Answer Choices:
a. Beneficence
b. Autonomy
c. Fidelity
d. Justice
Answer:
d. Justice
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 Choices:
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.
Answer:
b. Negotiate a way to provide medication so the patient can remain at home.
Question: A patient who immigrated to the United States from Honduras was diagnosed with schizophrenia. The patient took an antipsychotic medication for 3 weeks but showed no improvement. Which resource should the treatment team consult for information on more effective medications for this patient?
Answer Choices:
A. Clinical algorithm
B. Clinical pathway
C. Clinical practice guideline
D. International Statistical Classification of Diseases and Related Health Problems (ICD)
Answer:
A. Clinical algorithm
Question: A nurse wants to find a description of diagnostic criteria for a person diagnosed with schizophrenia. Which resource should the nurse consult?
Answer Choices:
A. U.S. Department of Health and Human Services
B. Journal of the American Psychiatric Association
C. North American Nursing Diagnosis Association International (NANDA-I)
D. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
Answer:
D. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
Question: A patient diagnosed with schizophrenia has taken fluphenazine 5 mg orally twice daily for 3 weeks. The nurse now assesses a shuffling, propulsive gait; a masklike face; and drooling. Which term applies to these symptoms? A) Neuroleptic malignant syndrome B) Hepatocellular effects C) Pseudoparkinsonism D) Akathisia
Answer Choices:
A) Neuroleptic malignant syndrome
B) Hepatocellular effects
C) Pseudoparkinsonism
D) Akathisia
Answer:
C
Question: A patient on antipsychotic medication reports side effects of medication. Which side effect is most likely due to a drug that blocks dopamine receptors?
Answer Choices:
a. Anticholinergic effects
b. Dopamine-blocking effects
c. Endocrine-stimulating effects
d. Ability to stimulate spinal nerves
Answer:
B. Dopamine-blocking effects
Question: A nurse set limits for a patient diagnosed with a borderline personality disorder. The patient tells the nurse, “You used to care about me. I thought you were wonderful. Now I can see I was mistaken. You’re terrible.” This outburst can be documented using what term?
Answer Choices:
a. Denial
b. Splitting
c. Reaction formation
d. Separation-individuation strategies
Answer:
b. Splitting
Question: The nurse gives positive feedback about the nurse’s communication techniques while stating, “I enjoy spending time with you.” Which analysis is most accurate? a. Patient is giving positive feedback about the nurse’s communication techniques. b. Nurse is viewing the patient’s behavior through a cultural filter. c. Patient’s verbal and nonverbal messages are incongruent. d. Patient is demonstrating psychotic behaviors.
Answer Choices:
a. Patient is giving positive feedback about the nurse’s communication techniques.
b. Nurse is viewing the patient’s behavior through a cultural filter.
c. Patient’s verbal and nonverbal messages are incongruent.
d. Patient is demonstrating psychotic behaviors.
Answer:
C
Question: A patient diagnosed with borderline personality disorder has been hospitalized several times after self-inflicted lacerations. The patient remains impulsive. Dialectical behavior therapy starts on an outpatient basis. Which nursing diagnosis is the focus of this therapy?
Answer Choices:
a. Risk for self-mutilation
b. Impaired skin integrity
c. Risk for injury
d. Powerlessness
Answer:
a. Risk for self-mutilation
Question: A patient diagnosed with borderline personality disorder self-inflicted wrist lacerations after gaining new privileges on the unit. The cause of the self-mutilation is probably related to what trigger?
Answer Choices:
a. An inherited disorder that manifests itself as an incapacity to tolerate stress.
b. The use of projective identification and splitting to bring anxiety to manageable levels.
c. A constitutional inability to regulate affect, predisposing to psychic disorganization.
d. The fear of abandonment associated with progress toward autonomy and independence.
Answer:
d. The fear of abandonment associated with progress toward autonomy and independence.
Question: A Puerto Rican–American patient uses dramatic body language when describing emotional discomfort. Which analysis most likely explains the patient’s behavior? a. A histrionic personality disorder is likely. b. A belief that dramatic body language is sexually appealing. c. Wishes to impress staff with the degree of emotional pain. d. Belongs to a culture in which dramatic body language is the norm.
Answer Choices:
a. A histrionic personality disorder is likely.
b. A belief that dramatic body language is sexually appealing.
c. Wishes to impress staff with the degree of emotional pain.
d. Belongs to a culture in which dramatic body language is the norm.
Answer:
D
Question: A participant at a community education conference asks, “What is the most prevalent type of mental disorder in the United States?” What is the nurse’s best response?
Answer Choices:
A. “Why do you ask?”
B. “Schizophrenia”
C. “Affective disorders”
D. “Anxiety disorders”
Answer:
D. “Anxiety disorders”
Question: The parent of a child diagnosed with schizophrenia tearfully asks a nurse, “What could I have done differently to prevent this illness?” Select the nurse’s most caring response.
Answer Choices:
a. “Although schizophrenia is caused by impaired family relationships, try not to feel guilty. No one can predict how a child will respond to parental guidance.”
b. “Most of the damage is done, but there is still hope. Changing your parenting style can help your child learn to cope more effectively with the environment.”
c. “Schizophrenia is a biological illness with similarities to diabetes and heart disease. You are not to blame for your child’s illness.”
d. “Most mental illnesses result from genetic inheritance. Your genes are more at fault than your parenting.”
Answer:
C. “Schizophrenia is a biological illness with similarities to diabetes and heart disease. You are not to blame for your child’s illness.”
Question: A patient diagnosed with schizophrenia begins to talk about “cracklomers” in the local shopping mall. The term “cracklomers” should be documented under what term? A. Neologism B. Concrete thinking C. Thought insertion D. An idea of reference
Answer Choices:
A) Neologism
B) Concrete thinking
C) Thought insertion
D) An idea of reference
Answer:
A
Question: A patient has delusions and hallucinations. Before beginning treatment with a psychotropic medication, the health care provider wants to rule out the presence of a brain tumor. For which test will a nurse need to prepare the patient?
Answer Choices:
a. Cerebral arteriogram
b. Functional magnetic resonance imaging (fMRI)
c. Computed tomography (CT) scan or magnetic resonance imaging (MRI)
d. Positron emission tomography (PET) or single-photon emission computed tomography (SPECT)
Answer:
C. Computed tomography (CT) scan or magnetic resonance imaging (MRI)
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 Choices:
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.
Answer:
b. Patient’s spouse will mark dates for prescription refills on the family calendar.
Question: A patient diagnosed with a personality disorder has used manipulation to get their needs met. The staff decides to apply limit setting interventions. What is the correct rationale for this action?
Answer Choices:
a. It provides an outlet for feelings of anger and frustration.
b. It respects the patient’s wishes so assertiveness will develop.
c. External controls are necessary while internal controls are developed.
d. Anxiety is reduced when staff members assume responsibility for the patient’s behavior.
Answer:
c. External controls are necessary while internal controls are developed.
Question: What behavior by a nurse caring for a patient diagnosed with an eating disorder indicates the nurse needs supervision? a. The nurse’s comments are compassionate and nonjudgmental. b. The nurse uses an authoritarian manner when interacting with the patient. c. The nurse teaches the patient to recognize signs of increasing anxiety and ways to intervene. d. The nurse refers the patient to a self-help group for individuals with eating disorders.
Answer Choices:
a. The nurse’s comments are compassionate and nonjudgmental.
b. The nurse uses an authoritarian manner when interacting with the patient.
c. The nurse teaches the patient to recognize signs of increasing anxiety and ways to intervene.
d. The nurse refers the patient to a self-help group for individuals with eating disorders.
Answer:
B
Question: As a nurse prepares to administer an oral medication to a patient diagnosed with a borderline personality disorder, the patient says, “Just leave it on the table. I’ll take it when I finish combing my hair.” What is the nurse’s best response?
Answer Choices:
a. “Alright. I’ll be back to make sure you’ve taken it.”
b. “I’m worried that you might not take it. I will come back later.”
c. “I must watch you take the medication. Please take it now.”
d. “Why don’t you want to take your medication now?”
Answer:
c. “I must watch you take the medication. Please take it now.”
Question: An adult expresses the wish to be taken care of and often behaves in a helpless fashion. This adult has needs related to which of Freud’s stages of psychosexual development?
Answer Choices:
a. Latency
b. Phallic
c. Anal
d. Oral
Answer:
D. Oral
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. Stop the medication administration procedure and say to the patient, “Tell me more about the side effects you’ve been having.”
Question: Which nursing intervention has priority as a patient diagnosed with anorexia nervosa begins to gain weight? a. Assess for depression and anxiety. b. Observe for adverse effects of refeeding. c. Communicate empathy for the patient’s feelings. d. Help the patient balance energy expenditure and caloric intake.
Answer Choices:
a. Assess for depression and anxiety.
b. Observe for adverse effects of refeeding.
c. Communicate empathy for the patient’s feelings.
d. Help the patient balance energy expenditure and caloric intake.
Answer:
B
Question: A nurse plans the care for an individual diagnosed with antisocial personality disorder. Which characteristic behaviors will the nurse expect? (Select all that apply.) a. Reclusive behavior b. Callous attitude c. Perfectionism d. Aggression e. Clinginess f. Anxiety
Answer Choices:
a. Reclusive behavior
b. Callous attitude
c. Perfectionism
d. Aggression
e. Clinginess
f. Anxiety
Answer:
B, D
Question: An experienced nurse says to a new graduate, “When you’ve practiced as long as I have, you will instantly know how to take care of psychotic patients.” What is the new graduate’s best analysis of this comment? (Select all that apply.)
Answer Choices:
a. The experienced nurse may have lost sight of patients’ individuality, which may compromise the integrity of practice.
b. New research findings must be continually integrated into a nurse’s practice to provide the most effective care.
c. Experience provides mental health nurses with the tools and skills needed for effective professional practice.
d. Experienced psychiatric nurses have learned the best ways to care for psychotic patients through trial and error.
e. Effective psychiatric nurses should be continually guided by an intuitive sense of patients’ needs.
Answer:
A, B
Question: A nursing care plan for a patient diagnosed with schizophrenia regards the importance of medication management. The patient repeatedly says, “I don’t like taking pills.” Which treatment strategy should the nurse discuss with the patient and health care provider?
Answer Choices:
a. Use of long-acting antipsychotic injections
b. Administration of medication in a liquid form
c. Adjunctive use of an antidepressant, such as amitriptyline
d. Inpatient hospitalization because of the high risk for exacerbation of symptoms
Answer:
A