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Exam #1 Mental Health, Exams of Nursing

Abilene Christian University (ACU)Nursing

Exam #1 Mental Health fully solved

Typology: Exams

2023/2024

Available from 10/18/2024

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Exam #1 Mental Health
1. One characteristics of mental health that allows people to adapt to tragedies, trauma, and loss is:
A. Dependence
B. Resilience
C. Pessimism
D. Altruism - correct answer โœ”โœ”B. Resilience
2. You and Jack are two of the nurses working on the psychiatric unit. Jack mentions to you that the
biological model for mental illness is the one he embraces, and states "it's the only one I really believe."
Which of the following statements is true regarding believing in only the biological model?
A. The biological model is the oldest and most reliable model for explaining mental illness.
B. The biological model does not explain every symptom of mental illness.
C. The biological model is the most popular theory among leading psychiatrists and therefore the one
that should be fully embraced.
D. In believing only the biological model, other influences on mental health including cultural,
environmental, social, and spiritual influences are not taken into account. - correct answer โœ”โœ”D. In
believing only the biological model, other influences on mental health including cultural, environmental,
social, and spiritual influences are not taken into account.
3. Vanessa's provider writes orders including medication to treat her depression. Based on current
understanding of brain physiology, which of the following neurotransmitters would you expect to see
targeted c the medication ordered?
A. Dopamine
B. GABA
C. Serotonin/Norepinephrine
D. Acetylcholine - correct answer โœ”โœ”C. Serotonin/Norepinephrine
4. Which of the following structural safety precautions is most important to prevent the most common
type of inpatient suicides?
A. Break-away closet bars to prevent hanging
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Exam #1 Mental Health

  1. One characteristics of mental health that allows people to adapt to tragedies, trauma, and loss is: A. Dependence B. Resilience C. Pessimism D. Altruism - correct answer โœ”โœ”B. Resilience
  2. You and Jack are two of the nurses working on the psychiatric unit. Jack mentions to you that the biological model for mental illness is the one he embraces, and states "it's the only one I really believe." Which of the following statements is true regarding believing in only the biological model? A. The biological model is the oldest and most reliable model for explaining mental illness. B. The biological model does not explain every symptom of mental illness. C. The biological model is the most popular theory among leading psychiatrists and therefore the one that should be fully embraced. D. In believing only the biological model, other influences on mental health including cultural, environmental, social, and spiritual influences are not taken into account. - correct answer โœ”โœ”D. In believing only the biological model, other influences on mental health including cultural, environmental, social, and spiritual influences are not taken into account.
  3. Vanessa's provider writes orders including medication to treat her depression. Based on current understanding of brain physiology, which of the following neurotransmitters would you expect to see targeted c the medication ordered? A. Dopamine B. GABA C. Serotonin/Norepinephrine D. Acetylcholine - correct answer โœ”โœ”C. Serotonin/Norepinephrine
  4. Which of the following structural safety precautions is most important to prevent the most common type of inpatient suicides? A. Break-away closet bars to prevent hanging

B. Bedroom and dining areas with locked windows to prevent jumping C. Double-locked doors to prevent escaping from the unit D. Platform beds to prevent crush injuries - correct answer โœ”โœ”A. Break-away closet bars to prevent hanging

  1. Josefina Juarez, aged 36 years, comes to the mental health clinic where you work after being referred by her primary care provider. Josefina came to live in the US from Brazil 5 years ago. She is now a single mother to 6 children, ages 2 to 15, following the death of her husband last year. During the initial intake assessment, Josefina tells you her problem is that she has headaches and backaches "almost every day" and "can't sleep at night." She shakes her head no and looks away when asked about anxiety or depression and states she does not know why she was referred to the mental health clinic. You recognize that Josefina may be exhibiting: A. regression. B. somatization. C. enculturation. D. assimilation. - correct answer โœ”โœ”B. somatization
  2. You are working on an inpatient psychiatric unit and caring for Elizabeth, who is becoming agitated. You speak with Elizabeth one to one in a private setting, finding out the reason for the agitation, and then assist Elizabeth with ways to calm down, possibly including prn medication to prevent further escalation of Elizabeth's agitation, which could lead to seclusion and/or restraints. You are making care decisions based on: A. Writ of habeas corpus B. Least restrictive alternative doctrine C. Veracity D. Bioethics - correct answer โœ”โœ”B. Least restrictive alternative doctrine
  3. Joel is a 43-year-old patient being seen in the mental health clinical c depression. Joel states "I have always been a practicing Jew, but in the past few mos. I am questioning everything. I just don't know if I believe in it anymore. Which of the following nursing diagnoses best describes Joel's comment? A. Ineffective coping B. Spiritual distress C. Risk for self-harm

E. Promotion of a feeling of belonging

  1. What is currently the most accepted explanation for mental illness? A. Diathesis-stress model (biological predisposition AND environmental stress/trauma or nature-plus- nurture) B. Family history of mental illness; e.g., depression, schizophrenia C. Physically, emotionally and/or sexually abusive parents D. Nature E. Nurture F. Stresses of nursing school - correct answer โœ”โœ”A. Diathesis-stress model (biological predisposition AND environmental stress/trauma or nature-plus-nurture)
  2. The presence of which symptom will exert the greatest pressure to admit an individual to an inpatient psychiatric unit? A. Suicidal ideation B. Moderate anxiety C. Feelings of sadness D. Auditory hallucinations E. Visual hallucinations - correct answer โœ”โœ”A. Suicidal ideation
  3. _________________ is the admission to a facility without the patient's consent. A. Voluntary admission B. Involuntary admission C. Informal admission D. Temporary admission E. General admission - correct answer โœ”โœ”B. Involuntary admission
  4. To provide appropriate care for a patient admitted involuntarily to a psychiatric unit and before court- ordered tx, the nurse must be aware of the fact that the patient has the right to: A. Refuse psychotropic medications

B. Be treated by unit staff of his or her choice C. Be released within 24 hours of making a written request D. Have a consultation with other mental health professionals at the hospital's expense - correct answer โœ”โœ”A. Refuse psychotropic medications

  1. What is the general rule in terms of placing patients in restraints and seclusion? A. Least restrictive and longest duration B. Most restrictive and longest duration C. Least restrictive and shortest duration D. Most restrictive and shortest duration - correct answer โœ”โœ”C. Least restrictive and shortest duration
  2. What is the order of nursing interventions in order to calm an agitated patient? A. Physical/mechanical interventions (restraint and seclusion), verbally ask for patient's cooperation, medication/chemical interventions B. Verbally ask for patient's cooperation, medication/chemical interventions, physical/mechanical interventions (restraint and seclusion) C. Medication/chemical interventions, verbally ask for patient's cooperation, physical/mechanical interventions (restraint and seclusion) D. Verbally ask for patient's cooperation, physical/mechanical interventions (restraint and seclusion), medication/chemical interventions - correct answer โœ”โœ”B. Verbally ask for patient's cooperation, medication/chemical interventions, physical/mechanical interventions (restraint and seclusion)
  3. What is it called when the patient unconsciously and inappropriately displaces onto the health care professional feelings and behaviors related to significant figures in the patient's past? For example, the patient may inform the nurse. "You remind me of my mother." A. Sympathy B. Countertransference C. Empathy D. Transference E. Neuropathy - correct answer โœ”โœ”D. Transference
  1. Which statement by a nurse would be considered nontherapeutic? A. "I'm not sure I understand what you mean." B. "Tell me more about what happened when you resigned." C. "I see that you are wringing your hands as we talk about the job interview." D. "I know EXACTLY how you feel!" - correct answer โœ”โœ”D. "I know EXACTLY how you feel!"
  2. Jerry is a 72-year-old patient c Parkinson's disease and anxiety. He is living by himself and he has had an unsteady gait lately. His provider orders lorazepam (Ativan), 1 mg PO bid for anxiety (Ativan is a benzodiazepine.). You question this order because: A. Jerry may become addicted faster than younger patients. B. Jerry is at increased risk for falls. C. Jerry has a hx of nonadherence c medications. D. Jerry should be treated c cognitive therapies rather than medication because of his advanced age. - correct answer โœ”โœ”B. Jerry is at increased risk for falls.
  3. A nurse administering a benzodiazepine should understand that the therapeutic effect of benzodiazepines results from potentiating the neurotransmitter: A. Serotonin B. Dopamine C. Acetylcholine D. Gamma-aminobutyric acid (GABA) - correct answer โœ”โœ”D. Gamma-aminobutyric acid (GABA)
  4. Which nursing action is NOT useful in promoting delivery of culturally relevant psychiatric mental health nursing care? A. Providing a culturally relevant patient assessment B. Working within the cultural context of the patient C. Using direct eye contact and touch to facilitate communication D. Bridging the gap between the U.S. health care system and the health belief system of the patient - correct answer โœ”โœ”C. Using direct eye contact and touch to facilitate communication
  1. Carrie Bradshaw, 34-years-old, is depressed about being single and unable to find the right man willing to make a commitment. Based on Erikson's Eight Stages of Development, Carrie is experiencing the psychosocial crisis called: A. Trust vs. mistrust B. Industry vs. inferiority C. Identity vs. role confusion D. Intimacy vs. isolation E. Integrity vs. despair - correct answer โœ”โœ”D. Intimacy vs. isolation
  2. Lithium has a _____________________ therapeutic index. A. Low B. High - correct answer โœ”โœ”A. Low
  3. A _________ therapeutic index means that the blood level of a drug that can cause death is not far above the blood level required for drug effectiveness. A. Low B. High - correct answer โœ”โœ”A. Low
  4. Lithium is a(n) _______________________ used to treat _______________. A. Antipsychotic and schizophrenia B. Antianxiety (anxiolytic) and anxiety C. Mood stabilizer and bipolar disorder D. Antidepressant and depression E. Anticonvulsant and bipolar disorder - correct answer โœ”โœ”C. Mood stabilizer and bipolar disorder
  5. What are the early adverse/toxic effects of lithium or the S/S a RN should be alert for in a patient on lithium? A. Fever, cough, sore throat B. Ataxia, tremor, confusion C. Extrapyramidal symptoms; e.g., akinesia, akathisia, parkinsonism

D. Anticonvulsants E. Benzodiazepines - correct answer โœ”โœ”B. MAOIs

  1. Foods that contain tyramine to avoid include: A. Yogurt, broccoli, oranges B. Aged cheeses, pickled/smoked fish, fermented meats C. Milk, blueberries and fresh meats D. Eggs, shellfish and iodine - correct answer โœ”โœ”B. Aged cheeses, pickled/smoked fish, fermented meats
  2. ____________________ are generally considered 1st-line treatment for depression. A. MAOIs B. SSRIs C. TCAs D. Lithium E. Anticonvulsants - correct answer โœ”โœ”B. SSRIs
  3. What class of medications is generally the 1st-line treatment for schizophrenia? A. 1st-generation (conventional/typical) antipsychotics B. 2nd-generation (atypical) antipsychotics C. SSRIs D. Lithium E. Anticonvulsants - correct answer โœ”โœ”B. 2nd-generation (atypical) antipsychotics A patient taking an atypical/2nd-generation antipsychotic, Clozaril (clozapine), needs to have the following lab work or test monitored regularly: A. Clozaril level B. WBC or ANC C. EKG D. Lithium level

E. Blood pressure - correct answer โœ”โœ”B. WBC or ANC After discontinuing a MAOI, a patient needs to wait AT LEAST _________to start another class of antidepressants; e.g. a SSRI. A. 24-48 hours B. 48-72 hours C. 7 days D. 14 days E. 28 days - correct answer โœ”โœ”D. 14 days Which class of medications can lead to extrapyramidal side effects (EPS) like akathisia and pseudoparkinsonism due to dopamine blockage? A. Antidepressants B. Antianxiety (anxiolytics) C. Antipsychotics D. Anticonvulsants E. Lithium - correct answer โœ”โœ”C. Antipsychotics Which of the following medications have the greatest potential for tolerance and dependence and is a controlled substance? A. Benzodiazepines B. SSRIs C. MAOIs D. TCAs E. Lithium - correct answer โœ”โœ”A. Benzodiazepines In a patient taking a MAOI, excess tyramine poses a threat of: A. Hypertensive crisis B. Extrapyramidal side effects (EPS)

B. A SSRI given concurrently with a MAOI C. The patient is placed on general suicide precautions. D. The patient has comorbid anxiety and is prescribed a SSRI for the depression. - correct answer โœ”โœ”A. A patient has a hx of heart disease and is prescribed a TCA. B. A SSRI given concurrently with a MAOI

  1. Lethal overdose is LEAST likely with which class of medications? A. Benzodiazepine combined with alcohol and other CNS depressant(s) B. SSRIs C. TCAs D. MAOIs - correct answer โœ”โœ”B. SSRIs
  2. A patient is taking Haldol, a 1st-generation/typical antipsychotic. The nurse observes motor abnormalities in the patient. The patient is likely experiencing S/S of: A. Hypertensive crisis B. Extrapyramidal side effects (EPS) C. Agranulocytosis D. Stevens-Johnson syndrome E. Anticholinergic side effects - correct answer โœ”โœ”B. Extrapyramidal side effects (EPS)
  3. A newly-admitted patient was involuntarily hospitalized. The nurse observes the patient frequently lurking near the front door to the unit. What precaution should be instituted for the patient? A. Suicide B. Fall C. Elopement D. Assaultive E. Seizure - correct answer โœ”โœ”C. Elopement

After discontinuing a MAOI, a patient needs to wait AT LEAST _________to start another class of antidepressants; e.g. a SSRI. A. 24-48 hours B. 48-72 hours C. 7 days D. 14 days E. 28 days - correct answer โœ”โœ”D. 14 days