Psychopharmacology for Nurses
Pre-Test Questions
Course Introduction
This course provides nursing students with a comprehensive understanding of psychopharmacology, focusing on the use of medications in the treatment of psychiatric disorders. Students will explore the mechanisms of action, therapeutic uses, side effects, and nursing implications of major classes of psychotropic drugs, including antidepressants, antipsychotics, mood stabilizers, anxiolytics, and stimulants. Emphasis is placed on safe medication administration, patient education, monitoring for adverse reactions, and collaboration with the interdisciplinary mental health team. By integrating theory with clinical practice, the course prepares nurses to make evidence-based decisions and provide holistic care to individuals experiencing mental health challenges.
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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Chapter 1: Roles and Functions of Psychiatric-Mental Health
Nurses: Competent Caring
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Sample Questions
Q1) To derive the theoretical framework of psychiatric nursing,knowledge from which sciences is included? (Select all that apply.)
A) Psychosocial
B) Biophysical
C) Personality behavior
D) Human behavior
E) Psychodynamics
F) Psychobiology
Answer: A,B,C,D
Q2) When considering psychiatric nursing roles and functions,in order to delegate effectively the nurse must have knowledge of the domains of: (Select all that apply.)
A) management.
B) communication.
C) direct care.
D) teaching.
E) collaboration.
Answer: A,C
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Page 3
Chapter 2: Therapeutic Nurse-Patient Relationship
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Sample Questions
Q1) According to transactional analysis theory,when a patient finally recognizes the importance of being medication-compliant,which type of transaction has occurred?
A) Ulterior
B) Crossed
C) Incongruent
D) Complementary
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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31 Verified Questions
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Sample Questions
Q1) A patient newly diagnosed with Chron's disease shares she is spending several hours each week on the Internet seeking information about the illness.The nurse can correctly hypothesize that this patient is initially:
A) engaged in a search for meaning.
B) devising a new coping strategy.
C) making a social attribution.
D) making a social comparison.
Answer: A
Q2) The nurse initiates the nursing process for the purpose of managing the psychiatric care for a patient with a maladaptive stress response when:
A) admission orders have been written by the admitting physician.
B) diagnostic tests rule out the presences of any organic pathology.
C) the patient relationship with the nurse has been established.
D) the nurse makes initial contact with the patient.
Answer: D
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Chapter 4: Evidence-Based Psychiatric Nursing Practice
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Sample Questions
Q1) A patient is scheduled to be discharged from the locked inpatient psychiatric unit.In order to best evaluate the appropriateness of the patient's care the nurse:
A) brings the care plan and ongoing documentation to an interdisciplinary team meeting, where the patient's progression towards discharge will be discussed.
B) gathers evidence from the chart that shows progression in the patient's medical condition to prepare for the evaluation of the outcomes.
C) asks the patient's family to discuss the discharge because they have visited daily since the patient's admission.
D) asks the patient to meet with you to discuss any feelings about discharge and returning home.
Q2) 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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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 patient diagnosed with depression tells a nurse,"I don't feel rested.It's as though I didn't sleep at all." Comments by night shift staff show that the patient slept through most of the night.How can these two observations be reconciled?
A) The patient is considered the more accurate reporter.
B) The staff observations are more objective than the patient's statement.
C) Studies show that people with depression have disturbed sleep cycles that can result in sleep deprivation.
D) People with depression characteristically underreport sleep satisfaction because of cognition flaws.
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Chapter 6: Psychological Context of Psychiatric Nursing Care
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Q1) The health care provider describes a patient as being dressed like a "typical patient with mania." From this statement,the nurse can assume that the patient's mode of dress was:
A) drab.
B) slovenly.
C) seductive.
D) flamboyant.
Q2) The patient believes that the CIA is "plotting to kill me." The report is given with the patient exhibiting little emotion.The nurse documents the patient's affect as:
A) flat.
B) elated.
C) labile.
D) congruent.
Q3) During a mental status evaluation,a nurse's intuition may indicate:
A) clues about the patient's physical well-being.
B) subtle emotions being expressed by the patient.
C) areas to be explored in the predischarge interview.
D) potential nursing diagnoses that relate to a patient knowledge deficit.
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Chapter 7: Social, Cultural, and Spiritual Context of Psychiatric Nursing Care
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18 Verified Questions
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Sample Questions
Q1) A nurse working in a mental health center would determine which patient to be the best candidate for a spirituality-based 12-step intervention program?
A) A patient who has generalized anxiety disorder
B) A patient who has an addiction to alcohol
C) A patient with a personality disorder
D) A patient who has agoraphobia
Q2) 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.
Q3) One task of an administrator of a culturally sensitive mental health system would be to:
A) eliminate all staff bias related to cultural diversity.
B) hire significant numbers of minority health care providers.
C) incorporate the values of culture competency into all levels of care.
D) keep access to care open for the dominant ethnic, social, and religious groups.
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Chapter 8: Legal and Ethical Context of Psychiatric Nursing Care
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Sample Questions
Q1) The parents of a patient with schizophrenia ask whether their child is likely to become violent.The best answer the nurse can give is that the vast majority of mentally ill individuals are:
A) somewhat more dangerous than ordinary people.
B) definitely more violence-prone than others on the street.
C) no more dangerous than other individuals in the population.
D) considerably more dangerous than others in the population.
Q2) A patient tried for the murder of a spouse and child was found guilty but mentally ill (GBMI).A psychiatric nurse is asked,"Does that mean this patient will be walking the streets after a short hospitalization?" Which reply shows the best understanding of GBMI?
A) "The patient will be hospitalized and released when no longer mentally ill."
B) "A person found guilty but mentally ill will be treated while serving the sentence."
C) "You sound as though you are angry with the way our criminal justice system works."
D) "It will depend on whether the American Law Institute's Test was applied or whether the Irresistible Impulse Test was used."
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Page 10
Chapter 9: Policy and Advocacy in Mental Health Care
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Sample Questions
Q1) In many rural communities the ratio of consumers to doctors is higher than it is in cities.This is an example of:
A) a health access problem in rural areas.
B) a lack of compassion among physicians.
C) reimbursement barriers in rural states.
D) appropriate distribution of health care providers.
Q2) To work effectively within the health care system,a nurse must understand the current interface between mental health care and the environment.Which statement accurately reflects this interface?
A) The once simple system has grown from two to six parts, which has significantly complicated the interface.
B) Biases on the part of providers have largely been abolished, greatly improving the effectiveness of the interface.
C) Reimbursers and insurers are primarily concerned with protecting the patient's constitutional rights regarding access to care and treatment received.
D) In general, families are becoming less concerned with education and empowerment for family members who are patients.
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Chapter 10: Families as Resources, Caregivers, and Collaborators
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Sample Questions
Q1) When providing education for families of mentally ill patients,the nurse realizes that which of the following organizations places the most importance on this intervention?
A) The Managed Care Association
B) National Alliance on Mental Illness
C) American Psychiatric Nurses Association
D) New Freedom Commission on Mental Health
Q2) 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
Q3) The symbolic interactionism theoretical model helps explain the:
A) hypotheses explaining why patients with schizophrenia hear voices.
B) basis for social difficulties experienced by patients with bipolar disorder.
C) impact that living with a mentally ill person has on their family structure.
D) relative lack of support for mentally ill patients of certain U.S. subcultures.
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Chapter 11: Implementing the Nursing Process: Standards of Practice
and Professional Performance
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25 Verified Questions
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Sample Questions
Q1) A new psychiatric staff nurse is asked to be a member of the Quality Improvement (QI) Committee.The nurse should be motivated to agree to do this because:
A) QI participation is a requirement stated in the nurse's job description.
B) evaluation of quality of care is a standard of professional performance.
C) salary increments depend on performance variables like committee work.
D) QI is an activity mandated by the accrediting agency, The Joint Commission.
Q2) A nurse teaching a patient about the effects and side effects of the prescribed medication bases the plan on the knowledge that learning is more effective when:
A) patients are actively included in the process.
B) topics are introduced only when the patient expresses an interest.
C) nurses establish realistic goals for learning on behalf of the patient.
D) patients have responsibility for directing the teaching-learning process.
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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Page 13
Chapter 12: Prevention and Mental Health Promotion
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Sample Questions
Q1) People with low self-efficacy:
A) are often found to engage in antisocial and/or criminal behavior.
B) usually require an inordinately large percentage of the available community health resources.
C) are usually well motivated and handle stress well and typically have low vulnerability to depression.
D) give up in the face of difficulty, recover slowly from setbacks, and easily fall victim to depression.
Q2) Which person is most vulnerable to the development of psychiatric illness based on sociocultural factors?
A) A 16-year-old who has a parent with bipolar disorder
B) A 55-year-old who has retired with full pay from a job as a high school teacher
C) A 24-year-old who was raised by a grandparent after both parents died in a plane crash
D) A 67-year-old from a minority group who is poor and has no social support system
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Chapter 13: Crisis Intervention
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Q1) When a patient in crisis intervention therapy alludes to the possibility of self-harm,the nurse should:
A) arrange for someone to check in on the patient.
B) take all steps necessary to ensure the patient's safety.
C) advise the patient that such thoughts are common in crisis.
D) tell the patient that he or she is too intelligent to consider that as a solution.
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."
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15
Chapter 14: Recovery and Psychiatric Rehabilitation
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Q1) To promote positive outcomes,nurses in psychiatric rehabilitation practices should be skilled in: (Select all that apply.)
A) teaching the patient living skills.
B) actively listening to patient complaints.
C) assisting the patient in developing his or her strengths.
D) helping patients accept their own disabilities.
E) accessing the appropriateness of environmental support.
Q2) To ensure complete data regarding family social support needs,the nurse should consider seeking information relating to which four categories?
A) Anger quotient, resiliency, flexibility, and guilt
B) Financial, dependency, worry, and involvement
C) Emotional, feedback, cognitive, and instrumental
D) Diagnosis, treatment, relapse prediction, and violence potential
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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Q1) Which nursing intervention would be most therapeutic for a newly admitted patient diagnosed with obsessive-compulsive disorder (OCD) who is busily cleaning and straightening a bedroom?
A) "I've inspected the room, and it's very clean."
B) "Tell me why your clothes and room need to be cleaned."
C) "You will not be allowed in your room if you cannot control your cleaning behaviors."
D) "I can see how uncomfortable you are, but I would like you to take a short walk so I can show you the unit."
Q2) A patient calls the community mental health center and shares,"For the past 6 months,whenever I even think about leaving my house,my heart pounds,my body shakes,and I cry and feel dizzy.There's no reason for me to feel this way,but I do." These symptoms can be assessed as being most consistent with:
A) panic disorder with agoraphobia.
B) obsessive-compulsive disorder.
C) posttraumatic stress disorder.
D) generalized anxiety disorder.
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17
Chapter 16: Psychophysiological Responses and Somatoform and Sleep Disorders
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Q1) Which nursing actions would enhance the development of a therapeutic relationship with a patient diagnosed with a psychophysiological disorder? (Select all that apply.)
A) Assure the patient that the problem is easily treated since it is imagined.
B) Approach the patient with the understanding that the symptoms are real.
C) Encourage the patient to identify triggers that make the symptoms worse.
D) Encourage the patient to identify situations that make the symptoms better.
E) Provide the patient with a list of behaviors that are the focus of the problem.
Q2) Which strategy would be most therapeutic when helping a patient with a psychophysiological disorder to develop insight?
A) Spend time with the patient to identify strengths.
B) Identify dysfunctional coping mechanisms for the patient.
C) Suggest that the patient's use of denial is interfering with developing insight.
D) Help the patient become aware of feelings when physical symptoms are present.
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Chapter 17: Self-Concept Responses and Dissociative Disorders
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Q1) During the process of self-exploration,it is important for a nurse to convey the message that the patient:
A) may be the victim of circumstances that created unsolvable psychosocial problems. B) is responsible for his or her own behavior, including maladaptive coping responses. C) cannot hope to make any changes without some professional, therapeutic guidance. D) needs to focus on changing the attitudes and behaviors of significant others.
Q2) Which individual would be at greatest risk for self-esteem disturbance?
A) A 5-year-old starting school
B) A 16-year-old high school junior
C) A 26-year-old licensed practical nurse (LPN) entering a college nursing program
D) A 45-year-old working toward a master's degree in business administration
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Chapter 18: Emotional Responses and Mood Disorders
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Q1) The initial response of a steelworker who was fired from a job was disbelief.At home the steelworker told family members about the firing but retreated to the bedroom,saying,"I'm too choked up to talk about it right now." These behaviors are characteristic of:
A) disbelief.
B) depression.
C) normal grief reaction.
D) delayed grief reaction.
Q2) Which findings indicate that the goal of returning to appropriate emotional responsiveness has been attained by a patient with mania?
A) The patient interacts superficially with staff but refuses involvement in a therapeutic alliance.
B) The patient manipulates another patient to create a disturbance and laughs at the outcome.
C) The patient identifies two attainable personal goals and offers a realistic (nongrandiose) self-appraisal.
D) The patient maintains aloof relationships with other patients and advises others based on personal preferences.
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Chapter 19: Self-Protective Responses and Suicidal Behavior
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Q1) What nursing diagnosis should be considered when caring for a patient who has engaged in direct or indirect self-destructive behavior?
A) Death anxiety
B) Chronic low self-esteem
C) Disturbed body image
D) Disturbed personal identity
Q2) A patient with depression tells a nurse,"I hope someone will make sure my family gets my jewelry when I'm gone." This statement can be assessed as a suicide: A) attempt.
B) gesture.
C) threat.
D) plan.
Q3) A nurse is working with a patient with depression whose identical twin committed suicide.In assessing this patient for suicidal risk,the nurse should consider that this patient:
A) is at increased risk for suicide.
B) has the same risk as the general population.
C) cannot be assigned a level of risk based on such limited data.
D) is at low risk because the patient has experienced the trauma of suicide.
Page 21
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Chapter 20: Neurobiological Responses and Schizophrenia and Psychotic Disorders
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Q1) 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?"
Q2) A novice nurse asks the assigned mentor,"Why should I avoid telling the patient that his ideas are bizarre and simply not logical?" The mentor responds,"If you do that:
A) it will give the patient the basis for beginning to self-reflect on the delusions."
B) the patient will probably incorporate you into the delusions as a persecutor."
C) it will be difficult to use empathy and calmness to foster the patient's trust."
D) you will have little chance of gaining the patient's cooperation."
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Page 22
Chapter 21: Social Responses and Personality Disorders
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Q1) Which statement best describes persons with personality disorders?
A) The patient's coping skills are severely impaired by cognitive impairment.
B) The patient's maladaptive behaviors involve only a single aspect of personality.
C) The patient has enduring ways of relating that often provoke negative reactions.
D) The patient has considerable resilience when faced with stressful life situations.
Q2) 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.
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Chapter 22: Cognitive Responses and Organic Mental Disorders
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Q1) 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.
Q2) A patient experiencing delirium secondary to drug toxicity is manifesting paranoid thinking and noisy,assaultive behavior and is currently pacing the room.The nurse's initial intervention is to:
A) prepare to apply supervised restraints.
B) request an intravenous sedative.
C) calmly attempt to quiet the patient.
D) attempt to divert the patient's attention.
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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Q1) 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."
Q2) 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.
Q3) A nurse should specifically assess a patient opiate withdrawal for:
A) lacrimation, rhinorrhea, dilated pupils, and muscle pain.
B) somnolence, constipation, normal pupils, and hypothermia.
C) tremors, hypertension, constricted pupils, and deep sleep.
D) visual and tactile hallucinations, agitation, and generalized seizures.
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Page 25
Chapter 24: Eating Regulation Responses and Eating Disorders
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Q1) An individual is seeking treatment for bulimia nervosa.The therapist decides to use cognitive behavioral therapy and medication.For what medication can a nurse expect to develop a patient education program?
A) A selective serotonin reuptake inhibitor (SSRI), such as escitalopram (Lexapro)
B) A mood stabilizer, such as lithium
C) A calcium channel blocker, such as nifedipine (Procardia)
D) An antianxiety medication, such as buspirone (Buspar)
Q2) After assessing a patient with anorexia nervosa,a nurse writes the following nursing diagnosis: imbalanced nutrition,less than body requirements related to refusal to eat as evidenced by being 25% below body weight for height.The expected outcome should be listed as "Patient will:
A) identify cognitive distortions about food, weight, and body shape."
B) exhibit fewer signs of malnutrition within 2 weeks of hospitalization."
C) be able to describe both the physical and emotional complications of the eating disorder."
D) restore healthy eating patterns and normalize physiological parameters related to ideal weight."
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Chapter 25: Sexual Responses and Sexual Disorders
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Q1) When a patient tells a nurse,"I think I'm impotent," which response by the nurse would be most therapeutic?
A) "That must be very scary for you."
B) "How is your overall health?"
C) "What medications are you currently taking?"
D) "Please tell me what you mean by 'impotent.'"
Q2) Which classification of drugs has the greatest potential for causing sexual dysfunction?
A) Diuretics
B) Antihypertensives
C) Appetite suppressants
D) Gastrointestinal (GI) antiinflammatory agents
Q3) What is the rationale for seeking information about the effects of prescribed medications on a patient's sexual function?
A) Sexual dysfunction may result from use of prescription medications.
B) The question eases the transition to questioning about sexual practices.
C) Patients are more comfortable talking about medications than about sex.
D) The question provides an opening to question about nonprescription drug use.
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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) A nurse who administers an antipsychotic medication explains to the client patient how the medication helps manage the symptoms by affecting:
A) dopamine and GABA.
B) serotonin and dopamine.
C) synaptic neurovesicles and neurodendrites.
D) monoamine oxidase inhibitors and serotonin.
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Chapter 27: Behavior Change and Cognitive Interventions
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Q1) Which strategy will help evoke relaxation when using meditation?
A) Playing soft background music
B) Ten-second deep breathing and exhaling
C) Ten-second tensing and relaxing of muscle groups
D) Providing a word or scene on which the patient can focus
Q2) When describing cognitive behavioral therapy,it would be stressed that nursing is responsible for: (Select all that apply.)
A) providing direct patient care.
B) assisting in actual psychotherapy sessions.
C) participating in planning the treatment program.
D) teaching family members how to use cognitive behavioral techniques.
E) reinforcing the expectations of the planned interventions of the treatment plan.
Q3) Which behavior would a nurse focus upon when using a token economy as a method of positive reinforcement?
A) Altering cognitive perceptions
B) Reinforcing cognitive congruence
C) Performing assigned tasks in a cooperative manner
D) Pairing desired behaviors with undesired behaviors
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Chapter 28: Preventing and Managing Aggressive Behavior
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Sample Questions
Q1) 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."
Q2) 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)
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Chapter 29: Somatic Therapies
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Q1) Which intervention would have the most therapeutic value for a patient who has just awakened after an ECT (electroconvulsive therapy) treatment and appears disoriented?
A) The nurse brings a family member into the recovery room to stay and talk with the patient until the patient is fully awake.
B) The nurse touches the patient's hand and in a calming voice assures the patient, "Everything is fine; the treatment is over."
C) The nurse tells the patient that the treatment is over and shares, "You'll be a little confused but for only a very short time."
D) The nurse addresses the patient by name and states, "I'm your nurse here at the hospital. Your treatment is over and you're doing fine."
Q2) Which finding indicates to a nurse that a patient experienced a brief generalized seizure while receiving bilateral ECT (electroconvulsive therapy) treatment?
A) A motor seizure lasting 200 seconds
B) A motor seizure lasting 150 seconds
C) Motoric movement in both feet and an unchanged EEG
D) Motoric movement in the cuffed foot and electroencephalogram (EEG) changes
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Chapter 30: Complementary and Alternative Therapies
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Q1) Which patient statement is the best indication that a nurse's teaching concerning the use of complementary and alternative medicine (CAM) therapies has been effective?
A) "I don't think these non-traditional treatments can help me at all."
B) "The latest studies show that kava-kava is as effective as some antidepressants."
C) "CAM therapies are often more expensive than traditional medical therapies."
D) "I'm going to discuss adding acupuncture to my depression treatment plan with my health care provider."
Q2) Which modality would a nurse plan to implement to best facilitate the patient's capacity to implement mind-body interventions? (Select all that apply.)
A) Hypnosis
B) Meditation
C) Reflexology
D) Music therapy
E) Electromagnets
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Chapter 31: Therapeutic Groups
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Q1) A male nurse and female psychiatric medical resident are leading a therapeutic group.Which statement made by a group member,would indicate acceptance regarding group leadership? (Select all that apply.)
A) "I'm glad the resident is a female. We women will have the power for a change."
B) "I guess I don't always treat you both with the respect that professionals deserve."
C) "It's not often that you see a doctor and a nurse working together leading a group."
D) "I'm glad there are two of you since two viewpoints are always better than one."
E) "It's really good to see a male finally being willing to share power with a female."
Q2) 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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33
Chapter 32: Family Interventions
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Q1) It is useful initially for a therapist who is completing a family assessment to:
A) have members also attend individual therapy.
B) interview members individually.
C) consider cultural influences.
D) visit the family home.
Q2) A nurse suspects that an adolescent patient is at risk for psychiatric problems according to the risk and protective factors model.Which information gathered during the intake assessment supports this suspicion?
A) The patient lives with a parent and a half-sibling whom the patient "hates."
B) The patient readily admits to regularly "having a few beers to loosen up."
C) The patient repeatedly says, "I want to play drums for a rock band for a living."
D) The patient's parents are divorced and "both of them date a lot of different people."
Q3) One of the primary goals identified in marital therapy is:
A) support from families of origin.
B) consensus in all decisions related to the marriage.
C) the preservation of good interpersonal communication skills.
D) the maintenance of a support system comprised of mutual friends.
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Page 34
Chapter 33: Hospital-Based Psychiatric Nursing Care
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Q1) Which intervention by the nurse is most therapeutic when a patient loses a pool game on the unit and begins acting aggressively?
A) Having the other unit staff present to demonstrate both a unified presence as well as a show of force
B) Saying to the patient, "Accompany me to your room so we can talk about what triggered your anger."
C) Stating, "The rules here are for everyone. If you cannot control your temper, you may need to leave the dayroom."
D) Setting limits on the behavior immediately, in front of other patients, to help communicate that the unit rules apply to everyone
Q2) 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."
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Page 35
Chapter 34: Community-Based Psychiatric Nursing Care
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Q1) Which patient would benefit from in-home psychiatric nursing services?
A) A patient with schizophrenia who still experiences hallucinations and is taking medication for treatment of the disorder
B) A patient with chronic depression with repeated crisis hospitalizations who is currently experiencing side effects from a newly prescribed medication
C) A patient with bipolar disorder successfully being treated with medication who also has diabetes
D) A patient newly diagnosed with HIV who is experiencing situational depression
Q2) The primary nursing responsibility of a community psychiatric nurse managing caring for patients diagnosed with serious and persistent mental illnesses residing in a group home is to conduct an ongoing:
A) assessment of the patients' life needs.
B) evaluation of care provided for the patients.
C) management of the funds allotted for individual patient care.
D) oversight of all day-to-day operations of the group home and its services.
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Chapter 35: Child Psychiatric Nursing
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Q1) A child has a history of anxiety disorder.Which statement by the child supports this diagnosis?
A) "I don't need to go to school like some other kids.
B) "School is really boring so I don't like to go there."
C) "My stomach aches in the morning so I can't go to school."
D) "My parents can't make me go to school if I don't want to."
Q2) When a 14-year-old child reports feeling "like I just want to blow that person's head off," the school nurse's initial reaction is to:
A) report the statement to parents, police, and school authorities.
B) say to the child, "Tell me what you mean when you say that."
C) restate, "You're feeling really angry with this person right now, aren't you?"
D) confer with other staff by asking, "What do you think the child meant by that?"
Q3) Which assessment finding most clearly indicates an adolescent has a conduct disorder?
A) Misses at least one day of school a month
B) Admits to pulling the dog's ears and tail for "fun"
C) Told the teacher that he is usually "sad and confused"
D) Consistently awakens during the night and has difficulty falling asleep again
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Chapter 36: Adolescent Psychiatric Nursing
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Q1) Which response by an adolescent during the termination of outpatient substance abuse therapy indicates the need to reevaluate the treatment plan? The adolescent:
A) says, "I'm ready to get started, but I'm just a little worried."
B) becomes tearful, and the voice quivers while saying, "goodbye."
C) says, "I never thought I'd be sorry to stop coming here!"
D) writes a note sharing fears of relapsing once independent.
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) 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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Sample Questions
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 older adult is at greatest risk for falls based on the medication profile? An older adult taking:
A) psyllium daily as a bulk-forming laxative.
B) calcium daily after hip replacement surgery.
C) an over-the-counter sleep aid an average of once per week.
D) an angiotensin-converting enzyme inhibitor daily for mild hypertension.
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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) Which intervention would be the best initial approach for a nurse to take when a young adult patient is verbally abusive?
A) Ask the patient to define "verbally abusive language."
B) Provide the patient with examples of assertive communication.
C) Identify the patient's verbal abuse in order to set standards for future dialogue.
D) Remove privileges from the patient until communications show less aggression.
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Chapter 39: The Military and Their Families
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Q1) Which assessment question is particularly important to ask of a veteran of the Iraq conflict?
A) "Have you ever experienced a migraine headache?"
B) "Could you ever see yourself considering suicide?"
C) "Do you feel anxious when you find yourself in a confined space like an elevator?"
D) "Would you say that your sleep patterns provide you with sufficient amounts of recuperative rest?"
Q2) The nurse is about to assess the possible incidence of sexual abuse.Based on an understanding of how males and females experience and internalize sexual trauma differently,the nurse would ask the male soldier:
A) "Have you ever been sexually abused?"
B) "Have you ever felt victimized sexually by anyone?"
C) "Has an unwanted sexual advance by anyone ever made you feel harassed or confused?"
D) "Has a superior officer ever made an unwanted sexual advancement that you felt you had to agree to?"
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Chapter 40: Psychological Care of Patients with Life-Threatening Illness
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Sample Questions
Q1) A patient with end-stage renal disease does not want further aggressive treatment but is reluctant to withdraw life-sustaining treatment.The nurse would help the patient to understand that life-sustaining treatment includes maintaining:
A) full code status.
B) comfort measures only.
C) nutrition, hydration, and dialysis.
D) nutrition and hydration but removal of dialysis.
Q2) 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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