1 >>Your patient has a diagnosis of major depressive disorder and has been started on sertraline (Zoloft) 50 mg bid. After taking the medications for three days, the patient says, “I don’t think this medicine is working. I don’t want to take it any longer.” What would be your best response? ?
- (A) I’ll let your doctor know and he may order a different medication.
- (B) These medications usually take a few weeks to bring about an improvement to your symptoms.
- (C) The important thing now is getting you more involved in patient activities.
- (D) It is important to eat a more balanced diet to help this medication work.
2 >>Your patient appears withdrawn and depressed. Which of the following would not be an effective intervention? ?
- (A) Develop a trust.
- (B) Show acceptance.
- (C) Be judgmental.
- (D) Be honest.
3 >>The nurse who is assessing a patient with major depression would expect to observe which of the following symptoms? ?
- (A) Euphoria
- (B) Extreme fear
- (C) Extreme sadness
- (D) Positive thinking
4 >>The nursing interventions for a patient with major depression would include all of the following except: ?
- (A) Active listening skills
- (B) Maintaining safe milieu
- (C) Encouraging adequate nutrition
- (D) Reassuring the patient everything will be “just fine”
5 >>Your new patient is taking an MAOI for severe depression. What would you tell the Dietary Department about her upcoming meals? ?
- (A) No caffeine
- (B) No processed lunch meat
- (C) No extra salt
- (D) Gluten-free diet
6 >>Your patient with major depressive disorder isolates herself in her room for the whole day. You find her sitting and staring out the window. What is the best therapeutic response when you walk in the room? ?
- (A) “Come with me. It’s time for group therapy.”
- (B) “I’d like to introduce you to other patients.”
- (C) “What are you thinking about?”
- (D) Make frequent short visits to her room and just sit there.
7 >>Your patient, Mr. A, had a recent myocardial infarction and open heart surgery with an uncomplicated recovery. His wife tells you that Mr. A has changed and is now uncommunicative, sad, and discouraged about the future. How would you respond to Mrs. A? ?
- (A) I’ll let the doctor know.
- (B) This is normal. I would just ignore it for now.
- (C) Tell me more about the changes in his behavior.
- (D) We should get a psychiatric consult.
8 >>Mrs. J has been diagnosed with dysthymic disorder and has been taking paroxetine for 3 years. On arrival in your mental health clinic, she presents very differently than on her last visit. She is cheerful, energetic, and talkative. Previously she had been fatigued and negative. What should you do? ?
- (A) Encourage the patient to no longer take her antidepressant.
- (B) Get more information from the patient about how she is feeling.
- (C) Recommend that she not be seen in the clinic today.
- (D) Talk with the patient’s husband to confirm these behavior changes.
9 >>Which of the following is not true about depression? ?
- (A) It is more common in men than in women.
- (B) It is common after myocardial infarction.
- (C) Grief after a major loss can mimic depression.
- (D) Children and adolescents can suffer from depression.
10 >>Mrs. A is admitted to the medical/surgical unit with a diagnosis of dehydration and pneumonia. She has a history of bipolar disorder and is controlled on lithium. As her nurse, you know you must: ?
- (A) Treat her carefully because she may become catatonic.
- (B) Observe for signs of lithium toxicity from dehydration.
- (C) Alert the other staff of the “psych”patient on the unit.
- (D) Treat the medical illness only.
11 >>Mrs. D has an appointment with the doctor. She began taking lithium one month ago as prescribed. She now states that her mouth and lips are constantly dry and she sometimes feels confused.She says, “I stagger like I’m drunk sometimes when I walk.” You suspect: ?
- (A) She is drinking to combat her depression.
- (B) She is making it up to get different medications.
- (C) She took too much lithium.
- (D) She is dehydrated.
12 >>Marge is a 68-year-old woman with a long history of bipolar disorder I. She is brought to the emergency room by her sister, who reports that Marge has been increasingly agitated, is unable to sleep, and told her daughter that the mayor was calling her for advice on running the city. The behavior is an example of: ?
- (A) Delusions of grandeur
- (B) Delusions of persecution
- (C) Auditory hallucinations
- (D) Schizophrenia
13 >>The physician orders lithium carbonate 600 mg tid for a newly diagnosed bipolar patient. The therapeutic blood level for acute mania is: ?
- (A) 1.0-1.5 mEq/L
- (B) 10-15 mEq/L
- (C) 0.5-1.0 mEq/L
- (D) 5-10 mEq/L
14 >>Which of the following drugs is NOT classified as mood stabilizer? ?
- (A) Carbamazepine
- (B) Olanzapine
- (C) Valproic acid
- (D) Gabapentin
15 >>Your manic patient says, “Everything I do is great.” How should you respond? ?
- (A) “Yes, I am happy for you.”
- (B) “Is there a time in your life when things didn’t go as planned?”
- (C) “No one can be great at everything.”
- (D) “Keep it up.”
16 >>Your manic patient has lost 5 pounds and is underweight. Which meal is most appropriate? ?
- (A) Grilled chicken and baked potato
- (B) Spaghetti and meatballs
- (C) Chili and crackers
- (D) Chicken fingers and French fries
17 >>A newly admitted patient in an acute manic state has a nursing diagnosis of risk for injury related to hyperactivity.Which nursing intervention is most appropriate? ?
- (A) Place the patient in a room with another hyperactive patient.
- (B) Have the patient sit in his room while you review all the rules of the unit.
- (C) Administer antipsychotic medication as ordered prn by the physician.
- (D) Reinforce previously learned coping mechanisms to calm the patient down.
18 >>Which statement is most true about bipolar disorder? ?
- (A) Bipolar disorders all follow the same pattern of behavior.
- (B) Bipolar disorders always include periods of major depression.
- (C) Manic depression is the same as hypomanic disorder.
- (D) Patients with bipolar II have major depression with hypomanic symptoms.
19 >>Which category of medication would not be given to a patient with bipolar disorder? ?
- (A) Stimulant
- (B) Antidepressant
- (C) Antipsychotic
- (D) Anti-anxiety
20 >>What is cyclothymic disorder? ?
- (A) A chronic mood disorder of at least 2 years
- (B) A one-time event of hypomania
- (C) A continuous state of hypomania for 2 years
- (D) A chronic depression for 2 years
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