Deck 57: Nursing Care of Patients With Mental Health Disorders

Question 1

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) "That's crazy; you know the books are not on fire!"
C) "You don't have any books; how could they be on fire?"
D) "I do not see any fire. Here is your supper; it's time to eat."

Answer 1

"I do not see any fire. Here is your supper; it's time to eat."

Question 2

A patient who is a war veteran states,"It should have been me that died.I'll never forgive myself for leaving my buddy when he needed me." The nurse recognizes this statement is most associated with which diagnosis?

A) Bipolar depression
B) Generalized anxiety
C) Obsessive-compulsive disorder
D) Post-traumatic stress disorder (PTSD)

Answer 2

Post-traumatic stress disorder (PTSD)

Question 3

The nurse notes that another nurse colleague has been acting differently lately.The nurse often has red watery eyes and a runny nose.Today,the nurse was unhappy with the patient assignment and screamed,"Someone is going to pay for this!" What should the nurse who has observed this behavior do?

A) Nothing; all nurses have stressful days sometimes.
B) Tell the clinical manager exactly what was observed.
C) Tell the clinical manager that the nurse is abusing drugs.
D) Confront the nurse with the behavior and provide information about counseling.

Answer 3

Tell the clinical manager exactly what was observed.

Question 4

A patient with schizophrenia has not bathed recently and a family member states that the patient has not been out of the house for 10 days.The patient tells the nurse,"They are trying to hurt me; don't let them hurt me." Which symptom is this patient demonstrating?

A) Paranoid delusions
B) Grandiose delusions
C) Auditory hallucinations
D) Persecutory hallucinations

Question 5

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

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

Question 6

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 the opioid but couldn't stop thinking about it.
D) The patient has been to three or four physicians to obtain new prescriptions for the drug.

Question 7

The nurse is providing care for a patient with symptoms of tardive dyskinesia from major tranquilizers.What treatment should 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 to the treatment plan

Question 8

The nurse is completing a mental status examination for a newly admitted patient.In which part of the nursing process is the nurse functioning?

A) Assessment
B) Planning
C) Implementation
D) Evaluation

Question 9

A patient with a mental illness says,"I have to go to the bank.The voices are telling me to go there." Which response by the nurse is best?

A) "Do you need money?"
B) "I will call you a cab later. Right now, it is time for therapy."
C) "Why do you think the voices are telling you to go to the bank?"
D) "I want to help you focus away from the voices. I am real, they are not."

Question 10

A patient who has schizophrenia has a dull facial expression and speaks in a monotone voice,even though a visitor is making an effort to be jovial.What terminology should the nurse use to document this observation?

A) Bored
B) Depressed
C) Flat affect
D) Ambivalent attitude

Question 11

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.What should the nurse do 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 12

A patient is newly diagnosed with a trauma related disorder.Which medication should the nurse expect to be prescribed for this patient?

A) Paroxetine (Paxil)
B) Sertraline (Zoloft)
C) Buspirone (Buspar)
D) Alprazolam (Xanax)

Question 13

The nurse is cautiously avoiding the temptation to take unused or wasted doses of narcotic medications when providing patient care.What percentages of nurses in the United States are chemically impaired?

A) 0% to 5%
B) 6% to 15%
C) 25% to 35%
D) 49% to 50%

Question 14

A patient cannot leave home without checking the coffee pot numerous times.This behavior makes the patient late to many functions.Which anxiety disorder should the nurse suspect the patient is experiencing?

A) Phobia
B) Generalized anxiety disorder (GAD)
C) Post-traumatic stress disorder (PTSD)
D) Obsessive-compulsive disorder (OCD)

Question 15

The nurse is assisting with teaching a patient who has been started on fluphenazine (Prolixin).About which side effect should the nurse focus this teaching?

A) Weight loss
B) Hypoglycemia
C) Photosensitivity
D) Elevated blood pressure

Question 16

The nurse is caring for an older adult patient with a history of depression.Which comment by the patient indicates an immediate need for further assessment?

A) "I am so old; all my friends have died."
B) "I am useless now; there is no reason to be alive."
C) "I retire in 6 months, and it will be all downhill from there."
D) "I am looking forward to seeing my husband in heaven someday."

Question 17

The nurse is assisting with medication teaching for a patient who is prescribed lithium carbonate (Eskalith)for bipolar disorder.Which instruction by the nurse is most important?

A) Instruct the patient to discontinue other antidepressant agents.
B) Teach the patient that the lithium will help stabilize mood swings.
C) Teach the patient side effects to report, such as nausea or weight gain.
D) Explain to the patient and significant other the importance of regular blood tests.

Question 18

The nurse assists with admission of a patient to the hospital with pancreatitis and a history of alcohol abuse.Why should the nurse observe the patient for agitation,tremors,and hallucinations?

A) These are symptoms of alcohol withdrawal.
B) These symptoms indicate possible cirrhosis of the liver.
C) The patient may be using alcohol in the hospital setting.
D) Patients with a history of alcohol abuse are at risk for mental illness.

Question 19

A patient is diagnosed as having a phobia.Which fear should the nurse expect to observe in this patient?

A) Fear of poisonous spiders
B) Fear of leaving the house during the day
C) Fear of failing a test that one has not studied for
D) Fear that a child playing in the street might get hurt

Question 20

A patient hospitalized for bipolar disorder is sitting in the corner of the room with the lights off,staring into space.Three hours later,the patient is in the same position.What should the nurse say to the patient?

A) "Cheer up! Come on out and join us in a game!"
B) "Come with me. I'd like you 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?"

Question 21

A patient with depression is prescribed duloxetine (Cymbalta).What should the nurse instruct the patient about this medication?

A) Take with fruit juice.
B) Do not take with St. John's wort.
C) Stop the medication if experiencing adverse effects.
D) Expect blood pressure to drop with this medication.

Question 22

A patient comes into the emergency department experiencing chest pain and feelings of impending doom.Which assessment findings should the nurse use to determine if this patient is experiencing a panic attack? (Select all that apply.)

A) Shaking
B) Neck pain
C) Dissociation
D) Vomiting brown emesis
E) Occurs at 3 p.m. every day

Question 23

The nurse is reviewing the causes of anxiety with a patient diagnosed with an anxiety disorder.Which neurotransmitter abnormalities should the nurse include as causing symptoms of anxiety? (Select all that apply.)

A) Increased substance P
B) Increased epinephrine
C) Increased somatostatin
D) Decreased norepinephrine
E) Decreased gamma-aminobutyric acid (GABA)

Question 24

A patient has been prescribed fluoxetine (Prozac)to treat depression.What should be included in the nurse's teaching about the drug? (Select all that apply.)

A) "You need to take this drug only once a week."
B) "Take the prescribed dose in the early evening."
C) "A decreased interest in sexual activity may occur with this medication."
D) "You should not consume red wine, aged cheese, or other tyramine-rich foods."
E) "Do not expect immediate results; it usually takes 6 to 8 weeks for therapeutic effects to be felt."
F) "You may experience some nausea, vomiting, and anorexia, but these side effects will subside in time."

Question 25

The nurse is assisting with teaching a patient who is to begin taking a monoamine oxidase inhibitor (MAOI).Which foods should the nurse teach the patient to avoid? (Select all that apply.)

A) Fish
B) Wine
C) Bread
D) Pastas
E) Aged cheese

Question 26

A patient with extreme anxiety is arriving for out-patient chemotherapy.What should the nurse do to help reduce the patient's anxiety during this current treatment?

A) Play a CD with nature sounds.
B) Select a television station with a sporting event.
C) Close the door to the room during the treatment.
D) Remind the patient that anxiety is not going to make the treatment effective.

Question 27

The nurse is assisting in planning care for a patient with extreme anxiety.Which interventions should the nurse include in this patient's plan of care? (Select all that apply.)

A) Maintain a calm environment.
B) Encourage verbalization of feelings.
C) Model and encourage positive self-talk.
D) Encourage participation in competitive activities.
E) Permit the patient to have time alone during acute anxiety events.

Question 28

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

A) Phobia
B) Panic disorder
C) Schizophrenia
D) Unipolar depression
E) Post-traumatic stress disorder
F) Obsessive-compulsive disorder

Question 29

A patient with schizophrenia is returning from a CT scan of the brain followed by an electroencephalogram.Which diagnostic test findings should 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 de-myelinization
D) Aneurysms of the cerebral vessels
E) Diminished prefrontal cortex activity

Question 30

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

A) Phenelzine (Nardil)
B) Buspirone (Buspar)
C) Isocarboxazid (Marplan)
D) Valproic acid (Depakote)
E) Lithium carbonate (Eskalith)

Question 31

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

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