essentials of psychiatric mental health nursing 4t
essentials of psychiatric mental health nursing 4t
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Essentials of Psychiatric Mental Health Nursing 4th Edition Varcarolis | 9780323625111 | All Chapters with Answers and Rationals
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Test Bank For Essentials of Psychiatric Mental Health Nursing
4th Edition Varcarolis | 9780323625111 | All Chapters with
Answers and Rationals
A person diagnosed with schizophrenia has had difficulty keeping a job because of severe
paranoia. Today the person shouts, "They're all plotting to destroy me." Select the nurse's
most therapeutic response.
a. "Everyone here is trying to help you. No one wants to harm you."
b. "Feeling that people want to destroy you must be very frightening."
c. "That is not true. People here are trying to help if you will let them."
d. "Staff members are health care professionals who are qualified to help you." - ANSWER: b. "Feeling
that people want to destroy you must be very frightening."
A newly admitted patient diagnosed with schizophrenia is hypervigilant and constantly scans
the environment. The patient states, "I saw two doctors talking in the hall. They were plotting
to kill me." The nurse may correctly assess this as what classic behavior?
a. Echolalia
b. An idea of reference
c. A delusion of infidelity
d. An auditory hallucination - ANSWER: b. An idea of reference
A patient diagnosed with schizophrenia says, "My coworkers are out to get me. I also saw two
doctors plotting to overdose me." What term identifies how this patient is perceiving the
environment?
a. Disorganized
b. Unpredictable
c. Dangerous
d. Bizarre - ANSWER: c. Dangerous
When a patient diagnosed with schizophrenia was discharged 6 months ago, haloperidol was
prescribed. The patient now says, "I stopped taking those pills. I didn't like how it made me
feel." What likely side effects did the patient experience?
a. Sedation and muscle stiffness
b. Sweating, nausea, and diarrhea
c. Mild fever, sore throat, and skin rash
d. Headache, watery eyes, and runny nose - ANSWER: a. Sedation and muscle stiffness
A nurse works with a patient diagnosed with schizophrenia regarding the importance of
medication management. The patient repeatedly says, "I don't like taking pills." Which treatment
strategy should the nurse discuss with the patient and health care provider?
a. Use of long-acting antipsychotic injections
b. Addition of a benzodiazepine, such as lorazepam
c. Adjunctive use of an antidepressant, such as amitriptyline
d. Inpatient hospitalization because of the high risk for exacerbation of symptoms - ANSWER: a. Use
of long-acting antipsychotic injections
patient's care plan includes monitoring for auditory hallucinations. Which assessment
findings suggest the patient may be hallucinating?
a. Aloofness, haughtiness, suspicion
b. Darting eyes, tilted head, mumbling to self
c. Elevated mood, hyperactivity, distractibility
d. Performing rituals, avoiding open places - ANSWER: b. Darting eyes, tilted head, mumbling to self
, A health care provider considers which antipsychotic medication to prescribe for a patient
diagnosed with schizophrenia who has auditory hallucinations and poor social functioning. The
patient is also overweight. Which drug should the nurse advocate?
a. Clozapine
b. Ziprasidone
c. Olanzapine
d. Aripiprazole - ANSWER: d. Aripiprazole
Aripiprazole is an atypical antipsychotic medication that is effective against both positive and
negative symptoms of schizophrenia. It causes little or no weight gain and no increase in
glucose, high- or low-density lipoprotein cholesterol levels, or triglycerides, making it a reasonable
choice for a patient with obesity or heart disease. Clozapine may produce
agranulocytosis, making it a poor choice as a first-line agent. Ziprasidone may prolong the QT
interval, making it a poor choice for a patient with cardiac disease. Olanzapine fosters weight
gain.
A patient diagnosed with schizophrenia is demonstration catatonia. The patient has little
spontaneous movement and waxy flexibility. Which patient needs are of priority importance?
a. Psychosocial
b. Physiological
c. Self-actualization
d. Safety and security - ANSWER: b. Physiological
Physiological needs must be met to preserve life. A patient who is catatonic may need to be
fed by hand or tube, toileted, and given range-of-motion exercises to preserve physiological
integrity. The assessment findings do not suggest safety concerns. Higher-level needs
(psychosocial and self-actualization) are of lesser concern.
A nurse observes a patient standing immobile, facing the wall with one arm extended in a
salute. The patient remains immobile in this position for 15 minutes, moving only when the
nurse gently lowers the arm. What is the name of this phenomenon?
a. Echolalia
b. Waxy flexibility
c. Depersonalization
d. Thought withdrawal - ANSWER: b. Waxy flexibility
A patient presenting with delusions of persecution about being poisoned has refused all
hospital meals for 3 days. Which intervention is most likely to be acceptable to the patient?
a. Allow the patient to have supervised access to food vending machines.
b. Allow the patient to telephone a local restaurant to deliver meals.
c. Offer to taste each portion on the tray for the patient.
d. Begin tube feedings or total parenteral nutrition. - ANSWER: a. Allow the patient to have supervised
access to food vending machines.
Patients diagnosed with schizophrenia who are suspicious and withdrawn generally present
with what additional characteristic?
a. Universally fear sexual involvement with therapists.
b. Are socially disabled by the positive symptoms of schizophrenia.
c. Exhibit a high degree of hostility as evidenced by rejecting behavior.
d. Avoid relationships because they become anxious with emotional closeness. - ANSWER: d. Avoid
relationships because they become anxious with emotional closeness.
A newly admitted patient diagnosed with schizophrenia says, "The voices are bothering me. They yell
and tell me I'm bad. I have got to get away from them." Select the nurse's most
helpful reply.
a. "Do you hear the voices often?"
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