Archive for February 2018

A patient taking medication for mental illness develops restlessness and an uncontrollable need to be in motion. Which drug action causes these symptoms to develop?

A patient taking medication for mental illness develops restlessness and an uncontrollable need to be in motion. Which drug action causes these symptoms to develop?



a. Anticholinergic effects
b. Dopamine-blocking effects
c. Endocrine-stimulating effectsd. Ability to stimulate spinal nerves




Answer: B

The therapeutic action of neurotransmitter inhibitors that block reuptake cause:

The therapeutic action of neurotransmitter inhibitors that block reuptake cause:



a. decreased concentration of the blocked neurotransmitter in the central nervous system.
b. increased concentration of the blocked neurotransmitter in the synaptic gap.
c. destruction of receptor sites specific to the blocked neurotransmitter.
d. limbic system stimulation.




Answer: B

A patient with a long history of hypertension and diabetes now develops confusion. The health care provider wants to make a differential diagnosis between Alzheimer's disease and multiple infarcts. Which diagnostic procedure should the nurse expect to prepare the patient for first?

A patient with a long history of hypertension and diabetes now develops confusion. The health care provider wants to make a differential diagnosis between Alzheimer's disease and multiple infarcts. Which diagnostic procedure should the nurse expect to prepare the patient for first?




a. Skull x-rays
b. Computed tomography (CT) scan
c. Positron-emission tomography (PET)
d. Single-photon emission computed tomography (SPECT)




Answer: B

A patient diagnosed with schizophrenia was hospitalized after arguing with co-workers and threatening to harm them. The patient is aloof, suspicious, and says, "Two staff members I saw talking were plotting to kill me." Based on data gathered at this point, which nursing diagnoses relate? Select all that apply.

A patient diagnosed with schizophrenia was hospitalized after arguing with co-workers and threatening to harm them. The patient is aloof, suspicious, and says, "Two staff members I saw talking were plotting to kill me." Based on data gathered at this point, which nursing diagnoses relate? Select all that apply.




a. Risk for other-directed violence
b. Disturbed thought processes
c. Risk for loneliness
d. Spiritual distress
e. Social isolation



Answer: A, B

A client says, "Facebook has a new tracking capacity. If I use the Internet, Homeland Security will detain me as a terrorist." Select the nurse's best initial action.

A client says, "Facebook has a new tracking capacity. If I use the Internet, Homeland Security will detain me as a terrorist." Select the nurse's best initial action.



a. Tell the client, "Facebook is a safe website. You don't need to worry about Homeland Security."
b. Tell the client, "You are in a safe place where you will be helped."
c. Administer a prn dose of an antipsychotic medication.
d. Tell the client, "You don't need to worry about that."



Answer: B

The nurse is developing a plan for psychoeducational sessions for several adults diagnosed with schizophrenia. Which goal is best for this group? Members will:

The nurse is developing a plan for psychoeducational sessions for several adults diagnosed with schizophrenia. Which goal is best for this group? Members will:




a. gain insight into unconscious factors that contribute to their illness.
b. explore situations that trigger hostility and anger.
c. learn to manage delusional thinking.
d. demonstrate improved social skills.


Answer: D

A patient receiving risperidone (Risperdal) reports severe muscle stiffness at 1030. By 1200, the patient has difficulty swallowing and is drooling. By 1600, vital signs are 102.8° F; pulse 110; respirations 26; 150/90. The patient is diaphoretic. Select the nurse's best analysis and action.

A patient receiving risperidone (Risperdal) reports severe muscle stiffness at 1030. By 1200, the patient has difficulty swallowing and is drooling. By 1600, vital signs are 102.8° F; pulse 110; respirations 26; 150/90. The patient is diaphoretic. Select the nurse's best analysis and action.


a. Agranulocytosis; institute reverse isolation.
b. Tardive dyskinesia; withhold the next dose of medication.
c. Cholestatic jaundice; begin a high-protein, high-cholesterol diet.
d. Neuroleptic malignant syndrome; notify health care provider stat.




Answer: D

A patient diagnosed with schizophrenia anxiously says, "I can see the left side of my body merging with the wall, then my face appears and disappears in the mirror." While listening, the nurse should:

A patient diagnosed with schizophrenia anxiously says, "I can see the left side of my body merging with the wall, then my face appears and disappears in the mirror." While listening, the nurse should:



a. sit close to the patient.
b. place an arm protectively around the patient's shoulders.
c. place a hand on the patient's arm and exert light pressure.
d. maintain a normal social interaction distance from the patient.




Answer: D

A patient diagnosed with schizophrenia has taken a conventional antipsychotic medication for a year. Hallucinations are less intrusive, but the patient continues to have apathy, poverty of thought, and social isolation. The nurse would expect a change to which medication?

A patient diagnosed with schizophrenia has taken a conventional antipsychotic medication for a year. Hallucinations are less intrusive, but the patient continues to have apathy, poverty of thought, and social isolation. The nurse would expect a change to which medication?



a. Haloperidol (Haldol)
c. Chlorpromazine (Thorazine)
b. Olanzapine (Zyprexa)
d. Diphenhydramine (Benadryl)



Answer: B

A patient diagnosed with schizophrenia begins a new prescription for lurasidone HCL (Latuda). The patient is 5'6" and currently weighs 204 lbs. Which topic is most important for the nurse to include in the teaching plan related to this medication?

A patient diagnosed with schizophrenia begins a new prescription for lurasidone HCL (Latuda). The patient is 5'6" and currently weighs 204 lbs. Which topic is most important for the nurse to include in the teaching plan related to this medication?



a. How to recognize tardive dyskinesia
c. Ways to manage constipation
b. Weight management strategies
d. Sleep hygiene measures




Answer: B

What assessment findings mark the prodromal stage of schizophrenia?

What assessment findings mark the prodromal stage of schizophrenia?




a. Withdrawal, misinterpreting, poor concentration, and preoccupation with religion
b. Auditory hallucinations, ideas of reference, thought insertion, and broadcasting
c. Stereotyped behavior, echopraxia, echolalia, and waxy flexibility
d. Loose associations, concrete thinking, and echolalia neologisms


Answer: A

A patient took trifluoperazine 30 mg po daily for 3 years. The clinic nurse notes that the patient grimaces and constantly smacks both lips. The patient's neck and shoulders twist in a slow, snakelike motion. Which problem would the nurse suspect?

A patient took trifluoperazine 30 mg po daily for 3 years. The clinic nurse notes that the patient grimaces and constantly smacks both lips. The patient's neck and shoulders twist in a slow, snakelike motion. Which problem would the nurse suspect?



a. Agranulocytosis
b. Tardive dyskinesia
c. Tourette's syndrome
d. Anticholinergic effects




Answer: B

A patient diagnosed with schizophrenia is very disturbed and violent. After several doses of haloperidol (Haldol), the patient is calm. Two hours later the nurse sees the patient's head rotated to one side in a stiff position, the lower jaw thrust forward, and drooling. Which problem is most likely?

A patient diagnosed with schizophrenia is very disturbed and violent. After several doses of haloperidol (Haldol), the patient is calm. Two hours later the nurse sees the patient's head rotated to one side in a stiff position, the lower jaw thrust forward, and drooling. Which problem is most likely?




a. An acute dystonic reaction.
b. Tardive dyskinesia.
c. Waxy flexibility
d. Akathisia



Answer: A

A patient diagnosed with schizophrenia has taken fluphenazine (Prolixin) 5 mg po bid for 3 weeks. The nurse now observes a shuffling propulsive gait, a mask-like face, and drooling. Which term applies to these symptoms?

A patient diagnosed with schizophrenia has taken fluphenazine (Prolixin) 5 mg po bid for 3 weeks. The nurse now observes a shuffling propulsive gait, a mask-like face, and drooling. Which term applies to these symptoms?




a. Neuroleptic malignant synd
b. Hepatocellular effects.
c. Pseudoparkinsonism
d. Akathisia



Answer: C

Withdrawn patients diagnosed with schizophrenia:

Withdrawn patients diagnosed with schizophrenia:



a. are usually violent toward caregivers.
b. universally fear sexual involvement with therapists.
c. exhibit a high degree of hostility as evidenced by rejecting behavior.
d. avoid relationships because they become anxious with emotional closeness.




Answer: D

A community mental health nurse wants to establish a relationship with a very withdrawn patient diagnosed with schizophrenia. The patient lives at home with a supportive family. Select the nurse's best plan.

A community mental health nurse wants to establish a relationship with a very withdrawn patient diagnosed with schizophrenia. The patient lives at home with a supportive family. Select the nurse's best plan.



a. Visit daily for 4 days, then every other day for 1 week; stay with patient for 20 minutes, accept silence; state when the nurse will return.
b. Arrange to spend 1 hour each day with the patient; focus on asking questions about what the patient is thinking or experiencing; avoid silences.
c. Visit twice daily; sit beside the patient with a hand on the patient's arm; leave if the patient does not respond within 10 minutes.
d. Visit every other day; remind the patient of the nurse's identity; encourage the patient to talk while the nurse works on reports.



Answer: A

A patient diagnosed with schizophrenia demonstrates little spontaneous movement and has waxy flexibility. The patient's activities of daily living are severely compromised. An appropriate outcome would be that the patient will:

A patient diagnosed with schizophrenia demonstrates little spontaneous movement and has waxy flexibility. The patient's activities of daily living are severely compromised. An appropriate outcome would be that the patient will:




a. demonstrate increased interest in the environment by the end of week 1.
b. perform self-care activities with coaching by the end of day 3.
c. gradually take the initiative for self-care by the end of week 2.
d. accept tube feeding without objection by day 2.


Answer: B

A health care provider considers which antipsychotic medication to prescribe for a patient diagnosed with schizophrenia who has auditory hallucinations and poor social function. The patient is also overweight and hypertensive. Which drug should the nurse advocate?

A health care provider considers which antipsychotic medication to prescribe for a patient diagnosed with schizophrenia who has auditory hallucinations and poor social function. The patient is also overweight and hypertensive. Which drug should the nurse advocate?




a. Clozapine (Clozaril)
b. Ziprasidone (Geodon).
c. Olanzapine (Zyprexa)
d. Aripiprazole (Abilify)




Answer: D

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 are common side effects the nurse should validate with the patient?

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 are common side effects the nurse should validate with the patient?



a. Sedation and muscle stiffness
b. Sweating, nausea, and diarrhea
c. Mild fever, sore throat, and skin rash
d. Headache, watery eyes, and runny nose




Answer: A

A newly admitted patient diagnosed with schizophrenia is hypervigilant and constantly scans the environment. The patient states, "I saw two doctors talking in the hall. They were plotting to kill me." The nurse may correctly assess this behavior as:

A newly admitted patient diagnosed with schizophrenia is hypervigilant and constantly scans the environment. The patient states, "I saw two doctors talking in the hall. They were plotting to kill me." The nurse may correctly assess this behavior as:



a. echolalia.
b. an idea of reference.
c. a delusion of infidelity.
d. an auditory hallucination.





Answer: B

A person has had difficulty keeping a job because of arguing with co-workers and accusing them of conspiracy. Today the person shouts, "They're all plotting to destroy me. Isn't that true?" Select the nurse's most therapeutic response.

A person has had difficulty keeping a job because of arguing with co-workers and accusing them of conspiracy. Today the person shouts, "They're all plotting to destroy me. Isn't that true?" Select the nurse's most therapeutic response.




a. "Everyone here is trying to help you. No one wants to harm you."
b. "Feeling that people want to destroy you must be very frightening."
c. "That is not true. People here are trying to help you if you will let them."
d. "Staff members are health care professionals who are qualified to help you."




Answer: B

The nurse wishes to use guided imagery to help a patient relax. Which comments would be appropriate to include in the guided imagery script? Select all that apply.

The nurse wishes to use guided imagery to help a patient relax. Which comments would be appropriate to include in the guided imagery script? Select all that apply.




a. "Imagine others treating you the way they should, the way you want to be treated ..."
b. "With each breath, you feel calmer, more relaxed, almost as if you are floating ..."
c. "You are alone on a beach, the sun is warm, and you hear only the sound of the surf ..."
d. "You have taken control, nothing can hurt you now. Everything is going your way..."
e. "You have grown calm, your mind is still, there is nothing to disturb your well-being ..."
f. "You will feel better as work calms down, as your boss becomes more understanding ..."



Answer: B, C, E

Which nursing comments are likely to help a patient to cope by addressing the mediators of stress? Select all that apply.

Which nursing comments are likely to help a patient to cope by addressing the mediators of stress? Select all that apply.




a. "A divorce, while stressful, can be the beginning of a new, better phase of life."
b. "You said you used to jog; getting back to aerobic exercise could be helpful."
c. "Journaling often promotes awareness of how experiences have affected people."
d. "Slowing your breathing by counting to three between breaths will calm you."
e. "Would a short-term loan make your finances less stressful?"
f. "There is a support group for newly divorced persons in your neighborhood."




Answer: A, C, E, F

Which changes reflect short-term physiological responses to stress? Select all that apply.

Which changes reflect short-term physiological responses to stress? Select all that apply.




a. Muscular tension, blood pressure, and triglycerides increase.
b. Epinephrine is released, increasing heart and respiratory rates.
c. Corticosteroid release increases stamina and impedes digestion.
d. Cortisol is released, increasing glucogenesis and reducing fluid loss.
e. Immune system functioning decreases, and risk of cancer increases.
f. Risk of depression, autoimmune disorders, and heart disease increases.



Answer: A, B, C, D

Which scenario best demonstrates an example of eustress? An individual:

Which scenario best demonstrates an example of eustress? An individual:



a. loses a beloved family pet.
b. prepares to take a one-week vacation to a tropical island with a group of close friends.
c. receives a bank notice there were insufficient funds in their account for a recent rent payment.
d. receives notification their current employer is experiencing financial problems and some workers will be terminated.





Answer: B

A patient reports, "I am overwhelmed by stress." Which question by the nurse would be most important to use in the initial assessment of this the patient?

A patient reports, "I am overwhelmed by stress." Which question by the nurse would be most important to use in the initial assessment of this the patient?



a. "Tell me about your family history. Do you have any relatives who have problems with stress?"
b. "Tell me about your exercise. How much activity do you typically get in a day?"
c. "Tell me about the kinds of things you do to reduce or cope with your stress."
d. "Stress can interfere with sleep. How much did you sleep last night?"




Answer: C

A patient tells the nurse, "I will never be happy until I'm as successful as my older sister." The nurse asks the patient to reassess this statement and reframe it. Which reframed statement by the patient is most likely to promote coping?

A patient tells the nurse, "I will never be happy until I'm as successful as my older sister." The nurse asks the patient to reassess this statement and reframe it. Which reframed statement by the patient is most likely to promote coping?



a. "People should treat me as well as they treat my sister."
b. "I can find contentment in succeeding at my own job level."
c. "I won't be happy until I make as much money as my sister."
d. "Being as smart or clever as my sister isn't really important."




Answer: B

A patient who had been experiencing significant stress learned to use progressive muscle relaxation and deep breathing exercises. When the patient returns to the clinic 2 weeks later, which finding most clearly shows the patient is coping more effectively with stress?

A patient who had been experiencing significant stress learned to use progressive muscle relaxation and deep breathing exercises. When the patient returns to the clinic 2 weeks later, which finding most clearly shows the patient is coping more effectively with stress?




a. The patient's systolic blood pressure has changed from the 140s to the 120s mm Hg.
b. The patient reports, "I feel better, and that things are not bothering me as much."
c. The patient reports, "I spend more time napping or sitting quietly at home."
d. The patient's weight decreased by 3 pounds.




Answer: A

A patient tells the nurse, "My doctor thinks my problems with stress relate to the negative way I think about things and suggested I learn new ways of thinking." Which response by the nurse would support the recommendation?

A patient tells the nurse, "My doctor thinks my problems with stress relate to the negative way I think about things and suggested I learn new ways of thinking." Which response by the nurse would support the recommendation?




a. Encourage the patient to imagine being in calm circumstances.
b. Provide the patient with a blank journal and guidance about journaling.
c. Teach the patient to recognize, reconsider, and reframe irrational thoughts.
d. Teach the patient to use instruments that give feedback about bodily functions.



Answer: C

A patient tells the nurse, "I know that I should reduce the stress in my life, but I have no idea where to start." What would be the best initial nursing response?

A patient tells the nurse, "I know that I should reduce the stress in my life, but I have no idea where to start." What would be the best initial nursing response?




a. "Physical exercise works to elevate mood and reduce anxiety."
b. "Reading about stress and how to manage it might be a good place to start."
c. "Why not start by learning to meditate? That technique will cover everything."
d. "Let's talk about what is going on in your life and then look at possible options."


Answer: D

When a nurse asks a newly admitted patient to describe social supports, the patient says, "My parents died last year and I have no family. I am newly divorced, and my former in-laws blame me. I don't have many friends because most people my age just want to go out drinking." Which action will the nurse apply?

When a nurse asks a newly admitted patient to describe social supports, the patient says, "My parents died last year and I have no family. I am newly divorced, and my former in-laws blame me. I don't have many friends because most people my age just want to go out drinking." Which action will the nurse apply?




a. Advise the patient that being so particular about potential friends reduces social contact.
b. Suggest using the Internet as a way to find supportive others with similar values.
c. Encourage the patient to begin dating again, perhaps with members of the church.
d. Discuss how divorce support groups could increase coping and social support.





Answer: D

A patient newly diagnosed as HIV-positive seeks the nurse's advice on how to reduce the risk of infections. The patient says, "I used to go to church and I was in my best health then. Maybe I should start going to church again." Which response will the nurse offer?

A patient newly diagnosed as HIV-positive seeks the nurse's advice on how to reduce the risk of infections. The patient says, "I used to go to church and I was in my best health then. Maybe I should start going to church again." Which response will the nurse offer?



a. "Religion does not usually affect health, but you were younger and stronger then."
b. "Contact with supportive people at church might help, but religion itself is not especially helpful."
c. "Studies show that spiritual practices can enhance immune system function and coping abilities."
d. "Going to church would expose you to many potential infections. Let's think about some other options."




Answer: C

According to the Recent Life Changes Questionnaire, which situation would most necessitate a complete assessment of a person's stress status and coping abilities?

According to the Recent Life Changes Questionnaire, which situation would most necessitate a complete assessment of a person's stress status and coping abilities?




a. A person who has been assigned more responsibility at work
b. A parent whose job required relocation to a different city
c. A person returning to college after an employer ceased operations
d. A man who recently separated from his wife because of marital problems



Answer: C

A patient nervously says, "Financial problems are stressing my marriage. I've heard rumors about cutbacks at work; I am afraid I might get laid off." The patient's pulse is 112/minute; respirations are 26/minute; and blood pressure is 166/88. Which nursing intervention will the nurse implement?

A patient nervously says, "Financial problems are stressing my marriage. I've heard rumors about cutbacks at work; I am afraid I might get laid off." The patient's pulse is 112/minute; respirations are 26/minute; and blood pressure is 166/88. Which nursing intervention will the nurse implement?



a. Advise the patient, "Go to sleep 30 to 60 minutes earlier each night to increase rest."
b. Direct the patient in slow and deep breathing via use of a positive, repeated word.
c. Suggest the patient consider that a new job might be better than the present one.
d. Tell the patient, "Relax by spending more time playing with your pet."




Answer: B

A recent immigrant from Honduras comes to the clinic with a family member who has been a U.S. resident for 10 years. The family member says, "The immigration to America has been very difficult." Considering cultural background, which expression of stress by this patient would the nurse expect?

A recent immigrant from Honduras comes to the clinic with a family member who has been a U.S. resident for 10 years. The family member says, "The immigration to America has been very difficult." Considering cultural background, which expression of stress by this patient would the nurse expect?



a. Motor restlessness.
b. Somatic complaints.
c. Memory deficiencies
d. Sensory perceptual




Answer: B

A nurse leads a psychoeducational group for depressed patients. The nurse plans to implement an exercise regime for each patient. The rationale to use when presenting this plan to the treatment team is that exercise:

A nurse leads a psychoeducational group for depressed patients. The nurse plans to implement an exercise regime for each patient. The rationale to use when presenting this plan to the treatment team is that exercise:



a. has an antidepressant effect comparable to selective serotonin reuptake inhibitors.
b. prevents damage from overstimulation of the sympathetic nervous system.
c. detoxifies the body by removing metabolic wastes and other toxins.
d. improves mood stability for patients with bipolar disorders.




Answer: A

A patient diagnosed with emphysema has severe shortness of breath and needs portable oxygen when leaving home. Recently the patient has reduced activity because of fear that breathing difficulty will occur. A nurse suggests using guided imagery. Which image should the patient be encouraged to visualize?

A patient diagnosed with emphysema has severe shortness of breath and needs portable oxygen when leaving home. Recently the patient has reduced activity because of fear that breathing difficulty will occur. A nurse suggests using guided imagery. Which image should the patient be encouraged to visualize?



a. Engaging in activity without using any supplemental oxygen
b. Sleeping comfortably and soundly, without respiratory distress
c. Feeling relaxed and taking regular deep breaths when leaving home
d. Having a younger, healthier body that knows no exercise limitations




Answer: C

The adult child of a patient diagnosed with major depression asks, "Do you think depression and physical illness are connected? Since my father's death, my mother has had shingles and the flu, but she's usually not one who gets sick." Which answer by the nurse best reflects current knowledge about psychoneuroimmunology?

The adult child of a patient diagnosed with major depression asks, "Do you think depression and physical illness are connected? Since my father's death, my mother has had shingles and the flu, but she's usually not one who gets sick." Which answer by the nurse best reflects current knowledge about psychoneuroimmunology?




a. "It is probably a coincidence. Emotions and physical responses travel on different tracts of the nervous system."
b. "You may be paying more attention to your mother since your father died and noticing more things such as minor illnesses."
c. "So far, research on emotions or stress and becoming ill more easily is unclear. We do not know for sure if there is a link."
d. "Negative emotions and stress may interfere with the body's ability to protect itself and can increase the likelihood of infection."




Answer: D
Subscribe to: Posts (Atom)