Professional Documents
Culture Documents
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. Pete has recently been admitted to the hospital and is being treated for bipolar disorder. When you
go to check in on him, he tells you that he is feeling very drowsy and has been vomiting. He is also
running a fever. You suspect that Pete’s problem is caused by:
A. Anxiety over his new surroundings after being admitted to the hospital for
treatment.
B. Side effects of the lithium therapy he is receiving.
C. A hospital-acquired viral infection.
D. Food poisoning.
____ 2. Your manic patient is being discharged on lithium. Which of the following would NOT be in the
teaching plan?
A. Blood levels must be closely monitored.
B. Continue to take lithium even when your manic symptoms are resolved.
C. Restrict fluids while taking this drug.
D. Contact your doctor if you experience side effects rather than stopping the drug.
____ 4. Nurse Arlene recognizes that the focus of environmental (MILIEU) therapy is to:
A. Control the environment to bring about a positive behavior change.
B. Allow the patient freedom to decide whether they want to participate in activities.
C. Use role-play to meet their personal needs.
D. Use natural medicines rather than drugs to control behavior.
____ 5. During electroconvulsive therapy (ECT), the patient is monitored carefully before and after the
procedure. The nurse assisting with this procedure is aware that monitoring is necessary because the
patient may suffer from:
A. Euphoria.
B. Immediate alertness after the procedure and sleepy later in the day.
C. Urine retention.
D. Seizure activity.
____ 6. Lynn, the LPN/LVN, is providing care for a patient diagnosed with depression. The patient is not
responding to any of the medications ordered. The nurse foresees this patient may be a candidate for:
A. Neuroleptic medication.
B. Short-term seclusion.
C. Psychosurgery.
D. Electroconvulsive therapy.
____ 7. When teaching Mary, who has depression, about foods to avoid while taking phenelzine (Nardil),
which of the following would Audrey LPN include?
A. Peanut butter
B. Fresh fish
C. Salami
D. Soup
____ 8. When developing a care plan for Ms. Smith, who was diagnosed with schizophrenia and is receiving
haloperidol, which of the following medications would Nurse Janet expect to administer if the
patient developed extrapyramidal side effects (EPS)?
A. Olanzapine (Zyprexa)
B. Paroxetine (Paxil)
C. Benztropine mesylate (Cogentin)
D. Lorazepam (Ativan)
____ 9. Nurse Maryse invites a recently discharged patient’s family to attend an outpatient support group.
This type of program would most likely help the family with which of the following issues?
A. Learning from others in the same situations
B. Gaining insight into why they feel guilty
C. Recognizing the client’s weakness
D. Managing the client’s financial concern and problems
____ 10. Linda says that she feels confused and anxious. In addition, Linda feels unorganized and states, “It is
as not bad as it seems.” What phase of crisis is Linda experiencing?
A. Precrisis
B. Impact
C. Adaptive
D. Postcrisis
____ 11. Andrea, the charge nurse, spoke to the director of nursing about one of the staff nurses having a
crisis. The nurse suggested a crisis intervention group to the staff nurse. Crisis intervention groups
are successful because:
A. The crisis intervention worker is a psychologist and understands the presenting
behavior patterns.
B. They supply a workable solution to the patient’s problem.
C. The patient is encouraged to share with others about personal problems.
D. The patient is assisted to develop new insights and return to the precrisis phase.
____ 12. Which of the following best explains why tricyclic antidepressants (TCA) are used cautiously with
the elderly population?
A. Central nervous system effects
B. Cardiovascular system effects
C. Gastrointestinal system effects
D. Serotonin syndrome effects
____ 13. Which of the following drugs indicates the patient is toxic with a serum level of 1.5 mEq/L?
A. Lithium
B. Ritalin
C. Tofranil
D. Buspar
____ 14. The patient taking lithium should understand that the following could affect fluid and sodium levels
and increase the chances of becoming toxic:
A. Muscle weakness.
B. Lithium level of 0.7.
C. Dehydration.
D. Hypertension.
____ 15. A patient being medicated with haloperidol for over 4 weeks has started to display symptoms of
involuntary movements of the mouth that resemble chewing. Of the following extrapyramidal
adverse reactions, the client is showing signs of:
A. Dystonia.
B. Akathisia.
C. Drug-induced Parkinsonism.
D. Tardive dyskinesia.
____ 16. A client comes to the outpatient mental health clinic 2 days after being discharged from the hospital.
The client was given a 1-week supply of clozapine (Clozaril). The nurse reviews information about
clozapine with the client. Which client statement indicates an accurate understanding of the nurse’s
teaching about this medication?
A. “I don’t need to see my doctor for a new prescription when this runs out.”
B. “I need to keep my appointment this week for a blood test to monitor my white
blood cells.”
C. “I can have a martini with this medication.”
D. “I don’t need to come into the clinic for a few months if I don’t have side effects”
____ 17. A patient is admitted to the Mental Illness and Chemical Abuse unit. The patient has been placed on
a 1:1. After reviewing the client’s progress notes, the nurse notes that the admission was voluntary.
The nurse would expect which of the following:
A. The patient will be angry at being forced to be on the unit.
B. The patient was given an informed consent.
C. The patient may not leave the unit without a court order.
D. The patient’s wife has signed the consent form for admission.
____ 18. While doing a 24-hour chart check, the LPN/LVN notes a patient was admitted to a mental health
unit on an involuntary status. The nurse becomes aware that this type of admission could be because
the patient attempted to do the following:
A. Presented harm to self.
B. Scheduled this admission.
C. Signed an informed consent.
D. Looked at several facilities prior to this admission.
____ 20. Counseling is a field that requires licensing. This licensing is providing by:
A. The municipality.
B. The office
C. The state.
D. There are no regulations for counselors.
____ 22. Dr. Albert Ellis, who developed the theory of RET, thought that people teach themselves to be ill.
He used the following terminology:
A. Musturbation and awareness.
B. Awfulizing and musting.
C. Musturbation and awfulizing.
D. Realizing and supersizing.
____ 23. When observing a patient receiving tricyclic antidepressant therapy, ________________would bring
attention to the nurse that the patient was undergoing anticholinergic effects.
A. Urine retention and changes in blood glucose
B. Respiratory depression
C. Delirium
D. Cardiac arrhythmias
Completion
Complete each statement.
25. The drug category _______________ blocks dopamine receptors and is a major treatment for
schizophrenia.
27. The form of therapy that focuses on the cause of the problem, originated from Sigmund Freud, is
_____________________.
28. The category of medication that promotes alertness, diminishes appetite, and combats narcolepsy
and attention deficit hyperactivity disorder is __________________.
29. The act of purging or purification of emotions is known as ____________________.
30. The movie about Patch Adams represents this type of therapy: __________ __________.
31. This type of intervention might be used for states of extreme emotional or physical turmoil in which
the patient feels out of control of self: ______________ _______________.
33. The patient in what type of therapy gains knowledge that there are others with similar problems?
_____________________
34. The category of drugs that treat manic phase of bipolar disorder are called _______________.
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 35. Commonly used typical antipsychotic agents are (select all that apply):
A. Thorazine.
B. Stelazine.
C. Prolixin.
D. Risperdal.
E. Haldol.
____ 36. Which of the following should be included in patient teaching about antidepressants (select all that
apply)?
A. Medications take 1 week to become effective.
B. Encourage patients to continue taking the medication.
C. Not all antidepressant medications have to be tapered gradually.
D. Patients don’t have to be monitored for suicidal ideations.
E. If it is an MAOI antidepressant, the patient should avoid foods containing the
amino acid tyramine.
____ 37. Which of the following may affect African Americans seeking to comply with medical or mental
health treatment (select all that apply)?
A. Usually receive treatment from primary health care provider rather than a mental
health specialist
B. More likely to receive substandard treatment
C. Approximately 20% to 30% of this group do not have health insurance.
D. Tend to be more receptive to taking medications that any other group
____ 38. The following medications are used for treatment in mental health disorders (select all that apply):
A. Antipsychotics.
B. Antibiotics.
C. Antifungals.
D. Stimulants.
E. Mood stabilizers.
____ 39. Which of the following items should be included when providing patient teaching about monoamine
oxidase inhibitor (MAOI) antidepressants (select all that apply):
A. Avoid foods containing the amino acid tyramine.
B. Have blood levels screened weekly for leukopenia.
C. Need sun exposure at least 1 hour a day.
D. Don’t take prescribed or over-the-counter medications without consulting the
physician.
____ 40. Nursing preparations for a client undergoing electroconvulsive therapy (ECT) resemble those used
for general anesthesia (select all that apply):
A. Monitors the patient’s vital signs before and after the procedure.
B. Medicate prior to procedure if ordered.
C. Educate patient and patient’s family.
D. Consent is not required.
E. The patient may be slightly confused after the procedure.
____ 41. Patients who practice Judaism may have concerns about the following (select all that apply):
A. Dietary selection.
B. Having tests scheduled between sundown Friday and sundown Saturday.
C. Tests scheduled between sundown Saturday and sundown Tuesday.
D. Meeting with the shamans.
E. Meeting with the imam.
Other
42. Nursing preparation for a client undergoing electroconvulsive therapy (ECT) resemble those used for
general anesthesia. The nurse should follow these steps for this procedure (place in the order they
will occur):
_____ A. Monitor the patient’s vital signs before the procedure.
_____ B. Medicate as prior to procedure if ordered.
_____ C. Educate patient and patient’s family.
_____ D. Check a signed consent.
_____ E. Monitor the patient’s vital signs after the procedure.
Chapter 8: Mental Health Treatments
Answer Section
MULTIPLE CHOICE
1. ANS: B
These are common early warning signs of toxicity, so further investigation is needed right away.
PTS: 1 REF: Chapter 8: Mental Health Treatments: Lithium Carbonate; page 120-121
KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology |
Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral
therapies: Adverse effects/contraindications/side effects/interactions
2. ANS: C
Dehydration promotes lithium toxicity.
PTS: 1 REF: Chapter 8: Mental Health Treatments: Lithium Carbonate; page 120-121
KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology |
Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral
therapies: Adverse effects/contraindication/side effects/interactions
3. ANS: D
All of these responses are incorrect about lithium.
PTS: 1 REF: Chapter 8: Mental Health Treatments: Lithium Carbonate; page 120
KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology |
Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and parenteral
therapies: Medication administration
4. ANS: A
Environmental (MILIEU) therapies aim to provide safety and a therapeutic environment.
PTS: 1
REF: Chapter 8: Mental Health Treatments; Electroconvulsive Therapy; page 132-133
KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health | Cognitive
Level: Synthesis | Client Need: Physiological Integrity: Reduction of Risk Potential: Therapeutic Procedures
6. ANS: D
Electroconvulsive therapy is an effective treatment for those experiencing severe depression that is
not helped with medication.
PTS: 1
REF: Chapter 8: Mental Health Treatments; Electroconvulsive Therapy; page 132-133
KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Treatment |
Cognitive Level: Comprehension | Client Need: Physiological Integrity: Therapeutic Procedures
7. ANS: C
Foods containing the amino acid tyramine should be avoided. MAOIs block the metabolism of
tyramine, resulting in an increase of norepinephrine. Aged and processed meats are an example. A
hypertensive crisis may occur.
PTS: 1
REF: Chapter 8: Mental Health Treatments; Psychopharmacology-Antidepressants; page 120
KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive
Level: Application | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Adverse
Effects/Contraindications/Side Effects/Interactions
8. ANS: C
Extrapyramidal side effects from haloperidol (Haldol) should be treated with benztropine mesylate
(Cogentin) because of its anticholinergic properties.
PTS: 1
REF: Chapter 8: Mental Health Treatments; Psychopharmacology-Antiparkinson Agents; page 116
KEY: Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Pharmacology |
Cognitive Level: Comprehension | Client Need: Physiological Integrity: Pharmacological and Parenteral
Therapies: Adverse Effects/Contraindications/Side Effects/Interactions
9. ANS: A
In a group treatment modality, the members realize there are others with similar problems.
PTS: 1 REF: Chapter 8: Mental Health Treatments; Crisis Intervention; page 134
KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: crisis |
Cognitive Level: Analysis | Client Need: Psychosocial Integrity: Stress Management
11. ANS: D
A crisis intervention group helps patients determine their stressors. Patients are assisted in
developing new coping techniques or modifying their current coping mechanisms.
PTS: 1 REF: Chapter 8: Mental Health Treatments; Crisis Intervention; page 134-135
KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Crisis | Cognitive Level:
Analysis | Client Need: Psychosocial Integrity: Crisis Intervention
12. ANS: B
The TCAs affect norepinephrine as well as other neurotransmitters and thus have significant
cardiovascular side effects. Therefore, they are used with caution in elderly clients who may have
increased risk factors for cardiac problems because of their age and other medical conditions. The
remaining side effects would apply to any patient taking a TCA and are not particular to an elderly
person.
PTS: 1
REF: Chapter 8: Mental Health Treatments; Psychopharmacology-Tricyclics; page 118
KEY: Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology |
Cognitive Level: Knowledge | Client Need: Physiological Integrity: Adverse Effects/Contraindications/Side
Effects/Interactions
13. ANS: A
When the drug lithium cannot be cleared and excreted by the kidney, toxicity can occur. A 1.5
toxicity lithium level is considered mild.
PTS: 1
REF: Chapter 8: Mental Health Treatments; Psychopharmacology | Chapter 15: Schizophrenia Spectrum and
Other Psychotic Disorders; Box 15-1, Extrapyramidal Side Effects; page 115
KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive
Level: Application | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Adverse
Effects/Contraindications/Side Effects/Interactions
16. ANS: B
Clozapine can cause bone marrow depression; therefore, frequent blood counts are necessary to
monitor the patient’s WBCs. This drug needs to be taken regularly and should not be discontinued
abruptly.
PTS: 1 REF: Chapter 8: Mental Health Treatments; Legal Considerations; page 137-138
KEY: Integrated Processes: Communication and Documentation | Content Area: Legal | Cognitive Level:
Analysis | Client Need: Safe and Effective Care Environment: Management of Care: Client Rights
18. ANS: A
The patient is confined to the facility due to being a harm to himself or herself. The goal is to
maintain patient safety.
PTS: 1 REF: Chapter 8: Mental Health Treatments; Legal Considerations; page 138
KEY: Integrated Processes: Communication and Documentation | Content Area: Mental Health: Legal
Considerations | Cognitive Level: Analysis | Client Need: Safe and Effective Care Environment: Management
of Care: Client Rights
19. ANS: C
A positive response to humor can bring about improvement in outlook and neurochemical changes to
improve mood.
PTS: 1 REF: Chapter 8: Mental Health Treatments; Humor Therapy; page 133-134
KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Therapeutic Communication |
Cognitive Level: Analysis | Client Need: Psychosocial Integrity: Mental Health Concepts
20. ANS: C
Each state has specific requirements for licensing of counselors.
PTS: 1 REF: Chapter 8: Mental Health Treatments; Cognitive Therapies; page 130
KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level:
Comprehension | Client Need: Psychosocial Integrity: Therapeutic Communication
23. ANS: A
Anticholinergic effects include hypotension, lethargy, weight gain, urine retention, blurred vision,
dry mouth, constipation, and changes in blood glucose.
COMPLETION
24. ANS:
milieu
The milieu can have an effect on behavior, thus making it a therapeutic environment.
PTS: 1 REF: Chapter 8: Mental Health Treatments; Crisis Intervention; page 134-135
KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level:
Comprehension | Client Need: Psychosocial Integrity: Crisis Intervention
32. ANS:
voluntary
Voluntary admission means the patient has given informed consent to seek care in the facility. The
informed consent means that the patient has been made aware of his or her behaviors, the
implications of the behaviors, and expectations from the treatment.
PTS: 1 REF: Chapter 8: Mental Health Treatments; Legal Considerations; page 137-138
KEY: Integrated Processes: Teaching/Learning |Content Area: Legal | Cognitive Level: Comprehension |
Client Need: Psychosocial Integrity: Mental Health Concepts/Safe and Effective Care Environment:
Management of Care: Legal Rights and Responsibilities
33. ANS:
group therapy
There are various types of group therapy; some are short-term or they can be long-term. All types of
group therapy emphasize the sharing of feelings and experiences of the group members.
PTS: 1
REF: Chapter 8: Mental Health Treatments; Table 8-3, Summary of Commonly Used Treatment Modalities;
page 139
KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level:
Knowledge | Client Need: Psychosocial Integrity: mental health concepts
34. ANS:
mood stabilizers
Mood stabilizers work biochemically to control manic behavior and include lithium as well as some
anticonvulsants.
MULTIPLE RESPONSE
35. ANS: A, B, C, E
The typical antipsychotic agents treat the positive symptoms of schizophrenia and are generally the
older agents.
PTS: 1
REF: Chapter 8: Mental Health Treatments; Psychopharmacology; Table 15-4, Comparison of Side Effects
Among Typical and Atypical Antipsychotic Agents; page 236
KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive
Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies:
Expected actions/outcomes
36. ANS: B, E
The nursing considerations for all antidepressants are the same. Patients taking antidepressants
should be reminded it takes 2 to 3 weeks to become effective, they should not be discontinued
abruptly, and MAOIs require a special diet.
PTS: 1
REF: Chapter 8: Mental Health Treatments; Psychotherapies; Table 6-1, Concepts that may affect certain
cultural groups seeking or complying with mental health treatment; page 131
KEY: Integrated Processes: Teaching/Learning | Content Area: Cultural Diversity | Cognitive Level:
Analysis | Client Need: Health Promotion and Maintenance: Health and Wellness
38. ANS: A, D, E
These medications control symptoms, helping the patient feel more comfortable emotionally. These
medications are usually used in connection with some other type of therapy.
PTS: 1
REF: Chapter 8: Mental Health Treatments; Psychopharmacology; page 114, 120, and 122
KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive
Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies:
Expected Actions/outcomes
39. ANS: A, D
MAOI antidepressants can precipitate a hypertensive crisis in the presence of tyramine. Caution
should be used with other medication interactions as well.
PTS: 1
REF: Chapter 8: Mental Health Treatments; Electroconvulsive Therapy; Figure 8-4 Electroconvulsive
Therapy; page 132-133
KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level:
Application | Client Need: Physiological Integrity: Reduction of Risk Potential: Potential for complications of
diagnostic tests/treatments/procedures
41. ANS: A, B
These responses reflect practices of Judaism.The Sabbath is from sundown Friday to sundown
Saturday. Kosher diet may be preferred.
PTS: 1 REF: Chapter 8: Mental Health Treatments; Cognitive Therapies; page 130
KEY: Integrated Processes: Caring | Content Area: Cultural Diversity | Cognitive Level: Comprehension |
Client Need: Psychosocial Integrity: Cultural Awareness
OTHER
42. ANS:
A: 3
B: 4
C: 1
D: 2
E: 5
The patient/family should receive information regarding the procedure first. After the patient
teaching has occurred, then the patient will be able to sign the consent. Prior to the procedure, vital
signs are taken and the pre-medication given.
PTS: 1 REF: Chapter 8: Mental Health Treatments; Electroconvulsive Therapy; page 132
KEY: Integrated Processes: Teaching/Learning | Content Area: Mental Health: Treatment | Cognitive Level:
Application | Client Need: Physiological Integrity: Reduction of risk potential: Potential for complications of
diagnostic tests/treatments/procedures