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

1.

A patient is taking a first-generation antipsychotic medication. What should the nurse teach about the drug’s strong dopaminergic effect?

  • To arise slowly from bed

  • To report muscle stiffness

  • To chew sugarless gum

  • 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.


2.

Which of the following options best describes the basic elements of the communication model?

  • Receiver, feedback, flow, and expression

  • Sender, receiver, flow, and message

  • Message, sender, feedback, and gesture

  • 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.


3.

A team of nurses wants to integrate evidence-based practice into a facility's clinical pathways. Which step should the team implement first?

  • Apply the research findings to clinical practice

  • Ask questions to identify clinical problems

  • Acquire findings from published literature

  • Assess the performance of clinical practices

Explanation

The Correct Answer is:

B. Ask questions to identify clinical problems.

Detailed Explanation:

The first step in the evidence-based practice (EBP) process is to ask a well-formulated clinical question that identifies a problem or area for improvement. This step guides the rest of the process by focusing the inquiry on a specific, measurable, and relevant issue. The PICO framework (Population, Intervention, Comparison, Outcome) is often used to structure these questions.

Once the clinical problem is clearly defined, the team can acquire evidence
from credible sources, appraise the quality and applicability of the research, apply the findings to practice, and finally assess outcomes to determine effectiveness.


4.

Which statement most clearly reflects the stigma of mental illness?

  • "Mental illness can be evidence of a brain disorder."

  • "Many mental illnesses are a result of genetic predisposition."

  • "Even children may have diagnosable mental health conditions."

  • "Mental illness is a result of the breakdown of the American family."

Explanation

The Correct Answer is:

D. "Mental illness is a result of the breakdown of the American family."

Detailed Explanation:

Stigma refers to negative, misinformed, and discriminatory beliefs about people with mental illness. The statement that “mental illness is a result of the breakdown of the American family” reflects stigma because it blames social or moral failure rather than recognizing mental illness as a medical condition influenced by biological, psychological, and environmental factors. Such beliefs contribute to shame, misunderstanding, and barriers to treatment for those affected.


5.

After a client has been prescribed fluoxetine (Prozac) for a diagnosis of anxiety disorder, which of the following information should the nurse be sure to include in the client teaching?

  • The client should not stop this medication abruptly to avoid discontinuation syndrome.

  • The client may experience frequent constipation and should increase their intake of dietary fiber.

  • This medication takes 4–6 months to be effective; the client should be told to be patient.

  • This medication can cause addiction, so the client should not take more than prescribed.

Explanation

The Correct Answer is:

A. The client should not stop this medication abruptly to avoid discontinuation syndrome.

Detailed Explanation:

Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor (SSRI) used to treat anxiety and depressive disorders. When stopped abruptly, it can lead to SSRI discontinuation syndrome, characterized by symptoms such as dizziness, anxiety, irritability, sensory disturbances, and flu-like symptoms. The nurse should emphasize gradual tapering of the dose under medical supervision. Fluoxetine typically begins to show improvement within 2 to 4 weeks, not months, and is not habit-forming.


6.

Excess levels of which neurotransmitter are associated with the hallucinations, delusions, and bizarre behavior seen in schizophrenia?

  • Serotonin

  • γ-Aminobutyric Acid (GABA)

  • Dopamine

  • Acetylcholine

Explanation

The Correct Answer is:

C. Dopamine.

Detailed Explanation:

The dopamine hypothesis of schizophrenia proposes that excess dopamine activity, particularly in the mesolimbic pathway, is responsible for the positive symptoms of schizophrenia—such as hallucinations, delusions, disorganized thinking, and bizarre behavior. Overstimulation of D₂ (dopamine) receptors in this brain region leads to abnormal perception and thought processes.

First-generation (typical) antipsychotic medications, such as haloperidol
and chlorpromazine, work by blocking dopamine receptors, thereby reducing these psychotic symptoms.


7.

Your patient sometimes forgets to eat. In which part of the nursing care plan would the nurse expect to find this statement:
"Offer snacks and finger foods frequently."

  • Intervention

  • Planning/Goals

  • Assessment

  • Diagnosis

Explanation

The Correct Answer is:

A. Intervention.

Detailed Explanation:

The statement “Offer snacks and finger foods frequently” describes a nursing intervention, which outlines the specific actions the nurse will take to address an identified patient problem. Interventions are designed to help the patient achieve established goals and are based on the nurse’s clinical judgment and evidence-based practice.

In this case, offering snacks and finger foods is a behavioral and environmental strategy
intended to promote adequate nutrition for a patient who forgets to eat—often due to cognitive impairment, depression, or another mental health condition.


8.

A client is experiencing a panic attack. What medication will provide the quickest relief from acute severe anxiety symptoms?

  • Buspirone (Buspar)

  • Venlafaxine (Effexor)

  • Imipramine (Tofranil)

  • 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.


9.

Several nurses are concerned that agency policies related to restraint and seclusion are inadequate. Which statement about the relationship of substandard institutional policies and individual nursing practice should guide nursing practice?

  • The policies do not absolve an individual nurse of the responsibility to practice according to the professional standards of nursing care.

  • In an institution with substandard policies, the nurse has a responsibility to inform the supervisor and leave the premises.

  • Agency policies are the legal standard by which a professional nurse must act and therefore override other standards of care.

  • Interpretation of policies by the judicial system is rendered on an individual basis and therefore cannot be predicted.

Explanation

The Correct Answer is:

A. The policies do not absolve an individual nurse of the responsibility to practice according to the professional standards of nursing care.

Detailed Explanation:

Even when institutional policies are inadequate or outdated, nurses are still legally and ethically bound to uphold professional standards of practice established by state nurse practice acts, regulatory boards, and professional organizations such as the American Nurses Association (ANA). These standards take precedence over flawed institutional policies.

If a nurse follows a substandard policy that results in harm to a patient, the nurse—not the institution—may be held legally accountable
for negligence or malpractice. Therefore, nurses must advocate for policy review, notify leadership of unsafe practices, and ensure their care aligns with professional ethics, current evidence, and patient safety guidelines.


10.

After teaching a class about the rights of persons receiving mental health services, the nurse determines a need for additional discussion when the group wrongly identifies which as a right?

  • Freedom from restraints or seclusion

  • Refusal of treatment during an emergency situation

  • Access to one's own mental health records upon request

  • An individualized written treatment plan

Explanation

The Correct Answer is:

B. Refusal of treatment during an emergency situation.

Detailed Explanation:

While patients receiving mental health services generally have the right to refuse treatment, this right can be overridden during an emergency if the patient poses a danger to self or others. In such cases, emergency interventions—including medications, restraints, or seclusion—may be used to protect life and ensure safety. These actions must follow strict legal and ethical guidelines, be documented thoroughly, and end as soon as the crisis resolves.


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