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Psychiatric Mental Health Nursing 8th Edition Mohr Test Bank

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Psychiatric Mental Health Nursing 8th Edition Mohr Test Bank

ISBN-13: 978-1609137083

ISBN-10: 1609137086

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Psychiatric Mental Health Nursing 8th Edition Mohr Test Bank

ISBN-13: 978-1609137083

ISBN-10: 1609137086

 

 

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Free Nursing Test Questions:

  Origin:  Chapter 22- Sleep Disorders, 1

Chapter:  22

Client Needs:  D-4

Cognitive Level:  Knowledge

Difficulty:  Easy

Integrated Process:  Nursing Process

Objective:  01

Page and Header:  403, Circadian Rhythm

1. Sleep is believed to be biologically regulated by which structure?
  A) Hippocampus
  B) Hypothalamus
  C) Caudate nucleus and pineal glands
  D) Medulla
  Ans: B
  Feedback:
  The circadian rhythm is a pacemaker or biologic clock that regulates the daily patterning of sleep. In mammals, this structure is the suprachiasmic nucleus located in the hypothalamus. The circadian pacemaker stimulates changes in the daily patterns of sleep and wake that are endogenous (stimulated internally) to the organism.

 

 

  Origin:  Chapter 22- Sleep Disorders, 2

Chapter:  22

Client Needs:  D-4

Cognitive Level:  Analysis

Difficulty:  Moderate

Integrated Process:  Nursing Process

Objective:  01

Page and Header:  403, Circadian Rhythm

2. Which of the following circumstances would be most likely to cause the individual to experience sleep difficulties?
  A) Working the 7 PM to 7 AM shift on a regular basis
  B) Being awakened at 2 AM by a telephone call
  C) Taking a flight from the United States to Russia
  D) Waking at 5:30 AM 2 days a week for clinical rotations
  Ans: C
  Feedback:
  Sleep disturbances may result from changes in exogenous factors, such as night work or changes in time zones associated with airplane travel. The outcome of these changes is displacement of sleep periods to times of the day that are not part of the person’s typical sleep pattern. A person whose work schedule takes place consistently during the night is less likely to experience sleep difficulties than is someone who experiences a sudden change in time zones.

 

 

  Origin:  Chapter 22- Sleep Disorders, 3

Chapter:  22

Client Needs:  D-4

Cognitive Level:  Analysis

Difficulty:  Moderate

Integrated Process:  Nursing Process

Objective:  02

Page and Header:  404, Developmental Changes

3. The pediatric nurse assesses patients’ sleep patterns during admission assessments. Which of the following children is showing a sleep pattern that would most likely need further assessment?
  A) An adolescent who regularly sleeps 12 to 14 hours a night
  B) A school-age child who refuses a nap
  C) A preschool-age child who takes an occasional 30-minute nap in the afternoon
  D) A 1-year-old who sleeps 14 hours a night and naps during the day
  Ans: A
  Feedback:
  By the end of the first year, the infant sleeps 14 to 15 hours per day, with most sleep at night and one or two naps during the day. During the preschool years, children may stop napping. Normally, all sleep occurs during the night. As children move through their school years into their teens, total daily sleep time gradually declines from approximately 10 to 7 to 8 hours by the end of adolescence.

 

 

  Origin:  Chapter 22- Sleep Disorders, 4

Chapter:  22

Client Needs:  D-4

Cognitive Level:  Analysis

Difficulty:  Moderate

Integrated Process:  Nursing Process

Objective:  02

Page and Header:  406, Older Adults

4. The nurse is admitting an elderly client to the medical-surgical unit for observation following a fall in her home. Which of the following statements would require additional assessment?
  A) “I usually wake up early in the morning, even before the sun comes up, just raring to go!”
  B) “Sometimes after dinner I sit in my big chair, and before you know it I’m asleep!”
  C) “I don’t sleep as much as when I was younger.”
  D) “I don’t sleep very well anymore, but then I’m getting old.”
  Ans: D
  Feedback:
  The belief that sleep disturbance is a normal part of aging is particularly common among older adults and may prevent them from seeking help with genuine sleep problems. For this reason, health care providers must be especially cognizant of performing sleep assessments with older adult clients and assisting them with interventions to improve sleep.

 

 

  Origin:  Chapter 22- Sleep Disorders, 5

Chapter:  22

Client Needs:  B

Cognitive Level:  Analysis

Difficulty:  Moderate

Integrated Process:  Teaching/Learning

Objective:  03

Page and Header:  407, Drugs and Chemical Substances

5. The nurse has been teaching a patient ways to improve sleep patterns at home. The nurse determines that teaching has been effective when the patient states which of the following?
  A) “There isn’t enough caffeine in most drinks to really affect sleep.”
  B) “I quit smoking a few days ago so I should be sleeping better already.”
  C) “A glass of wine before bed should help me sleep all through the night.”
  D) “I need to take cold medicine that contains caffeine no later than midafternoon.”
  Ans: D
  Feedback:
  Caffeine is a stimulant that results in delayed sleep onset, decreased total sleep time, increased wake after sleep onset, and decreased rapid eye movement (REM) and slow–wave sleep. Caffeine is also found in over-the-counter cold preparations and stimulants. Although people differ in the intensity and duration of their response to caffeine-containing products, the effects of such products may last as long as 8 to 14 hours. Nicotine also has a powerful influence on sleep, producing more arousal with higher doses. Withdrawal from nicotine can result in irritability and inadequate sleep. Many people use alcohol to self-treat insomnia. Although its acute sedative effects may lead to drowsiness and shorten sleep latency, its longer-term effects include arousal and wakefulness.

 

 

  Origin:  Chapter 22- Sleep Disorders, 6

Chapter:  22

Client Needs:  D-1

Cognitive Level:  Comprehension

Difficulty:  Moderate

Integrated Process:  Nursing Process

Objective:  05

Page and Header:  409, Sleep-Related Breathing Disorders

6. A patient states that he has been treated for sleep apnea over the past year. You document this and note in the care plan that nurses should be aware of which of the following signs or symptoms?
  A) Loud snoring or gasping while asleep
  B) Calling out and moving excessively while asleep
  C) Evidence of teeth grinding while asleep
  D) Feeling agitated during the day
  Ans: A
  Feedback:
  Obstructive sleep apnea–hypopnea syndrome (OSAHS) is associated with repetitive episodes of reduced airflow (hypopnea) or cessation of airflow (apnea) resulting from collapse of the upper airway. Clients with this condition experience sleep disruption and excessive daytime sleepiness. They typically snore loudly and may gasp or choke during sleep. Narcolepsy is characterized by excessive daytime sleepiness and associated with cataplexy (sudden bilateral loss of postural muscle tone) and other rapid eye movement (REM) sleep phenomena. Parasomnias include problems such as sleepwalking and tooth grinding.

 

 

  Origin:  Chapter 22- Sleep Disorders, 7

Chapter:  22

Client Needs:  C

Cognitive Level:  Analysis

Difficulty:  Moderate

Integrated Process:  Nursing Process

Objective:  05

Page and Header:  413, Narcolepsy

7. A patient expresses that being diagnosed with narcolepsy has been devastating for him. Which statement by the patient should cause the nurse to suspect that the patient is depressed?
  A) “I don’t like the way the stimulant medication makes me feel.”
  B) “I sometimes wonder if it is worth living a life that has so many restrictions.”
  C) “I hate being so dependent. I have to have somebody drive me everywhere I go.”
  D) “It’s no fun having a disease that’s the object of ridicule in movies and TV shows.”
  Ans: B
  Feedback:
  Narcolepsy affects almost every aspect of daily life, including professional performance, ability to drive and operate machinery, and social interactions. Accompanying depressed mood is common, as suggested by the individual’s statement that he wonders if it is worth living.

 

 

  Origin:  Chapter 22- Sleep Disorders, 8

Chapter:  22

Client Needs:  D-1

Cognitive Level:  Comprehension

Difficulty:  Moderate

Integrated Process:  Teaching/Learning

Objective:  06

Page and Header:  409, Sleep-Related Breathing Disorders

8. A nurse has counseled a client who has a sleep disorder that losing weight may be beneficial. This client has most likely been diagnosed with what sleep disorder?
  A) Restless leg syndrome
  B) Narcolepsy
  C) Obstructive sleep apnea–hypopnea syndrome (OSAHS)
  D) Insomnia
  Ans: C
  Feedback:
  Effective treatments for OSAHS include weight loss, nightly nasal nocturnal continuous positive airway pressure (CPAP), and oral appliances designed to maintain patency of the upper airway during sleep. Weight loss does not assist with the other listed sleep disorders.

 

 

  Origin:  Chapter 22- Sleep Disorders, 9

Chapter:  22

Client Needs:  D-1

Cognitive Level:  Analysis

Difficulty:  Easy

Integrated Process:  Nursing Process

Objective:  05

Page and Header:  412, Circadian Rhythm Sleep Disorders

9. Bethany is a single mother studying nursing. As well, she works 25 hours a week to cover family and educational expenses. Last night driving home from work Bethany drifted off the road and nearly had an accident. Bethany is most likely suffering the negative consequences of which of the following?
  A) Sleep deprivation
  B) Insomnia
  C) Generalized anxiety disorder
  D) Excessive fatigue syndrome
  Ans: A
  Feedback:
  Sleep deprivation is the consequence of total or partial reduction in time spent asleep. Partial sleep deprivation is the most common form and one consequence of the very busy lives that many people live today. At least 20% of the population works shifts beyond the 9:00 AM to 5:00 PM “typical” working day. Accompanying sleep loss is associated with increased motor vehicle accidents and major industrial accidents.

 

 

  Origin:  Chapter 22- Sleep Disorders, 10

Chapter:  22

Client Needs:  D-1

Cognitive Level:  Application

Difficulty:  Moderate

Integrated Process:  Nursing Process

Objective:  06

Page and Header:  412, Circadian Rhythm Sleep Disorders

10. Josh is an emergency department nurse who has just finished a double shift. Many of the nurses scheduled to relieve Josh and his colleagues were unable to come to the hospital because of a snowstorm. Josh will be relieved within the hour, but he is not sure he is alert enough to drive home, especially in blizzard conditions. The best action for Josh to take would be to:
  A) Drive home slowly and carefully
  B) Ask the emergency physician for a one-time dose of a stimulant to help him be alert enough to get home safely
  C) Nap for a while in the nurses’ lounge before leaving the hospital
  D) Refuse to work any double shifts in the future
  Ans: C
  Feedback:
  Nurses and others who work shifts may benefit from avoiding working excessive double shifts, maintaining a 16-hour recovery period following a night shift, napping 15 to 30 minutes during breaks on the night shift, and sleeping before driving home from work.

 

 

  Origin:  Chapter 22- Sleep Disorders, 11

Chapter:  22

Client Needs:  D-1

Cognitive Level:  Analysis

Difficulty:  Moderate

Integrated Process:  Nursing Process

Objective:  04

Page and Header:  408, Insomnia

11. The nurse is admitting a 36-year-old woman to the unit. The woman reports that recently she has begun having significant trouble sleeping and consequently does not feel rested. She cannot identify any reason for this sleep disturbance but knows that it is causing her significant distress. The nurse suspects the patient is suffering from which form of insomnia?
  A) Primary insomnia
  B) Psychophysiological insomnia
  C) Idiopathic insomnia
  D) Endogenous insomnia
  Ans: A
  Feedback:
  Primary insomnia occurs when no cause of a sleep disturbance (eg, a mental health or medical diagnosis) can be identified. Primary insomnia often begins in young or middle-aged adults and tends to be more common in women. Clients with idiopathic insomnia have difficulty sleeping since childhood, and the cause is unknown. Psychophysiological insomnia is chronic insomnia in which clients worry about sleep, are cognitively and physiologically overaroused at bedtime, and have poor daytime functioning.Chapter: 22

 

 

  Origin:  Chapter 22- Sleep Disorders, 12

Chapter:  22

Client Needs:  A-1

Cognitive Level:  Application

Difficulty:  Moderate

Integrated Process:  Caring

Objective:  07

Page and Header:  408, Insomnia

12. You are the team leader on the unit during the night shift. The staff on your unit enjoys their work and has good working relationships with each other. Often they are heard laughing loudly while walking down the hall. Which of the following actions on your part provides for the most effective and quality patient care?
  A) Take no action; a cohesive staff will provide professional patient care.
  B) Check with the patients to make sure no one is distracted by the laughter.
  C) Initiate a disciplinary action against the loud staff because they are not adhering to ethical standards of practice.
  D) Remind the staff to keep volume at a minimum, considering most patients are trying to sleep.
  Ans: D
  Feedback:
  Many clients have difficulty initiating and maintaining sleep in an environment to which they are unaccustomed, such as the hospital or a hotel. Noise, lighting, and frequent client care activities may contribute to disturbed sleep in the hospital setting. Clustering care activities for hospitalized clients to allow adequate periods of rest and sleep are useful sleep promotion strategies. Reducing excessive lighting and noise levels are other helpful measures.

 

 

  Origin:  Chapter 22- Sleep Disorders, 13

Chapter:  22

Client Needs:  D-1

Cognitive Level:  Comprehension

Difficulty:  Moderate

Integrated Process:  Nursing Process

Objective:  07

Page and Header:  414, Anxiety Disorders

13. A military veteran has been diagnosed with post-traumatic stress disorder after returning from the Middle East. Which of the following sleep disturbances would the nurse expect this client to report?
  A) Daytime sleepiness
  B) Not feeling rested after sleep
  C) Sleep apnea
  D) Nightmares
  Ans: D
  Feedback:
  Clients with PTSD chronically “relive” a previous traumatic event. They have intrusive thoughts, crying, and anxiety and often are hypervigilant. They frequently have problems with initiating and staying asleep and nightmares about the traumatic event.

 

 

  Origin:  Chapter 22- Sleep Disorders, 14

Chapter:  22

Client Needs:  D-2

Cognitive Level:  Application

Difficulty:  Moderate

Integrated Process:  Teaching/Learning

Objective:  07

Page and Header:  415, Schizophrenia

14. A patient with schizophrenia is managing his illness with the antipsychotic Clozaril (clozapine). During his clinic visit he complains of not feeling rested during the day. As the nurse seeing patients on an outpatient basis, you would encourage the patient to do which of the following?
  A) Take a nap during the day
  B) Take his dose of Clozaril at bedtime
  C) Take his medication as soon as awakens in the morning
  D) Consult with the psychiatrist to modify his medicines
  Ans: B
  Feedback:
  Treatment of schizophrenia involves antipsychotic drugs, which exert effects on dopamine systems. First-generation antipsychotics and clozapine (Clozaril) cause sedation and increased total sleep time (Benson, 2006; Monti and Monti, 2004). Risperidone (Risperdal) and olanzapine (Zyprexa) cause less sedation. Giving antipsychotic medications at bedtime maximizes their sedative effects and improves sleep (Benson and Zarcone, 2000).

 

 

  Origin:  Chapter 22- Sleep Disorders, 15

Chapter:  22

Client Needs:  D-1

Cognitive Level:  Application

Difficulty:  Moderate

Integrated Process:  Teaching/Learning

Objective:  08

Page and Header:  416, Sleep Hygiene

15. As the rehabilitation nurse, you are planning a teaching activity for clients in a community-based treatment program. Health promotion regarding healthy sleep activities would include teaching the clients to do which of the following?
  A) Turn on a TV or radio to lull themselves to sleep
  B) Try to go to bed and wake up at the same time on the weekends as during the week
  C) Exercise late in the day to produce fatigue
  D) Complete paperwork or other activities in bed right before turning out the lights so as to already be relaxed
  Ans: B
  Feedback:
  General principles of sleep hygiene include a regular sleep–wake schedule, environmental modifications, and reductions in sources of arousals (Zarcone, 2000). Most sleep specialists teach clients to maintain a regular sleep schedule on weekdays and weekends, to reduce noise and light in the sleeping environment, to maintain a comfortable temperature in the room for sleeping, and to sleep in a comfortable bed.

 

 

  Origin:  Chapter 22- Sleep Disorders, 16

Chapter:  22

Client Needs:  A-1

Cognitive Level:  Knowledge

Difficulty:  Easy

Integrated Process:  Teaching/Learning

Objective:  04

Page and Header:  412, Sleep-Related Movement Disorders

16. A 70-year-old woman has been waking up frequently at night due to contractions of her calf muscles. This client is experiencing what condition?
  A) Restful legs syndrome
  B) Periodic limb movement disorder
  C) Narcolepsy
  D) Parasomnia
  Ans: B
  Feedback:
  Periodic limb movement disorder (PLMD) is a condition in which the legs move repetitively during the night, usually in approximately 90-second repetitive patterns. They result from contractions of the leg muscles during sleep. This condition causes frequent nighttime arousals, nonrestorative sleep, and excessive daytime sleepiness. Restless legs syndrome (RLS) is associated with disagreeable leg sensations, such as pain, cramping, and itching, which often interfere with the onset of sleep when they occur at bedtime.

 

 

  Origin:  Chapter 22- Sleep Disorders, 17

Chapter:  22

Client Needs:  A-1

Cognitive Level:  Knowledge

Difficulty:  Moderate

Integrated Process:  Teaching/Learning

Objective:  08

Page and Header:  415, Interdisciplinary Goals and Treatment

17. Bernie, a 54-year-old man, has been having difficulty sleeping for the past 3 years. He has problems falling asleep and, once asleep, he wakes frequently. After a discussion with his health care provider, Bernie is referred to a sleep center. The sleep center places Bernie on continuous monitoring using an electroencephalogram, electro-oculography, and chin electromyography. What is the collective name for this testing?
  A) Nocturnal polysomnography
  B) Multiple sleep latency testing
  C) Circadian rhythm monitoring
  D) Diurnal narcolepsy evaluation techniques
  Ans: A
  Feedback:
  When clients are suspected of having primary sleep disorders, they need referral to specialized sleep centers for evaluation. These centers, usually staffed by interdisciplinary teams of sleep specialists, administer thorough sleep evaluations and specialized testing, including nocturnal polysomnography (NPSG). NPSG uses continuous monitoring of at least one channel of electroencephalography (EEG) to monitor brain waves, electro-oculography (EOG) to monitor eye movements, and chin electromyography (EMG). Multiple sleep latency testing (MSLT) is a procedure that determines the extent of daytime sleepiness by evaluating how long it takes clients to fall asleep during a series of daytime naps.

 

 

  Origin:  Chapter 22- Sleep Disorders, 18

Chapter:  22

Client Needs:  D-2

Cognitive Level:  Knowledge

Difficulty:  Moderate

Integrated Process:  Teaching/Learning

Objective:  06

Page and Header:  416, Hypnotic Drugs

18. During an admission interview, a patient informs you that she has been taking an over-the-counter (OTC) sleeping pill. She asks you if the pill will interact with any medications. You tell the client that OTC sleep medications may have adverse effects when used with anticholinergic drugs and central nervous system depressants. You made this statement based on the knowledge that most OTC sleeping pills contain which of the following?
  A) Opioids
  B) Tricyclic antidepressants
  C) Benzodiazepines
  D) Antihistamines
  Ans: D
  Feedback:
  Most OTC medications for sleep contain the antihistamine diphenhydramine, which causes sedation, drowsiness, and tolerance, as well as the side effect of daytime sleepiness. Antihistamines may have adverse effects when used with anticholinergic drugs and central nervous system depressants.

 

 

  Origin:  Chapter 22- Sleep Disorders, 19

Chapter:  22

Client Needs:  A-1

Cognitive Level:  Comprehension

Difficulty:  Moderate

Integrated Process:  Nursing Process

Objective:  08

Page and Header:  419, Nursing Diagnosis

19. A 60-year-old man is admitted to a hospital with acute coronary syndrome. During the admission assessment, he reveals to the nurse that he has had sleeping difficulties for the past 2 years. After testing, it is discovered that the patient has sleep apnea. Which of the following would be the primary nursing diagnosis for this patient related to his sleep condition?
  A) Impaired Tissue Perfusion
  B) Readiness for Enhanced Sleep
  C) Disturbed Sleep Patterns
  D) Fatigue
  Ans: C
  Feedback:
  The primary nursing diagnosis of the client with a sleep disorder is Disturbed Sleep Patterns.

 

 

  Origin:  Chapter 22- Sleep Disorders, 20

Chapter:  22

Client Needs:  A-1

Cognitive Level:  Knowledge

Difficulty:  Easy

Integrated Process:  Teaching/Learning

Objective:  04

Page and Header:  413, Mood Disorders

20. Karyn is a 42-year-old woman who has been diagnosed with major depression. Which of the following sleep disorders is most likely to coincide with depressive disorders?
  A) Insomnia
  B) Narcolepsy
  C) Sleep apnea
  D) Parasomnias
  Ans: A
  Feedback:
  Insomnia and depressive disorders often coincide. In fact, disturbed sleep and depression share common underlying pathophysiology. Insomnia and hypersomnia are part of the diagnostic criteria for major depression (DSM-IV-TR), but insomnia is more common.

 

 

  Origin:  Chapter 22- Sleep Disorders, 21

Chapter:  22

Client Needs:  D-2

Cognitive Level:  Evaluation

Difficulty:  Difficult

Integrated Process:  Nursing Process

Objective:  08

Page and Header:  416, Hypnotic Drugs

21. Erica is a 50-year-old woman who developed insomnia around the time that she began menopause. She began treating her insomnia with over-the-counter hypnotics with reasonable success but stopped taking them early this week on the advice of a friend. Erica now describes her insomnia as being “worse than ever.” The nurse should recognize what factor as the likely cause of her present insomnia?
  A) The fact that she stopped taking hypnotics suddenly rather than gradually
  B) The fact that she did not replace the hypnotic with a different drug prior to stopping the first drug
  C) The fact that her insomnia is attributable to hormonal causes rather than psychosocial factors
  D) The fact that she did not allow enough time to develop a stable serum level of the drug
  Ans: A
  Feedback:
  Hypnotic drugs should usually be tapered down rather than abruptly discontinued. Stopping suddenly may result in rebound insomnia. The lack of a stable serum level and the role of hormonal factors are unlikely to be the cause of this client’s current sleep disorder. It would normally be unsafe to take two hypnotics concurrently.

 

 

  Origin:  Chapter 22- Sleep Disorders, 22

Chapter:  22

Client Needs:  D-1

Cognitive Level:  Comprehension

Difficulty:  Moderate

Integrated Process:  Nursing Process

Objective:  07

Page and Header:  414, Attention Deficit/Hyperactivity Disorder

22. A 14-year-old boy has been referred to a sleep clinic for evaluation due to his recent history of sleep difficulties. The nurse at the clinic should be aware that sleep disorders in this population often coexist with what mental health disorder?
  A) Obsessive-compulsive disorder (OCD)
  B) Oppositional defiant disorder
  C) Bipolar disorder
  D) Attention deficit/hyperactivity disorder (ADHD)
  Ans: D
  Feedback:
  Children with attention deficit/hyperactivity disorder (ADHD) have more daytime sleepiness, movement during sleep, total sleep time, and sleep-disordered breathing problems than do children without ADHD. OCD, ODD, and bipolar disorder are not noted to correlate with sleep disorders in children.

 

 

  Origin:  Chapter 22- Sleep Disorders, 23

Chapter:  22

Client Needs:  D-1

Cognitive Level:  Comprehension

Difficulty:  Moderate

Integrated Process:  Nursing Process

Objective:  07

Page and Header:  413, Mood Disorders

23. Deborah is a 36-year-old woman with a longstanding diagnosis of bipolar disorder. What change in sleep patterns should signal Deborah’s nurse to the possibility of an impending manic episode?
  A) Complaints of restless legs
  B) Daytime sleepiness
  C) Decreased sleep latency
  D) Decreased sleep
  Ans: D
  Feedback:
  Decreased sleep predicts manic episodes in clients with bipolar disorder. Restless legs, decreased sleep latency, and sleepiness are not associated with the onset of mania.

 

 

 

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