Question 1

Which principle has the highest priority when addressing a behavioral crisis in an inpatient setting?

Accepted Answer

A)  Resolve the crisis with the least restrictive intervention possible. 
B)  Swift intervention is justified to maintain the integrity of a therapeutic milieu. 
C)  Rights of an individual patient are superseded by the rights of the majority of patients. 
D)  Patients should have opportunities to regain control without intervention if the safety of others is not compromised. 
A)  Resolve the crisis with the least restrictive intervention possible. 
B)  Swift intervention is justified to maintain the integrity of a therapeutic milieu. 
C)  Rights of an individual patient are superseded by the rights of the majority of patients. 
D)  Patients should have opportunities to regain control without intervention if the safety of others is not compromised.

Question 2

A nurse surveys medical records.Which finding signals a violation of patients' rights?

Accepted Answer

A)  A patient was not allowed to have visitors. 
B)  A patient's belongings were searched at admission. 
C)  A patient with suicidal ideation was placed on continuous observation. 
D)  Physical restraint was used after a patient was assaultive toward a staff member. 
A)  A patient was not allowed to have visitors. 
B)  A patient's belongings were searched at admission. 
C)  A patient with suicidal ideation was placed on continuous observation. 
D)  Physical restraint was used after a patient was assaultive toward a staff member.

Question 3

Select the example of primary prevention.

Accepted Answer

A)  Assisting a person diagnosed with a serious mental illness to fill a pill-minder 
B)  Helping school-age children identify and describe normal emotions 
C)  Leading a psychoeducational group in a community care home 
D)  Medicating an acutely ill patient who assaulted a staff person 
A)  Assisting a person diagnosed with a serious mental illness to fill a pill-minder 
B)  Helping school-age children identify and describe normal emotions 
C)  Leading a psychoeducational group in a community care home 
D)  Medicating an acutely ill patient who assaulted a staff person

Question 4

Which scenario best depicts a behavioral crisis? A patient is:

Accepted Answer

A)  waving fists, cursing, and shouting threats at a nurse. 
B)  curled up in a corner of the bathroom, wrapped in a towel. 
C)  crying hysterically after receiving a phone call from a family member. 
D)  performing push-ups in the middle of the hall, forcing others to walk around. 
A)  waving fists, cursing, and shouting threats at a nurse. 
B)  curled up in a corner of the bathroom, wrapped in a towel. 
C)  crying hysterically after receiving a phone call from a family member. 
D)  performing push-ups in the middle of the hall, forcing others to walk around.

Question 5

Which assessment finding for a patient in the community deserves priority intervention by the psychiatric nurse? The patient:

Accepted Answer

A)  receives Social Security disability income plus a small check from a trust fund every month. 
B)  was absent from two of six planned Alcoholics Anonymous meetings in the past 2 weeks. 
C)  lives in an apartment with two patients who attend partial hospitalization programs. 
D)  has a sibling who was recently diagnosed with a mental illness. 
A)  receives Social Security disability income plus a small check from a trust fund every month. 
B)  was absent from two of six planned Alcoholics Anonymous meetings in the past 2 weeks. 
C)  lives in an apartment with two patients who attend partial hospitalization programs. 
D)  has a sibling who was recently diagnosed with a mental illness.

Question 6

The nurse should refer which of the following patients to a partial hospitalization program? A patient who:

Accepted Answer

A)  has a therapeutic lithium level and reports regularly for blood tests and clinic follow-up. 
B)  needs psychoeducation for relaxation therapy related to agoraphobia and panic episodes. 
C)  spent yesterday in a supervised crisis care center and continues to have active suicidal ideation. 
D)  states, "I'm not sure I can avoid using alcohol when my spouse goes to work every morning." 
A)  has a therapeutic lithium level and reports regularly for blood tests and clinic follow-up. 
B)  needs psychoeducation for relaxation therapy related to agoraphobia and panic episodes. 
C)  spent yesterday in a supervised crisis care center and continues to have active suicidal ideation. 
D)  states, "I'm not sure I can avoid using alcohol when my spouse goes to work every morning."

Question 7

The case manager plans to discuss the treatment plan with a patient's family.Select the case manager's first action.

Accepted Answer

A)  Determine an appropriate location for the conference. 
B)  Support the discussion with examples of the patient's behavior. 
C)  Obtain the patient's permission for the exchange of information. 
D)  Determine which family members should participate in the conference. 
A)  Determine an appropriate location for the conference. 
B)  Support the discussion with examples of the patient's behavior. 
C)  Obtain the patient's permission for the exchange of information. 
D)  Determine which family members should participate in the conference.

Question 8

A Category V tornado hits a community,destroying many homes and businesses.Which nursing intervention would best demonstrate compassion and caring?

Accepted Answer

A)  Encouraging persons to describe their memories and feelings about the event 
B)  Arranging transportation to the local community mental health center 
C)  Referring a local resident to a community food bank 
D)  Coordinating psychiatric home care services 
A)  Encouraging persons to describe their memories and feelings about the event 
B)  Arranging transportation to the local community mental health center 
C)  Referring a local resident to a community food bank 
D)  Coordinating psychiatric home care services

Question 9

Which activity is appropriate for a nurse engaged exclusively in community-based primary prevention?

Accepted Answer

A)  Medication follow-up 
B)  Teaching parenting skills 
C)  Substance abuse counseling 
D)  Making a referral for family therapy 
A)  Medication follow-up 
B)  Teaching parenting skills 
C)  Substance abuse counseling 
D)  Making a referral for family therapy

Question 10

A patient usually watches television all day,seldom going out in the community or socializing with others.The patient says,"I don't know what to do with my free time." Which member of the treatment team would be most helpful to this patient?

Accepted Answer

A)  Psychologist 
B)  Social worker 
C)  Recreational therapist 
D)  Occupational therapist 
A)  Psychologist 
B)  Social worker 
C)  Recreational therapist 
D)  Occupational therapist

Question 11

Which patient would be most appropriate to refer for assertive community treatment (ACT)? A patient diagnosed with:

Accepted Answer

A)  a phobic fear of crowded places. 
B)  a single episode of major depression. 
C)  a catastrophic reaction to a tornado in the community. 
D)  schizophrenia and four hospitalizations in the past year. 
A)  a phobic fear of crowded places. 
B)  a single episode of major depression. 
C)  a catastrophic reaction to a tornado in the community. 
D)  schizophrenia and four hospitalizations in the past year.

Question 12

A patient was hospitalized for 24 hours after a reaction to a psychotropic medication.While planning discharge,the case manager learned that the patient received a notice of eviction immediately prior to admission.Select the case manager's most appropriate action.

Accepted Answer

A)  Postpone the patient's discharge from the hospital. 
B)  Contact the landlord who evicted the patient to further discuss the situation. 
C)  Arrange a temporary place for the patient to stay until new housing can be arranged. 
D)  Determine whether the adverse medication reaction was genuine because the patient had nowhere to live. 
A)  Postpone the patient's discharge from the hospital. 
B)  Contact the landlord who evicted the patient to further discuss the situation. 
C)  Arrange a temporary place for the patient to stay until new housing can be arranged. 
D)  Determine whether the adverse medication reaction was genuine because the patient had nowhere to live.

Question 13

The nurse assigned to assertive community treatment (ACT)should explain the program's treatment goal as:

Accepted Answer

A)  assisting patients to maintain abstinence from alcohol and other substances of abuse. 
B)  providing structure and a therapeutic milieu for mentally ill patients whose symptoms require stabilization. 
C)  maintaining medications and stable psychiatric status for incarcerated inmates who have a history of mental illness. 
D)  providing services for mentally ill individuals who require intensive treatment to continue to live in the community. 
A)  assisting patients to maintain abstinence from alcohol and other substances of abuse. 
B)  providing structure and a therapeutic milieu for mentally ill patients whose symptoms require stabilization. 
C)  maintaining medications and stable psychiatric status for incarcerated inmates who have a history of mental illness. 
D)  providing services for mentally ill individuals who require intensive treatment to continue to live in the community.

Question 14

A health care provider prescribed depot injections every 3 weeks at the clinic for a patient with a history of medication noncompliance.For this plan to be successful,which factor will be of critical importance?

Accepted Answer

A)  The attitude of significant others toward the patient 
B)  Nutrition services in the patient's neighborhood 
C)  The level of trust between the patient and nurse 
D)  The availability of transportation to the clinic 
A)  The attitude of significant others toward the patient 
B)  Nutrition services in the patient's neighborhood 
C)  The level of trust between the patient and nurse 
D)  The availability of transportation to the clinic

Question 15

A nurse makes an initial visit to a homebound patient diagnosed with a serious mental illness.A family member offers the nurse a cup of coffee.Select the nurse's best response.

Accepted Answer

A)  "Thank you. I would enjoy having a cup of coffee with you." 
B)  "Thank you, but I would prefer to proceed with the assessment." 
C)  "No, but thank you. I never accept drinks from patients or families." 
D)  "Our agency policy prohibits me from eating or drinking in patients' homes." 
A)  "Thank you. I would enjoy having a cup of coffee with you." 
B)  "Thank you, but I would prefer to proceed with the assessment." 
C)  "No, but thank you. I never accept drinks from patients or families." 
D)  "Our agency policy prohibits me from eating or drinking in patients' homes."

Question 16

A nurse inspects an inpatient psychiatric unit and finds that exits are free of obstructions,no one is smoking,and the janitor's closet is locked.These observations relate to:

Accepted Answer

A)  coordinating care of patients. 
B)  management of milieu safety. 
C)  management of the interpersonal climate. 
D)  use of therapeutic intervention strategies. 
A)  coordinating care of patients. 
B)  management of milieu safety. 
C)  management of the interpersonal climate. 
D)  use of therapeutic intervention strategies.

Question 17

A nurse performed these actions while caring for patients in an inpatient psychiatric setting.Which action violated patients' rights?

Accepted Answer

A)  Prohibited a patient from using the telephone 
B)  In patient's presence, opened a package mailed to patient 
C)  Remained within arm's length of patient with homicidal ideation 
D)  Permitted a patient with psychosis to refuse oral psychotropic medication 
A)  Prohibited a patient from using the telephone 
B)  In patient's presence, opened a package mailed to patient 
C)  Remained within arm's length of patient with homicidal ideation 
D)  Permitted a patient with psychosis to refuse oral psychotropic medication

Exam 4: Settings for Psychiatric Care

Which principle has the highest priority when addressing a behavioral crisis in an inpatient setting?

A nurse surveys medical records.Which finding signals a violation of patients' rights?

Select the example of primary prevention.

Which scenario best depicts a behavioral crisis? A patient is:

Which assessment finding for a patient in the community deserves priority intervention by the psychiatric nurse? The patient:

The nurse should refer which of the following patients to a partial hospitalization program? A patient who:

The case manager plans to discuss the treatment plan with a patient's family.Select the case manager's first action.

A Category V tornado hits a community,destroying many homes and businesses.Which nursing intervention would best demonstrate compassion and caring?

Which activity is appropriate for a nurse engaged exclusively in community-based primary prevention?

A patient usually watches television all day,seldom going out in the community or socializing with others.The patient says,"I don't know what to do with my free time." Which member of the treatment team would be most helpful to this patient?

Which patient would be most appropriate to refer for assertive community treatment (ACT)? A patient diagnosed with:

A patient was hospitalized for 24 hours after a reaction to a psychotropic medication.While planning discharge,the case manager learned that the patient received a notice of eviction immediately prior to admission.Select the case manager's most appropriate action.

The nurse assigned to assertive community treatment (ACT)should explain the program's treatment goal as:

A health care provider prescribed depot injections every 3 weeks at the clinic for a patient with a history of medication noncompliance.For this plan to be successful,which factor will be of critical importance?

A nurse makes an initial visit to a homebound patient diagnosed with a serious mental illness.A family member offers the nurse a cup of coffee.Select the nurse's best response.

A nurse inspects an inpatient psychiatric unit and finds that exits are free of obstructions,no one is smoking,and the janitor's closet is locked.These observations relate to:

A nurse performed these actions while caring for patients in an inpatient psychiatric setting.Which action violated patients' rights?

Mental Health and Mental Illness

Relevant Theories and Therapies for Nursing Practice

Biological Basis for Understanding Psychiatric Disorders and Treatments

Cultural Implications for Psychiatric Mental Health Nursing

Legal and Ethical Guidelines for Safe Practice

The Nursing Process and Standards of Care for Psychiatric Mental Health Nursing

Therapeutic Relationships

Communication and the Clinical Interview

Understanding and Managing Responses to Stress

Childhood and Neurodevelopmental Disorders

Schizophrenia and Schizophrenia Spectrum Disorders

Bipolar and Related Disorders

Depressive Disorders

Anxiety and Obsessive Compulsive Related Disorders

Trauma, Stressor-Related, and Dissociative Disorders

Somatic Symptom Disorders

Feeding, Eating, and Elimination Disorders

Sleep-Wake Disorders

Sexual Dysfunctions, Gender Dysphoria, and Paraphilias

Impulse Control Disorders

Substance Related and Addictive Disorders

Neurocognitive Disorders

Personality Disorders

Suicide and Non-Suicidal Self-Injury

Crisis and Disaster

Anger, Aggression, and Violence

Child, Older Adult, and Intimate Partner Violence

Sexual Assault

Psychosocial Needs of the Older Adult

Serious Mental Illness

Forensic Psychiatric Nursing

Therapeutic Groups

Family Interventions

Integrative Care

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