Answer Options:
a. The nurse’s technique was effective.
b. Use of humor should be added to the plan of care.
c. This approach may prove useful in other, similar situations.
d. The nurse needs help developing therapeutic communication skills.
Answer: d. The nurse needs help developing therapeutic communication skills.
Question: The staff members discuss the décor for a specialized unit for patients with mania. Which of these selections is best for a room where a patient with mania will reside?
Answer Options:
a. Several large windows with a view of the street
b. Extra-textile padding, simple accessories
c. Brightly colored walls and print drapes
d. Deep colors for walls and upholstery
Answer: B. Extra-textile padding, simple accessories
Question: What is a priority nursing intervention for a patient diagnosed with major depressive disorder?
Answer Options:
a. Distracting the patient from self-absorption
b. Carefully and inconspicuously observing the patient around the clock
c. Allowing the patient to spend long periods alone in self-reflection
d. Offering opportunities for the patient to assume a leadership role in the therapeutic milieu
Answer: B. Carefully and inconspicuously observing the patient around the clock
Question: 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. What is the best method to defuse the situation?
Answer Options:
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 subdue the child.
Answer: a. Assign the child to a short time-out.
Question: A patient being treated with paroxetine 50 mg/day orally for major depressive disorder reports to the clinic nurse, “I took a few extra tablets earlier in the day and now I feel bad.” Which aspects of the nursing assessment are most critical? (Select all that apply.)
Answer Options:
a. Vital signs
b. Urinary frequency
c. Increased suicidal ideation
d. Presence of abdominal pain and diarrhea
e. Hyperactivity or feelings of restlessness
Answer: A, D, E
Multiple Choice Question 939
A person is directing traffic on a busy street while shouting and making obscene gestures at passing cars. The person has not slept or eaten for 3 days. What features of mania are evident?
Answer Options
a. Increased muscle tension and anxiety
b. Vegetative signs and poor grooming
c. Poor judgment and hyperactivity
d. Cognitive deficit and sad mood
C
Multiple Choice Question 940
A patient diagnosed with bipolar disorder is dressed in a red leotard and brightly colored scarves. The patient uses whistle twirling and shadowboxing. Then the patient says gaily, “Do you like my scarves? Here…they are my gift to you.” How should the nurse document the patient’s mood?
Answer Options
a. Labile and euphoric
b. Imitable and belligerent
c. Highly suspicious and arrogant
d. Excessively happy and confident
A
Multiple Choice Question 941
A patient experiencing mania has not eaten or slept for 3 days. Which nursing diagnosis has priority?
Answer Options
a. Risk for injury
b. Ineffective coping
c. Impaired social interaction
d. Ineffective therapeutic regimen management
A
Question: A nurse receives laboratory results indicating that the blood lithium level for a patient taking lithium is 1 mEq/L. How will the nurse interpret this information about the medication level?
Answer Options:
a. It requires no additional nursing intervention.
b. It is below recognized therapeutic serum limits.
c. It is above recognized therapeutic serum limits.
d. It indicates a need for immediate medical intervention.
Answer: A. It requires no additional nursing intervention.
Question: A woman says to the nurse, “It’s been 8 months since my husband died. I’m not feeling any better. I cry when I see his chair, when I have to make decisions alone, and sometimes just for no reason at all. What should I do?” What is the most therapeutic response?
Answer Options:
a. “Give yourself a time frame to stop grieving.”
b. “Become active in a church.”
c. Go to the spouse’s grave every day.
d. Understand this is a normal response.
Answer: d. Understand this is a normal response.
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.
Answer: a. Investigate the possibility of once-daily dosing of the antidepressant.
Question: A woman whose husband is terminally ill says, “I don’t want to cry in front of him. I don’t want him to know how soon death will occur or how sad I am.” Which response by the nurse would be most therapeutic?
Answer Options:
a. “I’m glad you are protecting him at a time when he is so vulnerable.”
b. “He might be more comforted than disturbed by your tears.”
c. “It’s important for you to know that time is running out.”
d. “You definitely need to be honest about your feelings.”
Answer: b. “He might be more comforted than disturbed by your tears.”
Question: A patient diagnosed with schizophrenia tells the community mental health nurse, “I threw away my pills because they interfere with God’s voice.” The nurse identifies what as the likely cause of the patient’s ineffective management of the medication regimen?
Answer Options:
a. Inadequate discharge planning
b. Poor therapeutic alliance with clinicians
c. Impaired reasoning secondary to schizophrenia
d. Dislike of the side effects of antipsychotic medications
Answer: c. Impaired reasoning secondary to schizophrenia
Question: After the death of his wife, a man tells the nurse, “I can’t live without her. She was my whole life.” Which is the nurse’s most therapeutic reply?
Answer Options:
a. “Each day will get a little better.”
b. “Her death is a terrible loss for you.”
c. “Remember, she’s no longer suffering.”
d. “Your friends will help you cope with this.”
Answer: b. “Her death is a terrible loss for you.”
Question: A patient says, “Please don’t share information about me with the other people.” How should the nurse respond?
Answer Options:
a. “I won’t share information with others without your permission, but I will share information about you with other staff members.”
b. “A therapeutic relationship is just between the nurse and the patient. It’s up to you to tell others what you want them to know.”
c. “It really depends on what you choose to tell me. I will be glad to disclose at the end of each session what I will report to others.”
d. “I cannot tell anyone about you. It will be as though I am talking about my own problems, and we can help each other by keeping it between us.”
Answer: A. “I won’t share information with others without your permission, but I will share information about you with other staff members.”
Question: A patient tells a nurse, “I sometimes get into trouble because I make quick decisions and act on them.” Which response by the nurse would be most therapeutic?
Answer Options:
a. “Let’s consider the benefits of stopping to think the consequences.”
b. “It sounds as though you’ve developed some insight into your situation.”
c. “I’ll bet you have some interesting stories to share about overreacting.”
d. “It’s good that you’re showing readiness for behavioral change.”
Answer: A. “Let’s consider the benefits of stopping to think the consequences.”
Question: The therapeutic action of monoamine oxidase inhibitors (MAOIs) blocks neurotransmitter reuptake, causing what effect?
Answer Options:
a. Increased concentration of neurotransmitters in the synaptic gap
b. Decreased concentration of neurotransmitters in serum
c. Destruction of receptor sites
d. Limbic system stimulation
Answer: a. Increased concentration of neurotransmitters in the synaptic gap
Question: A patient diagnosed with schizophrenia is being discharged from a facility, a nurse invites the patient to the annual staff picnic. What is the best analysis of this scenario?
Answer Options:
a. The invitation facilitates dependency on the nurse.
b. The nurse’s action blurs the boundaries of the therapeutic relationship.
c. The invitation is therapeutic for the patient’s diversional activity deficit.
d. The nurse’s action assists the patient’s integration into community living.
Answer: B. The nurse’s action blurs the boundaries of the therapeutic relationship.
Question: Which type of juice would a patient with a history of kidney stones be most likely to be instructed to avoid?
Answer Options:
a. Orange juice
b. Grapefruit juice
c. Cranberry juice
d. Lemonade
Answer: B. Grapefruit juice
Question: Which principle takes priority for the psychiatric inpatient staff when addressing behavioral crises?
Answer Options:
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. Resolve behavioral crises using the least restrictive intervention possible
Question: A patient diagnosed with schizophrenia tells the nurse, “They are out to get me. They have it in for me. I know that the CIA is after me with those special waves.” Which response would be most therapeutic?
Answer Options:
a. “The CIA is interested in criminals, not in private citizens like you.”
b. “It sounds like you’re concerned about your privacy.”
c. “The CIA is prohibited from operating in health care facilities.”
d. “You have lost touch with reality, which is a symptom of your illness.”
Answer: B. “It sounds like you’re concerned about your privacy.”