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PMH-BC.
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Exam of 29 pages for the course A level Biology at A level Biology (PMH-BC.)
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PMH-BCA rape victim with multiple injuries has been brought to the emergency department for
evaluation and treatment. The first thing that the psychiatric and mental health nurse should
communicate is:
A. "I am so sorry this happened to you"
B. "You are safe here. No one can hurt you."
C. "This was not your fault"
D. "I'm thankful you survived this attack." - correct answer-B. "you are safe here. No one can
hurt you."
Patients who have been raped are often severely traumatized emotionally and physically,
and are commonly very fearful and panicked, so the first thing that the mental health nurse
should communicate is "you are safe here, no one can hurt you". The psychiatric and mental
health nurse may need to repeat this a number of times because traumatized patients may
block out what people are saying. The nurse should also reassure the patient that the attack
was not the patient's fault and that the nurse is sorry for what the patient has gone through.
A patient has signed the consent form for ECT under pressure from her spouse but confides
in the psychiatric and mental health nurse that she does not want the treatment and is
terrified but afraid to stand up to her spouse. The psychiatric and mental nurse should:
A.) Ask the patient if she wants to rescind the content form.
B.) Tell the patient that she must tell her spouse she does not want the treatment .
C.) Tell the patient she must go through with the treatment since she signed the consent.
D.) Notify the physician of the patient's feelings about the treatment. - correct answer-(D.)
Notify the physician of the patients feelings about the treatment.
Because the patient is intimidated by her spouse and has stated she is afraid to stand up to
him, as an advocate for the patient, the nurse should notify the physician of the patient's
feelings about the treatment. Being coerced into signing a consent form is not the same is
not the same as giving informed consent, which is required by law. Because patients are
vulnerable to manipulation, the nurse must ensure that the actual wishes of the patient are
respected.
A patient was able to slowly read aloud an information sheet but when asked to state what
she had read in her own words was unable to do so. The most likely reason is:
A.) Low self-esteem
B.) Poor hearing
C.) Low health literacy
D.) Anxiety - correct answer-(C.) Low health literacy
The most likely reason the patient was able to read slowly but not state what she had read is
low health literacy. The ability to read is different from the ability to comprehend, and
,comprehension usually lags behind reading skills by about three grade levels. Thus, a
person whop is able to read at the fourth-grade level may have only a first-grade reading
comprehension, making it difficult for the person to understand health materials, especially
since the vocabulary is often more difficult.t to understand than that found in other readings.
Testing testing a patient who has repeated arrests for driving under the influence of alcohol
refuses to admit that he has a drinking problem and states that the police have targeted him
unfairly. The ego defense mechanisms that the patient is using is:
A.) Denial
B.) Reaction formation
C.) Regression
D.) Undoing - correct answer-A.) Denial
The patient is using the ego defense mechanism of denial when the patient, who has
repeated arrests for driving under the influence of alcohol, refuses to admit that he has a
drinking problem and states that the police have targeted him unfairly. Reaction formation is
refusing to acknowledge undesirable feelings, thoughts, or behavior by exaggerating the
opposite. Regression is retreating to an earlier level of development. Undoing is still carrying
out of an action to indicate a previous unacceptable action.
A patient with schizophrenia has delusions and believes that his family members cannot be
trusted. According to Maslow's hierarchy of needs, the patient's delusions are interfering with
the development at the level of:
A. Physiological needs
B. Love/belongings needs
C. Safety needs
D. Self-esteem needs - correct answer-B.) Love/Belongings needs
The patient's delusions are interfering with the development at the level of love/belonging
needs. Maslow's hierarchy of needs is based on the premise that 1 must satisfy one type of
need before 1 can obtain the next. The hierarchy of need includes:
Physiological: Basic needs such as air, food, water, shelter.
Safety and security: Freedom from fear:
Safety comfort:
Physical comfort
Love and belonging: Companionship, caring/giving receiving love, group identification,
satisfying interpersonal relationships.
Self-esteem: Working for success, desiring respecting prestige, seeking self respect.
Self-actualization: Feeling of self-fulfillment, satisfaction with achievement.
, The patient states that, on the advice of a friend, he has been treating his anxiety with large
doses of kava in addition to the amitriptyline that was prescribed for depression, but he has
been feeling excessively fatigued and has noted a dark urine. Which diagnostic test or tests
are indicated?
A. Renal function tests
B. CBC
C. Urinalysis
D. Liver function tests - correct answer-D. Liver function tests
Kava is contraindicated because of safety issues and can result liver damage, so the patient
should have liver function test completed. Early signs of liver damage include fatigue and
dark urine. Some people may exhibit jaundice as well. Amitriptyline is broken down by the
liver, so It may increase the rate which that occurs, also increasing the effects of the drug.
Kava, which has been used in the past for anxiety, may increase depression.
According to Erickson's stages of psychosocial development, which are the following best
characterizes the developmental task of adulthood and the generativity versus stagnation
stage?
A. Achieving self-confidence by performing successfully and gaining recognition from peers
B. Developing a sense of positive self worth from reviewing the advance of life
C. Achieving the personal life goals that the person has formulated
D. Make a commitment to another person as part of a long-term relationship. - correct
answer-C. Achieving the personal life goals that the person had formulated
Erickson had postulated that the stage of adulthood, generativity versus stagnation, is
characterized by achieving the personal life goals that the person had formulated. The 8
development stages include:
Trust versus mistrust (infancy, 0 to 18 months).
Autonomy versus shame and doubt (early childhood, 18 months to 3 years).
Initiative versus guilt (related adulthood, 3 to 5 years).
Identity versus role confusion (adolescence, 12 to 18 years).
Intimacy versus isolation (young adulthood, 18 to 40 years).
Generativity versus stagnation (adulthood, 40 to 65 years).
Ego integrity versus despair (65 years to death).
The International Society of psychiatric mental health nurses (ISPN) contains how many
divisions representing different nursing especially areas?
A. Two
B. Four
C. Six
D. Eight - correct answer-B. Four
4 different mental health associations came together to create the International Society of
psychiatric mental health nurses in 1989. These 4 associations became divisions of the new
organization:
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