Nursing 3381- Psychiatric-Mental Health Nursing of Individuals, Families, and Groups
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Free Nursing 3381- Psychiatric-Mental Health Nursing of Individuals, Families, and Groups Questions
Which neurotransmitter has both muscarinic and nicotinic receptor subtypes?
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Serotonin
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Acetylcholine
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Dopamine
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Gamma-aminobutyric acid (GABA)
Explanation
The Correct Answer is:
B. Acetylcholine.
Detailed Explanation:
Acetylcholine is the neurotransmitter that has both muscarinic and nicotinic receptor subtypes. Muscarinic receptors are primarily found in the central nervous system, the heart, and smooth muscles, where they mediate parasympathetic nervous system effects such as decreased heart rate and increased glandular secretions. Nicotinic receptors, on the other hand, are located at the neuromuscular junction, in autonomic ganglia, and in certain regions of the brain, where they facilitate muscle contraction and neural transmission. This dual receptor system allows acetylcholine to influence both voluntary and involuntary functions of the nervous system, making it essential for processes such as movement, memory, and autonomic regulation.
A patient is undergoing diagnostic tests. The patient says, "Nothing is wrong with me except a stubborn chest cold." The spouse reports that the patient smokes, coughs daily, has recently lost 15 pounds, and is easily fatigued. Which defense mechanism is the patient using?
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Projection
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Regression
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Denial
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Displacement
Explanation
The Correct Answer is:
C. Denial.
Detailed Explanation:
Denial is an ego defense mechanism in which an individual refuses to acknowledge painful or threatening realities. In this case, despite clear signs of possible serious illness (chronic cough, weight loss, fatigue), the patient insists that only a “stubborn chest cold” is the problem. Denial serves as a temporary protective response to reduce anxiety and fear associated with potentially bad news, such as a serious lung condition or cancer.
A patient discloses several concerns and associated feelings. If the nurse wants to seek clarification, which comment would be appropriate?
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“Am I correct in understanding that...?”
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“What are the common elements here?”
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“Tell me everything from the beginning.”
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“Tell me again about your experiences.”
Explanation
The Correct Answer is:
A. “Am I correct in understanding that...?”
Detailed Explanation:
When the nurse seeks clarification, the goal is to ensure an accurate understanding of what the patient has communicated. The phrase “Am I correct in understanding that...?” invites the patient to confirm, expand, or correct the nurse’s interpretation. This response promotes mutual understanding, avoids assumptions, and shows active listening — all key components of therapeutic communication.
Clarification allows the nurse to restate or summarize what the patient has said in order to verify meaning before moving further in the conversation. It demonstrates respect for the patient’s perspective and fosters trust.
A patient prescribed a muscarinic-receptor blocker will require assessment for what side effect?
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Dry mouth
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Orthostatic hypotension
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Pseudoparkinsonism
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Gynecomastia
Explanation
The Correct Answer is:
A. Dry mouth.
Detailed Explanation:
Muscarinic-receptor blockers (anticholinergic drugs) inhibit the action of acetylcholine on parasympathetic (muscarinic) receptors. This leads to a reduction in parasympathetic activity, producing anticholinergic side effects. The most common of these include dry mouth, blurred vision, constipation, urinary retention, and tachycardia.
Medications with anticholinergic properties—such as certain antipsychotics, tricyclic antidepressants, and antihistamines—require careful monitoring, especially in older adults, because these side effects can contribute to dehydration, confusion, and falls.
Which of the following options best describes the basic elements of the communication model?
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Receiver, feedback, flow, and expression
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Sender, receiver, flow, and message
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Message, sender, feedback, and gesture
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Feedback, sender, receiver, and message
Explanation
The Correct Answer is:
D. Feedback, sender, receiver, and message.
Detailed Explanation:
The communication model consists of four key elements: sender, message, receiver, and feedback. The sender is the person who initiates the communication by encoding and delivering a message. The message is the information, idea, or emotion being conveyed. The receiver is the individual who decodes and interprets the message, and feedback is the receiver’s response that lets the sender know whether the message was understood as intended.
This dynamic process ensures two-way interaction and mutual understanding between participants. Effective communication relies on clarity of the message, active listening, and accurate interpretation of feedback.
A patient is taking a first-generation antipsychotic medication. What should the nurse teach about the drug’s strong dopaminergic effect?
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To arise slowly from bed
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To report muscle stiffness
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To chew sugarless gum
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To increase dietary fiber
Explanation
The Correct Answer is:
B. To report muscle stiffness.
Detailed Explanation:
First-generation (typical) antipsychotics—such as haloperidol or chlorpromazine—work by blocking dopamine (D₂) receptors in the brain. While this reduces psychotic symptoms, the strong dopaminergic blockade can also produce extrapyramidal symptoms (EPS), which are drug-induced movement disorders.
Early signs of EPS include muscle stiffness, tremors, drooling, bradykinesia, and restlessness (akathisia). Severe muscle rigidity can progress to acute dystonia or neuroleptic malignant syndrome (NMS), both of which require immediate medical attention. Therefore, patients should be instructed to report muscle stiffness or rigidity immediately so treatment (e.g., benztropine or diphenhydramine) can be started.
A client is experiencing a panic attack. What medication will provide the quickest relief from acute severe anxiety symptoms?
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Buspirone (Buspar)
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Venlafaxine (Effexor)
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Imipramine (Tofranil)
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Alprazolam (Xanax)
Explanation
The Correct Answer is:
D. Alprazolam (Xanax).
Detailed Explanation:
Alprazolam (Xanax) is a benzodiazepine that provides rapid relief of acute anxiety and panic symptoms by enhancing the effect of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter that calms neuronal activity in the central nervous system. It has a quick onset of action, making it ideal for short-term or emergency management of panic attacks. However, due to the risks of tolerance, dependence, and withdrawal, benzodiazepines should be used only for short-term relief and under close medical supervision.
When assessing patients at a mental health clinic, our judgment about their current level of overall functioning should be made on the basis of:
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a continuum from mentally healthy to mentally unhealthy
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the rate of both their intellectual and emotional growth
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the degree of conformity of the individual to society’s norms
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the degree to which an individual appears logical and rational
Explanation
The Correct Answer is:
A. a continuum from mentally healthy to mentally unhealthy.
Detailed Explanation:
Mental health is best understood as a continuum rather than a fixed state. Individuals move along this continuum depending on factors such as stress, coping abilities, relationships, and life circumstances. At one end of the continuum is optimal mental health, characterized by resilience, emotional balance, and positive functioning; at the other end is mental illness, marked by significant distress or impairment.
Nurses assess where a person falls on this continuum by evaluating mood, behavior, thought processes, and the ability to function in daily life. This perspective recognizes that mental health fluctuates and allows for individualized, compassionate, and nonjudgmental care.
The spouse of a patient who experiences delusions asks the nurse, “Are there any circumstances under which the treatment team is justified in violating the patient’s right to confidentiality?” What is the nurse’s best response?
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“We are not bound if the patient threatens the life of another person.”
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“We can’t violate that confidence under any circumstances.”
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“We are obligated to answer questions asked by law enforcement.”
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“We can do that only at the discretion of the psychiatrist.”
Explanation
The Correct Answer is:
A. “We are not bound if the patient threatens the life of another person.”
Detailed Explanation:
The duty to warn and protect—established in the landmark Tarasoff v. Regents of the University of California case—requires mental health professionals to breach confidentiality if a patient poses a credible threat to harm an identifiable person. In such cases, the treatment team is legally and ethically justified in disclosing necessary information to protect potential victims and notify authorities.
This exception to confidentiality is based on the principle of nonmaleficence—the obligation to prevent harm. Outside of these circumstances, all patient information must remain confidential.
Which principle should guide the nurse in determining when to use silence during a patient interview?
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Patients withdraw if silences are prolonged.
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Nurses are responsible for breaking silences.
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Silence can provide meaningful moments for reflection
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Silence helps patients know that what they said is understood.
Explanation
The Correct Answer is:
C. Silence can provide meaningful moments for reflection.
Detailed Explanation:
Therapeutic silence is an important communication tool in psychiatric and therapeutic settings. It allows both the patient and the nurse time to process thoughts, emotions, and information. When used appropriately, silence encourages patients to reflect more deeply, organize their thoughts, and share at their own pace. It communicates respect, patience, and acceptance, especially when discussing emotionally charged or complex topics.
The nurse must be comfortable with silence and use nonverbal cues, such as an attentive posture and eye contact, to convey presence and support.
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