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Saturday, July 28, 2007

Psychiatric Nursing Q&A

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1. 60 years old post CVA (cardio vascular accident) patient is taking TPA for his disease, the nurse understands that this is an example of what level of prevention?

a. primary
b. secondary
c. tertiary
d. nota

2. A female client undergoes yearly mammography. This is a type of what level of prevention?

a. primary
b. secondary
c. tertiary
d. nota

3. A Diabetic patient was amputated following an unexpected necrosis on the right leg, he sustained and undergone BKA. He then underwent therapy on how to use his new prosthetic leg. this is a type of what level of prevention?

a. primary
b. secondary
c. tertiary
d. nota

4. As a care provider, The nurse should do first:

a. Provide direct nursing care.
b. Participate with the team in performing nursing intervention.
c. Therapeutic use of self.
d. Early recognition of the client’s needs.

5. As a manager, the nurse should:

a. Initiates nursing action with co workers.
b. Plans nursing care with the patient.
c. Speaks in behalf of the patient.
d. Works together with the team.

6. The nurse shows a patient advocate role when

a. defend the patients right
b. refer patient for other services she needs
c. work with significant others
d. intercedes in behalf of the patient.

7. Which is the following is the most appropriate during the orientation phase ?

a. patients perception on the reason of her hospitalization
b. identification of more effective ways of coping
c. exploration of inadequate coping skills
d. establishment of regular meeting of schedules

8. Preparing the client for the termination phase begins

a. pre orientation
b. orientation
c. working
d. termination

9. A helping relationship is a process characterized by :

a. recovery promoting
b. mutual interaction
c. growth facilitating
d. health enhancing

10. During the nurse patient interaction, the nurse assess the ff: to determine the patients coping strategy :

a. How are you feeling right now?
b. Do you have anyone to take you home?
c. What do you think will help you right now?
d. How does your problem affect your life?

11. As a counsellor, the nurse performs which of the ff: task?

a. Encourage client to express feelings and concerns
b. Helps client to learn a dance or song to enable her to participate in activities
c. Help the client prepare in group activities
d. Assist the client in setting limits on her behaviour

12. Freud stresses out that the EGO

a. Distinguishes between things in the mind and things in the reality.
b. Moral arm of the personality that strives for perfection than pleasure.
c. Reservoir of instincts and drives
d. Control the physical needs instincts.

13. A 16 year old child is hospitalized, according to Erik Erikson, what is an appropriate intervention?

a. tell the friends to visit the child
b. encourage patient to help child learn lessons missed
c. call the priest to intervene
d. tell the child’s girlfriend to visit the child.

14. Neuroleptic malignant syndrome (NMS) is characterized by :

a. hypertension, hyperthermia, flushed and dry skin.
b. Hypotension, hypothermia, flushed and dry skin.
c. Hypertension, hyperthermia, diaphoresis
d. Hypertension, hypothermia, diaphoresis

15. Which of the following drugs needs a WBC level checked regularly?

a. Lithane
b. Clozaril
c. Tofranil
d. Diazepam

Angelo, an 18 year old out of school youth was caught shoplifting in a department store. He has history of being quarrelsome and involving physical fight with his friends. He has been out of jail for the past two years

16. Initially, The nurse identifies which of the ff: Nursing diagnosis:

a. self centred disturbance
b. impaired social interaction
c. sensory perceptual alteration
d. altered thought process

17. Which of the ff: is not a characteristic of PD?

a. disregard rights of others
b. loss of cognitive functioning
c. fails to conform to social norms
d. not capable of experiencing guild or remorse for their behaviour

18. The most effective treatment modality for persons if anti social PD is

a. hypnotherapy
b. gestalt therapy
c. behaviour therapy
d. crisis intervention

19. Which of the following is not an example of alteration of perception?

a. ideas of reference
b. flight of ideas
c. illusion
d. hallucination

20. The type of anxiety that leads to personality disorganization is :

a. Mild
b. Moderate
c. Severe
d. Panic

21. A client is admitted to the hospital. Twelve hours later the nurse observes hand tremors, hyperexicitability, tachycardia, diaphoresis and hypertension. The nurse suspects alcohol withdrawal. The nurse should ask the client:

a. At what time was your last drink taken?
b. Why didn’t you tell us you’re a drinker?
c. Do you drink beer or hard liquor?
d. How long have you been drinking?

22. Client with a history of schizophrenia has been admitted for suicidal ideation. The client states "God is telling me to kill myself right now." The nurse's best response is:

a. I understand that god’s voice are real to you, But I don’t hear anything. I will stay with you.
b. The voices are part of your illness, it will stop if you take medication
c. The voices are all in your imagination, think of something else and itll go away
d. Don’t think of anything right now, just go and relax.

23. In assessing a client's suicide potential, which statement by the client would give the nurse the HIGHEST cause for concern?

a. My thoughts of hurting my self are scary to me
b. I’d like to go to sleep and not wake up
c. I’ve thought about taking pills and alcohol till I pass out
d. Id like to be free from all these worries

24. A client with paranoid schizophrenia has persecutory delusions and auditory hallucinations and is extremely agitated. He has been given a PRN dose of Thorazine IM. Which of the following would indicate to the nurse that the medication is having the desired effect?

a. Complains of dry mouth
b. State he feels restless in his body
c. Stops pacing and sits with the nurse
d. Exhibits increase activity and speech

25. A client who was wandering aimlessly around the streets acting inappropriately and appeared disheveled and unkept was admitted to a psychiatric unit and is experiencing auditory and visual hallucinations. The nurse would develop a plan of care based on:

a. borderline personality disorder
b. anxiety disorder
c. schizophrenia
d. depression

26. A decision is made to not hospitalize a client with obsessive-compulsive disorder. Of the following abilities the client has demonstrated, the one that probably most influenced the decision not to hospitalize him is his ability to:

a. Hold a job.
b. Relate to his peers.
c. Perform activities of daily living.
d. Behave in an outwardly normal

27. A client is admitted to the inpatient psychiatric unit. He is unshaven, has body odor, and has spots on his shirt and pants. He moves slowly, gazes at the floor, and has a flat affect. The nurse's highest priority in assessing the client on admission would be to ask him:

a. How he sleeps at night.
b. If he is thinking about hurting himself.
c. About recent stresses.
d. How he feels about himself.

28. The nurse should know that the normal therapeutic level of lithium is :

a. .6 to 1.2 meq/L
b. 6 to 12 meq/L
c. .6 to .12 cc/ml
d. .6 to .12 cc3/L

29. The patient complaint of vomiting, diarrhea and restlessness after taking lithane. The nurse’s initial intervention is :

a. Recognize that this is a sign of toxicity and withhold the next medication.
b. Notify the physician.
c. Check V/S to validate patient’s concerns.
d. Recognize that this is a normal side effects of lithium and still continue the drug.

30. The client is taking TOFRANIL. The nurse should closely monitor the patient for :

a. Hypertension
b. Hypothermia
c. Increase Intra Ocular Pressure
d. Increase Intra Cranial Pressure

31. A client was hospitalized with major depression with suicidal ideation for 1 week. He is taking venlafaxine (Effexor), 75 mg three times a day, and is planning to return to work. The nurse asks the client if he is experiencing thoughts of self-harm. The client responds, "I hardly think about it anymore and wouldn't do anything to hurt myself." The nurse judges:

a. The client to be decompensating and in need of being readmitted to the hospital.
b. The client to need an adjustment or increase in his dose of antidepressant.
c. The depression to be improving and the suicidal ideation to be lessening.
d. The presence of suicidal ideation to warrant a telephone call to the client's physician

32. The client is taking sertraline (Zoloft), 50 mg q AM. The nurse includes which of the following in the teaching plan about Zoloft?

a. Zoloft causes erectile dysfunction in men.
b. Zoloft causes postural hypotension
c. Zoloft increases appetite and weight gain
d. It may take 3-4 weeks before client will start feeling better.

33. After 3 days of taking haloperidol, the client shows an inability to sit still, is restless and fidgety, and paces around the unit. Of the following extrapyramidal adverse reactions, the client is showing signs of:

a. Dystonia
b. Akathisia
c. Parkinsonism
d. Tardive dyskinesia

34. After 10 days of lithium therapy, the client's lithium level is 1.0 mEq/L. The nurse knows that this value indicates which of the following?

a. A laboratory error.
b. An anticipated therapeutic blood level of the drug.
c. An atypical client response to the drug.
d. A toxic level.

35. When caring for a client receiving haloperidol (Haldol), the nurse would assess for which of the following?

a. Hypertensive episodes
b. Extrapyramidal symptoms
c. Hypersalivation
d. Oversedation

36. A client is brought to the hospital’s emergency room by a friend, who states, "I guess he had some bad junk (heroin) today." In assessing the client, the nurse would likely find which of the following symptoms?

a. Increased heart rate, dilated pupils, and fever.
b. Tremulousness, impaired coordination, increased blood pressure, and ruddy complexion.
c. Decreased respirations, constricted pupils, and pallor.
d. Eye irritation, tinnitus, and irritation of nasal and oral mucosa.

37. The client has been taking the monoamine oxidase inhibitor (MAOI) phenelzine (Nardil), 10 mg bid. The physician orders a selective serotonin reuptake inhibitor (SSRI), paroxetine (Paxil), 20 mg given every morning. The nurse:

a. Gives the medication as ordered.
b. Questions the physician about the order.
c. Questions the dosage ordered.
d. Asks the physician to order benztropine (Cogentin) for the side effects.

38. Which of the following client statements about clozapine (Clozaril) indicates that the client needs additional teaching?

a. "I need to have my blood checked once every several months while I’m taking this drug."
b. "I need to sit on the side of the bed for a while when I wake up in the morning."
c. "The sleepiness I feel will decrease as my body adjusts to clozapine."
d. "I need to call my doctor whenever I notice that I have a fever or sore throat."

39. A client has been taking lithium carbonate (Lithane) for hyperactivity, as prescribed by his physician. While the client is taking this drug, the nurse should ensure that he has an adequate intake of:

a. Sodium
b. Iron
c. Iodine
d. Calcium

40. The client has been taking clomipramine (Anafranil) for his obsessive-compulsive disorder. He tells the nurse, "I'm not really better, and I've been taking the medication faithfully for the past 3 days just like it says on this prescription bottle." Which of the following actions would the nurse do first?

a. Tell the client to continue taking the medication as prescribed because it takes 5 to 10 weeks for a full therapeutic effect.
b. Tell the client to stop taking the medication and to call the physician.
c. Encourage the client to double the dose of his medication.
d. Ask the client if he has resumed smoking cigarettes.

41. The nurse judges correctly that a client is experiencing an adverse effect from amitriptyline hydrochloride (Elavil) when the client demonstrates:

a. An elevated blood glucose level.
b. Insomnia
c. Hypertension
d. Urinary retention

42. Which of the following health status assessments must be completed before the client starts taking imipramine (Tofranil)?

a. Electrocardiogram (ECG)
b. Urine sample for protein
c. Thyroid scan
d. Creatinine clearance test

43. A client comes to the outpatient mental health clinic 2 days after being discharged from the hospital. The client was given a 1-week supply of clozapine (Clozaril). The nurse reviews information about clozapine with the client. Which client statement indicates an accurate understanding of the nurse's teaching about this medication?

a."I need to call my doctor in 2 weeks for a checkup."
b."I need to keep my appointment here at the hospital this week for a blood test."
c. "I can drink alcohol with this medication."
d. "I can take over-the-counter sleeping medication if I have trouble sleeping."

44. The client is taking risperidone (Risperdal) to treat the positive and negative symptoms of schizophrenia. Which of the following negative symptoms will improve?.

a. Abnormal thought form
b. Hallucinations and delusions
c. Bizarre behaviour
d. Asocial behaviour and anergia

45. The nurse would teach the client taking tranylcypromine sulfate (Parnate) to avoid which food because of its high tyramine content?

a. Nuts
b. Aged cheeses
c. Grain cereals
d. Reconstituted milk

46. Which of the following clinical manifestations would alert the nurse to lithium toxicity?

a. Increasingly agitated behaviour
b. Markedly increased food intake
c. Sudden increase in blood pressure
d. Anorexia with nausea and vomiting

47. The client with depression has been hospitalized for 3 days on the psychiatric unit. This is the second hospitalization during the past year. The physician orders a different drug, tranylcypromine sulfate (Parnate), when the client does not respond positively to a tricyclic antidepressant. Which of the following reactions should the client be cautioned about if her diet includes foods containing tryaminetyramine?

a. Heart block
b. Grand mal seizure
c. Respiratory arrest
d. Hypertensive crisis

48. After the nurse has taught the client who is being discharged on lithium (Eskalith) about the drug, which of the following client statements would indicate that the teaching has been successful?

a. "I need to restrict eating any foods that contain salt."
b. "If I forget a dose, I can double the dose the next time I take it."
c. "I'll call my doctor right away for any vomiting, severe hand tremors, or muscle weakness."
d. "I should increase my fluid”

49. A nurse is caring for a client with Parkinson's disease who has been taking carbidopa/levodopa (Sinemet) for a year. Which of the following adverse reactions will the nurse monitor the client for?

a. dykinesia
b. glaucoma
c. hypotension
d. respiratory depression

50. A client is taking fluoxetine hydrochloride (Prozac) for treatment of depression. The client asks the nurse when the maximum therapeutic response occurs. The nurse's best response is that the maximum therapeutic response for fluoxetine hydrochloride may occur in the:

a. 10-14 days
b. First week
c. Third week
d. Fourth week

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Anonymous said...

where can i get the ans from these questions..thanks!

Anonymous said...

the site is really good.. but i hope the answers are separated w/ rationales, not shown or italicized..

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