Answer Choices:
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
Question: A nurse cares for a patient diagnosed with paraphilia. The nurse expects the health care provider may prescribe which type of medication to reduce paraphilic behaviors?
Answer Choices:
a. Stimulants
b. Erectile dysfunction medication
c. Atypical antipsychotic medication
d. Mood stabilizer
Answer:
d. Mood stabilizer
Question: When admitting older adult patients, health care agencies receiving federal funds must provide written information about what topic?
Answer Choices:
A. Advance health care directives
B. The financial status of the institution
C. How to sign out against medical advice
D. The institution’s policy on the use of restraints
Answer:
A
Question: A homeless patient diagnosed with severe and persistent mental illness became suspicious and delusional. The patient was given depot antipsychotic medication and housing was arranged at a local shelter. After 2 weeks, which statement by the patient indicates significant improvement?
Answer Choices:
a. “I am feeling safe and comfortable here. Nobody bothers me.”
b. “They will not let me drink. They have many rules in the shelter.”
c. “Those guys are always watching me. I think someone stole my shoes.”
d. “That shot made my arm sore. I’m not going to take any more of them.”
Answer:
a. “I am feeling safe and comfortable here. Nobody bothers me.”
Question: Which economic factors are most critical to the success of discharge planning for a patient diagnosed with severe and persistent mental illness? (Select all that apply.)
Answer Choices:
a. Access to housing
b. Individual psychotherapy
c. Income to meet basic needs
d. Availability of health insurance
e. Ongoing interdisciplinary evaluation
Answer:
a. Access to housing
c. Income to meet basic needs
d. Availability of health insurance
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 Choices:
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: 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.)
Answer Choices:
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. ODD uses stereotypical or repetitive language.
e. CD often violates the rights of others.
Answer:
b. ODD tests limits and disobeys authority figures.
e. CD often violates the rights of others.
Question: 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.)
Answer:
a. Psychoeducation classes
Question: Shortly after a 15-year-old’s parents announce a plan to divorce, the adolescent stops participating in sports, sits alone at lunch, and avoids former friends. The adolescent says, “All the other kids have families. If my parents loved me, then they would stay together.” Which nursing intervention is most appropriate?
Answer Choices:
a. Develop a plan for activities of daily living.
b. Communicate disbelief relative to the adolescent’s feelings.
c. Assist the adolescent to differentiate reality from perceptions.
d. Assess and document the adolescent’s level of depression daily.
Answer:
c. Assist the adolescent to differentiate reality from perceptions.
Question: When making a distinction as to whether a patient is experiencing confusion related to depression or dementia, what information would be most important for the nurse to consider?
Answer Choices:
A. The patient with dementia is persistently angry and hostile.
B. Early morning agitation and hyperactivity occur in dementia.
C. Confusion seems to worsen at night when dementia is present.
D. A patient who is depressed is preoccupied with somatic symptoms.
Answer:
C
Question: A child diagnosed with attention-deficit/hyperactivity disorder (ADHD) is going to begin medication therapy. The nurse should plan to teach the family about which classification of medications?
Answer Choices:
a. Central nervous system stimulants and nonstimulants
b. Monamine oxidase inhibitors (MAOIs)
c. Antipsychotic medications
d. Anxiolytic medications
Answer:
a. Central nervous system stimulants and nonstimulants
Question: An older patient reports drinking a six-pack of beer daily. The patient tells the community health nurse, “I’ve been having trouble with my arthritis lately, so I take acetaminophen four times a day for pain.” What are the nurse’s priority interventions? (Select all that apply.)
Answer Choices:
A. Inquiring about sleep disturbances caused by mixing alcohol and analgesic medications
B. Determining the safety of the daily acetaminophen dose the patient is ingesting
C. Advising the patient of harmful effects of alcohol and acetaminophen on the liver
D. Suggesting an increase in the acetaminophen dose because alcohol produces faster excretion
E. Assessing the patient for declining functional status associated with medication-induced dementia
Answer:
B, C
Question: Which is the best statement for a nurse to use when beginning an interview with an older adult patient?
Answer Choices:
a. “Hello, [call patient by first name]. I am going to ask you some questions to get to know you better.”
b. “Hello. My name is [nurse’s name]. I am a nurse. Please tell me how you would like to be addressed by the staff.”
c. “I am going to ask you some questions about yourself. I would like to call you by your first name if you don’t mind.”
d. “You look as though you are comfortable and ready to participate in an admission interview. Shall we get started?”
Answer:
b. “Hello. My name is [nurse’s name]. I am a nurse. Please tell me how you would like to be addressed by the staff.”
Question: A nurse prepares the plan of care for a 15-year-old adolescent diagnosed with moderate intellectual developmental disorder (IDD) is believed capable of achieving which goal within 5 years? (Select all that apply.)
Answer Choices:
a. Live in graded or flat that the government provides.
b. Obtain employment in a local sheltered workshop.
c. Correctly use public buses to travel in the community.
d. Independently perform his or her own personal hygiene.
e. Complete high school or earn a general equivalency diploma (GED).
Answer:
b. Obtain employment in a local sheltered workshop.
c. Correctly use public buses to travel in the community.
d. Independently perform his or her own personal hygiene.
Question: A 4-year-old child cries and screams from the time the parents leave the child at preschool until the child is picked up 4 hours later. The child is calm and relaxed when the parents are present. The parents ask, “What should we do?” What is the nurse’s best recommendation?
Answer Choices:
a. “Send a picture of yourself to school to keep with the child.”
b. “Arrange with the teacher to let the child call home at playtime.”
c. “Talk with the school about withdrawing the child until maturity increases.”
d. “Talk with your health care provider about a referral to a mental health professional.”
Answer:
d. “Talk with your health care provider about a referral to a mental health professional.”
Question: How is severe and persistent mental best characterized?
Answer Choices:
a. Mental illness within person 2 weeks’ duration.
b. Severe illness present longer than 2 years.
c. Major ongoing mental illness marked by significant functional impairments.
d. Major mental illness that cannot be treated to relieve symptoms.
Answer:
b. Severe illness present longer than 2 years.
Question: The parent of a child diagnosed with Tourette’s disorder says to the nurse, “I think my child is faking the tics because they come and go.” Which response by the nurse is accurate?
Answer Choices:
a. “Perhaps your child was misdiagnosed.”
b. “Your observation indicates the medication is effective.”
c. “Tics often change frequency or severity. That does not mean they aren’t real.”
d. “This finding is unexpected. How have you been administering your child’s medication?”
Answer:
c. “Tics often change frequency or severity. That does not mean they aren’t real.”
Question: When group therapy is to be used as a treatment modality, the nurse should suggest placing a 9-year-old in a group that focuses on what?
Answer Choices:
a. Play activities exclusively.
b. Group discussion exclusively.
c. Talk focused on a specific issue.
d. Play and then talk about the play.
Answer:
d. Play and then talk about the play.
Question: An 80-year-old patient with depression reacts with aggression and pessimism to the staff. Every day is a struggle. No one cares about old people. Which is the nurse’s most therapeutic response?
Answer Choices:
A. “Everyone here cares about old people. That’s why we work here.”
B. “It sounds like you’re having a difficult time. Tell me about it.”
C. “Let’s not focus on the negative. Tell me something good.”
D. “You are still able to get around, and your mind is alert.”
Answer:
B
Question: A community mental health nurse plans an educational program for staff members at a home health agency that specializes in the care of older adults. What topic is of high priority?
Answer Choices:
a. Identifying depression in older adults
b. Providing cost-effective foot care for older adults
c. Identifying nutritional deficiencies in older adults
d. Psychosocial stimulation for those who live alone
Answer:
a. Identifying depression in older adults