NR 326 CMS FINAL EXAM ACTUAL EXAM 100 QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES
What are the 7 ethical principles? - ANSWER: 1. Autonomy
2. Beneficence
3. Nonmaleficence
4. Justice
5. Fidelity
6. Veracity
7. Confidentiality
Autonomy - ANSWER: Self-government and ability to make decisions for one's self
Benficence - ANSWER: To promote good
Nonmaleficence - ANSWER: To do no harm
Justice - ANSWER: Fairness
Fidelity - ANSWER: Faithfulness and loyalty
Veracity - ANSWER: Truthfulness and honesty
Confidentiality - ANSWER: Respecting privacy of the patient
What should the nurse do if a patient refuses their medication? - ANSWER: Educate
the patient on the importance of medication adherence
- Patient does have the right to refuse medication
How often should restraint/seclusion orders be renewed for a patient 18 or older? -
ANSWER: Every 4 hours
How often should restraint/seclusion orders be renewed for a patient age 9-17? -
ANSWER: Every 2 hours
How often should restraint/seclusion orders be renewed for a patient under the age
of 9? - ANSWER: Every hour
What are some important nursing interventions to remember for restraints? -
ANSWER: - Assess the patient every 15 minutes (Face-to-Face Assessment)
- Document everything, including renewal/order times
- Place criteria for removal
Transference - ANSWER: When the patient unconsciously displaces emotional
reactions or patterns of behaviors onto others (ex. the nurse)
,Countertransference - ANSWER: When the nurse displaces feelings related to people
in one's past onto the patient (mostly unconscious)
What is allowed to be delegated to assistive personnel? - ANSWER: - ADLs
- I&O
- Vitals
- Feedings
What should NOT be delegated to assistive personnel? - ANSWER: Anything to do
with the nursing process, client education, assessment, or judgement
How often is routine outpatient for mental health settings and which severity? -
ANSWER: For mild
- 2x a month
How often is intensive outpatient for mental health settings and which severity? -
ANSWER: For moderate
- 2-4 days a week, 3 hrs a day
How often is partial hospitalization for mental health settings and which severity? -
ANSWER: For moderate
- 5-7 days a week, 5 hrs a day
How often is inpatient for mental health settings and which severity? - ANSWER: For
severe
- 7 days a week, 24 hrs a day
Modeling - ANSWER: Leading my example
Ex. Staff demonstration
"Role Modeling"
Operant Conditioning - ANSWER: Positive behavior is reinforced based on a reward
system
Systemic Desensitization - ANSWER: Used for anxiety disorders
- Taught techniques to handle their fears as their fears are exposed
Aversion Therapy - ANSWER: Used to alcohol use disorder
- Unpleasant stimuli with maladaptive behaviors
Ex. Disulfiram (Antabuse)
Dialectical Behavior Therapy - ANSWER: Uses guided imagery and meditation for
pain, tension, and anxiety
What if the main contraindication for electrocompulsive therapy (ECT)? - ANSWER:
Increased ICP
, What are the indications for ECT? - ANSWER: 1. Severe depression (med resistant)
2. Mania with BP
3. Schizophrenia
What are the side effects of ECT? - ANSWER: - Short term memory loss
- Confusion
- Pain
- Nausea
- ECG changes
How long should the patient be NPO prior to ECT treatment? - ANSWER: 6-8 hours
What are the 3 meds used during ECT and what are they used for? - ANSWER: 1.
Atropine (Anticholinergic) - stops body fluids
2. Proprofol (Anesthetic)
3. Succinylcholine (Neuromuscular Blocking Agent) - muscle relaxant
What are the 4 levels of anxiety? - ANSWER: 1. Mild
2. Moderate
3. Severe
4. Panic
Mild Anxiety & Symptoms - ANSWER: Normal experience
- restlessness, irritability, fidgeting, foot tapping
Moderate Anxiety & Symptoms - ANSWER: Reduced perception and ability to think
- pacing, difficulty concentrating, increased RR and HR
Severe Anxiety & Symptoms - ANSWER: No ability to problem solve
- feeling of doom, tachycardia, hyperventilation, rapid speech
Panic Anxiety & Symptoms - ANSWER: Loses touch with reality, disturbed behaviors
- dilated pupils, hallucinations, severe withdrawal, shakiness
What are the nursing interventions for mild-moderate anxiety? - ANSWER: - Evaluate
past coping mechanisms
- Relaxation techniques like abdominal breathing exercises
What are the nursing interventions for severe-panic anxiety? - ANSWER: Quiet
environment with minimal stimuli
- NO PROBLEM SOLVING OCCURS HERE
Obsessive-Compulsive Disorder Treatment/Medications - ANSWER: SSRI's for long-
term maintenance
- Fluoxetine
- Paroxetine
CORRECT ANSWERS WITH RATIONALES
What are the 7 ethical principles? - ANSWER: 1. Autonomy
2. Beneficence
3. Nonmaleficence
4. Justice
5. Fidelity
6. Veracity
7. Confidentiality
Autonomy - ANSWER: Self-government and ability to make decisions for one's self
Benficence - ANSWER: To promote good
Nonmaleficence - ANSWER: To do no harm
Justice - ANSWER: Fairness
Fidelity - ANSWER: Faithfulness and loyalty
Veracity - ANSWER: Truthfulness and honesty
Confidentiality - ANSWER: Respecting privacy of the patient
What should the nurse do if a patient refuses their medication? - ANSWER: Educate
the patient on the importance of medication adherence
- Patient does have the right to refuse medication
How often should restraint/seclusion orders be renewed for a patient 18 or older? -
ANSWER: Every 4 hours
How often should restraint/seclusion orders be renewed for a patient age 9-17? -
ANSWER: Every 2 hours
How often should restraint/seclusion orders be renewed for a patient under the age
of 9? - ANSWER: Every hour
What are some important nursing interventions to remember for restraints? -
ANSWER: - Assess the patient every 15 minutes (Face-to-Face Assessment)
- Document everything, including renewal/order times
- Place criteria for removal
Transference - ANSWER: When the patient unconsciously displaces emotional
reactions or patterns of behaviors onto others (ex. the nurse)
,Countertransference - ANSWER: When the nurse displaces feelings related to people
in one's past onto the patient (mostly unconscious)
What is allowed to be delegated to assistive personnel? - ANSWER: - ADLs
- I&O
- Vitals
- Feedings
What should NOT be delegated to assistive personnel? - ANSWER: Anything to do
with the nursing process, client education, assessment, or judgement
How often is routine outpatient for mental health settings and which severity? -
ANSWER: For mild
- 2x a month
How often is intensive outpatient for mental health settings and which severity? -
ANSWER: For moderate
- 2-4 days a week, 3 hrs a day
How often is partial hospitalization for mental health settings and which severity? -
ANSWER: For moderate
- 5-7 days a week, 5 hrs a day
How often is inpatient for mental health settings and which severity? - ANSWER: For
severe
- 7 days a week, 24 hrs a day
Modeling - ANSWER: Leading my example
Ex. Staff demonstration
"Role Modeling"
Operant Conditioning - ANSWER: Positive behavior is reinforced based on a reward
system
Systemic Desensitization - ANSWER: Used for anxiety disorders
- Taught techniques to handle their fears as their fears are exposed
Aversion Therapy - ANSWER: Used to alcohol use disorder
- Unpleasant stimuli with maladaptive behaviors
Ex. Disulfiram (Antabuse)
Dialectical Behavior Therapy - ANSWER: Uses guided imagery and meditation for
pain, tension, and anxiety
What if the main contraindication for electrocompulsive therapy (ECT)? - ANSWER:
Increased ICP
, What are the indications for ECT? - ANSWER: 1. Severe depression (med resistant)
2. Mania with BP
3. Schizophrenia
What are the side effects of ECT? - ANSWER: - Short term memory loss
- Confusion
- Pain
- Nausea
- ECG changes
How long should the patient be NPO prior to ECT treatment? - ANSWER: 6-8 hours
What are the 3 meds used during ECT and what are they used for? - ANSWER: 1.
Atropine (Anticholinergic) - stops body fluids
2. Proprofol (Anesthetic)
3. Succinylcholine (Neuromuscular Blocking Agent) - muscle relaxant
What are the 4 levels of anxiety? - ANSWER: 1. Mild
2. Moderate
3. Severe
4. Panic
Mild Anxiety & Symptoms - ANSWER: Normal experience
- restlessness, irritability, fidgeting, foot tapping
Moderate Anxiety & Symptoms - ANSWER: Reduced perception and ability to think
- pacing, difficulty concentrating, increased RR and HR
Severe Anxiety & Symptoms - ANSWER: No ability to problem solve
- feeling of doom, tachycardia, hyperventilation, rapid speech
Panic Anxiety & Symptoms - ANSWER: Loses touch with reality, disturbed behaviors
- dilated pupils, hallucinations, severe withdrawal, shakiness
What are the nursing interventions for mild-moderate anxiety? - ANSWER: - Evaluate
past coping mechanisms
- Relaxation techniques like abdominal breathing exercises
What are the nursing interventions for severe-panic anxiety? - ANSWER: Quiet
environment with minimal stimuli
- NO PROBLEM SOLVING OCCURS HERE
Obsessive-Compulsive Disorder Treatment/Medications - ANSWER: SSRI's for long-
term maintenance
- Fluoxetine
- Paroxetine
