Care of the Patient with a Psychiatric Disorder

Question 1

The nurse discussing the differences between a patient with a neurosis and one with a psychosis explains that the patient experiencing neurosis:

Answer 1

has insight that there is an emotional problem.

An individual with a neurosis has insight that he or she has an emotional problem.

Question 2

When the patient with a psychosis is thought to be a danger to self or others, the admission to the hospital is by:

Answer 2

Probating can be done if the individual is thought to be a danger to self or others.

Question 3

The Diagnostic and Statistical Manual, 4th edition, text revision (DSM-IV-TR), is used by most hospitals and is the current tool used to examine mental health and illness. This tool is a(n):

Answer 3

multiaxial system.

Question 4

When all five axes of the Diagnostic and Statistical Manual, 4th edition, text revision (DSM-IV-TR) are used, it provides an assessment approach to comprehensive care called:

Answer 4

Using all five axes will provide a holistic assessment.

Question 5

When a young man with malaria spikes a temperature of 105° F and begins to hallucinate, the nurse assesses this as:

Answer 5

delirium.

An organic mental disorder is delirium that is frequently brought on by a severe physical illness.

Question 6

A patient admitted for delirium demonstrates increased disorientation and agitation only during the evening and nighttime. The nurse documents this as:

Answer 6

A patient with sundowning syndrome displays increased disorientation and agitation only during evening and nighttime.

Question 7

The nurse clarifies that dementia is a slow, progressive loss of brain function, which is an organic mental disease secondary to:

Answer 7

secondary to cerebral disease.

Question 8

The nurse observes a patient’s behavior to assess thought process disorders characterized by bizarre, nonreality thinking. This behavior is indicative of the most profound, disabling mental illness, which is:

Answer 8

Schizophrenia, a thought process disorder, is one of the most profoundly disabling mental illnesses.

Question 9

A patient believes himself to be the president of the United States and that terrorists are trying to kidnap him. The nurse records these observations as:

Answer 9

positive behaviors.

Prognosis for those exhibiting positive behavior patterns of delusions, hallucinations, and disordered thinking is good.

Question 10

The patient talks with his dead brother and arranges furniture so that his brother will have a place to sit. The nurse documents this behavior as:

Answer 10

A hallucination is a sensory experience without a stimulus trigger.

Question 11

The nurse recognizes during her assessment of schizophrenic individuals that they can exhibit positive or negative behaviors. The positive behaviors may be delusions, hallucinations, and disordered thinking. The prognosis for these patients is:

Answer 11

Prognosis for individuals exhibiting positive behavior patterns is good.

Question 12

When a patient who introduces herself as a famous movie star and treats everyone and everything in the environment as if it were a movie set, the nurse documents this behavior as:

Answer 12

A delusion is a false, fixed belief.

Question 13

When the nurse cautions a patient to watch his step, the nurse assesses evidence of concrete thinking when the patient:

Answer 13

fixedly begins to watch his feet.
-Concreteness is an indication of disordered thinking. The patient is unable to translate any words except by a very concrete definition.

Question 14

If the nurse asks a patient with schizophrenia if any visitors came on Sunday, the response that indicates loose association is:

Answer 14

“We visited Yellowstone Park last summer.”

-Disordered thinking occurs when the individual cannot interpret information and the conversation does not flow.

Question 15

The nurse is caring for a patient with a diagnosis of catatonic schizophrenia. The behavior consistent with this diagnosis is the patient:

Answer 15

stands on one foot for 15 minutes.

Maintaining a rigid pose for long periods of time is an example of behavior expected from a catatonic schizophrenic.

Question 16

When the adolescent begins to demonstrate lack of energy and motivation and withdraws, complaining of multiple physical problems, it may be that this is the beginning of a stage of schizophrenia called:

Answer 16

The prodromal phase often begins in adolescence and begins with lack of energy or motivation and withdrawal.

Question 17

For the past 3 weeks, the nurse has observed a patient interacting with staff and other patients, helping decorate the dining room for a party, and leading the singing in the activity room. Today, the patient tearfully refuses to dress or get out of bed. The nurse recognizes these behaviors as evidence of:

Answer 17

bipolar disorder
Mood disorders are also known as affective disorders. Bipolar disorders cause the patient to suddenly shift in emotions from one extreme to the other.

Question 18

The nurse recognizes that researchers have identified that hereditary factors account for what percentage of mood disorders?

Answer 18

Research indicates that hereditary factors account for 60% to 80% of mood disorders.

Question 19

A home health nurse cautions the patient taking lithium that she should be sure to:

Answer 19

Lithium has a very narrow therapeutic window. The drug blood levels must be checked monthly.

Question 20

The nurse alters the care plan for a patient with depression to include activities such as a:

Answer 20

group outing to view wildflowers.
The quiet, noncompetitive trip to view wildflowers would be the best option. Depressed people should not be put in situations where they must concentrate or compete.

Question 21

The nurse is assessing a patient who has become rapidly and exceedingly anxious because her fingernail polish is chipped. If the patient has remained in a prolonged state of anxiety, the nurse concludes the patient is demonstrating:

Answer 21

anxiety traits- has anxious reactions to relatively nonstressful events.

Question 22

The home health nurse assesses a patient who creates elaborate excuses for not leaving home. Further questioning reveals the patient had not left home for 6 months. The nurse documents these findings as:

Answer 22

Agoraphobia is a high level of anxiety in which an anxiety attack could occur in individuals who avoid other people, places, or events.

Question 23

When a patient demonstrates accelerated heart rate, trembling, choking, and chest pain along with acute, intense, and overwhelming anxiety, the nurse recognizes the patient is most likely experiencing:

Answer 23

Panic can be defined as an attack of acute, intense, and overwhelming anxiety.

Question 24

When a patient is experiencing a panic attack, the nurse coaches the patient in:

Answer 24

deep breathing.-Coaching in relaxation techniques such as deep breathing is an effective intervention.

Question 25

A patient is frequently late for appointments because he goes back to his room numerous times to assure himself that none of his belongings have been stolen. The nurse recognizes this behavior as:

Answer 25

Obsessive-compulsive disorders have two features: thoughts that are recurrent, intrusive, and senseless; and behaviors that are performed repeatedly and ritualistically.

Question 26

A 14-year-old survivor of a school shooting screams and dives under a table when firecrackers go off. The nurse recognizes this behavior as a manifestation of:

Answer 26

Post-traumatic stress disorder describes a response to an intense traumatic experience that is beyond the usual range of human experience.

Question 27

The nurse preparing a patient for a scheduled appointment for electroconvulsive therapy (ECT) reminds the patient to:

Answer 27

If the patient has not arranged for adequate transportation to and from the appointment, the treatment will be canceled because driving after ECT is dangerous.

Question 28

The nurse is told that a patient believes he was born into the wrong body. The nurse recognizes this desire to have the body of the opposite sex as:

Answer 28

Transsexualism is a persistent desire to be the opposite sex and to have the body of the opposite sex.

Question 29

The patient complains of recurrent, multiple physical ailments for which there is no organic cause. The nurse assesses this behavior as:

Answer 29

Somatoform disorder is characterized by recurrent, multiple physical complaints for which there is no organic cause.

Question 30

The nurse recognizes that a severe form of self-starvation that can lead to death is called:

Answer 30

Anorexia nervosa is a severe form of self-starvation that can lead to death.

Question 31

The patient is concerned about confidentiality and asks the nurse not to tell anyone what is said. The nurse’s best response is:

Answer 31

“I am required to report any intent to hurt yourself or others.”

-No secrets are allowed to be kept by a member of the health care team.

Question 32

A long-term and intense form of psychotherapy developed by Sigmund Freud that allows a patient’s unconscious thoughts to be brought to the surface is called:

Answer 32

Psychoanalysis technique was developed by Sigmund Freud and is a long-term and intense therapy.

Question 33

The nurse recognizes that electroconvulsive therapy (ECT) treatments will generally be scheduled for:

Answer 33

ECT is done as a treatment for depression, mania, and schizoaffective disorders that have not responded to other treatments. The usual protocol is 10 treatments over 7 weeks.

Question 34

A patient who is taking a monoamine oxidase inhibitor (MAOI) asks the nurse about the addition of St. John’s wort to help with his depression. The nurse’s best response is:

Answer 34

St. John’s wort can raise blood pressure dramatically in people who are also taking MAOIs.

Question 35

Adjunctive therapies are used for which reason(s)? (Select all that apply.)

Answer 35

a. To increase self-esteem
b. To promote interaction
c. To enhance reality orientation

Question 36

The nurse recognizes that a woman who has experienced physical abuse and has inadequate income to care for herself and her family would be categorized under Axis

Answer 36

Axis 4 queries the environmental and psychosocial information of a patient.

Question 37

The nurse instructs a patient who has just been prescribed a protocol of fluoxetine HCl (Prozac) that the drug takes ____ to ____ weeks to take effect.

Answer 37

Antidepressants of this type take 2 to 4 weeks before any effect is felt by the patient.

Question 38

The nurse explains that an alternative therapy that uses essential oils and scented candles to help a patient relax and focuses on the atmosphere of the moment is

Answer 38

Aromatherapy- uses essential oils and scented candles to soothe the senses and make people aware of the here and now of the pleasant environment.

Question 39

The nurse recognizes that stress can cause an ulcer, which is classified as a _______________ illness.

Answer 39

psychophysical