Answer Options:
a. “How are you taking care of yourself?”
b. “Let’s review your partner’s diagnostic results.”
c. “I have some web-based programs for you to visit.”
d. “Your partner is lucky to have someone so devoted.”
Answer: A
Question: As part of the stress response, the HPA axis is stimulated. Which structures make up this system?
Answer Options:
a. Hippocampus, parietal lobe, and amygdala
b. Hypothalamus, pituitary gland, and adrenal glands
c. Hind brain, pyramidal nervous system, and anterior cerebrum
d. Hepatic artery, parasympathetic nervous system, and acoustic nerve
Answer: B
Question: Termination of a therapeutic nurse-patient relationship with a patient has been successful when nurse engages in what action? a. Avoids upsetting the patient by shifting focus to other patients before the discharge. b. Gives the patient a personal telephone number and permission to call after discharge. c. Discusses with the patient changes that have happened during the relationship and evaluates the outcomes. d. Offers to meet the patient for coffee and conversation three times a week after discharge.
Answer: C
Question: Why should the nurse introduce the matter of a contract during the first session with a new patient?
Answer Options:
a. To specify what the nurse will do for the patient
b. To explain the participation and responsibilities of each party
c. To indicate the feeling tone established between the participants
d. To prevent either party from prematurely ending the relationship
Answer: B
Question: A nurse wants to enhance the growth of a patient by showing positive regard. What nursing action is consistent with this wish?
Answer Options:
a. Making patient rounds daily
b. Staying with a tearful patient
c. Administering daily medication as prescribed
d. Examining personal feelings about a patient
Answer: B
Question: A nurse explains to the family of a patient who is mentally ill how the nurse–patient relationship differs from social relationships. Which is the best explanation?
Answer Options:
a. “The focus is on the patient. Problems are discussed by the nurse and patient, but solutions are implemented by the patient.”
b. “The focus shifts from nurse to patient as the relationship develops. Advice is given by both, and solutions are implemented.”
c. “The focus of the relationship is socialization. Mutual needs are met, and feelings are openly shared.”
d. “The focus is the creation of a partnership in which each member is committed to growth and satisfaction of the other.”
Answer: A
Question: Which behavior shows that a nurse values autonomy?
Answer Options:
a. Setting limits on a patient’s romantic overtures toward the nurse
b. Suggesting one-on-one supervision for a patient who is suicidal
c. Informing a patient that the spouse will not be in during visiting hours
d. Helping the patient weigh the consequences of their behaviors and decisions
Answer: D
Question: A new psychiatric nurse is providing care to a parent diagnosed with bipolar disorder. This nurse angrily recalls embarrassing events concerning the parent’s behavior in the community. Select the best ways for this nurse to cope with these feelings. (Select all that apply.)
Answer Options:
a. Seeking ways to use the understanding gained from childhood to help patients cope with their own illnesses
b. Recognizing that these feelings are unhealthy and try to suppress them when working with patients
c. Recognizing that psychiatric nursing is not an appropriate career choice and explore other nursing specialties
d. Beginning new patient relationships by saying, “My own parent had mental illness, so I accept it without stigma”
e. Recognizing that the feelings may add sensitivity to the nurse’s practice, but supervision is important
Answer: A, E
Question: A patient says, “People should be allowed to commit suicide without interference from others.” A nurse replies, “You’re wrong. Nothing is bad enough to justify death.” What is the best analysis of this interchange?
Answer Options:
a. The patient is correct.
b. The nurse is correct.
c. Neither person is totally correct.
d. Differing values are reflected in the two statements.
Answer: D
Question: A person has minor physical injuries after an automobile accident. The person is unable to focus and says, “I feel like something awful is going to happen.” This person has nausea, dizziness, tachycardia, and hyperventilation. What is this person’s level of anxiety?
Answer Options:
a. Mild
b. Moderate
c. Severe
d. Panic
Answer: C
Question: A patient says, “I’ve done a lot of cheating and gambling in my relationships.” What nonjudgmental response by the nurse is most appropriate?
Answer Options:
a. “How do you feel about that?”
b. “It’s good that you realize this.”
c. “That’s not a good way to behave.”
d. “Have you outgrown that type of behavior?”
Answer: A
Question: A supervisor assigns a worker a new project. The worker initially agrees but feels resentful. The next day, when asked about the project, the worker says, “I’ve been working on other things.” When asked 4 hours later, the worker says, “Someone else was using the copier, so I couldn’t finish it.” The worker’s behavior demonstrates the use of what mechanism?
Answer Options:
a. Acting out
b. Projection
c. Suppression
d. Passive aggression
Answer: D
Question: A soldier returned 1 year ago from Afghanistan and was diagnosed with posttraumatic stress disorder (PTSD). Which social event would most likely be disturbing for this soldier?
Answer Options:
a. Halloween festival with neighborhood children
b. Singing carols around a Christmas tree
c. Family outing to the seashore
d. Fireworks display on July 4th
Answer: D
Question: A person with a fear of closed spaces enters into an elevator. Which division of the autonomic nervous system is stimulated in response to this experience?
Answer Options:
a. Limbic system
b. Peripheral nervous system
c. Sympathetic nervous system
d. Parasympathetic nervous system
Answer: C
Question: A nurse ends a relationship with a patient. Which actions by the nurse should be included in the termination phase? (Select all that apply.)
Answer Options:
a. Focus dialog with the patient on problems that may occur in the future.
b. Help the patient express feelings about the relationship with the nurse.
c. Help the patient prioritize and modify socially unacceptable behaviors.
d. Reinforce expectations regarding the parameters of the relationship.
e. Help the patient identify strengths, limitations, and problems.
Answer: B, C, D, E
Question: A patient approaches the nurse and impatiently blurts out, “You’ve got to help me! Something terrible is happening. My heart is pounding.” The nurse responds, “It’s almost time for visiting hours. Let’s get your hair combed.” Which approach has the nurse used?
Answer Options:
a. Bringing up an irrelevant topic
b. Responding to physical needs
c. Addressing false cognitions
d. Focusing
Answer: A
Question: A patient is undergoing diagnostic tests. The patient says, “Nothing is wrong with me except a stubborn chest cold.” The spouse reports that the patient smokes, coughs daily, has recently lost 15 pounds, and is easily fatigued. Which defense mechanism is the patient using?
Answer Options:
a. Displacement
b. Regression
c. Projection
d. Denial
Answer: D
Question: As a nurse escorts a patient being discharged after treatment for panic disorder, the patient gives the nurse a gold necklace with a heart pendant and says, “Thank you for helping mend my broken heart.” Which is the nurse’s best response?
Answer Options:
a. “Accepting gifts violates the policies and procedures of the facility.”
b. “I’m glad you feel so much better now. Thank you for the beautiful necklace.”
c. “I’m glad I could help you, but I can’t accept the gift. My reward is seeing you renewed sense of hope.”
d. “Helping people is what nursing is all about. It’s rewarding to me when patients recognize how hard we work.”
Answer: C
Question: Cortisol is released in response to a patient’s prolonged stress. Which initial effect would the nurse expect to result from the increased cortisol level?
Answer Options:
a. Diuresis and electrolyte imbalance
b. Focused and alert mental status
c. Drowsiness and lethargy
d. Restlessness and anxiety
Answer: B
Question: A patient says, “I’m still on restriction, but I want to attend some off-unit activities. Would you ask the doctor to change my privileges?” What is the nurse’s best response?
Answer Options:
a. “Why are you asking me when you’re able to speak for yourself?”
b. “I will be glad to address it when I see your doctor later today.”
c. “That’s a good topic for you to take up with your doctor.”
d. “Do you think you can’t speak to a doctor?”
Answer: C
Question: A soldier who served in a combat zone returned to the United States. The soldier’s spouse complains to the nurse, “We had planned to start a family, but now he won’t talk about it. He won’t even look at children.” The spouse is describing which symptom associated with posttraumatic stress disorder (PTSD)?
Answer Options:
a. Re-experiencing
b. Hyperarousal
c. Avoidance
d. Psychosis
Answer: C
Question: A patient with a high level of motor activity runs from chair to chair and cries, “They’re coming! They’re coming!” The patient does not follow instructions or respond to verbal interventions from staff. The initial nursing intervention of highest priority is to:
Answer Options:
a. provide for patient safety.
b. increase environmental stimuli.
c. respect the patient’s personal space.
d. encourage the clarification of feelings.
Answer: A
Question: What patient behavior is the desirable outcome for the orientation stage of a nurse-patient relationship? a. Gaining a sense of independence b. Building rapport and trust with the nurse c. Assuming self-responsibility and autonomy d. Effective resolution of feelings of transference
Answer: B