Deck 6: Psychological Context of Psychiatric Nursing Care

Question 1

Which question would best assess a patient's ability to make judgments?

A) "Who is the president of the USA?"
B) "How long have you been here?"
C) "What is the name of the building we're in?"
D) "If you won $10,000, what would you do with it?"

Answer 1

"If you won $10,000, what would you do with it?"

Question 2

The patient believes that the CIA is "plotting to kill me." The report is given with the patient exhibiting little emotion.The nurse documents the patient's affect as:

A) flat.
B) elated.
C) labile.
D) congruent.

Answer 2

flat.

Question 3

A patient visiting from Puerto Rico has become psychotic while staying with family here in the United States.When conducting the mental status examination,the nurse remembers that:

A) sociocultural factors may greatly affect the examination.
B) liking the patient as a person is important to the outcome.
C) an interpreter may help facilitate the verbal portion of the examination.
D) biological expressions of psychiatric illness are not relevant to someone from another culture.

Answer 3

sociocultural factors may greatly affect the examination.

Question 4

A cognitively impaired patient reports to the nurse that,"I had the best time.My husband took me out to dinner and then to a concert.The music was wonderful." Knowing that the patient is a widow,the nurse determines her remarks are an example of:

A) tangential thinking.
B) confabulation.
C) hallucination.
D) circumstantiality.

Question 5

Success in obtaining sufficient data in the initial psychiatric interview depends largely on the:

A) patient's ability to communicate effectively.
B) interviewer's ability to establish good rapport.
C) number of psychiatric interviews the nurse has performed.
D) interviewer's ability to organize and systematically record data.

Question 6

Which clinical skills used to conduct a mental status examination are most relevant to establishing rapport?

A) Clarification and restatement
B) Information giving and feedback
C) Systematic inquiry and organization of data
D) Attentive listening, observation, and focused questions

Question 7

The health care provider describes a patient as being dressed like a "typical patient with mania." From this statement,the nurse can assume that the patient's mode of dress was:

A) drab.
B) slovenly.
C) seductive.
D) flamboyant.

Question 8

A nurse assessing a patient's emotional intelligence will focus on the patient's:

A) linguistic and musical abilities.
B) body kinesthetic and spatial abilities.
C) interpersonal and intrapersonal skills.
D) logical mathematics and linguistic abilities.

Question 9

To assess for the presence of hallucinations during the mental status examination,a nurse should ask:

A) "Can you tell me what the name of this building is?"
B) "Do you ever see or hear things that others don't see or hear?"
C) "When did you start believing aliens were controlling your thoughts?"
D) "What do I mean when I say, 'Don't count your chickens before they hatch?'"

Question 10

A patient diagnosed with depression tells a nurse,"If I hadn't been admitted,I would have carried out my plan and everyone would have been better off without me." The nurse responds:

A) "It's frustrating when plans are interrupted."
B) "Things can still turn out all right for you while you're here."
C) "What specifically did you plan to do before you were admitted?"
D) "I know you're feeling bad now but if you talk, things will be better."

Question 11

Generally,a nurse can expect the motor activity of a patient with profound depression and the motor activity of a patient with mania to:

A) be similar.
B) show many tics and grimaces.
C) be at opposite ends of the continuum.
D) show unusual bizarre gestures or posturing.

Question 12

A patient tells a nurse,"God has given me special powers to heal the sick and raise the dead.I can cast out demons and cure cancer." The nurse assesses the patient's statements as indicating:

A) a phobia.
B) depersonalization.
C) grandiose delusions.
D) an idea of reference.

Question 13

A nurse plans to engage in participant observation while conducting a mental status examination.This will require the nurse to:

A) increase verbalization with the patient.
B) listen attentively to the patient's response.
C) engage in communication and observation simultaneously.
D) advise the patient on what to do about data obtained during the interview.

Question 14

A nurse asks a patient to remember the following object,color,and address: pencil,red,and 15 Maple Street.After 15 minutes the nurse asks the patient to repeat the object,color,and address.The nurse is assessing:

A) judgment.
B) recent memory.
C) ability to abstract.
D) immediate recall.

Question 15

When asked what a mental status examination is intended to reveal about the patient,the nurse answers:

A) "It gives us a more complete family history."
B) "It reflects the patient's current state of function."
C) "It reveals a lot about the patient's past experiences."
D) "It helps us determine the patient's future prognosis."

Question 16

A nurse will perform a mental status examination.The data most pertinent for determining the patient's affective response will be the patient's:

A) judgment and insight.
B) sensorium and memory.
C) appearance and thought content.
D) statements of mood and affect.

Question 17

During a mental status examination,a patient shouts angrily at the nurse,"You are too nosy for your own good!" Then,almost immediately,happily says,"Well,let's let bygones be bygones and be buddies." The nurse assesses this emotional display as:

A) labile affect.
B) hallucinations.
C) magical thinking.
D) ideas of reference.

Question 18

A patient admitted for treatment of uncontrolled diabetes mellitus is withdrawn and tearful.The patient says,"I just want to be normal again." The nurse determines there is a need for a psychiatric evaluation primarily to assist:

A) the patient in verbalizing distress about the disease.
B) in assessing the emotional factors affecting the patient's present condition.
C) in assessing priorities to be set for the patient's overall nursing plan of care.
D) the patient in emotionally accepting the chronic nature of the disease.

Question 19

A nurse conducting a mental status examination should plan to:

A) compare results with at least one other nurse.
B) perform the examination without the patient knowing.
C) integrate the examination into the nursing assessment.
D) perform the examination as the first communication with the patient.

Question 20

While interviewing a patient,a nurse notes that the patient uses invented words and that the patient's thoughts do not seem to flow logically.These observations are most consistent with a diagnosis of:

A) depression.
B) panic disorder.
C) schizophrenia.
D) defensive coping.

Question 21

A nurse managing the care of a depressed patient will use the Beck Depression Inventory Scale at admission and during the course of treatment.The nurse expects to obtain assessment data that would: (Select all that apply.)

A) confirm the patient's diagnosis.
B) measure the extent of the patient's problem.
C) identify co-morbid physiological disorders.
D) track the patient's progress over the hospitalization.
E) predict the patient's likelihood of experiencing a relapse.

Question 22

While being interviewed,a patient expresses the belief that other people can place beliefs in her mind.This statement can be assessed as evidence of:

A) thought insertion.
B) nihilistic delusions.
C) somatic delusions.
D) ideas of reference.

Question 23

During a mental status evaluation,a nurse's intuition may indicate:

A) clues about the patient's physical well-being.
B) subtle emotions being expressed by the patient.
C) areas to be explored in the predischarge interview.
D) potential nursing diagnoses that relate to a patient knowledge deficit.

Question 24

Asking a patient to give the meaning of the proverb "people who live in glass houses shouldn't throw stones" will assist a nurse in assessing the patient's:

A) short-term memory.
B) orientation to reality.
C) emotional intelligence.
D) ability to think abstractly.

Question 25

During an interview,a patient with mania demonstrates very rapid speech and talks continuously and loudly.The patient's speech pattern is best documented as:

A) tangential.
B) pressured.
C) inappropriate.
D) circumlocution.

Question 26

The Mini-Mental State Examination would be used by a nurse who is interested in obtaining information about:

A) affect changes.
B) cognitive processes.
C) thought content and processes.
D) abnormal psychological experiences.

Question 27

During a mental status examination,a patient sits looking tense and suspicious.The patient has a reddened scar on the left cheek and is wearing a torn,soiled shirt and only one shoe.Which observation about appearance has the greatest significance for the patient's current mental state?

A) The patient has a reddened scar on the left cheek.
B) The patient is wearing a torn, soiled shirt.
C) The patient appears tense and suspicious.
D) The patient is wearing only one shoe.

Question 28

To gather data about a patient's judgment,which question would be most appropriate?

A) "What brought you to the hospital?"
B) "On a scale of 1 to 100, what would you consider your stress level to be?"
C) "What problem would you like to work on while you are hospitalized?"
D) "If you found a stamped, addressed envelope lying in the street, what would you do with it?"