Psychiatric Nursing Practice
Final Exam Questions
Course Introduction
Psychiatric Nursing Practice focuses on the principles and application of nursing care for individuals, families, and groups experiencing mental health concerns. This course covers the assessment, diagnosis, planning, intervention, and evaluation processes specific to psychiatric disorders, emphasizing therapeutic communication, crisis intervention, medication management, and advocacy. Students learn to integrate evidence-based practices, cultural competence, and ethical considerations while collaborating with interdisciplinary teams to promote mental wellness, recovery, and holistic care for patients across the lifespan.
Recommended Textbook
Principles and Practice of Psychiatric Nursing 10th Edition by Gail Wiscarz Stuart
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40 Chapters
943 Verified Questions
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Page 2
Chapter 1: Roles and Functions of Psychiatric-Mental Health
Nurses: Competent Caring
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Sample Questions
Q1) 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
Q2) 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
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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Sample Questions
Q1) In the initial sessions a patient frequently asks the nurse for money and expresses doubt about the nurse's ability to help.Which principle provides guidance for the nurse in this situation?
A) This behavior is typical of transference reactions.
B) All patients have feelings of insecurity and low self-esteem.
C) Manipulative behavior is part of this patient's psychopathology.
D) Testing behavior is common during the introductory phase of a relationship.
Answer: D
Q2) When a patient is late for three consecutive therapy sessions,the nurse implements perception sharing as a communication technique when stating:
A) "You say how important therapy is to you, but you can't seem to get here on time."
B) "Do you think it's polite being late for therapy sessions like this?"
C) "Do you have really good reasons for being late so often?"
D) "I feel that you aren't ready to work on your problems."
Answer: D
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4
Chapter 3: The Stuart Stress Adaptation Model of Psychiatric Nursing Care
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Sample Questions
Q1) A patient mentions,"No one else I know is mentally ill." What reply would help the patient understand the extent of mental illness?
A) "You are not unique; many people experience mental illness."
B) "Let's concern ourselves with you and getting you well again."
C) "Being among people who understand your problem and want to help is what is important."
D) "You are truly not alone; almost 50% of adults experience some kind of mental illness.
Answer: D
Q2) A delusional patient believes that the accidental death of a child was actually caused by aliens.He has become severely anxious believing he is also in danger.During the acute stage of treatment,the expected outcome of nursing care is the:
A) patient will experience symptom relief.
B) nurse will validate the patient's strengths.
C) patient will identify vulnerabilities that led to the symptoms.
D) nurse will focus on the patient's quality of life and well-being.
Answer: A
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Chapter 4: Evidence-Based Psychiatric Nursing Practice
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Sample Questions
Q1) To what extent is outcome measurement important to the delivery of psychiatric nursing care?
A) It is more "nice" than it is necessary.
B) It will support the legitimacy of psychiatric nursing.
C) It will promote descriptive and correlational nursing research.
D) It gives information about the appropriate settings for treatment.
Q2) The psychiatric nurse uses evidence-based practice as a means to better meet patients' needs.The most current source of nursing research is:
A) textbooks.
B) journal articles.
C) the DSM-IV-TR.
D) databases of systematic reviews.
Q3) Which nursing activities are necessary to provide evidence-based psychiatric nursing care?
A) Obtaining advanced degrees and providing clinical supervision for peers
B) Seeking sound opinion-based processes and maintaining self-directed practice
C) Attending educational programs and supporting the advanced practice licensure
D) Critically synthesizing research findings and applying relevant evidence to practice
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Chapter 5: Biological Context of Psychiatric Nursing Care
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Sample Questions
Q1) A couple tells a nurse that they are concerned about having children because there is bipolar disorder in first-degree relatives of each of them.What advice should the nurse give?
A) "Do not have children."
B) "Seek genetic counseling."
C) "Do as your conscience dictates."
D) "Bipolar disorder is not hereditary."
Q2) A nurse explains to a patient undergoing diagnostic testing which brain imaging technique measures brain structure?
A) Computed tomography (CT)
B) Positron emission tomography (PET)
C) Brain electrical activity mapping (BEAM)
D) Single-photon emission computed tomography (SPECT)
Q3) A patient demonstrates disoriented thinking and irrational ideas.A nurse can anticipate that a PET scan would most likely show dysfunction in the brain's _____ lobe.
A) frontal
B) parietal
C) occipital
D) temporal
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Chapter 6: Psychological Context of Psychiatric Nursing Care
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Sample Questions
Q1) A cognitively impaired patient reports to the nurse that,"I had the best time.My husband took me out to dinner and then to a concert.The music was wonderful."
Knowing that the patient is a widow,the nurse determines her remarks are an example of:
A) tangential thinking.
B) confabulation.
C) hallucination.
D) circumstantiality.
Q2) A patient diagnosed with depression tells a nurse,"If I hadn't been admitted,I would have carried out my plan and everyone would have been better off without me." The nurse responds:
A) "It's frustrating when plans are interrupted."
B) "Things can still turn out all right for you while you're here."
C) "What specifically did you plan to do before you were admitted?"
D) "I know you're feeling bad now but if you talk, things will be better."
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?"
Page 8
D) "If you won $10,000, what would you do with it?"
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Chapter 7: Social, Cultural, and Spiritual Context of Psychiatric Nursing Care
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Sample Questions
Q1) During a team conference about a patient,the patient's spouse states,"My spouse is Irish,so I should have expected a drinking problem." This statement is an example of:
A) racism.
B) intolerance.
C) stereotyping.
D) discrimination.
Q2) A nurse assessing sociocultural risk factors for a 34-year-old female,single,poorly educated immigrant with three young children and who receives support from social services,should be most concerned about the effects of:
A) age.
B) gender.
C) immigration.
D) disadvantagement.
Q3) Sociocultural risk factors are identified by assessing which patient characteristic?
A) Belief system
B) Daily health habits
C) Stress management habits
D) Restfulness of the home environment
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Chapter 8: Legal and Ethical Context of Psychiatric Nursing Care
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Sample Questions
Q1) A patient,who is homeless and known to be schizophrenic,was arrested after vandalizing parked cars while naked.Which behaviors will be considered when determining if the patient should be involuntarily committed for care? Select all that apply.
A) The patient is a possible danger to others.
B) The patient is a diagnosed schizophrenic.
C) The patient is a disruptive factor to the community.
D) The patient is unable to provide for his or her own basic needs.
E) The patient is in need of either physical or mental health treatment.
Q2) Two nurses are discussing the rights of hospitalized psychiatric patients.Which of their beliefs requires follow-up by the nurse manager?
A) The hospital is responsible for the patient's safety.
B) If a committed patient is judged to be incompetent, he or she retains the right of habeas corpus.
C) Privileged communication does not apply to hospital charts, so they can be used in court.
D) Disclosure of patient information to law enforcement agencies is permitted without patient consent.
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Page 10
Chapter 9: Policy and Advocacy in Mental Health Care
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Sample Questions
Q1) A patient tells a nurse,"I belong to a health maintenance organization (HMO) that advertises being a capitated system.What does that mean?" The nurse replies:
A) "It's complicated but if you like I'll have the payments office discuss it with you."
B) "You pay a sliding fee for each illness based on your monthly take-home income."
C) "You pay a fixed fee per month while the HMO provides all medically necessary care."
D) "The HMO pays your physician a flat fee for a particular episode of illness regardless of the number of office visits you make."
Q2) 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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Sample Questions
Q1) When a family is having difficulty adjusting to the burden of having a mentally ill family member,which is the most therapeutic resource of ongoing support a nurse can suggest to the family?
A) American Medical Association (AMA)
B) National Alliance on Mental Illness (NAMI)
C) American Psychiatric Nurses Association (APNA)
D) National League for Nursing (NLN)
Q2) Which component would be part of a comprehensive program for working with families of mentally ill patients? (Select all that apply.)
A) Skill
B) Social
C) Debate
D) Emotional
E) Family process
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Chapter 11: Implementing the Nursing Process: Standards of Practice
and Professional Performance
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Sample Questions
Q1) While gathering a baseline history about a patient,a nurse is told by a team social worker that the patient "acts weird and has bad hygiene." The nurse's responsibility is to:
A) accept the data without question.
B) form impressions based on data personally gathered.
C) document the impression of the team social worker.
D) discuss the social worker's impression with the patient.
Q2) 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.
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.
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Chapter 12: Prevention and Mental Health Promotion
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Sample Questions
Q1) A nurse working in a community health agency wishes to implement a primary preventive program in mental health for the elderly.Which action should occur first?
A) Elaboration of specific preventive strategies
B) Identification of stressors that precipitate maladaptive responses
C) Application of selected nursing interventions to enhance adaptation
D) Determination of the effectiveness of the existing nursing activities
Q2) A psychiatric nurse is working with patients in a health education group on strategies to improve anger management.The nurse would best evaluate the effectiveness of this intervention by determining changes in a patient's:
A) routinely used coping skills.
B) opinion about own self-worth.
C) knowledge of people and events that trigger anger.
D) underlying mental health disorder, exhibited by the symptom of anger.
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14
Chapter 13: Crisis Intervention
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Sample Questions
Q1) Survivors of a hurricane are grieving the loss of loved ones and homes.Which level of crisis intervention would be most appropriate for a nurse to use?
A) General support
B) Generic approach
C) Individual approach
D) Environmental manipulation
Q2) Which statement made by a person in a crisis state indicates the presence of a balancing factor?
A) "I've been drinking more than usual."
B) "I've always been a loner. I don't need other people."
C) "I pray when things get tough. It's always helped me survive trouble."
D) "My spouse just went to the store. I don't believe it when they tell me my spouse is dead."
Q3) A nurse working with a patient in individual crisis intervention would characterize the approaches used as:
A) open-ended.
B) passive and indirect.
C) active, focused, and explorative.
D) psychoanalytic-based techniques.
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Page 15
Chapter 14: Recovery and Psychiatric Rehabilitation
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Sample Questions
Q1) A 27-year-old diagnosed with schizophrenia lives at home with both parents.A nurse is helping the family become better prepared to work with their child.Which nursing intervention would be most beneficial?
A) Having the family members remind the patient often about appointments and the schedule of daily activities
B) Helping the family members with scheduling regular daily activities and suggesting the family members allow the patient privacy and personal space
C) Suggesting that family members spend as much time as possible with the patient and continuously reassure the patient that he or she will never be left alone
D) Suggesting that a family member help the patient plan activities of daily living (ADLs) and make sure that all family members understand the need for vigilance with the patient
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16
Chapter 15: Anxiety Responses and Anxiety Disorders
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Sample Questions
Q1) A patient admitted to the psychiatric unit with a diagnosis of obsessive-compulsive disorder (OCD) tells a nurse of a need to perform oral hygiene at least 15 times each day while sleeping only 1 hour each night for the last 5 days.Within the next 48 hours,which outcome would best indicate that nursing interventions to relieve anxiety had been successful?
A) The patient sleeps 6 hours nightly.
B) The patient states that performing rituals is "silly."
C) The patient verbalizes that brushing one's teeth 15 times each day is "too much."
D) The patient admits to being acutely anxious and wants help.
Q2) 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
Q3) Defense mechanisms:
A) involve some degree of self-deception.
B) are rarely used by mentally healthy people.
C) seldom make the person feel more comfortable.
D) are rarely effective in resolving basic conflicts.
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Page 17
Chapter 16: Psychophysiological Responses and Somatoform and Sleep Disorders
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Sample Questions
Q1) A patient is diagnosed with conversion disorder that is evidenced by paralysis of the right hand.Which nursing intervention should be implemented?
A) Focus discussions on the patient's inability to fulfill usual roles.
B) Focus discussions on the patient's unusual and unexplainable physical symptom.
C) Spend time with the patient to give recognition for positive qualities and strengths.
D) Spend time with the patient when the patient is helpless to perform self-care activities because of paralysis.
Q2) A business executive is in the cardiac care unit (CCU) after a myocardial infarction.When the patient is told that it is not possible to have a telephone in the room,the patient angrily berates the nurse and demands to see a physician.Which response by the nurse would be the most therapeutic?
A) "I'll call your physician."
B) "I'll arrange for you to have a telephone."
C) "I can see that being ill is difficult for you."
D) "You are just too ill to make business calls."
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Page 18
Chapter 17: Self-Concept Responses and Dissociative Disorders
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Sample Questions
Q1) A nurse is working with a patient to improve self-concept.To best assist the patient in realistic goal planning,the nurse will:
A) note the patient's use of logical and illogical thinking.
B) provide support measures to reduce the patient's anxiety.
C) clarify that the patient's beliefs affect the patient's feelings and behaviors.
D) help the patient understand that the patient alone can bring about personal change.
Q2) A patient reports feeling detached and says,"It feels as though I'm watching a movie as life unfolds.I'm isolated,on the outside and not involved.I really don't feel anything.I don't know if I'm alive or dead,awake or sleeping." The nurse can determine that the patient is describing:
A) akathisia.
B) hypomania.
C) depersonalization.
D) boundary violations.
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Chapter 18: Emotional Responses and Mood Disorders
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Sample Questions
Q1) Which coping mechanism should a nurse expect to see a patient initially use to mourn the death of a spouse?
A) Denial
B) Introjection
C) Suppression
D) Dissociation
Q2) A patient is extremely hyperactive,distractible,and rarely sleeps.The patient eats little,resulting in a loss of 6 pounds since admission 3 days ago.Which measure is a priority when developing a plan for the patient's care?
A) Require that the patient remain in the dining room for at least 15 minutes per meal.
B) Offer high-calorie "portable" finger foods and nutritionally fortified fluids hourly.
C) Document all food and fluid intake.
D) Weigh the patient daily.
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Chapter 19: Self-Protective Responses and Suicidal Behavior
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Sample Questions
Q1) A psychiatric technician states,"This patient has frequently threatened suicide but has never attempted it.The patient should be sent home instead of encouraging the threats." The nurse supports admitting the patient by responding:
A) "There is no family to provide the social support that is vital to safety."
B) "Any suicide threat deserves serious attention and concern for safety."
C) "You seem to have a real problem when patients lose emotional control."
D) "Nursing staff are encouraged to share their concerns with the physician."
Q2) A nurse assessing a patient who has been noncompliant with the prescribed diabetic diet and exercise regimen should consider planning strategies to overcome patient use of:
A) denial.
B) projection.
C) dissociation.
D) displacement.
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21
Chapter 20: Neurobiological Responses and Schizophrenia and Psychotic Disorders
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Q1) A patient diagnosed with schizophrenia approaches the nurse and says,"I'm cold.Ice cream is cold.Freezers keep ice cream cold." This speech pattern can be assessed as:
A) hyperverbosity.
B) circumstantiality.
C) loose associations.
D) expressing delusions.
Q2) A patient reports,"My brain is controlled by government agents who can trace my whereabouts and listen to my thoughts." An appropriate nursing response to this information would be:
A) "Your story is very strange and too bizarre for me to believe."
B) "Tell me why you think your brain is being controlled by the government."
C) "Were you experiencing any stress just before you began to think your brain was being controlled?"
D) "Are you feeling frightened or angry about the government violating your body and controlling your brain?"
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22
Chapter 21: Social Responses and Personality Disorders
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Sample Questions
Q1) A nursing diagnosis appropriate to consider for a patient with antisocial personality disorder is:
A) risk for self-directed injury.
B) impaired social interaction.
C) disturbed personal identity.
D) disturbed sensory perception.
Q2) A goal for a patient with impulsive behavior is "The patient will explore the causes and consequences of impulsive behavior." A strategy that will best assist the patient in achieving this goal is:
A) using rewards for appropriate behavior.
B) using relaxation exercises to reduce interpersonal anxiety.
C) keeping a diary to describe events before and after the behavior.
D) frequent clinical supervision for the nurse providing therapy for the patient.
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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23
Chapter 22: Cognitive Responses and Organic Mental Disorders
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Q1) A nurse caring for a patient with Alzheimer disease can anticipate that the family will most likely need information about:
A) antimetabolites.
B) benzodiazepines.
C) immunosuppressants.
D) acetylcholinesterase inhibitors.
Q2) A person who is the caregiver of a parent with early-to-middle-stage Alzheimer disease is concerned about possible episodes of incontinence.What strategy should the nurse suggest?
A) Limiting the patient's fluid intake to 1000 ml daily
B) Discussing the use of an indwelling catheter with the health care provider
C) Putting plastic coverings on the beds, upholstered chairs, and sofas
D) Taking the patient to the bathroom at least every 2 hours when the patient is awake
Q3) A patient has sundown syndrome.The nurse can expect that the patient will:
A) exhibit chronic fatigue.
B) evidence extreme lethargy at night.
C) manifest confusion and agitation at night.
D) be more alert between 6 PM and 11 PM.
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Chapter 23: Chemically Mediated Responses and
Substance-Related Disorders
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Q1) It will be most helpful for a nurse to describe a relapse to a recovering substance abuser as a(n):
A) error from which to learn.
B) indicator of treatment failure.
C) event with a physiological cause.
D) need for additional environmental support.
Q2) An appropriate short-term goal related to abstinence for a drug abuser would be "The patient will:
A) verbalize details of the addiction to significant others."
B) declaratively state an intention to abstain from drug use of any sort."
C) be able to identify the underlying causes that resulted in an addiction to drugs."
D) contact a supportive person if experiencing an urge to use an addictive substance."
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.
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Chapter 24: Eating Regulation Responses and Eating Disorders
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Q1) A patient is diagnosed with anorexia nervosa.A nurse who is assessing for co-morbid psychiatric disorders should begin by looking for signs of which common,concurrent diagnosis?
A) Phobias
B) Depression
C) Schizophrenia
D) Personality disorder
Q2) A nurse assesses that which individual is most likely to engage in binge-eating behaviors characteristic of bulimia? A person who:
A) weighs 225 pounds and is 5 feet 4 inches tall.
B) is 5 pounds overweight and cannot stick to a diet.
C) lost 40 pounds but gained it back within 1 year.
D) monitors caloric intake in order to fit into a small suit.
Q3) Which statement would help the nurse conclude that a patient with an eating disorder is exhibiting cognitive distortion?
A) "I see now that I need to establish my own preferences and routines."
B) "Bingeing makes my feelings of both isolation and loneliness go away."
C) "Controlling what I eat has been a way for me to exert control over my life."
D) "I need to watch for hunger and fatigue as triggers for my eating disorder."
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Chapter 25: Sexual Responses and Sexual Disorders
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Sample Questions
Q1) A person states,"I feel as though I'm really a woman trapped in this male body." This type of statement is characteristically expressed by someone who is a:
A) transsexual.
B) transvestite.
C) pedophile.
D) homosexual.
Q2) A nurse caring for an attractive patient of similar age and background begins fantasizing about having a social and sexual relationship with the patient.The most effective means of dealing with these feelings is to:
A) make a personal promise to not act on the feelings.
B) limit contact with the patient to include only care.
C) ask to change patient assignments immediately.
D) seek advice from an experienced peer.
Q3) Which statement made by a patient shows a correct understanding of human sexuality?
A) "Oral intercourse is dangerous."
B) "Sex during menstruation should be avoided."
C) "Advanced age is not by itself a deterrent to sexual function."
D) "Alcohol ingestion enhances sexual pleasure and performance."
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Page 27
Chapter 26: Psychopharmacology
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Q1) A nurse observes a patient diagnosed with schizophrenia tapping both feet,smacking both lips,and making contorted faces while speaking to another patient.These behaviors prompt the nurse to suspect the patient is experiencing:
A) neuroleptic malignant syndrome.
B) Parkinson syndrome.
C) tardive dyskinesia.
D) torticollis.
Q2) 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
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Chapter 27: Behavior Change and Cognitive Interventions
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Q1) Which clinical manifestation would indicate to a nurse that a patient has been employing relaxation training successfully? (Select all that apply.)
A) Decreased blood pressure
B) Decreased bowel sounds
C) Decreased respirations
D) Decreased apical pulse
E) Decreased pupil size
Q2) A nurse explains the technique of response cost to parents who are seeking to reduce the frequency of unwanted behaviors in their children.What is an example of this type of strategy?
A) Ignoring a temper tantrum
B) Taking away the privilege to watch television until homework is finished
C) Grounding a child for a month after a very poor report card is received
D) Making a young child sit in a corner after fighting with a younger sibling
Q3) An important characteristic of cognitive behavioral therapy is its focus on the:
A) authoritarian role assumed by the therapist.
B) consistent collaboration with the patient.
C) subjective experiences of the patient.
D) approach to treatment.
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Chapter 28: Preventing and Managing Aggressive Behavior
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Q1) Which medication would a nurse expect to be prescribed to an adolescent patient diagnosed with a conduct disorder who has a history of physically abusing younger siblings?
A) Propranolol (Inderal)
B) Propranolol (Ritalin)
C) Clozapine (Clozaril)
D) Phenytoin (Dilantin)
Q2) Which response best reflects appropriate assertiveness by a nurse when approached by a patient who demands medications immediately?
A) "I will get your medications as soon as I am finished with what I am doing right now, so please wait for me in your room."
B) "I will give you your medications as soon as I finish here. It's not appropriate for you to keep asking me for your medications."
C) "I'll check on your medications as soon as I finish with what I am doing. If it is not quite time for your medications I will bring them to you when it is."
D) "We need to talk about your impatient behavior before I give you your medications. You must understand that you are not the only patient on the unit."
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Chapter 29: Somatic Therapies
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Q1) A patient shares with a nurse,"Since I moved from Florida to New York,I get depressed right before the winter holidays and it lasts for weeks.Is there anything I can do besides taking pills?" The most therapeutic nursing response is:
A) "Consider phototherapy since it's likely you are experiencing seasonal affective disorder (SAD)."
B) "I'm not clear about what you are saying. Please tell me more about what you are experiencing."
C) "If you have a biochemically based depression, you will need antidepressant medication if you want to see improvement."
D) "If you want dramatic results, ECT (electroconvulsive therapy) works the fastest and can usually be done on an outpatient basis."
Q2) A nurse is assisting in the preprocedure care of a patient scheduled for ECT (electroconvulsive therapy).Which nursing action must be taken immediately before the procedure?
A) The electrode sites are shaved and cleaned with a soap and water.
B) A blood pressure cuff and the oxygen saturation probe are applied.
C) A 12-lead electrocardiogram (ECG) is run and the strip placed in the chart.
D) The patient signs an informed consent form allowing for the treatment.
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Chapter 30: Complementary and Alternative Therapies
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Q1) A patient states,"One of my friends says it's possible to cure the fear of flying by using relaxation techniques.Do you think relaxation techniques would help my chronic depression?" What is a nurse's best response?
A) "Let's discuss what research has proven concerning relaxation and its role in the management of chronic depression."
B) "Holistic therapies such as relaxation have been known to cure several types of phobias and anxiety-based disorders."
C) "You must realize that while phobias may respond well to relaxation therapy, it is not necessarily going to have the same effect on chronic depression."
D) "Holistic therapies such as relaxation have been found to be as effective as conventional treatments in treating a wide variety of anxiety disorders."
Q2) 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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Page 32
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 of these observations would indicate to the nurse facilitator that some members of a therapeutic anger management group are demonstrating resistance?
A) Four of the group members share that the discussion is making them sad.
B) Three members claim, "We don't have problems controlling our tempers."
C) Two of the members are overheard discussing their fear of "disappointing the nurse."
D) Several members share that they have physically and verbally abused their significant others in the past.
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Chapter 32: Family Interventions
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Q1) An adolescent has been hospitalized after telling the mother,"I can't stand all the arguing between Dad and me; I just want to die and be away from all the yelling." The unit nurse manager expects the patient's psychiatric health provider will recommend _____ therapy.
A) group
B) family
C) social skills
D) short-term individual
Q2) A fundamental component of family therapy is: (Select all that apply.)
A) attendance at all sessions by all family members.
B) agreement on when the therapeutic sessions will terminate.
C) consensus among all parties regarding the amount of needed therapy.
D) understanding related to the target behaviors identified for therapeutic change.
E) willingness on the part of all family members to actively participate in sessions.
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Chapter 33: Hospital-Based Psychiatric Nursing Care
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Sample Questions
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 who displays dependent tendencies follows the nurse around the unit and repeatedly asks,"What do you think I should do,nurse?" Which is the nurse's most therapeutic response?
A) "You need to think for yourself. I can't do that for you."
B) "Instead of asking me what to do, you should be practicing decision making yourself."
C) "One of the things I've observed is your dependency on me. Let's discuss why you fear making your own decisions."
D) "Let's discuss your seeming discomfort regarding decision making when we meet today in group. In the meantime, think about why you feel you need my help."
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Chapter 34: Community-Based Psychiatric Nursing Care
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Q1) Which situation would be considered discrimination under the Americans with Disabilities Act?
A) A Hispanic with poor English-speaking skills is hospitalized for possible late-onset schizophrenia.
B) A patient hospitalized for detoxification after a drunk driving accident is not allowed to leave the unit.
C) Staff is responsible for bathing, dressing, and feeding a patient diagnosed with mild Alzheimer disease (AD) on a daily basis.
D) After evaluation a cognitively impaired individual diagnosed with obsessive compulsive disorder (OCD) is identified as being "unemployable."
Q2) A psychiatric nurse is focusing on the fifth area of service,based on the Community Mental Health Centers Act of 1963,when:
A) assisting with electroconvulsive therapy (ECT) treatments.
B) providing stress management technique classes to new mothers.
C) assessing patients for admission into an outpatient group program.
D) providing emergency psychiatric care to a rape victim demonstrating psychoses.
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Chapter 35: Child Psychiatric Nursing
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Q1) Which nursing intervention would be most effective when assisting a child with attention-deficit/hyperactivity disorder (ADHD) to learn to use good hygiene measures each morning?
A) Have the child watch parents groom and dress each morning.
B) Stay with the child while talking them through each activity every morning.
C) Add a new activity to the morning care routine each time the child masters a task.
D) Dress the child slowly and encourage him or her to practice redressing again alone.
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) Which statement would be the most therapeutic initially when interviewing an adolescent who attempted suicide in the school bathroom?
A) "Can you tell me what you were thinking that caused you to attempt suicide?"
B) "It appears that you were really interested in letting your classmates know you were angry."
C) "If you are willing to discuss the reasons you wanted to die, I'm certainly willing to listen to you."
D) "How do you feel I can help you, since most suicide attempts are really cries for help?"
Q2) When asked to manage the care of an intoxicated adolescent who was found drinking alcohol in the school bathroom,the school nurse should: (Select all that apply.)
A) arrange for the adolescent to sleep in a safe place.
B) report the adolescent's drinking to the local police.
C) inform the parents that the child will be suspended.
D) call the parents to notify them of the situation.
E) notify the school's alcohol counselor.
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Chapter 37: Geropsychiatric Nursing
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Q1) A mildly confused older adult patient states,"I am in the Mojave desert." A nurse who is using validation therapy with the patient would make which response?
A) "Are you feeling hot or thirsty?"
B) "Can you tell me about a time in your past when you were in a desert?"
C) "You are in a rehabilitation nursing center because you need help caring for yourself."
D) "Your medical record shows that you have hyperthyroidism, which is probably responsible for the confusion you are experiencing."
Q2) An older adult patient recently moved to a retirement community.Which behavior would prompt the nurse to suspect the patient is experiencing relocation stress syndrome?
A) Episodic dyspnea
B) Inappropriate affect
C) Increased withdrawal
D) Urinary incontinence
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Chapter 38: Care of Survivors of Abuse and Violence
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Q1) Which patient statements would be considered a potential risk factor for family-directed violence towards them? (Select all that apply.)
A) "My parents certainly believed in not spoiling a child."
B) "I'm angry that I had to get a part-time job to help buy food."
C) "My family thinks I'm just a burden, but they'll be sorry that they treated me so badly."
D) "When my spouse gets upset he tells me I'm no longer attractive because I've gained weight."
E) "I work long hours to pay the bills and put food on the table but I can't seem to Make my spouse happy."
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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Page 40
Chapter 39: The Military and Their Families
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Sample Questions
Q1) A military veteran being treated for substance abuse shares that the family is experiencing financial problems since being discharged.In order to assess the individual's coping skills,the nurse asks:
A) "Do you have any idea about how your finances got out of your control?"
B) "How well were you at managing your finances before leaving the military?"
C) "Can you give me some idea of the kind of financial help you feel you need?"
D) "Have your financial expenses increased dramatically since being discharged?"
Q2) Several nurses are newly assigned to a hospital unit that focuses on the care of military personnel who have sustained severe brain injuries and their families.The nurse manager would initially suggest that they:
A) focus on honing their therapeutic communication and assessment skills.
B) self-reflect concerning their feelings about working with the disabled.
C) learn to recognize and act upon the emotional needs of the family.
D) review the physical needs of the traumatic brain injured client.
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Chapter 40: Psychological Care of Patients with Life-Threatening Illness
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Sample Questions
Q1) A patient who is terminally ill expresses a wish to "hurry up and end it all." In exploring reasons for this wish,which should the nurse assess first?
A) Guilt and fatigue
B) Pain and depression
C) Self-esteem and hope
D) Competency and pain.
Q2) A nurse enters the room of a patient newly diagnosed with multiple sclerosis and notes that the patient is crying quietly while lying in bed.Which communication by the nurse would be most appropriate?
A) "You are crying. What are you feeling that's making you so sad?"
B) "Do you want me to call the health care provider to order some antidepressant medication for you?"
C) "I can understand why you would cry. I imagine most people would feel sad after being given your diagnosis."
D) "Crying is a normal response to a diagnosis such as yours. You'll feel better after your plan of care has been fully developed."
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