Nursing 4530 - Mental Health - Final Exam Questions and Answers Graded A+
The nurse is performing an assessment of geriatric patients in a community health care center. The
nurse reports that one of the patient's has schizophrenia. Which statement made by the patient while
interacting with the nurse supports the nurse's assessment?
A. "Every morning I enjoy the humming of birds; it relaxes me."
B. "Every day my friends wait for me in front of my gate for our morning walk."
C. "Every day birds sing songs for me and spread flowers on the path where I walk."
D. "Everyone feels as if I am a burden to them; I would like to put an end to their problem." - Answers C.
"Every day birds sing songs for me and spread flowers on the path where I walk."
Rationale
Patients with schizophrenia have delusions of self-importance and state false events related to them,
like birds singing songs for them and spreading flowers on their path.
A nurse understands that antipsychotic drugs may sometimes have toxic effects. The nurse suggests to
the patient' s guardians to give the patient foods rich in carbohydrates and protein and to ensure that
the patient undergoes a liver function test every 6 months. Which of these toxic effects was the nurse
thinking about when making such a suggestion?
A. Weight gain
B. Hyperpyrexia
C. Agranulocytosis
D. Cholestatic jaundice - Answers D. Cholestatic jaundice
Rational
Antipsychotics may cause cholestatic jaundice because of impaired liver function. Hence, a liver function
test should be performed every 6 months. The patients must be given foods rich in carbohydrates and
protein in order to enhance liver function.
A nurse manager plans to follow up with a nurse after hearing which comment while talking to a patient
who is reporting someone is trying to poison him or her?
A. "Let's discuss the stressors you have in your life right now."
,B. "Tell me more about how someone keeps trying to poison your food."
C. "Have other members of your family ever experienced this kind of thing?"
D. "How has this affected your ability to keep a job or care for yourself?" - Answers B. "Tell me more
about how someone keeps trying to poison your food."
Rationale
It is nontherapeutic to reinforce the delusion by encouraging the individual to focus on the details, as
suggested by asking the patient how his or her food is being poisoned. The statements "Have other
members of your family ever experienced this kind of thing?", "How has this affected your ability to
keep a job or care for yourself?", and "Let's discuss the stressors you have in your life right now" do not
reinforce the delusion. Rather, they help gain knowledge about the history of the disorder in the family,
the extent of the dysfunction the fear is causing, and the triggers that may have resulted in this behavior
Which side effect of antipsychotic medication is generally nonreversible?
A. Dystonic reaction
B. Tardive dyskinesia
C. Pseudoparkinsonism
D. Anticholinergic effects - Answers B. Tardive dyskinesia
Rationale
Tardive dyskinesia is not always reversible with discontinuation of the medication and has no proven
cure. The side effects of anticholinergic effects, pseudoparkinsonism, and dystonic reaction often appear
early in therapy and can be minimized with treatment.
A desired outcome for a patient diagnosed with schizophrenia who is experiencing auditory
hallucinations would be that the patient will...
A. Ask for validation of reality
B. Describe content of hallucinations
C. Demonstrate a cool, aloof demeanor
D. Identify prodromal symptoms of disorder - Answers A. Ask for validation of reality
,Rationale
Beginning to question his or her own altered perceptions by seeking input from staff is highly desirable.
A nurse works with a patient in the acute phase of schizophrenia. Which assessment findings increase
the risk of aggression and violence? (Select all that apply)
A. Paranoia
B. Flat affect
C. Poor hygiene
D. Delusional thinking
E. Command hallucinations - Answers A. Paranoia
D. Delusional thinking
E. Command hallucinations
Rationale
A small percentage of patients with schizophrenia, especially during the acute phase, may exhibit a risk
for physical violence, typically in response to hallucinations (especially command hallucinations),
delusions, paranoia, and impaired judgment or impulse control. Poor hygiene and a flat affect are
negative symptoms that usually are not associated with aggression or violence.
A patient diagnosed with schizophrenia is most likely to experience which type of hallucination?
A. Visual
B. Tactile
C. Auditory
D. Olfactory - Answers C. Auditory
Rationale
Patients diagnosed with schizophrenia may experience hallucinations arising out of any of the senses;
however, auditory hallucinations are experienced by 60% of people with schizophrenia at some time
during their lives. Visual hallucinations more commonly are associated with substance abuse and
withdrawal. Tactile and olfactory hallucinations are rare.
, What electrolyte imbalance can be seen in patients who have schizophrenia who are experiencing
polydipsia?
A. Hypokalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypercalcemia - Answers C. Hyponatremia
Rationale In patients with schizophrenia, polydipsia is seen as a result of dry mouth. Patients experience
excessive thirst because of antipsychotic drugs and drink a lot of water. Polydipsia is characterized by
hyponatremia, confusion, and severe symptoms of schizophrenia. It is caused by the inability of the
kidneys to filter excess fluids. Hypokalemia is a condition that produces reduced levels of potassium,
which can be caused by antibiotics. Hypocalcemia refers to increased levels of calcium as a result of a
deficiency of vitamin D or defective absorption. It can also happen because of impaired metabolism of
vitamin D in the body. Hypercalcemia is an increase in levels of calcium seen during
hyperparathyroidism.
A patient with schizophrenia was prescribed antipsychotics. After daily observation, the nurse finds the
patient's blood pressure has decreased. What is the most appropriate action by a nurse before
administering the prescribed drug to the patient?
A. The nurse should tell the patient to rise slowly.
B. The nurse should tell the patient to avoid taking fluids.
C. The nurse should avoid administering the drug for the day.
D. The nurse should give an adrenergic agonist to raise the blood pressure. - Answers A. The nurse
should tell the patient to rise slowly.
Rationale
Antipsychotics block the α -receptor, which may cause hypotension. The nurse can give advice to the
patient to rise slowly from the bed because the patient may feel dizzy as a result of reduced blood
pressure. The nurse cannot administer the adrenergic agonist but can report to the health care provider
if the patient's diastolic pressure falls below 80 mm Hg. The nurse should not stop administering the
drug because that may worsen the schizophrenic symptoms. The nurse should not advise the patient to
The nurse is performing an assessment of geriatric patients in a community health care center. The
nurse reports that one of the patient's has schizophrenia. Which statement made by the patient while
interacting with the nurse supports the nurse's assessment?
A. "Every morning I enjoy the humming of birds; it relaxes me."
B. "Every day my friends wait for me in front of my gate for our morning walk."
C. "Every day birds sing songs for me and spread flowers on the path where I walk."
D. "Everyone feels as if I am a burden to them; I would like to put an end to their problem." - Answers C.
"Every day birds sing songs for me and spread flowers on the path where I walk."
Rationale
Patients with schizophrenia have delusions of self-importance and state false events related to them,
like birds singing songs for them and spreading flowers on their path.
A nurse understands that antipsychotic drugs may sometimes have toxic effects. The nurse suggests to
the patient' s guardians to give the patient foods rich in carbohydrates and protein and to ensure that
the patient undergoes a liver function test every 6 months. Which of these toxic effects was the nurse
thinking about when making such a suggestion?
A. Weight gain
B. Hyperpyrexia
C. Agranulocytosis
D. Cholestatic jaundice - Answers D. Cholestatic jaundice
Rational
Antipsychotics may cause cholestatic jaundice because of impaired liver function. Hence, a liver function
test should be performed every 6 months. The patients must be given foods rich in carbohydrates and
protein in order to enhance liver function.
A nurse manager plans to follow up with a nurse after hearing which comment while talking to a patient
who is reporting someone is trying to poison him or her?
A. "Let's discuss the stressors you have in your life right now."
,B. "Tell me more about how someone keeps trying to poison your food."
C. "Have other members of your family ever experienced this kind of thing?"
D. "How has this affected your ability to keep a job or care for yourself?" - Answers B. "Tell me more
about how someone keeps trying to poison your food."
Rationale
It is nontherapeutic to reinforce the delusion by encouraging the individual to focus on the details, as
suggested by asking the patient how his or her food is being poisoned. The statements "Have other
members of your family ever experienced this kind of thing?", "How has this affected your ability to
keep a job or care for yourself?", and "Let's discuss the stressors you have in your life right now" do not
reinforce the delusion. Rather, they help gain knowledge about the history of the disorder in the family,
the extent of the dysfunction the fear is causing, and the triggers that may have resulted in this behavior
Which side effect of antipsychotic medication is generally nonreversible?
A. Dystonic reaction
B. Tardive dyskinesia
C. Pseudoparkinsonism
D. Anticholinergic effects - Answers B. Tardive dyskinesia
Rationale
Tardive dyskinesia is not always reversible with discontinuation of the medication and has no proven
cure. The side effects of anticholinergic effects, pseudoparkinsonism, and dystonic reaction often appear
early in therapy and can be minimized with treatment.
A desired outcome for a patient diagnosed with schizophrenia who is experiencing auditory
hallucinations would be that the patient will...
A. Ask for validation of reality
B. Describe content of hallucinations
C. Demonstrate a cool, aloof demeanor
D. Identify prodromal symptoms of disorder - Answers A. Ask for validation of reality
,Rationale
Beginning to question his or her own altered perceptions by seeking input from staff is highly desirable.
A nurse works with a patient in the acute phase of schizophrenia. Which assessment findings increase
the risk of aggression and violence? (Select all that apply)
A. Paranoia
B. Flat affect
C. Poor hygiene
D. Delusional thinking
E. Command hallucinations - Answers A. Paranoia
D. Delusional thinking
E. Command hallucinations
Rationale
A small percentage of patients with schizophrenia, especially during the acute phase, may exhibit a risk
for physical violence, typically in response to hallucinations (especially command hallucinations),
delusions, paranoia, and impaired judgment or impulse control. Poor hygiene and a flat affect are
negative symptoms that usually are not associated with aggression or violence.
A patient diagnosed with schizophrenia is most likely to experience which type of hallucination?
A. Visual
B. Tactile
C. Auditory
D. Olfactory - Answers C. Auditory
Rationale
Patients diagnosed with schizophrenia may experience hallucinations arising out of any of the senses;
however, auditory hallucinations are experienced by 60% of people with schizophrenia at some time
during their lives. Visual hallucinations more commonly are associated with substance abuse and
withdrawal. Tactile and olfactory hallucinations are rare.
, What electrolyte imbalance can be seen in patients who have schizophrenia who are experiencing
polydipsia?
A. Hypokalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypercalcemia - Answers C. Hyponatremia
Rationale In patients with schizophrenia, polydipsia is seen as a result of dry mouth. Patients experience
excessive thirst because of antipsychotic drugs and drink a lot of water. Polydipsia is characterized by
hyponatremia, confusion, and severe symptoms of schizophrenia. It is caused by the inability of the
kidneys to filter excess fluids. Hypokalemia is a condition that produces reduced levels of potassium,
which can be caused by antibiotics. Hypocalcemia refers to increased levels of calcium as a result of a
deficiency of vitamin D or defective absorption. It can also happen because of impaired metabolism of
vitamin D in the body. Hypercalcemia is an increase in levels of calcium seen during
hyperparathyroidism.
A patient with schizophrenia was prescribed antipsychotics. After daily observation, the nurse finds the
patient's blood pressure has decreased. What is the most appropriate action by a nurse before
administering the prescribed drug to the patient?
A. The nurse should tell the patient to rise slowly.
B. The nurse should tell the patient to avoid taking fluids.
C. The nurse should avoid administering the drug for the day.
D. The nurse should give an adrenergic agonist to raise the blood pressure. - Answers A. The nurse
should tell the patient to rise slowly.
Rationale
Antipsychotics block the α -receptor, which may cause hypotension. The nurse can give advice to the
patient to rise slowly from the bed because the patient may feel dizzy as a result of reduced blood
pressure. The nurse cannot administer the adrenergic agonist but can report to the health care provider
if the patient's diastolic pressure falls below 80 mm Hg. The nurse should not stop administering the
drug because that may worsen the schizophrenic symptoms. The nurse should not advise the patient to
