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Page | 1. 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 4. To have a less positive outcome 2. 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.” ¢. “You say you hear voices, what are they telling you?” d. “Please tell the voices to leave you alone for now.” 1. Anursing student new to psychiatric-mental health nursing asks a peer what resources he can usc to figure out which symptoms are present in a specific psychiatric disorder. The best answer would be: [Date] Page 2 a. Nursing Interventions Classification (NIC) b. Nursing Outcomes Classification (NOC) c. NANDA-I nursing diagnoses 4. DSM 2. Epidemiological studies contribute to improvements in care for individuals with mental disorders by: a. Providing information about effective nursing techniques. b. Identifying risk factors that contribute to the development of a disorder. ¢. Identifying individuals in the general population who will develop a specific disorder. d, Identifying which individuals will respond favorably to a specific treatment. 1. Besides antianxiety agents, which classification of drugs is also commonly given to treat anxiety and anxiety disorders? a. Antipsychotics b. Mood stabilizers c. Antidepressants d. Cholinesterase inhibitors Page 4 3. You realize that your patient who is being treated for a major depressive disorder requires more teaching when she makes the following statement: a. “Thave been on this antidepressant for 3 days. I realize that the full effect may not happen for a period of wecks.” ». “Tam going to ask my nurse practitioner to discontinue my Prozac today and let me c. “Imay ask to have my medication changed to Wellbutrin due to the problems Iam having being romantic with my wife.” d. “Irealize that there are many antidepressants and it might take a while until we find the one that works best for me.” 4, 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 this particular paticnt? a. Obsessive-compulsive disorder b. Generalized anxiety disorder c. Persistent depressive disorder 4. Substance use disorder 5. Which statement made by a patient prescribed bupropion (Wellbutrin) demonstrates that the medication education the patient received was effective? Select all that apply. Page 5 a. “Lhope Wellbutrin will help my depression and also help me to finally quit smoking,” b. “Pm happy to hear that Twon’t need to worry too much about weight gain.” ce. “Tt’s okay to take Wellbutrin since I haven’ t had a seizure in 6 months.” d. “T need to be careful about driving since the medication could make me drowsy.” e. “My partner and Ihave discussed the possible effects this medication could have on our sex life.” 6. Which drug group calls for nursing assessment for development of abnormal movement disorders among individuals who take therapeutic dosages? a. SSRIs Page 7 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?” . “Does the patient have intact judgment and insight into his situation?” c. “Does the patient have experiences with cither community or inpaticnt mental healtheare facilities?” 4. “Does the patient require a therapeutic environment to support the management of psychotic symptoms?” Page 8 9 10. Pablo is a homeless adult who has no family connection. Pablo passed out on the strect 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? Selectall that apply. a. Intermittent supervision is available in inpatient settings. s d. Medication adherence will be mandated. i 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.” | c. “Ifa 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.” Page 10 a. Change of shift report b. Admission interviews c. One-to-one conversations with patients d. Conversations with paticnt familics 4. During an admission assessment and interview, which channels of information communication should the nurse be monitoring? Select all that apply. 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, b. The patient is more interested in talking to you than listening to what you have to say and so isnot likely to be offended. c. Considering the patient’s history, there is little chance that the comment will do any actual [Date] 10 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. “Anew 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, bul you appear anxious or unhappy.” c. “Tnotice that you frowned and avoided eye contact just now. Don’t you feel well?” a Page 13 4. Asking “why” questions 10. Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the paticnt states, “I don’t need to come sce you anymore. | 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. “Tam 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?” a Page 14 1. Which statement demonstrates a well-structured attempt at limit setting? a. “Hitting me when you are angry is unacceptable.” b. “Lexpect 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 4. Tennis 3. Cognitive-bchavioral therapy is going well when a 12-year- old patient in therapy reports to the nurse practitioner: a. “I was so mad | wanted to hit my mother.” b. “I thought that everyone at school hated me. That's not true. Most people like me and Thavea c. “T forgot that you told me to breathe when I become angry.” on Page 16 5. Which factors tend to increase the difficulty of diagnosing young children who demonstrate behaviors associated with mental illness? Sclcct all that apply. a. b. Level of cognitive development e. 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 4. 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 [Date] b. Genetic factors ¢. Resilience d. Paradoxical cffects 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 effectivetool 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. [Date] 1 Page 19 a. Sercening 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 ofa 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 [Date] 19 Page 20 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 paticnt diagnosed with schizophrenia? a. Depersonalization b. Pressured speech c. Negative symptoms d. Paranoia 
