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Exam (elaborations)

Psychiatric Mental Health Nursing

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Psychiatric Mental Health Nursing

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  • September 6, 2024
  • 13
  • 2024/2025
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Pollard / Jakubec, Varcarolis's Canadian Psychiatric
Mental Health Nursing 3rd Edition TEST BANK


A 48-year-old Hispanic woman is seen by a psychiatric clinical nurse specialist after
receiving a call by her son. According to the son, since his father's death 7 months
ago, his mother has lost 30 pounds and can't sleep. During her initial visit, the
patient states, 'My husband talks to me in his visits, but his words make no sense to
me. I don't understand what he wants me to do.' What is an appropriate nursing
diagnosis?
A. Ineffective denial
B. Bipolar mood disorder
C. Hyper-religiosity
D. Grieving - ANSWER: D. Grieving
(Rationale: Grieving may be characterized by weight loss, sleep disturbances, and
messages from beyond.)

Your neighbor's husband comes to talk to you. He says his wife has not left the house
in 2 weeks, has a flat mood, and has lost interest in her usual activities. You
recognize these as the primary symptom of
A. Depression
B. Schizophrenia
C. Suicidal ideation
D. Bipolar manic episodes - ANSWER: A. Depression
(Rationale: Depressed mood and anhedonia (loss of interest or pleasure in activities)
are the primary symptoms of major depression.)

Your patient is ready for discharge after a 30-day hospitalization for manic
depression. About 30 minutes before his discharge, his roommates comes to you and
says, "He is talking crazy." When you ask the patient how he is feeling, he states, "I
feel like Superman. I can do anything. I can fly home today and then become a U.S.
Senator." Which type of mania-relation symptoms is this patient exhibiting?
A. Social
B. Cognitive
C. Behavioral
D. Perceptual - ANSWER: B. Cognitive
(Rationale: Cognitive symptoms include inflated self-esteem and grandiosity.)

You need to assess whether a patient hands a mood disorder is ready for discharge.
Which statement would indicate readiness for discharge?
A. "Right now, I can't bathe myself or dress myself, but I feel good about that."
B. "Going home will be fun, but if it isn't fun, I can always make my mother help or
tell her to do so. She better help me."

, C. "I will take my medicines as I should and know to call the number you gave me if I
have bad thoughts."
D. "Taking care of myself is important, but it's okay if I don't want to do anything." -
ANSWER: C. "I will take my medicines as I should and know to call the number you
gave me if I have bad thoughts."
(Rationale: Verbalization of a plan for help and demonstration of care are realistic
discharge criteria.)

An angry patient is in the community room. She picks up a chair and uses it to hit
another patient on the head. When you come into the community room, what
should your first response to the patient holding the chair be?
A. "Are you crazy? Hitting people can hurt them!"
B. "Hitting others is unacceptable. Please put the chair completely down on the
floor."
C. "How would you like it if I hit you over the head with a chair?"
D. "You're in big trouble now. It's probably prison you are looking at!" - ANSWER: B.
"Hitting others is unacceptable. Please put the chair completely down on the floor."
(Rationale: Use words to indicate your lack of acceptance in the patient's behavior in
as non threatening tone or voice.)

A 22-year-old female is admitted to the unit following a suicide attempt. She has a 2-
week history of depression as well as a history of abusing multiple substances and
anorexia nervosa. What is your first nursing priority?
A. Socialization
B. Contracting for eating behavior
C. Safety
D. Administering the Back depression scale - ANSWER: C. Safety
(Rationale: Safety is the major principle underlying psychiatric nursing.)

Gerald was admitted to the psychiatric acute care unit because he stood in the
center of a main two-way street in his underwear and a t-shirt shouting, "I am being
held against my will. I have personal rights." Gerald was diagnosed with bipolar
disorder, manic type. Which of the following interventions will add to everyone's
safety?
A. Having hectic surroundings
B. Have consistent unit routines
C. Minimize staff interventions
D. Medicate the patient only he has private health insurance - ANSWER: B. Having
consistent unit routines
(Rationale: Quiet environments with consistent routines will help calm patients and
add to safety.)

Your patient has just been physically cleaned up after slicing his left arm 8 times. To
show an appropriate evaluative response, which of the following would be your best
statement?
A. "I could care less if you cut yourself. It doesn't hurt me."
B. "If you wouldn't cut yourself, you would have a much happier life."

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