Question 1

The nurse is cautiously avoiding the temptation to take unused or wasted doses of narcotic medications when providing patient care.What percentages of nurses in the United States are chemically impaired?

Accepted Answer

A)  0% to 5% 
B)  6% to 15% 
C)  25% to 35% 
D)  49% to 50%

Question 2

A patient with depression is prescribed duloxetine (Cymbalta).What should the nurse instruct the patient about this medication?

Accepted Answer

A)  Take with fruit juice. 
B)  Do not take with St. John's wort. 
C)  Stop the medication if experiencing adverse effects. 
D)  Expect blood pressure to drop with this medication.

Question 3

The nurse is reviewing potential patient teaching needs.For which prescribed medications should the nurse plan to instruct patients to follow a tyramine-free diet? (Select all that apply.)

Accepted Answer

A)  Phenelzine (Nardil) 
B)  Buspirone (Buspar) 
C)  Isocarboxazid (Marplan) 
D)  Valproic acid (Depakote) 
E)  Lithium carbonate (Eskalith)

Question 4

A patient has been prescribed fluoxetine (Prozac)to treat depression.What should be included in the nurse's teaching about the drug? (Select all that apply.)

Accepted Answer

A)  "You need to take this drug only once a week." 
B)  "Take the prescribed dose in the early evening." 
C)  "A decreased interest in sexual activity may occur with this medication." 
D)  "You should not consume red wine, aged cheese, or other tyramine-rich foods." 
E)  "Do not expect immediate results; it usually takes 6 to 8 weeks for therapeutic effects to be felt."
F) "You may experience some nausea, vomiting, and anorexia, but these side effects will subside in time."

Question 5

The nurse is assisting in the preparation of an educational seminar on anxiety disorders.Which anxiety disorders should the nurse make sure are included in this presentation? (Select all that apply.)

Accepted Answer

A)  Phobia 
B)  Panic disorder 
C)  Schizophrenia 
D)  Unipolar depression 
E)  Post-traumatic stress disorder
F) Obsessive-compulsive disorder

Question 6

A patient with schizophrenia is returning from a CT scan of the brain followed by an electroencephalogram.Which diagnostic test findings should the nurse identify as supporting this patient's diagnosis? (Select all that apply.)

Accepted Answer

A)  Enlarged ventricles 
B)  Reduced amount of gray matter 
C)  Areas of nerve de-myelinization 
D)  Aneurysms of the cerebral vessels 
E)  Diminished prefrontal cortex activity

Question 7

A patient who is withdrawing from alcohol is restless and reports seeing snakes on the ceiling.Vital signs are blood pressure 180/100 mm Hg,pulse 92 beats/min,and respirations 22 breaths/min.What should the nurse do first?

Accepted Answer

A)  Teach the patient a relaxation technique. 
B)  Administer a dose of lorazepam (Ativan). 
C)  Search the patient's room for hidden alcohol. 
D)  Administer an antihypertensive agent as ordered.

Question 8

A patient with schizophrenia has not bathed recently and a family member states that the patient has not been out of the house for 10 days.The patient tells the nurse,"They are trying to hurt me; don't let them hurt me." Which symptom is this patient demonstrating?

Accepted Answer

A)  Paranoid delusions 
B)  Grandiose delusions 
C)  Auditory hallucinations 
D)  Persecutory hallucinations

Question 9

The nurse is reviewing the causes of anxiety with a patient diagnosed with an anxiety disorder.Which neurotransmitter abnormalities should the nurse include as causing symptoms of anxiety? (Select all that apply.)

Accepted Answer

A)  Increased substance P 
B)  Increased epinephrine 
C)  Increased somatostatin 
D)  Decreased norepinephrine 
E)  Decreased gamma-aminobutyric acid (GAB
A)

Question 10

A patient comes into the emergency department experiencing chest pain and feelings of impending doom.Which assessment findings should the nurse use to determine if this patient is experiencing a panic attack? (Select all that apply.)

Accepted Answer

A)  Shaking 
B)  Neck pain 
C)  Dissociation 
D)  Vomiting brown emesis 
E)  Occurs at 3 p.m. every day

Question 11

The nurse is caring for an older adult patient with a history of depression.Which comment by the patient indicates an immediate need for further assessment?

Accepted Answer

A)  "I am so old; all my friends have died." 
B)  "I am useless now; there is no reason to be alive." 
C)  "I retire in 6 months, and it will be all downhill from there." 
D)  "I am looking forward to seeing my husband in heaven someday."

Exam 57: Nursing Care of Patients With Mental Health Disorders