PMH NURSING FOUNDATIONS
A PMH nurse refrains from sharing personal struggles with a patient to maintain this professional boundary.
What is therapeutic use of self?
Rationale: The nurse uses self purposefully, not socially. Over-sharing shifts focus away from the patient.
A patient with schizophrenia shows flat affect, alogia, and avolition. These are classified as this symptom type.
What are negative symptoms?
Rationale: Negative symptoms reflect loss of function and respond poorly to meds.
The priority lab to monitor for a patient taking lithium long-term is this.
What is renal function (BUN/creatinine)?
Rationale: Lithium is renally excreted; toxicity risk is high.
Saying, “Tell me more about what you’re feeling right now,” is an example of this technique.
What is focusing?
Rationale: Directs attention without judgment.
Informed consent requires competence, disclosure, comprehension, and this.
What is voluntariness?
Rationale: Consent must be free of coercion.
The primary goal of milieu therapy on an inpatient psych unit is to promote this outcome.
What is adaptive functioning through a structured environment?
Rationale: Milieu therapy uses structure, safety, and social interaction to support behavior change.
The key distinction between bipolar II and major depressive disorder is a history of this.
What is hypomania?
Rationale: Bipolar II includes hypomanic episodes — not full mania.
A patient on clozapine develops fever and sore throat. The nurse should suspect this condition.
What is agranulocytosis?
Rationale: Life-threatening adverse effect — requires immediate CBC.
A patient states, “The TV is sending me messages.” The nurse’s best response uses this approach.
What is presenting reality without arguing?
Rationale: Do not validate delusions; gently redirect.
The ethical principle most closely related to “do no harm” is this.
What is nonmaleficence?
Rationale: Core nursing obligation.
A nurse recognizing countertransference should take this immediate action.
What is seeking supervision and reflecting on feelings?
Rationale: Awareness and supervision prevent impaired clinical judgment.
A patient with PTSD avoids crowds and reports hypervigilance. This symptom cluster is known as this.
What is arousal/reactivity?
Rationale: PTSD clusters: intrusion, avoidance, negative cognition/mood, arousal/reactivity.
Which medication class carries the highest risk for metabolic syndrome?
What are second-generation (atypical) antipsychotics?
Rationale: Weight gain, diabetes, dyslipidemia are major concerns.
Which response best addresses patient ambivalence in motivational interviewing?
What is reflective listening?
Rationale: Reflection promotes insight and readiness for change.
A patient threatens a specific person. The nurse’s legal duty is to do this.
What is warn/protect the identifiable victim?
Rationale: Tarasoff ruling.
Trauma-informed care assumes that this is true for all patients.
What is that trauma may be present even if not disclosed?
Rationale: Universal precautions prevent re-traumatization.
A patient presents with unstable relationships, fear of abandonment, and splitting. Most likely diagnosis?
What is borderline personality disorder?
Rationale: Splitting and affective instability are hallmark features.
A patient taking MAOIs must avoid tyramine to prevent this complication.
What is hypertensive crisis?
Rationale: Tyramine increases norepinephrine → severe hypertension.
A nurse avoids “why” questions because they do this.
What is increase defensiveness?
Rationale: “Why” implies judgment.
The least restrictive intervention principle guides decisions about this.
What are restraints and seclusion?
Rationale: Use only when necessary for safety.
A patient repeatedly tests limits with staff. The most therapeutic response is to do this.
What is set consistent, clear limits with follow-through?
Rationale: Inconsistency escalates behavior; structure promotes safety.
A patient has somatic symptoms with excessive anxiety despite negative medical findings. This is best described as
What is somatic symptom disorder?
Rationale: Focus is distress and dysfunction, not symptom falsification.
A patient develops tremor, diarrhea, confusion, and ataxia. Which medication level is most concerning?
What is elevated lithium level?
Rationale: These are classic lithium toxicity symptoms.
The most therapeutic response to manipulation is to do this.
What is remain neutral and set consistent limits?
Rationale: Emotional reactions reinforce maladaptive behavior.
A patient refusing medication while psychotic requires assessment of this first.
What is decision-making capacity?
Rationale: Capacity is task-specific and can fluctuate.