Question: How is severe and persistent mental best characterized?
Answer Choices:
A. Mental illness which last 2 weeks’ duration
B. Severe mental illness with a rapid onset of symptoms
C. Major ongoing mental illness marked by significant functional impairments
D. Major mental illness that cannot be treated to remission
Answer: C
Question: A 37 year old is involuntarily committed to outpatient treatment after sexually molesting a 12-year-old child. The patient says, “That girl looked like she was 19 years old.” Which defense mechanism is this patient using?
Answer Choices:
A. Denial
B. Identification
C. Displacement
D. Rationalization
Answer: D
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 Choices:
A. Insomnia
B. Substance abuse
C. Chronic low self-esteem
D. Impaired environmental interpretation syndrome
Answer: C
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
Question: A patient diagnosed with severe and persistent mental illness lives independently. This patient often has command hallucinations and shouts warnings to neighbors. After a short hospitalization, the patient’s landlord says, “You can’t come back here. You cause too much trouble.” What problem is the patient experiencing?
Answer Choices:
A. Grief
B. Stigmatization
C. Recidivism
D. Lack of insurance parity
Answer: B
Question: A person diagnosed with severe and persistent mental illness enters a shelter for the homeless. Which intervention should be the nurse’s initial priority?
Answer Choices:
A. Develop a relationship.
B. Find supported employment.
C. Administer prescribed medication.
D. Teach appropriate health care practices.
Answer: A
Question: A patient diagnosed with severe and persistent mental illness lives in a homeless shelter. The priority nursing diagnosis for this patient is Powerlessness. Which intervention should be included in the plan of care?
Answer Choices:
A. Encourage mutual goal setting.
B. Verbally communicate empathy.
C. Reinforce participation in activities.
D. Demonstrate an accepting attitude.
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
Question: For patients diagnosed with severe and persistent mental illness, what is the major advantage of case management?
Answer Choices:
A. Modification of traditional psychotherapy
B. Efficient access and use of resources
C. Focus on social skills training and self-esteem building
D. Bringing groups of patients together to discuss common problems
Answer: B
Question: The father of a child diagnosed with schizophrenia says, “I lost my job, so we have no health insurance.” The mother says, “I must watch this child all the time. Without supervision, our child becomes violent and destructive.” A sibling says, “My parents don’t pay attention to me.” These comments signify what related stress?
Answer Choices:
A. Life-cycle stressors
B. Psychobiological issues
C. Family burden of mental illness
D. Stigma associated with mental illness
Answer: C
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 Choices:
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
Question: An adult says, “When I was a child, I took medication because I couldn’t follow my teachers’ directions. I stopped taking it when I was about 13. I still have trouble getting organized, which causes difficulty at my job.” Which disorder is most likely?
Answer Choices:
A. Stress intolerance disorder
B. Generalized anxiety disorder (GAD)
C. Borderline personality disorder
D. Adult attention-deficit/hyperactivity disorder (ADHD)
Answer: D
Question: A patient says, “I often make careless mistakes and have trouble staying focused. Sometimes it’s hard to listen to what someone is saying. I have problems putting things in the right order and often lose equipment.” Which problem should the nurse document?
Answer Choices:
A. Inattention
B. Impulsivity
C. Hyperactivity
D. Social impairment
Answer: A
Question: A nurse prepares for an initial interview with a patient with suspected adult attention-deficit/hyperactivity disorder (ADHD). Questions should be focused to elicit information about which problem?
Answer Choices:
A. Headaches
B. Inattention
C. Sexual impulses
D. Trichotillomania
Answer: B
Question: A nurse prepares a plan of care for a patient diagnosed with adult attention-deficit/hyperactivity disorder (ADHD). Which intervention should be included?
Answer Choices:
A. Remind the patient of priorities and deadlines.
B. Teach work-related skills such as basic computer literacy.
C. Establish penalties for failing to organize and prioritize tasks.
D. Give encouragement and strategies for managing ongoing attention and focus.
Answer: D
Question: The treatment team believes medication will help a patient diagnosed with adult attention-deficit/hyperactivity disorder (ADHD). Which class of medications does the nurse expect will be prescribed?
Answer Choices:
A. Benzodiazepines
B. Stimulants
C. Antipsychotics
D. Anxiolytics
Answer: B
Question: An adult diagnosed with attention-deficit/hyperactivity disorder (ADHD) says, “I’ve always been stupid. I never had friends when I was a child. My parents often punished me because I made mistakes. Now, I can’t keep a job.” The nurse managing care should consider suggesting what intervention?
Answer Choices:
A. Aversive therapy to extinguish negative behaviors.
B. Cognitive therapy to help address internalized beliefs.
C. Group therapy to allow comparison of feelings with others.
D. Vocational counseling to identify needed occupational skills.
Answer: B
Question: A nurse counsels a patient diagnosed with serious and persistent mental illness. The patient lives at home with family. Which resource could the nurse suggest accessing that can help family to cope with the stigma of mental illness as well as provide support and education?
Answer Choices:
A. American Psychiatric Association (APA)
B. National Alliance on Mental Illness (NAMI)
C. Community Mental Health Centers (CMHCs)
D. Programs of Assertive Community Treatment (PACT)
Answer: B
Question: Which nursing action should occur first when preparing to work with a patient who has a problem of sexual functioning?
Answer Choices:
A. Acquire knowledge of the patient’s sexual roles and preferences.
B. Develop an understanding of human sexual responses.
C. Assess the patient’s sexual functioning.
D. Clarify the nurse’s own personal values.
Answer: D
Question: A patient tells the nurse, “My sexual functioning is normal when my partner wears lace. Without it, I’m not interested in sex.” This comment evidences which sexual disorder?
Answer Choices:
A. Exhibitionism
B. Voyeurism
C. Pedophilia
D. Fetishism
Answer: D