Psych review questions ch 1, 9, 2, 4, 5, 6

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ch. 1 The primary purpose of the Community Mental Health Cen-
ter Act of 1963 was

a. getting better treatment in larger, more urban areas. b. moving patients to their home community for treatment.
b. moving patients to their home community for treatment.
c. providing former patients with employment opportunities.
d. removing the stigma of living in an institution.
ch. 1 Managed care is designed to

a. control health-care costs by limiting access to care.

b. keep health-care costs from increasing over time. d. maintain a balance between the quality and costs of health care.
c. limit the amount of money paid to physicians and hospitals.
d. maintain a balance between the quality and costs of health
care.
ch. 1 Hospitals established by Dorothea Dix were designed to
provide which of the following?

a. Asylum a. Asylum
b. Confinement
c. Therapeutic milieu
d. Public safety
ch. 1 Hildegard Peplau is best known for her writing about which
of the following?

a. Community-based care d. Therapeutic nurse-client relationship

b. Humane treatment
c. Psychopharmacology
d. Therapeutic nurse-client relationship
ch. 1 Mental health parity laws ensure

a. better quality mental health treatment.

b. equality in insurance coverage for mental illness.
b. equality in insurance coverage for mental illness.
c. mental health treatment without stigma.
d. persons receiving treatment really need it.
ch. 1 Identify the person associated with the following.
Linda Richards
_________________________________ first American psychi-
atric nurse
ch. 1 Identify the person associated with the following.
Dorothea Dix
_________________________________ moral treatment of the
mentally ill
ch. 1 Identify the person associated with the following.
Hildegard Peplau
_________________________________ therapeutic
nurse-client relationship
ch. 1 Identify the person associated with the following.
Phillippe Pinel or William Dukes
_________________________________ asylum as a safe
refuge
ch. 1 Identify the person associated with the following.
Emil Kraepelin
_________________________________ classification of mental
disorders according to symptoms
ch. 1 SHORT-ANSWER QUESTIONS
Increased community-based clinics; increased screening for
mental illness in primary care settings; screening identified
Discuss ideas for increasing the number of people receiving treat-
high-risk populations; improved mental health parity in insurance
ment for mental illness.

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Psych review questions ch 1, 9, 2, 4, 5, 6
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coverage; increased services in jails, prisons, and other institu-
tional settings.
ch. 1 SHORT-ANSWER QUESTIONS
Cost containment and managed care, population diversity, and
community-based care.
Discuss three trends of mental health care in the United States.
ch. 1 SHORT-ANSWER QUESTIONS Examples of fears include saying the wrong thing, not knowing
what to do, being rejected by clients, handling bizarre or inappro-
Provide three different concerns nursing students might have as priate behavior, maintaining physical safety, and seeing a friend
they begin psychiatric nursing clinical experiences. or acquaintance as a client.
ch. 2 The nurse is teaching a client taking an MAOI about foods
with tyramine that he or she should avoid. Which of the following
statement indicates that the client needs further teaching?
a. "I'm so glad I can have pizza as long as I don't order pepperoni."
a. "I'm so glad I can have pizza as long as I don't order pepperoni."
b. "I will be able to eat cottage cheese without worrying."
c. "I will have to avoid drinking nonalcoholic beer."
d. "I can eat green beans on this diet."
ch. 2 A client who has been depressed and suicidal started taking
a tricyclic antidepressant 2 weeks ago and is now ready to leave
the hospital to go home. Which of the following is a concern for
the nurse as discharge plans are finalized?

a. The client may need a prescription for diphenhydramine (Be-

b. The nurse will evaluate the risk for suicide by overdose of the
nadryl) to use for side effects.
tricyclic antidepressant.
b. The nurse will evaluate the risk for suicide by overdose of the
tricyclic antidepressant.
c. The nurse will need to include teaching regarding the signs of
neuroleptic malignant syndrome.
d. The client will need regular laboratory work to monitor thera-
peutic drug levels.
ch. 2 The signs of lithium toxicity include which of the following?

a. Sedation, fever, restlessness

d. Severe vomiting, diarrhea, weakness
b. Psychomotor agitation, insomnia, increased thirst
c. Elevated WBC count, sweating, confusion
d. Severe vomiting, diarrhea, weakness
ch. 2 Which of the following is a concern for children taking
stimulants for ADHD for several years?

a. Dependence on the drug c. Growth suppression

b. Insomnia
c. Growth suppression
d. Weight gain
ch. 2 The nurse is caring for a client with schizophrenia who is
taking haloperidol (Haldol). The client complains of restlessness,
cannot sit still, and has muscle stiffness. Of the following PRN
medications, which would the nurse administer?
b. Benztropine (Cogentin), 2 mg PO
a. Haloperidol (Haldol), 5 mg PO
b. Benztropine (Cogentin), 2 mg PO
c. Propranolol (Inderal), 20 mg PO
d. Trazodone, 50 mg PO
ch. 2 Client teaching for lamotrigine (Lamictal) should include
which of the following?

a. Eat a well-balanced diet to avoid weight gain. b. Report any rashes to your doctor immediately.
b. Report any rashes to your doctor immediately.
c. Take each dose with food to avoid nausea.
d. This drug may cause psychological dependence.

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Psych review questions ch 1, 9, 2, 4, 5, 6
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ch. 2 Which of the following physician orders would the nurse
question for a client who has stated "I'm allergic to phenoth-
iazines?"
c. Prolixin, 5 mg PO tid
a. Haldol, 5 mg PO bid
b. Navane, 10 mg PO bid
c. Prolixin, 5 mg PO tid
d. Risperdal, 2 mg bid
ch. 2 Clients taking which of the following types of psychotropic
medications need close monitoring of their cardiac status?

a. Antidepressants b. Antipsychotics
b. Antipsychotics
c. Mood stabilizers
d. Stimulants
ch. 2 Identify the drug classification for each of the following
medications.
Atypical antipsychotic
Clozapine (Clozaril)
ch. 2 Identify the drug classification for each of the following
medications.
SSRI antidepressant
Fluoxetine (Prozac)
ch. 2 Identify the drug classification for each of the following
medications.
Tricyclic antidepressant
Amitriptyline (Elavil)
ch. 2 Identify the drug classification for each of the following
medications.
Anticholinergic
Benztropine (Cogentin)
ch. 2 Identify the drug classification for each of the following
medications.
Stimulant
Methylphenidate (Ritalin)
ch. 2 Identify the drug classification for each of the following
medications.
Anticonvulsant used as a mood stabilizer
Carbamazepine (Tegretol)
ch. 2 Identify the drug classification for each of the following
medications.
Benzodiazepine
Clonazepam (Klonopin)
ch. 2 Identify the drug classification for each of the following
medications.
Atypical antipsychotic
Quetiapine (Seroquel)
ch. 2 SHORT-ANSWER QUESTIONS Abrupt cessation results in a rebound effect (return of symp-
toms), recurrence of the original symptoms, or possible withdrawal
Explain the rationale for tapering psychotropic medication doses symptoms. Tapering gradually alleviates or minimizes these prob-
before the client discontinues the drug. lems.
ch. 2 SHORT-ANSWER QUESTIONS A radioactive substance will be injected into the bloodstream. The
client will be asked to perform "thinking" tasks while the camera
Describe the teaching needed for a client who is scheduled for takes scans of the brain working. The procedure will take 2 to 3
PET. hours.
ch. 2 SHORT-ANSWER QUESTIONS Just as kindling is used to start a larger fire, mild or small manic
mood swings can eventually trigger a major, acute manic episode.

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Psych review questions ch 1, 9, 2, 4, 5, 6
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Explain the kindling process as it relates to the manic episodes of
bipolar affective disorder.
ch. 9 The client who is involuntarily committed to an inpatient
psychiatric unit loses which of the following rights?

a. Right to freedom a. Right to freedom

b. Right to refuse treatment
c. Right to sign legal documents
d. The client loses no rights
ch. 9 A client has a prescription for Haloperidol, 5 mg orally two
times a day, as ordered by the physician. The client is suspicious
and refuses to take the medication. The nurse says, "If you don't
take this pill, I'll get an order to give you an injection." The nurse's
statement is an example of
a. assault.
a. assault.
b. battery.
c. malpractice.
d. unintentional tort.
ch. 9 A hospitalized client is delusional, yelling, "The world is
coming to an end. We must all run to safety!" When other clients
complain that this client is loud and annoying, the nurse decides
to put the client in seclusion. The client has made no threatening
gestures or statements to anyone. The nurse's action is an exam-
ple of b. false imprisonment.

a. assault.
b. false imprisonment.
c. malpractice.
d. negligence.
ch. 9 Which of the following would indicate a duty to warn a third
party?

a. A client with delusions states, "I'm going to get them before they
d. A client states, "If I can't have my girlfriend back, then no one
get me."
can have her."
b. A hostile client says, "I hate all police."
c. A client says he plans to blow up the federal government.
d. A client states, "If I can't have my girlfriend back, then no one
can have her."
ch. 9 The nurse gives the client quetiapine (Seroquel) in error
when olanzapine (Zyprexa) was ordered. The client has no ill
effects from the quetiapine. In addition to making a medication
error, the nurse has committed which of the following?
d. None of the above
a. Malpractice
b. Negligence
c. Tort (unintentional)
d. None of the above
ch. 9 Select all that apply.

Which of the following elements are essential in a clinician's duty

to warn?
a. Client makes threatening statements
a. Client makes threatening statements c. Potential victim(s) are identifiable
b. History of violence f. Threat of harm is serious
c. Potential victim(s) are identifiable
d. Potential victim is easy to locate
e. Threat is not a delusion
f. Threat of harm is serious

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Psych review questions ch 1, 9, 2, 4, 5, 6
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ch. 9 Select all that apply.

Which of the following elements are necessary to prove liability in

a malpractice lawsuit?
a. Client is injured
b. Failure to conform to standards of care
a. Client is injured
c. Injury caused by breach of duty
b. Failure to conform to standards of care
f. Recognized relationship between client and nurse
c. Injury caused by breach of duty
d. Injuries must be visible and verified
e. Nurse intended to cause harm
f. Recognized relationship between client and nurse
ch. 4 All are characteristics of ACT except which of the following?

a. Services are provided in the home or community.

b. Services are provided by the client's case manager.
b. Services are provided by the client's case manager.
c. There are no time limitations on ACT services.
d. All needed support systems are involved in ACT.
ch. 4 Research shows that scheduled intermittent hospital admis-
sions result in which of the following?

a. Fewer inpatient hospital stays b. Increased sense of control for the client
b. Increased sense of control for the client
c. Feelings of failure when hospitalized
d. Shorter hospital stays
ch. 4 Inpatient psychiatric care focuses on all the following, except

a. brief interventions.
c. independent living skills.
b. discharge planning.
c. independent living skills.
d. symptom management.
ch. 4 Which of the following interventions is an example of primary
prevention implemented by a public health nurse?

a. Reporting suspected child abuse

c. Teaching effective problem-solving skills to high school students
b. Monitoring compliance with medications for a client with schiz-
ophrenia
c. Teaching effective problem-solving skills to high school students
d. Helping a client to apply for disability benefits
ch. 4 The primary purpose of psychiatric rehabilitation is to

a. control psychiatric symptoms.

c. promote the recovery process.
b. manage clients' medications.
c. promote the recovery process.
d. reduce hospital readmissions.
ch. 4 Managed care provides funding for psychiatric rehabilitation
programs to

a. develop vocational skills. c. provide community skills training.

b. improve medication compliance.
c. provide community skills training.
d. teach social skills.
ch. 4 The mentally ill homeless population benefits most from

a. case management services.

d. a combination of housing, rehabilitation services, and commu-
b. outpatient psychiatric care to manage psychiatric symptoms.
nity support.
c. stable housing in a residential neighborhood.
d. a combination of housing, rehabilitation services, and commu-
nity support.

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Psych review questions ch 1, 9, 2, 4, 5, 6
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ch. 4 Identify the interdisciplinary team member responsible for
the functions listed below.
Psychiatric social worker
________________________________ Works with families,
community supports, and referrals
ch. 4 Identify the interdisciplinary team member responsible for
the functions listed below.
Occupational therapist
_________________________________ Focuses on functional
abilities and work using arts and crafts
ch. 4 Identify the interdisciplinary team member responsible for
the functions listed below.
Psychiatrist
________________________________ Makes diagnoses and
prescribes treatment
ch. 4 Identify the interdisciplinary team member responsible for
the functions listed below.
Vocational rehabilitation specialist
________________________________ Emphasizes job-seek-
ing and job-retention skills
The evolving consumer household is a group-living situation in-
ch. 4 SHORT-ANSWER QUESTIONS tended to transform itself into a residence where the residents
fulfill their own responsibilities and function without on-site super-
Discuss the concept of evolving consumer households. vision from paid staff. It is intended to be a permanent residence
for the client.
ch. 4 SHORT-ANSWER QUESTIONS
Deinstitutionalization, more rigid criteria for civil commitment, lack
List factors that have caused an increased number of persons with of adequate support, attitudes of police and society.
mental illness to be detained in jails.
ch. 4 SHORT-ANSWER QUESTIONS
Double stigma, lack of family or social support, comorbidity, ad-
Identify three barriers to community reintegration faced by men- justment problems, boundary issues.
tally ill offenders.
Ch. 5 Building trust is important in

a. the orientation phase of the relationship.

a. the orientation phase of the relationship.
b. the problem identification subphase of the relationship.
c. all phases of the relationship.
d. the exploitation subphase of the relationship.
ch. 5 Abstract standards that provide a person with his or her code
of conduct are

a. values. a. values.
b. attitudes.
c. beliefs.
d. personal philosophy.
ch. 5 Ideas that one holds as true are

a. values.
c. beliefs.
b. attitudes.
c. beliefs.
d. personal philosophy.
ch. 5 The emotional frame of reference by which one sees the
world is created by

a. values. b. attitudes.
b. attitudes.
c. beliefs.
d. personal philosophy.
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Psych review questions ch 1, 9, 2, 4, 5, 6
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ch. 5 The client tells the nurse "My biggest problem right now is
trying to deal with a divorce. I didn't want a divorce and I still don't.
But it is happening anyway!" Which of the following responses by
the nurse will convey empathy?
c. Sounds like it has been a difficult time.
a. Can you tell me about it?
b. I'm so sorry. No wonder you're upset.
c. Sounds like it has been a difficult time.
d. You must be devastated.
ch 5. Select all that apply.
Which of the following are specific tasks of the working phase of
a therapeutic relationship?

c. Encourage expression of feelings.

a. Begin planning for termination. e. Facilitate behavior change.
b. Build trust. f. Promote self-esteem.
c. Encourage expression of feelings.
d. Establish a nurse-client contract.
e. Facilitate behavior change.
f. Promote self-esteem.
ch 5. Select all that apply.
Confidentiality means respecting the client's right to keep his or
her information private. When can the nurse share information
about the client?
a. The client threatens to harm a family member.
a. The client threatens to harm a family member. c. The client gives written permission.
b. Sharing the information is in the client's best interest. d. The client's legal guardian asks for information.
c. The client gives written permission.
d. The client's legal guardian asks for information.
e. The client is discharged to the parent's care.
f. The client admits to domestic abuse.
Mr. Johnson: "I like to choose my student nurses; otherwise, I don't
get chosen."
Nurse: "I am honored that you chose me, Mr. Johnson. My name
is Sandy Moore, and I will be your student nurse for the next 6
weeks. You seem to have some experience with other groups of
ch 5. CLINICAL EXAMPLE students." (Nurse clearly states information about herself and her
Mr. Johnson is a suspicious client who doesn't want to be in the role and acknowledges client's previous experience.)
hospital. The nurse approaches him for the first time to introduce Mr. Johnson: "Oh, yeah, I've seen 'em come and go, but I never get
herself. Mr. Johnson says, "There's nothing I need from you! Why picked to be their patient. I guess I'm too crazy for them!" (laughs
should I talk to you?" How should the nurse proceed? What could nervously)
the nurse say to Mr. Johnson? Nurse: "Well, I'm delighted you chose me. It makes me feel hon-
ored." (Nurse makes it clear she is glad to be with client.)
Mr. Johnson: "Are you sure?"
Nurse: "Yes. I will be here on Tuesdays from 10 AM to 3 PM for
the next 6 weeks. I hope we can identify and work on some issues
together." (Provides clear parameters for the relationship.)
ch. 6 Client: "I had an accident."
Nurse: "Tell me about your accident."
This is an example of which therapeutic communication tech-
nique?
b. Offering self
a. Making observations
b. Offering self
c. General lead
d. Reflection
ch. 6 "Earlier today you said you were concerned that your son
was still upset with you. When I stopped by your room about an
hour ago, you and your son seemed relaxed and smiling as you
spoke to each other. How did things go between the two of you?"

7/9
Psych review questions ch 1, 9, 2, 4, 5, 6
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This is an example of which therapeutic communication tech-
nique?

a. Consensual validation a. Consensual validation

b. Encouraging comparison
c. Accepting
d. General lead
ch. 6 "Why do you always complain about the night nurse? She is
a nice woman and a fine nurse and has five kids to support. You're
wrong when you say she is noisy and uncaring."
This example reflects which nontherapeutic technique?
b. Defending
a. Requesting an explanation
b. Defending
c. Disagreeing
d. Advising
ch. 6 "How does Jerry make you upset?" is a nontherapeutic
communication technique because it

a. gives a literal response. b. indicates an external source of the emotion.

b. indicates an external source of the emotion.
c. interprets what the client is saying.
d. is just another stereotyped comment.
ch. 6 Client: "I was so upset about my sister ignoring my pain when
I broke my leg."
Nurse: "When are you going to your next diabetes education
program?"
This is a nontherapeutic response because the nurse has
b. changed the topic.
a. used testing to evaluate the client's insight.
b. changed the topic.
c. exhibited an egocentric focus.
d. advised the client what to do.
ch. 6 When the client says, "I met Joe at the dance last week,"
what is the best way for the nurse to ask the client to describe her
relationship with Joe?
a. "Joe who?" c. "Tell me about you and Joe."
b. "Tell me about Joe."
c. "Tell me about you and Joe."
d. "Joe, you mean that blond guy with the dark blue eyes?"
ch. 6 Which of the following is a concrete message?
a. "Help me put this pile of books on Marsha's desk."
b. "Get this out of here." a. "Help me put this pile of books on Marsha's desk."
c. "When is she coming home?"
d. "They said it is too early to get in."
ch 6. Select all that apply.
The advantages of assertive communication are:
a. All persons' rights are respected.
a. All persons' rights are respected.
c. It protects the speaker from being exploited.
b. It gains approval from others.
d. The speaker can say "no" to another person's request.
c. It protects the speaker from being exploited.
e. The speaker can safely express thoughts and feelings.
d. The speaker can say "no" to another person's request.
e. The speaker can safely express thoughts and feelings.
f. The speaker will get his or her needs met.
ch 6. Select all that apply.
Which of the following are examples of a therapeutic communi-
cation response? d. "Tell me more about your discharge plans."
f. "What might you do the next time you're feeling angry?"
a. "Don't worry—everybody has a bad day occasionally."
b. "I don't think your mother will appreciate that behavior."
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Psych review questions ch 1, 9, 2, 4, 5, 6
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c. "Let's talk about something else."
d. "Tell me more about your discharge plans."
e. "That sounds like a great idea."
f. "What might you do the next time you're feeling angry?"

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