NURS 128 Exam 3 Questions with Correct Answers
A 20-year-old male patient diagnosed with chronic schizophrenia is placed on an antipsychotic, 20 mg twice a day. At the evening medication time, he expresses that he is not feeling well. The nurse assesses the patient and finds the following sympto...
NURS 128 Exam 3 Questions with
Correct Answers
A 20-year-old male patient diagnosed with chronic schizophrenia is placed on an
antipsychotic, 20 mg twice a day. At the evening medication time, he expresses that he
is not feeling well. The nurse assesses the patient and finds the following symptoms:
oral temperature 103° F (39.4° C), pulse 110 beats/min, and respirations 24
breaths/min. The patient is diaphoretic and appears rigid. This patient is most likely
suffering from which of the following? - ANSWER-Neuroleptic malignant syndrome
.A 23-year-old male veteran of the war in Iraq is admitted with a diagnosis of
posttraumatic stress disorder (PTSD) following his arrest for destroying his girlfriend's
apartment. This is not his first angry outburst resulting in destruction of property. Which
interventions by the nurse will be most helpful to this patient? (Select all that apply.) -
ANSWER-Allow opportunities for him to express his anger.
Provide patient and family teaching regarding PTSD.
Exhibit a nonjudgmental attitude.
.A 25-year-old man is admitted to the psychiatric unit after being found by the police
walking naked down the middle of the street at 3:00 AM. He insists that he is the real
Santa Claus. Which of the following nursing interventions should the nurse implement
when working with this patient? - ANSWER-Consistently use the patient's name.
.A 50-year-old female patient is admitted to the psychiatric unit for an acute
exacerbation of paranoid schizophrenia after she stopped taking her medications for
several months. She tells the nurse that she believes her food is being poisoned, and
she refuses to eat. What is the most appropriate intervention by the nurse? - ANSWER-
Provide canned food while expressing reasonable doubt.
.A 90-year-old patient is admitted to the hospital. Shortly after admission, the family
notices that the patient is exhibiting disorientation and agitation. When questioned about
the behavior by the family, the nurse states that the patient is at risk for developing
which common complication of hospitalization in older adults? - ANSWER-Delirium
.A client demonstrating delusional behavior is escalating as a result of increasing
anxiety regarding his or her safety. Which action demonstrates that the client has an
understanding of actions to de-escalate his or her anxiety? - ANSWER-The client asks
that he or she be allowed to seclude him- or herself.
.A client has been prescribed an antipsychotic medication for the management of
symptoms associated with schizophrenia. Which behaviors will show improvement as a
result of adhering to the medication therapy? Select all that apply. - ANSWER-
Acknowledge regularly hearing voices.
Regularly discusses his or her alter identity as a spy for Hitler
,.A client has recently lost all his or her possessions in a fire a month ago. Which
assessment data suggests that hospitalization should be considered? - ANSWER-
States, "The fire made my life so hopeless."
.A client previously diagnosed as psychotic expresses to the nurse that he is seeing
spiders climbing up the walls in his room and he is concerned that they will get into his
bed. The nurse's best response to this behavior is to - ANSWER-express doubt that
there are spiders on the wall.
.A client with schizophrenia has relapsed and has been identified as being in stage four
of relapse. Behavior which is most consistent with this stage of relapse would include -
ANSWER-presence of hallucinations.
.A cognitively impaired patient newly admitted to the hospital is experiencing signs of
sundown syndrome. Which intervention is best for the nurse to implement? - ANSWER-
Leave a night light on in the room at all times.
.A community health nurse is preparing a course on protecting cognitive function. Which
population group should the nurse target for teaching? - ANSWER-Older male adults
with diabetes
.A community mental health nurse wants to establish a relationship with a very
withdrawn patient diagnosed with schizophrenia. The patient lives at home with a
supportive family. Select the nurse's best plan. - ANSWER-Visit daily for 4 days, then
visit every other day for 1 week; stay with the patient for 20 minutes; accept silence;
state when the nurse will return.
.A family member ask the nurse, "I know my uncle's Alzheimer's disease has
progressed but is there any medication that can help him now?" Which response by the
nurse is correct? - ANSWER-"There are a few medications that may help. Let's discuss
it with the health care provider."
.A health care provider considers which antipsychotic medication to prescribe for a
patient with schizophrenia who has auditory hallucinations and poor social functioning.
The patient is also overweight and has hypertension. Which drug should the nurse
advocate? - ANSWER-aripiprazole (Abilify)
.A hospitalized patient with delirium misinterprets reality and a patient with dementia
wanders about the home. Which outcome is the priority in both scenarios? Each patient
will: - ANSWER-remain safe in the present environment.
.A newly admitted patient diagnosed with paranoid 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 behavior as: -
ANSWER-idea of reference
, .A newly admitted patient 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. - ANSWER-"I'll stay with you. Focus on what we are talking about, not the
voices."
.A nurse administers to four patients with Alzheimers disease. Which medications would
be expected to antagonize N-methyl-D-aspartate (NMDA) channels rather than
cholinesterase? - ANSWER-memantine (Namenda)
.A nurse at the mental health clinic plans a series of psychoeducational groups for
persons with schizophrenia. Which two topics would take priority? - ANSWER-The
importance of correctly taking your medication.
Ways to quit smoking.
.A nurse begins a therapeutic relationship with a patient diagnosed with schizophrenia.
The patient has severe paranoia. Which comment by the nurse is most appropriate? -
ANSWER-"As you get to know me better, I hope you will feel comfortable talking to me."
.A nurse driving home after work comes upon a serious automobile accident. The driver
gets out of the car with no apparent physical injuries. Which assessment findings would
be expected from the driver immediately after this event?Select all that apply. -
ANSWER-Difficulty using a cell phone.
Rapid speech.
Trembling.
.A nurse observes a patient who is in a catatonic state and standing immobile, facing
the wall with one arm extended in a salute. The patient remains immobile in this position
for 15 minutes, moving - ANSWER-Waxy flexibility
.A nurse should anticipate that which symptoms of Alzheimer's disease will become
apparent as the disease progresses from moderate to severe to late stage? Select all
that apply. - ANSWER-Agraphia.
Hyperorality.
Hyper-metamorphosis.
.A nurse sits with a patient diagnosed with disorganized schizophrenia. The patient
starts to laugh uncontrollably, although the nurse has not said anything funny. Select
the nurse's best response. - ANSWER-"You're laughing. Tell me what's happening."
.A nurse working in a pediatric clinic recognizes that which child is most at risk for
cognitive impairment? - ANSWER-A toddler living in an older home that is being
remodeled.
.A nurse works with a patient with paranoid schizophrenia regarding the importance of
medication management. The patient repeatedly says, "I don't like taking pills." Family
members say they feel helpless to foster compliance. Which treatment strategy should
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