Psychosocial Integrity

Which question by the student nurse assessing a potentially suicidal patient requires prompt correction by the supervising nurse?

The patient with a history of psychiatric disorders tells the nurse that her neighbor is working with Mr. Dawsom at the World Financial Organization to bring the world under their control, and that she is the only one who knows about it. Which response by the nurse is best?

The patient requiring mechanical ventilation is dying of tuberculosis and is responsive only to tactile and painful stimulation. The family would like to give him holy water to drink in order to have peace in the afterlife. Which response by the nurse is most appropriate?

A patient with a history of schizophrenia states, “I know my doctor is trying to poison me with these medications.” Which statement by the nurse is most appropriate?

The family of a patient who is dying expresses a desire to feed him a traditional fruit and herb paste to ensure that his soul can have peace in the afterlife in accordance with their religious beliefs. The patient is NPO due to the risk of aspiration and is unable to make his wishes known due to decreased cognition. Which action by the nurse is most appropriate?

A patient with a signed Do Not Resuscitate (DNR) order suddenly becomes unresponsive and goes into cardiac arrest. His wife, who is his healthcare power of attorney, starts yelling hysterically, “Do everything you can! Save him! I don’t care that he didn’t want to be resuscitated, he would want to live for me!” Which action by the nurse is best?

Which statement by the patient’s spouse indicates an understanding of the teaching about bipolar disorder?

Which characteristic is considered to be a positive symptom of schizophrenia?

The nurse is caring for a 30-year-old male patient who is diagnosed with bipolar disorder. Which of the following is not a routine component of the patient's plan of care?

The 51-year-old male with major depressive disorder is ordered to receive trazodone 25 mg PO at bedtime. The nurse instructs the patient about which primary indication of trazodone for this patient? 

The patient is being treated for obsessive-compulsive disorder with medication and behavioral therapy. At a follow-up visit, the patient reports near complete resolution of symptoms. The nurse anticipates discussing which treatment plan?  

The patient is admitted with failure to thrive secondary to bulimia nervosa. The nurse anticipates administering which medication? 

The nurse learns in report the patient with schizophrenia has mainly exhibited negative symptoms. The nurse most expects to make which observation? 

Which question does the nurse ask to determine the patient's risk for suicide in the patient with major depressive disorder? 

The nurse is asking a 36-year-old man with schizophrenia to interpret the proverb, “Seize the day”. Which clinical symptom is assessed by the nurse?

Following electroconvulsive therapy, the patient with bipolar disorder tells the nurse he does not remember whether he arrived by bus or car. Which response by the nurse is appropriate? 

The nurse is assessing the patient with major depressive disorder. Which characteristic alerts the nurse that the patient may be planning to commit suicide? 

The 34-year-old G1P1 patient who just delivered a healthy baby via cesarean section four hours ago. The patient sits on the bed watching her newborn lying in the bed but does not touch or hold the baby. Which response by the nurse is most appropriate? 

The patient with delusional disorder tells the nurse that he needs to see the Pope in Rome because he is a messenger of God. Which response by the nurse is most therapeutic?

The nurse prioritizes which intervention in caring for the patient with borderline personality disorder? 

The patient with major depressive disorder who has been off medication for a couple of years has been prescribed fluoxetine (Zoloft) again. The patient states, "I'm concerned about starting this medication again. I'm a taxi driver and it always used to make me so sleepy." Which instruction from the nurse is appropriate?

Following a surgical procedure the patient experiences post-operative pain that is refractory to opioid medication. The patient requests acupuncture as a mode of pain relief in addition to the medications. The nurse advocates for this treatment modality based on which understanding of its action?

The patient has been prescribed lithium for treatment of bipolar disorder. Which instruction does the nurse include in teaching? 

The older adult patient is brought to the emergency department with sudden onset confusion, agitation, and hallucinations. The patient's past medical history is significant for type 2 diabetes managed with glyburide, anxiety managed with lorazepam, and insomnia managed with zolpidem. Upon assessment, the patient's heart rate and rhythm are regular, lungs are clear to auscultation, and bowel sounds are present. Vital signs are normal, with exception of a slightly elevated heart rate. Which is the most likely cause of the patient's symptoms?

The patient who recently lost her young child to acute lymphoblastic leukemia (ALL) tells the nurse that she is having trouble handling the grief and feels like she is to blame for her child’s death. Which response by the nurse is most appropriate? 

The man who lost his wife and child to a drunk driving accident one year ago is receiving care in a behavioral health unit. The patient tells the nurse that he has begun to feel better and feels like he is ready for release. Which statement indicates the patient should remain in the unit?

Which assessment is most consistent with disorganized schizophrenia? 

The patient brought to the emergency department by police was found in the middle of traffic, alternating between grandiose declarations and expressing a desire to commit suicide. On physical assessment, the patient is tachycardic and hypertensive. The nurse suspects which diagnosis will be made?

The unresponsive patient is brought via ambulance to the emergency department.  On physical assessment, the patient has a respiratory rate of 8 breaths per minute and pinpoint pupils. The nurse suspects which cause of the patient's condition?

A confused, minimally arousable patient is brought to the emergency department via ambulance. The patient is hypotensive and bradypneic. Paramedics report finding an empty bottle of diazepam next to the patient. The nurse prepares which therapy?

The patient with a hearing deficit has been stabilized in the emergency department following a spontaneous pneumothorax. Which action does the nurse take first?

A patient with longstanding alcohol abuse problems is admitted for COPD exacerbation. After reaching the floor, the patient becomes disoriented, anxious, tachycardic, diaphoretic, and tremulous. His oxygen saturation is 95% on 2 L supplemental oxygen via nasal cannula. Which intervention is most appropriate for this patient?

The nurse is caring for a patient with major depressive disorder. The nurse recognizes which sign/symptom supports the diagnosis of depression?

The nurse is caring for the preschool-age child in the hospital. Which are developmentally-appropriate comfort measures? Select all that apply.

Which medication is considered to be a first-generation antipsychotic?

The nurse is admitting an 89-year-old man with end stage liver disease. He declines a palliative care consult saying, “I’m not dying today.” Which responses by the nurse are appropriate to counsel the patient? Select all that apply.

The patient wants to quit smoking before starting hormonal birth control. Using motivational interviewing, which statement by the nurse would best elicit change talk from the patient?

The nurse is educating the parents of a patient who experienced a moderate traumatic brain injury. The patient is expected to be discharged to a rehabilitation facility within the next week. Which statement by the parents indicates a need for further teaching?

The nurse is completing discharge education with the parents of a child with congenital heart disease. Which statement by the mother indicates a need for further teaching?

Which patient is at highest risk for skin breakdown?

The extremely low birth weight neonate born at 22 weeks gestation is not expected to live through the night. The family has described to the nurse the importance of their church and Christian faith. Which action by the nurse demonstrates the nurse's ability to recognize and address the family's grief? 

The nurse is caring for a woman wearing a hijab. The woman does not speak English and has come to the emergency department (ED) with fever, vaginal bleeding, and abdominal pains. An interpreter is present for the interaction. Which question is appropriate for the nurse to ask first?

The emergency room nurse is caring for a patient who ambulated into the triage room wearing sunglasses and a scarf. Upon request, the patient removed her sunglasses and scarf, revealing bruising around her neck and eyes in various stages of healing. The patient became hysterical and stated her husband tried to kill her. Which response by the nurse is the most appropriate?

A 23-year-old woman presents to the emergency department (ED) after losing consciousness during class. Her vital signs are: blood pressure 95/68 mm Hg, heart rate 112 bpm, and oxygen saturation 95% on room air. She weighs 78 pounds. She confides in the nurse saying, “I am so scared of being fat. It controls me. I have not eaten in three days.” Which disorder does the nurse suspect in this patient?

In the days following a colon resection and ileostomy creation, which patient action indicates an alteration in body image?

A patient scheduled to undergo a Whipple procedure (pancreaticoduodenectomy) is extremely agitated and apprehensive, though still wants to undergo the procedure. Which interventions does the nurse employ to decrease the patient's anxiety? Select all that apply.

The patient with schizophrenia has refused medication for several days. When the nurse attempts to administer the medication he responds, "I don’t need this. Give it to somebody who has a mental disorder." The nurse suspects which condition?

The single parent of the child with a severe developmental disorder confides in the nurse that caring for the child is becoming impossible to do alone. Which actions by the nurse are most appropriate? Select all that apply. 

Which is a symptom of schizophrenia?

Which describes a psychiatric advance directive?