Answer Options:
a. Allow the patient to have supervised access to food vending machines.
b. Allow the patient to telephone a local restaurant to deliver meals.
c. Offer to taste each portion on the tray for the patient.
d. Begin tube feedings or total parenteral nutrition.
Answer: A. Allow the patient to have supervised access to food vending machines.
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 Options:
a. Stimulants
b. Erectile dysfunction medication
c. Atypical antipsychotic medication
d. Mood stabilizer
Answer: d. Mood stabilizer
Question: A patient diagnosed with schizophrenia begins a new prescription for lurasidone HCl. The patient is 5 feet 6 inches tall and currently weighs 204 pounds. Which topic is most important for the nurse to include in the teaching plan related to this medication?
Answer Options:
a. How to recognize tardive dyskinesia?
b. Weight management strategies.
c. Ways to manage constipation.
d. Sleep hygiene measures.
Answer: b. Weight management strategies.
Question: A patient diagnosed with schizophrenia is demonstration catatonia. The patient has little spontaneous movement and waxy flexibility. Which patient needs are of priority importance?
Answer Options:
a. Psychosocial
b. Physiological
c. Self-actualization
d. Safety and security
Answer: B. Physiological
Question: A patient diagnosed with schizophrenia is stuporous, demonstrates little spontaneous movement, and has waxy flexibility. The patient’s activities of daily living are severely compromised. An appropriate outcome is that the patient will:
Answer Options:
a. demonstrate increased interest in the environment by the end of week 1.
b. perform self-care activities with coaching by the end of day 3.
c. gradually take the initiative for self-care by the end of week 2.
d. voluntarily accept tube feeding by day 2.
Answer: B. perform self-care activities with coaching by the end of day 3.
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 Options:
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. 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.
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 Options:
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 schizophrenia is taking an antipsychotic medication. Today, the patient is diaphoretic, drooling, and has difficulty swallowing. By 4:00 pm, vital signs are body temperature, 102.8° F; pulse, 110 beats/min; respirations, 26 breaths per minute; and blood pressure, 150/90 mm Hg. Select the nurse’s best analysis and action.
Answer Options:
a. Agranulocytosis. Institute reverse isolation.
b. Tardive dyskinesia. Withhold the next dose of medication.
c. Cholestatic jaundice. Begin a high-protein, low-fat diet.
d. Neuroleptic malignant syndrome. Immediately notify the health care provider.
Answer: d. Neuroleptic malignant syndrome. Immediately notify the health care provider.
Question: A newly admitted patient diagnosed with schizophrenia says, “The therapists are evil, they yell and tell me I’m bad. I have got to get away from them.” Select the nurse’s most helpful reply.
Answer Options:
a. “Do you have plans for getting away from the voices?”
b. “The voices can’t hurt you. They are a part of your illness.”
c. “I will stay with you. Focus on what we are talking about, not the voices.”
d. “Forget about the voices. Ask some other patients to sit and talk with you.”
Answer: C. “I will stay with you. Focus on what we are talking about, not the voices.”
Question: A community mental health nurse wants to establish a relationship with a very withdrawn patient diagnosed with schizophrenia. The patient has a home visit multiple times daily. Select the nurse’s best plan.
Answer Options:
a. Visit daily for 4 days, then visit every other day for 1 week; stay with the patient for 20 minutes; accept silence; state when the nurse will return.
b. Arrange to spend 1 hour each day with the patient; focus on asking questions about what the patient is thinking or experiencing; avoid silences.
c. Visit twice daily; sit beside the patient with a hand on the patient’s arm; leave if the patient does not respond within 10 minutes.
d. Visit every other day; remind the patient of the nurse’s identity; encourage the patient to talk while the nurse works on reports.
Answer: A. Visit daily for 4 days, then visit every other day for 1 week; stay with the patient for 20 minutes; accept silence; state when the nurse will return.
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. Avoidance
Question: The family of a patient diagnosed with schizophrenia is unfamiliar with the illness and their role in recovery. Which type of therapy should the nurse recommend?
Answer Options:
a. Psychoeducational
b. Psychoanalytic
c. Transactional
d. Family
Answer: a. Psychoeducational
Question: A veteran of the war in Afghanistan was diagnosed with posttraumatic stress disorder (PTSD). The veteran says, “If there’s a loud noise at night, I get under my bed because I think we’re getting bombed.” What type of experience has the veteran described?
Answer Options:
a. Illusion
b. Flashback
c. Nightmare
d. Auditory hallucination
Answer: B. Flashback
Question: Which patient diagnosed with schizophrenia would be expected to have the lowest level of overall functioning?
Answer Options:
a. 39 years old; paranoid ideation since age 35 years
b. 32 years old; isolated episodes of catatonia since age 24 years; stable for 3 years
c. 19 years old; diagnosed with schizophreniform disorder 6 months ago
d. 40 years old; frequent relapses since age 18; often does not take medication as prescribed
Answer: D. 40 years old; frequent relapses since age 18; often does not take medication as prescribed
Question: The partner of a patient diagnosed with schizophrenia says, “I don’t understand why childhood experiences have anything to do with this disabling illness.” Which nurse’s response will best help the partner understand the condition?
Answer Options:
a. “Psychological stress is actually at the root of most mental disorders.”
b. “We now know that all mental illnesses are the result of genetic factors.”
c. “It must be frustrating for you that your spouse is sick so much of the time.”
d. “Research has shown that although schizophrenia is one of the ‘psychiatric illnesses,’ the impact of a patient’s environment, such as childhood, can influence who may develop this disorder and how severe it can become.”
Answer: d. “Research has shown that although schizophrenia is one of the ‘psychiatric illnesses,’ the impact of a patient’s environment, such as childhood, can influence who may develop this disorder and how severe it can become.”
Question: A patient diagnosed with schizophrenia anxiously says, “I can see the left side of my body merging with the wall, then my face appears and disappears in the mirror.” What phenomena is the patient describing?
Answer Options:
a. Derealization
b. Concrete thinking
c. Abstract thinking
d. Depersonalization
Answer: d. Depersonalization
Question: A patient experiencing fluctuating levels of awareness, confusion, and disturbed orientation shouts, “Bugs are crawling on my legs! Get them off!” Which problem is the patient experiencing?
Answer Options:
a. Speech hallucinations
b. Dystonia
c. Tactile hallucinations
d. Mnemonic disturbance
Answer: c. Tactile hallucinations
Question: Which documentation of a patient’s behavior best demonstrates a nurse’s observations?
Answer Options:
a. Isolates self from others. Frequently fell asleep during group. Vital signs stable.
b. Calmer and more cooperative. Participated actively in group. No evidence of psychotic thinking.
c. Appeared to hallucinate. Patient frequently increased volume on television, causing conflict with others.
d. Wears four layers of clothing. States, “I need protection from dangerous bacteria trying to penetrate my skin.”
Answer: D. Wears four layers of clothing. States, “I need protection from dangerous bacteria trying to penetrate my skin.”