Ch. 35- Practice Test

Question 1

1. The nurse is discussing the differences between a patient with a neurosis and one with a psychosis. What is true of the patient experiencing a neurosis?

a. The patient experiences a flight from reality.
b. The patient usually needs hospitalization.
c. The patient has insight that there is an emotional problem.
d. The patient has severe personality deterioration.

Answer 1

c. The patient has insight that there is an emotional problem.

Question 2

2. When the patient with a psychosis is thought to be a danger to self or others, by what method should the patient be admitted to the hospital?

a. Probating
b. Nurse’s request
c. Health care provider’s order
d. Family request

Answer 2

a. Probating

Question 3

3. The Diagnostic and Statistical Manual of Psychiatric Disorders, V (DSM-V), is used by
   most hospitals and is the current tool used to examine mental health and illness. What approach does the DSM-V use to classify mental disorders?

a. Holistic system
b. Hierarchical system
c. Multiaxial system
d. Evaluation system

Answer 3

c. Multiaxial system

Question 4

4. When all five axes of the Diagnostic and Statistical Manual of Psychiatric Disorders, V, are used, it provides what type of assessment approach to comprehensive care?

a. Personalized
b. Individualized
c. Holistic
d. Organic

Answer 4

c. Holistic

Question 5

5. A young man with malaria spikes a temperature of 105°F (40.5°C) and begins to
   hallucinate. How should the nurse assess this?

a. Delirium
b. Psychotic break
c. Possible stroke
d. Anxiety disorder

Answer 5

a. Delirium

Question 6

6. A patient admitted for delirium demonstrates increased disorientation and agitation only during the evening and nighttime. What is the term applied to this type of delirium?

a. Disordered thinking
b. Schizophrenia
c. Dementia
d. Sun-downing syndrome

Answer 6

d. Sun-downing syndrome

Question 7

7. Dementia is an organic mental disease secondary to what problem?

a. Chemical imbalance
b. Emotional problems
c. Circulatory impairment
d. Cerebral disease

Answer 7

d. Cerebral disease

Question 8

8. A profound, disabling mental illness is characterized by bizarre, nonreality thinking. What is the illness?

a. Manic depressive
b. Schizophrenia
c. Paranoia
d. Bipolar

Answer 8

b. Schizophrenia

Question 9

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 which type of behavior?

a. Absent behavior
b. Positive behavior
c. Negative behavior
d. False behavior

Answer 9

b. Positive behavior

Question 10

10. The patient talks with his dead brother and arranges furniture so that his brother will have a place to sit. How should the nurse document this behavior?

a. Disordered thinking
b. Anhedonia
c. Hallucination
d. Alogia

Answer 10

c. Hallucination

Question 11

11. What is the prognosis for a schizophrenic patient who is exhibiting positive behaviors?

a. Guarded
b. Poor
c. Good
d. Repeatable

Answer 11

c. Good

Question 12

12. The nurse cautions a patient to watch his step. What response indicates concrete thinking?

a. The patient fixedly begins to watch his feet.
b. The patient immediately examines his watch.
c. The patient begins to watch the nurse’s feet.
d. The patient stands rigidly in one place without moving.

Answer 12

a. The patient fixedly begins to watch his feet.

Question 13

13. The nurse asks a patient with schizophrenia if he had any visitors on Sunday. Which response indicates loose association?

a. “No.”
b. “Yes! I had 90 visitors who came from every state in the union.”
c. “Sunday is the Sabbath. Do we have visitors on the Sabbath?”
d. “We visited Yellowstone Park last summer.”

Answer 13

d. “We visited Yellowstone Park last summer.”

Question 14

14. The nurse is caring for a patient with a diagnosis of catatonic schizophrenia. What behavior is consistent with this diagnosis?

a. Talks excitedly about going home.
b. Suspiciously watches the staff.
c. Stands on one foot for 15 minutes.
d. States he has a cat under his bed that talks to him.

Answer 14

c. Stands on one foot for 15 minutes.

Question 15

15. What is the term used for the beginning stage of schizophrenia, characterized by a lack of energy and complaints of multiple physical problems?

a. Prepsychotic
b. Residual
c. Acute
d. Prodromal

Answer 15

d. Prodromal

Question 16

16. 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 which psychiatric disorder?

a. Unipolar depression
b. Dysthymic disorder
c. Hypomanic episode
d. Bipolar disorder

Answer 16

d. Bipolar disorder

Question 17

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

a. 10% to 15%
b. 20% to 30%
c. 35% to 50%
d. 60% to 80%

Answer 17

d. 60% to 80%

Question 18

18. A home health nurse has a patient who is taking lithium. What should be included in the teaching plan?

a. Examine her skin closely for eruptions.
b. Take her blood pressure twice a day to check for hypertension.
c. Have her drug blood level checked every month.
d. Avoid aged cheese and red wine.

Answer 18

c. Have her drug blood level checked every month.

Question 19

19. The nurse alters the care plan for a patient with depression to include what type of activity?

a. Domino game with three other patients
b. Ping-Pong game with one other patient
c. Group outing to view wildflowers
d. Magazine to read alone

Answer 19

c. Group outing to view wildflowers

Question 20

20. The nurse is assessing a female patient who has become rapidly and exceedingly anxious because her fingernail polish is chipped. What type of anxiety should the nurse conclude that the patient is exhibiting?

a. Signal anxiety
b. General anxiety
c. Anxiety traits
d. Panic disorder

Answer 20

c. Anxiety traits

Question 21

21. 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. How should this be documented?

a. Mania
b. Depression
c. Agoraphobia
d. Anxiety

Answer 21

c. Agoraphobia

Question 22

22. When a patient demonstrates accelerated heart rate, trembling, choking, and chest pain along with acute, intense, and overwhelming anxiety, the nurse should recognize that the patient is most likely experiencing what condition?

a. Terror
b. Fright
c. Fear
d. Panic

Answer 22

d. Panic

Question 23

23. When a patient is experiencing a panic attack, how should the nurse best assist the patient?

a. Assist with reality orientation.
b. Aid in decision making.
c. Assist with rational thought.
d. Coach in deep breathing.

Answer 23

d. Coach in deep breathing.

Question 24

24. 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. What does this behavior represent?

a. Senseless behavior
b. Controlled repetition
c. Obsessive-compulsive
d. Anxiety tension

Answer 24

c. Obsessive-compulsive

Question 25

25. A 14-year-old survivor of a school shooting screams and dives under a table when
    firecrackers go off. What does this behavior represent?

a. Phobia
b. Posttraumatic stress disorder
c. Obsessive-compulsive disorder
d. Disordered thinking

Answer 25

b. Posttraumatic stress disorder

Question 26

26. What should the nurse preparing a patient for a scheduled appointment for
    electroconvulsive therapy (ECT) remind the patient to do?

a. Drink plenty of fluids before ECT to ensure adequate hydration.
b. Bring a change of clothes in case of incontinence.
c. Be prepared for visual disturbances after the treatment.
d. Arrange for transportation to and from the appointment.

Answer 26

d. Arrange for transportation to and from the appointment.

Question 27

27. The nurse is told that a patient believes he was born into the wrong body. What is the correct terminology for the desire to have the body of the opposite sex?

a. Homosexuality
b. Transsexualism
c. Heterosexuality
d. Bisexuality

Answer 27

b. Transsexualism

Question 28

28. The patient complains of recurrent, multiple physical ailments for which there is no organic cause. How should the nurse assess this?

a. Obsessive-compulsive disorder
b. Phobia anxiety disorder
c. Somatic symptom disorder
d. Delusional disorder

Answer 28

c. Somatic symptom disorder

Question 29

29. What disorder is a severe form of self-starvation that can lead to death?

a. Bulimia nervosa
b. Anorexia nervosa
c. Teenage nervosa
d. Obesity nervosa

Answer 29

b. Anorexia nervosa

Question 30

30. The patient is concerned about confidentiality and asks the nurse not to tell anyone what is said. What is the best response by the nurse?

a. “I am required to report any intent to hurt yourself or others.”
b. “Conversations between patient and nurse are confidential.”
c. “What we say can be secret. What I write in the chart is available to the
health team.”
d. “I can’t help you unless you trust me.”

Answer 30

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

Question 31

31. What is the term for 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?

a. Adjunctive
b. Behavior
c. Psychoanalysis
d. Cognitive

Answer 31

c. Psychoanalysis

Question 32

32. What is the typical schedule for electroconvulsive therapy (ECT)?

a. 3 treatments over 2 weeks
b. 6 treatments over 2 months
c. 8 treatments over several weeks
d. 10 treatments over several weeks

Answer 32

d. 10 treatments over several weeks

Question 33

33. 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. What would be the best response of the nurse?

a. “That is a great idea. Alternative therapies can be very helpful.”
b. “You will feel better sooner if you include phenylalanine.”
c. “Did you know that St. John’s wort can raise your blood pressure dramatically?”
d. “You will need to drink lots of water.”

Answer 33

c. “Did you know that St. John’s wort can raise your blood pressure dramatically?”

Question 34

1. Adjunctive therapies are used for which reasons? (Select all that apply.)

a. To increase self-esteem
b. To promote positive interaction
c. To enhance reality orientation
d. To stimulate communication
e. To increase energy

Answer 34

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

Question 35

2. What are considered warning signs of suicide? (Select all that apply.)

a. Talking about suicide
b. Increased interactions with friends and family
c. Drug or alcohol abuse
d. Difficulty concentrating on work or school
e. Personality changes

Answer 35

a. Talking about suicide
c. Drug or alcohol abuse
d. Difficulty concentrating on work or school
e. Personality changes

Question 36

1. The nurse instructs a patient who has just been prescribed a protocol of fluoxetine
   HCl (Prozac) that the drug takes 2 to 4 ________ to take effect.

Answer 36

weeks

Question 37

2. 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 37

aromatherapy

Question 38

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

Answer 38

Somatic