Which prominent behavioral therapy is centered on positive and negative reinforcement quizlet?

Social Psychology

10th EditionElliot Aronson, Robin M. Akert, Samuel R. Sommers, Timothy D. Wilson

525 solutions

Myers' Psychology for the AP Course

3rd EditionC. Nathan DeWall, David G Myers

955 solutions

Consumer Behavior: Buying, Having, Being

13th EditionMichael R Solomon

449 solutions

Myers' Psychology for AP

2nd EditionDavid G Myers

900 solutions

Consumer Behavior: Buying, Having, Being

13th EditionMichael R Solomon

449 solutions

Social Psychology

10th EditionElliot Aronson, Robin M. Akert, Samuel R. Sommers, Timothy D. Wilson

525 solutions

Myers' Psychology for the AP Course

3rd EditionC. Nathan DeWall, David G Myers

955 solutions

Myers' Psychology for AP

2nd EditionDavid G Myers

900 solutions

The Language of Composition: Reading, Writing, Rhetoric

2nd EditionLawrence Scanlon, Renee H. Shea, Robin Dissin Aufses

661 solutions

Technical Writing for Success

3rd EditionDarlene Smith-Worthington, Sue Jefferson

468 solutions

Edge Reading, Writing and Language: Level C

David W. Moore, Deborah Short, Michael W. Smith

304 solutions

Technical Writing for Success

3rd EditionDarlene Smith-Worthington, Sue Jefferson

468 solutions

1. Physiological needs - Hunger, thirst, air, and sleep
Must be satisfied before moving to higher level needs

2. Safety needs - Security, stability, protection, structure,
order, and freedom from chaos
Prominent when the future is unpredictable

3.Belongingness and love needs
D-love - Need to satisfy the emptiness people
experience without it
B-love - Experienced and grows as a result of being in the relationship

4.Esteem needs
Need to perceive oneself as competent and achieving

5.Need for self-actualization
D Satisfied when people identify their true self and reach full potential

Administration of which medication calls for careful nursing assessment of fluid and electrolyte balance?

1- Clozapine (Clozaril)
2- Fluvoxamine (Luvox)
3- Lamotrigine (Lamictal)
4- Lithium (Eskalith, Lithobid)

4- Lithium (Eskalith, Lithobid)

Rationale:
Lithium can cause disturbances in fluid balance in various body compartments. Sodium and potassium play a strong role in regulating fluid balance. Hyponatremia can increase the risk of lithium toxicity because increased renal reabsorption of sodium leads to increased reabsorption of lithium.

Which skill in critical thinking requires to be orderly in data collection?

1- Analysis
2- Inference
3- Evaluation
4- Interpretation

4- Interpretation

Rationale:
Interpretation is involved in the orderly collection of data. When information about a client is collected with an open mind, then the skill called analysis is being used. When the data collected about the client helps in solving an existing problem, then the skill called inference is being used. Evaluation is used when the results of nursing actions are determined.

A client with dementia who feels highly anxious and confused believes that the current day is actually different than what it is. Which statement made by the nurse is an example of validation therapy?

1- "No, try to be in your sense of reality."
2- "Yes, today is the day that you just mentioned."
3- "You should try improving your awareness level."
4- "Try to recall your past memories associated with the day."

2- "Yes, today is the day that you just mentioned."

Rationale:
Validation therapy an approach to communication with a confused client with dementia. In this approach, the nurse accepts the description of the time and place as stated by the client. Therefore, the statement "Yes, today is the day that you just mentioned" represents the use of validation therapy.

Which critical thinking skill does the nurse associate with the concept of maturity?

1- Eagerness to acquire knowledge
2- Being tolerant of different views
3- Trust in own reasoning processes
4- Ability to reflect on own judgments

4- Ability to reflect on own judgments

Rationale:
Maturity is the ability of a critical thinker to reflect on his or her own judgments

On the basis of the current understanding of neurotransmitters, the nurse can view a patient's symptoms of profound depression as likely related in part to which of the following?

1- Increased dopamine level
2- Decreased serotonin level
3- Decreased acetylcholine level
4- Increased norepinephrine level

2- Decreased serotonin level

Rationale:
A lowered serotonin level is highly supported as being related to depression; however, depression more probably is influenced by a number of neurotransmitter abnormalities.

A patient has been prescribed a sedative drug. The patient reports to the nurse that he or she erroneously took the drug after eating breakfast. What instruction should the nurse give the patient in such a situation?

1- "Do not sleep right away."
2- "Do not drive right away."
3- "Do not eat food for 2 hours."
4- "Do not take a bath right away."

4- "Do not drive right away."

Rationale:
Sedative hypnotic drugs blunt the alertness of a patient. Therefore, the patient is cautioned against performing high-precision activities like driving after taking the drug. If the patient drives after taking the drug, accidents can occur.

The nurse is discussing prescription drugs with a patient. The side effect of one of the patient's prescribed drugs is drowsiness. What would the nurse explain is the most appropriate time to take this drug so that the side effects are reduced?

1- Before going to bed
2- Before going to work
3- Before doing physical activities
4- After waking up in the morning

1- Before going to bed

Rationale:
Drugs with a sedative-hypnotic effect can blunt the degree to which a person feels alert and focused and they may cause drowsiness. Therefore, the prescribed drug is best taken before going to sleep so that it does not affect the patient's daily activities.

The nurse is speaking to a Japanese patient who attempted suicide. On assessment the nurse finds that the patient does not show any signs of mental illness or depression. What does the nurse keep in mind about this patient?

1- The patient is trying to get attention
2- The patient may have an underlying health issue
3- Cultural factors affect how people view the act of suicide
4- The patient should be prescribed antidepressants to prevent suicide

3- Cultural factors affect how people view the act of suicide

Rationale:
Some traditional Japanese consider suicide to be an act of honor, whereas suicide attempts are seen as a symptom of mental illness in Western cultures. The nurse can perform a general health assessment of the patient, but should not assume that this particular patient has an unrelated health issue. Similarly, the nurse should not assume that the patient is simply trying to get attention or needs to be put on antidepressants. Before making assumptions about a patient, the nurse should consider the larger cultural context.

What is the basic functional unit of the nervous system is called?

1- Neuron
2- Synapse
3- Receptor
4- Neurotransmitter

1- Neuron

Rationale:
Neurons are nerve cells. Cells are the basic unit of function. A neurotransmitter is a chemical substance that functions as a neuromessenger. This neurotransmitter then diffuses across a space, or synapse, to an adjacent postsynaptic neuron, where it attaches to receptors on the neuron's surface.

During crisis management in an earthquake-hit area, a nurse comes across a woman who has lost her family in the earthquake. However, she is still helping the team to recover other dead bodies from the debris. What characteristic does the woman exhibit in this case?

1- Panic
2- Anxiety
3- Resilience
4- Depression

3- Resilience

Rationale:
Resilience means an ability to recover from a difficult situation quickly. A resilient person is able to adapt to the loss and does not become a victim of negative emotions. Panic, anxiety, and depression take away the power to think and make a proper decision. These characteristics may interfere with coping and increase stress.

The nurse is reviewing the chart of a female patient diagnosed with paranoid thoughts directed toward her mother. Which notation suggests that the patient is engaging in transference?

1- Reports, "I know my mother wants to hurt me."

2- Patient stated, "The art therapist reminds me of my mother."

3- Patient appears anxious when stating, "I don't want to take calls from my mother."

4- Reports, "The nurse on the night shift was nice enough to get me an extra pillow."

2- Patient stated, "The art therapist reminds me of my mother."

Rationale:
Transference refers to feelings that the patient has toward health care workers that were originally held toward significant others in his or her life. Identifying the art therapist as reminding the patient of her mother is the most suggestive option that the client may be demonstrating transference.

Which is the most significant dysfunction in a patient with Alzheimer disease?

1- Impaired cognitive abilities
2- Impaired emotional control
3- Impaired behavioral control
4- Impaired sensory perception

4-Impaired cognitive abilities

Rationale:
In Alzheimer disease, the primary impairment is in cognition due to degenerative changes in the brain.

Which situation expresses how Sullivan viewed anxiety?

1- A sign of guilt in adults
2- Emotional experience felt after the age of 5 years
3- Adults trying to go beyond experiences of guilt and pain
4- Any painful feeling or emotion arising from social insecurity

4- Any painful feeling or emotion arising from social insecurity

Rationale:
According to Sullivan, the purpose of all behavior is to get needs met through interpersonal interactions and decrease or avoid anxiety. He viewed anxiety as a key concept and defined it as any painful feeling or emotion arising from social insecurity or blocks to getting biological needs satisfied.

Which statement by an 86-year-old patient reflects successful resolution of the expected psychosocial crisis?

1- "I enjoy being retired and having time to myself. Sometimes I go two or three weeks without seeing anyone."

2- "After my spouse died five years ago, my siblings and I have become closer. That gives me a sense of contentment."

3- "I worked all my life to take care of my family but my kids never come to see me. That's okay because I like being alone."

4- "I had chemotherapy for colon cancer three years ago. Since then, I do not have much energy so I quit going to activities at the senior center."

2- "After my spouse died five years ago, my siblings and I have become closer. That gives me a sense of contentment."

Rationale:
According to Erikson, integrity vs. despair is the psychosocial crisis of this developmental group. Successful completion of this task leads to a sense of integrity and fulfillment. This patient has maintained meaningful relationships with others, despite the loss of a spouse. Going two or three weeks without seeing anyone, never having one's children come to visit, and not going to outside activities indicate despair, represented by social isolation.

A nurse works in a psychiatry clinic. In which age group is the nurse likely to find dementia and Alzheimer disease?

1- Old age
2- Childhood
3- Middle age
4- Adolescence

1- Old age

Rationale:
Dementia and Alzheimer disease are commonly found in old age or aging populations. These disorders are caused by impairment in the brain and the nervous system, mostly due to degenerative changes. These diseases are not very common in childhood, adolescents, or middle-aged adults.

A depressed patient tells the nurse, "I have never been able to have a successful relationship. I am not able to trust anybody. Is there a problem with me?" This type of behavior suggests an issue in what area?

1- Grief
2- Role disputes
3- Role transitions
4- Interpersonal deficit

4- Interpersonal deficit

Rationale:
According to interpersonal psychotherapy, there are four types of problems. They are grief, role disputes, role transition, and interpersonal deficit. Interpersonal deficit refers to the problems where an individual is unable to initiate or sustain close relationships. In this case, the patient has problems with developing trust and having close relationships. This is an example of interpersonal deficit.

The nurse providing anticipatory guidance to the mother of a toddler should advise that childhood temper tantrums are handled best by which action?

1- Giving the child what he or she is asking for

2- Spanking the child at the onset of the tantrum behaviors

3- Scolding the child when he or she displays tantrum behaviors

4- Ignoring the tantrum and giving attention when the child acts appropriately

Rationale:
Ignoring the tantrum provides no reinforcement of the undesirable behavior. Instead, approval and reinforcement are given when the child is behaving in the desired way. This is an example of absence of reinforcement, or extinction.

A nurse is explaining to a group of nursing students about various factors that lead to a mental disease. Which mental disease was commonly found in the soldiers of Vietnam after the war?

1- Sleep disorder
2- Bipolar mood disorders
3- Obsessive-compulsive disorder (OCD)
4- Posttraumatic stress disorder (PTSD)

4- Posttraumatic stress disorder (PTSD)

Rationale:
Posttraumatic stress disorder (PTSD) was found in soldiers after the war in about 30% of patients. This disorder can develop at any time after exposure to a traumatic event.

A nurse plans and implements effective care based on current valid research. Which term applies?

1- Competence
2- Holistic practice
3- Advanced practice
4- Evidence-based practice

4- Evidence-based practice

Rationale:
Evidence-based practice refers to optimal nursing care resulting from integrating the best current evidence from valid research.

A patient states, "My health care provider said something about the medicine being prescribed working on my neurotransmitters. What exactly are neurotransmitters?" How does the nurse best answer the patient's question?

1- "Neurotransmitters are the reason you are depressed."

2- "Neurotransmitters are chemical messengers in the brain that help regulate specific functions."

3- "Neurotransmitters are too complicated to explain easily. Just know that the medication will help your mood."

4- "I will ask your health care provider to give you a more in-depth explanation on neurotransmitters and their effects."

2- "Neurotransmitters are chemical messengers in the brain that help regulate specific functions."

Rationale:
Neurotransmitters are chemicals released from neurons that function as a neuromessenger and influence brain functions. Telling the patient that the answer is too complicated belittles the patient by implying he or she cannot understand; however, stating that neurotransmitters are the reason he or she is depressed is too simplistic. Asking the health care provider to give the education abdicates the nurse's responsibility to provide patient education.

What characteristic of mental health allows people to adapt to tragedies, trauma, and loss?

1- Altruism
2- Resilience
3- Pessimism
4- Dependence

2- Resilience

Rationale:
Resilience is a characteristic that helps individuals cope with loss and trauma that may occur in life.

A nurse is assessing behavior patterns in patients based on age-appropriate development. Which developmental model should the nurse apply?

1- Erik Erikson's eight stages of development
2- Harry Stack Sullivan's interpersonal theory
3- Sigmund Freud's psychosexual stages of development
4- Hildegard Peplau's theory of interpersonal relationships

1- Erik Erikson's eight stages of development

Rationale:
Erik Erikson's eight stages of development help to identify age-related normal development and interpersonal skills.

Which statement by the sibling of a person diagnosed with depression demonstrates effective learning about the disorder?

1- "If our family had better health insurance, we could afford better treatments for this disorder."

2- "This problem probably resulted from our mother's frequent alcohol use during pregnancy."

3- "This problem is the result of personality flaws. My sibling has always had difficulty getting along with others."

4- "This problem probably was caused by certain genes. There are several members of our family who also have depression."

Rationale:
There is often a genetic predisposition for psychiatric disorders. The incidence of both thought and mood disorders are higher in relatives of people with these diseases than in the general population. Maternal use of alcohol during pregnancy causes learning and behavioral problems. Personality characteristics may contribute to the problem but are not the cause.

Role-playing is associated with which type of therapy?

1- Modeling
2- Psychoanalysis
3- Operant conditioning
4- Systematic desensitization

1- Modeling

Rationale:
In modeling, the therapist provides a role model for specific identified behaviors, and the patient learns through imitation. The therapist may do the modeling, provide another person to model the behaviors, or present a video for the purpose. Some behavior therapists use role-playing in the consulting room for modeling therapy.

A nurse is learning about the theory of humanism presented by Carl Rogers. Which behavior model based on humanism would the nurse apply when managing patients?

1- Provide information for cognitive intervention
2- Evaluate moral decisions toward patient cure
3- View each patient as unique and show positive regard
4- Encourage the patient to focus on "here-and-now" issues

3- View each patient as unique and show positive regard

Rationale:
Carl Rogers's theory of humanism encourages the nurse to view each patient as unique and to show positive regard. Encouraging the patient to focus on "here-and-now" issues is presented in the theory of existentialism by Albert Ellis. Providing information for cognitive intervention is presented in the theory of cognitive development by Jean Piaget. Evaluating moral decisions toward patient cure is presented in the theory of moral development by Lawrence Kohlberg.

Which statement most clearly shows a holistic view of mental illness?

1- "Mental illness is the result of the moral deterioration of our society."

2- "People are not as tough as they once were, which has led to an epidemic of mental illness."

3- "Mental illness is difficult to define because different cultures vary regarding what is healthy."

4- "The main reason for so much mental illness is that families no longer spend enough time together."

3- "Mental illness is difficult to define because different cultures vary regarding what is healthy."

Rationale:
There is no standard measure for mental health, in part because it is culturally defined and is based on interpretations of effective functioning according to societal norms. Stating that mental illness is caused by the moral deterioration of society, that people are not as tough as they once were, and that families do not spend enough time together demonstrate stigma and overgeneralization.

A nurse working in a psychiatric unit plans to apply milieu therapy on a patient. Which intervention should the nurse include in the therapy?

1- Coordinate the implementation of the nursing care plan and documents
2- Apply current knowledge to assess the patient's response to medication
3- Provide and maintain a safe and therapeutic environment in collaboration with others
4- Give anticipatory guidance to prevent or reduce mental illness and enhance mental health

3- Provide and maintain a safe and therapeutic environment in collaboration with others

Rationale:
Milieu therapy means providing and maintaining a safe and therapeutic environment in collaboration with patients, families, and other health care clinicians. Applying current knowledge to assess the patient's response to medication pertains to pharmacological, biological, and integrative therapies. Coordinating the implementation of the nursing care plan and documents refers to coordination of care. Giving anticipatory guidance to prevent or reduce mental illness and enhance mental health is related to health teaching and health maintenance.

A cognitive therapist would help a patient restructure the thought "I am stupid!" to making which statement?

1- "What I did was stupid."
2- "I am not as smart as others."
3- "Things usually go wrong for me."
4- "Things like this should not happen to anyone."

1- "What I did was stupid."

Rationale:
Cognitive therapists help patients identify, reality test, and correct distorted conceptualizations and dysfunctional beliefs, such as realizing that doing a stupid thing does not mean the person is stupid.

A nurse plans the care for an adult with a tumor in the brain's frontal lobe. Initial interventions should focus on the patient's anticipated problems with what function?

1- Hearing and hygiene
2- Motor function and judgment
3- Interpretation of visual stimuli
4- Sensory and calculation abilities

2- Motor function and judgment

Rationale:
The premotor cortex is responsible for the coordinated movement of multiple muscles, and the somatic association cortex integrates motor commands. The somatic association cortex is the area of the brain responsible for coordinating learned motor skills. Cognition, memory, and analytic functions are largely functions of a third region of the frontal lobe, known as the prefrontal cortex. Damage to this area of the frontal lobe may cause changes in personality.

Treatment of mental illnesses with psychotropic drugs is directed toward which of the following?

1- Regulating social behaviors
2- Altering brain neurochemistry
3- Correcting brain anatomical defects
4- Activating the body's normal response to stress

2- Altering brain neurochemistry

Rationale:
Psychotropic drugs act to increase or decrease neurotransmitter substances within the brain, thus altering brain neurochemistry. Psychotropic drugs will not alter actual brain anatomy in any way. They also are not effective in regulating social behavior; cognitive and/or behavior therapy is used to achieve that outcome. The body's normal response to stress is mediated via a series of naturally occurring hormones and is not stimulated by the use of psychotropic medications

Sullivan's term "security operations" and Freud's term "defense mechanisms" both reflect actions that serve to accomplish which of the following?

1- The reduction of anxiety
2- The increase of self-esteem
3- The increase of self-awareness
4- The reduction of cognitive distortions

1- The reduction of anxiety

Rationale:
Both Sullivan and Freud coined terms to mean actions that individuals do as an attempt to reduce anxiety. The terms do not refer to activities that increase self-esteem. Security operations and defense mechanisms are not conscious and therefore do not increase self-awareness. These terms do not refer to reducing cognitive distortions.

To what is resilience most closely related?

1- Adaptation
2- Spirituality
3- Self-confidence
4- Self-actualization

1- Adaptation

Rationale:
Resilience is associated closely with the process of adapting and helps people facing tragedies, loss, trauma, and severe stress. Resilience refers to an ability and capacity to secure resources needed to support one's well-being.

A nurse wants to find a description of the diagnostic criteria for addictive disorders. Which resource would have the most complete information?

1- The Future of Nursing: Leading Change, Advancing Health
2- Nursing Diagnoses Definitions and Classifications 2015-2017 (10 th edition)
3- Diagnostic and Statistical Manual of Mental Disorders, 5 th edition (DSM-5)
4- International Classification of Diseases, 9 th Revision, Clinical Modification (ICD-9-CM)

3- Diagnostic and Statistical Manual of Mental Disorders, 5 th edition (DSM-5)

Rationale:
The DSM-5 is published by the American Psychiatric Association and serves as the official guideline for diagnosing psychiatric disorders. It is the dominant mode of understanding mental illness in the United States and the framework for describing psychiatric disorders.

A nurse is teaching a group of nursing students about cultural factors affecting suicide, which is considered a mental health disorder in the United States. Which culture sometimes considers suicide bombers holy warriors?

1- Western culture
2- Indowestern culture
3- Middle Eastern culture
4- Traditional Japanese culture

3- Middle Eastern culture

Rationale:
A concept in mental health may be perceived differently depending on the culture. In the Middle Eastern culture, suicide bombers are considered holy warriors or martyrs. In Western culture, suicide is an abnormal behavior. The traditional Japanese consider suicide a deed of honor. Even the Indowestern culture considers suicide a psychiatric disorder.

The nurse understands that which term is used to describe new cases of mental disorders in a healthy population within a given period of time?

1- Incidence
2- Prevalence
3- Comorbidity
4- Epidemiology

1- Incidence

Rationale
Incidence refers to the number of new cases of mental disorders in a healthy population within a given period of time. Prevalence describes the total number of cases (new and existing) in a given population and within a specific period of time. Epidemiology is the study of the distribution of illnesses and disorders in human populations. Comorbidity refers to the simultaneous existence of two or more disorders.

What influences the secretion of the neurotransmitters norepinephrine and serotonin?

1- Hypothalamus
2- Limbic system
3- Circadian rhythm
4- Sleep and wakefulness

3- Circadian rhythm

Rationale:
The circadian rhythm influences the secretion of norepinephrine and serotonin. It is the fluctuation of various physiological and behavioral patterns over a 24-hour cycle. The hypothalamus is responsible for secreting hormones called releasing factors that act on the pituitary gland to stimulate or inhibit the synthesis and release of pituitary hormones. The limbic system is involved in modulating the emotional value of sensory material and uses norepinephrine, serotonin, and dopamine. The cycle of sleep and wakefulness is regulated and controlled by various parts of the brain and is affected by neurotransmitters.

The nurse caring for a patient prescribed clonazepam (Klonopin) would evaluate treatment as being successful when the patient demonstrates which of the following?

1- Less anxiety
2- Normal appetite
3- Improved sleep pattern
4- Reduced auditory hallucinations

1- Less anxiety

Rationale:
γ-Aminobutyric acid is thought to modulate neuronal excitability and anxiety. A drug that increases the effectiveness of γ-aminobutyric acid would result in anxiety reduction.

Which prominent behavioral therapy is centered on positive and negative reinforcement?

1- Aversion
2- Modeling
3- Operant conditioning
4- Systematic desensitization

3- Operant conditioning

Rationale:
Theorist B.F. Skinner's work on operant conditioning was based on positive and negative reinforcement. Modeling happens when one demonstrates the desired behavior, but there is no negative consequence. Desensitization is used to reduce a patient's fears. Aversion therapy uses negative consequences but not motive.

The nurse understands which information can be obtained from the Diagnostic and Statistical Manual ( DSM)?

1- Classification of mental health disorders
2- An explanation of the mental health continuum
3- Treatment intervention options for people with illnesses
4- Diagnoses for mental health disorders based on international models

1- Classification of mental health disorders

Rationale:
The DSM is one of the two major classification systems used in the United States for mental health disorders. It identifies mental health disorders based on specific criteria. An explanation of the mental health continuum is not provided in the DSM. Treatment intervention options for people with illnesses comes from healthcare provider knowledge and other resources, not the DSM. Diagnoses for mental health disorders based on international models can be found in the International Classification of Diseases (ICD).

The nurse planning care for a 14-year-old patient needs to take into account that which is the developmental task of an adolescent?

1- Establish trust
2- Gain autonomy
3- Achieve identity
4- Develop a sense of industry

3- Achieve identity

Rationale:
According to Erikson, the task of adolescence is to achieve identity rather than to be left in role confusion. A sense of identity is essential to making the transition into adulthood.

The nurse has to administer an injectable drug to a child. The child is very frightened at the sight of the injection and cries out loudly. To eliminate the fear, the nurse asks the child to watch another child who is getting injected. The other child, who is used to taking injections, shows no reaction while receiving the injection. What type of behavior therapy does this represent?

1- Modeling
2- Aversion therapy
3- Operant conditioning
4- Systematic desensitization

1- Modeling

Rationale:
The nurse is trying to eliminate the fear in the child by providing a role model. The child has been asked to watch another child who does not react to the stimulus (injection). This may help the child to learn to react in the same way as the other child while taking the injection and cooperate while receiving the medication. Aversion therapy pairs maladaptive behavior with a noxious stimulus or punishment. Operant conditioning uses positive reinforcement to increase desired behaviors. Systematic desensitization involves the development of behavior tasks that are customized to the patient's fears.

How can a nurse who is active in state and national legislation affect the climate for mental health treatment?

1- By becoming active in politics leading to a potential political career.

2- By reducing the stigma of mental illness and advocating for equality in treatment.

3- By advocating for reduced mental health insurance benefits to discourage abuse of the system by inappropriate psychiatric admissions.

4- By encouraging laws that would make the involuntary long-term commitment process easier and faster for caregivers of mentally ill persons.

2- By reducing the stigma of mental illness and advocating for equality in treatment.

Rationale:
Nurses who are aware of legislative concerns and who are active in organizations that promote mental health awareness and appropriate and equal treatment for mental illness help achieve the goal of parity, or equality of treatment for mentally ill individuals.

A group of nurses take action to ensure that consumers have the authority to choose from various health care options, participate in their health care decisions, and provide education and support. Which component of the recovery process has been enhanced?

1- Hope
2- Respect
3- Empowerment
4- Responsibility

3- Empowerment

Rationale:
Recovery is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. It has multiple components. Empowered consumers have the authority to choose from a range of options, participate in all decisions that affect their lives, and are educated and supported to do so.

A patient is admitted to the hospital experiencing severe depression. The nurse recognizes the possibility that depression may be related to a stress-induced hormonal imbalance associated with which of the following?

1- Cortisol
2- Gonadotropin
3- Clomipramine
4- Luteinizing hormone

1- Cortisol

Rationale:
Cortisol is a hormone released during periods of stress.

The nurse is studying the reports of two patients who show signs of depression. One patient (Patient A) is depressed because his pet dog has passed away, and the other patient (Patient B) is depressed at losing a spouse and material possessions in a natural disaster. What does this indicate about biological vulnerability and depression?

1- Patient A may respond better to the treatment provided.
2- Patient B may respond better to the treatment provided.
3- Patient A may be more vulnerable to developing severe depression.
4- Patient B may be more vulnerable to developing severe depression.

4- Patient B may be more vulnerable to developing severe depression.

Rationale:
The reports indicate that Patient B has faced a worse situation than Patient A. According to the diathesis-stress model, the depression in Patient A is likely because of biological vulnerability and less due to the impact of the situation. Losing a pet is not a very traumatic event and not a cause of depression. Therefore, depression in Patient A is likely due to biological vulnerability triggered by the loss of a pet. On the other hand, Patient B suffers from depression mainly because of an environmental stressor; biological vulnerability has a limited role here. Based on the information provided, the nurse cannot tell which patient would respond better to therapy.

When a tumor of the cerebellum is present, the nurse should expect that the patient initially would demonstrate which of the following?

1- Disequilibrium
2- Abnormal eye movement
3- Impaired social judgment
4- Blood pressure irregularities

1- Disequilibrium

Rationale:
The cerebellum is the organ primarily responsible for symptoms of equilibrium or imbalance. The cranial nerves (3, 4, and 5) that control the ocular muscles responsible for eye movement are located in the mid-brain and pons, not the cerebellum. Impaired social judgement would be associated with a tumor of the frontal lobe of the brain. Blood pressure regulation is controlled by the medulla oblongata, not the cerebellum.

Which of the following roles would not be within the scope of practice for a basic level registered nurse (RN)?

1- Leading a psychotherapy group session
2- Conducting a home mental health assessment
3- Facilitating the administration of psychotropic medications
4- Arranging for a patient to receive medical treatment off the unit

1- Leading a psychotherapy group session

Rationale:
Basic level RNs cannot perform psychotherapy. Administration of psychotropic medications, arrangements for patients, and conducting a mental health assessment are all appropriate expectations of this level of mental health nursing.

A nurse is assessing a patient who is diagnosed with schizophrenia. On obtaining a family history, the nurse finds that the patient's twin has also been diagnosed with the same disease. What is the concordance rate in this case? Record your answer using a whole number.

________%

50%

Rationale:
Concordance refers to how often one twin will be affected by the same illness as the other twin. In schizophrenia, the concordance rate is 50%, which means that the cause of schizophrenia is 50% due to an inheritance factor and 50% due to other factors.

A nurse cares for an elderly retired physician hospitalized with a diagnosis of heart failure. Applying Erikson's ego theory, how should the nurse address this patient?

1- Using the patient's first name
2- Doctor, followed by the patient's surname
3- Mr., Ms., or Mrs., followed by the patient's surname
4- A familiar and endearing term, such as Dear or Sweetheart

2- Doctor, followed by the patient's surname

Rationale:
According to Erikson, integrity vs. despair is the psychosocial crisis of this developmental group. Successful completion of this task leads to a sense of integrity and fulfillment. Despite retirement, this patient retains the dignity and respect denoted by use of the term "Doctor." Using the patient's first name, calling the patient Mr., Mrs., or Ms., or calling the patient dear or sweetheart disregard the patient's identity and life achievements.

A nurse is assessing a patient who is impulsive and lacks control regarding basic desires. Which system of personality should the nurse consider for this patient?

1- Id
2- Ego
3-Superego
4- Transference

1- Id

Rationale:
A patient who lacks control about basic desires has a personality that defines the id. The id works on basic instincts, and its focus is to fulfill the needs. The ego is a problem solver, appreciates reality, and logically plans to fulfill desires. The superego appreciates the ideal and seeks perfection more than being real. Transference is not a system of personality. It is the set of feelings that the patient has for the health care worker, which were earlier experienced for someone else.

Which statement about diagnosis of a mental disorder is true?

1- The symptoms of each disorder are common among all cultures.
2- Culture may cause variations in symptoms for each clinical disorder.
3-Psychiatric diagnoses are listed separately from other physical disorders in a five axes system.
4- All mental disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 are seen in all cultures.

2- Culture may cause variations in symptoms for each clinical disorder.

Rationale:
Every society has its own view of health and illness and the types of behavior categorized as mental illness. Culture also influences the symptoms of a particular disorder. For example, individuals of certain cultures are more likely to express depression through somatic symptoms than through affect and feeling tone. The five axis system was abandoned in the 5th edition of the DSM.

Schemas, automatic thoughts, and cognitive distortions are terms that relate to which type of therapy?

1- Biofeedback
2- Psychoanalysis
3- Cognitive-behavioral therapy
4- Rational-emotive behavioral therapy

3- Cognitive-behavioral therapy

Rationale:
Cognitive-behavioral therapy is guided by how people think about the world and their place in it. Schemas are unique assumptions about oneself, others, and the world in general. Automatic thoughts, or cognitive distortions, are rapid, irrational unthinking responses based on schemas that lead to false assumptions and misinterpretations. Biofeedback uses self-monitoring equipment to gain conscious control over unconscious processes. Psychoanalysis uses transference and countertransference to resolve intrapsychic conflicts. The focus of rational-emotive behavior therapy is on present attitudes, painful feelings, and dysfunctional behaviors that contribute to depression and anxiety.

When asked, the nurse explains that which is a patient's id?

1- The control over the emotional frustration felt over a loss
2- The source of a person's instincts to save oneself from harm
3- Not in place if physical abuse occurs after the age of five months
4- Able to effectively differentiate between believed experiences and reality

2- The source of a person's instincts to save oneself from harm

Rationale:
At birth we are all id. The id is the source of all drives, instincts, reflexes, needs, genetic inheritance, and capacity to respond as well as all the wishes that motivate us.

A 10-year-old child has this nursing diagnosis: delayed growth and development related to insufficient opportunities to interact with other children as evidenced by inability to engage in group play. What is the best outcome for this child's plan of care within the next two months?

1- Voluntarily join a team sport.
2- Find useful ways to engage in solitary play.
3- Attend three sessions with a certified child psychologist.
4- Have an improved sense of self.

1- Voluntarily join a team sport.

Rationale:
Competence versus inferiority: in the school years (ages 6 to 12 years), children's social environment continues to expand as they make new friends and develop new relationships. Children gain new knowledge, learn new skills, and grow more competent. Solitary play, follow-up sessions, and improved sense of self do not relate to the inability to engage in group play.

What is the premise underlying behavioral therapy?

1- Behavior is learned and can be modified.
2- Behavior is a product of unconscious drives.
3- Motives must change before behavior changes.
4- Behavior is determined by cognitions; change in cognitions produces new behavior.

1- Behavior is learned and can be modified.

Rationale:
The premise underlying behavior therapy is that behavior is learned and can be modified. Behaviorists agree that behavior can be changed without insight into the underlying cause.

A nurse is learning about the characteristics of a self-actualized person. Which features should the nurse evaluate? Select all that apply.

1- Self-acceptance
2- Self-centeredness
3- Respect for others
4- Active social interest
5- Lack of social interest

1- Self-acceptance
3- Respect for others
4- Active social interest

Rationale:
A self-actualized person shows acceptance of self and others. A self-actualized person shows respect and is fair to others. A self-actualized person shows active social interest and is creative. A self-actualized person is problem-centered and not a self-centered person. Lack of social interest is not a feature of a self-actualized person; instead there is active social interest.

What are the cells that respond to stimuli, conduct electrical impulses, and release neurotransmitters?

1- Neurons
2- Synapses
3- Dendrites
4- Receptors

1- Neurons

Rationale:
Neurons are the basic functional unit of the nervous system responsible for sending and receiving messages as electrochemical events.

Which neuromodulator is involved in the regulation of mood and anxiety?

1- Dopamine
2- Substance P
3- Neurotensin
4- Somatostatin

2- Substance P

Rationale:
Substance P is involved in the regulation of mood and anxiety. Dopamine is a monoamine neurotransmitter. Neurotensin and somatostatin are neuromodulators, but they are not involved in the regulation of mood and anxiety.

Which physiological actions are carried out by the neuron? Select all that apply.

1- Responding to stimuli
2- Releasing neurotransmitters
3- Stimulating hormonal release
4- Conducting electrical impulses
5- Producing adenosine triphosphate (ATP)

1- Responding to stimuli
2- Releasing neurotransmitters
4- Conducting electrical impulses

Rationale:
The neuron responds to stimuli, releases neurotransmitters, and conducts electrical impulses. Neurons do not stimulate the release of hormones. Hormones are released as a result of a neural, hormonal, or humoral stimulus. A set of cellular processes generates ATP.

Based on current understanding of brain physiology, which of the following neurotransmitters would the nurse expect to see targeted with the medication prescribed for the treatment of depression?

1- Histamine
2- Serotonin
3- Dopamine
4- Gamma-amino butyric acid (GABA)

2- Serotonin

Rationale:
Antidepressant medication targets serotonin and norepinephrine. Dopamine is implicated in schizophrenia (increase) and Parkinson disease (decrease). GABA is implicated in anxiety disorders. Acetylcholine is implicated in Alzheimer disease, as well as Huntington disease and Parkinson disease. Histamine is associated with allergic reactions.