RN MENTAL HEALTH FINAL EXAM PRACTICE QUESTIONS WITH ANSWERS 2024, Exams of Psychiatry

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RN MENTAL HEALTH FINAL EXAM PRACTICE QUESTIONS

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1. A nursing student new to psychiatric-mental health nursing asks a peer what resourceshe can use to figure out which symptoms are present in a specific psychiatric disorder. The best answer would be:

aNursing Interventions Classification (NIC)

b) Nursing Outcomes Classification (NOC)

c) NANDA-I nursing diagnoses

d) DSM- 5

2. Epidemiological studies contribute to improvements in care for individuals with mentaldisorders by:

A) Providing information about effective nursing techniques.

b) Identifying risk factors that contribute to the development of a disorder.

C Identifying individuals in the general population who will develop a specific disorder.

D Identifying which individuals will respond favorably to a specific treatment.

3. Besides antianxiety agents, which classification of drugs is also commonly given totreat anxiety and anxiety disorders?

a. Antipsychotics

b. Mood stabilizers

c. Antidepressants

d. Cholinesterase inhibitors

4. What assessment question will provide the nurse with information regarding the effectsof a woman‟s circadian rhythms on her quality of life?

a. “How much sleep do you usually get each night?”

b. “Does your heart ever seem to skip a beat?”

c. “When was the last time you had a fever?”

d. “Do you have problems urinating?”

5. You realize that your patient who is being treated for a major depressive disorderrequires more teaching when she makes the following statement:

a) “I have been on this antidepressant for 3 days. I realize that the full effect may not happen for a period of weeks.”

b) “I am going to ask my nurse practitioner to discontinue my Prozac today and let me start taking a monoamine oxidase inhibitor tomorrow.”

c) “I may ask to have my medication changed to Wellbutrin due to the problems I am having being romantic with my wife.”

d) “I realize that there are many antidepressants and it might take a while until we find the one that works best for me.”

6. A patient being treated for insomnia is prescribed ramel-teon (Rozerem). Which comorbid mental health condition would make this medication the hypnotic of choice for thisparticular patient?

a) Obsessive-compulsive disorder

b) Generalized anxiety disorder

c) Persistent depressive disorder

d) Substance use disorder

7. Which statement made by a patient prescribed bupropion (Wellbutrin) demonstratesthat the medication education the patient received was effective? Select all that apply.

a) “I hope Wellbutrin will help my depression and also help me to finally quit smoking.”

b) “I‟m happy to hear that I won‟t need to worry too much about weight gain.”

c) “It‟s okay to take Wellbutrin since I haven‟t had a seizure in 6 months.”

d) “I need to be careful about driving since the medication could make me drowsy.”

e) “My partner and I have discussed the possible effects this medication could have on our sex life.”

8. Which drug group calls for nursing assessment for development of abnormalmovement disorders among individuals who take therapeutic dosages?

a) SSRIs

b) antipsychotics

c) benzodiazepines

d) tricyclic antidepressants

9. The nurse administers each of the following drugs to various patients. The patient who should be most carefully assessed for fluid and electrolyte imbalance is the one receiving:

a. lithium (Eskalith)

b. clozapine (Clozaril)

c. diazepam (Valium)

d. amitriptyline

10. A psychiatric nurse is reviewing prescriptions for a patient with major depression at the county clinic. Since the patient has a mild intellectual disability, the nurse would question which classification of antidepressant drugs:

a. Selective serotonin reuptake inhibitors

b. Monoamine oxidase inhibitors

c. Serotonin and norepinephrine reuptake inhibitors

d. All of the above

4. The mental health team is determining treatment options for a male patient who is experiencing psychotic symptoms. Which question(s) should the team answer to determine whether a community outpatient or inpatient setting is most appropriate? Select all that apply.

a. “Is the patient expressing suicidal thoughts?”

b. “Does the patient have intact judgment and insight into his situation?”

c. “Does the patient have experiences with either community or inpatient mental healthcare facilities?”

d. “Does the patient require a therapeutic environment to support the management of psychotic symptoms?”

e. “Does the patient require the regular involvement of their family/significant other in planning and executing the plan of care?”

10. Pablo is a homeless adult who has no family connection. Pablo passed out on the street and emergency medical services took him to the hospital where he expresses a wish to die. The physician recognizes evidence of substance use problems and mental health issues and recommends inpatient treatment for Pablo. What is the rationale for this treatment choice? Select all that apply.

a. Intermittent supervision is available in inpatient settings.

b. He requires stabilization of multiple symptoms.

c. He has nutritional and self-care needs.

d. Medication adherence will be mandated.

e. He is in imminent danger of harming himself.

1. Which statement made by the nurse demonstrates the best understanding of nonverbal communication?

a. “The patient‟s verbal and nonverbal communication is often different.”

b. “When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response.”

c. “If a patient is slumped in the chair, I can be sure he‟s angry or depressed.”

d. “It‟s easier to understand verbal communication that nonverbal communication.”

2. Which nursing statement is an example of reflection?

a. “I think this feeling will pass.”

b. “So you are saying that life has no meaning.”

c. “I‟m not sure I understand what you mean.”

d. “You look sad.”

3. When should a nurse be most alert to the possibility of communication errors resulting in harm to the patient?

a. Change of shift report

b. Admission interviews

c. One-to-one conversations with patients

d. Conversations with patient families

4. During an admission assessment and interview, which channels of information communication should the nurse be monitoring? Select all that apply.

a. Auditory

b. Visual

c. Written

d. Tactile

e. Olfactory

5. What principle about nurse-patient communication should guide a nurse‟s fear about “saying the wrong thing” to a patient?

a. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation.

b. The patient is more interested in talking to you than listening to what you have to say and so is not likely to be offended.

c. Considering the patient‟s history, there is little chance that the comment will do any actual harm.

d. Most people with a mentally illness have by necessity developed a high tolerance of forgiveness.

6. You have been working closely with a patient for the past month. Today he tells you he is looking forward to meeting with his new psychiatrist but frowns and avoids eye contact while reporting this to you. Which of the following responses would most likely be therapeutic?

a. “A new psychiatrist is a chance to start fresh; I‟m sure it will go well for you.”

b. “You say you look forward to the meeting, but you appear anxious or unhappy.”

c. “I notice that you frowned and avoided eye contact just now. Don‟t you feel well?”

d. “I get the impression you don‟t really want to see your psychiatrist—can you tell me why?”

7. Which student behavior is consistent with therapeutic communication?

a. Offering your opinion when asked to convey support.

b. Summarizing the essence of the patient‟s comments in your own words.

c. Interrupting periods of silence before they become awkward for the patient.

d. Telling the patient he did well when you approve of his statements or actions.

8. James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for day shift and anxiously reports, “Last night, demons came to my room and tried to rape me.” Which response would be most therapeutic?

a. “There are no such things as demons. What you saw were hallucinations.”

b. “It is not possible for anyone to enter your room at night. You are safe here.”

c. “You seem very upset. Please tell me more about what you experienced last night.”

d. “That must have been very frightening, but we‟ll check on you at night and you‟ll be safe.”

9. Therapeutic communication is the foundation of a patient- centered interview. Which of the following techniques is not considered therapeutic?

a. Restating

b. Encouraging description of perception

c. Summarizing

d. Asking “why” questions

10. Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the patient states, “I don‟t need to come see you anymore. I have found a therapy app on my phone that I love.” How should Carolina respond to this news?

a. “That sounds exciting, would you be willing to visit and show me the app?”

b. “At this time, there is no real evidence that the app can replace our therapy.”

c. “I am not sure that is a good idea right now, we are so close to progress.”

d. “Why would you think that is a better option than meeting with me?”

1. Which statement demonstrates a well-structured attempt at limit setting?

a. “Hitting me when you are angry is unacceptable.”

b. “I expect you to behave yourself during dinner.”

c. “Come here, right now!”

d. “Good boys don‟t bite.”

2. Which activity is most appropriate for a child with ADHD?

a. Reading an adventure novel

b. Monopoly

c. Checkers

d. Tennis

3. Cognitive-behavioral therapy is going well when a 12-year- old patient in therapy reports to the nurse practitioner:

a. “I was so mad I wanted to hit my mother.”

b. “I thought that everyone at school hated me. That‟s not true. Most people like me and I have a friend named Todd.”

c. “I forgot that you told me to breathe when I become angry.”

d. “I scream as loud as I can when the train goes by the house.”

4. What assessment question should the nurse ask when attempting to determine a teenager‟s mental health resilience? Select all that apply.

a. “How did you cope when your father deployed with the Army for a year in Iraq?”

b. “Who did you go to for advice while your father was away for a year in Iraq?”

c. “How do you feel about talking to a mental health counselor?”

d. “Where do you see yourself in 10 years?”

e. “Do you like the school you go to?”

5. Which factors tend to increase the difficulty of diagnosing young children who demonstrate behaviors associated with mental illness? Select all that apply.

a. Limited language skills

b. Level of cognitive development

c. Level of emotional development

d. Parental denial that a problem exists

e. Severity of the typical mental illnesses observed in young children

7. In pediatric mental health there is a lack of sufficient numbers of community-based resources and providers, and there are long waiting lists for services. This has resulted in: Select all that apply.

a. Children of color and poor economic conditions being underserved

b. Increased stress in the family unit

c. Markedly increased funding

d. Premature termination of services

8. Child protective services have removed 10-year-old Christopher from his parents‟ home due to neglect. Christopher reveals to the nurse that he considers the woman next door his “nice” mom, that he loves school, and gets above average grades. The strongest explanation of this response is:

a. Temperament

b. Genetic factors

c. Resilience

d. Paradoxical effects of neglect

9. April, a 10-year-old admitted to inpatient pediatric care, has been getting more and more wound up and is losing self-control in the day room. Time-out does not appear to be an effective tool for April to engage in self-reflection. April‟s mother admits to putting her in time-out up to 20 times a day. The nurse recognizes that:

a. Time-out is an important part of April‟s baseline discipline.

b. Time-out is no longer an effective therapeutic measure.

c. April enjoys time-out, and acts out to get some alone time.

d. Time-out will need to be replaced with seclusion and restraint.

10. Adolescents often display fluctuations in mood along with undeveloped emotional regulation and poor tolerance for frustration. Emotional and behavioral control usually increases over the course of adolescence due to:

a. Limited executive function

b. Cerebellum maturation

c. Cerebral stasis and hormonal changes

d. A slight reduction in brain volume

1. Which characteristic in an adolescent female is sometimes associated with the prodromal phase of schizophrenia?

a. Always afraid another student will steal her belongings.

b. An unusual interest in numbers and specific topics.

c. Demonstrates no interest in athletics or organized sports.

d. Appears more comfortable among males.

2. Which nursing intervention is particularly well chosen for addressing a population at high risk for developing schizophrenia?

a. Screening a group of males between the ages of 15 and 25 for early symptoms.

b. Forming a support group for females aged 25 to 35 who are diagnosed with substance use issues.

c. Providing a group for patients between the ages of 45 and 55 with information on coping skills that have proven to be effective.

d. Educating the parents of a group of developmentally delayed 5- to 6-year-olds on the importance of early intervention.

3. To provide effective care for the patient diagnosed with schizophrenia, the nurse should frequently assess for which associated condition? Select all that apply.

a. Alcohol use disorder

b. Major depressive disorder

c. Stomach cancer

d. Polydipsia

e. Metabolic syndrome

4. A female patient diagnosed with schizophrenia has been prescribed a first-generation antipsychotic medication. What information should the nurse provide to the patient regarding her signs and symptoms?

a. Her memory problems will likely decrease.

b. Depressive episodes should be less severe.

c. She will probably enjoy social interactions more.

d. She should experience a reduction in hallucinations.

5. Which characteristic presents the greatest risk for injury to others by the patient diagnosed with schizophrenia?

a. Depersonalization

b. Pressured speech

c. Negative symptoms

d. Paranoia

6. Gilbert, age 19, is described by his parents as a “moody child” with an onset of odd behavior about at age 14, which caused Gilbert to suffer academically and socially. Gilbert has lost the ability to complete household chores, is reluctant to leave the house, and is obsessed with the locks on the windows and doors. Due to Gilbert‟s early and slow onset of what is now recognized as schizophrenia, his prognosis is considered:

a. Favorable with medication

b. In the relapse stage

c. Improvable with psychosocial interventions

d. To have a less positive outcome

7. Which therapeutic communication statement might a psychiatric-mental health registered nurse use when a patient‟s nursing diagnosis is altered thought processes?

a. “I know you say you hear voices, but I cannot hear them.”

b. “Stop listening to the voices, they are NOT real.”

c. “You say you hear voices, what are they telling you?”

d. “Please tell the voices to leave you alone for now.”

8. When patients diagnosed with schizophrenia suffer from anosognosia, they often refuse medication, believing that:

a. Medications provided are ineffective.

b. Nurses are trying to control their minds.

c. The medications will make them sick.

d. They are not actually ill.

9. Kyle, a patient with schizophrenia, began to take the first-generation antipsychotic haloperidol (Haldol) last week. One day you find him sitting very stiffly and not moving. He is diaphoretic, and when you ask if he is okay he seems unable to respond verbally. His vital signs are: BP 170/100, P 110, T 104.2°F. What is the priority nursing intervention? Select all that apply.

a. Hold his medication and contact his prescriber.

b. Wipe him with a washcloth wet with cold water or alcohol.

c. Administer a medication such as benztropine IM to correct this dystonic reaction.

d. Reassure him that although there is no treatment for his tardive dyskinesia, it will pass.

e. Hold his medication for now and consult his prescriber when he comes to the unit later today.

10. Tomas is a 21-year-old male with a recent diagnosis of schizophrenia. Tomas‟s nurse recognizes that self-medicating with excessive alcohol is common in this disease and can co- occur along with:

a. Generally good health despite the mental illness.

b. An aversion to drinking fluids.

c. Anxiety and depression.

d. The ability to express his needs.

1. Which nursing response demonstrates accurate information that should be discussed with the female patient diagnosed with bipolar and her support system? Select all that apply.

a. “Remember that alcohol and caffeine can trigger a relapse of your symptoms.”

b. “Due to the risk of a manic episode, antidepressant therapy is never used with bipolar disorder.

c. “It‟s critical to let your healthcare provider know immediately if you aren‟t sleeping well.”

d. “Is your family prepared to be actively involved in helping manage this disorder?”

e. “The symptoms tend to come and go and so you need to be able to recognize the early signs.”

2. Which statement made by the patient demonstrates an understanding of the effective use of newly prescribed lithium to manage bipolar mania? Select all that apply.

a. “I have to keep reminding myself to consistently drink six 12 - ounce glasses of fluid every day.”

b. “I discussed the diuretic my cardiologist prescribed with my psychiatric care provider.”

c. “Lithium may help me lose the few extra pounds I tend to carry around.”

d. “I take my lithium on an empty stomach to help with absorption.”

e. “I‟ve already made arrangements for my monthly lab work.”

3. The nurse is providing medication education to a patient who has been prescribed lithium to stabilize mood. Which early signs and symptoms of toxicity should the nurse stress to the patient? Select all that apply.

a. Increased attentiveness

b. Getting up at night to urinate

c. Improved vision

d. An upset stomach for no apparent reason

e. Shaky hands that make holding a cup difficult

4. A male patient calls to tell the nurse that his monthly lithium level is 1.7 mEq/L. Which nursing intervention will the nurse implement initially?

a. Reinforce that the level is considered therapeutic.

b. Instruct the patient to hold the next dose of medication and contact the prescriber.

c. Have the patient go to the hospital emergency room immediately.

d. Alert the patient to the possibility of seizures and appropriate precautions.

5. Which intervention should the nurse implement when caring for a patient demonstrating manic behavior? Select all that apply.

a. Monitor the patient‟s vital signs frequently.

b. Keep the patient distracted with group-oriented activities.

c. Provide the patient with frequent milkshakes and protein drinks.

d. Reduce the volume on the television and dim bright lights in the environment.

e. Use a firm but calm voice to give specific concise directions to the patient.

6. Substance abuse is often present in people diagnosed with bipolar disorder. Laura, a 28-year- old with a diagnosis of bipolar disorder, drinks alcohol instead of taking her prescribed medications. The nurse caring for this patient recognizes that:

a. Anxiety may be present.

b. Alcohol ingestion is a form of self-medication.

c. The patient is lacking a sufficient number of neurotransmitters.

d. The patient is using alcohol because she is depressed.

7. Ted, a former executive, is now unemployed due to manic episodes at work. He was diagnosed with bipolar I 8 years ago. Ted has a history of IV drug abuse, which resulted in hepatitis C. He is taking his lithium exactly as scheduled, a fact that both Ted‟s wife and his blood tests confirm. To reduce Ted‟s mania the psychiatric nurse practitioner recommends:

a. Clonazepam (Klonopin)

b. Fluoxetine (Prozac)

c. Electroconvulsive therapy (ECT)

d. Lurasidone (Latuda)

8. A 33-year-old female diagnosed with bipolar I disorder has been functioning well on lithium for 11 months. At her most recent checkup, the psychiatric nurse practitioner states, “You are ready to enter the maintenance therapy stage, so at this time I am going to adjust your dosage by prescribing”:

a. A higher dosage

b. Once a week dosing

c. A lower dosage

d. A different drug

9. Tatiana has been hospitalized for an acute manic episode. On admission the nurse suspects lithium toxicity. What assessment findings would indicate the nurse‟s suspicion as correct?

a. Shortness of breath, gastrointestinal distress, chronic cough

b. Ataxia, severe hypotension, large volume of dilute urine

c. Gastrointestinal distress, thirst, nystagmus

d. Electroencephalographic changes, chest pain, dizziness

10. Luc‟s family comes home one evening to find him extremely agitated and they suspect in a full manic episode. The family calls emergency medical services. While one medic is talking with Luc and his family, the other medic is counting something on his desk. What is the medic most likely counting?

a. Hypodermic needles

b. Fast food wrappers

c. Empty soda cans

d. Energy drink containers

1. Which response by a 15-year-old demonstrates a common symptom observed in patients diagnosed with major depressive disorder?

a. “I‟m so restless. I can‟t seem to sit still.”

b. “I spend most of my time studying. I have to get into a good college.”

c. “I‟m not trying to diet, but I‟ve lost about 5 pounds in the past 5 months.”

d. “I go to sleep around 11 p.m. but I‟m always up by 3 a.m. and can‟t go back to sleep.”

2. Which assessment question asked by the nurse demonstrates an understanding of comorbid mental health conditions associated with major depressive disorder? Select all that apply.

a. “Do rules apply to you?”

b. “What do you do to manage anxiety?”

c. “Do you have a history of disordered eating?”

d. “Do you think that you drink too much?”

e. “Have you ever been arrested for committing a crime?”

3. Which nursing intervention focuses on managing a common characteristic of major depressive disorder associated with the older population?

a. Conducting routine suicide screenings at a senior center.

b. Identifying depression as a natural, but treatable result of aging.

c. Identifying males as being at a greater risk for developing depression.

d. Stressing that most individuals experience just a single episode of major depression in a lifetime.

4. Which characteristic identified during an assessment serves to support a diagnosis of disruptive mood dysregulation disorder? Select all that apply.

a. Female

b. 7 years old

c. Comorbid autism diagnosis

d. Outbursts occur at least once a week

e. Temper tantrums occur at home and in school

5. Which chronic medical condition is a common trigger for major depressive disorder?

a. Pain

b. Hypertension

c. Hypothyroidism

d. Crohn‟s disease

6. Tammy, a 28-year-old with major depressive disorder and bulimia nervosa, is ready for discharge from the county hospital after 2 weeks of inpatient therapy. Tammy is taking citalopram (Celexa) and reports that it has made her feel more hopeful. With a secondary diagnosis of bulimia nervosa, what is an alternative antidepressant to consider?

a. Fluoxetine (Prozac)

b. Isocarboxazid (Marplan)

c. Amitriptyline

d. Duloxetine (Cymbalta)

7. Cabot has multiple symptoms of depression including mood reactivity, social phobia, anxiety, and overeating. With a history of mild hypertension, which classification of antidepressants dispensed as a transdermal patch would be a safe medication?

a. Tricyclic antidepressants

b. Selective serotonin reuptake inhibitors

c. Serotonin and norepinephrine reuptake inhibitors

d. Monoamine oxidase inhibitor

8. When a nurse uses therapeutic communication with a withdrawn patient who has major depression, an effective method of managing the silence is to:

a. Meditate in the quiet environment

b. Ask simple questions even if the patient will not answer

c. Use the technique of making observations

d. Simply sit quietly and leave when the patient falls asleep

9. The biological approach to treating depression with electrodes surgically implanted into specific areas of the brain to stimulate the regions identified to be underactive in depression is:

a. Transcranial magnetic stimulation

b. Deep brain stimulation

c. Vagus nerve stimulation

d. Electroconvulsive therapy

10. Two months ago, Natasha‟s husband died suddenly and she has been overwhelmed with grief. When Natasha is subsequently diagnosed with major depressive disorder, her daughter, Nadia, makes which true statement?

a. “Depression often begins after a major loss. Losing dad was a major loss.”

b. “Bereavement and depression are the same problem.”

c. “Mourning is pathological and not normal behavior.”

d. “Antidepressant medications will not help this type of depression.”

1. Which statement made by the patient demonstrates an understanding of the treatment of choice for patients managing the effects of traumatic events?

a. “I attend my therapy sessions regularly.”

b. “Those intrusive memories are hidden for a reason and should stay hidden.”

c. “Keeping busy is the key to getting mentally healthy.”

d. “I‟ve agreed to move in with my parents so I‟ll get the support I need.”

2. Which goal should be addressed initially when providing care for 10-year-old Harper who is diagnosed with posttraumatic stress disorder (PTSD)?

a. Harper will be able to identify feelings through the use of play therapy.

b. Harper and her parents will have access to protective resources available through social services.

c. Harper will demonstrate the effective use of relaxation techniques to restore a sense of control over disturbing thoughts.

d. Harper and her parents will demonstrate an understanding of the personal human response to traumatic events.

3. The care plan of a male patient diagnosed with a dissociative disorder includes the nursing diagnosis ineffective coping. Which behavior demonstrated by the patient supports this nursing diagnosis?

a. Has no memory of the physical abuse he endured.

b. Using both alcohol and marijuana.

c. Often reports being unaware of surroundings.

d. Reports feelings of “not really being here.”

4. Which statement accurately describes the effects of emotional trauma on the individual physically?

a. Emotional trauma is a distinct category and unrelated to physical problems

b. The physical manifestations of emotional trauma are usually temporary

c. Emotional trauma is often manifested as physical symptoms

d. Patients are more aware of the physical problems caused by trauma

5. The school nurse has been alerted to the fact that an 8-year-old boy routinely playacts as a police officer “locking up” other children on the playground to the point where the children get scared. The nurse recognizes that this behavior is most likely an indication of:

a. The need to dominate others

b. Inventing traumatic events

c. A need to develop close relationships

d. A potential symptom of traumatization

6. A pregnant woman is in a relationship with a male who routinely abuses her. Her unborn child may engage in high-risk behavior as a teen as a result of:

a. Maternal stress

b. Parental nurturing

c. Appropriate stress responses in the brain

d. Memories of the abuse

7. Maggie, a child in protective custody, is found to have an imaginary friend, Holly. Her foster family shares this information with the nurse. The nurse teaches the family members about

children who have suffered trauma and knows her teaching was effective when the foster mother states:

a. “I understand that imaginary friends are abnormal.”

b. “I understand that imaginary friends are a maladaptive behavior.”

c. “I understand that imaginary friends are a coping mechanism.”

d. “I understand that we should tell the child that imaginary friends are unacceptable.”

8. An incest survivor undergoing treatment at the mental health clinic is relieved when she learns that her anxiety and depression are:

a. Going to be eradicated with treatment

b. Normal and will soon pass

c. Abnormal but will pass

d. A normal reaction to posttraumatic events

9. During a routine health screening, a grieving widow whose husband died 15 months ago reports emptiness, a loss of self, difficulty thinking of the future, and anger at her dead husband. The nurse suggests bereavement counseling. The widow is most likely suffering from:

a. Major depression

b. Normal grieving

c. Adjustment disorder

d. Posttraumatic stress disorder

10. A young child is found wandering alone at a mall. A male store employee approaches and asks where her parents are. She responds, “I don‟t know. Maybe you will take me home with you?” This sort of response in children may be due to:

a. A lack of bonding as an infant

b. A healthy confidence in the child

c. Adequate parental bonding

d. Normal parenting

1. Which patient statement acknowledges the characteristic behavior associated with a diagnosis of pica?

a. “Nothing could make me drink milk.”

b. “I‟m ashamed of it, but I eat my hair.”

c. “I haven‟t eaten a green vegetable since I was 3 years old.”

d. “I regurgitate and re-chew my food after almost every meal.”

2. When considering an eating disorder, what is a physical criterion for hospital admission?

a. A daytime heart rate of less than 50 beats per minute

b. An oral temperature of 100°F or more

c. 90% of ideal body weight

d. Systolic blood pressure greater than 130 mm Hg

3. When considering the need for monitoring, which intervention should the nurse implement for a patient with anorexia nervosa? Select all that apply.

a. Provide scheduled portion-controlled meals and snacks.

b. Congratulate patients for weight gain and behaviors that promote weight gain.

c. Limit time spent in bathroom during periods when not under direct supervision.

d. Promote exercise as a method to increase appetite.

e. Observe patient during and after meals/snacks to ensure that adequate intake is achieved and maintained.

4. Which intervention will promote independence in a patient being treated for bulimia nervosa?

a. Have the patient monitor daily caloric intake and intake and output of fluids.

b. Encourage the patient to use behavior modification techniques to promote weight gain behaviors.

c. Ask the patient to use a daily log to record feelings and circumstances related to urges to purge.

d. Allow the patient to make limited choices about eating and exercise as weight gain progresses.

5. Which patient statement supports the diagnosis of anorexia nervosa?

a. “I‟m terrified of gaining weight.”

b. “I wish I had a good friend to talk to.”

c. “I‟ve been told I drink way too much alcohol.”

d. “I don‟t get much pleasure out of life anymore.”

6. Obesity can be the end result of a binge-eating disorder. The nurse understands that the best treatment option in persons with a binge-eating disorder promotes:

a. Bariatric surgery

b. Coping strategies

c. Avoidance of public eating

d. Appetite suppression medications

7. Taylor, a psychiatric registered nurse, orients Regina, a patient with anorexia nervosa, to the room where she will be assigned during her stay. After getting Regina settled, the nurse informs Regina:

a. “I need to go through the belongings you have brought with you.”

b. “You can use the scale in the back room when you need to.”

c. “You will be eating five times a day here.”

d. “The daily structure is based around your desire to eat.”

8. Safety measures are of concern in eating-disorder treatments. Patients with anorexia nervosa are supervised closely to monitor: Select all that apply.

a. Foods that are eaten

b. Attempts at self-induced vomiting

c. Relationships with other patients

d. Weight

9. Malika has been overweight all of her life. Now an adult, she has health problems related to her excessive weight. Seeking weight loss assistance at a primary care facility Malika is surprised when the nurse practitioner suggests:

a. A trial of SSRI antidepressant therapy

b. Mild exercise to start, increasing in intensity over time

c. Removing snack foods from the home

d. Medication treatment for hypertension

10. Malika agrees to try losing weight according to the nurse practitioner‟s outlined plan. Additional teaching is warranted when Malika states:

a. “I am willing to admit I am depressed.”

b. “Psychotherapy will be a part of my treatment.”

c. “I prefer to have a gastric bypass rather than use this plan.”

d. “My comorbid conditions may improve with weight loss.”

6. Which patient has the greatest risk for suicide?

a. A patient who expresses the inability to stop searching the internet for child pornography.

b. A patient who reports having lost interest in having a sexual relationship with his wife.

c. A patient with a history of exposing himself to female strangers on the bus.

d. A patient whose attraction to prepubescent girls has increased.

7. When Melissa was a small child, she insisted that she was a boy, refused to wear dresses, and wanted to be called Mitch. As Melissa reached puberty, she no longer displayed a desire to be male. This change in identity is considered:

a. Gender dysphoria

b. Reaction formation

c. Normal

d. Early transgender syndrome

8. Phillip, a 63-year-old male, has exposed his genitals in public for all of his adult life, but the act has lost some of the former thrill. A rationale for this change in his experience may be:

a. An increasing sense of shame

b. Disgust over his lack of control

c. Desire waning with age

d. Progression into actual assault

9. A male arrested for inappropriate sexual contact in a subway car denies the allegation. Upon interviewing the man, the nurse suspects frotteuristic disorder due to his:

a. Lack of relationships

b. Overall aggressive nature

c. Criminal history including robbery

d. Intense hatred of women

10. Pedophilic disorder is the most common paraphilic disorder where adults who have a primary or exclusive sexual preference for prepubescent children. A subset of this disorder is termed hebephilia and is defined as attraction to:

a. Infants

b. Pubescent individuals

c. Teens between the ages of 15 and 19

d. Males only

1. Which statement made by the psychiatric nurse demonstrates an accurate understanding of the factors that affect an individual‟s personality?

a. “Therapy will help her identify that her problems are personality related.”

b. “I‟ll need to learn more about this patient‟s cultural beliefs.”

c. “It‟s encouraging to know that personality disorders respond well to treatment.”

d. “A person‟s personality is fluid and adjusts to current social situations.”

2. When assessing a patient diagnosed with a borderline personality disorder, which statement by the patient warrants immediate attention?

a. “My mother died ten years ago.”

b. “I haven‟t needed medication in weeks.”

c. “My dad never loved me.”

d. “I‟d really like to hurt her for hurting me.”

3. What is the current accepted professional view of the effect of culture on the development of a personality disorder?

a. There aren‟t sufficient studies to confirm the role that ethnicity and race have on the prevalence of personality disorders.

b. The North American and Australian cultures produce higher incidences of personality disorders among their populations.

c. Neither culture nor ethnic background is generally considered in the development of personality disorders.

d. Personality disorders have been found to be primarily the products of genetic factors, not cultural factors.

4. Which personality disorders are generally associated with behaviors described as “odd or eccentric”? Select all that apply.

a. Paranoid

b. Schizoid

c. Histrionic

d. Obsessive-compulsive

e. Avoidant

5. Which behaviors are examples of a primitive defense mechanism often relied upon by those diagnosed with a personality disorder? Select all that apply.

a. Regularly attempts to split the staff

b. Attempts to undo feelings of anger by offering to do favors