Test Bank Fundamentals Mental Health Nursing 4th, Linda
Chapter 1: History of Mental Health Nursing
1. The act of developing a clean environment is a factor in providing effective health care as demonstrated by:
2. What is the name of the publication written by Florence Nightingale?
A. Nursing Sanitation Notes
B. Nursing 101
C. Notes on Nursing
D. Nursing Notes
3. A long-term goal for in-patient mental health treatment is generally to:
A. Return the patient to the community.
B. Locate a facility for long term care.
C. Be arrested and placed in prison.
D. Be completely cured of the disorder.
4. The mentally ill were once housed in mental institutions known as:
B. Long-term care facilities.
D. Free-standing treatment centers.
5. Which nursing theorists promoted the interpersonal theory between the nurse and the patient?
A. Hildegard Peplau
B. Hattie Bessent
C. Mary Mahoney
D. Linda Richards
Complete each statement.
6. Phenothiazines were discovered in what year? ___.
7. The first psychiatric program of study was established by which nursing leader? __ ___ _
8. Who was the nurse theorist who was the first American-trained nurse credited with teaching how to provide care for people with mental illness? ___
9. The greatest advance in the early years of mental health care was the introduction of ___.
10. The legislation that provided funding for improving the care of the mentally ill is known as the National Mental Health Act of what year? __.
Chapter 2: Basics of Communications
1. Which question by the nurse would gain the most information from a patient experiencing a marital crisis?
A. “Do you hate your spouse?”
B. “Do you get along with your in-laws?”
C. “Do you talk out your problems with your spouse?”
D. “What is it like at home with your spouse?”
2. Mrs. R., the mother of a young schizophrenic patient, seeks you out and begins to cry. She expresses concern over her daughter’s behavior. Your best response to this woman is:
A. “What is it that concerns you the most, Mrs. R.?”
B. “Well, you know, that is part of the illness.”
C. “Here is a book on schizophrenia. This will help you.”
D. “Are you afraid your daughter will always be like this?”
3. Linda is pacing the floor and appears extremely anxious. The day shift nurse approaches Linda in an attempt to lessen her anxiety. The most therapeutic statement by the nurse would be:
A. How about watching a football game?
B. Tell me how you are feeling today.
C. What do you have to be upset about now?
D. Ignore the client.
4. A patient states, “I don’t know what the pills are for or why I am taking them, so I don’t want them.” What therapeutic communication would help this patient?
A. Ask for what you need
C. Using general leads
D. Giving information
5. To practice effectively in mental health, the nurse should be able to:
A. Solve his or her own personal problems without assistance from others.
B. Comfortably point out the patient shortcomings and provide advice about how to improve.
C. Bring patients and coworkers into compliance with societal rules and norms.
D. Demonstrate therapeutic communication.
Complete each statement.
6. The nurse plans to have a therapeutic communication with the client. To begin that therapeutic communication the nurse must first establish _ with the client.
7. Communication has three parts: the sender, the message, and the _.
8. When appropriate, the nurse can use _ as part of an interaction when there is no talking. This can communicate support.
9. A theory of communication that emphasizes the three ways to communicate—hearing, seeing, and touching—is called _
10. Expressive, receptive, and global are types of ___.
Chapter 3: Ethics and Law
1. A patient is expressing anger when the nurse attempts to make him take a medication that he is refusing. If the nurse pushes to give the medication against his will, the nurse is:
A. Violating the patient’s rights.
B. Achieving a treatment goal to get the medication in the patient any way possible.
C. Supporting the family’s demand that he take the medication.
D. Following orders from the charge nurse.
2. A mental health nurse bumps into a member of her church, who begins questioning her about a former neighbor. The woman from the church asks the nurse, “How is Rachael? We have been friends for over 20 years and I have seen her come out of your clinic a few times. Is she seeing one of the psychiatrists?” The nurse’s response is:
A. “The HIPAA law prevents me from disclosing any information about any patient.”
B. “All I can say is she is seeing Dr. Leone.”
C. “Rachael is seeing Dr. Leone because she is concerned about feeling extremely happy sometimes and about feeling extremely depressed other times.”
D. “Rachael was only there to renew her medication.”
3. You are working on a mental health unit and have a diverse group of patients. Some of the patients are of Middle Eastern descent. These patients have communicated to you that they would like to follow the same period for praying as they did prior to admission. What is your response?
A. “You are in America now.”
B. “You can go back to your regular time for praying when you are discharged.”
C. “How can I accommodate you with your prayer time?”
D. “Would you like to learn another prayer?”
4. The nursing student uses the client’s full name on the assigned care plan during her recent clinical rotation. What is the instructor’s priority intervention?
A. Express the importance of factual documentation and that it should include the patient’s name.
B. Remind the student of the importance of maintaining patient confidentiality.
C. Discuss with student that the patient is homeless and illiterate. As a result of this, maybe the patient will not be embarrassed about their homelessness status; therefore confidentiality is not an issue.
D. Explain to the student because the patient was committed involuntary, confidentiality is not an issue.
5. While shopping in the local supermarket, a mental health nurse encounters an individual who recently was a patient on her unit. Which is the proper response by the nurse?
A. Stop the person and ask how they are doing since discharge.
B. The closer you get to the patient, look in another direction.
C. Speak to the patient, but not by name.
D. If eye contact is made and the patient responds, then you should respond back.
6. The telephone rings at the nurses’ station of an inpatient psychiatric facility. The caller asks to speak with Ms. Honey. Which nursing response protects the patient’s rights and confidentiality?
A. “I cannot confirm or deny that Ms. Honey was admitted here.”
B. “Ms. Honey is in group therapy at present.”
C. “Hold on, I’ll go see if she is in her room.”
D. “Are you a family member? Ms. Honey can only receive calls from family members.”
Complete each statement.
7. In the group therapy session, the nurse speaks up to remind a patient of a recent improvement in his coping. The nurse’s action is an example of __.
8. Another term to describe the ethical principle of veracity is _.
9. The name of a law that provides immunity to a citizen who offers medical aid is _.
10. The patient is upset because her doctor has not been to see her today. The nurse tells the patient the doctor will be in by 3 p.m., even though the nurse does not know this to be true. This nurse has violated the ethical principle of _.
Chapter 4: Developmental Psychology Throughout the Life Span
1. Nurse Toni’s assignment included a 41-year-old male client. Per Erikson, which developmental stage is the patient at?
A. Focus on having a family
B. Does not assume responsibility for his actions
C. Unable to solve problems
D. Perceptions are based on illusions
2. A nursing intervention for the initial phase of grief should focus on:
A. Ignoring the patient until your presence is requested.
B. Staying available to provide support when the person demonstrates distress.
C. Insisting the person face reality of the loss.
D. Organizing a support group to provide a support system.
- Joy is occupied exclusively with thoughts of her father’s death. Although Joy is preoccupied with his death, she is still planning to purchase a gift for his birthday, which would have been in two more weeks. Dr. Leone advises the nurse to assist Joy through this stage of grief, which is known as:
4. Freud defines the ego as:
A. Helping to determine what is right and what is wrong.
B. Being concerned with self-gratification.
C. Focusing on reality.
D. The part where a person is only concerned with one’s individual needs.
5. A 16-year-old adolescent is hospitalized and acting like a child. According to Erik Erikson, what is the appropriate developmental task?
A. Industry vs. inferiority
B. Integrity vs. despair
C. Identity vs. role confusion
D. Trust vs. mistrust
6. Which level of Maslow’s hierarchy of need pyramid is necessary for survival?
A. Love and belonging
B. Physiological needs
D. Safety and security
7. This theorist supported the theory of moral reasoning. The theory of moral reasoning demonstrates how a person justifies right or wrong.
8. Jean Piaget’s cognitive theory elaborates on the way a person thinks and how these thoughts are used to adapt to the surrounding environment. The age group for the formal operation is:
A. Birth to 2 years of age.
B. 2 to 7 years of age.
C. 8 to 12 years of age.
D. 12 years of age to adulthood.
9. Karen Horney was a follower of Sigmund Freud. Dr. Horney believed that the abnormal behavior experienced by her patient was the result of ineffective:
B. Mother-child bonding.
C. Environmental stressors.
D. Genetic markers.
10. Jean Piaget’s theory focuses on a person’s ability to reason. The stage of a person between 12 years of age and an adult according to Piaget would be:
C. Concrete operational.
D. Formal operations.
Chapter 5: Sociocultural Influences on Mental Health
1. Which of the following is appropriate with a patient who is homeless?
A. Treat patients according to their ability to pay.
B. The homeless patient is only treated in the emergency room—they should not be admitted unless life threatening condition; never admit them to the unit.
C. Treat the homeless patient as you would treat any patient.
D. Some parts of the Patient Bill of Rights do not apply to the homeless.
2. A student recently moved from the Middle East and is attending a new school in the United States, where he is excluded from conversations pertaining to the Christmas holidays. The students assume that the new student doesn’t understand anything about the holiday. The students are most likely doing what to this new student?
A. Being hateful
B. Showing prejudice
C. Believing stereotypes
D. Being rude
3. According to Diana Baumrind, there are three types of parenting. When the parent sets up the rules and others have no voice, this is known as:
A. Permissive parent.
B. Authoritarian parent.
C. Authoritative parent.
D. Administrative parent.
4. According to Diana Baumrind, there are three types of parenting. When the parent provides a minimum amount of structure and the child does not learn any boundaries, this type of parenting is known as:
A. Permissive parent.
B. Authoritarian parent.
C. Authoritative parent.
D. Administrative parent.
5. Janet, an African American female, fell at the mall shopping and was transported to an urgent care center to be examined. The x-rays were negative for fracture and Janet was not prescribed anything for her pain. At the urgent care center where Janet was treated, the health care providers were aware that this type of injury can be painful. According to recent studies within health care, failure to offer Janet pain medication could be a form of:
6. Cultural competency is
A. The responsibility of the patient.
B. The nurse being competent in his or her own culture
C. The nurse being able to adapt care to meet the needs of patients from different backgrounds.
D. A written test required for all Americans.
Complete each statement.
7. _is a shared way of life and the combination of traditions and beliefs that that make a group of people bond together.
8. A person’s personal traits are defined by some of these factors (name two) ___.
9. is judging a person or a situation before all the facts are available.
10. A mother, a father, and biological children were once known as the ___ ___.
Chapter 6: Nursing Process in Mental Health
1. After the admission of the patient, Nurse Toni will get specific information from the patient. This method of getting information is known as the:
A. Termination phase when discharge plans are being made.
B. Working phase, when the patient shows some progress.
C. The patient interview.
D. Working phase, when the patient brings it up.
2. A systematic and individualized method of planning and providing care is best known as:
B. Nursing process.
3. A patient is admitted to the Mental Illness and Chemical Abuse (MICA) unit for detox from the use of alcohol. During the interview, the patient states, “My wife would rather see me dead.” To which part of the nursing process does this belong?
4. A patient is admitted into a mental health unit screaming and kicking. Although this patient is acting out, she also is verbalizing that her leg is hurting. What type of planning would benefit this patient the most?
A. Short-term goal
B. Long-term goal
5. You find a patient on the floor at shift change. She is awake and alert. She is confused now and was not confused prior to the being found on the floor. What is your first step in the nursing process in this situation?
A. Leave the patient to get help.
B. Gather more information by making observations about the patient.
C. Call the patient’s MD from your cell phone.
D. Help the patient get up and then document your findings in the chart.
6. Short-term and long-term goals are which part of the nursing process?
B. Nursing diagnosis
7. In the principles of teaching, which abbreviation is used to describe the nursing process?
8. NANDA is the acronym for:
A. New American Nursing Diagnosis Association.
B. National American Nursing Diagnosis Association.
C. North American Nursing Diagnosis Analyzer.
D. North American Nursing Diagnosis Association.
9. In the Mental Health Status Examination, which of the following focuses on what the person is thinking?
A. Speech and the ability to communicate
D. Thinking/content of thought
10. The component of the Mental Health Status Examination that focuses on the way a person experiences reality is assessing the person’s:
A. Thinking/content of thought.
D. Mood and affect.
Chapter 7: Coping and Defense Mechanisms
1. Your patient is sternly criticized by her doctor for not complying with the medication regimen. The patient walks out of the office and yells at the parking attendant. This may be an example of which defense mechanism?
C. Reaction formation
2. Which of the following best describes what defense mechanisms are?
A. Abnormal coping mechanisms
B. Genetically “wired” responses
C. Protective devices that reduce anxiety
D. All of the above
3. A new patient with schizophrenia is admitted to the psychiatric unit. He is standing at the locked exit door and yelling, “Help me, I don’t belong here.” This behavior is most likely an example of what defense mechanism?
4. Nurse Anne recognizes that John is always blaming others for his shortcomings. Finger pointing is usually related to the defense mechanism of:
5. Joy has just experienced her fifth spontaneous abortion. She is unable to understand why this is happening to her. Joy voices her anger toward her physician and the nurses, accusing them of incompetence. Assessing the situation, the nurse recognizes that the client may be using the coping mechanism of:
A. Conversion reaction.
6. Marion, a 25-year-old patient who lives with her parents, explains to the nurse at the community clinic, “I really don’t need to talk to anyone, even my parents.” The patient expresses that she is too busy and does not have the time to sit and talk. The nurse recognizes that the client is most likely using the defense mechanism known as:
A. Conversion reaction.
- Karen Ann, a patient on the mental health unit, is in the bathroom with the door locked. She was admitted to the unit as a result of her psychotic behavior. The mental health nurse is asking her to come out and take her medication. The patient responds by stating, “There is nothing wrong with my behavior. I don’t need any medication. I don’t know why everyone is so upset.” Her response indicates that the defense mechanism being used is:
8. “Unconscious refusal to see reality” describes this type of defense mechanism:
9. “Use of a logical-sounding excuse to cover up true thoughts and feelings” describes this defense mechanism:
10. “Emotion that is separated from the original feeling” describes this defense mechanism:
Chapter 8: Mental Health Treatments
1. Pete has recently been admitted to the hospital and is being treated for bipolar disorder. When you go to check in on him, he tells you that he is feeling very drowsy and has been vomiting. He is also running a fever. You suspect that Pete’s problem is caused by:
A. Anxiety over his new surroundings after being admitted to the hospital for treatment.
B. Side effects of the lithium therapy he is receiving.
C. A hospital-acquired viral infection.
D. Food poisoning.
2. Your manic patient is being discharged on lithium. Which of the following would NOT be in the teaching plan?
A. Blood levels must be closely monitored.
B. Continue to take lithium even when your manic symptoms are resolved.
C. Restrict fluids while taking this drug.
D. Contact your doctor if you experience side effects rather than stopping the drug.
3. Which of the following is true about lithium?
A. It is available in multiple formulations, including IV and suppository.
B. It is generally discontinued for 2 weeks prior to any major surgery.
C. It is used on a prn basis when the patient feels anxious.
D. None of the above
4. Nurse Arlene recognizes that the focus of environmental (MILIEU) therapy is to:
A. Control the environment to bring about a positive behavior change.
B. Allow the patient freedom to decide whether they want to participate in activities.
C. Use role-play to meet their personal needs.
D. Use natural medicines rather than drugs to control behavior.
5. During electroconvulsive therapy (ECT), the patient is monitored carefully before and after the procedure. The nurse assisting with this procedure is aware that monitoring is necessary because the patient may suffer from:
B. Immediate alertness after the procedure and sleepy later in the day.
C. Urine retention.
D. Seizure activity.
6. Lynn, the LPN/LVN, is providing care for a patient diagnosed with depression. The patient is not responding to any of the medications ordered. The nurse foresees this patient may be a candidate for:
A. Neuroleptic medication.
B. Short-term seclusion.
D. Electroconvulsive therapy.
7. When teaching Mary, who has depression, about foods to avoid while taking phenelzine (Nardil), which of the following would Audrey LPN include?
A. Peanut butter
B. Fresh fish
8. When developing a care plan for Ms. Smith, who was diagnosed with schizophrenia and is receiving haloperidol, which of the following medications would Nurse Janet expect to administer if the patient developed extrapyramidal side effects (EPS)?
A. Olanzapine (Zyprexa)
B. Paroxetine (Paxil)
C. Benztropine mesylate (Cogentin)
D. Lorazepam (Ativan)
9. Nurse Maryse invites a recently discharged patient’s family to attend an outpatient support group. This type of program would most likely help the family with which of the following issues?
A. Learning from others in the same situations
B. Gaining insight into why they feel guilty
C. Recognizing the client’s weakness
D. Managing the client’s financial concern and problems
10. Linda says that she feels confused and anxious. In addition, Linda feels unorganized and states, “It is as not bad as it seems.” What phase of crisis is Linda experiencing?
Chapter 9: Alternative and Complementary Treatment Modalities
1. The home health nurse is informed by her patient that she is taking a herbal over-the-counter medication. What action should the nurse take with this information?
A. This information is not part of the medication record.
B. The nurse should document this information and add it to the patient’s medication list and notify the charge nurse of the change.
C. Research the benefits of this medication before deciding if it should be added to medication record.
D. Tell the patient that herbal medications are not considered safe to take.
2. Reflexology is based on the massage of this body part:
3. Reiki is a term that means:
A. “Universal life energy.”
B. “Universal energy.”
C. “Energizing the universe.”
D. “Universal energy life.”
4. The three primary methods of sensory representations are:
A. Visual auditory, and kinesthetic.
B. Visual, auditory, and kindred.
C. Visa, authority, and kinesthetic.
D. Seeing, hearing, and smelling.
Complete each statement.
5. Important to the effectiveness of any type of treatment are the patient’s ___.
6. The type of therapy that seeks a response through the sense of smell is known as __.
7. _ therapy is done by massaging the feet of the patient to act upon pathways, unblocking and renewing energy flow.
Identify one or more choices that best complete the statement or answer the question.
8. The side effects of ginkgo biloba include (select all that apply):
B. Nausea and vomiting.
D. Fishy reflux.
9. It is helpful as a nurse to be able to recognize the channel through which your patient communicates if following the primary sensory representation philosophy. Your patient Tamara’s sensory representation is visual. Determine which terms would identify visual sensory and (select all that apply):
A. An eyeful.
B. An earful.
C. In light of.
D. In view of.
E. Hang in there.
10. When teaching patients taking St. John’s wort about drug and food interactions, the nurse will inform them of the following precautions (select all that apply):
A. Avoid foods containing large amounts of tyramine.
B. Eat adequate amounts of meat and cheese.
C. Increase the length of time in sunlight.
D. Consult your physician before taking any over-the-counter flu and cold medications.
E. It may decrease the effects of MAOIs.
Chapter 10: Anxiety, Anxiety-Related, and Somatic Symptom Disorders
1. Which of the following is a priority in dealing with a highly anxious patient?
A. Provide support to reinforce a sense of security.
B. Implement strict limit setting to control behavior.
C. Increase environmental stimuli to distract the patient.
D. Provide more freedom to promote self-expression.
2. Your new patient is admitted to the ER after a car accident. She is extremely anxious. Which intervention is most helpful?
A. Ask her to describe her feelings to you.
B. Stay with her in the exam room.
C. Set her up in a quiet exam room away from activity and give her privacy.
D. Encourage her to remember what happened in the accident.
3. Your patient has been taking Buspar for 1 month. On returning to the clinic for a follow-up visit, which statement would describe medication effectiveness?
A. Reduction in number of delusions
B. Less depressed
C. Sleeping better
D. Reduced desire for alcohol
4. To establish an open and trusting relationship with a male patient who is in the hospital with severe anxiety, which response by the charge nurse is best?
A. Urge the staff to have frequent interaction with the patient.
B. Share an activity with the patient.
C. Discipline the patient about his behavior.
D. Encourage enjoyable activities.
5. When working with a female client experiencing a phobia about spiders, Nurse Toni should anticipate that a problem for this client would be:
A. Anxiety when speaking of the feared item.
B. Depression toward the feared object.
C. Denying the existence of a phobia.
D. Distortion of reality.
6. Nurse Janet is aware that the symptoms that distinguish post-traumatic stress disorder (PTSD) from anxiety disorders include:
A. Avoiding situations and certain activities that resemble any type of stress.
B. Demonstrating a blunted affect when discussing the traumatic situations.
C. Having a minimum interest in family and others.
D. Re-experiencing the trauma in dreams or flashback.
7. Nurse Aubyn is aware that patients suffering from anxiety seem to do best in environments where they have:
B. Routine and enjoyable activities.
C. Complex thought processes.
D. A lot of alone time.
8. When planning care for a female patient diagnosed with obsessive and compulsive behavior, Nurse Barbara and case manager Marc must recognize that the ritual:
A. Assists the patient to understand their inability to deal with reality.
B. Helps the patient to be in control of their anxiety.
C. Helps the patient control the obsessive and compulsive behavior.
D. Is used to manipulate others.
9. When preparing the discharge plans for a patient with chronic anxiety, Nurse Barbara evaluates the goals that were set for the patient. Nurse Barbara also evaluates if the patient has achieved the discharge long-term goals. Which goal would be most appropriate to be include in the plan of care requiring evaluation?
A. The patient is completely stress free.
B. The patient ignores their feelings of anxiety.
C. The patient is able to identify triggers that produce anxiety.
D. The patient maintains contact with a crisis counselor.
10. Helenann, a long-term care nurse educator, noted that one of the staff members was complaining of stress and anxiety. A common physiological response to stress and anxiety is:
Chapter 11: Depressive Disorders
1. You are admitting a new patient who is depressed. Your initial contact should do what?
A. Address why he is depressed
B. Keep communication open
C. Lift his spirits
D. Establish trust
2. In caring for a patient with major depression, the nurse knows that the patient needs:
A. Frequent changes in activities.
B. Introduction to multiple new staff members.
C. Behavior modification that restructures feelings.
D. Well-defined, structured interactions at the beginning of treatment.
3. Patients with major depression commonly display signs of:
B. Repetitive, compulsive behaviors.
D. Visual hallucinations.
4. When your patient says “I am depressed,” what is the best response?
A. “We all feel that way now and then.”
B. “Why do you feel that way?”
C. “Everything will be OK once you snap out of it.”
D. “Tell me more about what is going on with you.”
5. Your patient takes tranylcypromine for depression. Which of the following is most likely to indicate dietary restrictions have not been followed?
A. Hypertensive crisis
C. Muscle spasms
D. Increased depression
6. Your depressed patient who is taking a tricyclic antidepressant is advised of possible anticholinergic side effects. Which of the following is NOT an anticholinergic side effect?
A. Blurred vision
B. Difficulty starting urine stream
C. Dry mouth
D. Muscle rigidity
7. Helen, a 47-year-old client with a long history of severe depression, has not responded to antidepressant medications or psychotherapy. The nurse caring for the patient knows that the treatment of choice for depression unresponsive to conventional treatment would be:
B. Electroconvulsive therapy (ECT).
C. Light therapy.
D. Neurolinguistic programming.
8. Your depressed patient is just started on duloxetine (Cymbalta). Which statement by the spouse tells you that family teaching has been effective?
A. “I can’t wait for him to be back to his old self in the next day or so.”
B. “I realize we can’t expect big changes right away.”
C. “I have to take him for weekly blood tests to monitor the drug dosage.”
D. “I will make sure he doesn’t eat any aged cheese for the next 2 months until the dose is stabilized.”
9. Biological theories of depressive disorders include all of the following except:
A. Chemical imbalances are responsible.
B. The patient experiences maladaptive thought processes.
C. There are genetic tendencies that run in families.
D. Hormonal factors make women more susceptible than men.
10. Light therapy has been shown to be effective in treating patients with:
A. Bipolar disorder.
C. Major depression with seasonal pattern.
Chapter 12: Bipolar Disorders
1. Your bipolar patient approaches you and says, “I will be running this hospital someday. I know I can change everything.” What is the best intervention?
A. Orient the patient by telling her that this would require multiple educational degrees that she does not have.
B. Ask the patient why she thinks she can do that.
C. Redirect the patient to what is going on around her now.
D. Contact the psychiatrist immediately.
2. Your new patient admitted to the psychiatric unit is pacing and agitated. Which of the following is the most appropriate intervention?
A. Introduce the patient to all the other patients.
B. Direct him to a group therapy session.
C. Place him in a quiet area away from other patients.
D. Review the unit rules with the patient to distract him.
3. Your patient in the psychiatric unit is still up at midnight playing cards. You tell him, “It’s time to get some sleep now.” What is the purpose of this response?
A. Limit setting
B. Reality testing
C. Controlling patient so other patients will respond the same way
D. Enforcing rules
4. Which statement is most likely to be from a patient in a manic episode?
A. “I don’t need to sleep.”
B. “I am Jesus Christ.”
C. “Leave me alone while I am reading this textbook.”
D. “I am worthless.”
5. Which diversional activity is most appropriate for a patient in a manic phase?
B. Exercise class
C. Cross stitch
D. Computer game
6. Lithium toxicity is most likely with which of the following patients?
A. Elderly man with diarrhea from food poisoning
B. Teenage girl on oral contraceptives
C. 40-year-old man who smokes marijuana on the weekend
D. All of the above are at high risk
7. Your 28-year-old patient was admitted to the psychiatric unit with a diagnosis of major depression with symptoms of withdrawal and extreme sadness. After 2 weeks on the unit, the patient suddenly becomes more talkative, sleeps only 2 hours a night, and acts seductively with the male patients. What is the most likely explanation for this change?
A. The antidepressants are effective.
B. The patient was diagnosed incorrectly.
C. She is having a manic episode as part of her illness.
D. She is recovering from her depression.
8. You are working with the RN to plan short-term goals for a 28-year-old hospitalized manic client. Which is the most important goal?
A. Protection from self-inflicted harm
B. Meals in excess of metabolic requirement
C. Strict participation in unit activities
D. Enforced medication compliance
9. A 30-year-old male client is admitted to the psychiatric unit with a diagnosis of bipolar disorder. His family reports that for the past 2 months he has been in constant motion, sleeping very little, spending lots of money, and has been “full of ideas.” During the initial assessment with the client, the nurse would expect him to exhibit which of the following?
A. Short, polite responses to interview questions
B. Introspection related to his present situation
C. Exaggerated self-importance
D. Feelings of helplessness and hopelessness
10. Lithium is most commonly used to treat which of the following disorders?
C. Generalized anxiety disorder
D. Bipolar disorder
Chapter 13: Suicide
1. Suicide is most likely to occur:
A. On admission to a psychiatric hospital.
B. At the beginning of psychotherapy.
C. As the depression begins lifting.
D. When the depression deepens.
2. Your new patient is admitted after a suicide attempt. She states, “Let me die, I don’t deserve to live.” What is your best response?
A. “Why do you want to die?”
B. “You have so much to live for.”
C. “How do you think your family feels now?”
D. “You must have been feeling very hopeless. Tell me about it.”
3. Your depressed patient has suddenly changed to being more cheerful and tells you he wants to reduce the clutter at home and give away some prized possessions to friends. What should be your response?
A. “I’m glad you are feeling better.”
B. “I’ll tell the doctor and maybe he will reduce your dose of antidepressant.”
C. Ask the patient if he has any thoughts about suicide.
D. Document what the patient tells you and see another patient.
4. Which of the following statements is true about suicide?
A. There is generally some warning when someone commits suicide.
B. Victims of suicide have a genetic predisposition to it.
C. Suicide can always be prevented.
D. Talking about suicide means the person is not serious about it.
5. A patient becomes suicidal and is transferred to the locked unit of your hospital. Because this patient is actively suicidal you should:
A. Keep the patient in your line of vision at all times.
B. Perform suicide assessments every half-hour.
C. Inform the doctor that the patient is now in a locked area.
D. Take vital signs every 15 minutes.
6. Patients are most likely to commit suicide when:
A. They are severely depressed.
B. The depression is lifting.
C. They are recently discharged from the hospital.
D. They have a significant other who is supportive.
7. As you perform a suicide assessment on your patient, you learn that the patient has only one person to call in times of need, has been thinking about suicide frequently in past weeks, and has attempted suicide once before. Given this information you believe this patient’s suicide risk is:
8. Which would be most important to find out next about the above patient?
A. Does he have a suicide plan now?
B. What is his psychiatric diagnosis?
C. Who does he live with?
D. What type of psychiatric therapy has he had recently?
9. The best approach a nurse can use to gain information relating to a patient’s potential for suicide is to ask:
A. “What do you plan to be doing 5 years from now?”
B. “Does your family know you are considering suicide?”
C. “What have other patients told you about their suicide attempts?”
D. “Are you thinking of killing yourself now?”
10. When planning care for a patient who is suicidal, the nurse knows:
A. Suicide attempts are only gestures.
B. Suicide is a crime and must be reported to the authorities.
C. Teaching new problem-solving skills is a priority of care for suicidal patients.
D. It is necessary to know the reasons why the patient has suicidal thoughts.
Chapter 14: Personality Disorders
1. Patients with antisocial personality disorder:
A. Generally must have immediate gratification.
B. Display a great deal of responsibility toward others.
C. Display a great deal of anxiety.
D. Have obsessive thoughts when in a social situation.
2. Barbara is a new patient on your floor who is being assessed for several disorders, including suicide potential. You learn she attempts suicide every 6 to 12 months because she cannot tolerate living alone. She is unable to see two sides of a situation or an individual; they are either all good or all bad. You consider which of the following as a potential diagnosis for Barbara?
A. Borderline personality disorder
B. Multiple personality disorder
C. Narcissistic personality disorder
D. Antisocial personality disorder
3. A nice-looking male patient is making suggestive comments to the female nursing staff. When he asks you for your phone number, you therapeutically respond:
A. “I do not believe in dating patients.”
B. “It is against the rules for me to date patients.”
C. “I’ll think about it and let you know.”
D. “You are very nice but our relationship is a professional one only.”
4. When planning care for an individual with borderline personality disorder, nurses realize that the patient:
A. Will not be able to make decisions.
B. Will expect special treatment.
C. Will “act out” when feeling afraid or disrespected.
D. Will withdraw and become uncommunicative.
5. A patient with borderline personality disorder approaches you and voices concern that she is being ignored and feels unimportant. The patient blames the nursing staff for these feelings because the nurses are “not paying attention” to her. Your best therapeutic response to this patient is:
A. “I will bring it up at our next meeting.”
B. “It’s all in your imagination.”
C. “Tell me more about your feeling of ‘being ignored.’”
D. “You need to share your feelings with the individual nurses you feel are ignoring you.”
6. The main mechanism used by patients who have personality disorders is:
7. Nurses understand that a major cause of personality disorders is:
A. Neurochemical imbalance.
C. Dysfunctional family relationships.
8. Nurses know that when working with patients who have personality disorders, the most difficult task for these patients will probably be:
A. Following rules.
B. Getting along with others.
C. Hoarding their medications.
D. Participating in care plan meetings.
9. A patient who is diagnosed with narcissistic personality disorder is constantly using the call light or following the nursing staff into other patient’s rooms to ask, “Are you sure I look good? You know they can’t get along without me at work. When can I leave here?” As the nurse caring for this patient, one of your goals for the patient will include all of the following except:
A. The patient will express reality about self-image.
B. The patient will require decreasing reinforcements from the nursing staff.
C. The patient will acknowledge the feelings of others.
D. The patient will not be introspective about his or her condition.
10. People who have borderline personality disorders:
A. Do not learn from past experiences
B. Know the consequences of their behavior but do not care.
C. Learn from past experiences and put that knowledge into practice.
D. Try to forget about past experiences.
Chapter 15: Schizophrenia Spectrum and Other Psychotic DisordersSchizophrenia
1. Your patient reports a hallucination where he is aware of “strange smells” that no one else is aware of. What type of hallucination is this?
2. You are asked to report any extrapyramidal symptoms (EPSs) of your patient. Which of the following are examples of EPS?
A. Dry mouth, anorexia
B. Heart palpitations
C. Muscle rigidity, tremors
D. Constipation, nausea
3. Which of the following is characteristic of a paranoid delusion?
A. Suspicion and jealousy
B. Self-pity and self-depreciation
C. Making up words and phrases
D. Exposing beliefs of inflated self-importance
4. Your new patient is admitted with a diagnosis of schizophrenia. Which of the following is he most likely to demonstrate?
A. Concrete thinking
B. Effective ego boundaries
C. Inflated self-image
D. Fatigue and loss of appetite
5. When is schizophrenia most likely to be diagnosed?
A. Grade school
B. College age
C. After the birth of the first child
D. After retirement
6. The schizophrenic patient tells you, “I know that the man down the hall wants to kill me.” How should you respond?
A. “I will protect you from him.”
B. “What makes you say that?”
C. “Let’s walk over here to join in afternoon activities.”
D. “You need to go to your room.”
7. The statement made by the patient in question 6 is an example of a(n):
A. Paranoid delusion.
B. Visual hallucination.
C. Idea of reference.
D. Flight of ideas.
8. Your patient with schizophrenia who is English speaking says “no acu moona” to you. What is this called?
9. Which statement is most true about schizophrenia treatment today?
A. Most require lifelong institutionalization.
B. Patients can stop taking their antipsychotics once stabilized.
C. Psycho-education for the family is part of the treatment plan.
D. Most can function normally in society with little support after treatment for the first episode.
10. A young man with severe schizophrenia is being discharged home. Which of the following medications would he most likely be taking?
B. Fluphenazine decanoate
Chapter 16: Neurocognitive Disorders: Delirium and Dementia
1. Your patient with advanced Alzheimer’s disease keeps searching the unit for her mother who died many years ago. How should you respond?
A. “Your mother isn’t here—she died long ago.”
B. “Let’s go to the activity room and see what’s going on.”
C. “You must be upset that you can’t find her.”
D. “What makes you keep looking for your mother?”
2. Your patient is diagnosed with delirium. He is awake most of the night and becomes increasingly confused. Which is the best initial intervention?
A. Keep the television on to provide stimulation.
B. Give him a sleeping pill.
C. Keep a night light on in the room and turn off the television.
D. Keep the lights on in the room.
3. Your patient is on donepezil HCL. This tells you your patient has which disorder?
B. Obsessive-compulsive disorder
C. Major depression
4. Team members working with patients who have dementia need to have a common, unified approach because this type of patient requires:
A. Sameness and consistency in their lives.
B. Strict rules and regulations.
C. Behavior modification at all times.
D. Staff who cannot be manipulated.
5. When preparing a care plan for a patient with a diagnosis of dementia, the nurse will:
A. Increase mental and physical stimulus to improve mental function.
B. State five current events from today’s newspaper.
C. Maintain consistent daily routines.
D. Encourage the patient to discuss memories from his or her childhood.
6. The best way to assist a patient who has mild Alzheimer’s disease is to:
A. Ask the physician to keep the patient sedated to avoid “acting out” behaviors.
B. Provide strict one-on-one behavior modification techniques to prevent further cognitive deterioration.
C. Encourage the family to begin preparations to move the person to a skilled nursing facility.
D. Provide a stable, safe, and consistent environment.
7. Nurses recognize that the main cause for Alzheimer’s disease is:
A. Unknown at this time.
C. Related to use of aluminum cookware.
D. Long-term alcohol use.
8. A person who is receiving tests to confirm a diagnosis of Alzheimer’s disease is preparing for a computerized tomography (CT) test. The patient becomes restless and is unable to follow the pre-examination directions given by the personnel. As the nurse who is assisting the patient, your best action at this time is to:
A. Tell the patient that refusing to cooperate will require having to return another day.
B. Give the patient the written instructions.
C. Take the patient to a quiet waiting area until it is time for the CT scan.
D. Make certain that the patient is tightly strapped to the examination table during the test.
9. Your new patient is admitted to your nursing home with a diagnosis of vascular dementia. You know that this type of dementia differs from Alzheimer’s dementia is what way?
A. The progression of symptoms is predictable based on the person’s heart disease.
B. The progression of symptoms is more variable than Alzheimer’s disease.
C. Vascular dementia can be treated successfully with surgery compared to Alzheimer’s disease where there is no surgical treatment.
D. Vascular dementia is temporary and Alzheimer’s dementia is permanent.
10. You are working with a patient who has dementia. The patient becomes withdrawn and negative. Your most therapeutic response to this patient is:
A. “Your family will feel very bad if you do not get along here!”
B. “Your doctor has ordered you to attend at least two activities each day.”
C. “Would you prefer to stay alone in your room?”
D. “I need a partner to play cards with.”
Chapter 17: Substance Use and Addictive Disorders
1. Poor impulse control, rapid speech, and hypertension are most characteristic of abusing which substance?
2. A new patient with a history of alcoholism is in the ER with agitation, vomiting, and tremors. He tells you he had his last drink 24 hours ago. Which medication would most likely be ordered?
D. Naloxone hydrochloride
3. Your patient has a long history of alcohol abuse. You know that denial is a frequently used defense mechanism. Which statement is indicative of denial?
A. “My father was a drinker so I guess that led me to this.”
B. “I can stop anytime I want, I just don’t feel like it now.”
C. “Drinking calms my nerves.”
D. “I drink when my kids upset me.”
4. Which of the following statements from an alcoholic patient reflects a good understanding of his or her condition?
A. “I will stick to wine or beer from now on.”
B. “I’ll be OK if my wife will just stop nagging me.”
C. “I plan to take my sobriety 1 day at a time.”
D. “I won’t need AA after I am sober for 1 year.”
5. Your 42-year-old patient in the alcohol treatment unit tells you he often can’t remember events while he was drinking. What is this most likely an example of?
6. A teenager admits to you that he has been smoking marijuana. The nurse knows that marijuana is a(n):
7. Which drug cannot be given if the patient reports alcohol intake in the last 24 hours?
8. Your patient in the ER waiting room is inebriated. He becomes increasingly loud and abusive while waiting to be seen. What would be the best intervention for the nurse?
A. Tell him he has to wait his turn, as others were here first.
B. Inform him he will be asked to leave if this behavior continues.
C. Offer to take him to an exam room to wait for the doctor.
D. Do nothing, as he is still in the waiting room.
9. Your patient tells you her husband has a serious drinking problem. Which statement tells you she may be in a codependent relationship?
A. “I’ve reached my limit with his drinking.”
B. “I called his job and told them he was sick when he couldn’t go to work.”
C. “The kids are ashamed of their father. I feel bad about that.”
D. “He is drinking less this week.”
10. What should be your response to the wife who says, “I should get out of this bad situation with his drinking”?
A. “That happened to me. It’s best to get out while you can.”
B. “Tell me more about the bad situation.”
C. “Why don’t you talk to your husband about his drinking?”
D. “You’ll do what’s right.”
Chapter 18: Eating Disorders
1. Which of the following are generally NOT associated with bulimia nervosa?
C. Erosion of teeth
D. Sore throat
2. Which statement is most true about anorexia nervosa?
A. It is only found in females.
B. A major symptom is loss of appetite.
C. Overuse of laxatives is a common symptom.
D. All of the above
3. Your patient with anorexia nervosa is in the bathroom running in place at a rapid rate. What is the most likely reason for this behavior?
A. She recently ate and wants to work off the calories to avoid gaining weight.
B. She wants her heart rate increased so you will think she is having heart problems.
C. She is a regular exerciser for good health.
D. She is depressed and hopes this will make her feel more alert.
4. How should you respond to the above patient?
A. Encourage her to finish her exercise session.
B. Interrupt her and have her weighed immediately.
C. Tell her she is not allowed to exercise.
D. Interrupt her and encourage her to take a walk with you.
5. Which of the following is NOT a characteristic of a patient with anorexia nervosa?
B. Slightly overweight
6. Which of the following interventions applies to all eating disorders?
A. Encourage patients to identify the thoughts and feelings associated with eating.
B. Do a strict intake, output, and calorie count for each shift.
C. Keep patients in view for 1 to 2 hours after meals.
D. Have a staff person monitoring each table during meals.
7. Your first goal in the care of a patient with an eating disorder is:
A. Reassure the patient that he or she is attractive.
B. Teach the patient nutrition requirements for his or her age and height.
C. Establish a trusting relationship with the patient.
D. Ask the patient to explain why he or she will not eat.
8. An appropriate goal for a patient who is on behavior modification for anorexia nervosa is:
A. Gain 2 pounds per week.
B. Eat all food at each meal.
C. Discuss the meaning of food to the patient for 1 hour every day.
D. Gain as much weight as possible in the first month of treatment to prevent serious complications of starvation.
9. Mark is a male model who has been admitted for weight loss and dehydration. Mark tells you, “I can eat anything I want and I don’t gain weight. Isn’t that great?” After dinner you hear a noise and you observe Mark vomiting in the bathroom. You document this and suspect:
A. Food poisoning.
B. Anorexia nervosa.
C. Bulimia nervosa.
D. Bipolar disorder.
10. Nurses know that the main difference between anorexia nervosa and bulimia nervosa is that the patient with bulimia nervosa:
A. Is morbidly obese.
B. Eats and purges in secret to keep the problem hidden.
C. Gets pleasure from being able to control the urge to eat.
D. Meal time is more stressful.
Chapter 19: Childhood and Adolescent Mental Health Issues
1. A boy with a conduct disorder diagnosis would be most likely to have which symptom?
B. Ritualistic behavior
C. Class bully
D. Class clown
2. Suzanne is a 10-year-old girl who has been diagnosed as experiencing depression. What is likely to be the most effective way to help Suzanne express her feelings?
A. Have her participate in a group therapy session with other young children who are depressed.
B. Ask her to draw some pictures about things that she’s been thinking about.
C. Arrange for individual psychotherapy sessions with a psychiatrist.
D. Observe her actions but don’t seek to draw her out into conversation.
3. Which of the following is the most common childhood mental disorder?
B. Asperger’s syndrome
C. Conduct disorder
4. Marty is a 15-year-old boy whose parents have brought him to a mental health clinic for evaluation. They are concerned because his grades have fallen and he has become angry and sometimes even violent. He spends long periods of time alone and does not want to see his friends. The parents report that he has never been a “bad” boy nor had problems in school. They are worried about the changes in his behavior. Which of the following is the most likely cause?
B. Running around with a tough crowd
C. Normal adolescent phase
D. Attention deficit hyperactivity disorder
5. Joey is a 5-year-old who is causing his parents a lot of concern. His mother reports that “he bounces off the walls all the time” and can’t focus on any one thing for very long. He is impulsive and has recently ran right out into the street in front of the family’s home. His teacher has told his parents that he has done similar things at school. The nurse understands that:
A. Joey shows all the signs of having ADHD and should probably be placed on Ritalin as soon as possible.
B. Joey is just an active, healthy child who needs to be disciplined more effectively.
C. Joey could be autistic, and additional testing will have to be done to confirm the diagnosis.
D. Joey shows signs of having ADHD, but is too young for that diagnosis to be made definitively now.
6. Marie is 16 years old. She has been referred to the clinic by the nurse at her school because she started a fight with a younger girl and hurt her badly. The school nurse reports that Marie has been troublesome before—skipping school, bullying, and smoking on school grounds on several occasions. Of the following, which diagnosis is most likely?
A. Bipolar depression
B. Paranoid schizophrenia
C. Conduct disorder
D. Dysthymic disorder
7. The single most common symptom of autism is:
A. Inability to grasp reality.
B. Impaired social interaction.
C. “Acting out” behaviors.
D. Diminished affect.
8. Which of the following would be the first priority for nurses caring for autistic children?
A. Assist the psychiatrist and mental health team in providing treatments to cure the disorder.
B. Determine which of the two different types of autism the child has.
C. Discourage and prevent self-destructive behavior.
D. Provide behavior modification tools, specifically limit setting and reward systems.
9. Which of the following statements is true about the differences in mental health problems between children and adults?
A. Children are affected by the same stressors as adults, but to different degrees and with different manifestations.
B. Children’s mental health disorders are generally much less severe and resolve more quickly than do those of adults.
C. Children’s mental health problems are different from those of adults because their brains are “wired” differently.
D. Children have better means of “working off” stresses than do adults.
10. The nurse knows that stimulant medication for ADHD should be administered:
A. At bedtime, to coincide with rising cortisol levels.
B. Only on school days to improve performance.
C. On an empty stomach.
D. With breakfast and lunch.
Chapter 20: Postpartum Issues in Mental Health
1. In the OB follow-up clinic, your patient, who is 4 weeks post-delivery, tells you she is sleeping for long hours, wants to avoid taking care of the baby, and wishes she had never had the baby. What would be your first response?
A. “It’s normal to feel overwhelmed at first.”
B. “Tell me more about these feelings.”
C. Report her to Child Protective Services.
D. “I’ll call your husband right away to get you back home to rest.”
2. Which statement best describes postpartum blues?
A. A rare condition that impacts bonding between mother and baby.
B. A transient, self-limiting period of sadness after the birth of the baby.
C. A psychiatric diagnosis similar to dysthymia.
D. A transient period of sadness that usually moves into postpartum depression.
3. Which is NOT a contributing factor to postpartum blues?
A. Hormone shifts
B. Lack of sleep
D. History of depression
4. Which of the following combines the best treatments for postpartum blues?
A. Antidepressants, sleep, crisis intervention
B. Rest, support, compassion
C. Mother-baby bonding session, family education, antidepressants
D. Analgesics for post-delivery pain, rest, longer hospital stay
5. Which statement by the nurse indicates a good understanding of postpartum blues?
A. “You need to get involved with taking care of this baby.”
B. “You are lucky to have a healthy baby. The patient in the next room would give anything to be in your place.”
C. “You look tired. Why don’t you rest for a bit and I will come back later to start some teaching.”
D. “I will call the social worker to check into alternate caregiving for the new baby.”
6. In addition to antidepressants, which of the following is usual treatment for postpartum depression?
C. Hormone replacement
D. Temporary removal of the baby from the home
7. Your pregnant patient has a history of major depression. Which of the following is she most likely to be at risk for?
A. She is at risk for development of manic episodes.
B. She is at risk for recurrence of depression after the birth of the baby.
C. She is more likely to have an autistic child.
D. She has no higher risk for emotional problems than other patients.
AND MUCH MORE