NursGuru

    Exam Review

    1. A patient diagnosed with major depressive disorder tells the nurse, "Bad things that happen are always my fault." To support the patient to reframe this overgeneralization, the nurse's best response is:
      A)
      I really doubt that one person can be blamed for all the bad things that happen.
      B)
      Let's look at one bad thing that happened to see if another explanation exists.
      C)
      How does your belief in fate relate to your cultural heritage?
      D)
      You are being exceptionally hard on yourself when you say those things.
    2. A patient presenting with delusions of persecution about being poisoned has refused all meals for 3 days. Which intervention will most likely be acceptable to the patient?
      A)
      Offer to taste each portion on the tray for the patient.
      B)
      Obtain a doctor's order for tube feedings or total parenteral nutrition.
      C)
      Allow the patient to telephone a local restaurant to deliver meals.
      D)
      Allow the patient to have supervised access to food vending machines.
    3. The nurse preparing to teach a patient diagnosed with post-traumatic stress disorder (PTSD) about recommended psychotherapy and psychopharmacology will discuss:
      A)
      Attachment-Based Therapy and Mirtazapine (Remeron).
      B)
      Dialectical Behavior Therapy and Lorazepam (Ativan).
      C)
      Cognitive Processing Therapy and Sertraline (Zoloft).
      D)
      Applied Behavior Analysis and Atomoxetine (Strattera).
    4. The nurse is caring for a patient diagnosed with Bipolar I who tells the nurse that frequent admissions for severe mania have adversely impacted their children and family. The nurse feels consumed with worry, concern, and has intrusive thoughts about the patient's family and their situation. The nurse recognizes that she is experiencing:
      A)
      Acute stress disorder.
      B)
      Derealization disorder.
      C)
      Compassion fatigue.
      D)
      Dissociative disorder.

    Exam Review

    1. The experience of trauma causes neurochemical changes in the brain that play a role in encoding fear memories that are implicated in Post Traumatic Stress Disorder. The nurse identifies the involvement of which neurotransmitters?
      A)
      Glutamate and norepinephrine.
      B)
      Gamma-aminobutyric acid (GABA) and glutamate.
      C)
      Histamine and gamma-aminobutyric acid (GABA).
      D)
      Acetylcholine and serotonin.
    2. As part of the stress response, the HPA axis is stimulated. Which structures make up this system?
      A)
      Hippocampus, parietal lobe, and amygdala.
      B)
      Hypothalamus, pituitary gland, and adrenal glands.
      C)
      Hindbrain, pyramidal nervous system, and anterior cerebrum.
      D)
      Hepatic artery, parasympathetic nervous system, and acoustic nerve.
    3. Which scenario best demonstrates an example of eustress?
      A)
      After many years of marital conflict, a couple have filed for divorce.
      B)
      A man receives notification that his employer is experiencing financial problems and he may be terminated.
      C)
      A couple receives a bank notice there were insufficient funds in their account for a recent rent payment.
      D)
      An older man is learning new skills to prepare for his promotion to a supervisory role.
    4. A patient states, "I feel detached from myself and weird all the time. It is as though I am looking at life through a cloudy window. Everything seems unreal. It really messes up things at work and school." This scenario is most suggestive of which health problem?
      A)
      Dissociative amnesia.
      B)
      Depersonalization disorder.
      C)
      Acute stress disorder.
      D)
      Disinhibited social engagement disorder.

    Exam Review

    1. A client is suspected to have dissociative identity disorder. Which characteristic does the nurse identify that the disturbed personal identity is most likely related to?
      A)
      High risk for self-directed violence.
      B)
      Chronic low self-esteem.
      C)
      Childhood trauma and abuse.
      D)
      Poor impulse control.
    2. A nurse provided medication education for a patient diagnosed with major depressive disorder who began a new prescription for phenelzine (Nardil). Which behavior indicates effective learning? The patient:
      A)
      Can identify foods with high selenium content that should be avoided.
      B)
      Confers with a pharmacist when selecting over-the-counter medications.
      C)
      Monitors sodium intake and weight daily.
      D)
      Wears support stockings and elevates the legs when sitting.
    3. A patient diagnosed with major depressive disorder began taking citalopram (Celexa) 4 days ago. The patient now says, "This medicine isn't working." The nurse's best intervention would be to:
      A)
      Explain the time lag before antidepressants relieve symptoms.
      B)
      Discuss with the health care provider the need to increase the dose.
      C)
      Critically assess the patient for symptoms of improvement.
      D)
      Reassure the patient that the medication will be effective soon.
    4. A client is brought to the emergency department after exhibiting vital sign instability, diaphoresis, shivering, incoordination, hyperreflexia, hyperpyrexia, and diarrhea. The client is taking paroxetine (Paxil) for depression. Which condition should the nurse most likely suspect?
      A)
      Neuroleptic malignant syndrome.
      B)
      Agranulocytosis.
      C)
      Acute dystonic reaction.
      D)
      Serotonin syndrome.

    Exam Review

    1. A nurse is reviewing the medical record of a client diagnosed with depression and notes that the client has been prescribed bupropion (Wellbutrin). The client asks, "What kind of medication is this anyway?" The nurse would inform the client this agent is a:
      A)
      Atypical antidepressant.
      B)
      Tricyclic antidepressant.
      C)
      Selective serotonin reuptake inhibitor.
      D)
      Monoamine oxidase inhibitor.
    2. Monoamine oxidase inhibitors are used to treat which of the following?
      A)
      Persistent depressive disorder.
      B)
      Treatment-resistant depression.
      C)
      Moderate depression.
      D)
      Mild depression.
    3. A client has been diagnosed with major depressive disorder. One clinical symptom of this diagnosis is what?
      A)
      Claims by family, friends, or coworkers that the client is depressed.
      B)
      Demonstrated examples of unwise decisions.
      C)
      A significant decrease in appetite.
      D)
      Self-report of being sad after a break-up.
    4. A depressed older adult client is being treated with a tricyclic antidepressant (TCA). Which side effects are important to assess for?
      A)
      Pseudoparkinsonism and tardive dyskinesia.
      B)
      Diarrhea and electrolyte imbalance.
      C)
      Orthostatic hypotension and urinary retention.
      D)
      Photosensitivity and skin rashes.

    Exam Review

    1. A client with bipolar disorder has advanced lithium toxicity with a lithium level of 1.7 mEq/L. Which symptom would the nurse expect to assess?
      A)
      Clonic movements.
      B)
      Muscle hyperirritability.
      C)
      Polyuria.
      D)
      Fine tremor.
    2. A patient diagnosed with bipolar disorder has rapidly changing mood cycles. The health care provider prescribes an anticonvulsant medication. Which drug should the nurse anticipate will be prescribed?
      A)
      Clomipramine (Anafranil).
      B)
      Risperidone (Risperdal).
      C)
      Clonidine (Catapres).
      D)
      Carbamazepine (Tegretol).
    3. A client with bipolar disorder is prescribed valproic acid (Depakote) as part of the treatment plan. Before administering the medication, which test should be done?
      A)
      Blood glucose concentration.
      B)
      Urinalysis.
      C)
      Weight assessment.
      D)
      Liver function tests.
    4. The plan of care for a patient in the manic state of bipolar disorder should include which intervention?
      A)
      Touch the patient to provide reassurance.
      B)
      Design activities that require the patient's concentration.
      C)
      Invite the patient to lead a community meeting.
      D)
      Provide a safe structured environment for the patient.

    Exam Review

    1. A client asks a nurse about the need to alter any activities because of taking lithium. Which response would be most appropriate?
      A)
      No changes are necessary for strenuous activities you do outdoors.
      B)
      Wear sunscreen when you are going to be outdoors in the summer.
      C)
      Increase your fluid intake if an activity causes you to perspire heavily.
      D)
      Drink less fluid than usual now that you are taking this drug.
    2. A client with bipolar disorder, having experienced a depressive episode, is prescribed lamotrigine (Lamictal). After educating the client on this medication, the nurse determines that the education was successful when the client makes which statement?
      A)
      I need to have my blood tested about once a month.
      B)
      This drug can affect my liver function.
      C)
      I need to notify my provider if I develop a skin rash.
      D)
      I have to watch how much salt I use every day.
    3. When teaching a group of new mental health nurses about the major difference between bipolar I and bipolar II disorders, which would be most appropriate to include?
      A)
      The mania symptoms of bipolar II disorder have less effect on functioning.
      B)
      Bipolar II is more often recognized than bipolar I.
      C)
      Unlike bipolar II, bipolar I disorder involves no symptoms of mania, but only depression.
      D)
      Both disorders are the same, except the risk for suicide is greater with bipolar I disorder.
    4. A client with schizophrenia is being treated with olanzapine (Zyprexa) 10 mg daily. The client asks the nurse how this medicine minimizes hallucinations. The nurse explains that the mechanism by which olanzapine controls the client's psychotic symptoms is believed to be what?
      A)
      Increasing the amount of serotonin and norepinephrine in the brain.
      B)
      Blocking dopamine receptors in the brain.
      C)
      Decreasing the amount of an enzyme that breaks down neurotransmitters.
      D)
      Normalizing the levels of serotonin, norepinephrine, and dopamine.