Kaplan And Sadock’s Synopsis of Psychiatry 11th Edition by Sadock – Test Bank

Complete Test Bank With Answers

 

Sample Questions Posted Below

Chapter 1: Neural Sciences

 

Test Bank

MULTIPLE CHOICE

1. A patient with depression mentions to the nurse, My mother says depression is a chemical

disorder. What does she mean? The nurses response is based on the theory that depression

primarily involves which of the following neurotransmitters?

1. Cortisol and GABA
2. COMT and glutamate
3. Monamine and glycine
4. Serotonin and norepinephrine

 

2. A patient has experienced a stroke (cerebral vascular accident) that has resulted in damage to

the Broca area. Which evaluation does the nurse conduct to reinforce this diagnosis?

1. Observing the patient pick up a spoon
2. Asking the patient to recite the alphabet
3. Monitoring the patients blood pressure
4. Comparing the patients grip strength in both hands

 

3. The patient diagnosed with schizophrenia asks why psychotropic medications are always

prescribed by the doctor. The nurses answer will be based on information that the therapeutic

action of psychotropic drugs is the result of their effect on:

1. The temporal lobe; especially Wernickes area
2. Dendrites and their ability to transmit electrical impulses
3. The regulation of neurotransmitters especially dopamine
4. The peripheral nervous system sensitivity to the psychotropic medications

 

4. A student nurse mutters that it seems entirely unnecessary to have to struggle with

understanding the anatomy and physiology of the neurologic system. The mentor would base a

response on the understanding that it is:

1. Necessary but generally for psychiatric nurses who focus primarily on

behavioral interventions

1. A complex undertaking that advance practice psychiatric nurses frequently use

in their practice

1. Important primarily for the nursing assessment of patients with brain

traumacaused cognitive symptoms

1. Necessary for planning psychiatric care for all patients especially those

experiencing psychiatric disorders

 

 

5. A patient asks the nurse, My wife has breast cancer. Could it be caused by her chronic

depression? Which response is supported by research data?

1. Too much stress has been proven to cause all kinds of cancer.
2. There have been no research studies done on stress and disease yet.
3. Stress does cause the release of factors that suppress the immune system.
4. There appears to be little connection between stress and diseases of the body

 

6. A patient who has a parietal lobe injury is being evaluated for psychiatric rehabilitation needs.

Of the aspects of functioning listed, which will the nurse identify as a focus of nursing

intervention?

1. Expression of emotion
2. Detecting auditory stimuli
3. Receiving visual images
4. Processing associations

 

7. At admission, the nurse learns that some time ago the patient had an infarct in the right

cerebral cortex. During assessment, the nurse would expect to find that the patient:

1. Demonstrates major deficiencies in speech
2. Is unable to effectively hold a spoon in the left hand
3. Has difficulty explaining how to go about using the telephone

 

8. A patient with chronic schizophrenia had a stroke involving the hippocampus. The patient will

be discharged on low doses of haloperidol. The nurse will need to individualize the patients

medication teaching by:

1. Including the patients caregiver in the education
2. Being careful to stress the importance of taking the medication as prescribed
3. Providing the education at a time when the patient is emotionally calm and

relaxed

1. Encouraging the patient to crush or dissolve the medication to help with

swallowing

 

9. The physician tells the nurse, The medication Im prescribing for the patient enhances the gaminobutyric

acid (GABA) system. Which patient behavior will provide evidence that the

medication therapy is successful?

1. The patient is actively involved in playing cards with other patients.
2. The patient reports that, I dont feel as anxious as I did a couple of days ago.
3. The patient reports that both auditory and visual hallucinations have decreased.
4. The patient says that, I am much happier than before I came to the hospital.

 

10. The patients family asks whether a diagnosis of Parkinsons disease creates an increased risk

for any mental health issues. What question would the nurse ask to assess for such a comorbid

condition?

1. Has your father exhibited any signs of depression?
2. Does your father seem to experience mood swings?
3. Have you noticed your father talking about seeing things you cant see?
4. Is your dad preoccupied with behaviors that he needs to repeat over and over?

 

11. Which explanation for the prescription of donepezil (Aricept) would the nurse provide for a

patient in the early stage of Alzheimers disease?

1. It will increase the metabolism of excess GABA.
2. Excess dopamine will be prevented from attaching to receptor sites.
3. Serotonin deficiency will be managed through a prolonged reuptake period.
4. The acetylcholine deficiency will be managed by inhibiting cholinesterase.

 

12. There remains a stigma attached to psychiatric illnesses. The psychiatric nurse makes the

greatest impact on this sociological problem when:

1. Providing educational programming for patients and the public
2. Arranging for adequate and appropriate social support for the patient
3. Assisting the patient to achieve the maximum level of independent functioning
4. Regularly praising the patient for seeking and complying with appropriate

treatment

 

13. The wife of a patient with paranoid schizophrenia tells the nurse, Ive learned that my

husband has several close relatives with the same disorder. Does this problem run in families?

The response based on recent discoveries in the field of genetics would be:

1. Your children should be monitored closely for the disorder.
2. Research tends to support a familiar tendency to schizophrenia.
3. There is no concrete evidence; it is just as likely a coincidence.
4. Only bipolar disorder has been identified to have a genetic component.

 

14. A patient whose symptoms of mild depression have been managed with antidepressants is

concerned about the affect of accepting a promotion that will require working the night shift.

What will be the basis of the response the nurse gives to address the patients concern?

1. The connection between a new job and possible depression does exist.
2. The medication can be adjusted to manage any increase in depression.
3. The interruption in normal wake-sleep patterns can influence mood disorders.
4. The change in sleep routine can be managed with a healthy sleep hygiene

routine.

 

15. The nurse is discouraged because the patient exhibiting negative symptoms of schizophrenia

has shown no improvement with the planned interventions to reduce the symptoms. The mentors

remark that helps place the problem in perspective is:

1. You arent responsible for the behavior of any other person.
2. Patients can be perverse and cling to symptoms despite our efforts.
3. Negative symptoms have been associated with genetic pathology.
4. It will take several trail and error attempts to get the right combination care.

 

MULTIPLE RESPONSE

1. What assessment data would reinforce the diagnosis of temporal lobe injury in patient who

experienced head trauma? Select all that apply.

1. Inability to balance a checkbook
2. Uncharacteristically aggressive
3. Affect fluctuates dramatically
4. Increased interest in sexual behaviors
5. Difficulty remembering the names of family members

 

2. A patient has begun experiencing dysfunction of the hypothalamus. What nursing

interventions will the nurse include in the patients plan of care? Select all that apply.

1. Reinforcing clear physical boundaries
2. Assisting the patient with completing daily menus
3. Learning about healthy sleep hygiene habits
4. Monitoring and recording temperature every 4 hours
5. Monitoring and recording blood pressure every 4 hours

 

3. The nurse is preparing a patient for a positron emission tomography (PET) scan. Which

instructions will the nurse include? Select all that apply.

1. There will likely be a 30 to 45 minute wait between the injection and the

beginning of the scan.

1. A blindfold and earplugs may be used to help decrease reaction to the

environment during the scan.

1. Make every attempt to lie still during the scan because movement will affect the

imaging produced.

1. No food or fluids are to be ingested for at least 8 full hours before the scan and

none during the scan.

1. Staying awake during the scan is important since the results are altered when the

patient is in any phase of the sleep state.

 

4. A patient with schizophrenia is described as having difficulty with executive functions. What

patient dysfunction can the nurse expect to assess behaviorally? Select all that apply.

1. Invades the personal space of others frequently
2. Consistently fails to bring money when going to buy snacks
3. Cannot remember the names of staff who often provide care
4. Requires repeated reinforcement on how to make a sandwich
5. Frequently speaks of hurting himself or of hurting other patients

 

5. The unit physicians have ordered magnetic resonance imaging (MRI) tests for the following

patients. For which patients would the nurse decline to make test arrangements without further

discussion with the physician? Select all that apply.

1. A patient who is claustrophobic
2. A patient who is breastfeeding
3. A patient who has an allergy to iodine
4. A patient who had a total knee replacement
5. A patient who is taking a neuroleptic medication

 

Chapter 2: Contributions of the Psychosocial Sciences

 

MULTIPLE CHOICE

1. Which understanding is the basis for the nursing actions focused on minimizing mental health

promotion of families with chronically mentally ill members?

1. Family members are at an increased risk for mental illness.
2. The mental health care system is not prepared to deal with family crises.
3. Family members are seldom prepared to cope with a chronically ill individual.
4. The chronically mentally ill receive care best when delivered in a formal setting.

 

2. Which nursing activity shows the nurse actively engaged in the primary prevention of mental

disorders?

1. Providing a patient, whose depression is well managed, with medication on time
2. Making regular follow-up visits to a new mother at risk for post-partum

depression

1. Providing the family of a patient, diagnosed with depression, information on

suicide prevention

1. Assisting a patient who has obsessive compulsive tendencies prepare and

practice for a job interview

 

3. Which intervention reflects attention being focused on the patients intentions regarding his

diagnosis of severe depression?

1. Being placed on suicide precautions
2. Encouraging visits by his family members
3. Receiving a combination of medications to address his emotional needs
4. Being asked to decide where he will attend his prescribed therapy sessions

 

4. When a patients family asks why their chronically mentally ill adult child is being discharged

to a community-based living facility, the nurse responds:

1. It is a way to meet the need for social support.
2. It is too expensive to keep stabilized patients in acute care settings.
3. This type of facility will provide the specialized care that is needed.
4. Being out in the community will help provide hope and purpose for living.

 

5. What is the best explanation to offer when the mother of a chronically ill teenage patient asks,

Under what circumstances would he be considered incompetent?

1. When you can provide the court with enough evidence to show that he is not

able to care for himself safely.

1. It is not likely that someone his age would be determined to be incompetent

regardless of his mental condition.

1. He would have to engage in behavior that would result in harm to himself or to

someone else; like you or his siblings.

1. If the illness becomes so severe that his judgment is impaired to the point where

the decisions he makes are harmful to himself or to others.

 

6. Which psychiatric nursing intervention shows an understanding of integrated care?
7. A chronically abused woman is assessed for anxiety.
8. A manic patient is taken to the gym to use the exercise equipment.
9. The older adult diagnosed with depression is monitored for suicidal ideations.
10. A teenager who refuses to obey the units rules is not allow to play video games.

 

7. What reason does the nurse give the patient for the emphasis and attention being paid to the

recovery phase of their treatment plan?

1. Recovery care, even when intensive, is less expensive than acute psychiatric

care.

1. Effective recovery care is likely to result in fewer relapses and subsequent

hospitalizations.

1. Planning for recovery care is time consuming and involves dealing with many

complicated details.

1. Recovery care is usually done on an outpatient basis and so is generally better

accepted by patients.

 

8. The nurse is attending a neighborhood meeting where a half-way house is being proposed for

the neighborhood when a member of the community states, We dont want the facility; we

especially dont want violent people living near us. The response by the nurse that best addresses

the publics concern is:

1. In truth, most individuals with psychiatric disorder are passive and withdrawn

and pose little threat to those around them.

1. The mentally ill seldom behave in the manner they are portrayed by movies; they

are people just like the rest of us.

1. Patients with psychiatric disorder are so well medicated that they do not display

violent behaviors.

1. The mentally ill deserve a safe, comfortable place to live among people who

truly care for them.

 

9. Which activity shows that a therapeutic alliance has been established between the nurse and

patient?

1. The nurse respects the patients right to privacy when visitors are spending time

with the patient.

1. The patient is eagerly attending all group sessions and working independently on

identifying their personal stressors.

1. The patient is freely describing their feelings related to the physical and

emotional trauma they experienced as a child with the nurse.

1. The nurse dutifully administers the patients medications on time and with

appropriate knowledge of the potential side effects.

 

 

10. Mental health care reform has called for parity between psychiatric and medical diagnoses.

Which is an example of such parity?

1. Depression treatment is not paid for as readily as is treatment for asthma.
2. The mentally ill patient will be protected by law against social stigma.
3. Medical practitioners are trained to be proficient at treating mental disorders.
4. Psychiatric service reimbursement will be equivalent to that of medical services.

 

 

MULTIPLE RESPONSE

1. Which assessment findings suggest to the nurse that this patient has characteristics seen in an

individual who has reached self-actualization? Select all that apply.

1. Reports to have, found peace and security in my religious faith
2. Effectively changed occupations when a chronic vision problem worsened
3. Has consistently earned a six-figure salary as an architect for the last 10 years
4. Has been in a supportive, loving relationship with the same individual for 15

years

1. Provides free literacy tutoring help at the local homeless shelter 3 evenings a

week

 

2. Which nursing activities represent the tertiary level of mental health care? Select all that

apply.

1. Providing a depression screening at a local college
2. Helping a mental-challenged patient learn to make correct change
3. Reporting an incidence of possible elder abuse to the appropriate legal agency
4. Regularly assessing a patients understanding of their prescribed antidepressants
5. Providing a 6-week parenting class to teenage parents through a local high

school

 

3. Which nursing actions indicate an understanding of the priority issues currently facing

psychiatric mental health nursing today? Select all that apply.

1. Working on the facilitys Safe Use of Restraints Policy revision committee
2. Advocating for increased salaries for all levels of psychiatric mental health

nurses

1. Attending a political rally for increased state funding for mental health service

providers

1. Offering an in-service to facility staff regarding the cultural implications of

caring for the Hispanic patient

1. Joining the state nursing committee working on the role and scope of practice of

the advanced practice psychiatric nurse

 

 

Kaplan and Sadock’s Synopsis of Psychiatry 11th Edition,