NURS 661 Exam 1 Questions with 100% Correct Answers | Verified | Updated 2023-2024, Exams of Advanced Education

Download NURS 661 Exam 1 Questions with 100% Correct Answers | Verified | Updated 2023-2024 and more Exams Advanced Education in PDF only on Docsity! NURS 661 Exam 1 Questions with 100% Correct Answers | Verified | Updated 2023- 2024 The nurse prepares to assess a patient diagnosed with major depression for disturbances in circadian rhythms. Which question should the nurse ask this patient? a. Have you ever seen or heard things that others do not? b. What are your worst and best times of the day? c. How would you describe your thinking? d. Do you think your memory is failing? Answer: B The nurse is serving on a committee charged with reviewing the roles and responsibilities of the nurses on the psychiatric unit. Which publication should the nurse bring to the first meeting? 1. Diagnostic and Statistical Manual of Mental Disorders 2. American Nurses Credentialing Center certification requirements 3. American Nurses Association, Code of Ethics 4. Psychiatric Mental Health Nursing Standards of Practice Answer: 4 The psychiatric mental health nurse reflecting on professional role activities is referred to the standards of professional performance by a colleague. To which organization should the nurse look for guidance? 1. North American Nursing Diagnosis Association 2. American Nurses Credentialing Center 3. National League for Nursing 4. American Nurses Association Answer: 4 The psychiatric mental health nurse is working with the new graduate nurse who is orienting to the psychiatric unit. Which comment by the new graduate indicates further clarification of the generalist- nursing role is needed? 1. I would feel better if you would look at my documentation that addresses progress toward treatment goals. 2. I will spend time each day evaluating the effectiveness of the therapeutic milieu. 3. I am a little nervous about conducting psychotherapy with clients. 4. I am doing some reading on how to incorporate complementary interventions into treatment plans. Answer: 3 The client on the psychiatric unit is asking questions about prevention of sexually transmitted diseases. Given the PsychiatricMental Health Nursing Standards of Practice, which action would be most appropriate for the nurse to take at this time? 1. Consult with the mental health care team. 2. Teach safer sexual practices. 3. Investigate the questions in individual psychotherapy. 4. Notify the attending psychiatrist. Answer: 2 The client asks the nurse if certain changes can be made in the unit milieu. Which action by the nurse indicates understanding of the nursing role in the therapeutic milieu? 1. The nurse refers the clients requests to the psychiatric social worker. 2. The nurse discusses the desired changes with the client. 3. The nurse refers the clients requests to the psychosocial rehabilitation worker. 4. The nurse instructs the client that no changes can be made. Answer: 2 Due to a staff members absence, the nurse is reviewing staff assignments for the day. Which task can the nurse delegate to the psychosocial rehabilitation worker? 1. Conflict resolution teaching to a small group of clients 2. Comparison of physicians orders with the medication records 3. Routine medication administration to a stable client 4. Assessment of a long-term client Answer: 1 If psychiatric nurses used Orems theory for structuring much of their nursing practice, a major focus area for assessment would be the clients ability to do which of the following? 1. Adapt and function to meet various role expectations. 2. Care about self and participate in self-healing. 3. Implement self-care to meet psychosocial needs. 4. Enter into a therapeutic one-to-one relationship with the nurse. b. improved memory c. more organized thinking d. fewer sensory perceptual alterations Answer: A A nurse would anticipate that treatment for a patient with memory difficulties might include medications designed to: A. inhibit gamma-aminobutyric acid (GABA). B. prevent destruction of acetylcholine. C. reduce serotonin metabolism. D. increase dopamine activity. Answer: B 8. A patient has disorganized thinking associated with schizophrenia. Neuroimaging would likely show dysfunction in which part of the brain? a. Hippocampus b. Frontal lobe c. Cerebellum d. Brainstem Answer: B The nurse should assess a patient taking a drug with anticholinergic properties for inhibited function of the: a. parasympathetic nervous system b. sympathetic nervous system c. reticular activating system d. medulla oblongata Answer: A The therapeutic action of neurotransmitter inhibitors that block reuptake cause: a. decreased concentration of the blocked neurotransmitter in the central nervous system. b. increased concentration of the blocked neurotransmitter in the synaptic gap. c. destruction of receptor sites specific to the blocked neurotransmitter. d. limbic system stimulation. Answer: B A patient taking medication for mental illness develops restlessness and an uncontrollable need to be in motion. Which drug action causes these symptoms to develop? a. Anticholinergic effects b. Dopamine-blocking effects c. Endocrine-stimulating effects d. ability to stimulate spinal nerves Answer: B A patient has fear as well as increased heart rate and blood pressure. The nurse suspects increased activity of which neurotransmitter? a. Gamma-aminobutyric acid (GABA) b. Norepinephrine c. Acetylcholine d. Histamine Answer: B A patient has acute anxiety related to an automobile accident 2 hours ago. The nurse should teach the patient about medication from which group? a. Tricyclic antidepressants b. Antipsychotic drugs c. Antimanic drugs d. Benzodiazepines Answer: D A patient is hospitalized for severe depression. Of the medications listed below, the nurse can expect to provide the patient with teaching about: a. chlordiazepoxide (Librium) b. clozapine (Clozaril) c. sertraline (Zoloft) d. tacrine (Cognex) Answer: C A patient diagnosed with bipolar disorder has an unstable mood, aggressiveness, agitation, talkativeness, and irritability. The nurse expects the health care provider to prescribe a medication from which group? a. psychostimulants b. mood stabilizers c. anticholinergics d. antidepressants Answer: B A drug causes muscarinic receptor blockade. The nurse will assess the patient for: a. dry mouth b. gynecomastia c. psedoparkinsonism d. orthostatic hypotension Answer: A A patient begins therapy with a phenothiazine medication. What teaching should the nurse provide related to the drugs strong dopaminergic effect? a. chew sugarless gum b. increase dietary fiber c. arise slowly from bed d. report changes in muscle movement Answer: D A patient tells the nurse, My doctor prescribed Paxil (paroxetine) for my depression. I assume Ill have side effects like I had when I was taking Tofranil (imipramine). The nurses reply should be based on the knowledge that paroxetine is a(n): a. selective norepinephrine reuptake inhibitor. b. tricyclic antidepressant. c. MAO inhibitor. d. SSRI Answer: A A nurse can anticipate anticholinergic side effects are likely when a patient takes: a. lithium (Lithobid) b. buspirone (BuSpar) c. imipramine (Tofranil) d. risperidone (Risperdal) Answer: C Which instruction has priority when teaching a patient about clozapine (Clozaril)? a. Avoid unprotected sex. b. Report sore throat and fever immediately. c. Reduce foods high in polyunsaturated fats. d. Use over-the-counter preparations for rashes. Answer: B A nurse cares for a group of patients receiving various medications, including haloperidol (Haldol), carbamazepine (Tegretol), trazodone (Desyrel), and phenelzine (Nardil). The nurse will order a special diet for the patient who takes: As part of the comprehensive admission assessment, the nurse talks with family and friends who may contribute additional data to a clients psychiatric history. When reviewing the data obtained from these sources, the nurse keeps in mind which of the following perspectives of the data? The information provided: 1. Will vary according to the sources relationship to the client. 2. Comes from each individuals perspective. 3. Is considered false. 4. Is considered accurate. Answer: 2 The nurse reviews the data family and friends provided in the comprehensive assessment of a clients 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: 2 The nurse is talking with the family of a mentally ill client who lives with them. The client is being admitted to the inpatient psychiatric unit. What is the priority information to gather from the family? 1. Whether the client had a flu shot recently 2. The number of medications prescribed for the client 3. How the clients symptoms are expressed at home 4. The type of soap the client prefers to use Answer: 3 A client makes the following statement during a mental status assessment: I cant use the phones; the CIA has bugged all the wires. Which of the following categories will the nurse use to document the clients response? 1. Orientation 2. Content of thought 3. Emotional state 4. General behavior Answer: 2 During a mental status assessment, the examiner asks the client to repeat these words: motorcar, teacup, and lilies. Five minutes later the client is asked to repeat the words again. The purpose of this exercise is to test the clients: 1. Insight. 2. Retention and recall. 3. Recall of recent past experiences. 4. Abstract thinking. Answer: 2 An anxious client is to complete the Minnesota Multiphasic Personality Inventory-2 as part of the psychological testing. The client is worried about not having enough time to prepare for the test. To decrease anxiety, the nurse reviews the purpose of the test and explains that the client will: 1. Just need to complete a series of sentences. 2. Interpret ink blots. 3. Only have to copy geometric designs. 4. Be answering true or false questions. Answer: 4 A family member reports that his mother has started hiding valuables around the house, then cant remember where she put them. He asks the nurse to explain what is happening. Which of the following assessment tools might the nurse utilize to screen the mother for signs of cognitive dysfunction? 1. Benton Visual Retention Test 2. Thematic Apperception Test 3. Ravens Progressive Matrices Test 4. Sentence Completion Test Answer: 1 A depressed client asks why a physical exam is necessary before being admitted for outpatient treatment. The nurse explains to the client that a physical exam will: 1. Provide information about medications the client will need. 2. Make sure the client gets all necessary treatment. 3. Complete the admission process. 4. Ensure the client has not ingested any caustic material or inhaled noxious vapors Answer: 2 The nurse in the community mental health clinic assesses a client and determines the presence of an Axis II diagnosis. What conclusions can the nurse draw? 1. The client is in need of further evaluation. 2. The client has a personality disorder. 3. The client will need a special diet. 4. The client is a candidate for the least restrictive environment. Answer: 2 A female client disclosed to the nurse that she is in an abusive situation. This information will be used to contribute to: 1. Axis IV. 2. Axis III. 3. Nothing, since this is confidential information and should not be shared. 4. Axis I. Answer: 1 The nurse on the inpatient unit is reviewing the record of a client admitted the previous day, and notes the client has an Axis I diagnosis. What inferences can the nurse make about the client? 1. The client has a clinical psychiatric disorder. 2. The client is in need of immediate medical attention. 3. The client has a chronic condition. 4. The client lacks a support system. Answer: 1 A client is admitted with the following diagnosis: Axis I: 300.01 Panic disorder without agoraphobia Axis II: 301.83 Borderline personality disorder Axis III: No diagnosis Axis IV: Unemployment What conclusions can the nurse make relative to the clients Axis III information? 1. This client has problems with environment, but they are not related to mental disorder. 2. The clients environment has not been evaluated. Answer: 3 During a group session, the clients are asked to make one positive statement about their home life. The nurse notices that one of the clients begins to fidget in the chair and interprets this behavior as: 1. A form of nonlanguage vocalization. 2. A therapeutic use of space. 3. An expression of discomfort. 4. An excuse to avoid answering the question. Answer: 3 During a group session, a client expresses anger at the nurse. The nurse sits tensely with arms and legs crossed while verbally agreeing that the clients point of view is correct. Which of the following messages is being sent by the nurse? 1. The nurse is expressing warmth toward the client 2. The nurse is being patient 3. The nurse is demonstrating empathy 4. The nurse is sending a mixed message Answer: 4 The nurse observed that during a teaching session, the overall emotional tone of a client remained unchanged. The nurse documents this as: 1. Affect that has range. 2. Flat affect. 3. Incongruent verbal and nonverbal responses. 4. Muted behavior. Answer: 2 The nurse is working with a teen admitted with a diagnosis of depression. Which of the following interventions demonstrates that the nurse is sensitive to the clients needs? 1. Avoiding the use of silence to decrease anxiety 2. Asking for details to demonstrate interest in the client 3. Using closed-ended questions 4. Listening to the clients feelings Answer: 4 A working goal for the nurseclient relationship is to achieve: 1. Facilitative intimacy. 2. Self-disclosure. 3. Interdependence. 4. Social superficiality Answer: 1 During the first interaction with a client, the nurse makes an introduction and identifies the purpose of the interaction. This serves to accomplish which of the following in developing a trusting relationship? 1. Setting goals 2. Building 3. Initiating 4. Maintaining Answer: 3 The nurse engaged in a therapeutic relationship with a client uses nonverbal communication to: 1. Enhance verbal messages. 2. Avoid the use of verbal messages. 3. Detract from verbal messages. 4. Terminate the therapeutic relationship. Answer: 1 A nurse acknowledges feeling anxious about meeting new people. By acknowledging feelings to the client, the nurse is demonstrating: 1. Sympathy. 2. Genuineness. 3. Empathy. 4. Superficiality. Answer: 2 Psychiatricmental health nursing interventions occur at which of the following levels of communication? 1. Public 2. Intrapersonal 3. Interpersonal 4. International Answer: 3 In planning care for a client who is gaining mental stability, the nurse develops measures to confirm the clients view of self. Which of the following responses made by the nurse would be categorized as disturbed communication? 1. I do not understand what you are telling me. 2. You are wrong. 3. How might you go about that differently? 4. Do you want to try that again? Answer: 2 Which of the following communication theories provides the most appropriate rationale for a nursing intervention to utilize the perceived strengths of the client in promoting effective communication? 1. Behavioral Effects and Human Communication Theory 2. Neurolinguistic Programming Theory 3. Theory of Communication Levels 4. Therapeutic Communication Theory Answer: 4 Which of the following is not related to the theory of successful versus disturbed communication patterns during an admission assessment? 1. The appropriateness of the content of the message. 2. The quality of the feedback provided. 3. The language level of the assessment nurse. 4. How efficiently the client delivers a message Answer: 3 A client asks the nurse about the doctors comment that he may have problems due to delayed synaptic transmission in his brain. The nurse explains that the best way to describe a synaptic transmission is which of the following? 1. An electrochemical process called neurotransmission 2. Where the axon is released 3. When the receptors bind to neurons 1. A perception check. 2. Nontherapeutic. 3. Necessary. 4. Therapeutic. Answer: 2 When considering communication skills, the nurse caring for an older client anticipates that the client will: 1. Interrupt frequently. 2. Take longer to respond. 3. Answer questions with one-word responses. 4. Remain silent. Answer: 2 The nurse is admitting a client from the emergency room. Which of the following would be used to clarify the nurses understanding of the clients chief complaint? 1. If you are bleeding, where is the blood? 2. I feel your pain when I see you hold your side. 3. Are you saying you feel that you are bleeding inside? 4. Dont worry; we have the technology to take care of you. Answer: 3 What is the history of EMDR? EMDR has created by Francine Shapiro PhD, discovered that moving her eyes in certain directions reduced emotional tension. Francine did further investigation into this phenomenon making EMDR the subject of her doctoral thesis in 1987. Integrating her clinical experience, Francine has formulated a unique method which she calls EMDR. Who can benefit from EMDR? Anyone who has ever experienced an upset that they have not recovered from. Often these people have one or more of the following symptoms in varying degrees: feeling "stuck", excess stress/tension, depression, anxiety, restlessness, sleep trouble, fatigue, appetite disturbances, and ongoing physical health concerns despite treatment. In the more severe cases: panic attacks, flashbacks, nightmares, obsessions, compulsions, eating disorder, and suicidal tendencies. How does EMDR treatment work? When an upset is experienced, it can become locked in the nervous system with the original picture, sounds, thoughts, feelings, and body sensations. This upset is stored in the brain (and also the body) in an isolated memory network preventing learning from taking place. Old material just keeps getting triggered over & over again and you end up feeling "stuck" emotionally. In another part of your brain, in a separate network, is most of the information you need to resolve the upset. It's just prevented from linking up to the old stuff. Once processing starts with EMDR, the 2 networks can link up. New information can then come to mind to resolve the old problems. How effective is EMDR? When compared to other methods of therapy (psychoanalysis, cognitive, behavioral, etc), EMDR has been rated as far more effective by mental health professionals. Clients experience emotional healing at an accelerated rate. If we use the metaphor of a driving a car through a tunnel to get to the other side, (where the tunnel represents the journey of healing and the other side of the tunnel represents the healed state), EMDR is like driving your car through the tunnel at very high speeds. Because of this accelerated processing, you should notice improvement within each session. How does the overall treatment with EMDR look? EMDR focuses first on the past, second on the present and third on the future. The past is focused on first because it is the past unresolved pain (whether it is childhood or the more recent past) which is causing pain in the present. Dealing with the past is therefore going to the root of the problem. For example, if a client comes in with depression and she has a history of being depressed since a death in her family, we would focus on the time around the death first because it is the root of the depression. To only focus on the symptoms of the depression in the present would be like taking an aspirin for a headache caused by a brain tumor rather than working with the brain tumor. 1. A patient says to the nurse, I dreamed I was stoned. When I woke up, I felt emotionally drained, as though I hadn't rested well. Which response should the nurse use to clarify the patient's comment? a. It sounds as though you were uncomfortable with the content of your dream. b. I understand what you're saying. Bad dreams leave me feeling tired, too. c. So you feel as though you did not get enough quality sleep last night? d. Can you give me an example of what you mean by stoned? Answer: D A patient diagnosed with schizophrenia tells the nurse, The CIA is monitoring us through the fluorescent lights in this room. Be careful what you say. Which response by the nurse would be most therapeutic? a. Let's talk about something other than the CIA. b. It sounds like you're concerned about your privacy. c. The CIA is prohibited from operating in health care facilities. d. You have lost touch with reality, which is a symptom of your illness Answer: B The patient says, My marriage is just great. My spouse and I always agree. The nurse observes the patients foot moving continuously as the patient twirls a shirt button. The conclusion the nurse can draw is that the patients communication is: a. clear. b. mixed c. recise d. inadequate Answer: B A nurse interacts with a newly hospitalized patient. Select the nurses comment that applies the communication technique of offering self. a. Ive also had traumatic life experiences. Maybe it would help if I told you about them. b. Why do you think you had so much difficulty adjusting to this change in your life? c. I hope you will feel better after getting accustomed to how this unit operates. d. Id like to sit with you for a while to help you get comfortable talking to me. Answer: D Which technique will best communicate to a patient that the nurse is interested in listening? a. Restating a feeling or thought the patient has expressed. b. Asking a direct question, such as Did you feel angry? c. Making a judgment about the patients problem. d. Saying, I understand what you're saying Answer: A A patient discloses several concerns and associated feelings. If the nurse wants to seek clarification, which comment would be appropriate? a. What are the common elements here? b. Tell me again about your experiences. c. Am I correct in understanding that . . . d. Tell me everything from the beginning Answer: C A patient tells the nurse, I dont think Ill ever get out of here. Select the nurses most therapeutic response. a. Dont talk that way. Of course you will leave here! b. Keep up the good work, and you certainly will. d. You dont think youre making progress? e. Everyone feels that way sometimes. Answer: C