Psychiatric Nursing Exam 2 (testbank)
with answers
A patient became severely depressed when the last of six children moved out of the home 4
months ago. The patient repeatedly says, No one cares about me. Im not worth anything.
Which response by the nurse would be the most helpful?
a. Things will look brighter soon. Everyone feels down once in a while.
b. The staff here cares about you and wants to try to help you get better.
c. It is difficult for others to care about you when you repeatedly say negative things about
yourself.
d. Ill sit with you for 10 minutes now and return for 10 minutes at lunchtime and again at
2:30 this afternoon. - VERIFIED ANSWERS **✔d
A patient became depressed after the last of six children moved out of the home 4 months
ago. The patient has been self-neglectful, slept poorly, lost weight, and repeatedly says, No
one cares about me anymore. Im not worth anything. Select an appropriate initial outcome
for the nursing diagnosis: Situational low self-esteem, related to feelings of abandonment.
The patient will:
a. verbalize realistic positive characteristics about self by (date)
b. consent to take antidepressant medication regularly by (date)
c. initiate social interaction with another person daily by (date)
d. identify two personal behaviors that alienate others by (date). - VERIFIED ANSWERS
**✔a
A nurse wants to reinforce positive self-esteem for a patient diagnosed with major
depressive disorder. Today, the patient is wearing a new shirt and has neat, clean hair.
Which remark is most appropriate?
a. You look nice this morning.
b. You are wearing a new shirt.
c. I like the shirt youre wearing.
,d. You must be feeling better today. - VERIFIED ANSWERS **✔b
An adult diagnosed with major depressive disorder was treated with medication and
cognitive behavioral therapy. The patient now recognizes how passivity contributed to the
depression. Which intervention should the nurse suggest?
a. Social skills training
b. Relaxation training classes
c. Use of complementary therapy
d. Learning desensitization techniques - VERIFIED ANSWERS **✔a
A priority nursing intervention for a patient diagnosed with major depressive disorder is:
a. distracting the patient from self-absorption.
b. carefully and inconspicuously observing the patient around the clock.
c. allowing the patient to spend long periods alone in self-reflection.
d. offering opportunities for the patient to assume a leadership role in the therapeutic
milieu. - VERIFIED ANSWERS **✔b
When counseling patients diagnosed with major depressive disorder, an advanced practice
nurse will address the negative thought patterns by using:
a. psychoanalytic therapy.
b. desensitization therapy.
c. cognitive behavioral therapy.
d. alternative and complementary therapies. - VERIFIED ANSWERS **✔c
A patient says to the nurse, My life does not have any happiness in it anymore. I once
enjoyed holidays, but now theyre just another day. How would the nurse document the
complaint?
a. Vegetative symptom
b. Anhedonia
,c. Euphoria
d. Anergia - VERIFIED ANSWERS **✔b
A patient diagnosed with major depressive disorder is taking a tricyclic antidepressant. The
patient says, I dont think I can keep taking these pills. They make me so dizzy, especially
when I stand up. The nurse should:
a. explain how to manage postural hypotension, and educate the patient that side effects go
away after several weeks.
b. tell the patient that the side effects are a minor inconvenience compared with the feelings
of depression.
c. withhold the drug, force oral fluids, and notify the health care provider to examine the
patient.
d. teach the patient how to use pursed-lip breathing. - VERIFIED ANSWERS **✔a
A patient diagnosed with major depressive disorder is receiving imipramine (Tofranil) 200
mg every night at bedtime. Which assessment finding would prompt the nurse to
collaborate with the health care provider regarding potentially hazardous side effects of this
drug?
a. Dry mouth
b. Blurred vision
c. Nasal congestion
d. Urinary retention - VERIFIED ANSWERS **✔d
A patient diagnosed with major depressive disorder tells the nurse, Bad things that happen
are always my fault. To assist the patient in reframing this overgeneralization, the nurse
should respond:
a. I really doubt that one person can be blamed for all the bad things that happen.
b. Lets look at one bad thing that happened to see if another explanation exists.
c. You are being exceptionally hard on yourself when you say those things.
, d. How does your belief in fate relate to your cultural heritage? - VERIFIED ANSWERS
**✔b
A nurse worked with a patient diagnosed with major depressive disorder who was severely
withdrawn and dependent on others. After 3 weeks, the patient did not improve. The nurse
is at risk for feelings of:
a. overinvolvement.
b. guilt and despair.
c. interest and pleasure.
d. ineffectiveness and frustration. - VERIFIED ANSWERS **✔d
A patient diagnosed with major depressive disorder begins selective serotonin reuptake
inhibitor (SSRI) antidepressant therapy. Priority information given to the patient and family
should include a directive to:
a. avoid exposure to bright sunlight.
b. report increased suicidal thoughts.
c. restrict sodium intake to 1 g daily.
d. maintain a tyramine-free diet. - VERIFIED ANSWERS **✔b
A nurse teaching a patient about a tyramine-restricted diet would approve which meal?
a. Mashed potatoes, ground beef patty, corn, green beans, apple pie
b. Avocado salad, ham, creamed potatoes, asparagus, chocolate cake
c. Macaroni and cheese, hot dogs, banana bread, caffeinated coffee
d. Noodles with cheddar cheese sauce, smoked sausage, lettuce salad, yeast rolls -
VERIFIED ANSWERS **✔a
What is the focus of priority nursing interventions for the period immediately after
electroconvulsive therapy treatment?
a. Supporting physiologic stability
with answers
A patient became severely depressed when the last of six children moved out of the home 4
months ago. The patient repeatedly says, No one cares about me. Im not worth anything.
Which response by the nurse would be the most helpful?
a. Things will look brighter soon. Everyone feels down once in a while.
b. The staff here cares about you and wants to try to help you get better.
c. It is difficult for others to care about you when you repeatedly say negative things about
yourself.
d. Ill sit with you for 10 minutes now and return for 10 minutes at lunchtime and again at
2:30 this afternoon. - VERIFIED ANSWERS **✔d
A patient became depressed after the last of six children moved out of the home 4 months
ago. The patient has been self-neglectful, slept poorly, lost weight, and repeatedly says, No
one cares about me anymore. Im not worth anything. Select an appropriate initial outcome
for the nursing diagnosis: Situational low self-esteem, related to feelings of abandonment.
The patient will:
a. verbalize realistic positive characteristics about self by (date)
b. consent to take antidepressant medication regularly by (date)
c. initiate social interaction with another person daily by (date)
d. identify two personal behaviors that alienate others by (date). - VERIFIED ANSWERS
**✔a
A nurse wants to reinforce positive self-esteem for a patient diagnosed with major
depressive disorder. Today, the patient is wearing a new shirt and has neat, clean hair.
Which remark is most appropriate?
a. You look nice this morning.
b. You are wearing a new shirt.
c. I like the shirt youre wearing.
,d. You must be feeling better today. - VERIFIED ANSWERS **✔b
An adult diagnosed with major depressive disorder was treated with medication and
cognitive behavioral therapy. The patient now recognizes how passivity contributed to the
depression. Which intervention should the nurse suggest?
a. Social skills training
b. Relaxation training classes
c. Use of complementary therapy
d. Learning desensitization techniques - VERIFIED ANSWERS **✔a
A priority nursing intervention for a patient diagnosed with major depressive disorder is:
a. distracting the patient from self-absorption.
b. carefully and inconspicuously observing the patient around the clock.
c. allowing the patient to spend long periods alone in self-reflection.
d. offering opportunities for the patient to assume a leadership role in the therapeutic
milieu. - VERIFIED ANSWERS **✔b
When counseling patients diagnosed with major depressive disorder, an advanced practice
nurse will address the negative thought patterns by using:
a. psychoanalytic therapy.
b. desensitization therapy.
c. cognitive behavioral therapy.
d. alternative and complementary therapies. - VERIFIED ANSWERS **✔c
A patient says to the nurse, My life does not have any happiness in it anymore. I once
enjoyed holidays, but now theyre just another day. How would the nurse document the
complaint?
a. Vegetative symptom
b. Anhedonia
,c. Euphoria
d. Anergia - VERIFIED ANSWERS **✔b
A patient diagnosed with major depressive disorder is taking a tricyclic antidepressant. The
patient says, I dont think I can keep taking these pills. They make me so dizzy, especially
when I stand up. The nurse should:
a. explain how to manage postural hypotension, and educate the patient that side effects go
away after several weeks.
b. tell the patient that the side effects are a minor inconvenience compared with the feelings
of depression.
c. withhold the drug, force oral fluids, and notify the health care provider to examine the
patient.
d. teach the patient how to use pursed-lip breathing. - VERIFIED ANSWERS **✔a
A patient diagnosed with major depressive disorder is receiving imipramine (Tofranil) 200
mg every night at bedtime. Which assessment finding would prompt the nurse to
collaborate with the health care provider regarding potentially hazardous side effects of this
drug?
a. Dry mouth
b. Blurred vision
c. Nasal congestion
d. Urinary retention - VERIFIED ANSWERS **✔d
A patient diagnosed with major depressive disorder tells the nurse, Bad things that happen
are always my fault. To assist the patient in reframing this overgeneralization, the nurse
should respond:
a. I really doubt that one person can be blamed for all the bad things that happen.
b. Lets look at one bad thing that happened to see if another explanation exists.
c. You are being exceptionally hard on yourself when you say those things.
, d. How does your belief in fate relate to your cultural heritage? - VERIFIED ANSWERS
**✔b
A nurse worked with a patient diagnosed with major depressive disorder who was severely
withdrawn and dependent on others. After 3 weeks, the patient did not improve. The nurse
is at risk for feelings of:
a. overinvolvement.
b. guilt and despair.
c. interest and pleasure.
d. ineffectiveness and frustration. - VERIFIED ANSWERS **✔d
A patient diagnosed with major depressive disorder begins selective serotonin reuptake
inhibitor (SSRI) antidepressant therapy. Priority information given to the patient and family
should include a directive to:
a. avoid exposure to bright sunlight.
b. report increased suicidal thoughts.
c. restrict sodium intake to 1 g daily.
d. maintain a tyramine-free diet. - VERIFIED ANSWERS **✔b
A nurse teaching a patient about a tyramine-restricted diet would approve which meal?
a. Mashed potatoes, ground beef patty, corn, green beans, apple pie
b. Avocado salad, ham, creamed potatoes, asparagus, chocolate cake
c. Macaroni and cheese, hot dogs, banana bread, caffeinated coffee
d. Noodles with cheddar cheese sauce, smoked sausage, lettuce salad, yeast rolls -
VERIFIED ANSWERS **✔a
What is the focus of priority nursing interventions for the period immediately after
electroconvulsive therapy treatment?
a. Supporting physiologic stability
