Deck 55: Psychiatric Disorders

Question 1

A patient who is admitted with PTSD says he had a very stressful experience when in high school and has never really recovered.Appropriate nursing action would be to:

A) Encourage the patient to talk about what caused the traumatic event.
B) Guide the patient in relaxation techniques to distract him when flashbacks occur.
C) Provide sleeping medication so that he can sleep at night.
D) Allow the patient to talk about his condition as often as he likes.

Answer 1

Guide the patient in relaxation techniques to distract him when flashbacks occur.

Question 2

A patient with schizophrenia has undergone eight electroconvulsive therapy treatments (ECTs)in the last 2 weeks.The daughter is upset that her parent is lethargic,confused,and does not recognize her.The nurse's response is based on the knowledge that:

A) The combination of ECTs and neuroleptic medications can make a patient drowsy.
B) These reactions indicate of a drug overdose.
C) Many patients with schizophrenia punish their families by pretending not to know them.
D) A temporary memory loss is common after several ECTs.

Answer 2

A temporary memory loss is common after several ECTs.

Question 3

One of the long-time patients with schizophrenia in the inpatient unit has developed involuntary movements of his tongue.The nurse assesses that this patient has developed:

A) Acute dystonic reaction
B) Tardive dyskinesia
C) Neuroleptic malignant syndrome
D) Laryngospasm

Answer 3

Tardive dyskinesia

Question 4

A patient given anxiolytic medications for his mental disorder is being treated using a(n)_______________ approach.

A) Analytical
B) Interpersonal
C) Biologic
D) Psychoanalytic

Question 5

When a patient says that he often feels restless,has a tight sensation in his chest,and has an increased heart rate at times,the nurse suspects that the patient has:

A) Anxiety disorder
B) Panic disorder
C) Agoraphobia
D) Obsessive-compulsive disorder

Question 6

The nurse instructor assures students taking their first major examination that many of them are experiencing:

A) Posttraumatic stress disorder (PTSD)
B) Panic disorder
C) Mild anxiety
D) Moderate anxiety

Question 7

A patient admitted with a conversion disorder after an automobile accident insists he is paralyzed,although no physical cause for his paraplegia can be found.When the patient asks the nurse to push him to his room,the nurse's best response would be:

A) "There is nothing wrong with your arms. Roll yourself to your room."
B) "I will help you to walk to your room. I know you can walk."
C) "Let me lift the foot rests so you can move your chair with your feet."
D) "OK. I am going that way myself."

Question 8

A patient with bipolar disorder is being treated with tricyclic medications.As part of the patient teaching information concerning its side effects,the nurse tells the patient to expect:

A) Orthostatic hypotension
B) Hypercholesterolemia
C) Fatigue
D) Blurred vision

Question 9

For a patient who is hyperactive with mania and has a nursing diagnosis of "Nutrition,altered,less than body requirements,related to hyperactivity," the nurse would add to the implementations:

A) Offer nutritious finger foods and high-protein milk shakes to eat on the go.
B) Spoon feed the patient while he or she is seated at the table.
C) Arrange for one large meal at noon to be eaten in the company of others.
D) Limit fluid intake to make the patient hungry at mealtime.

Question 10

The nurse explains that the probable causes of mood disorders include all of the following except:

A) Loss of significant others
B) Learned helplessness
C) Neurotransmitter dysregulation
D) Traumatic event in childhood

Question 11

A patient is brought in from the emergency department after telling the physician that he is a relative of the president of the United States.He says that he should not be detained,because he has important business to attend to that involves national security.He is dressed in a bright coat with plaid pants and gets very angry when you try to question him.This patient is experiencing a(n):

A) Panic attack
B) Hyperactive episode
C) Extrapyramidal effect
D) Manic episode

Question 12

A patient states that he feels angry at work for no reason and often yells at his coworkers.The therapist asks the patient to describe events,and then tells the patient to try different strategies to cope with these angry outbursts.This would be an example of a(n)___________________ approach.

A) Biologic
B) Analytical
C) Cognitive or behavioral
D) Interpersonal

Question 13

The nurse speaking to a patient who is depressed says,"So what you are saying is that you are feeling very sad today." This would be an example of:

A) Listening
B) Sharing observations
C) Clarifying
D) Being available

Question 14

A nursing diagnosis that would be appropriate for all patients with an anxiety,a somatoform,or a dissociative disorder would be:

A) Altered nutrition, less than body requirements
B) Disturbed body image
C) Ineffective denial
D) Ineffective coping

Question 15

When performing a mental status examination,the nurse notes that the patient keeps repeating,"I didn't do it.I didn't do it.I didn't do it." This response would be an example of which one of the components of the mental status examination?

A) Appearance
B) Mood and affect
C) Thought content
D) Memory and attention

Question 16

To listen therapeutically to the patient,the nurse should try to:

A) Concentrate on the patient and not think of responses to the patient while he or she is speaking.
B) Determine the cause of the patient's problem while the patient is speaking.
C) Ask the patient why he thinks he feels the way he does.
D) Tell the patient that you have had similar experiences.

Question 17

When the patient who is receiving large doses of chlorpromazine (Thorazine)began to exhibit extrapyramidal signs of involuntary muscle movement,the nurse anticipates that _________ drugs will be added to the protocol.

A) Antiparkinsonian
B) Antihypertensive
C) Anticonvulsant
D) Antiemetic

Question 18

The patient who went away to college in September returns in October,thinking that he is a drummer in a popular rock band.The nurse assesses this as a manifestation of:

A) Dissociative disorder
B) Conversion disorder
C) Schizophrenia
D) Amnesia

Question 19

The combination of medications that could be used to treat an anxiety disorder is:

A) Librium and Xanax
B) Effexor and Ativan
C) Effexor and Haldol
D) Klonopin and Valium

Question 20

The patient says,"I just don't think I can keep going on.I just want it all to end." The nurse assesses that this patient has suicidal ideation.Your best response is:

A) "Do you have any thoughts of harming yourself?"
B) "Have you felt like this before?"
C) "You are just depressed. Once you feel better, you won't think that way."
D) "We will keep you safe here."

Question 21

The nurse reminds the family of a patient who experiences delirium that some common causes are:

A) Overuse of steroids
B) Liver abnormalities
C) Parkinson disease
D) Neoplasms

Question 22

While in the dayroom,one of the patients becomes very agitated and begins to threaten to harm the other patients and is directing violence at the other patients and staff.Appropriate nursing implementations include:

A) Decreasing the stimuli, and using restraints if all other measures fail.
B) Offering to call the physician, and asking another staff member to call security.
C) Removing harmful objects, and trying to perform relaxation exercises with the patient.
D) Restraining the patient, and not allowing him or her to eat or drink anything by mouth (NPO).

Question 23

When the patient asks the nurse to touch him,the nurse asks why he needs this.The patient replies,"I just need to know that I am real." The nurse assesses that response as a primary sign of ____________________.

Question 24

Your coworker is noted to be very organized.However,you see that he is always making lists and citing the rules of the organization.He wants all his projects to be perfect and gets very upset when things happen that make him miss his deadlines.Your coworker is exhibiting signs of which personality disorder?

A) Avoidant
B) Obsessive-compulsive
C) Histrionic
D) Dependent

Question 25

When the nurse asks questions like,"What day is today?" or "What time is it now?" the nurse is testing the patient's ____________________.

Question 26

A patient who has a history of episodes of road rage thinks that she is a very good driver and does not understand why she keeps being told she is a poor driver.She is losing her license now,and she tells the nurse that she is feeling very unhappy and abandoned.She feels like she might hurt herself.The nurse realizes that the patient is exhibiting which personality disorder?

A) Narcissistic
B) Paranoid
C) Schizoid
D) Borderline

Question 27

The nurse assessing the patient with an acute stress disorder will note the evidence of: (Select all that apply.)

A) Diminished awareness of surroundings
B) Derealization
C) Depersonalization
D) Amnesia
E) Irritability

Question 28

The nurse explains that the difference between an illusion and a hallucination is that an illusion could be exemplified by: (Select all that apply.)

A) A car backfiring being perceived as gunfire.
B) The television news being perceived as someone talking to them.
C) Hearing God's voice directing you to drive your car off the road.
D) Seeing your dead spouse smile at you from a flower.
E) A spot on the wall being perceived as a spider.

Question 29

A patient who takes lithium for manic episodes has been walking daily.Now that the weather is hot,it is important to instruct the patient to:

A) Stay in the shade when walking.
B) Stop walking.
C) Maintain hydration.
D) Wear sunscreen.