Psychiatric Nursing Practice Exam
Course Introduction
Psychiatric Nursing focuses on the principles and practices essential for caring for individuals experiencing mental health disorders. The course emphasizes the development of therapeutic relationships, understanding various psychiatric illnesses, applying evidence-based interventions, and promoting mental wellness in diverse populations. Students learn about assessment techniques, crisis intervention, medication management, and legal and ethical issues in psychiatric care. Through both theoretical knowledge and practical experience, the course prepares nursing students to provide compassionate, holistic, and culturally sensitive care to patients with mental health needs in a variety of healthcare settings.
Recommended Textbook
Principles and Practice of Psychiatric Nursing 10th Edition by Gail Wiscarz Stuart
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40 Chapters
943 Verified Questions
943 Flashcards
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Page 2
Chapter 1: Roles and Functions of Psychiatric-Mental Health
Nurses: Competent Caring
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) A psychiatric nurse uses leadership skills to strengthen the profession by:
A) working as a change agent advocating for patients, families, and communities.
B) volunteering time each week to outpatient clinics in poor neighborhoods.
C) voting for candidates in local elections who will advocate for nurses.
D) working for state government representatives at local voting sites.
Answer: A
Q2) Nursing should increase its role in the advocating of funding for outcome studies because these studies:
A) increase patient compliance with therapeutic regimens.
B) document quality, cost, and effectiveness of psychiatric nursing.
C) update psychiatric nursing specialists on new practice developments.
D) lead to the implementation of untried interventions and practice guidelines.
Answer: B
Q3) The contribution of Linda Richards that remains a part of contemporary psychiatric nursing practice is the idea that:
A) psychiatric nurses should have advanced preparation.
B) nurses should assess both the physical and the emotional needs of patients.
C) psychotic behavior must be controlled before serious psychotherapy begins.
D) basic physical needs must always be met before emotional needs are addressed.
Answer: B
Page 3
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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 patient says to a nurse,"My spouse and I get along just fine.We usually agree on everything." The nurse observes nonverbal communication that disagrees with what the patient has verbally communicated.Which of the patient's actions is incongruent with her statement?
A) Getting up from her chair while making the statement
B) Walking toward the nurse while talking about her spouse
C) Staring down at her shoes during the conversation
D) Smiling while talking with the nurse
Answer: C
Q2) 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
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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) Precipitating stressors are stimuli that:
A) society views as being deviant or troublesome.
B) the family views as disruptive or burdensome.
C) the patient views as challenging, threatening, or demanding.
D) the nurse views as noxious, overwhelming, or culturally unacceptable.
Answer: C
Q2) 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
Q3) A comparison of the nursing and medical models of care shows that:
A) nurses assess disease states and causes.
B) physicians assess risk factors and vulnerability.
C) nursing intervention focuses on curative treatments.
D) nursing diagnoses focus on the effectiveness of coping responses.
Answer: D
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Chapter 4: Evidence-Based Psychiatric Nursing Practice
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22 Verified Questions
22 Flashcards
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Sample Questions
Q1) The categories of outcome indicators include:
A) process and reliability.
B) clinical and functional.
C) process and evaluation.
D) measurement and evaluation.
Q2) 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.
Q3) Most often,clinical pathways are used in:
A) inpatient units.
B) outpatient settings.
C) home-care settings.
D) mental health clinics.
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Page 6
Chapter 5: Biological Context of Psychiatric Nursing Care
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23 Verified Questions
23 Flashcards
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Sample Questions
Q1) A patient states,"I'm going to have a positron emission tomography (PET) scan.What are the doctors going to learn from it?" The best reply would be that they focus on:
A) "identifying structures like tumors and scars."
B) "highlighting activity in various portions of the brain."
C) "outlining the structures of the brain more clearly."
D) "providing data to support new treatment modalities."
Q2) A patient with a history of depression reports not feeling well rested in recent weeks.Before making the assumption that the complaint is related to depression,a nurse should investigate whether the patient has had any recent changes in:
A) work schedule that affect the hours of sleep.
B) vacations taken within the same time zone.
C) fluid intake with reduced overall intake of water.
D) food intake with decreased intake of heavy foods before bedtime.
Q3) Pharmacogenetics will eventually allow researchers to do which of the following?
A) Remove the genes that cause illness.
B) Allow the design of custom drugs.
C) Develop foods that fight disease.
D) Splice genes to improve health.
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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) A nurse assessing a patient's emotional intelligence will focus on the patient's:
A) linguistic and musical abilities.
B) body kinesthetic and spatial abilities.
C) interpersonal and intrapersonal skills.
D) logical mathematics and linguistic abilities.
Q2) A patient tells a nurse,"God has given me special powers to heal the sick and raise the dead.I can cast out demons and cure cancer." The nurse assesses the patient's statements as indicating:
A) a phobia.
B) depersonalization.
C) grandiose delusions.
D) an idea of reference.
Q3) 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.
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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) An elderly Hispanic woman has become depressed after the death of her husband.The nurse would anticipate that this patient is most likely to:
A) be less able to adapt than before.
B) recover and return to her preillness state.
C) believe the death is a punishment for past acts.
D) suffer recurrences of depression because of cultural strain.
Q2) Two patients,an African-American agnostic man and a Caucasian Baptist woman,are both diagnosed with schizophrenia,paranoid type.Both patients are 42 years old and live at the poverty level.The age of onset for the illness was 21 years in the male patient and 41 years in the female patient.What sociocultural factor accounts for the male patient's less favorable prognosis?
A) His religious belief system
B) Caucasian Americans are more amenable to treatment.
C) Males living in poverty receive less social support than women living in poverty.
D) He had an earlier onset of illness that has resulted in his longer course of illness.
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Page 9
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) Which action by a nurse violates the rights of a psychiatric patient?
A) Arranging for a patient to work in the hospital kitchen for minimum wage
B) Refusing to mail letters to the local newspaper written by a committed patient
C) Placing the wristwatch of a patient with delusions in the hospital's main safe
D) Discouraging a patient with paranoid delusions to sign a contract to sell a home
Q2) A patient was admitted voluntarily to the psychiatric unit.A nurse must understand that voluntary status confers the right of the patient to:
A) have visitors at any desired time.
B) come and go from the unit at will.
C) choose the nursing staff assigned to the patient's care.
D) accept or refuse any recommended treatment modalities.
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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) Health professionals planning treatment initiatives should be most concerned with the burden of disease created by:
A) violence and injury.
B) environmental quality.
C) behavioral health problems.
D) irresponsible sexual behavior.
Q2) Which nurse in a managed care setting has the greatest responsibility for allocating resources to an individual patient?
A) Treatment nurse
B) Case manager
C) Risk manager
D) Patient educator
Q3) A nurse who advocates for consumer empowerment will seek to help psychiatric patients:
A) achieve a sense of self-responsibility.
B) comply with provider-prescribed treatment programs.
C) understand that their viewpoints are flawed by mental illness.
D) use resources predominantly from the formal mental health system.
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11
Chapter 10: Families as Resources, Caregivers, and Collaborators
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23 Verified Questions
23 Flashcards
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Sample Questions
Q1) To plan and budget for preventive services,a nurse in charge of a community mental health center has reviewed the records to discern how many families received services in the current year.To estimate the need for the coming year,the nurse should:
A) increase the allocation, because most eligible families are underserved.
B) decrease the allocation, because most eligible families are overserved.
C) interview the families currently being supported to determine valid needs. D) ask for a consultant to ascertain community interest in preventive services.
Q2) Which observation best demonstrates that a patient is a member of a well functioning family?
A) Family members openly discuss the patient's needs and how to meet them effectively.
B) The patient looks forward to family members' visits and is less stressed after they spend time together.
C) The patient asks for his family members' input when making a decision and generally seeks their approval.
D) Family members are likely to provide the patient with suggestions on what should be done and when it should be done.
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Page 12
Chapter 11: Implementing the Nursing Process: Standards of Practice
and Professional Performance
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) A staff nurse is told in orientation to expect to receive performance appraisals in various forms.The nurse can expect that these will be: (Select all that apply.)
A) collaborative practice.
B) interdisciplinary.
C) administrative.
D) professional.
E) clinical.
Q2) A nurse interviewed a reluctant patient who answered questions with minimal responses and rarely made eye contact.When documenting baseline data collected in the interview,the nurse should include:
A) interview content only.
B) a description of the process of the interview.
C) both the content and the process of the interview.
D) both factual data about the patient and the nurse's emotional reaction.
Q3) 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.
Page 13
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Chapter 12: Prevention and Mental Health Promotion
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21 Verified Questions
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Sample Questions
Q1) A nurse focuses on increasing gang members' problem-solving and coping skills.This is an example of:
A) crime reduction.
B) community service.
C) competency building.
D) environmental manipulation.
Q2) 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
Q3) When a community mental health nurse focuses on intervention strategies designed to increase self-efficacy among members of a minority neighborhood group,a realistic primary prevention goal would be:
A) elimination of mental illness in the community.
B) resolving social problems within the community.
C) reducing both stressors and suffering in the group.
D) reducing the incidence of depression in the group.
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Page 14
Chapter 13: Crisis Intervention
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24 Verified Questions
24 Flashcards
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Sample Questions
Q1) A patient comes to the mental health clinic with insomnia,irritability,increased tension,and headaches.The symptoms began 1 week ago after the patient was laid off from work.The patient expresses concern that this will result in a relocation that will be hard on the entire family.The patient is most likely experiencing:
A) an anxiety reaction.
B) a situational crisis.
C) a maturational crisis.
D) an adjustment disorder.
Q2) A nurse notes that a patient is using alcohol each evening as a means of coping with the loneliness associated with a recent divorce.Pointing this out and encouraging the patient to join an exercise club or try jogging in lieu of drinking are examples of an approach called:
A) clarification.
B) support of defenses.
C) raising self-esteem.
D) reinforcement of behavior.
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15
Chapter 14: Recovery and Psychiatric Rehabilitation
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Sample Questions
Q1) A psychiatric nurse whose area of practice is tertiary prevention of mental illness is asked to describe the focus of this type of practice.The nurse can best describe it as:
A) enriching the understanding of mental illness.
B) preventing mental illness from occurring initially.
C) limiting disability related to an episode of mental illness.
D) increasing community awareness of the symptoms of mental illness.
Q2) A patient has been treated for a mental disorder on an outpatient basis.Function has deteriorated and the patient is hospitalized in an inpatient unit; a nurse will now implement the recovery model by:
A) comparing patient deficits to original baseline.
B) identifying and reinforcing patient strengths.
C) reviewing the patient's former treatment plan for updates.
D) reconsidering expectations when the patient is discharged.
Q3) The family burden associated with having a mentally ill family member is evidenced by:
A) decreased family stress and conflict.
B) family members blaming each other for the illness.
C) increased understanding and acceptance of the illness.
D) too little time, energy, and money given to the ill member.
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Page 16
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) A nurse explains a patient's behavior by stating,"The patient's anxiety stemmed from being unable to attain a desired goal." Which theory is the nurse basing the response upon?
A) Learning
B) Behaviorist
C) Interpersonal
D) Psychoanalytic
Q3) In the cognitive realm,which assessment finding most indicates depression?
A) Uncertainty in negative evaluations
B) Selective and specific negative appraisals
C) Global view that nothing will turn out right
D) Tentatively regards defects or mistakes as revocable
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Chapter 16: Psychophysiological Responses and Somatoform and Sleep Disorders
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Sample Questions
Q1) Which patient would be at greatest risk of encountering the exhaustion phase of the general adaptation syndrome?
A) A patient who is scheduled for knee replacement surgery
B) A patient who has high self-efficacy and has recently accepted a job promotion
C) A patient who has had elective rhinoplasty to correct a prominent hump in the bridge of the nose
D) A person who has severe osteoarthritis and was admitted to a nursing home after the death of a caretaker spouse 2 months ago
Q2) A nurse planning care for a patient who has somatoform disorder needs to be aware that these patients often have relationship problems associated with:
A) anger.
B) dependency.
C) detachment.
D) misplaced objectivity.
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Chapter 17: Self-Concept Responses and Dissociative Disorders
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Sample Questions
Q1) A patient tells a nurse,"I am a weak person." The patient feels inadequate and vulnerable and states often feeling helpless and frightened.The nursing diagnosis most likely to fit this situation is:
A) personal identity disturbance.
B) chronic low self-esteem.
C) personality fusion.
D) depersonalization.
Q2) When working with a patient experiencing an alteration in self-concept resulting from dissociative amnesia,a nurse should begin by:
A) identifying and supporting the patient's ego strength.
B) helping the patient to develop a realistic self-ideal.
C) taking measures to prevent further identity diffusion.
D) setting mutual goals for attitudinal and behavioral change.
Q3) 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) While talking with a nurse,a patient remarks,"My father's been dead for months.I think Mom needs to get on with her life." The most appropriate response by the nurse is:
A) "Giving her support will be more helpful than being critical."
B) "Have you thought of ways you might help her find more pleasure in her life?"
C) "It's possible that she still needs more time. Grieving often takes 1 year or more."
D) "A death is usually a crisis for the whole family. How has his death affected you?"
Q2) A patient's husband is distraught over his wife's behavior since their child died in a car accident 1 month ago.He says,"She still cries herself to sleep each night.Help my wife control herself." The nurse's most therapeutic response would be:
A) "I wonder why it is that you are so bothered by her crying."
B) "I'm more concerned that you don't seem to be grieving."
C) "I'll spend some time with her to help her see that crying is counterproductive."
D) "It's hard to see her so upset, but crying is one way of expressing her feelings."
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20
Chapter 19: Self-Protective Responses and Suicidal Behavior
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Sample Questions
Q1) The nursing diagnosis for a patient who is depressed and suicidal at admission is "risk for suicide." The most appropriate outcome for this diagnosis at discharge from the hospital is,"The patient will:
A) increase feelings of self-worth."
B) not harm self while hospitalized."
C) be able to problem solve effectively."
D) develop a trusting relationship with one staff member."
Q2) A psychiatric technician states,"This patient has frequently threatened suicide but has never attempted it.The patient should be sent home instead of encouraging the threats." The nurse supports admitting the patient by responding:
A) "There is no family to provide the social support that is vital to safety."
B) "Any suicide threat deserves serious attention and concern for safety."
C) "You seem to have a real problem when patients lose emotional control."
D) "Nursing staff are encouraged to share their concerns with the physician."
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Chapter 20: Neurobiological Responses and Schizophrenia and Psychotic Disorders
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Sample Questions
Q1) A severely withdrawn patient diagnosed with schizophrenia will spend time in the dayroom but will not speak to staff or other patients.The most therapeutic nursing intervention in response to this behavior would be to:
A) seat the patient with a group of patients who are talking to each other.
B) ignore the silence and talk about superficial topics such as the weather.
C) point out that the patient makes others uncomfortable by refusing to speak.
D) plan time for staff members to sit with the patient even though the patient does not talk with them.
Q2) The nurse is caring for a patient experiencing auditory hallucinations who says,"When I first heard the voices they said nice things about me but now they say bad things." Which question will have an impact on the care this patient is initially provided? (Select all that apply.)
A) "Do you trust me to help you with the voices?"
B) "Are the voices commanding you to hurt yourself?"
C) "How often during 24 hours do you hear the voices?"
D) "Do you hear the voices if you're busy in a noisy environment?"
E) "When did you first start hearing voices that were saying bad things?"
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Page 22
Chapter 21: Social Responses and Personality Disorders
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Sample Questions
Q1) After caring for a patient with a personality disorder the nurse states,"At first I thought this was such a nice person.Now I realize it's like working with the devil." The two different views held by the nurse are most likely the result of:
A) countertransference.
B) lack of emotional self-control.
C) objective assessment of the patient.
D) inability of the patient to profit from therapy.
Q2) The nurse is caring for a patient diagnosed with borderline personality disorder who cut both forearms after learning that the psychiatrist was going on vacation.While changing the dressing daily,it would be advisable for the nurse to:
A) express sympathy and concern.
B) maintain a matter-of-fact attitude.
C) encourage discussion of the self-mutilation.
D) reassure the patient by stating, "I will not abandon you."
Q3) 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.
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Page 23
Chapter 22: Cognitive Responses and Organic Mental Disorders
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Sample Questions
Q1) A nurse is working with a family with an elderly member who is in the prediagnostic phase of Alzheimer disease.The most important nursing intervention at this time would be to provide:
A) family consultation to facilitate communication.
B) information about support groups and counseling.
C) options directed toward the reduction of caregiver stress.
D) education that helps them understand their situation.
Q2) Family members of a delirious elderly patient are very anxious and express their concerns about placing the patient in a nursing home.What information should serve as a basis for the nurse's reply?
A) Delirium is reversible, and the patient will likely recover.
B) The symptoms are related to depression, which can be treated.
C) Delirium usually progresses to dementia, which is usually permanent.
D) Home care should be attempted; a nursing home should be the last resort.
Q3) Which nursing diagnosis would be appropriate for a patient with Alzheimer disease?
A) Disorientation related to hyperthermia
B) Anxiety (moderate) related to dementia
C) Disturbed sensory perception (visual) related to normal aging
D) Disturbed thought processes related to irreversible brain disorder
Page 24
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Chapter 23: Chemically Mediated Responses and
Substance-Related Disorders
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Sample Questions
Q1) A nurse has concerns about erratic behavior and slurred speech of another member of the nursing staff.The most appropriate action for the concerned nurse to take is to:
A) immediately confront the impaired nurse with the observation.
B) ask other nurses if they have observed anything unusual regarding the nurse in question.
C) personally supervise the team member whenever the care involves the preparation of pain medication.
D) notify the nursing supervisor to assess the team member's condition and performance.
Q2) The spouse of a patient with alcoholism asks,"How do I respond in a helpful way even though this abuse is so harmful to my family?" The nurse's best response would be:
A) "Search the house regularly for hidden alcohol."
B) "Include your spouse in family activities whether or not drinking has occurred."
C) "Make your spouse responsible for the consequences of the disruptive behavior."
D) "Refuse to be supportive when your spouse is under the influence of alcohol."
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25
Chapter 24: Eating Regulation Responses and Eating Disorders
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Sample Questions
Q1) A nurse would assess for which behavior to substantiate a diagnosis of bulimia nervosa?
A) Abuse of diuretics and laxatives
B) Introverted personality traits
C) Disinterest in sexual activity
D) Denial of hunger at all times
Q2) A nurse has completed the assessment for a patient who has a maladaptive response to eating regulation.Findings include: height,5 feet 3 inches; current weight,80 pounds with weight loss of 30% of body weight; poor skin turgor; lanugo; amenorrhea of 6 months' duration; and admits to restricting intake to 350 calories daily.These assessment findings are most consistent with the medical diagnosis of:
A) bulimia nervosa.
B) anorexia nervosa.
C) binge-eating disorder.
D) disturbed body image.
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26
Chapter 25: Sexual Responses and Sexual Disorders
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Sample Questions
Q1) A patient is seeking help after being diagnosed with hypertension.A nurse plans to include questions about sexual health in the assessment.Which question would be most effective to introduce this topic?
A) "Which elements of sexual dysfunction have you noticed since your diagnosis of hypertension?"
B) "I assume your hypertension hasn't caused you any significant problems with sex, has it?"
C) "How are you and your partner getting along sexually since you've developed hypertension?"
D) "Can you identify any changes in your sexual activity since you learned about your hypertension?"
Q2) Which nursing diagnosis could be applied to both a patient who is upset that she has developed vaginismus associated with fear of pregnancy as well as a patient with diabetes who is concerned that he cannot attain an erection?
A) Sexual dysfunction
B) Sexual arousal disorder
C) Sexual aversion disorder
D) Ineffective sexuality pattern
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Chapter 26: Psychopharmacology
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Q1) Which set of instructions is most appropriate when preparing the patient for collection of a 24-hour creatinine clearance for a prelithium workup?
A) "Collect all urine when you wake up and for 12 hours thereafter, and then discard all collected urine, noting the time. Begin again to collect all urine, and refrigerate it for the next 12 hours after your blood is drawn."
B) "Discard your first morning urine on awakening, and then begin to time and collect your urine. Keep it refrigerated in a clean 3-L plastic container. Your blood may be drawn at any time during the collection."
C) "Sign this consent form; then collect your urine for the next 24 hours after discarding the first urine of the morning and then refrigerate the clean 3-L container between voidings."
D) "Sign this consent form, and then begin to collect your urine in a clean 3-L plastic container for 24 hours. You may refrigerate the urine collection if you wish."
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Chapter 27: Behavior Change and Cognitive Interventions
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Sample Questions
Q1) A nurse teaches a group of parents about positive and negative reinforcement in shaping behavior.Which is an example of a positive reinforcer?
A) A parent who kisses a child who is crying to make the crying stop
B) An adolescent who runs away from home because of trouble in school
C) A parent who praises a child for putting toys away after playtime
D) An adolescent who drives within the speed limit to avoid getting a ticket
Q2) Which response best indicates that a nurse is employing reframing with a patient who responds angrily and aggressively when family members confront the patient's abusive drinking behavior?
A) "Would you like to take a 10-minute time-out to get your anger under control?"
B) "It is good that you can display anger. Now, can you tell us what it is you really want to say?"
C) "Would you consider joining Alcoholics Anonymous and offering this up to a higher power?"
D) "Can you feel the love and concern that prompted your family to say these things to you?"
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Chapter 28: Preventing and Managing Aggressive Behavior
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Q1) A unit has experienced several violent outbursts that have resulted in the forcible restraint of patients.On review,each violent event and all crisis management strategies were appropriately followed.To maximize staff efficiency the nurse manager should:
A) determine the institution's policies regarding the management of crisis situations should be reviewed in mandatory staff education sessions.
B) schedule staff breaks at intervals that allow staff members to leave the unit and relax while discussing the problems in the current milieu.
C) invite a team of experts to evaluate crisis management on the unit for 1 month to determine whether any procedures are being unintentionally omitted.
D) schedule a multidisciplinary team education meeting and invite a distinguished expert who can help staff members understand that they managed each crisis appropriately.
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Chapter 29: Somatic Therapies
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Q1) 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."
Q2) During the ECT (electroconvulsive therapy) stimulus,the nurse supports the patient's chin firmly against the bite-block positioned between the upper and lower teeth.The rationale for this intervention is to prevent:
A) involuntary biting of the lips.
B) tooth damage or gum laceration.
C) involuntary swallowing of the tongue.
D) development of TMJD (temporomandibular joint disorder).
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Chapter 30: Complementary and Alternative Therapies
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Q1) 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.
Q2) A nurse should advise a patient taking the herb kava-kava in conjunction with central nervous system medications that it may:
A) have addictive properties.
B) trigger asthmatic attacks.
C) cause fatal arrhythmias.
D) exacerbate depression.
Q3) Which activity should a nurse suggest to a patient who asks,"What kind of exercise should I do to raise my mood?"
A) Horseback riding four times per week
B) A game of softball three times per week
C) Weight lifting for 15 minutes twice per week
D) 30 minutes on the stationary bike four times per week
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Chapter 31: Therapeutic Groups
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Q1) After facilitating a therapeutic group,the nurse leader separately documents both individual and group data.Which observation would the nurse leader include in an individual note?
A) Group focused on results of medication noncompliance.
B) Member successfully identified the likely causes for recent relapse.
C) Three group members asked to change the time of scheduled sessions.
D) Decision was made to discuss reasons for acceptable absenteeism at next session.
Q2) Which nursing intervention would the nurse employ to help reduce group resistance?
A) Review accepted guidelines in the group's orientation stage.
B) Make group acceptance criteria as nonrestricting as possible.
C) Employ pretesting and posttesting regarding each session topic.
D) Avoid personal consequences for member absenteeism and tardiness.
Q3) Which comment by the nurse would be most therapeutic when a group member challenges a nurse leader's authority?
A) "Who do you think should be the group leader, if not me?"
B) "So you're asking, 'Who made me the leader?'"
C) "Do you want to be the group leader?"
D) "You resist my authority?"
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Chapter 32: Family Interventions
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Q1) Skill building may include relapse-prevention drills and disorder-related conflict skills for adult patients diagnosed with schizophrenia or a mood disorder.Along with skill building,the patient typically receives individualized: A) pharmacotherapy.
B) subsidized housing.
C) occupational therapy.
D) health care treatment.
Q2) The discharge plan for a patient newly diagnosed with bipolar disorder includes a variety of treatment modalities.The most likely rationale for including both psychoeducational and family therapy to the plan of care is that they are:
A) viewed as effective by most private insurance providers as well as Medicaid.
B) likely to affect the patient's compliance with the prescribed treatment plan.
C) likely to address the issues the disorder can cause for the patient and family. D) focused on communication and problem solving.
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Chapter 33: Hospital-Based Psychiatric Nursing Care
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Sample Questions
Q1) The multidisciplinary team is meeting to discuss discharge planning with the family of a patient who recently attempted suicide.Which statement by a family member might constitute criteria for delaying discharge?
A) The patient's spouse says, "I'll be taking long weekends from now on so we'll not be apart so much."
B) The patient's daughter asks, "Do I keep it a secret that I miscarried my baby the day of the attempt?"
C) The patient's son says, "If everyone thinks I'm going to make a fuss over this, they're wrong."
D) The patient's father says, "What can we do to make sure this doesn't happen again?"
Q2) A patient shares with a nurse,"I don't seem to be sleeping any better since I came here." Which nursing intervention will the nurse implement initially?
A) Comparing the patient's admission and current sleeping patterns
B) Giving the patient a warm glass of milk at bedtime
C) Teaching relaxation techniques to the patient
D) Starting a running program for the patient
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Chapter 34: Community-Based Psychiatric Nursing Care
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Q1) Rural suicide rates:
A) have surpassed urban suicide rates over the past 20 years.
B) are not tracked as effectively as urban rates.
C) cannot be determined with accuracy.
D) are very low in the United States.
Q2) Which interventions would be provided by an employee assistance program (EAP) when an employee is suspected of having an alcohol abuse problem? (Select all that apply.)
A) A consultation with their immediate supervisor
B) Referral to an alcohol abuse treatment program
C) Financial help while at an alcohol treatment center
D) Guarantee that one's job will be held until treatment is successful
E) Evaluation of the employee's need for a leave of absence from their job
Q3) A community mental health center is adjusting to severe budget cuts.Which service is most likely to be considered for elimination?
A) Toll-free suicide prevention telephone hotline services
B) Community education regarding the risk factors of depression
C) Transitional housing for a parent diagnosed with chronic depression
D) Follow-up laboratory testing regarding therapeutic medication levels
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Chapter 35: Child Psychiatric Nursing
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Q1) When planning immediate care for a child based on a biopsychosocial assessment,the nurse initially addresses any dysfunction in the:
A) biological development of the child.
B) effect of medical illness on the child.
C) social support systems available to the child.
D) child's mastery of specific ego competency skills.
Q2) Which statement best indicates that a child diagnosed with attention-deficit disorder (ADD) has difficulty tolerating frustration?
A) The child's sibling says, "He just can't seem to finish anything he starts."
B) The child says, "I guess I understand why it wasn't nice to do what I did."
C) The child's parent says, "He never stands up for himself. Even when he knows he's right, he'll give in to someone else."
D) The child's parent says, "He never believes me when I tell him he looks fine for a kid his age. He thinks he's fat and ugly."
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Chapter 36: Adolescent Psychiatric Nursing
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Q1) An adolescent relates a mutual masturbatory experience to a nurse and says,"I think I'm a homosexual." Which statement by the nurse with respect to the patient's development stage is most appropriate?
A) "Adolescence is the common time for sexual experimentation."
B) "It's important to be happy with your sexuality, whatever it may be."
C) "You might be bisexual. Tell me about your sexual behavior in detail."
D) "It's believed that many homosexual people begin to experiment at your age."
Q2) A nurse would be most concerned about the risk of suicide in which adolescent?
A) A 13-year-old girl with poor school performance
B) A 14-year-old male exhibiting hostile behavior
C) A 17-year-old female with alcohol abuse issues
D) An 18-year-old male with relationship problems
Q3) Which behavior would indicate to the nurse that an adolescent has entered the third stage of substance abuse? The adolescent:
A) is abusing alcohol on the weekends.
B) has been caught smoking hash in the school bathroom.
C) admits to being curious about the alcohol in the family liquor cabinet.
D) has begun selling drugs at school to support a serious drug addiction.
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Chapter 37: Geropsychiatric Nursing
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Q1) A 68-year-old being treated for depression has a history of a suicide attempt at age 26.When the patient reports feelings of uselessness related to selling the family business and retiring,the nurse should initially:
A) notify the patient's health care provider of the intensified feelings of despair.
B) provide one-on-one time with the patient for the purpose of discussing the stated feelings.
C) alert other staff members of the need to increase the visual monitoring of this patient. D) ask the patient if he is experiencing any suicidal ideations, including any plans to hurt himself.
Q2) Which assessment finding best indicates that an older adult who resides at an assisted living center has functional mobility?
A) The patient spends most of the day interacting with others in the dayroom.
B) The patient spends weekends and holidays at the home of family members.
C) The patient shows an interest in having his hair professionally styled.
D) The patient dresses, bathes, and eats independently.
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Chapter 38: Care of Survivors of Abuse and Violence
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Q1) What is the best initial approach for a nurse when managing the care of an individual with two children who works full-time and has been abused by a partner?
A) Teach the individual how to avoid provoking the abuser.
B) Assist the individual in filing a police report describing the abuse.
C) Help the individual identify needs to best obtain the appropriate support.
D) Facilitate the individual's move into a safe house located near the current workplace.
Q2) An Arab student new to an elementary school reports,"I don't want to go to gym class.It's never been a good class for me." Which factor would be of primary concern for a school nurse?
A) The student's family's cultural beliefs regarding females interacting with males in public
B) Complaints from others of "bullying" that occurs in gym class
C) The student's problems adjusting to the new school environment
D) A concern that the gym class is overcrowded and too competitive
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Chapter 39: The Military and Their Families
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Q1) 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?"
Q2) Which statement by a military veteran being treated for posttraumatic stress disorder (PTSD) is the strongest evidence that the condition is being managed?
A) "My mother said that I am much more like my old self."
B) "I hope my buddies get the type of professional help I'm getting."
C) "I didn't think my nightmares would ever stop but now I'm not so sure."
D) "My children and I went to the fireworks display and we all really enjoyed it."
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Chapter 40: Psychological Care of Patients with Life-Threatening Illness
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Sample Questions
Q1) A patient with liver failure rings the call bell and tells the nurse,"The lunch is cold,and my sheets are wrinkled.You never seem to have enough help to give me the care I need." Which intervention should the nurse implement initially?
A) Listen quietly but attentively until the patient has finished speaking.
B) Attempt to correct each problem the patient has identified immediately.
C) Say to the patient, "I'm sorry but please know that the staff is really doing the best they can."
D) Promise the patient to share all of the concerns with the unit's nurse manager on day shift.
Q2) A nurse working in the pediatric intensive care unit is assigned to pediatric patients who are experiencing pain.The nurse would select the Wong FACES Pain Rating Scale for use in which child?
A) A 6-month-old patient with failure to thrive
B) A 12-month-old patient with a burn injury
C) A 24-month-old patient with injuries after a fall
D) A 38-month-old patient with sickle cell disease
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