On a psychiatric unit,
the preferred milieu environment is best described as:
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Providing an environment
that is safe for the patient to express feelings
Fostering a sense of
well-being and independence in the patient
Providing an environment
that will support the patient in his or her therapeutic needs
Fostering a therapeutic
social, cultural, and physical environment
Correct answer
Fostering a therapeutic social, cultural, and physical
environment
When caring for clients
with psychiatric diagnoses, the nurse recalls that the purpose of psychiatric
diagnoses or psychiatric labelling to:
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Identify those
individuals in need of more specialized care
Identity those
individuals who are at risk for harming others
Define the nursing care
for individuals with similar diagnoses
Enable the client's
treatment team to plan appropriate and comprehensive care
Correct answer
Enable the client's treatment team to plan appropriate
and comprehensive care
A patient with antisocial
personality disorder enters the private meeting room of a nursing unit as a
nurse is meeting with a different patient. Which of the following statements by
the nurse is BEST?
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"Please leave and I
will speak with you when I am done"
"I need you to leave
us alone"
"You may sit with us
as long as you are quiet"
"I'm sorry, but
HIPPA says that you can't be here Do you mind leaving?"
Correct answer
"Please leave and I will speak with you when I am
done"
Which of the following
is a guiding principle for the nurse in distinguishing mental disorders from
the expected changes associated with aging?
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A competent clinician can
readily distinguish mental disorders from the expected changes associated with
aging
Older people are believed
to be more prone to mental illness than young people
The clinical presentation
of mental illness in older adults differs from that in other age groups
When physical
deterioration becomes a significant feature of an elder’s life, the risk of
comorbid psychiatric illness rises
Correct answer
The clinical presentation of mental illness in older
adults differs from that in other age groups
The Mental Capacity Act
2005 does not explore which of the following concepts?
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Advance treatment
decision
Act's code of practice
Independent mental
capacity advocates
Mental health advocates
Correct answer
Mental health advocates
Risk for health issues
in a person with mental health issues:
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Increased than in normal
people
Slightly decreased than
in normal people
Very low as compared to
normal people
Risk is same in people
with and without mental illness
Correct answer
Increased than in normal people
Patient's husband died.
The brother of the patient saw that she was upset but mentally and physically
unwell. After a few weeks, the patient called her brother and said that her
husband died yesterday, she verbalized "I didn't know he was sick".
She also told her brother that she has been seeing mice and rats in the house.
The patient had difficulty sleeping, had incontinence and pain in urinating. A
community nurse visited the patient. She observed that the patient is
reclusive, passive but pleasant. What could be the problem?
1/1
Delirium due to UTI
Uncoping ability because
her husband just died
Onset of Alzheimer's
disease from dementia
Delayed bereavement due
to dementia
What are the principles
of communicating with a patient with delirium?
1/1
Use short statements and closed questions in a well lit,
quiet, familiar environment
Use short statements and
open questions in a well lit, quiet, familiar environment
Write down all questions
for the patient to refer back to
Communicate only through
the family using short statements and closed questions
Which of the following
would be an appropriate strategy in reorienting a confused patient to where her
room is?
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Place picture of her
family on the bedside stand
Put her name in a large
letters on her forehead
Remind the patient where
her room is
Let the other residents
know where the patient's room is
Correct answer
Remind the patient where her room is
You are caring for a
patient who is known to have dementia. What particular issues should you
consider prior to discharge?
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You involve in his care:
Independent Mental Capacity Advocacy Service (Mental Capacity Act 2005)
You involve other support services in his discharge: The
hospital discharge team, social services, the metal health team
How should be the
surrounding area of a patient with dementia?
1/1
Increased stimuli
Creative environment
Restrict activities
What is the difference
between denial and collusion?
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Denial is when a
healthcare professional refuses to tell a patient their diagnosis for the
protection of the patient whereas collusion is when healthcare professionals
and the patient agree on the information to be told to relatives and friends
Denial is when a patient
refuses treatment and collusion is when a patient agrees to it
Denial is a coping
mechanism used by an individual with the intention of protecting themselves from
painful or distressing information whereas collusion is the withholding of
information from the patient with the intention of ‘protecting them’
Denial is a normal
acceptable response by a patient to a life threatening diagnosis whereas
collusion is not
Correct answer
Denial is a coping mechanism used by an individual with
the intention of protecting themselves from painful or distressing information
whereas collusion is the withholding of information from the patient with the
intention of ‘protecting them’
What is the first stage
of the grief process according to Kubler Ross?
0/1
Denial
Anger
Bargaining
Depression
Correct answer
Denial
A newly diagnosed
patient with cancer says "I hate cancer, why did God give it to me".
Nurse understands which stage patient is in according to Kubbler Ross stages of
death?
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Denial
Bargaining
Depression
Anger
Correct answer
Anger
A patient who refuses
to believe a terminal diagnosis is exhibiting:
0/1
Regression
Mourning
Denial
Rationalization
Correct answer
Denial
Sue’s husband passed
away. Sue handled this death by crying and withdrawing from friend and family.
As a nurse you would notice that Sue’s intensified grief is most likely a sign
of which type of grief?
0/1
Distorted or exaggerated
Grief
Anticipatory Grief
Chronic or Prolonged
Grief
Delayed or Inhibited
Grief
Correct answer
Distorted or exaggerated Grief
Missy is 23 years old and
looking forward to being married the following day. Missy’s mother feels happy
that her daughter is starting a new phase in her life but is feeling a little
bit sad as well. When talking to Missy’s mother you would explain this feeling
to her as a sign of what?
1/1
Anticipated Grief
Lifestyle Loss
Situational Loss
Maturational Loss
Self Loss
After the suicide of
her best friend Marry feels a sense of guilt, shame and anger because she had
not answered the phone when her friend called shortly before her death. Which
of the following statements is the most accurate when talking about Mary’s
feelings?
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Mary’s feelings are
normal and are a form of perceived loss
Mary’s feelings are
normal and are a form of situational loss
Mary’s feelings are not normal
and are a form of situational loss
Mary's feelings are not
normal and are a form of physical loss
Correct answer
Mary’s feelings are not normal and are a form of
situational loss
A 42 year old female
has been widowed for 3 years yet she becomes very anxious, sad, and tearful on
a specific day in June. Which of the following is this widow experiencing?
0/1
Preparatory depression
Psychological isolation
Acceptance
Anniversary reaction
Correct answer
Anniversary reaction
The wife of a recently deceased
male is contacting individuals to inform them of her husband's death. She
decides, however, to drive to her parent's home to tell them in person instead
of using the telephone. Of what benefit did this communication approach serve?
0/1
She needed to get out of
the house
For the family to gain
support from each other
No benefit
She was having a
pathological grief response
Correct answer
For the family to gain support from each other
A 52-year-old man is
admitted to a hospital after sustaining a severe head injury in an automobile
accident. When the patient dies, the nurse observes the patient’s wife
comforting other family members. Which of the following interpretations of this
behaviour is most justifiable?
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She has already moved
through the stages of the grieving process
She is repressing anger
related to her husband’s death
She is experiencing shock
and disbelief related to her husband’s death
She is demonstrating
resolution of her husband’s death
Correct answer
She is experiencing shock and disbelief related to her
husband’s death
If you were explaining
anxiety to a patient, what would be the main points to include?
1/1
Signs of anxiety include
behaviours such as muscle tension, palpitations, a dry mouth, fast shallow
breathing, dizziness and an increased need to urinate or defaecate
Anxiety has three aspects: physical - bodily sensations
related to flight and fight response, behavioural - such as avoiding the
situation, and cognitive (thinking) - such as imagining the worst
Anxiety is all in the
mind, if they learn to think differently, it will go away
Anxiety has three
aspects: physical - such as running away, behavioural - such as imagining the
worse (catastrophizing), and cognitive (thinking) - such as needing to urinate
Which of the following
is not a usual sign and symptom associated with depression?
1/1
Feeling of sadness,
hopelessness
Anorexia
Increased energy
Reserved and isolated
Which of the following
cannot be seen in a depressed client?
0/1
Inactivity
Sad facial expression
Slow monotonous speech
Increased energy
Correct answer
Increased energy
You have just finished
dressing a leg ulcer. You observe patient is depressed and withdrawn. You ask
the patient whether everything is okay. She says yes. What is your next action?
1/1
Say "I observe you don't seem as usual Are you sure
you are okay?"
Say "Cheer up ,
Shall I make a cup of tea for you?"
Accept her answer and
leave attend to other patients
Inform the doctor about
the change of the behaviour
An adolescent male
being treated for depression arrives with his family at the Adolescent Day
Treatment Centre for an initial therapy meeting with the staff. The nurse
explains that one of the goals of the family meeting is to encourage the
adolescent to:
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Trust the nurse who will
solve his problem
Learn to live with
anxiety and tension
Accept responsibility for
his actions and choices
Use the members of the
therapeutic milieu to solve his problems
Correct answer
Accept responsibility for his actions and choices
A 16 -year-old patient
had recently undergone an orthopaedic surgery due to an accident. She is stable
and can care for herself. Few days after, she started not to feed and wash
herself even though she is physically able to. What could be the reason for
this behaviour?
0/1
She wants to displace her
experience by not taking care of herself
She wants to repress her
feeling to forget the accident
She is depressed
She went to an earlier
state which is very dependent She wants the same attention she had before when
she was ill
Correct answer
She went to an earlier state which is very dependent She
wants the same attention she had before when she was ill
A 17-year old patient
who was involved in an orthopaedic accident is observed not eating the meals
that she previously ordered and refuses to take a bath even if she is already
in recovery stage. As a nurse what do you think is the best explanation for her
reaction to the accident that happened to her?
1/1
Suppression
Undoing
Regression
Repression
The supervisor
reprimands the charge nurse because the nurse has not adhered to the budget.
Later the charge nurse accuses the nursing staff of wasting supplies. This is
an example of
0/1
Denial
Repression
Suppression
Displacement
Correct answer
Displacement
The nurse cares for a
client diagnosed with conversion reaction. The nurse identifies the client is
utilizing which of the following defence mechanisms?
1/1
Introjection
Displacement
Identification
Repression
You are assessing a
patient who has a low BMI but complains that she is overweight. To whom shall
you refer this patient?
0/1
Psychiatric health
professional
Dietitian
Police
Social services
Correct answer
Psychiatric health professional
Patient has low BMI but
patient thinks she is fat- to whom should you refer?
0/1
Dietician
Mental health
Professional
GP
Correct answer
Mental health
On physical examination
of a 16 year old female patient, you notice partial erosion of her tooth enamel
and callus formation on the posterior aspect of the knuckles of her hand. This
is indicative of:
0/1
Self-induced vomiting and
she likely has bulimia nervosa
A genetic disorder and
her siblings should also be tested
Self-mutilation and
correlates with anxiety
A connective tissue
disorder and she should be referred to dermatology
Correct answer
Self-induced vomiting and she likely has bulimia nervosa
A suicidal Patient is
admitted to psychiatric facility for 3 days when suddenly he is showing signs
of cheerfulness and motivation. The nurse should see this as:
0/1
That treatment and
medication is working
She has made new friends
That she has finalised
suicide plan
Correct answer
That she has finalised suicide plan
What is an indication
that a suicidal patient has an impending suicide plan:
0/1
She/he is cheerful and
seems to have a happy disposition
Talk or write about
death, dying or suicide
Threaten to hurt or kill
themselves
Actively look for ways to
kill themselves, such as stockpiling tablets
Correct answer
She/he is cheerful and seems to have a happy disposition
Which of the following
situations on a psychiatric unit are an example of a trusting patient-nurse
relationship?
0/1
The patient tells the
nurse that he feels suicidal
The nurse offers to
contact the doctor if the patient has a headache
The nurse gives the
patient his daily medication right on schedule
The nurse enforce rules
strictly on the unit
Correct answer
The patient tells the nurse that he feels suicidal
After two weeks of
receiving lithium therapy, a patient in the psychiatric unit becomes depressed.
Which of the following evaluations of the patient’s behavior by the nurse would
be most accurate?
1/1
The treatment plan is not
effective; the patient requires a larger dose of lithium
This is a normal response
to lithium therapy; the patient should continue with the current treatment plan
This is a normal response to lithium therapy; the patient
should be monitored for suicidal behavior
The treatment plan is not
effective; the patient requires an antidepressant
A new mother is
admitted to the acute psychiatric unit with severe postpartum depression. She
is tearful and states, “I don’t know why this happened to me! I was excited for
my baby to come, but now I don’t know!” Which of the following responses by the
nurse is most therapeutic?
0/1
Having a new baby is
stressful, and the tiredness and different hormones levels don’t help It
happens to many new mothers and is very treatable
Maybe you weren’t ready
for a child after all
What happened once you
brought the baby home? Did you feel nervous?
Has your husband been
helping you with the housework at all?
Correct answer
Having a new baby is stressful, and the tiredness and
different hormones levels don’t help It happens to many new mothers and is very
treatable
The wife of a client
with PTSD (post-traumatic stress disorder) communicate to the nurse that she is
having trouble dealing with her husband's condition at home. Which of the
following suggestions made by the nurse is correct?
1/1
· “Discourage your husband from exercising, as this
will worsen his condition”
· “Encourage your husband to avoid regular contact
with outside family members”
· “Do not touch or speak to your husband during an
active flashback Wait until it is finished to give him support”
·
“Keep your cupboards free of high-sugar and high-fat
foods”
An eight year old girl
with learning disabilities is admitted for a minor surgery, she is very
restless and agitated and wants her mother to stay with her, what will you do?
0/1
Act according to company
policy
Inform the Doctor
Tell her you will take
care of the child
Advice the mother to stay
till she settles
Correct answer
Advice the mother to stay till she settles
A patient with dementia
is moaning and pulling the dress during night what do you understand from this?
0/1
Patient is incontinent
Patient is having pain
Patient has medication
toxicity
Correct answer
Patient is incontinent
A patient with a
history of schizophrenia is admitted to the acute psychiatric care unit. He
mutters to himself as the nurse attempts to take a history and yells. “I don’t
want to answer any more questions! There are too many voices in this room!”
Which of the following assessment questions should the nurse as next?
1/1
"Are the voices telling you to do things?"
"Do you feel as
though you want to harm yourself or anyone else?"
"Who else is talking
in this room? It’s just you and me."
"I don’t hear any other voices."
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