Mental health nursing worksheet with answers

What is a psychiatric advance directive (advance statement)?

1. AA contract in which the patient promises the team to take every prescribed medicine for life
2. BA document in which a person states their treatment wishes for a time when they may lack capacity
3. CA court order that allows a patient to be detained in hospital
4. DA note from the doctor that lists the patient's diagnoses

Which sequence describes the cycle of violence often seen in intimate partner abuse?

1. ATension-building, acute violence, then reconciliation (the "honeymoon" phase)
2. BTension-building, then a calm phase that lasts for the rest of the relationship
3. CAcute violence, then permanent separation of the partners
4. DReconciliation, acute violence, then tension-building with no further violence

A patient stops speaking in the middle of a sentence and cannot remember what he was saying. What is this called?

1. AThought blocking
2. BClang association
3. CWord salad
4. DFlight of ideas

A patient says, "Nobody at work likes me." Which nurse response best reflects cognitive restructuring?

1. A"You should find a new job where people like you."
2. B"What evidence do you have that nobody likes you?"
3. C"I'm sure everybody likes you."
4. D"Why do you care what people at work think?"

A patient who started lithium 2 weeks ago has a fine tremor of the hands and is passing more urine than usual. Her level is within the therapeutic range. How should the nurse interpret this?

1. AThese symptoms mean that the lithium is not working, so the dose should be stopped and a new drug chosen
2. BThese are signs of an allergic reaction, so she should never take lithium again
3. CThese are common side effects that are not by themselves signs of toxicity, but they should be reported and monitored
4. DThese are definite signs of severe lithium toxicity, so emergency dialysis is needed straight away

A 24-year-old woman with bipolar disorder is starting valproate. What is the most important teaching point?

1. AIt can seriously harm an unborn baby, so effective contraception and specialist advice are essential
2. BIt must be taken with grapefruit juice to be absorbed
3. CIt will cause her to lose weight quickly, so she should eat extra meals and snacks every day
4. DIt is safe in pregnancy and needs no special precautions

An 80-year-old surgical patient becomes confused overnight, with fluctuating attention and pulling at his IV line. He was well oriented on admission. What is the most appropriate interpretation?

1. ARapid progression of dementia that cannot be treated, so no further tests are needed
2. BNormal ageing that needs no action
3. CProbable delirium: look for an underlying physical cause and inform the team
4. DBad behaviour that needs restraint immediately

A patient with long-standing schizophrenia is often seen drinking from the taps. Today he is confused, has a headache and his serum sodium is 124 mmol/L (124 mEq/L). What is the most likely problem?

1. ADehydration caused by anticholinergic side effects
2. BNeuroleptic malignant syndrome from his antipsychotic medicine
3. CA worsening of his psychosis that needs a higher dose of antipsychotic
4. DWater intoxication from psychogenic polydipsia