NUR 326 Psychology/Mental Health Exam 1 QUESTIONS WITH CORRECT ANSWERS: 2021/2022 Rasmussen

A suicidal patient is found by the nurse as he tries to hang himself from the shower in the bathroom. What nursing intervention would address the patient's need for safety while maintaining his self -esteem? a. Assign a staff member to remain with him at all times. b. Place him in the seclusion room with 15 minute checks c. Request that he remain with the patient group at all times. d. Tell him he may use the bathroom only with staff supervision. 1. The nursing student learned of a high school classmate who recently committed suicide. The classmate's death surprised the student, because the classmate had always seemed very confident and popular. The student knows, however, that suicide is usually: a. An act with a message and purpose b. An impulsive act without meaning c. A random act of selfishness d. A random act without meaning or purpose 1. A voluntary patient mutilates herself whenever she leaves the unit. The nurse suggests use of four-point restraint to prevent the patient from further harming herself. What question should be considered before this measure is undertaken? a. Is this the least restrictive measure possible? b. Can four-point restraint be used for voluntary patients? c. What litigation is likely to follow from this action? d. What documentation will be necessary after restraint application? 1. A patient, who has recently lost a spouse, calls the crisis line stating the occurrence of suicidal ideations that involve jumping off a bridge over the river when no one is around. What level of lethality would a nurse assess for this plan? a. Low b. Moderate c. High d. Lethality cannot be determined from this data 1. Which of the following symptoms indicates Neuroleptic Malignant Syndrome (NMS), a potentially fatal side effect of an antipsychotic medication such as Haldol (haloperidol)? a) Photosensitivity and an itchy rash on face, neck, chest and extremities b) Hyperthermia and muscle rigidity c) Blurred vision, constipation, and urinary retention d) Tongue protrusion, lip smacking, and grimacing 1. The nurse using cognitive behavior techniques when working with patients knows that attributions are meanings the patient gives to events or circumstances that: a. may or may not be objectively accurate b. support a sense of autonomy c. promote rigidity and chaos d. isolate family members from each other 1. A patient was the driver of a car that struck and killed a child. The patient tells a nurse, "I killed a child! I'm haunted by the sight of the body being thrown into the air. If I hadn't been drinking I might have been able to stop. I don't know how I can go on living with myself!" The crisis nurse should give priority to assessing the patient's: a. suicidal risk. b. physical condition. c. recent drug dependency. d. current alcohol consumption. 1. A patient who was savagely attacked by a bear has no memory of the event. Which statement best explains the patients inability to remember the attack? a. The woman lost consciousness and was not cognitively aware of what happened during the attack b. The brain has produced a chemical anemia that will repress the memories of the attack indefinitely. c. The patient is unconsciously using a defense mechanism to protect against the repeated memory of the attack. d. It is a temporary suppression of the attack; her memory will return when she is physically and emotionally ready to handle the memories. Defense mechanisms are used unconsciously to protect us from threats to the physical, mental, and social aspects of ourselves. The memory of the event may or may not come back but this is not generally related to the patients ability to handle the memories. Memory may be lost or impaired as a result of brain trauma but not as likely from a chemical alteration. 2. Which assessment finding exhibited by a patient being assessed for posttraumatic stress disorder (PTSD) would be considered a defining behavior and support such a diagnosis? a. Can describe the attack in great detail b. Experiences dramatic swings in affect c. Describes vivid flashbacks of being attacked d. Is preoccupied with the need to tell someone about the attack One defining behavior that is seen when an individual has PTSD is that the person re-experiences the traumatic event. This takes place by having recurrent and intrusive disturbing recollections of the trauma, including thoughts, images, or perceptions about the incident. The person sometimes experiences recurrent dreams of the incident and acts or feels as though the event was recurring in the present (flashback). Generally the PTSD patient cannot remember all the details of the trauma nor are they particularly interested in re-telling the events of the trauma. The patient generally has a very limited range of affect. 3. What is the basis for assessing a male patient who is agoraphobic for panic attacks? a. Men are more likely to experience panic attacks. b. An overwhelming number of agoraphobic patients also have panic attacks. c. Patients are often unaware that the symptoms they are experiencing are those of panic. d. Panic attacks are generally the cause of a patient developing phobias like agoraphobia. Almost all patients who present with agoraphobia in clinical samples have a current diagnosis or history of panic disorder. Males are not more likely than females to experience panic attacks. Patients are not usually unaware of panic attack symptoms. Panic attacks dont cause, but are often triggered by, phobias. 4. Discharge preparation for a patient includes the administration of the Hamilton Anxiety Scale (HAS). When asked by the patient to explain the purpose of the assessment the nurse responds: a. It is an assessment tool used to evaluate the symptoms of anxiety. b. The tool is used to help confirm the diagnosis of anxiety disorder. c. This tool helps determine if your symptoms have improved with treatment. d. It helps identify the presence of any other disorder associated with anxiety. The HAS is a valid and time-tested tool that gives the most objective measure of the degree to which anxiety has been effectively treated. The HAS does not evaluate for symptoms of anxiety or act as a diagnosis tool for anxiety or another other associated disorder. 5. A patient is admitted for treatment for persistent, severe anxiety. Which nursing diagnosis would help effectively direct patient care? a. Disturbed sensory perception related to narrowed perceptual field b. Risk for injury related to closed perception c. Hopelessness related to total loss of control d. Risk for other-directed violence related to combative behavior A narrowed perceptual field occurs with severe anxiety; therefore this diagnosis should be considered. Data are not present to support the other diagnoses. 8. Which question would assist the nurse in determining whether the patient has been experiencing anxiety? a. Have you had difficulty concentrating lately? b. Have you been feeling sad and especially lonely? c. Do you have a history of failed personal relationships? d. Do you frequently experience difficulty controlling your anger? Concentration difficulties occur when moderate or greater levels of anxiety are present. Loneliness is more related to mood. A failed personal relationship is more related to poor self-esteem. Inability to control anger is related to poor impulse control. 9. The nurse working with patients diagnosed with posttraumatic stress disorder (PTSD) is aware of the need to intervene early in order to de-escalate a patients increasing anxiety level. Which patient behavior is likely an early indication of escalating anxiety? a. Talking rapidly b. Pacing around the unit c. Staring out the window d. Refusing to go to therapy Recognize the patients use of relief behaviors (e.g., pacing, wringing of hands) as indicators of anxiety. Talking rapidly is an indicator of manic behavior. Staring is more likely seen in depression. Refusing to attend therapy is seen in aggressive, defiant patients. 10. The nurse has been working with a patient who experiences anxiety. Which intervention should the nurse implement initially when the patient is observed pacing and wring her hands? a. Asking how she has managed anxiety effectively in the past b. Distracting her by offering to help her make a telephone call c. Asking her what she believes is causing her increased anxiety d. Teaching her to take deep, relaxing breaths to manage the anxiety First help the patient to build on the coping methods that the patient used to manage anxiety in the past. Coping methods that were previously successful will generally be effective in subsequent situations. Distraction is not usually successful initially. Assessing for the cause of the anxiety will not, in this situation, be helpful in managing it; often times patients are not aware of the cause. Teaching will not be effective while the patient is experiencing anxiety but should be done when the patient is relaxed and able to focus. 14. A patient is ordered medication therapy to manage the symptoms of anxiety disorder. Which statement by the patient indicates an understanding of the typical classification of