Psychiatric Nursing
Final Test Solutions
Course Introduction
Psychiatric Nursing is a specialized field of nursing that focuses on the care and treatment of individuals with mental health disorders. This course provides students with the theoretical foundation and practical skills necessary to assess, plan, implement, and evaluate nursing care for patients experiencing psychological, emotional, and behavioral challenges. Topics include therapeutic communication, psychiatric assessment, crisis intervention, psychopharmacology, and evidence-based nursing interventions for various mental health conditions. Emphasis is placed on fostering a compassionate, ethical, and culturally sensitive approach while working within interdisciplinary mental health teams to support patient recovery and well-being.
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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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) In the 1960s,the psychiatric nurse began to shift to primary prevention and psychiatric nursing practice began to focus more on community care.This focus was initiated by which act?
A) The Primary Prevention Act of 1960
B) The Deinstitutionalization Act of 1961
C) The Therapeutic Community Act of 1962
D) The Community Mental Health Centers Act of 1963
Answer: D
Q2) A nurse states,"I plan ways for patients assigned to me to participate in their own care and to be actively involved in all of the activities on the unit." This approach demonstrates the concept of:
A) social accountability.
B) therapeutic community.
C) nurse-patient relationship.
D) multidisciplinary mental health team.
Answer: B
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Chapter 2: Therapeutic Nurse-Patient Relationship
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28 Verified Questions
28 Flashcards
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Sample Questions
Q1) A teenager being treated for oppositional defiance behavior states: "I wish my parents would stop treating me like an irresponsible child." The nurse implements confrontation as a therapeutic technique when responding:
A) "How can they treat you like an adult when you are only a teenager?"
B) "You want to be treated like an adult, but is it adult-like when you skip school?"
C) "Your parents have a legal responsibility to care for you until you are eighteen."
D) "Your parents are worried about giving you more freedom than you can handle."
Answer: B
Q2) A nurse tells the unit supervisor,"I'm having a difficult time empathizing with my patient especially since he is so unwilling to change.Talking with him makes me feel both frustrated and depressed." The supervisor may suspect that the cause of the barrier in this nurse-client relation is the:
A) existence of countertransference on the part of the nurse.
B) patient's demonstration of resistance to the prescribed plan of care.
C) violation of a therapeutic boundary by either the nurse or the patient.
D) nurse's ineffective use of therapeutic verbal communication techniques.
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 would look at DSM-IV-TR Axis III to obtain information about the patient's:
A) clinical syndromes.
B) general medical conditions.
C) global assessment of functioning.
D) psychosocial and environmental problems.
Answer: B
Q2) Which criterion of mental health is a nurse assessing when exploring a patient's sense of self-determination,balance between dependence and independence,and acceptance of the consequences of behavior?
A) Autonomy
B) Integration
C) Reality perception
D) Environmental mastery
Answer: A
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Page 5
Chapter 4: Evidence-Based Psychiatric Nursing Practice
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22 Verified Questions
22 Flashcards
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Sample Questions
Q1) 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.
Q2) The categories of outcome indicators include:
A) process and reliability.
B) clinical and functional.
C) process and evaluation.
D) measurement and evaluation.
Q3) Several nursing colleagues have formulated a task force to identify a process to set up clinical pathways for patient care of those who are severely depressed.The initial step is to:
A) identify the nursing skills used while depressed patients are hospitalized.
B) review patient records to identify why most depressed patients are admitted.
C) identify the number of depressed patients who are admitted more than once within a calendar year.
D) review for efficiency and necessity of the interventions that are implemented during admission and aftercare for the depressed patient.
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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) Which part of the brain is responsible for fine motor coordination?
A) Medulla
B) Thalamus
C) Cerebellum
D) Temporal lobe
Q2) A patient tells a nurse,"My doctor thinks my problem is serious but it can be treated with medications.Does that mean I'll always have to be treated with drugs?" The nurse replies:
A) "How would you feel about being on medications for a lifetime?"
B) "What concerns do you have about having a serious mental disorder?"
C) "Did your doctor suggest your problem was related to neurotransmitter problems?"
D) "What do you know about this condition that the doctor is preparing to treat with medications?"
Q3) The function of the limbic system is to:
A) regulate emotional behavior.
B) perform abstract reasoning.
C) facilitate critical decision making.
D) coordinate stress-related responses.
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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) Generally,a nurse can expect the motor activity of a patient with profound depression and the motor activity of a patient with mania to:
A) be similar.
B) show many tics and grimaces.
C) be at opposite ends of the continuum.
D) show unusual bizarre gestures or posturing.
Q2) A patient visiting from Puerto Rico has become psychotic while staying with family here in the United States.When conducting the mental status examination,the nurse remembers that:
A) sociocultural factors may greatly affect the examination.
B) liking the patient as a person is important to the outcome.
C) an interpreter may help facilitate the verbal portion of the examination.
D) biological expressions of psychiatric illness are not relevant to someone from another culture.
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?"
Page 8
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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) Which statement will be most important for planning future community mental health services?
A) The population over age 65 years will continue to increase.
B) Many more people will move out of rural and into urban areas.
C) The U.S. population will increase drastically by the year 2050.
D) The U.S. population will become more diverse with regard to race and ethnicity.
Q2) A student nurse asks an instructor,"Since most of the patients on the unit are female,does that mean that women experience more mental illness than men?" The instructor replies:
A) "That's a very astute observation. You're right."
B) "The prevalence is relatively the same for men and women."
C) "As a matter of fact, mental illness is more prevalent among men."
D) "I'm sure that you will be able to find that information in your textbook."
Q3) A nurse working with individuals from ethnic minority groups recognizes which as a factor that affects mental health care?
A) They often delay seeking help until problems become intense or chronic.
B) They characteristically do not engage in early termination from care.
C) They tend to dislike using community support systems.
D) They tend to avoid using family support systems.
Page 9
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Chapter 8: Legal and Ethical Context of Psychiatric Nursing Care
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) An individual is advised to seek psychiatric hospitalization and agrees to receive treatment and abide by hospital rules.What type of admission is this?
A) Legal
B) Informal
C) Voluntary
D) Involuntary
Q2) What is the new staff nurse's immediate duty when a patient discloses a plan to kill a family member upon release from the hospital?
A) Discuss the statement with the patient's mental health team but otherwise keep the information confidential.
B) Immediately contact the family member and provide a verbal warning concerning his or her physical safety.
C) Inform the patient that the local police department will be called and that oral and written reports will be filed.
D) Document the information in the patient's medical record, and notify the nursing supervisor of the statement.
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Chapter 9: Policy and Advocacy in Mental Health Care
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23 Verified Questions
23 Flashcards
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Sample Questions
Q1) A psychiatric nurse advocating for behavioral health system change would focus on which topic?
A) Abolishing the health maintenance organization (HMO) system
B) Strengthening current utilization review guidelines
C) Limiting consumer empowerment initiative options
D) Increasing resources for chronic care mental health services
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 nurse works in an organization that provides an integrated behavioral continuum of care.The goal of treatment in the crisis clinic is:
A) remission.
B) recovery.
C) stabilization.
D) optimal level of wellness.
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Chapter 10: Families as Resources, Caregivers, and Collaborators
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23 Verified Questions
23 Flashcards
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Sample Questions
Q1) When providing education for families of mentally ill patients,the nurse realizes that which of the following organizations places the most importance on this intervention?
A) The Managed Care Association
B) National Alliance on Mental Illness
C) American Psychiatric Nurses Association
D) New Freedom Commission on Mental Health
Q2) A psychiatric nurse working within a competence paradigm would emphasize which of the following when working with a patient with an anxiety disorder?
A) Use of natural family support networks
B) Prevention of negative patient outcomes
C) The view of anxiety disorder as a disease
D) Treatment of dysfunctional characteristics
Q3) A nurse has established a helping relationship with the family of a mentally ill patient.This relationship should focus on:
A) the patient and the patient's needs.
B) family attending educational sessions.
C) family concerns with burden and grief.
D) helping the family members meet their own needs.
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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) Nursing interventions that have the greatest validity are those that:
A) are used by nurse clinicians.
B) are prescribed by physicians.
C) have been investigated by nurse researchers.
D) are based on evidence of the efficacy of the intended treatment.
Q2) The goal of the nursing care plan is to answer which question regarding the achievement of patient wellness? (Select all that apply.)
A) Why
B) When
C) How
D) Where
E) Who
Q3) When the cost of a patient's prescribed medication is discussed,the interdisciplinary team is engaging in patient-focused: (Select all that apply.)
A) discharge.
B) participation.
C) collaboration.
D) advocacy.
E) resource utilization.
Page 13
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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 nurse explains that the main goal of primary prevention is the reduction of the _____ of mental disorders.
A) severity
B) duration
C) incidence
D) prevalence
Q2) To effectively use the nursing primary prevention model,it is most important for a nurse to have knowledge of:
A) personality types.
B) psychiatric medications.
C) normal growth and development.
D) the DSM-IV-TR diagnostic categories.
Q3) A psychiatric nurse is responsible for providing patient-focused health education.In order to promote primary prevention of mental health problems,the nurse stresses: A) trust.
B) resilience.
C) networking.
D) motivation.
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Chapter 13: Crisis Intervention
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) 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.
Q2) A critically ill postsurgical patient tells a nurse about recent emergency surgery and the expected long-term postoperative course.As the patient speaks,the nurse notices that the speech lacks affect.Which technique of crisis intervention would be most therapeutic to use initially?
A) Catharsis
B) Manipulation
C) Raising self-esteem
D) Reinforcement of behavior
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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) A patient diagnosed with major affective disorder expresses concern to a nurse about how to spend time after discharge.The patient states,"I don't want to just sit at home alone but I'm a little afraid of how others will respond to me." The nurse should suggest:
A) "Just try to get out and meet people."
B) "You should really take it easy when you get home."
C) "Try taking a course at your local community college."
D) "Consider going to a consumer-run psychosocial program."
Q2) To promote positive outcomes,nurses in psychiatric rehabilitation practices should be skilled in: (Select all that apply.)
A) teaching the patient living skills.
B) actively listening to patient complaints.
C) assisting the patient in developing his or her strengths.
D) helping patients accept their own disabilities.
E) accessing the appropriateness of environmental support.
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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) When assessing a patient who gives the impression of being anxious,a nurse seeks to validate this impression because anxiety is:
A) necessary for survival.
B) communicated interpersonally.
C) an emotion without a specific object.
D) a subjective experience of the individual.
Q2) 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.
Q3) A nurse determines that a patient is able to follow directions but appears to experience a narrowed perceptual field and focus on immediate concerns.The nurse determines that the patient is experiencing anxiety at which level?
A) Mild
B) Moderate
C) Severe
D) Panic
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Page 17
Chapter 16: Psychophysiological Responses and Somatoform and Sleep Disorders
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25 Verified Questions
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Sample Questions
Q1) Which patient is most likely exhibiting a somatization disorder?
A) A person with chronic pain in the right ankle after a skiing injury
B) A person who experiences occasional chest pain after a myocardial infarction
C) A college graduate who cannot maintain steady employment because of multiple vague complaints
D) A person who dislikes going out to social events with large groups because of embarrassment about facial acne
Q2) A staff nurse decides to ignore an unfavorable evaluation from the nurse manager but now complains about getting little satisfaction from work,feels tired all the time,and can't wait for the shift to end.The nurse's behavior is characteristic of which stage of the general adaptation syndrome?
A) Alarm
B) Resistance
C) Exhaustion
D) Resolution
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Page 18
Chapter 17: Self-Concept Responses and Dissociative Disorders
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24 Verified Questions
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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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27 Verified Questions
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Sample Questions
Q1) The emergency department calls to say a patient experiencing symptoms of mania is being admitted.Which room placement should a nurse choose for the patient?
A) A single room near the unit entrance
B) A single room near the nurse's station
C) A double room shared with a patient with depression
D) A double room shared with a patient with schizophrenia
Q2) A patient shares,"My mood is really low,and even though I get plenty of sleep,I'm tired all the time.It seems like it happens every fall and winter." This patient is most likely experiencing:
A) poor REM sleep.
B) acute depression.
C) chronic depression.
D) seasonal affective disorder.
Q3) When a patient begins fluoxetine (Prozac),what information should be included in the plan for patient education?
A) The onset of action is 2 to 6 weeks.
B) Foods containing tyramine should be restricted.
C) Intake of salt and salty foods should be restricted.
D) The patient should be alert for symptoms of hypomania.
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Page 20
Chapter 19: Self-Protective Responses and Suicidal Behavior
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23 Verified Questions
23 Flashcards
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Sample Questions
Q1) A nurse is working with a patient with depression whose identical twin committed suicide.In assessing this patient for suicidal risk,the nurse should consider that this patient:
A) is at increased risk for suicide.
B) has the same risk as the general population.
C) cannot be assigned a level of risk based on such limited data.
D) is at low risk because the patient has experienced the trauma of suicide.
Q2) An assessment has been made that a patient is highly suicidal.One-to-one constant supervision with unit restriction has been ordered.How will this order be implemented?
A) By observing the patient while awake, both on and off the unit
B) By observing the patient at all times while revoking any off-unit privileges
C) By obtaining a no-suicide contract while removing all harmful objects from the environment
D) By observing the patient every 15 minutes around the clock while documenting whereabouts and activity level
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Chapter 20: Neurobiological Responses and Schizophrenia and Psychotic Disorders
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26 Verified Questions
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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) What part of the brain is dysfunctional in persons with schizophrenia? Research has implicated the:
A) medulla and cortex.
B) cerebellum and cerebrum.
C) hypothalamus and medulla.
D) prefrontal and limbic cortices.
Q3) A patient admitted in a semistuporous catatonic state has neither left the apartment nor attended to personal hygiene for several weeks.The patient's last 48 hours have been spent lying in bed,mute and motionless.The priority nursing diagnosis is:
A) self-care deficit.
B) situational low self-esteem.
C) disturbed thought processes.
D) impaired verbal communication.
Page 22
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Chapter 21: Social Responses and Personality Disorders
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26 Verified Questions
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Sample Questions
Q1) 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.
Q2) A patient with borderline personality disorder tells the nurse,"When my sister got married and had a baby,she ignored me and I got so angry with her because she is so inattentive to my needs." The patient's sense of entitlement to her sister's attention is consistent with:
A) impulsivity.
B) narcissism.
C) magical thinking.
D) passive aggression.
Q3) Which comment about relationships would be most characteristic of a patient with antisocial personality disorder?
A) "The only reason for interacting is to take advantage of others."
B) "'Live and let live' is as good a philosophy as any to live by."
C) "I've always found that 'help one another' is a good policy."
D) "I'll be your doormat. Feel free to take advantage of me."
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Page 23
Chapter 22: Cognitive Responses and Organic Mental Disorders
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Sample Questions
Q1) A patient diagnosed with dementia associated with excessive alcohol use tells a nurse,"Last week I had to take my baby to the hospital for major surgery.That's why I've been so nervous and needed to come here." The nurse is aware that the patient has never parented any children.The symptom described can be assessed as:
A) akathisia.
B) confabulation.
C) intellectualization.
D) magical thinking.
Q2) An individual brought to the emergency room fights against the restraints and shouts incoherently.The history reveals that the patient was weak and confused on awakening this morning and soon began "rambling and talking crazy." A nurse notes that the patient's skin is flushed and dry.The priority nursing action is to:
A) assess vital signs.
B) insert an intravenous catheter.
C) request a sedative prescription.
D) perform a mental status examination.
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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) The nursing intervention of highest priority relative to alcohol withdrawal delirium is:
A) application of restraints.
B) reorientation of the patient to reality.
C) identification of existing social supports.
D) maintenance of fluid and electrolyte balance.
Q3) A nursing diagnosis universally appropriate for patients who abuse mood-altering drugs would be:
A) confusion.
B) ineffective coping.
C) imbalanced nutrition.
D) impaired environmental interpretation syndrome.
Page 25
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Chapter 24: Eating Regulation Responses and Eating Disorders
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Sample Questions
Q1) A patient has a maladaptive response to eating regulation.Findings include the following: T,96.6° F; BP,68/40; P,40; R,20; poor skin turgor; admits to restricting intake to 350 calories daily; and diagnostic testing reveals serum potassium of 2.9 mEq/L and urine specific gravity of 1.028.What is the highest priority nursing diagnosis for this patient?
A) Imbalanced nutrition, less than body requirements
B) Disturbed body image
C) Deficient fluid volume
D) Powerlessness
Q2) Care planning requires that a nurse recognize that the dynamic focus directing care of a patient with anorexia nervosa is:
A) managing weight gain.
B) controlling personal stressors.
C) minimizing dependency on food.
D) expressing independence and autonomy.
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.
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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 hospitalized for depression will be discharged tomorrow.The patient asks a nurse,"Could the two of us meet for coffee away from the hospital sometime?" The most therapeutic response by the nurse would be:
A) "That sounds nice, but I'm already in a romantic relationship with someone."
B) "The hospital has a policy that does not allow professional staff to date patients."
C) "I guess there would be no harm in meeting for coffee, if we know in advance that we're meeting just as friends."
D) "We've developed a positive working relationship, and meeting socially would have a negative impact on that relationship."
Q2) A patient with a sexual response disorder reports hypersexuality.During the interview,a nurse should inquire about a history of which psychiatric disorder?
A) Mania
B) Depression
C) Personality disorder
D) Obsessive-compulsive disorder
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Chapter 26: Psychopharmacology
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Sample Questions
Q1) Which assessment data would indicate to the nurse that the patient who is prescribed a benzodiazepine is experiencing a medication side effect?
A) Dizziness
B) Reduced irritability
C) Reduced nervousness
D) Physiological dependency
Q2) A patient who has been treated with clozapine (Clozaril) for 9 months calls to cancel a clinic appointment because of flulike symptoms,including a sore throat,fever,and tiredness.The nurse demonstrates the best understanding on the management of these symptoms when responding:
A) "I think you need to drink lots of juices and water and go to bed. Call me at the end of the week to reschedule your appointment."
B) "I want you to please keep the appointment, and I will arrange for some blood work to be done while you are here."
C) "It's flu season all right. Get better soon, and call me to reschedule when you're feeling better."
D) "This may be something much more serious than the flu. Go to the hospital at once."
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Chapter 27: Behavior Change and Cognitive Interventions
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Sample Questions
Q1) A patient frequently experiences angry outbursts and asks,"Is there anything I can do to stop being rude every time I get angry?" The nurse responds:
A) "A social skills training program would be helpful."
B) "Do you really want to stop being rude when you become angry?"
C) "Patients who have trouble controlling their tempers are often helped by talking with a counselor."
D) "I could recommend for you to enter into therapy with a psychiatrist who is an expert in communications theory."
Q2) A nurse would implement social skills training for a patient with which problem?
A) Anxiety
B) Binge eating
C) Poor impulse control
D) Obsessive-compulsive disorder
Q3) Which behavior would a nurse focus upon when using a token economy as a method of positive reinforcement?
A) Altering cognitive perceptions
B) Reinforcing cognitive congruence
C) Performing assigned tasks in a cooperative manner
D) Pairing desired behaviors with undesired behaviors
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Page 29
Chapter 28: Preventing and Managing Aggressive Behavior
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Q1) At 7 AM,a patient demands in a loud,tremulous voice,"Where's my doctor? The doctor promised to see me first thing in the morning.Call the doctor and say that I'm waiting."
An appropriate response from the nurse would be:
A) "Please get ready for breakfast. It's only 7 AM. Your doctor will be in and I'll make sure that you're seen."
B) "Don't yell at me like that; it isn't polite and certainly isn't necessary. I want to help you, but I will not be verbally abused."
C) "You seem very angry that your doctor has not come in yet. Your doctor will be in this morning but not until later. The doctor spends time with everyone."
D) "Your doctor doesn't come to the unit until after breakfast and morning groups are over. Have your breakfast now so you'll be ready when your doctor gets here."
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Chapter 29: Somatic Therapies
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Q1) A patient has been enrolled in a clinical trial of repetitive transcranial magnetic stimulation (rTMS).A nurse should ensure that which item is available in the treatment area?
A) A blood pressure cuff
B) A reflex hammer
C) Suction
D) Earplugs
Q2) Which statement should be included during the educational preparation of a patient who will undergo ECT (electroconvulsive therapy) in 1 week?
A) "The induced seizure will last approximately 2 minutes and will be very mild."
B) "We encourage a family member to stay with the patient during the treatment."
C) "I'd be happy to arrange for you to speak with a patient who has experienced ECT."
D) "There may be a small amount of permanent memory loss, but it is usually related to the time of the seizure itself."
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Chapter 30: Complementary and Alternative Therapies
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Q1) When a patient asks if SAMe (S-adenosylmethionine) would be helpful for depression,a nurse responds most appropriately by stating:
A) "The research findings have demonstrated conclusively that SAMe is an effective antidepressant treatment therapy."
B) "The few research findings we have demonstrate that SAMe is effective in the treatment of depression that is accompanied by anxiety."
C) "SAMe has been found to be effective in the treatment of mild depression in a few research studies, but the long-term effects are not known."
D) "SAMe is an element that may create harmful effects in the human body and so always requires strict monitoring by your health care provider."
Q2) When asked about the benefits of complementary and alternative medicine (CAM) therapies,a nurse's best response is that CAM therapies usually:
A) are readily available to most patients.
B) are more costly than conventional therapies.
C) produce a variety of psychological side effects.
D) are most effective when implemented for chronic conditions.
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Chapter 31: Therapeutic Groups
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Q1) The nurse is leading a therapy session dealing with group guidelines.The nurse is confident that a chronically late patient is demonstrating a maintenance role when she states:
A) "I guess the reason I'm chronically late is that I don't particularly value what we do in here. Who believes that this stuff really works outside this group?"
B) "I know that I struggle to be on time, too. Can we agree to try to be on time and that we will start the group session after waiting only 5 minutes?"
C) "Although the rules were agreed on by everyone when the group was formed, I believe we should review them now."
D) "I thought we agreed last week that the rule was that everyone needed to be on time if possible."
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?"
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Chapter 32: Family Interventions
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Q1) When assessing a family for functional versus dysfunctional characteristics,which is a dysfunctional target symptom the nurse should identify?
A) An adolescent who is failing math
B) A teenage daughter who is 6 months pregnant
C) A spouse who maintains family peace at any price
D) A young adult who is working full-time as a laundry worker
Q2) The diagnosis of a parent-child relational problem is indicated on which DSM-IV-TR axis?
A) Axis I
B) Axis II
C) Axis III
D) Axis IV
Q3) An essential outcome of family therapy is:
A) change.
B) acceptance.
C) accountability.
D) participation.
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Chapter 33: Hospital-Based Psychiatric Nursing Care
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Q1) Which of these patients is the most appropriate candidate for assignment to a crisis bed? A patient who:
A) is found inebriated and claims to be "king of the universe."
B) shows a store clerk a knife after being refused use of the store's restroom.
C) has a history of violent outbursts and has been recently evicted from his or her home.
D) is known to have bipolar disorder who expresses a need to be hospitalized "for the winter."
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) 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
Q2) The primary nursing responsibility of a community psychiatric nurse managing caring for patients diagnosed with serious and persistent mental illnesses residing in a group home is to conduct an ongoing:
A) assessment of the patients' life needs.
B) evaluation of care provided for the patients.
C) management of the funds allotted for individual patient care.
D) oversight of all day-to-day operations of the group home and its services.
Q3) A psychiatric home care nurse's greatest patient care challenge is:
A) effectively assessing the home care needs of the patient.
B) documenting care to reflect the skilled service given.
C) providing all the attention each patient wants.
D) evaluating family situations accurately.
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Chapter 35: Child Psychiatric Nursing
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Q1) Which assessment finding most clearly indicates an adolescent has a conduct disorder?
A) Misses at least one day of school a month
B) Admits to pulling the dog's ears and tail for "fun"
C) Told the teacher that he is usually "sad and confused"
D) Consistently awakens during the night and has difficulty falling asleep again
Q2) Which response by a nurse is most therapeutic in response to parents who are concerned that their child has been drawing sexually explicit pictures?
A) "Are you sure your child fully understood what it was that was being drawn?"
B) "What did your child say when asked about why the drawings were made?"
C) "Most children experiment with this type of behavior at a certain age."
D) "I will need your permission to speak directly with your child."
Q3) 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
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Chapter 36: Adolescent Psychiatric Nursing
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Q1) When a teacher reports that an adolescent has begun failing in class and is isolated from friends during laboratory sessions,the nurse responds most therapeutically by stating:
A) "Let's discuss this. The symptoms of adolescent depression can look very different from those of adult depression."
B) "Have you set limits on the student's behavior and called for an immediate family intervention?"
C) "I'll call the student's parents and see if I can get their permission to assess for possible depression."
D) "Have you noticed whether others have been bullying the student in your class?"
Q2) Which nursing intervention would be most effective when assisting an adolescent who is in stage three of substance abuse?
A) Recommend a drug-free self-help group and family therapy.
B) Provide drug education and drug-free activities for the adolescent.
C) Recommend hospitalization at a drug abuse center to facilitate withdrawal.
D) Provide anticipatory guidance to help the adolescent develop healthy coping skills.
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Chapter 37: Geropsychiatric Nursing
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Q1) An older adult reports that "I know that I'm not the cheerful person I used to be but that's just a part of growing old." Using a psychological theoretical framework,the nurse might respond:
A) "When your life focuses on positive experiences from your adolescence, aging is reduced by that youthful mental status."
B) "There may be many causes for what you are feeling. I'd suggest seeing your health care provider to rule out any physical causes."
C) "The best way to prepare for a 'good death' is to systematically review your life and change any behaviors you feel might interfere with this process."
D) "You are in the last stage of development in your life, and it's important that you attempt to correct anything about your life that dissatisfies or saddens you."
Q2) Which nursing technique would be most effective when assessing an older adult patient's nutritional status?
A) Interact with the patient during meals.
B) Perform a comprehensive health assessment.
C) Supplement the patient's diet with preferred, nutritious snacks.
D) Ask the patient to complete a 7-day inclusive nutritional recall.
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Chapter 38: Care of Survivors of Abuse and Violence
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Q1) A young,newly married adult says,"My spouse never lets me out of sight.I'm not allowed to do anything on my own,and I'm constantly accused of cheating." Which nursing comment is most therapeutic for this individual?
A) "Have you discussed the behavior with your spouse?"
B) "How does your spouse's behavior make you feel?"
C) "Are there other examples of controlling behaviors on your spouse's part?"
D) "Do you feel that your spouse has anything to be upset or suspicious about?"
Q2) A nursing colleague says,"This patient was admitted claiming to have been raped by her boyfriend,but just look at the sexy clothes she's wearing." Which response reflects an understanding of the most likely source of the colleague's comment?
A) "Have you ever cared for other sexual assault victims?"
B) "Your sister was raped when she was in college, wasn't she?"
C) "You have three unmarried brothers about the patient's age, don't you?"
D) "Are you saying that wearing sexy clothes caused her to be sexually assaulted?"
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Chapter 39: The Military and Their Families
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Q1) 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.
Q2) Female military personnel who have recently returned from deployment in a war zone are being assessed for potential physical and sexual assault as well as for an increased risk for developing posttraumatic stress disorder (PTSD).During the assessment,the nurse would ask: (Select all that apply.)
A) "How safe did you feel while you were deployed?"
B) "Did you have much contact with potential enemy soldiers?"
C) "Have you ever experienced physical abuse as either a child or an adult?
D) "Do you feel the military is prepared to help you reenter a noncombat environment?"
E) "What is your greatest fear regarding your personal safety as a member of the military community?"
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Chapter 40: Psychological Care of Patients with Life-Threatening Illness
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Q1) A patient with end-stage renal disease does not want further aggressive treatment but is reluctant to withdraw life-sustaining treatment.The nurse would help the patient to understand that life-sustaining treatment includes maintaining:
A) full code status.
B) comfort measures only.
C) nutrition, hydration, and dialysis.
D) nutrition and hydration but removal of dialysis.
Q2) An older adult patient diagnosed with Parkinson-induced dementia becomes critically ill with severe pneumonia.No family is available.After repeated failed attempts to contact the patient's agent designated by the Health Care Power of Attorney,which standard should the health care team use as the best method for decision making in planning care for this patient?
A) Informed consent
B) Best interests standard
C) Patient's Bill of Rights
D) Substituted judgment standard
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