1. Mike is 17 year old, depressed patient, admitted to the hospital after breaking up with his girlfriend.

Which aspect of his mental status would be most important to document? B. Suicidal ideation 2. Nurse Lucy knows that sadness typically accompanies grief and depression. Which affective changes indicate major depression? D. Withdrawal, negative attitude, little/no eye contact 3. Which nursing approach is most important in depression? C. Providing motor outlets for aggressive, hostile feelings 4. The client in a severe major depressive episode is unable to address activity of daily living. The most appropriate nursing intervention is: A. Feed, bathe, and dress client as needed until he can perform ADL independently 5. A patient is receiving a MAOI. Nurse Leah teaches him about foods to avoid to prevent a hypertensive crisis. The patient is correct when he names which food: B. Aged cheese 6. Patient complains about not feeling any better since receiving Impiramine (Tofranil) for four days. Which statement by the nurse is MOST appropriate? B. therapeutic effects may take 2-3 weeks to show 7. A depressed patient is being interviewed by the nurse. The nurse notices the downcast eyes and which common characteristic: D. persistent feelings of dependency 8. A moderately depressed client who was hospitalized 2 days ago suddenly begins smiling and reporting that the crisis is over. The client says to the nurse Im finally cured. The nurse interprets this behavior as a cue to modify the treatment plan by: D. Increasing the level suicide precautions 9. ECT (electro convulsive therapy) is indicated to depressed clients who do not respond to pharmacological treatment. The mechanism of action of ECT is: B. related to an increase production of chemicals in the brain 10. Which medication is given prior ECT to prevent aspiration? B. Atropine sulfate 11. Which would the nurse least expect to assess post ECT treatment? A. headache 12. Karla is diagnosed of Bipolar Mood Disorder. She is mania phase and is admitted to the hospital. Karla dresses in bright clothes and heavy makeup. Which is common characteristic of Karla at this phase? D. mood swings 13. Karla is started on Lithium carbonate. Serum lithium is monitored. Which of the following, indicates that a therapeutic level of lithium has been reached? C. 0.7 to 1.2 mEq/L 15. When caring for Karla who is on Lithium, the nurse should monitor for patient which adverse effects? D. fluid retention 16. After 3 weeks of therapy, the patients blood lithium level is 1.6 mEq/L. The nurse should: C. observe patient for signs of toxicity

17. Which behavior of Karla would require the nurse immediate intervention? D. non-stop physical activity, poor nutritional intake 18. Which of the following is NOT a risk factor to Major Depression? D. independent personality 19. Antonio shows early signs of alcohol withdrawal. These include: D. diaphoresis, tremors, and nervousness 20. Antonio will most likely receive these medications: C. Thiamine, folic Acid, chlordiazepoxide (Librium) 21. Antonio trashes and yells, Go away, bugs, go away!. This behavior is reflective of which nursing diagnosis? A. Risk for injury 22. The BEST ACTION on No. 21 situation is to: C. Leave a light on his room 23. The nurse continues to monitor Antonio. Which of the following would alert the nurse to the potential for delirium tremens? A. HPN, changes in LOC, hallucinations 24. Antonio is placed on antabuse therapy. It is important that while treatment, Antonio will: B. remain alcohol free 25. Mr. DJ is a known alcoholic and suspected to be using narcotics. Which of the following characteristics can a nurse assess in an alcoholic? C. physical and psychological addiction to alcohol with impaired health 26. Mr. DJ is admitted for detoxification. During this phase of the treatment of alcoholism, which of the following is priority nursing action? D. carefully monitoring V/S and over-all health status 27. Prolonged use of alcohol may result in neuronal damage to the CNS and subsequent cognitive impairment. This may result in Korsakoffs syndrome. What is physiologic basis? D. destruction of brain tissue and of severe deficiency of Vit. B1 28. Presence of senile plaques, neurofibrillary tangles and atrophy are changes characteristics of which illness? D. Alzheimers disease 29. A son came to the center complaining to the nurse about his father endless talk of the past. He states Im tired of hearing about things were 30 years ago. This statement indicates A. lack of knowledge regarding the disease 30. Alzheimers disease is characterized by: C. progressive memory decline 31. A nurse visits a client at home and determines that the client is dependent on drugs. Which of the following assessment questions would assist the nurse to provide appropriate nursing care? C. How much do you use and what effect does it have on you? 32. The nurse determines that the client has increased intake of a substance to obtain the same effect is experiencing? C. tolerance 33. Which assessment questions will determine whether there is desire from client to stop drinking? B. Have you ever cut down your drinking? 34. Of the following assessment questions which will not determine whether the client has any problem drinking?

A. Have you ever cut down your drinking? 35. Which of the following should lead the nurse to suspect a client is addicted to Heroin? A. Hilarity 36. Opiate withdrawal causes several physical discomforts and can be life-threatening. To minimize effects, opiate users are detoxified through: C. Methadone 59. Nurse Linda notes bruises on Marias upper arms and asks about them. Maria initially denies any problem but starts to cry and says He did not really mean to hurt me but I hate the kids to see. Im so worried about them. During the interview, would be most important for Nurse Linda to determine: B. the potential of immediate danger to the patient and children 60. When planning her care, which of the following is most important to the patient? A. the phone number of the local crisis hotline 61. Nurse Linda assesses Marias method of coping. Nurse Linda would LEAST expect Maria to use: A. assertiveness 62. Nurse Linda will expect Marias husband to be: D. Low self esteem 63. In assessing abusive situation, the nurse would find what information most useful? D. age/developmental stage of mother 64. Before an effective working relationship with the parents of abused child can be established, which of the following is MOST important for the nurse to do? C. learn to deal with personal negative feelings about abusive caregivers 65. Nurse Linda examines Cathy, 5 years old, whose mother frequently brings her to the center of minor illness. Today she has broken arm and multiple bruises. Nurse Linda suspects child abuse. Which information would increase Nurse Lindas suspicion of the child abuse? D. Cathys parents childhood characterized by abuse. 66. An important goal in caring for hospitalized abused child is for the nurse to: B. provide for non-threatening, nurturing environment 67. One of the myths about sexual abuse of young children is that usually involves physically violent acts. Which of the following behaviors is more likely to be used by the abusers? C. coercion as a result of a trusting relationship