Answer Options:
a. GABA
b. Substance P
c. Histamine
d. Dopamine
e. Norepinephrine
Answer: d. Dopamine
e. Norepinephrine
Question: The parent of an adult diagnosed with severe and persistent mental illness asks the nurse, “Why are you making a referral to that vocational rehabilitation program? My child won’t ever be able to hold a job.” Which is the nurse’s best reply?
Answer Options:
a. “We made this referral to maintain eligibility for federal funding.”
b. “Are you concerned that we’re trying to make your child too independent?”
c. “If you think the program would be detrimental, we can postpone it for a time.”
d. “Most patients are capable of employment at some level, competitive or supported.”
Answer: d. “Most patients are capable of employment at some level, competitive or supported.”
Question: A patient being treated in an alcohol rehabilitation unit reveals to the nurse, “I feel terrible guilt for sexually abusing my 6-year-old child before I was admitted.” Based on state and federal law, what action is the nurse expected to take?
Answer Options:
a. Anonymously report the abuse by telephone to the local child abuse hotline.
b. Replying, “I’m glad you feel comfortable talking to me about it.”
c. Respecting the nurse–patient relationship of confidentiality.
d. Filing a written report on the agency letterhead.
Answer: a. Anonymously report the abuse by telephone to the local child abuse hotline.
Question: A widow grieving her husband’s sudden and unexpected death tells the nurse, “I’m not feeling well. Yesterday, I saw my husband walk through the door, stop, and smile at me. Then he just faded away.” Which is the nurse’s most appropriate action?
Answer Options:
a. Assess for recent substance abuse.
b. Suggest a referral to the mental health clinic.
c. Arrange for an evaluation for antidepressant medication.
d. Counsel the widow that visualizations are a normal part of grieving.
Answer: d. Counsel the widow that visualizations are a normal part of grieving
Question: The nurse is assessing a patient diagnosed with schizophrenia regarding the side effects of antipsychotic medications. Which of the following is the nurse most likely to find?
Answer Options:
a. Waxy flexibility
b. Echolalia
c. Depersonalization
d. Thought withdrawal
Answer: A. Waxy flexibility
Question: An individual has been diagnosed with a dissociative disorder. Which comorbid psychiatric disorders are most likely to accompany this type of mental illness? (Select all that apply.)
Answer Options:
a. Substance abuse disorders
b. Depression
c. Eating disorders
d. Personality disorders
e. Schizophrenia
Answer: A. Substance abuse disorders
B. Depression
C. Eating disorders
D. Personality disorders
Question: Which interventions should the nurse plan for a patient diagnosed with adult attention-deficit/hyperactivity disorder (ADHD)? (Select all that apply.)
Answer Options:
a. Tendency for genetic transmission
b. Prevention strategies related to substance abuse
c. Negative reinforcement strategies to help modify behaviors
d. Selective serotonin reuptake inhibitors (SSRIs) are usually prescribed for hyperactivity
e. Cognitive therapy may help resolve internalized negative beliefs about self
Answer: a. Tendency for genetic transmission
b. Prevention strategies related to substance abuse
e. Cognitive therapy may help resolve internalized negative beliefs about self
Question: In which situations does a nurse have a duty to intervene and report? (Select all that apply.)
Answer Options:
a. A peer is unable to write behavioral outcomes.
b. A health care provider consults the Physicians’ Desk Reference.
c. A peer tries to provide patient care in an alcohol-impaired state.
d. A team member has violated the boundaries of a vulnerable patient.
e. A patient refuses a medication prescribed by a licensed health care provider.
Answer: C. A peer tries to provide patient care in an alcohol-impaired state.
D. A team member has violated the boundaries of a vulnerable patient.
Question: A clinic nurse interviews four patients between 70 and 80 years of age. Which patient should have further assessment regarding the risk of alcohol addiction?
Answer Options:
A. One with a history of intermittent problems of alcohol misuse early in life and who now consumes one glass of wine nightly with dinner.
B. One with no history of alcohol-related problems until age 65 years, when the patient began to drink alcohol daily “to keep my mind off my arthritis.”
C. One who drank socially throughout adult life and continues this pattern, saying, “I’ve earned the right to do as I please.”
D. One who abused alcohol between the ages of 25 and 40 years but now abstains and occasionally attends Alcoholics Anonymous.
Answer: B. One with no history of alcohol-related problems until age 65 years, when the patient began to drink alcohol daily “to keep my mind off my arthritis.”
Question: A nurse plans health teaching for a patient diagnosed with generalized anxiety disorder (GAD) who takes lorazepam. What information should be included? (Select all that apply.)
Answer Options:
a. Use caution when operating machinery.
b. Allow only tyramine-free foods in diet.
c. Restrict intake of caffeine.
d. Avoid using alcohol and other sedatives.
e. Take the medication on an empty stomach.
Answer: A. Use caution when operating machinery.
C. Restrict intake of caffeine.
D. Avoid using alcohol and other sedatives.
Question: What assessment findings mark the prodromal stage of schizophrenia?
Answer Options:
a. Withdrawal, magical thinking, poor concentration, and perceptual disturbances
b. Auditory hallucinations, ideas of reference, thought insertion, and broadcasting
c. Stereotyped behavior, echopraxia, echolalia, and waxy flexibility
d. Loose associations, concrete thinking, and echolalia neologisms
Answer: A. Withdrawal, magical thinking, poor concentration, and perceptual disturbances
Question: Which nursing diagnosis is likely to apply to the plan of care for a homeless individual diagnosed with severe and persistent mental illness?
Answer Options:
a. Insomnia
b. Substance abuse
c. Chronic low self-esteem
d. Impaired environmental interpretation syndrome
Answer: c. Chronic low self-esteem
Question: A patient asks a nurse, “What are neurotransmitters? My doctor says mine are out of balance.” What is the nurse’s best response?
Answer Options:
a. “You must feel relieved to know that your problem has a physical basis.”
b. “Neurotransmitters are chemicals that pass messages between brain cells.”
c. “It is a high-level concept to explain. You should ask the doctor to tell you more.”
d. “Neurotransmitters are substances we eat daily that influence memory and mood.”
Answer: b. “Neurotransmitters are chemicals that pass messages between brain cells.”
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.)
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
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 patient being treated for major depressive disorder has taken 300 mg amitriptyline daily for a year. The patient has symptoms associated with abrupt withdrawal of the tricyclic antidepressant. Taking a dose of the drug will ameliorate the symptoms. Seeing the condition get worse with the patient is the nurse’s best intervention?
Answer Options:
a. Contact a health-care provider for a bridge prescription.
b. Advise the patient about symptoms of withdrawal of the tricyclic antidepressant.
c. Explain that the use of higher potency SSRIs can alleviate symptoms.
d. Calmly assessing the patient for symptom relief.
Answer: A. Contact a health-care provider for a bridge prescription.
Question: Which individual diagnosed with a mental illness may need emergency or involuntary hospitalization for mental illness?
Answer Options:
a. The patient who resumes using heroin while still taking methadone.
b. The patient who reports hearing angels playing harps during thunderstorms.
c. The patient who throws a heavy plate at a waiter at the direction of command hallucinations.
d. The patient who does not show up for an outpatient appointment with the mental health nurse.
Answer: c. The patient who throws a heavy plate at a waiter at the direction of command hallucinations.