Your patient Vicky just received a diagnosis of terminal cancer. You plan to speak to her about her response to the diagnosis.. When you reach her room, you find Vicky on the phone. As youre standing in the doorway, she starts laughing. You are startled when she states, Why are you looking so sad? Obviously the tests were wrong. I am not that sick. The patient is displaying:
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Question 2 of 103
A client reports feeling like he belongs among his peers with whom he shares a group home. The nurse incorporates this sense of belonging when formulating discharge plans because the nurse understands which of the following?
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Question 3 of 103
A nurse is caring for a patient diagnosed with schizophrenia who is exhibiting negative symptoms such as lack of motivation and limited speech. Which of the following interventions is most appropriate?
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Question 4 of 103
A cruel and abusive person often uses rationalization to explain the behavior. Which comment demonstrates use of this defense mechanism?
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Question 5 of 103
A nurse is working with a patient diagnosed with schizophrenia. The patient reports hearing voices and states, 'The voices tell me to hurt myself.' What is the priority nursing intervention?
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Question 6 of 103
A client has been making sexual comments when communicating with the nurse. The nurse wants to spend some time talking to the patient while respecting the patient's right to privacy. Which setting would be the most appropriate setting for the nurse to talk with the client?
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Question 7 of 103
A patient reports fears of having cervical cancer and says to the nurse, "I've had Pap smears by six different doctors. The results were normal, but I'm sure that's because of errors in the laboratory." Which disorder would the nurse suspect?
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Question 8 of 103
As a nurse discharges a patient, the patient gives the nurse a card of appreciation made in an arts and crafts group. What is the nurse's best action?
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Question 9 of 103
Three members of a therapy group share covert glances as other members of the group describe problems. When one makes a statement that subtly criticizes another speaker, the others nod in agreement. Which group dynamic should the leader suspect?
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Question 10 of 103
A patient says, "I've done a lot of cheating and manipulating in my relationships." Select a nonjudgmental response by the nurse.
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Question 11 of 103
A nurse is assessing a patient diagnosed with anorexia nervosa. Which of the following signs should the nurse monitor for in this patient?
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Question 12 of 103
Which principle should guide the nurse in determining the extent of silence to use during patient interview sessions?
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Question 13 of 103
Recent evidence suggests that at least some phobias are closely associated with the emotion of:
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Question 14 of 103
During the admission interview, the nurse asks the client what led to his hospitalization. The client responds, 'They lied about me. They said I murdered my mother. You're the killers. You all killed my mother. She died before I was born.' The best initial response by the nurse would be,
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Question 15 of 103
Which assessment finding best supports dissociative fugue? The patient states
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Question 16 of 103
Neurotransmitters elevated in Manic episode are
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Question 17 of 103
A team of providers, nurses, social workers, and counselors work together to provide care for a client with a substance use disorder. Which of the following names describes this group of clinicians?
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Question 18 of 103
The nurse is preparing to administer PRN medication to a client of a Japanese descent who is anxious. The prescription reads, 'Alprazolam (Xanax) 0.25 to 1.0 mg PO PRN.' The best dose for the nurse to give initially is
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Question 19 of 103
A person with a fear of heights drives across a high bridge. Which structure will stimulate a response from the autonomic nervous system?
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Question 20 of 103
A nurse is working with a patient whose background is very different from hers. A good question to ask herself to assure she can be effective working with this patient would be,
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Question 21 of 103
A patient in the emergency department says, Voices say someone is stalking me. They want to kill me because I developed a cure for cancer. I have a knife and will stab anyone who is a threat. Which aspects of the patients mental health have the greatest and most immediate concern to the nurse? Select one that does not apply.
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Question 22 of 103
A community health nurse visits the home of a child, age 11, to investigate frequent school absences. The nurse finds the child caring for three siblings, all younger than age 4. Both parents are at work. The child says, 'I want to go to school regularly, but when my mother has to work, I watch the kids. We can't afford a babysitter. It doesn't matter anyway. I'm too dumb to learn much. I don't have friends at school, probably because I don't deserve any.' What preliminary assessment can be made?
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Question 23 of 103
A nurse in the clinic has a full appointment schedule. A Hispanic American patient arrives at 1230 for a 1000 appointment. A Native American patient does not keep an appointment at all. What understanding will improve the nurses planning? These patients are:
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Question 24 of 103
A nurse on an inpatient mental health unit is caring for a client who was admitted for suicidal ideation. Which of the following statements by the client should the nurse identify as a continuation of suicidal ideation?
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Question 25 of 103
A patient diagnosed with depersonalization disorder tells the nurse, "It's starting again. I feel as though I'm going to float away." Which intervention would be most appropriate at this point?
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Question 26 of 103
What is complicated grief?
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Question 27 of 103
A leader plans to start a new self-esteem building group. Which intervention would be most helpful for assuring mutual respect within the group?
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Question 28 of 103
A patient discloses several concerns and associated feelings. If the nurse wants to seek clarification, which comment would be appropriate?
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Question 29 of 103
A nurse is working with a patient and attempts to communicate effectively with him or her. Techniques the nurse can use to help communication include (Select one that does not apply.):
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Question 30 of 103
A patient says to the nurse, 'I dreamed I was stoned. When I woke up, I felt emotionally drained, as though I hadn't rested well.' Which response should the nurse use to clarify the patient's comment?
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Question 31 of 103
The major problems with large state institutions are: Select one that does not apply.
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Question 32 of 103
A nurse is talking with a patient, and 5 minutes remain in the session. The patient has been silent most of the session. Another patient comes to the door of the room, interrupts, and says to the nurse, "I really need to talk to you." The nurse should
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Question 33 of 103
An adolescent asks a nurse conducting an assessment interview, 'Why should I tell you anything? You'll just tell my parents whatever you find out.' Which response by the nurse is appropriate?
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Question 34 of 103
The nurse on an addictive disorders unit receives a phone call inquiring about the status of a client. The caller is not on the client's allowed contact list. Which of the following is the appropriate response by the nurse to the caller?
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Question 35 of 103
In the Mental Health Status Examination, which of the following focuses on what the person is thinking?
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Question 36 of 103
The nurse is mindful of maintaining relationships with patients that are therapeutic. Certain characteristics of the relationships the nurse will foster include:Select one that does not apply.
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Question 37 of 103
A newly admitted patient diagnosed with major depressive disorder has gained 20 pounds over a few months and has suicidal ideation. The patient has taken antidepressant medication for 1 week without remission of symptoms. Select the priority nursing diagnosis.
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Question 38 of 103
In the majority culture of the United States, which individual has the greatest risk to be labeled mentally ill? One who:
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Question 39 of 103
A patient in the emergency department shows disorganized behavior and incoherence after a friend suggested a homosexual encounter. In which room should the nurse place the patient?
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Question 40 of 103
Direct eye contact is preferred by which of the following cultures?
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Question 41 of 103
Which comment best indicates that a patient perceived the nurse was caring? My nurse:
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Question 42 of 103
Cultural competency is
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Question 43 of 103
A nurse is caring for a patient diagnosed with anorexia nervosa. The patient states, 'I need to lose more weight.' What is the priority nursing diagnosis for this patient?
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Question 44 of 103
Which type of group is a staff nurse with 2 months' psychiatric experience best qualified to conduct?
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Question 45 of 103
A delusion represents a problem in which of the following areas?
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Question 46 of 103
Select the best outcome for a patient with the nursing diagnosis: Impaired social interaction related to sociocultural dissonance as evidenced by stating, 'Although I'd like to, I don't join in because I don't speak the language very well' Patient will:
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Question 47 of 103
A nurse is meeting with a new client at a substance use disorder clinic. During the meeting, the client states that they have been using cocaine at least once daily for the past 6 months. The nurse is collecting which of the following types of data from the client's account?
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Question 48 of 103
Which questions should the nurse ask to determine an individuals worldview? Select one that does not aplly.
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Question 49 of 103
An aide in a psychiatric hospital says to the nurse, 'We don't have time every day to help each patient complete a menu selection Let's tell dietary to prepare popular choices and send them to our unit' Select the nurse's best response
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Question 50 of 103
A nurse in an emergency department is assessing a client who has a personality disorder and reports that they recently used illicit drugs. Which of the following screening tools should the nurse use to determine if the client has recently used an illicit substance?
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Question 51 of 103
The nurse asks the client, 'What is similar about a cow and a horse?' and 'What do a bus and an airplane have in common?' These questions would best assess which of the following areas?
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Question 52 of 103
A person facing eminent death may cry often, become socially withdrawn, or become mute. This may be indicative of
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Question 53 of 103
A community health nurse makes a home visit to a family with four children. The father behaves angrily, finds fault with a child, and asks twice, 'Why are you such a stupid kid?' The wife says, 'I have difficulty disciplining the children. It's so frustrating.' The nurse seeks to gather more assessment data. Which comments by the nurse will facilitate communication? (More than one answer is correct.)
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Question 54 of 103
The desired outcome for a patient experiencing insomnia is, 'Patient will sleep for a minimum of 5 hours nightly within 7 days.' At the end of 7 days, review of sleep data shows the patient sleeps an average of 4 hours nightly and takes a 2-hour afternoon nap. The nurse will document the outcome as
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Question 55 of 103
The nurse is caring for a severely depressed client who has just been admitted to the in-client psychiatric unit. Which of the following is a PRIORITY of care?
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Question 56 of 103
A nurse is providing care to a client who has acute stress disorder. Which of the following client statements is consistent with this disorder?
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Question 57 of 103
Which behavior shows that a nurse values autonomy? The nurse:
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Question 58 of 103
A nurse introduces the matter of a contract during the first session with a new patient because contracts:
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Question 59 of 103
The nurse asks the client what that experience was like. Which communication skill is the nurse using?
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Question 60 of 103
A nurse is caring for a patient diagnosed with bipolar disorder during the manic phase. The nurse understands that during this phase, the patient is most likely to exhibit which behavior?
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Question 61 of 103
A nurse is discussing common misconceptions regarding clients who have substance use disorder. The nurse should include which of the following as a potential negative result of providers believing that addiction is the client's own fault?
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Question 62 of 103
Which question should the nurse ask when assessing for what Sullivan's Interpersonal Theory identifies as the most painful human condition?
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Question 63 of 103
During the initial interview at the crisis center, a patient says, "I've been served with divorce papers. I'm so upset and anxious that I can't think clearly." Which comment should the nurse use to assess personal coping skills?
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Question 64 of 103
A black patient says to a white nurse, 'There's no sense talking about how I feel. You wouldn't understand because you live in a white world.' The nurse's best action would be to
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Question 65 of 103
Several nurses are concerned that agency policies related to restraint and seclusion are inadequate. Which statement about the relationship of substandard institutional policies and individual nursing practice should guide nursing practice?
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Question 66 of 103
Select the most appropriate label to complete this nursing diagnosis: _____ related to feelings of shyness and poorly developed social skills as evidenced by watching television alone at home every evening.
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Question 67 of 103
A nurse works with a patient diagnosed with posttraumatic stress disorder (PTSD) who has frequent flashbacks as well as persistent symptoms of arousal. Which intervention should be included in the plan of care?
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Question 68 of 103
A psychiatric nurse discusses rules of the therapeutic milieu and patients rights with a newly admitted patient. Which rights should be included? (Select one that does not apply..) The right to:
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Question 69 of 103
Schemata, automatic thoughts, and cognitive distortions are terms that relate to:
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Question 70 of 103
Your patient is sternly criticized by her doctor for not complying with the medication regimen. The patient walks out of the office and yells at the parking attendant. This may be an example of which defense mechanism?
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Question 71 of 103
A patient diagnosed with schizophrenia has been stable for 2 months. Today the patients spouse calls the nurse to report the patient has not taken prescribed medication and is having disorganized thinking. The patient forgot to refill the prescription. The nurse arranges a refill. Select the best outcome to add to the plan of care.
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Question 72 of 103
Essential components of palliative care include;
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Question 73 of 103
A patient diagnosed with severe and persistent mental illness lives in a homeless shelter. The priority nursing diagnosis for this patient is Powerlessness. Which intervention should be included in the plan of care?
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Question 74 of 103
Which assessment findings support a diagnosis of ODD?
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Question 75 of 103
An experienced psychiatric nurse plans to begin a new job in a community-based medication clinic. The clinic sees culturally diverse patients. Which action should the nurse take first to prepare for this position?
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Question 76 of 103
The act of developing a clean environment is a factor in providing effective health care as demonstrated by:
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Question 77 of 103
A nurse is performing safety assessments on a client in mechanical restraints as required by policy. Which action by the nurse demonstrates the ethical principle of nonmaleficence?
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Question 78 of 103
A client is admitted to the psychiatric unit and states, 'I am president of the largest corporation in the world. Everyone comes to me for advice.' The client is exhibiting which of the following?
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Question 79 of 103
A nurse is assessing a patient diagnosed with major depressive disorder. The patient states, 'I feel like I have failed in everything I've done.' What is the priority nursing intervention?
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Question 80 of 103
Which individual with mental illness may need emergency or involuntary admission? The individual who:
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Question 81 of 103
A patient's employment is terminated, and major depressive disorder develops shortly afterward. The patient says to the nurse, 'I'm not worth the time you spend with me. I'm the most useless person in the world.' Which nursing diagnosis applies?
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Question 82 of 103
The nurse is preparing the preoperative client for surgery. The following statements indicate the client is knowledgeable about his impending surgery, except:
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Question 83 of 103
A nurse's neighbor says, "I saw a news story about a man without any known illness who died suddenly after his ex-wife committed suicide. Was that a coincidence, or can emotional shock be fatal?" The nurse should respond by noting that some serious medical conditions may be complicated by emotional stress, including (Select all that apply)
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Question 84 of 103
What is an essential step for health-care providers dealing with abuse cases?
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Question 85 of 103
A nurse receives these three phone calls regarding a newly admitted patient. The psychiatrist wants to complete an initial assessment. An internist wants to perform a physical examination. The patients attorney wants an appointment with the patient. The nurse schedules the activities for the patient. Which role has the nurse fulfilled?
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Question 86 of 103
A nurse and patient have just completed reviewing the patient's take-home medications. The nurse is exemplifying which role during this intervention?
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Question 87 of 103
A patient diagnosed with bipolar disorder is experiencing acute mania. Which of the following interventions should the nurse implement first?
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Question 88 of 103
A nurse is caring for an adolescent who has experienced abuse and neglect since early childhood. The nurse should understand that this is an example of which of the following types of trauma?
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Question 89 of 103
A patient has blindness related to conversion (functional neurological) disorder but is unconcerned about this problem. Which understanding should guide the nurse's planning for this patient?
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Question 90 of 103
Which of the following is defined as an advanced-level function in the practice area of psychiatric mental health nursing?
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Question 91 of 103
Recognizing the frequency of depression among the American population, the nurse should advocate for which mental health promotion intervention?
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Question 92 of 103
Generalised Anxiety Disorder (GAD) is a pervasive condition in which the sufferer experiences:
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Question 93 of 103
Select the example of a tort
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Question 94 of 103
A client underwent a procedure before the nurse verified the client's signature on the consent form. The client actually did not sign the form before the procedure. If the client is dissatisfied with the outcome of the procedure and files a suit against the health-care team, which kind of case can the client file?
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Question 95 of 103
A nurse is assessing a client who has paranoid personality disorder. Which of the following findings should the nurse expect?
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Question 96 of 103
While shopping in the local supermarket, a mental health nurse encounters an individual who recently was a patient on her unit. Which is the proper response by the nurse?
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Question 97 of 103
After formulating the nursing diagnoses for a new patient, what is a nurses next action?
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Question 98 of 103
Which statement by a patient diagnosed with schizophrenia demonstrates delusional thinking?
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Question 99 of 103
A nurse is caring for a client who is experiencing manifestations of anxiety. The nurse should recognize which of the following statements about the neurophysiologic manifestations of anxiety as correct?
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Question 100 of 103
A woman said, "I can't take anymore! Last year my husband had an affair and now we don't communicate. Three months ago, I found a lump in my breast. Yesterday my daughter said she's quitting college." What is the nurse's priority assessment?
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Question 101 of 103
A patient newly diagnosed as HIV-positive seeks the nurse's advice on how to reduce the risk of infections. The patient says, 'I went to church years ago and I was in my best health then. Maybe I should start going to church again.' Which response will the nurse offer?
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Question 102 of 103
A nurse is caring for a patient diagnosed with bulimia nervosa. The patient states, 'I feel so ashamed after I eat.' What is the most appropriate response by the nurse?
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Question 103 of 103
In the recovery room, the postoperative client suddenly becomes cyanotic. What is the most appropriate nursing action?
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