Deck 57: Nursing Care of Patients With Mental Health Disorders

Question 1

A patient hospitalized for bipolar disorder is sitting in the corner of the room with the lights off and staring into space. Three hours later, the patient is in the same position. Which statement by the nurse is appropriate?

A)"Cheer up! Come on out and join us in a game!"
B)"Come with me. I'd like you to join our group for a while."
C)"You won't make any progress if you stay in your room all the time."
D)"What's the matter? Don't you know you should be in your group right now?"

Answer 1

"Come with me. I'd like you to join our group for a while."

Question 2

A patient with schizophrenia is returning from a computerized tomography (CT) scan of the brain followed by an electroencephalogram. Which diagnostic test findings does the nurse identify as supporting this patient's diagnosis? (Select all that apply.)

A)Enlarged ventricles
B)Reduced amount of gray matter
C)Areas of nerve demyelinization
D)Aneurysms of the cerebral vessels
E)Diminished prefrontal cortex activity

Answer 2

Enlarged ventricles
Reduced amount of gray matter
Diminished prefrontal cortex activity

Question 3

The nurse has a coworker who becomes extremely upset when any spider is noticed, regardless of the size or type. Which characteristic of the coworker's phobia is untrue?

A)The coworker's fear is irrational.
B)The fear results from displacement.
C)The coworker's fear can be controlled.
D)The spider is a symbol of the real fear.

Answer 3

The coworker's fear can be controlled.

Question 4

The nurse is providing care for a patient with symptoms of tardive dyskinesia from major tranquilizers. Which treatment does the nurse anticipate?

A)Use of anticholinergic agents
B)Use of muscle relaxant agents
C)Discontinuance of the tranquilizers
D)Addition of rational emotive therapy

Question 5

A patient is self-admitted to a mental health facility for "problems related to military service." The nurse is collecting information for the patient's plan of care. Which behavior will prompt the nurse to immediately notify the RN or HCP?

A)Patient adamantly denies thoughts of suicide or self-harm.
B)Patient displays hypervigilant behavior and has hand tremors.
C)Patient begins to shout and cry in response to the nurse's questions.
D)Patient refuses to participate in activities with other patients in the unit.

Question 6

The nurse is making a home visit to an older adult patient who requires a dressing change for a recent surgery. The nurse notices that the patient seems unusually confused and disoriented. Which assessment is most likely to aid the nurse in making a determination for the patient's change in mental status?

A)Check the patient's surgical incision for signs of infection.
B)Determine if the patient is eating meals and drinking fluids.
C)Ask the patient specific questions to determine orientation.
D)Ask about the patient's ability to get adequate rest and sleep.

Question 7

The nurse is assisting in the preparation of an educational seminar on anxiety disorders. Which anxiety disorders does the nurse make sure are included in this presentation? (Select all that apply.)

A)Phobia
B)Panic disorder
C)Schizophrenia
D)PTSD
E)OCD

Question 8

The spouse of an older patient is concerned because, since retiring, the patient sits around the house, avoids eating, naps, and refuses to participate in sporting activities. Which disorder does the nurse recognize as being associated with these manifestations?

A)Depression
B)Bipolar disorder
C)Conversion disorder
D)Post-traumatic stress disorder (PTSD)

Question 9

A patient who experienced injuries from a motor vehicle crash 6 months ago continues to request prescriptions for an opioid analgesic. When assessing this patient for opioid dependency which finding is the nurse least likely to observe?

A)The patient drops out of a Saturday night bingo group.
B)The patient continues to manage to get to work each day.
C)The patient tried to quit using but was unable to stop thinking about it.
D)The patient is seeing multiple physicians to obtain new prescriptions.

Question 10

The nurse is assisting with a patient who is newly diagnosed with diabetes mellitus and is prescribed insulin. The patient voices a fear of needles and nearly faints when the insulin needle is uncapped. When the registered nurse (RN) suggests a process of desensitizing, which action does the nurse initiate?

A)Allow the patient to look at and describe an uncapped syringe.
B)Inquire about a family member who may be able to give the insulin.
C)Suggest that the patient may need to arrange for home nursing services.
D)Explain the condition to the health care provider (HCP) and ask if alternate treatment is possible.

Question 11

The nurse is assisting at a health fair being held in a community center for older adults. Screenings are being performed for suicide risk. Which participant does the nurse identify as being at highest risk for suicide?

A)A female who just retired from a career who is planning to travel
B)A male who laughs about how badly he and his friends play golf
C)A widow who shares how she visits grandchildren on the computer
D)A widower who said he recently bought a new gun, but does not hunt

Question 12

A patient who is withdrawing from alcohol is restless and reports seeing snakes on the ceiling. Vital signs are blood pressure 180/100 mm Hg, pulse 92 beats/min, and respirations 22 breaths/min. Which action does the nurse perform first?

A)Teach the patient a relaxation technique.
B)Administer a dose of lorazepam (Ativan).
C)Search the patient's room for hidden alcohol.
D)Administer an antihypertensive agent as ordered.

Question 13

The nurse is assisting with data collection on a patient newly diagnosed with schizophrenia. Which observations does the nurse consider as being positive symptoms of schizophrenia? (Select all that apply.)

A)Alogia
B)Apathy
C)Delusions
D)Hallucinations
E)Social isolation

Question 14

The nurse works on a mental health unit and is assisting with data collection from a patient just admitted through the court system with a diagnosis of personality disorder. Which comment by the patient is unexpected in regard to the diagnosis?

A)"Listen, I will buy what I want from anyone I want!"
B)"That judge will find out who I am-I know people."
C)"I was shocked to be sent here and need to control myself."
D)"My wife or kids will get out of here-they do what I say."

Question 15

The nurse is collecting data from a patient in an HCP's office. The patient was recently diagnosed with a chronic respiratory disorder and states, "I just cannot seem to enjoy any activity anymore." The patient's clothes are baggy and wrinkled, and the patient reports an inability to sleep. Which question does the nurse need to ask first?

A)"Do you think about hurting yourself?"
B)"What do you do that makes you happy?"
C)"What do you think is happening to you?"
D)"Have you considered getting counseling?"

Question 16

The nurse is reviewing potential patient teaching needs. For which prescribed medications does the nurse plan to reinforce instructions to follow a tyramine-free diet? (Select all that apply.)

A)Phenelzine
B)Buspirone
C)Isocarboxazid
D)Valproic acid
E)Lithium carbonate

Question 17

The nurse is assisting in the care of a patient admitted to a special unit for patients with eating disorders. Which nursing intervention is aimed at successful treatment?

A)Remove all mirrors from the unit.
B)Measure out the food that is to be eaten.
C)Avoid a weight check until time for discharge.
D)Deny access to a bathroom following a meal.

Question 18

A patient with schizophrenia calls the nurse into the room and says, "Help me! The books are on fire!" Which response by the nurse is best?

A)"I'll get some water and put it out."
B)"How do you think the fire got started?"
C)"Is there a reason your books are on fire?"
D)"I don't see any fire. Let's go to dinner now."

Question 19

The nurse is working with a patient diagnosed with obsessive-compulsive disorder (OCD) manifested by frequent handwashing. The nurse notes the patient's hands are severely dried and chapped. Which action by the nurse is contraindicated with this patient?

A)Supply the patient with a healing lotion.
B)Ask the patient what is causing the behavior.
C)Provide the patient with gentle soap and soft towels.
D)Make sure the patient has easy access to a sink and water.

Question 20

A patient who just completed an alcohol treatment program is prescribed disulfiram to help maintain sobriety. Which teaching is most important for the nurse to review with the patient?

A)Avoiding alcohol for 24 hours after taking the medication
B)The reactions that will occur if the patient ingests alcohol
C)Contacting the HCP if the patient contracts a cold or illness
D)Which nonmedication products should also be avoided