Clinical Psychiatry for Nurses Final
Test Solutions
Course Introduction
This course offers nursing students a comprehensive overview of clinical psychiatry, emphasizing the recognition, assessment, and management of common mental health disorders. Students will learn about psychiatric terminology, psychological theories, and the biological and social factors influencing mental health. The curriculum covers therapeutic communication, psychopharmacology, crisis intervention, and the legal and ethical aspects of psychiatric care. Through case studies and clinical scenarios, students develop practical skills essential for caring for patients with mental health needs in a variety of healthcare settings.
Recommended Textbook
Principles and Practice of Psychiatric Nursing 10th Edition by Gail Wiscarz Stuart
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Page 2
Chapter 1: Roles and Functions of Psychiatric-Mental Health
Nurses: Competent Caring
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Sample Questions
Q1) When considering psychiatric nursing roles and functions,in order to delegate effectively the nurse must have knowledge of the domains of: (Select all that apply.)
A) management.
B) communication.
C) direct care.
D) teaching.
E) collaboration.
Answer: A,C
Q2) Nursing should increase its role in the advocating of funding for outcome studies because these studies:
A) increase patient compliance with therapeutic regimens.
B) document quality, cost, and effectiveness of psychiatric nursing.
C) update psychiatric nursing specialists on new practice developments.
D) lead to the implementation of untried interventions and practice guidelines.
Answer: B
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Chapter 2: Therapeutic Nurse-Patient Relationship
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Sample Questions
Q1) During the working phase of the relationship,the nurse assesses that the patient may be demonstrating resistance.The most appropriate way to deal with this would be to:
A) assist the patient in exploring his or her past for uncovered issues and conflicts.
B) clarify, share observations, and reflect content and feelings with the patient.
C) confront the patient with the behavior and state, "You will be expected to work harder."
D) avoid mentioning the therapeutic barrier and wait until the patient again indicates readiness.
Answer: B
Q2) In the initial sessions a patient frequently asks the nurse for money and expresses doubt about the nurse's ability to help.Which principle provides guidance for the nurse in this situation?
A) This behavior is typical of transference reactions.
B) All patients have feelings of insecurity and low self-esteem.
C) Manipulative behavior is part of this patient's psychopathology.
D) Testing behavior is common during the introductory phase of a relationship. Answer: D
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Chapter 3: The Stuart Stress Adaptation Model of Psychiatric Nursing Care
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Sample Questions
Q1) A nurse states,"I don't understand why the Stuart Stress Adaptation Model uses both the health/illness and adaptation/maladaptation continua." The best reply is:
A) "The more information that's contained within the model, the more realistically it represents life."
B) "The model recognizes that nature is ordered as a social hierarchy from simple to complex. The health/illness continuum is a simple concept; the adaptation/maladaptation continuum is more complex."
C) "To integrate the theory of four stages of psychiatric treatment, Stuart had to have a health/illness frame of reference. The adaptation/maladaptation continuum was necessary to complement the holistic framework."
D) "The health/illness continuum reflects a medical world view, whereas the adaptation/maladaptation continuum is derived from nursing's world view. The two reflect the complementary nature of the nursing and medical models of practice."
Answer: D
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Chapter 4: Evidence-Based Psychiatric Nursing Practice
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Sample Questions
Q1) Which activity will be most useful to a nurse wishing to provide evidence-based psychiatric nursing care?
A) Relying on findings of one properly designed, randomized, controlled trial
B) Using a protocol from several well-designed, cohort, quasiexperimental studies
C) Seeking sound, opinion-based processes and maintaining self-directed practice
D) Applying findings from a meta-analysis of relevant randomized, controlled trials
Q2) The psychiatric nurse is preparing discharge information for a patient diagnosed with schizophrenia.Knowing that the patient will be discharged to a home shared with the patient's elderly parents,you want to develop evidence-based care for the patient.You will first:
A) identify the major support person for the patient.
B) define the patient's current acute clinical problems.
C) help the patient to find appropriate, attainable employment.
D) help the patient to be reoriented to living outside a locked psychiatric unit.
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Chapter 5: Biological Context of Psychiatric Nursing Care
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Sample Questions
Q1) A depressed patient scheduled for an MRI asks about the purpose of the test and whether it will hurt.The response would include that the test: (Select all that apply.)
A) takes a picture of the brain.
B) is used to diagnose mental illness.
C) should not produce any physical pain.
D) may be uncomfortable if tight spaces bother you.
E) machinery produces loud noises while the test is being conducted.
Q2) The objective information that has helped mental health professionals understand that schizophrenia has a biological component has been obtained primarily from which of the following?
A) Genetic studies
B) Patient histories
C) Comparisons of blood chemistries
D) Magnetic resonance imaging (MRI) studies
Q3) Pharmacogenetics will eventually allow researchers to do which of the following?
A) Remove the genes that cause illness.
B) Allow the design of custom drugs.
C) Develop foods that fight disease.
D) Splice genes to improve health.
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Page 7
Chapter 6: Psychological Context of Psychiatric Nursing Care
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Sample Questions
Q1) A nurse managing the care of a depressed patient will use the Beck Depression Inventory Scale at admission and during the course of treatment.The nurse expects to obtain assessment data that would: (Select all that apply.)
A) confirm the patient's diagnosis.
B) measure the extent of the patient's problem.
C) identify co-morbid physiological disorders.
D) track the patient's progress over the hospitalization.
E) predict the patient's likelihood of experiencing a relapse.
Q2) While being interviewed,a patient expresses the belief that other people can place beliefs in her mind.This statement can be assessed as evidence of:
A) thought insertion.
B) nihilistic delusions.
C) somatic delusions.
D) ideas of reference.
Q3) Which question would best assess a patient's ability to make judgments?
A) "Who is the president of the USA?"
B) "How long have you been here?"
C) "What is the name of the building we're in?"
D) "If you won $10,000, what would you do with it?"
Page 8
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Chapter 7: Social, Cultural, and Spiritual Context of Psychiatric Nursing Care
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Sample Questions
Q1) A nurse working in a mental health center would determine which patient to be the best candidate for a spirituality-based 12-step intervention program?
A) A patient who has generalized anxiety disorder
B) A patient who has an addiction to alcohol
C) A patient with a personality disorder
D) A patient who has agoraphobia
Q2) Which intervention will the nurse consider to be a central responsibility when planning for culturally competent treatment?
A) Learn what the illness means to the patient and how the patient's beliefs can help mediate the stressors.
B) Learn as much as possible regarding the beliefs of both the patient and the patient's extended family.
C) Ask the patient about beliefs in a formal organized religion and daily or weekly religious practices that can be factored into treatment.
D) Tell the patient that it will be important to examine together the belief systems of both the nurse and patient to be sure that they are congruent.
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Chapter 8: Legal and Ethical Context of Psychiatric Nursing Care
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Sample Questions
Q1) A patient is about to receive electroconvulsive therapy (ECT) when a nurse sees that a consent form for treatment has not been signed.Which fact should determine the nurse's immediate action?
A) Verbal consent by the patient is sufficient.
B) A staff member is needed to witness the consent form.
C) Failure to obtain the patient's written consent constitutes battery.
D) Permission was implied when the patient signed the hospital's admission form.
Q2) Which action by a nurse violates the rights of a psychiatric patient?
A) Arranging for a patient to work in the hospital kitchen for minimum wage
B) Refusing to mail letters to the local newspaper written by a committed patient
C) Placing the wristwatch of a patient with delusions in the hospital's main safe
D) Discouraging a patient with paranoid delusions to sign a contract to sell a home
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Chapter 9: Policy and Advocacy in Mental Health Care
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Sample Questions
Q1) Which type of managed care plan allows the most flexibility in choosing health services and providers?
A) Health maintenance organization (HMO)
B) Independent practice organization (IPO)
C) Preferred provider organization (PPO)
D) Point of service plan (POS)
Q2) When a facility administrator mentions that the employee assistance program (EAP) may be discontinued because of its expense,the health liaison nurse disagrees,stating that the program pays for itself through: (Select all that apply.)
A) prevention of illness encouraged by educational programs.
B) early disease detection brought about by offered screenings.
C) its primary focus on alcohol and drug abuse awareness sessions.
D) decreased work-related injuries resulting from ergonomics training.
E) mandated immunization policies regarding acquired job-related illnesses.
Q3) Access to care refers to the:
A) availability of health care.
B) degree to which services are comprehensive.
C) overall use of mental health services in a community.
D) convenience and ease of obtaining service and information.
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Page 11
Chapter 10: Families as Resources, Caregivers, and Collaborators
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Sample Questions
Q1) When dealing with the family of a patient being admitted to a psychiatric unit,the nurse should give priority to the possibility that family members may:
A) also be in need of support.
B) view the staff in a negative light.
C) be relieved that someone else is responsible for the patient care.
D) want more information sharing than confidentiality rules allow.
Q2) Which observation best demonstrates that a patient is a member of a well functioning family?
A) Family members openly discuss the patient's needs and how to meet them effectively.
B) The patient looks forward to family members' visits and is less stressed after they spend time together.
C) The patient asks for his family members' input when making a decision and generally seeks their approval.
D) Family members are likely to provide the patient with suggestions on what should be done and when it should be done.
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12
Chapter 11: Implementing the Nursing Process: Standards of Practice
and Professional Performance
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Sample Questions
Q1) As a nurse formulates expected outcomes for a patient who will be taking an antidepressant medication,consideration should be given to which psychosocial domain? (Select all that apply.)
A) Psychomotor
B) Cognitive
C) Affective
D) Conscious
E) Process
Q2) While gathering a baseline history about a patient,a nurse is told by a team social worker that the patient "acts weird and has bad hygiene." The nurse's responsibility is to:
A) accept the data without question.
B) form impressions based on data personally gathered.
C) document the impression of the team social worker.
D) discuss the social worker's impression with the patient.
Q3) Which action best demonstrates a nurse displaying accountability?
A) Volunteering to serve on a hospital committee
B) Notifying the nurse manager when a medication error occurs
C) Planning patient care strategies for a newly admitted adult patient
D) Coordinating a patient-centered conference for the health care team
Page 13
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Chapter 12: Prevention and Mental Health Promotion
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Q1) Which interventions would be helpful in achieving the goal of improving the social support system of an individual at risk for developing maladaptive coping responses? (Select all that apply.)
A) Hospitalization in a mental health facility
B) Encouraging participation in a self-help group
C) Explaining to concerned others how they can help
D) Providing services in a caring and supportive manner
E) Identifying consequences for ineffective coping strategies
Q2) A nurse working in a community health agency wishes to implement a primary preventive program in mental health for the elderly.Which action should occur first?
A) Elaboration of specific preventive strategies
B) Identification of stressors that precipitate maladaptive responses
C) Application of selected nursing interventions to enhance adaptation
D) Determination of the effectiveness of the existing nursing activities
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Chapter 13: Crisis Intervention
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Sample Questions
Q1) A patient who was held hostage for 12 hours by a carjacker now repeatedly states,"I can't believe it happened to me!" while admitting to feeling anxious and being afraid of strangers and of ever driving again.The nurse's interventions should target: (Select all that apply.)
A) denial.
B) anxiety.
C) confusion.
D) self-efficacy.
E) suicide potential.
Q2) A teenaged new mother reports she has felt apathetic,fatigued,and helpless since giving birth.She states,"I don't know what's expected of me." The nurse believes the patient will benefit from:
A) crisis intervention.
B) short hospitalization.
C) neuroleptic medication.
D) antidepressant medication.
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15
Chapter 14: Recovery and Psychiatric Rehabilitation
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Sample Questions
Q1) A psychiatric nurse whose area of practice is tertiary prevention of mental illness is asked to describe the focus of this type of practice.The nurse can best describe it as:
A) enriching the understanding of mental illness.
B) preventing mental illness from occurring initially.
C) limiting disability related to an episode of mental illness.
D) increasing community awareness of the symptoms of mental illness.
Q2) To promote positive outcomes,nurses in psychiatric rehabilitation practices should be skilled in: (Select all that apply.)
A) teaching the patient living skills.
B) actively listening to patient complaints.
C) assisting the patient in developing his or her strengths.
D) helping patients accept their own disabilities.
E) accessing the appropriateness of environmental support.
Q3) The family burden associated with having a mentally ill family member is evidenced by:
A) decreased family stress and conflict.
B) family members blaming each other for the illness.
C) increased understanding and acceptance of the illness.
D) too little time, energy, and money given to the ill member.
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Page 16
Chapter 15: Anxiety Responses and Anxiety Disorders
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Sample Questions
Q1) A patient calls the community mental health center and shares,"For the past 6 months,whenever I even think about leaving my house,my heart pounds,my body shakes,and I cry and feel dizzy.There's no reason for me to feel this way,but I do." These symptoms can be assessed as being most consistent with:
A) panic disorder with agoraphobia.
B) obsessive-compulsive disorder.
C) posttraumatic stress disorder.
D) generalized anxiety disorder.
Q2) If a penny-pinching patient rationalizes personal behavior,a nurse will expect that the patient is most likely to:
A) call other people wasteful.
B) start spending money liberally.
C) claim to exemplify the virtue of thrift.
D) give vast amounts of money to charity on death.
Q3) In the cognitive realm,which assessment finding most indicates depression?
A) Uncertainty in negative evaluations
B) Selective and specific negative appraisals
C) Global view that nothing will turn out right
D) Tentatively regards defects or mistakes as revocable
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Page 17
Chapter 16: Psychophysiological Responses and Somatoform and
Sleep
Disorders
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Q1) Which patient is most likely exhibiting a somatization disorder?
A) A person with chronic pain in the right ankle after a skiing injury
B) A person who experiences occasional chest pain after a myocardial infarction
C) A college graduate who cannot maintain steady employment because of multiple vague complaints
D) A person who dislikes going out to social events with large groups because of embarrassment about facial acne
Q2) A nurse is caring for a patient diagnosed with extreme stress.The nurse is focusing interventions on the promotion of adaptive psychophysiological patient responses.Which intervention is included in the plan of care?
A) Monitoring the patient's medication
B) Monitoring the patient's physical health
C) Shifting the patient's attention away from the symptoms
D) Providing education to promote change in the patient's health practices
Q3) Which patient is most likely exhibiting a conversion disorder?
A) A toddler with frequent ear infections
B) An athlete with exercise-induced asthma
C) A night guard who suddenly goes blind
D) An older adult whose fractured foot is not healing well
Page 18
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Chapter 17: Self-Concept Responses and Dissociative Disorders
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Q1) Select the best goal when working with a patient who has an alteration in self-concept.
A) The patient will develop insight into his or her problems and current life situation.
B) The patient will clarify his or her concept of self in relation to relationships with others.
C) The patient will attain the maximum level of self-actualization to realize his or her potential.
D) The patient will effectively evaluate coping choices made in the past and their consequences.
Q2) A nurse is working with a patient to improve self-concept using an intervention directed toward self-evaluation.Which intervention is best?
A) Providing support measures to reduce the patient's anxiety
B) Clarifying that the patient's beliefs affect the patient's feelings and behaviors
C) Documenting the patient's use of both logical and illogical thinking
D) Helping the patient understand that the patient alone can bring about personal change
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19
Chapter 18: Emotional Responses and Mood Disorders
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Q1) When a nurse shares that "caring for the manic client is less stressful than caring for a depressed one since they aren't at risk for injury," the nurse manager responds:
A) "Every patient requires an assessment for injury risk."
B) "Let's consider the ways that acute mania can also cause injuries."
C) "You're right that suicide potential always exists with depression."
D) "The potential for injury is high for all patients with an affective disorder."
Q2) A patient being treated for severe depression shows resistance to involvement in the nurse-patient relationship by being withdrawn and unresponsive.There is also preoccupation with guilt and hopelessness.When interacting with the patient,which response would have the greatest therapeutic impact?
A) "Everything will work out."
B) "Let's explore the origins of your pessimism."
C) "It's very likely that you will feel better as your treatment continues."
D) "You have to help yourself by getting rid of your negative thoughts."
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Chapter 19: Self-Protective Responses and Suicidal Behavior
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Q1) A person calls the crisis hotline and says,"Nobody can help me now.I just want to say goodbye to somebody before I do it." The best response to this statement would be:
A) "I can help you. Will you let me try?"
B) "You're still alive, so you can still get help."
C) "You sound very discouraged. What are you planning to do?"
D) "I'll arrange transportation so you can come here and tell me about the problem."
Q2) Which remark by a nurse best represents an attempt to assess the patient's current ability to organize and enact a suicide wish?
A) "What is your educational background?"
B) "What plan do you have for committing suicide?"
C) "Have you ever thought about or tried to hurt yourself?"
D) "Are your self-destructive thoughts constant or intermittent?"
Q3) Patients of which demographic group have the highest suicide rate in the United States?
A) Female between the ages of 13 and 19 years
B) Male between the ages of 19 and 27 years
C) Female age 65 years or older
D) Male age 50 years or older
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Chapter 20: Neurobiological Responses and Schizophrenia and Psychotic Disorders
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Q1) An appropriate short-term goal for a withdrawn,isolated patient diagnosed with schizophrenia is,"The patient will:
A) participate in all therapeutic activities."
B) define major barriers to communication."
C) talk about feelings of withdrawal in group."
D) consistently interact with an assigned nurse."
Q2) The nursing diagnosis most likely to be applicable for a person who has schizophrenia,paranoid type,is:
A) social isolation related to impaired ability to trust.
B) impaired mobility related to fear of losing control of hostile impulses.
C) fear of being alone related to lack of confidence in significant others.
D) impaired memory related to poor information processing associated with brain deficits.
Q3) A patient displays positive symptoms of schizophrenia as evidenced by psychotic disorders of thinking.The nurse can expect the patient to evidence:
A) delusions and hallucinations.
B) grimacing and mannerisms.
C) echopraxia and echolalia.
D) avolition and anhedonia.
Page 22
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Chapter 21: Social Responses and Personality Disorders
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Q1) A nurse working with a patient diagnosed with borderline personality disorder will need to consider therapeutic strategies for which likely patient characteristics? (Select all that apply.)
A) Unpredictable mood shifts
B) A strong sense of interdependence
C) Impulsivity that leads to extreme risk taking
D) Tendency to overreact to even minor criticism
E) Hallucinations that may be either visual or auditory
Q2) Which statement best describes persons with personality disorders?
A) The patient's coping skills are severely impaired by cognitive impairment.
B) The patient's maladaptive behaviors involve only a single aspect of personality.
C) The patient has enduring ways of relating that often provoke negative reactions.
D) The patient has considerable resilience when faced with stressful life situations.
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23
Chapter 22: Cognitive Responses and Organic Mental Disorders
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Q1) An individual being treated in the emergency room is found to have flushed,dry skin and sensorium that alternates between clouded and clear.A friend reveals the patient has not voided or ingested food or fluid in 18 hours.When the health care provider diagnoses fever of unknown origin,the plan is to make an effort to orally hydrate before attempting to start an IV line.The intervention most likely to be effective will be:
A) placing a pitcher of water at the patient's bedside.
B) placing a "force fluids" sign at the head of the bed.
C) asking the friend to give the patient a drink whenever the patient is alert.
D) staying with the patient to ensure that a glass of liquid is ingested once every hour.
Q2) A 72-year-old female patient has delirium secondary to anticholinergic medication toxicity.The nurse planning discharge care teaches the family to be alert for maladaptive cognitive symptoms because:
A) delirium is a hypersensitivity reaction.
B) the elderly often deny changes in cognition.
C) elderly females are more prone to delirium than elderly males.
D) slower metabolism in the elderly predisposes to medication toxicity.
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Chapter 23: Chemically Mediated Responses and
Substance-Related Disorders
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Q1) When designing a teaching plan for a patient taking disulfiram (Antabuse),a nurse should include an explanation on the importance of avoiding certain over-the-counter substances.With the appropriate instruction,which substance could the patient identify as being safe to use?
A) Antacids
B) Mouthwash
C) Cough syrups
D) Cold medications
Q2) A patient sustained a fractured femur while driving under the influence of drugs.Family members indicate that the patient has "dabbled in drugs" for years.When the patient obtains little relief from the prescribed dose of narcotic analgesic,the nurse suspects the ineffective pain relief is related to:
A) drug tolerance to the narcotic prescribed.
B) the predictable onset of withdrawal symptoms.
C) insufficient analgesic dosage to manage the pain.
D) the strong likelihood of a history of substance abuse.
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Chapter 24: Eating Regulation Responses and Eating Disorders
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Q1) A nurse assesses that which individual is most likely to engage in binge-eating behaviors characteristic of bulimia? A person who:
A) weighs 225 pounds and is 5 feet 4 inches tall.
B) is 5 pounds overweight and cannot stick to a diet.
C) lost 40 pounds but gained it back within 1 year.
D) monitors caloric intake in order to fit into a small suit.
Q2) A nurse would expect to assess which feature in a patient diagnosed with anorexia nervosa without bingeing or purging?
A) Claims of sexual activity
B) Denial of hunger at all times
C) Extroverted personality traits
D) Abuse of diuretics and laxatives
Q3) When undertaking care for patients with eating disorders,a nurse should first:
A) perform a complete patient assessment.
B) obtain a history from the patient's family.
C) examine personal feelings about weight.
D) question the patient as to when he or she last ate a meal.
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Page 26
Chapter 25: Sexual Responses and Sexual Disorders
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Q1) A person states,"I feel as though I'm really a woman trapped in this male body." This type of statement is characteristically expressed by someone who is a:
A) transsexual.
B) transvestite.
C) pedophile.
D) homosexual.
Q2) Parents are upset after learning that their child is homosexual.They ask the nurse,"What causes homosexuality; was it something we did?" The nurse responds best when stating:
A) "The cause of homosexuality has not been determined as of yet."
B) "It's thought that homosexuality is transmitted via the X chromosome."
C) "Many people consider homosexuality to be an expression of normal sexual behavior."
D) "You sound as though you are expressing concern about both your child and yourself."
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Chapter 26: Psychopharmacology
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Q1) In order to effectively provide appropriate patient teaching regarding the effects of psychotropic medications,the nurse is required to have a thorough understanding of which drug-related topic?
A) Clinical indicators
B) Pharmacology algorithms
C) Monotherapeutic symptoms
D) Doses of all atypical psychotropic drugs
Q2) Which medication would the nurse expect to administer when observing that a patient being treated for schizophrenia is fidgety,demonstrates motor restlessness,and jiggles both legs when asked to sit down?
A) Olanzapine (Zyprexa)
B) Molindone (Moban)
C) Biperiden (Akineton)
D) Thioridazine (Mellaril)
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28
Chapter 27: Behavior Change and Cognitive Interventions
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Q1) A nurse teaches a group of parents about positive and negative reinforcement in shaping behavior.Which is an example of a positive reinforcer?
A) A parent who kisses a child who is crying to make the crying stop
B) An adolescent who runs away from home because of trouble in school
C) A parent who praises a child for putting toys away after playtime
D) An adolescent who drives within the speed limit to avoid getting a ticket
Q2) What is the correct order for performing progressive muscle relaxation (PMR)?
A) Tensing and relaxing muscle groups from the middle of the body outward to the extremities
B) Relaxing and tensing muscle groups from the middle of the body outward to the extremities
C) Tensing and releasing muscle groups from the facial muscles and moving down to the muscles in the feet
D) Relaxing and tightening muscle groups from the facial muscles and moving down to the muscles in the feet
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Chapter 28: Preventing and Managing Aggressive Behavior
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Sample Questions
Q1) A newly licensed nurse tells a nurse manager,"I'd like you to stop referring to me as 'the smart new degree nurse.'" The nurse manager replies,"I was only teasing.You are being overly sensitive." Which statement accurately evaluates the newly licensed nurse's comment to the nurse manager?
A) The nurse is appropriately assertive, but now the nurse manager will likely belittle the nurse even more.
B) The nurse is behaving aggressively because of the newness of being a graduate licensed nurse and owes the nurse manager an apology.
C) The nurse is assertive, and responding that the nurse does not regard the nurse manager's comments as "teasing" would be an effective follow-up communication.
D) The nurse is overly sensitive and ought to have ignored the nurse manager's teasing until it was extinguished. Now the nurse manager will be more sarcastic than ever.
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Chapter 29: Somatic Therapies
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Sample Questions
Q1) A patient scheduled for an initial ECT (electroconvulsive therapy) treatment asks a nurse,"Isn't the electrical current dangerous?" Which response would be the most therapeutic?
A) "The amount of electricity is very small and used for only a few seconds."
B) "The chance of you being shocked is minimal; you won't feel anything."
C) "There's a small chance of something going wrong; the risk is about the same as with minor surgery."
D) "You're worried about being electrocuted, aren't you? Don't worry; there is no chance of that happening."
Q2) A patient who has received three ECT (electroconvulsive therapy) treatments with no ill effects displays confusion and memory loss after the fourth treatment.Which nursing intervention would be most therapeutic based on a nurse's knowledge of ECT effects?
A) Administer a benzodiazepine by IM injection immediately.
B) Call the health care provider and report this sudden alteration immediately.
C) Inform the family that the short-term memory loss may be permanent.
D) Orient the patient periodically, emphasizing that the memory loss is temporary.
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Page 31
Chapter 30: Complementary and Alternative Therapies
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Sample Questions
Q1) What is the best nursing response when a patient asks,"What do you know about massage therapy? A friend of mine says it can be more helpful than antidepressants."
A) "The research has shown that massage is very beneficial, so this is a good question for you to ask your doctor. Why not bring up the topic with your psychiatrist today during your visit?"
B) "While a few research studies indicate that massage will help relieve depression and anxiety, it's effective for only a short time, and no studies have compared massage with medication."
C) "I know very little, because there really is no current research available on the effectiveness of massage. However, many of these new therapies can do damage, so I wouldn't do it."
D) "I know very little, because there are few research findings on the effectiveness of massage. It certainly can't hurt, and it might help, so why not try it?"
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Chapter 31: Therapeutic Groups
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Sample Questions
Q1) A member in a psychotherapy group tells another member,"I'm tired of hearing you whine all the time.Why won't you just try to stick with the topic we are trying to discuss?"
The nurse recognizes that the criticized member of the group best understands the goal of group work when he is heard stating:
A) "You are always criticizing me. Don't talk to me like that."
B) "I understand that you have a hard time talking with people. I do too."
C) "You seem to always say nasty things that will hurt people's feelings. Maybe you should think before you speak."
D) "I've learned that speaking without thinking often results in hurt feelings. We all need to think before we speak."
Q2) Which comment by the nurse would be most therapeutic when a group member challenges a nurse leader's authority?
A) "Who do you think should be the group leader, if not me?"
B) "So you're asking, 'Who made me the leader?'"
C) "Do you want to be the group leader?"
D) "You resist my authority?"
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Chapter 32: Family Interventions
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Sample Questions
Q1) To conduct research based on family intervention,the researcher would focus on the family as a unit or system to better understand family:
A) roles.
B) economics.
C) ethnicity.
D) functioning.
Q2) An adolescent with a history of multiple minor physical injuries is sent to the school nurse because of a large bruise on the lower left leg.The adolescent says,"I think I got the bruise when I fell." The school nurse should interview the adolescent with a primary focus on:
A) having the adolescent describe the circumstances of the fall that resulted in the bruise.
B) determining whether this adolescent will identify other risk factors for physical abuse. C) gathering data to include in a report to the department of social services for adolescent abuse.
D) establishing the likelihood that the adolescent has a physical condition that accounts for the frequent injuries.
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34
Chapter 33: Hospital-Based Psychiatric Nursing Care
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Sample Questions
Q1) During a group session,a flirtatious patient with mania shares that several patients and the nurse "have bodies that are really nice." The most therapeutic response from the nurse would be:
A) "Please go to your room. You're being inappropriate to me and the other patients."
B) "I know your thoughts are very rapid right now. Let's walk to your room where you can take a 30-minute time-out."
C) "Were you aware before you spoke that what you just said would offend me and the other patients on the unit very much?"
D) "Do not speak to me or others like this. Would you like to take this opportunity to apologize to me and the other patients?"
Q2) A patient with a history of chronic alcohol abuse and impaired cognitive function has been successfully taught to interpret a community bus schedule.The nurse should now be confident that the patient would benefit from attending:
A) a community resource group in the day hospital.
B) a substance abuse group on an outpatient basis.
C) a life skills group at the outpatient clinic.
D) Alcoholics Anonymous at the YMCA.
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Page 35
Chapter 34: Community-Based Psychiatric Nursing Care
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Sample Questions
Q1) Which situation would be considered discrimination under the Americans with Disabilities Act?
A) A Hispanic with poor English-speaking skills is hospitalized for possible late-onset schizophrenia.
B) A patient hospitalized for detoxification after a drunk driving accident is not allowed to leave the unit.
C) Staff is responsible for bathing, dressing, and feeding a patient diagnosed with mild Alzheimer disease (AD) on a daily basis.
D) After evaluation a cognitively impaired individual diagnosed with obsessive compulsive disorder (OCD) is identified as being "unemployable."
Q2) An example of the primary responsibility of a nurse case manager for psychiatric patients in a residential home is to:
A) assure each patient is bathed and clothed appropriately.
B) conduct the unit's socialization group session daily.
C) participate in the feeding of a severely depressed patient.
D) arrange for a patient to move into a private apartment.
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Chapter 35: Child Psychiatric Nursing
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Sample Questions
Q1) Which observation gives the best indication that an adolescent is able to effectively balance relaxation and work?
A) After being reminded to clean his bedroom the child goes back to playing computer games.
B) When found sitting quietly in the living room the child indicates to parents that the behavior is a way to relax.
C) The child enjoys several group sports and delivers newspapers before school for 25 families in the neighborhood.
D) The child seems to enjoy participating in activities such as cleaning and learning complicated software on the family computer.
Q2) A nurse is working with primary school-age children diagnosed with psychiatric disorders.To most therapeutically address low self-esteem issues the nurse should:
A) give positive feedback for small goal accomplishment.
B) reward all acceptable behavior with positive feedback.
C) set major goals so that they can strive for accomplishments.
D) encourage active participation in a peer self-esteem self-help group.
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Chapter 36: Adolescent Psychiatric Nursing
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Sample Questions
Q1) When a teacher reports that an adolescent has begun failing in class and is isolated from friends during laboratory sessions,the nurse responds most therapeutically by stating:
A) "Let's discuss this. The symptoms of adolescent depression can look very different from those of adult depression."
B) "Have you set limits on the student's behavior and called for an immediate family intervention?"
C) "I'll call the student's parents and see if I can get their permission to assess for possible depression."
D) "Have you noticed whether others have been bullying the student in your class?"
Q2) Which nursing intervention would be most effective when assisting an adolescent who is in stage three of substance abuse?
A) Recommend a drug-free self-help group and family therapy.
B) Provide drug education and drug-free activities for the adolescent.
C) Recommend hospitalization at a drug abuse center to facilitate withdrawal.
D) Provide anticipatory guidance to help the adolescent develop healthy coping skills.
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Chapter 37: Geropsychiatric Nursing
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Sample Questions
Q1) An older adult reports that "I know that I'm not the cheerful person I used to be but that's just a part of growing old." Using a psychological theoretical framework,the nurse might respond:
A) "When your life focuses on positive experiences from your adolescence, aging is reduced by that youthful mental status."
B) "There may be many causes for what you are feeling. I'd suggest seeing your health care provider to rule out any physical causes."
C) "The best way to prepare for a 'good death' is to systematically review your life and change any behaviors you feel might interfere with this process."
D) "You are in the last stage of development in your life, and it's important that you attempt to correct anything about your life that dissatisfies or saddens you."
Q2) Which older adult is at greatest risk for falls based on the medication profile? An older adult taking:
A) psyllium daily as a bulk-forming laxative.
B) calcium daily after hip replacement surgery.
C) an over-the-counter sleep aid an average of once per week.
D) an angiotensin-converting enzyme inhibitor daily for mild hypertension.
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Chapter 38: Care of Survivors of Abuse and Violence
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Sample Questions
Q1) Which comment best reflects the nurse's use of an empowerment model with an individual who has been abused?
A) "Let me share with you my knowledge of what happens psychologically to individuals who have been abused."
B) "I know that you feel that your partner will change, but the current research does not validate your thinking."
C) "It's up to you to end the violence. You are the only one who can set limits on how your partner is allowed to treat you."
D) "Let's consider what you believe your options are in terms of your relationship with your partner in light of the behavior toward you."
Q2) Which behavior would the nurse expect in a person who commits psychic rape? The perpetrator:
A) gives money to the victim after the rape.
B) seduces the victim by providing wine, flowers, and music.
C) threatens the victim to submit or else be severely beaten.
D) always mentions including violent bondage in sexual activities.
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Chapter 39: The Military and Their Families
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Sample Questions
Q1) Several nurses are newly assigned to a hospital unit that focuses on the care of military personnel who have sustained severe brain injuries and their families.The nurse manager would initially suggest that they:
A) focus on honing their therapeutic communication and assessment skills.
B) self-reflect concerning their feelings about working with the disabled.
C) learn to recognize and act upon the emotional needs of the family.
D) review the physical needs of the traumatic brain injured client.
Q2) Six months after returning from a combat zone,a discharged Marine reports having both memory and concentration problems that resulted in earning failing grades in two college courses.An understanding of the pathophysiology of traumatic brain injury would prompt the nurse to initially ask:
A) "Were you ever treated for a traumatic brain injury?"
B) "Were you ever hit on the head during your military deployment?"
C) "Has a blow to the head ever resulted in you being unconscious for more than 20 minutes?"
D) "When did the memory problems and difficulty with concentration begin to affect your schoolwork?"
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Chapter 40: Psychological Care of Patients with Life-Threatening Illness
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Source URL: https://quizplus.com/quiz/6414
Sample Questions
Q1) A nurse explained hospice services to a patient with metastatic cancer.In evaluating the teaching,the nurse determines the need for further information when the patient states that one of the services provided in hospice care is:
A) experimental chemotherapy.
B) symptom management.
C) psychosocial support.
D) nutritional counseling.
Q2) When a terminally ill patient is attempting to make the decision to withhold further treatment,the nurse would indicate that which medication would no longer be prescribed if treatment were to be withheld?
A) Antibiotics
B) Antiemetics
C) Opioid analgesics
D) Nonopioid analgesics
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