Mental Health Final (Other 33%)
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2. Two nursing students discuss their career plans after graduation. One student wants to enter psychiatric nursing. The other asks, “Why would you want to be a psychiatric nurse? The only thing they do is talk. You’ll lose all your skills.” Select the best response.
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“Psychiatric nurses practice in safer environments than other specialties. Nurse-to-patient ratios must be better because of the nature of the patients’ problems.”
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“Psychiatric nurses use complex communication skills as well as critical thinking to solve multidimensional problems. I am challenged by those situations.”
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“I think I will be good in the mental health field. I did not like clinical rotations in school, so I do not want to continue them after I graduate.”
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“Psychiatric nurses do not have to deal with as much pain and suffering as medical-surgical nurses do. That appeals to me.”
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This quiz titled 'Mental Health Final' assesses knowledge in psychiatric nursing, focusing on roles, advocacy, patient care, and mental health issues. It evaluates critical thinking, communication skills, and professional responsibilities in mental health contexts.
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3. A new bill introduced in Congress would reduce funding for care of persons with mental illness. Groups of nurses write letters to their elected representatives in opposition to the legislation. Which role have the nurses fulfilled?
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Advocacy
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Attending
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Recovery
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Evidence-based practice
Correct Answer
A. AdvocacyExplanation
The nurses have fulfilled the role of advocacy by writing letters to their elected representatives in opposition to the legislation. Advocacy involves speaking up and taking action on behalf of others to promote their rights, needs, and interests. In this case, the nurses are advocating for the care of persons with mental illness by opposing the bill that would reduce funding for their care.Rate this question:
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4. An informal group of patients discusses their perceptions of nursing care. Which comment best indicates a patient perceived the nurse was caring? “My nurse:
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Always asks me which type of juice I want to help me swallow my medication.”
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Explained my treatment plan to me and asked for my ideas about how to make it better.”
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Told me that if I take all the medicines the doctor prescribes, then I will get discharged soon.”
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Spends time listening to me talk about my problems. That helps me feel like I’m not alone.”
Correct Answer
A. Spends time listening to me talk about my problems. That helps me feel like I’m not alone.”Explanation
The comment "spends time listening to me talk about my problems. That helps me feel like I’m not alone" indicates that the patient perceived the nurse as caring because the nurse is actively listening and providing emotional support. This shows that the nurse is attentive, empathetic, and willing to spend time with the patient, which can help create a sense of trust and comfort. This kind of interaction fosters a therapeutic relationship and demonstrates a caring attitude from the nurse towards the patient.Rate this question:
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6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” was achieved? A patient:
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Sees self as approaching ideals and capable of meeting demands.
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Seeks others to assume responsibility for major areas of own life. seeks others to assume responsibility for major areas of own life.
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Behaves without considering the consequences of personal actions.
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Aggressively meets own needs without considering the rights of others.
Correct Answer
A. Sees self as approaching ideals and capable of meeting demands.Explanation
The finding that best indicates that the goal "Demonstrate mentally healthy behavior" was achieved is when the patient sees themselves as approaching ideals and capable of meeting demands. This suggests that the patient has a positive self-perception and believes in their own abilities to handle challenges and responsibilities. It indicates a sense of self-confidence and a healthy mindset.Rate this question:
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6. A patient in a group therapy session listens for a time and then remarks, “I used to think I was the only one who felt afraid. I guess I’m not as alone as I thought.” This is an example of:
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Ventilation.
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Altruism
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Universality
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Group cohesiveness.
Correct Answer
A. UniversalityExplanation
The patient's remark about realizing that they are not alone in feeling afraid indicates universality. This means that the patient has recognized that their fears and emotions are shared by others in the group therapy session. This realization can be comforting and reassuring, as it helps the patient feel understood and less isolated in their experiences.Rate this question:
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10. The nurse is co-leader of a group. The guidelines followed by the leaders include focusing on recognizing dysfunctional behavior and thinking patterns, then identifying and practicing alternate behaviors and thinking that are more adaptive. What theory is represented by this group approach?
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Behavioral
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Interpersonal
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Psychodynamic
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Cognitive-behavioral
Correct Answer
A. Cognitive-behavioralExplanation
The group approach described in the question focuses on recognizing dysfunctional behavior and thinking patterns, and then practicing alternate behaviors and thinking that are more adaptive. This approach aligns with the principles of cognitive-behavioral theory, which emphasizes the connection between thoughts, feelings, and behaviors. In cognitive-behavioral therapy, individuals are encouraged to identify and challenge negative or maladaptive thoughts and replace them with more positive and adaptive ones. Therefore, the correct answer is cognitive-behavioral.Rate this question:
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13. Three members of the therapy group share covert glances as other members of the group bring up problems. One of them often makes a statement that subtly puts down another speaker or takes exception to a comment by the group leader. The others then nod in agreement. What explanation should the leader suspect underlies this group dynamic?
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Some members are acting as a subgroup instead of as members of the main group.
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The members in question are showing their frustration with slower members.
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Some of the members have become bored and are tuning out the rest.
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The members in question are passive aggressive in their personality style.
Correct Answer
A. Some members are acting as a subgroup instead of as members of the main group.Explanation
The behavior described suggests that a subgroup has formed within the therapy group. The covert glances and subtle put-downs indicate that these members are excluding themselves from the main group and forming their own smaller group within. This behavior may be a result of a lack of trust or dissatisfaction with the larger group dynamic.Rate this question:
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5. Which finding best indicates that a patient has a mental illness? The patient:
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Responds to rules, routines, and customs of a group.
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Reports mood is consistently sad, discouraged, and hopeless.
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Performs tasks attempted within the limits set by own abilities.
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Answer option 4
Correct Answer
A. Responds to rules, routines, and customs of a group.Explanation
This answer indicates that the patient has a mental illness because it suggests that the patient is conforming to societal norms and expectations without questioning or challenging them. This behavior can be indicative of a lack of independent thinking or impaired judgment, which are common symptoms of mental illness.Rate this question:
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5. During a group therapy session, a newly admitted patient suddenly says to the nurse, “How old are you? You seem too young to be leading a group.” The most appropriate response the nurse might make is:
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“I am wondering what leads you to ask. Could you tell me more, please?”
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“I am old enough to be a nurse, so that would make me in my 20s at least.”
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“My age is not pertinent to why we are here and should not really concern you.”
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“You are wondering whether I have enough experience to lead this group.”
Correct Answer
A. “You are wondering whether I have enough experience to lead this group.”Explanation
The correct answer is "You are wondering whether I have enough experience to lead this group." This response acknowledges the patient's concern and addresses the underlying question about the nurse's experience. It shows empathy and invites the patient to express their thoughts further, allowing for open communication and discussion.Rate this question:
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9. A patient, Mary, has talked constantly throughout the group therapy session. She has repeated the same material several times. Other members were initially attentive then became bored, inattentive, and finally sullen. Which intervention would be most effective for the nurse leader to take?
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“Most of you have become quiet. I’m wondering if it might be related to concerns you may have about how the group is progressing today.”
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“Mary has been doing most of the talking. I think it would be helpful for everyone to tell Mary how that has affected your experience of the group.”
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“I noticed that as the group went on, most members became quiet, then disinterested, and now seem almost angry. What is going on?”
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“Mary, you have been doing most of the talking, and others have not had much chance to speak as a result. Could you please yield to others now?”
Correct Answer
A. “Most of you have become quiet. I’m wondering if it might be related to concerns you may have about how the group is progressing today.”Explanation
The correct answer acknowledges the change in behavior of the group members and addresses their concerns about the group's progress. It shows empathy and invites the group members to share their thoughts and feelings, creating a safe space for open communication. This intervention allows the nurse leader to gain insight into the group dynamics and address any issues that may be affecting the group's engagement and participation.Rate this question:
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15. During an inpatient therapy group that uses existential/Gestalt theory, feelings experienced by patients at the time of their admission to the unit are discussed. As a silence falls, one member mentions, “We have heard from several people who describe feeling angry. I would like to hear from some people who experienced other feelings.” The nurse identifies this comment as an example of the group role of:
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Energizer
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Compromiser
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Encourager
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Self-confessor.
Correct Answer
A. EncouragerExplanation
The nurse identifies the comment as an example of the group role of an encourager because the member is actively encouraging others to share their experiences and feelings that are different from anger. This role helps create a supportive and inclusive environment where everyone's perspectives and emotions are acknowledged and valued.Rate this question:
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16. “We aren’t getting much done; let’s speed things up and make our decision.”
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Playboy
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Energizer
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Organizer
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Gatekeeper
Correct Answer
A. EnergizerExplanation
The correct answer is "Energizer" because the phrase "let's speed things up and make our decision" suggests that the person wants to increase the pace and efficiency of the decision-making process. An energizer is someone who motivates and encourages others, often by increasing their enthusiasm and energy levels. Therefore, choosing an energizer in this context would be appropriate as they can help to drive the decision-making process forward and keep everyone engaged and focused.Rate this question:
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17. “Last week we finished our first goal, and today we are starting on our second.”
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Playboy
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Energizer
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Organizer
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Gatekeeper
Correct Answer
A. OrganizerExplanation
The correct answer is "Organizer" because the statement mentions completing a goal and starting on another one. An organizer is someone who plans and manages tasks and goals, making sure they are completed in an organized and efficient manner. Playboy, Energizer, and Gatekeeper do not fit the context of the statement and do not involve goal-setting or task management.Rate this question:
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23. A group has two more sessions before it ends. One member who previously has been vocal and has shown much progress has grown silent. What explanation most likely underlies his current silence?
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He has said what is on his mind and now has nothing more to offer.
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He wants to give quieter members a chance to talk in the time remaining.
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Quiet members are dominating now in order to talk more before group ends.
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He is having trouble dealing with his feelings about the group’s ending.
Correct Answer
A. He is having trouble dealing with his feelings about the group’s ending.Explanation
The most likely explanation for the member's current silence is that he is having trouble dealing with his feelings about the group's ending. This can be inferred from the fact that he has been vocal and shown progress in the past, but has now grown silent. It suggests that something has changed for him emotionally, and the impending end of the group may be causing him difficulty in expressing himself or participating in discussions.Rate this question:
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24. A group has two more sessions before it ends. One member who previously has been vocal and has shown much progress has grown silent. Which response by the leader would be most helpful for the quiet member and others as well?
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“The end of a group can stir up a lot of feelings, both good and bad. I’d like to hear from each of you about what the end of the group is stirring up in you.”
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“Sometimes the end of a group is welcome, other times regretted. What are people feeling as we wind down and face the end of the group?”
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“I’ve enjoyed the group and hope it has been helpful to you all. How about if today we focus on what everyone will be doing now that group is ending.”
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“The end of the group is upon us. I wish you all well and would appreciate it if everyone could take a moment to talk about what you have learned in group.”
Correct Answer
A. “The end of a group can stir up a lot of feelings, both good and bad. I’d like to hear from each of you about what the end of the group is stirring up in you.”Explanation
This response by the leader acknowledges that the end of the group can evoke different emotions in individuals. By asking each member to share their feelings about the group coming to an end, it creates a safe space for the quiet member to express themselves and also allows others to reflect on their own experiences. This response shows empathy and understanding towards the members and encourages open communication, which can be helpful for the quiet member and others as well.Rate this question:
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1. A new staff nurse completes orientation to a psychiatric unit. This nurse may expect an advanced practice nurse to perform which additional interventions?
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Conduct mental health assessments
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Establish therapeutic relationships
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Individualize nursing care plans
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Prescribe psychotropic medication
Correct Answer
A. Prescribe psychotropic medicationExplanation
A new staff nurse completing orientation to a psychiatric unit can expect an advanced practice nurse to perform the additional intervention of prescribing psychotropic medication. Advanced practice nurses, such as nurse practitioners or clinical nurse specialists, have the authority and expertise to prescribe medications, including psychotropic medications used in psychiatric treatment. This is a specialized skill that is beyond the scope of practice for a staff nurse. Conducting mental health assessments, establishing therapeutic relationships, and individualizing nursing care plans are all within the scope of practice for both staff nurses and advanced practice nurses in a psychiatric unit.Rate this question:
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5. Which finding best indicates that a patient has a mental illness? The patient:
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Responds to rules, routines, and customs of a group.
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Reports mood is consistently sad, discouraged, and hopeless.
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Performs tasks attempted within the limits set by own abilities.
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Is able to see the difference between the “as if” and the “for real.”
Correct Answer
A. Reports mood is consistently sad, discouraged, and hopeless.Explanation
The finding that a patient consistently reports a sad, discouraged, and hopeless mood is indicative of a mental illness. This is because persistent negative emotions can be a symptom of conditions such as depression or anxiety. The other options do not directly indicate a mental illness. Responding to rules, routines, and customs of a group is a normal social behavior. Performing tasks within one's abilities and being able to differentiate between the "as if" and the "for real" are indicators of cognitive functioning.Rate this question:
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7. A nurse encounters an unfamiliar psychiatric disorder on a new patient’s admission form. To determine criteria used to establish this diagnosis, the nurse should consult which resource?
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Diagnostic and Statistical Manual of Mental Disorders
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A nursing diagnosis handbook
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A psychiatric nursing textbook
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A behavioral health reference manual
Correct Answer
A. Diagnostic and Statistical Manual of Mental DisordersExplanation
The correct answer is the Diagnostic and Statistical Manual of Mental Disorders. This manual is widely recognized as the standard reference for diagnosing psychiatric disorders. It provides criteria and guidelines for diagnosing various mental health conditions and is used by healthcare professionals, including nurses, to establish a diagnosis. A nursing diagnosis handbook may provide information on nursing interventions and care plans, but it does not provide the criteria for diagnosing psychiatric disorders. A psychiatric nursing textbook may provide general information on psychiatric disorders, but it may not have the specific criteria needed for diagnosis. A behavioral health reference manual may provide information on behavioral health conditions, but it may not have the comprehensive criteria needed for diagnosis.Rate this question:
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8. Which documentation of diagnosis would a nurse expect in a psychiatric treatment setting?
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I Acute renal failure II 75 III Bipolar disorder I, mixed IV Loss of disability benefits 2 months ago V None
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I Schizophrenia, paranoid type II Death of spouse last year III 60 IV None V Diabetes, type 2
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I Polysubstance dependence II Narcissistic Personality Disorder III 90 IV Hyperlipidemia V Charges pending for assault
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I Major Depression II Avoidant Personality Disorder III Hypertension IV Home destroyed by hurricane last year V 80
Correct Answer
A. I Major Depression II Avoidant Personality Disorder III Hypertension IV Home destroyed by hurricane last year V 80 -
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9. A nurse explains the multiaxial DSM-IV-TR to a psychiatric technician and includes information that it:
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Focuses on plans for treatment.
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Includes nursing and medical diagnoses.
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Classifies problems in multiple areas of functioning.
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Uses the framework of a specific biopsychosocial theory.
Correct Answer
A. Classifies problems in multiple areas of functioning.Explanation
The correct answer is "classifies problems in multiple areas of functioning." The multiaxial DSM-IV-TR is a diagnostic tool used in psychiatry to assess and classify mental disorders. It includes five axes, with the fifth axis specifically focusing on problems in multiple areas of functioning such as occupational, social, and psychological functioning. This allows for a comprehensive understanding of the individual's mental health and helps in developing appropriate treatment plans. The other options mentioned, such as focusing on plans for treatment, including nursing and medical diagnoses, and using a specific biopsychosocial theory, are not specific to the multiaxial DSM-IV-TR.Rate this question:
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10. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource would have the most complete information?
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The ICD-10
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Nursing Outcomes Classification
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Diagnostic and Statistical Manual of Mental Disorders
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The ANA Psychiatric-Mental Health Nursing Scope and Standards of Practice
Correct Answer
A. Diagnostic and Statistical Manual of Mental DisordersExplanation
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a widely recognized and comprehensive resource for diagnosing mental disorders, including anxiety disorders. It provides detailed descriptions of diagnostic criteria, as well as information on prevalence, risk factors, and treatment options. The ICD-10 also includes diagnostic criteria for mental disorders, but it is more focused on medical coding and classification. Nursing Outcomes Classification and the ANA Psychiatric-Mental Health Nursing Scope and Standards of Practice may provide some information on anxiety disorders, but they are not as comprehensive as the DSM.Rate this question:
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15. The Diagnostic and Statistical Manual of Mental Disorders classifies:
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Deviant behaviors.
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People with mental disorders.
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Present disability or distress.
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Mental disorders people have.
Correct Answer
A. Mental disorders people have.Explanation
The correct answer is "mental disorders people have." The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a widely used classification system for mental disorders. It categorizes and defines various mental disorders based on their symptoms, behaviors, and other diagnostic criteria. Therefore, the DSM classifies the mental disorders that people have, rather than deviant behaviors, people with mental disorders, or present disability or distress.Rate this question:
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20. Which belief will best support a nurse’s efforts to provide patient advocacy during a multidisciplinary patient care planning session?
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All mental illnesses are culturally determined.
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Schizophrenia and bipolar disorder are cross-cultural disorders.
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Symptoms of mental disorders are unchanged from culture to culture.
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Assessment findings in mental disorders reflect a person’s cultural patterns.
Correct Answer
A. Assessment findings in mental disorders reflect a person’s cultural patterns.Explanation
The belief that assessment findings in mental disorders reflect a person's cultural patterns will best support a nurse's efforts to provide patient advocacy during a multidisciplinary patient care planning session. This belief recognizes the importance of considering cultural factors when assessing and planning care for individuals with mental disorders. It acknowledges that symptoms and behaviors may be influenced by cultural norms, values, and beliefs, and emphasizes the need for culturally sensitive and appropriate care.Rate this question:
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21. A nurse is part of a multidisciplinary team working with groups of depressed patients. Half the patients receive supportive interventions and antidepressant medication. The other half receives only medication. The team measures outcomes for each group. Which type of study is evident?
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Prevalence
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Clinical epidemiology
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Descriptive epidemiology
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Experimental epidemiology
Correct Answer
A. Clinical epidemiologyExplanation
The given scenario describes a study where a nurse is working with a multidisciplinary team to measure outcomes for groups of depressed patients. The study involves comparing two groups of patients, one receiving supportive interventions and antidepressant medication, and the other receiving only medication. This type of study, which involves measuring outcomes and comparing different interventions, is known as clinical epidemiology.Rate this question:
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23. A 40-year-old who lives with parents and works at an unchallenging job says, “I’m as happy as anyone else, even though I don’t socialize much outside of work. My work is routine, but when new things come up, my boss explains things a few times to make sure I catch on. At home, my parents make decisions for me, and I go along with their ideas.” The nurse should identify interventions to improve this patient’s:
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Self-concept.
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Overall happiness.
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Appraisal of reality.
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Control over behavior.
Correct Answer
A. Self-concept.Explanation
The patient's statement suggests that they have a low sense of self-concept. They rely on their parents to make decisions for them and do not socialize much outside of work. This indicates a lack of independence and self-confidence. Improving the patient's self-concept would involve helping them develop a stronger sense of self, assertiveness, and autonomy.Rate this question:
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24. The psychiatric nurse addresses axis I of the DSM as the focus of treatment but must also consider physical health problems that may affect treatment. Which axis contains the desired information?
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II
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III
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IV
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V
Correct Answer
A. IIIExplanation
Axis III of the DSM contains information about any physical health problems that may affect treatment. This axis is important for the psychiatric nurse to consider because physical health issues can have a significant impact on the effectiveness of treatment for mental health conditions. By addressing both the psychiatric condition on axis I and any physical health problems on axis III, the nurse can provide comprehensive and holistic care to the patient.Rate this question:
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1. A patient asks, “What are neurotransmitters? The doctor said mine are imbalanced.” Select the nurse’s best response.
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“How do you feel about having imbalanced neurotransmitters?”
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“You must feel relieved to know that your problem has a physical basis.”
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“Neurotransmitters are substances we eat daily that influence memory and mood.”
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“Neurotransmitters are natural chemicals that pass messages between brain cells.”
Correct Answer
A. “Neurotransmitters are natural chemicals that pass messages between brain cells.”Explanation
Neurotransmitters are natural chemicals that pass messages between brain cells. This response provides a clear and concise explanation of what neurotransmitters are and their function in the body. It directly addresses the patient's question and provides them with the information they need to understand the concept of imbalanced neurotransmitters.Rate this question:
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2. The parent of an adolescent with schizophrenia asks the nurse, “My child’s doctor ordered a PET. What kind of test is that?” Select the nurse’s best reply.
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“This test uses a magnetic field and gamma waves to identify problem areas in the brain. Does your teenager have any metal implants?”
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“PET means positron-emission tomography. An injection is given and images are taken. It shows blood flow and activity in the brain.”
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“A PET scan passes an electrical current through the brain and shows brain-wave activity. It can help diagnose seizures.”
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“It’s a special type of x-ray that shows structures of the brain and whether there has ever been a brain injury.”
Correct Answer
A. “PET means positron-emission tomography. An injection is given and images are taken. It shows blood flow and activity in the brain.”Explanation
The nurse's best reply is "PET means positron-emission tomography. An injection is given and images are taken. It shows blood flow and activity in the brain." This answer accurately describes what a PET scan is and how it is performed. It explains that a radioactive tracer is injected into the patient's bloodstream, which allows the scanner to detect areas of high metabolic activity in the brain. This information is important for the parent to understand the purpose and process of the test.Rate this question:
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3. A patient with a long history of hypertension and diabetes now develops confusion. The health care provider wants to make a differential diagnosis between Alzheimer’s disease or multiple infarcts. Which diagnostic procedure should the nurse expect to prepare the patient for first?
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PET
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Skull X-ray
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CT
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SPECT
Correct Answer
A. CTExplanation
The nurse should expect to prepare the patient for a CT scan as the first diagnostic procedure. A CT scan, or computed tomography, uses X-rays and computer technology to create detailed cross-sectional images of the body. It can help identify structural abnormalities in the brain, such as infarcts or areas of decreased blood flow, which can help differentiate between Alzheimer's disease and multiple infarcts. PET, SPECT, and skull X-ray may also be used in the diagnostic process, but CT is typically the initial imaging test performed.Rate this question:
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6. The nurse administers a medication that potentiates the action of GABA. Which effect would be expected?
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Reduced anxiety
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Improved memory
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More organized thinking
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Fewer sensory perceptual alterations
Correct Answer
A. Reduced anxietyExplanation
The nurse administers a medication that potentiates the action of GABA. GABA is an inhibitory neurotransmitter in the brain that helps reduce neural activity and promote relaxation. By potentiating the action of GABA, the medication would enhance its calming effects, leading to a reduction in anxiety. Therefore, the expected effect of the medication would be reduced anxiety.Rate this question:
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8. A patient has disorganized thinking associated with schizophrenia. Neuroimaging would most likely show dysfunction in which part of the brain?
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Hippocampus
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Frontal lobe
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Cerebellum
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Brainstem
Correct Answer
A. Frontal lobeExplanation
Disorganized thinking is a symptom commonly associated with schizophrenia. The frontal lobe of the brain is responsible for executive functions such as planning, decision-making, and problem-solving. Dysfunction in the frontal lobe can lead to disorganized thinking and difficulty in organizing thoughts and actions. Neuroimaging would most likely show dysfunction in the frontal lobe of the brain in a patient with disorganized thinking associated with schizophrenia.Rate this question:
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10. The therapeutic action of neurotransmitter inhibitors that block reuptake cause:
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Decreased concentration of the neurotransmitter in the central nervous system.
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Increased concentration of neurotransmitter in the synaptic gap.
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Destruction of receptor sites.
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Limbic system stimulation.
Correct Answer
A. Increased concentration of neurotransmitter in the synaptic gap.Explanation
When neurotransmitter inhibitors block reuptake, they prevent the reabsorption of neurotransmitters by the presynaptic neuron. This leads to an accumulation of neurotransmitters in the synaptic gap, increasing their concentration. As a result, there is a greater availability of neurotransmitters to bind to receptor sites on the postsynaptic neuron, enhancing the transmission of signals between neurons.Rate this question:
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11. A patient taking medication for mental illness develops restlessness and an uncontrollable need to be in motion. The nurse analyzes that these symptoms relate to which drug action?
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Anticholinergic effects
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Dopamine-blocking effects
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Endocrine-stimulating effects
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Ability to stimulate spinal nerves
Correct Answer
A. Dopamine-blocking effectsExplanation
The symptoms described, restlessness and an uncontrollable need to be in motion, are consistent with the side effects of dopamine-blocking medications. Dopamine-blocking medications can lead to a condition called akathisia, which is characterized by restlessness and an inability to sit still. This is a known side effect of antipsychotic medications, which work by blocking dopamine receptors in the brain. Therefore, the correct answer is dopamine-blocking effects.Rate this question:
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12. A nurse assesses that a patient has fear as well as increased heart rate and blood pressure. The nurse suspects increased activity of which neurotransmitter?
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GABA
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Histamine
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Acetylcholine
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Norepinephrine
Correct Answer
A. NorepinephrineExplanation
The nurse suspects increased activity of norepinephrine because fear and increased heart rate and blood pressure are commonly associated with the release of norepinephrine in the body. Norepinephrine is a neurotransmitter that is involved in the body's "fight or flight" response, which is activated during times of stress or fear. It increases heart rate and blood pressure to prepare the body for action.Rate this question:
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13. A patient has acute anxiety related to an automobile accident 2 hours ago. The patient needs teaching about drugs from which group?
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Tricyclic antidepressants
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Antipsychotic drugs
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Antimanic drugs
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Benzodiazepines
Correct Answer
A. BenzodiazepinesExplanation
A patient who has acute anxiety related to an automobile accident would benefit from drugs from the benzodiazepine group. Benzodiazepines are commonly used to treat anxiety disorders as they work by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain, which helps to calm down excessive activity and reduce anxiety. Tricyclic antidepressants, antipsychotic drugs, and antimanic drugs are not typically used to treat acute anxiety and may not provide the immediate relief needed in this situation.Rate this question:
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14. A patient is hospitalized for severe depression. Of the medications listed below, the nurse can expect to provide the patient with teaching about:
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Chlordiazepoxide (Librium).
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Clozapine (Clozaril).
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Sertraline (Zoloft).
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Tacrine (Cognex).
Correct Answer
A. Sertraline (Zoloft).Explanation
The nurse can expect to provide teaching about sertraline (Zoloft) because it is commonly used to treat depression. Chlordiazepoxide (Librium) is a benzodiazepine used to treat anxiety and alcohol withdrawal symptoms. Clozapine (Clozaril) is an antipsychotic medication used to treat schizophrenia. Tacrine (Cognex) is a medication used to treat symptoms of Alzheimer's disease. Therefore, sertraline (Zoloft) is the most appropriate medication to provide teaching about in the context of severe depression.Rate this question:
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16. A drug causes muscarinic receptor blockade. The nurse will assess the patient for
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Dry mouth.
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Gynecomastia.
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Pseudoparkinsonism.
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Orthostatic hypotension.
Correct Answer
A. Dry mouth.Explanation
A drug that causes muscarinic receptor blockade would inhibit the action of acetylcholine on these receptors. Muscarinic receptors are found in various organs including salivary glands, so their blockade would result in decreased saliva production and subsequently dry mouth. Therefore, the nurse should assess the patient for this side effect. Gynecomastia refers to the development of breast tissue in males and is not related to muscarinic receptor blockade. Pseudoparkinsonism refers to symptoms resembling Parkinson's disease, such as tremors and bradykinesia, and is not directly related to muscarinic receptor blockade. Orthostatic hypotension refers to a drop in blood pressure upon standing and is also not specifically associated with muscarinic receptor blockade.Rate this question:
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18. A patient tells the nurse, “My doctor prescribed Paxil (paroxetine) for my depression. I assume I’ll have side effects like I had when I was taking Tofranil (imipramine).” The nurse’s reply should be based on the knowledge that paroxetine is a:
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Selective norepinephrine reuptake inhibitor.
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Tricyclic antidepressant.
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MAO inhibitor.
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SSRI
Correct Answer
A. Selective norepinephrine reuptake inhibitor.Explanation
The nurse should reply that paroxetine is a selective norepinephrine reuptake inhibitor. This means that it works by increasing the levels of norepinephrine in the brain, which can help improve mood and relieve symptoms of depression. It is different from Tofranil (imipramine), which is a tricyclic antidepressant. Therefore, the patient should not assume that they will have the same side effects with paroxetine as they did with Tofranil.Rate this question:
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- 39.
19. A nurse can anticipate anticholinergic side effects are likely when a patient takes:
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Lithium (Lithobid).
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Buspirone (BuSpar).
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Risperidone (Risperdal).
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Fluphenazine (Prolixin).
Correct Answer
A. Fluphenazine (Prolixin).Explanation
Fluphenazine is a typical antipsychotic medication that has strong anticholinergic properties. Anticholinergic side effects include dry mouth, blurred vision, constipation, urinary retention, and confusion. Lithium, buspirone, and risperidone do not typically have anticholinergic side effects.Rate this question:
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- 40.
20. Which instruction has priority when teaching a patient taking clozapine (Clozaril)?
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“Avoid unprotected sex.”
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“Report sore throat and fever immediately.”
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“Reduce foods high in polyunsaturated fats.”
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“Use over-the-counter preparations for rashes.”
Correct Answer
A. “Report sore throat and fever immediately.”Explanation
The instruction to "Report sore throat and fever immediately" has priority when teaching a patient taking clozapine (Clozaril) because these symptoms could indicate a serious condition called agranulocytosis, which is a potentially life-threatening side effect of clozapine. Agranulocytosis is characterized by a severe decrease in white blood cells, which can lead to an increased risk of infection. Therefore, it is crucial for patients taking clozapine to report any signs of infection, such as a sore throat and fever, to their healthcare provider immediately for further evaluation and management.Rate this question:
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- 41.
21. A nurse cares for patients taking various medications, including buspirone (BuSpar), haloperidol (Haldol), carbamazepine (Tegretol), trazodone (Desyrel), and phenelzine (Nardil). The nurse will order a special diet for the patient who takes:
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Buspirone.
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Haloperidol.
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Carbamazepine.
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Phenelzine.
Correct Answer
A. Phenelzine.Explanation
Phenelzine is a monoamine oxidase inhibitor (MAOI) used to treat depression. MAOIs require dietary restrictions due to potential interactions with certain foods and beverages. Foods high in tyramine, such as aged cheeses, cured meats, and fermented foods, can cause a hypertensive crisis when combined with MAOIs. Therefore, a special diet is necessary for patients taking phenelzine to avoid these foods and prevent complications. Buspirone, haloperidol, and carbamazepine do not have specific dietary restrictions associated with their use.Rate this question:
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- 42.
22. A nurse instructs a patient taking a drug that inhibits monoamine oxidase (MAO) to avoid certain foods and drugs because of the risk of:
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Cardiac dysrhythmia.
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Hypotensive shock.
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Hypertensive crisis.
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Cardiogenic shock.
Correct Answer
A. Hypertensive crisis.Explanation
When a patient takes a drug that inhibits monoamine oxidase (MAO), certain foods and drugs can cause a hypertensive crisis. This is because MAO is responsible for breaking down certain substances in the body, including tyramine, which is found in certain foods and drugs. When MAO is inhibited, tyramine can accumulate and cause a sudden increase in blood pressure, leading to a hypertensive crisis. Therefore, it is important for the patient to avoid these foods and drugs to prevent this potentially dangerous situation.Rate this question:
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- 43.
25. The laboratory report for a patient taking clozapine (Clozaril) shows a white blood cell count of 3000 mm3. Select the nurse’s best action.
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Report these results to the health care provider immediately.
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Give the next dose as prescribed.
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Give aspirin and force fluids.
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Repeat the laboratory test.
Correct Answer
A. Report these results to the health care provider immediately.Explanation
The nurse's best action in this situation is to report the white blood cell count of 3000 mm3 to the health care provider immediately. This is because clozapine (Clozaril) is known to cause agranulocytosis, a potentially life-threatening condition characterized by a low white blood cell count. The health care provider needs to be informed promptly so that appropriate interventions can be taken to ensure the patient's safety. Giving the next dose as prescribed, giving aspirin and force fluids, or repeating the laboratory test would not address the urgency of the situation.Rate this question:
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- 44.
30. Consider these medications: carbamazepine (Tegretol), lamotrigine (Lamictal), gabapentin (Neurontin). Which medication below also belongs with this group?
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Galantamine (Reminyl)
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Valproate (Depakote)
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Buspirone (BuSpar)
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Tacrine (Cognex)
Correct Answer
A. Valproate (Depakote)Explanation
Valproate (Depakote) belongs with the group of medications carbamazepine (Tegretol), lamotrigine (Lamictal), and gabapentin (Neurontin) because it is also used to treat seizures and certain types of epilepsy.Rate this question:
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- 45.
2. A Hispanic woman comes to the mental health center at the urging of her adult children. The patient has lost 5 pounds since her husband’s death 6 months ago and says, “My husband comes to visit me in the night but I cannot understand what he says.” How should the nurse analyze this situation? The patient is:
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Experiencing auditory and visual hallucinations.
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At high risk for imbalanced nutrition.
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Grieving the husband’s death.
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Denying the husband’s death.
Correct Answer
A. Grieving the husband’s death.Explanation
The patient's statement about her husband visiting her in the night and not being able to understand him suggests that she is experiencing grief and possibly longing for her husband. This is a common reaction to the loss of a loved one and is consistent with the symptoms of grief. The fact that she has lost weight since her husband's death further supports the idea that she is grieving. There is no mention of auditory and visual hallucinations, imbalanced nutrition, or denial of the husband's death, so these options can be ruled out.Rate this question:
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- 46.
6. An African American patient is suspicious, has angry outbursts, and accuses staff of discriminating when they remove possibly harmful objects. Which factor best demonstrates cultural awareness regard this patient’s behavior?
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The patient may have feelings of powerlessness.
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Family solidarity is this patient’s priority need.
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Institutional policies promote discrimination.
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The patient fears abandonment.
Correct Answer
A. The patient may have feelings of powerlessness.Explanation
The patient's suspicious behavior, angry outbursts, and accusations of discrimination suggest that they may feel powerless in their interactions with the staff. This behavior could be a result of past experiences of discrimination or a lack of trust in the healthcare system. Understanding the patient's feelings of powerlessness can help healthcare providers approach the situation with empathy and cultural sensitivity.Rate this question:
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- 47.
17. A Chinese American patient diagnosed with an anxiety disorder says, “My problems began when my energy became imbalanced.” When the nurse asks for the patient’s ideas about how to treat the imbalance, the patient may request:
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Eating special foods.
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Taking antianxiety medication.
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Undergoing cognitive behavior therapy.
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Having a native healer perform a ritual.
Correct Answer
A. Eating special foods.Explanation
The patient's statement about their energy becoming imbalanced suggests that they may have a belief in traditional Chinese medicine or other alternative healing practices. In these practices, imbalances in energy are often believed to be the cause of illness or disorder. Therefore, the patient may request eating special foods as a way to rebalance their energy and treat their anxiety disorder.Rate this question:
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- 48.
22. A hospice nurse plans care for four culturally diverse patients, each of whom has advanced cancer. Which patient will most likely wish to engage actively in end-of-life planning?
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Native American; worked as a forest ranger
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Female immigrant from China; acupuncturist
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Refugee laborer from war-torn African country
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Fourth-generation New England native; accountant
Correct Answer
A. Fourth-generation New England native; accountantExplanation
The fourth-generation New England native who is an accountant is the most likely to wish to engage actively in end-of-life planning because individuals in this profession often value organization and planning. Additionally, being a native of the area may indicate a strong sense of community and family ties, which can contribute to a desire to plan for end-of-life care.Rate this question:
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- 49.
2. Which action by a psychiatric nurse best supports the right of patients to be treated with dignity and respect?
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Consistently addresses patients by title and surname
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Strongly encourages a patient to participate in the unit milieu
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Discusses a patient’s condition with the health care provider in the elevator
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Informs a treatment team that a patient is too drowsy to participate in care planning
Correct Answer
A. Consistently addresses patients by title and surnameExplanation
Consistently addressing patients by title and surname is the best action by a psychiatric nurse to support the right of patients to be treated with dignity and respect. This shows that the nurse recognizes and acknowledges the individuality and importance of each patient, promoting a sense of dignity and respect in the therapeutic relationship. It also demonstrates professionalism and creates a more equal and respectful environment between the nurse and the patient.Rate this question:
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Nov 10, 2023Quiz Edited by
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Jan 23, 2015Quiz Created by
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