While assessing your patient, Simon, a 63 year old man in the psychiatric unit with a diagnosis of generalized anxiety disorder, he asks you, "Can you
... [Show More] tell me why my family thinks that I am just acting sick to get attention?" Drawing from your knowledge on the impact of mental illness on families, which of the following would you include in your discussion to help Simon see his illness as a real illness? (Select all that apply)
A. Mental health is fundamental to health
B. Mental disorders are r - correct answer A. Mental health is fundamental to health
B. Mental disorders are real health conditions that have an immense impact on individuals and families
C. The efficacy of mental health treatment is well documented.
D. A range of treatments exists for most mental disorders
A 25 year old man barely avoids a motor vehicle accident. His heart is pounding, his palms are sweaty and his respirations are increased. This is an example of which stage of the general adaptation syndrome?
A. Alarm reaction stage
B. Stage of resistance
C. Stage of exhaustion
D. Stage of biological stress - correct answer A. Alarm reaction stage
A client hates her mother because of childhood neglect. The nurse determines which client statement represents the use of the defense mechanism of reaction formation?
A. "I don't like to talk about my relationship with my mother."
B. "My mother hates me."
C. "I have a very wonderful mother whom I love very much."
D. "My mom always loved my sister more than she loved me." - correct answer C. "I have a very wonderful mother whom I love very much."
A nursing student is learning about the human limbic system. Which student statement demonstrates that teaching about the function of the limbic system has been effective?
A. "The limbic system helps stabilize emotional behavior."
B. "The limbic system functions to assist with symbolic thinking."
C. "The limbic system aids in analytical thinking."
"The limbic system helps modulate motor coordination." - correct answer A. "The limbic system helps stabilize emotional behavior."
A client is brought to the emergency department and diagnosed with a panic level of anxiety. What biological system domination would be responsible for this diagnosis?
A. Parasympathetic division of the autonomic nervous system
B. Sympathetic division of the autonomic nervous system
C. The cerebral cortex
D. The cerebellum - correct answer B. Sympathetic division of the autonomic nervous system
An operating room nurse asks a psychiatric nurse "How can you work with the mentally ill day in and day out?" The psychiatric nurse replies "It's just the right thing to do." The psychiatric nurse is operating from which ethical framework?
A. Kantianism
B. Christian Ethics
C. Ethical Egoism
D. Utilitarianism - correct answer A. Kantianism
As a last resort, an agitated physically aggressive client placed in four point restraints. The client yells "I'll sue you for assault and battery." The unit manger determines that the nurses are protected under which condition?
A. The client is voluntarily committed and poses a danger to others on the unit.
B. The client is voluntarily committed and has a history of being a danger to others
C. The client is involuntarily committed because of a history of violent behavior.
D. The client is inv - correct answer A. The client is voluntarily committed and poses a danger to others on the unit.
A nurse gave a client 5mg of haloperidol for agitation. The client's chart was clearly stamped "Allergic haloperidol." The client suffered anaphylactic shock and died. How would the nurse's actions be labeled?
A. Intentional tort
B. Negligence
C. Battery
D. Assault - correct answer B. Negligence
Extrapyramidal side effects are the result of which one of the following?
A. Too much serotonin
B. Dopamine blocking
C. Too little serotonin
D. Too few receptors - correct answer B. Dopamine blocking
Which of the following medications would be an appropriate prn medication for an individual with anxiety symptoms?
A. Buspirone
B. Alprazolam
C. Fluoxetine
D. Sertraline - correct answer B. Alprazolam
A child is taking guanfacine for ADHD. Which of the following would be part of the client education associated with administration of this medication?
A. Do not take with foods that contain tyramine
B. Always use sunblock when spending time outdoors
C. Report for blood tests once a month
D. Do not discontinue the medication abruptly - correct answer D. Do not discontinue the medication abruptly
Which is the primary nursing goal when establishing a therapeutic relationship with a client?
A. To promote client growth
B. To develop the nurse's personal identity
C. To establish a purposeful social interaction
D. To develop communication skills - correct answer
A client threatens to kill himself, his wife, and their children if the wife follows through with divorce proceedings. During the preinteraction phase of the nurse-client relationship, which interaction should the nurse employ?
A. Acknowledging the client's actions and encouraging alternative behaviors
B. Establishing rapport and developing treatment goals
C. Providing community resources on aggression management
D. Exploring personal thoughts and feelings that may adversely impact the provisio - correct answer
The unit manager needs to meet with a client who is exhibiting escalating hostility. Which would be the most appropriate location for the nurse to meet with this client?
A. the client's room with the door shut
B. A quiet corner of the day room
The nurse's station
The unit's treatment room - correct answer
As the move out date to leave the shelter gets closer, a battered wife states, "I'm afraid to leave here. I'm afraid for my safety and the safety of my children." Which nursing statement is most supportive?
A. "This is a difficult situation. Let's formulate a plan to keep you all safe in the community."
B. "It's the policy that client can only live here for 30 days. Maybe we can ask for more time."
C. "You've had a month to come up with a plan for keeping you and your family safe."
D. "Hopefull - correct answer
The nurse is performing an initial assessment on a newly admitted client who is oriented times four. Which of the following communication techniques would best facilitate obtaining accurate and complete client data?
A. closed-ended questions
B. requesting an explanation
C. open-ended questions
D. Interpreting - correct answer
The physician orders a computed tomography scan for a client that is having problems with short-term memory loss. On which lobe of the cerebrum will the study focus?
1. Occipital
2. Frontal
3. Temporal
4. Parietal - correct answer 3. Temporal
Option 1:
The primary functions of the occipital lobe are visual reception and interpretation.
Option 2:
The primary functions of the frontal lobe are voluntary body movement, including movements that permit speaking, as well as thinking, judgment formation, and expression of feelings.
Option 3:
The primary functions of the temporal lobe are hearing, short-term memory, sense of smell, and expression of emotions through connection with limbic system.
Option 4:
The primary functions of the parietal lobe are perception and interpretation of most sensory information (including touch, pain, taste, and body position).
The hypothalamus is located just above the pituitary gland. Which of the following would be considered major functions of this region of the forebrain?
1. Integration of sensory input
2. Regulation of the pituitary gland
3. Regulation of visual interpretation
4. Blocking of minor sensations - correct answer 2. Regulation of the pituitary gland
Option 1:
The thalamus integrates all sensory input.
Option 2:
The hypothalamus regulates the pituitary gland.
Option 3:
The thalamus regulates visual interpretation.
Option 4:
The thalamus is also involved in temporarily blocking minor sensations so that an individual can concentrate on one important event.
The registered nurse is teaching a group of student nurses about the effects of psychotropic medications on neurotransmitters. Which statement made by the registered nurse needs correction?
1. "Increased sweating, insomnia, and tremors are the side effects associated with selective serotonin reuptake inhibitors."
2. "Chlorpromazine is useful in the treatment of intractable hiccoughs."
3. "Depression, decreased libido, and stress intolerance are the side effects associated with antipsychotic me - correct answer 1. "Increased sweating, insomnia, and tremors are the side effects associated with selective serotonin reuptake inhibitors."
Option 1:
Selective serotonin reuptake inhibitors (SSRIs) are the potent inhibitors of serotonin reuptake. Sweating, insomnia, and tremors are the side effects associated with the blockade of norepinephrine reuptake. Therefore, these side effects are not associated with SSRIs as they do not block norepinephrine reuptake.
Option 2:
Chlorpromazine is an antipsychotic useful in the treatment of psychosis and intractable hiccoughs.
Option 3:
Prolactin hypersecretion is a side effect associated with antipsychotics. The behavioral symptoms associated with prolactin hypersecretion are depression, decreased libido, and stress intolerance.
Option 4:
Moclobemide is a monoamine oxidase (MAO) inhibitor. The reason for the hypertensive crisis with the MAO inhibitors is interaction of medication with tyramine.
The hypothalamus is located just above the pituitary gland. Which is a major function of this region of the forebrain?
1. Integrates all sensory input
2. Responsible for emotional experience
3. Regulates the appetite
4. Temporarily blocks minor sensations - correct answer 3. Regulates the appetite
Option 1:
The thalamus integrates all sensory input.
Option 2:
The limbic system is responsible for the experience of emotions.
Option 3:
The hypothalamus regulates the appetite.
Option 4:
The thalamus is involved in temporarily blocking minor sensations so that an individual can concentrate on one important event.
Which neurotransmitter is decreased in clients with schizophrenia?
1. Glutamate
2. Norepinephrine
3. Dopamine
4. Serotonin - correct answer 1. Glutamate
Option 1:
Glutamate and aspartate are decreased in clients with schizophrenia.
Option 2:
Norepinephrine is increased in clients with mania, anxiety states, and schizophrenia.
Option 3:
Dopamine is decreased in clients with Parkinson's disease and depression.
Option 4:
Serotonin is decreased in clients with depression.
The RN is educating a nursing student about dopamine. Which statement made by the nursing student indicates a need for further education?
1.
"People with Parkinson's disease experience a decrease in dopamine."
2.
"Dopamine is a neurotransmitter that is released by the pituitary."
3.
"Increased dopamine levels have been found in people with schizophrenia."
4.
"Decreased dopamine levels are noted in people with depression." - correct answer 2. "Dopamine is a neurotransmitter that is released by the pituitary."
Option 1:
People with Parkinson's disease present with a decrease in dopamine levels.
Option 2:
Dopamine is released by the hypothalamus. This statement indicates a need for further education.
Option 3:
People with schizophrenia are found to have increased dopamine levels.
Option 4:
People with depression do have a decrease in dopamine levels.
The nurse is caring for a client who experienced a cerebral vascular accident (CVA) in the occipital lobe of the brain. Which deficit will the nurse find when doing an assessment?
1.
Taste
2.
Speech
3.
Vision
4.
Smell - correct answer 3. Vision
Option 1:
Damage to the parietal lobe will lead to problems with taste.
Option 2:
Damage to the frontal lobe will lead to problems with speech.
Option 3:
Damage to the occipital lobe will lead to problems with vision.
Option 4:
Damage to the temporal lobe will lead to problems with smell.
Which neurotransmitter(s) might show decreased levels in a client with a diagnosis of schizophrenia?
1.
Glutamate and aspartate
2.
Norephinephrine
3.
Dopamine
4.
Serotonin - correct answer 1. Glutamate and aspartate
Option 1:
Glutamate and aspartate exist in decreased levels in clients with schizophrenia.
Option 2:
Norepinephrine levels are increased in mania, anxiety states, and schizophrenia.
Option 3:
Dopamine levels are decreased in clients with Parkinson disease and also in clients with depression.
Option 4:
Serotonin levels are decreased in clients with depression.
Which physiological activity occurs at sustained stress during the "fight or flight" syndrome?
1.
Increased libido
2.
Decreased metabolic rate
3.
Decreased fluid retention
4.
Increased gluconeogenesis - correct answer 4.
Increased gluconeogenesis
The nurse is preparing a care plan for a client who is experiencing the second Kubler-Ross stage of grief. Which intervention in the care plan will help to reduce these symptoms in the client?
1.
Secluding the client for some time
2.
Enhancing the self-esteem of the client
3.
Providing health education to the client
4.
Teaching the client proper decision-making - correct answer 1.
Secluding the client for some time
Which basic need is at the top of Maslow's hierarchy of needs?
1.
Protection
2.
Affection
3.
Self-respect
4.
Self-fulfillment - correct answer 4.
Self-fulfillment
The nurse is managing a support group for clients who have lost spouses. Which client is demonstrating behaviors of acceptance?
1.
A client who is very quiet and appears sad and depressed
2.
A client who pleads with a higher power for help to get through the tough time
3.
A client who is angry at friends who go out on dates with their spouses
4.
A client who has found hobbies and interests with others - correct answer 4.
A client who has found hobbies and interests with others
Which are common responses that can be observed in a client with general adaptation syndrome? Select all that apply.
1.
Alarm
2.
Resistance
3.
Exhaustion
4.
Reflex pain response
5.
Inflammatory response - correct answer 1.
Alarm
2.
Resistance
3.
Exhaustion
Which biological responses occur at the sustained stage of stress during the "fight or flight" syndrome? Select all that apply.
1.
Decreased fluid retention
2.
Decreased immune response
3.
Decreased retention of sodium
4.
Decreased inflammatory response
5.
Decreased basal metabolic rate (BMR) - correct answer 2.
Decreased immune response
4.
Decreased inflammatory response
Which biological response occurs at the initial stage of stress during "fight or flight" syndrome?
1.
Lipogenesis
2.
Constriction of pupils
3.
Increase in intestinal motility
4.
Increase in lacrimal secretions - correct answer 4.
Increase in lacrimal secretions
The nurse informs a client that his/her spouse was killed in an automobile accident. The client begins to scream "No, no, that's a lie!" while covering her ears and rocking back and forth. Which stage of grief would the nurse anticipate next?
1.
Denial
2.
Anger
3.
Bargaining
4.
Depression - correct answer 2.
Anger
While assessing a client, the nurse learns that client has been diagnosed with anxiety in the past. The client also he or she is afraid of "going crazy." Which level of anxiety will the nurse expect to see when reviewing the client's previous history? [Show Less]