Psyche - Exam 2/ Psychiatric Mental Health Nursing - Questions and answers- latest spring26/27 - Miami Dade College, Miami.

Psyche - Exam 2/ Psychiatric Mental Health Nursing - Questions and answers- latest spring26/27 - Miami Dade College, Miami. Question 1 An adult has recently been absent from work for 3-day periods on several occasions. Each time, the individual returns to work wearing dark glasses. Facial and body bruises are apparent. What is the occupational health nurse's priority assessment? A. Interpersonal relationships B. Physical injuries C. Socialization skills D. Work responsibilities Question 2 An adult tells the nurse, "My partner abuses me only when drinking. The drinking has increased lately, but I always get an apology afterward and a box of candy. I've considered leaving but haven't been able to bring myself to actually do it." Which phase in the cycle of violence prevents the patient from leaving? A. Tension building B. Recovery C. Acute battering D. Honeymoon Question 3 An older adult diagnosed with dementia lives with family and attends an adult day care center. A nurse at the center notices the adult has a disheveled appearance, a strong odor of urine, and bruises on the limbs and back. What type of abuse might be occurring? A. Financial B. Physical C. Sexual D. Psychological Question 4 Which referral is most appropriate for a woman who is severely beaten by her husband, has no relatives or friends in the community, is afraid to return home, and has limited financial resources? A. Law enforcement B. Women's shelter C. Support group D. Vocational counseling Question 5 Which referral is most appropriate for a woman who is severely beaten by her husband, has no relatives or friends in the community, is afraid to return home, and has limited financial resources? A. Law enforcement B. Vocational counseling C. Women's shelter D. Support group Question 6 A child was abducted and raped. Which personal reaction by the nurse could interfere with the child's care? A. Compassion B. Empathy C. Anger D. Concern Question 7 The nurse cares for a victim of a violent sexual assault. What is the most therapeutic intervention? A. Educate the victim about strategies to avoid attacks in the future B. Use accepting, nurturing, and empathetic communication techniques C. Discourage the expression of feelings until the victim stabilizes D. Maintain a matter-of-fact manner and objectivity Question 8 What is the primary motivator for most rapists? A. Desire to humiliate or control others B. Need for humiliation C. Overwhelming sexual desires D. Anxiety Question 9 Which scenario predicts the highest risk for directing violent behavior toward others? A. Completion of alcohol withdrawal and beginning a rehabilitation program B. Obsessive-compulsive disorder; performing many rituals C. Major depressive disorder with delusions of worthlessness D. Paranoid delusions of being followed by a military attack team Question 10 A patient is hospitalized after an arrest for breaking windows in the home of a former intimate partner. The history reveals childhood abuse by a punitive parent, torturing family pets, and an arrest for disorderly conduct. Which nursing diagnosis has priority? A. Post-trauma response B. Disturbed thought processes C. Risk for other-directed violence D. Risk for injury Question 11 What symptoms should a nurse recognize that differentiate a client diagnosed with panic disorder from a client diagnosed with generalized anxiety disorder (GAD)? A. Hyperventilation is a common symptom in GAD and panic disorder B. Depersonalization is commonly seen in panic disorder and absent in GAD C. GAD is acute in nature, and panic disorder is chronic D. Chest pain is a common GAD symptom, whereas this symptom is absent in panic disorder Question 12 Which treatment should a nurse identify as most appropriate for clients diagnosed with generalized anxiety disorder (GAD)? A. Acute symptom control with ziprasidone (Geodon) B. Acute symptom control with citalopram (Celexa) C. Long-term treatment with diazepam (Valium) D. Long-term treatment with buspirone (BuSpar) Question 13 A cab driver, stuck in traffic, becomes lightheaded, tremulous, diaphoretic, tachycardic, and dyspneic. A workup in an emergency department reveals no pathology. Which medical diagnosis should a nurse suspect, and what nursing diagnosis should be the nurse's first priority? A. Altered sensory perception and a nursing diagnosis of panic disorder B. Pain disorder and a nursing diagnosis of altered role performance C. Generalized anxiety disorder and a nursing diagnosis of fear D. Panic disorder and a nursing diagnosis of anxiety Question 14 A client is experiencing a severe panic attack. Which nursing intervention would meet this client's physiological need? A. Teach deep breathing relaxation exercises B. Place the client in a Trendelenburg position C. Have the client breathe into a paper bag D. Administer the ordered PRN buspirone (BuSpar) Question 15 A college student is unable to take a final exam owing to severe test anxiety. Instead of studying, the student relieves stress by attending a movie. Which priority nursing diagnosis should a campus nurse assign for this client? A. Powerlessness R/T fear B. Non-adherence R/T test taking C. Ineffective role performance R/T helplessness D. Altered coping R/T anxiety Question 16 A client diagnosed with obsessive-compulsive disorder is admitted to a psychiatric unit. The client has an elaborate routine for toileting activities. Which would be an appropriate initial client outcome during the first week of hospitalization? A. The client will wake early enough to complete rituals prior to breakfast B. The client will refrain from ritualistic behaviors during daylight hours C. The client will participate in three unit activities by day three D. The client will substitute a constructive activity for rituals by day one Question 17 A client is prescribed alprazolam (Xanax) for acute anxiety. What client history should cause a nurse to question this order? A. History of alcohol use disorder B. History of schizophrenia C. History of personality disorder D. History of hypertension Question 18 Which factors differentiate the diagnosis of PTSD from the diagnosis of adjustment disorder (AD)? A. PTSD results from exposure to an extreme traumatic event, whereas AD results from exposure to "normal" daily events B. AD results from exposure to an extreme traumatic event, whereas PTSD results from exposure to "normal" daily events C. Depressive symptoms occur in PTSD and not in AD D. Depressive symptoms occur in AD and not in PTSD Question 19 Which principle takes priority for the psychiatric inpatient staff when addressing behavioral crises? A. Resolve behavioral crises using the least restrictive intervention possible B. Allow patients opportunities to regain control without intervention if safety is not compromised C. Swift intervention is justified to maintain the integrity of the therapeutic milieu D. Rights of the majority of patients supersede the rights of individual patients Question 20 Which scenario best demonstrates an example of eustress? An individual: A. Receives notification that their employer is having financial problems and workers will be terminated B. Receives a bank notice of insufficient funds for rent C. Loses a beloved family pet D. Prepares to take a 1-week vacation to a tropical island with close friends Question 21 As part of the stress response, the HPA axis is stimulated. Which structures make up this system? A. Hepatic artery, parasympathetic nervous system, and autonomic nerve B. Hippocampus, parietal lobe, and amygdala C. Hindbrain, pyramidal nervous system, and anterior cerebrum D. Hypothalamus, pituitary gland, and adrenal glands Question 22 A veteran of the war in Afghanistan was diagnosed with posttraumatic stress disorder (PTSD). The veteran says, "If there's a loud noise at night, I get under my bed because I think we're getting bombed." What type of experience has the veteran described? A. Illusion B. Auditory hallucination C. Flashback D. Nightmare Question 23 A soldier returned one year ago from Afghanistan and was diagnosed with posttraumatic stress disorder (PTSD). Which social event would most likely be disturbing for this soldier? A. Halloween festival with neighborhood children B. Fireworks display on July 4th C. Singing carols around a Christmas tree D. Family outing to the seashore Question 24 A veteran of military combat tells the nurse, "I saw a child get blown up over a year ago, and now I keep seeing bits of flesh everywhere. I see something red and the visions race back to my mind." Which phenomenon associated with PTSD is this veteran describing? A. Avoidance B. Hyperarousal C. Psychosis D. Re-experiencing Question 25 A patient has a fear of public speaking. The nurse should be aware that social anxiety disorders (social phobias) are often treated with which type of medication? A. Antipsychotic medications B. Tricyclic antidepressant agents C. Monoamine oxidase inhibitors D. Beta blockers Question 26 A patient has blindness related to a functional neurological (conversion) disorder but is unconcerned about this problem. Which understanding should guide the nurse's planning for this patient? The patient is: A. Relieving anxiety through the physical symptom B. Suppressing accurate feelings regarding the problem C. Refusing to disclose genuine fears D. Meeting needs through hospitalization Question 27 Which assessment finding best supports the diagnosis of dissociative amnesia with fugue? The patient states: A. "I feel as if I'm living in a fuzzy dream state." B. "I feel very anxious and worried about my problems." C. "I cannot recall why I'm living in this town." D. "I feel like different parts of my body are at war." Question 28 An adolescent comes to the crisis clinic and reports sexual abuse by an uncle. The patient told the parents about the uncle's behavior, but the parents did not believe the adolescent. What type of crisis exists? A. Adventitious B. Maturational C. Situational D. Organic brain Question 29 A patient visiting the crisis clinic for the first time asks, "How long will I be coming here?" The nurse's reply should consider that the usual duration of crisis intervention is ______ weeks. A. 1 to 2 B. 4 to 6 C. 3 to 4 D. 6 to 12 Question 30 Which scenario is an example of an adventitious crisis? A. A riot at a rock concert B. Being fired from a job because of company downsizing C. Death of a child from sudden infant death syndrome D. Retirement of a 55-year-old Question 31 A soldier returns to the United States from active duty in a combat zone. The soldier is diagnosed with posttraumatic stress disorder (PTSD). Which comment by the soldier requires the nurse's immediate attention? A. "I want to continue my education but I'm not sure how I will fit in with other college students." B. "I saw my best friend get killed by a roadside bomb. It should have been me instead." C. "It's good to be home. I missed my family and friends." D. "Sometimes I think I hear bombs exploding, but it's just the noise of traffic in my hometown." Question 32 A person with a fear of heights drives across a high bridge. Which division of the autonomic nervous system is stimulated in response to this experience? A. Sympathetic nervous system B. Parasympathetic nervous system C. Peripheral nervous system D. Limbic system Question 33 A patient is brought to the emergency department after a motorcycle accident. The patient is alert, responsive, and diagnosed with a broken leg. The patient's vital signs are temperature (T) 98.6°F, pulse (P) 72 bpm, and respirations (R) 16 breaths per minute. After being informed that surgery is required for the broken leg, which vital sign readings would be expected? A. T 98.6°, P 68, R 12 B. T 98.6°, P 84, R 22 C. T 98.6°, P 64, R 14 D. T 98.6°, P 62, R 16 Question 34 A patient tells the nurse, "I don't go to restaurants because people might laugh at the way I eat, or I could spill food and be laughed at." The nurse assesses this behavior as consistent with: A. Posttraumatic stress disorder (PTSD) B. Agoraphobia C. Acrophobia D. Social anxiety disorder (social phobia) Question 35 A woman says, "I can't take anymore! Last year my husband had an affair. Three months ago, I found a lump in my breast. Yesterday my daughter said she's quitting college." What type of crisis is this person experiencing? A. Maturational B. Situational C. Adventitious D. Recurring Question 36 A mental health nurse working in the unit is assessing a client diagnosed with schizophrenia spectrum disorder. The nurse asks the client, "Do you receive special messages from certain sources, such as the television or radio?" The nurse is assessing which potential symptom of this disorder? A. Delusions of reference B. Thought insertion C. Paranoid delusions D. Magical thinking Question 37 A nursing student is learning about nurse-client relationship. Which nursing behavior will enhance the establishment of a trusting relationship with a client diagnosed with schizophrenia spectrum disorder? A. Sharing limited personal information B. Establishing personal contact with family members C. Being reliable, honest, and consistent during interactions D. Sitting close to the client to establish rapport Question 38 A mental health nurse is caring for a client diagnosed with schizophrenia spectrum disorder. A physician orders haloperidol (Haldol) 50 mg BID, benztropine (Cogentin) 1 mg PRN, and zolpidem (Ambien) 10 mg HS. Which client behavior would warrant the nurse to administer benztropine? A. Restlessness and muscle rigidity B. Reports of hearing disturbing voices C. Tardive dyskinesia D. Tactile hallucinations Question 39 A psychiatric nurse in the unit is caring for a client who is experiencing a flat affect, paranoid delusions, anhedonia, anergia, neologisms, and echolalia. Which statement correctly differentiates the client's positive and negative symptoms of schizophrenia? A. Paranoid delusions, anergia, and echolalia are negative symptoms B. Paranoid delusions, anhedonia, and anergia are positive symptoms C. Paranoid delusions, flat affect, and anhedonia are negative symptoms D. Paranoid delusions, neologisms, and echolalia are positive symptoms Question 40 A mental health nurse is caring for an aging client diagnosed with schizophrenia spectrum disorder. The client is taking an antipsychotic and a beta-adrenergic blocking agent for hypertension. Understanding the combined side effects of these drugs, which statement by a nurse is most appropriate? A. "Rise slowly when you change position from lying to sitting or sitting to standing." B. "Watch your diet and try to engage in some regular physical activity." C. "Make sure you concentrate on taking slow, deep, cleansing breaths." D. "Wear sunscreen and try to avoid midday sun exposure." Question 41 A mental health nurse is caring for a client diagnosed with schizophrenia spectrum disorder, and the client is prescribed clozapine (Clozaril). Which client symptoms, related to the side effects of this medication, should prompt a nurse to intervene immediately? A. Akathisia and hypersalivation B. Sore throat, fever, and malaise C. Akinesia and insomnia D. Dry mouth and urinary retention Question 42 A mental health nurse administers 100 percent oxygen to a client during and after electroconvulsive therapy (ECT). What is the rationale for this procedure? A. To prevent decreased blood pressure, pulse, and respiration owing to electrical stimulation B. To prevent anoxia resulting from medication-induced paralysis of respiratory muscles C. To prevent blocked airway resulting from seizure activity D. To prevent increased intracranial pressure resulting from anoxia Question 43 A mental health nurse assisted during an electroconvulsive therapy session. Immediately after electroconvulsive therapy (ECT), in which position should a nurse place the client? A. On his or her side, to prevent aspiration B. In high Fowler's position, to prevent increased intracranial pressure C. In prone position, to prevent airway blockage D. In Trendelenburg's position, to promote blood flow to vital organs Question 44 A patient diagnosed with schizophrenia says, "My coworkers are out to get me. I also saw two doctors plotting to overdose me." How does this patient perceive the environment? A. Unpredictable B. Bizarre C. Disorganized D. Dangerous Question 45 When a patient diagnosed with schizophrenia was discharged 6 months ago, haloperidol (Haldol) was prescribed. The patient now says, "I stopped taking those pills. They made me feel like a robot." What likely side effects did the patient experience? A. Sweating, nausea, and diarrhea B. Mild fever, sore throat, and skin rash C. Sedation and muscle stiffness D. Headache, watery eyes, and runny nose Question 46 A patient's care plan includes monitoring for auditory hallucinations. Which assessment findings suggest the patient may be hallucinating? A. Elevated mood, hyperactivity, distractibility B. Darting eyes, tilted head, mumbling to self C. Aloofness, haughtiness, suspicion D. Performing rituals, avoiding open places Question 47 A health care provider considers which antipsychotic medication to prescribe for a patient diagnosed with schizophrenia who has auditory hallucinations and poor social functioning. The patient is also overweight and has hypertension. Which drug should the nurse advocate? A. Olanzapine (Zyprexa) B. Aripiprazole (Abilify) C. Clozapine (Clozaril) D. Ziprasidone (Geodon) Question 48 A patient diagnosed with schizophrenia has catatonia. The patient has little spontaneous movement and waxy flexibility. Which patient needs are of priority importance? A. Psychosocial B. Physiologic C. Safety and security D. Self-actualization Question 49 Patients diagnosed with schizophrenia who are suspicious and withdrawn: A. Are socially disabled by the positive symptoms of schizophrenia B. Avoid relationships because they become anxious with emotional closeness C. Exhibit a high degree of hostility as evidenced by rejecting behavior D. Universally fear sexual involvement with therapists Question 50 A patient diagnosed with schizophrenia has taken fluphenazine (Prolixin) 5 mg orally twice daily for 3 weeks. The nurse now assesses a shuffling, propulsive gait; a masklike face; and drooling. Which term applies to these symptoms? A. Neuroleptic malignant syndrome B. Akathisia C. Hepatocellular effects D. Pseudoparkinsonism Question 51 The parent of an adolescent diagnosed with schizophrenia asks a nurse, "My child's doctor ordered a positron-emission tomography (PET) scan. What is that?" Select the nurse's best reply. A. "It's a special type of x-ray image that shows structures of the brain and whether a brain injury has ever occurred." B. "PET is a scan that passes an electrical current through the brain and shows brain wave activity. PET can help diagnose seizures." C. "PET is a special scan that shows blood flow and activity in the brain." D. "PET uses a magnetic field and gamma waves to identify problem areas in the brain. Does your teenager have any metal implants?" Question 52 A patient has disorganized thinking associated with schizophrenia. Neuroimaging would most likely show dysfunction in which part of the brain? A. Temporal lobe B. Brainstem C. Prefrontal cortex D. Cerebellum Question 53 A patient has taken many conventional antipsychotic drugs over the years. The health care provider, who is concerned about early signs of tardive dyskinesia, prescribes risperidone (Risperdal). A nurse planning care for this patient understands that second-generation antipsychotics: A. are more readily available B. have higher potency C. are less costly D. produce fewer motor side effects Question 54 An angry client has just thrown a chair across the room and is racing to pick up another chair to throw. Which is the most appropriate action by the nurse? A. Assist the client to use problem-solving techniques instead of aggression B. Calmly call the client by name and encourage verbal expression of anger C. Approach the client and firmly say, "Stop, put it down." D. Call for an emergency response from trained personnel Question 55 The nurse observes two clients in the day room arguing. One client runs into the corner and huddles while the other follows and continues with verbal abuse. Which is the best action by the nurse? A. Comfort the client huddled in the corner B. Take an authoritative step between the two clients C. Directly address both clients and ask what is going on D. Engage the attention of the client who is still yelling and ask what is happening Question 56 The nurse is caring for a client with obsessive-compulsive disorder (OCD). Which action by the nurse will increase the client's sense of security? A. Allowing the client to perform the rituals B. Stopping the client from performing the rituals C. Distracting the client from rituals with other activities D. Encouraging the client to talk about the purpose of the rituals Question 57 Before eating a meal, a client with obsessive-compulsive disorder (OCD) must wash the hands for 14 minutes, comb the hair for 114 strokes, and switch the light off and on 44 times. Which intervention will the nurse include when planning the care of this client? A. Omit one ritualistic behavior every 4 days until all rituals are eliminated B. Increase the client's acceptance of the need for medication to control rituals C. Gradually decrease the amount of time spent for performing rituals D. Allow ample time for completion of all rituals before each meal Question 58 An older adult client without a history of obsessive-compulsive disorder (OCD) is beginning to exhibit compulsions and obsessions. Which action by the nurse is a priority? A. Obtain a 24-hour food recall from the client to determine if the symptoms are food allergies B. Educate the client regarding the medications that will be prescribed by the health care provider C. Inform the client that these behaviors are indicative of OCD and not caused by other factors D. Assist with the monitoring of diagnostic testing to rule out an organic cause Question 59 The nurse is obtaining a history from a client with depression and suicidal ideations and observes the client is very slow to respond with facial expressions during the conversation. Which documentation will the nurse provide in regards to this assessment? A. Broad affect B. Labile mood C. Blunted affect D. Waxy flexibility Question 60 The nurse asks the client to restate in their own words: "A stitch in time saves nine." Which sensorium and intellectual process is the nurse attempting to identify? A. The client's ability to concentrate B. The client's orientation C. The client's ability to use abstract thinking D. The client's memory