The quantitative study of the distribution of mental disorders in human populations is called which of the following? A. Mortality B. Prevalence C.Epidemiology D.Clinical epidemiology
Which statement best describes the DSM-5? A.It is a medical psychiatric assessment system. B.It is a compendium of treatment modalities. C.It offers a complete list of nursing diagnoses. D.It suggests common interventions for mental disorders.
A.It is a medical psychiatric assessment system.
Current information suggests that the most disabling mental disorders are the result of which of the following? A.Biological influences B.Psychological trauma C.Learned ways of behaving D.Faulty patterns of early nurturance
A nurse's identification badge includes the term, Psychiatric Mental Health Nurse. A patient with a history of paranoia asks, "What does that title mean?" The nurse responds best by answering with which of the following? A."Don't be afraid; it means I'm here to help, not hurt, you." B."Psychiatric mental health nurses care for people with mental illnesses." C."We have the specialized skills needed to care for people with mental illnesses." D."The nurses who work in mental health facilities have that title."
C."We have the specialized skills needed to care for people with mental illnesses."
Which statement about diagnosis of a mental disorder is true? A.The symptoms of each disorder are common among all cultures. B.Culture may cause variations in symptoms for each clinical disorder. C.All mental disorders listed in the DSM-5 are seen in all cultures. D.Psychiatric diagnoses are listed separately from other physical disorders in a five-axes system.
B.Culture may cause variations in symptoms for each clinical disorder.
The prevalence rate over a 12-month period for major depressive disorder is which of the following? A.Lower than the prevalence rate for panic disorder B.Greater than the prevalence rate for social phobia C.Equal to the prevalence rate for schizophrenia D.Greater than the prevalence rate for generalized anxiety
D.Greater than the prevalence rate for generalized anxiety
Which of the following severe mental illnesses are recognized across cultures? A.Antisocial and borderline personality disorders B.Schizophrenia and bipolar disorder C.Bulimia and anorexia nervosa D.Amok and social phobia
B.Schizophrenia and bipolar disorder
Providing a large group of patients minimal care through assistance with tasks such as bathing, eating, and toileting was historically referred to as what form of care? A.Structural B.Moral treatment C.Custodial D.Asylum
Asylum-based training programs began in the late 1800s in Canada. What was the rationale for initiating psychiatric nursing training? A.There were greater needs for custodial care B.Changes in treatment approaches meant greater needs for nursing care and assistance C.The early feminist movement advocated for career training for women and girls D.The moral treatment era meant that early psychotherapy strategies were desired in asylum settings
B.Changes in treatment approaches meant greater needs for nursing care and assistance
Which of the following is the major distinction between fear and anxiety? A.Fear is a universal experience; anxiety is neurotic. B.Fear enables constructive action; anxiety is dysfunctional. C.Fear is a psychological experience; anxiety is a physiological experience. D.Fear is a response to a specific danger; anxiety is a response to an unknown danger.
D.Fear is a response to a specific danger; anxiety is a response to an unknown danger.
Which of the following is the initial nursing action for a newly admitted anxious patient? A.Assess the patient's use of defence mechanisms B.Assess the patient's level of anxiety C.Limit environmental stimuli D.Provide antianxiety medication
B.Assess the patient's level of anxiety
Selective inattention is first noted when experiencing which level of anxiety? A.Mild B.Moderate C.Severe D.Panic
Delusionary thinking is a characteristic of which of the following? A.Chronic anxiety B.Acute anxiety C.Severe anxiety D.Panic level anxiety
D.Panic level anxiety
Which of the following is generally true about ego defence mechanisms? A.They often involve some degree of self-deception. B.They are rarely used by mentally healthy people. C.They seldom make the person more comfortable. D.They are usually effective in resolving conflicts.
A.They often involve some degree of self-deception.
A 20-year-old man was sexually molested at age 10, but he can no longer remember the incident. Which ego defence mechanism is in use? A.Projection B.Repression C.Displacement D.Reaction formation
The defence mechanisms that can be used in only healthy ways include which of the following? A.Suppression and humour B.Altruism and sublimation C.Idealization and splitting D.Reaction formation and denial
B.Altruism and sublimation
Which behaviour would be characteristic of an individual who is displacing anger? A.Lying B.Stealing C.Slapping D.Procrastinating
A person recently gave up smoking and now talks constantly about how smoking fouls the air, causes cancer, and "burns" money that could be better spent to feed the poor. This person is demonstrating which of the following defence mechanisms? A.Projection B.Rationalization C.Reaction formation D.Undoing
A man continues to speak of his wife as though she were still alive, 3 years after her death. This behaviour suggests the use of which of the following defence mechanisms? A.Altruism B.Denial C.Undoing D.Suppression
What can be said about the comorbidity of anxiety disorders? A.Anxiety disorders generally exist alone. B.A second anxiety disorder may coexist with the first. C.Anxiety disorders virtually never coexist with mood disorders. D.Substance abuse disorders rarely coexist with anxiety disorders.
B.A second anxiety disorder may coexist with the first.
Studies of patients diagnosed with post-traumatic stress disorder suggest that the stress response of which of the following is considered abnormal? A. Brain Stem B. Hypothalamus-pituitary-adrenal system C. Frontal Lobe D. Limbic system
B. Hypothalamus-pituitary-adrenal system
An obsession is defined as which of the following? A.Thinking of an action and immediately taking the action. B.A recurrent, persistent thought or impulse. C.An intense irrational fear of an object or situation. D.A recurrent behaviour performed in the same manner.
B.A recurrent, persistent thought or impulse.
Which of the following is a symptom commonly associated with panic attacks? A.Obsessions B.Apathy C.Fever D.Fear of impending doom
D.Fear of impending doom
Working to help the patient view an occurrence in a more positive light is called which of the following? A.Flooding B.Desensitization C.Response prevention D.Cognitive restructuring
Which of the following is the primary purpose of performing a physical examination before beginning treatment for any anxiety disorder? A.Protect the nurse legally B.Establish the nursing diagnosis of priority C.Obtain information about the patient's psychosocial background D.Determine whether the anxiety is primary or secondary in origin
D.Determine whether the anxiety is primary or secondary in origin
Which of the following is an important question to ask during the assessment of a patient diagnosed with anxiety disorder? A."How often do you hear voices?" B."Have you ever considered suicide?" C."How long has your memory been bad?" D."Do your thoughts always seem jumbled?"
B."Have you ever considered suicide?"
Which of the following is a possible outcome criterion for a patient diagnosed with anxiety disorder? A.Patient demonstrates effective coping strategies B.Patient reports reduced hallucinations C.Patient reports feelings of tension and fatigue D.Patient demonstrates persistent avoidance behaviours
A.Patient demonstrates effective coping strategies
Inability to leave one's home because of avoidance of severe anxiety suggests which of the following anxiety disorders? A.Panic attacks with agoraphobia B.Obsessive-compulsive disorder C.Post-traumatic stress response D.Generalized anxiety disorder
A.Panic attacks with agoraphobia
A new psychiatric nursing assistant mentions to the nurse, "Depression seems to be a disorder of old people. All the depressed patients on the unit are older than 60 years." Which of the following replies by the nurse clarifies the prevalence of this disorder? A."That is a good observation. Depression does mostly strike people older than 50 years." B."Depression is seen in people of all ages, from childhood to old age." C."Depression is most often seen among the middle adult age group." D."The age of onset for most depressive episodes is given as 18 years."
B."Depression is seen in people of all ages, from childhood to old age."
Which of the following statements about the co-morbidity of depression is accurate? A.Depression most often exists in an individual as a single entity. B.Depression is commonly seen in individuals with medical disorders. C.Substance abuse and depression are seldom seen as co-morbid disorders. D.Depression may coexist with other disorders but is rarely seen with schizophrenia.
B.Depression is commonly seen in individuals with medical disorders.
Beck's cognitive theory suggests that the etiology of depression is related to which of the following? A.Sleep abnormalities B.Serotonin circuit dysfunction C.Negative processing of information D.A belief that one has no control over outcomes
C.Negative processing of information
When the clinician mentions that a patient has anhedonia, what can the nurse expect about the patient? A.The patient has poor retention of recent events. B.The patient experienced a weight loss from anorexia. C.The patient obtains no pleasure from previously enjoyed activities. D.The patient has difficulty with tasks requiring fine motor skills.
C.The patient obtains no pleasure from previously enjoyed activities.
Assessment of the thought processes of a patient diagnosed with depression is most likely to reveal which of the following? A.Good memory and concentration B.Delusions of persecution C.Self-deprecatory ideation Correct D.Sexual preoccupation
C.Self-deprecatory ideation Correct
A patient who has been assessed by the nurse as moderately depressed is given a prescription for daily doses of a selective serotonin reuptake inhibitor. The patient mentions that she will take the medication along with the St. John's wort she uses daily. Which of the following should the nurse do? A.Agree that taking the drugs at the same time will help her remember them daily. B.Caution the patient to drink several glasses of water daily. C.Suggest that the patient also use a sun lamp daily. D.Explain the high possibility of an adverse reaction.
D.Explain the high possibility of an adverse reaction.
The nursing diagnosis of Imbalanced nutrition: less than body requirements has been identified for a patient diagnosed with severe depression. The most reliable evaluation of outcomes will be based on which of the following? A.The patient's energy level B.The patient's weekly weights C.The patient's observed eating patterns D.The patient's statement of appetite
B.The patient's weekly weights
It is likely that a patient diagnosed with seasonal affective disorder will begin to experience fewer symptoms in which season? A.Fall B.Winter C.Spring D.Summer
A depressed patient is noted to pace most of the time, pull at her clothes, and wring her hands. These behaviours are consistent with which of the following? A.Senile dementia B.Hypertensive crisis C.Psychomotor agitation D.Central serotonin syndrome
Dysthymia cannot be diagnosed unless it has existed for how long? A.At least 3 months B.At least 6 months C.At least 1 year D.At least 2 years
D.At least 2 years
Which of the following is the first-line drug used to treat mania? A.Lithium carbonate (Lithium) B.Carbamazepine (Tegretol) C.Lamotrigine (Lamictal) D.Clonazepam (Rivotril)
A.Lithium carbonate (Lithium)
A person who has numerous hypomanic and dysthymic episodes can be assessed as demonstrating characteristics of which of the following? A.Bipolar II disorder B.Bipolar I disorder C.Cyclothymia D.Seasonal affective disorder
A bipolar patient tells the nurse, "I have the best voice in the world. The three tenors who do all those TV concerts are going to retire because they can't compete with me." The nurse would make the assessment that the patient is displaying which of the following? A.Flight of ideas B.Distractibility C.Limit testing D.Grandiosity
Which behaviour would be most characteristic of a patient during a manic episode? A.Going rapidly from one activity to another B.Taking frequent rest periods and naps during the day C.Being unwilling to leave home to see other people D.Watching others intently and talking little
A.Going rapidly from one activity to another
The nurse can expect a patient demonstrating typical manic behaviour to be attired in which of the following types of clothing? A.Dark coloured and modest B.Colourful and outlandish C.Compulsively neat and clean D.Ill-fitted and ragged
B.Colourful and outlandish
Which of the following outcomes for a manic patient during the acute phase would indicate that the treatment plan was successful? A.The patient reports racing thoughts. B.The patient is free of injury. C.The patient is highly distractible. D.The patient ignores food and fluid.
B.The patient is free of injury.
When a patient experiences four or more mood episodes in a 12-month period, the patient is said to be which of the following? A.Dyssynchronous B.Incongruent C.Cyclothymic D.Rapid cycling
Which room placement would be best for a patient experiencing a manic episode? A.A shared room with a patient with dementia B.A single room near the unit activities area C.A single room near the nurses' station D.A shared room away from the unit entrance
C.A single room near the nurses' station
When a hyperactive manic patient expresses the intent to strike another patient, the initial nursing intervention would be to do which of the following? A.Question the patient's motive B.Set verbal limits C.Initiate physical confrontation D.Prepare the patient for seclusion
B.Set verbal limits
When a patient reports that lithium causes an upset stomach, the nurse suggests taking the medication in which of the following ways? A.With meals B.With an antacid C.30 minutes before meals D.2 hours after meals
Which of the following would be assessed as a negative symptom of schizophrenia? A.Anhedonia B.Hostility C.Agitation D.Hallucinations
Which of the following types of altered perception are most commonly experienced by patients with schizophrenia? A.Delusions B.Illusions C.Tactile hallucinations D.Auditory hallucinations
The most common course of schizophrenia is an initial episode followed by which of the following? A.Recurrent acute exacerbations and deterioration B.Recurrent acute exacerbations C.Continuous deterioration D.Complete recovery
A.Recurrent acute exacerbations and deterioration
The causation of schizophrenia is currently understood to be which of the following? A.A combination of inherited and non-genetic factors B.Deficient amounts of the neurotransmitter dopamine C.Excessive amounts of the neurotransmitter serotonin D.Stress related and ineffective stress management skills
A.A combination of inherited and non-genetic factors
Which symptom would NOT be assessed as a positive symptom of schizophrenia? A.Delusion of persecution B.Auditory hallucinations C.Affective flattening D.Idea of reference
When a patient diagnosed with schizophrenia hears voices saying that he is a horrible human being, what can the nurse correctly assume about the hallucination? A.It is a projection of the patient's own feelings. B.It derives from neuronal impulse misfiring. C.It is a retained memory fragment. D.It may signal seizure onset.
A.It is a projection of the patient's own feelings.
Which adverse effect of antipsychotic medication is generally nonreversible? A.Anticholinergic effects B.Pseudoparkinsonism C.Dystonic reaction D.Tardive dyskinesia
The patient with bulimia differs from the patient with anorexia nervosa in which of the following ways? A.By maintaining a normal weight B.By holding a distorted body image C.By doing more rigorous exercising D.By purging to keep weight down
A.By maintaining a normal weight
Which of the following is a subjective symptom the nurse would expect to note during assessment of a patient with anorexia nervosa? A.Lanugo B.Hypotension C.25-lb weight loss D.Fear of gaining weight
D.Fear of gaining weight
During assessment of a patient with anorexia nervosa, which of the following indications is it unlikely that the nurse would note? A.Introversion B.Social isolation C.High self-esteem D.Obsessive-compulsive tendencies
Biological theorists suggest that the cause of eating disorders may be which of the following? A.Normal weight phobia B.Body image disturbance C.Serotonin imbalance D.Dopamine excess
A patient who is 16 years old, is 160 cm tall, and weighs 36 kilograms eats one tiny meal daily and engages in a rigorous exercise program. The nursing diagnosis for this patient would be A.Death anxiety B.Ineffective denial C.Disturbed sensory perception D.Imbalanced nutrition: less than body requirements
D.Imbalanced nutrition: less than body requirements
Which of the following is a coping mechanism used excessively by patients with anorexia nervosa? A.Denial B.Humour C.Altruism D.Projection
A patient reveals that she induces vomiting as often as a dozen times a day. Which of the following would the nurse expect assessment findings to reveal? A.Tachycardia B.Hypokalemia C.Hypercalcemia D.Hypolipidemia
A patient with bulimia nervosa uses enemas and laxatives to purge to maintain her weight. For which imbalance should the nurse assess? A.An increase in the red blood cell count B.A disruption of the fluid and electrolyte balance C.An elevated serum potassium level D.An elevated serum sodium level
B.A disruption of the fluid and electrolyte balance
A patient has been hospitalized with anorexia nervosa. The patient's weight is 65% of normal. For this patient, a realistic short-term goal for the first week of hospitalization would be that by the end of week 1, the patient will do which of the following? A.Gain a maximum of 1.5 kg/week B.Develop a pattern of normal eating behaviour C.Discuss fears and feelings about gaining weight D.Verbalize awareness of the sensation of hunger
A.Gain a maximum of 1.5 kg/week
Bupropion (Wellbutrin), although seemingly effective, is contraindicated in patients who purge because of which of the following? A.Historically poor patient compliance B.An increased risk of seizures C.The long-term effects on liver function D.The potential to cause gastric ulcers
B.An increased risk of seizures
Which problem is NOT considered a causative agent in delirium? A.Elevated blood urea nitrogen levels B.Infection C.Anticholinergic drugs D.Antibiotic therapy
The term perceptual disturbance refers to difficulty with which of the following? A.Processing information about one's internal and external environment B.Changing one's way of thinking to accommodate new information C.Performing purposeful motor movements D.Formulating words appropriately
A.Processing information about one's internal and external environment
Which event would a patient with stage 4 Alzheimer's disease have greatest difficulty remembering? A.His or her high school graduation B.The births of his or her children C.The story of a teenage escapade D.What he or she ate for breakfast
D.What he or she ate for breakfast
When a delirious patient insists that a vacuum hose is a large, poisonous snake, the nurse recognizes which of the following? A.The patient is hallucinating. B.The patient is experiencing an illusion. C.The patient is hypervigilant. D.The patient is demonstrating agnosia.
B.The patient is experiencing an illusion.
A patient with delirium strikes out at a staff member. The nurse can most correctly hypothesize that this behaviour is related to which of the following? A.Anger B.Fear C.An unmet physical need D.The need for social interaction
Which type of dementia has a clear genetic link? A.Alcohol-induced dementia B.Multi-infarct dementia C.Creutzfeldt-Jakob disease D.Alzheimer's disease
What is the usual progression of Alzheimer's disease? A.A single, short episode followed by years of normal function B.Recurring remissions and exacerbations C.Progressive deterioration D.There is no usual progression
A patient diagnosed with Alzheimer's disease looks confused when the phone rings and cannot recall many common household objects by name, such as a pencil or glass. The nurse can document this loss of function as which of the following? A.Apraxia B.Agnosia C.Aphasia D.Anhedonia
The family of a patient diagnosed with Alzheimer's disease mentions to the nurse that seeing his loss of function has been very difficult. A nursing diagnosis that might be considered for such a family would be which of the following? A.Ineffective denial B.Anticipatory grieving C.Disabled family coping D.Ineffective family therapeutic regimen management
A nursing diagnosis appropriate for a patient with Alzheimer's disease, regardless of the stage, would be which of the following? A.Risk for injury B.Acute confusion C.Imbalanced nutrition D.Impaired environmental interpretation syndrome
A.Risk for injury
A syndrome that occurs after stopping the long-term use of a drug is called which of the following? A.Amnesia B.Tolerance C.Enabling D.Withdrawal
Which of the following is the only class of commonly abused drugs that has a specific antidote? A.Opiates B.Hallucinogens C.Amphetamines D.Benzodiazepines
The term tolerance, as it relates to substance abuse, refers to which of the following? A.The use of a substance beyond acceptable societal norms B.The additive effects achieved by taking two drugs with similar actions C.The signs and symptoms that occur when an addictive substance is withheld D.The need to take larger amounts of a substance to achieve the same effects
D.The need to take larger amounts of a substance to achieve the same effects
Benzodiazepines are useful for treating alcohol withdrawal because they do which of the following? A.Block cortisol secretion B.Increase dopamine release C.Decrease serotonin availability D.Exert a calming effect
D.Exert a calming effect
A person who covertly supports the substance-abusing behaviour of another is called which of the following? A.Dependant B.Enabler C.Participant D.Minimizer
A patient who is dependent on alcohol tells the nurse, "Alcohol is no problem for me. I can quit anytime I want to." The nurse can assess this statement as indicating which of the following? A.Denial B.Projection C.Rationalization D.Reaction formation
What is the ethical obligation of the nurse who sees a peer divert a narcotic, compared with the ethical obligation when the nurse observes a peer who is under the influence of alcohol? A.The nurse should immediately report the peer who is diverting narcotics and should defer reporting the alcohol-using nurse until a second incident takes place. B.Neither should be reported until the nurse has collected factual evidence. C.No report should be made until suspicions are confirmed by a second staff member. D.Supervisory staff should be informed as soon as possible in both cases.
D.Supervisory staff should be informed as soon as possible in both cases.
A young woman reports that although she has no memory of the event, she believes that she was raped. This raises suspicion that she unknowingly ingested which of the following? A.LAAM B.GHB C.Naltrexone (ReVia) D.Clonidine (Catapres)
What is the most significant predictor of treatment success, considering the ambivalence of most patients? A.Ongoing support from at least two family members. B.Employment of the patient. C.An empathic, hopeful, and consistently motivational approach. D.A regular schedule of appointments with a primary care provider.
C.An empathic, hopeful, and consistently motivational approach.
Which of the following symptoms would signal opioid withdrawal? A.Rhinorrhea, chills, fever, and muscle aches B.Illusions, disorientation, tachycardia, and tremors C.Fatigue, lethargy, sleepiness, and convulsions D.Synesthesia, depersonalization, and hallucinations
A.Rhinorrhea, chills, fever, and muscle aches
A nurse caring for a patient diagnosed with a personality disorder should expect that the patient will exhibit which of the following? A.Frequent episodes of psychosis B.Overinvolvement with the needs of significant others C.Challenges in self-identity and self-direction D.Abnormal ego functioning
C.Challenges in self-identity and self-direction
Which of the following statements is descriptive of patients with a personality disorder? A.They are resistant to behavioural change. B.They have an ability to tolerate frustration and pain. C.They usually seek help to change maladaptive behaviours. D.They have little difficulty forming satisfying and intimate relationships.
A.They are resistant to behavioural change.
Research has indicated that the antisocial personality may be characterized by which of the following? A.Social isolation B.Lack of remorse C.Learning difficulties D.Difficulty with reality testing
B.Lack of remorse
Which of the following is the primary goal of milieu therapy for patients diagnosed with personality disorders? A.To manage the effect the behaviour has on the entire group B.To provide one-on-one therapy for each member of the milieu C.To help the patient remain uninvolved with other patients D.To promote a laissez-faire attitude among the staff members
A.To manage the effect the behaviour has on the entire group
Which characteristic behaviours will the nurse assess in the narcissistic patient? A.Dramatic expression of emotion, being easily led B.Perfectionism and preoccupation with detail C.Grandiose, exploitive, and rage-filled behaviour D.Angry, highly suspicious, aloof, withdrawn behaviour
C.Grandiose, exploitive, and rage-filled behaviour
Which of the following patients diagnosed with a personality disorder is most likely to be admitted to a psychiatric unit? A.One who has paranoid personality disorder and is suspicious of his neighbours B.One who has narcissistic personality disorder and is highly self-important C.One who has borderline personality disorder and is impulsive D.One who has dependent personality disorder and clings to her husband
C.One who has borderline personality disorder and is impulsive
Which of the following characteristics will the nurse assess in the patient diagnosed with antisocial personality disorder? A.Deceitfulness, impulsiveness, and lack of empathy. B.Perfectionism, preoccupation with detail, and verbosity C.Avoidance of interpersonal contact and preoccupation with being criticized D.A need for others to assume responsibility for decision making and seeking nurture
A.Deceitfulness, impulsiveness, and lack of empathy.
Playing one staff member against another is an example of which of the following? A.Devaluation B.Staff splitting C.Impulsiveness D.Social ineptitude
Splitting is a process in which the patient does which of the following? A.Unconsciously represses undesirable aspects of self B.Places responsibility for his or her behaviour outside the self C.Sees things as divided into "all good" or "all bad" D.Evidences lack of personal boundaries
C.Sees things as divided into "all good" or "all bad"
A patient arrested for an assault in which he savagely beat a classmate states, "The guy deserved everything he got." The behaviours described are most consistent with the clinical picture of which of the following? A.Antisocial personality disorder B.Borderline personality disorder C.Schizotypal personality disorder D.Narcissistic personality disorder
A.Antisocial personality disorder
Crises that occur as an individual moves from one developmental level to another are called which of the following? A.Reactive crises B.Recurring crises C.Situational crises D.Maturational crises
When a person becomes unemployed, he is likely to experience which of the following? A.A reactive crisis B.A situational crisis C.An adventitious crisis D.A substance abuse crisis
B.A situational crisis
A crisis is so acutely uncomfortable to the individual that it is likely to self-resolve in what period of time? A.1 to 10 days B.1 to 3 weeks C.4 to 6 weeks D.3 to 4 months
C.4 to 6 weeks
The nurse caring for a patient in crisis shows signs of a problematic nurse-patient relationship by doing which of the following? A.Offering to change the time of the counselling session for the second time in 3 weeks B.Experiencing frustration about the decisions the patient is making C.Giving the patient permission to call him or her at home when the patient "needs to talk" D.Suggesting that the patient attend an extra counselling session each month
C.Giving the patient permission to call him or her at home when the patient "needs to talk"
When a stressful event occurs and the individual is unable to resolve the situation by using his or her usual coping strategies, the individual does which of the following? A.Becomes disorganized and uses trial-and-error problem solving B.Withdraws and acts as though the problem does not exist C.Develops severe personality disorganization D.Resorts to planning suicide
A.Becomes disorganized and uses trial-and-error problem solving
Which statement would suggest to the crisis intervention nurse the need to arrange for hospitalization of a patient? A/"I'm feeling overwhelmed by all that has happened, and I need help sorting it out." B."I see no solution for this situation if nothing changes by tomorrow." C."There are three possibilities that might help, but I can't decide what to do." D."I feel a little calmer than yesterday at this time, but things are still very difficult."
B."I see no solution for this situation if nothing changes by tomorrow."
Which is the greatest protective factor against the risk of suicide? A.One or more previous suicide attempts B.A sense of responsibility to family, including spouse and children C.Fear of dying D.A cultural belief that suicide is a shameful resolution for a dilemma
B.A sense of responsibility to family, including spouse and children
Which of the following is a useful assessment tool for nurses in rating suicide risk? A.AIMS scale B.SAD PERSONS scale C.CAGE questionnaire D.Mini-Mental Status Examination
B.SAD PERSONS scale
Which statement is a fact about suicide? A.More women than men commit suicide. B.Suicide is the tenth leading cause of death in Canada C.First Nations and Inuit Canadians have lower suicide rates than the rest of the Canadian population. D.A patient with schizophrenia is at great risk for attempting suicide.
D.A patient with schizophrenia is at great risk for attempting suicide.
Which neurotransmitter has been implicated as playing a part in the decision to commit suicide? A. γ-Aminobutyric acid B.Dopamine C.Serotonin D.Acetylcholine
When working with a patient who may have made a covert reference to suicide, the nurse should do which of the following? A.Be careful not to mention the idea of suicide B.Listen carefully to see whether the patient mentions it a second time C.Ask about the possibility of suicidal thoughts in a covert way D.Ask the patient directly if he or she is thinking of attempting suicide
D.Ask the patient directly if he or she is thinking of attempting suicide
Nurses should assess the lethality of the patient's plan for suicide. What factor would be irrelevant to that assessment? A.How long the patient has been suicidal B.Whether the plan has specific details C.Whether the method is one that causes death quickly D.Whether the patient has the means to implement the plan
A.How long the patient has been suicidal
Which of the following suicide interventions has the greatest impact on a patient's safety? A.Educating visitors about potentially dangerous gifts B.Restricting the patient from potentially dangerous areas of the unit. C.One-on-one observation by the staff D.Removal of personal items that might prove harmful
C.One-on-one observation by the staff
Which of the following are some of the most important characteristics of staff members who work with suicidal patients? A.The ability to be consistently organized B.The ability to teach problem-solving skills C.Warmth and consistency when interacting D.Interview and counselling skills
C.Warmth and consistency when interacting
Since learning that he will have a trial pass yo a new group home tomorrow, Bill's behaviour has changed. He has started to pace rapidly. He has trouble focusing on anything other than the group home issue and complains that he suddenly feels very nauseated. Which initial nursing response is most appropriate for Bill's level of anxiety? A. "You seem anxious. Would you like to talk about how you are feeling?" B. "If you do no calm down, I will have to give you medicine to calm you" C. "Bill, slow down. Listen to me. You are safe. Take a nice, deep breath..." D. "We can delay the visit to the group home if that would help you calm down."
C. "Bill, slow down. Listen to me. You are safe. Take a nice, deep breath..."
A patient who seems to be angry when his family again fails to visit as promised tells the nurse that he is fine and that the visit was not important to him anyway. When the nurse suggests that perhaps he might be disappointed or even a little angry that the family has again let him down, the patient responds that it is his family who is angry, not him, or else they would have visited. Which of the following defence mechanisms is this patient using to deal with his feelings? A. Rationalization B.Introjection C.Regression D.Dissociation
John a construction worker, is on duty when a wall under construction suddenly falls, crushing a number of co-workers. Shaken initially, he seems to be coping well with the tragedy but later begins to experience tremors, nightmares, and periods during which he feels dumb or detached from his environment. He finds himself frequently thinking about the tragedy and feeling guilty that he was spared while many others died. Which statement about this situation is most accurate? A.John is experiencing post-tramautic stress disorder (PTSD) and requires therapy. B.John has acute stress disorder and should be treated wit anti anxiety medications. C.John is experiencing anxiety and grief and should be monitored for PSTD symptoms. D. John is experiencing mild anxiety and a normal grief reaction; no intervention is needed
C.John is experiencing anxiety and grief and should be monitored for PSTD symptoms.
Various medications are used in the treatment of severe anxiety disorders. Which class of medication used to treat anxiety is potentially addictive? A. Benzodiazepines B. Select serotonin reuptake inhibitors C. Antihistamines D. Nonbenzodiazepine anxiolytics
An older adult in the outpatient internal medicine clinic complains of feeling a sense of dread and fearfulness without apparent cause. It has been growing steadily worse and is to the point that it is interfering with the patient's sleep and volunteer work. After a brief interview and cursory physical exam, the nurse diagnoses the patient with generalized anxiety disorder and suggests a referral to the mental health clinic. Which response by the medical clinic nurse would be the priority response? A. Complete the referral to the mental health clinic. B. Meet with patient's family to discuss treatment options for generalized anxiety disorder. C. Instruct the client in deep-breathing and basic cognitive-behavioural techniques for coping with worry. D. Suggest that a battery of blood tests, including a CBC, be ordered and reviewed.
D. Suggest that a battery of blood tests, including a CBC, be ordered and reviewed.
The nurse is caring for a patient who exhibits disorganized thinking and delusions. The patient repeatedly states, "I hear voices of aliens trying to contact me." The nurse should recognize this presentation as which type of major depressive disorder (MDD) A. Catatonic B. Atypical C.Melancholic D. Psychotic
Which patient statement indicates learned helplessness? A. "I am a horrible person" B. "Everyone in the world is just out to get me" C. "It's all my fault that my husband left me for another woman" D. "I hate myself"
C. "It's all my fault that my husband left me for another woman"
The nurse is planning care for a patient with depression who will be discharged to home soon. What aspect of teaching should be priority on the nurse's discharge plan of care? A. Pharmacological teaching B. Safety risk C. Awareness of symptoms of increasing depression D. The need for interpersonal contact
B. Safety risk
The nurse is reviewing orders given for a patient with depression. Which order should the nurse question? A. A low starting dose of tricyclic antidepressants. B. An SSRI given initially with an MAOI C. Electroconvulsive therapy to treat suicidal thoughts D. Elavil to address the patient's agitation
B. An SSRI given initially with an MAOI
Which of the following are considered vegetative signs of depression? A. Hallucinations and delusions B. Expressions of guilt and worthlessness C. Feelings of helplessness and hopelessness D. Changes in physiological functioning such as appetite and sleep disturbances
D. Changes in physiological functioning such as appetite and sleep disturbances
Which behaviour exhibited by a person with mania should the nurse choose to address first? A. Indiscriminate sexual relations B. Excessive spending of money C. Declaration of "being at one with the world" D.Demonstration of flight of ideas
A. Indiscriminate sexual relations
The nurse is planning care for a person experiencing the acute phase of mania. Which is the priority intervention? A. Prevent injury B. Maintain stable cardiac status C. Get the person to demonstrate self-control D. Ensure that the person gets sufficient sleep and rest
A. Prevent injury
What critical information should the nurse provide about the use of lithium? A. "You will still have hyper sexual tendencies, so be certain to use protection when engaging in intercourse" B." Lithium will help you to feel only the euphoria of mania but not the anxiety." C. "It will take one to two weeks and maybe longer for this medication to start working fully." D. "This medication is a cure for bipolar disorder"
C. "It will take one to two weeks and maybe longer for this medication to start working fully."
The nurse has provided education for a person in the continuation phase, after discharge from the hospital. What indicates that the plan of care has been successful? A. Person identifies three signs and symptoms of relapse. B. Person states, "My wife doesn't mind if I still drink a little" C. Person reports that medication has been helpful but he is ready to stop. D.Person states, "I no longer have a disease"
A. Person identifies three signs and symptoms of relapse.
A person is found in a closet with an empty two-litter bottle of cola taken from the staff refrigerator. The bottle was full but now is empty. Recently, staff have noticed an increase in this person's response to auditory hallucinations and the recent addition of confusion to his symptoms. For the past several days, the person has been seen drinking from the hallway water cooler and taking items from his peer's dinner trays. Which response is most appropriate for decreasing these behaviours? A. Place the person on every-15 minute checks to identify any further deterioration. B.Restrict his access to fluids, and evaluate for water intoxication via daily weights. C. Attempt to distract the person from excess fluid intake and other bizarre behaviour. D. Request an increase in antipsychotic medication, owing to the worsening of his psychosis
B.Restrict his access to fluids, and evaluate for water intoxication via daily weights.
Jim is sometimes seen moving his lips silently or murmuring to himself when he does not realize others are watching. Sometimes when he is conversing with others, he suddenly stops, appears distracted for a moment, and then resumes. Based on these observations, which symptom or set of symptoms is Jim most likely experiencing? Select all that apply. A. Illusions B. Paranoia C. Delusional thinking D. Auditory hallucinations E. Impaired reality testing F. Stereotyped behaviours
D. Auditory hallucinations E. Impaired reality testing
Maricel a person diagnosed with schizophrenia is encouraged to attend groups but stays in er room instead. Staff and peers encourage her participation, but her hygiene remains poor. She does to seem to care that others wish that she would believe differently. Which is the most likely explanation for Maricel's failure to respond to other's efforts to help her behave in a more adaptive fashion? Select all that apply. A. She is avocational B. She is displaying anergia C. She is displaying negativism D.She is exhibiting paranoid delusion E.She is being resistant of oppositional F. She is experiencing social withdrawal G. She is apathetic to her schizophrenia
A. She is avocational B. She is displaying anergia C. She is displaying negativism F. She is experiencing social withdrawal G. She is apathetic to her schizophrenia
The nurse is attempting to interview Mr.Jones a newly admitted involuntary person with schizophrenia. Mr. Jones seems evasive and uncomfortable and gives one-word responses that are minimally informative. Which response would be most useful for facilitating the interview? A. "Why did you come to the hospital today?" B. "It must be difficult to be admitted to a hospital against your will" C. " If you could cooperate for just a few minutes, we could get this done" D. "Did your schizophrenia get worse because you stopped taking your medication?"
B. "It must be difficult to be admitted to a hospital against your will"
Which female patient should the nurse recognize as having the highest risk to have or develop bulimia nervosa? A. Grew up in an underserved area B. Lives in a society influenced by Eastern cultural beliefs C. Is a 20 year old D. Is Asian Canadian
C. Is a 20 year old
The nurse is caring for a 16-year old female patient with anorexia nervosa. What should the initial nursing intervention be upon the patient's admission to the unit? A. Build a therapeutic relationships B. Increase the patients caloric consumption C. Involve the patient in group therapy to build a support group. D. Self-asses to decrease tendencies toward authoritarianism
D. Self-asses to decrease tendencies toward authoritarianism
The nurse is caring for a patent with bulimia. Which nursing intervention is most appropriate? A. Monitor patient on bathroom trips after eating. B. Allow patient extensive private time with family members. C. Provide meals whenever the patient requests them. D. Encourage patient to select food that she or he likes.
A. Monitor patient on bathroom trips after eating.
The nurse is planning care for a patient with and eating disorder. What outcomes are appropriate? Select all that apply A. The patient will experience a decrease in depression B. The patient will indemnify four method to control anxiety. C. The patient will collect different kinds of cookbooks D. The patient will identify two people in contact if suicidal thoughts occur.
A. The patient will experience a decrease in depression B. The patient will indemnify four method to control anxiety. D. The patient will identify two people in contact if suicidal thoughts occur.
Which statement about dementia is accurate? A. The majority of people over age 85 are affected by dementia. B. Disorientation is the dominant and most disruptive symptom of dementia. C. People with dementia tend to be distressed by it and complain about its symptoms. D. Hypertension, diminished activity levels, and head injury increase the risk for dementia.
D. Hypertension, diminished activity levels, and head injury increase the risk for dementia.
The nurse is caring for a patient wit an addictive disorder who is currently drug-free. The patient is experiencing repeated occurrences of vivid, frightening images and thoughts. Which term would the nurse use to document this finding. A. Tolerance B. Flashbacks C. Withdrawal D. Synergistic effect
Which patient behaviours should the nurse suspect as related to alcohol withdrawal? A. Hyperalert state, jerky movements, easily startled B. Tachycardia, diaphoresis, evaluated blood pressure C. Peripheral vascular collapse, electrolyte imbalance D. Paranoid delusions, fever, fluctuating levels of consciousness
A. Hyperalert state, jerky movements, easily startled
Ms. Rallyea,58 years old, is admitted with severe clinical depression and started on antidepressant medications. Her mood has remained low and she has not initiated conversation. On her fifteenth day of hospitalization, she informs the nurse she is feeling great and energetic. What should the nurse do? A.Notify the social worker of improvement to schedule a discharge planning conference. B. Invite Ms.Rallyea to talk and ask her if she is thinking of hurting herself C. Report the team that the antidepressant medication is effective. D. Chart the mood change and share the observation at the team meeting the next day.
B. Invite Ms.Rallyea to talk and ask her if she is thinking of hurting herself