NUR 2488 Mental Health Nursing: Midterm Exam Questions and Answers Latest 2023/2024 | 100% VERIFIED

An adult with depression has been treated with medication and cognitive behavioral therapy. The patient now verbalizes that being passive and letting others make decisions for her contributed to the depression. What referrals could the nurse make to help this patient prevent recurrence of depression? Selected Answer: Social skills training Answers: Social skills training Use of complementary therapy NUR 2488 Mental Health Nursing: Exam 2 Relaxation training classes Learning desensitization techniques Response Feedback : Social skills training is helpful in treating and preventing the recurrence of depression. Training focuses on assertiveness and coping skills that lead to positive reinforcement from others. Use of complementary therapy refers to adjunctive therapies such as herbals. Assertiveness would be of greater value than relaxation training because passivity has been identified as a concern. Desensitization is used in treatment of phobias  Question 3 1 out of 1 points A patient with suicidal impulses is placed on the highest level of suicide precautions. Which measures should be incorporated into the plan of care by the nurse caring for the patient? (Select all that apply.) Selected Answers: Maintain arm’s-length distance, institute one-on-one nursing observation around the clock Allow no glass or metal on meal trays Remove all potentially harmful objects from the patient’s possession Answers: Maintain arm’s-length distance, institute one-on-one nursing observation around the clock Allow no glass or metal on meal trays Keep patient within visual range while awake, but only check every 15 to 30 minutes while the patient is sleeping Only check the patient’s whereabouts every 15 minutes and make frequent verbal contacts. Remove all potentially harmful objects from the patient’s possession Response Feedback : One-on-one observation is necessary for anyone who has limited control over suicidal impulses. Plastic dishes on trays and the removal of potentially harmful objects from the patient’s possession are measures included in any-level suicide precautions. The remaining options are used in less stringent levels of suicide precautions.  Question 4 0 out of 1 points Which statement indicates a patient with major depression’s most likely outlook on life during the acute phase of the illness? Selected Answer: “If I ignore this, it will go away.” Answers: “It’s just a matter of time and I’ll be well.” “I deserve to be this way.” “I can fight this and get better.” “If I ignore this, it will go away.” Response Feedback: Patients with depression feel worthless and often believe they deserve to have “bad” things happen. Patients with depression are usually hopeless and would not respond optimistically. Patients with depression usually feel helpless and unable to fight.  Question 5 0 out of 1 points The nurse knows that sedation is a side effect of many antipsychotics. Which of the following medications should the nurse question if ordered for a patient taking antipsychotics? Selected Answer: hydrochlorothia zide Answers: hydrochlorothia zide diphenhydrami ne acetaminophen verapamil Response Feedback: Diphenhydramine is an antihistamine that is likely to cause drowsiness and enhance the sedative effect of an antipsychotic. Hydrochlorothiazide (diuretic), acetaminophen (antipyretic and pain reliever) and verapamil (antihypertensive) do not cause sedation.  Question 6 1 out of 1 points The nurse is caring for a patient who experiences orthostatic hypotension related to taking chlorpromazine. The nurse should suggest which of the following interventions for managing this side effect? Selected Answer: Sit on the side of the bed before standing up. Answers: Stay in bed for an hour after taking the medication. Sit on the side of the bed before standing up. Stand quickly, then wait a moment before walking. Take the medication with milk or food. Response Feedback : Sudden position changes lead to dizziness associated with postural hypotension, so arising slowly from sitting or lying down is a good suggestion. It’s not necessary to stay in bed for an hour after taking the medication. The patient should not stand quickly, as this can lead to a sudden drop in blood pressure. Taking the medication with milk or food will not affect blood pressure.  Question 7 1 out of 1 points The nurse is evaluating the effectiveness of an antipsychotic on negative symptoms of psychosis. Which of the following symptoms would be classified as negative symptoms of psychosis? Selected Answer: flat affect Answers: illogical speech bizarre behavior delusions flat affect Response Feedback: Muscle rigidity, hyperpyrexia, tachypnea, diaphoresis, and drooling are all symptoms of neuromuscular malignant syndrome (NMS). The primary indications of serotonin syndrome, tardive dyskinesia (TD) and pseudo-Parkinsonism do not include these symptoms.  Question 8 1 out of 1 points During the maintenance phase of treatment a patient with bipolar disorder asks the nurse, “Do I have to keep taking this lithium even though my mood is stable now?” Which is the most appropriate response? Selected Answer: “Taking the medication every day helps prevent relapses and recurrences.” Answers: “You will be able to stop the medication in about 1 month.” “Usually patients take medication for approximately 6 months after discharge.” “Taking the medication every day helps prevent relapses and recurrences.” “It’s unusual that the health care provider hasn’t already stopped your medication.” Response Feedback: Bipolar patients may be maintained on lithium indefinitely to prevent recurrences. Helping the patient understand this need will promote medication compliance.  Question 9 0 out of 1 points A patient with bipolar disorder commands another patient to “Get me that book. Take this other stuff out of here,” and makes other similar demands. Which of the following actions could the nurse use to interrupt this behavior without entering into a power struggle with the patient? Select all that Apply Providing a distraction Setting clear limits Provide advice on how to correct behavior Answer s: Using humor Providing a distraction Setting clear limits Provide advice on how to correct behavior Response Feedback : The distractibility characteristic of manic episodes can assist the nurse to direct the patient toward more appropriate, constructive activities without entering into power struggles. Limit setting is a main theme in treating a client with mania. Humor usually backfires by either encouraging the patient or inciting anger. Giving advice is considered a non-therapeutic communication technique, and should be avoided.  Question 10 1 out of 1 points A patient with depression is evaluated at the clinic and started on citalopram. The patient tells the nurse, “I have some pills I previously took for depression. They’re called MAOIs. I think I should take them along with this new medication.” What information is essential for the nurse to communicate regarding her statements? Selected Answer: The risk of a serious reaction if SSRIs and MAOIs are combined. Answers: The need to have blood pressure carefully monitored That SSRI antidepressant will be more effective in 3 weeks. The dietary restrictions required when taking MAOIs. The risk of a serious reaction if SSRIs and MAOIs are combined. Response Feedback : The patient is at risk for a hypertensive crisis if he or she takes MAOIs and citalopram, which is an SSRI, without an appropriate washout period. The duration of the washout period is determined by the half-life of the SSRI. The other options do not address the priority concern of the drug interaction.  Question 11 1 out of 1 points A patient with schizophrenia begins to talks about “volmers” hiding in the warehouse at work. Which of the following should the term “volmers” be assessed as? Selected Answer: A neologism Answers: A neologism Concrete thinking Thought insertion An idea of reference Response Feedback : A neologism is a newly coined word having special meaning to the patient. “Volmer” is not a known common noun. Concrete thinking refers to the inability to think abstractly. Thought insertion refers to the idea that the thoughts of others are being planted in one’s mind. Ideas of reference are a type of delusion in which trivial events are given personal significance.  Question 12 1 out of 1 points The nurse is caring for a female patient diagnosed with schizophrenia who believes that her thoughts are broadcast to others. What is the most appropriate nursing diagnosis for this patient? Selected Answer: Disturbed Thought Processes Answers: Risk for Self-Directed Violence Impaired Communication Disturbed Thought Processes Disturbed Sensory Perception Response Feedback : Thought broadcasting and thought withdrawal are disturbed thought processes. There is no indicated that the patient is planning self-harm. Disturbed Sensory Perception would refer to the interpretation of sensory stimuli, such as sights and sounds. The patient does not have a problem with communication, but with her thought process.  Question 13 1 out of 1 points A nurse receives this laboratory result: lithium level 1.7 mEq/L. How should the nurse interpret this lab value? Selected Answer: Above therapeutic limits Answers: Within therapeutic limits Below therapeutic limits Above therapeutic limits Incorrect because of inaccurate testing Response Feedback: Normal range for a blood sample taken 8 to 12 hours after the last dose of lithium is 0.8 to 1.4 mEq/L for maintenance. This lab value represents likely lithium toxicity.  Question 14 1 out of 1 points Which of the following interventions should the nurse prioritize for a patient with severe depression? Selected Answer: Careful unobtrusive observation around the clock Answers: Allowing the patient to spend long periods alone in meditation. Careful unobtrusive observation around the clock Encouraging the patient to spend a major portion of each day in bed Provide opportunities for the patient to assume a leadership role on the unit Response Feedback: Approximately two thirds of people with depression contemplate suicide. Patients with depression who exhibit feelings of worthlessness are at higher risk. Regular planned observations of the patient with depression may prevent a suicide attempt on the unit  Question 15 1 out of 1 points Which comment by a patient experiencing severe anxiety would indicate the possibility of obsessive-compulsive disorder? Selected Answer: “I have to keep checking to see where my car keys are.” Answers: “I have to keep checking to see where my car keys are.” “My legs feel weak most of the time.” “I’m afraid to go out in public.” “I keep reliving the car accident.” Response Feedback : Recurring doubt (obsessive thinking) and the need to check (compulsive behavior) suggest obsessive-compulsive disorder. The repetitive behavior is designed to decrease anxiety but fails and must be repeated. Stating “My legs feel weak most of the time” is more in keeping with a somatoform disorder. Being afraid to go out in public is associated with agoraphobia and reliving a traumatic event is associated with posttraumatic stress disorder  Question 16 1 out of 1 points When educating a client and their family about taking a serotonin reuptake inhibitor (SSRI), which should the nurse prioritize for teaching purposes? Selected Answer: Report increased suicidal thoughts Answers: Avoid exposure to bright sunlight Report increased suicidal thoughts Restrict sodium intake to 1 g. daily Maintain a tyramine free diet Response Feedback : Some evidence indicates that suicidal ideation may worsen at the beginning of antidepressant therapy; thus close monitoring is necessary. Avoiding exposure to bright sunlight and restricting sodium intake are unnecessary. Tyramine restriction is associated with monoamine oxidase inhibitor (MAOI) therapy.  Question 17 0 out of 1 points Which of the following are potential complications that the patient receiving lithium should be assessed for? Selected Answer: Sore throat, dry eyes, and dystonia Answers: Hair loss, rash, and drowsiness Sore throat, dry eyes, and dystonia Diaphoresis, weakness, and nausea Abdominal distention, dyspnea, and edema Response Feedback: Diaphoresis, weakness, and nausea are early signs of lithium toxicity. All other problems mentioned are unrelated to lithium therapy.  Question 18 1 out of 1 points Which statement by a patient in the continuation phase of treatment for bipolar disorder indicates that a referral may still be needed? Selected Answer: “It is difficult to live down all the crazy stuff I did during my last manic episode.” Answers: “It is difficult to live down all the crazy stuff I did during my last manic episode.” “I am getting better at problem solving thanks to the group I attend every Wednesday.” “Using a financial counselor to help manage my money is keeping me out of debt.” “I used to drink a lot, but Alcoholics Anonymous helps me manage stress without drinking.” Response Feedback: The only option in which the patient identifies a problem that is not being adequately addressed is the first response, reconciling illness behaviors. Ongoing therapy may be called for to address these issues.  Question 19 1 out of 1 points Which nursing diagnosis is likely to apply to an individual with a severe and persistent mental illness who is homeless? Selected Answer: Chronic low selfesteem Answers: Substance abuse Chronic low selfesteem Insomnia Schizophrenia Response Feedback : Of the 40% to 70% of individuals with severe mental illness who do not live with their families, many become homeless. Life on the street or in a shelter has a negative influence on the individual’s self-esteem, making this nursing diagnosis one that should be considered. Substance abuse and Schizophrenia is not an approved NANDA-International diagnosis. Insomnia may be noted in some patients but is not a universal problem.  Question 20 0 out of 1 points A patient is undergoing a series of diagnostic tests. The patient says, “Nothing is wrong with me except a stubborn chest cold.” The spouse reports the patient smokes and coughs a lot, has lost 15 pounds, and is easily fatigued. Which defense mechanism is the patient using? Selected Answer: Displacem ent Answers: Regression Displacem ent Denial Projection Response Feedback : Denial is an unconscious blocking of threatening or painful information or feelings. Regression involves using behaviors appropriate at an earlier stage of psychosexual development. Displacement shifts feelings to a more neutral person or object. Projection attributes one’s own unacceptable thoughts or feelings to another.  Question 21 1 out of 1 points A patient with generalized anxiety disorder comes to the clinic with severe anxiety. Of these medications in the patient’s medical record, which is most appropriate to give as an as needed (prn) anxiolytic medication? Selected Answer: Lorazep am Answers: Buspiron e Lorazep am Phenytoi n Fluoxeti ne