Midterm Review Chapters 15, 16, 25, 26, and 30

Question 1

What is the most commonly used antidepressant?

Answer 1

benzodiazepine

Question 2

T/F

Benzodiazepines are used for long-term drug therapy.

Answer 2

false; short-term

Question 3

__________ used shortly before delivery can result in a dystonia and muscle weakness in the newborn baby known as floppy infant syndrome.

A. SSRIs
B. benzodiazepines
C. antihistamines
D. antipsychotics

Answer 3

B. benzodiazepines

Question 4

__________ enhance the inhibitory effects of gamma-aminobutyric acid in the CNS; relief from anxiety occurs rapidly following administration.

A. SSRIs
B. MAOIs
C. barbiturates
D. benzodiazepines

Answer 4

D. benzodiazepines

Question 5

T/F

Buspirone is effective in managing anxiety and can be taken for long-term treatment of anxiety.

Answer 5

true

Question 6

Does buspirone cause sedation?

Answer 6

no

Question 7

Buspirone is contraindicated for concurrent use with __________, or 14 days after __________ are d/c.

Answer 7

MAOIs ; MAOIs

Question 8

T/F

You can take buspirone with food.

Answer 8

true

Question 9

Therapy that involves teaching and physical practice of activities to decrease anxious to avoidant behavior.

Answer 9

behavioral therapy

Question 10

Name this type of behavioral therapy.

the therapist or significant other acts as a role model to demonstrate appropriate behavior in a feared situation, and then the patient imitates it.

A. thought stopping
B. modeling
C. flooding
D. systemic desensitization

Answer 10

B. modeling

Question 11

Name this type of behavioral therapy.

the patient is gradually introduced to a feared object or experience through a series of steps, from the least frightening to the most frightening.

A. thought stopping
B. modeling
C. flooding
D. systemic desensitization

Answer 11

D. systemic desensitization

Question 12

Name this type of behavioral therapy.

This method exposes the patient to a large amount of an undesirable stimulus in an effort to extinguish the anxiety response.

A. thought stopping
B. modeling
C. flooding
D. systemic desensitization

Answer 12

C. flooding

Question 13

Name this type of behavioral therapy.

interrupting a negative thought of obsession

A. thought stopping
B. modeling
C. flooding
D. systemic desensitization

Answer 13

A. thought stopping

Question 14

intense excessive anxiety or fear about being in places or situations from which escape might be difficult or embarrassing or where help might not be available

Answer 14

agoraphobia

Question 15

a feeling of apprehension, uneasiness, uncertainty, or dread resulting from a real or perceived threat

Answer 15

anxiety

Question 16

ritualistic behaviors individuals feel driven to perform in an attempt to reduce anxiety or prevent an imagined calamity

Answer 16

compulsions

Question 17

automatic coping styles that protect people from anxiety and enable them to maintain their self-image by blocking feelings, conflicts, and memories

Answer 17

defense mechanisms

Question 18

the most extreme level of anxiety and results in markedly deregulated behavior

Answer 18

panic

Question 19

first-line of PTSD treatment

Answer 19

SSRIs

Question 20

The nurse is providing care for a patient demonstrating behaviors associated with moderate levels of anxiety. What question should the nurse ask initially in attempting to help the patient de-escalate the anxiety?

A. “Do you know what will help manage your anxiety?”
B. “Do you need help to manage your anxiety?”
C. “Can you identify what was happening when your anxiety began to increase?”
D. “Are you feeling anxious right now?”

Answer 20

C. “Can you identify what was happening when your anxiety began to increase?”

Question 21

Which patient is at increased risk for the development of anxiety and will require frequent assessment by the nurse? (SATA)

A. exacerbation of asthma signs and symptoms
B. history of peanut and strawberry allergies
C. history of COPD
D. current treatment for unstable angina pectoris
E. history of a TBI

Answer 21

A. exacerbation of asthma signs and symptoms
C. history of COPD
D. current treatment for unstable angina pectoris
E. history of a TBI

Question 22

Which medication should the nurse be prepared to educate patients on when they are prescribed an SSRI for panic attacks?

A. alprazolam (Xanax)
B. fluoxetine (Prozac)
C. clonazepam (Klonopin)
D. Venlafaxine (Effexor)

Answer 22

B. fluoxetine (Prozac)

Question 23

Which statement or statements made by the nurse demonstrates an understanding of the effective use of relaxation therapy for anxiety management? (SATA)

A. “Relaxation therapy’s main goal is to prevent exhaustion by removing muscle tension.”
B. “Muscle relaxation promotes the relaxation response.”
C. “Show me how you learned to deep breathe in yesterday’s therapy session.”
D. “You’ve said that going to group makes you nervous, so let’s start relaxing now.”
E. “I’ve given you written descriptions of the various relaxation exercises for you to review.”

Answer 23

B. “Muscle relaxation promotes the relaxation response.”
C. “Show me how you learned to deep breathe in yesterday’s therapy session.”
D. “You’ve said that going to group makes you nervous, so let’s start relaxing now.”
E. “I’ve given you written descriptions of the various relaxation exercises for you to review.”

Question 24

Isabel is a straight-A student, yet she suffers from severe test anxiety and seeks medical attention. The nurse interviews Isabel and develops a plan of care. The nurse recognizes effective teaching about mild anxiety when Isabel states the following:

A.”I would like to try a benzodiazepine for my anxiety.”
B. “If I study harder, my anxiety level will go down.”
C. “Mild anxiety is okay because it helps me to focus.”
D. “I have fear that I will fail at college.”

Answer 24

C. “Mild anxiety is okay because it helps me to focus.”

Question 25

The activity of GABA contributes to a slowing of neural activity. Which of the following drugs facilitate the action of GABA?

A. benzodiazepines
B. antihistamines
C. anticonvulsants
D. noradrenergics

Answer 25

A. benzodiazepines

Question 26

A homebound patient diagnosed with agoraphobia has been reviewing therapy at home. The nurse recognizes effective teaching when the patient states the following:

A. “I may never leave the house again.”
B. “Having groceries delivered is very convenient.”
C. “My risk for agoraphobia is increased by my family history.”
D. “I will go out again someday, just not today.”

Answer 26

C. “My risk for agoraphobia is increased by my family history.”

Question 27

A nurse is assessing a client who has generalized anxiety disorder. Which of the following findings should the nurse expect? (SATA)

A. excessive worry for 6 months
B. impulsive decision-making
C. delayed reflexes
D. restlessness
E. sleep disturbances

Answer 27

A. excessive worry for 6 months

D. restlessness

E. sleep disturbances

Question 28

A nurse is caring for a client who is experiencing a panic attack. Which of the following actions should the nurse take?

A. discuss new relaxation techniques
B. show the client how to change the behavior
C. distract the client with a television show
D. stay with the client, and remain quiet

Answer 28

D. stay with the client, and remain quiet

Question 29

A nurse is caring for a client who is to begin taking fluoxetine for treatment of panic disorder. Which of the following statements indicates the client understands the use of this medication?

A. “I will take the medication at bedtime.”
B. “I will follow a low-sodium diet while taking this medication.”
C. “I will need to discontinue this medication slowly.”
D. “I will be at risk for weight loss with long-term use of this medication.”

Answer 29

C. “I will need to discontinue this medication slowly.”

Question 30

Children with __________ have a consistent pattern of inhibited and emotionally withdrawn behavior.

A. disinhibited social engagement disorder
B. reactive attachment disorder
C. PTSD
D. bipolar disorder

Answer 30

B. reactive attachment disorder

Question 31

Children with this disorder demonstrate no normal fear of strangers.

A. disinhibited social engagement disorder
B. reactive attachment disorder
C. PTSD
D. bipolar disorder

Answer 31

A. disinhibited social engagement disorder

Question 32

Which SSRIs are approved for the treatment of PTSD?

Answer 32

sertraline (Zoloft)
paroxetine (Paxil)

Question 33

T/F

Psychiatric disorders are risk factors for suicide.

Answer 33

true

Question 34

Which patient statement does not demonstrate an understanding of a suicide plan?

A. “Going for a really long, hard run helps clear my mind and stops the suicidal thoughts.”
B. “I will take extra medication if I start getting those self-destructive feelings.”
C. “My sister is always there for me when I start getting suicidal.”
D. “I keep the suicide prevention phone number in my wallet.”

Answer 34

B. “I will take extra medication if I start getting those self-destructive feelings.”

Question 35

Which intervention will help make the environment on the unit safer for patients with suicidal ideation? (SATA)

A. all windows are kept locked
B. every shower has a breakaway shower rod
C. eating utensils are counted when trays are collected
D. patient doors are kept open
E. staying within listening distance of the patient

Answer 35

A. all windows are kept locked

B. every shower has a breakaway shower rod

C. eating utensils are counted when trays are collected

D. patient doors are kept open

Question 36

What are the nursing responsibilities to a patient expressing suicidal thoughts? (SATA)

A. instituting one-to-one observation
B. documenting the patient’s whereabouts and mood every 15 to 30 minutes.
C. ensuring that the patient has no contact with glass or metal utensils
D. ensuring that the patient has swallowed each individual dose of medication
E. discussing triggers of depression

Answer 36

A. instituting one-to-one observation

B. documenting the patient’s whereabouts and mod every 15 to 30 minutes.

C. ensuring that the patient has no contact with glass or metal utensils

D. ensuring that the patient has swallowed each individual dose of medication

Question 37

When considering community suicide prevention programs, what population should the nurse plan to service with regular suicide screenings? (SATA)

A. 10 to 34 year olds
B. males
C. college-educated adults
D. rural population
E. Native Americans

Answer 37

A. 10 to 34 year olds

B. males

E. Native Americans

Question 38

Research supports that which intervention implemented on a long-term basis significantly reduces the incidence of suicide and suicide attempts in a patient diagnosed with bipolar disorder?

A. antipsychotic medication
B. electroconvulsive therapy
C. one-on-one observation
D. lithium

Answer 38

D. lithium

Question 39

Gladys is seeing a therapist because her husband died by suicide 6 months ago. Gladys tells her therapist, “I know he was in pain, but why didn’t he leave me a note?” The therapist’s best response would be:

A. “He probably acted quickly on his impulse to kill himself.”
B. “He did not want to think about the pain he would cause you.”
C. “He was not able to think clearly due to his emotional pain.”
D. “He thought you may think it was an accident if there was no note.”

Answer 39

C. “He was not able to think clearly due to his emotional pain.”

Question 40

Kara is a 23-year-old patient admitted with major depressive disorder and suicidal ideation. Which intervention(s) would be therapeutic for Kata? (SATA)

A. focus primarily on developing solutions to the problems that lead the patient to feel suicidal
B. assess the patient thoroughly and reassess the patient at regular intervals as levels of risk fluctuate
C. avoid talking about the suicidal ideation as this may increase the patient’s risk for suicidal behavior
D. meet regularly with the patient to provide opportunities for the patient to express and explore feelings
E. administer antidepressant medications cautiously and conservatively because of their potential to increase the suicide risk in Kara’s age group
F. help the patient to identify positive self-attributes and to question negative self-perceptions that are unrealistic

Answer 40

B. assess the patient thoroughly and reassess the patient at regular intervals as levels of risk fluctuate

D. meet regularly with the patient to provide opportunities for the patient to express and explore feelings

E. administer antidepressant medications cautiously and conservatively because of their potential to increase the suicide risk in Kara’s age group

F. help the patient to identify positive self-attributes and to question negative self-perceptions that are unrealistic

Question 41

You are caring for Connor, an 8-year-old boy who has been diagnosed with reactive attachment disorder. Which of the following nursing outcomes would be the most appropriate to achieve?

A. increases ability to self-control and decreases impulsive behavior
B. avoids situations that trigger conflicts
C. expresses complex thoughts
D. writes or draws feelings in a journal

Answer 41

D. writes or draws feelings in a journal

Question 42

A young child is found wandering alone at a mall. A male store employee approaches and ask where her parents are. She responds, “I don’t know. Maybe you will take me home with you?” This sort of response in children may be due to:

A. a lack of bonding as an infant
B. a healthy confidence in the child
C. adequate parental bonding
D. normal parenting

Answer 42

A. a lack of bonding as an infant

Question 43

Which statement made to the grieving patient demonstrates effective therapeutic communication? (SATA)

A. “Your loved one was irreplaceably special.”
B. “It must be comforting to know that he is with God now.”
C. “You can be very grateful for the time you had together.”
D. “I would like to take the flowers from the funeral home to your house.”
E. “Your loss must be devastating. I can’t imagine how you must be feeling right now.”

Answer 43

A. “Your loved one was irreplaceably special.”

D. “I would like to take the flowers from the funeral home to your house.”

E. “Your loss must be devastating. I can’t imagine how you must be feeling right now.”

Question 44

Dying patients with a neurocognitive disorder such as Alzheimer’s disease are especially challenging to provide care for. They may have symptoms or pain that they are unable to adult describe or define. What is a reversible condition that could respond to an intervention and improve anxiety, or agitation?

A. inability to communicate
B. distended bladder, constipation, or nausea
C. reduced urinary output
D. weakness due to the dying process

Answer 44

B. distended bladder, constipation, or nausea

Question 45

Which statement concerning a crisis experience is true and should be used as a guideline for crisis management care? (SATA)

A. a crisis is self-limiting and usually resolves within 4 to 6 weeks
B. the earlier the interventions are implemented, the better the expected prognosis
C. the nurse should maintain a non-directive role
D. the patient in crisis is assumed to be mentally unhealthy and in an extreme state of disequilibrium
E. the goal of crisis management is to return the patient to at least the pre-crisis level of functioning

Answer 45

A. a crisis is self-limiting and usually resolves within 4 to 6 weeks

B. the earlier the interventions are implemented, the better the expected prognosis

E. the goal of crisis management is to return the patient to at least the pre-crisis level of functioning