Test Bank for Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry, 11th Edition (Chapters 1-37)

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COMPLETE:KAPLAN AND SADOCK’SSYNOPSIS OFPSYCHIATRY 11THEDITION SADOCK TEST BANK|ALLCHAPTERS INCLUDEDChapter 1: Neural SciencesTestBankMULTIPLECHOICE1.A patient with depression mentions to the nurse, My mother says depression is a chemicaldisorder. What does she mean? The nurses response is based on the theory that depressionprimarilyinvolveswhichofthefollowing neurotransmitters?1.CortisolandGABA2.COMTandglutamate3.Monamineandglycine4.Serotoninandnorepinephrine2.A patient has experienced a stroke (cerebral vascular accident) that has resulted indamage to the Broca area. Which evaluation does the nurse conduct to reinforce thisdiagnosis?1.Observingthepatientpickupaspoon2.Askingthepatienttorecitethealphabet3.Monitoringthepatientsbloodpressure4.Comparingthepatientsgripstrengthinbothhands3.The patient diagnosed with schizophrenia asks why psychotropic medications are alwaysprescribedbythe doctor.Thenursesanswerwillbebasedoninformationthatthetherapeuticaction ofpsychotropicdrugsis theresultoftheireffecton:1.Thetemporallobe;especiallyWernickesarea2.Dendritesandtheirabilitytotransmitelectricalimpulses3.Theregulationofneurotransmittersespeciallydopamine4.Theperipheralnervoussystemsensitivitytothepsychotropicmedications4.A student nurse mutters that it seems entirely unnecessary to have to struggle withunderstandingtheanatomyandphysiologyofthe neurologicsystem.Thementorwouldbasearesponseontheunderstandingthatitis:1.Necessary but generally for psychiatric nurses who focus primarily on behavioralinterventions

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1.A complex undertaking that advance practice psychiatric nurses frequently use in theirpractice1.Important primarily for the nursing assessment of patients with brain traumacausedcognitivesymptoms1.Necessaryforplanningpsychiatriccareforallpatientsespeciallythoseexperiencingpsychiatricdisorders5.A patient asks the nurse, My wife has breast cancer. Could it be caused by her chronicdepression? Which response is supported by research data? 1. Too much stress has beenproventocauseall kindsofcancer.2.Therehavebeennoresearchstudiesdoneonstressanddiseaseyet.3.Stressdoescausethereleaseoffactorsthatsuppresstheimmunesystem.4.Thereappearstobe little connectionbetweenstressanddiseasesofthebody6.Apatientwhohasaparietallobeinjury isbeingevaluatedforpsychiatricrehabilitationneeds.Oftheaspectsoffunctioninglisted,whichwillthe nurseidentifyasa focusofnursingintervention?1.Expressionofemotion2.Detectingauditorystimuli3.Receivingvisualimages4.Processingassociations7.At admission, the nurse learns that some time ago the patient had an infarct in the rightcerebralcortex.Duringassessment,thenursewouldexpecttofindthatthepatient:1.Demonstratesmajordeficienciesinspeech2.Isunabletoeffectivelyholdaspooninthelefthand3.Hasdifficultyexplaininghowtogoaboutusingthetelephone8.A patient with chronic schizophrenia had a stroke involving the hippocampus. Thepatientwillbe dischargedonlowdosesofhaloperidol.The nursewillneedtoindividualizethepatients medicationteaching by:1.Includingthepatientscaregiverintheeducation2.Beingcarefultostresstheimportance oftakingthemedicationasprescribed3.Providingtheeducationata timewhenthe patientisemotionallycalmandrelaxed1.Encouragingthepatienttocrushordissolvethemedicationtohelpwithswallowing

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9.The physician tells the nurse, The medication Im prescribing for the patient enhances thegaminobutyric acid (GABA) system. Which patient behavior will provideevidence that themedication therapyis successful?1.Thepatientisactivelyinvolvedinplayingcardswithotherpatients.2.Thepatientreportsthat,IdontfeelasanxiousasIdidacoupleofdaysago.3.Thepatient reportsthatbothauditoryandvisualhallucinationshavedecreased.4.Thepatientsaysthat,Iammuchhappier thanbeforeIcametothehospital.10. The patients family asks whether a diagnosis of Parkinsons disease creates an increasedrisk for any mental health issues. What question wouldthe nurse ask to assess for such acomorbid condition?1.Hasyourfatherexhibitedanysignsofdepression?2.Doesyourfather seemtoexperiencemoodswings?3.Haveyounoticedyourfathertalkingaboutseeingthingsyoucantsee?4.Isyourdadpreoccupiedwithbehaviorsthatheneedstorepeatoverand over?11. Which explanation for the prescription of donepezil (Aricept) would the nurse provide for apatientintheearly stageofAlzheimers disease?1.ItwillincreasethemetabolismofexcessGABA.2.Excessdopaminewillbepreventedfromattachingtoreceptorsites.3.Serotonindeficiencywillbe managedthroughaprolongedreuptakeperiod.4.Theacetylcholinedeficiencywillbemanagedbyinhibitingcholinesterase.12. There remains a stigma attached to psychiatric illnesses. The psychiatric nurse makes thegreatestimpactonthis sociologicalproblemwhen:1.Providingeducationalprogrammingforpatientsandthepublic2.Arrangingforadequateandappropriatesocialsupportforthe patient3.Assistingthepatienttoachievethemaximumlevelofindependent functioning4.Regularlypraisingthepatientforseekingandcomplyingwithappropriatetreatment13. The wife of a patient with paranoid schizophrenia tells the nurse, Ive learned that myhusband has several close relatives with the same disorder. Does this problem run in families?Theresponsebasedon recentdiscoveriesinthefieldofgenetics wouldbe:1.Yourchildrenshouldbemonitoredcloselyforthe disorder.2.Researchtendstosupporta familiartendencytoschizophrenia.3.Thereisnoconcreteevidence;it isjustaslikelyacoincidence.4.Onlybipolardisorderhasbeenidentifiedtohave ageneticcomponent.14. A patient whose symptoms of mild depression have been managed with antidepressants isconcerned about the affect of accepting a promotion that will require working the night shift.Whatwillbethebasisoftheresponsethenursegives toaddressthepatientsconcern?

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1.Theconnectionbetweenanewjobandpossibledepressiondoes exist.2.Themedicationcan beadjustedtomanageanyincreaseindepression.3.Theinterruptioninnormalwake-sleeppatternscaninfluencemooddisorders.4.Thechangeinsleeproutinecanbemanagedwithahealthysleephygieneroutine.15. The nurse is discouraged because the patient exhibiting negative symptoms ofschizophreniahasshownnoimprovementwiththeplannedinterventionstoreducethesymptoms.Thementorsremarkthathelpsplacetheproblemin perspectiveis:1.Youarentresponsibleforthebehaviorofanyotherperson.2.Patientscanbeperverseandclingtosymptomsdespiteourefforts.3.Negativesymptomshavebeenassociatedwithgeneticpathology.4.Itwilltakeseveraltrailanderrorattempts togettherightcombinationcare.MULTIPLERESPONSE1.What assessment data would reinforce the diagnosis of temporal lobe injury in patientwhoexperiencedheadtrauma?Selectallthatapply.1.Inabilitytobalanceacheckbook2.Uncharacteristicallyaggressive3.Affectfluctuatesdramatically4.Increasedinterestinsexualbehaviors5.Difficultyrememberingthenamesoffamilymembers2.A patient has begun experiencing dysfunction of the hypothalamus. What nursinginterventionswillthenurseincludeinthepatientsplanofcare?Selectall thatapply.1.Reinforcingclearphysicalboundaries2.Assistingthepatientwithcompletingdailymenus3.Learningabouthealthysleephygienehabits4.Monitoringandrecordingtemperatureevery4hours5.Monitoringandrecordingbloodpressureevery4hours3.The nurse is preparing a patient for a positron emission tomography (PET) scan. Whichinstructionswillthenurseinclude?Selectallthatapply.1.Therewilllikelybea30to45minutewaitbetweentheinjectionandthe beginningofthescan.1.Ablindfold andearplugsmaybeusedtohelpdecreasereactiontotheenvironmentduringthescan.1.Makeeveryattempttoliestillduringthescanbecausemovementwillaffecttheimagingproduced.1.No food or fluids are to be ingested for at least 8 full hours before the scan and none duringthescan.1.Stayingawakeduringthescanisimportantsincetheresultsarealteredwhenthepatientis inany phaseofthesleepstate.

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4.Apatientwithschizophreniaisdescribedashavingdifficultywithexecutivefunctions.Whatpatientdysfunctioncanthenurseexpecttoassessbehaviorally?Selectallthatapply.1.Invadesthepersonalspaceofothersfrequently2.Consistentlyfailstobringmoneywhengoingtobuysnacks3.Cannotrememberthenamesofstaffwhooftenprovidecare4.Requiresrepeatedreinforcementonhowtomakeasandwich5.Frequentlyspeaksofhurtinghimselforofhurtingotherpatients5.The unit physicians have ordered magnetic resonance imaging (MRI) tests for the followingpatients. For which patients would the nurse decline to make test arrangements withoutfurther discussionwiththephysician?Selectallthatapply.1.Apatientwhoisclaustrophobic2.Apatientwhoisbreastfeeding3.Apatientwhohasanallergytoiodine4.Apatientwhohadatotalknee replacement5.ApatientwhoistakinganeurolepticmedicationChapter2:ContributionsofthePsychosocialSciencesMULTIPLECHOICE1.Which understanding is the basis for the nursing actions focused on minimizing mentalhealthpromotion offamilies withchronicallymentally illmembers?1.Familymembersareatanincreased riskformentalillness.2.Thementalhealthcaresystemisnotpreparedtodealwithfamilycrises.3.Familymembersareseldompreparedtocopewithachronicallyillindividual.4.Thechronicallymentallyillreceivecare bestwhendelivered inaformalsetting.2.Whichnursingactivityshowsthenurse activelyengagedintheprimarypreventionofmentaldisorders?1.Providingapatient,whosedepressioniswellmanaged,withmedicationontime2.Makingregularfollow-upvisitstoanewmotheratriskforpost-partumdepression1.Providing the family of a patient, diagnosed with depression, information on suicideprevention1.Assisting a patient who has obsessive compulsive tendencies prepare and practice forajobinterview3.Which intervention reflects attention being focused on the patients intentionsregarding his diagnosis of severe depression? 1. Being placed on suicideprecautions2.Encouragingvisitsbyhisfamilymembers

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3.Receivingacombinationofmedicationstoaddresshisemotionalneeds4.Beingaskedtodecidewherehewillattendhisprescribedtherapysessions4.When a patients family asks why their chronically mentally ill adult child is being dischargedtoacommunity-basedliving facility,thenurseresponds:1.Itisawaytomeettheneedforsocialsupport.2.Itistooexpensivetokeepstabilizedpatientsinacutecaresettings.3.Thistypeoffacilitywillprovidethespecializedcarethatisneeded.4.Beingoutinthecommunitywillhelpprovidehopeandpurposeforliving.5.Whatisthebestexplanationtoofferwhenthemotherofachronicallyillteenagepatientasks,Underwhatcircumstanceswouldhebeconsideredincompetent?1.When you can provide the court with enough evidence to show that he is not able tocareforhimselfsafely.1.It is not likely that someone his age would be determined to be incompetent regardlessofhis mentalcondition.1.He would have to engage in behavior that would result in harm to himself or to someoneelse;likeyouorhis siblings.1.Iftheillnessbecomessoseverethathisjudgmentisimpairedtothepointwherethedecisions hemakes areharmful tohimselfortoothers.6.Whichpsychiatricnursinginterventionshowsanunderstanding ofintegratedcare?Achronically abusedwomanis assessedforanxiety.Amanicpatientistakento thegymtousetheexerciseequipment.Theolderadult diagnosedwithdepressionismonitoredforsuicidalideations.Ateenagerwhorefuses toobeytheunitsrules isnotallowto playvideogames.7.Whatreasondoesthenursegivethepatientfortheemphasisandattentionbeingpaidtotherecovery phaseoftheirtreatmentplan?1.Recoverycare,evenwhenintensive,islessexpensivethanacutepsychiatriccare.1.Effectiverecoverycare islikelytoresultinfewerrelapsesandsubsequenthospitalizations.1.Planning for recovery care is time consuming and involves dealing with many complicateddetails.1.Recovery care is usually done on an outpatient basis and so is generally better accepted bypatients.8.Thenurseisattendinganeighborhoodmeetingwhereahalf-wayhouseisbeingproposedfor

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theneighborhoodwhenamemberofthecommunitystates,Wedontwantthe facility;weespecially dont want violent people living near us. The response by the nurse that bestaddresses thepublics concernis:1.Intruth,mostindividualswithpsychiatricdisorderarepassiveandwithdrawnandposelittlethreattothosearoundthem.1.The mentally ill seldom behave in the manner they are portrayed by movies; they arepeoplejustliketherestofus.1.Patients with psychiatric disorder are so well medicated that they do not display violentbehaviors.1.The mentally ill deserve a safe, comfortable place to live among people who truly careforthem.9.Which activity shows that a therapeutic alliance has been established between the nurseandpatient?1.The nurse respects the patients right to privacy when visitors are spending time with thepatient.1.The patient is eagerly attending all group sessions and working independently onidentifyingtheirpersonalstressors.1.Thepatientisfreelydescribingtheirfeelingsrelatedtothephysicalandemotionaltraumathey experiencedasachildwiththenurse.1.The nurse dutifully administers the patients medications on time and with appropriateknowledgeofthepotentialsideeffects.10. Mental health care reform has called for parity between psychiatric and medicaldiagnoses.Whichisanexampleofsuchparity?1.Depressiontreatmentisnotpaidforasreadilyasistreatmentforasthma.2.Thementallyillpatientwillbeprotectedbylawagainstsocialstigma.3.Medicalpractitionersaretrainedtobeproficientattreatingmentaldisorders.4.Psychiatricservicereimbursementwillbeequivalenttothatofmedicalservices.MULTIPLERESPONSE1.Whichassessmentfindingssuggesttothenursethatthispatienthascharacteristicsseeninanindividualwho has reachedself-actualization. Selectallthatapply.Reportstohave,foundpeaceandsecurityinmyreligiousfaithEffectively changed occupations when a chronic vision problem worsenedHasconsistently earned a six-figure salary as an architect for the last 10 yearsHasbeen in a supportive, loving relationship with the same individual for 15 yearsProvides free literacy tutoring help at the local homeless shelter 3 evenings aweek

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2.Whichnursingactivitiesrepresentthetertiarylevelofmentalhealthcare?Selectallthatapply.Providingadepressionscreening atalocal collegeHelpinga mental-challengedpatientlearntomakecorrectchangeReporting an incidence of possible elder abuse to the appropriate legal agencyRegularly assessing a patients understanding of their prescribed antidepressantsProvidinga6-weekparentingclasstoteenageparentsthroughalocalhighschool3.Whichnursingactionsindicateanunderstanding ofthepriorityissuescurrentlyfacingpsychiatricmentalhealth nursing today?Selectallthatapply.1.Working on the facilitys Safe Use of Restraints Policy revision committee2. Advocating forincreasedsalaries foralllevels of psychiatricmentalhealthnurses1.Attending a political rally for increased state funding for mental health service providers1.Offeringanin-servicetofacilitystaffregardingtheculturalimplicationsofcaringfortheHispanicpatient1.Joiningthestatenursingcommitteeworkingontherole andscopeofpracticeoftheadvancedpracticepsychiatricnurse4.Whichassessmentfindingsdescribe riskfactorsthatincreasethepotentialriskformentalillness?Selectall thatapply.1.Possesseshightolerance forstress2.Isverycuriousabouthowthingswork3.Admitstobeingamemberofan ethnicgang4.OnlypracticingJewamongschoolclassmates5.Hasayoungersiblingwhoismentallychallenged5.Which nursing actions show a focus on the fundamental goals that guide psychiatricmentalhealth nursesin providingpatientcare?Selectall thatapply.1.Offeringaninformationalsessionofidentifyingsignsofdepressionata localseniorcenter1.Attendingaworkshoponevidencepracticeinterventionsforthechronicallydepressedpatient1.Keeping strict but appropriate boundaries with a patient diagnosed with a personalitydisorder1.Askingaparentwhohasjustexperienced thedeathofachildiftheycouldconsidertalkingwithagriefcounselor1.IdentifyingwhathelpapatientdiagnosedwithAlzheimersdiseasewillneedwithinstrumentalactivitiesofdaily living(IADLs)Chapter3:ContributionsoftheSocioculturalSciences

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MULTIPLECHOICE1.Which nursing action is a reflection of Hildegard Peplaus theoretic framework regardingpsychiatricmentalhealthnursing?1.Basingpatientoutcomesonexpectedinstinctualresponses2.Discussingapatientsfeelingsregardingparentsandsiblings3.Providingthepatientwithcleanclothesandwholesomefood4.Centeringprofessionalpracticeinastaterunpsychiatricfacility2. The nurse is attempting to provide a safe environment for a patient at great risk forselfharm.Whichinterventionshowsanunderstandingofevidence-basedpractice(EBP)?1.Usingphysicalrestraintsonlyafterallother optionshavebeenprovenineffective1.Referringtothefacilityspoliciesmanualforguidelinesforapplyingphysicalrestraints1.Collecting data regarding the short-term effects of using physical restraints on anaggressivepatient1.Requiring constant monitoring of a patient whose inability to self-regulate anger hasrequiredtheuseof physical restraints3.Which statement by the patient reflects patient education that was based on the conceptofintegratedpatientcare?1.IknowImanxiouswhenIgetatensionheadache.2.MyanxietyisaresultofstressorsIdontcopewellwith.3.Medicationhashelpedmetremendouslywithanxietycontrol.4.Anxietyrunsinmyfamily;myentirefamilyistryingtodealwithit.4.Thenursedemonstratesobjectivepatient carewhen:5.Beingsympathetictothepatientsrecentlossofaspouse6.Protectingtheanxiouspatient byeliminatingstressorsinthemilieu7.Respondingtothepatientbystating,Iknowexactlyhowyoufeel.8.Facilitatingthepatientsexplorationofvariousstressreductiontechniques5.Which nursing intervention would be appropriately addressed during the orientation phaseofthenursepatientrelationship?1.Selfreflectionbythe nurse regardingpersonalbiasesandprejudicesregardingthepatient1.Patientworksatprioritizing personalneedsanddevelopsrealisticexpectedoutcomes1.Establishing the contract between the nurse and the patient regarding mutual needsandexpectations1.Patient commits to the reinforcement of positive personal characteristics while working onproblems andconcerns6.Which action on the part of a novicepsychiatric mental health nurse shows a need forfuturedevelopmentofaltruism?

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1.Excusing a patient from attending group because, all that talking makes me soanxious1.Not permitting two patients who are physically attracted to each other to engage in publicdisplaysofaffection1.Placing a physically aggressive patient in restraints when they are unable to internally calmtheiranger1.Self-reflecting on why I continue to work with patients who are so emotionally damagedtheywill neverbenormal7.Thegreatestnegativeoutcomeresultingfrom anursesfearofamentallyillpatientisthatthe:8.Nursewillreinforcenegativestereotypingofthementallyill.9.Patientwillexperienceincreasedbiasagainstthenursingstaff.10.Publicsfearfulnessofthementallyillwillcontinuetobeexaggerated.11.Therapeuticalliancebetweenthenurseandpatient willnotdevelopeffectively.8.Which action on the part of a novice mental health nurse will best minimize fear related toeffectivelyworking withthepsychoticpatient?1.Be knowledgeable about psychotropic medications and their affect on psychosis. 2. Alwaysarrangeforstaffsupportwhenworkingone-on-onewithapsychoticpatient.1.Takeadvantageofopportunitiestoattendworkshopsdevotedtothecareofthepsychoticpatient.1.Recognize that the psychotic patient is not in control of their behaviors due to their alteredthoughprocesses.9.Which response by the nurse manager to a novice mental health nurse is most effectivewhenthenurseasks,HowdoIjustify notkeepingapatients secret?1.Neverpromisethepatientthatyouwillkeepasecretfor them.2.Alwaysstopthepatientfromtellingyousomethingasasecret.3.Letthepatientknowthatyouwillnotkeepasecretthatcouldultimatelycauseharmoraffecttheirtreatment.1.Keep reminding yourself that you are not the patients friend but rather a professionalmentalhealthprovider.10.Thenurseiseffectivelyfacilitatingthenurse-patientrelationshipwhen:11.Sharingwithanangrypatientwhoisverballyabusivethat,AlthoughIcanacceptthatyouareangry, I cannotandwillnotacceptyourverbalabuse.1.Focusing on the patients life experience without relating to the similarities of ones ownexperiences1.Objectively providing constructive criticism that is directed to helping the patient identifyinappropriatebehaviors

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1.Refrainingfromabandoningthe patientregardlessofthefrustrationtheinteractioncauses11.Anoftenexpressedintrinsicrewardofpsychiatric mentalhealthnursingis:12.Seeingtheseriously ill recovertheirhealth13.Workingwithpatientsofallages andwalksoflife14.Workingwithwell-trained,caringhealthcareproviders15.Havingtimetoreallyfocusonthehumanwho isthepatient12.Whichstatementisanexampleofan inference?13.Heisanalcoholicbecausehiswifenagsalot.14.Hestateshebingesafterarguingwithhiswife.15.Yousayyouralcoholintakeexceedsaquartaday.16.Soyouaresayingthatyouweredrinkingearlier today.MULTIPLERESPONSE1. Which interactions are likely outcomes of a well-established therapeutic alliance? Select allthatapply.1.Thenursestates,Imnotheretojudgebutrathertohelp.2.Thepatientstates,IreallythinkIcanhandlethisproblemnow.3.Thepatientaskshisabusivefathertoattendcounselingwithhim.4.Thenursesetsboundariesforapatientwho hasfewsocialskills.5.Thepatientwithangerissuesvoluntarilygoesintotheseclusionroom.2.Which nursing interventions are directly related to the principles on which a therapeuticallianceis based?Selectallthatapply.1.Graciouslydecliningto,ComevisitwhenIgetdischarged.2.Establishingthetopic tobediscussedateachgroupsession3.Explainingtothe patientthe purposeofterminatingthealliance4.Sharinghowthenursealsohasexperiencedthesameproblems5.Providingsubjectivefeedbacktothepatientseffortsattherapy3.The nurse is attempting to minimize the groups display of resistance during a therapysession.Whichpatientsareatriskfordisplayingsuchbehavior?Selectallthatapply1.Thepatientwhoiscognitivelyimpaired2.Thepatientwho isolderandwelleducated3.Thepatientwhoisaggressiveandattentionseeking4.Thepatientwhohasattendedsimilartherapygroupsinthepast5.ThepatientwhohasbeendiagnosedwithparanoidschizophreniaChapter4: Theories ofPersonalityand Psychopathology

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TestBankMULTIPLECHOICE1.The nurse leading parent education classes bases instruction on Eriksons developmentalstages.Itfollowsthatthenursewillplantoinstructtheparentsthatahelpfulstrategytofosterachilds initiativewouldbeto:1.Offerseveraldifferentoptionsfordressingandencouragethechildtoselectoneofthem.1.Allowthechildtohelpwashtheunbreakabledishesusedtoservebreakfast.2.Provideone-on-oneparentchildtimeeacheveningbeforebed.3.Enrollthechildinaweekend,age-appropriatesportsprogram.2.Which of the following responses would the nurse expect from a 12-year-old regardingstealing?1.Youareneverallowedtosteal.2.Yougotojail isyoustealsomeoneelses things.3.Myparentswould punishmeifIwascaughtstealing.4.Stealingfoodwhenyoudonthaveanythingtoeatisalright.3.Anursingdiagnosisofhopelessnesswouldbe consideredforanindividualwho:4.Wasconsistentlyoverprotectedbyfamilymembers5.Wasraisedby parentswhowerestrictdisciplinarians6.Hadinconsistent,unpredictablephysicalcareasaninfant7.Asateenageralwaysfeltunacceptedbyhissocialpeers4.An adolescent has been a consistently, poor academic student due to a learning disorder.Whichstatementoverheardbythe nursewouldsupportthepossibilityofa problemwiththedevelopmentalstagecompetenceversusinferiority?1.Itstoohardto getgoodgrades.2.Illneverbeabletogetintoagood college.3.MyparentsaredisappointedthatIdosopoorlyinschool.4.IdontwantpeopletoknowIcan barelyreadorwrite.5.A parent is concerned with the interpersonal skills of her 12-year-old son. Based oninterpersonaltheory,thenurseasks:1.Doesyoursonbelongtoteamorclubwith friendsorclassmates?2.Doeshefeelbadwhen hedoessomethingheknowsheshouldntdo?3.Howdoeshetend toactwhen hedoesntgetexactlywhathewants?4.Howconfidentisheinsituationsthatare generallyunfamiliarforhim?

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6.The parents of an 8-year-old are attempting to help their child comprehend newinformation.Whichinterventionsuggestedbythenurseshowsanunderstandingofthecognitivedevelopmenttheoryforthisagegroup?1.Theuseofdrawingandillustrations2.Comparingthechildsexperiencestothenewmaterial3.Encouragingthechildtotalkaboutthisnew information4.Askingthechildtogivea reasonforhowtheyfeelaboutnewinformation7.According to Piaget, which of the following would the nurse consider normal whenassessinga6-year-old?1.Playingwithanimaginary friend2.Talkingabouttheirbestfriend3.Enjoyingputtingpuzzlestogether4.Knowingitswrongtotellalie8.Which developmental level would be characterized by a child being able to focus, tocoordinate, andtoimagineaseriesofevents?1.Preoperational2.Concreteoperational3.Formaloperational4.Postoperational9.Which strategy will the nurse include in the plan of care for a 6-year-old child for whomoperantconditioning has been recommended?1.Periodicallyaskingthechildtoattempttosolveincreasinglydifficult puzzles2.Consistentlyofferingpraisewhenthechildputshisdirtyclothesinthe hamper3.Expectingthechildtorinseandtoplace hisdirtydishesinthesink4.Conditioningthechildtoexpectpunishmentwhenhemisbehaves.10. A child who has been physically abused becomes emotionally distorted when told that theparentwillnolongerbeallowedtovisit.Whichprinciple ofsociallearningtheoryismostlikelyforthechilds response?1.Thechildviewstheabusetobemore desirablethantheparentleaving.2.Theparenthasfosteredafearinthe childthatincreaseswhentheyareapart.3.Thechildbelievesthatheisresponsiblefortheparentnow beingpunished.4.Theparenthaslikelytoldthechildthathedeservedtheabuseasapunishment.11. Which nursing intervention supports the principles on which the cross-links theory of agingisbased?1.Applyinganelastinsustainingmoisturizertoanadultpatientsskin2.Assessingapatientsfamilyhistoryforgeneticdiseasesanddisorders

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3.Questioningapatientregardinglong-termexposuretoenvironmentaltoxins4.AssistinganadultpatientisselectingfoodsthatarehighinvitaminsA,C,and E12. The nurse determines that a patient is showing a decline in explicit memory. Whichcharacterizes suchadeficiency?1.Inabilitytorememberhowtooperateacommonkitchenappliance2.Difficultyrememberingthename ofa place visited20yearsago3.Beingunsuccessfulatretainingnewinformation4.Forgettingtheingredientsofafavoriterecipe13. A patient is experiencing distress with midlife transition. Which statement provides supportthatthepatientis successfully managingthis stressor?1.Iwontgiveuponmydreamtoberich.2.Beingrichdoesntnecessarilymakeapersonhappy.3.IllneverberichbutIcansaveenoughtolivecomfortably.4.IwasntbeingrealisticwhenIsetbeingrichasmylifesgoal.14. According to Maslows hierarchy of needs, the nursing strategies a psychiatric nurse wouldusetoassistinmeeting self-esteemneeds ofelderly patientswouldinclude:1.Providingprivacywhenspousesarevisiting2.Arrangingforthespousestodinewiththepatientswhenvisiting3.Includingboththepatientsandspousesinalleducationalsessions4.Attendingtopatienthygieneanddressinpreparationforspousalvisits15. A patient is involved in a smoking cessation program that encourages self-control therapyinterventions.Whichinterventionwouldthenursesuggesttothispatient?1.Limitingtheactofsmoking tocertaintimesof theday2.Keepingabehavioraldiarythattrackswhenthe patientsmokes3.Identifyingthefactorsthatinitiallyencouragedthepatienttostartsmoking4.Makingplansthatinvolvespendingthemoneysavedwhenthesmokingstops16. A 70-year-old male has the nursing diagnosis situational low self-esteem related to forcedretirement. Using Maslows hierarchy of human needs, the nurse is confident the patient ismeetingtheoutcomeofexperiencingself-worthwhenthepatient:1.Movestoasecureapartmentbuilding2.Exercisesregularlywithfriendsatthegym3.Attendshisgrandchildrensschoolfunctions4.Volunteersatthelocalhomelesssheltereachweek

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17. The spouse of a patient recently diagnosed with early stage Alzheimers disease asks, Isthere anything I can do to help delay the progression of this disease? Which strategy has thegreatestpotentialforpreservingtheprotectiveabilitiesofimmunecellsrelatedtothe disease?1.Minimizecontactwiththe publicduringcoldandfluseason.2.Enrollthepatient inanexerciseprogramthatmeetsregularly.3.Providesupplementstoenhancethepatientsimmunesystem.4.Identifycreativewaystokeepthepatientmentallychallenged.MULTIPLERESPONSE1.A nurse is using Piagets model to assess a childs developmental stage. Which behaviorswould determine that a child is successfully achieving the skills required of the formaloperationslevelofdevelopment?Selectall thatapply.1.Becomessadwhenthefamilypetdies2.Plansatriptoattendabasketballgame3.Identifiestwodifferentbowlsthathold1cup4.Selectstheappropriateclothingforaskitrip5.Enjoyssolvingwhatiftypesofwordproblems2.The nurse is assessing a child according to Kohlbergs developmental theory. Whichstatement would support the belief the child is showing appropriate behaviors of thepreconventionalstate?Selectall thatapply.1.IfIpickup mytoys,canIgetan icecreamcone?2.IcantwatchcartoonswhenIdontpickup mytoys.3.Ialwayspickupmytoysbecausemommyneedsmyhelp.4.WhenI pickupallofmytoys Imakemommyvery happy.5.IfIdontpickup mytoys,mommycould triponthemandfall.e3.Which activities should the nurse evaluate in an assessment of an older patientsfunctionalstatus?Selectallthatapply.1.Possessingtheabilitytopreparenutritiousmeals independently2.Havingthefinancialresourcesavailabletoliveindependently3.Performingregular,simplemaintenanceontheirprimaryresidence4.Effectivelytoiletingthemselvesforbothbowelandbladderelimination5.Safelymovingaroundtheirresidencewithoutanincreasedriskforfalls4.Which older adult patients medical conditions appear to support the hypothesis uponwhich the immunologic theory of aging is based? Select all that apply.1.Has, at age64,beendiagnosedwithtype2diabetes2.Hasbeentreatedformultiplesclerosissinceage303.Ismanaginga36-yearhistoryofchronicGravesdisease

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4.Hasbeguntoexperiencesymptomsofrheumatoidarthritis5.Isexperiencingaflareupofceliac disease,whichwasdiagnosedatage265.The nurse manages the care for several older adult patients. Which strategies shows anunderstandingoftheeffectsofagingon cognitivefunction?Selectallthatapply.1.Allowingampletimeforcompletionofpatientactivities2.Breakingcomplicatedpatientactivitiesintosingle tasks3.Planningpatientactivitiesthatcanbe completedratherquickly4.Excludingcomplexproblem-solvingpatientactivitiesinthedailyroutine5.Planningforcomplexpatientactivitiestobe introducedearlyintheday6.Accordingtomostbiologicaltheoriesofaging,predisposingfactorscreatetheaffects seen in aging. Which behaviors are considered predisposing factorsregardingaging?Selectallthatapply.1.Diagnosisofa chronic geneticdisease2.Lackofhealthydietandregularexercise3.Familyhistoryofseveraldifferentcancers4.Occupationthatinvolvedworkingwithtoxins5.Radiationexposurefromnumerousdiagnosticstudies7.The nurse is preparing to educate a group of middle-aged adults on longevity strategies.Whichbehaviors wouldthenursestress?Selectallthatapply.1.Havingwarmand caringpeopleinyourlife2.Engaginginage-appropriateexerciseonaregularbasis3.Acceptingthefactthatagingnegativelyimpactsyourlife4.Seekinghelpifchangesofagingcausedepressionoranxiety5.Avoidingretirementforaslongaspossible inordertokeepactive8.A nurse is working with a group of older adults attending a seminar on the physical andemotionaleffectsofaging.Whichpatientstatementsaregoodpredictorsofpositivewellbeingandperceivedmortality?Selectall thatapply.1.Beingsatisfiedwithgrowingolder2.FeelingyoungerthanmybirthdayssayIshould3.Retirementgives metimetodo thethingsIveputoffdoing.4.Nothavingtodealwiththestressofanymajorchronicillnesses5.AtleastIdonthavetoworry abouthaving enoughmoney to retire.Chapter5:ExaminationandDiagnosisofthePsychiatricPatient

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MULTIPLECHOICE1.A new staff nurse completes an orientation to the psychiatric unit.This nurse will expect toaskanadvancedpracticenursetoperformwhich actionforpatients?1.Performmentalhealthassessmentinterviews.2.Prescribepsychotropicmedication.3.Establishtherapeuticrelationships.4.Individualizenursingcareplans.2.A newly admitted patient diagnosed with major depression has gained 20 pounds over afewmonthsandhassuicidalideation.Thepatienthastakenanantidepressantmedicationfor1weekwithoutremission of symptoms.Selecttheprioritynursingdiagnosis.1.Imbalancednutrition:morethanbodyrequirements2.Chroniclowself-esteem3.Riskforsuicide4.Hopelessness3.A patient diagnosed with major depression has lost 20 pounds in one month, has chroniclow self-esteem, and a plan for suicide. The patient has taken an antidepressant medicationfor 1week.Whichnursinginterventionhas thehighestpriority?1.Implementsuicideprecautions.2.Offerhigh-caloriesnacksandfluidsfrequently.3.Assistthepatienttoidentifythreepersonalstrengths.4.Observepatientfortherapeuticeffectsofantidepressantmedication.4.The desired outcome for a patient experiencing insomnia is, Patient will sleep for aminimumof5hoursnightlywithin7days.Attheendof7days,reviewofsleepdatashowsthepatientsleeps an average of 4 hours nightly and takes a 2-hour afternoon nap. The nurse willdocumenttheoutcomeas:1.consistentlydemonstrated.c.sometimesdemonstrated.2.oftendemonstrated.3.d.neverdemonstrated.5.Thedesiredoutcomeforapatientexperiencinginsomniais,Patientwillsleepforaminimumof 5 hours nightly within 7 days. At the end of 7 days, review of sleep data shows the patientsleepsanaverageof4hoursnightlyandtakes a2-hour afternoonnap.Whatisthenurses nextaction?1.Continuethe currentplanwithoutchanges.2.Removethisnursingdiagnosisfrom theplanofcare.3.Writeanewnursingdiagnosisthatbetterreflectstheproblem.4.Examineinterventionsforpossible revisionofthe targetdate.

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6.A patient begins a new program to assist with building social skills. In which part of the planof care should a nurse record the item, Encourage patient to attend one psychoeducationalgroupdaily?A.AssessmentB.ImplementationC.AnalysisD.Evaluation7.Before assessing a new patient, a nurse is told by another health care worker, I know thatpatient. No matter how hard we work, there isnt much improvement by the time of discharge.Thenursesresponsibility is to:1.documenttheotherworkersassessmentofthepatient.2.assessthepatientbasedon datacollectedfromallsources.3.validatetheworkers impressionbycontactingthepatientssignificantother.4.discusstheworkersimpressionwiththepatient duringtheassessmentinterview.8.A patient presents to the emergency department with mixed psychiatric symptoms. Theadmission nurse suspects the symptoms may be the result of a medical problem. Lab resultsshowelevatedBUN(bloodureanitrogen)andcreatinine.Whatisthenurses nextbestaction?1.Reportthe findingstothehealthcareprovider.2.Assessthepatientfora historyofrenalproblems.3.Assessthepatientsfamilyhistoryforcardiacproblems.4.Arrangeforthepatientshospitalizationonthepsychiatricunit.9.A patient states, Im not worth anything. I have negative thoughts about myself. I feelanxiousand shakyallthetime.Sometimes I feelsosadthatIwanttogoto sleepand neverwakeup.Whichnursinginterventionshouldhavethehighestpriority?1.Self-esteembuildingactivitiesc.Sleepenhancementactivities2.Anxietyself-controlmeasuresd.Suicideprecautions10. Select the best outcome for a patient with the nursing diagnosis: Impaired social interactionrelated to sociocultural dissonance as evidenced by stating, Although Id like to, I dont join inbecauseI dontspeakthelanguageverywell. Patientwill:1.showimproveduseoflanguage.2.demonstrateimprovedsocialskills.3.becomemoreindependent indecisionmaking.4.selectandparticipate inonegroupactivityperday.

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11. Nursing behaviors associated with the implementation phase of nursing process areconcernedwith:1.participatinginmutualidentificationofpatientoutcomes.2.gatheringaccurateandsufficientpatient-centereddata.3.comparingpatientresponsesandexpectedoutcomes.4.carrying outinterventionsandcoordinatingcare.12.Which statement made by a patient during an initial assessment interview should serve asthepriority focus fortheplanofcare?1.Icanalwaystrustmyfamily.2.ItseemslikeIalwayshavebadluck.3.Youneverknowwhowillturnagainstyou.4.Ihearevilvoices thattellmetodobadthings.13.Whichentryinthemedicalrecordbestmeetstherequirementforproblem-orientedcharting?14.A: Pacing and muttering to self. P: Sensory perceptual alteration related to internalauditorystimulation.I:GivenfluphenazineHCL(Prolixin) 2.5mgpoat0900andwenttoroomtoliedown.E:Calmerby0930.Returnedto loungetowatch TV.1.S: States, I feel like Im ready to blow up.O: Pacing hall, mumbling to self. A:Auditoryhallucinations.P:Offerhaloperidol(Haldol)2mgpo.I:Haloperidol(Haldol)2mgpogivenat0900.E: Returnedtoloungeat0930andquietlywatchedTV.1.Agitatedbehavior.D:Patientmutteringtoselfasthoughansweringanunseenperson.A:Givenhaloperidol(Haldol)2mg po andwenttoroomtoliedown.E:Patientcalmer.ReturnedtoloungetowatchTV.1.Pacing hall and muttering to self as though answering an unseen person.haloperidol(Haldol) 2mgpoadministered at0900withcalmingeffectin30minutes.Stated,Imnolongerbotheredby thevoices.14. A nurse assesses an older adult patient brought to the emergency department by a familymember. The patient was wandering outside saying, I cant find my way home. The patient isconfusedandunabletoanswerquestions. Selectthenurses bestaction.1.Recordthepatientsanswerstoquestionsonthenursingassessmentform.2.Askanadvancedpracticenursetoperformtheassessmentinterview.3.Callforamentalhealthadvocatetomaintain thepatientsrights.4.Obtainimportantinformationfromthefamilymember.15.Anurseasks apatient,Ifyouhadfeverandvomitingfor3days,whatwould youdo?Whichaspectof thementalstatus examination isthenurseassessing?1.Behaviorc.Affectandmood2.Cognitiond.Perceptualdisturbances

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16. An adolescent asks a nurse conducting an assessment interview, Why should I tell youanything?Youlljusttellmyparentswhateveryoufindout.Whichresponsebythenurseisappropriate?1.That isnt true. What you tell us is private and held in strict confidence. Your parents havenorighttoknow.1.Yes, your parents may find out what you say, but it is important that they know about yourproblems.1.Whatyousayaboutfeelingsisprivate,butsomethings,likesuicidalthinking,mustbereportedtothetreatmentteam.1.Itsoundsasthoughyouarenotreallyreadytoworkonyour problemsandmakechanges.17. A nurse wants to assess an adult patients recent memory. Which question would best yieldthedesiredinformation?1.Wheredidyougotoelementaryschool?2.Whatdidyouhaveforbreakfastthismorning?3.Canyounamethecurrentpresidentof theUnitedStates?4.Afewminutes ago,Itoldyoumy name.Canyou rememberit?18. When a nurse assesses an older adult patient, answers seem vague or unrelated to thequestions. The patient also leans forward and frowns, listening intently to the nurse. Anappropriatequestionforthenursetoaskwouldbe:1.AreyouhavingdifficultyhearingwhenIspeak?2.HowcanImakethisassessmentintervieweasierforyou?3.Inoticeyouarefrowning.Areyou feelingannoyedwithme?4.YourehavingtroublefocusingonwhatImsaying.Whatisdistractingyou?19. At what point in an assessment interview would a nurse ask, How does your faith helpyouinstressfulsituations?Duringtheassessmentof:1.childhoodgrowthanddevelopmentc.educationalbackground2.substanceuseandabused.copingstrategies20. When a new patient is hospitalized, a nurse takes the patient on a tour, explains rules oftheunit,anddiscusses thedailyschedule. Thenurseisengagedin:1.counseling.c.milieumanagement.2.healthteaching.d.psychobiologicalintervention.21.Afterformulatingthenursingdiagnosesfora newpatient,whatisanursesnextaction?22.Designinginterventionstoincludeintheplanofcare23.Determiningthegoalsandoutcomecriteria24.Implementingthenursingplanofcare25.Completingthespiritualassessment

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22.Selectthemostappropriatelabeltocompletethisnursingdiagnosis:related to feelings of shyness and poorly developed social skills as evidenced bywatchingtelevisionalone athomeeveryevening.1.Deficient knowledgec. Socialisolation2.Ineffectivecopingd.Powerlessness23.QSENrefersto:24.QualitativeStandardizedExcellenceinNursing25.QualityandSafetyEducationforNurses26.QuantitativeEffectivenessinNursing27.QuickStandardsEssentialforNurses24. A nurse documents: Patient is mute despite repeated efforts to elicit speech. Makes no eyecontact. Inattentive to staff. Gazes off to the side or looks upward rather than at speaker.Whichnursing diagnosis shouldbeconsidered?1.Defensivecopingc.Riskforother-directedviolence2.Decisionalconflictd.Impairedverbalcommunication25. A nurse prepares to assess a new patient who moved to the United States from CentralAmericathreeyearsago.Afterintroductions, whatisthenurses nextcomment?1.Howdidyouget totheUnitedStates?2.Wouldyou likeforafamilymembertohelpyoutalkwithme?3.Aninterpreterisavailable.Wouldyoulikeformetomakearequestfortheseservices?1.AreyoucomfortableconversinginEnglish,orwouldyouprefertohaveatranslatorpresent?26.Thenurserecordsthisentryina patientsprogressnotes:PatientescortedtounitbyERnurseat2130.Patientsclothingwasdirty.Ininterviewroom,patient sat with hands over face, sobbing softly. Did not acknowledge nurse or reply toquestions. After several minutes, abruptly arose, ran to window, and pounded. Shoutedrepeatedly, Let me out of here. Verbal intervention unsuccessful. Order for stat dose 2 mghaloperidol PO obtained; medication administered at 2150. By 2215, patient stoppedshouting and returned to sit wordlessly in chair. Patient placed on one-to-one observation.Howshouldthis documentationbeevaluated?1.Usesunapprovedabbreviations2.Containssubjectivematerial3.Toobrieftobeofvalue4.Excessivelywordy5.Meetsstandards

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MULTIPLERESPONSE1.A nurse assessed a patient who reluctantly participated in activities, answered questionswith minimal responses, and rarely made eye contact. What information should be includedwhendocumenting theassessment?Selectallthatapply.1.Thepatientwasuncooperative2.Thepatientssubjectiveresponses3.Onlydataobtained fromthepatientsverbalresponses4.Adescriptionofthe patientsbehaviorduringtheinterview5.Analysisofwhythepatientwasunresponsiveduringtheinterview2.A nurse performing an assessment interview for a patient with a substance use disorderdecidestouseastandardized ratingscale.Whichscalesareappropriate?Selectallthatapply.1.AddictionSeverityIndex(ASI)2.BriefDrugAbuseScreenTest(B-DAST)3.AbnormalInvoluntaryMovementScale(AIMS)4.CognitiveCapacityScreeningExamination(CCSE)5.RecoveryAttitudeandTreatmentEvaluator(RAATE)3.Whatinformationisconveyedbynursingdiagnoses?Selectallthatapply.4.Medicaljudgmentsaboutthedisorder5.Unmetpatientneedscurrentlypresent6.Goalsandoutcomesfortheplanofcare7.Supportingdatathatvalidatethediagnoses8.Probablecausesthatwillbetargetsfornursinginterventions4.A patient is very suspicious and states, The FBI has me under surveillance. Which strategiesshouldanurseusewhengatheringinitialassessmentdataaboutthispatient?Selectallthat apply.1.Tellthepatientthatmedicationwillhelpthistype ofthinking.2.Askthepatient,Tellmeabouttheproblemasyouseeit.3.Seekinformationaboutwhentheproblembegan.4.Tellthepatient,Yourideasarenot realistic.5.Reassurethepatient,Youaresafehere.Chapter6:ClassificationinPsychiatryTestBankMULTIPLECHOICE1.The patient asks the nurse, Ive heard the student nurses talk about the nursing process.Whyistheresomuchemphasisonusingthe nursingprocess?The responsethatexplainstheneedfornursestounderstandandusethenursing process is:1.Doyouthinkyou haveabettermethod wemightuse?

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2.Thenursingprocessisasystematicproblem-solvingmethodencompassingallcomponentsnecessary tocareforpatients.1.Using the nursing process is a way of legitimizing our profession and placing us on anequalfooting withthepuresciences.1.Thenursingprocessisaunidimensional,static,linearapproachusedtoguidenursesastheymakeclinicaljudgments.2.Whenpreparingtoconductanursinghistoryandassessmentonapatienttransferredfrom the emergency department (ED) whose family believes the patient to be aquestionable historian due to cognitive impairment, the nurse initially begins theinterviewby:1.ReviewingtheEDchart2.Contactingtheadmittingphysician3.Directingthequestionstothefamilymembers4.Establishingalineofcommunicationwiththepatient3.The nurse shows the ability to effectively state a nursing diagnosis reflective of theimplicationsofdepressiononapatientslifeprocesseswhenstatinginthepatientsplanofcarethat:1.Patientoutcomeswerepartiallyattained.Implementationofpresentplantocontinue.1.Patient will initiate and support conversation with nurse therapist by (date 3 weeksinfuture).1.Oral medication for anxiety should be administered when depression is assessed to beatthemoderatelevel.1.Impairedverbalcommunicationr/t impoverishedthoughtssecondarytodepressionasevidencedby monosyllabicresponses.4.Whenengaginginoutcomesidentification,thenurse:5.Interviewsandcollectspatient-focuseddata6.Re-assessesthepatientsphysicalandemotionalstatusevaluation7.Reviewsthepatientsexistingproblemsandprojectstheresultsofthenursingcare1.Considersthepatientspresentingsymptomsandidentifiesnursing-relatedproblems5.While discussing assessment of suicidal patients, a novice nurse mentions, I was taught toalways base my care on concrete, evidence-based scientific reasoning and never to rely onintuition. Which response by the experienced nurse shows understanding of intuitivereasoning?1.Thats wise, because intuition went out of favor with the scientific revolution. 2. Criticalthinkingandintuitionareatoppositepoles.Keep relying onyourexpertise.

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Itspossiblethatintuitionaboutsuicidalityisgeneratedbytransferoffeelingsfromthepatienttothenurse.1.Itsbeendeterminedthat intuitionisnothingmorethatextrasensoryperception,sosomefolks haveit, andsomedont.6.Anurseshowseffectivecriticalthinkingskillsdirectedtowardsnursingcareofacognitivelyimpairedpatientwhocontinuestosociallyisolateby:1.Clearlystatingthatthepatientmustsociallyinteractoncedaily2.Documentingthatthepatientcontinuestoresistsocialization3.Askingthepatienttoidentifywhichunitactivitytheyarewillingtoattend4.Suggestingthatstafftakethepatientwiththemwhenrunningerrandsofftheunit7.A depressed patient shares with the nurse that he, has been thinking about ending it all.BasedonNANDArecommendations, thenurse:1.Implementssuicideprecautionsforthispatient2.IncludesRiskforSelfHarmtothepatientscareplan3.Documentsregardingthe patientssafetyevery15minutes4.Reviewsthepatientschartforreferencestopastincidencesofhopeless8.Thenurseshowsanunderstandingoftheappropriateuseofnursingoutcomesregardingtriggersfora patientdiagnosedwithchronic alcoholabusewhenstating:1.Canyouworkonidentifyingthreesituationsthatcauseyoutoabusealcohol?2.Illhelpyoutoidentifythreetriggersforyourdrinkingduringtodayssession.3.Impleasedyouveidentifiedthreesituationsthattriggeryourabuseofalcohol.4.Doyouthinkyouwillbeabletoavoidthethreetriggersthatcauseyoutodrink?9.Whenapatientexperiencingacutedepressionaskswhatthedifference isbetweenamedicalandanursingdiagnosis, thenurserespondsbestwhenstating:1.Actuallytheyareverysimilarinthattheybothare concernedwithhelpingyougetbetterandleadahappierlife.1.Medicaldiagnosesarefocusedonwhyyouaredepressedwhereasnursingdiagnosesareconcernedaboutmaking yourlifeless sad.1.Nursingdiagnosesaremore directedatcaringforyou,unlikemedicaldiagnosesthatfocusonfinding thecauseforyourproblem.1.Themedicaldiagnosisidentifiesthatyouareexperiencingdepressionwhereasthenursingdiagnosisidentifies howthedepressionisaffectingyou.10.Anursebestshowsanunderstandingofthe roleofevidence-basedresearchinachievingtherapeuticpatientcareoutcomeswhen:1.Subscribingtoandreadingamonthlypsychiatricresearchnursingjournal2.Working on a committee to revise current facility policies regarding the use ofchemicalrestraints

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1.Registeringtoattendapsychiatricworkshoponnewlydevelopedpsychotropicmedication therapies1.Askinganexperienced staffmembertoreviewtheinterventionsbeingproposedforanewly admittedpatient11.Whencaringforapatientadmittedwithadiagnosisifbipolardisorder,managed careregulationsisthedrivingforcebehindthenursesuseof:1.NANDAnursingdiagnoses2.Short-termstressmanagementtherapy3.Aspecialized clinicalpathwayforsuchpatients4.Genericinsteadofbrandnamemedications12.Abenefitoftheimplementationofclinicalpathwaysisevidencedwhenthe patientstates:13.Iknowmydoctorsandnursesreallycareaboutme.14.Mymedicationhasreallyhelpedlessenmysymptoms.15.IhavehopesthatIwillbeabletoleadaproductive,healthylife.16.Mycareteamhasreallyhelped memanagemostofmyproblems.13.Anurseshowsthebestunderstandingofthelegalimportanceofthepatientschartwhenstating:1.You always document in ink and never erase or use white out in the nursingnotes.1.Itsadocumentthatshowsproofthatthepatientreceivedcarethatmettheexpectedstandards.1.Patientchartsarecarefullyprotectedfromunlawfulaccessbyinappropriateindividualsor institutions.1.Thepatienthasalegalrighttotheinformationcontained inthe chartbutnottheoriginaldocumentationitself.14.Thenursebestfulfillstheobligationtobeaccountableforprovidingcarethatmeetstheexpectedstandards ofcarewhen:1.Developingatherapeuticrelationswiththe patient2.Applyingevidence-basednursingpracticetotheplanofcare3.Providingappropriatedischargeplanningtomeetthepatientsneeds4.Evaluatingtheeffectivenessofinterventionsthroughachievementofoutcomes15.Thenurseassesses apatientsjudgmentbyasking:16.Whydidyou runaway?17.Whendidyoufirststarthearingvoices?18.Whatwouldyoudoifyousmelledsmokeinyourhome?19.Doyoubelieveyou hearvoices,ordoyouthinkitisinyourmind?

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16.Thenurseresponsibleforthecare planofapatientdiagnosedwithcognitiveimpairmentincludes rationalesforthenursinginterventionsprimarilyto:1.Provideameansforoutcome evaluation2.Accountfor thereasoningthatdrivesthenursingactionSupportthepatientssuccessinachievingtheexpectedoutcome4.Provideinformationtoaide inthe implementationofthenursingaction17.A patient who has a nursing diagnosis of ineffective coping related to ineffectiveproblemsolvinghasbeeninvolvedintreatmentfor6months.Thenursedeterminesthattheplannedinterventions requirerevisionwhenthepatientstates:1.Ireallydontthinkmypsychiatristactuallyhelpsme.2.IcantdecideifIshouldgetmyownapartmentornot.3.IcantacceptthatIwillneverbeabletocomfortablymakedecisions.4.IdontthinkImliked wellenoughtoseekelectionasacommitteechairperson.18.To best facilitate interdisciplinary communication regarding the plan of care for apatientdiagnosedwithparanoidschizophrenia,thenurse:1.Requiresweeklymeetingsofthecareteam2.Ensurestheteamincludesmembersfromallappropriatedisciplines3.UsesthestandardizedNICclassificationsystemofcareinterventions4.Recognizestheneedforteamaccesstopatientrecordsandmakes themavailable19.Whenreviewingthehistoryofanewlyadmittedpatientdiagnosedwithseverechronicdepression,thenurseismostconcernedaboutpatientsafetyissues whennoting:1.ThepatientsAxisIIincludesadiagnosisofmentalretardation2.Documentationthatthepatient hasbeennoncompliant regardingmedications3.The patients current Global Assessment of Functioning (GAF) Scale rating is 94.Referencetoarecent physicalinjuryresultingfromthepatientsimpulsivebehavior20.Anappropriatenursingdiagnosisforapatientwhomanifestsapsychologicalproblemthrough frequent expressions of unfounded or excessive guilt or shame, states that he isunabletodeal withsituations,andhasahesitationtotrynew thingswould be:1.Hopelessness2.Powerlessness3.Ineffectivecoping4.Chroniclowself-esteem

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21.Awell-statedoutcomecriteria forapatientwitha nursingdiagnosisofriskforlonelinessrelatedto socialisolationwould includeThepatientwill:1.Nolongerexperiencelonelinessbytheendofthe fifthdayofhospitalization.2.Agreetoattendtwoon-unit,staff-directed groupsessionsdaily.3.Continuetomaintainsocialsolitude50%ofthetime.4.Interactwithapeeronadailybasisbydischarge.22.Careplanningforapatientdiagnosedwithparanoidschizophreniawillinclude:23.Analyzingeffectivenessofcareprovided24.Determiningthepatientsneedsandproblems25.Establishingrealisticpatient-focusedoutcomecriteria26.Identifyingprioritiesofcare basedonthepatientscondition23.Theexpertnurseisconfidentthatthenovicenurseunderstandstheprinciplesthatguidetheplanningofpatientcareinterventions whenthe:1.Novicenurseasksthepatienttoidentifytheirprimaryconcerns2.Patientsuccessfullyachievestheagreeduponnursingoutcomes3.Expertnurserequeststhatthenovicenurseobserveseveralcareplanningsessions1.Novice nurse includes interventions that are supported byevidence-basedpracticesChapter7:SchizophreniaSpectrumandOtherPsychoticDisordersMULTIPLECHOICE1.Anewlyadmittedpatienthasthediagnosisofcatatonicschizophrenia.Whichbehaviorobservedinthepatientsupportsthatdiagnosis?1.Usesarhymingformofspeech2.Refusestoeatanyunwrappedfoods3.Laughswhenwatchingasadmovie4.Maintainsanimmobilizedstateforhours2.Whatwouldbeanappropriateshort-term outcomefora patient diagnosedwithresidualschizophreniawho exhibits ambivalence?1.Decidetheirowndailyschedule.2.Decidewhichunitgroupstheywillattend.3.Choosewhich clinicstaffmembertoworkwith.4.Choosebetweentwooutfits toweareachmorning.3.Whatisthe prioritynursingdiagnosisforacatatonicpatient?4.Ineffectivecoping5.Impairedphysicalmobility

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6.Impairedsocialinteraction7.Riskfordeficientfluidvolume4.Whichnursingdiagnosisisappropriate forapatientwhoinsistsbeingcalledYourHighnessanddemonstrateslooselyassociatedthoughts?1.Riskforviolence2.Defensivecoping3.Impairedmemory4.DisturbedthoughtprocessesWhichinitialshort-termoutcomewouldbeappropriateforapatientwhowasadmittedexpressingdelusionalthoughts?1.Acceptthatdelusionisillogical.2.Distinguishexternalboundaries.3.Explainthebasisforthedelusions.4.Engageinreality-orientedconversation.6.Whichofthefollowinginterventionsshouldthenurseplantousetoreduce patientfocusondelusionalthinking?1.Confrontingthedelusion2.Refutingthedelusionwithlogic3.Exploring reasonsthepatienthasthedelusion4.Focusingonfeelingssuggestedbythedelusion7.Whichassessmentobservationsupportsapatientsdiagnosisofdisorganizedschizophrenia?8.Reportssuicidalideations9.Lastrelapsewas 6yearsago10.Consistentinappropriatelaughing11.Believesthatthegovernmentisouttogetme8.Apatienttriedtogougeouthiseyeinresponsetoauditoryhallucinationscommanding,Ifthineeyeoffendsthee,pluckitout.Thenursewouldanalyzethisbehavior asindicating:1.Derealization2.Inappropriateaffect3.Impairedimpulsecontrol4.Inabilitytomanageanger9.Anappropriateinterventionforapatientwithanidentifiednursingdiagnosisofsituational lowself-esteemwouldbe:1.Providinglargemuscleactivitiestorelievestress

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2.Attemptingtodeterminetriggerstohallucinations3.Engagingpatientinactivitiesdesigned topermitsuccess4.Encouragingverbalizationoffeelingsinasafeenvironment10.A 19-year-old patient is admitted for the second time in 9 months and is acutelypsychotic with a diagnosis of undifferentiated schizophrenia.The patient sits alone rubbingherarmsandsmiling.Shetellsthenurseherthoughtscauseearthquakesandthattheworldisburning.The nurseassessestheprimarydeficitassociatedwiththepatientsconditionas:1.Socialisolation2.Disturbedthinking3.Alteredmoodstates4.Poorimpulsecontrol11.A patient has been admitted with disorganized type schizophrenia. The nurse observesbluntedaffectandsocialisolation.Heoccasionallycursesorcallsanotherpatientajerkwithoutprovocation.Thenurseasksthepatienthowhe isfeeling,andheresponds,Everybodypickson1.Theyfrobitzme.The patientscommunicationexhibits:2.Aneologism3.Looseassociations4.Delusionalthinking5.Circumstantialspeech12.A patient has been admitted with disorganized type schizophrenia. The nurse asks thepatient how he is feeling, and he responds, Everybody picks on me. They frobitz me. The bestresponseforthenursetomakewouldbe:1.Thatsreallytoobadthatyouarebeing treatedthatway.2.Whodoyoumeanwhenyousayeverybody?3.Whatdifferencedoesfrobitzingmake?4.Whydotheyfrobitz?13.Whichpatient behaviorwouldsupportthediagnosisofresidualschizophrenia withnegativesymptoms?1.Communicatingusingonlyrhymingphases2.Claimsthatwormsarecrawlinginmybrain3.Maintainingbotharmssuspendedawkwardly overhead4.Showsnoemotionwhentellingthestoryofasistersrecentdeath14.Bydischarge,whichoutcome isappropriateforapatientwhohearsvoicestellinghimheisevil?1.Respondverballytothe voices.2.Verbalizethereasonthevoicessayheisevil.

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