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Module 1 Content Questions

Terms in this set (22)

A nurse wants to demonstrate genuineness with a patient diagnosed with schizophrenia. The nurse should:
a. restate what the patient says
b. use congruent communication strategies
c. use self-revelation in patient interactions
d. consistently interpret the patient's behaviors
B: use congruent communication strategies
A college student said, "Most of the time I'm happy and feel good about myself. I have learned that what I get out of something is proportional to the effort I put into it." Which number on this mental health continuum should the nurse select?
Mental Illness Mental Health
1 2 3 4 5
a. 1
b. 2
c. 3
d. 4
e. 5
E: 5
A patient in the emergency department says, "The voices say someone is stalking me. They want to kill me because I developed a cure for cancer. I have a knife and will stab anyone who is a threat." Which aspect(s) of mental health should be of greatest immediate concern to the nurse? Select all that apply.
a.
Happiness
b.
Appraisal of reality
c.
Control over behavior
d.
Effectiveness in work
e.
Healthy self-concept
B. Appraisal of reality

C: Control over behavior
A 2-year-old child often displays negative behaviors. The parent says, "My child refuses toilet training and shouts 'No!' when given directions. What do you think is wrong?" Select the nurse's best reply.
a. "The child needs firmer control. It is important to set limits now."
b. "This is normal for your child's age. The child is striving for independence."
c. "There may be developmental problems. Most children are toilet trained by age 2."
d. "Some undesirable attitudes are developing. A child psychologist can help you develop a plan."
B: "This is normal for your child's age. The child is striving for independence."
A patient states, "I'm starting cognitive-behavioral therapy. What can I expect from the sessions?" Which response(s) by the nurse would be appropriate? Select all that apply.
a. "The therapist will be active and questioning."
b. "You may be given homework assignments."
c. "The therapist will ask you to describe your dreams."
d. "The therapist will help you look at ideas and beliefs you have about yourself."
e. "The goal is to increase subjectivity about thoughts that govern your behavior."
A: "The therapist will be active and questioning."
B: "You may be given homework assignments."
D: "The therapist will help you look at ideas and beliefs you have about yourself."
A patient says, "I never know the answers," and "My opinion doesn't count." The nurse correctly assesses that this patient had difficulty resolving which psychosocial crisis?
a.
Initiative versus guilt
b.
Trust versus mistrust
c.
Autonomy versus shame and doubt
d.
Generativity versus self-absorption
C: Autonomy versus shame and doubt
A drug causes muscarinic receptor blockade. The nurse will assess the patient for
a.
dry mouth.
b.
gynecomastia.
c.
pseudoparkinsonism.
d.
orthostatic hypotension.
A: dry mouth.
A nurse prepares to administer antipsychotic medication to a patient with schizophrenia. Additional monitoring for adverse effects will be most important if the patient is also has which health problem? Select all that apply.
a.
Diabetes
b.
Parkinson's disease
c.
Osteoarthritis
d.
Grave's disease
e.
Epilepsy
A: Diabetes

B: Parkinson's disease

E: Epilepsy
A patient with schizophrenia had an exacerbation related to medication noncompliance. During 4 days of hospitalization, medication was resumed. The patient's thought processes are now more organized, and discharge is planned. The patient's family is upset and tells the nurse, "It's too soon for discharge. We will just go through all this again." The nurse should:
a.
call the psychiatrist to explain the discharge rationale.
b.
explain that health insurance will not pay for a longer stay.
c.
call security to handle the disturbance, and escort the family off the unit.
d.
explain that the patient will continue to improve if medication is taken regularly.
D: explain that the patient will continue to improve if medication is taken regularly.
A nurse performed these actions while caring for patients in an inpatient psychiatric setting.
1. Removed cuticle scissors from a suicidal patient.
2. Helped a patient make an appointment with an attorney.
3. In patient's presence, opened a package mailed to patient.
4. Remained within arm's length of patient with homicidal ideation.
5. Permitted a patient with psychosis to refuse oral psychotropic medication.
Which action violated patients' rights? (Select all that apply.)
a. none
b. 1
c. 2
d. 3
e. 4
f. 5
A: none
A community mental health nurse has worked for months to establish a relationship with a delusional, suspicious patient. The patient recently lost employment and could no longer afford prescribed medications. The patient says, "Only a traitor would make me go to the hospital." Select the nurse's best initial intervention.
a.
With the patient's consent, contact resources to provide medications without charge temporarily.
b.
Arrange a bed in a local homeless shelter with nightly on-site supervision.
c.
Hospitalize the patient until the symptoms have stabilized.
d.
Seek inpatient hospitalization.
A: With the patient's consent, contact resources to provide medications without charge temporarily.
Which statement(s) by patients with serious, persistent mental illness best demonstrate that the case manager has established an effective long-term relationship? (Select all that apply.)
"My case manager:
a.
talks in language I can understand."
b.
helps me keep track of my medication."
c.
gives me little gifts from time to time."
d.
looks at me as a whole person with lots of needs."
e.
lets me do whatever I choose without interfering."
A: talks in language I can understand."

B: helps me keep track of my medication."

D: looks at me as a whole person with lots of needs."
An experienced psychiatric nurse plans to begin work in a community-based medication clinic on Monday. The clinic sees culturally diverse patients. Which action should the nurse take first to prepare for this position?
a.
Investigate cultural differences in patients' responses to psychotropic medications.
b.
Examine the literature on various health beliefs of members of diverse cultures.
c.
Contact the clinical nurse specialist for guidelines for cultural competence.
d.
Take a course in psychopharmacology.
A: Investigate cultural differences in patients' responses to psychotropic medications.
Which belief best fosters provision of culturally competent nursing care? (Select all that apply.)
a.
Eye contact promotes nonverbal communication.
b.
Nurses should foster assimilation and conformity to the dominant culture.
c.
Reading about practices of various cultures will ensure cultural competence.
d.
The ability to work within a patient's cultural context requires ongoing effort.
e.
Self-examination of attitudes toward various cultures promotes competent care.
(D) The ability to work within a patient's cultural context requires ongoing effort.
(E) Self-examination of attitudes toward various cultures promotes competent care.
Two hospitalized patients fight when they are in the same room. During a team meeting, a nurse asserts that safety is of paramount importance, so treatment plans should call for both patients to be secluded to keep them from injuring each other. This assertion:
a.
reinforces the autonomy of the two patients.
b.
violates the civil rights of both patients.
c.
represents the intentional tort of battery.
d.
correctly places emphasis on safety.
D: correctly places emphasis on safety.
A nurse at the mental health center prepares to administer a scheduled injection of haloperidol decanoate (Haldol depot) to a patient with schizophrenia. As the nurse swabs the site, the patient shouts, "Stop, stop. I don't want to take that medicine anymore because I hate the side effects." Select the nurse's first action.
a.
Assemble other staff for a show of force and proceed with the injection, using restraint if necessary.
b.
Stop the medication administration procedure and say to the patient, "Tell me more about the side effects you've been having."
c.
Proceed with the injection but explain to the patient that there are medications that will help reduce the unpleasant side effects.
d.
Say to the patient, "Since I've already drawn the medication in the syringe, I'm required to give it, but let's talk to the doctor about delaying next month's dose."
B: Stop the medication administration procedure and say to the patient, "Tell me more about the side effects you've been having."
In which situations would a nurse have the duty to intervene and report? Select all that apply.
a.
A peer is unable to write measurable outcomes.
b.
The health care provider consults the Physician's Desk Reference.
c.
A peer tries to provide patient care in an alcohol-impaired state.
d.
A team member violates relationship boundaries with a patient.
e.
A patient refuses medication prescribed by a licensed health care provider.
C: A peer tries to provide patient care in an alcohol-impaired state.

D: A team member violates relationship boundaries with a patient.
Select the best outcome for a patient with this nursing diagnosis: Impaired social interaction related to sociocultural dissonance as evidenced by stating, "Although I'd like to, I don't join in because I don't speak the language very well." Within 1 week, the patient will:
a.
demonstrate improved social skills.
b.
express a desire to interact with others.
c.
become more independent in decision making.
d.
select and participate in one group activity per day.
D: select and participate in one group activity per day.
A patient is very suspicious and states, "The FBI has me under surveillance." Which strategies should the nurse to use when gathering initial assessment data about this patient? More than one answer is correct.
a.
Say to the patient, "Tell me about the problem as you see it."
b.
Tell the patient medication will help this type of thinking.
c.
Seek information about when the problem began.
d.
Tell the patient, "Your ideas are not realistic."
e.
Reassure the patient, "You are safe here."
A: Say to the patient, "Tell me about the problem as you see it."

C: Seek information about when the problem began.

E: Reassure the patient, "You are safe here."
After several therapeutic encounters with a patient who recently attempted suicide, which behavior should cause the nurse to consider the possibility of countertransference?
a.
The patient's reactions toward the nurse seem realistic and appropriate.
b.
The nurse feels very happy when the patient's mood begins to lift.
c.
The patient states, "Talking to you is like talking to my parents."
d.
The nurse develops a trusting relationship with the patient.
B: The nurse feels very happy when the patient's mood begins to lift.
A nurse explains to the family of a mentally ill patient how the nurse-patient relationship differs from other interpersonal relationships. Which is the best explanation? "The focus:
a.
is on the patient. Problems are discussed by the nurse and patient, but solutions are implemented by the patient."
b.
shifts from nurse to patient as the relationship develops. Advice is given by both and solutions implemented."
c.
is creation of a partnership in which each member is concerned with growth and satisfaction of the other."
d.
of the relationship is socialization. Mutual needs are met and feelings are shared openly."
A: is on the patient. Problems are discussed by the nurse and patient, but solutions are implemented by the patient."
A nurse ends a relationship with a patient. Which action(s) by the nurse should be included in the termination phase? (Select all that apply.)
a.
Establish expectations of how long the relationship will last.
b.
Work with the patient to identify strengths, limitations, and problems.
c.
Help the patient express feelings about the relationship with the nurse.
d.
Help the patient prioritize and modify socially unacceptable behaviors.
e.
Focus dialogues with the patient on problems that may develop in the future.
C: Help the patient express feelings about the relationship with the nurse.

E: Focus dialogues with the patient on problems that may develop in the future.
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