptoms.
B) increased appetite and weight gain.
C) decreased suicidal ideation.
D) improved mood and affect.
Q2) A TCA is prescribed for a patient newly diagnosed with depression. What information should be included in patient teaching?
A) "Take this medication on an empty stomach."
B) "Do not eat aged cheese while using this medication."
C) "You might experience sweating, tremors, and excessive urination."
D) "It might be 2 weeks or more before you notice the effects of this medicine."
Q3) A 75-year-old patient with a long history of depression begins amitriptyline (Elavil) 100 mg/day. The patient also takes a diuretic daily for hypertension. The highest priority nursing diagnosis is risk for:
A) falls related to dizziness and orthostatic hypotension.
B) ineffective thermoregulation related to anhidrosis.
C) infection related to suppressed white blood cell count.
D) constipation related to slowed peristalsis.
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Page 17
Chapter 16: Antimanic Drugs
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Q1) A patient who is to be discharged on a maintenance dose of lithium should be taught to report which symptoms/signs immediately?
A) Large amounts of dilute urine and blurred vision
B) Nasal congestion and dry mouth
C) Muscle stiffness and anorexia
D) Drowsiness and sweating
Q2) For patients with bipolar disorder, valproate anticonvulsants are likely to help control rapid-cycling episodes by:
A) inhibition of kindling activity in the brain.
B) decreasing availability of norepinephrine.
C) increasing dopamine levels at synapses.
D) decreasing GABA metabolism.
Q3) A nurse should schedule a weekly complete blood cell count ( CBC ) for a patient beginning therapy with which antimanic drug?
A) Lithium
B) Valproate ( Depakote )
C) Quetiapine ( Seroque l)
D) Carbamazepine ( Tegretol )
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Chapter 17: Antianxiety Drugs
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Q1) A patient in the emergency room is suspected to have an overdose of benzodiazepines. Which assessment findings validate this diagnosis? Select all that apply.
A) Blood pressure 180/94 mm Hg
B) Diminished reflexes
C) Hypervigilance
D) Somnolence
E) Confusion
Q2) A patient started diazepam (Valium) 5 mg twice daily 6 months ago. Now, the patient requires 10 mg to achieve the same effect. This phenomenon results from:
A) addiction.
B) tolerance.
C) dependence.
D) disinhibition.
Q3) Lorazepam ( Ativan ) reduces anxiety by:
A) increasing serotonin levels.
B) blocking dopamine receptors.
C) depressing norepinephrine levels.
D) potentiating gamma-aminobutyric acid ( GABA ).
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Page 19
Chapter 18: Antidementia Drugs
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Q1) The family of a patient diagnosed with AD asks the nurse, "How can drugs help our parent?" The reply that provides the most realistic expectations would be:
A) "Unfortunately, drugs are not helpful."
B) "Drugs are available to stop the disease process."
C) "Drugs can help preserve mental abilities for a time."
D) "We will teach you ways of helping your parent adjust."
Q2) An adult says, "I take provastatin (Pravachol) for my high cholesterol. It will prevent stroke and heart attack." Select the nurse's most informative response.
A) "That's correct. I'm glad to see you taking such good care of yourself."
B) "There is limited research-based evidence of the effectiveness of statin medications."
C) "Some research indicates that statin drugs may also interfere with development of AD."
D) "Perhaps you should discuss your family history with your doctor. Statin drugs may cause early development of AD."
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Chapter 19: Over-the-Counter Drugs
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Q1) A patient reports taking melatonin daily. Which aspect of the patient's health and function would be most important for the nurse to assess?
A) Urinary and bowel elimination
B) Energy and activity tolerance
C) Sleep hygiene and patterns
D) Memory and cognition
Q2) 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.
Q3) A neighbor asks a nurse, "Are there any resources that would help me get reliable information about alternative and complementary therapies?" Which resource should the nurse recommend?
A) National Center for Complementary and Alternative Medicine
B) American Psychiatric Association
C) American Medical Association
D) Centers for Disease Control and Prevention
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21
Chapter 20: Introduction to Milieu Management
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Q1) While nurses are engaged in shift change report, one patient becomes loud and aggressive. This patient verbally harasses and frightens another patient. Which element of the therapeutic environment has been jeopardized?
A) Norms
B) Safety
C) Balance
D) Structure
Q2) A newly admitted patient is withdrawn and does not seek out interaction with staff or patients. Nursing interventions should focus on which element of the treatment environment?
A) Norms
B) Safety
C) Structure
D) Limit-setting
Q3) Which element of therapeutic environmental management has the highest priority?
A) Clearly establishing norms and designating limits
B) Scheduling purposeful activities throughout the day
C) Creating an environment of psychologic and physical safety
D) Promoting a balance between patient dependence and independence
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Page 22
Chapter 21: Variables Affecting the Therapeutic
Environment: Violence and Suicide
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Q1) A patient is becoming increasingly tense, pacing the hall, alternately whispering and shouting. Other patients receive hostile, suspicious glares as they walk by. Which phase of the assault cycle is the patient demonstrating?
A) Crisis phase
B) Triggering phase
C) Escalation phase
D) Depression phase
Q2) A novice nurse on an inpatient psychiatric unit says to a colleague, "My newest patient has been diagnosed with schizophrenia. At least I won't have to monitor for a suicide risk." Select the colleague's most accurate response.
A) "Our structured milieu provides a safe environment for all patients, regardless of their suicide risk."
B) "Delusions usually protect a patient with schizophrenia from thinking about suicide."
C) "Suicide is a higher risk for adolescents than for patients with schizophrenia."
D) "Any mental illness substantially increases the risk of suicide."
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23
Chapter 22: Therapeutic Environment in Various Treatment Settings
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Q1) Which therapeutic intervention should the nurse suggest for a patient with panic attacks and problems with concentration?
A) Occupational therapy
B) Medication education
C) Recreational therapy
D) Group therapy
Q2) A nurse working on a geropsychiatric unit designs new clinical protocols. Which potential problems have the highest priority?
A) Risks for falls
B) Cognitive errors
C) Memory deficits
D) Nutritional deficits
Q3) A patient diagnosed with depression has a need for divisional activities. Which team member is best qualified to assess the patient's leisure needs and plan the interventions?
A) Occupational therapist
B) Recreational therapist
C) Exercise physiologist
D) Chaplain
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Chapter 23: Introduction to Psychopathology
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Q1) A patient who has taken antipsychotic medication for a year presents with these signs and symptoms: jaundice, headache, pruritus, and abdominal discomfort. Which finding should be documented as objective data?
A) Pruritus
B) Jaundice
C) Headache
D) Abdominal discomfort
Q2) 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.
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25
Chapter 24: Schizophrenia Spectrum and Other Psychotic Disorders
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Q1) When a patient experiencing a first episode of type I schizophrenia is hospitalized, the nurse can expect to administer:
A) a typical antipsychotic drug.
B) an atypical antipsychotic drug.
C) a mood-stabilizing anticonvulsant.
D) a selective serotonin reuptake inhibitor.
Q2) How long must the symptoms of schizophrenia be present before a diagnosis can be made?
A) At least 6 months
B) At least 1 month
C) More than 1 week
D) On at least three occasions in the past year
Q3) A highly suspicious patient tells the nurse, "When I sit in the dayroom I can see other people whispering about me and laughing. It makes me want to punch them." The direction that the nurse should give staff is:
A) "Gently and frequently touch the patient while conversing."
B) "Stop laughing immediately when the patient enters the room."
C) "Be direct. Do not whisper, laugh, or look sideways at the patient."
D) "Engage the patient in conversation by leaning close to speak softly."
Page 26
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Chapter 25: Depressive Disorders
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Q1) The medical record notes that a newly admitted depressed patient has delusional thoughts. Which statement by this patient is most likely?
A) "I am a presidential advisor."
B) "Cancer is rotting my body."
C) "There are aliens chasing me."
D) "I discovered a cure for cancer."
Q2) Which account of history and symptoms is most consistent with dysthymia?
A) Depressed mood for 2 weeks; anhedonia; feelings of worthlessness
B) Delusions of guilt and poverty; weight loss; agitation beginning 3 weeks ago
C) Depressed mood for 3 months; suicidal ruminations; hypersomnia; sullen affect
D) Depressed for 3 years; poor concentration; anhedonia; low self-esteem; indecision
Q3) A clinic nurse assesses a new Latino patient who repeatedly reports feeling nervous and having headaches. No organic pathology is present. The symptoms began about 3 years ago when the patient's parent died. Select the nurse's best first action.
A) Explore the patient's grief.
B) Encourage the patient to take frequent rest periods.
C) Reassure the patient that these feelings are normal.
D) Screen for additional signs and symptoms of depression.
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Chapter 26: Bipolar Disorders
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Q1) A nurse teaching about bipolar disorder should inform patients and their families of possible depressive symptoms. Which symptoms should the nurse include? Select all that apply.
A) Passivity
B) Aggression
C) Hyperactivity
D) Psychomotor retardation
E) Preoccupation with death
Q2) A nurse assesses a new patient experiencing a manic episode. Which behavior is most likely to have occurred before hospitalization?
A) Watching others closely but avoiding interaction
B) Taking frequent rest periods during the day
C) Going rapidly from one activity to another
D) Remaining in the home for long periods
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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Page 28
Chapter 27: Anxiety-Related, Obsessive-Compulsive,
Trauma- and Stressor-Related, Somatic, and Dissociative
Disorders
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Q1) The effects of stress can be seen by measurement of clinical changes of the body. This statement is a tenet of which theorist?
A) Freud
B) Selye
C) Peplau
D) Sullivan
Q2) Which statement by an individual with PTSD best indicates that treatment was effective?
A) "I'm drinking less now that I've faced my problems."
B) "I feel like the accident happened to someone else."
C) "I sleep for 3 to 4 hours a night without nightmares."
D) "My artwork distracts me and eases my anxiety."
Q3) A patient is demonstrating severe (+3) anxiety. Nursing interventions will center around:
A) encouraging ventilation and refocusing attention.
B) discussing possible sources of anxiety.
C) taking control to guide the patient.
D) decreasing stimuli and pressure.
Page 29
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Chapter 28: Cognitive Disorders
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Q1) A patient diagnosed with delirium stares at the corner of the room, wrings hands, and says, "I'm scared those snakes will bite me." The nurse should document:
A) agnosia.
B) disorientation.
C) confabulation.
D) visual hallucinations.
Q2) 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.
Q3) Which assessment finding would be expected in a patient in the later stages of Huntington's disease?
A) Jerking movements
B) Cogwheel rigidity
C) Withdrawal
D) Irritability
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Chapter 29: Personality Disorders
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Sample Questions
Q1) A patient demonstrating borderline personality disorder says, "When I met him, he was perfect and gave me everything. Now I know how bad he really is. He left me alone tonight to go out with others, so I had to cut myself." Which feature is evident?
A) Splitting
B) Paranoia
C) Grandiosity
D) Submissiveness
Q2) A psychiatric technician says, "I get annoyed with patients who self-mutilate over things other people would ignore. I think they just do it to get attention." Select the nurse's best response.
A) "Many people feel the way you do. If you are unable to come to terms with the issue, we can transfer you."
B) "Self-mutilation is a serious problem. Patients with this personality disorder may complete suicide."
C) "We have to consider each case individually. Some are manipulative, and others are serious."
D) "You seem to be having difficulty empathizing and remaining nonjudgmental."
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Chapter 30: Sexual Disorders
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Sample Questions
Q1) A nurse assesses a patient recently diagnosed with pedophilia. Which findings are most likely? Select all that apply.
A) History of childhood sexual abuse
B) Antisocial personality traits
C) Limbic system abnormalities
D) An endocrine disorder
E) Grandiosity
Q2) While volunteering at a homeless shelter, a nurse observes a known pedophile leaving the restroom with a small child. Select the nurse's priority action.
A) Report the observation to authorities by the child abuse hotline.
B) Protect the child without involving herself/himself with the perpetrator.
C) Notify staff of the homeless shelter to address the situation.
D) Continue to observe the interaction and document findings.
Q3) A patient's medical record documents sexual masochism. This patient derives sexual pleasure:
A) from inanimate objects.
B) by inflicting pain on a partner.
C) when sexually humiliated by a partner.
D) from touching a nonconsenting person.
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Page 32
Chapter 31: Substance Abuse Disorders
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Sample Questions
Q1) A patient with Wernicke-Korsakoff syndrome has the nursing diagnosis impaired memory, related to neurotoxicity of alcohol. Which defining characteristic applies to this diagnosis?
A) Confabulation
B) Hallucinosis
C) Flashbacks
D) Blackouts
Q2) Which assessment findings support a nurse's suspicion that a patient has been using inhalants?
A) Perforated nasal septum and hypertension
B) Drowsiness, euphoria, and constipation
C) Pinpoint pupils and respiratory rate 12 breaths/min
D) Confusion, mouth ulcers, and ataxia
Q3) An individual experiencing a heroin overdose has been given one dose of naloxone (Narcan) intravenously. The priority nursing intervention is:
A) close observation to determine the need for an additional dose of naloxone.
B) seizure precautions for 2 hours immediately after administration of naloxone.
C) acidification of urine by encouraging the patient to drink cranberry juice.
D) a nonstimulating environment and administration of oral fluids.
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Page 33
Chapter 32: Eating Disorders
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Sample Questions
Q1) A patient diagnosed with an eating disorder refuses to be weighed and says, "I just drank a big glass of water." Select the nurse's best response.
A) "Call me after you have emptied your bladder."
B) "This is weight day. Please step on the scale."
C) "I will weigh you tomorrow."
D) "You know the rules."
Q2) A patient diagnosed with an eating disorder asks to be excused from a meal to use the restroom. Select the nurse's best response.
A) "No one is permitted to leave the table during meals."
B) "You may go after you've finished your meal."
C) "I will go with you to the restroom."
D) "No. I know you want to vomit."
Q3) A nurse is engaged in psychoeducational activities with a hospitalized patient diagnosed with bulimia nervosa. The nurse says, "When you feel the need to vomit,
A) do vigorous aerobic exercise until the urge goes away."
B) seek out a staff member to talk about your feelings."
C) call your parents on the phone to show you care."
D) allow yourself to vomit, but avoid purging."
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Chapter 33: Survivors of Violence and Trauma
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Sample Questions
Q1) A survivor of childhood abuse is hospitalized following an episode of wrist cutting. The patient has a history of binge-purge eating disorder as well as difficulty trusting and relating to others. What is the nurse's priority intervention?
A) Set limits on self-harmful behavior.
B) Foster belief in and valuing of family unity.
C) Confront abnormal eating patterns and self-mutilation.
D) Encourage discussion of personal responsibilities associated with abuse.
Q2) Choose the initial desired outcome for a person who was a victim of mind control and torture. The person will:
A) make independent decisions for herself.
B) repress emotions experienced during event.
C) reestablish relationships with support persons.
D) use desensitization strategies to restore equilibrium.
Q3) For a victim of spousal abuse, a deterrent to leaving the abusive situation are the events that occur in which stage?
A) Tension building
B) Honeymoon
C) Processing
D) Battering
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Page 35
Chapter 34: Children and Adolescents
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Q1) A nurse assesses a 3-year-old child diagnosed with autistic disorder. Which finding is most associated with the child's disorder?
A) Toilet training complete
B) Inability to identify colors
C) Failure to develop interpersonal skills
D) Anxiety when separated from a parent
Q2) Which factor presents the most imminent risk for a child to develop a psychiatric disorder?
A) Having an uncle with schizophrenia
B) Living in a middle-income family
C) Being the oldest child in a family
D) Living with an alcoholic parent
Q3) A child being treated for which of the following has a high risk for suicide and should be monitored closely?
A) Depression with fluoxetine ( Prozac )
B) ADHD with methylphenidate ( Ritalin )
C) Bipolar disorder with aripiprazole ( Abilify )
D) Asperger's disorder with social skills training
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Chapter 35: Mental Disorders of Older Adults
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Sample Questions
Q1) A resident in a senior community has lost weight, feels depressed, and has lost interest in former social activities. The nurse asks, "When you last saw your doctor, did you share these problems?" The resident replies, "Yes, but the doctor said I shouldn't expect to feel good every day." Which barrier to mental health care is evident?
A) Legislative failures to provide services for older adults
B) The physician's inadequate mental health assessment
C) The resident's inadequate description of symptoms
D) Economic obstacles to adequate programming
Q2) Reducing aggressive outbursts on a unit for older adults with mental disorders can be best achieved by:
A) liberal use of antipsychotic medication.
B) practicing redirection and diversion.
C) restricting diversional activities.
D) limiting personal space.
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Chapter 36: Soldiers and Veterans
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Sample Questions
Q1) A combat veteran diagnosed with a mild TBI returned to college after discharge from the armed forces. The veteran began tutoring after scoring poorly in three courses. Which strategy can the tutor use to assist the veteran's academic achievement?
A) Decrease extraneous stimuli to improve attention span.
B) Practice deep breathing to increase the brain's oxygen supply.
C) Increase caffeine intake to counteract drowsiness and fatigue.
D) Play background music while studying to improve concentration.
Q2) A combat veteran with TBI, depression, and anxiety begins new prescriptions for sertraline (Zoloft) and lorazepam (Ativan). In recognition of potential long-term repercussions, the nurse should provide teaching related to which topic?
A) Nonpharmacologic strategies for managing anxiety
B) Identifying signs and symptoms of hepatotoxicity
C) Recognizing evidence of tardive dyskinesia
D) Strategies for preventing obesity
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