Chapter 1

1. When providing respectful, appropriate nursing care, how should the nurse identify the patient and his or
her observable characteristics?
a. The manic patient in room 234
b. The patient in room 234 is a manic
c. The patient in room 234 is possibly a manic
d. The patient in room 234 is displaying manic behavior
2. Recognizing the frequency of depression among the American population, the nurse should advocate for
which mental health promotion intervention?
a. Including discussions on depression as part of school health classes
b. Providing regular depression screening for adolescent and teenage students
c. Increasing the number of community-based depression hotlines available to the public
d. Encouraging senior centers to provide information on accessing community depression
resources

3. Which statement made by a patient demonstrates a healthy degree of resilience? Select all that apply.
a. “I try to remember not to take other people’s bad moods personally.”
b. “I know that if I get really mad I’ll end up being depressed.”
c. “I really feel that sometimes bad things are meant to happen.”
d. “I’ve learned to calm down before trying to defend my opinions.”
e. “I know that discussing issues with my boss would help me get my point across.”

4. Which statement demonstrates the nurse’s understanding of the effect of environmental factors on a
patient’s mental health?
a. “I’ll need to assess how the patient’s family views mental illness.”
b. “There is a history of depression in the patient’s extended family.”
c. “I’m not familiar with the patient’s Japanese’s cultural view on suicide.”
d. “The patient’s ability to pay for mental health services needs to be assessed.”

5. When considering stigmatization, which statement made by the nurse demonstrates a need for immediate
intervention by the nurse manager?
 a. “Depression seems to be a real problem among the teenage population.”
b. “My experience has been that the Irish have a problem with alcohol use.”
c. “Women are at greater risk for developing suicidal thoughts then acting on them.”
d. “We’ve admitted several military veterans with posttraumatic stress disorder this month.”

6. A nursing student new to psychiatric-mental health nursing asks a peer what resources he can use to figure
out which symptoms are present in a specific psychiatric disorder. The best answer would be:
a. Nursing Interventions Classification (NIC)
b. Nursing Outcomes Classification (NOC)
c. NANDA-I nursing diagnoses
d. DSM-5

7. Epidemiological studies contribute to improvements in care for individuals with mental disorders by:
a. Providing information about effective nursing techniques.
b. Identifying risk factors that contribute to the development of a disorder.
c. Identifying individuals in the general population who will develop a specific disorder.
d. Identifying which individuals will respond favorably to a specific treatment.

8. Which of the following activities would be considered nursing care and appropriate to be performed by a
basic level nurse for a patient suffering from mental illness?
a. Treating major depression
b. Teaching coping skills for a specific family dynamic
c. Conducting psychotherapy
d. Prescribing antidepressant medication
9. Which statement about mental illness is true?
a. Mental illness is a matter of individual nonconformity with societal norms.
b. Mental illness is present when irrational and illogical behavior occurs.
c. Mental illness changes with culture, time in history, political systems, and the groups
defining it.
d. Mental illness is evaluated solely by considering individual control over behavior and
appraisal of reality.
10. The World Health Organization describes health as “a state of complete physical, mental, and social
wellbeing and not merely the absence of disease or infirmity.” Which statement is true in regards to overall
health? Select all that apply.
a. There is no relationship between physical and mental health.
b. Poor physical health can lead to mental distress and disorders.
c. Poor mental health does not lead to physical illness.
d. There is a strong relationship between physical health and mental health.
e. Mental health needs take precedence over physical health needs.

Answers
1. d; 2. b; 3. a, d, e; 4. c; 5. b; 6. d; 7. b, d; 8. b; 9. c; 10. b, d

CHAPTER 2

1. A male patient reports to the nurse, “I’m told I have memories of childhood abuse stored in my
unconscious mind. I want to work on this.” Based on this statement, what information should the nurse
provide the patient?
a. To seek the help of a trained therapist to help uncover and deal with the trauma associated with
those memories.
b. How to use a defense mechanism such as suppression so that the memories will be less
threatening.
c. Psychodynamic therapy will allow the surfacing of those unconscious memories to occur in just a
few sessions.
d. Group sessions are valuable to identify underlying themes of the memories being suppressed.

2. Which question should the nurse ask when assessing for what Sullivan’s Interpersonal Theory identifies as
the most painful human condition?
a. “Is self-esteem important to you?”
b. “Do you think of yourself as being lonely?”
c. “What do you do to manage your anxiety?”
d. “Have you ever been diagnosed with depression?”
3. When discussing therapy options, the nurse should provide information about interpersonal therapy to
which patient? Select all that apply.
a. The teenager who is the focus of bullying at school
b. The older woman who has just lost her life partner to cancer
c. The young adult who has begun demonstrating hoarding tendencies
d. The adolescent demonstrating aggressive verbal and physical tendencies
e. The middle-aged adult who recently discovered her partner has been unfaithful

4. When considering the suggestions of Hildegard Peplau, which activity should the nurse regularly engage
in to ensure that the patient stays the focus of all therapeutic conversations?
a. Assessing the patient for unexpressed concerns and fears
b. Evaluating the possible need for additional training and education
c. Reflecting on personal behaviors and personal needs
d. Avoiding power struggles with the manipulative patient

5. Which action reflects therapeutic practices associated with operant conditioning?

a. Encouraging a parent to read to their children to foster a love for learning
b. Encouraging a patient to make daily journal entries describing their feelings
c. Suggesting to a new mother that she spend time cuddling her newborn often during the day
d. Acknowledging a patient who is often verbally aggressive for complimenting a picture another
patient drew

6. A nurse is assessing a patient who graduated at the top of his class but now obsesses about being
incompetent in his new job. The nurse recognizes that this patient may benefit from the following type of
psychotherapy:
a. Interpersonal
b. Operant conditioning
c. Behavioral
d. Cognitive-behavioral

7. According to Maslow’s hierarchy of needs, the most basic needs category for nurses to address is:
a. physiological
 b. safety
c. love and belonging
d. self-actualization

8. In an outpatient psychiatric clinic, a nurse notices that a newly admitted young male patient smiles when
he sees her. One day the young man tells the nurse, “You are pretty like my mother.” The nurse recognizes
that the male is exhibiting:
a. Transference
b. Id expression
c. Countertransference
d. A cognitive distortion

9. Linda is terrified of spiders and cannot explain why. Because she lives in a wooded area, she would like to
overcome this overwhelming fear. Her nurse practitioner suggests which therapy?
a. Behavioral
b. Biofeedback
c. Aversion
d. Systematic desensitization

10. A patient is telling a tearful story. The nurse listens empathically and responds therapeutically with:
a. “The next time you find yourself in a similar situation, please call me.”
b. “I am sorry this situation made you feel so badly. Would you like some tea?”
c. “Let’s devise a plan on how you will react next time in a similar situation.”
d. “I am sorry that your friend was so thoughtless. You should be treated better.”
Answers
1. a; 2. b; 3. a, b, e ; 4. c; 5. d; 6. d; 7. a; 8. a; 9. d; 10. c

CHAPTER 3

1. Besides antianxiety agents, which classification of drugs is also commonly given to treat anxiety and
anxiety disorders?
 a. Antipsychotics
b. Mood stabilizers
c. Antidepressants
d. Cholinesterase inhibitors

2. What assessment question will provide the nurse with information regarding the effects of a woman’s
circadian rhythms on her quality of life?
a. “How much sleep do you usually get each night?”
b. “Does your heart ever seem to skip a beat?”
c. “When was the last time you had a fever?”
d. “Do you have problems urinating?”

3. You realize that your patient who is being treated for a major depressive disorder requires more teaching
when she makes the following statement:
a. “I have been on this antidepressant for 3 days. I realize that the full effect may not happen for a
period of weeks.”
b. “I am going to ask my nurse practitioner to discontinue my Prozac today and let me start taking a
monoamine oxidase inhibitor tomorrow.”
c. “I may ask to have my medication changed to Wellbutrin due to the problems I am having being
romantic with my wife.”
d. “I realize that there are many antidepressants and it might take a while until we find the one that
works best for me.”

4. A patient being treated for insomnia is prescribed ramel-teon (Rozerem). Which comorbid mental health
condition would make this medication the hypnotic of choice for this particular patient?
a. Obsessive-compulsive disorder
b. Generalized anxiety disorder
c. Persistent depressive disorder
d. Substance use disorder

5. Which statement made by a patient prescribed bupropion (Wellbutrin) demonstrates that the medication
education the patient received was effective? Select all that apply.
a. “I hope Wellbutrin will help my depression and also help me to finally quit smoking.”
b. “I’m happy to hear that I won’t need to worry too much about weight gain.”
 c. “It’s okay to take Wellbutrin since I haven’t had a seizure in 6 months.”
d. “I need to be careful about driving since the medication could make me drowsy.”
e. “My partner and I have discussed the possible effects this medication could have on our sex life.”

6. Which drug group calls for nursing assessment for development of abnormal movement disorders among
individuals who take therapeutic dosages?
a. SSRIs
b. antipsychotics
c. benzodiazepines
d. tricyclic antidepressants

7. A nurse reviews an order for a CYP450 test. He explains to his patient from Thailand that the test will
determine how the antidepressant will be:
a. Metabolized
b. Absorbed
c. Administered
d. Excreted

8. Psychotropic drugs have been used for more than half a century. What statement regarding their current
status is true?
a. Only one classification of psychotropic drugs exists.
b. The Food and Drug Administration no longer approves new antidepressants.
c. We do not know exactly how they work.
d. Chlorpromazine (Thorazine), the first psychotropic, continues to be the treatment of choice with
hallucinations.

9. The nurse administers each of the following drugs to various patients. The patient who should be most
carefully assessed for fluid and electrolyte imbalance is the one receiving:
a. lithium (Eskalith)
b. clozapine (Clozaril)
c. diazepam (Valium)
d. amitriptyline
10. A psychiatric nurse is reviewing prescriptions for a patient with major depression at the county clinic.
Since the patient has a mild intellectual disability, the nurse would question which classification of
antidepressant drugs:
a. Selective serotonin reuptake inhibitors
b. Monoamine oxidase inhibitors
c. Serotonin and norepinephrine reuptake inhibitors
d. All of the above

Answers
1. c; 2. a; 3. b; 4. d; 5. a, b; 6. b; 7. a; 8. c; 9. a; 10. b

CHAPTER 4

1. A patient needs supportive care for the maintenance treatment of bipolar disorder. The new nurse
demonstrates an understanding of the services provided by the various members of the patient’s mental
healthcare team when he makes which statement:
a. “Your social worker will help you learn to budget your money effectively.”
b. “Your counselor asked me to remind you of the group session on critical thinking at 2:00 today.”
c. “The mental health technician on staff today will administer the medication that you require.”
d. “Remember to ask the occupational therapist about sources of financial help that you are qualified
for.”

2. A patient has been voluntarily admitted to a mental health facility after an unsuccessful attempt to harm
himself. Which statement demonstrates a need to better educate the patient on his patient’s rights?

a. “I understand why I was restrained when I was out of control.”

b. “You can’t tell my boss about the suicide attempt without my permission.”
c. “I have a right to know what all of you are planning to do to me.”
d. “I can hurt myself if I want too. It’s none of your business.”

3. Which intervention demonstrates an attempt by nursing staff to meet the goals identified by the Joint
Commission as National Patient Safety Goals? Select all that apply.

a. Identifying patients using both name and date of birth before drawing blood.
b. Sitting with the patient diagnosed with an eating disorder during meals.
 c. Administering the Beck Scale on each patient at the time of admission.
d. Performing a medication history assessment on each new patient.
e. Using appropriate hand washing technique at all times.

4. The mental health team is determining treatment options for a male patient who is experiencing psychotic
symptoms. Which question(s) should the team answer to determine whether a community outpatient or
inpatient setting is most appropriate? Select all that apply.

a. “Is the patient expressing suicidal thoughts?”

b. “Does the patient have intact judgment and insight into his situation?”
c. “Does the patient have experiences with either community or inpatient mental healthcare
facilities?”
d. “Does the patient require a therapeutic environment to support the management of psychotic
symptoms?”
e. “Does the patient require the regular involvement of their family/significant other in planning and
executing the plan of care?”

5. The nurse frequently includes daily sessions involving relaxation techniques. Which assessment data
would most indicate a need for this intervention to be included in the initial plan of care for a patient?
a. Family history of anxiety and symptoms of anxiety
b. Significant other has a chronic health issue
c. Hopes to retire in 6 months
d. Recently adopted infant twins

6. A newly divorced 36-year-old mother of three has difficulty sleeping. When she shares this information to
her gynecologist, she suggests which of the following services as appropriate for her patient’s needs?
a. Assertive community treatment
b. Patients-centered medical home
c. Psychiatric home care
d. Primary care provider
7. A Gulf War veteran has been homeless since being discharged from military service. He is now diagnosed
with schizophrenia. The nurse practitioner recognizes that assertive community treatment (ACT) is a good
option for this patient since ACT provides:
a. Psychiatric home care
b. Care for hard-to-engage, seriously ill patients
c. Outpatient community mental health center care
d. A comprehensive emergency service model
8. An adolescent female is readmitted for inpatient care after a suicide attempt. What is the most important
nursing intervention to accomplish upon admission?

a. Allowing the patient to return to her previous room so that she will feel safe

b. Orienting the patient to the unit and introduce her to patients and staff

c. Building trust through therapeutic communication

d. Checking the patient’s belongings for dangerous items

9. Emma is a 40-year-old married female who has found it increasingly difficult to leave her home due to
agoraphobia. Emma’s family is appropriately concerned and suggests that she seek psychiatric care. After
investigating her options, Emma decides to try:

a. Telepsychiatry

b. Assertive community treatment

c. Psychiatric home care

d. Outpatient psychiatric care

10. Pablo is a homeless adult who has no family connection. Pablo passed out on the street and emergency
medical services took him to the hospital where he expresses a wish to die. The physician recognizes
evidence of substance use problems and mental health issues and recommends inpatient treatment for Pablo.
What is the rationale for this treatment choice? Select all that apply.

a. Intermittent supervision is available in inpatient settings.

b. He requires stabilization of multiple symptoms.

c. He has nutritional and self-care needs.

d. Medication adherence will be mandated.

e. He is in imminent danger of harming himself.

Answers
1. b; 2. d; 3. a, c, d, e; 4. a, b, d, e; 5. a; 6. d; 7. b; 8. d; 9. a; 10. b, c, e
CHAPTER 5
1. Which intervention demonstrates the nurse’s understanding of what guides effective nursing care with a
diverse patient population?
a. Treating all patients the same to avoid prejudicial actions.
b. Identifying the cultural norms of the population being served.
c. Recognizing that race and ethnicity result in specific illness management views.
d. Addressing the physical and emotional needs that originate from genetic factors.

2. Which statement indicates the beliefs and values that tend to be representative of a member of an
indigenous culture? Select all that apply.
a. “I’ve reinforced the importance of taking medications at the time they are prescribed.”
b. “The patient believes that illness is a result of being out of harmony with nature.”
c. “Spending money on medicine for his diabetes is not a comfortable concept for my patient.”
d. “The patient refuses treatment.”
e. “We discussed the patient’s needs regarding warding off evil spirits before her surgery.”

3. Which assessment questions will support effective communication with a patient who recently emigrated
from an Asian country? Select all that apply.
a. “What do you call this kind of pain?”
b. “What do you think is causing your pain?”
c. “How do you think your pain should be treated?”
d. “Do you consider this kind of pain a serious problem?”
e. “Do you think American medicine will help your pain?”
4. When considering culturally competent care for a Muslim patient diagnosed with cardiac problems, which
intervention is particularly important to implement initially when a low fat diet is prescribed?
a. Requesting a dietary consult
b. Identifying dietary considerations
c. Explaining the importance of a low-fat diet
d. Including the family in conversation about food preparation
5. Which statement by the nurse demonstrates ethnocentrism toward the Hispanic patient?
a. “What do you want us to do to help your symptoms?”
b. “Tell me more about what you think is causing these symptoms.”
c. “I’m sure we can do something to make your symptoms more manageable.”
d. “How much have these symptoms made it more difficult for you to go to work?”

6. Ling has a nursing diagnosis of risk for other-directed violence. Ling’s Eastern culture family is having
difficulty coping with the illness due to their beliefs. A favorable therapeutic modality for this patient might
include:
a. Outpatient therapy
b. Family therapy
c. Long-term inpatient care
d. Assimilation therapy
7. A nurse practitioner is interviewing a female patient from Southeast Asia. She complains of stomach pain
and chest discomfort. Knowing that the patient’s adult son died in a car accident last month, the nurse
suspects:
a. Vulnerability
b. Acid reflux
c. Somatization
d. Transference
8. Which nursing intervention can assist a Hindu patient in maintaining his religious practice?
a. Assisting the patient to choose his own food from the menu
b. Contacting the hospital pastor for a visit
c. Showing him which side of the room faces east
d. Offering a Torah to the patient
9. Intergenerational conflict may arise in immigrant families because the process of acculturation may be:
a. Ignored due to cultural beliefs
b. Filled with traumatic experiences
c. Easier for children
d. A function of assimilation
10. Which nursing actions demonstrate cultural competence? Select all that apply.
 a. Planning mealtime around the patient’s prayer schedule
b. Helping a patient to visit with the hospital chaplain
c. Researching foods that a lacto-ovo-vegetarian patient will eat
d. Providing time for a patient’s spiritual healer to visit
e. Ordering standard meal trays to be delivered three times daily
Answers
1. b; 2. a, b, c, e; 3. a, b, c, d; 4. b; 5. c; 6. b; 7. c; 8. a; 9. c; 10. a, b, c, d

CHAPTER 6
1. Which statement made by the nurse concerning ethics demonstrates the best understanding of the concept?
a. “It isn’t right to deny someone healthcare because they can’t pay for it.”
b. “I never discuss my patient’s refusal of treatment.”
c. “The hospital needs to buy more respirators so we always have one available.”
d. “Not all ICU patients have the right to unbiased attention from the staff.”

2. Which nursing intervention demonstrates the ethical principle of beneficence?

a. Refusing to administer a placebo to a patient.
b. Attending an in-service on the operation of the new IV infusion pumps
c. Providing frequent updates to the family of a patient currently in surgery
d. Respecting the right of the patient to make decisions about whether or not to have
electroconvulsive therapy

3. How can a newly hired nurse best attain information concerning the state’s mental health laws and
statutes?
a. Discuss the issue with the facility’s compliance officer
b. Conduct an internet search using the keywords “mental + health + statutes + (your state)”
c. Consult the American Nurses Association’s (ANA) Code of Ethics for Nurses
d. Review the facility’s latest edition of the policies manual
4. When considering facility admissions for mental healthcare, what characteristic is unique to a voluntary
admission?
a. The patient poses no substantial threat to themselves or to others
b. The patient has the right to seek legal counsel
c. A request in writing is required before admission
d. A mental illness has been previously diagnosed

5. Which situations demonstrate liable behavior on the part of the staff? Select all that apply.
a. Forgetting to obtain consent for electroconvulsive therapy for a cognitively impaired patient
b. Leaving a patient with suicidal thoughts alone in the bathroom to shower
c. Promising to restrain a patient who stole from another patient on the unit
d. Reassuring a patient with paranoia that his antipsychotic medication was not tampered with
e. Placing a patient who has repeatedly threatened to assault staff in seclusion

6. A nurse makes a post on a social media page about his peer taking care of a patient with a crime-related
gunshot wound in the emergency department. He does not use the name of the patient. The nurse:
a. Has not violated confidentiality laws because he did not use the patient’s name.
b. Cannot be held liable for violating confidentiality laws because he was not the primary nurse for
the patient.
c. Has violated confidentiality laws and can be held liable.
d. Cannot be held liable because postings on a social media site are excluded from confidentiality
laws.

7. In providing care for patients of a mental health unit, Li recognizes the importance of standards of care.
When Li notices that some policies fall short of the state licensing laws, which of the following statements
represents the most appropriate standard of care pathway?
a. Professional association, customary care, facility policy
b. State board of nursing, facility policy, customary care
c. Facility policy, professional associations, state board of nursing
d. State board of nursing, professional association, facility policy

8. Lucas has completed his inpatient psychiatric treatment, which was ordered by the court system. Which
statement reveals that Lucas does not understand the concept of conditional release?
 a. “I will continue treatment in an outpatient treatment center.”
b. “My nurse practitioner has recommended group therapy.”
c. “I am finally free, no more therapy.”
d. “Attending therapy and taking my meds are a part of this conditional release.”

9. Implied consent occurs when no verbal or written agreement takes place prior to a caregiver delivering
treatment. Which of the following examples represents implied consent?
a. The mother of an unconscious patient saying okay to surgery
b. Care given to a heroin overdose victim
c. Immobilizing a patient who has refused to take medication
d. Signing general intake paperwork with specific parameters
10. Based on Maslow’s hierarchy of needs, physiological needs for a restrained patient include:
Select all that apply.
a. Private toileting, oral hydration
b. Checking the tightness of the restraints
c. Therapeutic communication
d. Maintaining a patent airway

Answers
1. a; 2. c; 3. b; 4. c; 5. a, b, c; 6. c; 7. d; 8. c; 9. b; 10. a, b, d

CHAPTER 7
1. What is the purpose of the Health Insurance Portability and Accountability Act (HIPAA)? Select all that
apply.
a. Ensuring that an individual’s health information is protected
b. Providing third-party players with access to patient’s medical records
c. Facilitating the movement of a patient’s medical information to the interested parties
d. Guaranteeing that all those in need of healthcare coverage have options to obtain it
e. Allowing healthcare providers to obtain personal health to provide high-quality healthcare.
2. Which intervention demonstrates a nurse’s understanding of the initial action associated with the
assessment of a patient’s spiritual beliefs?
a. Offering to pray with the patient
b. Providing a consult with the facility’s chaplain
c. Asking the patient what role spirituality plays in his or her daily life
d. Arranging for care to be provided with respect to religious practices
3. Which nursing interventions best demonstrate an understanding of the Quality and Safety Education in
Nursing (QSEN) competences? Select all that apply.
a. Asking the patient what he or she expects from the treatment he or she is receiving
b. Seeking recertification for cardiopulmonary resuscitation (CPR)
c. Accessing the internet to monitor social media related to opinions on healthcare
d. Consulting with a dietician to discuss a patient’s cultural food preferences and restrictions
e. Reviewing the literature regarding the best way to monitor the patient for a fluid imbalance
4. Which disadvantage is inherent to the problem-oriented charting system (SOAPIE)?
a. Does not support a universal organizational system
b. Commonly allows for the inclusion of subjective information
c. Documentation is not listed in chronological order
d. Does not support the nursing process as a format
5. Which standardized rating scale will the nurse specifically include in the assessment of a newly admitted
patient diagnosed with major depressive disorder?
a. Mini-Mental State Examination (MMSE)
b. Body Attitude Test
c. Global Assessment of Functioning Scale (GAF)
d. Beck Inventory
6. A 13-year-old boy is undergoing a mental health assessment. The nurse practitioner assures him that his
medical records are protected and private. The nurse recognizes that this promise cannot be kept when the
youth divulges:
a. “I lost my virginity last year.”
b. “I am angry with my parents most of the time.”
c. “I have thoughts of being in love with boys.”
d. “My parents do not know that I hit my grandpa.”
7. During an interview with a non–English-speaking middle-aged woman recently diagnosed with major
depression, the patient’s husband states, “She is happy now and doing very well.” The patient, however, sits
motionless, looking at the floor, and wringing her hands. A professional interpreter would provide better
information due to the fact that a family member in the interpreter role may: Select all that apply.
a. Be too close to accurately capture the meaning of the patient’s mood.
b. Censor the patient’s thoughts or words.
c. Avoid interpretation.
d. Leave out unsavory details.
8. A nurse identified a nursing diagnosis of self-mutilation for a female diagnosed with borderline
personality disorder. The patient has multiple self-inflicted cuts on her forearms and inner thighs. What is the
most important patient outcome for this nursing diagnosis?
a. Identify triggers to self-mutilation
b. Demonstrate a decrease in frequency and intensity of cutting
c. Describe strategies in increase socialization on the unit
d. Describe two strategies to increase self-care

9. Medical records are considered legal documents. Proper documentation needs to reflect patient condition
along with changes. It should also be based on professional standards designated by the state board of
nursing, regulatory agencies, and reimbursement requirements. Proper documentation can be enhanced by:
a. Only using objective data
b. Using the nursing process as a guide
c. Using language the specific patient can understand
d. Avoiding legal jargon
10. Amadi is a 40-year-old African national being treated in a psychiatric outpatient setting due to a court
order. Amadi’s medical record is limited in scope, so where can Renata, his registered nurse, obtain more
data on Amadi’s condition within legal parameters? Select all that apply.
a. Emergency department records
b. Police records related to the offense resulting in the court order for treatment
c. Calling his family in Africa for details about Amadi’s mental health
d. Past medical records in the current facility
Answers
1. a, e; 2.c; 3. a, b, d, e; 4. c; 5. d; 6. d; 7. b; 8. a; 9. b; 10. a, b, d
Chapter 10
1. What assessment question is focused on identifying a long-term consequence of chronic stress on physical
health?
a. “Do you have any problems with sleeping well?”

b. “How many infections have you experienced in the past 6 months?”

c. “How much moderate exercise do you engage in on a regular basis?”

d. “What management techniques to you regularly use to manage your stress?”

2. Which nursing assessments are directed at monitoring a patient’s fight-or-flight response? Select all that
apply.
a. Blood pressure
b. Heart rate
c. Respiratory rate
d. Abdominal pain
e. Dilated pupils

3. The patient you are assigned unexpectedly suffers a cardiac arrest. During this emergency situation, your
body will produce a large amount of:
a. carbon dioxide.
b. growth hormone.
c. epinephrine
d. aldosterone

4. Which question is focused on the assessment of an individual’s personal ability to manage stress? Select
all that apply.
a. “Have you ever been diagnosed with cancer?”

b. “Do you engage in any hobbies now that you have retired?”

c. “Have you been taking your antihypertensive medication as it is prescribed?”

d. “Who can you rely on if you need help after you’re discharged from the hospital?”

e. “What do you do to help manage the demands of parenting a 4-year-old and a newborn?”
5. When considering stress, what is the primary goal of making daily entries into a personal journal?
a. Providing a distraction from the daily stress

b. Expressing emotions to manage stress

c. Identifying stress triggers

d. Focusing on one’s stress

6. Jackson has suffered from migraine headaches all of his life. Fatima, his nurse practitioner, suspects
muscle tension as a trigger for his headaches. Fatima teaches him a technique that promotes relaxation by
using:
a. Biofeedback

b. Guided imagery

c. Deep breathing

d. Progressive muscle relaxation

7. Hugo is 21 and diagnosed with schizophrenia. His history includes significant turmoil as child and
adolescent. Hugo reports his father was abusive and routinely beat him, all of his siblings, and his mother.
Hugo’s early exposure to stress most likely:
a. Made him resilient to stressful situations

b. Increased his future vulnerability to psychiatric disorders

c. Developed strong survival skills

d. Shaped his nurturing nature

8. Hugo has a fraternal twin named Franco who is unaffected by mental illness even though they were raised
in the same dysfunctional household. Franco asks the nurse, “Why Hugo and not me?” The nurse replies:
a. “Your father was probably less abusive to you.”

b. “Hugo likely has a genetic vulnerability.”

c. “You probably ignored the situation.”

d. “Hugo responded to perceived threats by focusing on an internal world.”

9. First responders and emergency department healthcare providers often use dark humor in an effort to:
a. Reduce stress and anxiety
b. Relive the experience
c. Rectify moral distress
d. Alert others to the stress

10. Your 39-year-old patient, Samantha, who was admitted with anxiety, asks you what the stress-relieving
technique of mindfulness is. The best response is:
a. Mindfulness is focusing on an object and repeating a word or phrase while deep breathing

b. Mindfulness is progressively tensing, then relaxing, body muscles

c. Mindfulness is focusing on the here and now, not the past or future, and paying attention to what is
going on around you

d. Mindfulness is a memory system to assist you in short-term memory recall

CHAPTER 18

1. Which patient statement acknowledges the characteristic behavior associated with a diagnosis of pica?
a. “Nothing could make me drink milk.”
b. “I’m ashamed of it, but I eat my hair.”
c. “I haven’t eaten a green vegetable since I was 3 years old.”
d. “I regurgitate and re-chew my food after almost every meal.”

2. When considering an eating disorder, what is a physical criterion for hospital admission?

a. A daytime heart rate of less than 50 beats per minute

b. An oral temperature of 100°F or more
c. 90% of ideal body weight
d. Systolic blood pressure greater than 130 mm Hg

3. When considering the need for monitoring, which intervention should the nurse implement for a patient
with anorexia nervosa? Select all that apply.

a. Provide scheduled portion-controlled meals and snacks.

b. Congratulate patients for weight gain and behaviors that promote weight gain.
 c. Limit time spent in bathroom during periods when not under direct supervision.
d. Promote exercise as a method to increase appetite.
e. Observe patient during and after meals/snacks to ensure that adequate intake is achieved and
maintained.

4. Which intervention will promote independence in a patient being treated for bulimia nervosa?

a. Have the patient monitor daily caloric intake and intake and output of fluids.
b. Encourage the patient to use behavior modification techniques to promote weight gain behaviors.
c. Ask the patient to use a daily log to record feelings and circumstances related to urges to purge.
d. Allow the patient to make limited choices about eating and exercise as weight gain progresses.

5. Which patient statement supports the diagnosis of anorexia nervosa?

a. “I’m terrified of gaining weight.”
b. “I wish I had a good friend to talk to.”
c. “I’ve been told I drink way too much alcohol.”
d. “I don’t get much pleasure out of life anymore.”

6. Obesity can be the end result of a binge-eating disorder. The nurse understands that the best treatment
option in persons with a binge-eating disorder promotes:

a. Bariatric surgery
b. Coping strategies
c. Avoidance of public eating
d. Appetite suppression medications

7. Taylor, a psychiatric registered nurse, orients Regina, a patient with anorexia nervosa, to the room where
she will be assigned during her stay. After getting Regina settled, the nurse informs Regina:

a. “I need to go through the belongings you have brought with you.”

b. “You can use the scale in the back room when you need to.”
c. “You will be eating five times a day here.”
d. “The daily structure is based around your desire to eat.”

8. Safety measures are of concern in eating-disorder treatments. Patients with anorexia nervosa are
supervised closely to monitor: Select all that apply.
a. Foods that are eaten
b. Attempts at self-induced vomiting
c. Relationships with other patients
d. Weight
9. Malika has been overweight all of her life. Now an adult, she has health problems related to her excessive
weight. Seeking weight loss assistance at a primary care facility Malika is surprised when the nurse
practitioner suggests:

a. A trial of SSRI antidepressant therapy

b. Mild exercise to start, increasing in intensity over time
c. Removing snack foods from the home
d. Medication treatment for hypertension

10. Malika agrees to try losing weight according to the nurse practitioner’s outlined plan. Additional teaching
is warranted when Malika states:

a. “I am willing to admit I am depressed.”

b. “Psychotherapy will be a part of my treatment.”

c. “I prefer to have a gastric bypass rather than use this plan.”

d. “My comorbid conditions may improve with weight loss.”

Answers
1. b; 2. a; 3. a, c, e; 4. d; 5. a; 6. b; 7. a; 8. a, b, d; 9. a; 10. c