Exam (elaborations)
Psychiatric Nursing Exam 2 (testbank)
Psychiatric Nursing Exam 2 (testbank)
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Psychiatric Nursing Exam 2 (testbank)A patient became severely depressed when the last of six children moved out of the
home 4 months ago. The patient repeatedly says, No one cares about me. Im not worth
anything. Which response by the nurse would be the most helpful?
a. Things will look brighter soon. Everyone feels down once in a while.
b. The staff here cares about you and wants to try to help you get better.
c. It is difficult for others to care about you when you repeatedly say negative things
about yourself.
d. Ill sit with you for 10 minutes now and return for 10 minutes at lunchtime and again at
2:30 this afternoon. - ANS-d
A patient became depressed after the last of six children moved out of the home 4
months ago. The patient has been self-neglectful, slept poorly, lost weight, and
repeatedly says, No one cares about me anymore. Im not worth anything. Select an
appropriate initial outcome for the nursing diagnosis: Situational low self-esteem, related
to feelings of abandonment. The patient will:
a. verbalize realistic positive characteristics about self by (date)
b. consent to take antidepressant medication regularly by (date)
c. initiate social interaction with another person daily by (date)
d. identify two personal behaviors that alienate others by (date). - ANS-a
A nurse wants to reinforce positive self-esteem for a patient diagnosed with major
depressive disorder. Today, the patient is wearing a new shirt and has neat, clean hair.
Which remark is most appropriate?
a. You look nice this morning.
b. You are wearing a new shirt.
c. I like the shirt youre wearing.
d. You must be feeling better today. - ANS-b
An adult diagnosed with major depressive disorder was treated with medication and
cognitive behavioral therapy. The patient now recognizes how passivity contributed to
the depression. Which intervention should the nurse suggest?
a. Social skills training
b. Relaxation training classes
c. Use of complementary therapy
d. Learning desensitization techniques - ANS-a
A priority nursing intervention for a patient diagnosed with major depressive disorder is:
,a. distracting the patient from self-absorption.
b. carefully and inconspicuously observing the patient around the clock.
c. allowing the patient to spend long periods alone in self-reflection.
d. offering opportunities for the patient to assume a leadership role in the therapeutic
milieu. - ANS-b
When counseling patients diagnosed with major depressive disorder, an advanced
practice nurse will address the negative thought patterns by using:
a. psychoanalytic therapy.
b. desensitization therapy.
c. cognitive behavioral therapy.
d. alternative and complementary therapies. - ANS-c
A patient says to the nurse, My life does not have any happiness in it anymore. I once
enjoyed holidays, but now theyre just another day. How would the nurse document the
complaint?
a. Vegetative symptom
b. Anhedonia
c. Euphoria
d. Anergia - ANS-b
A patient diagnosed with major depressive disorder is taking a tricyclic antidepressant.
The patient says, I dont think I can keep taking these pills. They make me so dizzy,
especially when I stand up. The nurse should:
a. explain how to manage postural hypotension, and educate the patient that side
effects go away after several weeks.
b. tell the patient that the side effects are a minor inconvenience compared with the
feelings of depression.
c. withhold the drug, force oral fluids, and notify the health care provider to examine the
patient.
d. teach the patient how to use pursed-lip breathing. - ANS-a
A patient diagnosed with major depressive disorder is receiving imipramine (Tofranil)
200 mg every night at bedtime. Which assessment finding would prompt the nurse to
collaborate with the health care provider regarding potentially hazardous side effects of
this drug?
a. Dry mouth
b. Blurred vision
c. Nasal congestion
d. Urinary retention - ANS-d
,A patient diagnosed with major depressive disorder tells the nurse, Bad things that
happen are always my fault. To assist the patient in reframing this overgeneralization,
the nurse should respond:
a. I really doubt that one person can be blamed for all the bad things that happen.
b. Lets look at one bad thing that happened to see if another explanation exists.
c. You are being exceptionally hard on yourself when you say those things.
d. How does your belief in fate relate to your cultural heritage? - ANS-b
A nurse worked with a patient diagnosed with major depressive disorder who was
severely withdrawn and dependent on others. After 3 weeks, the patient did not
improve. The nurse is at risk for feelings of:
a. overinvolvement.
b. guilt and despair.
c. interest and pleasure.
d. ineffectiveness and frustration. - ANS-d
A patient diagnosed with major depressive disorder begins selective serotonin reuptake
inhibitor (SSRI) antidepressant therapy. Priority information given to the patient and
family should include a directive to:
a. avoid exposure to bright sunlight.
b. report increased suicidal thoughts.
c. restrict sodium intake to 1 g daily.
d. maintain a tyramine-free diet. - ANS-b
A nurse teaching a patient about a tyramine-restricted diet would approve which meal?
a. Mashed potatoes, ground beef patty, corn, green beans, apple pie
b. Avocado salad, ham, creamed potatoes, asparagus, chocolate cake
c. Macaroni and cheese, hot dogs, banana bread, caffeinated coffee
d. Noodles with cheddar cheese sauce, smoked sausage, lettuce salad, yeast rolls -
ANS-a
What is the focus of priority nursing interventions for the period immediately after
electroconvulsive therapy treatment?
a. Supporting physiologic stability
b. Reducing disorientation and confusion
c. Monitoring pupillary responses
d. Assisting the patient to identify and test negative thoughts - ANS-a
, A nurse provided medication education for a patient who takes phenelzine (Nardil) for
depression. Which behavior indicates effective learning? The patient:
a. monitors sodium intake and weight daily.
b. wears support stockings and elevates the legs when sitting.
c. consults the pharmacist when selecting over-the-counter medications.
d. can identify foods with high selenium content, which should be avoided. - ANS-c
A patients employment is terminated and major depressive disorder results. The patient
says to the nurse, Im not worth the time you spend with me. Im the most useless person
in the world. Which nursing diagnosis applies?a. Powerlessness
b. Defensive coping
c. Situational low self-esteem
d. Disturbed personal identity - ANS-c
A patient diagnosed with major depressive disorder does not interact with others except
when addressed and then only in monosyllables. The nurse wants to show
nonjudgmental acceptance and support for the patient. Select the nurses most effective
approach to communication.
a. Make observations.
b. Ask the patient direct questions.
c. Phrase questions to require yes or no answers.
d. Frequently reassure the patient to reduce guilt feelings. - ANS-a
A patient being treated for major depressive disorder has taken 300 mg amitriptyline
(Elavil) daily for a year. The patient calls the case manager at the clinic and says, I
stopped taking my antidepressant 2 days ago. Now I am having cold sweats, nausea, a
rapid heartbeat, and nightmares. The nurse should advise the patient:
a. Go to the nearest emergency department immediately.
b. Do not to be alarmed. Take two aspirin and drink plenty of fluids.
c. Take one dose of the antidepressant. Come to the clinic to see the health care
provider.
d. Resume taking the antidepressant for 2 more weeks, and then discontinue it again. -
ANS-c
Which documentation indicates the treatment plan of a patient diagnosed with major
depressive disorder was effective?
a. Slept 6 hours uninterrupted. Sang with activity group. Anticipates seeing grandchild.
b. Slept 10 hours uninterrupted. Attended craft group; stated project was a failure, just
like me.
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