NCCAM has identified five major domains of complementary and alternative therapies.
The fifth domain of energy therapies does not include:
1. Healing touch.
2. Reiki.
3. Bioelectromagnetic-based therapies.
4. Ayurveda.
Answer:
When providing orientation to a group of students, the psychiatric”mental health nurse
describes use of an eclectic clinical approach with newly admitted clients with a
diagnosis of schizophrenia. Which of the following statements most accurately reflects
the therapeutic value of an eclectic approach?
1. There is limited scientific evidence about treatment for schizophrenia, so a variety of
medications and interventions must be tried over time.
2. Nurses do not need a philosophy of care to direct their practice.
3. It is difficult to determine a final plan of care for new clients with psychotic
disorders.
4. Strategies from one or a combination of psychiatric theories are used to determine
interventions and evaluation criteria for working with each client.
Answer:
The nurse suspects a client is unwilling to demonstrate self-sufficiency or independence
in the therapeutic relationship when the client says, “You are the only person I can talk
to or trust. Let’s go out to dinner tonight so we can spend more time together.” Which
one of the following nurse responses is most appropriate in this situation?
1. “I sense we are beginning to make real progress; I think that’s a great idea.”
2. “Maybe some other time, but right now I”m involved in a significant relationship and
don”t feel right about meeting you for dinner.”
3. “I sense you”ve become too dependent on this relationship; let’s examine your
feelings toward me.”
4. “You”ve become too dependent on me, so I will have to terminate our relationship.”
Answer:
Which answer choice, when placed in the blank, creates a correct statement?
The nurse maintaining a ______________ attitude will be more likely to understand the
experiences and difficulties of a client with schizophrenia.
1. sympathetic
2. enmeshed
3. complementary
4. nonjudgmental
Answer:
A son brought his 73-year-old widowed father into the emergency room. The client has
congestive heart failure but is under the care of a physician and has been in good health.
The son was called in by the fire department after they put out a small cooking fire at
the client’s home. The firefighters reported that they found the client sitting in a chair
mumbling incoherently, unaware of the fire and smoke. The client now appears to be
drifting in and out of consciousness and is having problems keeping his attention on
any one task. In this situation, the client is probably suffering from:
1. Dementia.
2. Cerebrovascular accident.
3. Delirium.
4. Depression.
Answer:
It would be inaccurate to state that the brain structure in people with schizophrenia:
1. Shows changes in the frontotemporal cortical gray matter.
2. Shows changes in the hippocampal area.
3. Shows changes in the parietal area.
4. Is different from those without schizophrenia.
Answer:
At a medication education meeting, a colleague asks the nurse how medications that
increase acetylcholine are helpful to people with dementia. What nursing response is
correct?
1. The cholinergic system is useful in helping to dull clients’ awareness of their
progressive losses.
2. Acetylcholine is involved in restoring serotonin and other chemicals that decrease
anxiety.
3. Acetylcholine is helpful in censoring feelings that arise in the midbrain and cause
distress.
4. The cholinergic system is involved in memory, problem solving, and other cognitive
skills.
Answer:
The nurse is told that the client most likely has the diagnosis of obsessive-compulsive
disorder. The nurse is not sure of the assessment data and behaviors that accompany this
disorder. Which action would be most appropriate for the nurse to take?
1. Document all subjective and objective data provided by the client.
2. Ask the primary health provider to identify needed subjective and objective
assessment data.
3. Research obsessive-compulsive disorder in the medical dictionary.
4. Consult the Diagnostic and Statistical Manual of Mental Disorders for diagnostic
criteria.
Answer:
An adolescent student tells the nurse, “I lost ten pounds in the last three months. I
believe I have anorexia.” The nurse’s response should be based on the following
understanding:
1. Since the student is willing to talk about the issue, the student is probably not
anorexic.
2. The student may be anorexic if the weight loss has lead to maintenance body weight
less than 85% of the expected.
3. The student is not anorexic because the student’s physical development has not been
affected by nutritional status.
4. There is cause for alarm since most adolescent females experience anorexia.
Answer:
The nurse refers a client for acupuncture. Stimulating acupuncture points has been
shown to be a promising treatment for:
Standard Text: Select all that apply.
1. Mood-related mental disorders.
2. Headache.
3. Posttraumatic stress syndrome.
4. Alcohol withdrawal.
5. Schizophrenia.
Answer:
Which of the following statements are accurate descriptions of schizoaffective disorder?
1. The mood component of schizoaffective disorder is depression.
2. Alterations in mood and thought process occur simultaneously in schizoaffective
disorder.
3. A client with schizoaffective disorder usually has hallucinations and delusions only
when experiencing a manic or depressed state.
4. The prognosis for schizoaffective disorder is substantially worse than for
schizophrenia.
Answer:
An older adult client is observed as having several cognitive problems, including
memory and attention deficits and fluctuating levels of orientation. The nurse confirms
that the client’s symptoms developed over a three-day period. The client’s symptoms are
most characteristic of:
1. Delirium.
2. Dementia.
3. Depression.
4. DAT.
Answer:
Which of the following medications carries the highest risk of QTc prolongation and,
therefore, the need to monitor cardiac side effects most carefully?
1. Thioridazine (Mellaril)
2. Risperidone (Risperdal)
3. Quetiapine (Seroquel)
4. Olanzapine (Zyprexa)
Answer:
The client reports that the medication must be effective since the hallucinations are now
markedly diminished. The nurse documents that the client is responding positively to
which of the following medications?
1. Paroxetine (Paxil)
2. Methylphenidate (Ritalin)
3. Zolpidem (Ambien)
4. Olanzapine (Zyprexa)
Answer:
A 79-year-old woman suffering from dementia of the Alzheimer’s type resides in an
independent living long-term care facility. During a recent nursing visit, the client was
quite upset about the loss of her frying pan. While complaining about its loss, she was
holding the pan in her hand. The nurse pointed out to the client that she had the pan she
was looking for. The client looked at the pan and stated, “No, this is not it.” The nurse
knows the client is exhibiting:
1. Aphasia.
2. Agnosia.
3. Apraxia.
4. Nystagmus.
Answer:
Which of the following is a grassroots, self-help support organization of families,
friends, and clients with severe mental illness?
1. National Institute of Mental Health (NIMH)
2. American Mental Health Association (AMHA)
3. A mental health clinic
4. National Alliance on Mental Illness (NAMI)
Answer:
A client’s daughter provides all the day-to-day care for her mother who has a diagnosis
of dementia. The daughter is experiencing symptoms of insomnia, stomach pains, and
frequent headaches. These symptoms may indicate that the daughter is in need of:
1. A nursing home placement for her mother.
2. Electroconvulsive treatment for depression.
3. A thorough mental status examination.
4. Supportive counseling and information about respite care.
Answer:
The nurse is providing discharge instructions to a client diagnosed with an anxiety
disorder. What will the nurse tell the client about the activity of the amino acid
gamma-aminobutyric acid (GABA), benzodiazepines, and the effect on anxiety?
1. GABA is an inhibitory neurotransmitter.
2. GABA increases neuronal excitability.
3. GABA increases can be neurotoxic.
4. GABA is an excitatory neurotransmitter.
Answer:
The wife of an older client is concerned that her husband has recently experienced
memory lapses, is unusually aggressive and was involved in three traffic accidents in
the past month. In planning a response, the nurse is guided by the knowledge that:
1. Further intervention is needed to prevent elder abuse of the wife.
2. Further assessment is needed to determine if alcohol abuse is possible.
3. These are normal responses to aging.
4. These are signs of depression or dementia.
Answer:
An individual is subjected to chronic uncontrollable stress. What will be the effect on
the client’s neuroendocrine function?
1. Hypoactivity of the hypothalamic-pituitary-adrenal (HPA) axis and release of
substance P
2. Hypoactivity of the hypothalamic-pituitary-adrenal (HPA) axis and release of
dopamine
3. Hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis and release of
dopamine
4. Hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis and release of
substance P
Answer:
The nurse is presenting information to a gatekeeper training class about the people in a
suicide victim’s life, including the most commonly recognized risk factors for suicidal
behavior, symptoms of mental illness, and barriers to mental health treatment. The
nurse teaches that both parents and friends were equally able to recognize many risk
factors, but friends were better than parents at recognizing risk factors for:
1. Suicide.
2. Mania.
3. Substance abuse.
4. Depression.
Answer:
The nurse reviews the data family and friends provided in the comprehensive
assessment of a client’s situation. The nurse knows to treat the data as:
1. Invalid until confirmed with the client.
2. Subjective data.
3. Primary data.
4. Peripheral to the assessment.
Answer:
A 7-year-old child recently experienced the death of the family’s pet dog, which was the
child’s constant companion. The child is at risk for:
1. A conduct disorder.
2. Elimination disorder.
3. Angoraphobia.
4. Separation anxiety disorder.
Answer:
A psychiatric”mental health nurse is attending a seminar. The speaker discusses how
certain psychiatric diagnoses are associated with stereotypes. Which of the following
actions ensures that the client’s social identity is not discredited?
1. Refer to a client as delusional and psychotic.
2. Refer to a client as a schizophrenic.
3. Refer to a client as a paranoid.
4. Refer to a client as X who has a diagnosis of schizophrenia.
Answer:
The psychiatric”mental health nurse is assessing a new client recently diagnosed with
an anxiety disorder and high blood pressure. The nurse knows to closely monitor vital
signs and review this client’s medication list for:
Standard Text: Select all that apply.
1. Haloperidol (Haldol).
2. Acetaminophen (Tylenol).
3. Aspirin.
4. Olanzapine (Zyprexa).
5. Thioridazine (Mellaril).
Answer:
The client with schizophrenia is on olanzapine (Zyprexa) and has gained ten pounds in
the four weeks after its initiation. The client asks the nurse if the weight gain is related
to this medication. What nursing response is correct?
1. This medication is associated with weight gain in some clients.
2. The client is most likely gaining weight due to a hidden alcohol problem.
3. The client was evidently not weighed correctly initially.
4. The client is probably just feeling better and eating more.
Answer:
An older client with mild dementia of the Alzheimer’s type is started on donepezil
(Aricept). The client’s daughter asks the nurse how long it will take for her mother to be
cured. Which response by the nurse is correct?
1. Cure rates vary by individuals and will take about six weeks to determine.
2. It takes about two weeks for the neurochemical cure to occur.
3. As long as she continues to take the medication, she will be symptom-free but not
cured.
4. The medication will improve her memory but not cure the dementia.
Answer:
A client is pacing in the hall. The nurse overhears the client say, “Leave me alone. I am
not in the Mafia.” The best response from the nurse would be:
1. “Remember you are safe from the Mafia here in the hospital.”
2. “Tell me what you are hearing right now.”
3. “You need to attend the next recreation group. That will help you ignore the voices.”
4. “You are hearing voices again, right?”
Answer:
The nurse and a client talk about Alcoholics Anonymous (AA). The client asks, “What’s
AA all about?” Which reply by the nurse best describes AA?
1. “It’s a group that learns about drinking from a group leader.”
2. “It’s a form of group therapy led by a psychiatrist.”
3. “It’s a group that advocates strong punishment for drunk drivers.”
4. “It’s a self-help group where the norm is sobriety.”
Answer:
A child with asthma was admitted to the hospital during an attack. The mother says,
“This is all my fault, if only I hadn”t smoked when I was pregnant.” Which response
would be helpful to the mother?
1. Tell her not to worry because her smoking did not cause the child’s asthma.
2. Explain that asthma involves a host of biological factors, of which heredity plays a
large role.
3. Tell the mother that she should feel guilty, and find out if she’s still smoking.
4. Ask why she believes that she caused the child’s admission.
Answer:
Which of the following laboratory studies are routinely done on patients taking second
generation antipsychotic medications?
1. Hemoglobin and hematocrit
2. Renal functions
3. Thyroid functions
4. Serum glucose levels
Answer:
A client with a diagnosis of paranoid personality disorder appears hypervigilant and sits
alone in an isolated area of the unit. The client does not acknowledge other clients and
often uses sarcasm when addressing staff. The nurse invites the client to attend a milieu
group, but the client ignores the nurse’s efforts. An appropriate nursing diagnosis for
this client is which of the following?
1. Activity Intolerance
2. Fear
3. Impaired Social Interaction
4. Powerlessness
Answer:
A client comes to the nurse’s station yelling, “I have to call the FBI. The bombs are set
to destroy Washington, D.C. at 1:00 p.m. Please help me. It will be your fault if I don”t
call.” Which intervention best demonstrates the nurse’s sensitivity?
1. Assist the client to become aware that this is a delusional belief.
2. Listen carefully for the underlying emotion expressed by the client’s request.
3. Share your concerns that the client’s request is unreasonable.
4. Switch the topic of conversation to defuse the client’s underlying agitation.
Answer:
The nurse is admitting a client who is from Kenya to the psychiatric unit. Which of the
following actions will demonstrate cultural competence?
1. Arrange for an interpreter to assist.
2. Ask a family member to stay during the assessment interview.
3. Follow the admission assessment form.
4. Talk with the client to determine fluency in English.
Answer:
In caring for victims of violence it is important for nurses to be aware of their personal
feelings and attitudes about the situation because:
1. Intense negative feelings interfere with assessment and judgment.
2. It allows the nurse to express sympathy for the client.
3. Intense protective feelings result in appropriate interventions for the victim’s care.
4. Self-awareness protects the nurse’s own mental health.
Answer:
The nurse is caring for a client with somatization disorder. When providing a report to
the staff on the next shift, it is important for the nurse to relate the:
1. Amount of time the client talked about physical complaints.
2. Trigger for the client’s worries.
3. Use of abdominal breathing at the first sign of anxiety.
4. The client’s source of the original anxiety.
Answer:
A psychiatric hospital was recently purchased by a large healthcare system. The new
administration’s business motto is “leaner and meaner,” consequently, the staff mix has
been adjusted by replacing some of the highly experienced nurses with robust male
mental health technicians who cost less and are able to provide physical interventions.
The change that is likely to increase the risk for violence in this hospital is the:
1. Change in hospital ownership.
2. Advanced age of nursing staff.
3. Adjustment in staff mix.
4. Motto that implies staff will be mean.
Answer:
To which of the following information sources for the client with an eating disorder
should the nurse limit exposure because of the many societal influences on perceptions
of attractiveness?
1. Information about coping behaviors
2. Articles about eating disorders
3. Programs that emphasize good nutrition
4. Media that glamorizes thinness
Answer:
The nurse is admitting a client to the unit after a substance abuse relapse. The nurse
assesses that the client’s family has not been supportive of recovery efforts and requires
education. Which of the following is a priority for client teaching?
1. Relapse triggers for the client
2. The effects of substance abuse on the client
3. Unit visiting hours
4. Local support group information
Answer:
A grieving widow tells a psychiatric”mental health nurse, “I feel so tired and alone.”
The nurse who incorporates an understanding of symbolic interactionism in practice
would not suggest which of the following to the client?
1. “You had a terrible loss. Feeling tired and alone must be very difficult for you.”
2. “I would like to hear more about how you are feeling now.”
3. “Try to get plenty of rest. Most people who suffer losses like yours need more sleep
than usual to cope effectively.”
4. “You seem sad. Can I sit with you for a while?”
Answer:
The nurse finds the client crying in the room. The client states, “I”m so sad and lonely.
I”m sitting here crying like a baby.” Which of the following responses best reflects the
nurse’s sensitivity toward the client?
1. “Why don”t you come to the dayroom to be with others?”
2. “Are you feeling embarrassed because you are crying?”
3. “Don”t worry about crying. I think you are a fine person.”
4. “It’s a gray, rainy day. A lot of clients are feeling sad.”
Answer:
A client is hospitalized for psychotic symptoms including auditory hallucinations and
paranoid delusions. Based on an understanding of neurobiology, the nurse knows the
psychotic symptoms arise from disruptions in which neurotransmitter?
1. Norepinephrine
2. Serotonin
3. Acetylcholine
4. Dopamine
Answer:
A nurse generalist and advanced practice nurse both work on the staff of an inpatient
unit. The advanced practice nurse has a comprehensive role as a primary caregiver in
child psychiatry. Which of the following will be performed by the advanced practice
nurse but not by the nurse generalist?
1. Explaining the treatment plan to a family
2. Performing admission assessments
3. Participating in discharge planning
4. Providing one-to-one counseling
Answer:
Which of the following community support programs should the nurse recommend to
family members of a client with severe and persistent mental illness (SPMI) who is
living independently in the community?
Standard Text: Select all that apply.
1. Residential special care units
2. Hospices
3. Day treatment
4. Case management
5. Medication management
Answer:
The nurse is talking with a client diagnosed with schizophrenia about the importance of
careful adherence to the medication regimen. Which of the following client reasons is
not commonly associated with noncompliance?
1. Lack of access to pharmacies due to financial or transportation concerns
2. Increased ability to trust healthcare providers who prescribe medications
3. Inability to understand instructions for taking medications
4. Side effects causing extreme discomfort
Answer: