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1. The nurse is caring for a patient who exhibits disorganized thinking and delusions. The patient repeatedly states, “I hear voices of aliens trying to contact me.” The nurse should recognize this presentation as which type of major depressive disorder (MDD)?
1. Catatonic
2. Atypical
3. Melancholic
4. Psychotic |
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2. Which patient statement indicates learned helplessness?
1. “I am a horrible person.”
2. “Everyone in the world is just out to get me.”
3. “It's all my fault that my husband left me for another woman.”
4. “I hate myself.” |
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3. The nurse is planning care for a patient with depression who will be discharged to home soon. What aspect of teaching should be the priority on the nurse's discharge plan of care?
1. Pharmacological teaching
2. Safety risk
3. Awareness of symptoms increasing depression
4. The need for interpersonal contact |
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4. The nurse is reviewing orders given for a patient with depression. Which order should the nurse question?
1. A low starting dose of a tricyclic antidepressant
2. An SSRI given initially with an MAOI
3. Electroconvulsive therapy to treat suicidal thoughts
4. Elavil to address the patient's agitation |
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5. A female patient tells the nurse that he would like to begin taking St. John's wort for depression. What teaching should the nurse provide?
1. “St. John's wort should be taken several hours after your other antidepressant.”
2. “St. John's wort has generally been shown to be effective in treating depression.”
3. “This supplement is safe to take if you are pregnant.”
4. “St. John's wort is regulated by the FDA, so you can be assured of its safety.” |
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1. Which behavior exhibited by a patient with mania should the nurse choose to address first?
1. Indiscriminate sexual relations
2. Excessive spending of money
3. Declaration of “being at one with the world”
4. Demonstration of flight of ideas |
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2. The nurse is caring for a patient experiencing mania. Which is the most appropriate nursing intervention?
1. Provide consistency among staff members when working with the patient.
2. Negotiate limits so the patient has a voice in the plan of care.
3. Allow only certain staff members to interact with the patient.
4. Attempt to control the patient's emotions. |
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3. The nurse is planning care for a patient experiencing the acute phase of mania. Which is the priority intervention?
1. Prevent injury.
2. Maintain stable cardiac status.
3. Get the patient to demonstrate thought self-control.
4. Ensure that the patient gets sufficient sleep and rest. |
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4. What critical information should the nurse provide about the use of lithium?
1. “You will still have hypersexual tendencies, so be certain to use protection when engaging in intercourse.”
2. “Lithium will help you to only feel the euphoria of mania but not the anxiety.”
3. “It will take 1 to 2 weeks and maybe longer for this medication to start working fully.”
4. “This medication is a cure for bipolar disorder.” |
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5. The nurse has provided education for a patient in the continuation phase after discharge from the hospital. What indicates that the plan of care has been successful? Select all that apply.
1. Patient identifies three signs and symptoms of relapse.
2. Patient states, “My wife doesn't mind if I still drink a little.”
3. Patient describes the purpose of each medication he has been prescribed.
4. Patient states, “I no longer have a disease.”
5. Patient identifies two ways to problem-solve a specific situation. |
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1. Which assessment statement(s) would be appropriate for a patient who may be suicidal? Select all that apply.
1. Do you ever think about suicide?
2. Are you thinking of hurting yourself?
3. Do you sometimes wish you were dead?
4. Has it ever seemed like life is not worth living?
5. If you were to kill yourself, how would you do it?
6. Does it seem like others might be better off if you were dead? |
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2. Which person is at the highest risk for suicide?
1. A 50-year-old married white male with depression who has a plan to overdose if circumstances at work do not improve.
2. A 45-year-old married white female who recently lost her parents, suffers from bipolar disorder, and attempted suicide once as a teenager.
3. A young, single white male who is alcohol dependent, hopeless, impulsive, has just been rejected by his girlfriend, and has ready access to a gun he has hidden.
4. An older Hispanic male who is Catholic, is living with a debilitating chronic illness, is recently widowed, and states: “I wish that God would take me too.” |
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3. Which intervention(s) maximize the safety of an actively suicidal patient on an inpatient mental health unit? Select all that apply.
1. Place the patient on every-15-minute checks.
2. Place the patient in a room near the nurses’ station.
3. Assign the patient to a private room to facilitate monitoring.
4. Install breakaway curtain rods, coat hooks, and shower rods.
5. Search the patient, his room, and his belongings for dangerous items.
6. Substitute blankets and thicker cloth items for sheets and thinner cloth items.
7. Withhold visitation privileges to prevent the patient from obtaining dangerous items via visitors. |
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4. Which are accurate statements about no-suicide contracts? Select all that apply.
1. Refusal to sign a no-suicide contract suggests higher risk.
2. No-suicide contracts have been shown to reduce the risk of suicide.
3. No-suicide contracts include alternate actions a patient should take if suicidal.
4. Short lengths of stay tend to reduce the effectiveness of no-suicide contracts.
5. Nurses should encourage ambivalent patients to sign a no-suicide contract.
6. Such contracts may inhibit some suicidal behavior but cannot be relied upon for safety. |
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5. Which intervention(s) would be therapeutic for a patient experiencing suicidal ideation? Select all that apply.
1. Focus primarily on developing solutions to the problems that are leading the patient to feel suicidal.
2. Assess the patient thoroughly, and reassess the patient at regular intervals as levels of risk fluctuate.
3. Meet regularly with the patient to provide opportunities for the patient to express and explore feelings.
4. Administer antidepressant, mood-stabilizing, and antianxiety medications cautiously and conservatively because of their potential to increase suicide risk.
5. Help the patient to identify positive self-attributes and question negative self-perceptions that are unrealistic. |
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