NURS 420: Exam 1- End of Chapter Questions 1, 2, 3, 9, 6, 25, 10, 15, 16

When providing respectful, appropriate nursing care, how

should the nurse identify the patient along with 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. 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?

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. 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.

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. “I’m not familiar with the patient’s cultural view on

suicide.”

When considering stigmatization, which statement made

by the nurse demonstrates a need for immediate interven-

tion by the nurse manager?

a. “Depression seems to be a real problem among the teen-

age population.”

b. “My experience has been that the Irish have a problem

with alcohol abuse.”

c. “Women are at greater risk for developing suicidal

thoughts than acting on them.”

d. “We’ve admitted several military veterans with posttrau-

matic stress disorder this month.”

b. “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 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-5-TR

d. DSM-5-TR

Epidemiological studies contribute to improvements in care

for individuals with mental disorders by: SATA

a. Providing information about effective nursing

techniques.

b. Identifying risk factors that contribute to the develop-

ment 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 nurs-

ing 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. Teaching coping skills for a specific family dynamic.

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 individ-

ual control over behavior and appraisal of reality.

c. Mental illness changes with culture, time in history,

political systems, and the groups defining it.

10. 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.

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

A male patient reports to the nurse, “I’m told I have memo-

ries of childhood abuse stored in my unconscious mind. I

want to work on this.” Based on this statement, what infor-

mation 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 for identifying underlying

themes of the memories being suppressed.

a. 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 pain-

ful 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. “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.

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 part-

ner has been unfaithful

A, B, E

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. Reflecting on personal behaviors and personal needs

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 cud-

dling her newborn often during the day

d. Acknowledging a patient who is often verbally aggressive

for complimenting a picture another patient drew

D

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. Behavior

d. Cognitive behavioral

d. Cognitive behavioral

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. 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:

a. Transference

b. Id expression

c. Countertransference

d. A cognitive distortion

A

9. Linda is terrified of spiders and cannot explain why. Because

she lives in a wooded area, she would like to overcome this over-

whelming fear. Her nurse practitioner suggests which therapy?

a. Psychoanalysis

b. Biofeedback

c. Aversion

d. Exposure and response prevention therapy

D

A patient is telling a tearful story. The nurse listens empathi-

cally 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

Which neurotransmitter is potentiated by nonbenzodiaz-

epine receptor agonists, such as zolpidem?

a. Gamma (γ) aminobutyric acid

b. Histamine

c. Melatonin

d. Orexin

A

Which selective serotonin reuptake inhibitor is most associ-

ated with anticholinergic side effects?

a. Citalopram

b. Escitalopram

c. Fluoxetine

d. Paroxetine

D

Antagonism of which receptor contributes to the sedation

and weight gain associated with tricyclic antidepressants?

a. Alpha-1

b. Dopamine-2

c. Histamine-1

d. Muscarinic-1

C

Which antidepressant is most associated with the side

effects of appetite stimulation and weight gain?

a. Bupropion

b. Fluoxetine

c. Mirtazapine

d. Vortioxetine

C

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

a. Brainstem

b. Cerebellum

c. Cerebrum

d. Hypothalamus

D

Which antidepressant is available as a nasal spray?

a. Bupropion

b. Esketamine

c. Venlafaxine

d. Zuranolone

B

Which mood stabilizer is most likely to produce hyponatremia?

a. Carbamazepine

b. Lamotrigine

c. Lithium

d. Valproate

A

Which adverse effect is most likely to occur if the dose of

lamotrigine is increased too rapidly?

a. Hypertensive crisis

b. Neuroleptic malignant syndrome

c. Serotonin syndrome

d. Stevens-Johnson syndrome

D

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

a. Mesocortical

b. Mesolimbic

c. Nigrostriatal

d. Tuberoinfundibular

B

which 2nd generation antipsychotic is available as a long-acting intramuscular injection?

a. Asenapine

b. Lumateperone

c. Quetiapine

d. Risperidone

D

Which statement made by the nurse concerning ethics

demonstrates the best understanding of the concept?

a. “It isn’t right to deny someone healthcare because they

can’t pay for it.”

b. “I never discuss my patient’s refusal of treatment.”

c. “The hospital needs to buy more respirators so we always

have one available.”

d. “Not all ICU patients have the right to unbiased atten-

tion from the staff.”

A

2. Which nursing intervention demonstrates the ethical prin-

ciple of beneficence?

a. Refusing to administer a placebo to a patient.

b. Attending an in-service on the operation of the new IV

infusion pumps.

c. Providing frequent updates to the family of a patient cur-

rently in surgery.

d. Respecting the right of the patient to make decisions

about whether or not to have electroconvulsive therapy.

C

How can a newly hired nurse best attain information con-

cerning the state’s mental health laws and statutes?

a. Discuss the issue with the facility’s compliance officer

b. Conduct an internet search using the keywords “men-

tal + health + statutes + (your state)”

c. Consult the ANA’s Code of Ethics for Nurses

d. Review the facility’s latest edition of the policies manual

B

When considering facility admissions for mental health-

care, what characteristic is unique to a voluntary admission?

a. The patient poses no substantial threat to themselves or

to others

b. The patient has the right to seek legal counsel

c. A request in writing is required before admission

d. A mental illness has been previously diagnosed

C

Which situations demonstrate liable behavior on the part of

the staff? Select all that apply.

a. Forgetting to obtain consent for electroconvulsive ther-

apy for a cognitively impaired patient

b. Leaving a patient with suicidal thoughts alone in the

bathroom to shower

c. Threatening to restrain a patient who stole from another

patient on the unit

d. Reassuring a patient with paranoia that his antipsychotic

medication was not tampered with

e. Placing a patient who has repeatedly threatened to

assault staff in seclusion

A, B, C

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:

a. Has not violated confidentiality laws because he did not

use the patient’s name.

b. Cannot be held liable for violating confidentiality laws

because he was not the primary nurse for the patient.

c. Has violated confidentiality laws and can be held liable.

d. Cannot be held liable because postings on a social media

site are excluded from confidentiality laws.

C

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?

a. Professional association, customary care, facility policy

b. State board of nursing, facility policy, customary care

c. Facility policy, professional associations, state board of

nursing

d. State board of nursing, professional association, facility

policy

D

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?

a. “I will continue treatment in an outpatient treatment

center.”

b. “My nurse practitioner has recommended group

therapy.”

c. “I am finally free, no more therapy.”

d. “Attending therapy and taking my meds are a part of this

conditional release.”

C

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?

a. The mother of an unconscious patient saying okay to

surgery

b. Care given to a heroin overdose victim

c. Immobilizing a patient who has refused to take medication

d. Signing general intake paperwork with specific

parameters

B

Based on Maslow’s hierarchy of needs, physiological needs

for a restrained patient include: Select all that apply.

a. Private toileting, oral hydration

b. Checking the tightness of the restraints

c. Therapeutic communication

d. Maintaining a patent airway

A, B, D

Which statement made by the nurse demonstrates the best

understanding of nonverbal communication?

a. “The patient’s verbal and nonverbal communication is

often different.”

b. “When my patient responds to my question, I check for

congruence between verbal and nonverbal communica-

tion to help validate the response.”

c. “If a patient is slumped in the chair, I can be sure he’s

angry or depressed.”

d. “It’s easier to interpret verbal communication than to

interpret nonverbal communication.”

B

Which nursing statement is an example of reflection?

a. “I think this feeling will pass.”

b. “So you are saying that life has no meaning.”

c. “I’m not sure I understand what you mean.”

d. “You look sad.”

D

When should a nurse be most alert to the possibility of

communication errors that could harm the patient?

a. Change-of-shift reports

b. Admission interviews

c. One-on-one conversations with patients

d. Conversations with patients’ families

A

During an admission assessment and subsequent counsel-

ing sessions, the nurse looks for congruence between:

a. Visual and tactile communication

b. Body posture and vocal quality

c. Personal space and eye contact

d. Verbal and nonverbal communication

D

What principle about nurse-patient communication should

guide a nurse’s fear about “saying the wrong thing” to a

patient?

a. Patients tend to appreciate a well-meaning person who

conveys genuine acceptance, respect, and concern for

their situation.

b. The patient is more interested in talking to you than lis-

tening to what you have to say and so is not likely to be

offended.

c. Considering the patient’s history, it is unlikely anything

you say could cause actual harm.

d. Most people with a mental illness have by necessity

developed a high tolerance of forgiveness.

A

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?

a. “A new psychiatrist is a chance to start fresh. I’m sure it

will go well for you.”

b. “You say you look forward to the meeting, but you appear

anxious or unhappy.”

c. “I notice that you frowned and avoided eye contact just

now. Don’t you feel well?”

d. “I get the impression you don’t really want to see your

psychiatrist—can you tell me why?”

B

Which student behavior is consistent with therapeutic

communication?

a. Offering your opinion to convey support and direction.

b. Summarizing the essence of the patient’s comments in

your own words.

c. Interrupting periods of silence before they become awk-

ward for the patient.

d. Telling the patient he did well when you approve of his

statements or actions.

B

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?

a. “There are no such things as demons. What you saw were

hallucinations.”

b. “It is not possible for anyone to enter your room at night.

You are safe here.”

c. “You seem upset. Please tell me more about what you

experienced last night.”

d. “That must have been frightening, but we’ll check on you

at night and you’ll be safe.”

C

Therapeutic communication is the foundation of a patient-

centered care. Which of the following techniques is not con-

sidered therapeutic?

a. Restating

b. Encouraging description of perception

c. Summarizing

d. Asking “why” questions

D

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?

a. “That sounds exciting. Would you be willing to visit and

show me the app?”

b. “At this time, there is no real evidence that the app can

replace our therapy.”

c. “I am not sure that is a good idea right now. We are so

close to making real progress.”

d. “Why would you think that is a better option than meet-

ing with me?”

A

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 pro-

duce a large amount of:

a. Carbon dioxide

b. Growth hormone

c. Epinephrine

d. Aldosterone

C

Which question is focused on the assessment of an individ-

ual’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 medica-

tion as it is prescribed?”

d. “Who can you rely on if you need help after you’re dis-

charged from the hospital?”

e. “What do you do to help manage the demands of parent-

ing a 4-year-old and a newborn?”

B, D, E

When considering stress, what is the primary goal of mak-

ing 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

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 anxi-

ety 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 demon-

strates 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 relax-

ation 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

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 speak because she doesn’t know what to say

A

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 focus.”

d. “I have fear that I will fail at college.”

C

The activity of gamma-aminobutyric acid (GABA) contrib-

utes 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

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 practitio-

ner 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

A homebound patient diagnosed with agoraphobia has

been receiving therapy at home. The nurse recognizes effec-

tive 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 his-

tory, but treatment can help.”

d. “I don’t see the point in going out anymore.”

C

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 envi-

ronment. 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 may be experiencing acute stress disorder and

should be assessed further.

b. Nick is experiencing posttraumatic stress disor-

der (PTSD) and should be referred for outpatient

treatment.

c. Nick is experiencing anxiety and grief and PTSD should

be considered.

d. Nick is experiencing mild anxiety and a normal grief

reaction; no intervention is needed.

A

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 depart-

ment with deep cuts on her arms with no memory of how

this occurred. The priority nursing intervention for Susan-

nah 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

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

Ashley is a 21-year-old college student who was sex-

ually 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

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 inpa-

tient treatment to deal with her traumatic memories as

well as to work through her delusions.”

c. “Most mental health providers are skeptical about dis-

sociative 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

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

Emptiness, a loss of self, difficulty thinking of the future,

and anger at her dead husband. The nurse suggests bereave-

ment counseling. The widow is most likely suffering from:

a. Major depression

b. Normal grieving

c. Adjustment disorder

d. Posttraumatic stress disorder

C

Maggie, a child in protective custody, is found to have an

imaginary friend, Holly. The foster family shares this infor-

mation with the nurse. The nurse teaches the family mem-

bers 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 imagi-

nary friends are unacceptable.”

C

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

 A pregnant woman is in a relationship with a male who rou-

tinely 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

Which patient statement does not demonstrate an under-

standing of a suicide safety plan?

a. “Going for a really long, hard run helps clear my mind

and stops the suicidal thoughts.”

b. “I will take extra medication if I start getting those self-

destructive feelings.”

c. “My sister is always there for me when I start getting

suicidal.”

d. “I keep the suicide prevention phone number in my

wallet.”

B

Which interventions will help make the environment on the

unit safer for patients with suicidal ideation? Select all that

apply.

a. All windows are kept locked.

b. Every shower has a breakaway shower rod.

c. Eating utensils are counted when trays are collected.

d. Patient doors are kept open.

e. Staying within listening distance of the patient.

A, B, C, D

What are the nursing responsibilities to a patient expressing

suicidal thoughts? Select all that apply.

a. Instituting one-to-one observation.

b. Documenting the patient’s whereabouts and mood every

15 to 30 minutes.

c. Ensuring that the patient has no contact with glass or

metal utensils.

d. Ensuring that patient has swallowed each individual

dose of medication.

e. Discussing triggers of depression.

A, B, C, D

When considering community suicide prevention pro-

grams, what population should the nurse plan to service

with regular suicide screenings? Select all that apply.

a. 10- to 34-year-olds

b. Males

c. College-educated adults

d. Rural population

e. Native American

A, B, D, E

Research supports that which intervention implemented on

a long-term basis significantly reduces the incidence of sui-

cide and suicide attempts in a patient diagnosed with bipo-

lar disorder?

a. An antipsychotic medication

b. Electroconvulsive therapy (ECT)

c. One-on-one observation

d. Lithium

D

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 thera-

pist’s best response would be:

a. “He probably acted quickly on his impulse to kill himself.”

b. “He did not want to think about the pain he would cause

you.”

c. “He was not able to think clearly due to his emotional

pain.”

d. “He thought you may think it was an accident if there

was no note.”

C

Martin is a 23-year-old male with a new diagnosis of schizo-

phrenia, and his family is receiving information from a

home health nurse. The topic of education is suicide pre-

vention, and the nurse recognizes effective teaching when

the mother says:

a. “Persons with schizophrenia rarely die by suicide.”

b. “Suicide risk is greatest in the first few years after

diagnosis.”

c. “Suicide is not common in schizophrenia due to

confusion.”

d. “Most people diagnosed with schizophrenia die of

suicide.”

B

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:

a. Elevated dopamine levels

b. Low levels of serotonin

c. Outward aggression turned inward

d. A lack of perfectionism

B

Which person is at the highest risk for suicide?

a. A 50-year-old married white male with major depressive

disorder who has a plan to overdose if circumstances at

work do not improve.

b. A 45-year-old married white female who recently lost

her parents, suffers from bipolar disorder, and attempted

suicide once as a teenager.

c. 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 gun he has hidden.

d. An older Hispanic male who is Catholic, living with a

debilitating chronic illness, recently widowed, and who

states, “I wish that God would take me too.”

C

Kara is a 23-year-old patient admitted with major depres-

sive disorder and suicidal ideation. Which intervention(s)

would be therapeutic for Kara? Select all that apply.

a. Focus primarily on developing solutions to the problems

that lead the patient to feel suicidal.

b. Assess the patient thoroughly and reassess the patient at

regular intervals as levels of risk fluctuate.

c. Avoid talking about the suicidal ideation as this may

increase the patient’s risk for suicidal behavior.

d. Meet regularly with the patient to provide opportunities

for the patient to express and explore feelings.

e. Administer antidepressant medications cautiously and

conservatively because of their potential to increase the

suicide risk in Kara’s age group.

f. Help the patient identify positive self-attributes and to

question negative self-perceptions that are unrealistic

B, D, E, F