, Table of Contents
Chapter 01. The Concept of Stress Adaptation
Chapter 02. Mental Health/Mental Illness: Historical and Theoretical Concepts
Chapter 03. Psychopharmacology
Chapter 04. Concepts of Psychobiology
Chapter 05. Ethical and Legal Issues in Psychiatric/Mental Health Nursing
Chapter 06. Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing
Chapter 07. Relationship Development
Chapter 08. Therapeutic Communication
Chapter 09. The Nursing Process in Psychiatric/Mental Health Nursing
Chapter 10. Therapeutic Groups
Chapter 11. Intervention With Families
Chapter 12. Milieu Therapy - The Therapeutic Community
Chapter 13. Crisis Intervention
Chapter 14. Assertiveness Training
Chapter 15. Promoting Self-Esteem
Chapter 16. Anger/Aggression Management
Chapter 17. The Suicidal Client
Chapter 18. Behavior Therapy
Chapter 19. Cognitive Therapy
Chapter 20. Electroconvulsive Therapy
Chapter 21. The Recovery Model
Chapter 22. Neurocognitive Disorders
Chapter 23. Substance-Related and Addictive Disorders
Chapter 24. Schizophrenia Spectrum and Other Psychotic Disorders
Chapter 25. Depressive Disorders
Chapter 26. Bipolar and Related Disorders
Chapter 27. Anxiety, Obsessive-Compulsive, and Related Disorders
Chapter 28: Trauma and Stressor-Related Disorders
Chapter 29. Somatic Symptom and Dissociative Disorders
Chapter 30. Issues Related to Human Sexuality and Gender Dysphoria
Chapter 31. Eating Disorders
Chapter 32. Personality Disorders
Chapter 33. Children and Adolescents
Chapter 34. The Aging Individual
Chapter 35. Survivors of Abuse or Neglect
Chapter 36. Community Mental Health Nursing
Chapter 37. The Bereaved Individual
Chapter 38. Military Families
,Chapter 01. Psychopharmacology
Multiple Choice
1. The NURSE manager on the psychiatric unit was explaining to the new staff the differences between
typical and atypical antipsychotics. The NURSE correctly states that atypical antipsychotics:
A. Remain in the system longer
B. Act more quickly to reduce delusions
C. Produce fewer extrapyramidal effects
D. Are risk free for neuroleptic malignant syndrome (NMS)
CORRECT ANSWER:C
Atypical antipsychotics produce less D2blockade; thus movement disorders are less of a problem. No evidence
suggests that the medication remains in the system longer nor that it acts more quicklyto reduce delusions. The
atypicals are not risk free for NMS.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need:
Physiological Integrity: Pharmacological and Parenteral Therapies
2. The NURSE would assess for neuroleptic malignant syndrome (NMS) if a patient on haloperidol
(Haldol) develops a:
A. 30 mm Hg decrease in blood pressure reading
B. Respiratory rate of 24 respirations per minute
C. Temperature reading of 104° F
D. Pulse rate of 70 beats per minute
CORRECT ANSWER:C
Increased temperature is the cardinal sign of NMS. This BP is not a significant feature of NMS. There are no
significant findings to support the options related to respirations or pulse rate.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
Physiological Integrity: Pharmacological and Parenteral Therapies
3. A patient taking fluphenazine (Prolixin) complains of dry mouth and blurred vision. What would the NURSE
assess as the likely cause of these symptoms?
A. Decreased dopamine at receptor sites
B. Blockade of histamine
C. Cholinergic blockade
D. Adrenergic blocking
CORRECT ANSWER:C
Fluphenazine administration produces blockade of cholinergic receptors giving rise to anticholinergic effects,
such as dry mouth, blurred vision, and constipation.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
Physiological Integrity: Pharmacological and Parenteral Therapies
, 4. Which behavior displayed by a patient receiving a typical antipsychotic medication would be assessed as
displaying behaviors characteristic of tardive dyskinesia (TD)?
A. Grimacing and lip smacking
B. Falling asleep in the chair and refusing to eat lunch
C. Experiencing muscle rigidity and tremors
D. Having excessive salivation and drooling
CORRECT ANSWER:A
TD manifests as abnormal movements of voluntary muscle groups after a prolonged period of dopamine
blockade. Movements may affect any muscle group, but muscles of the face, mouth, tongue, and digits are
commonly affected. Falling asleep is reflective of the sedative effect of these medications. Muscle rigidity and
drooling reflect EPS caused from imbalance between dopamine and acetylcholine.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
Physiological Integrity: Pharmacological and Parenteral Therapies
5. A NURSE administers a medication that potentiates the action of GABA. Which finding would be expected?
A. Reduced anxiety
B. Improved memory
C. More organized thinking
D. Fewer sensory perceptual alterations
CORRECT ANSWER:A
Increased levels of GABA reduce anxiety, thus any potentiation of GABA action should result in anxiety
reduction. Memory enhancement is associated with acetylcholine and substance P. Thought disorganization is
associated with dopamine. GABA is not associated with sensory perceptual alterations.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
Physiological Integrity: Pharmacological and Parenteral Therapies
6. On the basis of current knowledge of neurotransmitter effects, a NURSE could anticipate that the
treatment plan for a patient with memory difficulties might include medications designed to:
A. inhibit GABA.
B. increase dopamine at receptor sites.
C. decrease dopamine at receptor sites.
D. prevent destruction of acetylcholine.
CORRECT ANSWER:D
Increased acetylcholine plays a role in learning and memory. Preventing destruction of acetylcholine by
acetylcholinesterase would result in higher levels of acetylcholine, with the potential for improved memory.
GABA is known to affect anxiety level rather than memory. Increased dopamine would cause symptoms
associated with schizophrenia or mania rather than improve memory. Decreasing dopamine at receptor sites is
associated with Parkinson’s disease rather than improving memory.
KEY: Cognitive Level: Comprehension | Integrated Processes: Nursing Process: Planning | Client Need:
Physiological Integrity: Pharmacological and Parenteral Therapies
Chapter 01. The Concept of Stress Adaptation
Chapter 02. Mental Health/Mental Illness: Historical and Theoretical Concepts
Chapter 03. Psychopharmacology
Chapter 04. Concepts of Psychobiology
Chapter 05. Ethical and Legal Issues in Psychiatric/Mental Health Nursing
Chapter 06. Cultural and Spiritual Concepts Relevant to Psychiatric/Mental Health Nursing
Chapter 07. Relationship Development
Chapter 08. Therapeutic Communication
Chapter 09. The Nursing Process in Psychiatric/Mental Health Nursing
Chapter 10. Therapeutic Groups
Chapter 11. Intervention With Families
Chapter 12. Milieu Therapy - The Therapeutic Community
Chapter 13. Crisis Intervention
Chapter 14. Assertiveness Training
Chapter 15. Promoting Self-Esteem
Chapter 16. Anger/Aggression Management
Chapter 17. The Suicidal Client
Chapter 18. Behavior Therapy
Chapter 19. Cognitive Therapy
Chapter 20. Electroconvulsive Therapy
Chapter 21. The Recovery Model
Chapter 22. Neurocognitive Disorders
Chapter 23. Substance-Related and Addictive Disorders
Chapter 24. Schizophrenia Spectrum and Other Psychotic Disorders
Chapter 25. Depressive Disorders
Chapter 26. Bipolar and Related Disorders
Chapter 27. Anxiety, Obsessive-Compulsive, and Related Disorders
Chapter 28: Trauma and Stressor-Related Disorders
Chapter 29. Somatic Symptom and Dissociative Disorders
Chapter 30. Issues Related to Human Sexuality and Gender Dysphoria
Chapter 31. Eating Disorders
Chapter 32. Personality Disorders
Chapter 33. Children and Adolescents
Chapter 34. The Aging Individual
Chapter 35. Survivors of Abuse or Neglect
Chapter 36. Community Mental Health Nursing
Chapter 37. The Bereaved Individual
Chapter 38. Military Families
,Chapter 01. Psychopharmacology
Multiple Choice
1. The NURSE manager on the psychiatric unit was explaining to the new staff the differences between
typical and atypical antipsychotics. The NURSE correctly states that atypical antipsychotics:
A. Remain in the system longer
B. Act more quickly to reduce delusions
C. Produce fewer extrapyramidal effects
D. Are risk free for neuroleptic malignant syndrome (NMS)
CORRECT ANSWER:C
Atypical antipsychotics produce less D2blockade; thus movement disorders are less of a problem. No evidence
suggests that the medication remains in the system longer nor that it acts more quicklyto reduce delusions. The
atypicals are not risk free for NMS.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need:
Physiological Integrity: Pharmacological and Parenteral Therapies
2. The NURSE would assess for neuroleptic malignant syndrome (NMS) if a patient on haloperidol
(Haldol) develops a:
A. 30 mm Hg decrease in blood pressure reading
B. Respiratory rate of 24 respirations per minute
C. Temperature reading of 104° F
D. Pulse rate of 70 beats per minute
CORRECT ANSWER:C
Increased temperature is the cardinal sign of NMS. This BP is not a significant feature of NMS. There are no
significant findings to support the options related to respirations or pulse rate.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
Physiological Integrity: Pharmacological and Parenteral Therapies
3. A patient taking fluphenazine (Prolixin) complains of dry mouth and blurred vision. What would the NURSE
assess as the likely cause of these symptoms?
A. Decreased dopamine at receptor sites
B. Blockade of histamine
C. Cholinergic blockade
D. Adrenergic blocking
CORRECT ANSWER:C
Fluphenazine administration produces blockade of cholinergic receptors giving rise to anticholinergic effects,
such as dry mouth, blurred vision, and constipation.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
Physiological Integrity: Pharmacological and Parenteral Therapies
, 4. Which behavior displayed by a patient receiving a typical antipsychotic medication would be assessed as
displaying behaviors characteristic of tardive dyskinesia (TD)?
A. Grimacing and lip smacking
B. Falling asleep in the chair and refusing to eat lunch
C. Experiencing muscle rigidity and tremors
D. Having excessive salivation and drooling
CORRECT ANSWER:A
TD manifests as abnormal movements of voluntary muscle groups after a prolonged period of dopamine
blockade. Movements may affect any muscle group, but muscles of the face, mouth, tongue, and digits are
commonly affected. Falling asleep is reflective of the sedative effect of these medications. Muscle rigidity and
drooling reflect EPS caused from imbalance between dopamine and acetylcholine.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need:
Physiological Integrity: Pharmacological and Parenteral Therapies
5. A NURSE administers a medication that potentiates the action of GABA. Which finding would be expected?
A. Reduced anxiety
B. Improved memory
C. More organized thinking
D. Fewer sensory perceptual alterations
CORRECT ANSWER:A
Increased levels of GABA reduce anxiety, thus any potentiation of GABA action should result in anxiety
reduction. Memory enhancement is associated with acetylcholine and substance P. Thought disorganization is
associated with dopamine. GABA is not associated with sensory perceptual alterations.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need:
Physiological Integrity: Pharmacological and Parenteral Therapies
6. On the basis of current knowledge of neurotransmitter effects, a NURSE could anticipate that the
treatment plan for a patient with memory difficulties might include medications designed to:
A. inhibit GABA.
B. increase dopamine at receptor sites.
C. decrease dopamine at receptor sites.
D. prevent destruction of acetylcholine.
CORRECT ANSWER:D
Increased acetylcholine plays a role in learning and memory. Preventing destruction of acetylcholine by
acetylcholinesterase would result in higher levels of acetylcholine, with the potential for improved memory.
GABA is known to affect anxiety level rather than memory. Increased dopamine would cause symptoms
associated with schizophrenia or mania rather than improve memory. Decreasing dopamine at receptor sites is
associated with Parkinson’s disease rather than improving memory.
KEY: Cognitive Level: Comprehension | Integrated Processes: Nursing Process: Planning | Client Need:
Physiological Integrity: Pharmacological and Parenteral Therapies
