FINAL Ch 35

Question 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

ANS: C

Question 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

ANS: A

Question 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

ANS: C

Question 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

ANS: C

Question 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

ANS: A

Question 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. Sundowning syndrome

Answer 6

ANS: D

Question 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

ANS: D

Question 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

ANS: B

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 which type of behavior?
a. Absent behavior
b. Positive behavior
c. Negative behavior
d. False behavior

Answer 9

ANS: B

Question 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

ANS: C

Question 11

What is the prognosis for a schizophrenic patient who is exhibiting positive behaviors?
a. Guarded
b. Poor
c. Good
d. Repeatable

Answer 11

ANS: C

Question 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

ANS: A

Question 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

ANS: D

Question 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

ANS: C

Question 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

ANS: D

Question 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

ANS: D

Question 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

ANS: D

Question 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

ANS: C

Question 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

ANS: C

Question 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

ANS: C

Question 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

ANS: C

Question 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

ANS: D

Question 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

ANS: D

Question 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

ANS: C

Question 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

ANS: B

Question 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

ANS: D

Question 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

ANS: B

Question 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

ANS: C

Question 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

ANS: B

Question 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

ANS: A

Question 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

ANS: C

Question 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

ANS: D

Question 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

ANS: C