Midterm Study Guide

Question 1

Maslow’s hierarchy of needs?

Answer 1

Physiological (food & shelter)
Safety ( personal & financial)
Love and belonging ( social & friendships)
Self esteem
Self actualization (personal growth)

Question 2

After several therapeutic encounters with a suicidal patient, which thought by the nurse would be countertransference?

Answer 2

The nurses feels unusually happy when the patient’s mood begins to lift

Question 3

A patient diagnosed with schizophrenia states “I saw two doctors in the hall taking. They are plotting against me.” The nurse knows this is:

Answer 3

Ideas of reference

Question 4

A patient with schizophrenia taking fluphenazine has shuffle gait, drooling, mask like face. The nurse knows this is:

Answer 4

Pseudoparkinsonism

Question 5

Haloperidol can cause you to feel these side effects:

Answer 5

Sedation and muscle stiffness

Question 6

Patient with bipolar disorder tells other patients to get him a book and water. The nurse’s best therapeutic action is:

Answer 6

Distraction techniques: offer a snack

Question 7

A person is making obscene gestures and directing traffic on a busy street, has not slept or eatened in days: what symptoms of mania are present:

Answer 7

Poor judgement and hyperactivity

Question 8

A patient receiving risperidone reports severe muscle stiffness, then is diaphoretic, drooling and difficulty swallowing . What is the nurse best intervention?

Answer 8

Call the doctor STAT. Possible neuroleptic malignant syndrome

Question 9

The nurse received a lab report indicating a patient’s lithium serum level is 1mEq/L. The patient’s last dose was 8 hours ago.

Answer 9

This lab value is within normal limits

Question 10

Patient diagnosed with depressive disorder begins SSRI antidepressant therapy. The nurse should provide education on:

Answer 10

Report increased suicide ideation.

Question 11

A nurse instructs a patient taking MAOIs to avoid certain foods (Tyramine) and drugs. What would be the risk for?

Answer 11

Hypertensive crisis due to high levels of Tyramine.

Question 12

Tyramine restricted meal, what foods are ok?

Answer 12

Mashed potatoes
Ground beef
Corn
Green beans
Apple pie

Question 13

Patient’s family reported that patient was taking antidepressants and started having chest pain after eating avocados and cheese. What antidepressants med would this be?

Answer 13

Isocarboxazid

Question 14

The nurse understands that second generation antipsychotic (SGAs) atypical agents may cause which side effect?

Answer 14

Obesity

Question 15

A patient who exhibits concrete thinking is unable to communicate in which manner?

Answer 15

Abstractly

Question 16

Why should the nurse introduce the matter of a contract during the first session with a new patient?

Answer 16

To explain the participation and responsibilities of each party

Question 17

Patient says “my marriage is great. My spouse and usually agree on everything.” The nurse observes the patients foot moving continuously

Answer 17

This is mixed communication

Question 18

An anticonvulsant medication for bipolar disorder

Answer 18

Carbamazepine

Question 19

Which information gathered from the ER patient requires crisis intervention?

Answer 19

New onset of hallucinations

Question 20

Which side effect of antipsychotic medication therapy is not reversible?

Answer 20

Tardive Dyskinesia ( ex. pill rolling of hands) these are permanent

Question 21

Which part of the nursing process is often neglected ?

Answer 21

Evaluation

Question 22

Patient with bipolar disorder cusses while twirling, patient’s mood is what?

Answer 22

Labile and euphoric

Question 23

Which nursing intervention demonstrates false imprisonment?

Answer 23

The nurse tells the patient to stay in their room until later

Question 24

What assessment findings suggest patient may be hallucinating?

Answer 24

Darting eyes. Tilting head and mumbling to self

Question 25

Which of the following supports the diagnosis of severely depressed patient?

Answer 25

Insomnia.
Flat affect
Substantial weight loss.
Reports “I don’t have anymore tears to cry”.

Question 26

A client says “I’m all alone in the world, I have no reason to live’” which would encourage further communication?

Answer 26

You sound like you’re feeling lonely and frightened

Question 27

A patient says she is Queen Elizabeth, what is this?

Answer 27

Grandiose Delusion

Question 28

Which assessment is most important when evaluating s/s of mental illness?

Answer 28

The client’s social and cultural norms

Question 29

A patient with MDD remains in his room and avoids others. According to Erickson, what describes his developmental task?

Answer 29

Isolation

Question 30

True statements of neurotransmitters

Answer 30

• are responsible for essential functions in human emotions and behaviors
• targets or the mechanism of action of many psychotropic medications

Question 31

Which function does the limbic system regulate?

Answer 31

Emotional experiences (flight or fight).

Question 32

What is the nurse’s primary goal during the assessment phase of nursing process for a patient with depressive disorder?

Answer 32

To collect and organize information

Question 33

Which nursing intervention would establish trust with a client experiencing concrete thinking?

Answer 33

Being consistent and adhering to unit guidelines

Question 34

Behaviors of countertransference?

Answer 34

• the nurse defends the client’s inappropriate behavior to the psychiatrist
• the nurse subjectively appreciates the client’s feelings
• the nurse is uneasy when interacting with the client

Question 35

Which determines the scope of practice for RN employed in a psychiatric inpatient facility?

Answer 35

State law, which may vary from state to state.

Question 36

The right to determine one’s own destiny is to “autonomy” as the duty to benefit or promote the good of others is to:

Answer 36

Beneficence

Question 37

Which client does not have the ability to refuse meds?

Answer 37

A client who is an imminent danger to him or herself

Question 38

A patient says “my children are refusing to visit me. I feel like giving up.” Which Erickson’s stage is she in?

Answer 38

Integrity vs Despair

Question 39

A client has been fired and says “imagine what I can do with all this time”. What defense mechanism is this?

Answer 39

Intellectualization

Question 40

Examples of cognitive responses to mild levels of anxiety?

Answer 40

Increased concentration and heightened alertness

Question 41

Example of behavior response to moderate levels of anxiety?

Answer 41

Restlessness

Question 42

Example of physical response to a panic level of anxiety?

Answer 42

Dilated pupils

Question 43

What are true about crisis?

Answer 43

• specific to an individual and cause may vary
• precipitated by specific identifiable event
• contains potential for psychological growth or deterioration

Question 44

Which statement suggest podromal syndrome has occurred

Answer 44

Behaviors associated with podromol syndrome necessitate immediate action by the nurse .

Question 45

Etiology of OCD from a biological theory perspective?

Answer 45

Abnormalities in various regions of the brain have been implicated in the cause of OCD.

Question 46

Medications can be used for anxiety disorders

Answer 46

Buspirone
Alprazolam
Clonidine
Fluvoxamine

Question 47

Which situations would Benzo be prescribed appropriately?

Answer 47

Short term treatment of general anxiety disorder (GAD), alcohol induced withdrawal and preop sedation

Question 48

What symptoms are seen when client abruptly stops taking diazepam?

Answer 48

Tremor
Insomnia
Delirium

Question 49

Which non therapeutic communication technique can make a person feel interrogated?

Answer 49

Excessive questioning

Question 50

Which scenario is most urgent to act as a patient advocate?

Answer 50

A homeless adult with schizophrenia where a category 5 hurricane is.

Question 51

What is the therapeutic level of lithium for treatment of bipolar?

Answer 51

0.4 to 1 mEq/L

Question 52

A persecution delusion (false belief) with schizophrenia is what.

Answer 52

False belief that one is being singled out for harm by another .

Question 53

What is serotonin syndrome?

Answer 53

Overaction of the central serotonin receptors due to high dose of SSRI