Exam 1 Ch 5-11
Due Apr 26 at 3pm Points 50 Questions 50
Available after Apr 26 at 8am Time Limit 80 Minutes
Instructions
Attempt History
Attempt Time Score
LATEST Attempt 1 60 minutes 40.5 out of 50
Score for this quiz: 40.5 out of 50
Submitted Apr 26 at 1:40pm
This attempt took 60 minutes.
Question 1 pts
Which of these individuals would the nurse consider at highest risk for a
suicide attempt?
Woman who, during a past episode of major depression, attempted
suicide
Man who jokes about death
, Adolescent who just broke up with her boyfriend and states that she
would like to kill herself
Correct!
Older adult man who tells the nurse that he is going to “join his wife in
heaven tomorrow."
When the person expresses feelings of sadness, hopelessness,
despair, or grief, assessing any possible risk for physical harm to
him or herself is important. The interview should begin with more
general questions. If the nurse hears affirmative answers, then
he or she should continue with more specific questions. A
precise suicide plan to take place in the next 24 to 48 hours with
use of a lethal method constitutes high risk.
Question 2 pts
A patient is admitted to the unit after a motorcycle accident. The nurse
begins the mental status examination and finds that the patient has
dysarthric speech and arouses only to painful stimuli. How should the
nurse proceed?
Proceed with the examination and assess the patient for suicidal
thoughts because dysarthria is often accompanied by severe
depression.
rrect Answe r Defer the rest of the mental status examination.
, Skip the language portion of the examination and proceed onto
assessing mood and affect.
u Answered
Conduct an in-depth speech evaluation and defer the mental status
examination to another time.
In the mental status examination, the sequence of steps forms a
hierarchy in which the most basic functions (consciousness,
language) are assessed first. The first steps must be accurately
assessed to ensure validity of the steps that follow. For example,
if consciousness is clouded, then the person cannot be expected
to have full attention and to cooperate with new learning. If
language is impaired, then a subsequent assessment of new
learning or abstract reasoning (anything that requires language
functioning) can give erroneous conclusions. Dysarthric speech
and lethargy are signs of altered consciousness and answers to
questions on the mental status examination may be invalid. The
nurse should not proceed with any further part of the mental
status examination at this time.
Question 3 pts
An elderly client with pneumonia is being treated in the intensive care
unit (ICU). He is acutely agitated, restless, and disoriented. The nurse
documents his level of consciousness as:
, Correct! Delirious
Demented
Drowsy
Manic
Delirium is marked by disorientation, agitation, restlessness,
poor attention span, impaired judgment.
Question 4 pts
During a mental status examination, the nurse wants to assess a
patient’s mood. Which question the nurse should ask?
“Has this pain affected your ability to get dressed by yourself?”
“Would you please repeat the following words?”
“Have these medications had any effect on your pain?”
Correct! “How do you feel today?”
Due Apr 26 at 3pm Points 50 Questions 50
Available after Apr 26 at 8am Time Limit 80 Minutes
Instructions
Attempt History
Attempt Time Score
LATEST Attempt 1 60 minutes 40.5 out of 50
Score for this quiz: 40.5 out of 50
Submitted Apr 26 at 1:40pm
This attempt took 60 minutes.
Question 1 pts
Which of these individuals would the nurse consider at highest risk for a
suicide attempt?
Woman who, during a past episode of major depression, attempted
suicide
Man who jokes about death
, Adolescent who just broke up with her boyfriend and states that she
would like to kill herself
Correct!
Older adult man who tells the nurse that he is going to “join his wife in
heaven tomorrow."
When the person expresses feelings of sadness, hopelessness,
despair, or grief, assessing any possible risk for physical harm to
him or herself is important. The interview should begin with more
general questions. If the nurse hears affirmative answers, then
he or she should continue with more specific questions. A
precise suicide plan to take place in the next 24 to 48 hours with
use of a lethal method constitutes high risk.
Question 2 pts
A patient is admitted to the unit after a motorcycle accident. The nurse
begins the mental status examination and finds that the patient has
dysarthric speech and arouses only to painful stimuli. How should the
nurse proceed?
Proceed with the examination and assess the patient for suicidal
thoughts because dysarthria is often accompanied by severe
depression.
rrect Answe r Defer the rest of the mental status examination.
, Skip the language portion of the examination and proceed onto
assessing mood and affect.
u Answered
Conduct an in-depth speech evaluation and defer the mental status
examination to another time.
In the mental status examination, the sequence of steps forms a
hierarchy in which the most basic functions (consciousness,
language) are assessed first. The first steps must be accurately
assessed to ensure validity of the steps that follow. For example,
if consciousness is clouded, then the person cannot be expected
to have full attention and to cooperate with new learning. If
language is impaired, then a subsequent assessment of new
learning or abstract reasoning (anything that requires language
functioning) can give erroneous conclusions. Dysarthric speech
and lethargy are signs of altered consciousness and answers to
questions on the mental status examination may be invalid. The
nurse should not proceed with any further part of the mental
status examination at this time.
Question 3 pts
An elderly client with pneumonia is being treated in the intensive care
unit (ICU). He is acutely agitated, restless, and disoriented. The nurse
documents his level of consciousness as:
, Correct! Delirious
Demented
Drowsy
Manic
Delirium is marked by disorientation, agitation, restlessness,
poor attention span, impaired judgment.
Question 4 pts
During a mental status examination, the nurse wants to assess a
patient’s mood. Which question the nurse should ask?
“Has this pain affected your ability to get dressed by yourself?”
“Would you please repeat the following words?”
“Have these medications had any effect on your pain?”
Correct! “How do you feel today?”
