Chapter 56: Psychiatric Disorders
Linton: Introduction to Medical–Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. A patient is given anxiolytic medications for a mental disorder. What type of approach is this
considered?
a.
Analytical
b.
Interpersonal
c.
Biologic
d.
Psychoanalytic
2. A patient states that he feels angry at work for no reason and often yells at his coworkers. 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?
a.
Biologic
b.
Analytical
c.
Cognitive or behavioral
d.
Interpersonal
3. What is the best action for the nurse to implement to effectively listen therapeutically to a
patient?
a.
Concentrate on the patient and not think of responses to the patient while he or she
is speaking.
b.
Determine the cause of the patient’s problem while the patient is speaking.
c.
Ask the patient why he thinks he feels the way he does.
d.
Tell the patient that you have had similar experiences.
4. 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?
a.
Listening
b.
Sharing observations
c.
Clarifying
d.
Being available
5. 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?
a.
Appearance
b.
Mood and affect
c.
Thought content
d.
Memory and attention
6. 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?
a.
“Do you have any thoughts of harming yourself?”
b.
“Have you felt like this before?”
c.
“You are just depressed. When you feel better, you won’t think that way.”
d.
“We will keep you safe here.”
7. 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”?
a.
Anxiety disorder
b.
Panic disorder
c.
Agoraphobia
d.
Obsessive-compulsive disorder
8. A group of nursing students are taking their first major examination. What should the nursing
instructor expect the students might experience?
a.
Posttraumatic stress disorder
b.
Panic disorder
c.
Mild anxiety
d.
Moderate anxiety
9. A patient 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?
a.
Encourage the patient to talk about what caused the traumatic event.
b.
Guide the patient in relaxation techniques to distract him when flashbacks occur.
c.
Provide sleeping medication so that he can sleep at night.
d.
Allow the patient to talk about his condition as often as he likes.
10. 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?
a.
“There is nothing wrong with your arms. Roll yourself to your room.”
b.
“I will help you to walk to your room. I know you can walk.”
c.
“Let me lift the foot rests so you can move your chair with your feet.”
d.
“OK. I am going that way myself.”
11. Which combination of medications could be used to treat an anxiety disorder?
a.
Librium and Xanax
b.
Effexor and Ativan
c.
Effexor and Haldol
d.
Klonopin and Valium
12. Which nursing diagnosis is appropriate for all patients with an anxiety, a somatoform, or a
dissociative disorder?
a.
Altered nutrition, less than body requirements
b.
Disturbed body image
c.
Ineffective denial
d.
Ineffective coping
13. 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?
a.
Dissociative disorder
b.
Conversion disorder
c.
Schizophrenia
d.
Amnesia
14. 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?
a.
Antiparkinsonian
b.
Antihypertensive
c.
Anticonvulsant
d.
Antiemetic
15. A long-time patient with schizophrenia in the inpatient unit has developed involuntary
movements of his tongue. What has this patient developed?
a.
Acute dystonic reaction
b.
Tardive dyskinesia
c.
Neuroleptic malignant syndrome
d.
Laryngospasm
16. Which is not considered as a probable cause of mood disorders?
a.
Loss of significant others
b.
Learned helplessness
c.
Neurotransmitter dysregulation
d.
Traumatic event in childhood
17. 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?
a.
Orthostatic hypotension
b.
Hypercholesterolemia
c.
Fatigue
d.
Blurred vision
18. A patient with schizophrenia has undergone eight electroconvulsive therapy treatments
(ECTs) in the past 2 weeks. The daughter is upset that her parent is lethargic, confused, and
does not recognize her. What knowledge should the nurse consider when preparing to
respond?
a.
The combination of ECTs and neuroleptic medications can make a patient drowsy.
b.
These reactions indicate a drug overdose.
c.
Many patients with schizophrenia punish their families by pretending not to know
them.
d.
A temporary memory loss is common after several ECTs.
19. A patient is hyperactive with mania and has a nursing diagnosis of “Nutrition, altered, less
than body requirements, related to hyperactivity,” What implementation is most appropriate
when considering this diagnosis?
a.
Offer nutritious finger foods and high-protein milk shakes to eat on the go.
b.
Spoon-feed the patient while the patient is seated at the table.
c.
Arrange for one large meal at noon to be eaten in the company of others.
d.
Limit fluid intake to make the patient hungry at mealtime.
20. 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?
a.
Panic attack
b.
Hyperactive episode
c.
Extrapyramidal effect
d.
Manic episode
21. 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?
a.
Decrease the stimuli and use restraints if all other measures fail.
b.
Offer to call the physician and ask another staff member to call security.
c.
Remove harmful objects and try to perform relaxation exercises with the patient.
d.
Restrain the patient and do not allow him or her to eat or drink anything by mouth.
22. 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?
a.
Stay in the shade when walking.
b.
Stop walking.
c.
Maintain hydration.
d.
Wear sunscreen.
23. A patient who has a history of episodes of road rage thinks that she is a very good driver and
does not understand why she keeps being told she is a poor driver. She is losing her license
now, and she tells the nurse that she is feeling very unhappy and abandoned. She feels like she
might hurt herself. The nurse realizes that the patient is exhibiting which personality disorder?
a.
Narcissistic
b.
Paranoid
c.
Schizoid
d.
Borderline
24. A coworker is noted to be very organized. However, you see that he is always making lists
and citing the rules of the organization. He wants all his projects to be perfect and gets very
upset when things happen that make him miss his deadlines. The coworker is exhibiting signs
of which personality disorder?
a.
Avoidant
b.
Obsessive-compulsive
c.
Histrionic
d.
Dependent
25. What is a common cause of delirium?
a.
Overuse of steroids
b.
Liver abnormalities
c.
Parkinson disease
d.
Neoplasms
MULTIPLE RESPONSE
26. A nurse is assessing a patient with an acute stress disorder. What characteristics of this
disorder should the nurse assess? (Select all that apply.)
a.
Diminished awareness of surroundings
b.
Derealization
c.
Depersonalization
d.
Amnesia
e.
Irritability
27. A nursing instructor is explaining the difference between illusion and hallucination. Which
examples provided by students in the class indicate an illusion? (Select all that apply.)
a.
A car backfiring being perceived as gunfire
b.
The television news being perceived as someone talking to you
c.
Hearing God’s voice directing you to drive your car off the road
d.
Seeing your dead spouse smile at you from a flower
e.
A spot on the wall being perceived as a spider
COMPLETION
28. When a patient asks a nurse to touch him, the nurse asks why he needs this. The patient
replies, “I just need to know that I am real.” The nurse assesses that response as a primary
sign of _____.
29. When a nurse asks questions like, “What day is today?” or “What time is it now?” the nurse is
testing the patient’s _____.