Deck 57: Nursing Care of Patients With Mental Health Disorders

Question 1

A patient was in a car accident and was placed on opioid analgesics for pain. Six months later, the patient's injuries have healed, but the patient continues to want prescriptions for the opioid. Which of the following assessment findings is least likely to be present in the patient who is dependent on an opioid analgesic?

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.

Answer 1

The patient continues to manage to get to work each day.

Question 2

Which of the following fears would be considered a phobia?

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

Answer 2

Fear of leaving the house during the day

Question 3

The nurse is caring for a patient who is hospitalized for bipolar disorder. The nurse finds the patient sitting in the corner of the room with the lights off, staring into space. Three hours later, the patient is still there. Which of the following responses by the nurse is best?

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

Answer 3

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

Question 4

The nurse is caring for a patient who says, "I have to go to the bank. The voices are telling me to go there." Which of the following responses by the nurse is best?

A)"I want to help you focus away from the voices. I am real, they are not."
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)"Do you need money?"

Question 5

The nurse is caring for a patient admitted to the psychiatric unit with a diagnosis of schizophrenia. The patient has not bathed recently, and a family member states that the patient has not been out of the house for 10 days. On admission, the patient tells the nurse, "They are trying to hurt me; don't let them hurt me." This is an example of which symptom?

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

Question 6

A patient who has 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)"I do not see any fire. Here is your supper; it's time to eat."
D)"You don't have any books; how could they be on fire?"

Question 7

An older woman brings her husband to an outpatient clinic. She says, "He wouldn't come on his own, so I finally just brought him. Ever since he retired last year, he just sits around the house. He isn't eating, and he naps all the time. He won't even go fishing, and he's always loved to fish." The nurse recognizes the patient's symptoms are most likely related to which of the following disorders?

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

Question 8

The nurse is caring for an older adult patient who has 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 am looking forward to seeing my husband in heaven someday."
D)"I retire in 6 months, and it will be all downhill from there."

Question 9

The nurse is caring for a patient who is withdrawing from alcohol. The patient is restless and reports seeing snakes on the ceiling. Vital signs are as follows: blood pressure 180/100 mm Hg, pulse 92 beats/min, and respirations 22 breaths/min. What should the nurse do first?

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

Question 10

The nurse is assisting with teaching a patient who has been started on fluphenazine (Prolixin). The nurse should teach the patient how to adapt to which side effect?

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

Question 11

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

A)These symptoms indicate possible cirrhosis of the liver.
B)These are symptoms of alcohol withdrawal.
C)Patients with a history of alcohol abuse are at risk for mental illness.
D)The patient may be using alcohol in the hospital setting.Multiple Response
Identify one or more choices that best complete the statement or answer the question.

Question 12

The mental status examination is done during which part of the nursing process?

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

Question 13

The nurse is caring for a war veteran who 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 of the following diagnoses?

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

Question 14

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

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

Question 15

A hospitalized patient was admitted with chest pain that has been determined to be a somatoform disorder. The nurse answers the patient's call light, and the patient relates experiencing chest pain. Which response by the nurse is best?

A)Further assess the patient's pain and vital signs.
B)Gently remind the patient that the symptoms are not based on a physiological cause.
C)Administer a placebo analgesic.
D)Ask if the pain is the same type of pain the patient has been experiencing in the past.

Question 16

Nurses must be cautious to avoid temptations to abuse drugs that are readily available in health-care settings. What percentage of nurses in the United States are chemically dependent at some point in their lives?

A)0% to 5%
B)5% to 20%
C)25% to 35%
D)49% to 50%

Question 17

The nurse notes that another nurse on a surgical unit 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 that the nurse is abusing drugs.
C)Tell the clinical manager exactly what was observed.
D)Confront the nurse with the behavior and provide information about counseling.

Question 18

A patient cannot leave home without checking the coffee pot numerous times. This makes the patient late to many functions. These are symptoms of which kind of anxiety disorder?

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

Question 19

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

Question 20

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 does the nurse use to document this observation?

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

Question 21

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)"Do not expect immediate results; it usually takes 2 to 4 weeks for therapeutic effects to be felt."
B)"You may experience some nausea, vomiting, and anorexia, but these side effects will subside in time."
C)"Take the prescribed dose in the early evening."
D)"You need to take this drug only once a week."
E)"You should not consume red wine, aged cheese, or other tyramine-rich foods."
F)"A decreased interest in sexual activity may occur with this medication."

Question 22

The nurse is assisting with data collection on a patient newly diagnosed with schizophrenia. Which of the following would be considered positive symptoms of schizophrenia? (Select all that apply.?

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

Question 23

Which of the following are types of anxiety disorders? (Select all that apply.?

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

Question 24

Which neurotransmitter abnormalities can cause symptoms of anxiety? (Select all that apply.?

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

Question 25

Which of the following medications require patients to follow a tyramine-free diet? (Select all that apply)?

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

Question 26

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

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