Kathleen Jackson
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Psychiatric and Mental Health Nursing Textbook Module 1 - Chapter 2,3,9 and 4 Module 2 - Chapter 1,5,25,2 and 23 Module 3 - Chapter 17,19,16,21,18 and 20

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Kathleen Jackson
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2809NRS Mental Health Nursing Practice

2809NRS Mental Health Nursing Practice

Question 1 of 150

1

Preceptorship is a long-term relationship that extends outside the person’s workplace and helps people to grow and develop and achieve their personal potential.

Select one of the following:

  • True
  • False

Explanation

Question 2 of 150

1

One of the most important principles of the therapeutic relationship when the nurse works with a client with a mental disorder is that:

Select one of the following:

  • the nurse should self-disclose.

  • the client is the primary focus of the interaction.

  • the nurse should have an empathetic relationship with the client.

  • the client’s conversation should be recorded.

Explanation

Question 3 of 150

1

A client tells you, the student nurse, that she doesn’t want to talk about her problems to anyone, as she feels that she will be seen as ‘crazy’ and is worried that people will reject her. As the student nurse, you would:

Select one of the following:

  • advise her not to be worried, as that would never happen in this unit.

  • allow the client to continue talking and use your active listening techniques.

  • tell the client she needs to speak to someone more senior than you.

  • ask the client whether she feels anxious and commence relaxation and slow-breathing techniques.

Explanation

Question 4 of 150

1

The primary purpose of reflection for a nurse is to:

Select one of the following:

  • better understand the client’s situation.

  • develop assessment and intervention skills.

  • increase their own understanding and self-awareness.

  • develop self-management and leadership skills.

Explanation

Question 5 of 150

1

The elements of ‘burnout’ syndrome are:

Select one of the following:

  • positive patterns of coping in a stressful situation.

  • feelings of exhaustion and depersonalisation.

  • a catalyst for effecting positive change.

  • an underlying component of stress.

Explanation

Question 6 of 150

1

Whose responsibility is it to maintain professional boundaries?

Select one of the following:

  • The nurse

  • The client

  • The supervisor

  • The employer

Explanation

Question 7 of 150

1

A nurse experiencing ‘burnout’ should keep working, because the feelings will pass. After all, everyone feels exhausted, uninterested and ineffective at work, and so there is no reason to be unduly concerned.

Select one of the following:

  • True
  • False

Explanation

Question 8 of 150

1

To develop self-awareness, a nurse must be willing to be:

Select one of the following:

  • reflective.

  • thorough.

  • uncritical.

  • non-judgemental.

Explanation

Question 9 of 150

1

The main focus of clinical supervision for nursing staff is:

Select one of the following:

  • professional support for the nurse’s clinical work, interactions and interventions.

  • personal problems that interfere with work.

  • collegiality and professional behaviour.

  • developing empathy, acceptance and reflection.

Explanation

Question 10 of 150

1

Central to a therapeutic relationship in mental health nursing is:

Select one of the following:

  • countertransference.

  • diagnostic criteria.

  • interpretation.

  • empathy.

Explanation

Question 11 of 150

1

Reflection is an important part of recovery-informed practice.

Select one of the following:

  • True
  • False

Explanation

Question 12 of 150

1

What is the best description of peer support in mental health? Peer support is described as:

Select one of the following:

  • a set of constructs, hypotheses, principles and propositions about a specific phenomenon.

  • a combination of professional–client interactions within a recovery paradigm.

  • a recovery-oriented approach to mental healthcare that includes community peers.

  • support to peers by people who have also experienced mental health challenges.

Explanation

Question 13 of 150

1

The recovery paradigm focuses on which one of the following factors?

Select one of the following:

  • Participation by health professionals in problem solving.

  • Involving the consumer’s family and significant others.

  • Active participation, choices and the person’s right to self-determine.

  • An intense rehabilitation program designed for the consumer.

Explanation

Question 14 of 150

1

Recovery-informed practice focuses on:

Select one of the following:

  • consumer-directed goals and outcomes.

  • advice from the multidisciplinary team.

  • implementing mental health policy.

  • evidence-based practice.

Explanation

Question 15 of 150

1

Focusing on a person’s strengths has superseded the deficits-based approach to practice. The main aim of working with strengths is to:

Select one of the following:

  • gain an understanding of what a person finds helpful in their illness.

  • value a person’s talents, uniqueness and resilience.

  • protect a person’s autonomy and individuality.

  • share this information with the multidisciplinary team.

Explanation

Question 16 of 150

1

Reflection informs nursing practice by:

Select one of the following:

  • promoting client-awareness and holistic care.

  • self-awareness and a sense of empowerment.

  • using evidence to inform client interactions.

  • promoting self-awareness and critical thinking.

Explanation

Question 17 of 150

1

Psychiatric rehabilitation has shifted to the concept of recovery because of:

Select one of the following:

  • emphasis on the goals of the service and of the staff who work in the service.

  • working more closely with the client’s family and their part in the client’s illness.

  • emphasis on the goals, outcomes and options of the consumer.

  • redirecting rehabilitation towards a community focus.

Explanation

Question 18 of 150

1

The nurses primary role is to:

Select one of the following:

  • adopt distinct professional approaches to treatment.

  • provide a holistic and person-centred approach to care.

  • emphasise the different approaches taken by professional groups.

  • practise within the framework of community mental health.

Explanation

Question 19 of 150

1

The foundation for recovery-informed practice is:

Select one of the following:

  • diagnosis.

  • treatment plan.

  • relationships.

  • management plan.

Explanation

Question 20 of 150

1

The Tidal Model is the right theory on which beginning practitioners should base their nursing practice.

Select one of the following:

  • True
  • False

Explanation

Question 21 of 150

1

The first public hospital was created in Egypt five centuries before the Christian Era.

Select one of the following:

  • True
  • False

Explanation

Question 22 of 150

1

Many formal medical schools were founded in Mediterranean cities in the centuries before the Christian Era.

Select one of the following:

  • True
  • False

Explanation

Question 23 of 150

1

The Sisters of Charity, who combined care of the insane with general nursing, developed from an association formed by St Vincent de Paul in which year?

Select one of the following:

  • 1210

  • 1455

  • 1617

  • 1894

Explanation

Question 24 of 150

1

One belief regarding mental illness that spread with the spread of Christianity is that:

Select one of the following:

  • hallucinations and delusions were the devil’s work.

  • hallucinations and delusions were supernatural beings.

  • there were no such things as hallucinations and delusions.

  • there was no such thing as mental illness.

Explanation

Question 25 of 150

1

The Latin term insana means:

Select one of the following:

  • not of right mind.

  • violent and agitated.

  • withdrawn and listless.

  • loss of respect and position.

Explanation

Question 26 of 150

1

The humoural theory, which underpinned the ancient Greek medical system described in the Hippocratic Corpus, was based on the belief that the body contained within it four humours:

Select one of the following:

  • urine, phlegm, water and bile.

  • yellow, red, brown and black bile.

  • blood, and yellow, black and green bile.

  • blood, phlegm, yellow bile and black bile.

Explanation

Question 27 of 150

1

The first medical writers to have differentiated between madness caused by a physiological problem and divinely caused madness were:

Select one of the following:

  • Egyptian.

  • Babylonian.

  • Roman.

  • Greek.

Explanation

Question 28 of 150

1

The ‘melancholic’ person in the Hippocratic Corpus was believed to have:

Select one of the following:

  • excessive yellow bile in their system.

  • excessive black bile in their system.

  • excessive phlegm in their system.

  • excessive blood in their system.

Explanation

Question 29 of 150

1

H. Fuller Torrey postulated that schizophrenia is the product of:

Select one of the following:

  • increased technological advances occurring in the past century.

  • immunisation in the past century.

  • a genetic mutation occurring in recent centuries.

  • historical events occurring in the past two millennia.

Explanation

Question 30 of 150

1

In the ancient Graeco-Roman world which of these conditions was considered to be a mental disorder requiring treatment?

Select one of the following:

  • Epilepsy

  • Phobia

  • Alcoholism

  • Personality disorder

Explanation

Question 31 of 150

1

Deinstitutionalisation was a process that eventually led to the closure of psychiatric hospitals and a reduced focus on custodial care in favour of care in the community. Underlying deinstitutionalisation is the premise that:

Select one of the following:

  • all consumers need to be looked after by the community.

  • personal autonomy outweighs duty of care.

  • consumers need to be treated in the least restrictive environment.

  • homeless shelters and gaols are to replace psychiatric hospitals.

Explanation

Question 32 of 150

1

The principle of least restrictive alternative implies that:

Select one of the following:

  • the consumer has the right to be placed only in the community.

  • the family’s needs are to be considered first before this principle is applied.

  • treatment can only commence when this principle is enforced.

  • a consumer’s level of autonomy, acceptance and potential for harm have been taken into consideration.

Explanation

Question 33 of 150

1

Enrolled nurses are accountable for their practice within the relevant framework of competencies, but they work under the direction and supervision of registered nurses.

Select one of the following:

  • True
  • False

Explanation

Question 34 of 150

1

Membership of professional and industrial bodies is compulsory in Australian and New Zealand workplaces, because all nurses need to maintain the advantages gained by these bodies and to be responsible as health professionals for the representative bodies that maintain their conditions of employment and advocate on professional issues.

Select one of the following:

  • True
  • False

Explanation

Question 35 of 150

1

Authorities in Australia and New Zealand are charged with maintaining professional standards. Which task(s) do nurse registration and practice regulation authorities not oversee?

Select one of the following:

  • Complaints and disciplinary processes

  • Wages

  • Accreditation of educational institutions and nursing programs

  • Registers of individuals licensed to practise nursing

Explanation

Question 36 of 150

1

Consumers can reveal personal information during conversations and ask that confidentiality be maintained. Which of the following examples is a breach of confidentiality?

Select one of the following:

  • Posting the information on Facebook

  • Not disclosing to friends

  • Not discussing with another consumer

  • Discussing with another nurse

Explanation

Question 37 of 150

1

Standards of practice in mental health nursing predominantly:

Select one of the following:

  • involve the department of health in individual states and countries.

  • describe the expected performance of nurses providing mental healthcare.

  • document rules of practice among mental health nurses in all states and countries.

  • recognise individual differences in each nurse’s workplace.

Explanation

Question 38 of 150

1

Mental health nurses in Australia and New Zealand follow the ethical principles of autonomy, justice, beneficence and non-maleficence.

Select one of the following:

  • True
  • False

Explanation

Question 39 of 150

1

Power should not be abused in therapeutic relationships. Which of the following form the basis for ethical practice in interpersonal therapy?

Select one of the following:

  • Protecting the consumer from exploitation.

  • Upholding consumer rights.

  • Fostering growth and wellness.

  • All the answers are correct.

Explanation

Question 40 of 150

1

In emergency situations, the essence of the principle of ‘duty of care’ for the nurse is to:

Select one of the following:

  • balance the necessity for emergency treatment against the consumer’s right to autonomy.

  • ensure that there is a reasonable duty by the nurse to organise care that is not injurious to the nurse.

  • admit a consumer who has been injured by loss of care by another consumer or a nurse.

  • avoid a consumer because the duty of care has been enacted by another nurse.

Explanation

Question 41 of 150

1

The first step in the progression towards culturally safe practice that involves understanding that there is a difference is referred to as:

Select one of the following:

  • cultural sensitivity.

  • cultural safety.

  • cultural awareness.

  • cultural competence.

Explanation

Question 42 of 150

1

Culturally safe nurses:

Select one of the following:

  • treat everyone in exactly the same way.

  • learn about themselves and their own culture, examining their own attitudes and values.

  • standardise care by creating stereotypes and generalisations.

  • share the client’s cultural practices.

Explanation

Question 43 of 150

1

Which of the following factors promote a person’s wellbeing?

Select one of the following:

  • Being healthy

  • Personal relationships

  • A sense of achievement and purpose

  • All answers are correct

Explanation

Question 44 of 150

1

Anxiety and affective disorders have a higher incidence in:

Select one of the following:

  • boys.

  • women.

  • men.

  • girls.

Explanation

Question 45 of 150

1

Some commonly held misconceptions about mental health consumers are:

Select one of the following:

  • all people with mental health problems are unpredictable, violent and dangerous.

  • people who are mentally ill have an intellectual disability or brain damage.

  • people with a mental health problem will never recover.

  • All answers are correct.

Explanation

Question 46 of 150

1

Cultural safety is the practice of:

Select one of the following:

  • describing the practices of diverse ethnic groups.

  • learning about the diverse cultural practices of consumers and clients.

  • the nurse being aware of his or her own cultural bias.

  • describing how one can be safe when using different cultural beliefs.

Explanation

Question 47 of 150

1

Culture may be defined as learned behaviours, passed on by role modelling, learning and tradition, and used by the individual to interpret experience and to generate social behaviour.

Select one of the following:

  • True
  • False

Explanation

Question 48 of 150

1

People with comorbid conditions are:

Select one of the following:

  • more vulnerable to alcohol and drug relapses.

  • more vulnerable to relapse of mental health problems

  • greater users of health services.

  • All answers are correct.

Explanation

Question 49 of 150

1

Which of the following constitutes a misconception about mental health?

Select one of the following:

  • People with a mental illness will never recover.

  • The media can have a negative impact on the image of mental illness.

  • More contact with people with a mental illness can lessen stigma.

  • The media can be used as a tool to educate and change public opinion.

Explanation

Question 50 of 150

1

Ethnically diverse service users are those who are indigenous or who are refugees.

Select one of the following:

  • True
  • False

Explanation

Question 51 of 150

1

The therapeutic milieu refers to environments where the emphasis is:

Select one of the following:

  • a holistic approach to client needs.

  • inpatient safety.

  • integrated healthcare.

  • community health.

Explanation

Question 52 of 150

1

In all settings the client is supported as a person in interactions with others, rather than as someone suffering from a health problem or disability.

Select one of the following:

  • True
  • False

Explanation

Question 53 of 150

1

The French physician Philippe Pinel (1745–1826) believed that the cure for mental illness was:

Select one of the following:

  • arrest and confinement.

  • confinement outside the community.

  • moral treatment.

  • use of chains.

Explanation

Question 54 of 150

1

The goal of involvement in the therapeutic community is to:

Select one of the following:

  • encourage clients to be actively engaged in their treatment.

  • assess individual health and wellbeing rather than relationships.

  • work out problems within the therapeutic community.

  • work more effectively in the therapeutic community.

Explanation

Question 55 of 150

1

Components of the therapeutic milieu are:

Select one of the following:

  • containment and structure.

  • support and involvement.

  • validation and symptom management.

  • All the answers are correct.

Explanation

Question 56 of 150

1

The Englishman and Quaker tea merchant William Tuke (1732–1822) followed the contemporary trends in the treatment of the mentally ill when he employed blood-letting, purges, chains and denial of the basic necessities of life to treat mental illness at the York Retreat.

Select one of the following:

  • True
  • False

Explanation

Question 57 of 150

1

An underlying principle of validation in a therapeutic milieu for the client involves:

Select one of the following:

  • information being available for medication compliance.

  • accessibility of treatment programs such as group work.

  • encouraging open discussion of values, feelings and goals.

  • openness with family members concerning treatment options.

Explanation

Question 58 of 150

1

What is the overarching strategy that staff can use to empower clients?

Select one of the following:

  • Commitment to supporting clients/families

  • Commitment to spending time with clients

  • Telling them what they should do

  • Providing support to find solutions to problems

Explanation

Question 59 of 150

1

One of the main purposes of the multidisciplinary team is to:

Select one of the following:

  • ensure comprehensive coordinated care by a range of health professionals.

  • provide an opportunity for communication.

  • establish routine work delegation among team members.

  • establish rules and regulations for team membership.

Explanation

Question 60 of 150

1

The principles of caring in the community are:

Select one of the following:

  • open communication, democratisation, reality confrontation, permissiveness and the multidisciplinary team.

  • collaboration, recovery and goal setting, and working with clients’ strengths.

  • containment, structure, support, involvement, validation and symptom management.

  • development of the client as a person in interaction with others.

Explanation

Question 61 of 150

1

Electroconvulsive therapy involves the application of two metal electrodes to the head, through which an electric current is delivered.

Select one of the following:

  • True
  • False

Explanation

Question 62 of 150

1

A person classified with a borderline personality disorder might be most effectively helped by which of the following interventions?

Select one of the following:

  • Electroconvulsive therapy

  • Psychopharmacology

  • Psychotherapy

  • Dialectical behaviour therapy

Explanation

Question 63 of 150

1

Motivational interviewing (MI) was initially an intervention developed for working with which type of clients?

Select one of the following:

  • People with mood disorders

  • People with perceptual disorders and problems

  • People with substance abuse and dependence problems

  • People with depressive and suicidal problems

Explanation

Question 64 of 150

1

The underlying principle of family therapy is based on the fundamental premise that:

Select one of the following:

  • the family is a unit that needs to be opened up to scrutiny.

  • when a person has a problem, it usually involves the whole family.

  • when a family has a problem, there is usually one person to blame.

  • the multidisciplinary team needs to use family therapy.

Explanation

Question 65 of 150

1

One of the main concerns regarding the use of electroconvulsive therapy (ECT) as an intervention is that:

Select one of the following:

  • people prefer medication to ECT.

  • it remains controversial.

  • people have family options to consider.

  • people are not certain of how ECT is seen by the media.

Explanation

Question 66 of 150

1

Social skills training helps people to:

Select one of the following:

  • relearn skills.

  • manage psychodynamic groups.

  • understand psychoeducation.

  • role-play.

Explanation

Question 67 of 150

1

When a family is deemed to have high levels of expressed emotion (EE), which of the following is the appropriate intervention?

Select one of the following:

  • Psychotherapy

  • Psychopharmacology

  • Psychoeducation

  • Psychogenesis

Explanation

Question 68 of 150

1

The nurse is counselling a client with schizophrenia and their family about the effects of the illness and exploring the ways in which they can prevent relapse. The nurse is using a counselling approach known as:

Select one of the following:

  • conflict management.

  • psychoeducation.

  • bibliotherapy.

  • token economy.

Explanation

Question 69 of 150

1

Routine case management usually involves a ratio of around 50–60 clients per case manager.

Select one of the following:

  • True
  • False

Explanation

Question 70 of 150

1

When beginning a group counselling session using the open group system, the nurse/therapist should explain to the group members that one advantage of an open group system is that:

Select one of the following:

  • it can offer the best treatment outcomes.

  • the topics for the group can be controlled.

  • relationships are more easily established in the group.

  • new members can join the group at any time.

Explanation

Question 71 of 150

1

Which type of medication can affect both the ‘positive’ and the ‘negative’ symptoms of schizophrenia?

Select one of the following:

  • Atypical antipsychotic

  • Traditional antipsychotic

  • Antiparkinsonian

  • Antidepressant

Explanation

Question 72 of 150

1

Benzodiazepines are a commonly prescribed anti-anxiety drug. They reduce anxiety by facilitating the:

Select one of the following:

  • action of the neurotransmitter GABA.

  • elevation of CNS depressants.

  • anticonvulsant potentiation.

  • inhibition of CNS.

Explanation

Question 73 of 150

1

The nurse is caring for a client who is receiving lithium carbonate therapy. It is important for the nurse to educate the client on:

Select one of the following:

  • side effects and signs of toxicity.

  • respiratory pattern disturbances.

  • mobility pattern disturbances.

  • muscle tone.

Explanation

Question 74 of 150

1

The biological action of a drug depends on how its structure interacts with a specific:

Select one of the following:

  • organ.

  • enzyme.

  • ion.

  • receptor.

Explanation

Question 75 of 150

1

Tardive dyskinesia results in the client developing a rigid, mask-like facial expression, shuffling gait and drooling.

Select one of the following:

  • True
  • False

Explanation

Question 76 of 150

1

The term ‘non-compliance’ was used to indicate that a prescribed medication regimen was not being followed by the client, but the accepted terminology has been changed to ‘non-adherence’.

Select one of the following:

  • True
  • False

Explanation

Question 77 of 150

1

In the past, the traditional antipsychotics, particularly haloperidol, have been prescribed as prn medication for acute agitation and disturbed behaviour. New evidence suggests that:

Select one of the following:

  • mood stabilisers are now more effective than traditional antipsychotics as prn medication.

  • SSRIs can be just as effective as traditional antipsychotic prn medication.

  • antiparkinsonian drugs are more effective than traditional antipsychotics as prn medication.

  • benzodiazepines are just as effective as traditional antipsychotics as prn medication.

Explanation

Question 78 of 150

1

Selective serotonin reuptake inhibitors (SSRIs) belong to which group of psychotropic drugs?

Select one of the following:

  • Antipsychotics

  • Mood stabilisers

  • Anxiolytics

  • Antidepressants

Explanation

Question 79 of 150

1

One side effect of traditional or typical antipsychotic medication is an adverse anticholinergic effect such as:

Select one of the following:

  • dry mouth.

  • hypertension.

  • dizziness.

  • tremors.

Explanation

Question 80 of 150

1

Non-adherence to the prescribed medication regimen may result in:

Select one of the following:

  • recurring side effects for a client.

  • hospital readmission for a client.

  • family interaction with a client.

  • multidisciplinary interaction with a client.

Explanation

Question 81 of 150

1

If the nurse feels unsure about the best course of action following an interview, they should do which of the following?

Select one of the following:

  • Summarise the discussion and further validate the consumer’s concerns

  • Provide opportunity to further discuss important issues

  • Discuss their concerns with the consumer’s family

  • Openly discuss this with a co-interviewer and include the consumer in that discussion

Explanation

Question 82 of 150

1

A patient’s affect describes:

Select one of the following:

  • an internal feeling or emotion.

  • a delusional feeling or thought.

  • an observable expressed emotion.

  • language disturbance.

Explanation

Question 83 of 150

1

Prior to the interview commencing the nurse will have some indication of the consumer’s level of distress and willingness to participate in the interview. To ensure safety the nurse should take all of the follow actions during the course of the interview except:

Select one of the following:

  • ensuring a second clinician is present.

  • continuously assessing the consumer’s mental state.

  • abandoning the interview if the consumer becomes too distressed.

  • continuing the interview if feeling threatened.

Explanation

Question 84 of 150

1

An assessment of strengths and resources for a consumer would include which of the following?

Select one of the following:

  • Realistic expectations

  • Support systems

  • Financial insight

  • Dietary factors

Explanation

Question 85 of 150

1

Which of the following may contribute to the consumer feeling vulnerable during an interview?

Select one of the following:

  • Gender

  • Ethnicity

  • Age difference

  • All answers are correct

Explanation

Question 86 of 150

1

Standardised assessment instruments are used to assess cognitive function and include all of the following except:

Select one of the following:

  • MMSE (Mini-Mental State Examination).

  • ACE-R (Addenbrooke’s Cognitive Examination—Revised).

  • GDS (Geriatric Depression Scale short form).

  • CAM (Confusion Assessment Method) .

Explanation

Question 87 of 150

1

The mental health nurse who is interviewing a client for the first time should begin the client’s assessment with:

Select one of the following:

  • delineating common goals.

  • open-ended questions.

  • closed questions.

  • observation of the client’s behaviour.

Explanation

Question 88 of 150

1

The ICD-10 is a comprehensive manual of all known diseases, with its fifth chapter being devoted to mental and behavioural disorders, while the DSM-5 exclusively catalogues mental illnesses.

Select one of the following:

  • True
  • False

Explanation

Question 89 of 150

1

There is no set format for recording a mental state assessment, but the BATOMI mnemonic is a useful for guiding assessment and includes all of the following except:

Select one of the following:

  • behaviour and appearance.

  • attitude and temperament.

  • affect and mood.

  • cognition and sensorium.

Explanation

Question 90 of 150

1

Standardised assessment instruments cannot assist in the actual process of assessment and in evaluating changes in consumers’ clinical presentation.

Select one of the following:

  • True
  • False

Explanation

Question 91 of 150

1

In Western industrialised countries and urban communities, people with schizophrenia tend to be:

Select one of the following:

  • socially disadvantaged.

  • lower middle class.

  • middle class.

  • upper class.

Explanation

Question 92 of 150

1

Delusional thinking may be described by which of the following definitions?

Select one of the following:

  • Retreat into an inner fantasy world, socially isolating or withdrawing oneself and losing contact with reality

  • False, fixed belief that is inconsistent with one’s social, cultural and religious beliefs and cannot logically be reasoned with

  • Severe and debilitating illness with disorganised motor behaviour and the inability to relate to external stimuli

  • False, fixed perception that one can see, hear, smell, touch or taste external stimuli, but is losing contact with reality

Explanation

Question 93 of 150

1

One effective nursing management strategy for auditory hallucinations is to:

Select one of the following:

  • touch the client on the shoulder to ‘reality base’ them.

  • place medication in the client’s food to calm them.

  • discuss the client’s care with their family for suggestions.

  • identify with the person activities that appear to stimulate hallucinations and devise ways of coping.

Explanation

Question 94 of 150

1

A client who has schizophrenia is preparing to be discharged from the hospital. The nurse should instruct the client and family members that relapse is most likely to occur if the client:

Select one of the following:

  • loses their job.

  • stops taking the prescribed medications.

  • develops an infection.

  • loses a favourite possession.

Explanation

Question 95 of 150

1

A client is experiencing a hallucination that includes ‘being watched by the FBI via cameras attached to the overhead lighting’. The most appropriate response for the nurse to make is:

Select one of the following:

  • ‘I’m sure many people have felt the same way you do.’

  • ‘It must be frightening to feel as if you are being watched.’

  • ‘There are staff members here who believe we are being watched.’

  • ‘You know that this is not true. Why do you believe you are being watched?’

Explanation

Question 96 of 150

1

A client who continually says that ‘men are after me’ and ‘the water is poisoned’ but whose speech is clear and who has a normal affect is most likely to have a diagnosis of the schizophrenia subtype termed:

Select one of the following:

  • undifferentiated type.

  • paranoid type.

  • disorganised type.

  • catatonic type.

Explanation

Question 97 of 150

1

Individuals are far more likely to show symptoms of schizophrenia if one or more parents have the disorder, an identical twin has the disorder, or a fraternal twin or non-twin sibling has the disorder.

Select one of the following:

  • True
  • False

Explanation

Question 98 of 150

1

Atypical antipsychotics target unusual or ‘atypical’ symptoms of schizophrenia, such as depression and anxiety.

Select one of the following:

  • True
  • False

Explanation

Question 99 of 150

1

An acute dystonic reaction that is a side effect of some typical antipsychotic medications is:

Select one of the following:

  • uncontrollable coarse tremor.

  • restless leg syndrome.

  • salivary drooling.

  • oculogyric crisis.

Explanation

Question 100 of 150

1

Bleuler’s ‘four As’ for identification of symptoms of schizophrenia consisted of:

Select one of the following:

  • attrition, association disturbance, autism and association looseness.

  • autism, ambivalence, affective disturbance and associative looseness.

  • ambiguousness, affective disturbance, autism and association looseness.

  • autism, affective disturbance, attrition and associative looseness.

Explanation

Question 101 of 150

1

Women are 40% more likely than men to be diagnosed with a mood or anxiety disorder. (Ministry of Health 2014 New Zealand Health Survey: annual update of key results 2013/2014. Ministry of Health, Wellington)

Select one of the following:

  • True
  • False

Explanation

Question 102 of 150

1

Methods that the nurse can employ to deal with the depressed client’s distressing negative thoughts and anger include:

Select one of the following:

  • limit setting.

  • group work.

  • focusing on their strengths.

  • behaviour modification.

Explanation

Question 103 of 150

1

A major depressive disorder is a condition wherein the client experiences significant distress and either a depressed mood or the loss of interest or pleasure in nearly all activities, for at least:

Select one of the following:

  • 1 Week.

  • 2 Weeks.

  • 1 Month.

  • 2 Months.

Explanation

Question 104 of 150

1

Mania is characterised by three main features: persistently elevated mood (elation or irritability), plus increased activity and:

Select one of the following:

  • poor judgement.

  • one depressive episode.

  • substance misuse.

  • physical exhaustion.

Explanation

Question 105 of 150

1

The depressed person can undergo many changes in behaviour, cognition, communication and physical functioning. The observable behaviours associated with changes in a person’s mood, such as crying and looking dejected, are called:

Select one of the following:

  • ruminations.

  • withdrawal.

  • self-awareness.

  • affect.

Explanation

Question 106 of 150

1

A client diagnosed with major depression should be assessed for one of the most common sleep disturbances associated with depression, which is:

Select one of the following:

  • narcolepsy.

  • somnambulism.

  • sleep apnoea.

  • insomnia.

Explanation

Question 107 of 150

1

During the period of mood disturbance associated with a manic episode, which of the following symptoms may be present?

Select one of the following:

  • Inflated self-esteem or grandiosity

  • Decreased need for sleep

  • More talkative than usual

  • All answers are correct

Explanation

Question 108 of 150

1

A major depressive disorder is usually recognised when the client presents with a range of physical ailments.

Select one of the following:

  • True
  • False

Explanation

Question 109 of 150

1

Withdrawn people are still very aware of where they are and who they are with. Which of the following are appropriate nursing interventions to support the person?

Select one of the following:

  • Spending time with them

  • Being non-threatening

  • Providing positive regard

  • All answers are correct

Explanation

Question 110 of 150

1

One of the underlying principles for nursing a person with a mood disorder is to recognise that the key to working effectively with the person is a collaborative relationship characterised by:

Select one of the following:

  • group work activities.

  • openness and respect.

  • therapeutic medication administration.

  • community-based services.

Explanation

Question 111 of 150

1

A person is exhibiting evidence of some paranoid ideation, lacking social networks or friends, expressing odd beliefs and thinking in their speech, and is odd in their appearance. They may be showing signs of which of the following personality disorders?

Select one of the following:

  • Antisocial personality disorder

  • Avoidant personality disorder

  • Obsessive-compulsive personality disorder

  • Schizotypal personality disorder

Explanation

Question 112 of 150

1

Cognitive behavioural therapy (CBT) is used to treat people with personality disorders by focusing on the client’s dependence issues and teaching the client better financial planning, social skills and assertiveness.

Select one of the following:

  • True
  • False

Explanation

Question 113 of 150

1

Personality disorders:

Select one of the following:

  • have their onset in adolescence.

  • fluctuate over time.

  • intensify in adulthood.

  • have their onset in childhood.

Explanation

Question 114 of 150

1

The onset of symptoms for some personality disorders may be attributed to which of the following?

Select one of the following:

  • Childhood abuse and neglect

  • Drug dependence

  • Alcohol dependence

  • Adolescent illness

Explanation

Question 115 of 150

1

A person who exhibits disregard for the law; is reckless, aggressive, deceitful and impulsive; and does not show remorse may be showing signs of which of the following personality disorders?

Select one of the following:

  • Antisocial personality disorder

  • Avoidant personality disorder

  • Obsessive-compulsive personality disorder

  • Schizotypal personality disorder

Explanation

Question 116 of 150

1

The nurse assessing a client who has borderline personality disorder would expect to find a history of:

Select one of the following:

  • anxiety disorders.

  • hallucinations.

  • intense and unstable relationships.

  • substance abuse.

Explanation

Question 117 of 150

1

One interactive therapy that helps to actively incorporate social skills training for the client is:

Select one of the following:

  • pharmacological therapy.

  • therapeutic community.

  • dialectical behaviour therapy.

  • individual therapy.

Explanation

Question 118 of 150

1

One of the principles of nursing care of a client with a personality disorder is that the nurse must:

Select one of the following:

  • reject the client’s dependence on their primary care.

  • monitor the client for signs of self-harm and suicidality.

  • monitor involvement of this client with others.

  • isolate this client from other clients in the unit.

Explanation

Question 119 of 150

1

A person who experiences considerable impairment in activities of daily living, such as disturbances in relationships and impulsivity, may have borderline personality disorder.

Select one of the following:

  • True
  • False

Explanation

Question 120 of 150

1

A person can be considered to have a personality disorder when personality traits seem to be beyond the scope of what is considered reasonable as observed by their behaviour and attitude to others.

Select one of the following:

  • True
  • False

Explanation

Question 121 of 150

1

A diagnosis of PTSD is not made in the first month of symptoms because what percentage of people fully recover within three months of onset?

Select one of the following:

  • 10%

  • 35%

  • 50%

  • 100%

Explanation

Question 122 of 150

1

When a client is having a panic attack, it is best to speak to them in short, simple sentences, and to take a directive and instructive approach—for example, to say, ‘Please sit down’ rather than asking, ‘Would you like to sit down?’.

Select one of the following:

  • True
  • False

Explanation

Question 123 of 150

1

A client with obsessive-compulsive disorder does not gain enjoyment from any ritual but is compelled to undertake the ritual in an effort to:

Select one of the following:

  • dispel any contamination that has occurred.

  • ward off uncomfortable and relentless anxiety.

  • combat feelings of inadequacy.

  • undertake their own duty of care.

Explanation

Question 124 of 150

1

Which of the following is a component of cognitive behavioural interventions?

Select one of the following:

  • ECT.

  • Arousal management.

  • Dialectical therapy.

  • Increased negative reinforcement.

Explanation

Question 125 of 150

1

Which technique might a client be able to learn in order to help reduce anxiety and prevent hyperventilation occurring during a panic attack?

Select one of the following:

  • Desensitisation

  • Graded exposure

  • Slow breathing

  • Focused exposure

Explanation

Question 126 of 150

1

The patient experiencing a panic attack may exhibit which of the following symptoms?

Select one of the following:

  • Various phobias

  • Increased verbalisations

  • Tachycardia or chest pain

  • Persistent fears

Explanation

Question 127 of 150

1

An examination of the contemporary epidemiology of anxiety disorders reveals that, despite being highly publicised and effectively treated in the population, they are not an extreme health concern, being neither highly prevalent nor greatly disabling.

Select one of the following:

  • True
  • False

Explanation

Question 128 of 150

1

According to current evidence, psychological interventions for anxiety disorders include:

Select one of the following:

  • acceptance and commitment therapy.

  • applied relaxation.

  • mindfulness-based stress reduction.

  • All answers are correct.

Explanation

Question 129 of 150

1

A client with a panic disorder has been prescribed a benzodiazepine medication. One of the risks of benzodiazepines is:

Select one of the following:

  • dietary restrictions.

  • dependence.

  • agitation.

  • constipation.

Explanation

Question 130 of 150

1

All of the following disorders may occur with substance abuse except:

Select one of the following:

  • social anxiety disorder.

  • panic disorder.

  • seasonal affective disorder.

  • generalised anxiety disorder.

Explanation

Question 131 of 150

1

Cognitive changes that may be associated with starvation in eating disorders include:

Select one of the following:

  • lack of concentration, and increased obsession with food and body image.

  • secretive behaviour in relation to disposal of food.

  • body image avoidance and dissatisfaction.

  • disrupted body mass index.

Explanation

Question 132 of 150

1

Cognitive behavioural therapy (CBT) for a client with an eating disorder focuses on encouraging the client to think more positively about meals that are higher in kilojoules and nutritionally sound, so that the weight-maintaining process in eating-disordered pathology is disrupted.

Select one of the following:

  • True
  • False

Explanation

Question 133 of 150

1

Anorexia nervosa is primarily characterised by determined efforts to lose weight or avoid weight gain, whereas bulimia nervosa is primarily characterised by:

Select one of the following:

  • low body mass index.

  • disturbed body image.

  • binge eating.

  • dependence behaviour.

Explanation

Question 134 of 150

1

A key strategy to successful inpatient treatment is:

Select one of the following:

  • providing a collaborative structured program.

  • planned goal-setting sessions.

  • decreased behaviour modification.

  • increased inpatient surveillance.

Explanation

Question 135 of 150

1

One of the major predictors of eating disorders is:

Select one of the following:

  • media exposure.

  • high-frequency dieting.

  • obsession with clothes.

  • obsessions and compulsions.

Explanation

Question 136 of 150

1

It might be anticipated that a client hospitalised with a diagnosis of anorexia nervosa might have a poor outcome if the disorder is associated with:

Select one of the following:

  • a comorbid mental disorder.

  • late age of onset.

  • dental enamel erosion.

  • impulsive behaviours.

Explanation

Question 137 of 150

1

In follow-up studies of clients with anorexia nervosa, the recovery rate for adolescents was reported to be:

Select one of the following:

  • up to 40%.

  • up to 50%.

  • up to 70%.

  • up to 90%.

Explanation

Question 138 of 150

1

Ninety per cent of clients with anorexia nervosa are female.

Select one of the following:

  • True
  • False

Explanation

Question 139 of 150

1

The most dangerous complication of vomiting and purgative abuse by people with an eating disorder is which of the following?

Select one of the following:

  • Amenorrhoea

  • Delayed gastric emptying

  • Depletion of potassium, chloride and sodium

  • Bone mineral density problems

Explanation

Question 140 of 150

1

Risk factors for the development of eating disorders include:

Select one of the following:

  • having a very thin father.

  • low self-esteem.

  • high self-confidence.

  • intimate family relationships.

Explanation

Question 141 of 150

1

Informing drug users about how to inject safely, reducing the quantity of the drug if the person has not used it for an extended period of time and providing supervised injecting rooms are making it easier for people to survive drug use and therefore encouraging drug use.

Select one of the following:

  • True
  • False

Explanation

Question 142 of 150

1

When a nurse is taking a substance use history, it is important to:

Select one of the following:

  • undertake an in-depth mental health exam.

  • approach the topic openly and treat substance use as an accepted behaviour.

  • ask why the patient needs to take these substances.

  • involve the family in the discussion about use.

Explanation

Question 143 of 150

1

The term ‘dual diagnosis’ is used when a patient is found to have a mental illness and a:

Select one of the following:

  • physical illness.

  • posttraumatic stress reaction.

  • substance use disorder.

  • somatoform disorder.

Explanation

Question 144 of 150

1

Teaching consumers cognitive and behavioural strategies may enhance their ability to cope with high-risk situations. This is called:

Select one of the following:

  • behavioural prevention.

  • reminiscence prevention.

  • relapse prevention.

  • psychiatric rehabilitation.

Explanation

Question 145 of 150

1

Marijuana is the most-used drug in Australia and New Zealand.

Select one of the following:

  • True
  • False

Explanation

Question 146 of 150

1

Harm-reduction strategies aim to:

Select one of the following:

  • prevent the client from doing any more harm to others.

  • reduce the involvement of the case manager in the reduction of alcohol and other drugs.

  • reduce problems associated with continuing use of alcohol and other drugs.

  • prevent the family from being harmed by a client using alcohol or other drugs.

Explanation

Question 147 of 150

1

‘Pre-contemplative’, ‘contemplative’ and moving into the ‘action stage’ are part of which therapy?

Select one of the following:

  • Dialectical behaviour therapy (DBT)

  • Motivational interviewing (MI)

  • Cognitive behaviour therapy (CBT)

  • Psychotherapy

Explanation

Question 148 of 150

1

A client has been admitted to the hospital with a diagnosis of Wernicke-Korsakoff syndrome. What is administered to treat this condition?

Select one of the following:

  • Thiamine

  • Vitamin C

  • Riboflavin

  • Vitamin K

Explanation

Question 149 of 150

1

Comorbidity is a term used to describe:

Select one of the following:

  • someone who is drug dependent.

  • anyone who has an alcohol and drug disorder problem.

  • someone who has more than one disorder at the same time.

  • someone who has a substance use disorder.

Explanation

Question 150 of 150

1

Nursing care for clients with a dual diagnosis (of substance use and mental illness) can be complicated by:

Select one of the following:

  • mandatory admissions.

  • the client’s ‘readiness to change’.

  • the requirement for appropriate medications.

  • confused care pathways.

Explanation

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