A. Severe Muscle Rigidity
B. Decreased Responsiveness
B. Decreased Responsiveness
A. Typical antipsychotic.
B. Mood stabilizers
D. Atypical antipsychotics
D. Atypical antipsychotics
B. Anticholinergic Toxicity
A. Non-reactive pupils
B. Hot, dry, red skin
C. Dry mucus membranes
D. All of the above
A. All require lab work to manage dosage.
B. There is a higher risk of suicide approximately 2 weeks after starting the med.
C. All require dietary restrictions.
D. All are effective for bipolar depression.
A. ECG changes
C. Mental confusion
D. Hand tremors
C. Mental confusion
D. Hand tremors
A. Tegretol level
True or false
True or false
A. Arrange for an emergent admit to a crisis unit.
B. Assist the pt to identify and choose a coping strategy.
C. Advise the pt to take an anxiolytic, then go to sleep.
D. Arrange for an emergent admit to an inpatient unit.
A. The patient has developed delirium, resulting in poor hygiene and injuries.
B. The patient is being inadequately cared for, resulting in accidents.
C. The dementia is progressing, reducing self-care and increasing falls.
D. The patient is being neglected and abused within the family.
A. Has perineal bruises and UTIs.
B. Displays reduced functioning at school.
C. Has repeated middle ear infections.
D. Complains of abd. cramps and upset stomach.
A. Pervasive developmental disorder.
B. Psychostimulant drugs
C. Antipsychotic drugs
D. Anxiolytic drugs
A. High levels of anxiety when separated from the parent.
B. Hyperactivity and attention deficits.
C. Failure to develop interpersonal skills.
D. A Hx of disobedience and destructive acts.
A. “Talk with the school about withdrawing the child until maturity increases.”
B. “Send a picture of yourself to school to keep with the child.”
C. “Talk with your health care provider about a referral to a mental health clinic.”
D. “Arrange with the teacher to let the child call home at play time.”
A. Art therapy
B. Family therapy
C. Play therapy
A. Developmental milestones achieved on schedule
B. Being raised by a mother with chronic major depression
C. Not being promoted to the next grade at the completion of a school year
D> Moving to three new homes over a 2-year period
A. Asperger’s disorder
B. Pervasive developmental disorder
C. Conduct disorder
A. “Attention everyone: we are all going to the craft room.”
B. “You will be taken to seclusion if you throw that ball.”
C. “Please do not lose control of your emotions.”
D. “Do not throw the ball. Put it back on the pool table.”
A. Aren’t you worried about the safety of your children?
B. Can you identify the situations that provoke your husband?
C. I am concerned about your safety.
D. I wouldn’t put up with this if I were you.
A. Perception of the presenting problem.
B. Description of the hallucinations
C. Feelings about hospitalization
D. Relationships with the family.
Description of hallucinations – appropriate for the assessment phase.
Feelings about hospitalization – appropriate for the assessment phase.
Relationship with the family – appropriate for the working phase.
A. “I can’t leave you alone when you are this upset. Sit down, and try to relax.”
B. “Let’s go to your room, and you can tell me what is bothering you.”
C. “I will give you space as long as you control yourself. I’d like to know what is causing you to feel so tense.”
D. “I will leave you alone for a few minutes while you try to compose yourself.”
A. “How long were you married to your husband?”
B. “Remember? Your husband died five years ago.”
C. “You’ve forgotten that your husband is dead, haven’t you?”
D. “You miss your husband a lot, don’t you?”
A. Lock the doors to the unit and secure all windows so they cannot be opened.
B. Remove belts, glass objects, and sharp instruments from the client’s environment.
C. Have a staff member stay with the client at all times.
D. Provide a relaxed and accepting environment to develop trust.
A. Denial and disbelief
B. Fear and anxiety
C. Anger and guilt
A. “You should attend an Al-Anon meeting. The group can teach you how best to help him stay sober.”
B. “You have already done a great deal by getting him here. Now, it is up to him.”
C. “Are you feeling some responsibility for his drinking?”
D. “Tell me more about the kind of help you feel you are able to provide at this time.”
A. The client frequently argues with her parents.
B. The client is getting C’s in school because she is absent a lot.
C. The client smokes half a pack of cigarettes per day.
D. The client gave her favorite necklace to her best friend.
A. “I do not feel that you really believe that.”
B. “Everyone feels this way when depressed.”
C. “You sound upset. Are you thinking of hurting yourself?”
D. “You’ll feel better once your medications start working.”
A. Share memories of past experiences and events.
B. Reorient pts with cognitive problems.
C. Stimulate and encourage social participation.
D. Resolve emotional problems
A. “You are being unreasonable, and I will not call your therapist at 3:00 in the morning.”
B. “Why do you need to see your therapist tonight?”
C. “Calm down, go back to your room, and I’ll try to get in touch with your therapist right away.”
D. “You must be very upset about something to want to see your therapist in the middle of the night.”
A. “You may feel good now, but what about when you get depressed?”
B. “What do you like about being manic?”
C. “You feel better when you don’t take your medication?”
D. “You really should follow your provider’s orders if you want to be well.”
A. Suggest calling her spouse for her.
B. Ask her if there is anything that can be done for her.
C. Sit silently with her while she cries.
D. Share feelings with her regarding the recent loss of a sibling.
A. “You must be getting better. You look great!”
B. “Let’s go put some make-up on to make you look even better.”
C. Why did you get all dressed up today? Is it a special occasion?
D. “You look nice after your bath and shampoo.”
A “Let’s discuss your feelings more after we finish admitting you.”
B. “I don’t think talking to you is a waste of time.”
C. “Why do you feel the way you do?”
D. “I think you are worthwhile, and I want to talk to you.”
A. “Everyone feels that way when they first start treatment.”
B. “You sound very discouraged and hopeless today.”
C. “You’ll feel so much better once you get up and into your own clothes.”
D. “Why do you say that you are too sick to bother?”
A. Increased sensitivity to other’s needs.
B. A poor sense of self-identity
C. Exaggerated feelings of guilt.
D. Excessive amounts of fear and suspicion.
A. “At breakfast today everyone was talking about me. They were all staring at me.”
B “I don’t feel like going to group therapy today. I don’t want to be with other people.”
C. “I have it all figured out. Everything is going to be okay now.”
D. “I don’t feel like showering or eating. I’d rather just stay in bed today.”
c. “I have it all figured out. Everything is going to be okay now.”
A. “My child is so active and gets into everything.”
B. “My child was riding a bicycle and got the R foot caught in the spokes.”
C. “My child slipped out of the high chair because the strap was too loose.”
D. “My child climbed up on a chair and fell down.”
A. A 14 mon. old who is reportedly “clumsy” with many bruises on bony prominences in various stages of healing.
B. A 9 mon. old who reportedly nearly drowned after climbing into the tub and turning on the water.
C. A 6 yr old with a tib/fib fracture, which reportedly occurred while riding a bicycle.
D. A 3 yr old with 15% burns in a splash pattern over the face and chest reportedly sustained when a tablecloth was pulled, spilling a teapot.
B. Reaction formation
A. “Have you attempted suicide before?”
B. “What happened to make you so desperate?”
C. “How will you carry out your plan?”
D. “What will you accomplish by taking your life?”
A. Closed spaces
B. Dark places
A. “Is there any pattern to your eating binges and vomiting?”
B. “Do you have a family Hx of eating disorders?”
C. “You are feeling helpless about changing this behavior?”
D. “You must stop. You are destroying your health.”
A. Permit the pt to remain alone.
B. Ignore the pt’s behavior.
C. Telephone the pt’s favorite RN to talk with the pt.
D. Help the pt verbalize her feelings and reasons for the acting-out behavior.
A. “Did I say something wrong that made you feel tense?”
B. “Do you often feel tense when you are talking to a health care provider?”
C. “What were we discussing when you began to feel uncomfortable?”
D. “I sometimes feel tense, too, when I am talking to a stranger.”
A. The pt is extremely alert.
B. The pt c/o a stomach ache.
C. The pt paces in the day room.
D. The pt has dilated pupils.
A. “They are permanent changes because the alcohol has destroyed your nerves.”
B. “They will persist for a few days now that you are not drinking.”
C. “This is unusual. We will have to notify your provider immediately.”
D. “These are very typical of the seizures that are associated with alcohol withdrawal.”
A. Develop more adaptive family relationships
B. Sign a contract pledging not to act on suicide plans
C. Explore the motivating factors for suicide
D. No longer verbalize thoughts or feelings as they relate to suicide.
Physical safety is priority. The RN should prevent the pt from carrying out suicide.
A. “Why do you think that someone would want to kill you?”
B. “You are frightened. This is a hospital and we are here to help.”
C. “Don’t worry. No one here wants to kill you.”
D. “Who in particular do you think wants to kill you?”
A. Explain to the pt that this time is for him.
B. Introduce an unrelated topic to distract the pt.
C. Accept this behavior as a sign of the pt developing trust.
D. Relate to the pt that you do not wish to engage in this conversation.
A. “Tell me who would do such things to you?”
B. “You are mistaken. Nobody has told lies about you or tried to poison you.”
C. “Tell me more about your concerns about being poisoned.”
D. “You’re having very frightening thoughts.”
Focus on the fear, which is real, rather than the beliefs, which are not real.
A. Identify the cause of the anxiety.
B. Reduce the pt’s immediate anxiety.
C. Investigate the situation that preceeded the attack.
D. Explain the physical manifestations of anxiety to the pt.
A. Fine hand tremor
D. Urinary retention
A potentially serious side effect. In addition to monitoring the client’s I&O, the nurse should check for abd distention, hold the next dose of the antidepressant, and report the client’s condition to the provider. Urinary retention can lead to bladder infection and loss of bladder tone.
A. Method of reducing anxiety
B. Form of manipulation to avoid work
C. Strategy to get attention
D. Rationalization for avoiding social contact.
A. Education about alcohol abuse and treatment
B. Assessing coping skills
C. Confronting the use of denial and other defense mechanisms
D. Rest and nutrition.
Early phase = detox. The RN should focus on the client’s physical and medical needs.
A. Pinpoint pupils
A. Ask other clients to be more sympathetic of complaining client.
B. Encourage the client to participate in group diversional activities.
C. Ask the client to stop talking about physical complaints.
D. Encourage the client to rest alone when upset.
A. Flight of ideas
A. Should not be taken during pregnancy.
B. Must be discontinued by gradual tapering over time.
C. Is contraindicated for clients with asthma.
D. Is a safe medication with no known adverse effects.
A. Spaghetti and meat balls, salad, banana.
B. Beef and vegetable stew, bread, vanilla pudding.
C. Chicken nuggets, ear of corn, apple
D. Fish fillets, stewed tomatoes, cake
A. Preoccupation with physical health.
B. Loss of a physical function without pathology
C. Attention seeking by deliberately causing harm to his child
D. Ritualistic handwashing as a way to avoid contact with germs.
A. Skin rashes
B. Excessive sweating
D. Muscle breakdown
A. Acetaminophen (Tylenol)
B. Ranitidine (Zantac)
C. Benztropine (Cogentin)
D. Pseudoephedrine (Sudafed)
A. Side effects include insomnia and seizures
B. Valium can be habit forming.
C. This medication is administered solely by mouth
D. It takes 2 to 3 weeks to reach full therapeutic effect.
A. Jerky, choreiform movements of the UE’s
B. Slow, involuntary athetoid movement of the arms and legs
C. Involuntary grimacing, lip smacking, and tongue protrusion.
D. Tonic contractions of the neck and back.
A. A unit picnic in a local park
B. Occupational therapy
C. The hospital gift shop
D. Daily group therapy
A. Clang association
C. Pressured speech
D. Word salad.
A. Increasing sodium intake
B. Mild exercise
D. Carbamazepine (Tegretol) therapy
A. An illusion
D. Grandiose delusion
A. Sodium and fluid intake should be increased
B. Fluid intake should not exceed 100mL per day
C. Sodium intake should be restricted to 1200mg per day.
D. An adequate daily intake of sodium and fluids should be maintained.
A. Speak in a calm manner.
B. Leave the client alone regain control
C. Encourage the client to express her feelings.
D. Ask the client to describe what occurred before the panic.
B. Conversion disorder
C. Panic disorder
A. Move the client to a calm, non-stimulating environment.
B. Encourage the expression of feelings
C. Lower the client’s level of anxiety by offering medication.
D. Suggest the client engage in some automatic behavior, such as pacing, to reduce anxiety levels.
A. Carbamazepine (Tegretol)
B. Valproic acid (Depakote)
C. Paroxetine (Paxil)
D. Lithium (Lithane)
C. tardive dyskinesia
A. Plan the client’s schedule to allow extra time to perform the rituals to keep anxiety within manageable levels.
B. Set strict limits on the behaviors so the client can better conform to the unit rules and schedules.
C. Isolate the client for a period of time to lower anxiety about offending others.
D. Confront the client about the senseless nature of the ritualistic behaviors.
A. Perception of reality
B. Ability to follow directions
C. Physical needs
D. Mental status
A. “You will need to be careful of exposure to the sun and wear a sunscreen when outdoors.”
B. “While you are taking Seroquel, you will need to have weekly blood counts.”
C. “Weight gain is less common with Seroquel than with other atypical antipsychotics.”
D. “Seroquel is effective in managing rapid-cycling manic episodes.”
A. “Thorazine is an antipsychotic that can cure your disorder.”
B. “Thorazine is a sedative that helps to calm you down.”
C. “Thorazine will help to control the symptoms of your illness.”
D. “Thorazine controls the side effects of antipsychotic drugs.”
A. Relief of anxiety
B. Gaining attention
C. Avoiding daily responsibilities
D. Controlling a phobia for germs.
A. Chart observations and reassure the client that these manifestations are normal.
B. Administer diazepam (Valium) 5mg PO (ordered PRN).
C. Encourage deep breathing and relaxation
D. Administer benztropine Mesylate (Cogentin) 1mg PO (ordered PRN).
A. “You should increase your fluid intake to prevent dry mouth.”
B. “You should take this medication with food to prevent GI upset.”
C. “You will need to watch your caloric intake to prevent weight gain.”
D. “You will have to read food labels careful to eliminate tyramine from your diet.”
A. Teach the client strategies to decrease the hallucinations.
B. Check that the client is on antipsychotic medications.
C. Establish rapport with the client.
D. Explore what the voices are saying to the client.
Therapeutic = focus on patient’s problem and needs
– Hallucinations (alterations in speech)
– Delusions (bizarre behavior; walking backward)
Affect – blunted or flat
Alogia – poverty of thought or speech patient mumbles
Anergia – lack of energy
Anhedonia – lack of pleasure or joy
Avolition – lack of motivation
A. Remain calm and talk quietly to the client.
B. Obtain assistance to restrain the client for safety.
C. Firmly state to the client that morning care will be performed.
D. Call the provider to request a prescription for a sedative medication.
A. Poor school performance
B. Relentless exercise
C Honesty in eating habits
D. Lack of self-control
A. Lorazepam (Ativan) PRN
B. Hydroxyzine (Vistaril) twice daily
C. Chlorpromazine (Thorazine) TID
D. Haloperidol (Haldol) at HS
A. Skeletal muscle injuries
B. Status epilepticus
C. Chronic pain syndrome
A. Little responsibility or concern for his current situation.
B. Anger and rage with the police and court for hospitalizing him against his will.
C. Withdrawal from others because of shame over his recent actions.
D. Remorse for stealing and destroying the car.
A. Displacing feelings of anger onto hospital staff.
B. Guilt, shame, and the feeling that she provoked or should have prevented the rape.
C. Re-experiencing the fear and hopelessness of the original trauma.
D. Unconsciously denying the rape and rapidly returning the normal activities.
B. Antianxiety agents
C. Antipsychotic drugs
A. Mood swings and suicidal ideation
B. Aggression and impulsiveness
C. Short-term memory loss and disorientation.
D. Suspicion and fearfulness
A. “What are the voices saying?”
B. “Do you recognize the voices?”
C. “That must be very frightening.”
D. “Is the TV turned on?”
A. Maintain the pt’s contact with family.
B. Discourage pt’s use of vulgar language.
C. Protect the pt from impulsive behavior.
D. Redirect excessive energy to creative tasks.
A. Peppermint candy
B. Vanilla extract
A. “Aricept prolongs the time and functioning of the earlier stages of the disease.”
B. “This med halts the disease process if it’s started upon the first recognition of dementia.”
C. “Aricept prevents memory loss evident in the last phase of the disease.”
D. “This med works most effectively when administered slowly with increasing daily dosages.”
A. “Attending group therapy, even if you’re tired, may help your depression.”
B. “That’s okay for today, but you will have to go tomorrow.”
C. “I will tell your provider how depressed you are.”
D. “If you do not go to therapy, I will have to chart that you refused.”
A. Chairing the unit’s self-government group
B. Identifying 3 strengths
C. Competing in a unit volleyball game
D. Painting alone for 15 mins
A. With 8oz of water
B. With dinner
C. Before breakfast
D. At bedtime
A. Good problem-solving skills
B. Commitment to long-term goals
C. Ability to delay gratification
D. Low tolerance for frustration
A. Appetite loss
A. Promoting and maintaining pt safety.
B. Exploring the reasons for the pt’s behavior
C. Assisting the pt to recognize feelings
D. Providing strategies for alternative coping
A. “I just found out I am 3 months pregnant.”
B. “I only ate a light breakfast this morning.”
C. “I am having memory problems since the last treatment.”
D. “My partner will be back later to drive me home.”
A. Elderly pts require lower doses of antidepressants than younger pts
B. Elderly pts cannot be safely treated with tricyclic antidepressants
C. Elderly pts respond more quickly to the therapeutic effects of antidepressants than younger pts
D. Elderly pts can be treated safely and effectively with all antidepressants
A. Set limits on the inappropriate behavior
B. Ignore the inappropriate behavior
C. Isolate the pt during activity periods
D. Provide diversion for inappropriate behavior
A. Repeated exposure to situations that the pt fears
B. Distraction each time the pt brings up the problem
C. Teaching relaxation techniques
D. Gradual desensitization by controlled exposure to the situation the pt fears
A. Stability of mood
B. Understanding of med regimen
C. Improvement in judgment
D. Adequate nutrition and rest patterns
A. WBCs must be monitored regularly
B. A pretreatment EEG must be performed and repeated in 6 months.
C. Thyroid function tests must be performed every 6 months.
D. Liver function and hematology levels must be monitored regularly.
A. “It must be difficult for you to talk about these family problems.”
B. “You should continue attending the counseling sessions until the therapist tells you to stop.”
C. “Because your spouse’s condition is improving, you will be less involved in family therapy.”
D. “Continuing counseling is necessary if your spouse is to continue making progress.”
A. Assisting a roommate who is depressed to fill out a menu
B. Volunteering to chair the pt government meeting
C. Requesting a weekend pass to go home
D. Serving as the judge for a unit talent show
E. Leading a weekly community group
C. Requesting a weekend pass to go home
A. Supervising the pt to prevent any destructive behavior
B. Ignoring the pt’s past acts and focusing on current issues
C. Setting clear rules and expectations for the pt’s behavior
D. Help the pt to gain insight into what motivates the behavior
A. Confusion, visual hallucinations, delusions
B. Coarse tremors, tachycardia, insomnia
C. Disorientation, confabulation, memory deficits
D. Incoordination, impaired thinking, irregular eye movements.
A. Negotiating the treatment plan with the pt.
B. a one-to-one RN-pt relationship
C. Participation in group therapy
D. Providing an unstructured environment
A. Pinpoint pupils
B. Dilated pupils
C. Bloodshot sclera
D. Rapid movement
C. Slurred speech
D. Head nodding
A. Poor frustration tolerance
B. Intense guilt
A. Haloperidol (Haldol)
B. Disulfiram (Antabuse)
C. Chlordiazepoxide (Librium)
D. Promethazine (Phenergan)
A. There is inconsistency between the Hx and the injury
B. A child presents with visible bruises
C. A caregiver, rather than a parent, brings the child to the clinic.
D. A child is crying inconsolably while being held by a parent.
A. Allowing the pt to select meals from the same menu offered to all pts
B. Providing positive reinforcement for each pound the pt gains?
C. Permitting the pt to spend some quiet time alone after each meal
D. Refraining from commenting about the pt’s eating during meal times.
A. “The change in behavior came on so quickly! I wasn’t sure what was happening to her.”
B. “This is so unlike my mother to behave like this. Maybe, the behavior is age-related.”
C. “She just didn’t seem to know what she was doing. She would forget what she had for breakfast.”
D. “My mother has always been so independent. She’s lived alone since my father died years ago.”
A. Taper the med gradually.
B. Provide a high-calorie dietary replacement.
C. Monitor serum blood levels.
D. Implement restraints and seclusion PRN
A. ibuprofen (Advil)
B. succinylcholine (Anectine)
C. valproic acid (Depakene)
D. HCTZ (HydroDIURIL)
A. Remembering a daily schedule
B. Solving a simple math problem
C. Coping with stressful experiences
D. Recalling events of the distant past
A. Filling silent periods by talking about topics interesting to the RN
B. Sitting quietly with the pt until the pt indicates a willingness to talk
C. Encouraging the pt to talk by asking direct questions
D. Continuing to speak with the pt using short, clear statements, or open-ended questions
A. Avoid directly asking if the pt has ever been hurt by someone.
B. Be confrontational
C. Be non-threatening and non-judgmental
D. Avoid asking the pt about the potential abuse
A. Disorientation and impaired judgment
B. Acute confusion and inattention
C. Personality change and apathy
D. Anxiety and memory loss
A. Seizure activity
B. Resp. depression
D. Kidney failure
A. Request an order for a sedative med
B. Remain calm, and encourage the pt to verbally express fears.
C. Keep a nightlight on in the pt’s room
D. Assess the pt’s level of px or the presence of other physical discomfort
A. The pt is unable to manage the affairs necessary for daily life.
B. The pt has broken the law
C. A psychiatrist has determined that the pt’s behavior is irrational
D. The pt exhibits behavior that is a threat to either himself or society
A. Gather several staff members and approach the pt together.
B. Prepare a PRN does of IM haloperidal (Haldol) for the pt
C. Observe the pt’s behavior, and approach him in a non-threatening manner
D. Contact the pt’s provider to request an order to place the pt in seclusion.