Question 1

Which therapeutic nursing intervention would a nurse initiate just before ECT (electroconvulsive therapy) treatment?

Accepted Answer

A)  Providing the patient the opportunity to void in order to prevent incontinence 
B)  Insertion of a straight urinary catheter to ensure the patient has an empty bladder 
C)  Administration of diazepam (Valium) to minimize the presence of muscle spasms 
D)  Administration of thiopental sodium (Pentothal) to help induce muscle relaxation 
A)  Providing the patient the opportunity to void in order to prevent incontinence 
B)  Insertion of a straight urinary catheter to ensure the patient has an empty bladder 
C)  Administration of diazepam (Valium) to minimize the presence of muscle spasms 
D)  Administration of thiopental sodium (Pentothal) to help induce muscle relaxation A

Question 2

A nurse is discussing ECT (electroconvulsive therapy) treatments with a patient with chronic depression and the patient's parents.Which is the first therapeutic comment appropriate for this situation?

Accepted Answer

A)  "What do you know about ECT treatment?" 
B)  "ECT treatment is used very successfully in treating your disorder." 
C)  "The risks most often associated with ECT treatment are both minor and rare." 
D)  "Do you have any questions about ECT treatment that I can answer for you now?" 
A)  "What do you know about ECT treatment?" 
B)  "ECT treatment is used very successfully in treating your disorder." 
C)  "The risks most often associated with ECT treatment are both minor and rare." 
D)  "Do you have any questions about ECT treatment that I can answer for you now?" A

Question 3

A nurse is planning a unit education with staff about vagus nerve stimulation (VNS) in the field of psychiatry.The nurse would conclude that patients with which type of disorder would be most likely to benefit from this therapy,given current evidence?

Accepted Answer

A)  Depression 
B)  Anxiety disorders 
C)  Sleep disorders 
D)  Addiction disorders 
A)  Depression 
B)  Anxiety disorders 
C)  Sleep disorders 
D)  Addiction disorders A

Question 4

An ancillary staff member new to the night shift states,"I love working,but lately I'm so depressed for no apparent reason.What should I do?" Which nursing response would be most therapeutic?

Accepted Answer

A)  "I'm sure it is just temporary. If you just visit a tanning salon, the depression will be relieved more quickly." 
B)  "As your friend I cannot advise you. You need to see a psychiatrist. Remember, the longer you wait, the worse depression becomes." 
C)  "It may be that you aren't getting enough sunlight working the night shift. I'd suggest you discuss the possibility of phototherapy with your health care provider." 
D)  "This seems temporary and will most likely disappear when you get used to this work schedule. In the meanwhile, get one of those special lights for your home." 
A)  "I'm sure it is just temporary. If you just visit a tanning salon, the depression will be relieved more quickly." 
B)  "As your friend I cannot advise you. You need to see a psychiatrist. Remember, the longer you wait, the worse depression becomes." 
C)  "It may be that you aren't getting enough sunlight working the night shift. I'd suggest you discuss the possibility of phototherapy with your health care provider." 
D)  "This seems temporary and will most likely disappear when you get used to this work schedule. In the meanwhile, get one of those special lights for your home."

Question 5

A patient tells a nurse,"I've been having excellent results with phototherapy,but as soon as I stop,my mood gets worse." The nurse responds:

Accepted Answer

A)  "That is a strange reaction, but we know so little about light therapy that you may need to increase the dose." 
B)  "That is one of the drawbacks with light therapy; depression may come back rapidly once the therapy is stopped." 
C)  "I cannot account for your response to phototherapy. It is idiosyncratic, and you may need to take medication for your depression." 
D)  "I think your response to phototherapy is unusual, but your health care provider will be best able to advise you regarding what to do next." 
A)  "That is a strange reaction, but we know so little about light therapy that you may need to increase the dose." 
B)  "That is one of the drawbacks with light therapy; depression may come back rapidly once the therapy is stopped." 
C)  "I cannot account for your response to phototherapy. It is idiosyncratic, and you may need to take medication for your depression." 
D)  "I think your response to phototherapy is unusual, but your health care provider will be best able to advise you regarding what to do next."

Question 6

Which intervention would have the most therapeutic value for a patient who has just awakened after an ECT (electroconvulsive therapy) treatment and appears disoriented?

Accepted Answer

A)  The nurse brings a family member into the recovery room to stay and talk with the patient until the patient is fully awake. 
B)  The nurse touches the patient's hand and in a calming voice assures the patient, "Everything is fine; the treatment is over." 
C)  The nurse tells the patient that the treatment is over and shares, "You'll be a little confused but for only a very short time." 
D)  The nurse addresses the patient by name and states, "I'm your nurse here at the hospital. Your treatment is over and you're doing fine." 
A)  The nurse brings a family member into the recovery room to stay and talk with the patient until the patient is fully awake. 
B)  The nurse touches the patient's hand and in a calming voice assures the patient, "Everything is fine; the treatment is over." 
C)  The nurse tells the patient that the treatment is over and shares, "You'll be a little confused but for only a very short time." 
D)  The nurse addresses the patient by name and states, "I'm your nurse here at the hospital. Your treatment is over and you're doing fine."

Question 7

Which statement should be included during the educational preparation of a patient who will undergo ECT (electroconvulsive therapy) in 1 week?

Accepted Answer

A)  "The induced seizure will last approximately 2 minutes and will be very mild." 
B)  "We encourage a family member to stay with the patient during the treatment." 
C)  "I'd be happy to arrange for you to speak with a patient who has experienced ECT." 
D)  "There may be a small amount of permanent memory loss, but it is usually related to the time of the seizure itself." 
A)  "The induced seizure will last approximately 2 minutes and will be very mild." 
B)  "We encourage a family member to stay with the patient during the treatment." 
C)  "I'd be happy to arrange for you to speak with a patient who has experienced ECT." 
D)  "There may be a small amount of permanent memory loss, but it is usually related to the time of the seizure itself."

Question 8

Which patient has the greatest potential for symptom improvement after ECT (electroconvulsive therapy) treatment?

Accepted Answer

A)  A patient who has a dual diagnosis of cocaine and alcohol abuse 
B)  A patient who appears stuporous and is diagnosed with major depression 
C)  A patient diagnosed with depression who exhibits a sociopathic personality disorder 
D)  A patient diagnosed with chronic schizophrenia who is exhibiting signs of dementia 
A)  A patient who has a dual diagnosis of cocaine and alcohol abuse 
B)  A patient who appears stuporous and is diagnosed with major depression 
C)  A patient diagnosed with depression who exhibits a sociopathic personality disorder 
D)  A patient diagnosed with chronic schizophrenia who is exhibiting signs of dementia

Question 9

What equipment should be available to the staff caring for a patient after receiving an ECT (electroconvulsive therapy) treatment?

Accepted Answer

A)  Spirometer 
B)  Suctioning equipment 
C)  Tympanic thermometer 
D)  Padded wrist and ankle restraints 
A)  Spirometer 
B)  Suctioning equipment 
C)  Tympanic thermometer 
D)  Padded wrist and ankle restraints

Question 10

A patient diagnosed with major depression tells a nurse,"My cousin talked about sleep deprivation therapy as a treatment for depression.Can you tell me about it?" Which response by the nurse is most therapeutic?

Accepted Answer

A)  "Your cousin is right; sleep deprivation is a successful, scientifically based emerging therapy. I can suggest several health care providers who work with the therapy." 
B)  "That therapy modality is not widely used at this time. It appears that the effects are not permanent, and there needs to be more scientific research done to prove its value." 
C)  "Sleep deprivation therapy appears useful only when a patient is taking a monoamine oxidase inhibitor (MAOI) type of antidepressant in conjunction with the therapy." 
D)  "Yes, the literature shows that this is a very promising therapy for a majority of patients with depression, and many clinical research studies are now under way to investigate this further." 
A)  "Your cousin is right; sleep deprivation is a successful, scientifically based emerging therapy. I can suggest several health care providers who work with the therapy." 
B)  "That therapy modality is not widely used at this time. It appears that the effects are not permanent, and there needs to be more scientific research done to prove its value." 
C)  "Sleep deprivation therapy appears useful only when a patient is taking a monoamine oxidase inhibitor (MAOI) type of antidepressant in conjunction with the therapy." 
D)  "Yes, the literature shows that this is a very promising therapy for a majority of patients with depression, and many clinical research studies are now under way to investigate this further."

Question 11

A patient scheduled for an early-morning electroconvulsive therapy (ECT) treatment asks a nurse,"Am I going to be able to eat breakfast before I go for ECT?" Which response by the nurse is most appropriate?

Accepted Answer

A)  "No, but you can have your breakfast when you get back to the unit." 
B)  "You can have a light, liquid breakfast along with your medications." 
C)  "You may only have enough liquids before the procedure to swallow your allergy medications." 
D)  "Yes, but you need to get up early so you can fast for 2 to 4 hours before your ECT treatment begins." 
A)  "No, but you can have your breakfast when you get back to the unit." 
B)  "You can have a light, liquid breakfast along with your medications." 
C)  "You may only have enough liquids before the procedure to swallow your allergy medications." 
D)  "Yes, but you need to get up early so you can fast for 2 to 4 hours before your ECT treatment begins."

Question 12

During the ECT (electroconvulsive therapy) stimulus,the nurse supports the patient's chin firmly against the bite-block positioned between the upper and lower teeth.The rationale for this intervention is to prevent:

Accepted Answer

A)  involuntary biting of the lips. 
B)  tooth damage or gum laceration. 
C)  involuntary swallowing of the tongue. 
D)  development of TMJD (temporomandibular joint disorder). 
A)  involuntary biting of the lips. 
B)  tooth damage or gum laceration. 
C)  involuntary swallowing of the tongue. 
D)  development of TMJD (temporomandibular joint disorder).

Question 13

A nurse reviewing the medical records of inpatients on the psychiatric unit would conclude that which patient may gain the most benefit from transcranial magnetic stimulation (TMS)?

Accepted Answer

A)  A patient with anorexia nervosa 
B)  A patient with a personality disorder 
C)  A patient with generalized anxiety disorder 
D)  A patient with a chronic severe mood disorder 
A)  A patient with anorexia nervosa 
B)  A patient with a personality disorder 
C)  A patient with generalized anxiety disorder 
D)  A patient with a chronic severe mood disorder

Question 14

A patient has been enrolled in a clinical trial of repetitive transcranial magnetic stimulation (rTMS).A nurse should ensure that which item is available in the treatment area?

Accepted Answer

A)  A blood pressure cuff 
B)  A reflex hammer 
C)  Suction 
D)  Earplugs 
A)  A blood pressure cuff 
B)  A reflex hammer 
C)  Suction 
D)  Earplugs

Question 15

A patient who has received three ECT (electroconvulsive therapy) treatments with no ill effects displays confusion and memory loss after the fourth treatment.Which nursing intervention would be most therapeutic based on a nurse's knowledge of ECT effects?

Accepted Answer

A)  Administer a benzodiazepine by IM injection immediately. 
B)  Call the health care provider and report this sudden alteration immediately. 
C)  Inform the family that the short-term memory loss may be permanent. 
D)  Orient the patient periodically, emphasizing that the memory loss is temporary. 
A)  Administer a benzodiazepine by IM injection immediately. 
B)  Call the health care provider and report this sudden alteration immediately. 
C)  Inform the family that the short-term memory loss may be permanent. 
D)  Orient the patient periodically, emphasizing that the memory loss is temporary.

Question 16

A patient shares with a nurse,"Since I moved from Florida to New York,I get depressed right before the winter holidays and it lasts for weeks.Is there anything I can do besides taking pills?" The most therapeutic nursing response is:

Accepted Answer

A)  "Consider phototherapy since it's likely you are experiencing seasonal affective disorder (SA
D) ." 
B)  "I'm not clear about what you are saying. Please tell me more about what you are experiencing." 
C)  "If you have a biochemically based depression, you will need antidepressant medication if you want to see improvement." 
D)  "If you want dramatic results, ECT (electroconvulsive therapy) works the fastest and can usually be done on an outpatient basis." 
A)  "Consider phototherapy since it's likely you are experiencing seasonal affective disorder (SA
D) ." 
B)  "I'm not clear about what you are saying. Please tell me more about what you are experiencing." 
C)  "If you have a biochemically based depression, you will need antidepressant medication if you want to see improvement." 
D)  "If you want dramatic results, ECT (electroconvulsive therapy) works the fastest and can usually be done on an outpatient basis."

Question 17

A patient scheduled for an initial ECT (electroconvulsive therapy) treatment asks a nurse,"Isn't the electrical current dangerous?" Which response would be the most therapeutic?

Accepted Answer

A)  "The amount of electricity is very small and used for only a few seconds." 
B)  "The chance of you being shocked is minimal; you won't feel anything." 
C)  "There's a small chance of something going wrong; the risk is about the same as with minor surgery." 
D)  "You're worried about being electrocuted, aren't you? Don't worry; there is no chance of that happening." 
A)  "The amount of electricity is very small and used for only a few seconds." 
B)  "The chance of you being shocked is minimal; you won't feel anything." 
C)  "There's a small chance of something going wrong; the risk is about the same as with minor surgery." 
D)  "You're worried about being electrocuted, aren't you? Don't worry; there is no chance of that happening."

Question 18

A patient with recurring depression who experiences anhedonia,early-morning awakening,and sadness asks a nurse,"Do you think this sleep deprivation therapy would work for me?" Which response reflects the best attempt to answer the patient's question?

Accepted Answer

A)  "It's a legitimate therapy that works for some people. What do you know about it?" 
B)  "Up to 60% of patients improve after sleep deprivation, but the depression tends to return soon after sleeping." 
C)  "You can't go without sleep forever. What didn't you like about the treatment you received the last time?" 
D)  "Sleep deprivation therapy may or may not help, but you've responded well in the past to antidepressant drug therapy." 
A)  "It's a legitimate therapy that works for some people. What do you know about it?" 
B)  "Up to 60% of patients improve after sleep deprivation, but the depression tends to return soon after sleeping." 
C)  "You can't go without sleep forever. What didn't you like about the treatment you received the last time?" 
D)  "Sleep deprivation therapy may or may not help, but you've responded well in the past to antidepressant drug therapy."

Question 19

A nurse is assisting in the preprocedure care of a patient scheduled for ECT (electroconvulsive therapy).Which nursing action must be taken immediately before the procedure?

Accepted Answer

A)  The electrode sites are shaved and cleaned with a soap and water. 
B)  A blood pressure cuff and the oxygen saturation probe are applied. 
C)  A 12-lead electrocardiogram (ECG) is run and the strip placed in the chart. 
D)  The patient signs an informed consent form allowing for the treatment. 
A)  The electrode sites are shaved and cleaned with a soap and water. 
B)  A blood pressure cuff and the oxygen saturation probe are applied. 
C)  A 12-lead electrocardiogram (ECG) is run and the strip placed in the chart. 
D)  The patient signs an informed consent form allowing for the treatment.

Question 20

A patient with a history of depression who has a pacemaker tells a nurse,"I want to receive transcranial magnetic stimulation (TMS) to help with my depression.Do you think that's possible?" Which is the nurse's best response?

Accepted Answer

A)  "I really can't assess whether or not you are a likely candidate for the treatment, but I'll share your interest with your health care provider." 
B)  "Of course. Individuals who were willing to volunteer for groundbreaking treatments are so courageous." 
C)  "TMS may be effective for depression, and it is safe for patients with an implanted pacemaker like you." 
D)  "This treatment is far too experimental for a patient with your complex health problems." 
A)  "I really can't assess whether or not you are a likely candidate for the treatment, but I'll share your interest with your health care provider." 
B)  "Of course. Individuals who were willing to volunteer for groundbreaking treatments are so courageous." 
C)  "TMS may be effective for depression, and it is safe for patients with an implanted pacemaker like you." 
D)  "This treatment is far too experimental for a patient with your complex health problems."

Exam 29: Somatic Therapies

Which therapeutic nursing intervention would a nurse initiate just before ECT (electroconvulsive therapy) treatment?

A nurse is discussing ECT (electroconvulsive therapy) treatments with a patient with chronic depression and the patient's parents.Which is the first therapeutic comment appropriate for this situation?

A nurse is planning a unit education with staff about vagus nerve stimulation (VNS) in the field of psychiatry.The nurse would conclude that patients with which type of disorder would be most likely to benefit from this therapy,given current evidence?

An ancillary staff member new to the night shift states,"I love working,but lately I'm so depressed for no apparent reason.What should I do?" Which nursing response would be most therapeutic?

A patient tells a nurse,"I've been having excellent results with phototherapy,but as soon as I stop,my mood gets worse." The nurse responds:

Which intervention would have the most therapeutic value for a patient who has just awakened after an ECT (electroconvulsive therapy) treatment and appears disoriented?

Which statement should be included during the educational preparation of a patient who will undergo ECT (electroconvulsive therapy) in 1 week?

Which patient has the greatest potential for symptom improvement after ECT (electroconvulsive therapy) treatment?

What equipment should be available to the staff caring for a patient after receiving an ECT (electroconvulsive therapy) treatment?

A patient diagnosed with major depression tells a nurse,"My cousin talked about sleep deprivation therapy as a treatment for depression.Can you tell me about it?" Which response by the nurse is most therapeutic?

A patient scheduled for an early-morning electroconvulsive therapy (ECT) treatment asks a nurse,"Am I going to be able to eat breakfast before I go for ECT?" Which response by the nurse is most appropriate?

During the ECT (electroconvulsive therapy) stimulus,the nurse supports the patient's chin firmly against the bite-block positioned between the upper and lower teeth.The rationale for this intervention is to prevent:

A nurse reviewing the medical records of inpatients on the psychiatric unit would conclude that which patient may gain the most benefit from transcranial magnetic stimulation (TMS)?

A patient has been enrolled in a clinical trial of repetitive transcranial magnetic stimulation (rTMS).A nurse should ensure that which item is available in the treatment area?

A patient who has received three ECT (electroconvulsive therapy) treatments with no ill effects displays confusion and memory loss after the fourth treatment.Which nursing intervention would be most therapeutic based on a nurse's knowledge of ECT effects?

A patient shares with a nurse,"Since I moved from Florida to New York,I get depressed right before the winter holidays and it lasts for weeks.Is there anything I can do besides taking pills?" The most therapeutic nursing response is:

A patient scheduled for an initial ECT (electroconvulsive therapy) treatment asks a nurse,"Isn't the electrical current dangerous?" Which response would be the most therapeutic?

A patient with recurring depression who experiences anhedonia,early-morning awakening,and sadness asks a nurse,"Do you think this sleep deprivation therapy would work for me?" Which response reflects the best attempt to answer the patient's question?

A nurse is assisting in the preprocedure care of a patient scheduled for ECT (electroconvulsive therapy).Which nursing action must be taken immediately before the procedure?

A patient with a history of depression who has a pacemaker tells a nurse,"I want to receive transcranial magnetic stimulation (TMS) to help with my depression.Do you think that's possible?" Which is the nurse's best response?

Roles and Functions of Psychiatric-Mental Health Nurses: Competent Caring

Therapeutic Nurse-Patient Relationship

The Stuart Stress Adaptation Model of Psychiatric Nursing Care

Evidence-Based Psychiatric Nursing Practice

Biological Context of Psychiatric Nursing Care

Psychological Context of Psychiatric Nursing Care

Social, Cultural, and Spiritual Context of Psychiatric Nursing Care

Legal and Ethical Context of Psychiatric Nursing Care

Policy and Advocacy in Mental Health Care

Families as Resources, Caregivers, and Collaborators

Implementing the Nursing Process: Standards of Practice and Professional Performance

Prevention and Mental Health Promotion

Crisis Intervention

Recovery and Psychiatric Rehabilitation

Anxiety Responses and Anxiety Disorders

Psychophysiological Responses and Somatoform and Sleep Disorders

Self-Concept Responses and Dissociative Disorders

Emotional Responses and Mood Disorders

Self-Protective Responses and Suicidal Behavior

Neurobiological Responses and Schizophrenia and Psychotic Disorders

Social Responses and Personality Disorders

Cognitive Responses and Organic Mental Disorders

Chemically Mediated Responses and Substance-Related Disorders

Eating Regulation Responses and Eating Disorders

Sexual Responses and Sexual Disorders

Psychopharmacology

Behavior Change and Cognitive Interventions

Preventing and Managing Aggressive Behavior

Complementary and Alternative Therapies

Therapeutic Groups

Family Interventions

Hospital-Based Psychiatric Nursing Care

Community-Based Psychiatric Nursing Care

Child Psychiatric Nursing

Adolescent Psychiatric Nursing

Geropsychiatric Nursing

Care of Survivors of Abuse and Violence

The Military and Their Families

Psychological Care of Patients with Life-Threatening Illness

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