NUR 249/NUR 2488
MENTAL HEALTH EXAM 3.
Question 1
A patient with a history of cocaine use reports a concurrent history of using other drugs
in order to counteract the effects of cocaine. Which drug is this patient likely to have
abused?
Selected Answer: Alcohol
Answers:
A. PCP
B. Alcohol
C. Methylphenidate
D. Caffeine
Response Feedback:
Alcohol is a depressant which can neutralize the effects of cocaine, which is a stimulant.
Caffeine, methylphenidate (used to treat ADHD) and the illegal drug PCP are also
stimulating and would only exacerbate the effects of cocaine.
Question 2
A patient is admitted with a heart rate of 53 bpm, respirations 6/min, temp 96.8 and
pinpoint pupils. Based on these clinical manifestations, what substance did this patient
most likely overdose on?
Selected Answer: Marijuana
Answers:
A. Opioids
B. Alcohol
C. Marijuana
D. Amphetamine
Response Feedback:
Opioids include prescribed medications such as oxycodone and morphine, and the
illegal substance heroin. The above symptoms are typical of opioid overdose, but are
not typically seen with marijuana, alcohol or amphetamines.
Question 3
An elderly client with cognitive impairment is combative and pulled out a nasogastric
tube, intravenous line, and indwelling urinary catheter. What can the nurse anticipate
that the health care provider will most likely prescribe?
Selected Answer: A small dose of a selective serotonin reuptake inhibitor
Answers:
A. A small dose of a selective serotonin reuptake inhibitor
B. A large dose of a benzodiazepine
C. A maintenance dose of buspirone
D. A small dose of an atypical antipsychotic
Response Feedback:
Aggressive behavior can be safely managed by antipsychotic medication. Initial dosing
should be small and raised cautiously until behavior is controlled. Selective serotonin
reuptake inhibitors are not indicated for aggressive behavior. If a benzodiazepine is
used, the initial dose should be low. Buspirone is not effective if given on an as-needed
basis. It is administered in small divided doses daily to control agitation.
Question 4
A nursing care plan contains the intervention “monitor for complications of refeeding
syndrome.” Which body system should a nurse most closely monitor for clinical
manifestations of dysfunction?
Selected Answer: Central nervous
Answers:
A. Renal
B. Central nervous
C. Endocrine
D. Cardiovascular
Response Feedback:
Re feeding resulting in too-rapid weight gain can overwhelm the heart, resulting in
cardiovascular collapse; thus focused assessment becomes a necessity to ensure
patient physiological integrity. The other body systems are not initially involved in the
refeeding syndrome.
Question 5
Which of the following is the best example of all-or-nothing thinking, a common
cognitive distortion of patients with an eating disorder?
Selected Answer: “If I gain any weight, I’ll keep going until I’m huge.”
Answers:
A. “If I gain any weight, I’ll keep going until I’m huge.”
B. “When people tell me I’m looking better, they really mean I’m fatter.”
C. “No one likes me because I’m fat.”
D. “When I’m thin, I’m perfect.”
Response Feedback:
In all-or-nothing thinking, the person cannot see any middle ground between extremes;
a person with an eating disorder will see themselves as either thin or immense. The
other comments are common in eating disorders but are not examples of all-ornothing
thinking.
Question 6
A nurse reports to the interdisciplinary team that a patient with an antisocial personality
disorder lies to other patients, verbally abuses a patient with Alzheimer’s disease, and
flatters the primary nurse. This patient is detached and superficial during counseling
sessions. Which behavior most clearly warrants limit setting?
Selected Answer: Flattering the nurse
Answers:
A. Lying to other patients
B. Flattering the nurse
C. Verbal abuse of another patient