Student is writing words that are suggestive of having thoughts of suicide on her notebook and has dried superficial wounds on her arms. She tells the teacher she has no longer wants to keep living. The teacher is aware too that her uncle died by suicide and her father has depression. In assessing risk for self-harm what would be most concerning?
A. The student’s words that she no longer wants to keep living.
B. Wounds to her arms.
C. Death messages written on the notepad.
D. Mental illness and suicide of significant others.
A. The student’s words that she no longer wants to keep living.
A person presents at emergency with both suicidal ideation and a plan but agrees to a voluntary admission in the hospital’s mental health unit. In the unit, this person continues to express risk for self-harm and decides to leave. The doctor determines that status will need to change to involuntary and places on which form?
A. Form 4
B. Form 3
C. Form 2
D. Form 1
D. Form 1
Form 1 (Application by Physician for Psychiatric Assessment) is a provision under the Ontario Mental Health Act that allows a physician to detain a patient for a psychiatric assessment for up to 72 hours at a Schedule 1 Facility. A Form 42 (Notice to Person) is always given to a patient to notify them that they are under a Form 1.
A nurse is volunteering for a crisis hotline and receives a call from someone who sounds sad, saying they just want to talk. The person explains a close family member died last year and the nurse proceeds with a risk assessment for suicide. Which is NOT a suicide risk factor:
A. cannabis use
B. discussing circumstances of family member who died
C. suicide attempt previously
D. ETOH use to decrease pain
E. Depressive periods
B. discussing circumstances of family member who died
Which two medications does suboxone contain?
A. Naloxone and buprenorphine
B. Buprenorphine and codeine
C. Naloxone and morphine
D. Naloxone and methadone
A. Naloxone and buprenorphine
Which response best clarifies the difference between culture and ethnicity:
A. culture refers to having the same world view, ethnicity refers to race
B. culture refers to sharing the same beliefs and values ethnicity refers to shared history and heritage
C. culture refers to shared likes and dislikes ethnicity refers to norms within a culture
D. culture refers to race ethnicity refers to having the same life goals, whereas
B. culture refers to sharing the same beliefs and values ethnicity refers to shared history and heritage
Which indicator suggests the highest risk of violence?
A. a history of recurrent severe depression
B. admission into an alcohol rehabilitation program
C. delusions of persecution
D. somatic symptoms for which no organic basis is found
C. delusions of persecution
A 26-year-old man was refused opioids for back pain a week before by his doctor because he presented with symptoms of withdrawal – runny nose, pupils dilated, mild tachycardia and fever. Now he is brought into emergency unconscious with mild cyanosis, slow respirations – what is the tx most appropriate?
A. naloxone
B. suboxone
C. glucose
D. methadone
A. naloxone
A man refused to leave his home to go for his vaccine, he says he want the vaccine but never goes out from his home, he explains once he was at the mall at Christmas time and had to run out because he felt like he was going to have a heart attack or die. This happened a few times in public and now he never ventures out from his home. Which illness might this be?
A. OCD
B. Major depression
C. GAD
D. Panic disorder
D. Panic disorder
Donepezil used for Alzheimer’s works by reversibly inhibiting acetylcholinesterase
A. TRUE
B. FALSE
A. TRUE
Cognitive behavioural therapy is a therapeutic modality that has the greatest evidence base.
A. TRUE
B. FALSE
A. TRUE
A person with schizophrenia who has a hx of hallucinations telling him to harm a relative state he does not have a psychiatric illness. Which aspect of capacity is the patient unable to demonstrate?
A. Appreciation of his illness
B. Understanding
C. Decision making
D. Communication choices
A. Appreciation of his illness
Erotomaniac refers to a delusional disorder that is a false belief that an individual is in love with him or her.
A. TRUE
B. FALSE
A. TRUE
Autonomy is the ethical principle that refers to the individual’s right to make his or her own decisions
A. TRUE
B. FALSE
A. TRUE
Hypothalamus dysfunction is likely for a person eating more than 6000 calories and 5 litres of fluid per day.
A. TRUE
B. FALSE
A. TRUE
A person’s psychiatric symptoms are improving on the atypical antipsychotic med olanzapine, but he has gained over 10lbs and now has an elevated cholesterol profile. This is consistent with metabolic syndrome.
A. TRUE
B. FALSE
A. TRUE
Typical antipsychotics are associated with extrapyramidal symptoms including muscle rigidity.
A. TRUE
B. FALSE
A. TRUE
The brand / trade name for Diazepam (generic name) is Valium
A. TRUE
B. FALSE
A. TRUE
Neurofibrillary tangles and senile plaques are classic pathologic features of Alzheimer’s
A. TRUE
B. FALSE
A. TRUE
A questionnaire which collects information about trauma experienced in the first 18 years of life is termed the
A. Montreal Cognitive Assessment
B. Mental Status Exam
C. Adverse Childhood Experiences Questionnaire (ACE score)
D. GAD-7
C. Adverse Childhood Experiences Questionnaire (ACE score)
Matilida is a nurse who looks forwards to her interactions with a patient who reminds her of her mother. This is an example of countertransference.
A. TRUE
B. FALSE
A. TRUE
An occupational therapist focuses on:
A. helps the injured person improve their ability to perform activities of daily living independently following a period of physical impairment
B. treating a client’s injury and working to improve his/her ability to perform movement of the human body
C. transcribing medication onto the medication record
D. massage and ambulation transferring
A. helps the injured person improve their ability to perform activities of daily living independently following a period of physical impairment
Prescribing high doses of atypical antipsychotics to prevent a crisis is considered an important factor in early intervention
A. TRUE
B. FALSE
B. FALSE
Substituting irrational for rational beliefs and eliminating self-defeating behavior is a goal of cognitive-behavioural therapy
A. TRUE
B. FALSE
A. TRUE
Persons diagnosed with BD II experience reoccurring episode of depression with episodic occurrences of hypomania
A. TRUE
B. FALSE
A. TRUE
In order to initiate a culturally humble approach, a nurse organizing a refugee service arranges for an interpreter and a cultural consultant to be available.
A. TRUE
B. FALSE
A. TRUE
Tachycardia, diaphoresis, agitation, pupil dilation, tremors and yawning are indicative of serotonin syndrome.
A. TRUE
B. FALSE
A. TRUE
Community primary prevention may involve such activities as seminars for grief management and stress reduction.
A. TRUE
B. FALSE
A. TRUE
Regular blood tests are need for monitoring lithium carbonate.
A. TRUE
B. FALSE
A. TRUE
Positron emission tomography scan provides information about which parts of your brain are particularly active.
A. TRUE
B. FALSE
A. TRUE
Which statement best describes the DSM-5?
A. It provides descriptions of psychiatric disorders with associated symptoms
B. It is a compendium of treatment modalities.
C. It offers a complete list of nursing diagnoses.
D. It suggests common interventions for mental disorders.
A. It provides descriptions of psychiatric disorders with associated symptoms
Asylum-based training programs began in the late 1800s in Canada. What was the rationale for initiating psychiatric nursing training?
A. There were greater needs for custodial care
B. Changes in treatment approaches meant greater needs for nursing care and assistance
C. The early feminist movement advocated for career training for women and girls
D. The moral treatment era meant that early psychotherapy strategies were desired in asylum settings
B. Changes in treatment approaches meant greater needs for nursing care and assistance
A cognitive therapist would help a patient restructure the thought “I am stupid!” to
A. “What I did was stupid.”
B. “I am not as smart as others.”
C. “Things usually go wrong for me.”
D. “Things like this should not happen to anyone.”
A. “What I did was stupid.”
Treatment of mental illnesses with psychotropic drugs is directed at which of the following?
A. Altering brain neurochemistry
B. Correcting brain anatomical defects
C. Regulating social behaviours
D. Activating the body’s normal response to stress
A. Altering brain neurochemistry
Which imaging technique can provide information about brain function?
A. Computed tomography (CT) scan
B. Positron emission tomography (PET) scan
C. Magnetic resonance imaging (MRI) scan
D. Skull radiograph
B. Positron emission tomography (PET) scan
Which statement regarding patients’ rights after being voluntarily admitted to an acute care psychiatric unit is true?
A. All rights remain intact.
B. All rights are temporarily suspended.
C. The right to refuse treatment is no longer guaranteed.
D. Only rights that do not involve decision making remain intact.
A. All rights remain intact.
The mental status examination aids in the collection of what type of data?
A. Numeric
B. Physical
C. Objective
D. Subjective
A. Numeric
What therapeutic communication technique is the nurse using by asking a newly admitted patient, “Can you tell me what was happening to you that led to your being hospitalized here?”
A. Using a minimal encourager
B. Using an open-ended question
C. Paraphrasing
D. Reflecting
B. Using an open-ended question
A man continues to speak of his wife as though she were still alive, 3 years after her death. This behaviour suggests the use of which of the following defence mechanisms?
A. Altruism
B. Denial
C. Undoing
D. Suppression
B. Denial
An obsession is defined as which of the following?
A. Thinking of an action and immediately taking the action.
B. A recurrent, persistent thought or impulse.
C. An intense irrational fear of an object or situation.
D. A recurrent behaviour performed in the same manner.
B. A recurrent, persistent thought or impulse.
Which of the following is the primary purpose of performing a physical examination before beginning treatment for any anxiety disorder?
A. Protect the nurse legally
B. Establish the nursing diagnosis of priority
C. Obtain information about the patient’s psychosocial background
D. Determine whether the anxiety is primary or secondary in origin
D. Determine whether the anxiety is primary or secondary in origin
Which of the following is an important question to ask during the assessment of a patient diagnosed with a depressive disorder?
A. “How often do you hear voices?”
B. “Have you ever considered suicide?”
C. “How long has your memory been bad?”
D. “Do your thoughts always seem jumbled?”
B. “Have you ever considered suicide?”
Inability to leave one’s home because of avoidance of severe anxiety suggests which of the following anxiety disorders?
A. Panic attacks with agoraphobia
B. Obsessive-compulsive disorder
C. Post-traumatic stress response
D. Generalized anxiety disorder
A. Panic attacks with agoraphobia
A new psychiatric nursing assistant mentions to the nurse, “Depression seems to be a disorder of old people. All the depressed patients on the unit are older than 60 years.” Which of the following replies by the nurse clarifies the prevalence of this disorder?
A. “That is a good observation. Depression does mostly strike people older than 50 years.”
B. “Depression is seen in people of all ages, from childhood to old age.”
C. “Depression is most often seen among the middle adult age group.”
D. “The age of onset for most depressive episodes is given as 18 years.”
B. “Depression is seen in people of all ages, from childhood to old age.”
When the clinician mentions that a patient has anhedonia, what can the nurse expect about the patient?
A. The patient has poor retention of recent events.
B. The patient experienced a weight loss from anorexia.
C. The patient obtains no pleasure from previously enjoyed activities.
D. The patient has difficulty with tasks requiring fine motor skills.
C. The patient obtains no pleasure from previously enjoyed activities.
Dysthymia or persistent depressive disorder cannot be diagnosed unless it has existed for how long?
A. At least 3 months
B. At least 6 months
C. At least 1 year
D. At least 2 years
D. At least 2 years
A person who has numerous hypomanic and dysthymic episodes can be assessed as demonstrating characteristics of which of the following?
A. Bipolar II disorder
B. Bipolar I disorder
C. Cyclothymia
D. Seasonal affective disorder
C. Cyclothymia
Which behaviour would be most characteristic of a patient during a manic episode?
A. Going rapidly from one activity to another
B. Taking frequent rest periods and naps during the day
C. Being unwilling to leave home to see other people
D. Watching others intently and talking little
A. Going rapidly from one activity to another
Which of the following would be assessed as a negative symptom of schizophrenia?
A. Anhedonia
B. Hostility
C. Agitation
D. Hallucinations
A. Anhedonia
Which of the following is a subjective symptom the nurse would expect to note during assessment of a patient with anorexia nervosa?
A. Lanugo
B. Hypotension
C. 25-lb weight loss
D. Fear of gaining weight
D. Fear of gaining weight
Which problem is NOT considered a causative agent in delirium?
A. Elevated blood urea nitrogen levels
B. Infection
C. Anticholinergic drugs
D. Antibiotic therapy
D. Antibiotic therapy
What is the usual progression of Alzheimer’s disease?
A. A single, short episode followed by years of normal function
B. Recurring remissions and exacerbations
C. Progressive deterioration
D. There is no usual progression
C. Progressive deterioration
A patient diagnosed with Alzheimer’s disease looks confused when the phone rings and cannot recall many common household objects by name, such as a pencil or glass. The nurse can document this loss of function as which of the following?
A. Apraxia
B. Agnosia
C. Aphasia
D. Anhedonia
B. Agnosia Correct
The family of a patient diagnosed with Alzheimer’s disease mentions to the nurse that seeing his loss of function has been very difficult. A nursing diagnosis that might be considered for such a family would be which of the following?
A. Ineffective denial
B. Anticipatory grieving
C. Disabled family coping
D. Ineffective family therapeutic regimen management
B. Anticipatory grieving
A syndrome that occurs after stopping the long-term use of a drug is called which of the following?
A. Amnesia
B. Tolerance
C. Enabling
D. Withdrawal
D. Withdrawal
Which of the following is the only class of commonly abused drugs that has a specific antidote?
A. Opiates
B. Hallucinogens
C. Amphetamines
D. Benzodiazepines
A. Opiates
The term tolerance, as it relates to substance abuse, refers to which of the following?
A. The use of a substance beyond acceptable societal norms
B. The additive effects achieved by taking two drugs with similar actions
C. The signs and symptoms that occur when an addictive substance is withheld
D. The need to take larger amounts of a substance to achieve the same effects
D. The need to take larger amounts of a substance to achieve the same effects
Benzodiazepines are useful for treating alcohol withdrawal because they do which of the following?
A. Block cortisol secretion
B. Increase dopamine release
C. Decrease serotonin availability
D. Exert a calming effect
D. Exert a calming effect
Which of the following symptoms would signal opioid withdrawal?
A. Rhinorrhea, chills, fever, and muscle aches
B. Illusions, disorientation, tachycardia, and tremors
C. Fatigue, lethargy, sleepiness, and convulsions
D. Synesthesia, depersonalization, and hallucinations
A. Rhinorrhea, chills, fever, and muscle aches
Which is the greatest protective factor against the risk of suicide?
A. One or more previous suicide attempts
B. A sense of responsibility to family, including spouse and children
C. Fear of dying
D. A cultural belief that suicide is a shameful resolution for a dilemma
B. A sense of responsibility to family, including spouse and children
Which of the following is a useful assessment tool for nurses in rating suicide risk?
A. AIMS scale
B. SAD PERSONS scale
C. CAGE questionnaire
D. Mini-Mental Status Examination
B. SAD PERSONS scale
When working with a patient who may have made a covert reference to suicide, the nurse should do which of the following?
A. Be careful not to mention the idea of suicide
B. Listen carefully to see whether the patient mentions it a second time
C. Ask about the possibility of suicidal thoughts in a covert way
D. Ask the patient directly if he or she is thinking of attempting suicide
D. Ask the patient directly if he or she is thinking of attempting suicide
Which of the following suicide interventions has the greatest impact on a patient’s safety?
A. Educating visitors about potentially dangerous gifts
B. Restricting the patient from potentially dangerous areas of the unit.
C. One-on-one observation by the staff Correct
D. Removal of personal items that might prove harmful
C. One-on-one observation by the staff
Which would be the most appropriate response by the nurse to help a patient who is demonstrating escalating anger?
A. Walk the patient to his room and help him practice stress-reduction techniques, such as deep breathing or muscle relaxation
B. Suggest that the patient spend some time in the gym with a punching bag to relieve his stress
C. Suggest that the patient spend some time pacing rapidly in the hallway until he feels less stressed
D. Sit with the patient in the day room so that he can vent his anger and not isolate himself
A. Walk the patient to his room and help him practice stress-reduction techniques, such as deep breathing or muscle relaxation
Criminal responsibility under Canadian Criminal Code is determined by which factors?
A. If the accused has a mental illness.
B. If the accused is unable to judge the nature of the crime.
C. If the accused has just cause for the crime.
D. If the accused can sustain socially acceptable behaviour for 30 days.
B. If the accused is unable to judge the nature of the crime.
When a patient is encouraged to talk with others who have had similar problems, the nurse is suggesting what type of group?
A. Cognitive-behavioural group
B. Time-limited group
C. Support group
D. Milieu group
C. Support group