TEST BANK for Neeb's Fundamentals of Mental Health Nursing, 4th Edn by Linda M. Gorman and Robynn An

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Neebs Fundamentals of Mental Health Nursing, 4th Edition test bank Chapter 1: History of Mental Health Nursing My Nursing Test Banks Chapter 2: Basics of Communications My Nursing Test Banks Chapter 3: Ethics and Law My Nursing Test Banks Chapter 4: Developmental Psychology Throughout the Life Span My Nursing Test Banks Chapter 5: Sociocultural Influences on Mental Health My Nursing Test Banks Chapter 6: Nursing Process in Mental Health My Nursing Test Banks Chapter 7: Coping and Defense Mechanisms My Nursing Test Banks Chapter 8: Mental Health Treatments My Nursing Test Banks Chapter 9: Alternative and Complementary Treatment Modalities My Nursing Test Banks Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders My Nursing Test Banks Chapter 11: Depressive Disorders My Nursing Test Banks Chapter 12: Bipolar Disorders My Nursing Test Banks Chapter 13: Suicide My Nursing Test Banks Chapter 14: Personality Disorders My Nursing Test Banks Chapter 15: Schizophrenia Spectrum and Other Psychotic DisordersSchizophrenia My Nursing Test Banks Chapter 16: Neurocognitive Disorders: Delirium and Dementia My Nursing Test Banks Chapter 17: Substance Use and Addictive Disorders My Nursing Test Banks Chapter 18: Eating Disorders My Nursing Test Banks Chapter 19: Childhood and Adolescent Mental Health Issues My Nursing Test Banks Chapter 20: Postpartum Issues in Mental Health My Nursing Test Banks Chapter 21: Aging Population My Nursing Test Banks

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Chapter 22: Victims of Abuse and Violence My Nursing Test Banks

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Chapter 1: History of Mental Health Nursing My Nursing Test Banks Chapter 1: History of Mental Health Nursing Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. The act of developing a clean environment is a factor in providing effective health care as demonstrated by: A. Nightingale.

B. Benner.

C. Swanson.

D. King. ____ 2. What is the name of the publication written by Florence Nightingale?

A. Nursing Sanitation Notes B. Nursing 101 C. Notes on Nursing D. Nursing Notes ____ 3. A long-term goal for in-patient mental health treatment is generally to: A. Return the patient to the community.

B. Locate a facility for long term care.

C. Be arrested and placed in prison.

D. Be completely cured of the disorder. ____ 4. The mentally ill were once housed in mental institutions known as: A. Hospitals.

B. Long-term care facilities.

C. Asylums.

D. Free-standing treatment centers. ____ 5. Which nursing theorists promoted the interpersonal theory between the nurse and the patient?

A. Hildegard Peplau B. Hattie Bessent

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C. Mary Mahoney D. Linda Richards Completion Complete each statement.

6. Phenothiazines were discovered in what year? _______________________.

7. The first psychiatric program of study was established by which nursing leader? ______ _______ _________ 8. Who was the nurse theorist who was the first American-trained nurse credited with teaching how to provide care for people with mental illness? _______________________ 9. The greatest advance in the early years of mental health care was the introduction of ___________________.

10. The legislation that provided funding for improving the care of the mentally ill is known as the National Mental Health Act of what year? ______.

11. Which nursing organization established the first certification of psychiatric nursing? _____________________________ 12. One of the goals of the American Nurses Association (ANA) is to promote ________________ of nursing care in the United States.

13. ______________ ____________ has always been called the founder of nursing.

14. A schoolteacher by the name of _____________ _________established asylums and a psychiatric hospital for the mentally ill.

15. Special facilities designed to care for the mentally ill in the past were known as ______________.

16. The first psychotropic drug category was known as ____________________.

17. Each state adopts its own set of rules and guidelines that govern the nurses performance. These rules are known as the ___________ Practice Act. 18. The first major federal law to address mental illness was called the ____________ Act. Multiple Response Identify one or more choices that best complete the statement or answer the

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question. ____ 19. What trends contributed to the deinstitutionalization of mental health facilities to outpatient care (select all that apply): A. Cost of the facilities.

B. The increased use of phenothiazines.

C. Staff cost.

D. Establishment of Outpatient clinics.

Chapter 1: History of Mental Health Nursing Answer Section MULTIPLE CHOICE 1. ANS: A Florence Nightingales commitments to improved outcomes at a military hospital were directly related to introducing sanitation methods.

PTS: 1 REF: Chapter 1: History of Mental Health Nursing; Nightingale; page 4 KEY: Integrated Processes: Teaching/Learning | Content Area: Community Health | Cognitive Level: Application | Client Need: Safe and Effective Care Environment: Safety and Infection Control 2. ANS: C Florence Nightingale wrote the book Notes on Nursing, which specified the importance of a clean environment.

PTS: 1 REF: Chapter 1: History of Mental Health Nursing; Nightingale; page 4 KEY: Integrated Processes: Teaching/Learning| Content Area: Nursing Trends| Cognitive Level: Knowledge| Client Need: Health Promotion and Maintenance: Health Promotion/Disease Prevention 3. ANS: A To eventually return the patient to the community by creating a good support system and appropriate medication if needed is generally the long-term goal.

PTS: 1 REF: Chapter 1: History of Mental Health Nursing; The Breakthroughs; page 9 KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health | Cognitive Level: Comprehension | Client Need: Safe and Effective Care Environment: Management of Care: Coordinated Care

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4. ANS: C Asylums were known as a refuge for the mentally ill as well as the poor in the past.

PTS: 1 REF: Chapter 1: History of Mental Health Nursing; Asylums; page 8 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Therapeutic Environment 5. ANS: A Dr. Peplau brought together theories from psychiatry and merged them with theories for nursing and communication.

PTS: 1 REF: Chapter 1: History of Mental Health Nursing; Hildegard Peplau; page 6-7 KEY: Integrated Processes: Communication and Documentation | Content Area: Nursing Trends | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Coordinated Care COMPLETION 6. ANS: 1955 Phenothiazine is a group of psychotropics that have a calming effect on patients with psychotic through processes.

PTS: 1 REF: Chapter 1: History of Mental Health Nursing; The Breakthroughs; page 9 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Expected Actions/Outcomes 7. ANS: Effie Jane Taylor In 1913 the first psychiatric program for nurses was established. Ms. Taylor also believed in patient-centered care.

PTS: 1 REF: Chapter 1: History of Mental Health Nursing; Effie Jane Taylor; page 6 KEY: Integrated Processes: Teaching/Learning 8. ANS:

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Linda Richards Linda Richards wanted to upgrade the nursing education field and the Boston city hospital training school for nurses to teach the specialty of caring for the mentally ill.

PTS: 1 REF: Chapter 1: History of Mental Health Nursing; Linda Richards; page 5 KEY: Integrated Processes: Teaching/Learning | Content Area: Nursing Trends | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental Health Concepts 9. ANS: phenothiazines This medication controlled psychotic symptoms and led to reductions in the population in mental health institutions.

PTS: 1 REF: Chapter 1: History of Mental Health Nursing; The Breakthroughs; page 9 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies 10. ANS: 1946 Money was provided by this legislation for research and training for the improvement of care for patients with mental health issues.

PTS: 1 REF: Chapter 1: History of Mental Health Nursing; The Laws; page 12 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental Health Concepts 11. ANS: ANA The American Nurses Association (ANA) developed the certification criteria for psychiatric nurses. The ANA has developed standards for professional nursing.

PTS: 1 REF: Chapter 1: History of Mental Health Nursing; Nursing Organizations

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and Recommendations; page 9 KEY: Integrated Processes: Teaching/Learning | Content Area: Nursing Trends | Cognitive Level: Comprehension | Client Need: Safe and Effective Care Environment: Coordinated Care 12. ANS: standardization The ANA has developed standards for a number of different specialties.

PTS: 1 REF: Chapter 1: History of Mental Health Nursing; Nursing Organizations and Recommendations; page 9 KEY: Integrated Processes: Teaching/Learning | Content Area: Nursing Trends | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Management: Management of care: establishing priorities 13. ANS: Florence Nightingale Florence Nightingale observed that a clean environment improved the health of the soldiers in the Crimean War. As a result, deaths from infection decreased.

PTS: 1 REF: Chapter 1: History of Mental Health Nursing; Trailblazers; page 3 KEY: Integrated Processes: Teaching/Learning | Content Area: Nursing Trends | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Safety and Infection Control 14. ANS: Dorothea Dix Dorothea Dix was not a nurse but was concerned about the treatment of the mentally ill and prisoners.

PTS: 1 REF: Chapter 1: History of Mental Health Nursing; Trailblazers; page 5 KEY: Integrated Processes: Teaching/Learning | Content Area: Nursing Trends | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Management of Care: Advocacy 15. ANS: asylums

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In the early days of health care asylums were special facilities designed for care of the needy including prisoners and the mentally ill.

PTS: 1 REF: Chapter 1: History of Mental Health Nursing; Asylums; page 8 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental Health Concepts 16. ANS: phenothiazines Phenothiazine medications were introduced in the 1950s. These drugs had a calming and tranquilizing effect and treated psychotic thought processes.

PTS: 1 REF: Chapter 1: History of Mental Health Nursing; Psychotropic Medications; page 9 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Expected Actions/Outcomes 17. ANS: Nurse The Nurse Practice Act of each state is based on federal guidelines. Each state has its own Nurse Practice Act. PTS: 1 REF: Chapter 1: History of Mental Health Nursing; Nursing Organizations and Recommendations; page 10 KEY: Integrated Processes: Teaching/Learning | Content Area: Nursing Licensure/Legal | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Legal Rights and Responsibilities 18. ANS: Hill-Burton The Hill-Burton Act of 1946 provided much needed funding for psychiatric care in the United States.

PTS: 1 REF: Chapter 1: History of Mental Health Nursing; The Laws; page 11 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Legal | Cognitive Level: Knowledge | Client Need: Safe and Effective

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Care Environment: Coordinated Care MULTIPLE RESPONSE 19. ANS: A, B, C, D All of the above led to the deinstitutionalization of mental health facilities.

PTS: 1 REF: Chapter 1: History of Mental Health Nursing; The Facilities; page 9 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health | Cognitive Level: Synthesis | Client Need: Safe and Effective Care Environment: Advocacy

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Chapter 2: Basics of Communications My Nursing Test Banks Chapter 2: Basics of Communications Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Which question by the nurse would gain the most information from a patient experiencing a marital crisis?

A. Do you hate your spouse?

B. Do you get along with your in-laws?

C. Do you talk out your problems with your spouse?

D. What is it like at home with your spouse? ____ 2. Mrs. R., the mother of a young schizophrenic patient, seeks you out and begins to cry. She expresses concern over her daughters behavior. Your best response to this woman is: A. What is it that concerns you the most, Mrs. R.?

B. Well, you know, that is part of the illness.

C. Here is a book on schizophrenia. This will help you.

D. Are you afraid your daughter will always be like this? ____ 3. Linda is pacing the floor and appears extremely anxious. The day shift nurse approaches Linda in an attempt to lessen her anxiety. The most therapeutic statement by the nurse would be: A. How about watching a football game?

B. Tell me how you are feeling today.

C. What do you have to be upset about now?

D. Ignore the client. ____ 4. A patient states, I dont know what the pills are for or why I am taking them, so I dont want them. What therapeutic communication would help this patient?

A. Ask for what you need B. Silence C. Using general leads

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D. Giving information ____ 5. To practice effectively in mental health, the nurse should be able to: A. Solve his or her own personal problems without assistance from others.

B. Comfortably point out the patient shortcomings and provide advice about ho C. Bring patients and coworkers into compliance with societal rules and norms D. Demonstrate therapeutic communication.

Completion Complete each statement.

6. The nurse plans to have a therapeutic communication with the client. To begin that therapeutic communication the nurse must first establish _________________ with the client.

7. Communication has three parts: the sender, the message, and the _____________.

8. When appropriate, the nurse can use _____________________ as part of an interaction when there is no talking. This can communicate support.

9. A theory of communication that emphasizes the three ways to communicatehearing, seeing, and touchingis called _________________________ 10. Expressive, receptive, and global are types of _______________.

11. Advising, asking closed-ended questions, and changing the subject are examples of ________________ to therapeutic communication.

Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 12. A nurse is working with a patient and attempts to communicate effectively with him or her. Techniques the nurse can use to help communication include (select all that apply): A. Clarifying terms.

B. Remaining silent.

C. Asking open-ended questions.

D. Offering false reassurance E. Discouraging the person from expressing feelings that are unacceptable. ____ 13. The nurse may find that patients from other countries use different

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terminology than the nurse born in the United States. The difference in terminology may seem harmless to us but offensive to the foreign patient.

Differences noted between different cultures are (select all that apply): A. Eye contact.

B. Slang terms.

C. Hand gestures.

D. Gender references. ____ 14. The three components of communication are (select all that apply): A. Impairment.

B. Message.

C. Sender.

D. Receiver. ____ 15. Nurses understand that when caring for patients with mental illnesses, a nurses communication is (select all that apply): A. An active process that includes participating and listening and speaking.

B. A complex activity.

C. Exchanging information.

D. Verbal and nonverbal.

E. A one way path from nurse to patient.

F. Advising. ____ 16. The patient is concerned about his doctor and what the doctor has prescribed. The nurse making rounds notices the patient sitting on the side of the bed in deep thought. The nurse comes into the room and the patient begins to tell her his concerns about a new order. The nurse advises the patient, If I were you, I would find another doctor.

How does this statement by the nurse block communication (select all that apply)?

A. It tells the patient that his concerns are not valid.

B. It gives the idea that the nurses values are the correct ones.

C. It puts words in the patients mouth.

D. It hurts the nurses credibility if the solution doesnt help the patient.

E. It discourages yes or no answers.

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F. It inhibits the patient from telling you what his concerns are. ____ 17. The following types of patients require adaptive communication techniques (select all that apply): A. A patient who is blind.

B. A patient who has dysphasia.

C. A patient who is schizophrenic.

D. A patient who is elderly.

E. A patient with dysphagia.

F. A patient who has language differences from the staff. ____ 18. Which of the following are characteristics of assertive communication (select all that apply)?

A. Statements begin with the word you.

B. Statements deal with thoughts and feelings.

C. It is a form of blaming.

D. It puts responsibility for the interaction on the other person.

E. It is a technique of personal empowerment.

F. It is self-responsible.

Chapter 2: Basics of Communications Answer Section MULTIPLE CHOICE 1. ANS: D Encourages expression of feelings rather than a yes/no answer. Use of openended questions facilitates more open communication.

PTS: 1 REF: Chapter 2: Basics of Communication; Therapeutic Communication; page 21-25 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Therapeutic communication 2. ANS: A The correct response is open ended to seek out more specifically why she is upset. Responses B and C shut down communication. Response D is making an assumption of why she is upset.

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PTS: 1 REF: Chapter 2: Basics of Communication; Therapeutic Communication; page 24-25 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Psychotic disorders: Therapeutic nursing process | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 3. ANS: B To keep open communication with the patient, the nurse should ask openended questions.

PTS: 1 REF: Chapter 2: Basics of Communication; Therapeutic Communication; page 24 KEY: Integrated Processes: Caring | Content Area: Mental Health: Communication | Cognitive Level: Synthesis | Client Need: Psychosocial Integrity: Stress Management 4. ANS: D Giving information can increase rapport, reduce patient anxiety, and suggest patient collaboration.

PTS: 1 REF: Chapter 2: Basics of Communication; Therapeutic Communication; page 25 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic Communication/Health Promotion and Maintenance: Principles of Teaching/Learning 5. ANS: A Good communication skills are essential for working in mental health. Good communication skills center around being able to promote open communication with such techniques as good listening, use of open-ended questions, and appropriate use of silence to be therapeutic.

PTS: 1 REF: Chapter 2: Basics of Communication; Techniques of Therapeutic/Helping Communication; page 23 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Nursing Process | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic

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Communication COMPLETION 6. ANS: rapport Rapport implies there is mutual understanding and trust. The communication can be both verbal and nonverbal.

PTS: 1 REF: Chapter 2: Basics of Communication; Therapeutic Communication; page 23 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Synthesis | Client Need: Psychosocial Integrity: Therapeutic Communication 7. ANS: receiver Communication is not just about getting your message out, it also includes how the message is received.

PTS: 1 REF: Chapter 2: Basics of Communication; Communication Theory; page 16 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Communication | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Therapeutic Communication 8. ANS: silence Silence allows the nurse and the patient time to collect their thoughts. It is a therapeutic technique of communication and demonstrates support and acceptance.

PTS: 1 REF: Chapter 2: Basics of Communication; Therapeutic Communication; page 26 KEY: Integrated Processes: Caring/Communication and documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Therapeutic Communication 9. ANS: neurolinguistic programming Neurolinguistic programming (NLP) was developed by Milton Erickson,

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John Grinder, and Richard Bandler. NLP can be used in conjunction with hypnosis and other treatment modalities giving insight into how one views the world.

PTS: 1 REF: Chapter 2: Basics of Communication; Types of Communication; page 18-19 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Therapeutic Communication 10. ANS: aphasia Patients with speech difficulties or challenges have an aphasic disorder. Expressive is difficulty in verbal expression, receptive is difficulty with interpretation of written or verbal communication, and global is a combination of receptive and expressive.

PTS: 1 REF: Chapter 2: Basics of Communication; Challenges to Communication; Table 2-1 Types of Aphasia; page 20 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Therapeutic Communication 11. ANS: blocks or barriers These blocks to communication interfere with patient-nurse interaction to inhibit good communication.

PTS: 1 REF: Chapter 2: Basics of Communication; Blocks to Therapeutic Communication; page 22-23 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Therapeutic Communication MULTIPLE RESPONSE

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12. ANS: A, B, C Effective communication between the nurse and the patient includes approaches that give the patient opportunities to express himself or herself.

PTS: 1 REF: Chapter 2: Basics of Communication; Techniques for Therapeutic Communication; page 24 and 26 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic Communication 13. ANS: A, B, C, D Verbal and nonverbal communication doesnt always have the same meaning in other cultures. The same communication can be understood by another culture as offensive.

PTS: 1 REF: Chapter 2: Basics of Communication; Nonverbal Communication ; Box 2-1 Examples of Communication with Cultural Implications; page 17 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Communication | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Therapeutic Communication 14. ANS: B, C, D Communication with others requires these three components.

PTS: 1 REF: Chapter 2: Basics of Communication; Communication Theory; page 16 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Therapeutic Communication 15. ANS: A, B, C, D Communication is important when determining the patients needs. It is not a passive process but an active, two-way activity between patient and nurse.

Generally the nurses role is not to advise patients but to listen and support.

PTS: 1 REF: Chapter 2: Basics of Communication; Therapeutic Communication; page 24

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KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Application 16. ANS: B, C, D, F Communication with patients should be purposeful and unbiased. Giving advice when the patient has not fully expressed his concerns inhibits and distracts the patient from what he is trying to communicate.

PTS: 1 REF: Chapter 2: Basics of Communication; Therapeutic Communication; page 21-22 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Communication | Cognitive Level: Evaluation 17. ANS: A, B, F Although communication can be challenging, there may be temporary or permanent techniques to assist with communication. Patients with challenges to sight, sound, and speech require adaptive techniques. Those who speak a different language than the provider also need adaptive techniques.

PTS: 1 REF: Chapter 2: Basics of Communication; Challenges to Communication; page 28-29 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Comprehension 18. ANS: B, E, F Assertive communication begins with the word I. Other characteristics include speaking up for oneself in a respectful manner, verbalizing ones thoughts and feelings, and being honest.

PTS: 1 REF: Chapter 2: Basics of Communication; Types of Communication; page 18 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic Communication

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Chapter 3: Ethics and Law My Nursing Test Banks

Chapter 3: Ethics and Law Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. A patient is expressing anger when the nurse attempts to make him take a medication that he is refusing. If the nurse pushes to give the medication against his will, the nurse is: A. Violating the patients rights.

B. Achieving a treatment goal to get the medication in the patient any way poss C. Supporting the familys demand that he take the medication.

D. Following orders from the charge nurse. ____ 2. A mental health nurse bumps into a member of her church, who begins questioning her about a former neighbor. The woman from the church asks the nurse, How is Rachael? We have been friends for over 20 years and I have seen her come out of your clinic a few times. Is she seeing one of the psychiatrists? The nurses response is: A. The HIPAA law prevents me from disclosing any information about any pat B. All I can say is she is seeing Dr. Leone.

Rachael is seeing Dr. Leone because she is concerned about feeling extreme C. and about feeling extremely depressed other times.

D. Rachael was only there to renew her medication. ____ 3. You are working on a mental health unit and have a diverse group of patients. Some of the patients are of Middle Eastern descent. These patients have communicated to you that they would like to follow the same period for praying as they did prior to admission. What is your response?

A. You are in America now.

B. You can go back to your regular time for praying when you are discharged.

C. How can I accommodate you with your prayer time?

D. Would you like to learn another prayer? ____ 4. The nursing student uses the clients full name on the assigned care plan during her recent clinical rotation. What is the instructors priority

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intervention?

A. Express the importance of factual documentation and that it should include t B. Remind the student of the importance of maintaining patient confidentiality.

Discuss with student that the patient is homeless and illiterate. As a result of patient will not be embarrassed about their homelessness status; therefore co C. an issue.

Explain to the student because the patient was committed involuntary, confi D. issue. ____ 5. While shopping in the local supermarket, a mental health nurse encounters an individual who recently was a patient on her unit. Which is the proper response by the nurse?

A. Stop the person and ask how they are doing since discharge.

B. The closer you get to the patient, look in another direction.

C. Speak to the patient, but not by name.

D. If eye contact is made and the patient responds, then you should respond bac ____ 6. The telephone rings at the nurses station of an inpatient psychiatric facility. The caller asks to speak with Ms. Honey. Which nursing response protects the patients rights and confidentiality?

A. I cannot confirm or deny that Ms. Honey was admitted here.

B. Ms. Honey is in group therapy at present.

C. Hold on, Ill go see if she is in her room.

D. Are you a family member? Ms. Honey can only receive calls from family m Completion Complete each statement.

7. In the group therapy session, the nurse speaks up to remind a patient of a recent improvement in his coping. The nurses action is an example of ______________________.

8. Another term to describe the ethical principle of veracity is _________________.

9. The name of a law that provides immunity to a citizen who offers medical aid is _________________________.

10. The patient is upset because her doctor has not been to see her today. The nurse tells the patient the doctor will be in by 3 p.m., even though the nurse

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does not know this to be true. This nurse has violated the ethical principle of _____________.

11. The basic concepts and fundamental moral principles that govern conduct are known as _________________________.

12. Another term for accepting responsibility is ________________.

13. _____________________ relates to space, time, and waiting and is influenced by culture.

14. The National Federation of Licensed _________ Nurse organization adopted the standards of practice that include ethics for the LPN/LVN. 15. The American Nurse Association has written guidelines for minimum __________________ of care.

16. The Nurse Practice _____ indicates the acceptable scope of nursing practice for the different levels of nursing.

17. _________________ addresses the security and privacy involved with medical records and how that information is identified and passed between care providers.

18. The _____________ ________________ is the leading national accreditation body of health care organizations.

19. Immunity for citizens who stop to assist someone in need of medical help is protected by the Good ___________ Act. 20. This document protects patients who are receiving care in a facility: Patient Bill of _________.

21. Abuse should be reported by ________________________.

22. Nurses are expected to be respectful of the beliefs of their patients and coworkers and not to force their personal beliefs on others at work. This is a demonstration of the trait of ______________, which is required to be nurse.

23. The _________Commission is the leading accrediting body of health care organizations.

Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 24. Patients Bill of Rights includes the right(s) to (select all that apply): A. Open mail and make personal phone calls.

B. Have privacy and visitors.

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C. Treat staff in a disrespectful manner.

D. Be identified as a client.

E. Choose ones own nurse. ____ 25. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was developed by the Department of Health and Human Services to provide national standards pertaining to transmission and communication of medical information. Which of the following are true about HIPAA (select all that apply)?

A. Only applies to electronic chart, not the paper one Provides national standards relating to the electronic transmission and comm B. medical information between patients, providers, employers, and insurers C. Allows less control on the part of the patient as to what part of health inform D. Gives the patient immediate access to his/her medical record at any time it is E. Eliminates the need for patients to sign informed consents F. HIPAA was implemented in 2003 ____ 26. The goals and objectives of the Joint Commission (JC) include (select all that apply): A. Committing to quality on a daily basis within the entire facility.

B. Reducing risk of undesirable patient outcomes.

C. Encouraging continuous improvement.

D. Reducing health care costs.

E. Promoting nursing education through scholarships and financial aid. ____ 27. The LPNs/LVNs will use the Nurse Practice Act as a guide in their practice. The Nurse Practice Act (select all that apply): A. Is a federal document that all states must follow.

B. Is established by each state to define the scope of nursing practice in that sta C. Protects nurses from lawsuits for violating rules about patients confidentialit D. Established fair compensation and benefits for nurses.

E. Dictates the acceptable scope of practice for the different levels of nursing.

Chapter 3: Ethics and Law Answer Section MULTIPLE CHOICE

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1. ANS: A The Patient Bill of Rights provides the patients right to refuse medications and treatments. The nurse has a responsibility to advocate for the patients and assure them of their rights. In addition, patients have the right to be educated about medications and treatment, which allows them to make an informed decision.

PTS: 1 REF: Chapter 3: Ethics and Law; Patient Bill of Rights; page 42 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Legal | Cognitive Level: Application | Client Need: Safe and Effective Care Environment: Client Rights 2. ANS: A HIPAA (Health Insurance Portability and Accountability Act) states what can be disclosed about a patient and emphasizes patient privacy.

PTS: 1 REF: Chapter 3: Ethics and Law; Confidentiality; page 40 KEY: Integrated Processes: Teaching/Learning | Content Area: Legal | Cognitive Level: Application | Client Need: Safe and Effective Care Environment: Confidentiality/Information 3. ANS: C It is within the nurses scope of practice to advocate for the patient. The nurse is the voice for the patient when needed. The nurse defends the patients rights to their beliefs and values.

PTS: 1 REF: Chapter 3: Ethics and Law; Patient Advocacy; page 42-43 KEY: Integrated Processes: Nursing Process: Planning | Content Area: Cultural Diversity | Cognitive Level: Analysis | Client Need: Psychosocial Integrity: Religious and Spiritual Influences on Health 4. ANS: B All patient information is confidential, and only initials should be used during the student clinical rotation.

PTS: 1 REF: Chapter 3: Ethics and Law; Confidentiality; page 40 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Confidentiality | Cognitive Level: Application | Client Need: Safe and Effective Care Environment: Confidentiality/Information Security 5. ANS: D

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Confidentiality is maintained, whether in a facility or out in public. If the patient initiates contact, then responding back is appropriate.

PTS: 1 REF: Chapter 3: Ethics and Law; Confidentiality; page 38 KEY: Integrated Processes: Caring | Content Area: Legal | Cognitive Level: Application | Client Need: Safe and Effective Care Environment: Confidentiality/Information Security 6. ANS: A Patient information is confidential this includes even acknowledging the presence of that person in the facility.

PTS: 1 REF: Chapter 3: Ethics and Law; Confidentiality; page 38 KEY: Integrated Processes: Communication and Documentation | Content Area: Legal | Cognitive Level: Synthesis | Client Need: Safe and Effective Care Environment: Confidentiality/Information Security COMPLETION 7. ANS: patient advocacy The nurse understands that patients learn from their peers and can help others. The nurse is providing information in the group to help this patient acknowledge a recent success.

PTS: 1 REF: Chapter 3: Ethics and Law; Patient Advocacy; page 45 KEY: Integrated Processes: Caring | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Synthesis | Client Need: Safe and Effective Care Environment: Management of Care: Advocacy 8. ANS: honesty Veracity is telling the truth.

PTS: 1 REF: Chapter 3: Ethics and Law; Honesty; page 36 KEY: Integrated Processes: Teaching/Learning | Content Area: Nursing Ethics | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Management of Care: Ethical Practice 9. ANS: Good Samaritan law The basis for all Good Samaritan laws is that a third party cannot be charged with negligence unless help is given recklessly or that person makes the

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situation significantly worse, according to the guidelines for that particular state.

PTS: 1 REF: Chapter 3: Ethics and Law; Good Samaritan Laws; page 41-42 KEY: Integrated Processes: Teaching/Learning | Content Area: Legal | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Management of Care: Legal Rights and Responsibilities 10. ANS: honesty, or veracity The professional choice is to tell the truth. Even though giving false information to the patient reassured the patient, it is not ethical.

PTS: 1 REF: Chapter 3: Ethics and Law; Honesty; page 36 KEY: Integrated Processes: Caring | Content Area: Nursing Ethics | Cognitive Level: Application | Client Need: Safe and Effective Care Environment: Ethical Practice 11. ANS: ethics Ethics provide a framework of action to address conflicting principles.

PTS: 1 REF: Chapter 3: Ethics and Law; Ethical Practices; page 34 KEY: Integrated Processes: Teaching/Learning | Content Area: Nursing Ethics | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Management of Care: Ethical Practice 12. ANS: accountability Accountability is accepting responsibility for any actions performed while caring for a patient.

PTS: 1 REF: Chapter 3: Ethics and Law; Accountability; page 41 KEY: Integrated Processes: Teaching/Learning | Content Area: Legal | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Concepts of Management and Supervision 13. ANS: Proxemics Study of spatial relationships including space, time, and waiting, which are all influenced by ones culture.

PTS: 1 REF: Chapter 3: Ethics and Law; Culture of Nurses; page 37

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KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Therapeutic Communication 14. ANS: Practical Ethical guidelines and practice standards for the LPN/LVN have been developed by NFLPN. PTS: 1 REF: Chapter 3: Ethics and Law; Professionalism; page 34 KEY: Integrated Processes: Teaching/Learning | Content Area: Nursing Ethics | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Coordinated Care 15. ANS: standards The standards of care are written at a minimum level and for each discipline of nursing. A nurse below the minimum competency is unsafe.

PTS: 1 REF: Chapter 3: Ethics and Law; Professionalism; page 34 KEY: Integrated Processes: Teaching/Learning | Content Area: Nursing Licensure | Cognitive Level: Comprehension | Client Need: Safe and Effective Care Environment: Coordinated Care 16. ANS: Act The Nurse Practice Act defines the level of practice for the nurse. A nurse can consult with the Nurse Practice Act when unsure about a specific skill.

The Nurse Practice Acts varies from state to state.

PTS: 1 REF: Chapter 3: Ethics and Law; Professionalism; page 34 KEY: Integrated Processes: Teaching/Learning | Content Area: Nursing Licensure | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Coordinated Care and Legal Rights and Responsibilities 17. ANS: HIPAA The Health Insurance Portability and Accountability Act (HIPAA) was developed by the U.S. Department of Health and Human Services to provide national standards pertaining to the electronic transmission and communication of medical information between patients, providers,

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employers, and insurers.

PTS: 1 REF: Chapter 3: Ethics and Law; Professionalism; page 39 KEY: Integrated Processes: Teaching/Learning | Content Area: Legal | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Confidentiality/Information Security 18. ANS: Joint Commission The Joint Commission ensures that standards in the hospital and other health care organizations are met and maintained. Their goal is to reduce the risk of undesirable patient outcomes and encourage continuous improvement.

PTS: 1 REF: Chapter 3: Ethics and Law; Professionalism; page 40 KEY: Integrated Processes: Teaching/Learning | Content Area: Management of Care | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Concepts of Management 19. ANS: Samaritan The Good Samaritan Act protects individuals who attempt to provide medical treatment. The Good Samaritan Act does not always protect nurses, physicians, and other medically trained persons.

PTS: 1 REF: Chapter 3: Ethics and Law; Abiding by Current Laws; page 4142 KEY: Integrated Processes: Teaching/Learning | Content Area: Legal | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Management of Care: Legal Rights and Responsibilities 20. ANS: Rights In many cases, this document was adopted to protect the rights of patients while in the facility; thus the Bill of Rights may vary from state to state, even though they are based on federal guidelines. These rights are to be listed in the facility and placed in a prominent area of the facility or the patients room.

PTS: 1 REF: Chapter 3: Ethics and Law; Patient Rights; page 42 KEY: Integrated Processes: Teaching/Learning | Content Area: Legal | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Management of Care: Legal Rights and Responsibilities

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21. ANS: everyone Everyone should report any form of abuse and negligence toward those considered as vulnerable. Nurses and health care workers have a moral, legal, and ethical responsibility to report known or suspected abuse of people who cannot care for themselves. By law nurses are mandated to report child abuse throughout the United States.

PTS: 1 REF: Chapter 3: Ethics and Law; Patient Advocacy; page 34 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Abuse | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Abuse/Neglect 22. ANS: professionalism Being a professional means we respect others and are committed to providing safe care to our patients.

PTS: 1 REF: Chapter 3: Ethics and Law; Professionalism; page 33 KEY: Integrated Processes: Caring | Content Area: Nursing Ethics | Cognitive Level: Comprehension | Client Need: Safe and Effective Care Environment: Ethical Practice 23. ANS: Joint Earning accreditation by Joint Commission indicates commitment to quality on a daily basis within the entire institution. The commissions goal is to reduce the risk of undesirable patient outcomes and encourage continuous improvement.

PTS: 1 REF: Chapter 3: Ethics and Law; Professionalism; page 40 KEY: Integrated Processes: Nursing Process: Evaluation | Content Area: Management of Care | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Coordinated Care MULTIPLE RESPONSE 24. ANS: A, B, D It is a legal right that advocates for the patient. Facilities are required to post the Patients Bill of Rights.

PTS: 1

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REF: Chapter 3: Ethics and Law; Patients Rights; Table 3-1, Most Frequently Adopted Patient Rights; page 43 and 44 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Patient Advocacy/Legal | Cognitive Level: Analysis 25. ANS: B, F HIPAA was established to maintain confidentiality to anyone receiving healthcare. HIPAA provides guidelines on how confidential health care information is handled, including with the use of technology. HIPAA does not impact other patient rights such as giving informed consent. The patient has a right to access to his or her medical record, but there is a specific process to be followed to achieve this for each health care institution so immediate access is usually not available.

PTS: 1 REF: Chapter 3: Ethics and Law; Confidentiality; page 40 KEY: Integrated Processes: Communication and Documentation | Content Area: Legal | Cognitive Level: Application | Client Need: Safe and Effective Care Environment: Management of Care: Confidentiality/Information Security 26. ANS: A, B, C The Joint Commission is the leading national accreditation body of health care organizations that monitors quality outcomes.

PTS: 1 REF: Chapter 3: Ethics and Law; Joint Commission; page 40 KEY: Integrated Processes: Teaching/Learning | Content Area: Management of Care | Cognitive Level: Comprehension | Client Need: Safe and Effective Care Environment: Management of Care: Concepts of Management 27. ANS: B, E A nurse will consult the Nurse Practice Act in his ro her state to determine if the nurse is performing at the appropriate level based on ones preparation.

PTS: 1 REF: Chapter 3: Ethics and Law; Professionalism-Nurse Practice Act; page 34 KEY: Integrated Processes: Teaching/Learning | Content Area: Nursing Licensure/Legal | Cognitive Level: Comprehension | Client Need: Safe and Effective Care Environment: CoLegal Rights and Responsibility

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Chapter 4: Developmental Psychology Throughout the Life Span My Nursing Test Banks Chapter 4: Developmental Psychology Throughout the Life Span Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Nurse Tonis assignment included a 41-year-old male client. Per Erikson, which developmental stage is the patient at?

A. Focus on having a family B. Does not assume responsibility for his actions C. Unable to solve problems D. Perceptions are based on illusions ____ 2. A nursing intervention for the initial phase of grief should focus on: A. Ignoring the patient until your presence is requested.

B. Staying available to provide support when the person demonstrates distress.

C. Insisting the person face reality of the loss.

Organizing a support group to provide a support system.

D. ____ 3. Joy is occupied exclusively with thoughts of her fathers death.

Although Joy is preoccupied with his death, she is still planning to purchase a gift for his birthday, which would have been in two more weeks. Dr. Leone advises the nurse to assist Joy through this stage of grief, which is known as: A. Denial.

B. Anger.

C. Bargaining.

D. Acceptance. ____ 4. Freud defines the ego as: A. Helping to determine what is right and what is wrong.

B. Being concerned with self-gratification.

C. Focusing on reality.

D. The part where a person is only concerned with ones individual needs.

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____ 5. A 16-year-old adolescent is hospitalized and acting like a child.

According to Erik Erikson, what is the appropriate developmental task?

A. Industry vs. inferiority B. Integrity vs. despair C. Identity vs. role confusion D. Trust vs. mistrust ____ 6. Which level of Maslows hierarchy of need pyramid is necessary for survival?

A. Love and belonging B. Physiological needs C. Self-actualization D. Safety and security ____ 7. This theorist supported the theory of moral reasoning. The theory of moral reasoning demonstrates how a person justifies right or wrong.

A. Freud B. Erikson C. Kohlberg D. Peters ____ 8. Jean Piagets cognitive theory elaborates on the way a person thinks and how these thoughts are used to adapt to the surrounding environment.

The age group for the formal operation is: A. Birth to 2 years of age.

B. 2 to 7 years of age.

C. 8 to 12 years of age.

D. 12 years of age to adulthood. ____ 9. Karen Horney was a follower of Sigmund Freud. Dr. Horney believed that the abnormal behavior experienced by her patient was the result of ineffective: A. Parenting.

B. Mother-child bonding.

C. Environmental stressors.

D. Genetic markers.

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____ 10. Jean Piagets theory focuses on a persons ability to reason. The stage of a person between 12 years of age and an adult according to Piaget would be: A. Sensorimotor.

B. Preoperational.

C. Concrete operational.

D. Formal operations. ____ 11. The id, the ego, and the superego theory was established by: A. Freud.

B. Horney.

C. Skinner.

D. Pavlov. ____ 12. When caring for a young child, Nurse Andrea realizes that trust is a normal part of growth and further development. Trust is primary in which age group according to Erikson?

A. 36 years old B. Over 65 C. Birth 18 months D. 1218 Completion Complete each statement.

13. The treatment method known as behavior modification is based on the theory of the behavioral theorists Skinner and ____________________.

14. The theorist__________ ________ believed that a persons behavior is related to ineffective personality development in childhood.

15. The eight stages of development with each one having contradictory developmental tasks was identified by _________ ___________.

16. Cognitive Development is the central thesis of the theorist _________________.

17. According to Freud, ______ is the part of the personality that is concerned with the gratification of self.

18. The humanistic theorist _________________ developed the hierarchy of needs.

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19. In Abraham Maslows hierarchy of needs, the level for survival is also known as the level of __________ __________.

20. According the Maslow, the highest level of need is _____________________.

21. Dr. Elisabeth Kbler-Rosss theory about facing death consists of a process of _____(number) stages.

22. This theorist ____________ ________________ identified eight developmental tasks or stages that are expressed as opposites or contraindications of each other.

Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 23. The physiological needs components in Maslows Hierarchy of Needs are (select all that apply): A. Water B. Oxygen C. Elimination D. Safety E. Freedom from fear F. Giving and receiving ____ 24. The love and belonging needs components in Maslows Hierarchy of Needs are (select all that apply): A. Companionship B. Physical safety C. Elimination D. Caring E. Freedom from fear F. Giving and receiving of affection ____ 25. Self-esteem components in Maslows Hierarchy of Needs are (select all that apply): A. Companionship B. Self-respect

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C. Achieve success D. Love E. Recognition F. Giving and receiving of affection ____ 26. The components of self-actualization in Maslows Hierarchy of Needs are (select all that apply): A. Achievement B. Working to ones potential C. Achieve success D. Love E. Self-fulfillment F. Giving and receiving of affection ____ 27. Which of the following are components of Freuds theory of personality (select all that apply): A. Personality is fully developed by age 12.

B. The personality is not fully developed until after adolescence.

C. Developmental behaviors can happen at any age.

D. Failure to progress in a particular manner will lead to dysfunction.

E. Behaviors resulting from ineffective personality development are unconscio Ineffective personality development was in some way related to the relations F. the parent and is called psychosexual development. ____ 28. Toni T is a 5-year-old girl who has a broken pelvis as a result of falling out of her tree house. Toni was ordered to stay in bed for 3 weeks.

What would be the most appropriate activities for this child (select all that apply)?

A. An age-appropriate video game B. Sports video C. Finger paints D. A chess set E. A punching bag F. A Scrabble game set ____ 29. The expected behavioral development of the child that is between

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the ages of 6 and 12 is the following (select all that apply): A. Learning to share B. Forming friendships with same-sex friends C. Beginning to show acceptance of moral issues by questions and discussions D. Socializing E. Being self-centered F. Learning independence Other 30. Maslows Hierarchy of Needs is arranged from the lowest level to the highest level (placed in the order they will occur): ___A. Self-actualization ___B. Self-esteem ___C. Physiological needs ___D. Love and belonging ___E. Safety and security 31. According to Freud, personality development stages follow this order.

(Place in order these stages occur.) ___ A. Phallic ___ B. Latency ___ C. Oral ___ D. Anal ___ E. Genital 32. The five stages of death and dying based on Elisabeth Kubler-Rosss work are (place in the order they will occur): ___ A. Anger ___ B. Acceptance ___ C. Denial ___ D. Bargaining ___ E. Depression Chapter 4: Developmental Psychology Throughout the Life Span Answer Section MULTIPLE CHOICE 1. ANS: A

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The developmental tasks for adults aged 2145 are generativity vs. stagnation.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span: Developmental Theorist-Erickson; Table 4-2, Eriksons Eight Stages of Development; page 55 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Developmental Theory | Cognitive Level: Analysis | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 2. ANS: B The initial phase of grief is denial. The individual may have difficulty facing the scope of the loss initially, so being available to support him or her when the emotions come is important.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Elisabeth Kbler-Ross/Death and Dying; page 69-70 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Grief | Cognitive Level: Application | Client Need: Psychosocial Integrity: Grief and Loss 3. ANS: A To protect themselves from the pain of the death, people use denial to unconsciously avoid facing reality and pain from the loss. Denial can seem irrational and can be intermittent.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Elisabeth Kbler-Ross/Death and Dying; Table 4-8 Five Stages of Grief/Death and Dying; page 69 KEY: Integrated Processes: Caring | Content Area: Mental Health: Grief | Cognitive Level: Synthesis | Client Need: Psychosocial Integrity: Coping Mechanism 4. ANS: C The ego is responsible for meeting and interacting with the outside world.

The id is balanced by the ego.

PTS: 1

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REF: Chapter 4: Developmental Psychology Throughout the Life Span; Freud; Table 4-1, Freuds Stages of Development; page 42 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Knowledge | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 5. ANS: C A 16-year-old is experiencing role confusion perhaps in response to the stress of hospitalization.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Table 4-2, Eriksons Eight Stages of Development; page 54-55 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Development | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance: Developmental Stages 6. ANS: B Physiological needs are the foundation of the pyramid; they must be met before any other needs can be addressed.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Maslow; page 60 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Knowledge | Client Need: Health Promotion and Maintenance: Developmental Stages 7. ANS: C Kohlberg believed there are three levels for determining moral reasoning: preconventional, conventional, and postconventional.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Table 4-4, Lawrence Kohlbergs Theory of Development of Moral Reasoning; page 54-55 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Analysis | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 8. ANS: D

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Twelve years to adulthood is the age for formal operations. The person develops adult logic, can plan for the future, and is able to solve abstract problems.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Table 4-3, Developmental Theory of Jean Piaget; page 56 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Knowledge | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 9. ANS: B Horney believed abnormal behaviors were related to ineffective mother and child bonding.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span: Developmental Theorist-Horney; page 58 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Knowledge | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 10. ANS: D During the formal operational age, the person develops adult logic, is able to reason, plans for the future, and able to form conclusions.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Development Theorist; Newborn to Adolescence; Table 4-3 Developmental Theory of Jean Piaget; page 56 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Analysis | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 11. ANS: A Dr. Freud developed these personality components and believed that these components are all set in the unconscious.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Developmental Theorist; Adolescence to Adulthood; page 57

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KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Knowledge | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 12. ANS: C Trust versus mistrust is the developmental task in the formative yearsbirth to 18 months.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Table 4-2, Eriksons Eight Stages of Development (Psychoanalytic or Psychosexual Stages); page 54 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions COMPLETION 13. ANS: Pavlov Behavior modification is used to eliminate and decrease the frequency of identified negative behaviors. Skinner and Pavlov were leaders in developing this theory.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Pavlov and Skinner; page 58 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental Health Concepts 14. ANS: Sigmund Freud One of Freuds beliefs was that behaviors resulting from ineffective personality development are unconscious. Freud believed that ineffective personality development was in some way related to the relationship of the child to the parent and that it was related to what he called psychosexual development.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span;

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Developmental Theorist; page 52 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Knowledge | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 15. ANS: Erik Erikson Erik Erikson developed eight stages of development of the life span that related developmental tasks to a persons approximate age. Each stage has an expected task and a contradictory one if not achieved (e.g., identify vs role confusion).

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Developmental Theorist; page 52-53 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Knowledge | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 16. ANS: Piaget Piagets theory was known as the cognitive theory. Piaget believed that intelligence consists of coping with the environment. Piaget also believed that a person had to complete each stage of development in order to progress to the next stage.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Developmental Theorist; page 53-54 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Knowledge | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 17. ANS: id Sigmund Freud described the three components of the personality s the id, the ego, and the superego. All three parts are in your unconscious.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span;

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Developmental Theorist; page 57 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Knowledge | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 18. ANS: Maslow Abraham Maslow introduced the hierarchy of needs as part of his humanist theory. This theory consisted of five levels of need. Maslows hierarchy of needs begins at a lower level and proceeds to a higher level. These levels are physiological needs, safety and security needs, love and belonging, the selfesteem, and self-actualization.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Developmental Theorist; page 60 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Knowledge | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 19. ANS: physiological needs The physiological level of needs consists of what a person needs to survive: food, water, oxygen, clothing, ability to eliminate, and sexual activity for procreation.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Developmental Theorist; page 60 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Basic Care and Comfort 20. ANS: self-actualization Needs hierarchies are physiologic, safety, love and belongingness, esteem, and self-actualization.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span;

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Maslow; page 62 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Knowledge | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 21. ANS: five; 5 Dr. Elisabeth Kbler-Ross felt that people went through different stages of dying relating to their different life experiences: denial, anger, bargaining, depression, and acceptance.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Death and Dying; page 69 KEY: Integrated Processes: Teaching/Learning | Content Area: End of Life | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Grief and Loss 22. ANS: Erik Erikson Eriksons developmental concepts were derived partly from Sigmund Freuds concepts of personality development. Eriksons stages related to developmental task based on age.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Developmental Theorist: Newborn to Adolescence; page 52 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Knowledge | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions MULTIPLE RESPONSE 23. ANS: A, B, C This level is related to survival.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Abraham Maslow; page 60 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Application | Client Need: Health Promotion

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and Maintenance: Developmental Stages and Transitions 24. ANS: A, D, F If the person has the previous level of needs taken care of (safety and security), then he or she can proceed to this level.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Abraham Maslow; page 61 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Application | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 25. ANS: B, C, E If the person has the previous level of needs taken care of (love and belonging), then he or she can proceed to this level.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Abraham Maslow; page 61 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Application | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 26. ANS: A, B, C, E This is the fifth and highest level of the pyramid that can be accomplished after all of the other levels are completed.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Abraham Maslow; page 62 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Application | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 27. ANS: A, D, E, F One of Freuds main beliefs was that behaviors resulting from personality development are unconscious. He also believed that ineffective personality development was in some way related to the relationship of the child and parent.

PTS: 1

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REF: Chapter 4: Developmental Psychology Throughout the Life Span; Developmental Theorist Newborn to Adolescence; page 52 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 28. ANS: A, C An overall view of the 5-year-old and developmental stage is important for self-expression. Primary activities at this time are cognitive development.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Table 4-7, Overall View of Human Development; page 66 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Application | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 29. ANS: A, B, C The child is school age and interacting with others. There will be more sharing and forming of friendships and beginning to show acceptance of moral issues by questions and discussions.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Table 4-7, Overall View of Human Development; page 66 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions OTHER 30. ANS: A: 5 B: 4 C: 1 D: 3 E: 2 Maslows Hierarchy of Needs starts at the lowest level, beginning with the level of survival. The lowest level is necessary for survival. Self-actualization is the highest.

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PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Developmental Theorist-Adolescence through Adulthood-Maslow; Figure 49 Maslows Hierarchy of Needs; page 61 KEY: Integrated Processes: Analysis | Content Area: Growth and Development | Cognitive Level: Knowledge | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 31. ANS: A: 3 B: 4 C: 1 D: 2 E: 5 Freud believed the childs personality was fully developed by age 12 and all the stages would be completed by that age.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Developmental Theorist; Table 4 Freuds Stages of Development ( Psychoanalytic or Psychosexual Stages); page 53 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Analysis | Client Need: Health Promotion and Maintenance: Developmental Stages and Transitions 32. ANS: A: 2 B: 5 C: 1 D: 3 E: 4 The five stages of dying do not always progress in order and not everyone will experience all five stages. The stages of dying are related to a persons life experiences and also apply to losses other than death.

PTS: 1 REF: Chapter 4: Developmental Psychology Throughout the Life Span; Table 4-8, Five Stages of Grief/Death and Dying by Dr. Elisabeth Kbler-

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Ross; page 69 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Grief | Cognitive Level: Analysis | Client Need: Psychosocial Integrity: Grief and Loss

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Chapter 5: Sociocultural Influences on Mental Health My Nursing Test Banks

Chapter 5: Sociocultural Influences on Mental Health Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Which of the following is appropriate with a patient who is homeless?

A. Treat patients according to their ability to pay.

The homeless patient is only treated in the emergency roomthey should not b B. life threatening condition; never admit them to the unit.

C. Treat the homeless patient as you would treat any patient.

D. Some parts of the Patient Bill of Rights do not apply to the homeless. ____ 2. A student recently moved from the Middle East and is attending a new school in the United States, where he is excluded from conversations pertaining to the Christmas holidays. The students assume that the new student doesnt understand anything about the holiday. The students are most likely doing what to this new student?

A. Being hateful B. Showing prejudice C. Believing stereotypes D. Being rude ____ 3. According to Diana Baumrind, there are three types of parenting.

When the parent sets up the rules and others have no voice, this is known as: A. Permissive parent.

B. Authoritarian parent.

C. Authoritative parent.

D. Administrative parent. ____ 4. According to Diana Baumrind, there are three types of parenting.

When the parent provides a minimum amount of structure and the child does not learn any boundaries, this type of parenting is known as:

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A. Permissive parent.

B. Authoritarian parent.

C. Authoritative parent.

D. Administrative parent. ____ 5. Janet, an African American female, fell at the mall shopping and was transported to an urgent care center to be examined. The x-rays were negative for fracture and Janet was not prescribed anything for her pain. At the urgent care center where Janet was treated, the health care providers were aware that this type of injury can be painful. According to recent studies within health care, failure to offer Janet pain medication could be a form of: A. Prejudice.

B. Ethnocentrism.

C. Stereotype.

D. Malpractice. ____ 6. Cultural competency is A. The responsibility of the patient.

B. The nurse being competent in his or her own culture C. The nurse being able to adapt care to meet the needs of patients from differe D. A written test required for all Americans.

Completion Complete each statement.

7. _________________is a shared way of life and the combination of traditions and beliefs that that make a group of people bond together.

8. A persons personal traits are defined by some of these factors (name two) ___________________.

9. ________________ is judging a person or a situation before all the facts are available.

10. A mother, a father, and biological children were once known as the ___________ ___________.

Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 11. The following are classified as a nontraditional family (select all

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that apply): A. Single-parent family B. Blended family C. Mother, father, and biological children D. Gay family True/False Indicate whether the statement is true or false. ____ 12. Culture is the same as ethnicity.

Chapter 5: Sociocultural Influences on Mental Health Answer Section MULTIPLE CHOICE 1. ANS: C Homelessness is not considered a mental illness but can be a stressor to the patient. This patient must be treated the same as any other patient.

PTS: 1 REF: Chapter 5: Sociocultural Influences on Mental Health; Homelessness; page 82 KEY: Integrated Processes: Caring | Content Area: Cultural Diversity | Cognitive Level: Application 2. ANS: C Stereotype is a fixed belief about a group of people. These students may have believed that someone from the Middle East is not Christian and has no interest in Christmas holiday.

PTS: 1 REF: Chapter 5: Sociocultural Influences on Mental Health; Culture; page 77 KEY: Integrated Processes: Caring | Content Area: Cultural Diversity | Cognitive Level: Application 3. ANS: B The authoritarian parent makes all of the decisions; the children do not have a voice in this family.

PTS: 1 REF: Chapter 5: Sociocultural Influences on Mental Health; Poor Parenting; page 83 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Comprehension 4. ANS: A

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This type of parenting has very little structure and few guidelines.

PTS: 1 REF: Chapter 5: Sociocultural Influences on Mental Health; Poor Parenting; page 84 KEY: Integrated Processes: Teaching/Learning | Content Area: Growth and Development | Cognitive Level: Comprehension 5. ANS: A A study at Emory University found that African Americans at times were offered less pain medication than other ethnicities. If the basis for this was race, that is prejudice.

PTS: 1 REF: Chapter 5: Sociocultural Influence on Mental Health; Ethnicity; page 78 KEY: Integrated Processes: Caring | Content Area: Nursing Ethics | Cognitive Level: Application 6. ANS: C Cultural competency implies that the nurse is able to adapt care to the needs of patients from different cultures.

PTS: 1 REF: Chapter 5: Sociocultural Influences on Mental Health: Culture; page 76 KEY: Integrated Processes: Teaching/Learning | Content Area: Cultural Diversity | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Cultural Diversity COMPLETION 7. ANS: Culture Culture is not based on skin color or religion but rather on shared aspects of the identified group.

PTS: 1 REF: Chapter 5: Sociocultural Influences on Mental Health; Culture; page 75 KEY: Integrated Processes: Teaching/Learning | Content Area: Cultural Diversity | Cognitive Level: Knowledge 8. ANS: Ethnicity, culture, religion, family history, life experience There are many contributors to ones personal traits and ethnicity is an important part. Ethnicity is made up of ones language, country of origin, and

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skin color. Other factors include culture, religion, family history, and life experience.

PTS: 1 REF: Chapter 5: Sociocultural Influences on Mental Health; Ethnicity; page 78 KEY: Integrated Processes: Teaching/Learning | Content Area: Cultural Diversity | Cognitive Level: Comprehension 9. ANS: Prejudice Prejudice can take place in health care when people make judgments about a patient based on minimal data such as age, skin color, and mental status.

PTS: 1 REF: Chapter 5: Sociocultural Influences on Mental Health; Ethnicity; page 78 KEY: Integrated Processes: Teaching/Learning | Content Area: Cultural Diversity | Cognitive Level: Knowledge 10. ANS: traditional or nuclear family The definition of the traditional family has changed. Nontraditional lifestyles have expanded the definition of family.

PTS: 1 REF: Chapter 5: Sociocultural Influences on Mental Health; Nontraditional Lifestyles; page 80 KEY: Integrated Processes: Caring | Content Area: Adolescent, Child, Adult, Aging | Cognitive Level: Knowledge MULTIPLE RESPONSE 11. ANS: A, B, D The nontraditional family has selected the lifestyle in which they feel the most comfortable.

PTS: 1 REF: Chapter 5: Sociocultural Influences on Mental Health; Nontraditional Lifestyle; page 79 KEY: Integrated Processes: Caring | Content Area: Cultural Diversity | Cognitive Level: Application TRUE/FALSE 12. ANS: F

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Culture is a shared way of life, the combination of traditions and beliefs that make a group of people bond together. It is unrelated to country of origin, race, or skin color.

PTS: 1 REF: Chapter 5: Sociocultural Influences on Mental Health; Culture; page 75 and 78 KEY: Integrated Processes: Teaching/Learning | Content Area: Cultural Diversity | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Cultural Diversity

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Chapter 6: Nursing Process in Mental Health My Nursing Test Banks Chapter 6: Nursing Process in Mental Health Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. After the admission of the patient, Nurse Toni will get specific information from the patient. This method of getting information is known as the: A. Termination phase when discharge plans are being made.

B. Working phase, when the patient shows some progress.

C. The patient interview.

D. Working phase, when the patient brings it up. ____ 2. A systematic and individualized method of planning and providing care is best known as: A. Assessment.

B. Nursing process.

C. Diagnosis.

D. Implementation. ____ 3. A patient is admitted to the Mental Illness and Chemical Abuse (MICA) unit for detox from the use of alcohol. During the interview, the patient states, My wife would rather see me dead. To which part of the nursing process does this belong?

A. Planning B. Implementation C. Evaluation D. Assessment ____ 4. A patient is admitted into a mental health unit screaming and kicking.

Although this patient is acting out, she also is verbalizing that her leg is hurting. What type of planning would benefit this patient the most?

A. Short-term goal B. Long-term goal

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C. Intervention D. Evaluation ____ 5. You find a patient on the floor at shift change. She is awake and alert.

She is confused now and was not confused prior to the being found on the floor. What is your first step in the nursing process in this situation?

A. Leave the patient to get help.

B. Gather more information by making observations about the patient.

C. Call the patients MD from your cell phone.

D. Help the patient get up and then document your findings in the chart. ____ 6. Short-term and long-term goals are which part of the nursing process?

A. Assessment B. Nursing diagnosis C. Planning D. Implementation E. Evaluation ____ 7. In the principles of teaching, which abbreviation is used to describe the nursing process?

A. ABES B. AAPE C. APIE D. ABLE ____ 8. NANDA is the acronym for: A. New American Nursing Diagnosis Association.

B. National American Nursing Diagnosis Association.

C. North American Nursing Diagnosis Analyzer.

D. North American Nursing Diagnosis Association. ____ 9. In the Mental Health Status Examination, which of the following focuses on what the person is thinking?

A. Speech and the ability to communicate B. Judgment C. Memory

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D. Thinking/content of thought ____ 10. The component of the Mental Health Status Examination that focuses on the way a person experiences reality is assessing the persons: A. Thinking/content of thought.

B. Perception.

C. Judgment.

D. Mood and affect. ____ 11. The Mental Health Status Exam takes place in what step of the nursing process?

A. Evaluation B. Nursing diagnosis C. Intervention D. Assessment ____ 12. In the planning phase of the nursing process, establishing short- and long-term goals is very important. Planning should: A. Include positive and negative outcomes.

B. Be realistic and measureable.

C. Be formal and informal.

D. Focus on the best possible options even if unrealistic. ____ 13. Which is an accurate planning goal?

A. The patient will lose 20 pounds when he agrees to follow the prescribed diet B. The patient will lose 20 pounds in 20 days C. The patient will lose 1 to 2 pounds a week until the goal of 20 pounds is reac D. The patient will lose 2 pounds a week for 10 weeks.

Completion Complete each statement.

14. The interaction of the nurse and patient that requires a nurse to obtain specific information from a patient is known as the _______________ ______________.

15. While on your way to another room, you notice a patient is having trouble using the call light. You stop and provide directions on how to use the call light. This is an example of what type of __________________ teaching.

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16. The final step in the nursing process is ____________________.

17. The most important component of the nursing process that precedes the nursing intervention and is prepared by the registered nurse is the ____________ ___________.

18. The organization that developed the initial concept of nursing diagnosis is _______________.

19. The nursing diagnosis is the function of this member of the health care team: ___________ ____________.

20. Carrying out the specific steps to achieve a patients goals is called the _______________.

21. When the LPN/LVN sets a specific time to sit with the patient to go over diabetes education, this is considered ________________ teaching.

Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 22. Informal teaching takes place under the following conditions (select all that apply): A. Anytime B. Anywhere C. A preset curriculum D. Whenever the patient needs information E. You notice the patient looking at the dressing on their wound F. A scheduled class ____ 23. The LPN/LVN, assisting in the preparation of the care plan of the elderly patient with moderate cognitive impairment, should plan the goals to be (select all that apply): A. The entire responsibility of the nurse.

B. Measurable.

C. Realistic.

D. Should include the patient in the process. ____ 24. The following are guidelines for the nurse-patient interview (select all that apply): A. Advise the patient

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B. Be aggressive C. Be sensitive D. Use empathy E. Use open-ended questions ____ 25. The following are components of the principles of teaching (select all that apply): A. Know the patient B. Lecture C. Demonstration D. Be flexible E. Plan to allow a few minutes after the class for questions F. Have a teaching plan ____ 26. The Mental Health Status Examination is an assessment of the patients mental status and current mental functioning. The following are components of the Mental Health Status Examination (select all that apply): A. Appearance and behavior.

B. Level of awareness and orientation.

C. Glasgow scale.

D. Judgment.

E. Mood and effect. ____ 27. The role of the LPN/LVN to the nursing process is (select all that apply): A. Assisting the registered nurse with the nursing diagnosis.

B. Collecting data.

C. Completing the initial assessment.

D. Developing principles of teaching.

E. Planning care and prioritizing goals. ____ 28. The nursing process includes: (select all that apply) A. Assessment.

B. Planning.

C. Diagnosis.

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D. Implementation.

E. Case management.

F. Evaluation.

Other 29. The nursing process is a systematic method of caring for a patient (place in the order they will occur): ____A. Evaluation. ____B. Planning. ____C. Assessment. ____D. Nursing diagnosis. ____E. Implementation.

Chapter 6: Nursing Process in Mental Health Answer Section MULTIPLE CHOICE 1. ANS: C When the nurse and patient agree to work together, data is collected from the patient. The patient interview process begins as soon as the nurse walks in the room with the intention of obtaining the information.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; The Intake Admission Interview; page 94 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Comprehension | Client Need: Safe and Effective Care Environment: Coordinated Care 2. ANS: B The nursing process is a tool used in nursing to assist in providing care in a systematic manner.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; The Steps of the Nursing Process; page 89 KEY: Integrated Processes: Nursing Process: Planning | Content Area: Nursing Process | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Continuity of Care

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3. ANS: D The patient is making a statement that would be included with subjective data as part of the assessment.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; page 90 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Therapeutic Nursing Process | Cognitive Level: Synthesis | Client Need: Safe and Effective Care Environment: Management of Care: Continuity of Care 4. ANS: A The plan should be to provide the patient with short-term care first. If the pain in her leg is reduced, the patient will possibly stop screaming. Planning needs to occur before intervention.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; page 95-96 KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Nursing Process | Cognitive Level: Application | Client Need: Safe and Effective Care Environment: Coordinated Care 5. ANS: B Being the first person on scene, you need to find out as much information as possible to report to the charge nurse as part of data collection. Never leave the patient alone until you are sure the patient is secure.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Data Collection; page 90 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Management of Care | Cognitive Level: Application | Client Need: Safe and Effective Care Environment: Coordinated Care 6. ANS: C Short-term and long-term goals are part of planning in the nursing process.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Nursing Process; page 95-96 KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Therapeutic Nursing Process: | Cognitive Level: Comprehension | Client Need: Safe and Effective Care Environment: Coordinated Care 7. ANS: C

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The very simple formats APIE for the nursing process may be easily transformed into a teaching format. APIE stands for Assessment, Plan, Intervention, Evaluation.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Principles of Teaching; page 90, 94-97, 100 KEY: Integrated Processes: Teaching/Learning: Nursing Process: Planning | Content Area: Management of Care | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance: Data-Collection Techniques 8. ANS: D The North American Nursing Diagnosis Association developed nursing diagnoses that define the patients problems after performing the patients assessment using a universal language. The nursing diagnosis can only be written by the registered nurse.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Nursing DiagnosisDefining Patient Problems; page 95 KEY: Integrated Processes: Nursing Process: Assessment, Planning | Content Area: Management of Care | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance: Data-Collection Techniques 9. ANS: D Thinking/content of thought describes the content and process used in thinking. Alterations can include flight of ideas or obsessions.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Table 6-1, Mental Health Status Examination; page 92 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Nursing Process: Management of Care | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance: Data-Collection Techniques 10. ANS: B Perception is the way a person experiences reality. This assessment also is based on the patients statement of his or her environment and behaviors

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associated with those statements.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Table 6-1, Mental Health Status Examination; page 93 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Nursing Process | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance: DataCollection Techniques 11. ANS: D The Mental Health Status Exam aids in the assessment process. The Mental Health Status checks eight different areas.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Assessing the Patients Mental Health; page 90 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Nursing Process: Assessment | Cognitive Level: Synthesis | Client Need: Health Promotion and Maintenance: Data-Collections Techniques 12. ANS: B Goals need to be realistic, attainable, and measurable by establishing a realistic target date of achievement.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Planning Care; page 96 KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Therapeutic Nursing Process | Cognitive Level: Analysis | Client Need: Safe and Effective Care Environment: Management of Care: Establishing Priorities 13. ANS: C In order to provide attainable goals, each goal should be measurable, realistic and individualizedaccording to the patients emotional and physical health.

The goal should also be measurable, by establishing a realistic target date of achievement.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Planning Care; page 96

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KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Therapeutic Nursing Process | Cognitive Level: Application | Client Need: Safe and Effective Care Environment: Management of Care: Establishing Priorities COMPLETION 14. ANS: patient interview The patient interview is the primary method of data collecting used in health care.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Step 1: Assessing the patients mental health; page 94 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Process | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Coordinated Care: 15. ANS: informal teaching Informal teaching happens anytime, anywhere, whenever the patient needs information.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Patient Teaching; page 97 KEY: Integrated Processes: Teaching/Learning | Content Area: Management of Care | Cognitive Level: Application | Client Need: Health Promotion and Maintenance: Principles of Teaching/Learning 16. ANS: evaluation The LPN/LVN will note if the interventions performed were ineffective in attaining the patients goals.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Evaluating Interventions; page 100 KEY: Integrated Processes: Nursing Process: Evaluation | Content Area: Management of Care | Cognitive Level: Comprehension | Client Need: Safe and Effective Care Environment: Management of care: continuity of care

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17. ANS: nursing diagnosis The nursing diagnosis defines the problem of the patient using standardized language.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Nursing DiagnosisDefining Patient Problems; page 95 KEY: Integrated Processes: Nursing Process: Nursing Diagnosis | Content Area: Mental Health: Nursing Process in Mental Health | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Coordinated Care 18. ANS: NANDANorth American Nursing Diagnosis Association NANDA developed the first list of standardized nursing diagnoses that are used worldwide by nurses to communicate about patients needs.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Nursing DiagnosisDefining Patient Problems; page 95 KEY: Integrated Processes: Communication and Documentation/ Nursing Process: Planning | Content Area: Nursing Trends | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Management of Care: Continuity of Care 19. ANS: registered nurse Processing the collected data from the assessment is a function of the registered nurse according to the ANA. PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Nursing DiagnosisDefining Patient Problems; page 95 KEY: Integrated Processes: Nursing Process: Planning | Content Area: Licensure | Cognitive Level: Knowledge | Client Need: Health Promotion and Maintenance: Data-Collection Techniques 20. ANS: intervention or implementation

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The implementation/intervention identifies the steps that the LPN/LVN will carry out to meet the patients goal. The nurse should be able to supply the reason for each intervention.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Step 4 Implementations/Interventions; page 96 KEY: Integrated Processes: Nursing Process: Planning/Implementation | Content Area: Nursing Licensure | Cognitive Level: Comprehension | Client Need: Safe and Effective Care Environment: Coordinated Care 21. ANS: formal Formal teaching is any situation in which a class is scheduled or a specific objective must be met such as management of blood sugars.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Step 4: Implementations/Interventions; page 97 KEY: Integrated Processes: Teaching/Learning | Content Area: Management of Care | Cognitive Level: Application | Client Need: Health Promotion and Maintenance: Principles of Teaching/Learning MULTIPLE RESPONSE 22. ANS: A, B, D, E Informal teaching can occur anytime or any place, especially when the patient asks for information or when the nurse notices the patient is in need of education.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Implementations/Interventions; page 97 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Nursing Process: Implementation | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance: Health Promotion/Disease Prevention 23. ANS: B, C, D Goals and planning set by the nurse should be realistic and measureable for the patient. A goal date should be established during planning.

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PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Step 3 Planning; page 95-96 KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Therapeutic Nursing Process | Cognitive Level: Application | Client Need: Health Promotion and Maintenance: Aging Process 24. ANS: C, D, E The patient interview is the time to obtain information rather than give advice.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Patient Interview; page 95 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Nursing Process | Cognitive Level: Application | Client Need: Health Promotion and Maintenance: DataCollection Techniques 25. ANS: A, D, E, F The principles of teaching allow the nurse to provide an appropriate type of education concerning the patient in the disease process. B and C are teaching methods.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Patient Teaching; page 98-99 KEY: Integrated Processes: Teaching/Learning | Content Area: Management of Care | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance: Principles of Teaching/Learning 26. ANS: A, B, D The mental health status examination includes the following: appearance, behavior, level of awareness, orientation, thought content, memory, speech, mood and affect, judgment, and perception.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Table 6.1, Mental Health Status Examination; page 91 and 93 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance: Health Screening

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27. ANS: A, B The LPN/LVN can assist the registered nurse with the nursing diagnosis. The nursing diagnosis is the responsibility of the registered nurse. The LPN/LVN can collect data in order to implement care.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Step-by-Step Implementation of the Nursing Process; page 97 KEY: Integrated Processes: Nursing Process | Content Area: Nursing Licensure | Cognitive Level: Comprehension | Client Need: Safe and Effective Care Environment: Coordinated Care 28. ANS: A, B, C, D, F The nursing process has these five components.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Step-by-Step Implementation of the Nursing Process; Figure 6-1 Steps in the nursing process; page 90 KEY: Integrated Processes: Nursing Process | Content Area: Management of Care | Cognitive Level: Comprehension | Client Need: Safe and Effective Care Environment: Coordinated Care OTHER 29. ANS: A: 5 B: 3 C: 1 D: 2 E: 4 The order of the nursing process is assessment, nursing diagnosis, planning, implementation, and outcome. The nursing process is a systematic approach in taking care of a patient.

PTS: 1 REF: Chapter 6: Nursing Process in Mental Health; Step-by-Step Implementation of the Nursing Process; Figure 6-1 Steps in the nursing process; page 90 KEY: Integrated Processes: Nursing Process | Content Area: Mental Health:

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Therapeutic Nursing Process | Cognitive Level: Application | Client Need: Health Promotion and Maintenance: Coordinated Care

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Chapter 7: Coping and Defense Mechanisms My Nursing Test Banks Chapter 7: Coping and Defense Mechanisms Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Your patient is sternly criticized by her doctor for not complying with the medication regimen. The patient walks out of the office and yells at the parking attendant. This may be an example of which defense mechanism?

A. Projection B. Intellectualization C. Reaction formation D. Displacement ____ 2. Which of the following best describes what defense mechanisms are?

A. Abnormal coping mechanisms B. Genetically wired responses C. Protective devices that reduce anxiety D. All of the above ____ 3. A new patient with schizophrenia is admitted to the psychiatric unit.

He is standing at the locked exit door and yelling, Help me, I dont belong here. This behavior is most likely an example of what defense mechanism?

A. Denial B. Regression C. Enabling D. Projection ____ 4. Nurse Anne recognizes that John is always blaming others for his shortcomings. Finger pointing is usually related to the defense mechanism of: A. Scapegoating.

B. Identification.

C. Restitution.

D. Avoidance. ____ 5. Joy has just experienced her fifth spontaneous abortion. She is unable

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to understand why this is happening to her. Joy voices her anger toward her physician and the nurses, accusing them of incompetence. Assessing the situation, the nurse recognizes that the client may be using the coping mechanism of: A. Conversion reaction.

B. Displacement.

C. Denial.

D. Regression. ____ 6. Marion, a 25-year-old patient who lives with her parents, explains to the nurse at the community clinic, I really dont need to talk to anyone, even my parents. The patient expresses that she is too busy and does not have the time to sit and talk. The nurse recognizes that the client is most likely using the defense mechanism known as: A. Conversion reaction.

B. Avoidance.

C. Isolation.

Denial.

D. ____ 7. Karen Ann, a patient on the mental health unit, is in the bathroom with the door locked. She was admitted to the unit as a result of her psychotic behavior. The mental health nurse is asking her to come out and take her medication. The patient responds by stating, There is nothing wrong with my behavior. I dont need any medication. I dont know why everyone is so upset.

Her response indicates that the defense mechanism being used is: A. Denial.

B. Obsession.

C. Displacement.

D. Projection. ____ 8. Unconscious refusal to see reality describes this type of defense mechanism: A. Denial.

B. Repression.

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C. Compensation.

D. Isolation. ____ 9. Use of a logical-sounding excuse to cover up true thoughts and feelings describes this defense mechanism: A. Denial.

B. Rationalization.

C. Compensation.

D. Isolation. ____ 10. Emotion that is separated from the original feeling describes this defense mechanism: A. Denial.

B. Repression.

C. Compensation.

D. Isolation. ____ 11. Anthony is a 40-year-old patient who lost his job recently and wishes that he was back home living with his parents. Anthony has been noted to do things he used to do when he was a child. Anthony is going through a period of regression. Regression is best defined as: A. A retreat to a less stressful time in ones life.

B. An immature response technique.

C. An assertive response.

D. A therapeutic mechanism. ____ 12. Your patient Vicky just received a diagnosis of terminal cancer.

You plan to speak to her about her response to the diagnosis.. When you reach her room, you find Vicky on the phone. As youre standing in the doorway, she starts laughing. You are startled when she states, Why are you looking so sad? Obviously the tests were wrong. I am not that sick. The patient is displaying: A. Transference.

B. Regression.

C. Denial.

D. Isolation.

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____ 13. Audrey, a mental health nurse, has noticed that every day prior to going to work, she starts off with headaches, loose stools, episodes of feeling light-headed, and other disorders. These symptoms may be an expression of emotional disturbances. Audrey is aware she could be experiencing: A. Isolation.

B. Repression.

C. Splitting.

D. Conversion. ____ 14. Lilas three-year-old daughter is an only child who recently started day care. It was only 6 months ago that Lila had toilet trained her daughter.

After 1 week in the day care, her daughter has started wetting herself and crawling. Her mother has become quite concerned. The school nurse explained to her that her daughter probably is experiencing: A. Regression.

B. Depression.

C. Manipulation.

D. Compensation. ____ 15. An overweight male college student is unable to participate in competitive sports. Although he cant be a sports hero, the student becomes the life of the party when socializing. This student also uses his student loan to purchase a new sports car. The student is displaying: A. Compensation.

B. Reaction formation.

C. Transference.

D. Identification. ____ 16. One of the female patients on the mental health unit starts to have delusions of persecution and is hearing voices. Prior to this admission, she attempted several times to poison her boyfriend after the voices told her to do so. During your initial rounds, you enter her room and ask her how she is doing. The patient states, shes a bad person. Your patient is exhibiting: A. Transference.

B. Aggression.

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C. Dissociation.

D. Denial. ____ 17. The charge nurse has been in a meeting with the director of nursing (DON). The DON has been given some very unpleasant mandates by administration, which came down to the charge nurse. It is now the charge nurses responsibility to disseminate these mandates to the nursing staff.

When the charge nurse gives the news to the nursing staff, she gives it to them in a very harsh manner toward the staff. This is an example of: A. Compensation.

B. Identification.

C. Displacement.

D. Reaction formation. ____ 18. A patient who has survived a motor vehicle accident has just learned that the passenger in the car has died. The survivor is unable to recall being in the car. The nurse on duty realizes that this is: A. Dissociation.

B. Denial.

C. Regression.

D. Transference.

Completion Complete each statement.

19. The patient yells at the nurse right after having a stressful conversation with his spouse. What defense mechanism is the patient most likely using? ________________ 20. __________________is an unconscious burying or forgetting mechanism.

21. Using a logical-sounding excuse is known as ___________________________.

22. The physically unattractive person who wants to model and instead becomes a famous designer is demonstrating ____________________.

23. A wellness instructor who lectures on love and happiness but who is actually an abusive husband is using the defense mechanisms of ___________________.

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24. The student who fails her finals is told she is out of the nursing program.

She goes home and verbally abuses family members. This type of behavior is known as ___________________.

25. I didnt get the position because the director doesnt like me is an example of the defense mechanism ________________.

26. I can quit smoking any time I want to. The person is in ___________________.

27. A young married woman is attracted to a male coworker. To counteract these feelings, she tells the boss she cant work with him. The defense mechanism used here is _________________.

28. _________________ is the way a person adapts to a stressor psychologically, physically, and behaviorally.

Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 29. Defense mechanisms are methods used for reducing anxiety.

Defense mechanisms unconsciously assist a person in handling stressful events in an effective manner. People have a group of defense mechanisms learned from childhood. The following are defense mechanisms (select all that apply): A. Compensation.

B. Rationalization.

C. Depression.

D. Regression.

E. Denial. ____ 30. Which of the following defense mechanisms do people typically use in times of stress (select all that apply): A. Denial.

B. Bargaining.

C. Compensation.

D. Rationalization.

E. Acceptance.

Chapter 7: Coping and Defense Mechanisms

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Answer Section MULTIPLE CHOICE 1. ANS: D Displacement is transferring anger and hostility to another person or object that is perceived to be less powerful.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108-109 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Coping | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 2. ANS: C Defense mechanisms are learned responses to anxiety that help us cope with stress. Though they can be maladaptive, they are not considered abnormal.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Defense Mechanisms; page 107 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Coping | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 3. ANS: A This patient is struggling to accept a painful reality. Denial serves as a way to avoid this reality. Regression is emotionally returning to an earlier time in life when there was far less stress. Projection is blaming others. Enabling is not a defense mechanism.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108-109 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: coping | Cognitive Level: Application | Client Need: Psychosocial Integrity: Coping mechanisms 4. ANS: A Scapegoating is blaming others for ones own unacceptable behavior.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly

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Used Defense Mechanisms; page 109 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms 5. ANS: B Displacement is transferring anger and hostility to another person or object that is perceived less powerful.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109 KEY: Integrated Processes: Caring | Content Area: Mental Health: Defense Mechanism | Cognitive Level: Analysis | Client Need: Psychosocial Integrity: Coping Mechanisms 6. ANS: B The person is avoiding situations that may open up feelings.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Defense Mechanisms | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Coping Mechanisms 7. ANS: A Denial is unconscious refusal to see reality.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Application | Client Need: Psychosocial Integrity: Coping Mechanism 8. ANS: A Denial is the attempt to remove an experience or a feeling from consciousness.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly

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Used Defense Mechanisms; page 108 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms 9. ANS: B Rationalization is the most frequently used defense. It is substituting acceptable reasons for real reasons for personal behaviortruth is too threatening.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Coping Mechanisms 10. ANS: D Isolation is the blocking of feelings that are associated with an unpleasant or threatening situation.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms 11. ANS: A During a stressful event, people may revert back to a time that was less stressful.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Comprehension 12. ANS: C The patient is experiencing unconscious refusal to see reality that provides a protection from facing something so distressing.

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PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Application 13. ANS: D The patients anxiety about going to work can be channeled into physical symptoms; once the anxiety of work is reduced, the physical symptoms disappear.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108 KEY: Integrated Processes: Caring | Content Area: Mental Health: Coping | Cognitive Level: Application | Client Need: Psychosocial Integrity: Coping Mechanisms 14. ANS: A The child is emotionally returning to an early time in her life when there was far less stress.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Application 15. ANS: A Compensation is making up for something we perceive as an inadequacy by developing some other desirable trait.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: coping | Cognitive Level: Application 16. ANS: C The patient may be referring to herself in third person due to unacceptable feelings she is experiencing, so she disassociates from the emotion.

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PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Psychotic disorder | Cognitive Level: Analysis 17. ANS: C Transferring anger and hostility to another person or object that is perceived to be less powerful is the definition of displacement. It is easier to display anger to her employees than her supervisor.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Analysis 18. ANS: A Dissociation occurs when painful events or situations are separated from the conscious mind.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Application | Client Need: Psychosocial Integrity: Coping Mechanisms COMPLETION 19. ANS: Displacement In displacement, feelings are transferred to a less threatening object.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109 KEY: Integrated Processes: Analysis | Content Area: Mental Health: Coping | Cognitive Level: Application | Client Need: Psychosocial Integrity: Coping mechanism 20. ANS:

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Repression; Repression is the unconscious exclusion of painful impulses, desires, or fears from the conscious mind.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms 21. ANS: rationalization It is the most frequently used defense mechanism. It is often seen when a logical-sounding excuse is used to cover up true thoughts and feelings.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms 22. ANS: compensation Making up for something perceived as an inadequacy by developing some other desirable trait.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms 23. ANS: sublimation Unacceptable traits or characteristics are diverted into acceptable traits or characteristics.

PTS: 1

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REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms 24. ANS: displacement; transference Transferring anger and hostility to another person or object that is perceived to be less powerful.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms 25. ANS: Scapegoating Scapegoating is unfairly blaming others. The origin of this term is from the Bible, which describes a ritual in which a goat is sent into the desert bearing the sins of the people of Israel.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms 26. ANS: denial Denial is usually the first defense learned and used. It is an unconscious refusal to see reality.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental

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Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms 27. ANS: avoidance Unconsciously staying away from events or situations that might open feelings of aggression or anxiety.

Integrated Process: Teaching/Learning | Content Area: Mental Health; Coping | Cognitive Level: Application | Client Need: Psychosocial Integrity: Coping Mechanisms Ref. Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109 PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 109 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms 28. ANS: Coping Coping is the ability to deal consciously with problems and stress.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Coping; page 105 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanisms MULTIPLE RESPONSE 29. ANS: A, B, D, E Defense mechanisms are used by all people and are not necessarily a sign of psychiatric disorder unless they are used excessively. The main purpose of defense mechanisms is to decrease anxiety.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Defense Mechanisms; Commonly Used Defense Mechanisms; page 108 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Analysis | Client Need: Psychosocial

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Integrity: Coping Mechanism 30. ANS: A, C, D These are all commonly used defense mechanisms.

PTS: 1 REF: Chapter 7: Coping and Defense Mechanisms; Table 7-1, Commonly Used Defense Mechanisms; page 108 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Coping | Cognitive Level: Analysis

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Chapter 8: Mental Health Treatments My Nursing Test Banks

Chapter 8: Mental Health Treatments Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Pete has recently been admitted to the hospital and is being treated for bipolar disorder. When you go to check in on him, he tells you that he is feeling very drowsy and has been vomiting. He is also running a fever. You suspect that Petes problem is caused by: A. Anxiety over his new surroundings after being admitted to the hospital for tr B. Side effects of the lithium therapy he is receiving.

C. A hospital-acquired viral infection.

D. Food poisoning. ____ 2. Your manic patient is being discharged on lithium. Which of the following would NOT be in the teaching plan?

A. Blood levels must be closely monitored.

B. Continue to take lithium even when your manic symptoms are resolved.

C. Restrict fluids while taking this drug.

D. Contact your doctor if you experience side effects rather than stopping the d ____ 3. Which of the following is true about lithium?

A. It is available in multiple formulations, including IV and suppository.

B. It is generally discontinued for 2 weeks prior to any major surgery.

C. It is used on a prn basis when the patient feels anxious.

D. None of the above ____ 4. Nurse Arlene recognizes that the focus of environmental (MILIEU) therapy is to: A. Control the environment to bring about a positive behavior change.

B. Allow the patient freedom to decide whether they want to participate in activ C. Use role-play to meet their personal needs.

D. Use natural medicines rather than drugs to control behavior. ____ 5. During electroconvulsive therapy (ECT), the patient is monitored

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carefully before and after the procedure. The nurse assisting with this procedure is aware that monitoring is necessary because the patient may suffer from: A. Euphoria.

B. Immediate alertness after the procedure and sleepy later in the day.

C. Urine retention.

D. Seizure activity. ____ 6. Lynn, the LPN/LVN, is providing care for a patient diagnosed with depression. The patient is not responding to any of the medications ordered.

The nurse foresees this patient may be a candidate for: A. Neuroleptic medication.

B. Short-term seclusion.

C. Psychosurgery.

D. Electroconvulsive therapy. ____ 7. When teaching Mary, who has depression, about foods to avoid while taking phenelzine (Nardil), which of the following would Audrey LPN include?

A. Peanut butter B. Fresh fish C. Salami D. Soup ____ 8. When developing a care plan for Ms. Smith, who was diagnosed with schizophrenia and is receiving haloperidol, which of the following medications would Nurse Janet expect to administer if the patient developed extrapyramidal side effects (EPS)?

A. Olanzapine (Zyprexa) B. Paroxetine (Paxil) C. Benztropine mesylate (Cogentin) D. Lorazepam (Ativan) ____ 9. Nurse Maryse invites a recently discharged patients family to attend an outpatient support group. This type of program would most likely help the family with which of the following issues?

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A. Learning from others in the same situations B. Gaining insight into why they feel guilty C. Recognizing the clients weakness D. Managing the clients financial concern and problems ____ 10. Linda says that she feels confused and anxious. In addition, Linda feels unorganized and states, It is as not bad as it seems. What phase of crisis is Linda experiencing?

A. Precrisis B. Impact C. Adaptive D. Postcrisis ____ 11. Andrea, the charge nurse, spoke to the director of nursing about one of the staff nurses having a crisis. The nurse suggested a crisis intervention group to the staff nurse. Crisis intervention groups are successful because: The crisis intervention worker is a psychologist and understands the presenti A. patterns.

B. They supply a workable solution to the patients problem.

C. The patient is encouraged to share with others about personal problems.

D. The patient is assisted to develop new insights and return to the precrisis pha ____ 12. Which of the following best explains why tricyclic antidepressants (TCA) are used cautiously with the elderly population?

A. Central nervous system effects B. Cardiovascular system effects C. Gastrointestinal system effects D. Serotonin syndrome effects ____ 13. Which of the following drugs indicates the patient is toxic with a serum level of 1.5 mEq/L? A. Lithium B. Ritalin C. Tofranil D. Buspar ____ 14. The patient taking lithium should understand that the following

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could affect fluid and sodium levels and increase the chances of becoming toxic: A. Muscle weakness.

B. Lithium level of 0.7.

C. Dehydration.

D. Hypertension. ____ 15. A patient being medicated with haloperidol for over 4 weeks has started to display symptoms of involuntary movements of the mouth that resemble chewing. Of the following extrapyramidal adverse reactions, the client is showing signs of: A. Dystonia.

B. Akathisia.

C. Drug-induced Parkinsonism.

Tardive dyskinesia.

D. ____ 16. A client comes to the outpatient mental health clinic 2 days after being discharged from the hospital. The client was given a 1-week supply of clozapine (Clozaril). The nurse reviews information about clozapine with the client. Which client statement indicates an accurate understanding of the nurses teaching about this medication?

A. I dont need to see my doctor for a new prescription when this runs out.

B. I need to keep my appointment this week for a blood test to monitor my whi C. I can have a martini with this medication.

I dont need to come into the clinic for a few months if I dont have side effec D. ____ 17. A patient is admitted to the Mental Illness and Chemical Abuse unit.

The patient has been placed on a 1:1. After reviewing the clients progress notes, the nurse notes that the admission was voluntary. The nurse would expect which of the following: A. The patient will be angry at being forced to be on the unit.

B. The patient was given an informed consent.

C. The patient may not leave the unit without a court order.

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D. The patients wife has signed the consent form for admission. ____ 18. While doing a 24-hour chart check, the LPN/LVN notes a patient was admitted to a mental health unit on an involuntary status. The nurse becomes aware that this type of admission could be because the patient attempted to do the following: A. Presented harm to self.

B. Scheduled this admission.

C. Signed an informed consent.

D. Looked at several facilities prior to this admission. ____ 19. The desired outcome from humor therapy is: A. The patient will feel accepted.

B. The patient will have increased feelings of depression.

C. The patient will demonstrate a more positive outlook.

D. The patient will be discharged sooner. ____ 20. Counseling is a field that requires licensing. This licensing is providing by: A. The municipality.

B. The office C. The state.

D. There are no regulations for counselors. ____ 21. The ABCs of rational-emotive therapy (RET) are: A. Acting, believing, concise.

B. Able, belief, consequences.

C. Activating, belief, consequence.

D. Awareness, believing, conclusions. ____ 22. Dr. Albert Ellis, who developed the theory of RET, thought that people teach themselves to be ill. He used the following terminology: A. Musturbation and awareness.

B. Awfulizing and musting.

C. Musturbation and awfulizing.

D. Realizing and supersizing. ____ 23. When observing a patient receiving tricyclic antidepressant therapy,

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________________would bring attention to the nurse that the patient was undergoing anticholinergic effects.

A. Urine retention and changes in blood glucose B. Respiratory depression C. Delirium D. Cardiac arrhythmias Completion Complete each statement.

24. A therapeutic environment in mental health terminology is called a ________________.

25. The drug category _______________ blocks dopamine receptors and is a major treatment for schizophrenia.

26. The drug category _______________________________ increases the availability of serotonin, which is decreased in the brains of depressed individuals.

27. The form of therapy that focuses on the cause of the problem, originated from Sigmund Freud, is _____________________.

28. The category of medication that promotes alertness, diminishes appetite, and combats narcolepsy and attention deficit hyperactivity disorder is __________________.

29. The act of purging or purification of emotions is known as ____________________.

30. The movie about Patch Adams represents this type of therapy: __________ __________.

31. This type of intervention might be used for states of extreme emotional or physical turmoil in which the patient feels out of control of self: ______________ _______________.

32. A patient consents to be hospitalized for psychiatric treatment. This is a _______________ _________________________ admission.

33. The patient in what type of therapy gains knowledge that there are others with similar problems? _____________________ 34. The category of drugs that treat manic phase of bipolar disorder are called _______________.

Multiple Response

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Identify one or more choices that best complete the statement or answer the question. ____ 35. Commonly used typical antipsychotic agents are (select all that apply): A. Thorazine.

B. Stelazine.

C. Prolixin.

D. Risperdal.

E. Haldol. ____ 36. Which of the following should be included in patient teaching about antidepressants (select all that apply)?

A. Medications take 1 week to become effective.

B. Encourage patients to continue taking the medication.

C. Not all antidepressant medications have to be tapered gradually.

D. Patients dont have to be monitored for suicidal ideations.

If it is an MAOI antidepressant, the patient should avoid foods containing th E. tyramine. ____ 37. Which of the following may affect African Americans seeking to comply with medical or mental health treatment (select all that apply)?

Usually receive treatment from primary health care provider rather than a m A. specialist B. More likely to receive substandard treatment C. Approximately 20% to 30% of this group do not have health insurance.

D. Tend to be more receptive to taking medications that any other group ____ 38. The following medications are used for treatment in mental health disorders (select all that apply): A. Antipsychotics.

B. Antibiotics.

C. Antifungals.

D. Stimulants.

E. Mood stabilizers. ____ 39. Which of the following items should be included when providing

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patient teaching about monoamine oxidase inhibitor (MAOI) antidepressants (select all that apply): A. Avoid foods containing the amino acid tyramine.

B. Have blood levels screened weekly for leukopenia.

C. Need sun exposure at least 1 hour a day.

D. Dont take prescribed or over-the-counter medications without consulting the ____ 40. Nursing preparations for a client undergoing electroconvulsive therapy (ECT) resemble those used for general anesthesia (select all that apply): A. Monitors the patients vital signs before and after the procedure.

B. Medicate prior to procedure if ordered.

C. Educate patient and patients family.

D. Consent is not required.

E. The patient may be slightly confused after the procedure. ____ 41. Patients who practice Judaism may have concerns about the following (select all that apply): A. Dietary selection.

B. Having tests scheduled between sundown Friday and sundown Saturday.

C. Tests scheduled between sundown Saturday and sundown Tuesday.

D. Meeting with the shamans.

E. Meeting with the imam.

Other 42. Nursing preparation for a client undergoing electroconvulsive therapy (ECT) resemble those used for general anesthesia. The nurse should follow these steps for this procedure (place in the order they will occur): _____ A. Monitor the patients vital signs before the procedure. _____ B. Medicate as prior to procedure if ordered. _____ C. Educate patient and patients family. _____ D. Check a signed consent. _____ E. Monitor the patients vital signs after the procedure.

Chapter 8: Mental Health Treatments Answer Section

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MULTIPLE CHOICE 1. ANS: B These are common early warning signs of toxicity, so further investigation is needed right away.

PTS: 1 REF: Chapter 8: Mental Health Treatments: Lithium Carbonate; page 120-121 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Adverse effects/contraindications/side effects/interactions 2. ANS: C Dehydration promotes lithium toxicity.

PTS: 1 REF: Chapter 8: Mental Health Treatments: Lithium Carbonate; page 120-121 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Adverse effects/contraindication/side effects/interactions 3. ANS: D All of these responses are incorrect about lithium.

PTS: 1 REF: Chapter 8: Mental Health Treatments: Lithium Carbonate; page 120 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration 4. ANS: A Environmental (MILIEU) therapies aim to provide safety and a therapeutic environment.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Milieu; page 123 KEY: Integrated Processes: Caring | Content Area: Mental Health: Therapy | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Therapeutic Environment 5. ANS: D

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ECT does have some side effects, which can be unpleasant. The patient will need to be monitored.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Electroconvulsive Therapy; page 132-133 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health | Cognitive Level: Synthesis | Client Need: Physiological Integrity: Reduction of Risk Potential: Therapeutic Procedures 6. ANS: D Electroconvulsive therapy is an effective treatment for those experiencing severe depression that is not helped with medication.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Electroconvulsive Therapy; page 132-133 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Treatment | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Therapeutic Procedures 7. ANS: C Foods containing the amino acid tyramine should be avoided. MAOIs block the metabolism of tyramine, resulting in an increase of norepinephrine. Aged and processed meats are an example. A hypertensive crisis may occur.

PTS: 1 REF: Chapter 8: Mental Health Treatments; PsychopharmacologyAntidepressants; page 120 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Adverse Effects/Contraindications/Side Effects/Interactions 8. ANS: C Extrapyramidal side effects from haloperidol (Haldol) should be treated with benztropine mesylate (Cogentin) because of its anticholinergic properties.

PTS: 1 REF: Chapter 8: Mental Health Treatments; PsychopharmacologyAntiparkinson Agents; page 116

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KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Adverse Effects/Contraindications/Side Effects/Interactions 9. ANS: A In a group treatment modality, the members realize there are others with similar problems.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Psychotherapies; page 132 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level: Synthesis | Client Need: Psychosocial Integrity: Support Systems 10. ANS: B In this phase the person acknowledges feeling stress but minimizes its severity.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Crisis Intervention; page 134 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: crisis | Cognitive Level: Analysis | Client Need: Psychosocial Integrity: Stress Management 11. ANS: D A crisis intervention group helps patients determine their stressors. Patients are assisted in developing new coping techniques or modifying their current coping mechanisms.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Crisis Intervention; page 134-135 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Crisis | Cognitive Level: Analysis | Client Need: Psychosocial Integrity: Crisis Intervention 12. ANS: B The TCAs affect norepinephrine as well as other neurotransmitters and thus have significant cardiovascular side effects. Therefore, they are used with caution in elderly clients who may have increased risk factors for cardiac problems because of their age and other medical conditions. The remaining

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side effects would apply to any patient taking a TCA and are not particular to an elderly person.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Psychopharmacology-Tricyclics; page 118 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Adverse Effects/Contraindications/Side Effects/Interactions 13. ANS: A When the drug lithium cannot be cleared and excreted by the kidney, toxicity can occur. A 1.5 toxicity lithium level is considered mild.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Psychopharmacology; page 118 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Adverse Effects/Contraindications/Side Effects/Interactions 14. ANS: C Dehydration is a major trigger for lithium toxicity. Monitor the patients vital signs, and fluid intake and output.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Psychopharmacology; page 121 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Fluid and Electrolyte Imbalances 15. ANS: D Protrusion of the tongue and movements of the mouth are the common symptoms of tardive dyskinesia.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Psychopharmacology | Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Box 15-1, Extrapyramidal Side Effects; page 115 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental

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Health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Adverse Effects/Contraindications/Side Effects/Interactions 16. ANS: B Clozapine can cause bone marrow depression; therefore, frequent blood counts are necessary to monitor the patients WBCs. This drug needs to be taken regularly and should not be discontinued abruptly.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Psychopharmacology; page 115 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Application | Client Need: Psychosocial Integrity 17. ANS: B The informed consent from the patient is an indication that the patient has volunteered for care.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Legal Considerations; page 137-138 KEY: Integrated Processes: Communication and Documentation | Content Area: Legal | Cognitive Level: Analysis | Client Need: Safe and Effective Care Environment: Management of Care: Client Rights 18. ANS: A The patient is confined to the facility due to being a harm to himself or herself. The goal is to maintain patient safety.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Legal Considerations; page 138 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Legal Considerations | Cognitive Level: Analysis | Client Need: Safe and Effective Care Environment: Management of Care: Client Rights 19. ANS: C A positive response to humor can bring about improvement in outlook and neurochemical changes to improve mood.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Humor Therapy; page 133-134

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KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Analysis | Client Need: Psychosocial Integrity: Mental Health Concepts 20. ANS: C Each state has specific requirements for licensing of counselors.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Counseling; page 129 KEY: Integrated Processes: Teaching/Learning | Content Area: Legal | Cognitive Level: Application | Client Need: Safe and Effective Practice: Legal Rights and Responsibilities 21. ANS: C The rational-emotive therapy proposes that people teach themselves to be ill because of the way they think about a situation. The theory proposes ways of rethinking situations.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Psychotherapies; page 127 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Implementing Behavioral Interventions/Mental Health Concepts 22. ANS: C Dr. Ellis believed there was no musts and shoulds. He often used the words in Response C to demonstrate how we teach ourselves to have problems.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Cognitive Therapies; page 130 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Therapeutic Communication 23. ANS: A Anticholinergic effects include hypotension, lethargy, weight gain, urine retention, blurred vision, dry mouth, constipation, and changes in blood glucose.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Antidepressants; page 118 KEY: Integrated Processes: Nursing Process: Assessment | Content Area:

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Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Adverse Effects/Contraindications/Side Effects/Interactions COMPLETION 24. ANS: milieu The milieu can have an effect on behavior, thus making it a therapeutic environment.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Milieu; page 123 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Therapeutic Environment | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Non-Pharmacological Comfort Interventions 25. ANS: antipsychotics Antipsychotics are major tranquilizers. Antipsychotic agents block both serotonin and dopamine.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Antipsychotics; page 114 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Medication administration 26. ANS: antidepressants Used in the treatment of depression, anxiety, obsessive disorders, and impulse-control disorders, antidepressants increase the availability of serotonin.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Psychopharmacology; page 117 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Medication Administration 27. ANS: psychoanalysis Psychoanalysis focuses on the problem, which is buried somewhere in the

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unconscious. Freud believed it had something to do with poor parent-child relationships.

PTS: 1 REF: Chapter 8: Mental Health Treatments: Psychoanalysis; page 124 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental Health Concepts 28. ANS: stimulant These drugs directly stimulate the central nervous system.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Psychopharmacology; page 122 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Expected Actions/Outcomes 29. ANS: catharsis Catharsis assists in the elimination of a complex problem by bringing it to consciousness and affording it expression.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Psychotherapies; page 125-126 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental Health Concepts 30. ANS: humor therapy Studies have shown that the effects of smiles, hugs, and humor can have a beneficial effect on ones outlook and even biochemical processes.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Psychotherapies; page 133-134 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Therapeutic Communication 31. ANS:

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crisis intervention Crisis is a state of psychological disequilibrium. The person in crisis is at risk for physical and emotional harm. Crisis intervention strategies provide a structured way to help the person crisis return to at least pre crisis level of functioning.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Crisis Intervention; page 134-135 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Crisis Intervention 32. ANS: voluntary Voluntary admission means the patient has given informed consent to seek care in the facility. The informed consent means that the patient has been made aware of his or her behaviors, the implications of the behaviors, and expectations from the treatment.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Legal Considerations; page 137-138 KEY: Integrated Processes: Teaching/Learning |Content Area: Legal | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental Health Concepts/Safe and Effective Care Environment: Management of Care: Legal Rights and Responsibilities 33. ANS: group therapy There are various types of group therapy; some are short-term or they can be long-term. All types of group therapy emphasize the sharing of feelings and experiences of the group members.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Table 8-3, Summary of Commonly Used Treatment Modalities; page 139 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: mental health concepts 34. ANS:

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mood stabilizers Mood stabilizers work biochemically to control manic behavior and include lithium as well as some anticonvulsants.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Psychopharmacology; page 120-121 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Expected Actions/Outcomes MULTIPLE RESPONSE 35. ANS: A, B, C, E The typical antipsychotic agents treat the positive symptoms of schizophrenia and are generally the older agents.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Psychopharmacology; Table 154, Comparison of Side Effects Among Typical and Atypical Antipsychotic Agents; page 236 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Expected actions/outcomes 36. ANS: B, E The nursing considerations for all antidepressants are the same. Patients taking antidepressants should be reminded it takes 2 to 3 weeks to become effective, they should not be discontinued abruptly, and MAOIs require a special diet.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Psychopharmacology; page 118 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Pharmacology | Cognitive Level: Synthesis | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Expected Actions/Outcomes 37. ANS: A, B, D Community education can modify attitude. Emphasis should be placed on

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talking about problems. This assists in early diagnosis, which is crucial.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Psychotherapies; Table 6-1, Concepts that may affect certain cultural groups seeking or complying with mental health treatment; page 131 KEY: Integrated Processes: Teaching/Learning | Content Area: Cultural Diversity | Cognitive Level: Analysis | Client Need: Health Promotion and Maintenance: Health and Wellness 38. ANS: A, D, E These medications control symptoms, helping the patient feel more comfortable emotionally. These medications are usually used in connection with some other type of therapy.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Psychopharmacology; page 114, 120, and 122 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Expected Actions/outcomes 39. ANS: A, D MAOI antidepressants can precipitate a hypertensive crisis in the presence of tyramine. Caution should be used with other medication interactions as well.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Antidepressants; page 119-120 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Expected Actions/Outcomes 40. ANS: A, B, C, E The nurse should prepare the patient for ECT in a manner similar to that for general anesthesia. Under general anesthesia, the patient should sign consent, the vital signs need to be monitored before and after the procedure, and the patient should be educated about the procedure and the expected outcome.

PTS: 1

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REF: Chapter 8: Mental Health Treatments; Electroconvulsive Therapy; Figure 8-4 Electroconvulsive Therapy; page 132-133 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level: Application | Client Need: Physiological Integrity: Reduction of Risk Potential: Potential for complications of diagnostic tests/treatments/procedures 41. ANS: A, B These responses reflect practices of Judaism.The Sabbath is from sundown Friday to sundown Saturday. Kosher diet may be preferred.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Cognitive Therapies; page 130 KEY: Integrated Processes: Caring | Content Area: Cultural Diversity | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Cultural Awareness OTHER 42. ANS: A: 3 B: 4 C: 1 D: 2 E: 5 The patient/family should receive information regarding the procedure first.

After the patient teaching has occurred, then the patient will be able to sign the consent. Prior to the procedure, vital signs are taken and the premedication given.

PTS: 1 REF: Chapter 8: Mental Health Treatments; Electroconvulsive Therapy; page 132 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level: Application | Client Need: Physiological Integrity: Reduction of risk potential: Potential for complications of diagnostic tests/treatments/procedures

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Chapter 9: Alternative and Complementary Treatment Modalities My Nursing Test Banks

Chapter 9: Alternative and Complementary Treatment Modalities Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. The home health nurse is informed by her patient that she is taking a herbal over-the-counter medication. What action should the nurse take with this information?

A. This information is not part of the medication record.

The nurse should document this information and add it to the patients medic B. the charge nurse of the change.

Research the benefits of this medication before deciding if it should be adde C. record.

D. Tell the patient that herbal medications are not considered safe to take. ____ 2. Reflexology is based on the massage of this body part: A. Hands.

B. Feet.

C. Spine.

D. Temples. ____ 3. Reiki is a term that meANS: A. Universal life energy.

B. Universal energy.

C. Energizing the universe.

D. Universal energy life. ____ 4. The three primary methods of sensory representations are: A. Visual auditory, and kinesthetic.

B. Visual, auditory, and kindred.

C. Visa, authority, and kinesthetic.

D. Seeing, hearing, and smelling.

Completion

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Complete each statement.

5. Important to the effectiveness of any type of treatment are the patients _______________.

6. The type of therapy that seeks a response through the sense of smell is known as __________________________.

7. _____________________________ therapy is done by massaging the feet of the patient to act upon pathways, unblocking and renewing energy flow.

Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 8. The side effects of ginkgo biloba include (select all that apply): A. Bleeding.

B. Nausea and vomiting.

C. Diarrhea.

D. Fishy reflux.

E. Headache. ____ 9. It is helpful as a nurse to be able to recognize the channel through which your patient communicates if following the primary sensory representation philosophy. Your patient Tamaras sensory representation is visual. Determine which terms would identify visual sensory and (select all that apply): A. An eyeful.

B. An earful.

C. In light of.

D. In view of.

E. Hang in there. ____ 10. When teaching patients taking St. Johns wort about drug and food interactions, the nurse will inform them of the following precautions (select all that apply): A. Avoid foods containing large amounts of tyramine.

B. Eat adequate amounts of meat and cheese.

C. Increase the length of time in sunlight.

D. Consult your physician before taking any over-the-counter flu and cold med

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E. It may decrease the effects of MAOIs. Chapter 9: Alternative and Complementary Treatment Modalities Answer Section MULTIPLE CHOICE 1. ANS: B The charge nurse and the physicians need to know the over-the-counter medications that the patient is taking, especially when the patient is taking other prescribed medications or there is a pending surgery. These need to be included on the medication list.

PTS: 1 REF: Chapter 9: Complementary and Alternative Treatment Modalities; Common Complementary and Alternative Treatments; page 147 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Medication Administration 2. ANS: B Reflexology is based on the belief that energy pathways and zones cross the body and the feet are connected to vital organs.

PTS: 1 REF: Chapter 9: Complementary and Alternative Treatment Modalities; Massage, Energy, and Touch; page 150 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Non-Pharmacological Comfort Interventions 3. ANS: A Reiki is performed with touch, a process where energy is drawn along the bodys meridians.

PTS: 1 REF: Chapter 9: Complementary and Alternative Treatment Modalities; Massage, Energy, and Touch; page 150 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Non-Pharmacological Comfort Interventions

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4. ANS: A These are the three major methods of sensory representations of the different channels that people use in their environment and with other people .

PTS: 1 REF: Chapter 9: Complementary and Alternative Treatment Modalities; Common Complementary and Alternative Treatments-Primary Sensory Representation; page 152 KEY: Integrated Processes: Teaching/Learning COMPLETION 5. ANS: beliefs Everyone has a different way of viewing the world, and our beliefs and emotions impact the bodys function, even on a cellular level.

PTS: 1 REF: Chapter 9: Complementary and Alternative Treatment Modalities; Mind, Body, and Belief; page 144 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Religious and Spiritual Influences on Health 6. ANS: aromatherapy Aromatherapy provides treatment by both the direct pharmacological effects of aromatic substances and the indirect effect of certain smells in mood and affect.

PTS: 1 REF: Chapter 9: Complementary and Alternative Treatment Modalities; Aromatherapy; page 145-146 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Non-Pharmacological Comfort Interventions 7. ANS: Reflexology Reflexology is based upon the belief that energy pathways and zones cross the body, connecting vital organs and body parts.

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PTS: 1 REF: Chapter 9: Complementary and Alternative Treatment Modalities; Common Complementary and Alternative Treatments; page 150 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Complementary and Alternative Therapy | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Non-Pharmacological Comfort Interventions MULTIPLE RESPONSE 8. ANS: A, B, C, E Nurses need to know it is important to advise the patient to consult with their doctors before attempting to take herbal supplements.

PTS: 1 REF: Chapter 9: Complementary and Alternative Treatment Modalities; Common Complementary and Alternative Treatments; Table 9-1, Common Herbal and Dietary Therapies; page 148 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Adverse Effects/Contraindications/Side Effects/Interactions 9. ANS: A, C, D Paying attention to speech pattern gives the nurse information on how the person processes information. This can be useful to achieve more effective communication with the patient. Visual representation makes reference to any words associated with vision such as light, view, and eyeful.

PTS: 1 REF: Chapter 9: Complementary and Alternative Treatment Modalities; Primary Sensory Representation; Table 9-2, Representational Systems Predicates; page 153 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic Communication 10. ANS: A, D St Johns wort is known to cause photo sensitivity and may increase the effects of MAOIs and cold/flu medications.

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PTS: 1 REF: Chapter 9: Complementary and Alternative Treatment Modalities; Table 9-1, Common Herbal and Dietary Therapies; page 149 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Complementary and Alternative Therapy/Pharmacology | Cognitive Level: Evaluation | Client Need: Physiological Integrity: NonPharmacological Comfort Interventions

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Chapter 10: Anxiety, AnxietyRelated, and Somatic Symptom Disorders My Nursing Test Banks Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Which of the following is a priority in dealing with a highly anxious patient?

A. Provide support to reinforce a sense of security.

B. Implement strict limit setting to control behavior.

C. Increase environmental stimuli to distract the patient.

D. Provide more freedom to promote self-expression. ____ 2. Your new patient is admitted to the ER after a car accident. She is extremely anxious. Which intervention is most helpful?

A. Ask her to describe her feelings to you.

B. Stay with her in the exam room.

C. Set her up in a quiet exam room away from activity and give her privacy.

D. Encourage her to remember what happened in the accident. ____ 3. Your patient has been taking Buspar for 1 month. On returning to the clinic for a follow-up visit, which statement would describe medication effectiveness?

A. Reduction in number of delusions B. Less depressed C. Sleeping better D. Reduced desire for alcohol ____ 4. To establish an open and trusting relationship with a male patient who is in the hospital with severe anxiety, which response by the charge nurse is best?

A. Urge the staff to have frequent interaction with the patient.

B. Share an activity with the patient.

C. Discipline the patient about his behavior.

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D. Encourage enjoyable activities. ____ 5. When working with a female client experiencing a phobia about spiders, Nurse Toni should anticipate that a problem for this client would be: A. Anxiety when speaking of the feared item.

B. Depression toward the feared object.

C. Denying the existence of a phobia.

D. Distortion of reality. ____ 6. Nurse Janet is aware that the symptoms that distinguish posttraumatic stress disorder (PTSD) from anxiety disorders include: A. Avoiding situations and certain activities that resemble any type of stress.

B. Demonstrating a blunted affect when discussing the traumatic situations.

C. Having a minimum interest in family and others.

D. Re-experiencing the trauma in dreams or flashback. ____ 7. Nurse Aubyn is aware that patients suffering from anxiety seem to do best in environments where they have: A. Competition.

B. Routine and enjoyable activities.

C. Complex thought processes.

D. A lot of alone time. ____ 8. When planning care for a female patient diagnosed with obsessive and compulsive behavior, Nurse Barbara and case manager Marc must recognize that the ritual: A. Assists the patient to understand their inability to deal with reality.

B. Helps the patient to be in control of their anxiety.

C. Helps the patient control the obsessive and compulsive behavior.

D. Is used to manipulate others. ____ 9. When preparing the discharge plans for a patient with chronic anxiety, Nurse Barbara evaluates the goals that were set for the patient. Nurse Barbara also evaluates if the patient has achieved the discharge long-term goals. Which goal would be most appropriate to be include in the plan of care requiring evaluation?

A. The patient is completely stress free.

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B. The patient ignores their feelings of anxiety.

C. The patient is able to identify triggers that produce anxiety.

D. The patient maintains contact with a crisis counselor. ____ 10. Helenann, a long-term care nurse educator, noted that one of the staff members was complaining of stress and anxiety. A common physiological response to stress and anxiety is: A. Urticaria.

B. Light-headiness.

C. Sedation.

D. Palpitations. ____ 11. According to Hans Seyle, if a person does not adapt to the stress in his or her surroundings, eventually the person will experience: A. Fright or flight.

B. Exhaustion.

C. Resistance.

D. Adaptation. ____ 12. Which of the following is TRUE in the stage of fight or flight of the general adaptation syndrome?

A. Heart rate is decreased.

B. The blood vessels constrict.

C. The blood vessels dilate.

D. Exhaustion occurs. ____ 13. What type of behavior modification is being used when the patient transforms into a relaxed state? (Documented by checking their heart rate and blood pressure.)

A. Biofeedback.

B. Massage.

C. Hypnosis.

D. Imagery. ____ 14. A client is unwilling to go out of the house for fear of having to get on a elevator or be in small room. Because of this fear, the client remains home except when accompanied outside by the spouse. The nurse suspects

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that the client has: A. Agoraphobia.

B. Hematophobia.

C. Claustrophobia.

D. Hypochondriasis. ____ 15. An elderly patient explains to the nurse that while weeding his garden, he was suddenly startled by a 6-foot non-poisonous snake. He immediately displayed extreme fear and suddenly had a burst of energy and ran from the snake. The nurse realizes that this client is describing which of the following stages identified in GAS? A. Exhaustion B. Problem solving C. Crisis D. Delirium Completion Complete each statement.

16. An irrational fear is known as a _____________.

17. The positive form of stress is called _________________ 18. The most common anxiety disorder is ______________.

19. The uncomfortable feeling of dread that is a response to periods of stress is known as __________________.

20. When you know the cause of the tension, that is an example of ______________ anxiety.

Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 21. Which of the following may be seen in a patient experiencing panic attacks? (Select all that apply) A. Feels faint B. Thinks he or she is having a heart attack C. Gains a sense of serenity D. Able to focus on minute details E. Dry mouth and trembling hands

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____ 22. Which of the following medications would generally NOT used to treat anxiety? (Select all that apply) A. Haloperidol B. Carbamazepine C. Buspirone D. Alprazolam E. Clonidine F. Lorazepam ____ 23. Daria is admitted to the medical-surgical unit experiencing an anxiety episode. Nurses on the unit are aware of several nursing interventions that can reduce the anxiety that Daria is experiencing (select all that apply): A. Attempt to calm the patient by placing an arm around the person.

B. Maintain a calm environment.

C. Promote open communication.

D. Provide the client with a safe, quiet, and private place.

E. Document the patients behavior. ____ 24. While observing a female patient on the oncology unit who has a secondary diagnosis of panic attacks, the nurse would expect to observe which of the following symptoms (select all that apply): A. Nausea.

B. Diaphoresis.

C. Ritualistic behavior.

D. Increased pulse.

E. Reliving the experience. ____ 25. The following are levels of anxiety (select all that apply): A. Mild.

B. Moderate.

C. Severe.

D. Panic. ____ 26. Commonly used medications for anxiety disorders include (select all that apply): A. Xanax.

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B. Valium.

C. Zoloft.

D. Ambien.

E. Altivan. ____ 27. The following conditions can be stress related (select all that apply): A. Asthma.

B. Cancer.

C. Burnout.

D. Hunger.

E. Immunity impairment.

Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders Answer Section MULTIPLE CHOICE 1. ANS: A Support and safety are key interventions in anxiety. Responses B, C, and D may all add to anxiety.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; General Interventions; page 168-169 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Anxiety | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 2. ANS: B This patient is most likely overwhelmed and may feel abandoned, so staying with her will be most reassuring. Encouraging her to talk about feelings or memories of the accident will probably increase anxiety, and leaving her alone will increase her sense of abandonment.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; General Interventions; page 169 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Anxiety | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

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3. ANS: C Buspar is used for anxiety disorders. Sleeping better would be an indication of reduction in anxiety.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Table 10-2, Commonly Used Anti-Anxiety Medications; page 168 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration 4. ANS: D Activities can provide a diversion from intense feelings that can be lead to the patient being more receptive in beginning a relationship PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Nursing Care for People with Anxiety and Anxiety-Related Disorders; page 161 KEY: Integrated Processes: Caring | Content Area: Mental Health: Anxiety | Cognitive Level: Application | Client Need: Psychosocial Integrity: Stress Management 5. ANS: A Phobia is an irrational fear that creates intense anxiety with even thinking about the feared item.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Types of Anxiety and Anxiety-Related Disorders-Phobias; page 163 KEY: Integrated Processes: Caring | Content Area: Mental Health: Phobias | Cognitive Level: Analysis | Client Need: Psychosocial Integrity: Stress Management 6. ANS: D In the DSM-5, PTSD symptoms are described as re-experiencing a traumatic event, avoidance, negative cognitions and mood, and arousal. Experiencing the actual trauma in dreams or flashbacks is one of the major symptoms that

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separate post-traumatic stress disorder from other anxiety disorders.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Post-Traumatic Stress Disorder; page 165-166 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental Health Concepts 7. ANS: B Diversion is an effective intervention. An activity that is enjoyable and nonstressful provides a diversion. The other choices would increase anxiety.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Nursing Care for People with Anxiety and Anxiety-Related Disorders; page 169 KEY: Integrated Processes: Caring | Content Area: Mental Health: Anxiety | Cognitive Level: Evaluation | Client Need: Psychosocial Integrity: Therapeutic Environment 8. ANS: B The rituals performed by the patient with obsessive-compulsive disorder are a substitute for the cause of the anxiety.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Obsessive-Compulsive Disorder; page 164-165 KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental Health Concept 9. ANS: C Recognizing triggers that produce anxiety will permit the patient to cope with anxiety or avoid specific triggers. Response C is the most realistic and measurable goal.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Nursing Care for People with Anxiety and Anxiety-Related Disorders; page 169

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KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health | Cognitive Level: Evaluation | Client Need: Psychosocial Integrity: Stress Management 10. ANS: D Palpitations are a common physiological response to stress and anxiety.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Anxiety-Differential Diagnosis; page 162 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Stress Management 11. ANS: B Hans Selye is the theorist who developed the general adaptation syndrome (GAS) theory, which explains that if a person continues to resist change, he or she will eventually decrease the immune system, which could result in complete exhaustion or death.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Etiology of Anxiety and Stress; page 161 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Synthesis | Client Need: Health Promotion and Maintenance: Health Promotion/Disease Prevention 12. ANS: B During fight or flight, the blood vessels constrict because norepinephrine and epinephrine have been released.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Differential Diagnosis; page 161 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Synthesis | Client Need: Health Promotion and Maintenance: Health Promotion and Disease Prevention 13. ANS: A Biofeedback is a form of behavior modification that patients learn to control physical responses to stress. Biofeedback is done without the use of

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medication.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Alternative Interventions for People with Anxiety Disorder; page 168 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Application | Client Need: Psychosocial Integrity: Stress Management 14. ANS: A A patient suffering with agoraphobia is afraid of open spaces; therefore this patient will hesitate about being outside.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Phobias; page 164 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Synthesis | Client Need: Psychosocial Integrity: Mental Health Concepts 15. ANS: C General adaptation syndrome (GAS) disorder consists of three different stages: fright/crisis; resistance or adaptation; and exhaustion.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; page 161 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Reduction of Risk Potential: Potential for Alternations in Body Systems COMPLETION 16. ANS: phobia PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Phobias; page 163 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Anxiety | Cognitive Level: Comprehension | Client Need:

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Psychosocial Integrity: Mental health concepts 17. ANS: eustress Eustress comes from positive experiences, like weddings and job promotions.

The anxiety produced by positive stress can be just as distressing as negative stress due to the changing expectations and unknowns.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Anxiety Disorders; page 160 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Stress Management 18. ANS: phobia The person is aware of the fear and is aware that it is an irrational fear.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Phobias; page 163 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental Health Concepts 19. ANS: anxiety Stress produces anxiety. The feeling of dread is a classic symptom of anxiety.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Anxiety Disorders; page 160 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanism 20. ANS: signal Signal anxiety is an uncomfortable feeling in response to a known stressor.

PTS: 1

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REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Anxiety Disorders; page 160 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental Health Concepts MULTIPLE RESPONSE 21. ANS: A, B, E Panic attacks are an anxiety disorder that creates symptoms of fight or flight.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Panic Disorder; page 163 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Anxiety | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 22. ANS: A, B Haloperidol is an antipsychotic and carbamazepine is a mood stabilizer used to treat bipolar disorder. All of the others are anti-anxiety medications.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Table 10-2, Commonly Used Anti-Anxiety Medications; page 168 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration 23. ANS: B, C, D, E The nurse must establish trust with the anxious patient before using therapeutic touch. A calm, safe environment is useful when someone is anxious.

PTS: 1 REF: Chapter 10 Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Nursing Care for Patients with Anxiety and Related Disorders; page 169 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Anxiety | Cognitive Level: Application | Client Need:

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Psychosocial Integrity: Therapeutic Environment 24. ANS: A, B, D With a panic attack, the patient will experience common symptoms of the fight or flight response. The person has an episode of fear that is classified as intense. This intense episode can go from being calm to being anxious very quickly.

PTS: 1 REF: Chapter 10 Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Panic Disorders; Nursing Care for Patients with Anxiety and Related Disorders; page 169 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Analysis | Client Need: Psychosocial Integrity: Coping Mechanisms 25. ANS: A, B, C, D Panic is the only level of anxiety that leads to personality disorganization.

PTS: 1 REF: Chapter 10 Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Anxiety Disorders; page 160 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Stress Management 26. ANS: A, B, D, E All these medications can be used for different symptoms and types of anxiety disorders.

PTS: 1 REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Table 10-1, Adaptation Responses to Stress and the Outcome of Stress on the Body; page 162 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Anxiety | Cognitive Level: Analysis | Client Need: Health Promotion and Maintenance: Health Promotion/Disease Prevention 27. ANS: A, B, C, E All of these disorders may have stress as a contributor.

PTS: 1

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REF: Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders; Table 10-1, Adaptation Responses to Stress and the Outcome of Stress on the Body; page 162 KEY: Integrated Processes: Teaching/Learning

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Chapter 11: Depressive Disorders My Nursing Test Banks Chapter 11: Depressive Disorders Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. You are admitting a new patient who is depressed. Your initial contact should do what?

A. Address why he is depressed B. Keep communication open C. Lift his spirits D. Establish trust ____ 2. In caring for a patient with major depression, the nurse knows that the patient needs: A. Frequent changes in activities.

B. Introduction to multiple new staff members.

C. Behavior modification that restructures feelings.

D. Well-defined, structured interactions at the beginning of treatment. ____ 3. Patients with major depression commonly display signs of: A. Energy.

B. Repetitive, compulsive behaviors.

C. Worthlessness.

D. Visual hallucinations. ____ 4. When your patient says I am depressed, what is the best response?

A. We all feel that way now and then.

B. Why do you feel that way?

C. Everything will be OK once you snap out of it.

D. Tell me more about what is going on with you. ____ 5. Your patient takes tranylcypromine for depression. Which of the following is most likely to indicate dietary restrictions have not been followed?

A. Hypertensive crisis

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B. Syncope C. Muscle spasms D. Increased depression ____ 6. Your depressed patient who is taking a tricyclic antidepressant is advised of possible anticholinergic side effects. Which of the following is NOT an anticholinergic side effect?

A. Blurred vision B. Difficulty starting urine stream C. Dry mouth D. Muscle rigidity ____ 7. Helen, a 47-year-old client with a long history of severe depression, has not responded to antidepressant medications or psychotherapy. The nurse caring for the patient knows that the treatment of choice for depression unresponsive to conventional treatment would be: A. Lithium.

B. Electroconvulsive therapy (ECT).

C. Light therapy.

D. Neurolinguistic programming. ____ 8. Your depressed patient is just started on duloxetine (Cymbalta).

Which statement by the spouse tells you that family teaching has been effective?

A. I cant wait for him to be back to his old self in the next day or so.

B. I realize we cant expect big changes right away.

C. I have to take him for weekly blood tests to monitor the drug dosage.

D. I will make sure he doesnt eat any aged cheese for the next 2 months until th ____ 9. Biological theories of depressive disorders include all of the following except: A. Chemical imbalances are responsible.

B. The patient experiences maladaptive thought processes.

C. There are genetic tendencies that run in families.

D. Hormonal factors make women more susceptible than men. ____ 10. Light therapy has been shown to be effective in treating patients

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with: A. Bipolar disorder.

B. Dysthymia.

C. Major depression with seasonal pattern.

D. Schizophrenia. ____ 11. You are doing patient teaching for Margaret, who has been prescribed amitriptyline (Elavil) for treatment of depression. Which of the following statements suggests that Margaret needs further instruction?

I know I might not start feeling better for a few weeks, but Ill keep taking th A. the doctor prescribed.

B. Ill keep some hard candies in my purse in case my mouth gets dry from the m C. Once I start feeling better, Im looking forward to cutting down on this medic D. Im worried I may gain some weight, but thats a small price to pay for feeling ____ 12. What is the main difference between major depression and dysthymic depression?

A. Dysthymia is a short-term depression and major depression lasts for years.

Dysthymia is a chronic, low-level depression that lasts for years, while majo B. severe.

Dysthymia is more likely to be caused by psychological factors and major d C. by neurological dysfunction.

Dysthymia is normally treated with psychotherapy only, while major depres D. antidepressants and psychotherapy. ____ 13. Your depressed patient is starting a new medication called phenelzine (Nardil). Which teaching would be most important to emphasize?

A. Educate the patient to take this medication ongoing, even as symptoms impr B. Instruct the patient and family about the many food-drug interactions.

C. Instruct the patient about interventions to relieve dry mouth.

D. Inform the patient that this medication takes 4 to 6 weeks to take full effect. ____ 14. Which of the following antidepressants is a tricyclic?

A. Bupropion (Wellbutrin) B. Sertraline (Zoloft) C. Nortripyline (Pamelor)

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D. Venlafaxine (Effexor) ____ 15. Which statement is most true about depression?

A. It is more common in women than men.

B. It is rare to have more than one episode of major depression in ones lifetime C. Young children do not suffer from depression.

D. As one ages, there is reduced risk of depression. ____ 16. A newly admitted client has been diagnosed with major depressive disorder. Which nursing diagnosis takes priority?

A. Impaired social interaction B. Self-esteem deficit C. Hopelessness D. Self-care deficit ____ 17. The nurse knows that the two factors that often differentiate major depression from dysthymia depression are: A. Amounts of mania and sadness.

B. Presence or absence of anger and guilt.

C. Severity and duration of symptoms.

D. Patients gender and age. ____ 18. You are caring for an older adult who is recently widowed. She says, No one cares if I die. Everyone I ever loved is dead. What is the best response?

A. I am sure that you still have people who care about you.

B. You sound like you are feeling all alone.

C. Boy, that is depressing.

D. I dont believe that. ____ 19. Your patient with major depression tells you he suffers from urinary retention. Which medication would be most likely to cause this?

A. Amitriptyline B. Duloxetine C. Carbamazepine D. Ritalin ____ 20. Which activity would be best for a depressed patient?

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A. A puzzle B. Drawing C. Crossword puzzles D. Television ____ 21. Which of the following meal choices indicates the patient understands the diet restrictions when taking an MAOI? A. Pepperoni pizza and beer B. Roast chicken, baked potato, and beer C. Fried fish, rice, and cola D. Pickled herring, eggs, and coffee ____ 22. Your patient with major depression sits in her room for hours staring out the window. Which of the following would be the most appropriate intervention?

A. Sit with the patient and gently offer your availability to help.

B. Keep encouraging the patient to go to exercise class.

C. Offer the class once and then let the patient decide.

D. Sit with the patient and ask her to list reasons for her depression. ____ 23. Which of the following drugs is a tricyclic antidepressant?

A. Bupropion (Wellbutrin) B. Amitriptyline (Elavil) C. Fluoxetine (Prozac) D. Citalopram (Celexa) ____ 24. Some medications such as tricyclics cause blurred vision. What is the cause of this effect?

A. Hyperglycemia B. Anticholinergic effect C. Hypoxia D. Hypertension ____ 25. Your patient has been taking a SSRI antidepressant for 6 weeks. On arrival at the clinic, which observation would indicate a positive outcome from the medication?

A. Patient reports sleeping 12 hours a night.

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B. Patient reports sleeping 3 hours a night.

C. Patient reports a weight loss of 10 pounds.

D. Patient arrives neatly dressed. ____ 26. Which response best describes how dysthymic disorder is different from major depression?

A. More severe depression with psychotic features B. Chronic low level depression C. Mild depression with episodes of hypomania D. Depression with more anxiety symptoms ____ 27. Which of the following would be the most effective intervention for a depressed patient?

A. Establish one small goal to accomplish today.

B. Help the patient develop a goal to complete in the next month.

C. Encourage the patient to talk about recent failures in his or her life.

D. Let the patient guide what is the next best action. ____ 28. Which of the following is an important intervention for a patient taking nortriptyline?

A. Make sure that CBC is ordered to monitor blood counts.

B. Monitor for anticholinergic side effects.

C. Ensure that the patients diet is gluten free.

D. Push fluids to prevent dehydration. ____ 29. A patient admitted to the mental unit has shown a deficit in providing self-care and has a medical diagnosis of major depression. The nursing diagnosis for this would be: A. Knowledge deficit related to personal choices.

B. Self-care deficit related to impaired ability to provide personal hygiene.

C. Risk for violence related to poor hygiene.

D. Impaired social interaction related to poor hygiene.

Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 30. Annie has been diagnosed as having dysthymic depression. The

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nurse knows that symptoms of this disorder include: (Select all that apply) A. A depressed mood that lasts for most of each day over a 2-year period B. Low self-esteem C. Hallucinations D. Difficulty in making decisions E. Periods of euphoria F. Sleep pattern disturbances ____ 31. Which of the following nursing interventions apply to all depressed patients? (Select all that apply) A. Show patience B. Monitor lithium levels C. Monitor for suicidal ideation D. Communicate effectively E. Provide meaningful activities F. Include alternative therapies in the treatment plan Chapter 11: Depressive Disorders Answer Section MULTIPLE CHOICE 1. ANS: D Responses A and C are not helpful in just meeting the patient. Though response B is important, it begins with trust.

PTS: 1 REF: Chapter 11: Depressive Disorders; Table 11-2, Nursing Care Plan for Depressed Patient; page 187 KEY: Integrated Processes: Caring | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 2. ANS: D The depressed patient may become overwhelmed if too much is offered too soon. Structured, goal-directed activities are less stressful.

PTS: 1 REF: Chapter 11: Depressive Disorders; Table 11-3, Nursing Care Plan for Depressed Patient; page 188

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KEY: Integrated Processes: Caring | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 3. ANS: C Feelings of worthlessness are part of the common symptoms of sadness and low self-worth seen in major depression.

PTS: 1 REF: Chapter 11: Depressive Disorders; Major Depressive Disorders; page 182 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Mood disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 4. ANS: D This response gives the patient an opening to share feelings without being pressured to come up with reasons for these feelings. Responses A and C are not helpful for someone with depression because they minimize what the patient is experiencing.

PTS: 1 REF: Chapter 11: Depressive Disorders; General Nursing Interventions; page 186-187 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 5. ANS: A This medication is a MAOI (monoamine oxidase inhibitor). Eating foods with this enzyme can trigger a hypertensive crisis.

PTS: 1 REF: Chapter 11: Depressive Disorders; Table 11-2, Antidepressants; page 187 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration as well as expected actions/outcomes as well as adverse effects/contraindications/side effects/interactions 6. ANS: D Muscle rigidity is not an anticholinergic side effect.

PTS: 1 REF: Chapter 11: Depressive Disorders; Table 11-2, Antidepressants;

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page 187 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration as well as adverse effects/contraindications/side effects/interactions 7. ANS: B Though antidepressants are the treatment of choice for depression, electroconvulsive therapy is sometimes needed in cases of severe depression unresponsive to antidepressants. Lithium is generally not useful in depression. Light therapy and neurolinguistic programming may be adjuvants, not primary treatment in severe depression.

PTS: 1 REF: Chapter 11: Depressive Disorders; Treatment of Depressive Disorders; page 185 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 8. ANS: B This response tells you the spouse understands that antidepressants can take some time before seeing improvements. Response A tells you the spouse incorrectly thinks the drug will work immediately. There are no blood tests or food restrictions with this drug.

PTS: 1 REF: Chapter 11: Depressive Disorders; Pharmacology Corner; page 286 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders and Adult health: Pharmacology | Cognitive Level: Application | Client Need: Health Promotion and Maintenance: Principles of Teaching/Learning: Psychosocial Integrity: Mental health concepts 9. ANS: B Responses A, C, and D are all contributing biological factors to depression.

PTS: 1 REF: Chapter 11: Depressive Disorders; Etiology of Depressive disorders; page 185

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KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 10. ANS: C Exposure to light has been shown to lift mood in this disorder.

PTS: 1 REF: Chapter 11: Depressive Disorders; Alternative Treatment; pages 185-186 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorder | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 11. ANS: C Antidepressants need to be taken consistently, including when the patient starts feeling better. Tricyclic antidepressants like amitriptyline can cause dry mouth.

PTS: 1 REF: Chapter 11: Depressive Disorders; Pharmacology Corner; page 186 KEY: Integrated Processes: Nursing Process: Analysis: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration and Health Promotion and Maintenance: Principles of Teaching/Learning 12. ANS: B Dysthymia is depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least 2 years. The level of depression is less than in major depression. Major depression is more severe and affects all areas of ones life.

PTS: 1 REF: Chapter 11: Depressive Disorders; Dysthymic Disorder; page 183 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 13. ANS: B Though all the responses are correct, response B is most important. Nardil is a MAOI (monoamine oxidase inhibitor) with a potentially life-threatening

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side effect of hypertensive crisis in the presence of certain aged and/or processed foods.

PTS: 1 REF: Chapter 11: Depressive Disorders; Table 11-2, Antidepressants; page 187 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration and adverse effects/contraindications/side effects/interactions: Health Promotion and Maintenance: Principles of Teaching/Learning 14. ANS: C The other medications are examples of SSRIs and SSNIs. PTS: 1 REF: Chapter 11: Depressive Disorders; Table 11-2, Antidepressants; page 187 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration and adverse effects/contraindications/side effects/interactions 15. ANS: A Nearly twice as many women as men are affected by depression. Men are more likely to mask depression in other ways, such as substance abuse. The elderly and children are also at risk for depression.

PTS: 1 REF: Chapter 11: Depressive Disorders; Box 11-1, General Information About Depressive Disorders; page 182 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 16. ANS: C While all of these diagnoses are important, the presence of hopelessness may be a sign of suicidal ideation and would take priority.

PTS: 1 REF: Chapter 11: Depressive Disorders; General Nursing Interventions; page 186-187

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KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Analysis | Client Need: Psychosocial Integrity 17. ANS: C Major depression and dysthymia are differentiated by severity and duration.

The other responses are not factors.

PTS: 1 REF: Chapter 11: Depressive Disorders; Major Depressive Disorder; page 182; Dysthymic Disorder; page 183 KEY: Integrated Processes: Nursing Process: Application | Content Area: Mental Health: Mood disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 18. ANS: B By translating words into feelings you are helping her focus on why she is feeling low. Responses A and D disavow her reality, and response C expresses the nurses sense of being overwhelmed.

PTS: 1 REF: Chapter 11: Depressive Disorders; General Nursing Interventions; page 186 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Grief: Mood disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 19. ANS: A Amitriptyline is a tricyclic antidepressant and is known to cause anticholinergic effects such as urinary retention.

PTS: 1 REF: Chapter 11: Depressive Disorders; Table 11-2, Antidepressants; page 187 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Adverse effects/contraindications/side effects/interactions 20. ANS: B This response has no right or wrong answer and doesnt tax memory or concentration, which would occur in responses A and C. Television is passive and the patient can withdraw into his or her own world.

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PTS: 1 REF: Chapter 11: Depressive Disorders; General Nursing Interventions; page 187 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders: Therapeutic nursing process | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 21. ANS: C The other responses contain dangerous foods, including pepperoni, beer, and pickled herring.

PTS: 1 REF: Chapter 11: Depressive Disorders; Pharmacology Corner; page 186 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Adverse effects/contraindications/side effects/interactions 22. ANS: A This approach is the best one to establish trust without making too many demands on someone who has little energy to deal with demands. It is also important not to leave the patient alone too much, as that will send a message of not caring for her.

PTS: 1 REF: Chapter 11: Depressive Disorders; Table 11-3, Care Plan for the Depressed Patient; page 188 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Mood disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 23. ANS: B The other choices are other categories of antidepressants.

PTS: 1 REF: Chapter 11: Depressive Disorders; Table 11-2, Antidepressants; page 187 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration

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24. ANS: B Anticholinergic effect can create blurred vision, urinary retention, and dry mouth caused by the blockage of acetylcholine.

PTS: 1 REF: Chapter 11: Depressive Disorders; Table 11-2, Antidepressants; page 187 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Adverse effects/contraindications/side effects/interactions 25. ANS: D Attention to personal appearance is an important indicator of improved mood.

The other responses are not indicative of improvements in depression.

Abnormal sleep patterns indicate continued depression. Weight loss can occur with some antidepressants but would not be used as a measure of positive outcome for depression.

PTS: 1 REF: Chapter 11: Depressive Disorders; Pharmacology Corner; page 186 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration 26. ANS: B The symptoms are less severe than major depressive disorder but have gone on for long periods.

PTS: 1 REF: Chapter 11: Depressive Disorders; Dysthymic Disorder; page 183 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 27. ANS: A Small, achievable goals are the hallmark of helping a depressed person. One goal today is more concrete and achievable than one to be completed in a month. Talking about failures emphasizes negativity. The depressed patient may have no energy to identify the next best action.

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PTS: 1 REF: Chapter 11: Depressive Disorders; General Nursing Interventions; page 186 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Mood disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 28. ANS: B Anticholinergic effects from tricyclic antidepressants are a common initial side effect.

PTS: 1 REF: Chapter 11: Depressive Disorders; Table 11-2, Antidepressants; page 187 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Adverse effects/contraindications/side effects/interactions 29. ANS: B Patient has the ability to provide own self-care, but cognitive ability to select the appropriate choice can be impaired by the depression.

PTS: 1 REF: Chapter 11: Depressive Disorders; General Nursing Interventions; Table 11-3 Nursing Care Plan for the Depressed Patient; page 188 KEY: Integrated Processes: Nursing Process: Planning Nursing Diagnosis | Content Area: Mental Health: Depression | Cognitive Level: Analysis | Client Need: Psychosocial Integrity: Mental Health Concepts MULTIPLE RESPONSE 30. ANS: A, B, D, F Dysthymic disorder includes symptoms of low level depression over a long period of time. It does not include hallucinations or periods of euphoria.

PTS: 1 REF: Chapter 11: Depressive Disorders; Dysthymic Disorder; page 183 KEY: Integrated Processes: Nursing Process: Analysis 31. ANS: A, D, E Basic supportive interventions focus on communication and promoting selfesteem. All depressed patients do not need to be monitored for suicidal ideation. Lithium is usually not a medication for depression. Alternate

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therapies may not be appropriate for some patients.

PTS: 1 REF: Chapter 11: Depressive Disorders; General Nursing Interventions; page 186-187 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic environment and communication

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Chapter 12: Bipolar Disorders My Nursing Test Banks Chapter 12: Bipolar Disorders Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Your bipolar patient approaches you and says, I will be running this hospital someday. I know I can change everything. What is the best intervention?

Orient the patient by telling her that this would require multiple educational A. does not have.

B. Ask the patient why she thinks she can do that.

C. Redirect the patient to what is going on around her now.

D. Contact the psychiatrist immediately. ____ 2. Your new patient admitted to the psychiatric unit is pacing and agitated. Which of the following is the most appropriate intervention?

A. Introduce the patient to all the other patients.

B. Direct him to a group therapy session.

C. Place him in a quiet area away from other patients.

D. Review the unit rules with the patient to distract him. ____ 3. Your patient in the psychiatric unit is still up at midnight playing cards. You tell him, Its time to get some sleep now. What is the purpose of this response?

A. Limit setting B. Reality testing C. Controlling patient so other patients will respond the same way D. Enforcing rules ____ 4. Which statement is most likely to be from a patient in a manic episode?

A. I dont need to sleep.

B. I am Jesus Christ.

C. Leave me alone while I am reading this textbook.

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D. I am worthless. ____ 5. Which diversional activity is most appropriate for a patient in a manic phase?

A. Bridge B. Exercise class C. Cross stitch D. Computer game ____ 6. Lithium toxicity is most likely with which of the following patients?

A. Elderly man with diarrhea from food poisoning B. Teenage girl on oral contraceptives C. 40-year-old man who smokes marijuana on the weekend D. All of the above are at high risk ____ 7. Your 28-year-old patient was admitted to the psychiatric unit with a diagnosis of major depression with symptoms of withdrawal and extreme sadness. After 2 weeks on the unit, the patient suddenly becomes more talkative, sleeps only 2 hours a night, and acts seductively with the male patients. What is the most likely explanation for this change?

A. The antidepressants are effective.

B. The patient was diagnosed incorrectly.

C. She is having a manic episode as part of her illness.

D. She is recovering from her depression. ____ 8. You are working with the RN to plan short-term goals for a 28-yearold hospitalized manic client. Which is the most important goal?

A. Protection from self-inflicted harm B. Meals in excess of metabolic requirement C. Strict participation in unit activities D. Enforced medication compliance ____ 9. A 30-year-old male client is admitted to the psychiatric unit with a diagnosis of bipolar disorder. His family reports that for the past 2 months he has been in constant motion, sleeping very little, spending lots of money, and has been full of ideas. During the initial assessment with the client, the nurse would expect him to exhibit which of the following?

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A. Short, polite responses to interview questions B. Introspection related to his present situation C. Exaggerated self-importance D. Feelings of helplessness and hopelessness ____ 10. Lithium is most commonly used to treat which of the following disorders?

A. Dysthymia B. Schizophrenia C. Generalized anxiety disorder D. Bipolar disorder ____ 11. Marnie is a 16-year-old patient with bipolar disorder. She is manic right now and is in the hallway naked, making sexual requests of the staff and other patients. What is your best course of action?

A. Quietly approach her, escort her to her room, and assist her in getting dresse Quietly approach her, escort her to her room, and explain to her the inapprop B. actions.

C. Approach her, confront her behavior as it is happening, and escort her to her D. Confront her behavior in the hall, apologize to the other patients, and escort ____ 12. Which activity would you select as best for your patient in a manic state?

A. Brown bag lunch at a book review group B. Badminton C. Paint by numbers class D. Guided imagery ____ 13. Which of the following best describes bipolar I disorder?

A. Full manic cycles with possibility of depression.

B. Disturbance in mood that is a direct result of physiological effects of substan C. Periods of mild mania followed by mild depression.

D. Intense depression followed by normal mood. ____ 14. Which of the following would present the greatest risk to develop bipolar disorder?

A. Use of stimulant medications as a child

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B. History of anxiety disorder as a teenager C. First-degree relative with the bipolar disorder diagnosis D. History of conduct disorder ____ 15. Toni, diagnosed with bipolar disorder, is currently in the mania stage. The staff noted that Toni has placed her lipstick on in an exaggerated way. She is currently pacing the floor and is easily angered. The duty nurse approaches in an attempt to ease some of Tonis behaviors. The most therapeutic response by the nurse would be: A. Would you like to watch TV? B. Would you like me to talk with you?

C. Lets walk and talk Avoid giving attention to the patient by not responding to her behavior D. ____ 16. For a patient diagnosed with bipolar disorder, what would be the drug of choice?

A. Lithium carbonate B. Valium C. Paxil D. Haldol Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 17. Which of the following are signs of mania? (Select all that apply) A. Pessimistic feelings B. Increased sexual drive C. Denial that anything is wrong D. Decreased energy E. Decreased need for sleep F. Thoughts of death or suicide ____ 18. While assessing your patient, you realize the patient is experiencing a manic episode. You will most likely expect (select all that apply): A. Decreased need for sleep.

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B. Extreme irritability.

C. Extreme depression.

D. A surge of energy.

E. A loss of interest in ordinary activities.

Chapter 12: Bipolar Disorders Answer Section MULTIPLE CHOICE 1. ANS: C Rather than challenge the patients thinking or overreacting, it is best to acknowledge what she said and then distract her to more reality-based thoughts.

PTS: 1 REF: Chapter 12: Bipolar Disorders; General Nursing Interventions for Bipolar Disorder; page 198-199 KEY: Integrated Processes: Caring | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 2. ANS: C Rather than adding more information and added stimuli, you are focusing on helping him cope.

PTS: 1 REF: Chapter 12: Bipolar Disorders; General Nursing Interventions for Bipolar Disorder; page 198-199 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Coping | Cognitive Level: Application | Client Need: Psychosocial Integrity: Behavioral intervention 3. ANS: A Limit setting is an important intervention that defines what is expected and what is not allowed. It is more therapeutic than just controlling or enforcing rules.

PTS: 1 REF: Chapter 12: Bipolar Disorders; General Nursing Interventions for Bipolar Disorder; page 198-199 KEY: Integrated Processes: Nursing Process: Implementation | Content Area:

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Mental Health: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 4. ANS: A Manic patients usually have very little need for sleep. Response B is a delusion of grandeur that may be present but is not most likely. Manic patients are unable to concentrate on reading and less likely to make depressive statements in a manic state.

PTS: 1 REF: Chapter 12: Bipolar Disorders; Manic Phase; page 193-194 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Mood disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 5. ANS: B Physical activity to discharge pent-up energy can be useful. The other activities are sedentary and require concentration, which would be difficult for the manic patient.

PTS: 1 REF: Chapter 12: Bipolar Disorders; General Nursing Interventions; page 198-199 KEY: Integrated Processes: Nursing Process: Analysis 6. ANS: A Diarrhea can precipitate dehydration, which is a common cause of lithium toxicity. Responses B and C are not indicators of high risk behaviors for toxicity.

PTS: 1 REF: Chapter 12: Bipolar Disorders; Treatment of Bipolar Disorders; page 197 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Adult health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration and adverse effects/contraindications/side effects/interactions 7. ANS: C Sudden shifts to manic behavior after depression may indicate bipolar disorder I. Responses A and D are unlikely, given the rapid change in behavior. Depression diagnosis was accurate initially related to response B. PTS: 1 REF: Chapter 12: Bipolar Disorders; Manic Phase; page 193-194

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KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 8. ANS: A Safety is always the priority. The other goals may be part of the plan, but protection from self-inflicted harm is most important.

PTS: 1 REF: Chapter 12: Bipolar Disorders; General Nursing Interventions; page 198-199 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity 9. ANS: C In the manic phase the client will be unable to control his response or be introspective. He will also not be in touch with feelings of helplessness or hopelessness unless he moves into the depressive phase.

Integrated process: Nursing process: Assessment | Content Area: Mental health: Mood disorder | Cognitive Level: Application | Client Need: Psychosocial integrity: Mental health concepts PTS: 1 REF: Chapter 12: Bipolar Disorders; Manic Phase; page 193-194 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Mood disorder | Cognitive Level: Application 10. ANS: D Lithium is a drug commonly used to treat bipolar disorder and is not used to treat the other disorders.

PTS: 1 REF: Chapter 12: Bipolar Disorders; Treatment of Bipolar Disorders; page 197 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration 11. ANS: A With a patient in a manic state, the intervention should be calming with the emphasis on limit setting rather than confrontational and/or encouraging insight.

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PTS: 1 REF: Chapter 12: Bipolar Disorders; General Nursing Interventions; page 198-199 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Mood disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 12. ANS: B Physical activity is more effective than these other activities that require concentration.

PTS: 1 REF: Chapter 12: Bipolar Disorders; General Nursing Interventions; page 199 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 13. ANS: A Bipolar I is a full syndrome of manic symptoms and may also have depression. Response B is bipolar disorder due to substance abuse.

PTS: 1 REF: Chapter 12: Bipolar Disorders; Table 12-1, Forms of Bipolar Disorders; page 194 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 14. ANS: C Family history is the strongest risk factor.

PTS: 1 REF: Chapter 12: Bipolar Disorders; Etiology; page 195-196 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 15. ANS: C To reduce the level of anger and aggression the patient may be experiencing, the nurse should encourage the patient to discharge some energy by physical activity. Talking about feelings may be difficult. The patient may not be able to concentrate.

PTS: 1 REF: Chapter 12: Bipolar Disorders; General Nursing Interventions;

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page 193-195 KEY: Integrated Processes: Caring | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic Communication 16. ANS: A Lithium is one of the major drugs that assist in mood stabilizing.

PTS: 1 REF: Chapter 12: Bipolar Disorders; Pharmacology Corner; page 196 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Expected Actions/Outcomes MULTIPLE RESPONSE 17. ANS: B, C, E The manic patient will have increased energy and drive and not exhibit insight into the maladaptive behavior.

PTS: 1 REF: Chapter 12: Bipolar Disorders; Manic Phase; page 193 KEY: Integrated Processes: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 18. ANS: A, B, D Mania is part of the bipolar disorder. The patients moods shift from mania to depression, both in the extreme. The changes are noticeable and can be described as dramatic. During a manic episode the patient is hyperactive, irritable, reduced need for sleep without signs of depression.

PTS: 1 REF: Chapter 12: Bipolar Disorders; Manic Phase; page 193-194 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Mood Disorder | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health Concepts

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Chapter 13: Suicide My Nursing Test Banks Chapter 13: Suicide Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Suicide is most likely to occur: A. On admission to a psychiatric hospital.

B. At the beginning of psychotherapy.

C. As the depression begins lifting.

D. When the depression deepens. ____ 2. Your new patient is admitted after a suicide attempt. She states, Let me die, I dont deserve to live. What is your best response?

A. Why do you want to die?

B. You have so much to live for.

C. How do you think your family feels now?

D. You must have been feeling very hopeless. Tell me about it. ____ 3. Your depressed patient has suddenly changed to being more cheerful and tells you he wants to reduce the clutter at home and give away some prized possessions to friends. What should be your response?

A. Im glad you are feeling better.

B. Ill tell the doctor and maybe he will reduce your dose of antidepressant.

C. Ask the patient if he has any thoughts about suicide.

D. Document what the patient tells you and see another patient. ____ 4. Which of the following statements is true about suicide?

A. There is generally some warning when someone commits suicide.

B. Victims of suicide have a genetic predisposition to it.

C. Suicide can always be prevented.

D. Talking about suicide means the person is not serious about it. ____ 5. A patient becomes suicidal and is transferred to the locked unit of your hospital. Because this patient is actively suicidal you should: A. Keep the patient in your line of vision at all times.

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B. Perform suicide assessments every half-hour.

C. Inform the doctor that the patient is now in a locked area.

D. Take vital signs every 15 minutes. ____ 6. Patients are most likely to commit suicide when: A. They are severely depressed.

B. The depression is lifting.

C. They are recently discharged from the hospital.

D. They have a significant other who is supportive. ____ 7. As you perform a suicide assessment on your patient, you learn that the patient has only one person to call in times of need, has been thinking about suicide frequently in past weeks, and has attempted suicide once before. Given this information you believe this patients suicide risk is: A. Low. B. Moderate.

C. None.

D. Imminent. ____ 8. Which would be most important to find out next about the above patient?

A. Does he have a suicide plan now?

B. What is his psychiatric diagnosis?

C. Who does he live with?

D. What type of psychiatric therapy has he had recently? ____ 9. The best approach a nurse can use to gain information relating to a patients potential for suicide is to ask: A. What do you plan to be doing 5 years from now?

B. Does your family know you are considering suicide?

C. What have other patients told you about their suicide attempts?

D. Are you thinking of killing yourself now? ____ 10. When planning care for a patient who is suicidal, the nurse knows: A. Suicide attempts are only gestures.

B. Suicide is a crime and must be reported to the authorities.

C. Teaching new problem-solving skills is a priority of care for suicidal patient

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D. It is necessary to know the reasons why the patient has suicidal thoughts. ____ 11. You have been consistently caring for a patient who is suicidal who now tells you, Nurse, I finally have it all figured out. Its going to be just fine.

Your best response to this patient is: A. Im so glad to hear that!

B. What a relief for you!

C. Im not sure I understand what you mean. Tell me more.

D. You are not depressed anymore then ____ 12. Of the following patient statements, which do nurses recognize as the highest risk for a patient to commit suicide?

Ive been saving my pain medications for when I really need them.

A. me I think I will use them right before the holidays.

B. I told my boss if he fires me, Ill kill myself.

C. Nobody appreciates the work I do. Theyd miss me if I just killed myself and D. I really admire people who have enough nerve to kill themselves. Im not tha ____ 13. You are caring for an adolescent patient who has swallowed all of his mothers sleeping pills and pain pills. The patient has had a gastric lavage and is able to answer questions. The best question to ask this patient is: A. What are your thoughts right now about hurting yourself?

B. Why on earth did you do that?

Dont you know how much your family loves you and how much they will m C. yourself?

D. This is a very immature way to get attention. ____ 14. A suicidal patient has been transferred to your unit from the medical floor and asks you why he or she has to be watched every minute. I have a right to my privacy; Im an adult and can come and go as I please.

The bestresponse to this patient is: A. Why do you think you are being watched?

B. We are concerned that you might attempt to seriously hurt yourself.

C. It shouldnt bother you if you have nothing to hide from us.

D. This is a direct order from your doctor. ____ 15. Your 15-year-old neighbor, who knows you are a mental health

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nurse, informs you that he has a friend who is talking about suicide. Your best initial response to the young neighbor is: A. Who is it? Another neighbor?

B. I have some time. Tell me a little about this friend.

C. Who else knows? Has this friend told anyone else?

D. Your friend needs help right away! ____ 16. Of the following, which response is the most important for a nurse when evaluating suicide risk in a newly admitted depressed patient?

A. The patients plans for the immediate future after discharge B. How long the person has felt depressed C. How many personal problems the patient lists as stressors D. How the patient plans to handle the upcoming anniversary of his or her spou ____ 17. Denise is brought by ambulance to the emergency room with agitation related to an overdose of prescribed antipsychotic medication.

Initially the most important piece of information the charge nurse should obtain is: A. How long the patient has been on the medication.

B. The name and amount of the ingested medication.

C. Reason for the suicide attempt.

D. The name of the nearest relative and their phone number. ____ 18. The LPN/LVN is assisting with the data collection of a patient recently admitted to the mental health unit. During the interview, the patient makes a statement that concerns the nurse. Which of the following statements would be most likely to prompt immediate attention?

A. When I get out of here I am going to overdose on my mothers medication.

B. When I get discharged, I am thinking I might try suicide again.

C. I dont feel any better since I got here.

D. If I get the chance, I just might run away.

Chapter 13: Suicide Answer Section MULTIPLE CHOICE 1. ANS: C

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As depression lifts, the patient may have more energy to carry out a suicide plan.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210211 KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 2. ANS: D This answer allows the patient to acknowledge her feelings and talk about them. The other responses sound more judgmental.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 3. ANS: C Giving away prized possessions often precedes planned suicide. Being direct and asking about suicide intent is important.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 4. ANS: A Most people give some warning about being at risk to commit suicide.

Responses B, C, and D are all incorrect information about suicide risk.

PTS: 1 REF: Chapter 13: Suicide; The Warning Signs of Suicide; page 207208 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Suicide | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental health concepts 5. ANS: A If the patient has been determined to be at high risk for suicide, protection of the patient requires constant supervision because the patient could have access to a method that could lead to sudden death.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210

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KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts and Safe and Effective Care Environment 6. ANS: B This is the highest risk because the patient has more energy when the depression is lifting but may still suffer from sadness and hopelessness.

PTS: 1 REF: Chapter 13: Suicide; The Warning Signs of Suicide; page 208 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 7. ANS: B This patient has suicidal thoughts, a limited support system, and previous history, all of which indicate a moderate risk. For imminent risk the patient would need to have access to a highly lethal method at that time.

PTS: 1 REF: Chapter 13: Suicide; The Reality of Suicide; page 205; Warning Signs of Suicide; page 208 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 8. ANS: A Asking directly about a suicide plan is the most important question to ask a person with some suicide risk. All the other choices give important information but would not be a priority given the situation.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 9. ANS: D A direct approach is the best way to gain this information.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application |

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Client Need: Psychosocial Integrity: Mental health concepts 10. ANS: C Helping the person to identify new ways to address problems so he or she can see alternatives is a key intervention. The patient may not know the reason for these feelings. A past history of suicide attempts can be a predictor of future attempts.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 11. ANS: C You would want to know the meaning of the patients words, as they could be interpreted as a decision to commit suicide rather than making assumptions about what they mean.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 12. ANS: A This patient clearly has the means available and a specific plan along with suicidal intent.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 13. ANS: A Response A is an open-ended question to encourage the patient to talk. The other responses are judgmental and not helpful.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 14. ANS: B This response communicates clearly and honestly your concern. The other

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responses are indirect communication about the patients risk for self-injury.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 15. ANS: B You should use open-ended statements to elicit more information rather than jump to conclusions that might close off communication.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 16. ANS: D This upcoming anniversary could represent an imminent increased risk for suicide, so it would be the most important information to have.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 210 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Self-destructive behaviors | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 17. ANS: B In an emergency, information relating to the patients drug history is important. In this case, the medications name and amount taken will be needed to provide effective treatment. The other responses are important but can be obtained after initial emergency care.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 209 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Pharmacology | Cognitive Level: Application | Client Need: Safe and Effective Care Environment: Management of Care: Establishing Priorities 18. ANS: A The patient expresses the desire to end her life and verbalizes that there is a method for ending her life. This would be the highest risk that would need immediate action because the patient has motivation and the means to commit suicide.

PTS: 1 REF: Chapter 13: Suicide; General Nursing Interventions; page 94

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KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Suicide | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental Health Concepts

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Chapter 14: Personality Disorders My Nursing Test Banks Chapter 14: Personality Disorders Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Patients with antisocial personality disorder: A. Generally must have immediate gratification.

B. Display a great deal of responsibility toward others.

C. Display a great deal of anxiety.

D. Have obsessive thoughts when in a social situation. ____ 2. Barbara is a new patient on your floor who is being assessed for several disorders, including suicide potential. You learn she attempts suicide every 6 to 12 months because she cannot tolerate living alone. She is unable to see two sides of a situation or an individual; they are either all good or all bad. You consider which of the following as a potential diagnosis for Barbara?

A. Borderline personality disorder B. Multiple personality disorder C. Narcissistic personality disorder D. Antisocial personality disorder ____ 3. A nice-looking male patient is making suggestive comments to the female nursing staff. When he asks you for your phone number, you therapeutically respond: A. I do not believe in dating patients.

B. It is against the rules for me to date patients.

C. Ill think about it and let you know.

D. You are very nice but our relationship is a professional one only. ____ 4. When planning care for an individual with borderline personality disorder, nurses realize that the patient: A. Will not be able to make decisions.

B. Will expect special treatment.

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C. Will act out when feeling afraid or disrespected.

D. Will withdraw and become uncommunicative. ____ 5. A patient with borderline personality disorder approaches you and voices concern that she is being ignored and feels unimportant. The patient blames the nursing staff for these feelings because the nurses are not paying attention to her. Your best therapeutic response to this patient is: A. I will bring it up at our next meeting.

B. Its all in your imagination.

C. Tell me more about your feeling of being ignored.

D. You need to share your feelings with the individual nurses you feel are igno ____ 6. The main mechanism used by patients who have personality disorders is: A. Projection.

B. Manipulation.

C. Introjection.

D. Repression. ____ 7. Nurses understand that a major cause of personality disorders is: A. Neurochemical imbalance.

B. Genetics.

C. Dysfunctional family relationships.

D. Anoxia. ____ 8. Nurses know that when working with patients who have personality disorders, the most difficult task for these patients will probably be: A. Following rules.

B. Getting along with others.

C. Hoarding their medications.

D. Participating in care plan meetings. ____ 9. A patient who is diagnosed with narcissistic personality disorder is constantly using the call light or following the nursing staff into other patients rooms to ask, Are you sure I look good? You know they cant get along without me at work. When can I leave here? As the nurse caring for this patient, one of your goals for the patient will include all of the

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following except: A. The patient will express reality about self-image.

B. The patient will require decreasing reinforcements from the nursing staff.

C. The patient will acknowledge the feelings of others.

D. The patient will not be introspective about his or her condition. ____ 10. People who have borderline personality disorders: A. Do not learn from past experiences B. Know the consequences of their behavior but do not care.

C. Learn from past experiences and put that knowledge into practice.

D. Try to forget about past experiences. ____ 11. Nancy has antisocial personality disorder. Which of the following is a goal of treatment for Nancy?

A. Comply with her medication regimen B. Participate in long-term therapy C. Become a group facilitator D. Eliminate her anxiety ____ 12. Tony is a 25-year-old male patient who is being treated at your hospital day-treatment center. Tony is very charming and seems popular. He has the ability to draw crowds around him, but you know he has been in trouble with the law several times since adolescence and lies constantly. You realize that Tonys behavior is most likely which personality disorder?

A. Paranoid personality disorder B. Schizoid personality disorder C. Dependent personality disorder D. Antisocial personality disorder ____ 13. Schizotypal personality disorder may be confused with what other psychiatric disorder?

A. Bipolar B. Schizophrenia C. Dual diagnosis D. Paranoid personality ____ 14. Which characteristic is unlikely to be present in a patient with

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avoidant personality?

A. Low self-esteem B. Lack of pleasure in life C. Avoidance of social situations D. Very close relationships with family ____ 15. You know your patient has a personality disorder. He tells you, You are the best nurse. I am so glad you are here today and not that mean nurse who was here yesterday. Which personality disorder would be most associated with this statement?

A. Paranoid B. Antisocial C. Passive aggressive D. Borderline ____ 16. Personality disorders are organized into three clusters. Which cluster is the diagnosis of schizotypal disorder placed in?

A. Cluster A B. Cluster 1 C. Cluster B D. Cluster C ____ 17. Your male patient tells you that he has women throwing themselves at him everywhere he goes. From this statement, what is the most likely personality disorder he is exhibiting?

A. Borderline B. Narcissistic C. Paranoid D. Antisocial ____ 18. Your male patient tells you that he has women throwing themselves at him everywhere he goes. The best nursing response to the patient is: A. Wow, that is impressive. Give me some tips.

B. Tell me about a recent relationship.

C. Lets focus on activities for today.

D. Lets go to the dayroom and see what happens.

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____ 19. Which of the following statements best describes schizotypal personality disorder?

A pervasive pattern of social and interpersonal deficits with reduced capacit A. relationships B. Disregard and violation of the rights of others C. A pattern of preoccupation with orderliness and perfectionism D. Pervasive submissive and clinging behavior ____ 20. You find your patient with antisocial personality disorder smoking in the lounge. Which response is best?

A. Make a general overhead announcement about no smoking.

B. Bring up the smoking issue at the next group session.

C. Tell the patient directly he is not to be smoking here.

D. Encourage the patient to identify why he has the need to smoke now. ____ 21. Theodore, a 45-year-old male, is admitted to a mental health unit displaying inappropriate behavior. The patient has been responding to voices when no one is in the room and isolating himself in his room. Which of the following best describes this patient?

A. Phobia B. Neurosis C. Effective coping D. Psychosis Chapter 14: Personality Disorders Answer Section MULTIPLE CHOICE 1. ANS: A Antisocial personality disorder is a pattern of irresponsible, exploitive, and guiltless behavior with tendency to fail to conform to the law and exploit and manipulate others for personal gain.

PTS: 1 REF: Chapter 14: Personality Disorders; Antisocial Personality; page 219 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

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2. ANS: A Borderline personality disorder is associated with intense and chaotic relationships as well as self-destructive, impulsive, and dramatic coping.

PTS: 1 REF: Chapter 14: Personality Disorders; Borderline Personality Disorder; page 220 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 3. ANS: D This response clarifies the inappropriateness of the patients request and sets clear limits.

PTS: 1 REF: Chapter 14: Personality Disorders; Table 14-1 Nursing Interventions for Personality Disorders; page 224 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Therapeutic nursing process | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 4. ANS: C This response demonstrates understanding of the dynamics behind the behavior.

PTS: 1 REF: Chapter 14: Personality Disorders; Borderline Personality; page 220 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 5. ANS: D This response promotes the patient taking responsibility to follow through on her feelings. Response A takes the responsibility away from the patient.

Response B ignores the patients feelings. Response C is less effective with a borderline patient who may not understand her feelings.

PTS: 1 REF: Chapter 14: Personality Disorders; Table 14-1 Nursing Interventions for Personality Disorders; page 224 KEY: Integrated Processes: Nursing Process: Analysis | Content Area:

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Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 6. ANS: B Though these other mechanisms may be used, manipulation is the major one.

PTS: 1 REF: Chapter 14: Personality Disorders; Introduction; page 217 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 7. ANS: C Dysfunctional family relationships are generally the major cause of personality disorders, though genetics plays a role in some.

PTS: 1 REF: Chapter 14: Personality Disorders; Introduction; page 218 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 8. ANS: B Those with personality disorders generally have the most problems in the social sphere.

PTS: 1 REF: Chapter 14: Personality Disorders; Introduction; page 218 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 9. ANS: D The narcissistic patient has difficulty with introspection and insight into his or her behavior.

PTS: 1 REF: Chapter 14: Personality Disorders; Narcissistic Personality; page 221-222 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Therapeutic nursing process | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 10. ANS: A Generally, the borderline patient does not have insight into the consequences of behavior and tends to repeat the same behaviors over and over even if not successful.

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PTS: 1 REF: Chapter 14: Personality Disorders; Borderline Personality; page 220 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 11. ANS: B Treatment is geared toward working with the client to gain insight into her behavior, which can be done with long-term therapy. Medications are generally not useful and this patient will probably not be experiencing anxiety and should not be a group leader due to being a poor influence on others.

PTS: 1 REF: Chapter 14: Personality Disorders; Table 14-1 Nursing Interventions for Personality Disorders; page 224 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 12. ANS: D People with antisocial personality disorder are usually gregarious, intelligent, and likable, but they often use manipulation to achieve their goals.

PTS: 1 REF: Chapter 14: Personality Disorders; Antisocial Personality; page 219 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 13. ANS: B Behavior in this disorder is often odd and eccentric, but not to the level of schizophrenia.

PTS: 1 REF: Chapter 14: Personality Disorders; Schizotypal Personality Disorder; page 219 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental health concepts 14. ANS: D

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Those with avoidant personality disorder have distant relationships with family.

PTS: 1 REF: Chapter 14: Personality Disorders; Avoidant Personality Disorder; page 222 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 15. ANS: D A common characteristic of borderline personality is to see people as all good and all bad and attempt to pit one against the other to split the staff.

PTS: 1 REF: Chapter 14: Personality Disorders; Borderline Personality; page 220 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 16. ANS: A Schizotypal is in the cluster with paranoid and schizoid personality.

PTS: 1 REF: Chapter 14: Personality Disorders; Introduction; page 218 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 17. ANS: B Narcissistic personality is associated with a constant need for attention, exaggerated sense of self-importance, and fantasies of ongoing success.

PTS: 1 REF: Chapter 14: Personality Disorders; Narcissistic Personality; page 221-222 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 18. ANS: B Encouraging the patient to focus on a specific relationship to gain some insight rather than focusing on generalizations is more helpful for the patient.

Encouraging the patient or testing this belief is not therapeutic.

PTS: 1

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REF: Chapter 14: Personality Disorders; Table 14-1, Nursing Interventions for Personality Disorders; page 224 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 19. ANS: A Schizotypal personality disorders major characteristic is deficits in maintaining social relationships of any kind. Response B is a description of antisocial personality. Response C is obsessive-compulsive disorder.

Response D is dependent personality.

PTS: 1 REF: Chapter 14: Personality Disorders; Schizotypal Disorder; page 219 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Personality disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 20. ANS: C This patient needs clear limits at the time of the infraction and it should be handled directly. Reponses A and B are indirect. Focusing on insight into why he smokes is not effective for patients with this disorder.

PTS: 1 REF: Chapter 14: Personality Disorders; Table 14-1 Nursing Interventions for Personality Disorders; page 224 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Personality disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 21. ANS: D Psychosis is a mental state in which there is a severe loss of contact with reality.

PTS: 1 REF: Chapter 14: Personality Disorders; page 219 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Psychotic disorder | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental Health Concepts

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Chapter 15: Schizophrenia Spectrum and Other Psychotic DisordersSchizophrenia My Nursing Test Banks Chapter 15: Schizophrenia Spectrum and Other Psychotic DisordersSchizophrenia Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Your patient reports a hallucination where he is aware of strange smells that no one else is aware of. What type of hallucination is this?

A. Olfactory B. Tactile C. Gustatory D. Auditory ____ 2. You are asked to report any extrapyramidal symptoms (EPSs) of your patient. Which of the following are examples of EPS? A. Dry mouth, anorexia B. Heart palpitations C. Muscle rigidity, tremors D. Constipation, nausea ____ 3. Which of the following is characteristic of a paranoid delusion?

A. Suspicion and jealousy B. Self-pity and self-depreciation C. Making up words and phrases D. Exposing beliefs of inflated self-importance ____ 4. Your new patient is admitted with a diagnosis of schizophrenia.

Which of the following is he most likely to demonstrate?

A. Concrete thinking B. Effective ego boundaries C. Inflated self-image

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D. Fatigue and loss of appetite ____ 5. When is schizophrenia most likely to be diagnosed?

A. Grade school B. College age C. After the birth of the first child D. After retirement ____ 6. The schizophrenic patient tells you, I know that the man down the hall wants to kill me. How should you respond?

A. I will protect you from him.

B. What makes you say that?

C. Lets walk over here to join in afternoon activities.

D. You need to go to your room. ____ 7. The statement made by the patient in question 6 is an example of a(n): A. Paranoid delusion.

B. Visual hallucination.

C. Idea of reference.

D. Flight of ideas. ____ 8. Your patient with schizophrenia who is English speaking says no acu moona to you. What is this called?

A. Neologism B. Echolalia C. Echopraxia D. Concretism ____ 9. Which statement is most true about schizophrenia treatment today?

A. Most require lifelong institutionalization.

B. Patients can stop taking their antipsychotics once stabilized.

C. Psycho-education for the family is part of the treatment plan.

D. Most can function normally in society with little support after treatment for ____ 10. A young man with severe schizophrenia is being discharged home.

Which of the following medications would he most likely be taking?

A. Amitriptyline

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B. Fluphenazine decanoate C. Lithium D. Lorazepam ____ 11. Which of the following is not a positive sign of schizophrenia?

A. Hallucinations B. Avolition C. Flat affect D. Social withdrawal ____ 12. Which of the following is not an atypical antipsychotic?

A. Aripiprozole B. Clozaril C. Olanzapine D. Haloperidol ____ 13. Your hospitalized schizophrenic patient has been taking clozapine (Clozaril) for several months. You recognize this medication is effective by which of the following patient reports?

A. He no longer has a memory of past psychotic behavior.

B. He is drowsier, so less bothered by the hallucinations.

C. He no longer hears voices.

D. He is more uncomfortable around others. ____ 14. Which of the following is most important to monitor for your patient on Clozaril?

A. White blood cell count B. Clozaril blood level C. Urine output D. Vision ____ 15. Your psychotic patient states my arms and legs are on fire. What would be your best response?

A. Thats silly. There is nothing wrong with your legs.

B. Does the fire travel from one side of your body to the other?

C. That must be distressing. How do you stop it?

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D. I will get you some ice to put out the burning feeling. ____ 16. Your schizophrenic patient is sitting in her room with her hands over her ears and crying. Which is the best way to approach her?

A. Take her hands away from her ears and hold her hands in a sympathetic man B. Leave her alone as she most likely wants privacy.

C. Make eye contact with her and ask her what is going on.

Leave the room and call the charge nurse to determine if she needs an adjust D. medication. ____ 17. Later in the day you find this patient standing in the lounge in a strange position: on one leg with both arms extended. How should you respond?

A. Ignore the behavior, as this must be something she needs to do.

B. Tell the patient sternly that this is not appropriate and to move to her room.

C. Calmly acknowledge the position and ask the patient to stand on both legs.

Encourage other patients in the lounge to do the same position to make the p D. comfortable. ____ 18. Which of the following medications would this schizophrenic patient be least likely to have prescribed?

A. Fluphenazine B. Carbamazepine C. Olanzapine D. Quetiapine ____ 19. This schizophrenic patient has been taking Prolixin for 6 months.

She now is experiencing extrapyramidal symptoms (EPS). Which medication is most likely to be added?

A. Acetaminophen (Tylenol) B. Alprazolam (Xanax) C. Benztropine (Cogentin) D. Amitriptyline (Elavil) ____ 20. Which of the following side effects is most common with olanzapine?

A. Weight gain

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B. Orthostatic hypotension C. Dry mouth D. Diarrhea ____ 21. Your schizophrenic patient suddenly is observed with her head turned in an awkward position that she is unable to move. What would be your first action?

A. Obtain a blood specimen per standing order.

B. Ignore the patient, as this is most likely part of her psychotic behavior.

C. Call the charge nurse and physician immediately.

D. Administer an additional dose of prn antipsychotic medication. ____ 22. Your patient reports feeling that bugs are crawling on his skin.

Which type of hallucination is this most likely an example of?

A. Visual B. Tactile C. Paranoid D. Histrionic ____ 23. The ability to think abstractly is often absent in which diagnosis?

A. Depression B. Anorexia nervosa C. Schizophrenia D. Sociopathic personality ____ 24. Your schizophrenic patient tells you he is suspicious that his doctor is trying to kill him. Which nursing diagnosis would be most appropriate?

A. Impaired verbal communication B. Disturbed thought processes C. Risk for violence D. Ineffective communication ____ 25. You find your schizophrenic patient sitting in a wet bed and singing nursery rhymes. What should you do?

A. Scold the patient for wetting the bed.

B. Help the patient clean up in a calm manner.

C. Show the patient again where the bathroom is.

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D. Tell the patient his privileges will be withdrawn if this happens again. ____ 26. What is the purpose of detoxification in substance abuse?

A. Slowly removing the substance from the body under medical supervision.

B. A quick treatment for addiction.

C. Replacing one addictive substance with another.

D. Reducing the length of treatment for the abused substance. ____ 27. Another term for codependency is: A. Enabling.

B. Dual diagnosis.

C. Rationalization.

D. Identification with the alcoholic. ____ 28. Which response is most accurate about hallucinations?

A. Hallucinations are the same thing as hearing voices.

B. Hallucinations occur without external stimulus.

C. Hallucinations present only in schizophrenia.

D. Hallucinations are the same thing as illusions. ____ 29. You notice a patient who seems to be listening to someone, but you do not see anyone else in the room. You interpret this behavior as a(n): A. Illusion.

B. Delusion.

C. Hallucination.

D. Confabulation. ____ 30. Which of the following characteristics are most closely associated with schizophrenia?

A. Flat affect, autism, ambivalence, and loose associations B. Bright affect, paranoia, and anhedonia C. Autistic behavior, inability to function in school or work, accuracy of percep D. Insight, suspiciousness, and flight of ideas ____ 31. A patient who is diagnosed with schizophrenia would display all of the following characteristics except: A. Suspiciousness.

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B. Hallucinations.

C. Intense relationships with friends.

D. Delusions. ____ 32. A teenage patient is brought to your hospital by her parents. The patient exhibits unusual behaviors, including illogical thought processes and strange combinations of words that you do not understand. She is wearing dirty clothes and has body odor. The patient also appears to carry on a conversation with a person who is not seen by you. Your first priority for this patient is: A. Have her shower and change clothes.

B. Bring her a snack.

C. Resocialize her.

D. Ensure her safety. ____ 33. Tim is a new patient to your mental health unit. He gets your attention, and when the two of you are alone he informs you that he has the secret to eternal youth. He offers to tell you, but he is unable to because theyre out there hiding so they can steal it from me. I must be very careful.

Your best therapeutic response to Tim is: Tim, I dont see anyone but you and me. Its time for dinner now. Ill walk wit A. room.

B. Tim, nobody can have eternal youth. Thats not realistic, so dont talk about th C. Id love to hear about it, Tim. Lets go to the other room so no one else can he D. Ill make sure they are all gone, then you can tell me. ____ 34. Which of the following is the most appropriate nursing intervention for a patient with schizophrenia?

A. Teach the patient about the illness.

B. Maintain consistency with the patients plan of care.

C. Insist that the patient participate in all activities provided on the unit.

D. Allow the patient time to listen to the radio alone in his or her room. ____ 35. Max says, Nurse, see that man on the television? He is the reason why I am sick. He told them to make me this way. The nurse documents this as an episode of a(n):

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A. Hallucination.

B. Delusion.

C. Illusion.

D. Autistic thought. ____ 36. When providing discharge teaching to a patient who has schizophrenia and is taking clozapine (Clozaril), it is important to teach all of the following except: A. Be sure to have you lab work on time and as ordered.

B. Do not stop this drug abruptly. First call your doctor.

Do not take any over-the-counter medications or alcohol while on this medic C. doctors approval.

D. You may begin driving immediately while taking this medication. ____ 37. Which of the following drugs is NOT an atypical antipsychotic?

A. Asenapine B. Olanzapine C. Haloperidol D. Risperidone ____ 38. When discharging a schizophrenic patient who is taking haloperidol (Haldol), it is important for the nurse to advise the patient to: A. Keep track of how much salt and water he or she consumes.

B. Avoid exercise.

C. Report any symptoms of tremors right away.

D. Stop taking the medication if dry mouth develops and call the doctor immed ____ 39. Sally is experiencing an exacerbation of symptoms of her schizophrenia. She tells you, her nurse, that the voices are getting louder and that they are telling her to walk in front of a big truck. Your first nursing action for Sally would be to: A. Divert her into a group activity immediately.

B. Implement suicide precautions to keep her safe.

C. Explain that there is nobody telling her to walk in front of a big truck.

D. Notify her family and ask them if she has said this before. ____ 40. You are one of the nurses monitoring the dining room during

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dinner. A male patient who has schizophrenia asks a table mate to please pass the pepper. When the table mate does so, the first patient throws the pepper shaker at you. He or she screams, Now look what youve done! There are spiders all over my food! I cant eat this! Get the spiders out of there! Your best response is: A. Those arent spiders; that is the pepper you asked for!

B. I dont see any spiders. Lets go to the game room for a little while before you C. Where are the spiders? I am also afraid of them!

D. It is inappropriate for you to throw things; you need to go to the locked unit ____ 41. Mrs. Jones has been taking chlorpromazine to combat the effects of her auditory hallucinations. Which response is the best indication that the medication is effective?

A. There is more than one voice now!

B. They are whispering instead of talking loudly now!

C. I dont hear the voices now!

D. I only hear them sometimes now. ____ 42. You are helping with breakfast service in the dining room. A resident begins screaming and hitting at her food stating, There are bugs on my eggs. Bugs! Get them off. You approach her to see that someone sprinkled pepper on her eggs. An appropriate response is: A. No, those arent bugs! That is just pepper.

Dont eat them then if you believe those are bugs. Eat the toast instead.

B. toast.

C. I see no bugs; only pepper. I will get you a new plate of food.

D. There are no bugs! Nobody else sees bugs! ____ 43. The doctor ordered a lithium level to be drawn on a patient who is suspected to be toxic. The patient, although bipolar, is also experiencing hallucinations. The lab technician enters the patients room to draw the specimen. The patient begins to shout, I am going to be sucked dry. The nurse enters the patients room and states the following: A. The technician must draw your blood now.

B. Dont worry, we will leave enough for you to live.

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C. Ill stay with you awhile and we can go over todays activities.

D. The technician is here to help you and needs to take your blood in order to a Completion Complete each statement.

44. Your patient describes feeling spiders crawling on his skin rather than seeing spiders. This is an example of a ____________________ hallucination.

45. The nurse tells the schizophrenic patient its time to go to bed. The patient responds with its time for bed, its time for bed, its time for bed. The patients response is an example of ____________________.

Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 46. Which of the following is (are) true about atypical antipsychotics?

(Select all that apply) A. Weak dopamine receptor antagonists B. Strong dopamine receptor antagonists C. Higher risk of extrapyramidal symptoms D. Used to treat negative and positive symptoms of schizophrenia E. Only available in oral form ____ 47. Which of the following are valid nursing interventions in treating schizophrenic patients? (Select all that apply) A. Do not reinforce hallucinations, delusions, or illusions.

B. Provide a stimulating environment for the patient to provide distraction.

C. Keep communication simple.

D. Promote the patients problem-solving skills.

E. Emphasize behavior that is appropriate to the situation.

F. Encourage the patient to confront stressful situations. ____ 48. Antipsychotics are used to treat schizophrenia and other acute psychotic behavior. Typical antipsychotic agents treat these symptoms (select all that apply): A. The negative symptoms of schizophrenia

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B. Hallucinations C. Delusions D. Social Withdrawal E. Suspiciousness ____ 49. Describe the symptoms that appear in drug-induced Parkinsonism (select all that apply): A. Shuffling gait B. Drooling C. Muscle rigidity D. Tremors E. Fatigue and masklike facial expression True/False Indicate whether the statement is true or false. ____ 50. Schizophrenia is caused by a major trauma in childhood.

Chapter 15: Schizophrenia Spectrum and Other Psychotic DisordersSchizophrenia Answer Section MULTIPLE CHOICE 1. ANS: A Olfactory refers to hallucinations involving the sense of smell.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Table 15-3, Recognizing Hallucinations; page 234 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental health concepts 2. ANS: C The classic symptoms include muscle rigidity, tremors, shuffling gait, and restlessness.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Box 15-1, Extrapyramidal Symptoms; page 237 KEY: Integrated Processes: Nursing Process: Assessment | Content Area:

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Mental Health: Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Adverse effects/contraindications/side effects/interactions 3. ANS: A These are the classic signs of paranoid delusions. Response B is associated with depression, response C with general psychotic process, and response D with manic episode.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Table 15-2, Common Delusions; page 234 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 4. ANS: A Concrete thinking is one of the classic symptoms of schizophrenia.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Symptoms; page 233 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 5. ANS: B Late adolescence/young adulthood is the most common age for this diagnosis to be initially made.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Introduction; page 233 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental health concepts 6. ANS: C The response does not get involved in the patients delusion and refocuses on here and now. Response A is communicating that the threat is real to you; response B is not helpful, because the patient will not know why he says that;

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and response D may increase the patients anxiety by promoting isolation.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Nursing Care of the Schizophrenic Patient; page 238 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 7. ANS: A A paranoid delusion is a belief of deliberate harassment and persecution, such as the belief that a stranger wants to kill the patient.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Table 15-2, Common Delusions; page 234 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorder | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 8. ANS: A Neologisms are invented new words that only have meaning to the individual.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Positive Symptoms of Schizophrenia; page 233 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorder | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 9. ANS: C Most schizophrenics require lifelong treatment including medication and their families require extensive support and education to help maintain the patient in society. Recurrence rate after the first psychotic episode is high.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Introduction and Psychiatric Treatment of Schizophrenia; pages 231 and 235 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorder | Cognitive Level: Application | Client

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Need: Psychosocial Integrity: Mental health concepts 10. ANS: B This long-acting antipsychotic is commonly used for treatment of schizophrenia on an outpatient basis when the patient may be noncompliant with the medication regimen.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Psychiatric Treatment of Schizophrenia; page 235 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration as well as expected actions/outcomes 11. ANS: A Hallucinations are a negative sign of schizophrenia. All of the other responses are positive signs.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Symptoms; page 233 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental health concepts 12. ANS: D Haloperidol is one of the oldest antipsychotics and is classified as typical.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Table 15-4, Comparison of Side Effects Among Typical and Atypical Antipsychotic Agents; page 236 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorder | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration as well as expected actions/outcomes 13. ANS: C Reduction in hallucinations is a target symptom that atypical antipsychotics, such as Clozaril, treat. Drowsiness may be a side effect. Responses A and D

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would not be indicative of effectiveness of the medication.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Psychiatric Treatment of Schizophrenia; page 235 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration as well as expected actions/outcomes 14. ANS: A Clozaril has been associated with agranulocytosis, a serious blood disorder that is diagnosed by low white blood cell count.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Psychiatric Treatment of Schizophrenia; page 237 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration and Physiological Integrity: Reduction of risk potential: Laboratory values 15. ANS: C This response acknowledges the distress and supports that the patient has some control over the distress. Responses B and D reinforce the delusion, and response A minimizes her experience.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; General Nursing Interventions; page 238 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 16. ANS: C The patients behavior may be indicative of hearing voices that are creating distress. This response acknowledges the distress. Touching the schizophrenic patient, as in response A, is usually too threatening. Responses B and D both demonstrate inadequate information. Leaving the patient in

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distress alone will increase anxiety. The patient may need an adjustment in medication but would not be your first action.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Table 15-6, Nursing Care Plan; page 239 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 17. ANS: C This response demonstrates acceptance of the patients behavior and also reinforces reality. Response A is not reality based. Responses B and D could be viewed as punitive or embarrassing to the patient.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Table 15-6, Nursing Care Plan of the Schizophrenic Patient; page 239 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 18. ANS: B Carbamazepine is a mood stabilizer that is usually used to treat bipolar disorder. This would not be given to a schizophrenic patient unless she had that additional diagnosis. The other three drugs are all antipsychotics.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Table 15-4, Comparison of side effects among typical and atypical antipsychotic agents | Chapter 12: Bipolar Disorders; Pharmacology Corner; page 196 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration as well as expected actions/outcomes 19. ANS: C Cogentin works as an anticholinergic to reduce EPS. The other medications are not used to treat EPS.

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PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Psychiatric Treatment of Schizophrenia; page 237 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorders: Adult health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration as well as expected actions/outcomes 20. ANS: A Olanzapine is an antipsychotic and weight gain is the most common of these side effects. Orthostatic hypotension and dry mouth occur to a lesser extent and diarrhea is not listed as a side effect.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Table 15-4, Comparison of Side Effects Amongst Typical and Atypical Antipsychotic Agents; page 236 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorders: Adult health: Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration as well as adverse effects/contraindications/side effects/interactions 21. ANS: C This patient may be experiencing torticollisa severe EPS (extrapyramidal symptom) reaction to antipsychotic medication that needs treatment. The physician should be notified to determine if an anticholinergic drug should be given.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Box 15-1, Extrapyramidal Symptoms; page 237 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorders: Adult health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration as well as adverse effects/contraindications/side effects/interactions

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22. ANS: B Tactile hallucinations involve bizarre or unusual perceptions of something touching the skin. Responses C and D are not types of hallucinations. Visual hallucinations are false visual perceptions.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Table 15-3, Recognizing Hallucinations; page 234 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 23. ANS: C Schizophrenics are often unable to think abstractly and tend to make literal interpretations of their environment. This is not normally a characteristic of the other conditions.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Symptoms; page 233-234 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 24. ANS: B Delusions are an example of disturbed thought processes.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Nursing Care of the Schizophrenic Patient; page 238 KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 25. ANS: B This response offers reassurance and assistance. Responses A, C, and D all imply that the patient had control of his behavior.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Nursing Care of the Schizophrenic Patient; page 238

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KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 26. ANS: A Detoxification involves the safe removal of the addictive substance from the body under medical supervision to control withdrawal symptoms. It does not treat the actual addictive behaviors.

PTS: 1 REF: Chapter 15: Substance Use and Addictive Disorders; Pharmacology Corner for Substance Use; page 278 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Substance Abuse | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts: Physiological Integrity: Physiological adaptation: Illness management 27. ANS: A Enabling is another term for codependency. Dual diagnosis is a co-occurring psychiatric disorder. Responses C and D are defense mechanisms.

PTS: 1 REF: Chapter 15: Substance Use and Addictive Disorders; Impact on the family; page 265 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Substance Abuse | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Chemical and other dependencies 28. ANS: B Hallucinations occur in a wide variety of diagnoses and are the result of brain dysfunction. These false sensory perceptions can affect any of the five senses.

Illusions are different, as the stimulus is external.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Schizophrenia: Symptoms; Table 15-3, Recognizing Hallucinations; page 234 and Glossary; page 399 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Sensory/perceptual alterations

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29. ANS: C Hallucinations are real to the patient who could be experiencing a sensory perception of someone in the room even though no one is there. Illusions are misinterpretations of a real external stimulus. Delusions are false beliefs.

Confabulations are creating imaginary events to fill in memory gaps.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; General Nursing Interventions; page 238 and Glossary; page 399 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 30. ANS: A Response A includes the classic schizophrenia symptoms. Bright affect, accuracy of perception, and insight are all characteristics you would not see in the schizophrenic.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Symptoms; page 233 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 31. ANS: C Schizophrenics tend to be challenged in social situations and avoid close relationships. Change is often very challenging. The other responses are common characteristics.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Symptoms; page 233 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 32. ANS: D While all of these responses may be appropriate, the first priority is safety, as you do not know how the patient will respond in this new situation.

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PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; General Nursing Interventions; page 238 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Psychotic disorders and therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 33. ANS: A By focusing gently on reality and then encouraging the participation in the here and now, you are helping this patient stay in reality. The other responses give the impression that you are validating his unrealistic claim.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; General Nursing Interventions; page 238 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Psychotic disorders and therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 34. ANS: B Consistency is a primary intervention. Responses A and C may be too demanding for the patient. Response D may reinforce hallucinations and delusions.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; General Nursing Interventions; page 238 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 35. ANS: B A delusion is a fixed, false belief. Hallucinations refer to altered sensory perceptions and illusions are misinterpretations of real stimuli. Autistic thoughts would not be as organized as this delusion.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders;

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Table 15-2, Common Delusions and Glossary; page 397 KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 36. ANS: D Clozaril may contribute to sedation, so more time must pass before approving driving.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Table 15-4, Comparison of Side Effects Amongst Typical and Atypical Antipsychotic Agents; page 236 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Adverse effects/contraindications/side effects/ interactions 37. ANS: C Haloperidol is one of the older antipsychotics and is categorized as typical.

PTS: 1 REF: Chapter 15: Schizophrenic Spectrum and Other Psychotic Disorders; Table 15-4, Comparison of Side Effects Among Typical and Atypical Antipsychotic Agents; page 236 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration 38. ANS: C Tremors could be a sign of extrapyramidal symptoms. Medications need to be added to treat this to prevent further complications. Dry mouth is a common side effect and would not be a reason to stop taking this drug. The drug has no restrictions on exercise.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Box 15-1, Extrapyramidal Side Effects; page 237 KEY: Integrated Processes: Nursing Process: Analysis | Content Area:

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Mental Health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration and adverse effects/contraindications/side effects/interactions 39. ANS: B Auditory hallucinations telling a patient to harm herself require immediate intervention for safety, which would include suicide precautions so she is not left unsupervised. Distraction, determining past behavior, or challenging her thinking are not appropriate in this serious situation.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; General Nursing Interventions; page 238 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic environment 40. ANS: B This response acknowledges the patients distress, describes reality, and then focuses on other behaviors. Response A is reality based, but it devalues the patients view of reality. Response C is reinforcing the presence of spiders.

Response D is punishing the patient for his psychosis.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Table 15-7, Suggested Interventions for Patients with Schizophrenia Who Are Hallucinating; page 240 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Therapeutic communication and psychotic disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 41. ANS: C Chlorpromazine is an effective medication for positive symptoms of schizophrenia such as hallucinations. Elimination of the voices would be a sign of effective action of this drug.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders;

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Pharmacology Corner; page 235 KEY: Integrated Processes: Nursing Process: Evaluation | Content Area: Mental Health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration 42. ANS: C This response is reality based, lets the patient know you heard her, and then directs attention to a new plate of food. There is a difference in meaning between I see no bugs from no, those arent bugs. Response C acknowledges the patient experience rather than denying it.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Table 15-7, Suggested Interventions for Patients with Schizophrenia Who Are Hallucinating; page 240 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 43. ANS: C Reduce the patients anxiety first. Then proceed with attempting the blood draw.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; General Nursing Interventions; page 238 KEY: Integrated Processes: Caring | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental Health Concepts COMPLETION 44. ANS: tactile Tactile hallucination involves the sense of touch.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Table 15-3, Recognizing Hallucinations; page 234 KEY: Integrated Processes: Nursing Process: Analysis | Content Area:

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Mental Health: Psychotic disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 45. ANS: echolalia This is a symptom seen in schizophrenia where the patient repeats words over and over.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; page 234 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts MULTIPLE RESPONSE 46. ANS: A, D Atypicals are newer antipsychotics that are weak dopamine receptor antagonists which lead to a milder side effect profile and less extrapyramidal symptoms. They treat both positive and negative symptoms and some formulations are available in long-acting injectable forms.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Psychiatric Treatment of Schizophrenia; page 235 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration and adverse effects/contraindications/side effects/interactions 47. ANS: A, C, E These responses reinforce reality without creating more stress for the patient, which would be the case in promoting more stimulation, problem solving, and confrontation.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; General Nursing Interventions; page 238 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Application |

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Client Need: Psychosocial Integrity: Therapeutic communication 48. ANS: B, C, E Typical antipsychotic agents treat the positive symptoms of schizophrenia. Positive symptoms are those that are found among people with schizophrenia but not present among those who do not have the disorder.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Symptoms; page 233 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Psychotic Disorders | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies; Expected actions/outcomes 49. ANS: A, B, C, D, E These are major symptoms manifested in Parkinsonism, which can be a side effect of anti psychotic medications.

PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Box 15-1, Extrapyramidal Side Effects; page 237 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Adverse Effects/Contraindications/Side Effects/Interactions TRUE/FALSE 50. ANS: F Schizophrenia is now known to be brain disorder and unrelated to the individuals personal experiences.

Integrated Process: Teaching/Learning | Content Area: Mental Health: Psychotic Disorders | Cognitive Level: Knowledge | Client Needs: Psychosocial Integrity: Mental Health Concepts Ref. Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders: Etiology; page 234 PTS: 1 REF: Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders; Etiology; page 234

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KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Psychotic Disorders | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental Health Concepts

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Chapter 16: Neurocognitive Disorders: Delirium and Dementia My Nursing Test Banks Chapter 16: Neurocognitive Disorders: Delirium and Dementia Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Your patient with advanced Alzheimers disease keeps searching the unit for her mother who died many years ago. How should you respond?

A. Your mother isnt hereshe died long ago.

B. Lets go to the activity room and see whats going on.

C. You must be upset that you cant find her.

D. What makes you keep looking for your mother? ____ 2. Your patient is diagnosed with delirium. He is awake most of the night and becomes increasingly confused. Which is the best initial intervention?

A. Keep the television on to provide stimulation.

B. Give him a sleeping pill.

C. Keep a night light on in the room and turn off the television.

D. Keep the lights on in the room. ____ 3. Your patient is on donepezil HCL. This tells you your patient has which disorder?

A. Dementia B. Obsessive-compulsive disorder C. Major depression D. Delirium ____ 4. Team members working with patients who have dementia need to have a common, unified approach because this type of patient requires: A. Sameness and consistency in their lives.

B. Strict rules and regulations.

C. Behavior modification at all times.

D. Staff who cannot be manipulated.

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____ 5. When preparing a care plan for a patient with a diagnosis of dementia, the nurse will: A. Increase mental and physical stimulus to improve mental function.

B. State five current events from todays newspaper.

C. Maintain consistent daily routines.

D. Encourage the patient to discuss memories from his or her childhood. ____ 6. The best way to assist a patient who has mild Alzheimers disease is to: A. Ask the physician to keep the patient sedated to avoid acting out behaviors.

Provide strict one-on-one behavior modification techniques to prevent furthe B. deterioration.

C. Encourage the family to begin preparations to move the person to a skilled n D. Provide a stable, safe, and consistent environment. ____ 7. Nurses recognize that the main cause for Alzheimers disease is: A. Unknown at this time.

B. Genetic.

C. Related to use of aluminum cookware.

D. Long-term alcohol use. ____ 8. A person who is receiving tests to confirm a diagnosis of Alzheimers disease is preparing for a computerized tomography (CT) test. The patient becomes restless and is unable to follow the pre-examination directions given by the personnel. As the nurse who is assisting the patient, your best action at this time is to: A. Tell the patient that refusing to cooperate will require having to return anoth B. Give the patient the written instructions.

C. Take the patient to a quiet waiting area until it is time for the CT scan.

D. Make certain that the patient is tightly strapped to the examination table duri ____ 9. Your new patient is admitted to your nursing home with a diagnosis of vascular dementia. You know that this type of dementia differs from Alzheimers dementia is what way?

A. The progression of symptoms is predictable based on the persons heart disea B. The progression of symptoms is more variable than Alzheimers disease.

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Vascular dementia can be treated successfully with surgery compared to Alz where there is no surgical treatment.

D. Vascular dementia is temporary and Alzheimers dementia is permanent. ____ 10. You are working with a patient who has dementia. The patient becomes withdrawn and negative. Your most therapeutic response to this patient is: A. Your family will feel very bad if you do not get along here!

B. Your doctor has ordered you to attend at least two activities each day.

C. Would you prefer to stay alone in your room?

D. I need a partner to play cards with. ____ 11. Mavis Brown is a 75-year-old patient in your nursing home. She has Alzheimers disease. Mavis comes to you at the desk one day and is crying.

She says, You all hate me. Everyone hates me! Your therapeutic reply is: A. Nobody here hates you, Mavis.

B. Why do you feel hated, Mavis?

C. You seem upset, Mavis. Lets go for a walk and talk.

D. Its time for your medication, Mavis. ____ 12. Henry Smith is 88 years old and has been having periods of disorientation and confusion that worsen at night. He has been given a diagnosis of Alzheimers disease. When you pick up Henrys tray after supper, you observe that he has not touched any of the food. As his nurse, you understand that the most likely cause of his not eating is: A. He is too depressed to eat.

B. He sees ants in his food.

C. He is too forgetful to remember to eat.

D. He is deliberately obstinate. ____ 13. Henry Smith may be suffering from sundowning. What is the alternate name for this condition?

A. Nocturnal delirium B. Vascular dementia C. Pseudodementia D. Neurocognitive confusion C.

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____ 14. Which of the following activities would be most appropriate for a patient who is in the moderate stage of Alzheimers disease?

A. A large jigsaw puzzle B. Trivial Pursuit C. A scavenger hunt D. Playing a game of catch with a soft ball ____ 15. When planning interventions for a patient who has Alzheimers disease, the nurse knows that patients with this disorder: A. Should be able to remember teaching that was done yesterday.

B. Will most likely havememory impairment particularly for recent events.

Will most likely continue to be able to perform activities of daily living like C. grooming.

D. The disease often stabilizes at one level. ____ 16. Aricept is a medication used to treat which condition(s)?

A. Delirium only B. Dementia only C. Delirium and dementia D. Pseudodementia ____ 17. Pharmacological treatment of delirium is most likely to include which medication?

A. Antidepressants B. Tranquilizers C. Antipsychotics D. Stimulants ____ 18. Which statement best describes pseudodementia?

A. Schizophrenia in the elderly.

B. Depression in the elderly that looks like dementia.

C. Substance abuse related delirium that looks like dementia.

D. Autism in children that mimics dementia. ____ 19. Andreas mother has been becoming more and more forgetful. It seems to have gotten worse over the past 15 years. Her most likely diagnosis could be:

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A. Depression.

B. Alzheimers Disease.

C. Hyperthyroidism.

D. Delirium.

Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 20. Of the following, which one(s) are part of an effective care plan for someone with advanced dementia? (Select all that apply) A. Keep the patient busy with structured activities.

B. Keep televisions and radios on whenever possible to encourage patient inter C. Allow more time for performing care.

D. Emphasize reality orientation.

E. Encourage independent decision making.

F. Provide group therapy opportunities to share feelings and problems. ____ 21. Which of the following are characteristics of delirium? (Select all that apply) A. Slow onset B. Sudden onset C. Fluctuating mental status D. Treatment is focused on finding the cause E. Progressive decline common despite treatment F. Can be caused by psychological stress G. Treatment the same no matter what the cause H. Consistent pattern of decline True/False Indicate whether the statement is true or false. ____ 22. All dementias are a form of Alzheimers disease.

Chapter 16: Neurocognitive Disorders: Delirium and Dementia Answer Section MULTIPLE CHOICE 1. ANS: B

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With advanced Alzheimers disease, reorientation is often ineffective because the patient will not remember. Open-ended questions are also less effective.

Response B uses distraction to refocus the patients attention on the here and now.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; General Nursing Interventions; page 254-255 KEY: Integrated Processes: Implementation | Content Area: Mental Health: Cognitive disorder | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 2. ANS: C Reducing stimulating sounds and providing some light to keep him oriented to his surroundings is the best initial intervention. A sleeping pill can add to confusion.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; General Nursing Interventions; page 254 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Cognitive disorder | Cognitive Level: Application | Client Need: Psychosocial Integrity: Sensory/perceptual alterations 3. ANS: A This drug is Aricept and is a major treatment for dementia.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Table 16-4 Cholinesterase Inhibitors; page 252 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Geriatrics: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration 4. ANS: A Consistency is important when short-term memory is limited. The patient can count on that approach even when he or she cant remember details. Strict rules and behavior modification arent useful when the short-term memory is impaired. These patients are not using manipulation, again, due to poor

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memory.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Nursing Care of Patients With Delirium and Dementia; page 254 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Cognitive disorder | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts: Therapeutic environment 5. ANS: C Consistency is effective for all types of dementias to reduce anxiety and promote participation in the care plan. Stimulating the patient to do mental functions such as reviewing current events, or discussing memories may create more anxiety.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Nursing Care of Patients With Delirium and Dementia; page 254 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Cognitive disorder | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts: Therapeutic environment 6. ANS: D A stable, consistent environment will give the patient cues to maintain participation and orientation. Response A is a chemical restraint and is never appropriate. Behavior medication is generally ineffective with cognitive deterioration if the person cannot remember the rewards. Though the family may be thinking about future plans, it is too early for placement.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Nursing Care of Patients With Delirium and Dementia; page 254 KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Therapeutic Nursing Process | Cognitive Level: Comprehension | Client Need: Safe and Effective Care Environment: Coordinated Care 7. ANS: A

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Though extensive research is being conducted in a number of areas, no clear cause has been identified.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Alzheimers disease; page 248 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Cognitive disorders | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance 8. ANS: C Rather than flood the patient with a lot of information or demands, it is more important to create a calm environment to reduce the patients fear of the unknown.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Nursing Care of Patients With Delirium and Dementia; page 254 KEY: Integrated Processes: Nursing Process: Analysis/implementation | Content Area: Mental Health: Cognitive disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic environment and communication 9. ANS: B Vascular dementias progression depends on the recurrence of new strokes. It can be stable for long periods if there are no strokes. The progression is not predictable, there is no surgical treatment for this type of dementia, and the damage that is done is permanent.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Other Forms of Dementia; page 252 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Cognitive disorders | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance 10. ANS: D Distracting the patient to another activity is a positive way to change a behavior rather than promoting guilt.

PTS: 1

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REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Nursing Care of Patients With Delirium and Dementia; page 254-255 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Cognitive disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 11. ANS: C This response acknowledges her feelings but uses an activity to distract her rather than focus on analyzing the cause, which she does not know.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Nursing Care of Patients With Delirium and Dementia; page 254-255 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Cognitive disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 12. ANS: C Memory loss can lead to forgetting to perform daily, routine functions like eating. This is the most likely cause.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Box 16-1, Symptoms of Alzheimers Disease; page 248 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Cognitive disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 13. ANS: A Nocturnal delirium is increased agitation and confusion at dusk.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Delirium; page 245 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Cognitive disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 14. ANS: D The other responses require concentration and memory. Physical activity can improve mood and does not put stress on the patient to concentrate.

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PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Nursing Care of Patients With Delirium and Dementia; page 254-255 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Cognitive disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication and environment 15. ANS: B All interventions for Alzheimers patients must incorporate the understanding that memory impairment especially for recent events will impact all aspects of the patients activities. Alzheimers is a progressive deterioration.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Box 16-1, Symptoms of Alzheimers Disease; page 248 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Cognitive disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 16. ANS: B Aricept has been approved for the treatment of Alzheimers type dementia not delirium or pseudodementia.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Pharmacology Corner for Dementia; page 251 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology and geriatrics: Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration 17. ANS: C Using antipsychotic medications to treat delirium has some risk because they can exacerbate symptoms, but the most commonly used are low-dose antipsychotics if the patient is agitated.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Pharmacology Corner for Delirium; page 246 KEY: Integrated Processes: Nursing Process: Implementation | Content Area:

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Mental Health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration 18. ANS: B Depressive symptoms in the elderly such as forgetfulness, withdrawal, and lack of involvement in life can be confused with early dementia.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Dementia; page 247 and Glossary; page 402 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Cognitive disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 19. ANS: B Alzheimers is a slow, progressive form of dementia where deterioration is expected consistently over many years.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Nursing Care of Patients with Delirium and Dementia; page 254 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Cognitive disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication and environment MULTIPLE RESPONSE 20. ANS: A, C B, D, E, and F incorporate added stimulation that can increase the stress level of a patient with impaired memory.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Table 16-5 Characteristics of Delirium and Dementia; page 254 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Cognitive disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 21. ANS: B, C, D, F Delirium is characterized by sudden onset and fluctuating mental status.

Treating the cause such as dehydration and electrolyte imbalance often

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improves symptoms. Psychological stress can contribute to delirium.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Alzheimers disease; page 248 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Cognitive Disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental Health Concepts TRUE/FALSE 22. ANS: F Alzheimers disease is a specific type of dementia. There are several other types not considered to be Alzheimers disease.

PTS: 1 REF: Chapter 16: Neurocognitive Disorders: Delirium and Dementia; Dementia; page 247 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Cognitive disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

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Chapter 17: Substance Use and Addictive Disorders My Nursing Test Banks Chapter 17: Substance Use and Addictive Disorders Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Poor impulse control, rapid speech, and hypertension are most characteristic of abusing which substance?

A. Alcohol B. Heroin C. Cocaine D. LSD ____ 2. A new patient with a history of alcoholism is in the ER with agitation, vomiting, and tremors. He tells you he had his last drink 24 hours ago. Which medication would most likely be ordered?

A. Chlordiazepoxide B. Disulfiram C. Chlorpromazine D. Naloxone hydrochloride ____ 3. Your patient has a long history of alcohol abuse. You know that denial is a frequently used defense mechanism. Which statement is indicative of denial?

A. My father was a drinker so I guess that led me to this.

B. I can stop anytime I want, I just dont feel like it now.

C. Drinking calms my nerves.

D. I drink when my kids upset me. ____ 4. Which of the following statements from an alcoholic patient reflects a good understanding of his or her condition?

A. I will stick to wine or beer from now on.

B. Ill be OK if my wife will just stop nagging me.

C. I plan to take my sobriety 1 day at a time.

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D. I wont need AA after I am sober for 1 year. ____ 5. Your 42-year-old patient in the alcohol treatment unit tells you he often cant remember events while he was drinking. What is this most likely an example of?

A. Denial B. Blackouts C. Psychosis D. Depression ____ 6. A teenager admits to you that he has been smoking marijuana. The nurse knows that marijuana is a(n): A. Cannabinol.

B. Amphetamine.

C. Hallucinogen.

D. Narcotic. ____ 7. Which drug cannot be given if the patient reports alcohol intake in the last 24 hours?

A. Chlorpromazine B. Chlordiazepoxide C. Disulfiram D. Risperidone ____ 8. Your patient in the ER waiting room is inebriated. He becomes increasingly loud and abusive while waiting to be seen. What would be the best intervention for the nurse?

A. Tell him he has to wait his turn, as others were here first.

B. Inform him he will be asked to leave if this behavior continues.

C. Offer to take him to an exam room to wait for the doctor.

D. Do nothing, as he is still in the waiting room. ____ 9. Your patient tells you her husband has a serious drinking problem.

Which statement tells you she may be in a codependent relationship?

A. Ive reached my limit with his drinking.

B. I called his job and told them he was sick when he couldnt go to work.

C. The kids are ashamed of their father. I feel bad about that.

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D. He is drinking less this week. ____ 10. What should be your response to the wife who says, I should get out of this bad situation with his drinking?

A. That happened to me. Its best to get out while you can.

B. Tell me more about the bad situation.

C. Why dont you talk to your husband about his drinking?

D. Youll do whats right. ____ 11. Your new patient is at risk for alcohol withdrawal. You know that alcohol withdrawal tends to develop within what period after the last drink?

A. 1 week B. 24 to 48 hours C. 1 hour D. More than 1 week ____ 12. The wife of your alcoholic patient has been attending Al-Anon meetings for the past 2 weeks. Which statement tells you the wife is benefitting from the meetings?

A. I can tolerate his destructive behavior now that I see how bad other women h B. I realize that I provoke his drinking when I go out with my friends.

C. I no longer feel that I have to tolerate his berating me.

D. It is great to get out of the house and away from the tension. ____ 13. Which of the following are signs of withdrawal from heroin?

A. Insomnia, muscle cramps, vomiting B. Excessive sleeping, low blood pressure, depression C. Seizures, brain damage, excessive sleeping D. Lethargy, panic disorder, increased appetite ____ 14. Mr. Thomas, who is 50 years old, is being treated for pneumonia and dehydration. He has a history of alcoholism and admits to starting to drink heavily again. He tells you, Im a horrible person. My family deserves someone better than me to care for them. Your most therapeutic response to him is: It sounds as though you are feeling guilty about drinking, Mr. Thomas.

A. you mean by that.

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B. Why do you say that, Mr. Thomas?

C. Im sure that your family is satisfied, Mr. Thomas.

D. Your drinking doesnt sound that serious. ____ 15. You are caring for a patient who has a long history of alcohol abuse.

Recently, this patient went on a 5-day drinking binge, of which she has no memory. This is an example of: A. Selective memory.

B. Wernickes syndrome.

C. Blackout.

D. Denial. ____ 16. Nurses understand that in people who are addicted to alcohol, the person who is most responsible for the patients recovery is the: A. Psychiatrist.

B. Nurse.

C. AA sponsor.

D. Patient. ____ 17. You are socializing with a group of nurses who you work with on a routine basis. Terri is getting very loud and tells you that she usually has six or eight beers most evenings. She is defensive about your reaction to the amount of alcohol she consumes. She says, I have days where I cant remember what happened the night before, sure, but only once in a while. If you were Terris friend, the best action you could suggest to her would be: A. Maybe you should stop at four beers, Terri.

B. I wont tell your husband what you told me.

It sounds to me like your drinking is getting out of control. I cant continue to C. if you continue to drink this much.

D. Terri, I will call AA for you when you are ready. ____ 18. Randi is a young model. She had been taking high doses of amphetamines to keep her weight down. She recently decided to cut back on the drugs and she is now experiencing amphetamine withdrawal. She presented to the clinic with which of the following sets of symptoms of amphetamine withdrawal?

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A. Chest pain, palpitations, and diaphoresis B. Depression, vivid dreams, and confusion C. Euphoria, hyperactivity, and hyperalertness D. Diaphoresis, clammy palms, and diarrhea ____ 19. A young adult arrives in the after-hours clinic with dilated pupils, an elevated heart rate, extreme sensitivity to sounds around him, sense of being outside of his body, and fine tremors of the hands. The patient admits to recent use of an illegal street drug. As the nurse collecting this data, you suspect: A. LSD. B. Crack cocaine.

C. Amphetamines.

D. Downers. ____ 20. Alcohol is a(n): A. Central nervous system (CNS) stimulant.

B. CNS depressant.

C. Antipsychotic.

D. Antidepressant. ____ 21. You are caring for a female patient who is a long-term alcoholic.

She screams, Get the bugs off of my skin. I feel them all over my body! Get them off! She is experiencing what type of hallucination?

A. Auditory B. Visual C. Taste D. Tactile ____ 22. A 35-year-old male patient signs in as a voluntary commitment for treatment for drug abuse. He strongly maintains that he does not have a problem and states, Im only here because my boss threatened to fire me if I didnt come in. The best nursing response to this patient is: A. I wonder why your boss said that, if you dont have a problem.

B. What happened that your boss threatened to fire you?

C. Your boss sounds pretty harsh!

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D. Well, you are here on your own, so you can leave whenever you want to. ____ 23. A patient has completed treatment for alcoholism. If treatment was successful, a nurse might expect which of the following outcome statements from this patient upon discharge?

A. Now, if my family will just be good, I wont be back!

B. I just know I can have an occasional drink and be fine. I know how to handl I realize that Alcoholics Anonymous will always be a requirement.

C. sobriety.

D. I am so glad I found out what my problem is. I am cured now! ____ 24. Which of the following is a club drug?

A. Rohypnal B. Crack C. Placidyl D. Angel dust Completion Complete each statement.

25. You are completing the discharge plan for an alcoholic patient. Which support group should be included in the plan? ___________________ Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 26. You find out that your schizophrenic patient is also using opioids to counteract the frightening hallucinations. What term(s) is used to describe this? (Select all that apply) A. Dual diagnosis B. Bipolar schizophrenia C. Co-occurring disorder D. Opioid-related schizophrenia E. Schizophrenia: Addiction type ____ 27. Which of the following are true about Alcoholics Anonymous?

(Select all that apply) A. A physician referral is needed.

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B. Family and friends are encouraged to attend the regular meetings with the al C. No last names are used at the meetings.

D. The group for family members is Al-Anon.

E. Offshoots such as Narcotics Anonymous follow a different philosophy.

F. The individual is encouraged to admit he or she is powerless over alcohol.

Chapter 17: Substance Use and Addictive Disorders Answer Section MULTIPLE CHOICE 1. ANS: C These three symptoms are common with a stimulant such as cocaine. They could occur with the other substances but are not the hallmark symptoms.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Table 17-3, Comparing Commonly Abused Substances; page 272 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Substance Abuse | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Chemical and other dependencies 2. ANS: A This medication is often initially used to treat alcohol withdrawal symptoms.

Response B is a treatment for alcoholism not withdrawal. Response C is an antipsychotic and response D is used in opioid addiction.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Table 17-2, Commonly Used Medications for Withdrawal Management; page 270 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Substance Abuse | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Chemical and other dependencies 3. ANS: B This response indicates the person is minimizing or not acknowledging that he or she has a problem. In the other responses the patient is acknowledging drinking but rationalizing the causes.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Table 17-4, Common Coping Styles of Substance Abusers; page 279

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KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Substance Abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Coping mechanisms 4. ANS: C Responses A, B, and D all reinforce use of ineffective defense mechanisms, including denial, rationalization, and minimization. Response C reflects understanding of the disease as a lifelong struggle.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Table 17-4, Common Coping Styles of Substance Abusers; page 279 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Substance Abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 5. ANS: B Blackouts are gaps in memory that are symptomatic of advanced alcoholism.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Alcohol; Early Signs of Serious Problems With Alcohol; page 264 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Substance Abuse | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 6. ANS: A Marijuana is a cannabinol. It is not a narcotic or an amphetamine.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Table 17-3, Comparing Commonly Abused Substances; page 271 KEY: Integrated Processes: Analysis | Content Area: Adolescent: Substance abuse | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Chemical and other dependencies 7. ANS: C Disulfiram (Antabuse) is used to treat alcoholism by producing severe adverse effects in the presence of alcohol. Responses A and D are antipsychotics, and response B is an antianxiety medication used to treat alcohol withdrawal.

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PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Pharmacology Corner for Alcohol; page 269 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Substance Abuse: Adult health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration and adverse effects/contraindications/side effects/interactions 8. ANS: C This response supports a safe environment for this patient, the other patients, visitors, and staff. Ignoring him will escalate the situation. Because his judgment is impaired, trying to reason with him will be unsuccessful.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Table 17-5, Problems with substance abuse: Symptoms and nursing interventions; page 280 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Substance Abuse: Mental health: Therapeutic nursing process | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 9. ANS: B This response shows that the wife is covering for her husband so he doesnt have to take responsibility for his actions. Response D is more denial.

Responses A and C are indications of facing the reality of this situation.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Table 17-5, Problems With Substance Abuse: Symptoms and Nursing Interventions; page 280 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Substance Abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Family dynamics, chemical and other dependencies 10. ANS: B Supporting problem solving and helping her express herself is most important. Response A is advice giving, which is not appropriate. You dont

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have enough information to know if response C or D is correct.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Table 17-5, Problems With Substance Abuse: Symptoms and Nursing Interventions; page 280 KEY: Integrated Processes: Nursing Process: Analysis/implementation | Content Area: Substance Abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication; chemical and other dependencies 11. ANS: B Withdrawal symptoms in a heavy drinker generally begin within 24 to 48 hours after the last drink, although they can occur as early as 8 hours after the last drink.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Withdrawal; page 267 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Substance Abuse | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Reduction of risk potential: Potential for alterations in body systems 12. ANS: C This is the healthiest response that she is not accepting a victim role. In response A she continues to accept his bad behavior. In response B she is taking responsibility for his drinking, which is codependent. Response D views the meetings as escape rather than a place to work on issues.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Table 17-5, Problems With Substance Abuse: Symptoms and Nursing Interventions; page 280 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Substance Abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Chemical and other dependencies: Coping mechanisms 13. ANS: A These are classic symptoms along with irritability, rhinorrhea, and chills.

PTS: 1

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REF: Chapter 17: Substance Use and Addictive Disorders; Table 17-3, Comparing Commonly Abused Substances; page 273 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Substance Abuse | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Chemical and other dependencies 14. ANS: A Response A is an open-ended statement to help him identify his feelings and encourage further exploration. Response B asks for him to understand why he feels this way and he may not know. Responses C and D reinforce denial.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Table 17-5, Problems with substance abuse: Symptoms and nursing interventions; page 280 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Substance Abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 15. ANS: C Blackouts are indications of advanced alcoholism when the person has no memory of recent events.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Alcohol; page 265 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Substance Abuse | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Physiological adaptation: Illness management 16. ANS: D Taking personal responsibility for the misuse of alcohol and the distress it has caused others is key to beginning recovery. It is the basis of Alcoholics Anonymous. Blaming others for ones problem may be an initial coping mechanism.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Table 17-1, The Twelve Steps and Twelve Traditions of Alcoholics Anonymous; page 268 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Substance Abuse | Cognitive Level: Comprehension | Client Need:

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Psychosocial Integrity: Mental health concepts 17. ANS: C Response C is reality based and avoids any enabling behavior that reinforce/support her drinking. The other responses are enabling.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Table 17-5, Problems With Substance Abuse: Symptoms and Nursing Interventions; pagae 280 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Substance Abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 18. ANS: B Withdrawal symptoms also include insomnia and lethargy.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Table 17-3, Comparing Commonly Abused Substances; page 271 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Substance Abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Chemical and other dependencies 19. ANS: A Hallucinogenics like LSD produce a sense of enhanced perception of the environment, which can contribute to a sense of depersonalization and panic.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Table 17-3, Comparing Commonly Abused Substances; page 272 KEY: Integrated Processes: Analysis | Content Area: Substance Abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Chemical and other dependencies 20. ANS: B Though the initial reaction may be more like a stimulant, it is a CNS depressant.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Alcohol; page 264 KEY: Integrated Processes: Nursing Process: Analysis | Content Area:

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Substance Abuse | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Chemical and other dependencies 21. ANS: D Tactile hallucinations are false perceptions of the sense of touch that often are described as something crawling on or under ones skin. Tactile hallucinations can occur as part of delirium tremens from long-term alcohol use and withdrawal.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Alcohol; Alcohol Withdrawal; page 267 | Chapter 15: Schizophrenia Spectrum and other psychotic disorders; Table 15-3 Recognized Hallucinations; page 234 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Substance Abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Chemical and other dependencies and Physiological Integrity: Physiological adaptation: Medical emergencies 22. ANS: B This response asks the patient to focus on reality rather than blaming others.

This is the best response to challenge the probable denial.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Table 17-5, Problems With Substance Abuse: Symptoms and Nursing Interventions; page 280-1 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Substance Abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 23. ANS: C This response indicates the patient understands his or her personal responsibility to stay sober. The other responses show a lack of understanding that alcoholism is a lifelong disorder and that it is not caused by family problems.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Table 17-5, Problems With Substance Abuse: Symptoms and Nursing Interventions; page 280

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KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Substance Abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Chemical and other dependencies 24. ANS: A Rohypnal along with Ecstasy create disinhibition and amnesia.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Table 17-3, Comparing Commonly Abused Substances; page 275 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Substance Abuse | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Chemical and other dependencies COMPLETION 25. ANS: Alcoholics Anonymous Alcoholics Anonymous is the most accepted support group widely available throughout the world.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Treatment of Alcoholism; page 267 KEY: Integrated Processes: Teaching/Learning | Content Area: Substance Abuse | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Chemical and other dependencies MULTIPLE RESPONSE 26. ANS: A, C Dual diagnosis, also known as co-occurring disorder, is very common in people with psychiatric disorders who self-medicate for uncomfortable symptoms.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Introduction; page 262 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Psychotic disorders and substance abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Coping mechanisms and Physiological Integrity: Pharmacological and parenteral therapies: Adverse effects/contraindications/side effects/interactions

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27. ANS: C, D, F One of the strengths of this program is its anonymity, so last names are never used and meetings are closed. Admitting powerlessness over the substance abused is key to making progress.

PTS: 1 REF: Chapter 17: Substance Use and Addictive Disorders; Treatment of Alcoholism; page 267-268 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Substance Abuse | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

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Chapter 18: Eating Disorders My Nursing Test Banks

Chapter 18: Eating Disorders Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Which of the following are generally NOT associated with bulimia nervosa?

A. Starvation B. Depression C. Erosion of teeth D. Sore throat ____ 2. Which statement is most true about anorexia nervosa?

A. It is only found in females.

B. A major symptom is loss of appetite.

C. Overuse of laxatives is a common symptom.

D. All of the above ____ 3. Your patient with anorexia nervosa is in the bathroom running in place at a rapid rate. What is the most likely reason for this behavior?

A. She recently ate and wants to work off the calories to avoid gaining weight.

B. She wants her heart rate increased so you will think she is having heart prob C. She is a regular exerciser for good health.

D. She is depressed and hopes this will make her feel more alert. ____ 4. How should you respond to the above patient?

A. Encourage her to finish her exercise session.

B. Interrupt her and have her weighed immediately.

C. Tell her she is not allowed to exercise.

D. Interrupt her and encourage her to take a walk with you. ____ 5. Which of the following is NOT a characteristic of a patient with anorexia nervosa?

A. Male B. Slightly overweight

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C. Anxious D. Perfectionistic ____ 6. Which of the following interventions applies to all eating disorders?

A. Encourage patients to identify the thoughts and feelings associated with eati B. Do a strict intake, output, and calorie count for each shift.

C. Keep patients in view for 1 to 2 hours after meals.

D. Have a staff person monitoring each table during meals. ____ 7. Your first goal in the care of a patient with an eating disorder is: A. Reassure the patient that he or she is attractive.

B. Teach the patient nutrition requirements for his or her age and height.

C. Establish a trusting relationship with the patient.

D. Ask the patient to explain why he or she will not eat. ____ 8. An appropriate goal for a patient who is on behavior modification for anorexia nervosa is: A. Gain 2 pounds per week.

B. Eat all food at each meal.

C. Discuss the meaning of food to the patient for 1 hour every day.

Gain as much weight as possible in the first month of treatment to prevent se D. of starvation. ____ 9. Mark is a male model who has been admitted for weight loss and dehydration. Mark tells you, I can eat anything I want and I dont gain weight.

Isnt that great? After dinner you hear a noise and you observe Mark vomiting in the bathroom. You document this and suspect: A. Food poisoning.

B. Anorexia nervosa.

C. Bulimia nervosa.

D. Bipolar disorder. ____ 10. Nurses know that the main difference between anorexia nervosa and bulimia nervosa is that the patient with bulimia nervosa: A. Is morbidly obese.

B. Eats and purges in secret to keep the problem hidden.

C. Gets pleasure from being able to control the urge to eat.

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D. Meal time is more stressful. ____ 11. A 14-year-old patient is diagnosed with anorexia nervosa. Nurses know this disorder is most associated with: A. Poor parenting.

B. Anger at parents.

C. Low self-esteem.

D. Distorted body image. ____ 12. Rob, a 15-year-old, has lost 30 pounds in 3 months. Rob is 6 feet tall and weighs 110 pounds. He is aspiring to be a model and he tells you that he is fat: Just look at how puffy my feet and arms still are. I have to get rid of the fat there. The nursing diagnosis based on this information is: A. Body image disturbance: distorted perception.

B. Knowledge deficit: nutritional requirements.

C. Altered nutrition, more than body requirements.

D. Potential for suicide. ____ 13. Nurses realize the importance of family relationships in the life of a patient with anorexia nervosa. As a nurse, you would expect which of the following attitudes or behaviors in the parents of an adolescent with anorexia nervosa?

A. Indifferent and inattentive B. Permissive and providing loose boundaries C. Immature and concerned with themselves D. Perfectionistic and overly demanding ____ 14. When preparing a therapeutic milieu for a patient who has bulimia nervosa, the nurse should provide: A. Realistic limits and guidelines on behavior after eating.

B. A strict regimen of activities to ease the patients anxiety.

C. Constant focus on the correct type and amount of food to instill adequate nu D. Sympathy for the patients condition. ____ 15. A 15-year-old female is 15 pounds underweight. She believes she is grossly overweight and exercises vigorously daily. She is a straight-A student in school and is the lead singer in her school choir and musical theater group.

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She is well liked by adults but has few friends her own age. Your nursing assessment of this patient leads you to the potential diagnosis of: A. Social anxiety disorder.

B. Paranoid schizophrenia.

C. Generalized anxiety disorder.

D. Eating disorder. ____ 16. In addition to gastrointestinal disorders associated with eating disorders, nurses must be aware of and assess for other medical complications including: A. Electrolyte imbalances.

B. Cardiac irregularities.

C. Dehydration.

D. All of the above. ____ 17. Ana is admitted to the medical surgical floor for severe weight loss.

Her diagnosis is anorexia nervosa. She is 16 and looks about 8. Her daily intake is about eight cans of diet soda. Your initial nursing goal is: A. Establish trust.

B. Request nutritional supplements from Dietary.

C. Explore with her the rationale for refusing to eat.

D. B and C ____ 18. As a nurse, you understand that anorexia nervosa in adolescents may be related to: A. Poor self-esteem.

B. Fear of moving into adulthood.

C. Anger at parents.

D. A desire to die. ____ 19. Morbid obesity is defined as: A. Body weight over 200 pounds no matter how tall the person is.

B. Body mass index (BMI) over 30.

C. Whatever is determined by the individuals physician.

D. BMI over 35. ____ 20. What do the initials BMI stand for?

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A. Basal metabolic inhibitor B. Body mass index C. Bodys metabolic index D. Basic mass indicator ____ 21. Bariatric surgery is now an accepted treatment for people with which of the following?

A. Poor body image B. BMI over 40 C. Untreatable bulimia D. BMI of 25 with diabetes ____ 22. Of the following observations, which is the most objective measure of improvement in your patient with anorexia nervosa?

A. She eats all of her food on the tray at lunch.

B. She gains 2 pounds from last week.

C. She weighs herself daily.

D. She tells you her friends are bringing her special foods.

Chapter 18: Eating Disorders Answer Section MULTIPLE CHOICE 1. ANS: A Starvation is associated with anorexia nervosa. In bulimia nervosa, the patient is eating large amounts and then purging.

PTS: 1 REF: Chapter 18: Eating Disorders; Box 18-2, Behaviors, Signs, and Symptoms of Bulimia; page 291 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 2. ANS: C Laxative abuse is often part of purging behaviors to promote weight loss. The disorder is found in men, and patients are often hungry while denying themselves food.

PTS: 1 REF: Chapter 18: Eating Disorders; Anorexia Nervosa; page 287-288

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KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental health concepts 3. ANS: A Excessive exercise is a common behavior used by anorexics to purge calories after eating.

PTS: 1 REF: Chapter 18: Eating Disorders; Box 18-1, Behaviors, Signs and Symptoms of anorexia nervosa; page 288 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 4. ANS: D Excessive exercise is not healthy in this patient. By encouraging her to walk with you, you are distracting her from this compulsion to exercise.

PTS: 1 REF: Chapter 18: Eating Disorders; General Nursing Interventions; page 295 KEY: Integrated Processes: Nursing Process: Analysis/implementation | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 5. ANS: B Anorexic patients are generally severely underweight, can be male or female, anxious, and perfectionistic. They would not be overweight.

PTS: 1 REF: Chapter 18: Eating Disorders; Anorexia Nervosa; page 288 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental health concepts 6. ANS: A As a general rule, eating disorders are associated with anxiety around meal time, so understanding thoughts and feelings associated with food is important for treatment. The other interventions may be needed for some patients at times, but not for all.

PTS: 1 REF: Chapter 18: Eating Disorders; General Nursing Interventions; page 295

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KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 7. ANS: C Establishing trust is key to the ongoing relationship. Response A is false reassurance. Response B is unrelated to the patients emotional issues. In response D the patient may not be aware of the etiology.

PTS: 1 REF: Chapter 18: Eating Disorders; General Nursing Interventions; page 295 KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Safe and Effective Care Environment: Establishing priorities 8. ANS: A Slow, steady weight gain is associated with good outcomes physically and emotionally. Eating all food at each meal is unrealistic. The meaning of food would be difficult to discuss for the patient. This disorder has nothing to do with cooking techniques.

PTS: 1 REF: Chapter 18: Eating Disorders; Treatment of Anorexia Nervosa; page 289 KEY: Integrated Processes: Nursing Process: Analysis/planning | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Safe and Effective Care Environment: Management of care: Establishing priorities 9. ANS: C Bulimia nervosa is known to be common in men and women who feel pressure to keep their weight at a certain level. Self-induced vomiting is a frequent method of purging food.

PTS: 1 REF: Chapter 18: Eating Disorders; Bulimia; page 290 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 10. ANS: B Bulimia nervosa is a secretive disorder where the individual is often normal weight or slightly overweight and binges and purges in secret. Pleasure from

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controlling the urge to eat is associated with anorexia nervosa. Meal time is stressful for other disorders. .

PTS: 1 REF: Chapter 18: Eating Disorders; Table 18-1, Comparison of anorexia nervosa and bulimia; page 292 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 11. ANS: D Though responses A, B, and C may be present, distorted body image is the primary disturbance.

PTS: 1 REF: Chapter 18: Eating Disorders; Etiology of Anorexia Nervosa; page 289 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental health concepts 12. ANS: A The patients view of self as fat indicates a distorted body image. This has nothing to do with knowledge about nutrition. Suicide is generally not viewed as a motivation in self-starvation.

PTS: 1 REF: Chapter 18: Eating Disorders; Nursing care of patients with eating disorders; page 292 KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 13. ANS: D The parents of an adolescent with anorexia nervosa have often set very high standards that the child fears cannot be met.

PTS: 1 REF: Chapter 18: Eating Disorders; Anorexia Nervosa Etiology; page 289 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

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14. ANS: A Establishing realistic limits will give the patient a sense of control over his or her urge to binge and purge.

PTS: 1 REF: Chapter 18: Eating Disorders; General Nursing Interventions; page 295 KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic environment 15. ANS: D These are the classic symptoms for anorexia nervosa.

PTS: 1 REF: Chapter 18: Eating Disorders; Box 18-1, Behaviors, signs and symptoms of anorexia nervosa; page 288 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental health concepts 16. ANS: D All of these responses are associated with anorexia nervosa and bulimia nervosa.

PTS: 1 REF: Chapter 18: Eating Disorders; Treatment of Anorexia Nervosa; page 289 and Treatment of Bulimia; page 291 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Physiological adaptation: Illness management 17. ANS: A Though your first impulse might be one of the other responses, establishing trust is the initial goal.

PTS: 1 REF: Chapter 18: Eating Disorders; General Nursing Interventions; page 295 KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 18. ANS: B

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Anorexia nervosa is often associated with an unconscious fear of moving into adolescence and adulthood.

PTS: 1 REF: Chapter 18: Eating Disorders; Anorexia Nervosa Etiology; page 289 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 19. ANS: D BMI of 35 takes into account height and weight. BMI of 30 is considered obese.

PTS: 1 REF: Chapter 18: Eating Disorders; Morbid Obesity; page 292 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Eating disorders: Child, adolescent, adult health | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance 20. ANS: B BMI is an approximation of body fat based on a calculation of weight divided by the square of ones height in adults.

PTS: 1 REF: Chapter 18: Eating Disorders; Morbid Obesity; page 292 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Child, adolescent, adult health | Cognitive Level: Knowledge | Client Need: Health Promotion and Maintenance 21. ANS: B BMI of 40 is generally accepted, though BMI of 35 with major health complications such as diabetes is also standard.

PTS: 1 REF: Chapter 18: Eating Disorders; Treatment of Morbid Obesity; page 293-294 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Child, adolescent, adult health | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance 22. ANS: B Response B is the most objective to indicate improvement with an anorexia nervosa patient. Response A is a one-time observation, response C could be anxiety behavior, and response D could have many meanings.

PTS: 1

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REF: Chapter 18: Eating Disorders; Anorexia Nervosa; Treatment of anorexia nervosa; page 289 KEY: Integrated Processes: Nursing Process: Planning | Content Area: Mental Health: Eating disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

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Chapter 19: Childhood and Adolescent Mental Health Issues My Nursing Test Banks

Chapter 19: Childhood and Adolescent Mental Health Issues Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. A boy with a conduct disorder diagnosis would be most likely to have which symptom?

A. Withdrawal B. Ritualistic behavior C. Class bully D. Class clown ____ 2. Suzanne is a 10-year-old girl who has been diagnosed as experiencing depression. What is likely to be the most effective way to help Suzanne express her feelings?

A. Have her participate in a group therapy session with other young children w B. Ask her to draw some pictures about things that shes been thinking about.

C. Arrange for individual psychotherapy sessions with a psychiatrist.

D. Observe her actions but dont seek to draw her out into conversation. ____ 3. Which of the following is the most common childhood mental disorder?

A. ADHD B. Aspergers syndrome C. Conduct disorder D. Enuresis ____ 4. Marty is a 15-year-old boy whose parents have brought him to a mental health clinic for evaluation. They are concerned because his grades have fallen and he has become angry and sometimes even violent. He spends long periods of time alone and does not want to see his friends. The parents report that he has never been a bad boy nor had problems in school. They are worried about the changes in his behavior. Which of the following is the most

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likely cause?

A. Depression B. Running around with a tough crowd C. Normal adolescent phase D. Attention deficit hyperactivity disorder ____ 5. Joey is a 5-year-old who is causing his parents a lot of concern. His mother reports that he bounces off the walls all the time and cant focus on any one thing for very long. He is impulsive and has recently ran right out into the street in front of the familys home. His teacher has told his parents that he has done similar things at school. The nurse understands that: Joey shows all the signs of having ADHD and should probably be placed on A. possible.

B. Joey is just an active, healthy child who needs to be disciplined more effecti C. Joey could be autistic, and additional testing will have to be done to confirm Joey shows signs of having ADHD, but is too young for that diagnosis to be D. now. ____ 6. Marie is 16 years old. She has been referred to the clinic by the nurse at her school because she started a fight with a younger girl and hurt her badly. The school nurse reports that Marie has been troublesome beforeskipping school, bullying, and smoking on school grounds on several occasions. Of the following, which diagnosis is most likely?

A. Bipolar depression B. Paranoid schizophrenia C. Conduct disorder D. Dysthymic disorder ____ 7. The single most common symptom of autism is: A. Inability to grasp reality.

B. Impaired social interaction.

C. Acting out behaviors.

D. Diminished affect. ____ 8. Which of the following would be the first priority for nurses caring for autistic children?

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A. Assist the psychiatrist and mental health team in providing treatments to cur B. Determine which of the two different types of autism the child has.

C. Discourage and prevent self-destructive behavior.

D. Provide behavior modification tools, specifically limit setting and reward sy ____ 9. Which of the following statements is true about the differences in mental health problems between children and adults?

Children are affected by the same stressors as adults, but to different degrees A. manifestations.

Childrens mental health disorders are generally much less severe and resolve B. do those of adults.

Childrens mental health problems are different from those of adults because C. wired differently.

D. Children have better means of working off stresses than do adults. ____ 10. The nurse knows that stimulant medication for ADHD should be administered: A. At bedtime, to coincide with rising cortisol levels.

B. Only on school days to improve performance.

C. On an empty stomach.

D. With breakfast and lunch. ____ 11. Which of the following statements by your ADHD childs parents indicate they need further teaching?

A. We will establish firm but reasonable limits on his behavior.

B. We will give him his medication at night so it wont decrease his appetite.

C. We will set him up in a special program at his school so we he will get extra D. We will work to ensure he gets 8 hours of sleep a night. ____ 12. You are caring for a 13-year-old boy with a diagnosis of conduct disorder. Which of the following would you be most likely to expect given this diagnosis?

A. Severe separation anxiety from parents B. Making up stories to make him appear more important C. History of cruelty to schoolmates and pets D. Insomnia and anorexia nervosa

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Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 13. Which of the following statements about attention deficit hyperactivity disorder (ADHD) are true? (Select all that apply) A. ADHD is more common in boys than in girls.

B. Children with ADHD tend to be of below-average intelligence.

C. ADHD is caused by dysfunctional parental relationships.

D. Children with ADHD are often treated with the use of stimulants.

Children with ADHD often benefit from behavior modification tools like lim E. systems, and positive reinforcement.

F. Even though we think of ADHD as a disorder in children, adults can also ha Chapter 19: Childhood and Adolescent Mental Health Issues Answer Section MULTIPLE CHOICE 1. ANS: C A pattern of bullying is a common sign of conduct disorder. Responses A and B may reflect autism.

PTS: 1 REF: Chapter 19: Childhood and Adolescent Mental Health Issues; Conduct Disorders; page 315-316 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Child health | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Mental health concepts 2. ANS: B Younger children who may have more difficulty verbally expressing feelings may be able to draw them.

PTS: 1 REF: Chapter 19: Childhood and Adolescent Mental Health Issues; Nursing Care of Children and Adolescents With Depression, Bipolar Disorder, and Suicide; page 308 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Mood disorders | Cognitive Level: Application | Client Need:

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Psychosocial Integrity: Behavioral interventions 3. ANS: A ADHD (attention deficit /hyperactivity disorder) is the most common mental disorder in the 8 to 15 year old age group.

PTS: 1 REF: Chapter 19: Childhood and Adolescent Mental Health Issues; Introduction; page 304 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Child health | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 4. ANS: A In addition to classic symptoms of depression, adolescents often display irritability and problems in school performance. This is not normal teen behavior. Because Marty has been functioning well in school up until now, it is unlikely that ADHD would be exhibited at this point.

PTS: 1 REF: Chapter 19: Childhood and Adolescent Mental Health Issues; Depression, Bipolar Disorders, and Suicide in Children and Adolescents; page 304 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Child health: Mood disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 5. ANS: D Definitive diagnosis of ADHD should not be made before age 7 because developmentally the child has a shorter attention span.

PTS: 1 REF: Chapter 19: Childhood and Adolescent Mental Health Issues; Attention Deficit/ Hyperactivity Disorder; page 309 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: child health | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 6. ANS: C Conduct disorder is characterized by a pattern of aggressive behavior and violating the rights of others, including defiance and rule breaking. The other

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responses are psychiatric disorders that would not be the most likely diagnosis given Maries behavior.

PTS: 1 REF: Chapter 19: Childhood and Adolescent Mental Health Issues; Conduct Disorder; page 316 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Child health | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 7. ANS: B Though all of these behaviors may occur at some time in autism, impaired social interaction is the overriding symptom that occurs in this disorder.

PTS: 1 REF: Chapter 19: Childhood and Adolescent Mental Health Issues; Autism Spectrum Disorder; page 312 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Child health | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 8. ANS: C Safety is the primary nursing intervention. Behavior medication tools are important, but safety comes first. Autism at this point is not curable.

Determining the type of autism is not a nursing goal.

PTS: 1 REF: Chapter 19: Childhood and Adolescent Mental Health Issues; Autism Spectrum Disorder; General Nursing Interventions; page 314 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Child health | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 9. ANS: A Mental health disorders in children have many similarities and differences from the same disorders in adults. The other responses are not correct.

PTS: 1 REF: Chapter 19: Childhood and Adolescent Mental Health Issues; Introduction; page 303 KEY: Integrated Processes: Nursing Process: Analysis | Content Area:

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Mental Health: Child health | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concept 10. ANS: D Because these medications can contribute to insomnia, it is best to administer them earlier in the day with food. These are generally taken daily unless the doctor orders a drug holiday.

PTS: 1 REF: Chapter 19: Childhood and Adolescent Mental Health Issues; Pharmacology Corner Under Attention Deficit Hyperactivity Disorder; page 310 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration 11. ANS: B Stimulant medications are given for treatment of ADHD. These can cause insomnia if given later in the day.

PTS: 1 REF: Chapter 19: Childhood and Adolescent Mental Health Issues; ADHD; Pharmacology Corner; page 310 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Child health | Cognitive Level: Application | Client Need: Health Promotion and Maintenance: Principles of Teaching/Learning 12. ANS: C Conduct disorder is associated with long-term problems with defiance, rulebreaking, and violating the basic rights of others.

PTS: 1 REF: Chapter 19: Childhood and Adolescent Mental Health Issues; Conduct Disorder; pages 315-316 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Adolescent: Mental health: Child health | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts MULTIPLE RESPONSE 13. ANS: A, D, E, F

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Children with ADHD tend to be of above normal intelligence but often dont function at those levels. The causes of ADHD are more associated with brain dysfunction and genetic factors.

PTS: 1 REF: Chapter 19: Childhood and Adolescent Mental Health Issues; Attention Deficit /Hyperactivity Disorder; page 308-309 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Child health | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

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Chapter 20: Postpartum Issues in Mental Health My Nursing Test Banks

Chapter 20: Postpartum Issues in Mental Health Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. In the OB follow-up clinic, your patient, who is 4 weeks postdelivery, tells you she is sleeping for long hours, wants to avoid taking care of the baby, and wishes she had never had the baby. What would be your first response?

A. Its normal to feel overwhelmed at first.

B. Tell me more about these feelings.

C. Report her to Child Protective Services.

D. Ill call your husband right away to get you back home to rest. ____ 2. Which statement best describes postpartum blues?

A. A rare condition that impacts bonding between mother and baby.

B. A transient, self-limiting period of sadness after the birth of the baby.

C. A psychiatric diagnosis similar to dysthymia.

D. A transient period of sadness that usually moves into postpartum depression ____ 3. Which is NOT a contributing factor to postpartum blues?

A. Hormone shifts B. Lack of sleep C. Stress D. History of depression ____ 4. Which of the following combines the best treatments for postpartum blues?

A. Antidepressants, sleep, crisis intervention B. Rest, support, compassion C. Mother-baby bonding session, family education, antidepressants D. Analgesics for post-delivery pain, rest, longer hospital stay ____ 5. Which statement by the nurse indicates a good understanding of postpartum blues?

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A.

You need to get involved with taking care of this baby.

You are lucky to have a healthy baby. The patient in the next room would gi B. your place.

C. You look tired. Why dont you rest for a bit and I will come back later to star D. I will call the social worker to check into alternate caregiving for the new ba ____ 6. In addition to antidepressants, which of the following is usual treatment for postpartum depression?

A. Antipsychotics B. Psychotherapy C. Hormone replacement D. Temporary removal of the baby from the home ____ 7. Your pregnant patient has a history of major depression. Which of the following is she most likely to be at risk for?

A. She is at risk for development of manic episodes.

B. She is at risk for recurrence of depression after the birth of the baby.

C. She is more likely to have an autistic child.

D. She has no higher risk for emotional problems than other patients.

Chapter 20: Postpartum Issues in Mental Health Answer Section MULTIPLE CHOICE 1. ANS: B The open-ended question will give you more information and be less judgmental to this patient. This behavior is not normal at 4 weeks post delivery and more rest is probably not adequate treatment. You would like a lot more information before reporting this as neglect.

PTS: 1 REF: Chapter 20: Postpartum Issues in Mental Health; Treatment of Postpartum Depression; page 325 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Maternity: Postpartum: Mental health: Mood disorder | Cognitive Level: Analysis | Client Need: Psychosocial Integrity: Therapeutic communication 2. ANS: B This definition of postpartum blues differentiates it from dysthymia and

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postpartum depression. It occurs in 70 percent of new mothers.

PTS: 1 REF: Chapter 20: Postpartum Issues in Mental Health; Postpartum Blues; page 323 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Womens health | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 3. ANS: D History of depression is a contributor to postpartum depression, not postpartum blues.

PTS: 1 REF: Chapter 20: Postpartum Issues in Mental Health; Postpartum Blues; page 323 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Womens health | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 4. ANS: B Antidepressants have no use in postpartum blues. Rest, support, and compassion are the main interventions.

PTS: 1 REF: Chapter 20: Postpartum Issues in Mental Health; Treatment of Postpartum Blues; page 324 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Womens health | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 5. ANS: C This response indicates understanding that postpartum blues is transient and that time and rest are major healers. The other responses are all inappropriate, as they are judgmental.

PTS: 1 REF: Chapter 20: Postpartum Issues in Mental Health; Treatment of Postpartum Blues; page 324 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Womens health | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts 6. ANS: B

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Psychotherapy along with antidepressants are the major treatments. Patients usually are not psychotic, so there is no need for antipsychotics, and hormone replacement is not indicated. Mother and baby should be kept together with added support from the family to ensure the baby is well cared for.

PTS: 1 REF: Chapter 20: Postpartum Issues in Mental Health; Treatment of Postpartum Depression; page 325 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Womens health | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts 7. ANS: B History of major depression is the biggest risk factor for postpartum depression.

PTS: 1 REF: Chapter 20: Postpartum Issues in Mental Health; Postpartum Depression; page 324 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Womens health | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

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Chapter 21: Aging Population My Nursing Test Banks Chapter 21: Aging Population Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. An 85-year-old patient is admitted to the hospital with the diagnosis of cerebrovascular accident and depression. The symptom that is unrelated to depression would be?

A. Crying and refusing to perform task B. Answering I forgot to questions C. Having positive self-esteem D. Neglecting ADLs ____ 2. The Omnibus Budget Reconciliation Act (OBRA) provides standards of care for which of the following: A. Very young B. Older adults C. Those who have certain intellectual communication difficulties D. Those without medical insurance ____ 3. In the elderly, administering medication is a great concern for the nurse since these patients are more prone to side effects. The primary cause of this is: A. Altered circulation and renal function B. Accelerated gastrointestinal system C. Enlarged Lymph nodes D. Musculoskeletal system weakness Completion Complete each statement.

4. The federal act that establishes the standards of care for older adults is known as the Omnibus Budget ______________ Act. 5. Major concerns of the elderly living alone in their home are: (Name 2) ____________________________________________ Multiple Response

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Identify one or more choices that best complete the statement or answer the question. ____ 6. When assessing the elderly for depression, the nurse may find that a depressed person over 70 years of age without a medical diagnosis, may have the following symptoms of depression (select all that apply): A. Aches B. Pains C. Constipation D. One-sided weakness E. Sleep disturbances Chapter 21: Aging Population Answer Section MULTIPLE CHOICE 1. ANS: C The patient may suffer from depression as a result of limitations produced by the stroke. The patients cerebrovascular event also will have an impact on the patient and his family. Depression can be evidenced by sadness, confusion, and lack of self-care.

PTS: 1 REF: Chapter 21: Aging Population; Cerebrovascular Accident; page 339 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Aging Population | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Coping Mechanism 2. ANS: B OBRA provides regulations for proper assessment of the elderly; for this reason, registered nurses have to provide the initial physical assessment.

PTS: 1 REF: Chapter 21: Aging Population; Introduction; page 337 KEY: Integrated Processes: Nursing Process: Assessment | Content Area: Legal | Cognitive Level: Analysis | Client Need: Physiological Integrity: Reduction of Risk Potential: System Specific Assessments 3. ANS: A LPNs/LVNs are accountable for medications administered to their patients. It is important to know the side effects of all medications distributed. Document

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and report any signs of toxicity. The elderly are more likely to have side effects when there is altered metabolism through the kidneys and liver as well as altered circulatory function.

PTS: 1 REF: Chapter 21: Aging Population; Medication Concerns; Table 211Common Drug Side Effects and Nursing Actions for Elderly Patients; page 341 KEY: Integrated Processes: Nursing Process: Intervention | Content Area: Mental Health: Pharmacology | Cognitive Level: Comprehension | Client Need: Physiological Integrity: Adverse Effects/Contraindications/Side Effects/Interventions COMPLETION 4. ANS: Reconciliation The Omnibus Budget Reconciliation Act (OBRA) ensures that proper assessment of elderly people will be provided in the health care facility and in the home.

PTS: 1 REF: Chapter 21: Aging Population; Restorative Nursing; page 337 KEY: Integrated Processes: Communication and Documentation | Content Area: Legal | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Client Rights 5. ANS: Safety, quality of life, support system, access to medical care, financial support, emotional support The elderly remaining in the home have a greater chance of remaining healthier longer.

Integrated Process: Caring | Content Area: Mental Health: Aging | Cognitive Level: Application | Client Need: Health Promotion and Maintenance: Aging Process Ref. Chapter 21: Aging Population; Introduction; page 336 PTS: 1 REF: Chapter 21: Aging Population; Restorative Nursing; page 337 KEY: Integrated Processes: Communication and Documentation | Content Area: Legal | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Client Rights

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MULTIPLE RESPONSE 6. ANS: A, B, C, E These symptoms can be confused with other conditions, such as electrolyte imbalance, drug reactions, and dementia. Observation and documentation by the practical nurse can assist the physician in ruling out a medical diagnosis.

The elderly are more likely to have physical symptoms with depression.

PTS: 1 REF: Chapter 21: Aging Population; Depression; page 339 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Aging Population | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental Health Concepts

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Chapter 22: Victims of Abuse and Violence My Nursing Test Banks

Chapter 22: Victims of Abuse and Violence Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Your new patient in the ER states that she was been beaten and raped. What should you do first?

A. Ask for a psychiatric consult.

B. Stay with her and provide support.

C. Wash and dress her wounds before the rape kit is performed.

D. Encourage her to tell you the details of what happened. ____ 2. Who is the most likely perpetrator of child abuse?

A. Parent B. Other relatives C. Hired babysitter D. Teacher ____ 3. What are safe surrender sites?

A. A place where a mother can safely give up her newborn with no questions as B. A facility for teens who are unable to live with their parents.

C. A law enforcement action to give up guns in the home to reduce violence.

D. A place for teens with substance abuse problems to go to avoid arrest. ____ 4. Which of the following is NOT a risk factor for becoming a child abuser?

A. Abused as a child B. Grew up in poverty C. Heavy drinker D. Poor coping mechanisms to deal with frustration ____ 5. Your new 90-year-old patient is admitted with a broken wrist and multiple bruises. The caregiver reports the patient falls when she wanders.

Which of the following would lead you to suspect elder abuse?

A. Inconsistent explanations about the details of the falls.

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B. The patient tells you she doesnt like the caregiver.

C. The patient begins crying when her daughter arrives.

D. The patient has a UTI. ____ 6. Nurses would expect that a nonthreatening form of therapy for a child who has been sexually abused would be: A. Systematic desensitization.

B. Group therapy.

C. Art or play therapy.

D. Rational emotive therapy. ____ 7. Because a woman who is being hurt by her partner may try to keep the abuse private, which of the following is known to be an indirect source to identify the abuse?

A. Pediatric clinics B. Emergency rooms C. Womens shelters D. Mental health clinics ____ 8. A battered woman in the womens shelter states that she is afraid to go home because he drinks. Thats when he gets violent and he beats me.

Which of the following reflects accurate knowledge about domestic violence and alcohol use?

A. If you can get him to quit drinking, the beating will stop.

B. Alcohol use can increase the chances of abuse.

C. People who use alcohol almost always end up as abusers.

D. Hes just using the alcohol as an excuse to beat you. ____ 9. You are working nights in the free clinic. A woman is brought in by a female friend. According to the friend, the woman has been raped.

The first nursing intervention for this patient is: A. Reassure her that she is safe.

B. Get the rape kit and perform the examination.

C. Ask her who did this to her.

D. Call the police for her. ____ 10. Nurses must care for the abuser, as well as the abused person. You

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are caring for a middle-aged man who is under medical and psychiatric care for molesting a 7-year-old girl. You inform him that dinner is being served in the dining room. He tells you to leave and that he does not want anyone to see him or know what I did. You respond: A. You will need to face people sooner or later.

B. You are here for treatment of an illness, not judgment of an action.

C. I guess I wouldnt want to been seen either. You may stay here.

D. Only the staff knows the reason for your admission. ____ 11. You are caring for a 6-year-old boy who allegedly has been abused by his mother. During his mothers visits, which of the following is most associated with her being an abuser?

A. A strong and loving relationship with her parents B. Single parent home C. A history of being abused as a child D. Unemployed ____ 12. Which statement is NOT true about elder abuse?

A. Inappropriate misuse of patients funds by a caregiver is not considered abus B. Inappropriate use of restraints is a form of abuse.

C. The abuser can be a hired caregiver or family.

D. Sexual contact with a woman with dementia is considered elder abuse. ____ 13. Your patient, who has reported domestic violence, now tells you she is going home with her husband because he has apologized and says he is taking her to Hawaii on a romantic vacation. Which statement best helps you understand her actions?

A. Her husband has received treatment for anger management.

B. This is the honeymoon phase of the abuse cycle.

C. This is the resolution phase of the family crisis.

D. She mistakenly reported domestic violence. ____ 14. The difference between child abuse and child neglect is: A. Abuse is done on purpose; neglect is accidental.

B. Abuse is an act of commission; neglect is an act of omission.

C. Abuse is a crime; neglect is not.

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D. Children are often afraid to report abuse, but are willing to report neglect. ____ 15. Shaken baby syndrome refers to: The increasing rate of epilepsy and other seizure disorders in infants born to A. history of psychiatric disorders.

B. A form of child abuse in which a baby is shaken hard enough to cause traum C. The physical and developmental problems faced by infants of drug-addicted D. The psychological trauma that children experience from perceived threats to ____ 16. Annie is a 5 year old who has been the victim of sexual abuse by a family member. Which of the following therapeutic techniques would be especially useful in helping Annie express her feelings?

A. Individual psychotherapy B. Behavior modification C. Family therapy sessions D. Drawing Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 17. Which of the following are actions the nurse can take to help victims of abuse? (Select all that apply) A. Reassure the patient that everything possible is being done to ensure his or h B. Dont show empathy to the abuser.

C. Know your own thoughts and feelings about abuse.

D. Take the burden of deciding about notifying authorities off the patient and d E. Remain nonjudgmental.

F. Know and follow agency policies. ____ 18. Which of the following statements about sexual abuse of children are true? (Select all that apply) A. The abuser is most often someone the child knows and trusts.

B. The nurse must confront the abuse victim to make him or her admit to the ab C. Abused children often act out the abuse in their own play behaviors.

The abused child is confused about whether the acts are right, but believes th D. do anything wrong.

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Because children are resilient, they tend to get over acts of sexual abuse fair minimal intervention.

F. One thing the nurse must do is reinforce that the child is not to blame for the True/False Indicate whether the statement is true or false. ____ 19. Purposely hurting a family pet is a warning sign of other types of abuse in the home.

Completion Complete each statement.

20. The misuse of a person, substance, or situation is called ________________.

Chapter 22: Victims of Abuse and Violence Answer Section MULTIPLE CHOICE 1. ANS: B Providing security and support are the best initial interventions. Response C is incorrect. Responses A and D may be needed later.

PTS: 1 REF: Chapter 22: Victims of Abuse and Violence; General Nursing Interventions; page 362-363 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 2. ANS: A The parent is the most likely child abuser.

PTS: 1 REF: Chapter 22: Victims of Abuse and Violence; Child Abuse; page 356 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Child abuse | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Abuse/neglect 3. ANS: A Safe surrender sites are available around the country to prevent abandonment of infants.

PTS: 1 REF: Chapter 22: Victims of Abuse and Violence; Child Abuse; page E.

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357 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Newborn at risk: Maternity: Newborn at risk | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance: Ante/intra/postpartum and newborn care 4. ANS: B Poverty by itself is not a risk factor though it may contribute to it in the presence of these other responses. Child abuse occurs at all socioeconomic levels.

PTS: 1 REF: Chapter 22: Victims of Abuse and Violence; Child Abuse; page 356 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Child abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Abuse/neglect 5. ANS: A Inconsistent explanations of injuries are a common indicator of abuse. All of the other responses would not be indicators on their own, but with other factors may lead you to suspect abuse.

PTS: 1 REF: Chapter 22: Victims of Abuse and Violence; Elder Abuse page 360 and Box 22-1 Common Warning signs of abuse; page 356 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Geriatrics: Elder abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Abuse/neglect 6. ANS: C Art and play therapy allow the child to work through feelings without having to have the words for them.

PTS: 1 REF: Chapter 22: Victims of Abuse and Violence; Treatment of Abuse; page 362 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Child health: Abuse: Mental health: Child abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Abuse/neglect 7. ANS: A Because a woman will seek medical care for her children, this is a common

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site for initial identification of the abuse.

PTS: 1 REF: Chapter 22: Victims of Abuse and Violence; Domestic Violence; page 358 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Womens health | Cognitive Level: Application | Client Need: Psychosocial Integrity: Abuse/neglect 8. ANS: B The other responses are inaccurate. Alcohol reduces inhibitions that can lead to aggressive behaviors.

PTS: 1 REF: Chapter 22: Victims of Abuse and Violence; The Abuser; page 354 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Substance Abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Abuse/neglect and Psychosocial Integrity: Chemical and other dependencies 9. ANS: A Initial intervention should be focused on safety.

PTS: 1 REF: Chapter 22: Victims of Abuse and Violence; Table 22-3 Nursing Interventions for Victims of Abuse; page 365 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 10. ANS: B This response is professional and communicates support to this patient.

Responses A and C are judgmental. Response D is true, but is not as supportive as response B. PTS: 1 REF: Chapter 22: Victims of Abuse and Violence; General Nursing Interventions; pages 362-3 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication 11. ANS: C

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Continuing of the abuse cycle into adulthood remains a frequent pattern.

PTS: 1 REF: Chapter 22: Victims of Abuse and Violence; The Abuser; page 354 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Abuse/neglect 12. ANS: A Misuse of an elderly persons funds by a trusted person is a form of elder abuse.

PTS: 1 REF: Chapter 22: Victims of Abuse and Violence; Elder Abuse; page 359-360 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Geriatrics: Elder abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Abuse/neglect 13. ANS: B The honeymoon phase is part of the domestic violence cycle when the abuser shows repentance for his violence. The patient remains hopeful, but without treatment the cycle will continue.

PTS: 1 REF: Chapter 22: Victims of Abuse and Violence; Domestic Violence; page 359 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Womens health | Cognitive Level: Application | Client Need: Psychosocial Integrity: Abuse/neglect 14. ANS: B Abuse is purposeful mistreatment of another (therefore commission) and neglect is deprivation that is an omission of needed care.

PTS: 1 REF: Chapter 22: Victims of Abuse and Violence: Introduction; page 353 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Child health: Abuse | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Abuse/neglect 15. ANS: B Shaken baby syndrome occurs when a caregiver shakes a child to control crying. It is a form of child abuse.

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PTS: 1 REF: Chapter 22: Victims of Abuse and Violence; Child Abuse; page 356 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Child health: Abuse | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance: High risk behaviors 16. ANS: D Because she is so young, Annie may have great difficulties expressing her feelings and experiences in words. Drawing allows her self-expression in an age-appropriate manner.

PTS: 1 REF: Chapter 22: Victims of Abuse and Violence; Treatment of Abuse; page 360 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Child health | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concept MULTIPLE RESPONSE 17. ANS: A, C, E, F These responses all recognize the nurses role to promote safety, remain nonjudgmental, and follow agency policy for reporting. In adults with capacity to make their own decisions, the patient needs to consent to reporting abuse.

PTS: 1 REF: Chapter 22: Victims of Abuse and Violence; General Nursing Interventions; page 362-363 KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health | Cognitive Level: Application | Client Need: Psychosocial Integrity: Abuse/neglect: Therapeutic communication 18. ANS: A, C, D, F It is not the nurses role to deal with the abuser. Though children are often resilient, sexual abuse is traumatic and requires treatment.

PTS: 1 REF: Chapter 22: Victims of Abuse and Violence; Sexual Abuse; page 357358 and Table 22-3 Nursing Interventions for Victims of Abuse; page 366 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Child health | Cognitive Level: Application | Client Need:

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Psychosocial Integrity: Mental health concepts TRUE/FALSE 19. ANS: T Studies indicate that abuse of family pets can be an indicator of family violence as the abuser demonstrates his power and control.

PTS: 1 REF: Chapter 22: Victims of Abuse and Violence: The Abuser; page 355 KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: coping | Cognitive Level: Application | Client Need: Psychosocial Integrity: abuse/neglect COMPLETION 20. ANS: abuse Abuse includes child, domestic partner, elder, and sexual. Neglect of the vulnerable is also considered abuse.

PTS: 1 REF: Chapter 22: Victims of Abuse and Violence; Introduction; page 353 KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Abuse | Cognitive Level: Knowledge | Client Need: Safe and Effective Care Environment: Management of Care: Advocacy, Legal Rights and Responsibilities

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