Question 1

Which is not considered as a probable cause of mood disorders?

Accepted Answer

Traumatic event in childhood is a common cause of mood disorders such as depression and anxiety. It is not excluded as a probable cause of mood disorders.

Question 2

When performing a mental status examination, a 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?

Accepted Answer

The patient repeating "I didn't do it" is an example of a type of thought content disturbance known as perseveration, which is characterized by the repeating of words, phrases, or ideas. This falls under the thought content component of the mental status examination. Appearance refers to the patient's physical appearance, mood and affect refer to their emotional state and expression, and memory and attention refer to cognitive abilities.

Question 3

A patient who went away to college in September returns in October, thinking that he is a drummer in a popular rock band.What is this most likely a manifestation of?

Accepted Answer

This scenario is most likely a manifestation of schizophrenia, which can include delusions (false beliefs) such as believing oneself to be someone famous or having an extraordinary identity, which is not grounded in reality.

Question 4

Which combination of medications could be used to treat an anxiety disorder?

Accepted Answer

Effexor (an antidepressant) and Ativan (a benzodiazepine) are commonly used in combination to treat anxiety disorders. Effexor helps to control chronic anxiety, while Ativan works quickly to relieve acute anxiety symptoms. The other combinations listed may not be effective or safe for treating anxiety disorders.

Question 5

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.What is this patient is experiencing?

Accepted Answer

The patient is exhibiting symptoms of a manic episode, including grandiosity (claiming to be related to the president and having important national security business), pressured speech (getting angry when questioned), and potentially poor judgment (wearing a flashy outfit). A panic attack would not likely cause such grandiose statements, a hyperactive episode and extrapyramidal effect are not relevant in this case.

Question 6

A patient is receiving large doses of chlorpromazine (Thorazine)and begins to exhibit extrapyramidal signs of involuntary muscle movement.Which classification of drugs should the nurse anticipate will be added to the patient's protocol?

Accepted Answer

Chlorpromazine is a typical antipsychotic drug that can cause extrapyramidal side effects, which are a group of movement disorders that include dystonia, akathisia, Parkinsonism, and tardive dyskinesia. The addition of an antiparkinsonian drug, such as benztropine or trihexyphenidyl, may be necessary to alleviate these symptoms. Antihypertensive drugs are used to treat high blood pressure, anticonvulsant drugs to treat seizures, and antiemetic drugs to treat nausea and vomiting.

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.What is the best nursing response when the patient asks the nurse to push him to his room?

Accepted Answer

The best response is to support the patient's current experience while maintaining a therapeutic relationship. Option D respects the patient's current state without challenging or invalidating their experience.

Question 8

A patient is hyperactive with mania and has poor nutritional intake due to hyperactivity.What implementation is most appropriate when considering this diagnosis?

Accepted Answer

Offering nutritious finger foods and high-protein milkshakes to eat on the go is the best option for a hyperactive patient with mania and poor nutritional intake as it accommodates their hyperactivity while still providing proper nutrition. Spoon-feeding or limiting fluid intake may cause frustration or distress for the patient, while having one large meal may not be feasible or effective for their hyperactivity.

Question 9

A patient with bipolar disorder is being treated with tricyclic medications.What should the nurse inform the patient to expect when teaching information concerning side effects?

Accepted Answer

Tricyclic medications can cause orthostatic hypotension, which is a sudden drop in blood pressure when standing up. The nurse should inform the patient to expect this side effect and to change positions slowly to prevent falls or injury. Hypercholesterolemia, fatigue, and blurred vision are not typically associated with tricyclic medications.

Question 10

What is the best action for the nurse to implement to effectively listen therapeutically to a patient?

Accepted Answer

Concentrating on the patient and not thinking of responses allows for active listening and a deeper understanding of the patient's needs and concerns. It shows the patient that the nurse is truly engaged and interested in their well-being. Determining the cause of the patient's problem while they are speaking or telling the patient about similar experiences may shift the focus away from the patient and their needs. Asking the patient why they feel a certain way can be helpful, but it is important to allow the patient to express themselves without interruption or leading questions.

Question 11

A patient is given anxiolytic medications for a mental disorder.What type of approach is this considered?

Accepted Answer

Anxiolytic medications are biologic interventions used to treat symptoms of mental disorders related to anxiety. While other approaches, such as psychoanalytic and interpersonal, may also be used in conjunction with medication therapy, the use of anxiolytic medications is primarily a biologic approach.

Question 12

A long-time patient with schizophrenia in the inpatient unit has developed involuntary movements of his tongue.What has this patient developed?

Accepted Answer

The patient has developed tardive dyskinesia, which is a side effect of long-term use of antipsychotic medications. It is characterized by involuntary movements of the tongue, lips, and face. Acute dystonic reactions are characterized by sudden and severe muscle spasms, usually of the neck, jaw or eyelids, and can occur shortly after starting or increasing the dose of antipsychotic medication. Neuroleptic malignant syndrome is a rare but potentially fatal reaction to antipsychotic medication, characterized by fever, muscle rigidity, and altered mental status. Laryngospasm is a sudden and involuntary contraction of the vocal cords, typically causing breathing difficulties.

Question 13

What should a nurse suspect a patient diagnosis might be when the patient states, "I often feel restless, have a tight sensation in my chest, and have an increased heart rate at times"?

Accepted Answer

The patient's symptoms are consistent with those of anxiety disorder, which includes feelings of restlessness, increased heart rate, and chest tightness. Depressive disorder usually presents with a persistent low mood and lack of interest, while agoraphobia is characterized by fear of being in situations where escape might be difficult or help might not be available. Obsessive-compulsive disorder involves intrusive thoughts and compulsive behaviors.

Question 14

A 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.What is the nurse's best response?

Accepted Answer

The nurse should ask directly about thoughts of self-harm or suicide to assess the patient's risk and take appropriate interventions. A direct question allows the patient to open up and express their feelings without feeling judged.

Question 15

A nurse speaking to a patient who is depressed says, "So what you are saying is that you are feeling very sad today." What is this considered?

Accepted Answer

The nurse is clarifying what the patient is expressing, making sure she understands the patient's feelings correctly. This is an example of clarifying.

Question 16

Since the summer weather began, a patient taking lithium for manic episodes has been walking daily.What important instruction should the nurse provide to this patient?

Accepted Answer

Lithium is a medication that can cause dehydration and electrolyte imbalances. Therefore, it is important for this patient to maintain hydration by drinking plenty of water while walking. While shade, sunscreen, and stopping walking may have their own benefits, maintaining hydration is the most important instruction for this patient taking lithium.

Question 17

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.What is the most appropriate nursing implementation?

Accepted Answer

Decreasing stimuli and using restraints as a last resort is appropriate to ensure safety while trying to calm the patient. Restraints should only be used if other measures fail.

Question 18

A patient who is admitted with posttraumatic stress disorder (PTSD)says he had a very stressful experience when in high school and has never really recovered.What is the most appropriate nursing action?

Accepted Answer

Guiding the patient in relaxation techniques can provide a distraction when flashbacks occur which can help the patient cope with their symptoms. While it is important for the patient to talk about their condition, it is also important to have some tools to manage their symptoms. Providing sleeping medication may be necessary, but it should not be the first line of treatment and should be used in conjunction with other interventions. Encouraging the patient to talk about their trauma as often as they like may be helpful, but it is not specific enough to manage their symptoms.

Question 19

A group of nursing students are taking their first major examination.What should the nursing instructor expect the students might experience?

Accepted Answer

Mild anxiety is a common experience for students taking their first major examination.

Question 20

A patient states that he feels angry at work for no reason and often yells at his co-workers.The therapist asks the patient to describe events and then tells the patient to try different strategies to cope with these angry outbursts.What type of approach is this considered?

Accepted Answer

The answer of A patient states that he feels angry...

Quiz 61: Psychobiological Disorders