S.A.T.A PRACTICE QUESTIONS

A patient with a guardian of person is admitted to the hospital inpatient psychiatric unit. Which of the following are true? Select all that apply. a. The power of attorney for healthcare should be contacted to verify awareness of the admission. b. The guardian of person will make decisions regarding finances for healthcare. c. The nurse does not need to notify the guardian of person of basic medication changes. d. The nurse will regularly update the guardian of person about the patient's treatment plan. e. The nurse cannot force medications without a court order. f. The patient is not permitted to consent for surgery. - ANSWERSd, f A patient is involuntarily emergency admitted (pink slipped) to the hospital inpatient psychiatric unit. Which of the following might be true in this situation? Select all that apply. a. The patient is at risk of harming self. b. The patient is unable to care for self in the community due to mental illness. c. The patient can sign out of the hospital at any time. d. The patient is at risk of hurting others. e. Medications may be forced upon the patient when the patient is calm. f. Social service can retain the patient for 7 days awaiting for a court date. - ANSWERSa, b, d What is included in the Mental Status Exam? Select all that apply. a. Thought processes. b. Defense mechanisms. c. Insight. d. IQ level. e. Affect. f. Memory - ANSWERSa, c, e, f A patient states, "The FBI keeps putting thoughts in my head. They want to kill me. I wish I was dead already." How does the nurse chart this? Select all that apply. a. Clang associations. b. Thought insertion. c. Visual hallucinations. d. Suicidal ideation. e. Paranoid delusion. f. Psychotic symptoms. - ANSWERSb, d, e, f The patient unconsciously favors female nurses who are older with short gray hair, because they remind him of his grandmother. What is the patient experiencing? a. Transference. b. Corrective recapitulation of the family group. c.Countertransference d. Catharsis. - ANSWERSa Which nursing interventions are generally considered non-therapeutic in the psychiatric patient setting? Select all that apply. a. Stating, "I will get to you when I am finished with this patient." b. Hugging every patient the day of discharge. c. Bringing gifts to select patients. d. Discussing with a patient negative feelings the nurse is having about other staff members. e. Providing telephone contact and home address for the primary nurse. f. Encouraging a patient to attend the nurse's church after discharge. - ANSWERSa, b, c, d, e, f A patient states, "Can cars conspiritate completely to congratulate?" during the nurse's assessment. How does the nurse chart this? Select all that apply. a. Neologism b. Clang associations. c. Depersonalization. d. Euphoria. e. Phobia. f. Poverty of thought. - ANSWERSa, b What resulted from the major deinstitutionalization of patients with mental illness? Select all that apply. a. Increased access to care. b. Decreased compliance with psychotropic medications in patients with chronic mental illness. c. Reduced stigma for those people with mental illness. d. Increased governmental funding for mental illness. e. Decreased rates of crime in the population of patients with mental illness. f. An increase in the number of people with mental illness who are homeless. - ANSWERSb, f What are treatment modalities for post-traumatic stress disorder? Select all that apply. a. Eye movement desensitization and reprocessing. b. Trans-magnetic stimulation. c. Prazosin (Minipress). d. Hypnosis. e. Electro-convulsive therapy. f. Amphetamine sulfate (Adderall). - ANSWERSa, c What are common side effects of risperidone (Risperdal) and olanzapine (Zyprexa)? Select all that apply. a. Addiction. b. Weight gain. c. Anticholinergic activity. d. Insomnia. e. Sedation. f. Metabolic syndrome. - ANSWERSb, e, f A patient is experiencing mild increases in respirations, fidgeting, and focus to the point of improved comprehension of surroundings. What level of anxiety is the patient experiencing? a. Panic. b. Severe. c. Moderate. d. Mild. - ANSWERSd During psychiatric group work in the outpatient setting, a patient is crying and complaining about the awful care received from the therapist. What interventions by the nurse group leader are therapeutic? Select all that apply. a. Ignore the crying outburst. b. Redirect the patient to a more neutral topic. c. State, "It sounds like you are having a hard time. How can the group help today?" d. State, "It is not appropriate to talk negatively about staff." e. Allow the patient time to process feelings. f. Ask a fellow patient to sit with the crying patient in the hallway until the crying stops. - ANSWERSc, e A group is nearing the termination phase, and the leader has asked members to list 3 things found helpful in group. One member lists helping me learn how to interact with others better, feeling like other people really care for me, and knowing I am not alone in my mental illness. What Yalom therapeutic group factors does this list demonstrate? Select all that apply. a. Universality. b. Development of socializing techniques. c. Projection. d. Existential resolution. e. Group cohesiveness. f. Conversion. - ANSWERSa, b, e Which medications are indicated for treatment of generalized anxiety disorder? Select all that apply. a. Catapres (clonidine). b. Tegretol (carbamazepine). c. Zoloft (sertraline). d. Haldol (haloperidol). e. Effexor (venlafaxine). f. Cymbalta (duloxetine). - ANSWERSc, e, f During an intake interview on the inpatient psychiatric unit, a patients states to the nurse, "Don't you hear that music playing? It sounds like Frank Sinatra." In fact, there is no music playing. Which nursing responses are appropriate? Select all that apply. a. "Why would you make that up? There isn't any music playing." b. "I don't hear any music right now. I think you might be having an auditory hallucination." c. "Do you hear anything other than music playing?" d. "Have you ever had hallucinations before?" e. "I'm so sorry you are hearing that. It would be very frightening to hear that." f. "That sounds fun. Let's sing the song together." - ANSWERSb, c, d When providing education on clozapine (Clozaril) as part of a new nurse orientation to the psychiatric unit, what are the priority teaching points? Select all that apply. a. This medication should be avoided in patients with dementia related psychosis. b. Patients on Clozaril need drug levels, white blood cell levels, and absolute neutrophil levels checked regularly. c. This medication is helpful in treating panic disorder. d. If this medication is titrated up too quickly, there is an increased risk of Stevens - Johnson syndrome. e. Clozaril is a second generation antipsychotic. f. The patient should be informed to not discontinue this medication unless first discussing it with the physician or nurse practitioner. - ANSWERSa, b, e, f Clark is a 63 year old white male who is admitted to the inpatient psychiatric unit after being transferred from the medical unit following being found hanging by his neck from a tree in a public park. He confirms he was trying to kill himself. He recently lost his job as a long distance truck driver. He is happily married, and he and his wife have custody of their 3 young grandchildren. He was diagnosed 4 years ago with chronic pain issues, and buys Percocet on the street which he snorts to manage his pain. He is a devout Christian and is heavily involved in his local church. When the nurse questions Clark, he states, "The voices told me I am bad and that I need to kill myself." What are Clark's risk factors for suicide? Select all that apply. a. He is married. b. Suffering from command hallucinations. c. Having custody of young children. d. Recently attempted suicide. e. Recent job loss. f. Strong Christian f - ANSWERSb, d, e A patient is admitted to the inpatient psychiatric unit following a suicide attempt. The patient reports a history of 10 major depressive episodes in the past, as well as 3 hypomanic episodes. Which medications are appropriate for use with this patient? Select all that apply. a. Venlafaxine (Effexor). b. Buprenorphine (Suboxone). c. Valproic acid (Depakote). d. Lithium. e. Risperidone (Risperdal). f. Bupropion (Wellbutrin). - ANSWERSc, d, e What should the nurse include when teaching about trans magnetic stimulation (TMS)? Select all that apply. a. TMS is approved for treatment of bipolar disorder. b. Confusion and memory impairment are common side effects. c. A seizure is induced. d. Anesthesia is used which may cause nausea. e. TMS is useful for treating major depressive disorder. f. Length of treatment usually is 5 days a week for up to 5 weeks. - ANSWERSe, f What are symptoms of major depressive disorder? Select all that apply. a. Flight of ideas and pressured speech. b. Psychomotor retardation and slowed thoughts. c. Preoccupation with death and hypersomnia. d. Euthymic affect and good eye contact. e. Depersonalization and disorientation. f. Sad mood and constricted affect. - ANSWERSb, c, f Which statements would be likely from a patient with antisocial personality disorder? Select all that apply. a. "Animals do not have feelings." b. "I feel so horrible about hurting you like that." c. "Why would I care what happens to you?' d. "Every day is a roller coaster of emotions." e. "The rules do not apply to me." f. "Cutting helps me feel something real." - ANSWERSa, c, e Tina is a 37 year old who has always been a high achiever. She works as a bank teller and frequently stays hours past her shift to count and recount money, and check her colleagues' work. She finds it hard to delegate anything to others because they are unable to meet her standards. She has saved a large amount of money in preparation for a possible future financial disaster. Her family has come to accept that she is extremely stubborn, and that she refuses to throw out even the most worn out objects that are no longer useful. She frequently misses family functions to work overtime, despite being completely financially stable. Which of the following statements are true regarding Tina? Select all that apply. a. These are symptoms of obsessive-compulsive disorder. b. It is recommended to begin a trial of lisdexamphetamine (Vyvanse). c. She is manifesting symptoms of obsessive-compulsive personality disorder. d. Sh - ANSWERSc, f What questions should the nurse include in a lethality risk assessment? Select all that apply. a. "Have you had any suicidal gestures in the last 3 months?" b. "Do you have access to firearms?" c. "Are you planning to hurt or kill anyone?" d. "Do you have a family member who has attempted suicide?" e. "Do you have a history of cutting or burning yourself, or trying to harm yourself in anyway?" f. "Have you had any particularly stressful situations in your life recently?" - ANSWERSa, b, c, d, e, f Which statements are most therapeutic when working with the patient performing non-suicidal self-injury? Select all that apply. a. "Stop cutting yourself." b. "There are better ways to get attention than hurting yourself." c. "Let's talk about why this is happening." d. "How has your mood been lately?" e. "Would it be all right if I take a look at your wound?" f. "You are setting a poor example for your children." - ANSWERSc, d, e A patient is admitted to the hospital inpatient unit intoxicated on many substances but denies having any issues with drug abuse. The nurse states to the patient, "Your urine drug screen was positive for cocaine and amphetamines. I am concerned you have a drug problem. Would it be all right to discuss drug treatment options available to you?" What intervention is the nurse using? a. Self-disclosure. b. Confrontation. c. Limit setting. d. Universality. - ANSWERSb A patient scores a 25 on the CIWA scale. Which of the following are true regarding this patient? Select all that apply. a. The patient does not require any medication at this time. b. The patient needs a dose of benzodiazepine. c. The nurse should reassess the patient using the CIWA tool in 1 hour. d. Vital signs only need to be monitored every 8 hours in this patient. e. The patient is currently in moderate cocaine withdrawal. f. The patient requires a dose of buprenorphine (Suboxone). - ANSWERSb, c What signs and symptoms does the nurse expect from a patient who is withdrawing from alprazolam (Xanax)? Select all that apply. a. Pinpoint pupils. b. Tremors. c. Hallucination. d. Symptoms similar to alcohol withdrawal. e. Excessive sedation. f. Diaphoresis. - ANSWERSb, c, d, f A patient presents to the detoxification center requesting treatment for heroin addiction. He patient has been using IV heroin daily for the past 2 years. What teaching should the nurse provide to the patient? Select all that apply. a. Rehabilitation is a proven method of treatment for substance abuse disorders. b. Dolophine (Methadone) can be used as a maintenance treatment for opiate addiction. c. Addiction is due to a lack of will power. d. Diazepam (Valium) can be used as a maintenance treatment for opiate addiction. e. Opiate withdrawal normally lasts 5-7 days. f. Symptoms of opiate withdrawal include hallucinations and delirium. - ANSWERSa, b, e What questions does the nurse include when assessing spirituality? Select all that apply. a. "What helps you find meaning in life?" b. "Are you tired of your mental illness?" c. "Have you ever abused street drugs?" d. "Do you associate with a formal religious practice?" e. "As your nurse, how can I help address your spiritual needs?" f. "How has your illness affected your personal beliefs?" - ANSWERSa, d, e, f What qualities may indicate the patient is struggling with codependency? Select all that apply. a. High self-worth and confidence. b. Bipolar disorder and post-traumatic stress disorder. c. Rigidity and perfectionism. d. Difficulty making decisions and highly valuing the opinion of others over self. e. Catharsis and universality. f. Failed attempts to control the action of others. - ANSWERSc, d, f The charge nurse on the hospital inpatient psychiatric unit encounters a patient screaming, "Screw all of you staff! I'm going to come back here and shoot you when I get out!" The patient is throwing furniture around the unit and has received a total of lorazepam (Ativan) 2 mg IM and haloperidol (Haldol) 10 mg IM in the past hour. What are appropriate nursing interventions for this scenario? Select all that apply. a. Attempt to calm the patient using therapeutic physical touch. b. Call security for assistance. c. Notify the unit manager of the patient's threatening statements once the milieu is deemed safe. d. Use a team approach to intervene with the patient. e. Administer duloxetine (Cymbalta) 30 mg PO STAT. f. Move the patient to the seclusion room and lock the door. - ANSWERSb, c, d, f When caring for a patient with severe major depressive disorder, what nursing communication techniques are therapeutic? Select all that apply. a. Silence. b. Open-ended questions. c. Allow plenty of time for the patient to answer questions. d. Reflection. e. Clarifying statements. f. Confront the patient's self-deprecating thoughts. - ANSWERSa, b, c, d, e, f What are rationales for nurses using trauma informed care? Select all that apply. a. Many patients with psychiatric issues have experiences abuse in their lives. b. It decreases the likelihood of re-traumatizing the patient. c. It is an evidenced-based cure for post-traumatic stress disorder. d. It helps reduce rates of restraint and seclusion. e. Most people diagnosed with schizophrenia are homeless. f. It protects newborns against abuse. - ANSWERSa, b, d A female patient presents to the emergency department via her boyfriend with a broken arm. The patient has limited eye contact, appears disheveled, and speaks in a nearly inaudible voice. Her boyfriend hovers over her and answers most questions. What are the appropriate nursing actions? Select all that apply. a. Ask the boyfriend to leave the room. b. Assess the patient for abuse. c. Call Adult Protective Services to file a report. d. Consult the social worker to provide domestic violence resources if the patient approves the consult. e. Call the police to file a complaint against the boyfriend. f. Immediately have security remove the boyfriend from the hospital so assessment of the patient can be accomplished. - ANSWERSa, b, d Which of the following may be a side effect of haloperidol (Haldol)? Select all that apply. a. Neuroleptic malignant syndrome. b. Metabolic syndrome. c. Priapism. d. Tardive dyskinesia. e. Pseudo Parkinsonism. f. Sedation. - ANSWERSa, c, d, e, f A 23 year old female presents to the Emergency Department after breaking up with her boyfriend, reporting that she overdosed on sixty 40 mg capsules of fluoxetine (Prozac) approximately 20 minutes before her presentation to the emergency department. What are the priority nursing interventions for this patient? Select all that apply. a. Restrict fluid intake. b. Administer venlafaxine (Effexor) 75mg STAT. c. Monitor the patient for signs and symptoms of serotonin syndrome. d. Contact the physician to discuss if suicide precautions are indicated. e. Maintain the patient's safety. f. Contact the patient's boyfriend to inform him that the patient is safe. - ANSWERSc, d, e A patient is in the ICU being treated for neuroleptic malignant syndrome. What is the nursing priority for this patient? a. Build a therapeutic alliance with the patient. b. Avoid administering antipsychotic medications to the patient. c. Keep the patient in bilateral wrist restraints at all times. d. Contact the Guardian of person to make all medical decisions. - ANSWERSb The school nurse is working with a child diagnosed with moderate autism spectrum disorder. Which of the following are appropriate therapeutic techniques to utilize with this child? Select all that apply. a. Encourage the child to engage in self-soothing stereotyped behaviors. b. Provide frequent redirection for inappropriate behaviors. c. Assist the child to participate in social activities with his peers. d. Use sarcasm to model appropriate communication. e. Use the child's special interests to engage the child in everyday activities. f. Encourage the child to use language to express his emotions. - ANSWERSb, c, e, f The postpartum nurse is working with a mother who just gave birth to a stillborn baby at 32 weeks gestation. The nurse states "I know how you feel, I had a miscarriage 10 years ago and I have never gotten over it." This is an example of which nursing intervention? a. Therapeutic self-disclosure. b. Non-therapeutic confrontation. c. Therapeutic confrontation. d. Non-therapeutic self-disclosure. - ANSWERSd After assessing a patient, the nurse charts: The patient endorses grandiose delusions, believing he owns the Eiffel Tower. Which section of the mental status exam would this statement be charted under? a. Thought process. b. Judgement. c. Thought content. d. Speech. - ANSWERSc A 63 year old female patient states to the nurse "I just don't understand why God would let this happen." What are the appropriate nursing interventions for this patient? Select all that apply. a. Utilize open-ended questions to engage the patient about her spirituality. b. Offer to make a referral to the hospital chaplain. c. State to the patient, "God cares about you. Everything happens for a reason." d. Allow the patient to experience catharsis by crying openly. e. State to the patient, "How can I help you during this difficult time?" f. Acknowledge that the patient may be experiencing a spiritual crisis. - ANSWERSa, b, d, e, f A patient states, "I'm dead, I'm in Hell. The demons took my brain. The demons are telling me right now that I'm worthless and need to kill myself." This statement exemplifies which of the following? Select all that apply. a. Dementia. b. Nihilistic statements. c. A somatic delusion. d. A command hallucination. e. A visual hallucination. f. Thought blocking. - ANSWERSb, c, d For the past 3 years, Don must wear his wife's bra and high-heels in order to become sexually aroused. His wife is becoming increasingly uncomfortable with this behavior and is considering divorcing him because of this. Which disorder is Don most likely manifesting? a. Frotteuristic Disorder. b. Exhibitionism. c. Transvestic Disorder. d. Schizophrenia. - ANSWERSc Which of the following symptoms does the nurse recognize as most likely to result in acute medical issues with a patient with bulimia nervosa? a. Eating 5000 calories a day. b. Restricting diet to 1300 calories a day. c. Acute diuretic abuse. d. Running 5 miles, and doing 100 abdominal crunches a day. - ANSWERSc When completing the initial assessment on an acutely manic patient, what are important areas for the nurse to assess? Select all that apply. a. Chance of pregnancy in female patients. b. Recent alcohol intake. c. Current sleep issues. d. Recent street drug use. e. Suicidal ideation. f. Acute medical complaints. - ANSWERSa, b, c, d, e, f The nurse is caring for a patient experiencing opiate withdrawal. Which as needed medications might the nurse administer after assessment if the patient is complaining of withdrawal symptoms? Select all that apply. a. Furosemide (Lasix). b. Dicyclomine (Bentyl). c. Loperamide (Imodium). d. Paroxetine (Paxil). e. Promethazine (Phenergan). f. Ibuprofen (Motrin). - ANSWERSb, c, e, f The urine drug screen on your patient is positive for methamphetamine and the patient reports last use was a couple hours ago. What are the signs and symptoms the nurse might expect to see? Select all that apply. a. Formication. b. Insomnia. c. Agitation. d. Somnolence. e. Flat affect. f. Poor dentition. - ANSWERSa, b, c, f An 85 year old presents from an extended care facility due to agitation. He started hallucinating in the past 24 hours, is overtly confused, and is speaking in gibberish, which is not the baseline speech pattern. The patient is diagnosed with pneumonia in the emergency room and admitted to the medical unit. Which nursing interventions are appropriate? Select all that apply. a. Avoid direct eye contact with the patient. b. Reduce environmental stimuli. c. Promote normal sleep-wake cycle. d. Monitor the patient during meals to ensure stable nutrition. e. Utilize PRN agitation medications when needed to keep the patient calm. f. Consult the Power of Attorney for Healthcare for information on patient's desires. - ANSWERSb, c, d, e, f Which statements are true about dementia? Select all that apply. a. Cognition declines. b. Hallucinations are never experienced. c. Executive functioning is not affected. d. Long term memory is impaired, but short term memory remains intact. e. Cholinesterase inhibitors slightly enhance cognition. f. Antihistamines help reverse cognitive symptoms. - ANSWERSa, e How does the nurse therapeutically interact with the child diagnosed with oppositional defiant disorder? Select all that apply. a. Model positive coping techniques. b. Provide firm boundaries. c. Monitor for bullying behaviors and redirect the child if they are noted. d. Help the child reduce tics by using negative reinforcement. e. Refrain from exposing child to experiences where frustration occurs. f. Clearly state consequences for truant behavior before it occurs. - ANSWERSa, b, c, f The nurse stops in to interview a patient on a medical unit and finds the patient lying supine in her bed with the head elevated at 10 degrees. Which initial response(s) would most enhance the chances of achieving a therapeutic interaction? Select all that apply. a. Apologize for the differential in height and proceed while standing to avoid delay. b. Introduce yourself and your position, and explain to the patient why you are interviewing her. c. If permitted, raise the head of the bed and, with the patient's permission sit on the bed. d. Locate a chair or stool that would place the nurse at approximately the level of the patient. e. Assess the patient for any cultural differences that may need taken into consideration, such as a language barrier. f. State "I will come back when you are feeling better". - ANSWERSb, d, e Which student behavior(s) are consistent with therapeutic communication? Select all that apply. a. Asking open-ended questions to better understand the patient's point of view. b. Offering your opinion when asked in order to convey support. c. Summarizing the essence of the patient's comments in your own words. d. Interrupting periods of silence before they become awkward for the patient. e. Telling the patient he did well when you approve of his statements or actions. f. Presenting reality in a non-argumentative manner to an actively hallucinating patient. - ANSWERSa, c, f You are the nurse leading a psychoeducation group when a patient, Mac, stands up and states "I can't take it anymore, you are just like my mom, always telling me what to do", he then storms out, slamming the door. You are very annoyed with him, and after group you approach Mac and say "Don't you think slamming the door is disrespectful. I'm sure that's not how your mother raised you." Which of the following statements best describes this scenario? Select all that apply. a. Mac is demonstrating countertransference towards you. b. Your statement to Mac is non-therapeutic. c. Your statement to Mac is an example of limit setting. d. Mac is demonstrating transference towards you. e. Your statement to Mac is therapeutic. f. Your statement to Mac demonstrates the nursing intervention of confrontation. - ANSWERSb, d, f A patient with schizophrenia that you know well approaches you when you arrive for your shift on the inpatient psych unit. The patient anxiously reports, "Last night demons came to my room and told me to hurt myself". Which response(s) would be most therapeutic? Select all that apply. a. "There are no such things as demons; what you saw were hallucinations". b. "That sounds frightening. Has anyone been telling you to hurt yourself today?" c. "It is not possible for anyone to enter your room at night; you are safe here." d. "Yesterday we discussed the symptoms of your mental illness. I am concerned this was a hallucination. Do you think that could be the case?" e. "You seem very upset; please tell me more about what you experienced last night". f. "Let's not think about that. How was breakfast this morning?" - ANSWERSb, d, e The medical-surgical nurse educator is teaching staff nurses about appropriate patient boundaries. Which scenarios represent boundary violations? Select all that apply. a. Dating a patient one year after discharge. b. Going to a patient's house to feed his dog because he has no family available to do it. c. Viewing pictures of a patient's grandchild on the patient's phone. d. Accepting a facebook friend request from the husband of a former patient. e. Accepting a $50.00 giftcard from the family of a deceased patient. f. Calling nutrition services to get a specific flavor of Ensure for a patient. - ANSWERSa, b, d, e A patient continues to dominate the group conversation despite having been asked to allow others to speak. What are the most appropriate nursing interventions? Select all that apply a. Allow the patient to talk as much as he wants. b. State, "When you talk constantly, it makes everyone feel angry." c. Redirect the patient to allow others to participate. d. Ask pointed questions to other members of the group. e. State, "You are supposed to allow others to talk also". f. State, "When you speak out of turn, I feel concerned that others cannot participate equally." - ANSWERSC, d, f A patient starts crying during group stating, "My mom was never there for me, and I feel like all of you are abandoning me too". The leader points out that the patient is reverting back to childhood insecurities based in his family or origin. The group members provide feedback regarding this and encourage the patient, stating that they do want to support and include him. The patient feels a sense of emotional relief by sharing his feelings, and also due to the support from the other group members. Which of Yalom's therapeutic group factors are present in this scenario? Select all that apply a. Instillation of Hope. b. Catharsis. c. Non-verbal communication. d.Countertransference e. Corrective recapitulation of the primary family group. f. Universality. - ANSWERSA, b, e The mother of a 4 year old presents to the Emergency Department after receiving a call that her child is the victim of a dog attack. At the front desk the mom is noted to be crying, complaining of shortness of breath, trembling, and having trouble forming sentences. What are the immediate nursing priorities? Select all that apply a. Ask the mother to sit in her car until she is able to calm down, so as not to disturb other patients. b. Take the mom to a private room if available. c. Administer Chlorpromazine (Thorazine) to mom. d. Stay with the mother. e. Call children's services because the nurse is a mandatory reporter. f. Tell the mother "a chaplain will talk to you when he has time." - ANSWERSB, d. Which of the following are evidence-based treatment modalities for anxiety disorders? Select all that apply. a. Stimulants. b. Antidepressants. c. Cognitive-Behavioral Therapy. d. Moderate exercise at least 5 days a week. e. Benzodiazepines. f. Group Therapy. - ANSWERSB, c, d, e, f Which of the following statements is accurate regarding second generation antipsychotics? Select all that Apply. a. Avoid concurrently using diuretics. b. Do not eat tyramine containing foods. c. Weight gain frequently occurs. d. Do not abruptly discontinue this medication without talking with your prescriber. e. This medication may cause QTC prolongation. f. This medication is highly addictive. - ANSWERSC, d, e A patient taking Lithium Carbonate (Lithium) presents to the Emergency Department complaining of 5 days of intense nausea, vomiting, and diarrhea. The nurse recommends which laboratory studies be drawn? Select all that Apply. a. Lithium Level. b. Depakote Level. c. Ammonia Level. d. Thyroid function tests. e. Platelets. f. Comprehensive metabolic panel. - ANSWERSA, d, f Which of the following medications require routine blood monitoring? Select all that apply. a. Fluoxetine (Prozac). b. Benztropine (Cogentin). c. Venlafaxine (Effexor). d. Clozapine (Clozaril). e. Valproic Acid (Depakote). f. Carbamazepine (Tegretol). - ANSWERSD, e, f Maria, a 21 year old college student, presents to the emergency room reporting a productive cough for 1 week. During the initial nursing assessment, the nurse notes Maria has multiple superficial lacerations to both wrists. What are the priority nursing interventions with this patient? (Select all that apply) a. Place Maria in bilateral wrist restraints for her own protection. b. Assess Maria for suicidal thoughts. c. Administer Ativan 2mg IV STAT. d. Ask the patient if she feels safe in her current living environment. e. Prepare for psychiatric admission. f. State "Why would you hurt yourself? You have so much to live for." - ANSWERSb, d Which teaching points should the nurse include in the psychoeducational group on non-suicidal self-injury? (Select all that apply) a. Non-suicidal self-injury is a risk factor for suicide. b. Non-suicidal self-injury is a way of expressing emotional pain. c. Non-suicidal self-injury is always an attention seeking behavior. d. Persons with Borderline Personality Disorder frequently participate in non-suicidal self-injury. e. The best treatment for non-suicidal self-injury is consistently taking your prescribed medications. f. Non-suicidal self-injury is most common in Adolescents. - ANSWERSa, b, d, f Which of the following statements would be characteristic of a patient diagnosed with Borderline personality disorder? (Select all that apply): a. "All of the nurses hate me and are always plotting against me". b. "I get along well with my family and always have." c. "I have never had a suicide attempt." d. "All of my past boyfriends were horrible to me, and when we broke up it was very stressful." e. "Every day is a roller coaster of emotions." f. "I cut myself to feel something real." - ANSWERSa, d, e, f What are appropriate nursing interventions for a patient diagnosed with Obsessive-Compulsive Personality Disorder? (Select all that apply): a. Call the prescriber to request an order for Risperdal 2mg PO Qhs. b. Suggest Cognitive Behavioral Therapy. c. Involve the family in treatment. d. Do not allow the patient to participate in treatment decisions. e. Suggest exposure therapy to treat phobias. f. Confront the patient's compulsions to increase insight. - ANSWERSb,c Manuel is a 55 year old Hispanic male who presented to the Emergency Department after being found down in the community, with 6 respirations a minute. He was intubated in the field but is now extubated. He is homeless and has presented multiple times like this before to the hospital. His urine drug screen was positive for cocaine and oxycodone, but he denies any recent drug use. He denies that this was a suicide attempt, but has a history of Overdosing in the past to try and kill himself. Which of the following statements are true? (Select all that apply): a. Suicide precautions are not indicated because Manuel is denying this was a suicide attempt. b. Substance abuse does not increase the risk for suicide. c. Being homeless and a history of suicide attempts are risk factors for suicide. d. A consult to Psychiatry is indicated. e. The patient should be placed in seclusion. f. The nurse should further question - ANSWERSc, d, f Agatha, an 83 year old female, presents via her family to the Emergency Department with 2 days of reported confusion. Upon assessment, the nurse notes that Agatha has moderate tremors of her bilateral upper extremities, sweat dripping down her forehead, and is having visual hallucinations of spiders crawling on her skin. Her medical workup is negative except for a urine drug screen positive for opiates. The family reports her home meds include Alprazolam (Xanax) 1mg QID, Oxycodone/acetaminophen (Percocet) 5mg-325mg Q6hr PRN, and Paroxetine (Paxil) 20mg Qam. There have been no changes to her medications in the past year, but she has been having trouble regularly filling prescriptions due to financial issues. What are the nursing priorities? Select all that apply. a. Frequently monitor vital signs. b. Call the doctor to get an order for Alprazolam (Xanax) 1mg STAT. c. Call the doctor to get an order for Oxycodone/ac - ANSWERSa, b, e What are common characteristics of codependency? Select all that apply. a. Perfectionism. b. Secretive behavior. c. Trouble with honest communication. d. Low self esteem. e. Rigidity. f. Feeling responsible for the feelings of others. - ANSWERSa, b, c, d, e, f (all) Which of the following might be included in a spiritual assessment? Select all that apply. a. Identify affiliation with formal religious groups. b. Discuss hallucinations. c. Determine lethality risk. d. Assess common spiritual practices. e. Discuss dietary traditions. f. Discover how illness has impacted the patient's belief system. - ANSWERSa, d, e, f Which of the following examples may result in a codependant relationship? Select all that apply. a. The spouse of a heroin addict who has been married to the addict for 15 years. b. The parent of a 4 year old child with cerebral palsy. c. The primary caregiver of a morbidly obese man who is completely dependent on the caregiver. d. A veteran returning from war. e. The newly-wed spouse of a lawyer. f. The cousin of an alcoholic who has minimal contact with the alcoholic. - ANSWERSa, b, c The nurse understands that a patient experiencing opiate withdrawal is likely to exhibit which symptoms? Select all that apply. a. Constipation. b. Vomiting. c. Visual hallucinations. d. Diffuse body aches. e. Confusion. f. Respiratory failure. - ANSWERSb, d Which of the following best describes religion? Select all that apply. a. Finding meaning in nature. b. Participation in organized worship. c. Working the Alcoholic Anonymous 12 step program. d. Seeking guidance from a Rabbi. e. Adherence to teachings in the Quran. f. Using essay writing to find meaning in life. - ANSWERSB, d, e When you enter the room of your psychiatric inpatient, she is crying and stating "why would God let this happen to me?" During report, you found out that her mother died of an unexpected stroke earlier in the day. What are appropriate nursing interventions for this patient? Select all that apply. a. Sit down on the bed and give the patient a hug until she stops crying. b. State, "Everything happens for a reason". c. Sit in silence and allow the patient to express her feelings. d. Immediately walk out of the room and call chaplain services to come consult. e. State, "I'm sorry this happened." f. Pray with the patient. - ANSWERSc,e The nurse understands that mandatory reporting would be required in which of the following instances? Select all that apply. a. A 3 year old is significantly underweight and reports that his Daddy does not let him eat breakfast or lunch. b. A 25 year old opiate addicted female who refuses to stop using heroin. c. A 17 year old male with severe autism who has herpes in his anus and evidence of extensive anal bruising. d. A 15 year old female who is having sex with her 15 year old girlfriend. e. An 86 year old male who has signs of cigarettes burns in the middle of his back. f. A 65 year old female who reports her husband is cheating on her. - ANSWERSa,c,e What interventions are utilized when working with a child diagnosed with Post Traumatic Stress Disorder? Select all that apply. a. Use developmentally appropriate language to explore feelings. b. Utilize art and play to promote expression. c. Involve parents if they are not the source of the trauma. d. Educate the child and family about community resources for victims of trauma. e. Assist parents/family in resolving their own emotional distress about the trauma. f. Complete mandatory reporting if indicated. - ANSWERSa,b,c,d,e,f (all). A patient enters the community mental health center with a baseball bat and is threatening staff. What are the appropriate nursing responses? Select all that Apply. a. Attempt to get the patient to enter your office, and shut yourself and the patient in. b. Place your hand on the patient's arm to calm him. c. Call the police. d. Rally other staff members to assist you in intervening with the patient. e. Make statements in a clear, firm tone and use short phrases f. State "What is wrong with you? Stop swinging around that bat!" - ANSWERSc,d,e Which medications are commonly used to decrease acute agitation? Select all that apply. a. Fluoxetine (Prozac) b. Chlorpromazine (Thorazine) c. Diazepam (Valium) d. Gabapentin (Neurontin) e. Diphenhydramine (Benadryl) f. Lorazepam (Ativan) - ANSWERSb,c,e,f. In which scenarios would the nurse utilize trauma informed care? Select all that apply. a. Working with a patient who survived a plane crash 20 years ago. b. Calling in a prescription to the pharmacy. c. During a presentation at grand nursing rounds. d. Leading a play group at Nationwide Children's Hospital. e. Interacting with patients on the inpatient psychiatric unit. f. Assisting the mother of a child who presents to the Emergency room as a level 1 trauma. - ANSWERSa,d,e,f. The nurse prioritizes which actions when interacting with the acutely agitated patient? Select all that apply. a. Promote adequate nutrition. b. Limit access to objects that could be used as a weapon. c. Provide PRN agitation medications. d. Protect other patients. e. Allow the patient to pace the halls. f. Limit interaction with the patient to the 1:1 sitter only. - ANSWERSb,c,d. The appropriate nursing goals for a patient diagnosed with Bulimia Nervosa include: Select all that apply. a. decreasing weight gain side effects of stimulant medications within 1 month. b. participation in Cognitive Behavioral Therapy every week for 6 months. c. reducing purging behaviors by 10% a week until they cease. d. encouraging loved ones to attend weekly family education groups for 1 month to increase patient's support system. e. restricting calorie intake to less than 1000 calories a day within 2 months. f. following a dietician approved meal plan 100% of the time within 6 months. - ANSWERSb, c, d, f The nurse working in the pediatric mental health clinic is most likely to see which diagnoses? Select all that apply. a. Attention Deficit Hyperactivity Disorder. b. Paranoid Personality Disorder. c. Intellectual Disabilities. d. Dementia. e. Conduct Disorder. f. Encopresis. - ANSWERSa, c, e, f. The socially conscious nurse considers which of the following when working with the patient with Gender Dysphoria? Select all that apply. a. Sexuality and Gender are the same concept. b. Only men suffer from Gender Dysphoria. c. Using a non-gender specific pronoun, such as "they", is appropriate. d. Gender Dysphoria may begin in childhood. e. Non-suicidal self-injury is a common feature. f. A strong desire to be of an alternative gender than the one assigned at birth is present. - ANSWERSc, d, f What should be included when teaching parents of adolescents about psychotropic medications? Select all that apply. a. Antidepressants have a black box warning about increased suicidal thoughts in those under age 25. b. Stimulants are potentially addicting. c. Therapy is an evidence-based alternative to medications. d. Psychotropic medications often require slow up-titration to reduce side effects. e. Birth control may be indicated when on psychotropics because many are teratogens. f. It is not recommended that medications be abruptly discontinued. - ANSWERSa, b, c, d, e, f (all) Which of the following intervention are therapeutic when working with Eating Disorder patients in a Residential Treatment Facility? Select All That Apply. a. Frequently talk to patients at length about their BMI and body imperfections. b. Take away the patient's personal belongings if they participate in purging behaviors. c. Do not allow the patients to see the daily weights. d. Staff should eat meals with patients to help with distraction. e. Do not allow patients to participate in group if they do not finish their meals. f. Provide PRN medications for panic attacks. - ANSWERSc, d, f What are the most common side effects of Donepezil (Aricept)? Select All That Apply. a. Insomnia. b. Addiction. c. Nausea. d. Diarrhea. e. Decreased Appetite. f. Vomiting. - ANSWERSA, c, d, e, f. Which of the following are in the registered nurses' scope of practice? Select All That Apply. a. Medically diagnosing psychiatric patients. b. Teaching a group on progressive muscle relaxation. c. Signing an application for involuntary admission (aka Pink slip). d. Using the self as a therapeutic tool for change in a patient. e. Billing for cognitive behavioral therapy services. f. Administering the GAD-7 tool to a patient. - ANSWERSB, d, f When describing the delirious patient in the chart, the nurse would likely include which descriptors? Select All That Apply. a. Alert and oriented to all spheres. b. Follows lengthy commands with ease. c. Fully aware of surroundings. d. Confused. e. Not at baseline mental status. f. Chronic memory impairment that is unchanged from baseline mental status. - ANSWERSD, e Evidence- based treatment for Eating Disorders include which of the following? Select All That Apply. a. Electroconvulsive therapy. b. Deep Brain Stimulation. c. Cognitive Behavioral Therapy. d. Fluoxetine (Prozac) for Bulimia Nervosa. e. (Vyvanse) for Binge Eating Disorder. f. Following a meal plan developed by a Registered Dietician. - ANSWERSc, d, e, f A child diagnosed with Conduct Disorder is likely to exhibit which behaviors? Select All That Apply. a. Phobic fear when separated from parents. b. Purposefully inflicting harm on younger siblings. c. Breaking and Entering. d. Taking pleasure in setting fire to buildings. e. Visual hallucinations. f. Short-term memory impairment. - ANSWERSb, c, d, The nurse is writing an information sheet on Selective Serotonin Reuptake Inhibitors (SSRIs). What information should be included? Select All That Apply. a. Stomach upset is common. b. Antidepressants take 4-8 weeks for full efficacy. c. Patients 25 and younger should be closely monitored for increased thoughts of suicide. d. Serotonin Syndrome is a rare, but life threatening, side effect. e. SSRIs treat both depression and anxiety. f. Weight gain may occur. - ANSWERSa, b, c, d, e, f (all of the above). When questioning a patient about suicide, the nurse obtains what information? Select All That Apply. a. Type of insurance. b. Risk factors for suicide. c. Family history of suicide attempts. d. Protective factors against suicide. e. Recent increase in social stressors. f. Dietary preferences. - ANSWERSb, c, d,e A patient presents after an intentional overdose on Lithium. What are the nursing priorities? Select All That Apply. a. Avoid administering additional doses of lithium. b. Check a Valproic Acid (Depakote) Level. c. Closely monitor Liver function. d. Place patient on a low sodium diet. e. Maintain suicide precautions. f. Administer Vitamin K. - ANSWERSa, e Which of the following psychotropic medications are considered High Alert? Select All that apply. a. Buspirone (Buspar) b. Carbamazepine (Tegretol) c. Buproprion (Wellbutrin) d. Hydroxyzine (Vistrail) e. Warfarin (Coumadin) f. Dolphine (Methadone) - ANSWERSb, f Which of the following constitutes a nursing boundary violation? Select All That Apply. a. Playing cards with a patient on the cancer unit. b. Dating the husband of a deceased patient. c. Accepting a week at a time-share from a grateful patient, free of charge. d. Reporting medication changes to the parents of a 12 year old patient. e. Anonymously donating money to a bake sale being held for a former patient. f. Posting pictures on Instagram of a patient's wound. - ANSWERSb, c, f Hallucinations are a common occurrence in which disorders? Select All That Apply. a. Alcohol Withdrawal. b. Schizophrenia. c. Obsessive-Compulsive Personality Disorder. d. Delirium. e. Binge Eating Disorder. f. Attention Deficit Hyperactivity Disorder. - ANSWERSa, b, d, Which of the following may be indicators of sexual abuse in a 7 year old child? Select All That Apply. a. Drawing sexually explicit images. b. Frequently acting out sexual interactions during play with Barbie dolls. c. Encopresis. d. Advanced understanding of sex beyond what is developmentally appropriate. e. Pica. f. Reporting to a teacher having sex with an adult. - ANSWERSa, b, c, d, f When intervening with a patient intoxicated on bath salts, it is useful to: Select All That Apply. a. allow the patient to sober up. b. question the patient regarding any other drugs of abuse. c. assess for suicidal and homicidal thoughts. d. place the patient in seclusion. e. gain adherence by sharing your personal history of drug abuse. f. assess the patient for confusion. - ANSWERSa, b, c, f When interacting with the pregnant patient diagnosed with schizophrenia, appropriate nursing interventions include: Select All That Apply. a. educating the patient on prescribed medications which may be teratogens. b. encouraging safe sexual practices. c. stating, "you will likely pass your disease on to your child." d. promoting adequate nutrition and vitamin supplementation. e. discussing breastfeeding options. f. assisting the patient to schedule follow up obstetrician appointments as needed. -