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NURS 661 Exam 1 Questions with Solved Correct Solutions, Exams of Nursing

NURS 661 Exam 1 Questions with Solved Correct Solutions

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2024/2025

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NURS 661 Exam 1 Questions with Solved Correct
Solutions
1. 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
2. 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
3. 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
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 interven-
tions into treatment plans.: Answer: 3
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NURS 661 Exam 1 Questions with Solved Correct

Solutions

  1. 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
  2. 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?
  3. Diagnostic and Statistical Manual of Mental Disorders
  4. American Nurses Credentialing Center certification requirements
  5. American Nurses Association, Code of Ethics
  6. Psychiatric Mental Health Nursing Standards of Practice: Answer: 4
  7. 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?
  8. North American Nursing Diagnosis Association
  9. American Nurses Credentialing Center
  10. National League for Nursing
  11. American Nurses Association: Answer: 4
  12. 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?
  13. I would feel better if you would look at my documentation that addresses progress toward treatment goals.
  14. I will spend time each day evaluating the effectiveness of the therapeutic milieu.
  15. I am a little nervous about conducting psychotherapy with clients.
  16. I am doing some reading on how to incorporate complementary interven- tions into treatment plans.: Answer: 3
  1. 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?
  2. Consult with the mental health care team.
  3. Teach safer sexual practices.
  4. Investigate the questions in individual psychotherapy.
  5. Notify the attending psychiatrist.: Answer: 2
  6. 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?
  7. The nurse refers the clients requests to the psychiatric social worker.
  8. The nurse discusses the desired changes with the client.
  9. The nurse refers the clients requests to the psychosocial rehabilitation worker.
  10. The nurse instructs the client that no changes can be made.: Answer: 2
  11. Due to a staff members absence, the nurse is reviewing staff assignments for the day. Which task can the nurse delegate to the psychosocial rehabilita- tion worker?
  12. Conflict resolution teaching to a small group of clients
  13. Comparison of physicians orders with the medication records
  14. Routine medication administration to a stable client
  15. Assessment of a long-term client: Answer: 1
  16. If psychiatric nurses used Orems theory for structuring much of their nurs- ing practice, a major focus area for assessment would be the clients ability to do which of the following?
  17. Adapt and function to meet various role expectations.
  18. Care about self and participate in self-healing.
  19. Implement self-care to meet psychosocial needs.
  20. Enter into a therapeutic one-to-one relationship with the nurse.: Answer: 3
  21. The psychiatric mental health nurse is asked to develop an intervention for the nursing unit based on Watsons theory of caring. Given this assignment, which intervention is most appropriate for the nurse to implement?

nurse, My childs doctor ordered a PET. What kind of test is that? Select the nurses best reply. A.This test uses a magnetic field and gamma waves to identify problem areas in the brain. Does your teenager have any metal implants? B. PET means positron-emission tomography. It is a special type of scan that

shows blood flow and activity in the brain. C. A PET scan passes an electrical current through the brain and shows brain-wave activity. It can help diagnose seizures. D. Its a special x-ray that shows structures of the brain and whether there has ever been a brain injury: Answer: B

  1. A patient with a long history of hypertension and diabetes now develops confusion. The health care provider wants to make a differential diagnosis be- tween Alzheimers disease and multiple infarcts. Which diagnostic procedure should the nurse expect to prepare the patient for first? a. Skull x-rays b. Computed tomography (CT) scan c. Positron-emission tomography (PET) d. Single-photon emission computed tomography (SPECT): Answer: B
  2. A patients history shows drinking 4 to 6 liters of fluid and eating more than 6,000 calories per day. Which part of the central nervous system is most likely dysfunctional for this patient? a. Amydala c. Hippocampus b. Parietal lobe d. Hypothalamus: Answer: D
  3. The nurse administers a medication that potentiates the action of gam- ma-aminobutyric acid (GABA). Which effect would be expected? a. reduced anxiety b. improved memory c. more organized thinking d. fewer sensory perceptual alterations: Answer: A
  4. A nurse would anticipate that treatment for a patient with memory difficul- ties 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
    1. A patient has disorganized thinking associated with schizophrenia. Neuroimaging would likely show dysfunction in which part of the brain?

b. Frontal lobe c. Cerebellum d. Brainstem: Answer: B

  1. 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
  2. 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
  3. 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
  4. 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
  5. 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

  1. 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
  2. A patient diagnosed with bipolar disorder has an unstable mood, aggres- siveness, 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
  3. 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
  4. 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
  5. 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 parox- etine is a(n): a. selective norepinephrine reuptake inhibitor.

c. MAO inhibitor. d. SSRI: Answer: A

  1. 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
  2. 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
  3. A nurse cares for a group of patients receiving various medications, in- cluding haloperidol (Haldol), carbamazepine (Tegretol), trazodone (Desyrel), and phenelzine (Nardil). The nurse will order a special diet for the patient who takes: a. carbamazepine b. haloperidol c. phenelzine d. trazodone: Answer: C
  4. A nurse instructs a patient taking a drug that inhibits monoamine oxidase (MAO) to avoid certain foods and drugs because of the risk of: a. cardiac dysrhythmia b. hypotensive shock c. hypertensive crisis d. hypoglycemia: Answer: C
  5. A nurse caring for a patient taking a selective serotonin reuptake inhibitor (SSRI) will develop outcome criteria related to: a. coherent thought processes b. improvement in depression c. reduced levels of motor activity d. decreased extrapyramidal symptoms: Answer: B
  1. By which mechanism do selective serotonin reuptake inhibitors (SSRI) improve depression? a. Destroying increased amounts of serotonin b. Making more serotonin available at the synaptic gap c. Increasing production of acetylcholine and dopamine d. Blocking muscarinic and 1 norepinephrine receptors: Answer: B
  2. The laboratory report for a patient taking clozapine (Clozaril) shows a white blood cell count of 3000 mm. Select the nurses best action. a. Report the results to the health care provider immediately. b. Administer the next dose as prescribed. c. Give aspirin and force fluids. d. Repeat the laboratory test.: Answer: A
  3. A drug blocks the attachment of norepinephrine to 1 receptors. The patient may experience: a. hypertensive crisis. b. orthostatic hypotension. c. severe appetite disturbance. d. an increase in psychotic symptoms.: Answer: B
  4. A nurse cares for four patients who are receiving clozapine, lithium, fluox- etine, and venlafaxine, respectively. With which patient should the nurse be most alert for problems associated with fluid and electrolyte imbalance? The patient receiving: a. lithium b. clozapine c. fluoxetine d. venlafaxine: Answer: A
  5. An obese patient has a diagnosis of schizophrenia. Medications that block which receptors would contribute to further weight gain? a. H b. 5HT c. Acetylcholine d. Gamma-aminobutyric acid (GABA): Answer: A
  1. 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?
  2. Orientation
  3. Content of thought
  4. Emotional state
  5. General behavior: Answer: 2
  6. 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:
  7. Insight.
  8. Retention and recall.
  9. Recall of recent past experiences.
  10. Abstract thinking.: Answer: 2
  11. 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:
  12. Just need to complete a series of sentences.
  13. Interpret ink blots.
  14. Only have to copy geometric designs.
  15. Be answering true or false questions.: Answer: 4
  16. 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?
  17. Benton Visual Retention Test
  18. Thematic Apperception Test
  19. Ravens Progressive Matrices Test
  20. Sentence Completion Test: Answer: 1
  21. A depressed client asks why a physical exam is necessary before being admitted for outpatient treatment. The nurse explains to the client
  1. Make sure the client gets all necessary treatment.
  2. Complete the admission process.
  3. Ensure the client has not ingested any caustic material or inhaled noxious vapors: Answer: 2
  4. 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?
  5. The client is in need of further evaluation.
  6. The client has a personality disorder.
  7. The client will need a special diet.
  8. The client is a candidate for the least restrictive environment.: Answer: 2
  9. A female client disclosed to the nurse that she is in an abusive situation. This information will be used to contribute to:
  10. Axis IV.
  11. Axis III.
  12. Nothing, since this is confidential information and should not be shared.
  13. Axis I.: Answer: 1
  14. 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?
  15. The client has a clinical psychiatric disorder.
  16. The client is in need of immediate medical attention.
  17. The client has a chronic condition.
  18. The client lacks a support system.: Answer: 1
  19. 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 informa- tion?
  20. This client has problems with environment, but they are not related to mental disorder.
  21. The clients environment has not been evaluated.
  22. The clients health status has not been evaluated.
  1. The client has no diagnosed physiological health problems relevant to mental disorder at the time of admission.: Answer: 4
  2. The school nurse, who must be familiar with mental health issues, will find child clinical disorders classified under:
  3. Axis II.
  4. Axis I.
  5. Axis X.
  6. Axis VII.: Answer: 2
  7. After interviewing a client for admission, the nurse gives the client a score of 50 on the Global Assessment of Functioning Scale (GAF). The nurse selected this score based on the clients level of functioning:
  8. Since being given a psychiatric diagnosis.
  9. Within the past week.
  10. Since beginning the psychotropic medication.
  11. Within the past year.: Answer: 2
  12. Select the priority nursing diagnosis for a client with a Global Assessment of Functioning (GAF) score of 10.
  13. Risk for Impaired Social Interaction
  14. Risk for Injury
  15. Knowledge Deficit
  16. Risk for Communication Deficit: Answer: 2
  17. The psychiatric home health nurse is evaluating whether a clients level of functioning has improved since starting the prescribed psychotropic medica- tion. What evidence does the nurse look for?
  18. There is no change in the GAF score.
  19. There is a significant decrease (by 10 or more points) in the clients GAF score.
  20. The client no longer qualifies for a GAF score.
  21. There is an increase in the clients GAF score.: Answer: 4
  22. The nurse is documenting observations of client interactions during a group session. The nurse strives to document the behaviors of the client interactions with:
  23. Objectivity.
  24. Serendipity.
  1. The nurse is expressing warmth toward the client 2. The nurse is being patient
  2. The nurse is demonstrating empathy
  3. The nurse is sending a mixed message: Answer: 4
  4. The nurse observed that during a teaching session, the overall emotional tone of a client remained unchanged. The nurse documents this as:
  5. Affect that has range.
  6. Flat affect.
  7. Incongruent verbal and nonverbal responses.
  8. Muted behavior.: Answer: 2
  9. 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?
  10. Avoiding the use of silence to decrease anxiety
  11. Asking for details to demonstrate interest in the client
  12. Using closed-ended questions
  13. Listening to the clients feelings: Answer: 4
  14. A working goal for the nurseclient relationship is to achieve:
  15. Facilitative intimacy.
  16. Self-disclosure.
  17. Interdependence.
  18. Social superficiality: Answer: 1
  19. 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?
  20. Setting goals
  21. Building
  22. Initiating
  23. Maintaining: Answer: 3
  24. The nurse engaged in a therapeutic relationship with a client uses nonver- bal communication to:
  25. Enhance verbal messages.
  26. Avoid the use of verbal messages.
  27. Detract from verbal messages.
    1. The type of soap the client prefers to use: Answer:
    1. Terminate the therapeutic relationship.: Answer: