end of chapter questions exam 1

when providing respectful, appropriate nursing care, how should the nurse identify the patient along with observable characteristics

the patient in room 234 is displaying manic behavior

recognizing the frequency of depression among the US population, the nurse should advocate for which mental health promotion intervention?

providing regular depression screening for adolescent and teenage students

which statement made by a patient demonstrates a healthy degree of resilience? select all that apply.

I try to remember not to take other peoples bad moods personally.

I've learned to calm down before trying to defend my opinions.

I know that discussing issues with my boss would help me get my point across

which statement demonstrates the nurse's understanding of the effect of environmental factors on a patients mental health?

I'm not familiar with the patients cultural view on suicide

when considering stigmatization, which statement made by the nurse demonstrates a need for immediate intervention by the nurse manager

my experience has been that the Irish have a problem with alcohol abuse

a nursing student new to psychiatric-mental health nursing asks a peer what resources he can us to figure out which symptoms are present in a specific psychiatric disorder. the best answer would be:

DSM-5-TR

epidemiological studies contribute to improvements in care for individuals with mental disorders by:

identifying risk factors that contribute to the development of a disorder

identifying which individuals will respond favorably to a specific treatment

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

teaching coping skills for a specific family dynamic

which statement about mental illness is true?

mental illness changes with culture, time in history, political systems, and the groups defining it

The WHO 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

poor physical health can lead to mental distress and disorders

there is a strong relationship between physical health and mental health

Which statement made by the nurse concerning ethics demonstrates the best understanding of the concept?

It isn’t right to deny someone healthcare because they can’t pay for it

Which nursing intervention demonstrates the ethical principle of beneficence?

Providing frequent updates to the family of a patient currently in surgery

How can a newly hired nurse best attain information concerning the state's mental health laws and statutes?

Conduct an internet search using the keywords “mental +health+statues+(your state)”

When considering facility admissions for mental healthcare, what characteristic is unique to a voluntary admission?

A request in writing is required before admission

Which situations demonstrate liable behavior on the part of the staff? Select all that apply

Forgetting to obtain consent for electroconvulsive therapy for a cognitively impaired patient

Leaving a patient with suicidal thoughts alone in the bathroom to shower

Threatening to restrain a patient who stole from another patient on the unit

A nurse makes a post on a social media page about his peer taking care of a patient with a crime-related gunshot wound in the emergency department. He does not use the name of the patient. The nurse:

Has violated confidentiality laws and can be held liable

In providing care for patients of a mental health unit, Maya recognizes the importance of standards of care. When Maya notices that some policies fall short of the state licensing laws, which of the following statements represents the most appropriate standard of care pathway?

State board of nursing, professional association, facility policy

Lucas has completed his inpatient psychiatric treatment that was a result of a court order. Which statement reveals that Lucas does not understand the concept of conditional release?

I am finally free, no more therapy

Implied consent occurs when no verbal or written agreement takes place prior to a caregiver delivering treatment. Which of the following examples represents implied consent?

care given to a heroin overdose victim

Based on Maslow's hierarchy of needs, physiological needs for a restrained patient include: Select all that apply

Private toileting, oral hydration

checking the tightness of the restraints

maintaining a patent airway

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

"I will take extra medication if I start getting those self-destructive feelings."

Which interventions will help make the environment on the unit safer for patients with suicidal ideation? Select all that apply.

All windows are kept locked

Every shower has a breakaway shower rod

Eating utensils are counted when trays are collected

Patient doors are kept open

What are the nursing responsibilities to a patient expressing suicidal thoughts? Select all that apply

Instituting one to one observation

Documenting the patient's whereabouts and mood every 15 to 30 minutes.

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

Ensuring that patient has swallowed each individual dose of medication.

When considering community suicide prevention programs, what population should the nurse plan to service with regular suicide screenings? Select all that apply

10 to 34 year olds

males

rural population

native Americans

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

Lithium

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

“He was not able to think clearly due to his emotional plan”

Martin is a 23-year-old male with a new diagnosis of schizophrenia, and his family is receiving information from a home health nurse. The topic of education is suicide prevention, and the nurse recognizes effective teaching when the mother say

Suicide risk is greatest in the first few years after diagnosis

Sigmund Freud, Karl Menninger, and Aaron Beck theorized that hopelessness was an integral part of why a person ends one's life by suicide. A more recent explanation suggests that suicide results from

Low levels of serotonin

Which person is at the highest risk for suicide?

A young single white male who misuses alcohol, is hope-less, impulsive, has just been rejected by his girlfriend, and has ready access to a g#n he has hidden.

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

Assess the patient thoroughly and reassess the patient at regular intervals as levels of risk fluctuate

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

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

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

 

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?

"Can you identify what was happening when your anxiety began to increase?

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

Select all that apply.

Exacerbation of asthma signs and symptoms

History of chronic obstructive pulmonary disease

Current treatment for unstable angina pectoris

History of a traumatic brain injury

Which medication should the nurse be prepared to educate patients on when they are prescribed a selective serotonin reuptake inhibitor (SSRI) for panic attacks?

Fluoxetine (Prozac)

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.

"Muscle relaxation promotes the relaxation response."

"Show me how you learned to deep breathe in yesterday's therapy session."

"You've said that going to group makes you nervous, so let's start relaxing now?"

"I've given you written descriptions of the various relaxation exercises for you to review."

To maximize the therapeutic effect, which lifestyle practice should the nurse discourage for a patient who has recently been prescribed an antianxiety medication?

Buying a large coffee with sugar and extra cream each morning on the way to work

In a parent-teacher conference, the school nurse meets wit 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

The inherited shyness trait

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:

"Mild anxiety is okay because it helps me focus."

The activity of gamma-aminobutyric acid (GABA) contributes to a slowing of neural activity. Which of the following drugs facilitate the action of GABA?

Benzodiazepines

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?

Glomerular filtration rate

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

"My risk for agoraphobia is increased by my family his-tory, but treatment can help."

A male patient reports to the nurse, “I’m told I have memories of childhood abuse stored in my unconscious mind. I want want to work on this.” Based on this statement, what information should the nurse provide the patient?

To seek the help of a trained therapist to help uncover and deal with the trauma associated with those memories.

Which question should the nurse ask when assessing what Sullivan's Interpersonal Theory identifies as the most painful human condition?

"Do you think of yourself as being lonely?"

When discussing therapy options, the nurse should provide information about interpersonal therapy to which patient?Select all that apply.

The teenager who is the focus of bullying at school

The older woman who has just lost her life partner to

Cancer

The middle-aged adult who recently discovered her partner has been unfaithful

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?

Reflecting on personal behaviors and personal needs

Which action reflects therapeutic practices associated with operant conditioning?

Acknowledging a patient who is often verbally aggressive for complimenting a picture another patient drew

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:

Cognitive behavioral

According to Maslow's hierarchy of needs, the most basic needs category for nurses to address is:

Physiological

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;

Transference

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?

Exposure and response prevention therapy

A Patient is telling a tearful story. The nurse listens empathically and responds therapeutically with:

“Let’s devise a plan on how you will react next time in a similar situation.”

Which neurotransmitter is potentiated by nonbenzodiaz-epine receptor agonists, such as zolpidem?

Gamma (y) aminobutyric acid

Which selective serotonin reuptake inhibitor is most associated with anticholinergic side effects?

Paroxetine

Antagonism of which receptor contributes to the sedation and weight gain associated with tricyclic antidepressants?

Histamine-1

Which antidepressant is most associated with the side effects of appetite simulation and weight gain?

Mirtazapine

Which part of the brain is responsible for regulating hunger, thirst, and sex drive?

Hypothalamus

Which antidepressant is available as a nasal spray?

Esketamine

Which mood stabilizer is most likely to produce hyponatremia?

Carbamazepine

Which adverse effect is most likely to occur if the dose of Lamotrigine is increased too rapidly?

Stevens-Johnson syndrome

Antipsychotics treat the symptoms of schizophrenia by blocking dopamine overactivity in which pathway?

Mesolimbic

Which second-generation antipsychotic is available as a long-acting intramuscular injection?

Risperidone

Which statement made by the nurse demonstrates the best understanding of nonverbal communication?

"When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response?

Which nursing statement is an example of reflection?

"You look sad""

When should a nurse be most alert to the possibility of communication errors that could harm the patient?

Change-of-shift reports

During an admission assessment and subsequent counseling sessions, the nurse looks for congruence between:

Verbal and nonverbal communication

What principle about nurse-patient communication should guide a nurse's fear about "saying the wrong thing" to a patient?

Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.

You have been working closely with a patient for the past month. Today, he tells you he is looking forward to meeting with his new psychiatrist but frowns and avoids eye contact while saying this. Which of the following responses would most likely be therapeutic?

"You say you look forward to the meeting, but you appear anxious or unhappy"

Which student behavior is consistent with therapeutic communication?

Summarizing the essence of the patient's comments in your own words.

James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for your day shift and anxiously reports, Last night, demons came to my room and tried to rape me" Which response would be most therapeutic?

"You seem upset. Please tell me more about what you experienced last night."

Therapeutic communication is the foundation of a patient-centered care. Which of the following techniques is not considered therapeutic?

Asking "why" questions

Carolina is surprised when her patient does not show up for a regularly scheduled appointment. When contacted, the patient states, "I don't need to come see you anymore. I have found a therapy app on my phone that I love." How should Carolina respond to this news?

"That sounds exciting. Would you be willing to visit and show me the app?"

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?

Nick may be experiencing acute stress disorder and should be assessed further.

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:

Maintain 1:1 observation.

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?

Writes or draws feelings in a journal.

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?

Cognitive behavioral therapy

Jamie, age 24, has been diagnosed with a dissociative disorder following a traumatic event. Jamies mother asks you, "Does this mean my daughter is now crazy?" Your best response would be:

“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"

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 lack of bonding as an infant

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:

Adjustment disorder

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:

"I understand that imaginary friends are a coping mechanism."

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 potential symptom of traumatization

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:

Maternal stress