Nursing Care of Clients with Psychiatric Disorders
Pre-Test Questions
Course Introduction
This course explores the principles and practices of nursing care for individuals experiencing psychiatric disorders across the lifespan. Emphasis is placed on developing therapeutic communication skills, understanding the biological, psychological, and social factors contributing to mental health conditions, and implementing evidence-based interventions. Students learn to assess, plan, and evaluate care in collaboration with clients, families, and interdisciplinary teams, while considering ethical, legal, and cultural aspects of psychiatric nursing. Topics include mood disorders, anxiety disorders, schizophrenia, substance use, crisis intervention, and the promotion of mental wellness, preparing students to support clients in both acute and community settings.
Recommended Textbook
Essentials of Psychiatric Mental Health Nursing 3rd Edition by Varcarolis
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28 Chapters
803 Verified Questions
803 Flashcards
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Chapter 1: Practicing the Science and Art of Psychiatric Nursing
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15 Verified Questions
15 Flashcards
Source URL: https://quizplus.com/quiz/2047
Sample Questions
Q1) A patient shows the nurse an article from the Internet about a health problem. Which characteristic of the web site's address most alerts the nurse that the site may have biased and prejudiced information?
A) Address ends in ".org"
B) Address ends in ".com"
C) Address ends in ".gov"
D) Address ends in ".net"
Answer: B
Q2) A nurse assesses a newly admitted patient diagnosed with major depressive disorder. Which statement is an example of "attending"?
A) "We all have stress in life. Being in a psychiatric hospital is not the end of the world."
B) "Tell me why you felt you had to be hospitalized to receive treatment for your depression."
C) "You will feel better after we get some antidepressant medication started for you."
D) "I'd like to sit with you a while so you may feel more comfortable talking with me."
Answer: D
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Chapter 2: Mental Health and Mental Illness
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17 Verified Questions
17 Flashcards
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Sample Questions
Q1) In the majority culture of the United States, which individual is at greatest risk to be incorrectly labeled mentally ill?
A) Person who is usually pessimistic but strives to meet personal goals
B) Wealthy person who gives $20 bills to needy individuals in the community
C) Person with an optimistic viewpoint about getting his or her own needs met
D) Person who attends a charismatic church and describes hearing God's voice
Answer: D
Q2) Which belief by a nurse supports the highest degree of patient advocacy during a multidisciplinary patient care planning session?
A) All mental illnesses are culturally determined.
B) Schizophrenia and bipolar disorder are cross-cultural disorders.
C) Symptoms of mental disorders are constant from culture to culture.
D) Some symptoms of mental disorders may reflect a person's cultural patterns.
Answer: D
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4
Chapter 3: Theories and Therapies
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) A nurse uses Maslow's hierarchy of needs to plan care for a psychotic patient. Which problem will receive priority? The patient:
A) refuses to eat or bathe.
B) reports feelings of alienation from family.
C) is reluctant to participate in unit social activities.
D) needs to be taught about medication action and side effects.
Answer: A
Q2) A nurse assesses that a patient is suspicious and frequently manipulates others. Using the Freudian theory, these traits are related to which psychosexual stage?
A) Oral
B) Anal
C) Phallic
D) Genital
Answer: A
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Chapter 4: Biological Basis for Understanding
Psychopharmacology
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28 Verified Questions
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Sample Questions
Q1) A nurse can anticipate anticholinergic side effects are likely to occur when a patient is taking:
A) lithium (Lithobid).
B) buspirone (BuSpar).
C) risperidone (Risperdal).
D) fluphenazine (Prolixin).
Q2) A patient is hospitalized for major depressive disorder. Of the medications listed, a nurse can expect to provide the patient with teaching about:
A) chlordiazepoxide (Librium).
B) fluoxetine (Prozac).
C) clozapine (Clozaril).
D) tacrine (Cognex).
Q3) A nurse caring for a patient taking a selective serotonin reuptake inhibitor (SSRI) will develop outcome criteria related to:
A) mood improvement.
B) logical thought processes.
C) reduced levels of motor activity.
D) decreased extrapyramidal symptoms.
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Chapter 5: Settings for Psychiatric Care
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Sample Questions
Q1) Which principle takes priority for the psychiatric inpatient staff when addressing behavioral crises?
A) Resolve behavioral crises using the least restrictive intervention possible.
B) Rights of the majority of patients supersede the rights of individual patients.
C) Swift intervention is justified to maintain the integrity of the therapeutic milieu.
D) Allow patients opportunities to regain control without intervention if the safety of other patients is not compromised.
Q2) A patient hurriedly tells the community mental health nurse, "Everything's a disaster! I can't concentrate. My disability check didn't come. My roommate moved out, and I can't afford the rent. My therapist is moving away. I feel like I'm coming apart." Nursing interventions should be focused on which problem?
A) Assisting the patient to clarify personal values
B) Coping with feelings of abandonment
C) Coping with anxiety that may lead to psychological disequilibrium
D) Clarifying misperceptions of the environment,
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Chapter 6: Legal and Ethical Basis for Practice
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Sample Questions
Q1) Several nurses are concerned that agency policies related to restraint and seclusion are inadequate. Which statement about the relationship of substandard institutional policies and individual nursing practice should guide nursing practice?
A) The policies do not absolve an individual nurse of the responsibility to practice according to the professional standards of nursing care.
B) Agency policies are the legal standard by which a professional nurse must act and therefore override other standards of care.
C) In an institution with substandard policies, the nurse has a responsibility to inform the supervisor and leave the premises.
D) Interpretation of policies by the judicial system is rendered on an individual basis and therefore cannot be predicted.
Q2) A psychiatric nurse best implements the ethical principle of autonomy when he or she:
A) intervenes when a self-mutilating patient attempts to harm self.
B) stays with a patient who is demonstrating a high level of anxiety.
C) suggests that two patients who are fighting be restricted to the unit.
D) explores alternative solutions with a patient, who then makes a choice.
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Page 8
Chapter
and Effective Care
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28 Verified Questions
28 Flashcards
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Sample Questions
Q1) A new staff nurse completes orientation to the psychiatric unit. This nurse will expect to ask an advanced practice nurse to perform which action for patients?
A) Perform mental health assessment interviews.
B) Establish therapeutic relationships.
C) Prescribe psychotropic medication.
D) Individualize nursing care plans.
Q2) An adolescent asks a nurse conducting an assessment interview, "Why should I tell you anything? You'll just tell my parents whatever you find out." Select the nurse's best reply.
A) "That is not true. What you tell us is private and held in strict confidence. Your parents have no right to know."
B) "Yes, your parents may find out what you say, but it is important that they know about your problems."
C) "What you say about feelings is private, but some things, like suicidal thinking, must be reported to the treatment team."
D) "It sounds as though you are not really ready to work on your problems and make changes."
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Page 9
Chapter 8: Communication Skills: Medium for All Nursing Practice
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Sample Questions
Q1) A patient tells the nurse, "I don't think I will ever get out of here." Select the nurse's most therapeutic response.
A) "Don't talk that way. Of course you will leave here."
B) "Keep up the good work and you certainly will."
C) "You don't think you're making progress?"
D) "Everyone feels that way sometimes."
Q2) Documentation in a patient's chart shows, "Throughout a 5-minute interaction, patient fidgeted and tapped left foot, periodically covered face with hands, and looked under chair while stating, 'I enjoy spending time with you.'" Which analysis is most accurate?
A) Patient is giving positive feedback about the nurse's communication techniques.
B) Nurse is viewing the patient's behavior through a cultural filter.
C) Patient's verbal and nonverbal messages are incongruent.
D) Patient is demonstrating psychotic behaviors.
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Chapter 9: Therapeutic Relationships and the Clinical
Interview
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Sample Questions
Q1) A nurse ends a relationship with a patient. Which actions by the nurse should be included in the termination phase? (Select all that apply.)
A) Focus dialog with the patient on problems that may occur in the future.
B) Help the patient express feelings about the relationship with the nurse.
C) Help the patient prioritize and modify socially unacceptable behaviors.
D) Reinforce expectations regarding the parameters of the relationship.
E) Help the patient identify strengths, limitations, and problems.
Q2) As a nurse discharges a patient, the patient gives the nurse a card of appreciation made in an arts and crafts group. What is the nurse's best action?
A) Recognize the effectiveness of the relationship and patient's thoughtfulness. Accept the card.
B) Inform the patient that accepting gifts violates the policies of the facility. Decline the card.
C) Acknowledge the patient's transition through the termination phase but decline the card.
D) Accept the card and invite the patient to return to participate in other arts and crafts groups.
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Chapter 10: Trauma and Stress-Related Disorders
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Sample Questions
Q1) A veteran of military combat tells the nurse, "I saw a child get blown up over a year ago, and now I keep seeing bits of flesh everywhere. I see something red and the visions race back to my mind." Which phenomenon associated with posttraumatic stress disorder (PTSD) is this veteran describing?
A) Re-experiencing
B) Hyperarousal
C) Avoidance
D) Psychosis
Q2) A nurse assesses the health status of veterans of the war in Afghanistan. Screening will be a priority for signs and symptoms of which health problems? (Select all that apply.)
A) Schizophrenia
B) Eating disorder
C) Traumatic brain injury
D) Seasonal affective disorder
E) Posttraumatic stress disorder
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Chapter 11: Anxiety, Anxiety Disorders, and
Obsessive-Compulsive and Related Disorders
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39 Verified Questions
39 Flashcards
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Sample Questions
Q1) A nurse encourages an anxious patient to talk about feelings and concerns. What is the rationale for this intervention?
A) Offering hope allays and defuses the patient's anxiety.
B) Concerns stated aloud become less overwhelming and help problem solving to begin.
C) Anxiety is reduced by focusing on and validating what is occurring in the environment.
D) Encouraging patients to explore alternatives increases the sense of control and lessens anxiety.
Q2) A patient experiences an episode of severe anxiety. Of these medications in the patient's medical record, which is most appropriate to administer as an as-needed (PRN) anxiolytic medication?
A) Buspirone (BuSpar)
B) Lorazepam (Ativan)
C) Amitriptyline (Elavil)
D) Desipramine (Norpramin)
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13
Chapter 12: Somatic Symptom Disorders and Dissociative Disorders
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Sample Questions
Q1) A patient diagnosed with somatic symptom disorder says, "I have pain from an undiagnosed injury. I can't take care of myself. I need pain medicine six or seven times a day. I feel like a baby because my family has to help me so much." It is important for the nurse to assess:
A) mood.
B) cognitive style.
C) secondary gains.
D) identity and memory.
Q2) A nurse assessing a patient diagnosed with a somatic system disorder is most likely to note that the patient:
A) readily sees a relationship between symptoms and interpersonal conflicts.
B) rarely derives personal benefit from the symptoms.
C) has little difficulty communicating emotional needs.
D) has unmet needs related to comfort and activity.
Q3) The causes of somatic system disorders may be related to:
A) faulty perceptions of body sensations.
B) traumatic childhood events.
C) culture-bound phenomena.
D) mood instability.
Page 14
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Chapter 13: Personality Disorders
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Sample Questions
Q1) A nurse reports to the interdisciplinary team that a patient diagnosed with an antisocial personality disorder lies to other patients, verbally abuses a patient diagnosed with dementia, and flatters the primary nurse. This patient is detached and superficial during counseling sessions. Which behavior most clearly warrants limit setting?
A) Flattering the nurse
B) Lying to other patients
C) Verbal abuse of another patient
D) Detached superficiality during counseling
Q2) A patient diagnosed with borderline personality disorder has been hospitalized several times after self-inflicted lacerations. The patient remains impulsive. Dialectical behavior therapy starts on an outpatient basis. Which nursing diagnosis is the focus of this therapy?
A) Risk for self-mutilation
B) Impaired skin integrity
C) Risk for injury
D) Powerlessness
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15
Chapter 14: Eating Disorders
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Sample Questions
Q1) What behavior by a nurse caring for a patient diagnosed with an eating disorder indicates the nurse needs supervision?
A) The nurse's comments are compassionate and nonjudgmental.
B) The nurse uses an authoritarian manner when interacting with the patient.
C) The nurse teaches the patient to recognize signs of increasing anxiety and ways to intervene.
D) The nurse refers the patient to a self-help group for individuals with eating disorders.
Q2) Over the past year, a woman has cooked gourmet meals for her family but eats only tiny servings. She wears layered, loose clothing and now has amenorrhea. Her current weight is 95 pounds, a loss of 35 pounds. Which medical diagnosis is most likely?
A) Binge eating disorder
B) Anorexia nervosa
C) Bulimia nervosa
D) Pica
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Chapter 15: Mood Disorders: Depression
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33 Verified Questions
33 Flashcards
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Sample Questions
Q1) A disheveled patient with severe depression and psychomotor retardation has not bathed for several days. The nurse should:
A) avoid forcing the issue.
B) bring up the issue at the community meeting.
C) calmly tell the patient, "You must bathe daily."
D) firmly and neutrally assist the patient with showering.
Q2) A patient diagnosed with major depressive disorder tells the nurse, "Bad things that happen are always my fault." To assist the patient in reframing this overgeneralization, the nurse should respond:
A) "I really doubt that one person can be blamed for all the bad things that happen."
B) "Let's look at one bad thing that happened to see if another explanation exists."
C) "You are being exceptionally hard on yourself when you say those things."
D) "How does your belief in fate relate to your cultural heritage?"
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Chapter 16: Bipolar Spectrum Disorders
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Sample Questions
Q1) A patient diagnosed with bipolar disorder commands other patients, "Get me a book. Take this stuff out of here," and other similar demands. The nurse wants to interrupt this behavior without entering into a power struggle. Select the best initial approach by the nurse.
A) Distraction: "Let's go to the dining room for a snack."
B) Humor: "How much are you paying servants these days?"
C) Limit setting: "You must stop ordering other patients around."
D) Honest feedback: "Your controlling behavior is annoying others."
Q2) A patient receiving lithium should be assessed for which evidence of complications?
A) Pharyngitis, mydriasis, and dystonia
B) Alopecia, purpura, and drowsiness
C) Diaphoresis, weakness, and nausea
D) Ascites, dyspnea, and edema
Q3) Which dinner menu is best suited for the patient diagnosed with bipolar disorder experiencing acute mania?
A) Spaghetti and meatballs, salad, a banana
B) Beef and vegetable stew, a roll, chocolate pudding
C) Broiled chicken breast on a roll, an ear of corn, apple
D) Chicken casserole, green beans, flavored gelatin with whipped cream
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Page 18
Chapter 17: Schizophrenia Spectrum Disorders and Other
Psychotic Disorders
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Sample Questions
Q1) A patient receiving risperidone (Risperdal) reports severe muscle stiffness at 10:30 AM. By noon, the patient is diaphoretic, drooling, and has difficulty swallowing. By 4:00 PM, vital signs are body temperature, 102.8° F; pulse, 110 beats per minute; respirations, 26 breaths per minute; and blood pressure, 150/90 mm Hg. Select the nurse's best analysis and action.
A) Agranulocytosis. Institute reverse isolation.
B) Tardive dyskinesia. Withhold the next dose of medication.
C) Cholestatic jaundice. Begin a high-protein, low fat diet.
D) Neuroleptic malignant syndrome. Immediately notify the health care provider.
Q2) A patient diagnosed with schizophrenia has taken a first generation antipsychotic medication for a year. Hallucinations are less intrusive but the patient continues to have apathy, poverty of thought, and social isolation. The nurse expects a change to which medication?
A) Haloperidol (Haldol)
B) Olanzapine (Zyprexa)
C) Chlorpromazine (Thorazine)
D) Diphenhydramine (Benadryl)
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Page 19
Chapter 18: Neurocognitive Disorders
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Sample Questions
Q1) Two patients in a residential care facility are diagnosed with dementia. One shouts to the other, "Move along, you're blocking the road." The other patient turns, shakes a fist, and shouts, "I know what you're up to; you're trying to steal my car." What is the nurse's best action?
A) Administer one dose of an antipsychotic medication to both patients.
B) Reinforce reality. Say to the patients, "Walk along in the hall. This is not a traffic intersection."
C) Separate and distract the patients. Take one to the day room and the other to an activities area.
D) Step between the two patients and say, "Please quiet down. We do not allow violence here."
Q2) Consider these health problems: Lewy body disease, Pick disease, and Korsakoff syndrome. Which term unifies these problems?
A) Intoxication
B) Dementia
C) Delirium
D) Amnesia
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Page 20
Chapter 19: Substance-Related and Addictive Disorders
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Sample Questions
Q1) The treatment team plans care for a person diagnosed with schizophrenia and cannabis abuse. The person has recently used cannabis daily and is experiencing increased hallucinations and delusions. Which principle applies to care planning?
A) Consider each disorder primary and provide simultaneous treatment.
B) The person will benefit from treatment in a residential treatment facility.
C) Withdraw the person from cannabis, and then treat the schizophrenia.
D) Treat the schizophrenia first, and then establish the goals for the treatment of substance abuse.
Q2) When assessing a patient who has ingested flunitrazepam (Rohypnol), the nurse would expect:
A) acrophobia.
B) hypothermia.
C) hallucinations.
D) anterograde amnesia.
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21
Chapter 20: Crisis and Mass Disaster
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Sample Questions
Q1) A nurse assesses an adult experiencing a crisis. An appropriate question for the nurse to ask to determine situational support is:
A) "Has anything upsetting occurred in the past few days?"
B) "Who can be helpful to you during this time?"
C) "How does this problem affect your life?"
D) "What led you to seek help at this time?"
Q2) Which communication technique is used more in crisis intervention than traditional counseling?
A) Role modeling
B) Giving direction
C) Information giving
D) Empathic listening
Q3) Which premise is most useful to a nurse planning crisis intervention for any patient? The patient:
A) is experiencing a state of disequilibrium.
B) is experiencing a type of mental illness.
C) poses a threat of violence to others.
D) has a high potential for self-injury.
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22
Chapter 21: Child, Partner, and Elder Violence
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Sample Questions
Q1) An adult has recently been absent from work for 3-day periods on several occasions. Each time, this person returns to work wearing dark glasses. Facial and body bruises are apparent. What is the occupational health nurse's priority question?
A) "Do you drink excessively?"
B) "Did your partner beat you?"
C) "How did this happen to you?"
D) "What did you do to deserve this?"
Q2) After treatment for a detached retina, a victim of intimate partner violence says, "My partner only abuses me when intoxicated. I've considered leaving, but I was brought up to believe you stay together, no matter what happens. I always get an apology, and I can tell my partner feels bad after hitting me." Which nursing diagnosis applies?
A) Social isolation, related to lack of community support system
B) Risk for injury, related to partner's physical abuse when intoxicated
C) Deficient knowledge, related to resources for escape from the abusive relationship
D) Disabled family coping, related to uneven distribution of power within a relationship
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23
Chapter 22: Sexual Violence
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Sample Questions
Q1) What is the primary motivator for most rapists?
A) Anxiety
B) Need for humiliation
C) Overwhelming sexual desires
D) Desire to humiliate or control others
Q2) A victim of a sexual assault that occurred approximately 1 hour earlier sits in the emergency department rocking back and forth and repeatedly saying, "I can't believe I've been raped." This behavior is characteristic of which phase of the rape trauma syndrome?
A) Anger phase
B) Acute phase
C) Outward adjustment phase
D) Long-term reorganization phase
Q3) A child was abducted and raped. Which personal reaction by the nurse could interfere with the child's care?
A) Anger
B) Concern
C) Empathy
D) Compassion
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Page 24
Chapter 23: Suicidal Thoughts and Behavior
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Sample Questions
Q1) The feeling experienced by a patient that should be assessed by the nurse as most predictive of elevated suicide risk is:
A) hopelessness.
B) sadness.
C) elation.
D) anger.
Q2) A college student failed two examinations. The student cried for hours and then tried to call a parent but got no answer. The student then suspended access to his social networking web site. Which suicide risk factors are present? (Select all that apply.)
A) History of earlier suicide attempt
B) Co-occurring medical illness
C) Recent stressful life event
D) Self-imposed isolation
E) Shame or humiliation
Q3) When assessing a patient's plan for suicide, what aspect has priority?
A) Patient's financial and educational status
B) Patient's insight into suicidal motivation
C) Availability of means and lethality of method
D) Quality and availability of patient's social support
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Page 25
Chapter 24: Anger, Aggression, and Violence
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Sample Questions
Q1) Which is an effective nursing intervention to assist an angry patient to learn to manage anger without violence?
A) Help the patient identify a thought that increases anger, find proof for or against the belief, and substitute reality-based thinking.
B) Provide negative reinforcement such as restraint or seclusion in response to angry outbursts, whether or not violence is present.
C) Use aversive conditioning, such as popping a rubber band on the wrist, to help extinguish angry feelings.
D) Administer an antipsychotic or antianxiety medication when the patient feels angry.
Q2) A patient has a history of impulsively acting out anger by striking others. Which would be an appropriate plan for avoiding such incidents?
A) Explain that restraint and seclusion will be used if violence occurs.
B) Help the patient identify incidents that trigger impulsive acting out.
C) Offer one-on-one supervision to help the patient maintain control.
D) Administer lorazepam (Ativan) every 4 hours to reduce the patient's anxiety.
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Chapter 25: Care for the Dying and Those Who Grieve
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Sample Questions
Q1) Which finding indicates the successful completion of an individual's grieving process?
A) For two years, a person has kept the deceased spouse's belongings in their usual places.
B) After 15 months, a widowed person realistically remembers both the pleasures and disappointments of the relationship with the spouse.
C) Three years after the death, a person talks about the spouse as if the spouse was still alive and weeps when others mention the spouse's name.
D) Eighteen months after the spouse's death, a person says, "I never cry or have feelings of loss even though we were always very close."
Q2) A family of a terminally ill patient asks the nurse, "What can we say when our family member mentions death is coming soon?" Which response could the nurse suggest?
A) "We think you will be around for a long time."
B) "We don't want you to give up trying to get well."
C) "We don't think we're ready to talk about this yet."
D) "We feel so sad when we think of life without you."
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Chapter 26: Children and Adolescents
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Sample Questions
Q1) What are the primary distinguishing factors between the behavior of children diagnosed with oppositional defiant disorder (ODD) and those diagnosed with conduct disorder (CD)? (Select all that apply.) The child diagnosed with:
A) ODD relives traumatic events by acting them out.
B) ODD tests limits and disobeys authority figures.
C) ODD has difficulty separating from the parents.
D) CD uses stereotypical or repetitive language.
E) CD often violates the rights of others.
Q2) An 11-year-old child, who has been diagnosed with oppositional defiant disorder (ODD), becomes angry over the rules at a residential treatment program and begins shouting at the nurse. Select the best method to defuse the situation.
A) Assign the child to a short time-out.
B) Administer an antipsychotic medication.
C) Place the child in a therapeutic hold.
D) Call a staff member to seclude the child.
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Chapter 27: Adults
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Sample Questions
Q1) An adult patient tells the case manager, "I don't have bipolar disorder anymore, so I don't need medicine. After I was in the hospital last year, you helped me get an apartment and disability checks. Now I'm bored and don't have any friends." Which resources should the nurse suggest for the patient? (Select all that apply.)
A) Psychoeducation classes
B) Vocational rehabilitation
C) Social skills training
D) Homeless shelter
E) Crisis intervention
Q2) The manager of a health club put a hidden camera in the women's locker room and videotaped women as they showered and dressed. Which sexual dysfunction is evident?
A) Frotteurism
B) Exhibitionism
C) Pedophilia
D) Voyeurism
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Chapter 28: Older Adults
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Sample Questions
Q1) Recognizing the risk for acquired immunodeficiency syndrome (AIDS) among older adults, nurses should provide health teaching aimed at:
A) discouraging sexual expression.
B) using birth control measures.
C) avoiding blood transfusions.
D) encouraging condom use.
Q2) A nurse wants to perform a preliminary assessment for suicidal ideation in an older adult patient. Which question would obtain the desired data?
A) "What thoughts do you have about a person's right to take his or her own life?"
B) "If you felt suicidal, would you communicate your feelings to anyone?"
C) "Do you have any risk factors that potentially contribute to suicide?"
D) "Do you think you are vulnerable to developing a depressed mood?"
Q3) If an older adult patient must be physically restrained, who is responsible for the patient's safety?
A) Nurse assigned to care for the patient
B) Nursing assistant who applies the restraint
C) Health care provider who ordered the application of the restraint
D) Family member who agrees to the application of the restraint
To view all questions and flashcards with answers, click on the resource link above.