Psych Bullets
Psych Bullets
College of Nursing
Bayombong, Nueva Vizcaya
1. According to Kübler-Ross, the five stages of death and dying are denial, anger,
bargaining, depression, and acceptance.
2. Flight of ideas is an alteration in thought processes that’s characterized by
skipping from one topic to another, unrelated topic.
7. A patient who is taking lithium must undergo regular (usually once a month)
monitoring of the blood lithium level because the margin between therapeutic
and toxic levels is narrow. A normal laboratory value is 0.5 to 1.5 mEq/L.
11. Lithium toxicity can occur when sodium and fluid intake are insufficient,
causing lithium retention.
13. According to Erikson, the school-age child (ages 6 to 12) is in the industry-
versus-inferiority stage of psychosocial development.
14. When caring for a depressed patient, the nurse’s first priority is safety
because of the increased risk of suicide.
16. According to psychoanalytic theory, the ego is the part of the psyche that
controls internal demands and interacts with the outside world at the conscious,
preconscious, and unconscious levels.
17. According to psychoanalytic theory, the superego is the part of the psyche
that’s composed of morals, values, and ethics. It continually evaluates thoughts
and actions, rewarding the good and punishing the bad. (Think of the superego
as the “supercop” of the unconscious.)
18. According to psychoanalytic theory, the id is the part of the psyche that
contains instinctual drives. (Remember i for instinctual and d for drive.)
19. Denial is the defense mechanism used by a patient who denies the reality of
an event.
21. Tyramine-rich food, such as aged cheese, chicken liver, avocados, bananas,
meat tenderizer, salami, bologna, Chianti wine, and beer may cause
severe hypertension in a patient who takes a monoamine oxidase inhibitor.
24. Common causes of child abuse are poor impulse control by the parents and
the lack of knowledge of growth and development.
27. Thought blocking is loss of the train of thought because of a defect in mental
processing.
29. A patient who has a chosen method and a plan to commit suicide in the next
48 to 72 hours is at high risk for suicide.
30. The therapeutic serum level for lithium is 0.5 to 1.5 mEq/L.
31. Phobic disorders are treated with desensitization therapy, which gradually
exposes a patient to an anxiety-producing stimulus.
36. According to Freud, a person between ages 12 and 20 is in the genital stage,
during which he learns independence, has an increased interest in members of
the opposite sex, and establishes an identity.
Prepared By: Prince Rener V. Pera, RN, MSN, MANc, EMT
37. According to Erikson, the identity-versus-role confusion stage occurs
between ages 12 and 20.
39. Suicide is the third leading cause of death among white teenagers.
40. Most teenagers who kill themselves made a previous suicide attempt and left
telltale signs of their plans.
44. A serum lithium level that exceeds 2.0 mEq/L is considered toxic.
45. Public Law 94-247 (Child Abuse and Neglect Act of 1973) requires reporting of
suspected cases of child abuse to child protection services.
46. The nurse should suspect sexual abuse in a young child who has blood in
the feces or urine, penile or vaginal discharge, genital trauma that isn’t readily
explained, or a sexually transmitted disease.
49. Asking a patient an open-ended question is one of the best ways to elicit or
clarify information.
50. The diagnosis of autism is often made when a child is between ages 2 and 3.
51. Defense mechanisms protect the personality by reducing stress and anxiety.
55. A patient who is taking disulfiram (Antabuse) must avoid ingesting products
that contain alcohol, such as cough syrup, fruitcake, and sauces and soups made
with cooking wine.
57. “People who live in glass houses shouldn’t throw stones” and “A rolling stone
gathers no moss” are examples of proverbs used during a psychiatric interview
to determine a patient’s ability to think abstractly. (Schizophrenic patients think
in concrete terms and might interpret the glass house proverb as “If you throw a
stone in a glass house, the house will break.”)
58. Signs of lithium toxicity include diarrhea, tremors, nausea, muscle weakness,
ataxia, and confusion.
65. Electroconvulsive therapy is normally used for patients who have severe
depression that doesn’t respond to drug therapy.
67. During the manic phase of bipolar affective disorder, nursing care is directed
at slowing the patient down because the patient may die as a result of self-
induced exhaustion or injury.
68. For a patient with Alzheimer’s disease, the nursing care plan should focus on
safety measures.
69. After sexual assault, the patient’s needs are the primary concern, followed by
medicolegal considerations.
72. The mood most often experienced by a patient with organic brain syndrome
is irritability.
75. The decision to use restraints should be based on the patient’s safety needs.
80. If a patient has symptoms of lithium toxicity, the nurse should withhold one
dose and call the physician.
82. A patient who constantly seeks approval or assistance from staff members
and other patients is demonstrating dependent behavior.
84. Methylphenidate (Ritalin) is the drug of choice for treating attention deficit
hyperactivity disorder in children.
85. Setting limits is the most effective way to control manipulative behavior.
86. Violent outbursts are common in a patient who has borderline personality
disorder.
87. When working with a depressed patient, the nurse should explore
meaningful losses.
91. The nurse should encourage an angry patient to follow a physical exercise
program as one of the ways to ventilate feelings.
96. When starting a therapeutic relationship with a patient, the nurse should
explain that the purpose of the therapy is to produce a positive change.
97. A basic assumption of psychoanalytic theory is that all behavior has meaning.
99. According to the pleasure principle, the psyche seeks pleasure and avoids
unpleasant experiences, regardless of the consequences.
102. For a patient who is at risk for alcohol withdrawal, the nurse should assess
the pulse rate and blood pressure every 2 hours for the first 12 hours, every 4
hours for the next 24 hours, and every 6 hours thereafter (unless the patient’s
condition becomes unstable).
104. The nurse should follow these guidelines when caring for a patient who is
experiencing alcohol withdrawal: Maintain a calm environment, keep intrusions
to a minimum, speak slowly and calmly, adjust lighting to prevent shadows and
glare, call the patient by name, and have a friend or family member stay with the
patient, if possible.
105. The therapeutic regimen for an alcoholic patient includes folic acid, thiamine,
and multivitamin supplements as well as adequate food and fluids.
106. A patient who is addicted to opiates (drugs derived from poppy seeds, such
as heroin and morphine) typically experiences withdrawal symptoms within 12
hours after the last dose. The most severe symptoms occur within 48 hours and
decrease over the next 2 weeks.
117. Family therapy focuses on the family as a whole rather than the individual. Its
major objective is to reestablish rational communication between family
members.
118. When caring for a patient who is hostile or angry, the nurse should attempt
to remain calm, listen impartially, use short sentences, and speak in a firm, quiet
voice.
119. Ritualism and negativism are typical toddler behaviors. They occur during the
developmental stage identified by Erikson as autonomy versus shame and
doubt.
122. Group therapy provides an opportunity for each group member to examine
interactions, learn and practice successful interpersonal communication skills,
and explore emotional conflicts.
129. Organic brain syndrome is the most common form of mental illness in
elderly patients.
132. Fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil) are serotonin
reuptake inhibitors used to treat depression.
133. The early stage of Alzheimer’s disease lasts 2 to 4 years. Patients have
inappropriate affect, transient paranoia, disorientation to time, memory loss,
careless dressing, and impaired judgment.
134. The middle stage of Alzheimer’s disease lasts 4 to 7 years and is marked by
profound personality changes, loss of independence, disorientation, confusion,
inability to recognize family members, and nocturnal restlessness.
135. The last stage of Alzheimer’s disease occurs during the final year of life and is
characterized by a blank facial expression, seizures, loss of appetite, emaciation,
irritability, and total dependence.
141. For a patient with substance-induced delirium, the time of drug ingestion can
help to determine whether the drug can be evacuated from the body.
144. Alcohol withdrawal may precipitate seizure activity because alcohol lowers
the seizure threshold in some people.
149. Patients with anorexia nervosa or bulimia must be observed during meals
and for some time afterward to ensure that they don’t purge what they have
eaten.
Prepared By: Prince Rener V. Pera, RN, MSN, MANc, EMT
150. Transsexuals believe that they were born the wrong gender and may seek
hormonal or surgical treatment to change their gender.
152. In a psychiatric setting, the patient should be able to predict the nurse’s
behavior and expect consistent positive attitudes and approaches.
153. When establishing a schedule for a one-to-one interaction with a patient, the
nurse should state how long the conversation will last and then adhere to the
time limit.
154. Thought broadcasting is a type of delusion in which the person believes that
his thoughts are being broadcast for the world to hear.
155. Lithium should be taken with food. A patient who is taking lithium shouldn’t
restrict his sodium intake.
156. A patient who is taking lithium should stop taking the drug and call his
physician if he experiences vomiting, drowsiness, or muscle weakness.
157. The patient who is taking a monoamine oxidase inhibitor for depression can
include cottage cheese, cream cheese, yogurt, and sour cream in his diet.
162. The three stages of general adaptation syndrome are alarm, resistance, and
exhaustion.
167. Clinical signs of lithium toxicity are nausea, vomiting, and lethargy.
168. Asking too many “why” questions yields scant information and may
overwhelm a psychiatric patient and lead to stress and withdrawal.
171. The nurse can use silence and active listening to promote interactions with a
depressed patient.
172. A psychiatric patient with a substance abuse problem and a major psychiatric
disorder has a dual diagnosis.
173. When a patient is readmitted to a mental health unit, the nurse should
assess compliance with medication orders.
175. Flight of ideas is movement from one topic to another without any
discernible connection.
180. Before electroconvulsive therapy, the patient is given the skeletal muscle
relaxant succinylcholine (Anectine) by I.V. administration.
Prepared By: Prince Rener V. Pera, RN, MSN, MANc, EMT
181. When a psychotic patient is admitted to an inpatient facility, the primary
concern is safety, followed by the establishment of trust.
182. An effective way to decrease the risk of suicide is to make a suicide contract
with the patient for a specified period of time.
183. A depressed patient should be given sufficient portions of his favorite foods,
but shouldn’t be overwhelmed with too much food.
184. The nurse should assess the depressed patient for suicidal ideation.
185. Delusional thought patterns commonly occur during the manic phase
of bipolar disorder.
188. When a patient who has schizophrenia begins to hallucinate, the nurse
should redirect the patient to activities that are focused on the here and now.
189. When a patient who is receiving an antipsychotic drug exhibits muscle rigidity
and tremors, the nurse should administer an antiparkinsonian drug (for
example, Cogentin or Artane) as ordered.
190. A patient who is receiving lithium (Eskalith) therapy should report diarrhea,
vomiting, drowsiness, muscular weakness, or lack of coordination to the
physician immediately.
191. The therapeutic serum level of lithium (Eskalith) for maintenance is 0.6 to 1.2
mEq/L.
195. After electroconvulsive therapy, the patient is placed in the lateral position,
with the head turned to one side.
197. Giving away personal possessions is a sign of suicidal ideation. Other signs
include writing a suicide note or talking about suicide.
199. A person who has paranoid personality disorder projects hostilities onto
others.
200. To assess a patient’s judgment, the nurse should ask the patient what he
would do if he found a stamped, addressed envelope. An appropriate response
is that he would mail the envelope.
201. After electroconvulsive therapy, the patient should be monitored for post-
shock amnesia.
204. Tardive dyskinesia causes excessive blinking and unusual movement of the
tongue, and involuntary sucking and chewing.
208. One theory that supports the use of electroconvulsive therapy suggests that
it “resets” the brain circuits to allow normal function.
210. In helping a patient who has been abused, physical safety is the nurse’s first
priority.
220. For a patient who has anorexia nervosa, the nurse should provide support at
mealtime and record the amount the patient eats.
223. Hypervigilance and déjà vu are signs of posttraumatic stress disorder (PTSD).