PSYCHIATRIC NURSING

SAS 11

1. A - If you take an MAOI and you eat high-tyramine foods, tyramine can quickly reach dangerous levels.
Caution must be exercised if ordering pizzas from smaller outlets or gourmet pizzas known to contain
aged cheeses. Tyramine is found most commonly in aged cheeses and cured meats. Thus, since this
patient is taking an MAOI, she/he should be advised to avoid pizza contain aged cheeses.

2. B – Some people may misuse or overdose on antidepressants can increase the drugs' effects or to
commit suicide and overdoses are more commonly seen with older tricyclic antidepressants (TCAs).

3. D - The sign for toxic Effects are severe diarrhea, drowsiness, muscle weakness, lack of coordination
(can lead to renal failure, coma and death).

4. C - The most common long-term problem with stimulants is the growth and weight suppression that
occurs in some children.

5. B – Akathisia is inability to sit or stand still, continual pacing and agitation. The treatment for this is
Beta - blocker, Cogentin, Benzodiazepine.

6. B – Lamotrigine can cause serious rashes requiring hospitalization, including Stevens-Johnson

syndrome and, rarely, life-threatening toxic epidermal necrolysis.

7. C – The client is allergic to phenothiazines, so the nurse should question the physician's order for
Prolixin because this drug belongs to phenothiazines. Haldol and Navane are belong to the Thiothixene,
Risperdol is belong to the atypical antipsychotics.

8. B – Most antipsychotic drugs cause relatively minor cardiovascular adverse effects such as postural
hypotension, palpitations, and tachycardia. Certain antipsychotic drugs, such as thioridazine (Mellaril),
droperidol (Inapsine), and mesoridazine (Serentil), also can cause a lengthening of the QT interval. A QT
interval that is longer than 500 milliseconds is considered dangerous and is associated with
lifethreatening dysrhythmias and sudden death.

9. A – The major side effect for Selective Serotonin Reuptake Inhibitor (SSRI) is sexual dysfunction,
specifically diminished sexual drive or difficulty achieving an erection or orgasm.

10. B – The antipsychotic Drugs is drug treatments intended to treat symptoms of psychosis and
schizophrenia.

SAS 12

1. B - ECT works through the electrophysiological response of the brain by inducing a grand mal seizure
through electric stimulation.
2. C - The patient has the right not to pursue treatment, and you need to accept it but as a nurse you
need to focus on the patient’s concern in order to provide immediate action.

3. A - Immediately after electroconvulsive therapy a nurse should monitor pulse, respirations, and blood
pressure every 15 minutes for the first hour, during which time the client should remain in bed.

4. D - Give preoperative medications as ordered: Give either glycopyrrolate (Robinul) or atropine to

prevent potential for aspiration and to help minimize brady-arrhythmias in response to electrical
stimulants.

5. C – Short-acting anesthesia, such as thiopental sodium, a barbiturate is used intravenously to induce

unconsciousness smoothly and rapidly or to put a patient peacefully to sleep that about to undergo
surgery.

6. A - Place the cl`ient who has received electroconvulsive therapy on his or her side to prevent
aspiration. After the treatment, most clients will awaken within 10 to 15 minutes and will be confused
and disoriented. Some clients will sleep for 1 to 2 hours.

7. C - The patient has the right not to pursue treatment, and you need to accept it but as a nurse, you
need to focus on the patient’s concern in order to provide immediate action.

8. B - An Electroencephalogram (EEG) is used throughout the procedure to record electrical activity in

the brain including episodes of seizures.

9. A – The most persistent adverse effect of electroconvulsive therapy is some clients develop
retrograde amnesia (trouble remembering memories before treatment), these problems usually resolve
within a few months after completion of therapy.

10. D - Indications for Electroconvulsive Therapy is major depression the most common that particularly
when accompanied by detachment from reality (psychosis), a desire to commit suicide or refusal to eat
and a severe depression that doesn't improve with medications or other treatments.
AL STRATEGY (difficulties):

The negative portrayal of ECT in the media and movies, beliefs that it may cause permanent brain
damage or that it may limit or curtail creativity are some examples of a myth that may play a part in a
patients' decision to refuse or accept ECT when offered during their care. Some patients who were
undergoing ECT for the first time were worried about the thought of seizures and the possible side
effects like afraid that the patient would chip his/her teeth during a seizure. During ECT, heart rate and
blood pressure increase, and in rare cases, that can lead to serious heart problems. If you have heart
problems, ECT may be more risky.

AL STRATEGY (solve):

Patient fears and anxieties decreased once they received clear explanations from the health care
provider. So as a nurse encourage the client to discuss feelings, including myths regarding ECT, and
teach the client and the family what to expect with ECT. Then ascertain if the client and the family have
received a full explanation, including the option to withdraw the consent at any time. Also as a nurse
you have the responsibility to monitor the vital signs throughout the treatment.

SAS 13

1. C - Prescriptive Bibliotherapy can be used in the treatment of a range of mental health concerns. In
this form of bibliotherapy, the therapist may suggest a self-help workbook with exercises and
techniques for the client to practice outside of the time spent in-session.

2. B - A form of group therapy in which the client and his or her family members participate. The goals
include understanding how family dynamics contribute to the client’s psychopathology, mobilizing the
family’s inherent strengths and functional resources, restructuring maladaptive family behavioral styles,
and strengthening family problem-solving behaviors.

3. A - Appreciation of the Work of the World is the correct answer because this step involves life –
related questions based from the poem/story/song.

4. B – A music therapy session may incorporate different elements, such as making music, writing songs,
or listening to music to address physical, emotional, cognitive, and social needs of individuals. During a
music therapy session, you may listen to different genres of music, play a musical instrument, or even
compose your own songs.

5. A - Creative bibliotherapy utilizes imaginative literature—novels, short stories, poetry, plays, and
biographies—to improve psychological well-being. Through the incorporation of carefully selected
literary works, therapists can often guide people in treatment on a journey of self-discovery.
SAS 14

1. B - This treatment approach may be known as milieu therapy (MT) because those in the program are
immersed in a small, structured community focused on helping them develop skills and behaviors that’ll
enable them to live healthier lives in a larger society.

2. C - Nondirective play therapy is based on the principle that children can resolve their own issues given
the right conditions and the freedom to play with limited instruction and supervision.

3. A - Art therapy is a form of expressive therapy that uses the creative process of making art to improve
a person’s physical, mental, and emotional well-being. The creative process involved in expressing one’s
self artistically can help people to resolve issues as well as develop and manage their behaviors and
feelings, reduce stress, and improve self-esteem and awareness.

4. A – Directive play therapy controlled approach in which the therapist is actively involved, structuring a
child’s activities by providing selected play materials and encouraging the child to use them in the
enactment of “pretend” situations and the expression of feelings.

5. D - A psycho-spiritual approach refers to the mind, the psyche and the spirit, so it includes both the
personal and the metaphysical. The psycho-spiritual includes themes like the mental, emotional and
physical trauma and spiritual healing. Typically, the patient will be guided into utilizing their symptoms
or difficulties as a catalyst for psycho-spiritual transformation.

SAS 15

1. A- The patient show the level of moderate anxiety that is disturbing feeling that something is
definitely wrong, the person becomes nervous or agitated, has difficulty concentrating but still be
redirected to the topic.

2. C- Base on the situation this is identify as severe anxiety that is involves feelings of dread or terror,
the person focuses only on scattered details, cannot be redirected to a task and has physiologic
symptoms such as tachycardia, diaphoresis and chest pain, they may feel they are having a heart attack
because of these symptoms.

3. C - Remain calm and reassure the person that they’re most likely experiencing a panic attack and that
it’s not dangerous. Explain that while what they’re feeling is frightening, the symptoms will pass. As you
talk, use short sentences and speak in a clear, firm manner. Be patient and stay with them throughout
the attack.

4. D - In an intensely anxious situation bee clear and concise with words. Ask detailed questions that
should be specific and direct, a way that invites patients to talk.
5. A - This is negative adaptive behaviors that result in maladaptive behaviors such as tension, pain
syndrome, and stress-related responses that reduce the efficiency of the immune system that patient
also experiences.

6. B - For severe anxiety, the appropriate intervention is lower client's anxiety level (ensure safety and
grounding), remain with the client, talk in calm, low voice, if restless walk with the client while talking.

7. D - Mild anxiety is a sensation that something is different or need specific attention, this type
motivates people to make changes or engage in goal-directed activity.

8. B - Alarm stage, the first stage of stress is your body's immediate reaction. You may notice an
increased heart rate, sweating, nervous fidgeting, or feeling tense, anxious, worried, or scared as your
body reacts to the cause of your stress. The sympathetic nervous system is stimulated and biological
changes occur to make you poised to take action.

9. A - Patient with moderate anxiety refocus client with calm imagery that is convenient and simple
relaxation technique that can help you quickly and easily manage stress and reduce tension in your
body. These techniques involve the systematic practice of creating a detailed mental image of an
attractive and peaceful setting or environment.

10. B - For positive adaptive behaviors the anxious client able to use imagery techniques to refocus
attention on pleasant scene, practice sequential relaxation of the body from head to toe, and breathing
slowly and steadily to reduce muscle tension and vital signs.

AL STRATEGY:

-I learn about the concept of anxiety and the various responses to stress caused by anxiety.

-I also learn the different levels and manifestations of anxiety

-I learn the appropriate intervention in caring for clients under the different levels of anxiety

This lesson is important because it gives us an understanding of anxiety disorder so we know what to do
when we encounter a patient struggling with an anxiety disorder when the time we can have a duty in a
hospital or community. Also, to avoid experiencing this disorder since we are students that experience a
lot of stress because of our course we took.

We also a student that sometimes experiences anxiety so this is oriented us, prepares and motivate us
to take action. It affects my thinking of course and cannot predict where are going since I am a student
that can experience anxiety but I will learn to seek help, learn to cope, and get on the road to recovery.
SAS 16

1. D - Rationalization is excusing own behavior to avoid guilt, responsibility, conflict, anxiety, or loss of
self-respect. The client is defending his substance abuse by providing reasons related to life stressors.

2. B - Regression is moving back to a previous developmental stage in order to feel safe or have needs
met. An adult who throws temper tantrums, such as this one, is displaying regressive behavior, or
behavior that is appropriate at a younger age.

3. C - Denial is failure to acknowledge an unbearable condition, failure to admit the reality of a situation,
or how one enables the problem to continue.

4. A - Conversion is expression of an emotional conflict through the development of a physical symptom,

usually sensorimotor in nature.

5. D - Repression is excluding emotionally painful or anxiety-provoking thoughts and feelings from

conscious awareness.

6. D - Isolation is a person separates ideas or feelings from the rest of their thoughts and that Elisa do,
avoiding the situation.

7. B - Denial is failure to acknowledge an unbearable condition, failure to admit the reality of a situation
and that Trent doing, continues to call Elisa and treat her as he did when they were going out.

8. C - Projection is unconscious blaming of unacceptable inclinations or thoughts on an external object,

that involves attributing ones own undesirable feelings to other people.

9. A - Undoing is exhibiting acceptable behavior to make up for or negate unacceptable behavior, and
that corrupt politician doing, he is corrupt that donates large amounts of money to his parish.

10. D - Reaction formation is acting the opposite of what one thinks or feels and that the student do, he
hate the teacher but say positive about the teacher to his friends.

SAS 17

1. D - Grounding techniques used when a victim is dissociating or experiencing a flashback, grounding

techniques remind the client that he or she is in the present, as an adult, and is safe.

2. D - These symptoms are normal for a patient who has been through such a traumatic event. During
the acute phase of rape crisis, the patient can display a wide variety of emotional responses.

3. A - The feelings of concern, compassion, and empathy are helpful. Anger may make objectivity
impossible.
4. B - Shock, emotional numbness, confusion, disbelief, restlessness, and agitated motor activity depict
the acute phase of rape trauma syndrome. Flashbacks, dreams, fears, and phobias occur in the long-
term reorganization phase of rape trauma syndrome.

5. D - In this case, the persons symptoms of rapid, dissociated speech, confusion, and indecisiveness
indicate severe anxiety. Weak is not a level of anxiety. Mild and moderate levels of anxiety allow the
person to function at a higher level.

6. C - For initial intervention, provide immediate safety and security, bring the victim to a separate room
and remain with the victim as much as possible.

7. B - The client face traumatize situation and became rape victim so avoid touch because it can give
other meaning to client and maybe it can trigger the client to remember the situation she experience.

8. B - It is important to also communicate to the victim that he/she is safe and that it is not his/her fault.
Nonjudgmental listening provides an avenue for catharsis, which contributes to the healing process.

9. A - Undergo crisis intervention therapy, the patient make a realization and state "I know that it was
not my fault" that indicate the patient is in good recovery and can handle the situation in a healthy
manner.

10. B - Exploitive predators is impulsively use their victims for objectives of gratification.

SAS 18

1. A- The symptoms of bruises and burns and when the child moves back or away because of fear or
disgust is an indication that the child is has been physically abused.

2. D – As a nurse you should report suspicion of abuse to the authorities because your priority is to
ensure the safety and well-being of the child. If you cannot report this it can cause more danger to the
child.

3. D – The child is 8 years old, for this age the child should interest and develops social and intellectual
skills, so when this child age of 8 years old that has an interest in sexual nature is an indication that she
is a victim of sexual abuse.

4. C – Remember when it comes to nursing intervention for abuse, the priority is to ensure the safety
and well-being of the child, safety, and security of the elderly.

5. B – The important risk factors when assessing a parent who abused her child are the history of the
parent having been abused as a child or when the parent giving an inconsistent history of the injury.
Option A is no indication of abuse. OptionC and D are not established risk factors for child abuse by a
parent.
6. C – The nurse should commend the mother's efforts to seek help but as a nurse, you should also
contact protective services because the priority here is to ensure the safety and well-being of the child.
After all, failure to do so can risk further endangerment of the child.

7. D – In this situation, the explanation that violence occurred because of Mrs. Smith that provoked her
son or abuser is accepted and owned by the victim, but Mrs. Smith is not responsible for the violence.

8. A – Cristina who quit her job to move in and care for a parent with severe dementia that she should
focus on her parent for the needs and safety of the parent can cause so much stress for her, it can
places Cristina at high risk for stress and abuse.

9. A, B, D - Good rapport creates a close and harmonious relationship with patients. It allows you to
understand your patient's feelings and communicate well with them. Identify areas of control and
support in the decisions he/she makes can empower the clients and can improve their problem-solving
skills.

10. A – Neglect abuse is about poor hygiene, lacking needed medications, dirty/smelly environment,
rashes/sores/lice, untreated condition, lacking clothing. So the situation here is an example of neglect
abuse.

SAS 19

1. B - Relaxation techniques are strategies used to reduce stress and anxiety. Relaxation skills address
anxiety from the standpoint of the body by reducing muscle tension, slowing down breathing, and
calming the mind.

2. C - Do not touch or attempt to physically comfort the client. Keep your distance, but not leave the
room. You can try to work with your client to slow down breathing, but this is unlikely to work well until
the client is already deescalating.

*3. A – Primary gain relief of an anxiety by performing anxiety-relieving activities such as staying in the
house, if going to a place is causing the client anxiety.

4. B - The feeling of overwhelming and uncontrollable doom is characteristic of a panic attack. Panic
disorder is an anxiety disorder characterized by recurrent unexpected panic attacks. Panic attacks are
sudden periods of intense fear that may include palpitations, sweating, shaking, shortness of breath,
numbness, or a feeling that something really bad is going to happen.

5. C – For the panic attack, the physical symptoms are palpitations, sweating, tremors, shortness of
breath, suffocation, chest pain, nausea, abdominal distress, dizziness, chills and hot flashes. The other
option is not example of physical symptoms.

6. B - Agoraphobia is a rare type of anxiety disorder. If you have it, your fears keep you from getting out
into the world. You avoid certain places and situations because you think you’ll feel trapped and not be
able to get help. You may feel that you need a companion, such as a relative or friend, to go with you to
public places.

7. B - Systematic desensitization is a behavioral technique in which the client with a specific phobia is
gradually able to work through hierarchal fears until the most fearful situation is encountered. In this
case, the most fearful is riding an airplane. The responses in options A and D may occur earlier in
treatment, but not indicative of success. Generally, a phobic individual recognizes that his fear is
disproportionate to the things he fears.

8. C - Specific phobias are an overwhelming and unreasonable fear of objects or situations that pose
little real danger but provoke anxiety and avoidance.

9. B - Phobic Beliefs: Beliefs about phobic stimuli that maintain the phobic’s fear and avoidance of that
stimulus or situation.

10. D – Flooding desensitization does so all at once, exposing the client to a visceral and immediate
representation of their fear or behavioral cue while in a safe environment.

SAS 20

1. C - All the choices may be exhibited in PTSD, but only the option C is a behavioral symptom.

2. D - The target clinical manifestation for a client with post-traumatic stress disorder is flashbacks that
re-experiencing a traumatic event through intrusive recollections, flashbacks, and nightmares.

3. C - This will help the client work through the strong emotions connected with the trauma and,
therefore foster the belief that she is able to cope.

4. B - Post-traumatic stress disorder is caused by the the experience of severe, specific trauma. Rape is a
severely traumatic event.

5. C - Clients who have experienced a traumatic event such as sexual abuse may experience flashbacks.
The triggers for these flashbacks may be visual, auditory, tactile, or olfactory.

6. A - All the option except for option A is common symptoms of post-traumatic stress disorder (PTSD).
Option A is characteristic of obsessive-compulsive disorder.

7. B - Post-Traumatic Stress Disorder, PTSD, is an anxiety disorder that can develop after exposure to a
terrifying event or ordeal in which grave physical harm occurred or was threatened.

8. C - One of the symptoms of PTSD in a children act younger than their age, such as thumb-sucking or
bedwetting.
9. B - Anger is a common emotion associated with PTSD. Anger can create major problems in the
personal lives of those who have experienced trauma and those who suffer from PTSD. Anger is also a
common response to events that seem unfair or in which you have been made a victim.

10. A - If the symptoms last longer than one month, cause great distress, or interfere with work or home
life, PTSD is likely to blame. PTSD symptoms usually start soon after the traumatic event, but they may
not happen until months or years later (delayed-onset PTSD). At three months or less, a patient is said to
have acute PTSD. At three months or longer, chronic PTSD is the diagnosis.