Your patient, whose wife died a few months ago, appears to be very unkempt and apathetic. Although several months have passed since his wife's death he
... [Show More] has not progressed at all through his grieving. You assess this condition as which of the following?
disenfranchised grief
panic disorder
complicated grief
physiologic grief
Correct Answer:
complicated grief
A person has uncomplicated grief when he or she has normal physical, psychological, cognitive and spiritual responses to the death of a significant other. But when the person shows persistent maladaptive behaviors such as not taking care of personal hygiene and/or appearance and does not progress through the mourning process, this is complicated grief.
If a patient has had a myocardial infarction, which of the following atypical antidepressants should not be prescribed within the recovery phase?
Trazodone
Duloxetine
Bupropion
Desvenlafaxine
Correct Answer:
Trazodone
If a patient has had a myocardial infarction, during the recovery phase, the patient should not be prescribed this medication. Trazodone (Desyrel) can cause the patient to develop orthostatic hypotension and priapism.
To get your teaching ideas and concepts across to a poor reader which of the following would be most appropriate?
Use longer sentences.
Use abstract concepts.
Discourage questioning.
Use examples and review.
Correct Answer:
Use examples and review.
To get the idea across to a poor reader use examples and review. The other choices are not helpful. You should use short sentences and easy to read layouts; be concrete rather than abstract; and teach them how to ask questions about their health. Also, tell context first and use visual, use common words and examples, and explain meaning.
A 21-year old woman presents with complaints of milky discharge from her breasts. She doesn't have any other symptoms and is not pregnant, nor has been before. She tells the nurse about each medication that she takes. Which of these drugs may be implicated as the cause of the symptom?
aspirin
Lamotrigine
Risperidone
sertraline
Correct Answer:
Risperidone
Risperidone can cause the greatest prolactin elevation among atypical psychotics. A milky white discharge known as galactorrhea could be a sign of an underlying condition. The fact that the woman takes Risperidone, an atypical antipsychotic, would likely point to the cause and should be switched with one less likely to have that same side effect.
Which of the following would be considered one of the main things that is responsible for about 2/3 of psychiatric hospital readmissions?
Not sufficient care.
Medication noncompliance
Biophysical assessments
None of the above
Correct Answer:
Medication noncompliance
Medication noncompliance is a major problem with the psychiatric mental health patients. The home health nurses assists by helping the patients
to see the relationship between their compliance with their medication regimen and control of their symptoms.
Which of the following would be considered an important form of communication that can help to promote consistency in the care of the patient at the
same time that it justifies their stay in the hospital?
Review of care.
Documentation
Verbal reporting
None of the above
Correct Answer:
Documentation
The other 3 options above are incorrect.
One of the most important aspects of nursing is documentation. Documentation can promote consistency in the care of the patient and is also used to help justify the patient remaining in the hospital.
Effects of an overdose of LSD (Lysergic acid diethylamide) can include all of the following except?
Vomiting
Respiratory failure
Hypertensive crisis
Seizures
Correct Answer:
Hypertensive crisis
Hypertensive crisis would be considered a symptom of PCP overdose. Vomiting, respiratory failure and seizures would be considered an effect
of LSD overdose.
Symptoms of serotonin syndrome include all of the following EXCEPT:
insomnia
nausea
loss of coordination
sweating or shivering with goose bumps
Correct Answer:
nausea
Symptoms of serotonin syndrome can present in patients that have drug combinations that are contraindicated. They can vary from restlessness and agitation to tremors, chills, headaches, and insomnia as well as loss of coordination. Nausea has not been implicated in serotonin syndrome.
What is the rate of suicide attempts for patients having dissociative identity disorder?
30%
45%
70%
60%
Correct Answer:
70%
People with dissociative identity disorder have one of the highest risks for suicide. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5),more than 70% of outpatients with DID have attempted suicide, and multiple suicide attempts are common.
Of the following, which would not be considered a phase of schizophrenia treatment?
Maintenance
Acute
Cognitive
Stabilization
Correct Answer:
Cognitive
Cognitive is not one of the three phases of schizophrenia treatment.
The three phases are:
Phase 1: acute
Phase 2: stabilization
Phase 3: maintenance
The patient should be monitored for effects of psychotropic medications which can impact cardiac rhythms. Which of the following could be a potential
cardiac side effect?
A prolonged QT interval
Narrowing of the QRS
Both A and B
None of the above
Correct Answer:
A prolonged QT interval
With antipsychotic drugs, the triclyclic action can cause problems. These medications can cause a widening of the QRS or a prolonged QT interval.
This is a measure of the ventricular repolarization.
Sullivan described three developmental cognitive modes of experience and believed that mental disorders are related to the persistence of one of the early modes. The mode that begins in early childhood as the child begins to connect experiences in sequence is which of the following?
prototaxic mode
parataxic mode
syntaxic mode
composite mode
Correct Answer:
parataxic mode
The parataxic mode begins in early childhood. The child may not make logical sense of the experiences and may see them as coincidence or chance events. The child seeks to relieve anxiety by repeating familiar experiences, although he or she may not understand what he or she is doing.
Which of the following acts have provided the greatest protection for the
individual not to lose or be denied health insurance coverage?
Patient Protection and Affordable Care Act
OSHA
ISPN
None of the above
Correct Answer:
Patient Protection and Affordable Care Act
The other 3 options above are incorrect.
For several decades now, the ANA (American Nurses Association) has been
working and advocating for reforms that will help to guarantee the access
of high-quality health care. This act has helped millions of people, but
ANA recognizes the fact that this debate is far from being over. The ANA
is dedicated to educating the nursing public about the changing systems
and their impacts on people's lives and the nursing profession.
Which of the following is an example of Western alternative medical systems?
TCM (traditional Chinese medicine)
naturopathy
ayurveda
acupuncture
Correct answer:
naturopathy
Naturopathy and homeopathy are examples of Western alternative medical systems. Naturopathy emphasizes health restoration rather than disease treatment and combines nutrition, homeopathy, therapeutic counseling and other therapies. The underlying belief is that the individual assumes responsibility for his or her recovery.
What is NOT a sign of alcohol intoxication?
Nystagmus
Mood lability
The face has pale skin.
Aggressive impulses
Correct Answer:
The face has pale skin.
A flushed face is a sign of alcohol intoxication. Other signs include disinhibition of sexual impulses, impaired judgment, and impaired occupational functioning.
In terms of styles of leadership in therapeutic groups, which type of leader encourages individual creativity and group cohesiveness?
autocratic
democratic
laissez-faire
psychotherapeutic
Correct Answer:
democratic
There are three main styles of group leadership: autocratic, democratic, and laissez-faire. A democratic leadership style focuses on the members of the group. Members are encouraged to participate fully in problem-solving of issues that relate to the group. This type of leader encourages individual creativity and group cohesiveness.
All of the following are considered to be types of family structures except?
Nuclear family
Behavioral family
Blended family
Extended family
Correct Answer:
Behavioral family
The major types of family structures are:
Nuclear family
Blended family
Extended family
Single-parent family
Other familial systems
What would NOT be an appropriate way to deal with a patient in the psychiatric unit who is prone to protracted angry outbursts?
Using reassuring touch
Determining the source of the patient's anger
Remaining calm
Setting verbal limits on behavior
Correct answer: Using reassuring touch
This would not be appropriate for interacting with an angry patient. When coping with an angry patient, don't shout or argue with the client and avoid touching the client or invading the client's space. This can escalate the anger. Touching the client can be threatening and make them feel cornered. This may result in retaliation.
N-STAT is an ANA program that does which of the following?
unifies nurses' political voices
recommends nursing health policies
assures a safe workplace for nurses
evaluates Medicare and Medicaid reforms
Correct Answer:
unifies nurses' political voices
Nurses are the largest group among the health care disciplines The Nurses Strategic Action Team (N-STAT) is an ANA program that unifies nurses' political voices across the country to enact measures to benefit health care for everyone.
Examples of DSM-V diagnostic criteria for schizophrenia include all of the following EXCEPT:
hallucinations
thought insertion
disorganized speech
delusions
Correct Answer:
thought insertion
DSM-V diagnostic criteria for schizophrenia include delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, and negative symptoms.
Abraham Maslow established that human needs are hierarchical, with lower level (most basic) needs being critical to survival. Which of the following is the highest level of needs in Maslow's hierarchy?
esteem and recognition
self-actualization
love and belonging
safety
Correct Answer:
self-actualization
Abraham Maslow's hierarchy of needs from lowest to highest are: physiologic, safety, love and belonging, esteem and recognition, and self-actualization. Self-actualization is the fulfillment of a person's unique potential.
How well a drug passes through natural body barriers such as the skin or stomach is known as the drug's:
diffusion
metabolism
bioavailability
absorption
Correct Answer:
absorption
A drug's absorption is how well it passes through natural body barriers such as the skin, stomach, intestines, blood-brain barrier and other membranous tissues. Some considerations include whether the barrier is a lipid base or not.
Antidepressant medications are known to work by increasing the concentration of which of the following in the body?
Serotonin
Dopamine
Norephinephrine
All of the above
Correct Answer:
All of the above
These actions occur because the brain blocks the reuptake of these
neurotransmitters by the neurons. In addition, the enzyme monoamine
oxidase can inactive these at various sites in the nervous system.
Which of the following would more than likely be included in treatment of the patient with depression?
Cognitive therapy
Psychopharmacology
Individual therapy
All of the above
Correct Answer:
All of the above
Treatment of depression can include:
Cognitive therapy
Psychopharmacology
Individual therapy
Group/family therapy
Electroconvulsive therapy
Light therapy
Transcranial magnetic stimulation
Which of the following individuals would be the most likely to be homeless?
16 year old white male.
67 year old Hispanic female
49 year old female Native American
19 year old Asian male
Correct Answer:
16 year old white male.
Studies have shown that approximately 39 percent of the homeless
are under the age of 18.
Studies have shown that more males are homeless then females.
Studies have shown that 39 percent of the homeless are white.
What test should be administered for a patient who is taking lithium, and it is suspected has arrhythmia?
ACH
EKG
ABG
EEG
Correct answer: EKG
Arrhythmia is a side effect of lithium. The patient needs to be monitored for risky side effects. An EKG or electrocardiogram would be used.
Akathisia, akinesia, dystonia, and tardive dyskinesia are all side effects considered to affect which system:
lymphatic
skeletal
endocrine
muscular
Correct Answer:
muscular
The muscular system is responsible for extrapyramidal side effects. The best way to prevent involuntary muscular movements that could be irreversible is to monitor carefully. If symptoms are present, it can be treated by reducing the current dose, or changing the patient to an atypical agent.
The gathering and interpretation of data based on valid observed and patient-reported information, in addition to research-derived evidence, is known as which of the following?
Interventions
Managed care
Evidence-based
Crisis intervention
Correct Answer:
Evidence-based
Evidence-based practice is typically used in the nursing process.
The best available evidence is applied in order to improve the quality of
clinical judgments.
Preventative factors are those that protect the individual from a disorder. Which of the following would be considered a social preventative factor?
healthy nutritional status
good self-esteem
healthy ego defenses
higher level of education
Correct answer:
higher level of education
Preventative factors are those that protect the individual from a disorder. They are coping mechanisms or resources that facilitate a healthy response to stress. Social preventative factors include: low-stress occupations; higher socioeconomic status; and a higher level of education.
Which of the following would probably not be considered as having a partnership with
community-based mental health care?
Crisis centers
Insurance companies
Group homes
Shelters
Correct Answer:
Insurance companies
Insurance companies would not be the typical partner with mental health care.
Such places could include:
Crisis centers
Group homes
Shelters
Patient homes
Work sites
Mental health clinics
Senior centers
Schools/colleges
Clinics for the homeless
What action would be appropriate for documenting a patient's care?
Charting opinions
Charting in ink
Charting events before they happen
Charting generalizations
Correct Answer:
Charting in ink
This is the only appropriate charting action. You would not chart the following: opinions that are not supported by facts or defame patients, chart events before they happen, chart generalizations, suppositions or pat phrases, obliterate, erase, alter or destroy a record, or leave blank spaces. If an incident report is filed, do not note it in the chart.
Relationships between people are each unique. However, all relationships can be categorized into three major types. They are:
social, intimate, and therapeutic
social, intimate, and empathetic
social, warm, and empathetic
public, private, and therapeutic
Correct Answer:
social, intimate, and therapeutic
The three categories of relationship types are: social, intimate, and therapeutic. Social relationships are primarily for friendship. Intimate relationships involve two people who are emotionally committed to each other. The therapeutic relationship focuses on the needs, experiences, feelings, and ideas of the client only.
If the client cannot organize his or her thoughts, or has difficulty answering open-ended questions, the nurse should do which of the following?
continue to ask the open-ended questions until the client can answer
stop questioning the client altogether
ask more direct questions focused on one specific behavior or symptom
ask general multiple choice questions
Correct Answer:
ask more direct questions focused on one specific behavior or symptom
If the client cannot organize his or her thoughts, or has difficulty answering open-ended questions, the nurse should use more direct questions to obtain information. Questions need to be clear simple, and focused on one specific behavior or symptom; they should not cause the client to remember several things at once.
The study of the distribution, incidence, prevalence, and duration of a disease is known by which of the following terms?
pharmacokinetics
etiology
epidemiology
pathogenesis
Correct Answer:
epidemiology
Epidemiology is the study of the distribution, incidence, prevalence, and duration of a disease. Etiology refers to cause or origination of a disease. Pathogenesis is the manner of development of the disease. Pharmacokinetics refers to the movement of the drug into, through and out of the body.
Which of the following would not be considered a common side effect of paroxetine?
Somnolence
GI upset
Headache
Hypokalemia
Correct Answer:
Hypokalemia
Some of the more common side effects of paroxetine would be considered:
Somnolence
GI upset
Headache
Dizziness
Insomnia
Which of the following physical conditions could potentially cause a patient
to exhibit potential psychiatric symptoms such as confusion?
Urinary tract infections
Chest pain
Thyroid disorders
Both A and C
Correct Answer:
Both A and C
When a patient is having an admission assessment, there should be a physical examination performed prior to the psychiatric assessment. Such problems as urinary tract infections, especially with the older adults can cause the patient to exhibit symptoms of confusion, among other things.
Which of the following does the nurse typically work with to help determine the
potential outcomes and goals for the patient?
Family
Housekeeping
Members of the interdisciplinary team
Both A and C
Correct Answer:
Both A and C
Housekeeping is not typically included.
The nurse typically communicates with the:
Family
significant others
Members of the interdisciplinary team
Patient
What is the best course of action to be taken for a patient who insists on taking Gingko Biloba for anxiety?
Explain that it is dangerous
Respect preference
Refuse to give consent
Try to dissuade the patient
Correct answer: Respect preference
Gingko Biloba is shown to have some effect in treating anxiety. The patient preference needs to be respected in care. Herbal remedies need to be considered when prescribing other medications.
Neurobiological defects found in schizophrenia are suspected to have abnormalities in chemical neuronal signal transmission. Which of the following is not a neuronal signal transmission found in people with schizophrenia?
excess dopamine in mesolimbic pathway
decreased norepinephrine
decreased GABA
decreased dopamine in the mesocortical pathway
Correct Answer:
decreased norepinephrine
Impaired neuronal communication is suspected to lead to the abnormalities in the brain. Excess glutamate and dopamine in the mesolimbic pathway; decreased dopamine in the mesocortical pathway, and in GABA and serotonin are implicated in people affected by schizophrenia. Decreased norepinephrine is implicated in depression.
What is the risk for a 50 year old patient taking NSAIDs while taking SSRIs?
Seizures
Arrhythmia
Serotonin syndrome
Gastrointestinal bleeding
Correct Answer:
Gastrointestinal bleeding
Patient medications need to be monitored for possible interactions. There are different risks with different medications. Gastrointestinal bleeding is a risk that will increase if a patient takes both SSRIs and NSAIDs.
When the registered nurse is making the decision about delegating any care
to an unlicensed person, which of the following statements would not be correct?
If the task is to be performed under the nurses scope of practice, then do
not delegate it.
If the outcome is not one that is reasonably predictable, then do not delegate it.
If the task cannot be safely performed according to clear directions, then
it is all right to delegate it.
If there are any specific laws against delegation of the task, do not
delegate it.
The other 3 options above would be correct examples of when not to delegate a task to an unlicensed person. If the task cannot be safely performed according to clear directions, then it would not be all right to delegate it.
Attention deficit hyperactivity disorder (ADHD) is divided into three subtypes that specify the dominant associated behaviors. They include all but which of the following?
hyperactive-impulsive type
manic type
inattentive type
combined type
Correct Answer:
manic type
There is no manic type of ADHD. ADHD is among the most common of childhood psychiatric conditions. It is characterized by symptoms of inattention, impulsivity, and overactivity that occur in at least two different settings, with significant impairment in functioning.
Typically, which type of mental health care involves a minimum of about 3 months and is reserved for patients that have been transferred from acute care setting
that are at a chronic risk for harming themselves or others because of mental illness?
Community-based care
Primary care
Long-term care
Residential services
Correct Answer:
Long-term care
This type care can be referred to as intermediate or long-term care. They can
admit a patient directly, but typically the patients are transferred there from
an acute care setting.
Which of the following would be an example of a secondary prevention measure for psychiatric practice?
disaster response
day treatment programs
social skills training
case management for vocational needs
Correct answer:
disaster response
Disaster response would be a secondary prevention measure that is aimed at decreasing the prevalence of mental disorders. The other three choices are tertiary prevention measures that are aimed at decreasing the disability and severity of a mental disorder.
What is used to delineate the responsibilities and authority at all levels for the various activities in the organization?
Mission statement
Policy
Philosophy statement
Procedures
Correct answer: Policy
The governing body of an organization establishes broad policies for regulating the relations, operations, and outcomes in a health care enterprise. Policies are needed to guide actions in given sets of circumstances. They serve to delineate responsibilities and authority at all levels and for various activities in the organization.
What activity is least likely to reduce role conflict and ambiguity of role?
Discouraging freedom in the role
Use of the chain of command
Personal development
Adaptation to change
Correct answer:
Discouraging freedom in the role
This is least likely to reduce role conflict and ambiguity of role. Toleration of freedom is more likely to reduce role conflict and ambiguity. Other activities to reduce role conflict and ambiguity include increased need fulfillment, structure and standards, and facilitation of teamwork.
Of the following statements about involuntary admission to a psychiatric facility, which is the least accurate?
Involuntary admission requires that the patient retain freedom from unreasonable bodily restraints.
Those patients who have been involuntarily admitted no longer have the right to refuse medications.
Patients have the right to legal counsel and to take their cases before a judge who may order release.
Forced treatment raises ethical dilemmas regarding autonomy versus paternalism.
Correct answer:
Those patients who have been involuntarily admitted no longer have the right to refuse medications.
This statement is least accurate. Involuntary admission requires that the patient retain the right to refuse medications. This refusal can include psychotropic or antipsychotic medications.
Managed care is used by whom?
Stake holders.
High Management.
Purchasers of health services.
Insurance companies.
Correct Answer:
Purchasers of health services.
Managed care is used or employed by purchasers of health services. These people will make decisions about different services so that quality and costs can be monitored. In this type of program, people will get health care based on their needs.
75 year old male is suffering from an altered mental status. What is happening to him?
The memory is overloaded.
There are changes to the brain's normal functions.
The patient is dying.
There is no change to the patient's brain activity.
Correct Answer: There are changes to the brain's normal functions
Patients suffering from an altered mental status suffer general changes to the brain's normal functions. Symptoms that are associated with this state are confusion, loss of orientation, amnesia, and poor regulation of emotions.
In order to provide health care, a health care professional must be assertive. This would include all of the following attributes EXCEPT:
confidence in the necessary competencies and skills
direct and effective communication
acting as an advocate and consultant to the client
pressuring a client to accept treatment
Correct Answer:
pressuring a client to accept treatment
A client has the right to accept or refuse treatment. Being assertive does not mean that the nurse can impose his or her opinions on the client.
What term best describes a nurse's ability to best determine the end result?
Expected outcome.
Evaluation.
Competency.
Autonomy.
Correct Answer:
Expected outcome.
An expected outcome occurs when you can determine the end results of a patient's care. Mental health nurses can make an educated assumption on what the outcome of their patient's health will be based on patient cooperation, assessments, tests, observations, and the diagnosis. All details related to the patient's health are considered, and used to determine the expect outcome.
What might be a cause for a member of the collaborative team to receive complaints concerning his communication skills?
Poor eye contact
Sitting too close
Professional dress
Gestures that accompany words
Correct Answer:
Sitting too close
Body language is an important communicator. Sitting too close to people invades their personal space. This results in negative communication.
When a nurse structures the relationship with a client to focus on the client and facilitates expression of problems and feelings, this is part of which phase of the nurse-client relationship?
identification
orientation
exploitation
resolution
Correct Answer:
identification
The phases of a nurse-client relationship are (in sequence): orientation, identification, exploitation, and resolution. In the identification phase the nurse structures the relationship to focus on the client and facilitates the expression of problems and feelings. The nurse avoids fostering unnecessary dependency and encourages self-care.
Most malpractice suits are filed under which of the following areas of law?
tort law
criminal law
administrative law
contract law
Correct Answer:
tort law
Most malpractice suits are filed under tort law. Torts are private civil wrongs committed by one individual against another for which money damages are collected by the injured party from the wrongdoer.
Conflict among members of a particular group is classified as which of the following?
intrapersonal
interpersonal
intergroup
intragroup
Correct Answer:
intragroup
Conflict among members of a particular group is intragroup conflict. Conflict among members of two or more groups is known as intergroup conflict.
Human development is what?
The ability of disease to live inside of the body.
The process of dying.
The process of growing to maturity.
The growth rate of humans.
Correct Answer:
The process of growing to maturity
The process of growing to maturity is referred to as human development. It is based upon the theory that humans are born, grow, age, and then die.
The NP sees a 12-year-old male who was referred to her because of disruptive behavior and physical aggression against his peers. He is generally hostile in temperament and easily irritated. The child is also failing academically. This child most likely suffers from which of the following disorders?
attention deficit hyperactivity disorder
oppositional defiant disorder
posttraumatic stress disorder
autistic disorder
Correct answer:
oppositional defiant disorder
This child would most likely be diagnosed with oppositional defiant disorder (ODD). Children with ODD are disruptive, argumentative, hostile and irritable. They have social problems with peers and adults and impaired academic functioning.
Under what category would employee vacation pay, sick leave, and education be listed?
Non productive time
Productive cost
Long term plan
Productive time
Correct answer:
Non productive time
Non productive time must be considered. This includes benefits and pay that employees receive that are not provided for work that has been accomplished. Vacation and sick time are included in the Non productive budget.
The neuroendocrine system contains all of the following EXCEPT:
hippocampus
hypothalamus
gonads
pancreas
Correct answer:
hippocampus
The hippocampus is not a part of the neuroendocrine system. It is a part of the brain located in the medial temporal lobe. It is an important site for the formation and storage of immediate and recent memories. The neuroendocrine system contains the hypothalamus, pituitary gland, thyroid gland, adrenal glands, gonads, and pancreas.
In which stage of the standards of practice for psychiatric nursing would the nurse document measurable goals?
assessment
implementation
planning
outcomes identification
Correct Answer:
outcomes identification
Outcomes identification includes documenting expected outcomes as measurable goals. It also includes identifying attainable and culturally expected outcomes and including time estimate for expected outcomes.
The type of hospital admission to a psychiatric inpatient setting that does not require a written application is which of the following?
voluntary admission
involuntary admission
temporary admission
informal admission
Correct Answer:
informal admission
Informal admission is one type of voluntary admission that is similar to any general hospital admission in which there is no formal or written application. An informal admission is sought by the patient. The normal doctor-patient relationship exists, and the patient is free to stay or leave, even against medical advice.
Which of the following is NOT a drug associated with date rape?
Risperidone
GHB
Rohypnol
Ketamine
Correct answer:
Risperidone
Risperidone is not a drug associated with date rape. It is an antipsychotic. Date rape drugs may render a woman incapable of resisting a rape and are purported to facilitate acquaintance rape. Once the drugs are ingested, victims lose their ability to ward off attackers, develop amnesia and become unreliable witnesses.
What is the term used for the study of ethical problems resulting from scientific advances?
Medical ethics
Ethical acculturation
Bioethics
Deontology
Correct Answer:
Bioethics
Nursing ethics is part of a broader system known as bioethics. New questions surface as science and technology produce new ways of knowing. Bioethics is the term used for the study of ethical problems resulting from scientific advances.
The responsibilities of the nurse leader in using change management include all but which of the following?
using change theory
serving as a change agent
supporting staff during times of difficult transitions
having a rigid leadership style
Correct Answer:
having a rigid leadership style
Having a rigid leadership style is not part of good change management. Adapting leadership style to situational needs is more effective. The responsibilities of the nurse leader in using change management include all of the first three choices. They also include: recognizing one's own reaction to change and striving to remain open to new ideas and approaches.
The NP asks a patient with schizophrenia what the saying, "people in glass houses shouldn't throw stones" means to him. The patient replies that "the glass might break." This is an example of the patients inability to process which of the following?
concrete thinking
abstract thinking
delusion
echolalia
Correct Answer:
abstract thinking
This patient is not able to process abstraction. Concreteness is often assessed through the patient's interpretation of proverbs. Concreteness reduces one's ability to understand and address abstract concepts such as love or the passage of time.
If you teach a client how to navigate through the complexities of the health care delivery system to receive prompt treatment this is a form of:
primary prevention
secondary prevention
tertiary prevention
enabling
Correct Answer:
secondary prevention
You should develop teaching programs that coincide with the level of prevention needed by the client. Because primary prevention is not possible in all cases, a significant share of your time is spent teaching at the secondary or tertiary level.
What is the best course of action to be taken if a peer arrives at work hung over, therefore it is necessary to act quickly to prevent patient injury?
Respect their privacy.
Report the individual.
Ignore the incident.
Discuss the incident with coworkers.
Correct answer: Report the individual
Employees and peers have the right to expect personal privacy. This right however, does not protect unethical conduct. The individual placed others in danger and should be reported.
What step of the nursing process, is the diagnoses, outcome and care revised if needed?
Evaluation.
Diagnosis.
Planning.
Implementation.
Correct Answer: Evaluation
The nursing process is a problem solving approach. There are 6 steps in the nursing process. They include: diagnosis, outcome identification, planning, implementation, evaluation, and reassessment. During evaluation, the diagnoses, outcome and care revised if needed.
Which of the following drugs is NOT one of the "Z-hypnotics" that have sedative effects without the antianxiety, anticonvulsant, or muscle relaxant effects of benzodiazepines?
Ambien
BuSpar
Lunesta
Sonata
Correct answer:
BuSpar
Buspirone (BuSpar) is a drug that reduces anxiety without having strong sedative-hypnotic properties. Because this drug does not leave the patient sleepy or sluggish, it is often much better tolerated than benzodiazepines. It is not a CNS depressant. All of the other choices are one of the "Z-hypnotics."
A 58 year old woman is dealing with symptoms of vasomotor instability, sleep disturbances, hot flashes, urinary frequency, and dyspareunia. What is the likely cause of her symptoms?
High cholesterol.
Estrogen deficiency.
Estrogen surplus.
Testosterone surplus.
Correct Answer: Estrogen deficiency
Menopause upsets the balance of estrogen in the body. There are many symptoms associated with menopause, and they are all commonly because of an estrogen deficiency.
Defamation of a person in written form is which of the following?
breach of contract
slander
fraud
libel
Correct Answer:
libel
Defamation is defined as an oral or written communication to a third party about another party that is false and that tends to injure the other party's reputation. Libel is defamation in written form; slander is oral defamation.
What leaders do or how they conduct themselves is the basis of what theory of leadership?
trait theory
contingency theory
behavioral theory
contemporary theory
Correct Answer:
behavioral theory
What leaders do, or how the behave, is the focus of behavioral theorists. For example, impoverished leaders have a low concern for both people and production, while the team leaders show high concern in both of these dimensions.
A psychiatric mental health nurse will work how?
In a restricted environment.
Alone and as a team player.
Alone only.
As a team only.
Correct Answer:
Alone and as a team player.
Registered nurses need to know how to work by themselves or as team players. Working as a team is an integral part of the nursing process. If nurses can collaborate, they can provide better care to patients.
What would be the first action to be taken if a patient who has been diagnosed with PTSD because she was a witness to her brother being killed and is now staying in a psychiatric unit is having trouble sleeping, thinks she hears people trying to get into her room, and at times having nightmares?
Listen to the patient's story of what has been happening to her.
Assess the risk of suicide.
Have the patient talk about the traumatic event.
Encourage her to talk to others who have had similar experiences.
Correct answer: Assess the risk of suicide.
A patient with post traumatic stress syndrome (PTSD) has experienced a traumatic event that has affected their life severely. The patient will be experiencing a high level of anxiety and as a result, the possibility of self-destructive behavior is present. This should be the first concern to be addressed.
What statement concerning conduct disorder in children is accurate?
Conduct disorder is more common in children of parents with antisocial personality disorder than in the general population.
Conduct disorder affects more girls than boys.
Onset is earlier for girls than boys.
The child must have one or more symptoms of the disorder in the past year to be diagnosed with conduct disorder.
Correct answer: Conduct disorder is more common in children of parents with antisocial personality disorder than in the general population.
This is the accurate statement. It is also more common in children of parents with alcohol dependence, mood disorders, or schizophrenia rather than in the general population. Conduct disorder affects more boys than girls. Its onset is earlier for boys than girls. The child must have three or more symptoms of the disorder in the past year and at least one symptom in the past 6 months to be diagnosed with conduct disorder.
What atypical antipsychotic is preferred for adolescent patients?
Haldol
Haloperidol
Zyprexa
ASA
Correct Answer:
Zyprexa
Zyprexa is an atypical antipsychotic. This medication is preferred for patients between the ages of 13 and 17. There are multiple formulations for specific needs.
In terms of complementary and alternative medicine which of the following would be classified as a whole medical system?
chiropractic therapy
meditation
naturopathy
herbal therapy
Correct Answer:
naturopathy
Naturopathy is a whole medical system. It focuses on enhancing the natural healing responses of the body. Interventions include nutrition, herbology, hydrotherapy, acupuncture, physical therapies, and counseling.
What term is used to describe the failure to exercise the standard of care that another would issue in the same situation?
Negligence.
Attention.
Disregard.
Heed.
Correct Answer: Negligence
Negligence is the failure to exercise the standard of care that another would issue in the same situation. Negligence also describes any conduct that falls below the legal standard that protects patients from risk of harm.
What is a characteristic of dementia, but is not characteristic of delirium?
Duration of hours to days
Gradual change in mental status
Change in psychomotor activity, either hyperactive or hypoactive
Perceptual disturbances
Correct answer: Gradual change in mental status
This is a characteristic of dementia. The other choices are all characteristic of delirium. Dementia has a gradual and insidious onset. Delirium does not have an insidious onset; its onset is abrupt. It can usually be noted at a precise date as a rapidly progressive change in mental status.
There are how many conditions that allow NPs to challenge a patient's refusal of treatment after informed consent?
3 .
4 .
5 .
6 .
Correct Answer:
5 .
There are five conditions that allow NPs to challenge a patient's refusal to treatment. They include: when a patient is mentally incompetent, when refusing treatment causes danger to the life/health of another, in an emergency situation, when the patient is a child, and in the case of therapeutic privilege.
When would a patient's informed consent not be necessary?
The patient has dementia.
The patient has delusional thoughts.
The patient is exhibiting violent ideation.
The patient has bipolar disorder.
Correct answer: The patient is exhibiting violent ideation.
Informed consent is not always necessary. Exceptions are made in an effort to preserve life. A patient who is experiencing violent ideation and is a threat to others may be treated without informed consent.
According to studies, which group of people with bipolar I is more likely to experience rapid cycling?
Older people
Men
Young people
Women
Correct answer: Women
According to evidence, female patients are more likely to experience rapid cycling. Male patients have a higher risk of manic episodes.
Long-term involuntary admission to a psychiatric inpatient setting is for extended care and treatment of the mentally ill. The patient can be admitted for this type of admission through which of the following means?
medical certification
judicial review
administrative action
all of the above
Correct answer:
all of the above
Long-term involuntary admission has as its primary purpose extended care and treatment of the mentally ill. Those who undergo extended involuntary hospitalization are admitted through medical certification, judicial review, or administrative actions. This type of involuntary hospitalization generally lasts 60 to 180 days, but may also be for an indeterminate period.
If there is an absence of state statutes, what is used as the basis of liability for injuries related to negligence?
Federal law.
Common law.
Administrative law.
Criminal law.
Correct Answer: Common law
If there is an absence of state statutes, common law is used as the basis of liability for injuries related to negligence. Common law is also used for malpractice as well, if there is an absence of state statutes.
What key principle of ethical decision making is defined as the right of self-determination, independence, and freedom?
Autonomy
Justice
Fidelity
Beneficence
Correct answer: Autonomy
Autonomy is the right of self-determination, independence, and freedom. Autonomy in the healthcare setting involves the healthcare provider's willingness to respect patients' rights to make decisions for themselves, even if the provider does not agree with those decisions.
A client who is alert at the time of an event which he then forgets along with other successive events as they occur suffers from which of the following types of amnesia?
localized
generalized
continuous
selective
Correct Answer:
continuous
A client with continuous amnesia forgets successive events as they occur, but is alert at the time of the event. Localized amnesia is for a short time period; generalized amnesia pertains to a whole lifetime of experiences; and selective amnesia occurs for some, but not all events.
Which of the following statements about mood disorders is least accurate?
The most common mood disorder is major depressive disorder.
Mood disorders are diseases.
The signs and symptoms of mood disorders tend to recur, often in periodic or cyclical fashion.
Mood disorders are caused by a complex interplay of biological and psychological factors.
Correct Answer:
Mood disorders are diseases.
Mood disorders are not diseases; they are syndromes. They consist of signs and symptoms that present a deviation from a person's normal functioning and are sustained over a period of weeks to months.
A patient with schizoaffective disorder and a substance abuse disorder experiences auditory hallucinations causing anxiety. What condition needs to be addressed first?
Substance abuse
Schizoaffective disorder
Anxiety
Delusions
Correct Answer:
Substance abuse
When there are comorbid conditions in a crisis situation determinations must be made. The substance abuse will compound the psychiatric condition. Interventions need to be made to address the substance abuse first.
In what situation would a psychiatric nurse provide forced treatment?
When court mandated
When the patient has Alzheimer's
When referred by a physician
Never
Correct Answer:
When court mandated
Psychiatric nurses have an ethical responsibility to balance patient's rights with necessary forced treatment for safety. Forced treatment is done when court mandated.
Which of the following medications is a cholinesterase inhibitor used to treat clients with dementia?
Cognex
Zyprexa
Seroquel
Zoloft
Correct Answer:
Cognex
Cognex (tacrine) is a cholinesterase inhibitor for treatment of cognitive impairment in clients with dementia. The daily dosage range is 40 - 160 mg. Side effects include dizziness, headache, GI upset, and elevated transaminase. Zyprexa and Seroquel are both antipsychotic drugs; Zoloft is an antidepressant (SSRI).
What would be the reason for hallucinations and delusions if a patient does not meet the criteria for schizoaffective disorder or bipolar disorder and exhibits no symptoms of a physical illness or drug abuse?
Paranoia
Delusional disorder
Bipolar I
Schizophreniform disorder
Correct Answer:
Schizophreniform disorder
Schizophreniform disorder is diagnosed after ruling out illness, drug use, schizoaffective disorder or bipolar disorder. Hallucinations and delusions are signs of schizophreniform disorder. Disorganized speech, negative symptoms, and catatonic behavior are also included in the diagnostic criteria.
Which of the following medications would decrease seizure activity in ECT?
fluoxetine
lithium
propofol anesthetic
bupropion
Correct Answer:
propofol anesthetic
Propofol anesthetic would decrease seizure activity in ECT. Other medications with this same effect include: benzodiazepines, barbiturate anesthetic, and anticonvulsants. All of the other choices would increase seizure activity in ECT.
You are interviewing a woman who has unexplained bruises. You know that in interviewing this woman you should do all of the following EXCEPT:
Conduct the interview in private.
Be understanding.
Inform the patient if a referral to protective services must be made.
Probe for answers that the patient is not willing to give.
Correct Answer:
Probe for answers that the patient is not willing to give.
The interview should be non-threatening and supportive. Probing for answers that the patient is not willing to give is something that you must not do. Also you should not try to prove abuse by accusations, display disapproval of the perpetrator or the situation, place blame or make judgments.
Which of the following best defines the term "values clarification"?
the science that deals with the rightness and wrongness of actions
conduct that results from serious critical thinking about how individuals ought to treat others
a process of self-exploration through which individuals identify and rank their own ideals and concepts that give meaning to their lives
a valid, legally recognized claim or entitlement
Correct answer:
a process of self-exploration through which individuals identify and rank their own ideals and concepts that give meaning to their lives [Show Less]