Question 2
A patient with schizophrenia tells the nurse that aliens from outer space are after him and want to torture and kill him. The nurse should base immediate nursing intervention on which principle?
- Voice doubt about delusions without arguing
- Redirect the conversation to not support the delusion
- Encourage detailed descriptions of delusions
- Set boundaries to prevent disruptive behaviors
Question 3
Family members of a patient ask the nurse to explain the difference between schizoid and avoidant personality disorders. Which is the appropriate nursing reply?
- “Patients diagnosed with avoidant personality disorder have a history of eccentric, odd behavior and patients with schizoid personality disorder are dull and vacant.”
- “Patients diagnosed with schizoid personality disorder often experience psychotic thought processes, whereas patients diagnosed with avoidant personality disorder remain based in reality.”
- “Patients diagnosed with schizoid personality disorder exhibit odd, bizarre, and eccentric behavior, whereas patients diagnosed with avoidant personality disorder…”
- “Patients diagnosed with avoidant personality disorder desire intimacy but fear it, and patients diagnosed with schizoid personality disorder prefer to be alone.”
Question 4
A patient is being treated for depression with phenelzine (Nardil). Which behavior would indicate to the nurse that the patient understands the potential side effects of the antidepressant Nardil?
- Patient elevates her legs when sitting
- Patient increases daily intake of water
- Patient does not eat pepperoni pizza
- Patient limits the intake of sodium
Question 5
The physician orders haloperidol 3 mg intramuscularly stat. Haloperidol injection 5 mg/2 mL’s is available. How many mL’s should the nurse administer to the patient?
- 1.2 mL
Question 6
The nurse documents that the patient is exhibiting negative symptoms of schizophrenia when observing the patient doing what? Select all that apply.
- Repeatedly turning down invitations to join in unit activities
- Sitting in the day room looking unkempt with body odor
- Using words in sentences that make no sense
- Threatening to “slap anyone that bothers my stuff”.
- Walking in circles around the unit until exhausted.
- Talking about controlling the weather
- Speaking in a voice that is void of emotional tone.
- Displaying no insight into their condition
Question 7
Which symptom experienced by a patient diagnosed with schizophrenia is more difficult to treat and would predict less patient participation in treatment?
- Hearing command hallucinations
- Echolalia and echopraxia
- Impaired volition and anergia
- Thinking the TV is controlling his or her behavior
Question 15
After ECT, a patient reports experiencing confusion and headache. What is the best initial nursing intervention?
- Reassure the patient these are common side effects.
- Encourage the patient to stay in a quiet, dimly lit room until symptoms improve.
- Document the patient’s symptoms and notify the physician immediately.
- Administer analgesics as ordered for the headache.
Question 16
A patient reports experiencing increased fatigue, weight gain, and food cravings over the last few weeks. She notices that this often happens around Halloween and typically lifts around springtime. Which of the following is a correct understanding of this disorder?
- Medication is the primary treatment for this condition.
- The use of light therapy is indicated in the treatment of this disorder.
- This is an isolated even that will never happen again.
- This condition only occurs in the winter months.
Question 17
Which patient should the nurse most carefully assess for the possible side effect of urinary retention?
- A middle-aged woman receiving lithium carbonate (Eskalith)
- A young man receiving citalopram (Celexa)
- An elderly man receiving imipramine (Tofranil)
- A young woman receiving clomipramine (Anafranil)
Question 18
The nurse is performing an admission interview with a patient who exhibits signs of narcissistic personality disorder. Which behavior pattern is characteristic of the narcissistic personality disorder?
- The patient has no desire for close friends
- The patient avoids work or school activities to participate in recreation
- The patient lacks empathy and focuses on personal needs
- The patient is reserved in social situations
Question 19
A depressed patient who is beginning to experience some symptom relief from SSRI’s has asked the nurse to arrange for her suicide precautions to be lifted so she can have more privacy and not take up so much of the staff’s time. What is the nurse’s best reply?
- “I don’t want you to worry about taking up staff time.”
- “We can discuss this tomorrow if you continue to be positive.”
- “It is too early in your treatment to discontinue safety measures.”
- “It’s good that you’re feeling so much better.”
Question 20
What is the nurses primary responsibility when caring for a patient who is about to undergo electroconvulsive therapy (ECT)?
- Ensure the patient is informed about the treatment options and procedure.
- Ensuring IV patency.
- Letting the treatment team know a patient is pregnant so ECT is contraindicated.
- Advising the patient to choose alternative therapies.
Question 21
The nurse should assess a patient with the diagnosis of Cyclothymic Disorder for which symptomatology?
- Chronic fluctuating mood changes involving hypomania and mild depression
- Chronic depressive symptoms interspersed with normal mood
- Severe depressive symptoms with hallucinations and suicidal ideations
- Fluctuating mood disturbances involving mania and depression
Question 22
Imbalances of which neurotransmitters contribute to anxiety?
- Histamine, glycine, and acetylcholine
- GABA, norepinephrine, and serotonin
- Serotonin, dopamine, and histamine
- Acetylcholine, glutamate, and GABA
Question 23
A 24-year-old with schizophrenia was started on clozapine (Clozaril) 4 days ago. At 8 p.m. today, the patient’s vital signs were T 101, P 143, R 20, BP 100/60. Regarding the p.m. dose of clozapine, what should the nurse do?
- Recognize the alterations in vital signs as typical for early therapy and administer the medication
- Hold the medication and notify the physician
- Give the drug and monitor vital signs q4h
- Check a clozapine level prior to administering the medication
Question 24
The nurse enters the dayroom to find a patient standing with their arms held out at a peculiar angle. The nurse should document this as which finding?
- Anhedonia
- Depersonalization
- Derealization
- Waxy flexibility
Question 25
Identify the positive symptoms of Schizophrenia. Select all that apply.
- Aphasia
- Hallucinations
- Derealization
- Paranoia
- Neologisms
- Anergia
- Anhedonia
- Echopraxia
- Obsessions
Question 26
Which symptom experienced by a patient diagnosed with schizophrenia would predict that the patient may not be an active participant in their recovery.
- Hearing hostile voices
- Thinking that the TV is controlling their behavior
- Having little or no interest in work or social activities
- Continuously repeating what has been said
Question 27
A patient asks the nurse, “What are neurotransmitters? My doctor says they’re at the root of my problem.” How should the nurse respond?
- “Your Neurotransmitter labs are abnormal and need to be treated.”
- “Neurotransmitters are amino acids we eat daily that are responsible for passing messages between brain cells.”
- “You must feel relieved to know that your problem has a physical basis.”
- “Neurotransmitters are chemicals manufactured in the brain that are responsible for passing messages between brain cells.”
Question 28
The nurse is providing education for the parents of a patient newly diagnosed with schizophrenia. The parents are very concerned about their son’s hallucinations and want to know why he is hearing voices. Which is the most appropriate reply from the nurse to the parents?
- “The patient is experiencing abnormal hormonal fluctuations that have precipitated auditory hallucinations.”
- “The patient has fluctuation levels of serotonin in the brain, causing delusions and hallucinations.”
- “The patient has a chemical imbalance of the brain, which leads to altered thoughts.”
- “The patient is taking antipsychotic medication that will stop delusions and hallucinations.”
Question 29
When reviewing the patient’s chart, the nurse becomes concerned about the patient’s risk for addiction and potentiation when seeing which three medications listed?
- temazepam (Restoril)
- paliperidone (Invega)
- alprazolam (Xanax)
- buspirone (Buspar)
- escitalopram (Lexapro)
- chlordiazepoxide (Librium)
Question 30
A patient admitted with major depression has lost weight. The nurse assesses the patient and identifies altered nutrition as a concern. What is the most appropriate nursing intervention?
- Weigh the patient 3 times a week and record on a log
- Offer frequent small meals and brief nursing interactions during meals
- Educate the patient about nutrition and the importance of a well-balanced diet
- Report to the physician and obtain a nutrition consult
Question 31
The physician order reads: Give Prolixin Deconate 16mg IM stat. Prolixin Deconate 25mg/2mL is available in the omnicell. (Round to the nearest tenth) How many mL’s should the nurse administer?
- 1.3
Question 32
Which of the following signs of impending relapse of bipolar 1 disorder should the nurse include in the teaching to a patient and their family prior to discharge? Select all that apply.
- suddenly changing one’s appearance dramatically and bizarrely
- racing thoughts
- joining an online discussion board about aliens
- purchasing a new hot tub while living on the second floor of an apartment building
- applying for a promotion at work
- increasing participation at church functions
Question 33
A patient is very dramatic and loves being the center of attention. Recently she cut her finger while at the office and called her own ambulance although no stitches were required. She is angry that her request for disability was denied. The nurse assesses that this patient is most clearly displaying traits that are consistent with which personality disorder?
- Dependent personality disorder
- Histrionic personality disorder
- Schizotypal personality disorder
- Antisocial personality disorder
Question 34
The nurse is assessing a group of adolescents for suicidal risk. Which adolescent is at the greatest risk for attempting suicide?
- A 14-year-old male that has challenged his parents boundaries and has been kicked out of the house
- A 16-year-old girl who just discovered that she is adopted and has run away from home
- A 15-year-old male whose parents want him to be a physician and he is failing biology
- A 17-year-old girl who just found out that her best friend committed suicide
Question 35
When teaching a patient about antipsychotic medications, which fact should the nurse include that describes one of the advantages of the antipsychotic medication risperidone (Risperdal) compared to haloperidol (Haldol)?
- Low risk of type II diabetes
- Less chance of weight gain
- No incidence of neuroleptic malignant syndrome
- A lower incidence of extrapyramidal effects
Question 36
A physician convicted of multiple counts of Medicare fraud told reporters, “Why not? Everybody takes advantage of the government. They have too many rules. No one can abide by all of them.” How should the nurse assess what these statements indicate?
- Superficial remorse
- Lack of guilt feelings
- Humor and charm
- Impulsivity
Question 37
A patient is to receive alprazolam (Xanax) 1 mg PO TID for 4 days. What is the rationale for prescribing this drug for a short period of time?
- Glaucoma develops from long-term therapy
- Side effects include hypoglycemic reactions
- Therapeutic dose dependence develops
- If given for weeks, it produces agranulocytosis
Question 38
A patient receiving haloperidol (Haldol) complains of a stiff jaw and difficulty swallowing. What should be the nurse’s first action?
- Administer prn lorazepam (Ativan) intramuscularly as ordered
- Administer prn diphenhydramine (Benadryl) intramuscularly as ordered
- Administer prn haloperidol (Haldol) intramuscularly as ordered
- Administer prn benztropine (Cogentin) orally as ordered
Question 39
What findings are relevant to the patient’s initial assessment? Select all that apply
- Why do you worry about your son?
- Do you really feel like no one cares about you?
- Tell me about your sleep.
- Do you have anything that gives you pleasure in life? If so, what?
- Do you have any problems concentrating on tasks?
- Have you ever taken drugs or alcohol? If so, how often and what did you use?
- Have you thought about harming yourself or others at any time?
- Tell me about your appetite.
Question 39
What findings are relevant to the patient’s initial assessment? Select all that apply.
- Why do you worry about your son?
- Do you really feel like no one cares about you?
- Tell me about your sleep.
- Do you have anything that gives you pleasure in life? If so, what?
- Do you have any problems concentrating on tasks?
- Have you ever taken drugs or alcohol? If so, how often and what did you use?
- Have you thought about harming yourself or others at any time?
- Tell me about your appetite.
Question 40
For each assessment finding, categorize each symptom into its specific category. Each answer should be used once.
- Behavioral Symptoms: Poor Hygiene
- Affective Symptoms: Apathy
- Cognitive Symptoms: Inability to concentrate
- Physiological Symptoms: Changes in appetite
Question 41
Which problem should the nurse address first?
- Not paying her bills on time
- Her overwhelm at home repairs needed
- 30lb weight loss over the past year
- Noncompliance with pharmacologic therapy
Question 42
Which of the following orders should the nurse anticipate?
- Continued inpatient treatment until goals met
- Group psychotherapy
- Forced pharmacological therapy
- 1:1 suicide precautions
- Strict intake and output
- Encourage independent completion of ADLs to the client’s ability
- Locked door order on admission
- Standard safety precautions
Question 43
Fluoxetine is a (1) that can be effective in treating depression. The nurse teaches the patient that this drug can cause common side effects including (2) and (3). In addition, the nurse teaches the patient that this class of drugs makes patients at increased risk for (4) and the patient must be monitored closely.
- selective serotonin reuptake inhibitor
- sexual dysfunction
- insomnia
- suicidal thoughts
Question 44
For each assessment finding decide whether the interventions were effective or ineffective by dragging the answers to the appropriate column. Each answer should be used once.
- Effective: Sets realistic goals for self
- Effective: Adheres to the treatment plan each week
- Effective: Gained 10lbs in 2 months
- Effective: Joined community support group
- Ineffective: Lack of focus on personal strengths
- Ineffective: Expresses a pessimistic outlook
- Ineffective: Dwells on past accomplishments
- Ineffective: Continues to engage in isolation
Question 45
Ongoing assessment and outcome planning for a patient with depression are facilitated if the nurse understands that medication prescribed to improve the patient’s symptoms address which neurotransmitters? Select all that apply.
- Serotonin
- Acetylcholine
- GABA
- Norepinephrine
- Histamine
- Oxytocin
- Dopamine
- Glutamate
