Psychosocial Integrity

The patient is verbally aggressive with a nurse and threatens physical violence unless he is given an IV dose of hydromorphone (Dilaudid). Which initial action by the nurse is appropriate?

The nurse is sitting with a family whose matriarch died within the last hour. The family is exhibiting which form of grief?

When is palliative care most appropriate?

The 18-year-old woman with anorexia nervosa has just learned she is pregnant. Which nursing intervention is appropriate?

The nurse is discussing palliative care with the patient with metastatic colorectal cancer. The patient responds, "I'm not ready to give up. I want to keep fighting this disease." Which response from the nurse is most appropriate? 

The nurse is providing education to the patient’s spouse regarding the patient’s new diagnosis of Alzheimer’s disease. Which statement indicates the teaching was successful?

The nurse is planning care for the patient with moderate Alzheimer’s disease. Which expected outcomes does the nurse include? Select all that apply.

The home health nurse is evaluating the home life of a patient with mild Alzheimer’s disease. The nurse provides reeducation to the family if which action is observed?

The nurse in the long-term care facility is assessing a new resident who has Parkinson's disease. The nurse usually explains which group activities are available during the intake interview. Which communication technique is most helpful for the nurse to utilize with this resident?

The patient with a history of depression and generalized anxiety disorder presents to the clinic seeking information on advance directives. Which action(s) by the nurse are appropriate? Select all that apply.

The nurse is planning an informational session at the community center to help parents identify when their children are at an increased risk for suicide. The nurse includes information about which activities in the class? Select all that apply.

The community health nurse is teaching an outreach course on how parents can help to prevent suicide attempts in their at-risk children. Which statement by a parent indicates a need for further teaching?

The 17-year-old male patient is brought to the clinic for a yearly check-up. The nurse observes the patient to be unkempt, with greasy hair and significant body odor. The patient has a flat affect during questioning. When the nurse provides education on safety practices such as wearing a seatbelt when in the car, not driving with impaired persons, and using protection during sexual intercourse, the patient retorts, “I don’t really see the point in wearing a seatbelt, if it helps me die more quickly.” Which initial response by the nurse is most appropriate?

The grown child of an elderly woman with dementia is trying to provide his mother with in-home hospice. The caregiver providing in-home hospice for the elderly patient with dementia reports nearly constant verbal and physical abuse at the hands of the patient including degrading talk, biting, and scratching. How does the nurse manage this situation?

The nurse suspects the patient dealing with a longstanding psychiatric trauma is entering Phase 3 of general adaptation syndrome. Which term is used to describe this phase?

The patient with a brain neoplasm reports experiencing visual misperceptions. The nurse suspects the brain tumor is in which lobe of the brain? 

The nurse is assigned to the patient with a brain neoplasm who has been experiencing symptoms of depression. During shift report, the off-going nurse reports observing the patient in a trance-like state. The nurse suspects that the tumor is in which lobe of the brain?

The patient with a brain neoplasm is combative and cursing at the staff. The family reports that this is a drastic change in the patient's personality. The nurse suspects the tumor is in which lobe of the patient's brain?

The elderly patient with moderate Alzheimer’s disease was brought to the emergency department (ED) for rapidly worsening mental status, fever, and anorexia over the last 24 hours. Portable chest x-ray shows a consolidation in the left lower lobe.Which diagnosis is most accurate?

Which motive is associated with fire-setting in individuals with pyromania?

Trichotillomania is associated with which condition?

The nurse questions the diagnosis of bulimia nervosa if which patient characteristic is present?

The patient presents to the emergency department exhibiting stiff, jerky movements of the face and neck. The nurse reviews the patient's medical history for a prescription for which medication? 

After failing to experience symptom relief from other antidepressants, the patient is prescribed a tricyclic antidepressant. The nurse instructs the patient to expect which side effect? 

Intoxication with which drug is most commonly associated with aggressive and violent behavior?

The nurse is admitting a patient with an extensive mental health history. The nurse’s knowledge of which system guides intervention planning?

The nurse is providing education to the patient newly diagnosed with major depressive disorder. The nurse includes information on which derangement of neurotransmitters?

The nurse is conducting a mental health assessment and plans to begin by taking the patient’s health history. Which behavioral clues does the nurse observe upon entering the room? Select all that apply.

The patient presents to the clinic with complaints of feeling down and depressed for a month. The nurse guides questioning to assess for which additional signs required for diagnosis of depression? Select all that apply.

The patient with bipolar disorder exhibits mania with which action?

Which observation does the nurse document as autism in the patient with schizophrenia?

The nurse suspects severe anxiety in the patient who reports which symptoms? Select all that apply.

The partner of a patient with obsessive-compulsive disorder is seeking information. Which information does the nurse provide for compulsions?

The patient is brought to the emergency room by friends after a night of drinking alcohol. The patient is unable to speak clearly, appears to fall asleep while talking, and cannot stand alone. The nurse anticipates which blood alcohol level?

The patient with a long history of alcohol use disorder is admitted to the hospital for observation at risk for alcohol withdrawal syndrome. The nurse anticipates which symptoms to peak 24 to 36 hours after the patient’s last drink? Select all that apply.

The nurse caring for the patient being treated for delirium tremens implements which nursing intervention for the patient?

The nurse is assessing a patient who was reported to have an altered level of consciousness. The patient presents with rapid speech, impaired judgement, and rapidly fluctuating emotional state. After admission and treatment, the patient returns to a functional baseline. Which diagnosis best describes the patient’s behavior?

While completing a patient’s history, the patient states: “I just don’t like the life I am living. I wish it were over.” Which is the most appropriate response from the nurse?

The nurse is conducting a history during a wellness exam. The patient states, “Honestly, I’m really stressed right now. My son is going to college, and my dad is moving in with us. Thankfully, I got a promotion at work so we will be able to move to a place without stairs. I’ve been leaning on my wife and friends a lot and trying to keep exercising and doing yoga.” How does the nurse interpret the patient’s reports?

The nurse is receiving bedside report on a patient experiencing tremors in his hands, profuse diaphoresis, and agitation during attempts to interview or exam him. Which information does the nurse make a priority to collect?

A patient seeing her primary care physician responds “no” to the domestic violence screening question, “Do you feel safe in your home?” Which action does the nurse take next?

Which is the best response by the nurse interviewing a patient who has just stated she feels unsafe in her own home?

The nurse is caring for a patient who was just pronounced dead. The patient’s adult children are with the patient. Which is the best response by the nurse to the family?

The nurse is caring for a patient transitioning to hospice care and completing his admission assessment. Which question will help the nurse most effectively attend to his spiritual needs?

The nurse working in the emergency room is assigned to care for an older Hispanic man seeking care for a hand injury sustained while working outside. The nurse hears the patient speaking in Spanish to the person who accompanied him. Which action does the nurse take next?

A Muslim man becomes ill on a cruise ship and is transported to a hospital in Anchorage, Alaska. While conducting his history, the nurse asks, “Are there any spiritual needs we can help you address?” The man replies that he is Muslim and will pray five times a day and asks, “Which way do I face to pray to Mecca?” Which is the best response by the nurse?

The nurse is creating an ethics training module. Which definition does the nurse use for ethnicity?

The nursing staff is undergoing cultural competence training. Which statement indicates a need for further teaching?

The nurse is conducting a detailed medical history interview. Which communication techniques demonstrate effective therapeutic communication skills? Select all that apply.

The adult child of the patient with dementia who is the patient’s in-home caregiver reports the patient exhibits increased confusion and agitation after 1600 each day. Which statement by the nurse will be most helpful to the caregiver?