Psychiatric Nursing

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions. Remember, there's only one answer to each question.

1.	The currently used system for classifying and diagnosing mental disorders was established by the:

a) American Nurses Association.
b) American Psychiatric Association.
c) state boards of nursing.
d) American Medical Association.

2.	The mental status examination (MSE) investigates all of the following except the patient’s:

a) LOC.
b) mood, affect, and perceptions.
c) medication effects.
d) activities of daily living.

3.	Over the course of a day, a patient may exhibit changes in:

a) orientation.
b) mood.
c) affect.
d) consciousness.

4.	Which test assesses a patient’s orientation and recall?

a) Beck Depression Inventory
b) Thematic apperception test
c) Mini-mental status examination
d) Millon Clinical Multiaxial Inventory III

5.	A preoccupation that’s acted out is called:

a) an obsession.
b) a compulsion.
c) a delusion
d) a hallucination

6.	What should the nurse teach the parents of a child who’s receiving methylphenidate (Ritalin)?

a) Monitor the child’s blood glucose level because the drug increases the diabetes risk.
b) Monitor the child’s growth closely because the drug may interfere with groth and development.
c) Have the child undergo IQ testing because the drug may decrease intelligence.
d) Have the child’s hearing tested because the drug can cause hearing loss.

7.	In a child with conduct disorder, aggressive behavior is:

a) caused by anxiety.
b) masking low self-esteem.
c) caused by temporary changes in relationships.
d) caused by heredity.

8.	A child with depression has limited interaction with classmates. When working with her, the nurse should assign top priority to:

a) developing her strengths and improving her self-esteem
b) addressing ways for her to learn to complete tasks.
c) determine strategies to help her handle fear.
d) developing her communication skills.

9.	Signs and symptoms of ODD include:

a) anxiety.
b) compulsive behavior.
c) testing of limits.
d) hallucinations.

10.	A child with Tourette syndrome who has both motor and vocal tics is most likely to experience:

a) academic difficulties.
b) peer teasing.
c) poor social skills.
d) speech impediment.

11.	A patient with gradually occurring global impairments of cognitive functioning, memory, and personality is most likely to have:

a) age related cognitive decline.
b) Alzheimer’s-type dementia.
c) vascular dementia.
d) dyskinesia

12.	Age-related declines in intelligence, learning ability, short-term memory, and reaction time may grow more significant by about age:

a) 60
b) 65
c) 70
d) 75

13.	An appropriate way to teach an elderly patient is to use:

a) audiotapes.
b) pictures and simple wording.
c) television programs.
d) musical recordings.

14.	OBRA requires that nursing home residents who have been diagnosed with a primary psychiatric disorder receive treatment for that disorder by a:

a) neurologist.
b) geropsychiatric CNS.
c) mental health professional.
d) psychiatrist.

15.	A drug used to treat Alzheimer’s disease is:

a) aspirin
b) chlorpromazine (Thorazine).
c) tacrine (Cognex).
d) sertraline (Zoloft)

16.	Flattening of emotions refer to:

a) anhedonia.
b) asociality.
c) blunted affect.
d) regression.

17.	False ideas or beliefs that the patient accepts as real are called:

a) delusions.
b) hallucinations.
c) illusions.
d) magical thinking.

18.	A newly admitted patient can’t take care of his personal needs, shows insensitivity to painful stimuli, and exhibits negativism, rigidity, and posturing. The most appropriate diagnosis is:

a) paranoid schizophrenia.
b) residual schizophrenia.
c) undifferentiated schizophrenia.
d) catatonic schizophrenia.

19.	A schizophrenic patient who began taking haloperidol (Haldol) 1 week ago now exhibits jerking movements of the neck and mouth. These are signs of:

a) dystonia.
b) psychosis.
c) akathisia.
d) parkinsonism.

20.	A positive symptom of schizophrenia is:

a) hallucination.
b) blunted affect.
c) anhedonia.
d) asociality.

21.	Severe pathologic mood swings, from hyperactivity and euphoria to sadness and depression occur in:

a) dysthymic disorder.
b) cyclothymic disorder.
c) bipolar disorder.
d) depressive disorder.

22.	In a patient who’s predisposed to bipolar disorder, a bipolar episode may be triggered by:

a) hypothyroidism.
b) hyperthyroidism.
c) antimanic drugs.
d) anti-seizure drugs.

23.	Rapid cycling refers to bipolar disorder with:

a) one or more episodes of depression or mania in 1 year.
b) two or more episodes of depression or mania in 1 year.
c) four or more episodes of depression or mania in 1 year.
d) no episodes of depression.

24.	ECT may be used to treat:

a) dysthymic disorder.
b) major depressive disorder.
c) cyclothymic disorder.
d) bipolar I disorder.

25.	A patient who has been prescribed lithium (Eskalith) should be taught to:

a) limit fluids to 1,500 ml daily.
b) maintain a high fluid intake.
c) restrict sodium intake.
d) exercise outside in hot weather.

26.	Signs and symptoms of acute stress disorder may occur:

a) immediately after a trauma.
b) as early as 2 days after a trauma.
c) about 1 month after a trauma.
d) several months after a trauma.

27.	Fear of situations or places that may be difficult or embarrassing to leave describes:

a) social phobia.
b) panic disorder.
c) agoraphobia.
d) generalized anxiety disorder.

28.	Unresolved conflicts, a tendency to misinterpret events, and avoidance of new situations may be risk factors for:

a) panic disorder.
b) GAD.
c) social phobia.
d) cacophobia.

29.	The fear of losing one’s mind or having a heart attack is most likely to occur in:

a) social phobia.
b) panic disorder.
c) GAD.
d) myctophobia.

30.	Flashbacks of an unpleasant, terrifying, or painful experience may occur in:

a) PTSD.
b) panic disorder.
c) agoraphobia.
d) obsessive-compulsive disorder.

31.	Fear of embarrassing oneself in public characterizes:

a) generalized anxiety disorder.
b) panic disorder.
c) specific phobia.
d) social phobia.

32.	A patient with a history of panic attacks says he feels trapped after an attack. He most likely fears:

a) loss of maturity.
b) loss of control.
c) loss of memory.
d) loss of identity.

33.	Manifestation of physical symptoms caused by psychological distress is termed:

a) pain disorder.
b) somatiziation.
c) conversion disorder.
d) psychosomatic.

34.	A patient concerned with an imagined or slight defect in physical appearance is most likely suffering from.

a) BDD.
b) conversion disorder.
c) hypochondriasis.
d) somatization.

35.	The behavioral technique that uses a painful stimulus to modify behavior is called:

a) thought-stopping.
b) aversion therapy.
c) implosion therapy.
d) response prevention.

36.	A patient who reports paralysis with no specific cause but has a history of a recent stressful event has a probable diagnosis of:

a) hypochondriasis.
b) somatic illness.
c) conversion disorder.
d) pain disorder.

37.	Misinterpretation of bodily sensations or symptoms is a chief feature of:

a) body dysmorphic disorder.
b) somatization.
c) conversion disorder.
d) hypochondriasis.

38.	In patient with dissociative disorders, the defense mechanism most often used to block traumatic experiences is:

a) passive aggression.
b) reaction-formation.
c) denial.
d) repression.

39.	Feelings of a dreamlike state or of being a detached observer typically occur in:

a) dissociative fugue.
b) dissociative amnesia.
c) depersonalization disorder.
d) dissociative identity disorder.

40.	Multiple personality disorder is also known as:

a) dissociative fugue.
b) depersonalization disorder.
c) dissociative amnesia.
d) DID

41.	Factors that may contribute to DID include all of these except:

a) history of seizures.
b) emotional, physical, or sexual abuse.
c) genetic predisposition.
d) extreme stress and trauma.

42.	Signs and symptoms of dissociative fugue are most pronounced:

a) weeks before the fugue episode.
b) during the fugue episode.
c) after the fugue episode.
d) hours before the fugue episode.

43.	The personality disorder that’s characterized primarily by mistrust is:

a) paranoid personality disorder.
b) antisocial personality disorder.
c) dependent personality disorder.
d) schizotypical personality disorder.

44.	For patients with most personality disorders, the treatment choice is:

a) group therapy.
b) individual psychotherapy.
c) self-help support groups.
d) inpatient therapy.

45.	Ideas of reference and magical thinking may occur in:

a) borderline personality disorder.
b) schizotypal personality disorder.
c) schizoid personality disorder.
d) histrionic personality disorder.

46.	The hallmark of borderline personality disorder is:

a) irresponsibility.
b) reckless disregard for others.
c) impulsivity.
d) unlawful behavior.

47.	If a patient with dependent personality disorder reports physical complaints, the nurse should:

a) overlook the symptoms.
b) encourage her to talk about her symptoms.
c) disregard symptoms until emotional issues have been explored.
d) explore symptoms in a matter-of-fact way.

48.	A patient who’s preoccupied with details and lists is most likely to have:

a) histrionic personality disorder.
b) obsessive-compulsive personality disorder.
c) schizotypal personality disorder.
d) narcissistic personality disorder.

49.	The most serious complication of anorexia nervosa is:

a) high risk of mortality.
b) coexisting depression
c) poor family relationships
d) social isolation

50.	To qualify for the diagnosis of anorexia nervosa, the patient’s weight must drop below:

a) 75% of ideal body weight.
b) 80% of ideal body weight.
c) 85% of ideal body weight.
d) 90% of ideal body weight.

51.	Purging behavior is usually triggered by:

a) sensations of fullness or bloating.
b) guilt, humiliation, and self-condemnation.
c) fear of being discovered as a binge eater.
d) feelings of nausea.

52.	Any of the following medications may be used to treat bulimia nervosa except:

a) paroxetine (Paxil).
b) amitriptyline (Elavil).
c) diazepam (Valium).
d) imipramine (Tofranil).

53.	Expected effects of a disulfiram reaction include:

a) chest pain, chills, and hypertension.
b) slow pulse, chills, and excitation.
c) slow pulse, slow respiratory rate, and hypertension.
d) chest pain, headache, and hypotension.

54.	A patient admits to taking “crystal.” This drug is classified as:

a) a depressant.
b) a stimulant.
c) a hallucinogen.
d) an antidepressant.

55.	The assessment finding that most strongly suggests I.V. drug abuse is:

a) skin lesions.
b) gastritis.
c) tachycardia.
d) tachypnea.

56.	To treat tachycardia induced by cocaine, the doctor may prescribe:

a) buprenorphine.
b) digoxin.
c) lidocaine.
d) propranolol.

57.	The effects of LSD typically last:

a) 4 to 6 hours.
b) 6 to 8 hours.
c) 8 to 12 hours.
d) 14 to 16 hours.

58.	An antagonist that’s administered for narcotic overdose is:

a) disulfiram.
b) naloxone.
c) diazepam.
d) bupropion.

59.	REM sleep is characterized by:

a) light sleep.
b) paralysis of the muscles.
c) restricted eye movements.
d) nonvivid dreams.

60.	NREM sleep is regulated by the:

a) pons.
b) hypothalamus.
c) basal forebrain.
d) amygdala.

61.	A classic feature of OSAS is:

a) snoring.
b) sneezing.
c) early morning awakening.
d) bursts of energy.

62.	Primary treatments for circadian rhythm sleep disorders include all of the following except:

a) chronotherapy.
b) short-acting sedative-hypnotics.
c) relaxation techniques.
d) luminotherapy.

63.	Cataplexy is a symptom of:

a) REM sleep.
b) primary hypersomnia.
c) OSAS.
d) narcolepsy.

64.	“Sleep drunkenness” is a common finding in patients with:

a) primary insomnia.
b) primary hypersomnia.
c) narcolepsy.
d) alcoholism.

65.	Information typically gathered in a sleep diary includes:

a) usual bedtime.
b) foods consumed before bedtime.
c) daily weights.
d) fluid consumption.

66.	The phase of the sexual response cycle involving fantasy and expectation is the:

a) desire phase.
b) excitement phase.
c) orgasm phase.
d) resolution phase.

67.	What may cause or contribute to sexual dysfunction?

a) drug use
b) dissociative disorders
c) supplemental vitamin use
d) exercise

68.	A persistent urge to show one’s private parts to a stranger occurs in:

a) fetishism.
b) pedophilia.
c) exhibitionism.
d) transsexualism.

69.	Treatments commonly recommended for a female with orgasmic disorder include:

a) taking soothing bubble baths.
b) touching her partner.
c) having sexual intercourse more often.
d) increasing the degree of sexual arousal.

70.	A nonliving object may replace a human partner in a patient with:

a) fetishism.
b) gender identity disorder.
c) transsexualism.
d) sexual desire disorder.

71.	Gender identity disorder should be suspected if the patient:

a) has a strong desire to be of the same sex.
b) insists that he or she is of the opposite sex.
c) prefers the opposite sex.
d) engages in games with the same sex.

72.	Sexual attraction to children is termed:

a) sadism.
b) necrophilia.
c) exhibitionism.
d) pedophilia.