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NUR2200 - Mental Health > Exam > Flashcards

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1

The following case has 3 multi choice questions to answer .

Trevor aged 15 has been admitted to the adolescent mental health unit after telling his school counselor that he wished he were dead, and had been experiencing suicidal thoughts for many months. He told the admitting nurse that he had been depressed since his father was killed in a car accident a year ago. Adding to his lower mood, is lack of time with his mother due to her need to work 2 jobs to support the family, and his closest friend moving from the town they live in. Trevor states that he has been thinking about suicide for the past 3 weeks and wishes that he could be with his father, feels he is a failure in life and has no hope for the future.



What question would you ask Trevor to determine his level of dynamic risk of suicide?
a. Have you thought about suicide in the past?
b. Have you had a family member that has completed suicide?
c. Have you any current plan on how you may suicide?
d. Have you undertaken any deliberate self harm activity?

Have you any current plan on how you may suicide?

2

Trevor's management plan has indicated that constant observations be commenced due to his high level of risk.

Which of the following statements best describes the term constant observations?

Select one:
a. The process by which 2 or more health workers, work together to provide care to Trevor
b. A multidisciplinary approach to co-ordinating the care of those who are experiencing severe symptoms of mental illness
c. The principal or moral obligation to do harm to himself
d. One to one nursing observation, with the person within the vision of an experienced nurse at all times

One to one nursing observation, with the person within the vision of an experienced nurse at all times

3

When completing a risk assessment and based on Trevor's situation, which of the following would be a significant static risk factor?






Select one:
a. Saying that he is going to kill himself
b. Previous suicidal thoughts
c. Non-adherence to prescribed antidepressants
d. Crying when the staff are communicating with him

Previous suicidal thoughts

4

The following case has 4 questions to answer

Colin has been in hospital several times in the last 6 months with medical concerns. Currently he is admitted surgically for an abscess on his arm. As his primary nurse, you notice that he is experiencing tremors, states he is feeling nauseated, has a headache and is sweating. Physical observations indicate hypertension and tachycardia. When you begin compiling his admission history, he appears uncomfortable with the questions about his drug and alcohol use and is becoming irritated. After some gentle questioning he starts to tell you about his difficulty finding work, the break up of his marriage and his addiction to substances to cope.



Which of the following substances may be resulting in Colin experiencing withdrawal symptoms are evidence by the symptoms documented in his case?

Select one:
a. Cannabis
b. Alcohol
c. Tobacco
d. Heroin

Alcohol

5

Which of the following terms describes Dependence related to illicit substance use?

Select one:
a. Requiring an increased amount of substances to achieve the desired effect
b. Not able to stop the illicit substance even if wanted to
c. A physical or psychological need to use a substance
d. Continue to use a substance despite adverse effects

Continue to use a substance despite adverse effects

6

Illicit substances may be classified according to which of the following?

A. Source of chemical grouping /classifications

B. Legal status

C. Effects they have on the central nervous system

D. Therapeutic purpose

Select one:
a. All of the above
b. None of the above
c. A, B & C
d. B, C & D

All of the above

7

The following case has 3 question to answer.

Lisa is a 35 years old. She has been brought to the hospital after being hit by a car on a pedestrian crossing. It has been established that she has no serious injuries apart from some minor grazes to her legs and arms. Lisa has paranoid delusions and has voiced to you as the primary nurse in ED that she thinks that there are people who want to hurt her and that ED staff are involved in plotting with these people.



Which of the following is a definition of a delusion?

Select one:
a. Early symptom that precedes the manifestation of an acute phase of mental illness
b. A symptom that reflects a decrease in a consumer's normal functioning
c. A perceptual disturbance that occurs without an external stimuli
d. Fixed, false belief that cannot be changed with logical reasoning

: Fixed, false belief that cannot be changed with logical reasoning

8

Addiction of an illicit substance develops when? Which of the following statements is correct .

Select one:
a. Drug use is increased to maintain the euphoric effects or avoid withdrawal
b. Drug use results in the user committing to drug related offences
c. The individual experiencing cravings
d. The individual's drug use causes intoxication

Drug use is increased to maintain the euphoric effects or avoid withdrawal

9

Given that Lisa is suffering from paranoid delusions, which of the following behaviours would be evident with this diagnosis?



A. Suspisciousness

B. Hypervigilence

C. Aggression

D. Irrational mistrust

Select one:
a. A, B & C
b. B,C & D
c. A, C & D
d. All of the above
e. None of the above

All of the above

10

Delusions of grandeur is often experienced by those who have a diagnosis of schizophrenia.

Which following characteristic would indicate that this category of delusion was being experienced by the consumer?

Select one:
a. They have a belief that the all the staff are devils
b. They have a belief that the government is intentionally inserting thoughts into their head
c. They believe that they are God and can control all the events happening in the world
d. They believe that they can receive "special" messages via the TV

: They believe that they are God and can control all the events happening in the world

11

The following case has 5 questions to answer

Penny is a single mother of an 8-year-old daughter. She has suffered with symptoms of anxiety since she was in high school, citing that she worried constantly about how she looked, whether she was liked by other people, or if she was smart enough to pass her year 12 subjects. Her anxiety symptoms often prevented her from leaving the house to attend school.

Persistent anxiety may lead to the development of phobias. Which of the following is the correct definition of a phobia?


Select one:
a. A persistent and irrational fear of a specific object, situation or activity
b. Recurrent attacks of severe anxiety
c. Consciously keeping unacceptable feelings and thoughts out of awareness
d. Inability to recognize the source of anxiety

: A persistent and irrational fear of a specific object, situation or activity

12

From Penny’s collateral information, which would be the most likely phobia that she is experiencing?


Select one:
a. acrophobia
b. Mysophobia
c. Agoraphobia
d. Claustrophobia

Agoraphobia

13

Post-Traumatic Stress Disorder (PTSD) is usually the result of a person being exposed to a significant event/trauma. Which of the following events may lead to PTSD?

Domestic Violence

Assault/rape

Military combat

Natural disasters



Select one:
a. A, B & C
b. B, C & D
c. A, C & D
d. None of the above
e. All of the above

All of the above

14

Anxiolytic medications are often prescribed as an adjunct to therapy for anxiety disorders. Which of the following is NOT a medication within the anxiolytic category of psychopharmacology?


Select one:
a. Diazepam
b. Olanzapine
c. Serepax
d. Xanax

Olanzapine

15

Nursing approaches to assisting those experiencing anxiety, focuses on supportive interventions, therapeutic communication and education. Which of the following would NOT be an appropriate intervention to implement when Penny is experiencing an anxiety attack?


Select one:
a. Remain calm, stay with Penny and use clear concise language
b. Decrease the amount of external stimuli
c. Encourage relaxation techniques
d. Commence cognitive behavioural therapy

Commence cognitive behavioural therapy

16

Following case has 5 multi choice question to answer



Pam is 65 years of age and has been diagnosed as of the age of 34, as having Bipolar Disorder and is currently is a manic phase. Since her admission 2 days ago, she is averaging 2 hours of sleep per night. The rest of night hours she spends pacing the hallways and talking to the staff. She is in constant motion, and brags about how energetic she is. Her clothing consists of a fluorescent pink mini skirt, low cut t-shirt and high heel shoes. Every few hours she is reapplying her make up to match frequent changes of clothing. Pam has voiced that she is a catwalk model and needs to fly to Milan to participate in a fashion shoot.



Which is the correct term to describe Pam’s constant physical motion.


Select one:
a. Tardive dyskinesia
b. Akathisia
c. Motor restlessness
d. Dystonia

Motor restlessness

17

Which of the following symptoms (other than those in the scenario) might you expect to witness or be experience , by Pam , in her manic phase, of Bipolar Disorder?

a. Sexual disinhibition

b. Risk taking

c. Excessive spending

d. Racing thoughts




Select one:
a. A, B & C
b. B, C & D
c. A, C & D
d. All of the above
e. None of the above

All of the above

18

Pam’s statement that is believes that she is a catwalk model and needs to fly to Milan to participate in a fashion shoot is which of the following categories of delusions?




Select one:
a. Erotomanic
b. Somatic
c. Control
d. Grandiose

d. Grandiose

19

Which of the following is the drug of choice that is administered in the treatment of Bipolar Disorder?


Select one:
a. Sertraline
b. Oxazepam
c. Serenace
d. Lithium Carbonate

d. Lithium Carbonate

20

Pam who has been prescribed Lithium Carbonate for the treatment of Bipolar should be educated on which of the following related to her food or fluid intake?

Select one.



Select one:
a. Limit her fluid intake to 1500 mls per day
b. Maintain a fluid intake of approx. 3000mls per day
c. Restrict sodium intake
d. Add additional salt to foods being cooked and eaten

b. Maintain a fluid intake of approx. 3000mls per day

21

The following case has 3 questions to answer

James is a 40 year old male whom his wife had raised concerns with the family GP about his behaviour. She felt that he was depressed with precipitants relating to the farm they were running. Drought had been a major factor with loss of crops and stock placing financial pressure on the family. To cope, James had started drinking heavily, he was generally non-communicable with family members, his mood was low, sleep disturbed, suffered anorexia and appeared not to be taking care of himself. Last night he voiced that he may as well be dead and had a plan.



Electroconvulsive therapy (ECT), is a safe and highly effective treatment for the most severe forms of depression, and which are often treatment resistant. Which of the following is a side effect for this treatment modality?



Select one:
a. Transient memory loss
b. Impaired sexual function
c. Urinary incontinence
d. Transient paralysis

: Transient memory loss

22

James has been prescribed antidepressant medication as a component of his treatment. Which of the following is an antidepressant drug?


Select one:
a. Diazepam
b. Chlorpromazine
c. Olanzapine
d. Citalopram

Citalopram

23

Based on James’ presentation, what do you believe would be the most appropriate form of overall management for him?


Select one:
a. Send him back to his GP to manage
b. Discharge him home to the care of his wife
c. Admission to an acute adult mental health unit
d. Care in the community with case manager input

Admission to an acute adult mental health unit

24

James had indicated that he has sleep pattern disturbance. Sleep hygiene nursing interventions that may assist James can be all of the following EXCEPT…”
Select one:


Select one:
a. Discourage caffeine-based drinks later in the day
b. Encourage James to play computer games prior to settling to bed
c. Encourage relaxation techniques
d. Increase physical activities during the day, but not in the few hours preceding retiring

Encourage James to play computer games prior to settling to bed

25

The following case has 4 questions to answer

Hannah (16) was brought to the emergency department by her mother, concerned at Hannah’s weight loss and lack of interest in food for some months. Her current BMI is 16.7. Weight loss had begun when life stresses had made her feel fairly sad some months before and she had lost her appetite. She had since found that she felt better if she didn’t eat and had avoided doing so even when she felt hungry. Hannah was admitted due to being medically compromised and she voiced to staff that she had too much fat on her thighs and stomach and voiced “I hate how I look”.


Which of the following equations is used to determine the Body Mass Index in relation to a consumer with a suspected eating disorder?


Select one:
a. Weigh divided by height M2
b. Height divided by weight M2
c. Height divided by weight
d. Weight divided by height

Weigh divided by height M2

26

Which of the following is NOT a behavioural activity evident in a consumer with a diagnosis of anorexia nervosa?


Select one:
a. Will cook food for others but not consume the food themselves
b. Solitary eating
c. Calorie counting
d. Eating large amounts of food when not hungry

d. Eating large amounts of food when not hungry

27

In post-menarcheal females , a symptom of anorexia nervosa is amenorrhoea. Which of the following terms describes amenorrhoea?


Select one:
a. Absence of at least 3 consecutive menstrual cycles
b. Absence of at least 1 menstrual cycle
c. Irregular menstrual cycles
d. Menstrual cycle has not commenced

Absence of at least 3 consecutive menstrual cycles

28

Hannah has voiced that she is dissatisfied with her body image. Which of the following interventions is NOT appropriate to incorporate into Hannah’s care plan regarding her body image?



Select one:
a. Identify and discuss with Hannah her personal strengths, goals, interests and talents
b. Psychoeducation related to benefits of a near normal weight
c. Help Hannah keep a food diary and associated feelings related to the food
d. Assist Hannah to view herself in ways not related to her body image

Help Hannah keep a food diary and associated feelings related to the food

29

This case has 3 questions to answer

Eric is an 89-year-old gentleman who has recently been admitted to an aged care facility due to suffering dementia where he was no longer able to care for himself independent at home. Eric’s treating doctor has described that his dementia is a result of numerous small strokes over the last 12 months.

Dementia that results from small strokes is referred to as which type of dementia?



Select one:
a. Alzheimer’s type
b. Lewy Body Dementia
c. Vascular Dementia
d. Korsakoff’s Dementia

c. Vascular Dementia

30

Dementia results in changes in cognitive functioning. In completing a mental state examination, for Eric the term confabulation was written in the cognition section of the Mental State Examination. What does this term refer to?



Select one:
a. Making up of a story to fill in gaps in memory
b. Inability to recall events and feelings
c. Refusal to accept the reality of his situation
d. Inability to recall existing memories

Making up of a story to fill in gaps in memory