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Chapter 19. Medical Problems and Psychiatric Syndromes
MULTIPLE CHOICE
1. The nurse learns at report that a newly admitted manic patient is demonstrating grandiosity.
Which statement would be most consistent with this symptom?
a. I cant do anything anymore.
b. Im the worlds most astute financier.
c. I can understand why my wife is upset that I overspend.
d. I cant understand where all the money in our family goes. ANS: B
An individual who is demonstrating grandiosity has an exaggerated view of his abilities. The
other options are more moderate statements and lack that element of exaggeration.
2. The nurse will base a discussion of dysthymia on the fact that the condition:
a. Typically has an acute onset b. Involves delusional thinking
c. Is chronic low-level depression
d. Does not include suicidal ideation
ANS: C
Dysthymia is identified as a chronic low-level depression frequently lasting over a period of
several years without remitting. Dysthymia has a slow, insidious onset. Delusional thinking is
not a common manifestation of dysthymia. Suicidal thoughts are seen among dysthymic
patients.
3. What is the priority nursing diagnosis for a patient exhibiting signs of acute mania that
include exaggerated physical activity, agitation, insomnia, and anorexia?
a. Risk for injury
b. Chronic low self-esteem c. Noncompliance
d. Insomnia
ANS: A
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Risk for injury is the priority diagnosis. Possible injuries include dehydration, which may
result from not drinking and trauma, which may result from bumping into objects or from
physical altercations. The other options are valid diagnoses, but not of highest priority.
4. A patient has been admitted with a diagnosis of atypical depression. In planning
interventions, the nurse would expect to consider the characteristic symptom of:
a. Seasonal episodes b. Leaden paralysis
c. Psychomotor agitation
d. Increased depression in the morning
ANS: B
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Behavioral characteristics of atypical depression include the feeling that ones limbs are so
heavy they cannot be lifted or moved (leaden paralysis). Seasonal mood changes are
characteristic of seasonal affective disorder. Psychomotor agitation and depression that is
greater in the morning than in the evening are characteristics more likely to be observed in
patients with melancholic depression.
5. An inappropriately dressed patient has not slept for 3 days while making excessive,
expensive long-distance phone calls. When the patient can be heard singing loudly in the
examining room, the nurse makes initial plans to focus on:
a. Assessing needs for food, liquids, and rest b. Setting strict limits on dress and behavior
c. Conducting an in-depth suicide assessment
d. Obtaining a complete psychosocial assessment
ANS: A
Patients with mania frequently ignore their basic physiologic needs, as evidenced by not
sleeping for 3 days, thus making these assessments the priority. Limits, although appropriate
to consider, are not the priority. The manic state precludes a thorough assessment initially.
Suicide
assessment is not a priority at this time but reckless behavior could result in personal injury.
6. Which statement by the patient would indicate the need for additional education regarding
the prescribed lithium treatment regimen?
a. I will restrict my daily salt intake.
b. I will take my medications with food.
c. I will have my blood drawn on schedule.
d. I will drink 8 to 12 glasses of liquids daily. ANS: A
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Chapter 19. Medical Problems and Psychiatric Syndromes
MULTIPLE CHOICE
1. The nurse learns at report that a newly admitted manic patient is demonstrating grandiosity.
Which statement would be most consistent with this symptom?
a. I cant do anything anymore.
b. Im the worlds most astute financier.
c. I can understand why my wife is upset that I overspend.
d. I cant understand where all the money in our family goes. ANS: B
An individual who is demonstrating grandiosity has an exaggerated view of his abilities. The
other options are more moderate statements and lack that element of exaggeration.
2. The nurse will base a discussion of dysthymia on the fact that the condition:
a. Typically has an acute onset b. Involves delusional thinking
c. Is chronic low-level depression
d. Does not include suicidal ideation
ANS: C
Dysthymia is identified as a chronic low-level depression frequently lasting over a period of
several years without remitting. Dysthymia has a slow, insidious onset. Delusional thinking is
not a common manifestation of dysthymia. Suicidal thoughts are seen among dysthymic
patients.
3. What is the priority nursing diagnosis for a patient exhibiting signs of acute mania that
include exaggerated physical activity, agitation, insomnia, and anorexia?
a. Risk for injury
b. Chronic low self-esteem c. Noncompliance
d. Insomnia
ANS: A
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Risk for injury is the priority diagnosis. Possible injuries include dehydration, which may
result from not drinking and trauma, which may result from bumping into objects or from
physical altercations. The other options are valid diagnoses, but not of highest priority.
4. A patient has been admitted with a diagnosis of atypical depression. In planning
interventions, the nurse would expect to consider the characteristic symptom of:
a. Seasonal episodes b. Leaden paralysis
c. Psychomotor agitation
d. Increased depression in the morning
ANS: B
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Behavioral characteristics of atypical depression include the feeling that ones limbs are so
heavy they cannot be lifted or moved (leaden paralysis). Seasonal mood changes are
characteristic of seasonal affective disorder. Psychomotor agitation and depression that is
greater in the morning than in the evening are characteristics more likely to be observed in
patients with melancholic depression.
5. An inappropriately dressed patient has not slept for 3 days while making excessive,
expensive long-distance phone calls. When the patient can be heard singing loudly in the
examining room, the nurse makes initial plans to focus on:
a. Assessing needs for food, liquids, and rest b. Setting strict limits on dress and behavior
c. Conducting an in-depth suicide assessment
d. Obtaining a complete psychosocial assessment
ANS: A
Patients with mania frequently ignore their basic physiologic needs, as evidenced by not
sleeping for 3 days, thus making these assessments the priority. Limits, although appropriate
to consider, are not the priority. The manic state precludes a thorough assessment initially.
Suicide
assessment is not a priority at this time but reckless behavior could result in personal injury.
6. Which statement by the patient would indicate the need for additional education regarding
the prescribed lithium treatment regimen?
a. I will restrict my daily salt intake.
b. I will take my medications with food.
c. I will have my blood drawn on schedule.
d. I will drink 8 to 12 glasses of liquids daily. ANS: A
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