Question: The original members of the American Psychological Association (APA) believed that anything in psychology worth applying to practical matters came from:
Answer Choices:
A. experimental psychology
B. structural psychology
C. functional psychology
D. clinical psychology
Answer: C – functional psychology
Question: A patient recently hospitalized for 2 weeks committed suicide during the night. Which initial measure will be most helpful for staff members and other patients regarding this event?
Answer Choices:
A. Request the public information officer to address inquiries from the local media.
B. Hold a staff meeting to express feelings and plan the care for other patients.
C. Ask the patient’s roommate not to discuss the event with other patients.
D. Quickly discharge as many patients as possible to prevent panic.
Answer: B – Hold a staff meeting to express feelings and plan the care for other patients.
Question: A severely depressed patient who has been on suicide precautions tells the nurse, “I am feeling a lot better, so you can stop watching me. I have taken too much of your time already.” Which is the nurse’s best response?
Answer Choices:
A. “I wonder what this sudden change is all about. Please tell me more.”
B. “I am glad you are feeling better. The team will consider your request.”
C. “You should not try to direct your care. Leave that to the treatment team.”
D. “Because we are concerned about your safety, we will continue with our plan.”
Answer: D – “Because we are concerned about your safety, we will continue with our plan.”
Question: A new nurse says to a peer, “My new patient is diagnosed with bipolar disorder. At least I won’t have to worry about suicide risk.” Which response by the peer would be most helpful?
Answer Choices:
A. “Let’s reconsider your plan. Suicide risk is high in patients diagnosed with bipolar disorder.”
B. “Suicide is a risk for any patient diagnosed with bipolar disorder who uses alcohol or drugs.”
C. “The thought processes of patients diagnosed with bipolar disorder are usually too disorganized to attempt suicide.”
D. “Racing thoughts during mania often prompt suicide among patients diagnosed with bipolar disorder.”
Answer: A – “Let’s reconsider your plan. Suicide risk is high in patients diagnosed with bipolar disorder.”
Question: The parents of identical twins ask a nurse for advice when one twin committed suicide a month ago. Now the parents are concerned that the other twin may also have suicidal tendencies. Which comment by the nurse is accurate?
Answer Choices:
A. “Genetics are associated with suicide risk. Monitoring and support are important.”
B. “Apathy underlies suicide. Instilling motivation is the key to health maintenance.”
C. “Your child is unlikely to act out suicide when identifying with a suicide victim.”
D. “Fraternal twins are at higher risk for suicide than identical twins.”
Answer: A – “Genetics are associated with suicide risk. Monitoring and support are important.”
Question: A college student failed two examinations. The student cried for hours and then tried to call a parent but got no answer. The student then suspended access to his social networking web site. Which suicide risk factors are present? (Select all that apply.)
Answer Choices:
A. History of earlier suicide attempt
B. Co-occurring medical illness
C. Recent stressful life event
D. Self-imposed isolation
E. Shame or humiliation
Answer: C – Recent stressful life event D – Self-imposed isolation E – Shame or humiliation
Question: A patient with suicidal impulses is on the highest level of suicide precautions. Which measures should the nurse incorporate into the patient’s plan of care? (Select all that apply.)
Answer Choices:
A. Allow no glass or metal on meal trays.
B. Remove all potentially harmful objects from the patient’s possession.
C. Maintain arm’s length, one-on-one nursing observation around the clock.
D. Remove the patient’s shoelaces and belt.
E. Check the patient’s whereabouts every 15 minutes and give frequent verbal contacts.
F. Keep the patient within visual range while he or she is awake. Check every 15 to 30 minutes while the patient is sleeping.
Answer: A – Allow no glass or metal on meal trays. B – Remove all potentially harmful objects from the patient’s possession. C – Maintain arm’s length, one-on-one nursing observation around the clock. D – Remove the patient’s shoelaces and belt.
Question: A nurse assesses five newly hospitalized patients. Which patients have the highest suicide risk? (Select all that apply.)
Answer Choices:
A. An 82-year-old white man
B. A 17-year-old white female adolescent
C. A 39-year-old African-American man
D. A 29-year-old African-American woman
E. A 22-year-old man with a traumatic brain injury
Answer: A – An 82-year-old white man B – A 17-year-old white female adolescent E – A 22-year-old man with a traumatic brain injury
Question: A nurse assesses the health status of soldiers returning from a war zone. Screening for which health problems will be a priority? (Select all that apply.)
Answer Choices:
A. Schizophrenia
B. Eating disorder
C. Traumatic brain injury
D. Oppositional defiant disorder
E. Posttraumatic stress disorder
Answer: C – Traumatic brain injury E – Posttraumatic stress disorder
Question: Which behavior best demonstrates aggression?
Answer Choices:
A. Stomping away from the nurses’ station, darting to another room, and grabbing a snack from another patient
B. Bursting into tears, leaving the community meeting, and sitting on a bed hugging a pillow and sobbing
C. Telling the primary nurse, “I felt angry when you said I could not have a second helping at lunch”
D. Telling the medication nurse, “I am not going to take that or any other medication you try to give me”
Answer: A – Stomping away from the nurses’ station, darting to another room, and grabbing a snack from another patient
Question: Which scenario predicts the highest risk for directing violent behavior toward others?
Answer Choices:
A. Major depressive disorder with delusions of worthlessness
B. Obsessive-compulsive disorder; performing ritualistic behavior
C. Schizophrenia; disorganized, fearful that food is being poisoned
D. Completion of alcohol withdrawal and beginning a recovery program
Answer: C – Schizophrenia; disorganized, fearful that food is being poisoned
Question: A patient is hospitalized after an arrest for breaking windows in the home of a former intimate partner. The history reveals childhood abuse by a punitive parent, torturing family pets, and an arrest for disorderly conduct. Which nursing diagnosis has priority?
Answer Choices:
A. Risk for injury
B. Post-trauma response
C. Disturbed thought processes
D. Risk for other-directed violence
Answer: D – Risk for other-directed violence
Question: A confused older adult patient in a skilled care facility is sleeping. A health care worker enters the room quietly and touches the bed to see if it is wet. The patient awakens and hits the health care worker in the face. Which statement best explains the patient’s action?
Answer Choices:
A. Older adult patients often demonstrate exaggerations of behaviors used earlier in life.
B. Crowding in skilled care facilities increases individual tendencies toward violence.
C. The patient interpreted the health care worker’s behavior as potentially harmful.
D. This patient learned violent behavior by watching other patients act out.
Answer: C – The patient interpreted the health care worker’s behavior as potentially harmful.
Question: A patient is pacing the hall near the nurses’ station and swearing in a loud voice. Which intervention for the nurse would be to address the patient by saying:
Answer Choices:
A. “What is going on?”
B. “Quiet down immediately. You are disturbing everyone.”
C. “I’d like to talk with you about what is going on. Can we sit here and talk?”
D. “You must go to your room and try to get control of yourself.”
Answer: C – “I’d like to talk with you about what is going on. Can we sit here and talk?”
Question: A patient has been responding to auditory hallucinations throughout the day. The patient approaches the nurse, shaking a fist and shouting, “Back off!” and then goes into the day room. As the nurse follows the patient into the day room, the nurse should take what precaution?
Answer Choices:
A. Making sure adequate physical space exists between the nurse and the patient
B. Moving into a position that allows the patient to be close to the door
C. Maintaining one arm’s length distance from the patient
D. Sitting down in a chair near the patient
Answer: A – Making sure adequate physical space exists between the nurse and the patient
Question: A patient being admitted suddenly pulls a knife from a coat pocket and threatens, “I will kill anyone who tries to get near me.” An emergency code is called. The patient is safely disarmed and placed in seclusion. What is the justification for the use of seclusion?
Answer Choices:
A. Patient demonstrates a thought disorder, rendering rational discussion ineffective.
B. Patient’s actions present a clear and present danger to others.
C. Patient demonstrates an apparent and plausible escape risk.
D. Patient’s actions display features of psychotic thinking.
Answer: B – Patient’s actions present a clear and present danger to others.
Question: A cognitively impaired patient has been a widow for 30 years. This patient is frantically trying to leave the unit, saying, “I have to go home to cook dinner before my husband arrives from work.” To intervene with validation therapy, what should the nurse first say?
Answer Choices:
A. “You must come away from the door.”
B. “You have been a widow for many years.”
C. “You want to go home to prepare your husband’s dinner?”
D. “Was your husband angry if you did not have dinner ready on time?”
Answer: C – “You want to go home to prepare your husband’s dinner?”
Question: A patient with a history of anger and impulsivity is hospitalized after an accident resulting in injuries. When in pain, the patient loudly scolds the nurse for “not knowing enough to give me pain medicine when I need it.” Which intervention would best address this problem?
Answer Choices:
A. Tell the patient to notify the nurse 30 minutes before the pain returns so the medication can be prepared.
B. Urge the health care provider to change the prescription for pain medication from as needed to a regular schedule.
C. Tell the patient that verbal assaults on nurses will not shorten the wait for pain medication.
D. Have the clinical nurse leader request a psychiatric consultation.
Answer: B – Urge the health care provider to change the prescription for pain medication from as needed to a regular schedule.
Question: A patient with severe physical injuries is irritable, angry, and belittles the nurses. As a nurse changes a dressing, the patient screams, “Don’t touch me! You are so stupid. You will make it worse!” Which intervention uses a cognitive technique to help this patient?
Answer Choices:
A. Discontinue the dressing change without comments and leave the room.
B. Stop the dressing change, saying, “Perhaps you would like to change your own dressing.”
C. Continue the dressing change, saying, “Do you know this dressing change is necessary?”
Answer: C – Continue the dressing change, saying, “Do you know this dressing change is necessary?”
Question: Which medication should a nurse administer to provide immediate intervention for a psychotic patient whose aggressive behavior continues to escalate despite verbal intervention?
Answer Choices:
A. Lithium
B. Trazodone
C. Olanzapine
D. Valproic acid
Answer: C – Olanzapine