Question set A: eight items on response choice and disorder recognition

Answer without looking back, then tag every distractor you rejected. Untagged distractors do not count as answered.

Item 1 MC A newly admitted patient with major depressive disorder tells the nurse, "My family would be better off without me." Which response is best?

1. "Your family loves you very much and would miss you terribly."
2. "You sound like you are in a great deal of pain. Are you thinking about killing yourself?"
3. "Why do you believe your family feels that way about you?"
4. "Let's talk about that after you have finished your breakfast."

Item 2 MC A patient in an acute manic episode has eaten nothing for ten hours and has not sat down since morning. Which action is the priority?

1. Serve a meal in the dining room with the group at the scheduled time.
2. Offer high-calorie finger foods and fluids the patient can carry while walking.
3. Explain the importance of nutrition and ask the patient to sit for twenty minutes.
4. Document the intake and reassess in four hours.

Item 3 SATA A patient reports hearing a voice telling him to hurt his roommate. Which nurse responses are therapeutic? Select all that apply.

1. "What is the voice telling you to do?"
2. "I do not hear a voice, but I can see this is frightening you."
3. "The voice is not real, so try your best to ignore it."
4. "Are you planning to do what the voice is telling you?"
5. "Tell me what you are feeling right now."
6. "You should turn on the television to drown it out."

Item 4 MC Two days after admission for alcohol withdrawal, a patient develops a temperature of 101.4 degrees Fahrenheit, gross tremor, agitation, and disorientation to place. Which action does the nurse take first?

1. Place the patient in a quiet, dimly lit room and reorient hourly.
2. Notify the provider and prepare to give a benzodiazepine per the withdrawal protocol with continuous monitoring.
3. Apply soft wrist restraints to prevent injury.
4. Give oral thiamine and encourage fluids.

Item 5 MC A patient who was terminated from his job last week tells the nurse, "I was going to quit that place anyway. They did me a favor." Which defense mechanism is the patient using?

1. Denial
2. Rationalization
3. Projection
4. Displacement

Item 6 SATA Which teaching points does the nurse include for a patient starting lithium? Select all that apply.

1. Drink about 2 to 3 quarts of fluid each day unless told otherwise.
2. Keep your salt intake about the same from day to day.
3. Take ibuprofen for headaches while on this medication.
4. Report vomiting, diarrhea, or heavy sweating to your provider.
5. Stop the medication once your mood has been stable for a month.
6. Report coarse hand tremor, unsteady walking, or new confusion right away.

Item 7 MC A patient with borderline personality disorder says to the nurse, "You are the only one here who understands me. The evening nurses are cruel." Which response is best?

1. "Thank you. I will ask to be assigned to you every shift."
2. "That is not true. All the nurses on this unit care about you."
3. "It sounds like you feel understood right now. Every nurse on this team follows the same plan with you."
4. "Why do you feel the evening nurses do not understand you?"

Item 8 DDT Complete the sentence by selecting from the drop-down lists.

A patient reports intense inner restlessness and cannot stop moving his legs. This finding, which began [drop-down 1] after his antipsychotic dose was increased, is most consistent with [drop-down 2].

Drop-down 1: within 3 hours | on day 6 | after 8 months | after 3 years Drop-down 2: acute dystonia | akathisia | tardive dyskinesia | pseudoparkinsonism

Margin notetag the blocker before you look. Tick boxes 1 through 8.

Takeawayan item is not finished when the answer is chosen; it is finished when the wrong options have names.