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TEST BANK FOR ANCC PMHNP PSYCH-MENTAL
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The NP sees a 12-year-old male who was referred to her because of disruptive behavior and physical aggression against his peers. He is generally hostile in temperament and easily irritated. The child is also failing academically. This child most likely suffers from which of the following disorders? attention deficit hyperactivity disorder oppositional defiant disorder posttraumatic stress disorder autistic disorder Correct answer: oppositional defiant disorder This child would most likely be diagnosed with oppositional defiant disorder (ODD). Children with ODD are disruptive, argumentative, hostile and irritable. They have social problems with peers and adults and impaired academic functioning. Under what category would employee vacation pay, sick leave, and education be listed? Non productive time Productive cost Long term plan Productive time Correct answer: Non productive time Non productive time must be considered. This includes benefits and pay that employees receive that are not provided for work that has been accomplished. Vacation and sick time are included in the Non productive budget.
The neuroendocrine system contains all of the following EXCEPT: hippocampus hypothalamus gonads pancreas Correct answer: hippocampus The hippocampus is not a part of the neuroendocrine system. It is a part of the brain located in the medial temporal lobe. It is an important site for the formation and storage of immediate and recent memories. The neuroendocrine system contains the hypothalamus, pituitary gland, thyroid gland, adrenal glands, gonads, and pancreas. In which stage of the standards of practice for psychiatric nursing would the nurse document measurable goals? assessment implementation planning outcomes identification Correct Answer: outcomes identification Outcomes identification includes documenting expected outcomes as measurable goals. It also includes identifying attainable and culturally expected outcomes and including time estimate for expected outcomes. The type of hospital admission to a psychiatric inpatient setting that does not require a written application is which of the following? voluntary admission involuntary admission temporary admission informal admission Correct Answer: informal admission Informal admission is one type of voluntary admission that is similar to any general hospital admission in which there is no formal or written application. An informal admission is sought by the patient. The normal doctor-patient relationship exists, and the patient is free to stay or leave, even against medical advice. Which of the following is NOT a drug associated with date rape? Risperidone GHB
Correct Answer: abstract thinking This patient is not able to process abstraction. Concreteness is often assessed through the patient's interpretation of proverbs. Concreteness reduces one's ability to understand and address abstract concepts such as love or the passage of time. If you teach a client how to navigate through the complexities of the health care delivery system to receive prompt treatment this is a form of: primary prevention secondary prevention tertiary prevention enabling Correct Answer: secondary prevention You should develop teaching programs that coincide with the level of prevention needed by the client. Because primary prevention is not possible in all cases, a significant share of your time is spent teaching at the secondary or tertiary level. What is the best course of action to be taken if a peer arrives at work hung over, therefore it is necessary to act quickly to prevent patient injury? Respect their privacy. Report the individual. Ignore the incident. Discuss the incident with coworkers. Correct answer: Report the individual Employees and peers have the right to expect personal privacy. This right however, does not protect unethical conduct. The individual placed others in danger and should be reported. What step of the nursing process, is the diagnoses, outcome and care revised if needed? Evaluation. Diagnosis. Planning. Implementation. Correct Answer: Evaluation The nursing process is a problem solving approach. There are 6 steps in the nursing process. They include: diagnosis, outcome identification, planning, implementation, evaluation, and reassessment. During evaluation, the diagnoses, outcome and care revised if needed. Which of the following drugs is NOT one of the "Z-hypnotics" that have sedative effects without the antianxiety, anticonvulsant, or muscle relaxant effects of benzodiazepines?
Ambien BuSpar Lunesta Sonata Correct answer: BuSpar Buspirone (BuSpar) is a drug that reduces anxiety without having strong sedative-hypnotic properties. Because this drug does not leave the patient sleepy or sluggish, it is often much better tolerated than benzodiazepines. It is not a CNS depressant. All of the other choices are one of the "Z-hypnotics." A 58 year old woman is dealing with symptoms of vasomotor instability, sleep disturbances, hot flashes, urinary frequency, and dyspareunia. What is the likely cause of her symptoms? High cholesterol. Estrogen deficiency. Estrogen surplus. Testosterone surplus. Correct Answer: Estrogen deficiency Menopause upsets the balance of estrogen in the body. There are many symptoms associated with menopause, and they are all commonly because of an estrogen deficiency. Defamation of a person in written form is which of the following? breach of contract slander fraud libel Correct Answer: libel Defamation is defined as an oral or written communication to a third party about another party that is false and that tends to injure the other party's reputation. Libel is defamation in written form; slander is oral defamation. What leaders do or how they conduct themselves is the basis of what theory of leadership? trait theory contingency theory behavioral theory contemporary theory Correct Answer: behavioral theory What leaders do, or how the behave, is the focus of behavioral theorists. For example, impoverished
What atypical antipsychotic is preferred for adolescent patients? Haldol Haloperidol Zyprexa ASA Correct Answer: Zyprexa Zyprexa is an atypical antipsychotic. This medication is preferred for patients between the ages of 13 and 17. There are multiple formulations for specific needs. In terms of complementary and alternative medicine which of the following would be classified as a whole medical system? chiropractic therapy meditation naturopathy herbal therapy Correct Answer: naturopathy Naturopathy is a whole medical system. It focuses on enhancing the natural healing responses of the body. Interventions include nutrition, herbology, hydrotherapy, acupuncture, physical therapies, and counseling. What term is used to describe the failure to exercise the standard of care that another would issue in the same situation? Negligence. Attention. Disregard. Heed. Correct Answer: Negligence Negligence is the failure to exercise the standard of care that another would issue in the same situation. Negligence also describes any conduct that falls below the legal standard that protects patients from risk of harm. What is a characteristic of dementia, but is not characteristic of delirium? Duration of hours to days Gradual change in mental status Change in psychomotor activity, either hyperactive or hypoactive Perceptual disturbances Correct answer: Gradual change in mental status
This is a characteristic of dementia. The other choices are all characteristic of delirium. Dementia has a gradual and insidious onset. Delirium does not have an insidious onset; its onset is abrupt. It can usually be noted at a precise date as a rapidly progressive change in mental status. There are how many conditions that allow NPs to challenge a patient's refusal of treatment after informed consent?
Correct Answer:
There are five conditions that allow NPs to challenge a patient's refusal to treatment. They include: when a patient is mentally incompetent, when refusing treatment causes danger to the life/health of another, in an emergency situation, when the patient is a child, and in the case of therapeutic privilege. When would a patient's informed consent not be necessary? The patient has dementia. The patient has delusional thoughts. The patient is exhibiting violent ideation. The patient has bipolar disorder. Correct answer: The patient is exhibiting violent ideation. Informed consent is not always necessary. Exceptions are made in an effort to preserve life. A patient who is experiencing violent ideation and is a threat to others may be treated without informed consent. According to studies, which group of people with bipolar I is more likely to experience rapid cycling? Older people Men Young people Women Correct answer: Women According to evidence, female patients are more likely to experience rapid cycling. Male patients have a higher risk of manic episodes. Long-term involuntary admission to a psychiatric inpatient setting is for extended care and treatment of the mentally ill. The patient can be admitted for this type of admission through which of the following means? medical certification judicial review administrative action all of the above
Which of the following statements about mood disorders is least accurate? The most common mood disorder is major depressive disorder. Mood disorders are diseases. The signs and symptoms of mood disorders tend to recur, often in periodic or cyclical fashion. Mood disorders are caused by a complex interplay of biological and psychological factors. Correct Answer: Mood disorders are diseases. Mood disorders are not diseases; they are syndromes. They consist of signs and symptoms that present a deviation from a person's normal functioning and are sustained over a period of weeks to months. A patient with schizoaffective disorder and a substance abuse disorder experiences auditory hallucinations causing anxiety. What condition needs to be addressed first? Substance abuse Schizoaffective disorder Anxiety Delusions Correct Answer: Substance abuse When there are comorbid conditions in a crisis situation determinations must be made. The substance abuse will compound the psychiatric condition. Interventions need to be made to address the substance abuse first. In what situation would a psychiatric nurse provide forced treatment? When court mandated When the patient has Alzheimer's When referred by a physician Never Correct Answer: When court mandated Psychiatric nurses have an ethical responsibility to balance patient's rights with necessary forced treatment for safety. Forced treatment is done when court mandated. Which of the following medications is a cholinesterase inhibitor used to treat clients with dementia? Cognex Zyprexa Seroquel Zoloft Correct Answer: Cognex
Cognex (tacrine) is a cholinesterase inhibitor for treatment of cognitive impairment in clients with dementia. The daily dosage range is 40 - 160 mg. Side effects include dizziness, headache, GI upset, and elevated transaminase. Zyprexa and Seroquel are both antipsychotic drugs; Zoloft is an antidepressant (SSRI). What would be the reason for hallucinations and delusions if a patient does not meet the criteria for schizoaffective disorder or bipolar disorder and exhibits no symptoms of a physical illness or drug abuse? Paranoia Delusional disorder Bipolar I Schizophreniform disorder Correct Answer: Schizophreniform disorder Schizophreniform disorder is diagnosed after ruling out illness, drug use, schizoaffective disorder or bipolar disorder. Hallucinations and delusions are signs of schizophreniform disorder. Disorganized speech, negative symptoms, and catatonic behavior are also included in the diagnostic criteria. Which of the following medications would decrease seizure activity in ECT? fluoxetine lithium propofol anesthetic bupropion Correct Answer: propofol anesthetic Propofol anesthetic would decrease seizure activity in ECT. Other medications with this same effect include: benzodiazepines, barbiturate anesthetic, and anticonvulsants. All of the other choices would increase seizure activity in ECT. You are interviewing a woman who has unexplained bruises. You know that in interviewing this woman you should do all of the following EXCEPT: Conduct the interview in private. Be understanding. Inform the patient if a referral to protective services must be made. Probe for answers that the patient is not willing to give. Correct Answer: Probe for answers that the patient is not willing to give. The interview should be non-threatening and supportive. Probing for answers that the patient is not willing to give is something that you must not do. Also you should not try to prove abuse by accusations, display disapproval of the perpetrator or the situation, place blame or make judgments.
Correct Answer: No specific action. It uses previous cases for decisions. For negligence cases, most outcomes are based on legal precedent. This means outcomes are based on previous decisions on similar cases. In these cases, the courts will not take specific action. What type of drug may cause a risk of floppy baby syndrome and/or cleft palate during a pregnancy? Lithium Benzodiazepines Depakote Tegretol Correct answer: Benzodiazepines Some drugs can be teratogenic for pregnant women. Benzodiazepines may result in floppy baby syndrome or cleft palate. Tegretol and Depakote may result in neural tube defects. Lithium may cause an Epstein anomaly. Approximately what percentage of people with mental retardation have profound mental retardation? less than 1% 1% - 2% 5% 3% - 5% Correct Answer: 1% - 2% Profound mental retardation is defined as an IQ level below 20 or 25. 1% - 2% of people with mental retardation have profound mental retardation. They have a minimal capacity for sensorimotor functioning. Motor development, self-care and communication skills may improve if appropriate training is provided. If a mental health nurse is found guilty by criminal law, her punishment may be which of the following? Fines. Loss of medical license. Imprisonment. All of the above Correct Answer: All of the above. If a mental health nurse is found guilty by criminal law, their punishment may be fines, loss of medical license, and even imprisonment. Nurses should be cautious in their practice, and to make sure to follow all set laws. Your patient, whose wife died a few months ago, appears to be very unkempt and apathetic. Although several months have passed since his wife's death he has not progressed at all through his grieving. You
assess this condition as which of the following? disenfranchised grief panic disorder complicated grief physiologic grief Correct Answer: complicated grief A person has uncomplicated grief when he or she has normal physical, psychological, cognitive and spiritual responses to the death of a significant other. But when the person shows persistent maladaptive behaviors such as not taking care of personal hygiene and/or appearance and does not progress through the mourning process, this is complicated grief. If a patient has had a myocardial infarction, which of the following atypical antidepressants should not be prescribed within the recovery phase? Trazodone Duloxetine Bupropion Desvenlafaxine Correct Answer: Trazodone If a patient has had a myocardial infarction, during the recovery phase, the patient should not be prescribed this medication. Trazodone (Desyrel) can cause the patient to develop orthostatic hypotension and priapism. To get your teaching ideas and concepts across to a poor reader which of the following would be most appropriate? Use longer sentences. Use abstract concepts. Discourage questioning. Use examples and review. Correct Answer: Use examples and review. To get the idea across to a poor reader use examples and review. The other choices are not helpful. You should use short sentences and easy to read layouts; be concrete rather than abstract; and teach them how to ask questions about their health. Also, tell context first and use visual, use common words and examples, and explain meaning. A 21-year old woman presents with complaints of milky discharge from her breasts. She doesn't have any other symptoms and is not pregnant, nor has been before. She tells the nurse about each medication that she takes. Which of these drugs may be implicated as the cause of the symptom? aspirin
Hypertensive crisis Seizures Correct Answer: Hypertensive crisis Hypertensive crisis would be considered a symptom of PCP overdose. Vomiting, respiratory failure and seizures would be considered an effect of LSD overdose. Symptoms of serotonin syndrome include all of the following EXCEPT: insomnia nausea loss of coordination sweating or shivering with goose bumps Correct Answer: nausea Symptoms of serotonin syndrome can present in patients that have drug combinations that are contraindicated. They can vary from restlessness and agitation to tremors, chills, headaches, and insomnia as well as loss of coordination. Nausea has not been implicated in serotonin syndrome. What is the rate of suicide attempts for patients having dissociative identity disorder? 30% 45% 70% 60% Correct Answer: 70% People with dissociative identity disorder have one of the highest risks for suicide. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5),more than 70% of outpatients with DID have attempted suicide, and multiple suicide attempts are common. Of the following, which would not be considered a phase of schizophrenia treatment? Maintenance Acute Cognitive Stabilization Correct Answer: Cognitive Cognitive is not one of the three phases of schizophrenia treatment. The three phases are:
Phase 1: acute Phase 2: stabilization Phase 3: maintenance The patient should be monitored for effects of psychotropic medications which can impact cardiac rhythms. Which of the following could be a potential cardiac side effect? A prolonged QT interval Narrowing of the QRS Both A and B None of the above Correct Answer: A prolonged QT interval With antipsychotic drugs, the triclyclic action can cause problems. These medications can cause a widening of the QRS or a prolonged QT interval. This is a measure of the ventricular repolarization. Sullivan described three developmental cognitive modes of experience and believed that mental disorders are related to the persistence of one of the early modes. The mode that begins in early childhood as the child begins to connect experiences in sequence is which of the following? prototaxic mode parataxic mode syntaxic mode composite mode Correct Answer: parataxic mode The parataxic mode begins in early childhood. The child may not make logical sense of the experiences and may see them as coincidence or chance events. The child seeks to relieve anxiety by repeating familiar experiences, although he or she may not understand what he or she is doing. Which of the following acts have provided the greatest protection for the individual not to lose or be denied health insurance coverage? Patient Protection and Affordable Care Act OSHA ISPN None of the above Correct Answer: Patient Protection and Affordable Care Act The other 3 options above are incorrect. For several decades now, the ANA (American Nurses Association) has been working and advocating for reforms that will help to guarantee the access
All of the following are considered to be types of family structures except? Nuclear family Behavioral family Blended family Extended family Correct Answer: Behavioral family The major types of family structures are: Nuclear family Blended family Extended family Single-parent family Other familial systems What would NOT be an appropriate way to deal with a patient in the psychiatric unit who is prone to protracted angry outbursts? Using reassuring touch Determining the source of the patient's anger Remaining calm Setting verbal limits on behavior Correct answer: Using reassuring touch This would not be appropriate for interacting with an angry patient. When coping with an angry patient, don't shout or argue with the client and avoid touching the client or invading the client's space. This can escalate the anger. Touching the client can be threatening and make them feel cornered. This may result in retaliation. N-STAT is an ANA program that does which of the following? unifies nurses' political voices recommends nursing health policies assures a safe workplace for nurses evaluates Medicare and Medicaid reforms Correct Answer: unifies nurses' political voices Nurses are the largest group among the health care disciplines The Nurses Strategic Action Team (N- STAT) is an ANA program that unifies nurses' political voices across the country to enact measures to benefit health care for everyone. Examples of DSM-V diagnostic criteria for schizophrenia include all of the following EXCEPT: hallucinations thought insertion
disorganized speech delusions Correct Answer: thought insertion DSM-V diagnostic criteria for schizophrenia include delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, and negative symptoms. Abraham Maslow established that human needs are hierarchical, with lower level (most basic) needs being critical to survival. Which of the following is the highest level of needs in Maslow's hierarchy? esteem and recognition self-actualization love and belonging safety Correct Answer: self-actualization Abraham Maslow's hierarchy of needs from lowest to highest are: physiologic, safety, love and belonging, esteem and recognition, and self-actualization. Self-actualization is the fulfillment of a person's unique potential. How well a drug passes through natural body barriers such as the skin or stomach is known as the drug's: diffusion metabolism bioavailability absorption Correct Answer: absorption A drug's absorption is how well it passes through natural body barriers such as the skin, stomach, intestines, blood-brain barrier and other membranous tissues. Some considerations include whether the barrier is a lipid base or not. Antidepressant medications are known to work by increasing the concentration of which of the following in the body? Serotonin Dopamine Norephinephrine All of the above Correct Answer: All of the above
