Test bank Flashcards
1
Q
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
A
D
2
Q
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
A
B
3
Q
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
A, D, E
4
Q
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.”
A
C
5
Q
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.”
A
B
6
Q
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
A
D
7
Q
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.
A
B, D
8
Q
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
A
B
9
Q
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.
A
C
10
Q
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.
A
B, D
11
Q
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.”
A
B
12
Q
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
A
13
Q
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.
A
B
14
Q
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
A
D
15
Q
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
A
16
Q
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
17
Q
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
A
C
18
Q
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.
A
B
19
Q
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”
A
C
20
Q
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
A
C
21
Q
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?”
A
B
22
Q
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
A, B, C, E
23
Q
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
A
C
24
Q
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?”
A
B, D, E
25
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
26
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
27
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
28
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
29
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
30
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
31
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
32
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
33
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
34
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
35
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
36
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
37
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
38
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
39
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
40
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
41
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
42
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
43
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
44
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
45
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
46
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
47
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
48
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
49
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
50
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
51
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
52
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
53
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
54
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
55
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
56
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
57
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
58
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
59
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
60
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
61
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
62
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
63
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
64
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
65
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
66
in a parent-teacher conference, the school nurse meets with the parents of a profoundly shy 8-year-old girl. The parents hold hands, speak softly, respond briefly, and have poor eye contact. The nurse recognizes that the child is most likely exposed to parental modeling and
a. The inherited shyness trait
b. A lack of affection in the home
c. Severe punishment by the parents
d. Is afraid to say something foolish
A
67
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.”
C
68
The activity of gamma-aminobutyric acid (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
A
69
Samantha is a new patient at the mental health clinic and is seeking assistance for what she describes as “severe anxiety.” In addition to daily self-medicating with alcohol, Samantha describes long-term use of herbal kava. The nurse practitioner knows that kava is associated with inhibiting P450 and orders which of the following tests?
a. Electrocardiogram
b. Liver enzymes
c. Glomerular filtration rate
d. Complete blood count
B
70
A homebound patient diagnosed with agoraphobia has been receiving 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.”
C
71
A male patient reports to the nurse, “I’m told I have memories of childhood abuse stored in my unconscious mind. I want to work on this.” Based on this statement, what information should the nurse provide the patient?
a. To seek the help of a trained therapist to help uncover and deal with the trauma associated with those memories.
b. How to use a defense mechanism such as suppression so that the memories will be less threatening.
c. Psychodynamic therapy will allow the surfacing of those unconscious memories to occur in just a few sessions.
d. Group sessions are valuable to identify underlying themes of the memories being suppressed.
A
72
Which question should the nurse ask when assessing for what Sullivan’s Interpersonal Theory identifies as the most painful human condition?
a. “Is self-esteem important to you?”
b. “Do you think of yourself as being lonely?”
c. “What do you do to manage your anxiety?”
d. “Have you ever been diagnosed with depression?”
B
73
When discussing therapy options, the nurse should provide information about interpersonal therapy to which patient? Select all that apply.
a. The teenager who is the focus of bullying at school
b. The older woman who has just lost her life partner to cancer
c. The young adult who has begun demonstrating hoarding tendencies
d. The adolescent demonstrating aggressive verbal and physical tendencies
e. The middle-aged adult who recently discovered her partner has been unfaithful
A, B, E
74
When considering the suggestions of Hildegard Peplau, which activity should the nurse regularly engage in to ensure that the patient stays the focus of all therapeutic conversations?
a. Assessing the patient for unexpressed concerns and fears
b. Evaluating the possible need for additional training and education
c. Reflecting on personal behaviors and personal needs
d. Avoiding power struggles with the manipulative patient
C
75
Which action reflects therapeutic practices associated with operant conditioning?
a. Encouraging a parent to read to their children to foster a love for learning
b. Encouraging a patient to make daily journal entries describing their feelings
c. Suggesting to a new mother that she spend time cuddling her newborn often during the day
d. Acknowledging a patient who is often verbally aggressive for complimenting a picture another patient drew
D
76
A nurse is assessing a patient who graduated at the top of his class but now obsesses about being incompetent in his new job. The nurse recognizes that this patient may benefit from the following type of psychotherapy:
a. Interpersonal
b. Operant conditioning
c. Behavioral
d. Cognitive behavioral
D
77
According to Maslow’s hierarchy of needs, the most basic needs category for nurses to address is:
a. Physiological
b. Safety
c. Love and belonging
d. Self-actualization
A
78
In an outpatient psychiatric clinic, a nurse notices that a newly admitted young male patient smiles when he sees her. One day the young man tells the nurse, “You are pretty like my mother.” The nurse recognizes that the male is exhibiting:
a. Transference
b. Id expression
c. Countertransference
d. A cognitive distortion
A
79
Linda is terrified of spiders and cannot explain why. Because she lives in a wooded area, she would like to overcome this overwhelming fear. Her nurse practitioner suggests which therapy?
a. Behavioral
b. Biofeedback
c. Aversion
d. Exposure and response prevention therapy
D
80
A patient is telling a tearful story. The nurse listens empathically and responds therapeutically with:
a. “The next time you find yourself in a similar situation, please call me.”
b. “I am sorry this situation made you feel so badly. Would you like some tea?”
c. “Let’s devise a plan on how you will react next time in a similar situation.”
d. “I am sorry that your friend was so thoughtless. You should be treated better.”
C
81
Natalya, a patient with a history of alcohol use disorder, has been prescribed disulfiram (Antabuse). Which physical effects support the suspicion that the patient has relapsed? Select all that apply.
a. Intense nausea
b. Diaphoresis
c. Acute paranoia
d. Confusion
e. Dyspnea
a, b, d, e
82
Which assessment data confirm the suspicion that a patient is experiencing opioid withdrawal? Select all that apply.
a. Pupils are dilated
b. Pulse rate is 62 beats/min
c. Slow movements
d. Extreme anxiety
e. Sleepy
A, D
83
The nursing diagnosis denial is especially useful when working with substance use disorders and gambling. Which statements describe this diagnosis? Select all that apply.
a. Reports inability to cope
b. Does not perceive the danger of substance use or gambling
c. Minimizes symptoms
d. Refuses healthcare attention
e. Unable to admit the impact of disease on life pattern
B, C, D, E
84
What action should you take when a female staff member is demonstrating behaviors associated with a substance use disorder?
a. Accompany the staff member when she is giving patient care.
b. Offer to attend rehabilitation counseling with her.
c. Refer her to a peer assistance program.
d. Confront her about your concerns and/or report your concerns to a supervisor immediately.
D
85
A patient diagnosed with opioid use disorder has expressed a desire to enter into a rehabilitation program. What initial nursing intervention during the early days after admission will help ensure the patient’s success?
a. Restrict visitors to family members only.
b. Manage the patient’s withdrawal symptoms well.
c. Provide the patient a low-stimulus environment.
d. Advocate for at least 3 months of treatment.
B
86
Lester and Alene have always enjoyed gambling. Lately, Alene has discovered that their savings account is down by $50,000. Alene insists that Lester undergo therapy for his gambling behavior. The nurse recognizes that Lester is making progress when he states:
a. “I understand that I am a bad person for depleting our savings.”
b. “Gambling activates the reward pathways in my brain.”
c. “Gambling is the only thing that makes me feel alive.”
d. “We have always enjoyed gaming. I do not know why Alene is so upset.”
B
87
Opioid use disorder is characterized by:
a. Lack of withdrawal symptoms
b. Intoxication symptoms of pupillary dilation, agitation, and insomnia
c. Tolerance
d. Requiring smaller amounts of the drug to achieve a high over time
C
88
Terry is a young male in a chemical dependency program. Recently, he has become increasingly distracted and disengaged. The nurse concludes that Terry is:
a. Bored
b. Depressed
c. Bipolar
d. Not ready to change
D
89
Max is a 30-year-old male who arrives at the emergency department stating, “I feel like I am having a stroke.” During the intake assessment, the nurse discovers that Max has been working for 36 hours straight without eating and has consumed 8 double espresso drinks and 12 caffeinated sodas. The nurse suspects:
a. Fluid overload
b. Dehydration and caffeine overdose
c. Benzodiazepine overdose
d. Sleep deprivation syndrome
B
90
Donald, a 49-year-old male, is admitted for inpatient alcohol detoxification. The rationale for admission into this program is due to:
a. Heavy use of a substance known to cause withdrawal
b. A need for rehabilitation
c. The potential for relapse
d. CNS hypoactivity following cessation of alcohol consumption
A
91
The care plan of a patient diagnosed with a somatic disorder includes the nursing diagnosis impaired coping. Which patient behavior demonstrates a successful outcome for that nursing diagnosis?
a. Showers and dresses in clean clothes daily
b. Calls a friend to talk when feeling lonely
c. Spends more time talking about pain in her abdomen
d. Maintains focus and concentration
B
92
Which patient is at greatest risk for developing a stress-induced myocardial infarction?
a. A patient who lost a child in an accidental shooting 24 hours ago
b. A woman who has begun experiencing early signs of menopause
c. A patient who has spent years trying to sustain a successful business
d. A patient who was diagnosed with chronic major depressive disorder 10 years ago
D
93
What precipitating emotional factor has been associated with an increased incidence of cancers? Select all that apply.
a. Anxiety
b. Job-related stress
c. Acute grief
d. Feelings of hopelessness and despair from depression
e. Prolonged, intense stress
D, E
94
You are caring for Aaron, a 38-year-old patient diagnosed with somatic symptom disorder. When interacting with you, Aaron continues to focus on his severe headaches. In planning care for Aaron, which of the following interventions would be appropriate?
a. Call for a family meeting with Aaron in attendance to confront Aaron regarding his diagnosis.
b. Educate Aaron on alternative therapies to deal with pain.
c. Improve reality testing by telling Aaron that you do not believe that the headaches are real.
d. After a limited discussion of physical concerns, shift focus to feelings and effective coping skills.
D
95
Living comfortable and materialistic lives in Western societies seems to have altered the original hierarchy proposed by Maslow in that:
a. Once lower-level needs are satisfied, no further growth feels necessary.
b. Self-actualization is easier to achieve with financial stability.
c. Esteem is more highly valued than safety.
d. Focusing on materialism reduces interests in love, belonging, and family.
D
96
Diane, a 63-year-old mother of three, was brought to the community psychiatric clinic. Diane and her son had a bitter fight over finances. Ever since, Diane has been complaining of “a severe pain in my neck.” She has seen several doctors who cannot find a physical basis for the pain. The nurse knows that:
a. Showing concern for Diane’s pain will increase her obsessional thinking.
b. Diane’s symptoms are manipulative and under conscious control.
c. Diane believes there is a physical cause for the pain and will resist a psychological explanation.
d. Diane is trying to make her son feel bad about the argument.
C
97
Conversion disorder is described as an absence of a neurological diagnosis that manifests in neurological symptoms. Channeling of emotions, conflicts, and stressors into physical symptoms is thought to be the cause of conversion disorder. Which statement is true?
a. People with conversion disorder are extremely upset about often dramatic symptoms.
b. Abnormal patterns of cerebral activation have been found in individuals with conversion disorder.
c. An organic cause is usually found in most cases of conversion disorder.
d. Symptoms can be turned off and on depending on the patient’s choice.
B
98
Melanie is a 38-year-old female admitted to the hospital to rule out a neurological disorder. The testing was negative, yet she is reluctant to be discharged. Today she has added lower back pain and a stabbing sensation in her abdomen. The nurse suspects a factitious disorder in which Melanie may:
a. Consciously be trying to maintain her role of a sick patient.
b. Not recognize her unmet needs to be cared for.
c. Protect her child from illness.
d. Recognize physical symptoms as a coping mechanism.
A
99
You are caring for Yolanda, a 67-year-old patient who has been receiving hemodialysis for 3 months. Yolanda reports that she feels angry whenever it is time for her dialysis treatment. You attribute this to:
a. Organic changes in Yolanda’s brain.
b. A flaw in Yolanda’s personality.
c. A normal response to grief and loss
d. Denial of the reality of a poor prognosis.
C
100
Lucas is a nurse on a medical floor caring for Kelly, a 48-year-old patient with newly diagnosed type 2 diabetes. He realizes that depression is a complicating factor in the patient’s adjustment to her new diagnosis. What problem has the most potential to arise?
a. Development of agoraphobia
b. Treatment nonadherence
c. Frequent hypoglycemic reactions
d. Sleeping rather than checking blood sugar
B
101
Which statement made by the primary caregiver of a person with dementia demonstrates an accurate understanding of providing the person with a safe environment?
a. “The local police know that he has wandered off before.”
b. “I keep the noise level low in the house.”
c. “We’ve installed locks on all the outside doors.”
d. “Our telephone number is always attached to the inside of his shirt pocket.”
C
102
2. Which statement made by a family member tends to support a diagnosis of delirium rather than dementia?
a. “She was fine last night but this morning she was confused.”
b. “Dad doesn’t seem to recognize us anymore.”
c. “She’s convinced tat snakes come into her room at night.”
d. “He can’t remember when to take his pills or whether he’s bathed.”
A
103
In terms of the pathophysiology responsible for both delirium and dementia, which intervention would be appropriate for delirium specifically?
a. Assisting with needs related to nutrition, elimination, hydration, and personal hygiene
b. Monitoring neurological status on an ongoing basis
c. Placing an identification bracelet on patient
d. Giving one simple direction at a time in a respectful tone of voice
B
104
What side effects should the nurse monitor for while caring for a patient taking donepezil (Aricept)? Select all that apply.
a. Insomnia
b. Constipation
c. Bradycardia
d. Signs of dizziness
e. Reports of headache
A, C, D, E
105
What is the rationale for providing a patient diagnosed with dementia easily accessible finger foods thorough the day?
a. It increases input throughout the day
b. The person may be anorexic
c. It helps with the monitoring of food intake
d. It helps to prevent constipation
A
106
Ophelia, a 69-year-old retired nurse, attends a reunion of her former coworkers. Ophelia is concerned because she usually knows everyone, and she cannot recognize faces today. A registered nurse colleague recognizes Ophelia’s distress and “introduces” Ophelia to those attending. The nurse practitioner understands that Ophelia seems to have a deficit in her
a. Lower-level cognitive domain
b. Delirium threshold
c. Executive function
d. Social cognition ability
D
107
After talking with her 85-year-old mother, Nancy became concerned enough to drive to her home and check on her. Her mother’s appearance was disheveled, her words were nonsensical, she smelled strongly of urine, and there was a stain on her dressing gown. Because she is a nurse, Nancy recognizes that her mother’s condition is likely due to
a. Early-onset dementia
b. A mild cognitive disorder
c. A urinary tract infection
d. Having skipped breakfast
C
108
Lucia, 70 years old, recently underwent a major orthopedic surgical procedure. On postoperative day 3, she responds to the nurse who has been caring for her with affection. At other times, however, she tells the nurse to leave because she does not recognize her and asks to have another nurse care for her, specifically naming the nurse as the “nice one.” The most likely reason for Lucia’s behavior is that she is
a. Attention-seeking and manipulative
b. Showing signs of early dementia
c. Experiencing an acute delirium
d. Playing one staff member off against another
C
109
Since his wife’s death 2 months earlier, Aaron, 90 years of age and in good health, has begun to pay less attention to his hygiene and seems less alert to his surroundings. He complains of difficulty concentrating, disrupted sleep, and lacks energy. His family has to remind and encourage him to shower, take his medications, and eat, all of which he then does. Which of the following responses would be most appropriate?
a. Reorient Mr. Smith by pointing out the day and date each time you have occasion to interact with him.
b. Meet with the family and support them to accept, anticipate, and prepare for the progression of his stage 2 dementia.
c. Avoid touch and proximity. These are likely to be uncomfortable for Mr. Smith and may provoke aggression when he is disoriented.
d. Arrange for an appointment with a mental health professional for the evaluation and treatment of suspected major depressive disorder.
D
110
Nurses caring for patients who have neurocognitive disorders are exposed to stress on many levels. Specialized skills training and continuing education are helpful to diffuse stress, as well as which of the following? Select all that apply.
a. Expressing emotions by journaling
b. Describing stressful events on Facebook
c. Engaging in exercise and relaxation activities
d. Having realistic patient expectations
e. Participating in a happy hour after work to blow off steam
A, C, D
111
During an interview with a patient, which question asked of an older adult is associated with the Patient Self-Determination Act?
a. “Who besides yourself may have access to your medical information?”
b. “Have you discussed your end-of-life choices with your family or designated surrogate?”
c. “Do you have the information you need to make an informed decision about your treatment?”
d. “How can I help you feel comfortable about this interview and any decisions you need to make?”
b
112
Which statement made by a nurse requires immediate correction by the supervisor?
a. “Many older patients are depressed.”
b. “Retirement is a difficult time for older patients.”
c. “Cognitive decline is normal in patients who are 65 and olDer.”
d. “Sleep-related problems are often reported by older adults."
C
113
Considering psychosocial role theory, which patient demonstrates healthy adjustment to aging?
a. The 70-year-old who is training for a 5-mile running race
b. The older adult who controls diabetes with diet and exercise
c. The retiree who volunteers 3 days a week at the local library
d. The 80-year-old who is upbeat and hopeful during chemotherapy for lung cancer
C
114
The older patient is discussing chronic pain and asks the primary care provider for a prescription. Which medication should the nurse anticipate being ordered rather than an opioid?
a. Gabapentin
b. Acetaminophen
c. Morphine
d. Fentanyl
A
115
Which statement by an older patient with a mild neurocognitive disorder demonstrates a safe response to beginning a new medication?
a. “I read the information the pharmacist gave me when I got the prescription filled.”
b. “My daughter comes with me to appointments so that we get all the information we need.”
c. “I know I can call my doctor if I think of any questions later.”
d. “I alWays follow the instructions on the medication bottle.”
B
116
Anxiety problems in older adults can manifest as a fear of falling, greatly influencing an older adult’s personal freedom. A home health nurse checking on a patient with mild dementia and anxiety related to falling should question which new order?
a. Yoga and tai-chi
b. Xanax
c. Relaxation techniques
d. Electric wheelchair
B
117
Fred is an older adult with spinal stenosis and who is being treated with a short-term prescription of opioids for an acute episode of back pain. His nurse recognizes additional teaching is necessary when Fred states:
a. “Sitting up straight seems to reduce the pain.”
b. “SOmetimes I use a heating pad on my back.”
c. “Once I get moving for the day my pain gets better.”
d. “My wife and I share my Norco for our aches and pains.”
D
118
Ling works as a registered nurse in an Alzheimer’s care home. Ling has a specialized rapport-building technique she uses called reminiscence. She uses this technique by:
a. Telling the residents stories about her grandparents’ lives.
b. Playing music from the residents’ formative years.
c. Reviewing movies that the residents enjoy.
d. Encouraging the residents to talk about pleasurable past events.
D
119
Marco, age 83, has dementia and difficulty feeding himself despite the fact that there is nothing wrong with his motor functions. Which term should the nurse use to document this finding?
a. Aphasia
b. Apraxia
c. Agnosia
d. Anergia
B
120
Programs recommended for ambulatory patients who do not need 24-hour nursing care with structured activities along with nursing and medical supervision, intervention, and treatment are called:
a. Respite programs
b. Inpatient care units
c. Hospice
d. Partial hospitalization programs
D
121
Which patient statement indicates the helpfulness of the nurse-patient relationship?
a. “I appreciate the time you spent with me. I have a better understanding of what I can do to manage my problem.”
b. “I really need to talk with you. You always give me good advice about how to address my anger issues.”
c. “If it wasn’t for you and the hours we’ve spent talking, I don’t think I would be on my way to getting my anxiety under control.”
d. “You always showed me sympathy when I was at my lowest point after the sexual assault. Knowing you had been there too was such a help.”
A
122
A female nurse had been sexually assaulted as a teenager. She finds it difficult to work with patients who have undergone the same trauma. What is the most helpful response?
a. Discussing these feelings with the nurse supervisor.
b. Requesting that these patients not be a part of her patient assignment.
c. Discussing these feelings with a mental health professional.
d. Accepting her role in providing unbiased, respectful, and professional care to all patients.
C
123
A patient whose history includes experiences with abusive partners is being treated for major depressive disorder. The patient’s care plan includes rape-trauma syndrome among its nursing diagnoses. What goal is directly associated with this diagnosis?
a. Remains free from self-harm
b. Wears appropriate clothing
c. Reports feeling stronger and having a sense of hopefulness
d. Demonstrates appropriate affect for both positive and negative emotions
C
124
The nurse is engaged in crisis intervention with a female patient who states, “I have no reason to keep on living.” What is the nurse’s initial intervention?
a. Advise the patient about the services available to help her.
b. Ask the patient, “Have you ever been this depressed before?”
c. Ask the patient, “Do you have any plan to hurt yourself or anyone else?”
d. Assure the patient that she is in a safe place and will be well cared for.
C
125
Which statement concerning a crisis experience is true and should be used as a guideline for crisis management care? Select all that apply.
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 nondirective 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.
A, B, E
126
Which statement about crisis theory will provide a basis for nursing intervention?
a. A crisis is an acute time-limited phenomenon experienced as an overwhelming emotional reaction to a problem perceived as unsolvable.
b. A person in crisis has always had adjustment problems and has coped inadequately in the usual life situations.
c. Crisis is precipitated by an event that enhances a person’s self-concept and self-esteem.
d. Nursing intervention in crisis situations rarely has the effect of stopping the crisis.
A
127
Lilly, a single mother of four, comes to the crisis center 24 hours after a fire in which all the houses within a one-block area were wiped out. All of Lilly’s household goods and clothing were lost. Lilly has no other family in the area. Her efforts to mobilize assistance have been disorganized, and she is still without shelter. She is distraught and confused. You assess the situation as:
a. A maturational crisis.
b. An adventitious crisis.
c. A crisis of confidence.
d. An existential crisis.
B
128
When responding to the patient in question 7, the intervention that takes priority is to:
a. Reduce anxiety.
b. Arrange shelter.
c. Contact out-of-area family.
d. Hospitalize and place the patient on suicide precautions.
A
129
Which belief would be least helpful for a nurse working in crisis intervention?
a. A person in crisis is incapable of responding to instruction.
b. The crisis counseling relationship is one between partners.
c. Crisis counseling helps the patient refocus to gain new perspectives on the situation.
d. Anxiety-reduction techniques are used so the patient’s inner resources can be accessed.
A
130
The highest-priority goal of crisis intervention is:
a. Anxiety reduction.
b. Identification of situational supports.
c. Teaching specific coping skills that are lacking.
d. Patient safety.
D
131
Which statement made by a new mother should be explored further by the nurse?
a. “I have three children, that’s enough.”
b. “I think the baby cries just to make me angry.”
c. “I wish my husband could help more with the baby.”
d. “Babies are a blessing, but they are a lot of work.”
B
132
Which problem is observed in children who regularly witness acts of violence in their family? Select all that apply.
a. Phobias
b. Low self-esteem
c. Major depressive disorder
d. Narcissistic personality disorder
e. Posttraumatic stress disorder
A, B, C, E
133
What situation associated with a caregiver presents the greatest risk that an older adult will experience abuse by that caregiver?
a. The caregiver is a single male relative.
b. The caregiver was neglected as a child.
c. The caregiver is under the age of 30.
d. The caregiver has little experience with older adults.
B
134
What safety-related responsibility does the nurse have in any situation of suspected abuse?
a. Protect the patient from future abuse by the abuser.
b. Inform the suspected abuser that the authorities have been notified.
c. Arrange for counseling for all involved parties, but especially the patient.
d. Report suspected abuse to the proper authorities.
D
135
The nurse is assisting a patient to identify safety issues that may occur now that she has left an abusive partner. What telephone numbers should be available to the patient? Select all that apply.
a. The police department
b. An abuse hotline
c. A responsible friend or family member
d. A domestic violence shelter
e. The hospital emergency department
A, B, C, D
136
Secondary effects of abuse often manifest as arrested development in children due to the fact that:
a. Coping is easier than emotional growth
b. Energy for development is diverted to coping
c. Children cannot differentiate love from abuse
d. Abuse fosters a sense of belonging, even if dysfunctional
B
137
The use of a patient-centered interview technique works well for gathering information about abusive situations. It is a good use of clinical time to sit near the patient and:
a. Establish trust and rapport
b. Ask lots of questions
c. Interrupt the patients’ story to allow for decompression
d. Utilize closed-ended questions
A
138
The abused person is often in a dependent position, relying on the abuser for basic needs. At particular risk are children and older adults due to:
a. The love they have for parents or children.
b. Their limited options.
c. The need to feel safe at home.
d. Other relatives do not want them.
B
139
An appropriate expected outcome in individual therapy regarding the perpetrator of abuse would be:
a. A decrease in family interaction so there are fewer opportunities for abuse to occur.
b. The perpetrator will recognize destructive patterns of behavior and learn alternate responses.
c. The perpetrator will no longer live with the family but have supervised contact while undergoing intensive inpatient therapy.
d. A triad of treatment modalities, including medication, counseling, and role-playing opportunities.
B
140
Perpetrators of domestic violence tend to: Select all that apply.
a. Have relatively poor social skills and have grown up with poor role models.
b. Believe they, if male, should be dominant and in charge in relationships.
c. Force their mates to work and expect them to handle the financial decisions.
d. Be controlling and willing to use force to maintain their power in relationships.
e. Prevent their mates from having relationships and activities outside the family.
A, B, D, E
141
Nick, a construction worker, is on duty when a nearly completed wall suddenly falls, crushing a number of his co-workers. Although badly shaken initially, he seemed to be coping well. About 2 weeks after the tragedy, he 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. Nick has acute stress disorder and will benefit from antianxiety medications.
b. Nick is experiencing posttraumatic stress disorder (PTSD) and should be referred for outpatient treatment.
c. Nick is experiencing anxiety and grief and should be monitored for PTSD symptoms.
d. Nick is experiencing mild anxiety and a normal grief reaction; no intervention is needed.
A
142
You are caring for Susannah, a 29-year-old who has been diagnosed with dissociative identity disorder. She was recently hospitalized after coming to the emergency department with deep cuts on her arms with no memory of how this occurred. The priority nursing intervention for Susannah is:
a. Assist in recovering memories of abuse.
b. Maintain 1:1 observation.
c. Teach coping skills and stress-management strategies.
d. Refer for integrative therapy.
B
143
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 behaviors.
b. Avoids situations that trigger conflicts.
c. Expresses complex thoughts.
d. Writes or draws feelings in a journal.
D
144
Ashley is a 21-year-old college student who was sexually assaulted at a party. She was seen in the local emergency department and referred for counseling after being diagnosed by the provider on call as having acute stress disorder. Which of the following treatment modalities would you expect to see used in therapy with Ashley?
a. Aversion therapy
b. Stress-reduction therapy
c. Cognitive behavioral therapy
d. Short-term classical analysis therapy
C
145
Jamie, age 24, has been diagnosed with a dissociative disorder following a traumatic event. Jamie’s mother asks you, “Does this mean my daughter is now crazy?” Your best response would be:
a. “People with dissociative disorders are out of touch with reality, so in that way, your daughter is now mentally ill. Don’t worry. Treatment is available.”
b. “Jamie will most likely need long-term intensive inpatient treatment to deal with her traumatic memories as well as to work through her delusions.”
c. “Most mental health providers are skeptical about dissociative disorders and aren’t sure they truly exist. Jamie may be making up her symptoms as a cry for help.”
d. “Jamie is dealing with the anxiety associated with the trauma by separating herself from it. With treatment, she can get back to her previous level of functioning.”
D
146
A young child is found wandering alone at a mall. A male store employee approaches and asks 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
A
147
During a routine health screening, a grieving widow whose husband died 15 months ago reports emptiness, a loss of self, difficulty thinking of the future, and anger at her dead husband. The nurse suggests bereavement counseling. The widow is most likely suffering from:
a. Major depression
b. Normal grieving
c. Adjustment disorder
d. Posttraumatic stress disorder
C
148
Maggie, a child in protective custody, is found to have an imaginary friend, Holly. The foster family shares this information with the nurse. The nurse teaches the family members about children who have suffered trauma and knows her teaching was effective when the foster mother states:
a. “I understand that imaginary friends are abnormal.”
b. “I understand that imaginary friends are a maladaptive behavior.”
c. “I understand that imaginary friends are a coping mechanism.”
d. “I understand that we should tell the child that imaginary friends are unacceptable.”
C
149
The school nurse has been alerted to the fact that an 8-year-old boy routinely play acts as a police officer, “locking up” other children on the playground to the point where the children get scared. The nurse recognizes that this behavior is most likely an indication of:
a. The need to dominate others
b. Inventing traumatic events
c. A need to develop close relationships
d. A potential symptom of traumatization
D
150
A pregnant woman is in a relationship with a male who routinely abuses her. Her unborn child may engage in high-risk behavior as a teen as a result of:
a. Maternal stress
b. Parental nurturing
c. Appropriate stress responses in the brain
d. Memories of the abuse
A
151
Which statement made by a sexually assaulted patient strongly suggests the drug gamma-hydroxybutyric acid (GHB) was involved in the attack?
a. “I remember everything that happened but felt too tired to fight back.”
b. “The drink I was given had a salty taste to it.”
c. “They tell me I was unconscious for 24 hours.”
d. “I heard that I was fighting the nursing staff and saying that they were trying to kill me.”
B
152
Considering the guilt that women feel after being sexually assaulted, which nursing assessment question has priority?
a. “Do you want the police to be called?”
b. “Did you recognize the person who assaulted you?”
c. “Do you have someone you trust that can stay with you?”
d. “Do you have any thoughts about harming yourself?”
D
153
Which statement is an accurate depiction of sexual assault?
a. Rape is a sexual act.
b. Most rapes occur in the home.
c. Rape is usually an impulsive act.
d. Women are usually raped by strangers.
B
154
Which signs and symptoms are associated with rape-trauma and rape-trauma response? Select all that apply.
a. Outbursts of anger
b. Major depressive disorder
c. Auditory hallucinations
d. Flashbacks
e. Amnesia for the event
A, B, D, E
155
Which racial identification places a woman at the greatest risk of being sexually assaulted in her lifetime?
a. Multiracial
b. American Indian
c. Black non-Hispanic
d. White
A
156
The stress of being raped often results in suffering similar to people who have witnessed a murder or had a physiological reaction to trauma, resulting in which of the following?
a. Posttraumatic stress disorder
b. Anxiety
c. Depression
d. All of the above
D
157
A young woman named Carly was raped after closing shift behind the restaurant where she works. Six months have passed and Carly has not been able to return to work, refuses to go out to eat, and feels that she has less value as a woman now that she has been raped. Carly’s clinical presentation suggests:
a. Reexperiencing
b. Hyperalertness
c. Avoidance
d. Physical effects
C
158
Ron is a victim of assault and has revealed to his family and friends the fact that he was raped. The family reacts with horror and disgust, and the nurse caring for Ron recognizes that
a. Ron’s family is being judgmental.
b. Ron’s family should leave the hospital.
c. Ron’s family will also need support.
d. Ron’s family’s dynamics are dysfunctional.
C
159
Perpetrators of sexual assault are often incarcerated but frequently do not undergo therapy. Samuel, convicted of rape and sentenced to 15 years in prison, has asked to see a therapist. The psychiatric nurse practitioner is surprised to learn of the request, as many perpetrators
a. Boast of their assault history.
b. Feel regret and remorse.
c. Do not acknowledge the need for change.
d. Are unable to recognize rape as a crime.
C
160
You are working at a telephone hotline center when Abby, a rape victim, calls. Abby states she is afraid to go to the hospital. What is your best response?
a. “I’m here to listen, and we can talk about your feelings.”
b. “You don’t need to go to the hospital if you don’t want to.”
c. “If you don’t go to the hospital, we can’t collect evidence to help convict your rapist.”
d. “Why are you afraid to seek medical attention?”
A
161
A staff nurse completes orientation to a psychiatric unit. This nurse may expect an advanced practice nurse to perform which additional intervention?
A. Conduct mental health assessments
B. Prescribe meds
C. establish therapeutic relationships
D. individualize nursing care plans
B
162
a nursing student expresses concerns that mental health nurses "lose all clinical nursing skills". Select the best response by the mental health nurse
A. Psych nurses practice something than other specialties. Nurse to patient ratios must be better bc of the nature of the pts
B. psych nurses use complex communication skills and critical thinking to solve multidimensional problems. i am challenged by those situations
C. That's a misconception. psych nurses frequently use high tech monitoring equipment and manage complex IV therapies
D. psych nurses don't have to deal w as much pain and suffering as med-surg nurses do. That appeals to me
B
163
when a new bill introduced in congress reduces funding for care of persons diagnosed w mental illness, a group of nurses write letters to their elected reps in opposition to the legislation. Which role has been fulfilled?
A. Recovery
B. Attending
C. advocacy
D. evidence based practice
C
