Deck 35: Care of the Patient with a Psychiatric Disorder

Question 1

When the adolescent begins to demonstrate lack of energy and motivation and withdraws,complaining of multiple physical problems,it may be that this is the beginning of a stage of schizophrenia called:

A) prepsychotic.
B) residual.
C) acute.
D) prodromal.

Answer 1

prodromal.

Question 2

A home health nurse cautions the patient taking lithium that she should be sure to:

A) examine her skin closely for eruptions.
B) take her blood pressure twice a day to check for hypertension.
C) have her drug blood level checked every month.
D) avoid aged cheese and red wine.

Answer 2

have her drug blood level checked every month.

Question 3

When a patient who introduces herself as a famous movie star and treats everyone and everything in the environment as if it were a movie set,the nurse documents this behavior as:

A) fantasy ideation.
B) delusional thinking.
C) fixation syndrome.
D) imaginary wishes.

Answer 3

delusional thinking.

Question 4

The Diagnostic and Statistical Manual,4th edition,text revision (DSM-IV-TR),is used by most hospitals and is the current tool used to examine mental health and illness.This tool is a(n):

A) holistic system.
B) hierarchical system.
C) multiaxial system.
D) evaluation system.

Question 5

The nurse alters the care plan for a patient with depression to include activities such as a:

A) domino game with three other patients.
B) Ping-Pong game with one other patient.
C) group outing to view wildflowers.
D) magazine to read alone.

Question 6

The nurse observes a patient's behavior to assess thought process disorders characterized by bizarre,nonreality thinking.This behavior is indicative of the most profound,disabling mental illness,which is:

A) manic depressive.
B) schizophrenia.
C) paranoia.
D) bipolar.

Question 7

When the nurse cautions a patient to watch his step,the nurse assesses evidence of concrete thinking when the patient:

A) fixedly begins to watch his feet.
B) immediately examines his watch.
C) begins to watch the nurse's feet.
D) stands rigidly in one place without moving.

Question 8

When all five axes of the Diagnostic and Statistical Manual,4th edition,text revision (DSM-IV-TR)are used,it provides an assessment approach to comprehensive care called:

A) personalized.
B) individualized.
C) holistic.
D) organic.

Question 9

A patient believes himself to be the president of the United States and that terrorists are trying to kidnap him.The nurse records these observations as:

A) absent behaviors.
B) positive behaviors.
C) negative behaviors.
D) false behaviors.

Question 10

The nurse is caring for a patient with a diagnosis of catatonic schizophrenia.The behavior consistent with this diagnosis is the patient:

A) talks excitedly about going home.
B) suspiciously watches the staff.
C) stands on one foot for 15 minutes.
D) states he has a cat under his bed that talks to him.

Question 11

The nurse discussing the differences between a patient with a neurosis and one with a psychosis explains that the patient experiencing neurosis:

A) experiences a flight from reality.
B) usually needs hospitalization.
C) has insight that there is an emotional problem.
D) has severe personality deterioration.

Question 12

When the patient with a psychosis is thought to be a danger to self or others,the admission to the hospital is by:

A) probating.
B) voluntary.
C) physician's order.
D) family request.

Question 13

For the past 3 weeks,the nurse has observed a patient interacting with staff and other patients,helping decorate the dining room for a party,and leading the singing in the activity room.Today,the patient tearfully refuses to dress or get out of bed.The nurse recognizes these behaviors as evidence of:

A) unipolar depression.
B) dysthymic disorder.
C) hypomanic episode.
D) bipolar disorder.

Question 14

A patient admitted for delirium demonstrates increased disorientation and agitation only during the evening and nighttime.The nurse documents this as:

A) evening.
B) nighttime.
C) bedtime.
D) sundowning.

Question 15

When a young man with malaria spikes a temperature of 105° F and begins to hallucinate,the nurse assesses this as:

A) delirium.
B) a psychotic break.
C) a possible stroke.
D) an anxiety disorder.

Question 16

The nurse recognizes that researchers have identified that hereditary factors account for what percentage of mood disorders?

A) 10% to 15%
B) 20% to 30%
C) 35% to 50%
D) 60% to 80%

Question 17

The nurse clarifies that dementia is a slow,progressive loss of brain function,which is an organic mental disease secondary to:

A) chemical imbalance.
B) emotional problems.
C) circulatory impairment.
D) cerebral disease.

Question 18

If the nurse asks a patient with schizophrenia if any visitors came on Sunday,the response that indicates loose association is:

A) "No."
B) "Yes! I had 90 visitors who came from every state in the union."
C) "Sunday is the Sabbath.Do we have visitors on the Sabbath?"
D) "We visited Yellowstone Park last summer."

Question 19

The patient talks with his dead brother and arranges furniture so that his brother will have a place to sit.The nurse documents this behavior as:

A) disordered thinking.
B) anhedonia.
C) hallucination.
D) alogia.

Question 20

The nurse recognizes during her assessment of schizophrenic individuals that they can exhibit positive or negative behaviors.The positive behaviors may be delusions,hallucinations,and disordered thinking.The prognosis for these patients is:

A) guarded.
B) poor.
C) good.
D) repeatable.

Question 21

A 14-year-old survivor of a school shooting screams and dives under a table when firecrackers go off.The nurse recognizes this behavior as a manifestation of:

A) phobia.
B) post-traumatic stress disorder.
C) obsessive-compulsive disorder.
D) disordered thinking.

Question 22

The patient complains of recurrent,multiple physical ailments for which there is no organic cause.The nurse assesses this behavior as:

A) obsessive-compulsive disorder.
B) phobia anxiety disorder.
C) somatoform disorder.
D) delusional disorder.

Question 23

Adjunctive therapies are used for which reason(s)? (Select all that apply.)

A) To increase self-esteem
B) To promote interaction
C) To enhance reality orientation
D) To stimulate communication
E) To increase energy

Question 24

The nurse explains that an alternative therapy that uses essential oils and scented candles to help a patient relax and focuses on the atmosphere of the moment is ______________.

Question 25

The patient is concerned about confidentiality and asks the nurse not to tell anyone what is said.The nurse's best response is:

A) "I am required to report any intent to hurt yourself or others."
B) "Conversations between patient and nurse are confidential."
C) "What we say can be secret.What I write in the chart is available to the health team."
D) "I can't help you unless you trust me."

Question 26

The nurse recognizes that a severe form of self-starvation that can lead to death is called:

A) bulimia nervosa.
B) anorexia nervosa.
C) teenage nervosa.
D) obesity nervosa.

Question 27

A patient who is taking a monoamine oxidase inhibitor (MAOI)asks the nurse about the addition of St.John's wort to help with his depression.The nurse's best response is:

A) "That is a great idea. Alternative therapies can be very helpful."
B) "You will feel better sooner if you include phenylalanine."
C) "Did you know that St.John's wort can raise your blood pressure dramatically?"
D) "You need to speak to your physician about that."

Question 28

The nurse preparing a patient for a scheduled appointment for electroconvulsive therapy (ECT)reminds the patient to:

A) drink plenty of fluids before ECT to ensure adequate hydration.
B) bring a change of clothes in case of incontinence.
C) be prepared for visual disturbances after the treatment.
D) arrange for transportation to and from the appointment.

Question 29

The nurse recognizes that electroconvulsive therapy (ECT)treatments will generally be scheduled for:

A) 3 treatments over 10 weeks.
B) 6 treatments over 2 months.
C) 8 treatments over 6 weeks.
D) 10 treatments over 7 weeks.

Question 30

A long-term and intense form of psychotherapy developed by Sigmund Freud that allows a patient's unconscious thoughts to be brought to the surface is called:

A) adjunctive.
B) behavior.
C) psychoanalysis.
D) cognitive.

Question 31

The nurse instructs a patient who has just been prescribed a protocol of fluoxetine HCl (Prozac)that the drug takes ____ to ____ weeks to take effect.

Question 32

The nurse is assessing a patient who has become rapidly and exceedingly anxious because her fingernail polish is chipped.If the patient has remained in a prolonged state of anxiety,the nurse concludes the patient is demonstrating:

A) signal anxiety.
B) general anxiety.
C) anxiety traits.
D) panic disorder.

Question 33

A patient is frequently late for appointments because he goes back to his room numerous times to assure himself that none of his belongings have been stolen.The nurse recognizes this behavior as:

A) senseless behavior.
B) controlled repetition.
C) obsessive-compulsive.
D) anxiety tension.

Question 34

When a patient demonstrates accelerated heart rate,trembling,choking,and chest pain along with acute,intense,and overwhelming anxiety,the nurse recognizes the patient is most likely experiencing:

A) terror.
B) fright.
C) fear.
D) panic.

Question 35

The nurse is told that a patient believes he was born into the wrong body.The nurse recognizes this desire to have the body of the opposite sex as:

A) homosexuality.
B) transsexualism.
C) heterosexuality.
D) bisexuality.

Question 36

When a patient is experiencing a panic attack,the nurse coaches the patient in:

A) reality orientation.
B) decision making.
C) rational thought.
D) deep breathing.

Question 37

The home health nurse assesses a patient who creates elaborate excuses for not leaving home.Further questioning reveals the patient had not left home for 6 months.The nurse documents these findings as:

A) mania.
B) depression.
C) agoraphobia.
D) anxiety.

Question 38

The nurse recognizes that a woman who has experienced physical abuse and has inadequate income to care for herself and her family would be categorized under Axis ______.

Question 39

The nurse recognizes that stress can cause an ulcer,which is classified as a _______________ illness.