Question: A suspicious and socially isolated patient lives alone, eats one meal a day at a nearby shelter, and spends the remaining daily food allowance on cigarettes. Select the community mental health nurse’s best initial action.
Answer Options: a. Report the situation to the manager of the shelter. b. Tell the patient, “You must stop smoking to save money.” c. Assess the patient’s weight; determine the foods and amounts eaten. d. Seek hospitalization for the patient while a new plan is being formulated. Correct Answer: c. Assess the patient’s weight; determine the foods and amounts eaten.
Question: A patient diagnosed with schizophrenia has been stable in the community. Today, the spouse reports the patient is expressing delusional thoughts. The patient says, “I’m willing to take my medicine, but I forgot to get my prescription refilled.” Which outcome should the nurse add to the plan of care?
Answer Options: a. Nurse will obtain prescription refills every 90 days and deliver them to the patient. b. Patient’s spouse will mark dates for prescription refills on the family calendar. c. Patient will report to the hospital for medication follow-up every week. d. Patient will call the nurse weekly to discuss medication-related issues. Correct Answer: b. Patient’s spouse will mark dates for prescription refills on the family calendar.
Question: A community mental health nurse has worked for 6 months to establish a relationship with a delusional, suspicious patient. The patient recently lost employment and stopped taking medications because of inadequate money. The patient says, “Only a traitor would make me go to the hospital.” Which solution is best?
Answer Options: a. Arrange a bed in a local homeless shelter with nightly onsite supervision. b. Negotiate a way to provide medication so the patient can remain at home. c. Hospitalize the patient until the symptoms have stabilized. d. Seek inpatient hospitalization for up to 1 week. Correct Answer: b. Negotiate a way to provide medication so the patient can remain at home.
Question: A community psychiatric nurse facilitates medication adherence for a patient by having the health care provider prescribe medications by injection every 3 weeks at the clinic. For this plan to be successful, which factor will be of critical importance?
Answer Options: a. Attitude of significant others toward the patient b. Nutritional services in the patient’s neighborhood c. Level of trust between the patient and the nurse d. Availability of transportation to the clinic Correct Answer: d. Availability of transportation to the clinic
Question: Which assessment finding for a patient living in the community requires priority intervention by the nurse?
Answer Options: a. Receives Social Security disability income plus a small check from a trust fund. b. Lives in an apartment with two patients who attend day hospital programs. c. Reports drinking four beers nightly. d. Has a history of seasonal employment. Correct Answer: c. Reports drinking four beers nightly.
Question: A patient tells the nurse at the clinic, “I haven’t been taking my antidepressant medication as directed. I leave out the midday dose. I have lunch with friends and don’t want them to ask me about the pills.” What is the nurse’s most appropriate intervention?
Answer Options: a. Investigate the possibility of once-daily dosing of the antidepressant. b. Suggest to the patient to take the medication when no one is watching. c. Explain how taking each dose of medication on time relates to health maintenance. d. Add the following nursing diagnosis to the plan of care: ineffective therapeutic regimen management, related to lack of knowledge. Correct Answer: a. Investigate the possibility of once-daily dosing of the antidepressant.
Question: A community psychiatric nurse assesses that a patient diagnosed with a mood disorder is more depressed than on the previous visit a month ago; however, the patient says, “I feel the same.” Which intervention supports the nurse’s assessment while preserving the patient’s autonomy?
Answer Options: a. Arrange for a short hospitalization. b. Schedule weekly clinic appointments. c. Refer the patient to the crisis intervention clinic. d. Call the family and ask them to observe the patient closely. Correct Answer: b. Schedule weekly clinic appointments.
Question: 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.” What should be the immediate focus of nursing care?
Answer Options: a. Assisting with the clarification of personal values b. Helping the patient cope with feelings of abandonment c. Assisting with the management of anxiety that may lead to psychological disequilibrium d. Facilitating the clarification of the patient’s misperceptions of the environment Correct Answer: c. Assisting with the management of anxiety that may lead to psychological disequilibrium
Question: Which patient would a nurse refer to partial hospitalization?
Answer Options: a. One who spent yesterday in the 24-hour supervised crisis care center and continues to be actively suicidal. b. One who is experiencing agoraphobia and panic episodes and who would benefit from psychoeducation for relaxation therapy. c. A patient who has limited coping skills and needs medication supervision and psychoeducation. d. A patient who states, “I’m not sure the medication is working. I don’t think I can keep a job. I feel like staying in bed all day, but I know I have to pay for blood tests every morning.” Correct Answer: d. A patient who states, “I’m not sure the medication is working. I don’t think I can keep a job. I feel like staying in bed all day, but I know I have to pay for blood tests every morning.”
Question: What is an example of a lack of parity in health care delivery today?
Answer Options: a. Payment for psychiatric health care is not equal to that of physical health care. b. Medicare is provided for only those 65 years of age and older. c. There is a sufficient need for mental health care providers. d. Most psychiatric care is provided on an outpatient basis. Correct Answer: a. Payment for psychiatric health care is not equal to that of physical health care.
Question: A nurse can best address factors of critical importance to successful community treatment for persons with mental illness by including assessments related to which of the following? (Select all that apply.)
A nurse can best address factors of critical importance to successful community treatment for persons with mental illness by including assessments related to which of the following? (Select all that apply.) Answer Options: a. Housing adequacy and stability b. Income adequacy and stability c. Family and other support systems d. Early psychosocial development e. Substance abuse history and current use Correct Answer: a. Housing adequacy and stability b. Income adequacy and stability c. Family and other support systems e. Substance abuse history and current use
Question: A community member asks a nurse, “People diagnosed with mental illnesses used to go to a hospital. What has happened?” Select the nurse’s accurate responses. (Select all that apply.)
A community member asks a nurse, “People diagnosed with mental illnesses used to go to a hospital. What has happened?” Select the nurse’s accurate responses. (Select all that apply.) Answer Options: a. “Science has made significant improvements in drugs for mental illness, so now many people may live in their communities.” b. “A better selection of less restrictive settings is now available in communities to care for individuals with mental illness.” c. “National rates of mental illness have declined significantly. The need for state institutions is actually no longer present.” d. “Most psychiatric institutions were closed because of serious violations of patients’ rights and unsafe conditions.” e. “Federal legislation and payment for treatment of mental illness have shifted the focus to community rather than institutional settings.” Correct Answer: a. “Science has made significant improvements in drugs for mental illness, so now many people may live in their communities.” b. “A better selection of less restrictive settings is now available in communities to care for individuals with mental illness.” e. “Federal legislation and payment for treatment of mental illness have shifted the focus to community rather than institutional settings.”
Question: How does a psychiatric nurse best implement the ethical principle of autonomy?
How does a psychiatric nurse best implement the ethical principle of autonomy? Answer Options: a. By intervening when a self-mutilating patient attempts to harm self. b. Staying with a patient who is demonstrating a high level of anxiety. c. Suggesting that two patients who are fighting be restricted to the unit. d. Exploring alternative options with a patient, regarding medications. Correct Answer: d. Exploring alternative options with a patient, regarding medications.
Question: Which action by a psychiatric nurse best supports a patient’s right to be treated with dignity and respect?
Which action by a psychiatric nurse best supports a patient’s right to be treated with dignity and respect? Answer Options: a. Consistently addressing a patient by title and surname. b. Strongly encouraging a patient to participate in unit activities. c. Discussing a patient’s condition with a health care provider in the elevator. d. Informing a treatment team that a patient is too drowsy to participate in care planning. Correct Answer: a. Consistently addressing a patient by title and surname.
Question: Two hospitalized patients resort to physical fighting when they are in the same room. During a team meeting, a nurse asserts that safety is of paramount importance and therefore the treatment plans should call for both patients to be secluded to prevent them from injuring each other. Which does this assertion indicate about the nurse who presented it?
Two hospitalized patients resort to physical fighting when they are in the same room. During a team meeting, a nurse asserts that safety is of paramount importance and therefore the treatment plans should call for both patients to be secluded to prevent them from injuring each other. Which does this assertion indicate about the nurse who presented it? Answer Options: a. Reveals that the nurse has a strong sense of justice. b. Values the reinforcement of the autonomy of the two patients. c. Has a poor understanding of the civil rights of the two patients. d. Doesn’t understand the actions that constitute the intentional tort of battery. Correct Answer: a. Reveals that the nurse has a strong sense of justice.
Question: Many believe that Watson’s lecture Psychology as the Behaviorists Views It to be the single most influential article in the history of psychology, certainly American psychology. It came to be known as “the Behaviorist Manifesto.” This nickname manifests no less likely a reverence to which other historical document that challenged a major paradigm or way of thinking within a certain discipline? You may have to do a little internet research to answer this. Then again, if you had a history teacher/professor who led you through Modern European history or perhaps a good economics teacher/professor you should know this off the top of your head.
Answer Options: A. Isaac Newton’s Philosophiæ Naturalis Principia Mathematica (1687) B. B.F. Skinner’s The Behavior of Organisms: An Experimental Analysis (1938) C. Karl Marx & Friedrich Engels’ political pamphlet attacking capitalism (1848) D. Thomas Paine’s pamphlet Common Sense (1776) E. The signing of the Magna Carta (1215) by King John of England Correct Answer: C. Karl Marx & Friedrich Engels’ political pamphlet attacking capitalism (1848)
Question: Watson’s article clearly states that psychology should abandon the concept of consciousness, arguing that consciousness is:
Answer Options: A. An irrelevant subject for psychology. B. A product of the nervous system. C. Impossible to measure scientifically. D. A byproduct of mental processes. E. Only observable through introspection. Correct Answer: C. Impossible to measure scientifically.
Question: Watson’s approach to psychology emphasizes the need for:
Answer Options: A. Studying subjective experiences. B. Understanding internal mental states. C. Focusing on observable behavior. D. Examining unconscious motives. E. Analyzing sensory perceptions. Correct Answer: C. Focusing on observable behavior.