Foundations of Psychiatric Mental Health Nursing

MULTIPLE CHOICE 1. A nurse works with a child who is sad and irritable because the childs parents are divorcing. Why is establishing a therapeutic alliance with this child a priority? a. Therapeutic relationships provide an outlet for tension. b. Focusing on the strengths increases a persons self-esteem. c. Acceptance and trust convey feelings of security to the child. d. The child should express feelings rather than internalize them. ANS: C Trust is frequently an issue because the ...

MULTIPLE CHOICE 1. A patient experiences a sudden episode of severe anxiety. Of these medications in the patients medical record, which is most appropriate to give as a prn anxiolytic? a. buspirone (BuSpar) b. lorazepam (Ativan) c. amitriptyline (Elavil) d. desipramine (Norpramin) ANS: B Lorazepam is a benzodiazepine used to treat anxiety. It may be given as a prn medication. Buspirone is long acting and is not useful as a prn drug. Amitriptyline and desipramine are tricyclic an...

MULTIPLE CHOICE 1. Major depression resulted after a patients employment was terminated. The patient now says to the nurse, Im not worth the time you spend with me. I am the most useless person in the world. Which nursing diagnosis applies? a. Powerlessness b. Defensive coping c. Situational low self-esteem d. Disturbed personal identity ANS: C The patients statements express feelings of worthlessness and most clearly relate to the nursing diagnosis of situational low self-estee...

MULTIPLE CHOICE 1. A patient waves a newspaper and says, I must have my credit card and use the computer right now. A store is having a big sale, and I need to order 10 dresses and four pairs of shoes. Select the nurses appropriate intervention. The nurse: a. suggests the patient have a friend do the shopping and bring purchases to the unit. b. invites the patient to sit together and look at new fashion magazines. c. tells the patient computer use is not allowed until self-control improves...

MULTIPLE CHOICE 1. Which entry in the medical record best meets the requirement for problem-oriented charting? a. A: Pacing and muttering to self. P: Sensory perceptual alteration related to internal auditory stimulation. I: Given fluphenazine HCL (Prolixin) 2.5 mg po at 0900 and went to room to lie down. E: Calmer by 0930. Returned to lounge to watch TV. b. S: States, I feel like Im ready to blow up. O: Pacing hall, mumbling to self. A: Auditory hallucinations. P: Offer haloperidol (Haldol...

MULTIPLE CHOICE 1. Insurance will not pay for continued private hospitalization of a mentally ill patient. The family considers transferring the patient to a public hospital but expresses concern that the patient will not get any treatment if transferred. Select the nurses most helpful reply. a. By law, treatment must be provided. Hospitalization without treatment violates patients rights. b. All patients in public hospitals have the right to choose both a primary therapist and a primary nu...

MULTIPLE CHOICE 1. A patient tells the nurse, I know that I should reduce the stress in my life, but I have no idea where to start. What would be the best initial nursing response? a. Physical exercise works to elevate mood and reduce anxiety. b. Reading about stress and how to manage it might be a good place to start. c. Why not start by learning to meditate? That technique will cover everything. d. Lets talk about what is going on in your life and then look at possible options. ANS: ...

MULTIPLE CHOICE 1. During a one-on-one interaction with the nurse, a patient frequently looks nervously at the door. Select the best comment by the nurse regarding this nonverbal communication. a. I notice you keep looking toward the door. b. This is our time together. No one is going to interrupt us. c. It looks as if you are eager to end our discussion for today. d. If you are uncomfortable in this room, we can move someplace else. ANS: A Making observations and encouraging the pa...

MULTIPLE CHOICE 1. A nurse wants to demonstrate genuineness with a patient diagnosed with schizophrenia. The nurse should: a. restate what the patient says. b. use congruent communication strategies. c. use self-revelation in patient interactions. d. consistently interpret the patients behaviors. ANS: B Genuineness is a desirable characteristic involving awareness of ones own feelings as they arise and the ability to communicate them when appropriate. The incorrect options are undes...

MULTIPLE CHOICE 1. The parent of a child diagnosed with schizophrenia tearfully asks the nurse, What could I have done differently to prevent this illness? Select the nurses best response. a. Although schizophrenia results from impaired family relationships, try not to feel guilty. No one can predict how a child will respond to parental guidance. b. Schizophrenia is a biological illness resulting from changes in how the brain and nervous system function. You are not to blame for your childs...