Test Bank Essentials of Psychiatric Nursing 2nd Edition Boyd Luebbert

Test Bank Essentials of Psychiatric Nursing 2nd Edition Boyd LuebbertTable of Contents Chapter 1 Mental Health and Mental Disorders ................................ .......... 2 Chapter 2 Cultural and Spiritual Issues Related to Mental ................................ 10 Chapter 3 Patient Rights and Legal Issues ................................ .............. 18 Chapter 4 Ethics, Standards, and Nursing Frameworks ................................ ... 26 Chapter 6 Biologic Foundations of Psychiatric ................................ .......... 34 Chapter 7 Recovery Framework for Mental Health ................................ ...... 42 Chapter 8 Therapeutic Communication ................................ ................ 50 Chapter 9 The Nurse–Patient Relationship ................................ ............. 59 Chapter 10 The Psychiatric–Mental Health Nursing ................................ ...... 68 Chapter 11 Psychopharmacology, Dietary Supplements, and Biologic Interventions ........... 77 Chapter 12 Group Interventions ................................ ...................... 87 Chapter 13 Stress and Mental Health ................................ .................. 96 Chapter 14 Management of Anger, Aggression, and Violence ............................. 105 Chapter 15 Crisis, Loss, Grief, Response, Bereavement, and DisasterManagement ........... 113 Chapter 16 Suicide Prevention ................................ ...................... 122 Chapter 17 Mental Health Care for Survivors of Violence ................................ 130 Chapter 18 Anxiety Disorders ................................ ....................... 139 Chapter 19 Trauma- and Stressor-Related Disorders ................................ ... 150 Chapter 20 Obsessive–Compulsive and Related Disorders ............................... 159 Chapter 21 Depression ................................ ............................. 172 Chapter 22 Bipolar Disorders ................................ ....................... 181 Chapter 23 Schizophrenia and Related Disorders ................................ ...... 188 Chapter 24 Personality and Impulse-Control Disorders ................................ . 199 Chapter 25 Addiction and Substance-Related Disorders ................................ . 206 Chapter 26 Eating Disorders ................................ ........................ 215 Chapter 27 Somatic Symptom and Dissociative Disorders ............................... 222 Chapter 28 Sleep–Wake Disorders ................................ ................... 230 Chapter 29 Sexual Disorders ................................ ........................ 238 Chapter 30 Mental Health Disorders of Childhood and Adolescence ....................... 245 Chapter 31 Mental Health Disorders of Older Adults ................................ .... 253 1 | P a g eChapter 1 Mental Health and Mental Disorders 1 . A nursing instructor is describing the DSM-IV-TR to a group of nursing students. Which of the following would the instructor include as the primary purpose of this classification? A) B) C) D) Provide a commonly understood diagnostic category for clinical practice. Describe treatment modalities for psychiatric disorders and mental illnesses. Identify various etiologies for mental disorders based on family histories. Provide optimal outcomes for treatment for individuals with mental illnesses. 2. A nurse is providing care to a patient with a mental disorder classified by the DSM-IV-TR. The nurse understands that although the first three axes appear to contain all the diagnostic information about a patient, a truly accurate picture of the client is incomplete without considering other factors such as an estimate of current functioning and: A) B) C) D) 3. Life stressors Cultural background Marital status Genetic history A patients global assessment functioning reveals that he has minimal symptoms with good functioning in all areas. Which score would the nurse correlate with these findings? 2 | P a g eA) B) C) D) 4. 94 82 75 63 A female patient was admitted to the hospital with pneumonia, and in the course of her treatment, it was determined that she was experiencing alcohol dependence because she began experiencing alcohol withdrawal while she was in the hospital. When the psychiatrist who was called in as a consultant documented the patients mental disorder, he identified her alcohol dependence on which axis? A) B) C) D) 5. Axis I Axis II Axis III Axis IV A 25-year-old woman who recently had abdominal surgery was admitted to the psychiatric unit, where it was determined that she had a borderline personality disorder. During the first week on the unit, it was determined that she also has diabetes. Her diabetes mellitus would be listed in which axis of her DSM-IV-TR diagnosis? A) B) Axis I Axis II 3 | P a g eC) D) 6. Axis III Axis IV As part of a class activity, nursing students are engaged in a small group discussion about the epidemiology of mental illness. Which statement best explains the importance of epidemiology in understanding the impact of mental disorders? A) Epidemiology helps promote understanding of the patterns of occurrence associated with mental disorders. B) C) D) Epidemiology helps explain research findings about the neurophysiology that causes mental disorders. Epidemiology provides a thorough theoretical explanation of why specific mental disorders occur. Epidemiology predicts when a specific psychiatric client will recover from a specific mental disorder. 7. A nurse is working in a community mental health center that provides care to a large population of Asian descent. When developing programs for this community, which of the following would be most important for the nurse to address? A) B) C) D) Public stigma Self-stigma Label avoidance Negative life events 4 | P a g e8. A group of students are reviewing the multiaxial diagnostic system of the DSM-IV-TR. The students demonstrate understanding of the axes when they identify that each axis represents which of the following? A) B) C) D) 9. An evidence-based research finding An experimental design to guide care A domain of information A laboratory test finding A nursing student is assigned to care for a patient diagnosed with schizophrenia. When talking about this patient in a clinical postconference, the student would use which terminology when referring to the patient? A) B) C) D) 1 0. Committed patient Schizophrenic Schizophrenic patient Person with schizophrenia Mrs. Green is a patient on a psychiatric unit. At the time of her admission, her dog was killed when a car accidentally ran over it; in addition to that, she just found out that her mother has been diagnosed with colon cancer. This information would be addressed in which DSM-IV axis? A) B) C) D) Axis I Axis II Axis III Axis IV 5 | P a g e1 1. A nursing student is reviewing journal articles about major depression. One of the articles describes the number of persons newly diagnosed with the disorder during the past year. The student interprets this as which of the following? A) B) C) D) 1 2. Rate Prevalence Point prevalence Incidence While working in a community mental health treatment center, the nurse overhears one of the receptionists saying that one of the patients is really psycho. Later in the day, the nurse talks with the receptionist about the comment. This action by the nurse demonstrates an attempt to address which issue? A) B) C) D) 1 3. Lack of knowledge Public stigma Label avoidance Self-stigma After teaching a group of students about mental health and mental illness, the instructor determines that the teaching was successful when the group identifies which of the following as reflecting mental disorders? A) B) C) D) Capacity to interact with others Ability to deal with ordinary stress Alteration in mood or thinking Lack of impaired functioning 6 | P a g e1 4. A nurse is preparing a presentation for a local community group about mental disorders and plans to include how mental disorders are different from medical disorders. Which statement would be most appropriate for the nurse to include? A) B) C) D) Mental disorders are defined by an underlying biological pathology. Numerous laboratory tests are used to aid in the diagnosis of mental disorders. Cluster of behaviors, thoughts, and feelings characterize mental disorders. Manifestations of mental disorders are within normal, expected parameters. 1 5. A) B) C) D) E) F) 1 6. Which of the following would a nurse identify as being categorized as Axis I in the DSM-IV-TR? Select all that apply. Paranoid personality disorder Posttraumatic stress disorder Anorexia nervosa Mental retardation Unemployment Coronary artery disease A psychiatricmental health nurse is providing care for a patient with a mental disorder. The patient is participating in the decision- making process. The nurse interprets this as which component of recovery? A) B) 7 | P a g e Self-direction EmpowermentC) D) 1 7. Person-centered Holistic A nurse is explaining recovery to the family of a patient diagnosed with a mental disorder. Which statement would be most appropriate for the nurse to include about this process? A) B) C) D) It is a step-by-step process from being ill to being well. The patient focuses mainly on the emotional aspects of his condition. The patient is helped to live a meaningful life to his fullest potential. Although peer support is important, the self-acceptance is essential. 1 8. A psychiatricmental health nurse is preparing a presentation about recovery for a group of newly hired nurses for the mental health facility. Which of the following would the nurse identify as one of the most important concepts? A) B) C) D) 1 9. A) B) 8 | P a g e Self-direction Peer support Respect Hope The nurse is reviewing the medical record of a patient and notes the information below. Which of the following would be found on Axis III? Select all that apply. Cocaine dependence Bipolar I disorderC) D) E) F) 2 0. Chronic obstructive pulmonary disorder Cellulitis Homelessness Arrest for cocaine possession with intent to sell A college-aged student and his friend arrive at the student health center. The friend reports that the patient has been having difficulties concentrating, remembering, and thinking. Hes had quite a few research papers due this past week. After ruling out other problems, the nurse determines that the patient is experiencing a culture- bound syndrome. Which of the following would the nurse most likely suspect? A) B) C) D) Answer Key 1. 2. 3. 4. 5. 6. 7. 8. 9. 9 | P a g e Ataque de nervios Brain fog Mal de ojo Shenjing shuairo A A B A C A C C D1 0. 1 1. 1 2. 1 3. 1 4. 1 1 6. 1 7. 1 8. 1 2 0. D D B C C B, C 5. B C D C, D 9. B Chapter 2 Cultural and Spiritual Issues Related to Mental 10 | P a g e1 . When reviewing several studies about Hispanic Americans and their use of mental health care facilities, the nurse notes that this cultural group tends to use all other resources before seeking help from mental health professionals. Which of the following would the nurse identify as a reason for this belief about many mental health facilities? A) B) C) D) Require periods of hospitalization Do not provide 24-hour emergency services Are not reimbursed by third party payers Do not accommodate their cultural needs 2. A nurse is preparing a presentation about mental health problems associated with specific cultural groups. When describing mental health problems associated with Asian Americans, Polynesians, and Pacific Islanders, the nurse would address high rates of which of the following? A) B) C) D) 3. Schizophrenia Manic disorders Dementia Suicide The nurse is doing an assessment interview of a patient. During the interview, the patient comments, Our people are connected with nature. Our world, our seasons, and our weatherthey all have many lessons to teach us. The nurse interprets the patients statement as an expression of which of the following? A) B) Religiousness Tribal law 11 | P a g eC) D) Spirituality Ecological values 4. A psychiatricmental health nurse is providing care to a patient who has recently emigrated to the United States from Eastern Europe. Which of the following would be least effective in providing culturally competent care? A) B) C) D) 5. Demonstrating a genuine interest in the patient Avoiding assumptions about the patients culture Speaking to the patient in his native language. Acquiring information about the patients country. A psychiatricmental health nurse working in a Veterans Administration Medical Center is meeting with a military wife who is an Asian American. The woman is to be joining a support group for wives of veterans who have posttraumatic stress syndrome. When asking her to describe her husbands mental health problems, which response would the nurse most likely expect? A) B) C) D) Oh, he may seem depressed, but it is just a vitamin deficiency. It runs in his family. I know the war messed his mind up. Hell never be the same. Sometimes he hallucinates that he is back in Vietnam. He just stays to himself; he never talks to me about what is bothering him. 6. A psychiatricmental health nurse is working with a patient who is being treated for depression. Which patient statement would indicate that her spirituality is intact? 12 | P a g eA) B) C) D) 7. My church friends came to visit me this past Sunday afternoon. Nothing will ever be the same again; my life is not worth living. I know I am as well off as I can be under the circumstances. I know God must be punishing me for all my sins. A patient is being treated for prostate cancer; his prognosis is very poor. The patient has a strong faith, and he has been active in his church for many years. He is concerned about his health and the challenges he faces as his cancer progresses. Which comment by the nurse reflects the most appropriate spiritual nursing intervention for the patient? A) B) C) D) 8. Ill take you to visit my church if you can get a pass. You have to belong to the same church I do if youre going to go to heaven. Would you like me to bring you a guided imagery audiotape? We can pray together if youd like. A psychiatricmental health nurse is teaching a class about social factors associated with mental illness at a community health center. When describing the influence of poverty and effects of the downward economic spiral on mental health, which population would the nurse identify as being the most at risk? A) B) C) 13 | P a g e Older adults Individuals with physical disabilities Single-parent familiesD) 9. Homeless individuals During an assessment, the patient states, We rely on our large extensive family for moral support and help and we treat our elders with a great deal of respect. If someone gets sick, the family takes care of him. The nurse interprets this as indicating which of the following? A) B) C) D) 1 0. Acculturation Cultural identity Cultural competence Linguistic competence Within the context of the culture of poverty, which of the following most clearly describes why individuals who are part of this culture become trapped in a downward economic spiral? A) Unemployment causes poverty; a lack of willpower and motivation can, in turn, cause unemployment in people who do not have a strong work ethic. B) Individuals lack the finances to pay rent, so they eventually do not have an address to use in filling out job applications. C) Characteristics of poverty (joblessness and lack of financial independence) can, in turn, contribute to attributes (feelings of powerlessness and low self- esteem) that sustain poverty. D) Poverty is passed on from generation to generation; individuals learn at an early age that there is no way to escape living in poverty. 14 | P a g e1 1. A group of nursing students are reviewing information about spirituality and religiousness. The group demonstrates understanding of these concepts when they identify religiousness as which of the following? A) B) C) D) 1 2. Feeling of connectedness Way of interpreting life events Relationship with a unifying force Community participation in common worship A nursing instructor is preparing a class about rural cultures and the influence on mental health problems. Which of the following would the instructor include as impacting the use of mental health services for this group? Select all that apply. A) B) C) D) E) 1 3. A) B) C) Limited access to care Lack of available resources Geographical similarities Diverse cultural groups Consistency in treatment approaches A psychiatricmental health nurse is working on developing cultural competence. Which of the following would be most appropriate for the nurse to do? Research information about the cultures of the population being served after assessing the patients. Recognize that ones own culture is the predominant way of addressing a patients health care needs. Assume that any individual of a racial or ethnic group is the same as another individual in that group. 15 | P a g eD) Demonstrate an appreciation of and a genuine interest in the individual and his or her cultural beliefs. 1 4. During assessment, a patient tells the nurse that he follows Buddhist beliefs. The nurse would integrate understanding of which of the following when developing the patients plan of care? A) B) C) D) 1 5. Desire is the cause of all human suffering and misery. Self-indulgence is necessary to reach nirvana. Present behavior is based on current unhappiness. Salvation is achieved through faith and humility. After teaching a group of students about the beliefs associated with the major religions, the instructor determines that additional teaching is needed when the students identify which belief as associated with Confucianism? A) B) C) D) 1 6. A) B) C) D) People are born good. People are assigned to castes. Authority figures are respected. Self-responsibility leads to improvement. During an interview, a patient states, God does not exist for me. The nurse interprets this statement as reflecting which of the following? Animism Agnosticism Atheism Polytheism 16 | P a g e1 7. After reviewing the major beliefs of Hinduism, a nursing student identifies the following castes. The student demonstrates understanding by identifying which of the following as the highest caste? A) B) C) D) 1 8. A) B) C) D) Answer Key 1. 2. 3. 4. 5. 6. 7. 8. 9. 17 | P a g e Kshatriyas Vaisyas Brahmans Untouchables The nurse is assessing an Asian American patient. During the interview, the nurse determines that the patient likely follows Taoism based on which statement? Purity and balance guide all of my actions. I strive to be in happy harmony with nature. Natures powers must be respected in life. God is worshipped out of love, not fear. D D C C A C D D B1 0. 1 1. 1 1 3. 1 4. 1 5. 1 6. 1 7. 1 8. C D A, B, D 2. D A B C C B Chapter 3 Patient Rights and Legal Issues 1 . A) A nurse is explaining advance care directives, or living wills, to a patient and the patients spouse. Which of the following would the nurse include in the description? The document tells what treatment is to be omitted if the patient is unable to make the decision. B) It requires that the patient sign the living will document while an attorney is present. 18 | P a g eC) The patients physician must act as a witness when the patient signs the document. D) An attorney draws up the papers to be given to the patient and his or her family. 2. A psychiatricmental health nurse determines that a patient is competent when he is able to do which of the following? A) B) C) D) 3. Speak coherent English. Communicate his or her choices. Write a living will. Comply with the medical regimen. A patient receives a court order for commitment. Which of the following best exemplifies the concept of least restrictive environment? A) B) C) D) Involuntary commitment to an outpatient community mental health center Medication administration for sedation so the patient cannot get out of bed Placing the patient in a locked padded room in response to threats of self-harm Allowing the patient to make the decision about whether treatment is necessary 4. A nurse is caring for a patient who is hospitalized for a mental disorder. The nurse is legally obligated to breach the patients confidentiality if the patient states which of the following? A) I think that the federal government is spying on me. 19 | P a g eB) C) D) 5. A) B) C) D) 6. I get really turned on by your appearance. That doctor I had today really made me angry. When I get out of here, Im going to kill my neighbor. Which patient would the nurse determine to be the most likely a candidate for involuntary commitment? The client who refuses to take the prescribed medication The client who is screaming in the street disturbing neighbors The client who refuses to participate in the planned therapy The client with a mental disorder who is homeless The nurse is providing care to a male patient who is hospitalized with a diagnosis of schizophrenia. Which of the following would be appropriate for the nurse to include in the patients medical record? A) B) C) D) Patient states that he had a good night with no complaints. Complained of being unable to sleep because he heard voices throughout the night. Had a typical night without incidence of insomnia or nightmares. Acted crazily throughout the night; kept hearing voices and noises. 20 | P a g e7. A nurse working on the psychiatric unit receives a telephone call from the employer of one of the patients on the unit. The employer asks to be sent a copy of Mr. Murrays latest laboratory work and psychological testing results so Mr. Murrays medical records in employee health can be kept up to date. Based on the nurses knowledge about issues surrounding breach of confidentiality, which response would be the most appropriate? A) B) C) D) Im sorry; were not allowed to give out that information about our patient. Ill have to get the patients signed consent before we can send that information to you. I am unable to acknowledge whether or not a Mr. Murray is a patient on this unit. Sure, give me your address, and I will see that the information is sent to you. 8. A patient is going to be discharged this afternoon from the mental health unit. The patient asks the nurse if a copy of his medical record could be sent to the psychologist he will be seeing on an outpatient basis. Which response by the nurse would be most appropriate? A) B) C) D) Sure, well have that information sent out in todays mail. You will need to sign written authorization for us before we can do this. I think it would just be best if you just told your psychologist everything he needs to know. How are you feeling about being discharged this afternoon? 21 | P a g e9. A patients psychiatrist informs her that he thinks she needs to participate in a 3-month outpatient aftercare program after her discharge. Which of the following would protect the patients right to request a second opinion before agreeing to this suggestion? A) B) C) D) 1 0. A) Self-determinism Least restrictive environment Confidentiality Mandates to inform A nurse is preparing to administer an as-needed (PRN) medication. Which of the following would the nurse need to keep in mind when documenting administration? It requires a separate entry that includes reason for administration, dosage, route, and response to the medication the first time it is administered to a patient. B) It requires a separate entry that includes reason for administration, dosage, route, and response to the medication every time it is administered to a patient. C) It requires a separate entry that includes reason for administration, dosage, and route the first time it is administered to a patient. D) It requires a separate entry that includes reason for administration, dosage, and route every time it is administered to a patient. 1 1. A) B) 22 | P a g e A nursing instructor is preparing a class discussion on the topic of self-determinism. Which of the following would the instructor expect to include? Select all that apply. Personal autonomy as a key value Choices based on pleasing othersC) D) E) 1 2. Activities reflect personal goals Right to refuse treatment Lack of empowerment A group of nursing students are reviewing information about internal rights protection systems. The students demonstrate understanding of this information when they identify which of the following as an example? A) B) C) D) 1 3. American Hospital Association American Public Health Association State mental health provider The Joint Commission After teaching a class about competency and how it is assessed, the nursing instructor determines the need for additional instruction when the class identifies which ability as being evaluated? A) B) C) D) 1 4. A) B) C) D) 23 | P a g e Communication of choices Understanding of relevant information Appreciation for situation and consequences Discussion of what is right and wrong A patient is involuntarily committed without a court order. The nurse understands that the emergency short- term hospitalization can occur for which time frame? A maximum of 24 hours 48 to 92 hours 3 to 5 days One week1 5. A) B) C) D) 1 6. A nurse is explaining the distinction between confidentiality and privacy. Which of the following would the nurse include as reflecting privacy? Part of personal life not governed by societys laws Ethical duty for nondisclosure Involvement of two individuals Knowledge of treatment costs and benefits A psychiatricmental health patient has an advance care directive on his medical record. A clinician provides treatment that disregards the patients directive. The clinician would be liable for which of the following? A) B) C) D) 1 7. Assault Battery Medical battery False imprisonment A group of students are preparing a class presentation about negligence. Which of the following would the group include as an element required for proving negligence? Select all that apply. A) B) C) D) E) F) Duty to provide care Proximate cause Resultant damages Breach of duty Cause in fact Evidence of mistake 24 | P a g e1 8. A psychiatricmental health nurse is documenting information in a patients medical record. Which of the following would be least likely to increase the nurses legal liability? A) B) C) D) 1 9. Patient reported that he was feeling better today than yesterday. Administered haloperidol 10 mg IM stat as ordered for agitation. Patient was talking with another staff member and started screaming. Applied restraints to all four patient extremities. After teaching a class of nursing students about the rights of persons receiving mental health services, the instructor determines a need for additional instruction when the students identify which of the following as a right? A) B) C) D) Answer Key 1. 2. 3. 4. 5. 6. A B A D B B Freedom from restraints or seclusion Access to ones own mental health records on request An individualized written treatment plan Refuse treatment during an emergency situation 25 | P a g e7. 8. 9. 1 0. 1 1 2. 1 3. 1 4. 1 5. 1 6. 1 1 8. 1 9. C B A B A, C, D 1. C D B A C A, B, C, D, E 7. B D Chapter 4 Ethics, Standards, and Nursing Frameworks 26 | P a g e1 . A) B) C) D) 2. When applying the biopsychosocial model to client care, the nurse integrates the psychological domain when involved with which of the following? Behavior therapy Family support Nutritional therapy Sleep hygiene measures A nursing instructor is describing the impact of technology and electronic health records on psychiatricmental health care. Which of the following would the instructor identify as a major challenge associated with it? A) B) C) D) 3. Maintaining confidentiality Establishing educational models Decreasing fragmented care Defining professional standards more clearly A psychiatric nursing class is discussing current trends in mental health care. A student voices the opinion that there should be equitable access to mental health care and resources for those who live in rural areas, for those without health insurance, and for those with very little income. The student nurses opinion most closely reflects which ethical principle? A) B) C) D) Nonmaleficence Paternalism Veracity Justice 27 | P a g e4. A nursing student is initiating a relationship with an assigned patient. After meeting and spending approximately 20 minutes talking with the patient, the student makes arrangements to visit again after lunch. After lunch, fellow classmates invite the student to go to the gym with them and a group of patients to play volleyball. The student starts to go with them but then remembers the promise to meet with the patient. The student decides to stay behind and talk to with her patient. The students decision reflects which ethical principle? A) B) C) D) 5. Autonomy Beneficence Fidelity Veracity In a postclinical conference, a group of students are engaged in a discussion with their instructor. The instructor repeatedly has the students analyze and evaluate the nursing interventions implemented throughout the clinical experience. The students are engaged in which of the following? A) B) C) D) 6. Therapeutic use of self Critical thinking Interdisciplinary care Planning care A group of students is reviewing the functions of psychiatric nurses. The students demonstrate understanding of the information when they identify which of the following as an advanced practice level function? 28 | P a g eA) B) C) D) 7. Milieu therapy Promotion of self-care Psychopharmacology interventions Health promotion activities A nursing instructor has prepared a lecture about the scope and standards of practice of psychiatric nurses. The instructor determines that the teaching was effective when the students identify which of the following as common to both basic and advanced level practice? A) B) C) D) Case management Program development Clinical supervision Community interventions 8. A nurse is working on developing ways to meet the challenge of knowledge development. Which of the following would be most appropriate? A) B) C) D) Access new information through continuing education programs. Improve access to community psychiatric care for all populations. Reduce the burden of mental illness by fighting stigma. Provide culturally competent, high-quality nursing care. 29 | P a g e9. A 22-year-old patient with schizophrenia is refusing his antipsychotic medication. He states, I dont like the dopey way it makes me feel. I feel like Im walking under water when I take it. The nurse explains to him, Your schizophrenia is caused by a chemical imbalance in your brain, and this medication helps fix that chemical imbalance. You need to take it so your symptoms will get better. This conversation reflects a conflict between which two types of ethical principles? A) B) C) D) 1 Autonomy and justice Paternalism and veracity Justice and nonmaleficence Autonomy and beneficence A nurse is faced with an ethical dilemma involving a 0. patient. Which question would be most important for the nurse to ask first when engaging in the process of ethical decision making? A) B) C) D) 1 What are my own feelings about the situation? What assumptions am I making that need more data? What do I know about the situation? What do I know about the patients values? A psychiatricmental health nurse is adhering to the 1. standards of practice. When engaging in clinical decision making, the nurse is integrating which of the following as the foundation? A) B) C) 30 | P a g e Developmental issues Nursing process CommitmentD) 1 2. Accountability A group of nursing students are reviewing the standards of professional performance. The students demonstrate understanding when they identify which as a standard of professional performance? A) B) C) D) 1 3. Prescriptive authority Consultation Planning Collegiality A psychiatricmental health nurse is providing care to patients with a mental illness and is investigating factors related to the patient safety, delivery of care services, and cost effectiveness. The nurse is involved with which area of professional performance? A) B) C) D) 1 4. Education Quality of practice Resource utilization Collaboration An instructor is preparing a class for a group of students about professional organizations and the leadership provided. Which of the following would the instructor include as an important function of the International Society of Psychiatric-Mental Health Nurses? A) B) Advocating for mental health nursing practice through liaison activities Advancing psychiatricmental health nursing practice 31 | P a g eC) D) Improving mental health care for culturally diverse individuals Providing a strong voice for psychiatricmental health nurses 1 5. When applying the biopsychosocial model for a patient with a mental health problem, the nurse addresses the psychological domain when assessing which of the following? A) B) C) D) 1 6. A) B) C) D) Sleep patterns Feelings Family functioning Cultural groups A nurse had developed a plan of care for a patient with depression. Which nursing diagnosis would reflect the social domain? Imbalanced Nutrition, Less Than Body Requirements related to lack of appetite. Powerlessness related to feelings of lack of control over the situation. Ineffective Role Performance related to inability to participate as family provider Risk for Suicide related to depressed mood and feelings of oneself as a failure 1 7. The plan of care for a patient with schizophrenia identifies the following outcomes. Which of the following would the nurse identify as addressing the biologic domain? Select all that apply. 32 | P a g eA) B) C) D) E) 1 8. A) B) C) D) Answer Key 1. 2. 3. 4. 5. 6. 7. 8. 9. 1 0. Improving problem-solving skills Promoting economic stability Minimizing adverse effects of drug therapy Improving nutritional status Providing family education A nurse is engaged in exercises to develop self- awareness. The nurse is using which tool? Interdisciplinary care Reflection Plan of care Clinical reasoning A A D C B C A A D C 33 | P a g e1 1. 1 2. 1 3. 1 4. 1 5. 1 6. 1 1 8. B D C D B C C, D 7. B Chapter 6 Biologic Foundations of Psychiatric 1 . A nurse is teaching a medication class to a group of psychiatric patients. One of them asks the nurse why he has so much more trouble learning now when hes in his 60s than he did when he was younger. Which of the following concepts would the nurse integrate into the response? A) B) C) The extrapyramidal motor system The amygdala Neuroplasticity 34 | P a g eD) Psychoneuroimmunology 2. Which of the following would a nursing instructor identify when describing the area of the brain involved with verbal language function, including areas for both receptive and expressive speech? A) B) C) D) 3. Right hemisphere Parietal lobe Occipital lobe Left hemisphere A nurse is developing a plan of care for a patient experiencing expressive aphasia. The nurse incorporates knowledge that the patient most likely has sustained damage to which of the following? A) B) C) D) 4. The postcentral gyrus Brocas area Basal ganglia The hippocampus The nurse is caring for an older adult who has experienced damage to the frontal lobe after an automobile accident. The nurse anticipates that the patient will have difficulty with which of the following? A) B) C) D) Smell Concept formation Receptive speech Hearing 35 | P a g e5. The nurse is caring for a patient who has experienced damage to the parietal lobes of the brain. The nurse anticipates that the patient with have difficulty with which of the following? A) B) C) D) 6. Perceiving sensory input Calculating a math problem Seeing objects in front of him Speaking fluently A patient has been diagnosed with memory dysfunction associated with Alzheimers disease. The nurse determines that damage to the patients brain includes deterioration of temporal lobe structures and the nerves of which of the following? A) B) C) D) 7. Basal ganglia Limbic system Frontal lobe Hippocampus The nurse is caring for a hospitalized patient who has a disorder of the hypothalamus. When developing the patients plan of care, in which of the following areas would the nurse anticipate a problem? A) B) C) D) Sleep Constipation Speech Motor activity 36 | P a g e8. A patient who is scheduled to undergo a sleep deprivation electroencephalogram (EEG) in the morning is experiencing moderate anxiety about the procedure. Based on an understanding of this test, which of the following would the nurse avoid? A) B) C) D) 9. Explaining in depth what to expect during the upcoming procedure Administering a benzodiazepine medication prescribed for anxiety Taking a thorough history of her use of prescribed and illicit drugs Giving her a noncaffeinated beverage of her choice A nursing instructor asks a student to explain the influence of chronobiology on depression. Which of the following would the student include when responding? A) B) C) D) The exact location of genes leads to identifying the gene responsible for causing depression. A break in the corpus coliseum blocks information exchange between the right and left hemispheres. Damage to the posterior areas of the parietal lobe leads to altered discriminative sensory function. Internal and external triggers can elicit biologic rhythm changes indicative of clinical depression. 1 0. A) B) When describing the various neurotransmitters, which of the following would the nurse identify as the primary cholinergic neurotransmitter? Dopamine Acetylcholine 37 | P a g eC) D) 1 1. Norepinephrine Serotonin A group of nursing students are reviewing the various neurotransmitters. The students demonstrate understanding when they identify which of the following as a neuropeptide? A) B) C) D) 1 2. A) B) C) D) 1 3. Melatonin Serotonin Glutamate Gamma-aminobutyric acid The nurse is assessing a patient experiencing anxiety and observes increased sweating and gooseflesh. The nurse understands that these are the result of which substance? Acetylcholine Norepinephrine Serotonin Histamine A nurse is developing a plan of care for a patient diagnosed with schizophrenia. The nurse integrates knowledge of this disorder, identifying which neurotransmitter as being primarily involved? A) B) C) D) Acetylcholine Dopamine Norepinephrine Serotonin 38 | P a g e1 4. A group of students are reviewing information about neurotransmitter subtypes. The group demonstrates understanding of the information when they identify which neurotransmitter as having muscarinic and nicotinic receptors? A) B) C) D) 1 5. Serotonin Gamma-aminobutyric acid (GABA) Dopamine Acetylcholine A nurse is involved in gathering information about the inheritance of mental disorders using population genetics. Which of the following would the nurse be least likely to be evaluating? A) B) C) D) 1 6. A) B) C) D) E) Concordance rates Occurrence in first-degree relatives Risk factor analysis Adoptions studies A nurse is reading a journal article about psychoneuroimmunology. Which information would the nurse most likely find? Select all that apply. Neurotoxins role in receptor site damage Hypothalamicpituitarythyroid axis disruption Static activity of natural killer cells in response to stress Hypothalamic damage leading to immune dysfunction Interruption in the typical circadian rhythm cycle 39 | P a g e1 7. A) B) C) D) A patient is scheduled for a challenge test. Which of the following would the nurse include when explaining this test to the patient? Intravenous administration of a substance to induce symptoms Application of electrodes to the scalp for monitoring Evaluation electrical impulses recorded on graph paper Exposure to a flashing strobe light to elicit abnormal activity 1 8. A patient with depression tells the nurse that he is to have a test that involves the recording of an electroencephalogram (EEG) throughout the night. The nurse most likely identifies this testing as which of the following? A) B) C) D) 1 9. Sleep deprivation EEG Polysomnography Evoked potentials Functional magnetic resonance imaging A group of nursing students are reviewing the role of serotonin in psychiatric disorders. The students demonstrate a need for additional study when they identify which disorder as being associated with its dysfunction? A) B) C) D) Depression Obsessive-compulsive disorder Panic disorder Schizophrenia 40 | P a g e2 When describing neuronal transmission, an instructor 0. A) B) C) D) Answer Key 1. 2. 3. 4. 5. 6. 7. 8. 9. 1 0. 1 1. 1 2. 1 3. C D B B B D A B D B A B B describes the area where the electrical intracellular signal becomes a chemical one. The instructor is describing which of the following? Soma Synaptic cleft Terminal Receptor site 41 | P a g e1 4. 1 5. 1 1 7. 1 8. 1 9. 2 0. D C A, B, D 6. A B D B Chapter 7 Recovery Framework for Mental Health 1 . A group of nursing students are reviewing information about the evolution of mental health care and are discussing the recommendations of the final report of the Joint Commission on Mental Illness and Health. The students demonstrate understanding of this information when they identify that the report recommended an increase in which of the following? A) B) C) D) Numbers of mental health hospitals State funding for mental health care Clinics supplemented by general hospital units Use of psychotherapy by psychiatrists 42 | P a g e2. A nurse is reviewing the American Nurses Associations Statement on Psychiatric Nursing Practice published in 1967, which sanctioned the involvement of psychiatricmental health nurses in the provision of holistic nursing care. Integrating knowledge of the various theories and views of mental health and illness, the nurse identifies which of the following as most strongly linked to this holistic approach? A) B) C) D) E) 3. Sigmund Freuds psychoanalytic theory Florence Nightingales Notes on Nursing Hildegarde Clifford Beers A Mind That Found Itself Peplaus Interpersonal Relations in Nursing A nursing instructor is preparing a presentation about key events and people that influenced the development of contemporary mental health and illness care. When describing the effects of World War II, which of the following would the instructor include? A) B) C) D) People began to view mental illness as more commonplace and acceptable. The biologic understanding of mental illness was almost fully developed. Deinstitutionalization occurred in response to the community health movement. Mental illnesses became categorized as psychoses or neuroses. 43 | P a g e4. A nursing student is presenting a discussion of the history of psychiatricmental health nursing and its place within nursing history. Which of the following would be most appropriate to include? A) Certification for the psychiatricmental health nursing specialty was first emphasized by Mary Adelaide Nutting. B) Psychiatric nurses played a part in seeing that all deinstitutionalized patients got treatment at community mental health centers. C) There is a historical link between the first nursing program to admit male students and the first training school for psychiatric nursing. D) The first graduate program in psychiatric nurses was established in response to the publication of psychiatric nursing specialty journals. 5. Two nursing students are discussing psychiatricmental health nursing and the role it has played in nursings overall history. Which statement is most accurate? A) B) C) D) The importance of using therapeutic communication was stressed by Nightingale. The use of self-care to enhance the immune system was taught by Dorothea Dix. The moral treatment of mental illness was a primary focus of deinstitutionalization. Peplau was the first nurse to stress the importance of therapeutic communication. 44 | P a g e6. When reviewing the evolution of mental health and illness care, which event is associated with mental disorders beginning to be viewed as illnesses requiring treatment? A) B) C) D) 7. Establishment of Pennsylvania Hospital in Philadelphia Quaker establishment of asylums Creation of the state hospital system Freuds views on the causes of mental illnesses A psychiatricmental health nurse is working on a committee that is developing programs that integrate the objectives for mental health and mental disorders as identified in Healthy People 2020. Which type of program would be least appropriate? A) B) C) D) Single substance abuse treatment programs Depression screening programs for primary care providers Mental health programs for the homeless population Employment programs for those with serious mental illness 8. A nursing instructor is describing the concept of evidence-based practice in psychiatricmental health nursing. Which of the following would the instructor include as being important? Select all that apply. A) B) C) D) Research findings Expert opinion Clinical experiences Patient data 45 | P a g eE) 9. Established routines The following events are important in the development of psychiatricmental health nursing practice. Which event occurred first? A) B) C) D) Publication of Standards of Psychiatric-Mental Health Nursing by the ANA Publication of Standards of Child and Adolescent Psychiatric and Mental Health Nursing Practice Establishment of the first graduate program in psychiatric nursing at Rutgers University Publication of the first psychiatric nursing text, Nursing Mental Disease, by Harriet Bailey 1 0. A nurse is preparing a presentation about the current status of mental health services in the United States. Which statement would the nurse include as the most reflective of this status? A) B) C) D) Mental health care in the United States is equally accessible to individuals. Mental illness ranks second in terms of causing disability in comparison. Mental health care primarily focuses on the cure of mental illness. Mental health care services are inadequate and fragmented. 1 1. A group of students are reviewing the goals identified by the New Freedom Commission on Mental Health. The students demonstrate understanding of this report when they identify which of the following as a goal? 46 | P a g eA) B) C) D) 1 2. A) B) C) D) Mental health is viewed as one component of overall health. The consumer and family are the driving forces for mental health care. Screening is of greater importance than assessment and referral for services. Disparities in mental health services are decreased. The following are important legislative and policy efforts influencing current mental health care. Which of the following is the most recent? Mental Health: A Report of the Surgeon General New Freedom Commission on Mental Health Action for Mental Health Mental Retardation Facilities and Community Mental Health Centers Construction Act 1 3. As part of a career day presentation to a group of nursing students, a psychiatricmental health nurse plans to describe how this specialty developed. Which individual would the nurse describe as playing a major role in the development of specialty training programs for psychiatric nurses? A) B) C) D) Mary Adelaide Nutting Hildegarde Peplau Harriet Bailey Linda Richards 47 | P a g e1 4. A psychiatricmental health nurse is asked to be a guest speaker at a community fund-raising event for mental health services. Which of the following would the nurse emphasize as the primary goal of mental health services? A) B) C) D) 1 5. Access to affordable mental health care Removal of exclusions because of preexisting conditions Recovery from mental illness Effective treatment for mental health care needs A psychiatricmental health nurse is implementing evidence-based practice. The nurse understands that this approach is developed by doing which of the following first? A) B) C) D) 1 6. Conducting research Identifying a clinical question Determining outcomes Collaborating with the patient A group of students are reviewing information about mental health care after World War II. The students demonstrate understanding of this information when they identify which of the following as a result of the National Mental Health Act? A) B) C) D) Discovery of psychopharmacology Passage of the Hill-Burton Act Establishment of the National Institute of Mental Health Development of community mental health centers 48 | P a g e1 When providing care to a patient, the psychiatricmental 7. health nurse is implementing the therapeutic use of self. The nurse is applying the concepts based on the work of which individual? A) B) C) D) 1 8. Hildegarde Peplau Florence Nightingale Dorothea Dix Sigmund Freud After teaching a class to a group of nursing students about the historical perspectives of mental health care, the instructor determines that the group has understood the information when they identify which of the following as a common belief about mental illness during the medieval period? A) B) C) D) Answer Key 1. 2. 3. 4. Mental illness in an individual was the result of being possessed by demons. A person was removed from a contaminated environment to protect him or her. Exorcisms were used as primary mode of treatment to cleanse the person of his or her sins. The focus was on moral treatment to promote the individuals safety and comfort. C B A C 49 | P a g e