PMHN Practice Questions & Answers, 100% Accurate. Graded A+

PMHN Practice Questions & Answers, 100% Accurate. Graded A+ A rape victim with multiple injuries has been brought to the emergency department for evaluation and treatment. The first thing that the psychiatric and mental health nurse should communicate is: A. I'm so sorry this happened to you B. You are safe here. No one can hurt you C. This was not your fault D. I'm thankful you survived this attack - -Answer: B. You are safe here. No one can hurt you. Rationale: Patients who have been raped are often severely traumatized emotionally as well as physically and are commonly very fearful and panicked, so the first thing that the mental health nurse should communicate is "You are safe here No one can hurt you." The psychiatric and mental health nurse may need to repeat this a number of times because traumatized patients may block out what people are saying. The nurse should also reassure the patient that the attack was not the patient's fault and the nurse is sorry for what the patient has gone through. A patient has signed the consent form for electroconvulsive therapy under pressure from her spouse but confides in the psychiatric and mental health nurse that she does not want the treatment and is terrified but afraid to stand up to her spouse. The psychiatric and mental health nurse should: A. ask the patient if she wants to rescind the consent form. B. tell the patient that she must tell her spouse she does not want the treatment. C. Tell the patient she must go through the treatment since she singed the consent. D. notify the physician of the patient's feelings about the treatment. - -Answer: D. notify the physician of the patient's feelings about the treatment. Rationale: Because the patient is intimidated by her spouse and has stated she is afraid to stand up to him, as an advocate for the patient, the nurse should notify the physician of the patient's feelings about the treatment. Being coerced into signing a consent form is not the same as giving informed consent, which is required by law. Because patients are vulnerable to manipulation, the nurse must ensure that the actual wishes of the patient are respected. A patient was able to slowly read aloud an information sheet but when asked to state what she had read in her own words was unable to do so. The most likely reason is: A. low self-esteem B. poor hearing C. low health literacy D. anxiety - -Answer: C low health literacy Rationale: The most likely reason the patient was able to read slowly but not state what she had read is low health literacy. The ability to read is different form the ability to comprehend, and comprehension usually lags behind reading skills by about three grade levels. Thus, a person who is able to read at the fourth-grade level may have only a first-grade reading comprehension, making it difficult for the person to understand health materials, especially since the vocabulary is often more difficult to understand than that found in other readings. A patient who has had repeated arrests for driving under the influence of alcohol refuses to admit that he has a drinking problem and states that the police have targeted him unfairly. The ego defense mechanism that the patient is using is: A. denial B. reaction formation C. regression D. undoing - -Answer: A. Denial Rationale: The patient is using the ego defense mechanism of denial when the patient, who has had repeated arrests for driving under the influence of alcohol, refuses to admit that he has a drinking problem and states that the police have targeted him unfairly. Reaction formation is refusing to acknowledge undesirable feelings, thoughts, or behavior by exaggerating the opposite. Regression is retreating to an earlier level of development. Undoing is carrying out an action to negate a previous unacceptable one. A patient with schizophrenia has delusions and believes that his family members cannot be trusted. According to Maslow's hierarchy of needs, the patient's delusions are interfering with development at the level of: A. physiological needs B. love/belonging needs C. safety needs D. self-esteem needs - -Answer: B. love/belonging needs Rationale: The patient's delusions are interfering with development at the level of love/belonging needs. Maslow's hierarchy of needs is based on the premise that one must satisfy one type of need before on can attain the next. The hierarchy of needs includes: - Physiological: Basic needs such as air, food, water, shelter. - Safety and Security: Freedom from fear; physical comfort, safety. - Love and belonging: Companionship, giving/receiving love, group identification, satisfying interpersonal relationships. - Self-esteem: Working for success, desiring respect and prestige, seeking self-respect. - Self-actualization: Feeling of self-fulfillment, satisfaction with achievements. A patient states that, on the advice of a friend, he has been treating his anxiety with large doses of kava in addition to the amitriptyline that was prescribed for depression, but has been feeling excessively fatigued and has noted dark urine. Which diagnostic test or tests are indicated? A. renal function tests B. CBC C. urinalysis D. liver function tests. - -Answer: D. liver function tests. Rationale: Kava is contraindicated because of safety issues and can result in liver damage, so the patient should have liver function tests completed. Early signs of liver damage include fatigue and dark urine. Some people may exhibit jaundice as well. Amitriptyline is broken down by the liver, so kava may increase the rate at which that occurs, also increasing the adverse effects of the drug. Kava, which has been used in the past for anxiety, may increase depression. According to Erikson's stages of psychosocial development, which of the following best characterizes the developmental task of adulthood and the generativity vs. stagnation stage? A. achieving self-confidence by performing successfully and gaining recognition from peers. B. Developing a sense of positive self-worth from reviewing the events of life. C. achieving the personal life goals that the person had formulated. D. Making a commitment to another person as part of a long-term relationship. - -Answer: C. Achieving the personal life goals that the person had formulated. Rationale: Erikson postulated that the stage of adulthood, generativity versus stagnation, is characterized by achieving the personal life goals that the person had formulated. The eight development stages include: - Trust vs. mistrust (Infancy, 0 to 18 months). - Autonomy vs. shame and doubt (early childhood, 18 months to 3 years). - Initiative vs. guilt (late childhood, 3-6 years) - Industry vs. inferiority (school age, 6-12 years) - Identity vs. role confusion (adolescence, 12-20 years) - Intimacy vs. isolation (young adulthood, 20-30 years) - Generativity vs. stagnation (adulthood, 30-65 years) - Ego integrity vs. despair (65 years-death) The International Society of Psychiatric-Mental Health Nurses (ISPN) contains how many divisions representing different nursing specialty areas? A. Two B. Four C. Six D. Eight - -Answer: B. Four Rationale: Four different mental health associations came together to create the International Society of Psychiatric-Mental Health Nurses in 1999. These four associations became divisions of the new organization: - Association of Child and Adolescent Psychiatric Nurses (ACAPN) - International Society of Psychiatric Consultation Liaison Nurses (ISPCLN) - Society of Education and Research in Psychiatric Mental Health Nursing (SERPN) - Adult and Geropsychiatric Mental Health Nurses (AGPN). The purpose of the ISPN includes promoting quality care, outlining essential educational requirements, promoting research, and developing health care policy. When utilizing AHRQ's You Can Quit Smoking guide to help a patient quit smoking, the first step of, "Getting Ready" includes: A. Talking with the physician about nicotine medication B. Telling friends and family members about quitting C. Getting group counseling D. Setting a date to quit, cold turkey. - -Answer: D. Setting a date to quit, cold turkey. Rationale: AHRQ's You Can Quit Smoking guide includes five steps: 1. Getting ready: Considering past attempts (successes/failures) and setting a date for quitting cold turkey. 2. Getting support/encouragement: Telling others and contacting support groups/helplines. 3. Learning new skills/behaviors: Drinking plenty of water, establishing new habits, practicing distractions, and reducing stress. 4. Getting and using medication correctly: Obtaining nicotine replacement or other medications as needed. 5. Preparing for relapse/difficult situations: Avoiding other smokers and alcohol or situations that rigger desire for cigarettes. Eating well and living a healthy lifestyle. An elderly patient scored 18 out of a possible maximum score of 30 on the Mini-Mental State Examination (MMSE). This score usually indicates: A. severe cognitive impairment B. mild cognitive impairment C. moderate cognitive impairment D. normal cognition - -Answer: C. moderate cognitive impairment Rationale: A score of 18 out of 30 on the MMSS usually indicates moderate cognitive impairment. Scores of 27 to 30 indicate normal cognition while 10 to 18 indicate moderate cognitive impairment. Scores may be affected by numerous variable (age, hearing, intelligence, vision, physical condition), so the MMSE score alone is not adequate for diagnosis of dementia. However, it is a good guide, and those with very low scores (9 or less) usually demonstrate severe cognitive impairment. The psychiatric and mental health nurse needs to complete a history and physical examination on a patient who is extremely depressed and suicidal. The best approach is to: A. delay the history and physical exam until the patient is stabilized B. conduct the baseline physical examination but delay the history taking C. obtain the history from a family member and conduct the physical exam. D. conduct the history and physical in a supportive manner. - -Answer: D. Conduct the history and physical in a supportive manner. Rationale: A patient who is severely depressed may not give complete answers or may even be reluctant to talk, but the psychiatric and mental health nurse should progress with the history and physical exam in a supportive manner. If the patient does not respond to open-ended questions, such as "How can we help you?" then the psychiatric and mental health nurse may need to use close-ended questions, such as "Have you attempted suicide?" which require short responses. The psychiatric and mental health nurse should remain non-judgmental in affect and tone of voice, understanding that some information regarding history may need to be obtained at a later time. Piaget's theory of cognitive development in children applies to adults in relation to concepts about: A. readiness to learn