Test bank Flashcards
when providing respectful, appropriate nursing care, how should the nurse identify the patient and his or her observable characteristics?
a. The manic patient in room 234
b. The patient in room 234 is a manic
c. The patient in room 234 is possibly a manic
d. The patient in room 234 is displaying manic behavior
D
Recognizing the frequency of depression among the American population, the nurse should advocate for which mental health promotion intervention?
a. Including discussions on depression as part of school health classes
b. Providing regular depression screening for adolescent and teenage students
c. Increasing the number of community-based depression hotlines available to the public
d. Encouraging senior centers to provide information on accessing community depression resources
B
Which statement made by a patient demonstrates a healthy degree of resilience? Select all that apply.
a. “I try to remember not to take other people’s bad moods personally.”
b. “I know that if I get really mad, I’ll end up being depressed.”
c. “I really feel that sometimes bad things are meant to happen.”
d. “I’ve learned to calm down before trying to defend my opinions.”
e. “I know that discussing issues with my boss would help me get my point across.”
A, D, E
Which statement demonstrates the nurse’s understanding of the effect of environmental factors on a patient’s mental health?
a. “I’ll need to assess how the patient’s family views mental illness.”
b. “There is a history of depression in the patient’s extended family.”
c. “I’m not familiar with the patient’s cultural view on suicide.”
d. “The patient’s ability to pay for mental health services needs to be assessed.”
C
When considering stigmatization, which statement made by the nurse demonstrates a need for immediate intervention by the nurse manager?
a. “Depression seems to be a real problem among the teenage population.”
b. “My experience has been that the Irish have a problem with alcohol use.”
c. “Women are at greater risk for developing suicidal thoughts than acting on them.”
d. “We’ve admitted several military veterans with posttraumatic stress disorder this month.”
B
A nursing student new to psychiatric-mental health nursing asks a peer what resources he can use to figure out which symptoms are present in a specific psychiatric disorder. The best answer would be:
a. National Institute of Mental Illness
b. National Alliance on Mental Illness
c. International Classification for Nursing Practice
d. DSM
D
Epidemiological studies contribute to improvements in care for individuals with mental disorders by: (select all that apply)
a. Providing information about effective nursing techniques.
b. Identifying risk factors that contribute to the development of a disorder.
c. Identifying individuals in the general population who will develop a specific disorder.
d. Identifying which individuals will respond favorably to a specific treatment.
B, D
Which of the following activities would be considered nursing care and appropriate to be performed by a basic level nurse for a patient suffering from mental illness?
a. Treating major depressive disorder
b. Teaching coping skills for a specific family dynamic
c. Conducting psychotherapy
d. Prescribing antidepressant medication
B
Which statement about mental illness is true?
a. Mental illness is a matter of individual nonconformity with societal norms.
b. Mental illness is present when irrational and illogical behavior occurs.
c. Mental illness changes with culture, time in history, political systems, and the groups defining it.
d. Mental illness is evaluated solely by considering individual control over behavior and appraisal of reality.
C
The World Health Organization describes health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Which statement is true in regard to overall health? Select all that apply.
a. There is no relationship between physical and mental health.
b. Poor physical health can lead to mental distress and disorders
c. Poor mental health does not lead to physical illness.
d. There is a strong relationship between physical health and mental health.
e. Mental health needs take precedence over physical health needs.
B, D
Which statement made by either the nurse or the patient demonstrates an ineffective patient-nurse relationship?
a. “I’ve given a lot of thought about what triggers me to be so angry.”
b. “Why do you think it’s acceptable for you to be so disrespectful to staff?”
c. “Will your spouse be available to attend tomorrow’s family group session?”
d. “I wanted you to know that the medication seems to be helping me feel less anxious.”
B
The patient expresses sadness at “being all alone with no one to share my life with.” Which response by the nurse demonstrates the existence of a therapeutic relationship?
a. “Loneliness can be a very painful and difficult emotion.”
b. “Let’s talk and see if you and I have any interests in common.”
c. “I use Facebook to find people who share my love of cooking.”
d. “Loneliness is managed by getting involved with people.”
A
Which patient outcome is directly associated with the goals of a therapeutic nurse-patient relationship?
a. Patient will be respectful of other patients on the unit.
b. Patient will identify suicidal feelings to staff whenever they occur.
c. Patient will engage in at least one social interaction with the unit population daily.
d. Patient will consume a daily diet to meet both nutritional and hydration needs.
B
What is the greatest trigger for the development of a patient’s nurse-focused transference?
a. The similarity between the nurse and someone the patient already dislikes
b. The nature of the patient’s diagnosed mental illness
c. The history the patient has with the patient’s parents
d. The degree of authority the nurse has over the patient
D
Which patient statement demonstrates a value held regarding children?
a. “Nothing is more important to me than the safety of my children.”
b. “I believe my spouse wants to leave both me and our children.”
c. “I don’t think my child’s success depends on going to college.”
d. “I know my children will help me through my hard times.”
A
Mary is a 39-year-old attending a psychiatric outpatient clinic. Mary believes that her husband, sister, and son cause her problems. Listening to Mary describe the problems, the nurse displays therapeutic communication in which response?
a. “I understand you are in a difficult situation.”
b. “Thinking about being wronged repeatedly does more harm than good.”
c. “I feel bad about your situation, and I am so sorry it is happening to you and your family.”
d. “It must be so difficult to live with uncaring people.”
A
A registered nurse is caring for an older male who reports depressive symptoms since his wife of 54 years died suddenly. He cries, maintains closed body posture, and avoids eye contact. Which nursing action describes attending behavior?
a. Reminding the patient gently that he will “feel better over time”
b. Using a soft tone of voice for questioning
c. Sitting with the patient and taking cues for when to talk or when to remain silent
d. Offering medication and bereavement services
C
A male patient frequently inquires about the female student nurse’s boyfriend, social activities, and school experiences. Which is the best initial response by the student?
a. The student requests assignment to a patient of the same gender as the student.
b. She limits sharing personal information and stresses the patient-centered focus of the conversation.
c. The student shares information to make the therapeutic relationship more equal.
d. She explains that if he persists in focusing on her, she cannot work with him.
B
Morgan is a third-year nursing student in her psychiatric clinical rotation. She is assigned to an 80-year-old widow admitted for major depressive disorder. The patient describes many losses and sadness. Morgan becomes teary and says meaningfully, “I am so sorry for you.” Morgan’s instructor overhears the conversation and says, “I understand that getting tearful is a human response. Yet, sympathy isn’t helpful in this field.” The instructor urges Morgan to focus on:
a. “Adopting the patient’s sorrow as your own”
b. “Maintaining pure objectivity”
c. “Using empathy to demonstrate respect and validation of the patient’s feelings”
d. “Using touch to let her know that everything is going to be alright”
C
Emily is a 28-year-old nurse who works on a psychiatric unit. She is assigned to work with Jenna, a 27-year-old who was admitted with major depressive disorder. Emily and Jenna realize that they graduated from the same high school and each has a 2-year-old daughter. Emily and Jenna discuss getting together for a play date with their daughters after Jenna is discharged. This situation reflects:
a. Successful termination
b. Promoting interdependence
c. Boundary blurring
d. A strong therapeutic relationship
C
What assessment question is focused on identifying a long-term consequence of chronic stress on physical health?
a. “Do you have any problems with sleeping well?”
b. “How many infections have you experienced in the past 6 months?”
c. “How much moderate exercise do you engage in on a regular basis?”
d. “What management techniques do you regularly use to manage your stress?”
B
Which nursing assessments are directed at monitoring a patient’s fight-or-flight response? Select all that apply.
a. Blood pressure
b. Heart rate
c. Respiratory rate
d. Abdominal pain
e. Dilated pupils
A, B, C, E
The patient you are assigned unexpectedly suffers a cardiac arrest. During this emergency situation, your body will produce a large amount of:
a. Carbon dioxide
b. Growth hormone
c. Epinephrine
d. Aldosterone
C
Which question is focused on the assessment of an individual’s personal ability to manage stress? Select all that apply.
a. “Have you ever been diagnosed with cancer?”
b. “Do you engage in any hobbies now that you have retired?”
c. “Have you been taking your antihypertensive medication as it is prescribed?”
d. “Who can you rely on if you need help after you’re discharged from the hospital?”
e. “What do you do to help manage the demands of parenting a 4-year-old and a newborn?”
B, D, E
When considering stress, what is the primary goal of making daily entries into a personal journal?
a. Providing a distraction from the daily stress
b. Expressing emotions to manage stress
c. Identifying stress triggers
d. Focusing on one’s stress
C
Jackson has suffered from migraine headaches all of his life. Fatima, his nurse practitioner, suspects muscle tension as a trigger for his headaches. Fatima teaches him a technique that promotes relaxation by using:
a. Biofeedback
b. Guided imagery
c. Deep breathing
d. Progressive muscle relaxation
D
Hugo is 21 and diagnosed with schizophrenia. His history includes significant turmoil as a child and adolescent. Hugo reports his father was abusive and routinely beat him, all of his siblings, and his mother. Hugo’s early exposure to stress most likely:
a. Made him resilient to stressful situations
b. Increased his future vulnerability to psychiatric disorders
c. Developed strong survival skills
d. Shaped his nurturing nature
B
Hugo has a fraternal twin named Franco who is unaffected by mental illness, even though they were raised in the same dysfunctional household. Franco asks the nurse, “Why Hugo and not me?” The nurse replies:
a. “Your father was probably less abusive to you.”
b. “Hugo likely has a genetic vulnerability.”
c. “You probably ignored the situation.”
d. “Hugo responded to perceived threats by focusing on an internal world.”
B
First responders and emergency department healthcare providers often use dark humor in an effort to:
a. Reduce stress and anxiety
b. Relive the experience
c. Rectify moral distress
d. Alert others to the stress
A
Your 39-year-old patient Samantha, who was admitted with anxiety, asks you what the stress-relieving technique of mindfulness is. The best response is:
a. Mindfulness is focusing on an object and repeating a word or phrase while deep breathing.
b. Mindfulness is progressively tensing, then relaxing, body muscles.
c. Mindfulness is focusing on the here and now, not the past or future, and paying attention to what is going on around you.
d. Mindfulness is a memory system to assist you in short-term memory recall.
C
Which intervention demonstrates the nurse’s understanding of what guides effective nursing care with a diverse patient population?
a. Treating all patients the same to avoid prejudicial actions.
b. Identifying the cultural norms of the population being served.
c. Recognizing that race and ethnicity result in specific illness management views.
d. Addressing the physical and emotional needs that originate from genetic factors.
B
Which statement indicates the beliefs and values that tend to be representative of a member of an Indigenous culture? Select all that apply.
a. “I’ve reinforced the importance of taking medications at the time they are prescribed.”
b. “The patient believes that illness is a result of being out of harmony with nature.”
c. “Spending money on medicine for his diabetes is not a comfortable concept for my patient.”
d. “The patient refuses treatment.”
e. “We discussed the patient’s needs regarding warding off evil spirits before her surgery.”
A, B, C, E
Which assessment questions will support effective communication with a patient who recently emigrated from an Asian country? Select all that apply.
a. “What do you call this kind of pain?”
b. “What do you think is causing your pain?”
c. “How do you think your pain should be treated?”
d. “Do you consider this kind of pain a serious problem?”
e. “Do you think American medicine will help your pain?”
A, B, C, D
When one is considering culturally competent care for a Muslim patient diagnosed with cardiac problems, which intervention is particularly important initially when a low-fat diet is prescribed?
a. Requesting a dietary consult
b. Identifying dietary considerations
c. Explaining the importance of a low-fat diet
d. Including the family in conversation about food preparation
B
Which statement by the nurse demonstrates ethnocentrism toward the Latinx patient?
a. “What do you want us to do to help your symptoms?”
b. “Tell me more about what you think is causing these symptoms.”
c. “I’m sure we can do something to make your symptoms more manageable.”
d. “How much have these symptoms made it more difficult for you to go to work?”
C
Ling has a nursing diagnosis of risk for violence. Ling’s Eastern culture family is having difficulty coping with the illness because of their beliefs. A favorable therapeutic modality for this patient might include
a. outpatient therapy.
b. family therapy.
c. long-term inpatient care.
d. assimilation therapy.
B
A nurse practitioner is interviewing a female patient from Southeast Asia. She complains of stomach pain and chest discomfort. Knowing that the patient’s adult son died in a car accident a month earlier, the nurse suspects
a. vulnerability.
b. acid reflux.
c. somatization.
d. transference.
C
Which nursing intervention can help a Hindu patient to maintain his religious practice?
a. Helping the patient to choose his own food from the menu
b. Contacting the hospital pastor for a visit
c. Showing him which side of the room faces east
d. Offering him a Torah
A
Intergenerational conflict may arise in immigrant families because the process of acculturation may be
a. ignored due to cultural beliefs.
b. filled with traumatic experiences.
c. easier for children.
d. a function of assimilation
C
Which nursing actions demonstrate cultural competence? Select all that apply.
a. Planning mealtime around the patient’s prayer schedule
b. Helping a patient to visit with the hospital chaplain
c. Researching foods that a lacto-ovo-vegetarian patient will eat
d. Providing time for a patient’s spiritual healer to visit
e. Ordering standard meal trays to be delivered three times daily
A, B, C, D
What is the purpose of the Health Insurance Portability and Accountability Act (HIPAA)? Select all that apply.
a. Ensuring that an individual’s health information is protected
b. Providing third-party players with access to patient’s medical records
c. Facilitating the movement of a patient’s medical information to the interested parties
d. Guaranteeing that all those in need of healthcare coverage have options to obtain it
e. Allowing healthcare providers to obtain health information to provide high-quality healthcare.
A, E
Which intervention demonstrates a nurse’s understanding of the initial action associated with the assessment of a patient’s spiritual beliefs?
a. Offering to pray with the patient
b. Providing a consult with the facility’s chaplain
c. Asking the patient what role spirituality plays in his daily life
d. Arranging for care to be provided with respect to religious practices
C
Which nursing interventions best demonstrate an understanding of the Quality and Safety Education in Nursing (QSEN) competences? Select all that apply.
a. Asking the patient what she expects from the treatment she is receiving
b. Seeking recertification for cardiopulmonary resuscitation (CPR)
c. Accessing the internet to monitor social media related to opinions on healthcare
d. Consulting with a dietitian to discuss a patient’s cultural food preferences and restrictions
e. Reviewing the literature regarding the best way to monitor the patient for a fluid imbalance
A, B, D, E
Which disadvantage is inherent to the problem-oriented charting system (SOAPIE)?
a. Does not support a universal organizational system
b. Commonly allows for the inclusion of subjective information
c. Documentation is not listed in chronological order
d. Does not support the nursing process as a format
C
Which standardized rating scale will the nurse specifically include in the assessment of a newly admitted patient diagnosed with major depressive disorder?
a. Mini-Mental State Examination (MMSE)
b. Body Attitude Test
c. Global Assessment of Functioning Scale (GAF)
d. Beck Inventory
D
A 13-year-old boy is undergoing a mental health assessment. The nurse practitioner assures him that his medical records are protected and private. The nurse recognizes that this promise cannot be kept when the youth divulges:
a. “I lost my virginity last year.”
b. “I am angry with my parents most of the time.”
c. “I have thoughts of being in love with boys.”
d. “My parents do not know that I hit my grandpa.”
D
During an interview with a non–English-speaking middle-aged woman recently diagnosed with major depressive disorder, the patient’s husband states, “She is happy now and doing very well.” The patient, however, sits motionless, looking at the floor, and wringing her hands. A professional interpreter would provide better information due to the fact that a family member in the interpreter role may
Select all that apply.
a. Be too close to accurately capture the meaning of the patient’s mood
b. Censor the patient’s thoughts or words
c. Avoid interpretation
d. Leave out unsavory details
B
A nurse identified a nursing diagnosis of self-mutilation for a female diagnosed with borderline personality disorder. The patient has multiple self-inflicted cuts on her forearms and inner thighs. What is the most important patient outcome for this nursing diagnosis? Patient will
a. Identify triggers to self-mutilation
b. Refrain from self-harm
c. Describe strategies to increase socialization on the unit
d. Describe two strategies to increase self-care
A
Medical records are considered legal documents. Proper documentation needs to reflect patient condition along with changes. It should also be based on professional standards designated by the state board of nursing, regulatory agencies, and reimbursement requirements. Proper documentation can be enhanced by:
a. Only using objective data
b. Using the nursing process as a guide
c. Using language the specific patient can understand
d. Avoiding legal jargon
B
Amadi is a 40-year-old African national being treated in a psychiatric outpatient setting due to a court order. Amadi’s medical record is limited in scope, so where can Renata, his registered nurse, obtain more data on Amadi’s condition within legal parameters? Select all that apply.
a. Emergency department records
b. Police records related to the offense resulting in the court order for treatment
c. Calling his family in Africa for details about Amadi’s mental health
d. Past medical records in the current facility
A, B, D
Which statement made to the grieving patient demonstrates effective therapeutic communication? Select all that apply.
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.”
A, D, E
Considering the subject of medically assisted death, which statements identify the pros and cons of the argument associated with the issue of nonmaleficence? Select all that apply.
a. From the patient’s perspective, there is no difference between ending life by providing a lethal prescription and by stopping treatment that prolongs life.
b. Assisted death violates the oath to “do no harm” and destroys trust between patient and nurse.
c. There is equal protection under the law that allows the right to refuse or withdraw treatment and to commit suicide.
d. Every competent person has the right to make decisions based on personal convictions.
e. Human beings are the stewards but not the absolute masters of the gift of life.
A, B
Which statement made by a patient demonstrates acceptance of criteria required of hospice care?
a. “I want my family to be with me.”
b. “There is no cure for my illness. I’ve accepted that.”
c. “It’s important to me that I die in my own home.”
d. “I don’t want my family to bear the burden of caring for me.”
B
Which statement made by a widow demonstrates that her grief work has been effective? Select all that apply.
a. “I can remember how much my deceased husband loved chocolate chip ice cream.”
b. “Painting is my new passion, and I really enjoy learning the various strokes.”
c. “Jim could be very stubborn when he thought he was right.”
d. “I don’t know why he had to die.”
e. “I just can’t believe he’s gone.”
A, B, C
Which factor has the greatest influence on the hospice nurse’s ability to provide respectful professional care?
a. Acceptance that death is a natural part of life.
b. Possession of excellent caregiving nursing skills.
c. The existence of a healthy, well-balanced personal life.
d. The desire to work with both the patient and the family.
C
There is conflict surrounding the dying experience in modern medicine. The medical model of treatment in the United States has traditionally been focused on the prolongation of life. What intrinsic factor plays into this medical model?
a. Healthcare workers do not want their patients to die.
b. Medicare is a fee-for-service model.
c. Palliative care is expensive to administer.
d. Keeping people alive as long as possible is the ethical thing to do.
D
Holly is a 53-year-old female with terminal breast cancer. Holly’s nurse in the hospital brings up the subject of hospice care. Holly becomes upset and states, “I am not ready to give up and die.” You respond that hospice is:
a. A model of healthcare that emphasizes quality of life for you and your family.
b. The end of curative treatments and pain management.
c. A multidiscIplinary team providing curative and therapeutic treatment.
d. An aggressive medical plan to end suffering and hasten death.
A
Guadalupe is the matriarch of a large family. She is terminally ill and none of her family members know her end-of-life wishes. The best action for the nurse is to:
a. Discuss a durable power of attorney.
b. Organize a family meeting with Guadalupe’s permission to discuss her goals and wishes.
c. Have a family meeting without Guadalupe so as not to upset her.
d. Ask the doctor to tell Guadalupe that she is dying
B
A bereavement group run by a local hospice includes a woman who is distraught over her supervisor’s death. The woman appears severely distressed. She has trouble functioning with activities of daily living and making the simplest of decisions. The group facilitator recognizes that this woman is suffering from disenfranchised grief after learning:
a. The woman was in love with her married supervisor.
b. She has not taken enough time off work to grieve properly.
c. The supervisor died over a year ago.
d. Her family is not involved enough to support her
A
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 adequately 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
B
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 you 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?”
c
Which patient is at increased risk for the development of anxiety and will require frequent assessment by the nurse? Select all that apply.
a. Exacerbation of asthma signs and symptoms
b. History of peanut and strawberry allergies
c. History of chronic obstructive pulmonary disease
d. Current treatment for unstable angina pectoris
e. History of a traumatic brain injury
A, C, D, E
Which medication should the nurse be prepared to educate patients on when they are prescribed a selective serotonin reuptake inhibitor (SSRI) for panic attacks?
a. Alprazolam (Xanax)
b. Fluoxetine (Prozac)
c. Clonazepam (Klonopin)
d. Venlafaxine (Effexor)
B
Which statement or statements made by the nurse demonstrates an understanding of the effective use of relaxation therapy for anxiety management? Select all that apply.
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.”
B, C, D, E
To maximize the therapeutic effect, which lifestyle practice should the nurse discourage for a patient who has recently been prescribed an antianxiety medication?
a. Eating high-protein foods.
b. Using acetaminophen without first discussing it with a healthcare provider
c. Taking medications after eating dinner or while having a bedtime snack
d. Buying a large coffee with sugar and extra cream each morning on the way to work
D
