QUIZ 2 PRACTICE QUESTIONS

Question 1

Which patient statement would the nurse attribute to a neurobiological basis of mental disease?
a. “I like to eat all day long.”
b. “I sleep 7 hours nightly.”
c. “I have a number of close friends.”
d. “I enjoy solving word puzzles.

Answer 1

a. “I like to eat all day long.”

Question 2

Which of the following medication orders would the nurse
question?
a. Buspirone hydrochloride—take in the morning
b. Temazepam—take at bedtime
c. Zopiclone—take early in the morning
d. Flurazepam—take at bedtime

Answer 2

c. Zopiclone—take early in the morning

Question 3

Which patient statement would require the nurse to provide further teaching?
a. “I should report any unusual bleeding when I take gingko biloba.”
b. “I should not take St. John’s wort with sertraline hydrochloride.”
c. “Natural health products are safe because they are made with all-natural ingredients.”
d. “I will tell my doctor that I am taking a natural health product.”

Answer 3

c. “Natural health products are safe because they are made with all-natural ingredients.”

Question 4

The nurse is caring for a patient who is taking lithium. Which adverse effect would the nurse anticipate?
a. Oliguria
b. Confusion
c. Constipation
d. Hyperthyroidism

Answer 4

b. Confusion

Question 5

5. The nurse understands that norepinephrine is involved with the stimulation of which bodily process?
   a. The fight-or-flight response to stress
   b. The hypothalamus to release hormones
   c. Involvement in the inflammatory response
   d. The parasympathetic nervous system

Answer 5

a. The fight-or-flight response to stress

Question 6

Since learning that he will have a trial pass to a new group home tomorrow, Bill’s behaviour has changed. He has started to pace rapidly, has become very distracted, and is breathing
rapidly. He has trouble focusing on anything other than the group home issue and complains that he suddenly feels very
nauseated. Which initial nursing response is most appropriate for Bill’s level of anxiety?
a. “You seem anxious. Would you like to talk about how you are feeling?”
b. “If you do not calm down, I will have to give you medicine to calm you.”
c. “Bill, slow down. Listen to me. You are safe. Take a nice, deep breath.”
d. “We can delay the visit to the group home if that would help you calm down.”

Answer 6

c. “Bill, slow down. Listen to me. You are safe. Take a nice, deep breath.”

Question 7

A patient who seems to be angry when his family again
fails to visit as promised tells the nurse that he is fine and
that the visit was not important to him anyway. When the
nurse suggests that perhaps he might be disappointed or
even a little angry that the family has again let him down,
the patient responds that it is his family who is angry, not
him, or else they would have visited. Which of the following
defence mechanisms is this patient using to deal with his
feelings?
a. Rationalization
b. Introjection
c. Regression
d. Dissociation

Answer 7

a. Rationalization

Question 8

John, a construction worker, is on duty when a wall under
construction suddenly falls, crushing a number of co-workers.
Shaken initially, he seems to be coping well with the tragedy
but later begins to experience tremors, nightmares, and periods
during which he feels numb or detached from his environment.
He finds himself frequently thinking about the tragedy and
feeling guilty that he was spared while many others died.
Which statement about this situation is most accurate?
a. John is experiencing post-traumatic stress disorder (PTSD)
and requires therapy.
b. John has acute stress disorder and should be treated with
antianxiety medications.
c. John is experiencing anxiety and grief and should be
monitored for PTSD symptoms.
d. John is experiencing mild anxiety and a normal grief
reaction; no intervention is needed.

Answer 8

c. John is experiencing anxiety and grief and should be
monitored for PTSD symptoms.

Question 9

A patient states that she has been ill for several months
with stomach pain, headache, and dizziness. A review of her
records shows that she has been tested repeatedly for various
conditions, She has been diagnosed with dyspepsia and vertigo.
She states that her pain is “10 out of 10” on a scale of 1 to 10.
She has been treated in the past for anxiety and depression.
Which condition should the nurse anticipate?
a. Illness anxiety disorder
b. Somatic symptom disorder
c. Dissociation disorder
d. Generalized anxiety disorder

Answer 9

a. Illness anxiety disorder

Question 10

An older adult in the outpatient internal medicine clinic
complains of feeling a sense of dread and fearfulness without
apparent cause. It has been growing steadily worse and is to
the point that it is interfering with the patient’s sleep and
volunteer work. After a brief interview and cursory physical
exam, the nurse diagnoses the patient with generalized anxiety
disorder and suggests a referral to the mental health clinic.
Which responses by the medical clinic nurse would be the
priority response?
a. Complete the referral to the mental health clinic.
b. Meet with the patient’s family to discuss treatment options
for generalized anxiety disorder.
c. Instruct the client in deep-breathing and basic cognitive
behavioural techniques for coping with worry.
d. Suggest that a battery of blood tests, including a complete
blood count (CBC), be ordered and reviewed.

Answer 10

d. Suggest that a battery of blood tests, including a complete
blood count (CBC), be ordered and reviewed.

Question 11

The nurse is caring for a patient who exhibits disorganized thinking and delusions. The patient repeatedly states, “I hear voices of aliens trying to contact me.” The nurse should recognize this presentation as which type of major depressive
disorder (MDD)?
a. Catatonic
b. Atypical
c. Melancholic
d. Psychotic another woman.”
d. “I hate myself.”

Answer 11

d. Psychotic another woman.”

Question 12

2. Which patient statement indicates learned helplessness?
   a. “I am a horrible person.”
   b. “Everyone in the world is just out to get me.”
   c. “It’s all my fault that my husband left me for

Answer 12

c. “It’s all my fault that my husband left me for

Question 13

3. The nurse is planning care for a patient with depression who
   will be discharged to home soon. What aspect of teaching
   should be the priority on the nurse’s discharge plan of care?
   a. Pharmacological teaching
   b. Safety risk
   c. Awareness of symptoms of increasing depression
   d. The need for interpersonal contact

Answer 13

b. Safety risk

Question 14

4. The nurse is reviewing orders given for a patient with depression. Which order should the nurse question?
   a. A low starting dose of a tricyclic antidepressant
   b. An SSRI given initially with an MAOI
   c. Electroconvulsive therapy to treat suicidal thoughts
   d. Elavil to address the patient’s agitation

Answer 14

b. An SSRI given initially with an MAOI

Question 15

5. Which of the following are considered vegetative signs of
   depression?
   a. Hallucinations and delusions
   b. Expressions of guilt and worthlessness
   c. Feelings of helplessness and hopelessness
   d. Changes in physiological functioning such as appetite and sleep disturbances

Answer 15

d. Changes in physiological functioning such as appetite and sleep disturbances

Question 16

6. Which assessment question asked by the nurse demonstrates
   an understanding of comorbid mental health conditions
   associated with major depressive disorder? Select all that apply.
   a. “Do rules apply to you?”
   b. “What do you do to manage anxiety?”
   c. “Do you have a history of disordered eating?”
   d. “Do you think that you drink too much?”
   e. “Have you ever been arrested for committing a crime?”

Answer 16

b. “What do you do to manage anxiety?”
c. “Do you have a history of disordered eating?”
d. “Do you think that you drink too much?”

Question 17

7. Which chronic medical condition is a common trigger for
   major depressive disorder?
   a. Pain
   b. Hypertension
   c. Hypothyroidism
   d. Crohn’s disease

Answer 17

c. Hypothyroidism

Question 18

1. Which behaviour exhibited by a person with mania should
   the nurse choose to address first?
   a. Indiscriminate sexual relations
   b. Excessive spending of money
   c. Declaration of “being at one with the world”
   d. Demonstration of flight of ideas

Answer 18

a. Indiscriminate sexual relations

Question 19

2. The nurse is caring for a person experiencing mania. Which
   is the most appropriate nursing intervention?
   a. Provide consistency among staff members when working
   with the person
   b. Negotiate limits so the person has a voice in the plan of
   care
   c. Allow only certain staff members to interact with the person
   d. Attempt to control the person’s emotions

Answer 19

a. Provide consistency among staff members when working
with the person

Question 20

3. The nurse is planning care for a person experiencing the
   acute phase of mania. Which is the priority intervention?
   a. Prevent injury
   b. Maintain stable cardiac status
   c. Get the person to demonstrate thought self-control
   d. Ensure that the person gets sufficient sleep and rest

Answer 20

a. Prevent injury

Question 21

4. What critical information should the nurse provide about
   the use of lithium?
   a. “You will still have hypersexual tendencies, so be certain
   to use protection when engaging in intercourse.”
   b. “Lithium will help you to feel only the euphoria of mania
   but not the anxiety.”
   c. “It will take 1 to 2 weeks and maybe longer for this
   medication to start working fully.”
   d. “This medication is a cure for bipolar disorder.”

Answer 21

c. “It will take 1 to 2 weeks and maybe longer for this
medication to start working fully.”

Question 22

5. The nurse has provided education for a person in the continuation phase, after discharge from the hospital. What
   indicates that the plan of care has been successful? Select all
   that apply.
   a. Person identifies three signs and symptoms of relapse.
   b. Person states, “My wife doesn’t mind if I still drink a little.”
   c. Person reports that medication has been helpful but he is
   ready to stop.
   d. Person states, “I no longer have a disease.”

Answer 22

a. Person identifies three signs and symptoms of relapse.

Question 23

6. Luc’s family comes home one evening to find him extremely
   agitated and they suspect in a full manic episode. The family
   calls emergency medical services. While one medic is talking
   with Luc and his family, the other medic is counting something
   on his desk. What is the medic most likely counting?
   a. Hypodermic needles
   b. Fast food wrappers
   c. Empty soda cans
   d. Energy drink containers

Answer 23

c. Empty soda cans

Question 24

7. Which nursing responses demonstrate accurate information that should be discussed with the female patient diagnosed
   with bipolar disorder and her support system? Select all that apply.
   a. “Remember that alcohol and caffeine can trigger a relapse of your symptoms.”
   b. “Due to the risk of a manic episode, you should not take birth control pills.”
   c. “It’s critical to let your health care provider know immediately if you aren’t sleeping well.”
   d. “Is your family prepared to be actively involved in helping you manage this disorder?”
   e. “The physical symptoms tend to come and go, so you need to be able to recognize the early signs.”

Answer 24

a. “Remember that alcohol and caffeine can trigger a relapse of your symptoms.”
c. “It’s critical to let your health care provider know immediately if you aren’t sleeping well.”
d. “Is your family prepared to be actively involved in helping you manage this disorder?”

Question 25

Which characteristic in an adolescent female is sometimes
associated with the prodromal phase of schizophrenia?
a. Always afraid another student will steal her belongings
b. An unusual interest in numbers and specific topics
c. Demonstrates no interest in athletics or organized sports
d. Appears more comfortable among males

Answer 25

b. An unusual interest in numbers and specific topics

Question 26

Which nursing intervention is particularly well chosen for addressing a population at high risk for developing schizophrenia?
a. Screening a group of males between the ages of 15 and 25 for early symptoms
b. Forming a support group for females ages 25 to 35 who are diagnosed with substance use issues
c. Providing a group for patients between the ages of 45 and 55 with information on coping skills that have proven to be effective
d. Educating the parents of a group of developmentally
delayed 5- to 6-year-olds on the importance of early intervention

Answer 26

a. Screening a group of males between the ages of 15 and 25 for early symptoms

Question 27

To provide effective care for the patient diagnosed with schizophrenia, the nurse should frequently assess for which associated conditions? Select all that apply.
a. Alcohol use disorder
b. Major depressive disorder
c. Stomach cancer
d. Polydipsia
e. Metabolic syndrome

Answer 27

a. Alcohol use disorder
b. Major depressive disorder
d. Polydipsia
e. Metabolic syndrome

Question 28

A female patient diagnosed with schizophrenia has been prescribed a first-generation antipsychotic medication. What information should the nurse provide to the patient regarding her signs and symptoms?
a. Her memory problems will likely decrease.
b. Depressive episodes should be less severe.
c. She will probably enjoy social interactions more.
d. She should experience a reduction in hallucinations.

Answer 28

d. She should experience a reduction in hallucinations.

Question 29

Which characteristic presents the greatest risk for injury to others by the patient diagnosed with schizophrenia?
a. Depersonalization
b. Pressured speech
c. Negative symptoms
d. Paranoia

Answer 29

d. Paranoia

Question 30

Gilbert, age 19, is described by his parents as a “moody
child” with an onset of odd behaviour at about age 14, which
caused Gilbert to suffer academically and socially. Gilbert
has lost the ability to complete household chores, is reluctant
to leave the house, and is obsessed with the locks on the
windows and doors. Due to Gilbert’s early and slow onset
of what is now recognized as schizophrenia, his prognosis
is considered:
a. Favourable with medication
b. In the relapse stage
c. Improvable with psychosocial interventions
d. To have a less positive outcome

Answer 30

d. To have a less positive outcome

Question 31

Which therapeutic communication statement might a
psychiatric mental health registered nurse use when a patient’s
nursing diagnosis is Altered thought processes?
a. “It must be difficult to hear voices like that, though I
cannot hear them.”
b. “Stop listening to the voices, they are NOT real.”
c. “You say you hear voices; what are they telling you?”
d. “Just tell the voices to leave you alone for now.”

Answer 31

a. “It must be difficult to hear voices like that, though I
cannot hear them.”

Question 32

When patients diagnosed with schizophrenia suffer from
anosognosia, they often refuse medication, believing that:
a. Medications provided are ineffective.
b. Nurses are trying to control their minds.
c. The medications will make them sick.
d. They are not actually ill.

Answer 32

d. They are not actually ill.

Question 33

Kyle, a patient with schizophrenia, began to take the
first-generation antipsychotic haloperidol (Haldol) last week.
One day you find him sitting very stiffly and not moving.
He is diaphoretic, and when you ask if he is okay he seems
unable to respond verbally. His vital signs are BP 170/100,
P 110, T 40.1°C/104.2°F. What is the priority nursing
intervention?
a. Hold his medication and contact his prescriber.
b. Wipe him with a washcloth wet with cold water or alcohol.
c. Administer a medication such as benztropine IM to correct
this dystonic reaction.
d. Reassure him that although there is no treatment for his
tardive dyskinesia, it will pass.
e. Hold his medication for now and consult his prescriber
when he comes to the unit later today.

Answer 33

a. Hold his medication and contact his prescriber.

Question 34

Tomas is a 21-year-old male with a recent diagnosis of
schizophrenia. Tomas’s nurse recognizes that self-medicating
with excessive alcohol is common in this disease and can
co-occur along with:
a. Generally good health despite the mental illness
b. An aversion to drinking fluids
c. Anxiety and depression
d. The ability to express his needs

Answer 34

c. Anxiety and depression

Question 35

A person complains that most staff do not like her or care
what happens to her, but says that you are special and she
can tell that you are a caring person. She talks with you about
being unsure of what she wants to do with her life and her
“mixed-up feelings” about relationships. When you tell her that
you will be on vacation next week, she becomes very angry.
Two hours later, she is found using a curling iron to burn her
underarms and explains that it “makes the numbness stop.”
Given this presentation, you would deduce that this person
most likely has which personality disorder?
a. Obsessive-compulsive
b. Borderline
c. Antisocial
d. Schizotypal

Answer 35

b. Borderline

Question 36

Which statement about people with personality disorders is
most accurate?
a. Unlike those with mood or psychotic disorders, they are
at very low risk for suicide.
b. They tend not to perceive themselves as having a problem
but instead believe that their problems are caused by how
others behave toward them.
c. They are believed to be purely psychological disorders,
that is, disorders arising from psychological rather than
neurological or other physiological abnormalities.
d. Their symptoms are not as disabling as most other mental
disorders; therefore their care tends to be less challenging
and less complicated for staff.

Answer 36

b. They tend not to perceive themselves as having a problem
but instead believe that their problems are caused by how
others behave toward them.

Question 37

life-threatening) self-inflicted cuts on her forearm. Which
response would be most therapeutic?
a. Convey empathy and explore issues that led to the self-injury
as you administer first aid to the wounds.
b. Care for the wounds; then search the person for sharp
objects, and place the person on one-to-one observation
or in seclusion for her own safety.
c. Recognizing that the self-injury is, at its heart, a maladaptive
attempt to obtain attention, extinguish the behaviour by
minimizing the attention paid to it.
d. Maintain a neutral demeanour while dressing the wounds,
and then assign the person to write a list of circumstances
that led to the injury before discussing it further

Answer 37

d. Maintain a neutral demeanour while dressing the wounds,
and then assign the person to write a list of circumstances
that led to the injury before discussing it further

Question 38

A patient is flirting with a peer and is overheard asking him
to intercede with staff so that she will be given privileges to
leave the inpatient mental health unit. Later, she offers a back
rub to a nurse if that nurse will give her the prn sedation
(sedation as needed) early, although it has been ordered for
1000 hours. Which response to such behaviours would be
most therapeutic?
a. Inform the patient that she is being manipulative.
b. Advise the other nurses that this patient is being manipulative and that they should ignore her when she behaves
this way.
c. Bargain with the patient to determine a reasonable compromise regarding how much of such behaviour is
acceptable before the patient crosses the line.
d. Ignore the behaviour for the time being so that the patient
will find it unrewarding and in turn seek other, hopefully
more adaptive, ways to meet her needs

Answer 38

a. Inform the patient that she is being manipulative.

Question 39

A person becomes frustrated and angry when trying to get
his MP3 player and headset to function properly and angrily
throws it across the room, nearly hitting a peer with it. Which
intervention would be the most therapeutic?
a. Place the person in seclusion for 1 hour to allow him to
de-escalate and think about his behaviour.
b. Point out that the behaviour is unacceptable.
c. Offer to help him learn about the operation of the MP3
player.
d. Explore with the person his feelings as he works out how
to operate his MP3 player.

Answer 39

d. Explore with the person his feelings as he works out how
to operate his MP3 player.

Question 40

Which statement about violence and nursing is accurate?
a. Unless working in psychiatric or mental health settings,
nurses are unlikely to experience patient violence.
b. About 3 in 10 nurses will face an injury due to patient
violence during their careers.
c. Emergency, psychiatric, and step-down units have the
highest rates of violence toward staff.
d. Violence primarily affects inexperienced or unskilled staff
who cannot calm their patients

Answer 40

b. About 3 in 10 nurses will face an injury due to patient
violence during their careers.

Question 41

A nurse working with a patient who describes himself as
“always angry” should assess the patient for which problems?
Select all that apply.
a. Pain
b. Dementia
c. Tachycardia
d. Hypertension
e. Traumatic brain injury

Answer 41

a. Pain
b. Dementia
c. Tachycardia
d. Hypertension
e. Traumatic brain injury

Question 42

Which statements by a patient indicate an increased likelihood
of violent behaviour? Select all that apply.
a. “People push me, but they can only push me so far.”
b. “I have a right to feel angry, and right now I am angry.”
c. “You are really stupid. I’d get better nursing care from a
monkey.”
d. “A man has to do what a man has to do when somebody
crosses him.”
e. “This is frustrating; I wish people would leave me alone.
That’s what would help me.”

Answer 42

a. “People push me, but they can only push me so far.”
c. “You are really stupid. I’d get better nursing care from a
monkey.”
d. “A man has to do what a man has to do when somebody
crosses him.”

Question 43

A nurse, Sarah, responds to loud, angry voices coming from
the day room, where she finds that Mr. Christopher is pacing
and shouting that he “isn’t going to take this (expletive)
anymore.” Which reaction by Sarah is likely to be helpful in
de-escalating the situation with Mr. Christopher?
a. Acts calm, quiet, and in control.
b. States, “You are acting inappropriately and must calm
yourself now.”
c. Matches the patient’s volume level so that he is able to
hear over his own shouting.
d. Stands close to the patient so she can intervene physically,
if needed, to protect others.

Answer 43

a. Acts calm, quiet, and in control.

Question 44

Andrea, a patient, is anxiously waiting her turn to speak with
a nurse. The nurse is very busy, however, and asks Andrea if
she can wait a few minutes so she can finish her task. The
nurse is distracted and forgets her promise temporarily, and
45 minutes pass before the nurse remembers and approaches
Andrea. On seeing the nurse, Andrea accuses the nurse of
lying and refuses to speak with her. Which response by the
nurse is most likely to be therapeutic at this time?
a. “You seem angry that I didn’t speak with you when I
promised I would.”
b. “Look, I’m sorry for being late, but screaming at me is not
the best way to handle it.”
c. “You are too angry to talk right now. I’ll come back in 20
minutes and we can try again.”
d. “Why are you angry? I told you that I was busy and would
get to you soon as I could.”

Answer 44

a. “You seem angry that I didn’t speak with you when I
promised I would.”