Nursing Care of Clients with Mental Health Disorders Exam
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Course Introduction
This course explores the principles and practices involved in providing holistic nursing care for individuals experiencing mental health disorders. Emphasizing the nurse's role in assessment, intervention, advocacy, and education, the course covers common psychiatric conditions, therapeutic communication, crisis intervention, psychopharmacology, and interdisciplinary collaboration. Students will develop an understanding of the biological, psychological, and social factors influencing mental health, recognize the impact of stigma, and apply evidence-based strategies to promote recovery and wellbeing in diverse client populations across the lifespan.
Recommended Textbook Essentials of Psychiatric Mental Health Nursing 3rd Edition by Varcarolis
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28 Chapters
803 Verified Questions
803 Flashcards
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Page 2
Chapter 1: Practicing the Science and Art of Psychiatric Nursing
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) Which patient statements identify qualities of nursing practice with high therapeutic value? (Select all that apply.) "My nurse:
A) talks in language I can understand."
B) helps me keep track of my medications."
C) is willing to go to social activities with me."
D) lets me do whatever I choose without interfering."
E) looks at me as a whole person with different needs."
Answer: A, B, E
Q2) A patient is hospitalized for depression and suicidal ideation after their spouse asks for a divorce. Select the nurse's most caring comment.
A) "Let's discuss some means of coping other than suicide when you have these feelings."
B) "I understand why you're so depressed. When I got divorced, I was devastated too."
C) "You should forget about your marriage and move on with your life."
D) "How did you get so depressed that hospitalization was necessary?"
Answer: A
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Chapter 2: Mental Health and Mental Illness
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17 Flashcards
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Sample Questions
Q1) A patient tells a nurse, "I have psychiatric problems and am in and out of hospitals all the time. Not one of my friends or relatives has these problems." Select the nurse's best response.
A) "Comparing yourself with others has no real advantages."
B) "Why do you blame yourself for having a psychiatric illness?"
C) "Mental illness affects 50% of the adult population in any given year."
D) "It sounds like you are concerned that others don't experience the same challenges as you."
Answer: D
Q2) In the majority culture of the United States, which individual is at greatest risk to be incorrectly labeled mentally ill?
A) Person who is usually pessimistic but strives to meet personal goals
B) Wealthy person who gives $20 bills to needy individuals in the community
C) Person with an optimistic viewpoint about getting his or her own needs met
D) Person who attends a charismatic church and describes hearing God's voice
Answer: D
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Chapter 3: Theories and Therapies
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Sample Questions
Q1) The parent of a child diagnosed with schizophrenia tearfully asks a nurse, "What could I have done differently to prevent this illness?" Select the nurse's most caring response.
A) "Although schizophrenia is caused by impaired family relationships, try not to feel guilty. No one can predict how a child will respond to parental guidance."
B) "Most of the damage is done, but there is still hope. Changing your parenting style can help your child learn to cope more effectively with the environment."
C) "Schizophrenia is a biological illness with similarities to diabetes and heart disease. You are not to blame for your child's illness."
D) "Most mental illnesses result from genetic inheritance. Your genes are more at fault than your parenting."
Answer: C
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Chapter 4: Biological Basis for Understanding
Psychopharmacology
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Sample Questions
Q1) A nurse should assess a patient taking a medication with anticholinergic properties for inhibited function of the:
A) parasympathetic nervous system.
B) sympathetic nervous system.
C) reticular activating system.
D) medulla oblongata.
Q2) An individual is experiencing problems associated with memory. Which cerebral structures are most likely to be involved in this deficit? (Select all that apply.)
A) Prefrontal cortex
B) Occipital lobe
C) Temporal lobe
D) Parietal lobe
E) Basal ganglia
Q3) The therapeutic action of monoamine oxidase inhibitors (MAOIs) blocks neurotransmitter reuptake, causing:
A) increased concentration of neurotransmitters in the synaptic gap.
B) decreased concentration of neurotransmitters in serum.
C) destruction of receptor sites.
D) limbic system stimulation.
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Chapter 5: Settings for Psychiatric Care
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Sample Questions
Q1) A patient tells the nurse at the clinic, "I haven't been taking my antidepressant medication as directed. I leave out the midday dose. I have lunch with friends and don't want them to ask me about the pills." Select the nurse's most appropriate intervention.
A) Investigate the possibility of once-daily dosing of the antidepressant.
B) Suggest to the patient to take the medication when no one is watching.
C) Explain how taking each dose of medication on time relates to health maintenance.
D) Add the following nursing diagnosis to the plan of care: ineffective therapeutic regimen management, related to lack of knowledge.
Q2) The following patients are seen in the emergency department. The psychiatric unit has one bed available. Which patient should the admitting officer recommend for admission to the hospital? The patient who:
A) is experiencing dry mouth and tremor related to side effects of haloperidol (Haldol).
B) is experiencing anxiety and a sad mood after a separation from a spouse of 10 years.
C) self-inflicted a superficial cut on the forearm after a family argument.
D) is a single parent and hears voices saying, "Smother your infant."
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7
Chapter 6: Legal and Ethical Basis for Practice
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Sample Questions
Q1) A patient being treated in an alcohol rehabilitation unit reveals to the nurse, "I feel terrible guilt for sexually abusing my 6-year-old child before I was admitted." Based on state and federal law, the best action for the nurse to take is to:
A) anonymously report the abuse by telephone to the local child abuse hotline.
B) reply, "I'm glad you feel comfortable talking to me about it."
C) respect the nurse-patient relationship of confidentiality.
D) file a written report on the agency letterhead.
Q2) An adolescent hospitalized after a violent physical outburst tells the nurse, "I'm going to kill my father, but you can't tell anyone." Select the nurse's best response.
A) "You're right. Federal law requires me to keep that information private."
B) "Those kinds of thoughts will make your hospitalization longer."
C) "You really should share this thought with your psychiatrist."
D) "I am required to share information with the treatment team."
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8
Chapter
7:
Nursing Process and QSEN: The Foundation for Safe and Effective Care
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Sample Questions
Q1) A patient begins a new program to assist with building social skills. In which part of the plan of care should a nurse record the item "Encourage patient to attend one psychoeducational group daily"?
A) Assessment
B) Analysis
C) Planning
D) Implementation
E) Evaluation
Q2) What information is conveyed by nursing diagnoses? (Select all that apply.)
A) Medical judgments about the disorder
B) Goals and outcomes for the plan of care
C) Unmet patient needs currently present
D) Supporting data that validate the diagnoses
E) Probable causes that will be targets for nursing interventions
Q3) Nursing behaviors associated with the implementation phase of the nursing process are concerned with:
A) participating in the mutual identification of patient outcomes.
B) gathering accurate and sufficient patient-centered data.
C) comparing patient responses and expected outcomes.
Page 9
D) carrying out interventions and coordinating care.
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Chapter 8: Communication Skills: Medium for All Nursing Practice
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Sample Questions
Q1) A patient tells the nurse, "I don't think I will ever get out of here." Select the nurse's most therapeutic response.
A) "Don't talk that way. Of course you will leave here."
B) "Keep up the good work and you certainly will."
C) "You don't think you're making progress?"
D) "Everyone feels that way sometimes."
Q2) A patient discloses several concerns and associated feelings. If the nurse wants to seek clarification, which comment would be appropriate?
A) "What are the common elements here?"
B) "Tell me again about your experiences."
C) "Am I correct in understanding that ?"
D) "Tell me everything from the beginning."
Q3) A patient says to the nurse, "I dreamed I was stoned. When I woke up, I felt emotionally drained, as though I hadn't rested well." Which comment would be appropriate if the nurse seeks clarification?
A) "It sounds as though you were uncomfortable with the content of your dream."
B) "I understand what you're saying. Bad dreams leave me feeling tired, too."
C) "So, all in all, you feel as though you had a rather poor night's sleep?"
D) "Can you give me an example of what you mean by 'stoned'?"
Page 10
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Chapter 9: Therapeutic Relationships and the Clinical
Interview
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Sample Questions
Q1) As a nurse discharges a patient, the patient gives the nurse a card of appreciation made in an arts and crafts group. What is the nurse's best action?
A) Recognize the effectiveness of the relationship and patient's thoughtfulness. Accept the card.
B) Inform the patient that accepting gifts violates the policies of the facility. Decline the card.
C) Acknowledge the patient's transition through the termination phase but decline the card.
D) Accept the card and invite the patient to return to participate in other arts and crafts groups.
Q2) Which descriptors exemplify consistency regarding therapeutic nurse-patient relationships? (Select all that apply.)
A) Having the same nurse care for a patient on a daily basis
B) Encouraging a patient to share initial impressions of staff
C) Providing a schedule of daily activities to a patient
D) Setting a time for regular sessions with a patient
E) Offering solutions to a patient's problems
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Chapter 10: Trauma and Stress-Related Disorders
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Sample Questions
Q1) A soldier returned one year ago from Afghanistan and was diagnosed with posttraumatic stress disorder (PTSD). Which social event would most likely be disturbing for this soldier?
A) Halloween festival with neighborhood children
B) Singing carols around a Christmas tree
C) Family outing to the seashore
D) Fireworks display on July 4th
Q2) A veteran of the war in Afghanistan was diagnosed with posttraumatic stress disorder (PTSD). The veteran says, "If there's a loud noise at night, I get under my bed because I think we're getting bombed." What type of experience has the veteran described?
A) Illusion
B) Flashback
C) Nightmare
D) Auditory hallucination
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Chapter 11: Anxiety, Anxiety Disorders, and
Obsessive-Compulsive and Related Disorders
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39 Verified Questions
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Sample Questions
Q1) A supervisor assigns a worker a new project. The worker initially agrees but feels resentful. The next day, when asked about the project, the worker says, "I've been working on other things." When asked 4 hours later, the worker says, "Someone else was using the copier, so I couldn't finish it." The worker's behavior demonstrates: A) acting out.
B) projection.
C) suppression.
D) passive aggression.
Q2) A patient tells a nurse, "My new friend is the most perfect person one could imagine-kind, considerate, and good looking. I can't find a single flaw." This patient is demonstrating: A) denial.
B) projection.
C) idealization.
D) compensation.
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Chapter 12: Somatic Symptom Disorders and Dissociative Disorders
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Sample Questions
Q1) A college student observes a roommate going out wearing uncharacteristically seductive clothing, returning 12 to 24 hours later, and then sleeping for 8 to 12 hours. At other times, the roommate sits on the floor speaking like a young child. Which health problem should be considered?
A) Functional neurological (conversion) disorder
B) Dissociative identity disorder
C) Dissociative amnesia
D) Derealization disorder
Q2) A patient says, "I feel detached and weird all the time, like I'm looking at life through a cloudy window. Everything seems unreal. These feelings really interfere with my work and study." Which term should the nurse use to document this complaint?
A) Depersonalization
B) Hypochondriasis
C) Dissociation
D) Malingering
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Chapter 13: Personality Disorders
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Sample Questions
Q1) Others describe a worker as very shy and lacking in self-confidence. This worker stays in an office cubicle all day and never comes out for breaks or lunch. Which term best describes this behavior?
A) Avoidant
B) Dependent
C) Histrionic
D) Paranoid
Q2) A patient who has been diagnosed with schizoid personality disorder is newly admitted to the unit. The best initial nursing intervention is to:
A) set firm limits.
B) engage in trust building.
C) involve in milieu and group activities.
D) encourage identification and expression of feelings.
Q3) The history shows that a newly admitted patient has impulsivity. The nurse would expect behavior characterized by:
A) adherence to a strict moral code.
B) manipulative, controlling strategies.
C) postponing gratification to an appropriate time.
D) little time elapsed between thought and action.
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Page 15
Chapter 14: Eating Disorders
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Sample Questions
Q1) A psychiatric clinical nurse specialist uses cognitive therapy techniques with a patient diagnosed with anorexia nervosa. Which statement by the staff nurse supports this type of therapy?
A) "What are your feelings about not eating the food that you prepare?"
B) "You seem to feel much better about yourself when you eat something."
C) "It must be difficult to talk about private matters to someone you just met."
D) "Being thin does not seem to solve your problems. You are thin now but still unhappy."
Q2) When a nurse finds a patient diagnosed with anorexia nervosa vigorously exercising before gaining the agreed-upon weekly weight, the nurse should state:
A) "You and I will have to sit down and discuss this problem."
B) "It bothers me to see you exercising. You'll lose more weight."
C) "Let's discuss the relationship between exercise and weight loss and how that affects your body."
D) "According to our agreement, no exercising is permitted until you have gained a specific amount of weight."
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16
Chapter 15: Mood Disorders: Depression
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Sample Questions
Q1) A patient being treated with paroxetine (Paxil) 50 mg/day orally for major depressive disorder reports to the clinic nurse, "I took a few extra tablets earlier in the day and now I feel bad." Which aspects of the nursing assessment are most critical? (Select all that apply.)
A) Vital signs
B) Urinary frequency
C) Increased suicidal ideation
D) Presence of abdominal pain and diarrhea
E) Hyperactivity or feelings of restlessness
Q2) A patient diagnosed with major depressive disorder begins selective serotonin reuptake inhibitor (SSRI) antidepressant therapy. Priority information given to the patient and family should include a directive to:
A) avoid exposure to bright sunlight.
B) report increased suicidal thoughts.
C) restrict sodium intake to 1 g daily.
D) maintain a tyramine-free diet.
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17
Chapter 16: Bipolar Spectrum Disorders
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Sample Questions
Q1) A health teaching plan for a patient taking lithium should include instructions to:
A) maintain normal salt and fluids in the diet.
B) drink twice the usual daily amount of fluids.
C) double the lithium dose if diarrhea or vomiting occurs.
D) avoid eating aged cheese, processed meats, and red wine.
Q2) Which nursing diagnosis would most likely apply to both a patient diagnosed with major depressive disorder (MDD) as well as one experiencing acute mania?
A) Deficient diversional activity
B) Disturbed sleep pattern
C) Fluid volume excess
D) Defensive coping
Q3) A patient develops mania after discontinuing lithium. New prescriptions are written to resume lithium twice daily and begin olanzapine (Zyprexa). The addition of olanzapine to the medication regimen will:
A) minimize the side effects of lithium.
B) bring hyperactivity under rapid control.
C) enhance the antimanic actions of lithium.
D) provide long-term control of hyperactivity.
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Chapter 17: Schizophrenia Spectrum Disorders and Other
Psychotic Disorders
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Sample Questions
Q1) A patient diagnosed with schizophrenia has catatonia. The patient is stuporous, demonstrates little spontaneous movement, and has waxy flexibility. The patient's activities of daily living are severely compromised. An appropriate outcome is that the patient will:
A) demonstrate increased interest in the environment by the end of week 1.
B) perform self-care activities with coaching by the end of day 3.
C) gradually take the initiative for self-care by the end of week 2.
D) voluntarily accept tube feeding by day 2.
Q2) The family members of a patient newly diagnosed with schizophrenia state that they do not understand what has caused the illness. The nurse's response should be based on which models? (Select all that apply.)
A) Neurobiological
B) Environmental
C) Family theory
D) Genetic
E) Stress
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19
Chapter 18: Neurocognitive Disorders
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Sample Questions
Q1) What is the priority nursing need for a patient diagnosed with late-stage dementia?
A) Promotion of self-care activities
B) Meaningful verbal communication
C) Maintenance of nutrition and hydration
D) Prevention of the patient from wandering
Q2) A patient diagnosed with moderate to severe Alzheimer disease has a dressing and grooming self-care deficit. Designate the appropriate interventions to include in the patient's plan of care. (Select all that apply.)
A) Provide clothing with elastic and hook-and-loop closures.
B) Label clothing with the patient's name and name of the item.
C) Administer antianxiety medication before bathing and dressing.
D) Provide necessary items, and direct the patient to proceed independently.
E) If the patient resists, use distraction and then try again after a short interval.
Q3) Which description best applies to a hallucination? A patient:
A) looks at shadows on a wall and says, "I see scary faces."
B) states, "I feel bugs crawling on my legs and biting me."
C) becomes anxious when the nurse leaves his or her bedside.
D) tries to hit the nurse when vital signs are taken.
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Chapter 19: Substance-Related and Addictive Disorders
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Sample Questions
Q1) A nurse worked at a hospital for several months, resigned, and then took a position at another hospital. In the new position, the nurse often volunteers to be the medication nurse. After several serious medication errors, an investigation reveals that the nurse was diverting patient narcotics for self-use. What early indicator of the nurse's drug use was evident?
A) Accepting responsibility for medication errors.
B) Seeking to be assigned as a medication nurse.
C) Frequent complaints of physical pain.
D) High sociability with peers.
Q2) A patient undergoing alcohol rehabilitation decides to accept disulfiram (Antabuse) therapy to avoid impulsively responding to drinking cues. Which information should be included in the discharge teaching for this patient? (Select all that apply.)
A) Avoid aged cheeses.
B) Read labels of all liquid medications.
C) Wear sunscreen and avoid bright sunlight.
D) Maintain an adequate dietary intake of sodium.
E) Avoid breathing fumes of paints, stains, and stripping compounds.
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21
Chapter 20: Crisis and Mass Disaster
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Sample Questions
Q1) Which scenario is an example of an adventitious crisis?
A) Death of a child from sudden infant death syndrome
B) Being fired from a job because of company downsizing
C) Retirement of a 55-year-old
D) A riot at a rock concert
Q2) An adult comes to the crisis clinic after being terminated from a job of 15 years. The patient says, "I don't know what to do. How can I get another job? Who will pay the bills? How will I feed my family?" Which nursing diagnosis applies?
A) Hopelessness
B) Powerlessness
C) Chronic low self-esteem
D) Disturbed thought processes
Q3) A patient visiting the crisis clinic for the first time asks, "How long will I be coming here?" The nurse's reply should consider that the usual duration of crisis intervention is ____________ weeks.
A) 1 to 2
B) 3 to 4
C) 4 to 6
D) 6 to 12
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Page 22
Chapter 21: Child, Partner, and Elder Violence
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Sample Questions
Q1) After treatment for a detached retina, a victim of intimate partner violence says, "My partner only abuses me when intoxicated. I've considered leaving, but I was brought up to believe you stay together, no matter what happens. I always get an apology, and I can tell my partner feels bad after hitting me." Which nursing diagnosis applies?
A) Social isolation, related to lack of community support system
B) Risk for injury, related to partner's physical abuse when intoxicated
C) Deficient knowledge, related to resources for escape from the abusive relationship
D) Disabled family coping, related to uneven distribution of power within a relationship
Q2) Which referral is most appropriate for a woman who is severely beaten by her husband, has no relatives or friends in the community, is afraid to return home, and has limited financial resources?
A) Support group
B) Law enforcement
C) Women's shelter
D) Vocational counseling
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Chapter 22: Sexual Violence
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Q1) Which activities are in the scope of practice of a sexual assault nurse examiner? (Select all that apply.)
A) Requiring HIV testing of a victim
B) Collecting and preserving evidence
C) Providing long-term counseling for rape victims
D) Obtaining signed consents for photographs and examinations
E) Providing pregnancy and sexually transmitted disease prophylaxis
Q2) After assessing a victim of sexual assault, which terms could the nurse use in the documentation? (Select all that apply.)
A) Alleged
B) Reported
C) Penetration
D) Intercourse
E) Refused
F) Declined
Q3) When working with rape victims, immediate care focuses first on:
A) collecting evidence.
B) notifying law enforcement.
C) helping the victim feel safe.
D) documenting the victim's comments.
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Chapter 23: Suicidal Thoughts and Behavior
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Sample Questions
Q1) A tearful, anxious patient at the outpatient clinic reports, "I should be dead." The initial task of the nurse conducting the assessment interview is to:
A) assess the lethality of a suicide plan.
B) encourage expression of anger.
C) establish a rapport with the patient.
D) determine risk factors for suicide.
Q2) A depressed patient says, "Nothing matters anymore." What is the most appropriate response by the nurse?
A) "Are you having thoughts of suicide?"
B) "I am not sure I understand what you are trying to say."
C) "Try to stay hopeful. Things have a way of working out."
D) "Tell me more about what interested you before you began feeling depressed."
Q3) Which statement by a patient during an assessment interview should alert the nurse to the patient's need for immediate, active intervention?
A) "I am mixed up, but I know I need help."
B) "I have no one for help or support."
C) "It is worse when you are a person of color."
D) "I tried to get attention before I shot myself."
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Chapter 24: Anger, Aggression, and Violence
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Q1) What information from a patient's record indicates compromised coping skills and the need for careful assessment of the risk for violence? A history of:
A) childhood trauma.
B) family involvement.
C) academic problems.
D) daily substance abuse.
Q2) Because an intervention is required to control a patient's aggressive behavior, a critical incident debriefing takes place. Which topics should be the focus of the discussion? (Select all that apply.)
A) Patient behavior associated with the incident
B) Genetic factors associated with aggression
C) Intervention techniques used by staff
D) Effect of environmental factors
E) Review of theories of aggression
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Chapter 25: Care for the Dying and Those Who Grieve
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Q1) A patient's fiancé died in an automobile accident several days ago. The patient reports crying and experiencing feelings of guilt and anger. This behavior is characteristic of which aspect of grief?
A) Denial
B) Reorganization
C) Development of awareness
D) Preoccupation with the loss
Q2) A woman whose husband is terminally ill says, "I don't want to cry in front of him. I don't want him to know how soon death will occur or how sad I am." Which response by the nurse would be most therapeutic?
A) "I'm glad you are protecting him at a time when he is so vulnerable."
B) "He might be more comforted than disturbed by your tears."
C) "It's important for you to know that time is running out."
D) "You definitely need to be honest about your feelings."
Q3) The mourning process is more difficult when the bereaved:
A) was relatively independent of the deceased.
B) has experienced many previous losses.
C) accepts that death is expected for everyone.
D) had resolved conflicts with the deceased.
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Page 27
Chapter 26: Children and Adolescents
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Sample Questions
Q1) A 5-year-old child diagnosed with attention deficit hyperactivity disorder (ADHD) bounces out of a chair in the waiting room, runs across the room, and begins to slap another child. What is the nurse's best action?
A) Call for emergency assistance from another staff member.
B) Instruct the parents to take the child home immediately.
C) Direct this child to stop, and then comfort the other child.
D) Take the child into another room with toys to act out feelings.
Q2) A nurse will prepare teaching materials regarding which medication for the parents of a child diagnosed with enuresis?
A) Haloperidol (Haldol)
B) Desmopressin (DDAVP)
C) Methylphenidate (Ritalin)
D) Carbamazepine (Tegretol)
Q3) When group therapy is to be used as a treatment modality, the nurse should suggest placing a 9-year-old in a group that uses:
A) play activities exclusively.
B) group discussion exclusively.
C) talk focused on a specific issue.
D) play and then talk about the play activity.
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Page 28
Chapter 27: Adults
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Q1) The father of a child diagnosed with schizophrenia says, "I lost my job, so we have no health insurance." The mother says, "I must watch this child all the time. Without supervision, our child becomes violent and destructive." A sibling says, "My parents don't pay attention to me." These comments signify:
A) life-cycle stressors.
B) psychobiologic issues.
C) family burden of mental illness.
D) stigma associated with mental illness.
Q2) Before working with patients regarding sexual concerns, a prerequisite for providing nonjudgmental care is:
A) sympathy.
B) assertiveness training.
C) sexual self-awareness.
D) effective communication.
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Chapter 28: Older Adults
Available Study Resources on Quizplus for this Chatper
31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/2074
Sample Questions
Q1) A 74-year-old patient is regressed and apathetic. This patient responds to others only when they initiate the interaction. Which therapy would be most useful to promote resocialization?
A) Medication
B) Re-motivation
C) Group psychotherapy
D) Individual psychotherapy
Q2) Which beliefs facilitate provision of safe, effective care for older adult patients? (Select all that apply.)
A) Sexual interest declines with aging.
B) Older adults are able to learn new tasks.
C) Aging results in a decline in restorative sleep.
D) Older adults are prone to become crime victims.
E) Older adults are usually lonely and socially isolated.
Q3) Which statement about aging provides the best rationale for focused assessment of older adult patients?
A) Older adults are often socially isolated and lonely.
B) As people age, they become more rigid in their thinking.
C) The majority of older adults sleep more than 12 hours per day.
D) The senses of vision, hearing, touch, taste, and smell decline with age.
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