Question: An individual is experiencing problems associated with memory. Which cerebral structures are most likely to be involved in this deficit? (Select all that apply.)
Answer Choices: a. Prefrontal cortex b. Occipital lobe c. Temporal lobe d. Parietal lobe e. Basal ganglia
Answer: A, C, D
Question: Planning for patients diagnosed with mental illness is facilitated by understanding that inpatient hospitalization is generally reserved for a patient presenting with what characteristic?
Answer Choices: a. Presents a clear danger to self or others. b. Consistently noncompliant with medications at home. c. Has no reliable support systems in the local community. d. Develops new symptoms during the course of an illness.
Answer: A
Question: A patient is hospitalized for a reaction to a psychotropic medication and then is closely monitored for 24 hours. During a pre-discharge visit, the case manager learns the patient received a notice of eviction on the day of admission. What is the most appropriate intervention for the case manager to implement?
Answer Choices: a. Cancel the patient’s discharge from the hospital. b. Contact the landlord who evicted the patient to discuss the situation. c. Arrange a temporary place for the patient to stay until new housing can be secured. d. Document that the patient’s recovery will be hampered because of homelessness.
Answer: C
Question: A multidisciplinary health care team meets 12 hours after an adolescent is hospitalized after a suicide attempt. Members of the team report their assessments. What outcome can be expected from this meeting?
Answer Choices: a. A treatment plan will be formulated. b. The health care provider will order neuroimaging studies. c. The team will request a court-appointed advocate for the patient. d. Assessment of the patient’s need for placement outside the home will be undertaken.
Answer: A
Question: The relapse of a patient diagnosed with schizophrenia is related to medication nonadherence. The patient is hospitalized for 5 days, medication is restarted, and the patient’s thoughts are now more organized. The patient’s family members are upset and say, “It’s too soon for discharge. Hospitalization is needed for at least a month.” The nurse should implement what intervention?
Answer Choices: a. Call the psychiatrist to come explain the discharge rationale. b. Explain that health insurance will not pay for a longer stay for the patient. c. Notify security to handle the disturbance and escort the family off the unit. d. Explain that the patient will continue to improve if medication is taken regularly.
Answer: D
Question: A nurse assesses an inpatient psychiatric unit, noting that exits are free from obstruction, no one is smoking, the janitor’s closet is locked, and all sharp objects are being used under staff supervision. These observations relate to what nursing responsibility?
Answer Choices: a. Management of milieu safety b. Coordinating care of patients c. Management of the interpersonal climate d. Use of therapeutic intervention strategies
Answer: A
Question: The following patients are seen in the emergency department. The psychiatric unit has one bed available. The patient demonstrating which problem should the admitting officer recommend for admission to the hospital?
Answer Choices: a. Experiencing dry mouth and tremor related to side effects of haloperidol b. Experiencing anxiety after divorcing a spouse after 10 years of marriage c. Has a self-inflicted a superficial cut on the forearm after a family argument d. Has begun hearing voices encouraging her to, “Smother your infant”
Answer: D
Question: A student nurse prepares to administer oral medication to a patient diagnosed with major depressive disorder. What should the student nurse do when the patient refuses the medication?
Answer Choices: a. Share with the patient, “I’ll get an unsatisfactory grade if I don’t give you the medication.” b. Tell the patient, “Refusing your medication is not permitted. You are required to take it.” c. Attempt to discuss the patient’s concerns about the medication, and report to the staff nurse. d. Document the patient’s refusal of the medication without further comment.
Answer: C
Question: A nurse surveys the medical records for violations of patients’ rights. Which finding signals a violation?
Answer Choices: a. No treatment plan is present in the record. b. Patient belongings were searched at admission. c. Physical restraints were used to prevent harm to self. d. Patient is placed on one-to-one continuous observation.
Answer: A
Question: Which principle takes priority for the psychiatric inpatient staff when addressing behavioral crises?
Answer Choices: 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.
Answer: A
Question: In a team meeting, a nurse says, “I’m concerned whether we are behaving ethically by using restraint to prevent one patient from self-mutilation while the care plan for another patient who has also self-mutilated calls for one-on-one supervision.” Which ethical principle most clearly applies to this situation?
Answer Choices: a. Beneficence b. Autonomy c. Fidelity d. Justice
Answer: D
Question: Which scenario is an example of a tort?
Answer Choices: a. The primary nurse completes the plan of care for a patient but takes a full 24 hours after the admission to do so. b. An advanced practice nurse recommends that a patient who has a history of danger to self and others be voluntarily hospitalized when reporting audio hallucinations. c. A patient’s admission status is changed from involuntary to voluntary after the patient’s hallucinations subside after medication is started. d. A nurse gives an as-needed dose of an antipsychotic drug to a patient to prevent any possible violence because the unit is short staffed.
Answer: D
Question: A nurse’s neighbor asks, “Why aren’t people with mental illness kept in state institutions anymore?” What is the nurse’s best response?
Answer Choices: a. “Many people are still in psychiatric institutions. Inpatient care is needed because many people who are mentally ill are violent.” b. “Less restrictive settings are now available to care for individuals with mental illness.” c. “Our nation has fewer persons with mental illness; therefore, fewer hospital beds are needed.” d. “Psychiatric institutions are no longer popular as a consequence of negative stories in the press.”
Answer: B
Question: Which nursing intervention demonstrates false imprisonment?
Answer Choices: a. A confused and combative patient says, “I’m getting out of here and no one can stop me.” The nurse restrains this patient without a health care provider’s order and then promptly obtains an order. b. A patient has been irritating, seeking the attention of nurses most of the day. Now a nurse escorts the patient down the hall, saying, “Stay in your room or you’ll be put in seclusion.” c. An involuntarily hospitalized patient with suicidal ideation runs out of the psychiatric unit. A nurse rushes after the patient and convinces the patient to return to the unit. d. An involuntarily hospitalized patient with suicidal ideation attempts to leave the unit. A nurse calls the security team and uses established protocols to prevent the patient from leaving.
Answer: B
Question: A patient should be considered for involuntary commitment for psychiatric care when demonstrating what behavior?
Answer Choices: a. Nonadherent with the treatment regimen. b. Sells and distributes illegal drugs. c. Threatens to harm self and others. d. Fraudulently files for bankruptcy.
Answer: C
Question: A nurse at the mental health center prepares to administer a scheduled injection of haloperidol decanoate to a patient diagnosed with schizophrenia. As the nurse swabs the site, the patient shouts, “Stop! I don’t want to take that medicine anymore. I hate the side effects.” Select the nurse’s best initial action.
Answer Choices: a. Stop the medication administration procedure and say to the patient, “Tell me more about the side effects you’ve been having.” b. Say to the patient, “Since I’ve already drawn the medication in the syringe, I’m required to give it, but let’s talk to the doctor about skipping next month’s dose.” c. Proceed with the injection but explain to the patient that other medications are available that may help reduce the unpleasant side effects. d. Notify other staff members to report to the room for a show of force and proceed with the injection, using restraint if necessary.
Answer: A
Question: 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?
Answer Choices: 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.
Answer: A
Question: A newly admitted patient who is acutely psychotic is a private patient of the senior psychiatrist. To whom does the psychiatric nurse who is assigned to this patient owe the duty of care?
Answer Choices: a. Health care provider b. Profession c. Hospital d. Patient
Answer: D
Question: What action by a nurse constitutes a breach of a patient’s right to privacy?
Answer Choices: a. Asking a family to share information about a patient’s prehospitalization behavior. b. Discussing the patient’s history with other staff members during care planning. c. Documenting the patient’s daily behaviors during hospitalization. d. Releasing unauthorized information to the patient’s employer.
Answer: D
Question: An adolescent hospitalized after a violent physical outburst tells the nurse, “I’m going to kill my father, but I know you can’t tell anyone.” What is the nurse’s best response?
Answer Choices: a. “You’re right. Federal law requires me to keep that information private.” b. “Those kinds of thoughts will make your hospitalization even longer.” c. “You really should share these kinds of thoughts with your psychiatrist.” d. “I am required to share information like this with your treatment team.”
Answer: D