Nursing 3600

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natalie.french
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217530
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Nursing 3600
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2013-05-03 23:19:14
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psych questions
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final exam practice questions
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  1. Which of the following is a true statement regarding anger?

    A. Men are angrier than women
    B. Anger behavior in adulthood is determined by temperament and childhood experiences
    C. People have to behave aggressively to get what they want
    D. Humans can choose to slow down their reactions and to think and behave differently in response to various events
    D. Humans can choose to slow down their reactions and to think and behave differently in response to various events
    (this multiple choice question has been scrambled)
  2. According to Johnson's systematic review of the literature about violence on inpatient psychiatric units, which of the following is a predictor of violence?

    A. Suspiciousness
    B. Age
    C. Gender
    D. Race
    A. Suspiciousness
    (this multiple choice question has been scrambled)
  3. Which of the following approaches is important in caring for patients who are aggressive or violent?

    A. Stating boundaries before the initiation of the conversation
    B. Using control as evidenced by verbal and nonverbal behavior
    C. Knowing where colleagues are and making sure that they know where you are
    D. Leaving the office door closed while talking to the patient
    C. Knowing where colleagues are and making sure that they know where you are
    (this multiple choice question has been scrambled)
  4. The nurse who works with potentially aggressive patients should do so with respect and concern. Which of the following are goals of de-escalation? Select all that apply.

    a. Empathize with the patient's persepective
    b. Approach patients calmly
    c. Work with patients to find solutions
    d. Sympathize with the patient's perspective
    e. Avoid a power struggle
    • a. Empathize with the patient's persepective
    • b. Approach patients calmly
    • c. Work with patients to find solutions
    • e. Avoid a power struggle
  5. Patients with a history of damage to the cerebral cortex are more likely to exhibit which of the following? Select all that apply.

    a. Decreased inhibition
    b. Decreased impulsivity
    c. Decreased judgement
    d. Increased inhibition
    e. Increased impulsivity
    • a. Decresed inhibition
    • c. Decreased judgement
    • e. Increased impulsivity
  6. Usually, there are precursors to aggression and violence. Which of the following behaviors indicate an impending aggressive episode? Select all that apply.

    a. Tone and volume
    b. Staring and eye contact
    c. Anxiety
    d. Lethargy
    e. Pacing
  7. Which of the following is accurate regarding a crisis?

    A. Last longer than 6 weeks
    B. Occurs from a common precipitating event
    C. Defined as being in constant turmoil
    D. Occurs when an individual is at a breaking point
    D. Occurs when an individual is at a breaking point
    (this multiple choice question has been scrambled)
  8. For a person involved in disaster, which of the following are predictive of later developing posttraumatic stress disorder? Select all that apply.

    a. Lack of finances
    b. Inability to access health care
    c. Fear
    d. Dissociation
    e. Lack of family support
    • c. Fear
    • d. Dissociation
  9. Which of the following would be considered a situation crisis?

    A. Job promotion
    B. War
    C. Murder
    D. Flood
    A. Job promotion
    (this multiple choice question has been scrambled)
  10. For a patient in crisis, the assessment of the psychological domain focuses on which of the following? Select all that apply.

    a. Capability of the community to respond in a supportive way
    b. Disturbances in sleep patterns
    c. Emotions
    d. Disturbances in nutrition
    e. Coping strengths
    • c. Emotions
    • e. Coping strengths
  11. Which of the following is an example of a traumatic crisis?

    A. Leaving home for the first time
    B. Graduation
    C. Kidnapping
    D. Completing school
    C. Kidnapping
    (this multiple choice question has been scrambled)
  12. Which of the following therapeutic factors refers to the group members' relationships to the therapist and other group members?

    A. Universality
    B. Group cohesiveness
    C. Catharsis
    D. Altruism
    B. Group cohesiveness
    (this multiple choice question has been scrambled)
  13. According to Yalom (2005), there are 11 primary factors through which therapeutic changes occur in group psychotherapy. Which of the following factors correlates with learning to give to others?

    A. Altruism
    B. Group cohesiveness
    C. Universality
    D. Catharsis
    A. Altruism
    (this multiple choice question has been scrambled)
  14. During which phase of Tuckman's model of group development does the group reach a consensus and develop cooperative relationships?

    A. Forming
    B. Performing
    C. Storming
    D. Norming
    B. Performing
    (this multiple choice question has been scrambled)
  15. During a group therapy session, the nurse restates the interaction with the patient to check the patient's meaning. The nurse is using which technique?

    A. Clarification
    B. Summarizing
    C. Confrontation
    D. Support
    A. Clarification
    (this multiple choice question has been scrambled)
  16. Which type of group is usually associated with patients who have dementia who have difficulty with recent memory?

    A. Reminiscence groups
    B. Self-care groups
    C. Medication groups
    D. Anger management groups
    A. Reminiscence groups
    (this multiple choice question has been scrambled)
  17. A patient diagnosed with schizophrenia is having hallucinations. Which type of group would be benefical for this patient?

    A. Symptom management
    B. Medication
    C. Self-care
    D. Anger management
    A. Symptom management
    (this multiple choice question has been scrambled)
  18. Which of the following is an accurate characteristic of small groups?

    A. They are usually no more than seven to eight members
    B. They usually form subgroups
    C. They have less interpersonal experiences than large groups
    D. They tend to be less cohesive
    A. They are usually no more than seven to eight members
    (this multiple choice question has been scrambled)
  19. During which phase of group development does the group leader develop rapport with the members?

    A. Beginning
    B. Pre-interaction
    C. Working
    D. Termination
    A. Beginning
    (this multiple choice question has been scrambled)
  20. Which group member attempts to stimulate the group to action or decision?

    A. Orienter
    B. Energizer
    C. Coordinator
    D. Recorder
    B. Energizer
    (this multiple choice question has been scrambled)
  21. During which phase of group development does the group realize its purpose?

    A. Beginning
    B. Working
    C. Termination
    D. Pre-interaction
    B. Working
    (this multiple choice question has been scrambled)
  22. A group has been given the assignment of planning their weekend trip. This is an example of which type of group?

    A. Supportive therapy
    B. Psychotherapy
    C. Task
    D. Decision making
    C. Task
    (this multiple choice question has been scrambled)
  23. Which of the following maintenance roles is responsible for mediating differences among group members and relieves tension in conflict situations?

    A. Compromiser
    B. Encourager
    C. Gatekeeper
    D. Harmonizer
    D. Harmonizer
    (this multiple choice question has been scrambled)
  24. The client states, "Who is confused? He said I should go, but I didn't. Is that weird?" Which response by the nurse would be best to clairfy the client's statement?

    A. "When did you first notice yourself feeling confused?"
    B. "I dont understand. Can you explain in another way?"
    C. "How did you feel before you talked with him?"
    D. "Did he indicate to you exactly what he meant?"
    B. "I dont understand. Can you explain in another way?"
    (this multiple choice question has been scrambled)
  25. The nurse assesses a client as being on the mental health end of the mental health/mental illness continuum. Which statement by the client best supports this assessment? Select all that apply.

    a. "I am satisfied with my life and life choices."
    b. "My family thinks that I am a good person."
    c. "Perhaps I would have been better off if I had remained single."
    d. "I'm an average person leading a normal average life."
    e. "I've always thought I should have been more successful."
    • a. "I am satisfied with my life and life choices."
    • d. "I'm an average person leading a normal average life."
  26. Which comment is an example of directing a conversation to explore a topic in depth?

    A. "Have you ever considered attending a weekly self-help group?"
    B. "Hmmm, I see."
    C. "Are you saying that you want to move out of your apartment?"
    D. "Let's go back to the situation where you felt uncomfortable in class."
    D. "Let's go back to the situation where you felt uncomfortable in class."
    (this multiple choice question has been scrambled)
  27. A client has been working on relationship issues with a psychiatric nurse. The client usually changes the subject or reverts to cracking jokes when discussing a sensitive, emotionally charged subject. Today, the client remains focused on the subject. Which therapeutic communication technique would MOST appropriately encourage the client to continue to explore new ideas or issues in more depth?

    A. "Have you considered talking with your psychiatrist about increasing the dosage of your medication?"
    B. "It's not like you to stay on topic. Usually you are pretty good at keeping the tone lighthearted or avoiding heavy topics."
    C. "Let's review your progress so far and see what else seems to be an important issue to focus on today?"
    D. "That sounds really important to you. Tell me more about this."
    D. "That sounds really important to you. Tell me more about this."
    (this multiple choice question has been scrambled)
  28. You are a psychiatric nurse working with a client who feels a strong need to be in control at all times. Which therapeutic communication technique would MOST appropriately encourage this client to consider a new treatment approach?

    A. "You've come to me for expert advice, yet you reject the treatment option that I suggest."
    B. "Would it help you to talk with people who have tried those treatments themselves?"
    C. "Let's go back over these treatment options to be sure you have your facts straight."
    D. "This chapter out of a textbook that I edited is the best source of information about these treatment options."
    B. "Would it help you to talk with people who have tried those treatments themselves?"
    (this multiple choice question has been scrambled)
  29. One of your assigned clients speaks about family members, indicating that the members are highly educated with advanced doctorate and medical degrees. The client states, "I can never measure up to them." The nurse's BEST reply would be:

    A. "Maybe you are just more sensitive than they are."
    B. "What are some of the things that you have accomplished."
    C. "What would somone have to do to measure up?"
    D. "You are just as smart as your family."
    C. "What would somone have to do to measure up?"
    (this multiple choice question has been scrambled)
  30. You are working with a client who becomes upset one day and tells you, "I've decided just to give up on finishing the nursing program; it's too much." The BEST response from the nurse would be:

    A. "I am sure you are capable of finishing the nursing program."
    B. "You don't need to make a decision about that right now."
    C. "You think it's too much for you?"
    D. "It is probably too much for you to handle right now."
    C. "You think it's too much for you?"
    (this multiple choice question has been scrambled)
  31. Which statement by a client would indicate that the termination phase of the nurse-client relationship is resolved?

    A. "I feel so sad all the time about leaving the nurse."
    B. "I'm glad that we have become good friends."
    C. "I wish that the nurse would continue to remain in contact with me."
    D. "I didn't always agree with the nurse, but she gave good nursing care."
    D. "I didn't always agree with the nurse, but she gave good nursing care."
    (this multiple choice question has been scrambled)
  32. A patient has undergone diagnostic testing to determine whether she has breast cancer. She goes shopping at the mall to stop thinking about the possibility of cancer. She is using which of the following defense mechanisms?

    A. Sublimation
    B. Undoing
    C. Suppression
    D. Intellectualization
    C. Suppression
    (this multiple choice question has been scrambled)
  33. A patient comes to the emergency department with alcohol intoxication. He fell and hit his head at home and has a minor laceration. The nurse asks when his last drink was. The patient states that he didn't have a drink and "never touches the stuff." The patient is exhibiting which of the following defense mechanisms?

    A. Denial
    B. Devaluation
    C. Dissociation
    D. Displacement
    A. Denial
    (this multiple choice question has been scrambled)
  34. Which of the following communication techniques does the nurse use in establishing trust and developing empathy?

    A. Acceptance
    B. Observation
    C. Doubt
    D. Confrontation
    A. Acceptance
    (this multiple choice question has been scrambled)
  35. Which of the following is inconsistent with principles of therapeutic communication?

    A. A professional attitude sets the tone of the therapeutic relationship.
    B. Interventions are implemented from a theoretic base.
    C. The nurse must maintain patient confidentiality
    D. The nurse is the primary focus of the relationship.
    D. The nurse is the primary focus of the relationship.
    (this multiple choice question has been scrambled)
  36. During which phase of the nurse-patient relationship does the patient identify and explore specific problems?

    A. Orientation
    B. Debriefing
    C. Working
    D. Resolution
    C. Working
    (this multiple choice question has been scrambled)
  37. A teenager is mad at his parents about not being able to drive his father's car. He begins to stay out late with his friends after curfew. What defense mechanism is the teenager using?

    A. Devaluation
    B. Denial
    C. Displacement
    D. Acting out
    D. Acting out
    (this multiple choice question has been scrambled)
  38. Which of the following would be considered a therapeutic communication technique? Select all that apply.

    a. Agreement
    b. Restatement
    c. Challenges
    d. Confrontation
    • b. Restatement
    • d. Confrontation
  39. A patient diagnosed with borderline personality disorder is pitting one nurse against the other, calling one a best friend and declaring that the other is horrible. The patient is using which defense mechanism?

    A. Self-observation
    B. Suppression
    C. Splitting
    D. Sublimation
    C. Splitting
    (this multiple choice question has been scrambled)
  40. In a nurse-patient relationship, the patient may exhibit "testing behaviors." During which stage of the relationship does the patient typically use these behaviors?

    A. Working
    B. Resolution
    C. Orientation
    D. Transference
    C. Orientation
    (this multiple choice question has been scrambled)
  41. A patient diagnosed with a delusional disorder who uses excessive health care resources most likely has which type of delusions?

    A. Erotomanic
    B. Somatic
    C. Grandiose
    D. Jealous
    B. Somatic
    (this multiple choice question has been scrambled)
  42. Schizoaffective disorder has symptoms typical of both schizophrenia and which of the following type of disorder?

    A. Mood disorders
    B. Substance abuse disorders
    C. Eating disorders
    D. Anxiety disorders
    A. Mood disorders
    (this multiple choice question has been scrambled)
  43. Medications are not often used for a person with delusional disorder, but which of the following medication classifications are helpful during exacerbations? Select all that apply.

    a. Benzodiazepines
    b. Antipsychotics
    c. Antidepressants
    d. Nonbenzodiazepines
    e. Antianxiety
    • a. Benzodiazepines
    • b. Antipsychotics
  44. Which of the follwing statements is accurate regarding a person with delusional disorder?

    A. High intelligence is noted
    B. Few, if any, psychological deficits are noted
    C. Personality is generally affected
    D. Mental status is usually affected
    B. Few, if any, psychological deficits are noted
    (this multiple choice question has been scrambled)
  45. A patient diagnosed with schizophrenia is telling everyone that he is the president of the United States. This patient is exhibiting which type of delusion?

    A. Erotomanic
    B. Jealous
    C. Grandiose
    D. Somatic
    C. Grandiose
    (this multiple choice question has been scrambled)
  46. Which type of disorder is frequently found in patients with delusional disorders?

    A. Anxiety
    B. Substance abuse
    C. Mania
    D. Mood
    D. Mood
    (this multiple choice question has been scrambled)
  47. Which of the following is the central focus of persecutory delusions?

    A. A great, unreconized talent
    B. Unfaithfulness
    C. Injustice that must be remedied by legal action
    D. Involves bodily functions
    C. Injustice that must be remedied by legal action
    (this multiple choice question has been scrambled)
  48. Encephalipathic syndrome has occurred in a few patients when haloperidol is taken with which of the following medications?

    A. Lithium carbonate (Lithium)
    B. Furosemide (Lasix)
    C. Diazepam (Ativan)
    D. Ibuprofen (Motrin)
    A. Lithium carbonate (Lithium)
    (this multiple choice question has been scrambled)
  49. Assessment is the deliberate and systematic collection of biopsychosocial information or date to determine current and past health and functional status and to evaluate present and past coping patterns. Which of the following is a component of the social assessment?

    A. Mental status
    B. Risk factor assessment
    C. Quality of life
    D. Pharm assessment
    C. Quality of life
    (this multiple choice question has been scrambled)
  50. The nurse is completing an assessment interview. The nurse is attempting to bring the conversation back to the questions at hand when the patient goes off on a tangent. Which assessment interview behavior is the nurse using?

    A. Focusing
    B. Reflecting
    C. Presenting reality
    D. Restating
    A. Focusing
    (this multiple choice question has been scrambled)
  51. Which of the following interventions uses the reading of written materials to express feelings or gain insight?

    A. Bibliotherapy
    B. Reminiscence
    C. Token economy
    D. Behavioral modification
    A. Bibliotherapy
    (this multiple choice question has been scrambled)
  52. According to the World Health Organization, by 2030, which mental illness is projected to be the leading burden of disese worldwide?

    A. Anxiety
    B. Depression
    C. Substance abuse
    D. Schizophrenia
    B. Depression
    (this multiple choice question has been scrambled)
  53. According to the DSM-IV-TR, antisocial personality is placed on which of the following axes?

    A. I
    B. IV
    C. III
    D. II
    D. II
    (this multiple choice question has been scrambled)
  54. Which of the following is an accurate statement regarding mental health recovery?

    A. It is a growth experience with setbacks
    B. It is a step-by-step process
    C. It focuses on the illness
    D. It is a linear process
    A. It is a growth experience with setbacks
    (this multiple choice question has been scrambled)
  55. A patient diagnosed with schizophrenia is being assessed using the DSM-IV-TR criteria. It has been determined that the patient has a Global Assessment Functioning (GAF) score of 46. This score is associated with which of the following descriptions?

    A. Serious symptoms or serious impairment in social, occupational, or school functioning
    B. Superior functioning; no symptoms
    C. Persistent danger of severly hurting self
    D. Absent of minimal symptoms; good functioning in all areas
    A. Serious symptoms or serious impairment in social, occupational, or school functioning
    (this multiple choice question has been scrambled)
  56. A patient diagnosed with an anxiety disorder and diabetes mellitus is being seen in the outpatient mental health clinic. When using the DSM-IV-TR, diabetes would be listed under which Axis?

    A. III
    B. I
    C. IV
    D. II
    A. III
    (this multiple choice question has been scrambled)
  57. Which question would best serve the crisis intervention nurse who wished to assess a client's coping skills?

    A. "What are the relevant cultural issues in your life?"
    B. "How do you usually manage problems or unhapiness?"
    C. "When did you last experiment with any substance?"
    D. "What personal supports are presently available to you?"
    B. "How do you usually manage problems or unhapiness?"
    (this multiple choice question has been scrambled)
  58. On the second appointment at the crisis clinic, the client tells the nurse, "I worry hour after hour about my problem. I can't get away from it. I feel as though I'm going crazy." A helpful technique the nurse can recommend to the client to limit worry is to:

    A. Call the crisis hot line whenever the worrisome thoughts intrude
    B. Reserve an hour a day for worrying and devote the entire time to worry
    C. Talk about the worry with family and friends wheneber it crops up
    D. Not think about the worrisome topic or situation at any time
    B. Reserve an hour a day for worrying and devote the entire time to worry
    (this multiple choice question has been scrambled)
  59. A client as the crisis clinic who is embarrassed over losing control when the crisis occurred tells the nurse, "I have never wept or withdrawn before in my life." The intervention that will be of greatest help to him in regaining self-esteem is to:

    A. Give the client unconditional positive regard during all interactions
    B. Tell the client that its conterproductive to look backward and that its better to focus on coping
    C. Contact family members and advise them to be particularly complimentary to the client
    D. Explain that its normal to feel embarrassment for crisis behavior
    A. Give the client unconditional positive regard during all interactions
    (this multiple choice question has been scrambled)
  60. An effective way of evaluating learning provided by crisis intervention therapy is to:

    A. Ask what the client would do if a similar situation ocurred
    B. Discuss perceived need for further therapy
    C. Determine whether the client thinks medication would be helpful
    D. Ask whether the client thinks past mistakes will be repeated
    A. Ask what the client would do if a similar situation ocurred
    (this multiple choice question has been scrambled)
  61. A client at the crisis clinic has had four prior admissions for suicidal gestures. This time the client relates having gone into the bathroom and making superficial cuts on her wrists when her boyfriend told her he was going to break off the relationship. She showed the boyfriend her bleeding wrists, and he responded by bringing her to the clinic. To the nurse it is apparent that the client is being rewarded for being in crisis. This situation is called:

    A. Primary reward
    B. Secondary gain
    C. A crisis trigger
    D. Circumstantiality
    B. Secondary gain
    (this multiple choice question has been scrambled)
  62. Which of the following are negative symptoms associated with schizophrenia? Select all that apply.

    a. Ambivalence
    b. Avolition
    c. Anhedonia
    d. Deulsions
    e. Hallucinations
    • a. Ambivalence
    • b. Avolition
    • c. Anhedonia
  63. Which of the following are key diagnostic criteria for schizophrenia? Select all that apply.

    a. A direct physiologic effect of a substance or medical condition
    b. Major depression occuring concurrently with active symptoms
    c. One or more major areas of social or occupational functioning markedly below previously achieved levels
    d. Delusions present for a significant portion of time during a 1-month period
    e. Continuous signs for at least 6 months
    • c. One or more major areas of social or occupational functioning markedly below previously achieved levels
    • d. Delusions present for a significant portion of time during a 1-month period
    • e. Continuous signs for at least 6 months
  64. A patient diagnosed with schizophrenia is in anticholinergic crisis. The nurse would expect which finding to be noted upon assessment?

    A. Bradycardia
    B. Hypothermia
    C. Facial flushing
    D. Incontinence
    C. Facial flushing
    (this multiple choice question has been scrambled)
  65. A patient has been prescribed clozapine (Clozaril) for treatment of schizophrenia. The patient must be taught to monitor which blood levels weekly while taking this drug?

    A. WBC
    B. Platelets
    C. Hemoglobin
    D. Hematocrit
    A. WBC
    (this multiple choice question has been scrambled)
  66. Patients diagnosed with schizophrenia may experience disordered water balance that may lead to water intoxication. Which of the following may occur as a result of water intoxication?

    A. Hyponatremia
    B. Weight loss
    C. Hypernatremia
    D. Oliguria
    A. Hyponatremia
    (this multiple choice question has been scrambled)
  67. A patient diagnosed with schizophrenia is having delusions that he is being plotted against by the government. This would be documented as which of the following types of delusion?

    A. Somatic
    B. Grandiose
    C. Nihilistic
    D. Persecutory
    D. Persecutory
    (this multiple choice question has been scrambled)
  68. Which of the following is an anticholinergic side effect associated with some antipsychotic medications?

    A. Photophobia
    B. Increased tearing
    C. Diarrhea
    D. Salivation
    A. Photophobia
    (this multiple choice question has been scrambled)
  69. Positive symptoms of schizophrenia, specifically hallucinations and delusions, are thought to be caused by hyperactivity of which neurotransmitter?

    A. Norepinephrine
    B. Epinephrine
    C. Dopamine
    D. Acetylcholine
    C. Dopamine
    (this multiple choice question has been scrambled)
  70. Which of the following extrapyramidal side effects is noted by the patient having bradykinesia (slow movements) and a shuffling gait?

    A. Acute dystonia
    B. Tardive dyskinesia
    C. Pseudoparkinsonism
    D. Akathisia
    C. Pseudoparkinsonism
    (this multiple choice question has been scrambled)
  71. The nurse in the emergency department is assessing a client suspected of being suicidal. Number the following assessment questions, beginning with the most critical and ending with the least critical.

    "Are you currently thinking about suicide?"
    "Do you have a gun in your possession?"
    "Do you have a plan to commit suicide?"
    "Do you live alone? Do you have local friends or family?"
    • 1. "Are you currently thinking about suicide?"
    • 2. "Do you have a plan to commit suicide?"
    • 3. "Do you have a gun in your possession?"
    • 4. "Do you live alone? Do you have local friends or family?"
  72. A suicidal Jewish-American client is admitted to an in-patient psychiatric unit 2 days after the death of a parent. Which intervention must the nurse include in the care of this patient?

    A. Allow the client time to mourn the loss during this time of shiva
    B. To distract the client from the loss, encourage participation in unit groups
    C. Teach the client alternative coping skills to deal with grief
    D. Discuss positive aspects the client has in his or her life to build on strengths
    A. Allow the client time to mourn the loss during this time of shiva
    (this multiple choice question has been scrambled)
  73. Which intervention takes priority when working with newly admitted clients experiencing suicidal ideations?

    A. Encourage the client to participate in group therapy
    B. Remind the client that it takes 4 to 6 weeks for antidepressants to be fully effective
    C. Enlist friends and family to assist the client to remain safe after discharge
    D. Monitor the client at close, but irregular intervals
    D. Monitor the client at close, but irregular intervals
    (this multiple choice question has been scrambled)
  74. A client notifies a staff member of current suicidal ideations. Which intervention by the nurse would take priority?

    A. Determine if the client has a specific plan to commit suicide
    B. Place the client on a one-to-one observation
    C. Assess for past history of suicide attempts
    D. Notify all staff members and place the client on suicide precautions
    A. Determine if the client has a specific plan to commit suicide
    (this multiple choice question has been scrambled)
  75. Theresa, who has been hospitalized following a suicide attempt, is placed on suicide precautions on the psychiatric unit. She admits that she is still feeling suicidal. Which of the following interventions is most appropriate in this instance?

    A. Obtain an order from the physician to give Theresa a sedative to calm her and reduce suicide ideas
    B. Obtain an order from the physican to place Theresa in restraints to prevent any attempts to harm herself
    C. Do not allow Theresa to participate in any unit activities while she is on suicide precautions
    D. Check on Theresa every 15 mins or assign a staff person to stay with her on a one-to-one basis
    D. Check on Theresa every 15 mins or assign a staff person to stay with her on a one-to-one basis
    (this multiple choice question has been scrambled)
  76. Which of the following interventions are appropriate for a client on suicide precautions? Select all that apply.

    a. Remove all sharp objects, belts, and other potentially dangerous articles from the client's enviornment
    b. Accompany the client to off-unit activities
    c. Obtain a promise from the client that she will not do anything to harm herself for the next 12 hours
    d. Put all of the client's possessions in storage and explain to her that she may have them back when she is off suicide precautions
    • a. Remove all sharp objects, belts, and other potentially dangerous articles from the client's enviornment
    • b. Accompany the client to off-unit activities
    • c. Obtain a promise from the client that she will not do anything to harm herself for the next 12 hours
  77. Which statement describes a major difference between a client diagnosed with major depressive disorder and a client diagnosed with dysthymic disorder?

    A. A client diagnosed with dysthymic disorder experiences excessive guilt
    B. A client diagnosed with dysthymic disorder may experience psychotic features
    C. A client diagnosed with dysthymic disorder is at higher risk for suicide
    D. A client diagnosed with dysthymic disorder has symptoms for at lest 2 years
    D. A client diagnosed with dysthymic disorder has symptoms for at lest 2 years
    (this multiple choice question has been scrambled)
  78. Which charting entry most accurately documents a client's mood?

    A. "The client appears euthymic and is interacting with others"
    B. "The client expresses an elevation in mood"
    C. "The client isolates self and is tearful most of the day"
    D. "The client rates mood at a 2 out of 10"
    D. "The client rates mood at a 2 out of 10"
    (this multiple choice question has been scrambled)
  79. Which client is at highest risk for the diagnosis of major depressive disorder?

    A. A 64 year old single woman
    B. A 30 year old single man
    C. A 24 year old married woman
    D. A 70 year old married man
    C. A 24 year old married woman
    (this multiple choice question has been scrambled)
  80. A client is admitted to an in-patient psychiatric unit with a diagnosis of major depressive disorder. Which of the following data would the nurse expect to assess? Select all that apply.

    a. Loss of interest in almost all activities and anhedonia
    b. A change of more than 5% of body weight in 1 month
    c. Fluctuation between increased energy and loss of energy
    d. Psychomotor retardation or agitation
    e. Insomnia or hypersomnia
    • a. Loss of interest in almost all activities and anhedonia
    • b. A change of more than 5% of body weight in 1 month
    • d. Psychomotor retardation or agitation
    • e. Insomnia or hypersomnia
  81. A client is exhibiting behavioral symptoms of depression. Which charting entry would appropriately document these symptoms?

    A. "Expresses thoughts of poor self-esteem during group"
    B. "Rates mood as 4/10"
    C. "Rates anxiety as 2/10 after receiving lorazepam (Ativan)"
    D. "Became irritable and agitated on waking"
    D. "Became irritable and agitated on waking"
    (this multiple choice question has been scrambled)
  82. Which symptom is an example of physiological alterations exhibited by clients diagnosed with moderate depression?

    A. Decreased libido
    B. Slumped posture
    C. Helplessness
    D. Difficulty concentrating
    A. Decreased libido
    (this multiple choice question has been scrambled)
  83. Which of the following medications may be administered before ECT? Select all that apply.

    a. Glycopyrrolate (Robinul)
    b. Thipental sodium (Pentothal)
    c. Succinylcholine chloride (Anectine)
    d. Lorazepam (Ativan)
    e. Divalproex sodium (Depakote)
    • a. Glycopyrrolate (Robinul)
    • b. Thipental sodium (Pentothal)
    • c. Succinylcholine chloride (Anectine)
  84. A client diagnosed with major depressive disorder is presribed phenelzine (Nardil). Which teaching should the nurse prioritize?

    A. Educate the client about the need to take the medication even after symptoms have improved
    B. Remind the client that the medication takes 4 to 6 weeks to take full effect
    C. Instruct the client and family about the many food-drug and drug-drug interactions
    D. Teach the client about the possible sexual side effects and insomnia that can occur
    C. Instruct the client and family about the many food-drug and drug-drug interactions
    (this multiple choice question has been scrambled)
  85. A client diagnosed with major depressive disorder is newly prescribed sertraline (Zoloft). Which of the following teaching points would the nurse review with the client? Select all that apply.

    a. Monitor the client for suicidal ideations related to depressed mood
    b. Discuss the need to take medications, even when symptoms improved
    c. Instruct the client about the risks of abruptly stopping the medication
    d. Alert the client to the risks of dry mouth, sedation, nausea, and sexual side effects
    e. Remind the client that the medications full effect does not occur for 4 to 6 weeks
    • b. Discuss the need to take medications, even when symptoms improved
    • c. Instruct the client about the risks of abruptly stopping the medication
    • d. Alert the client to the risks of dry mouth, sedation, nausea, and sexual side effects
    • e. Remind the client that the medications full effect does not occur for 4 to 6 weeks
  86. Which symptoms would the nurse expect to assess in a client suspected to have serotonin syndrome?

    A. Hypomania, akathisia, cardiac arrythmias, and panic attacks
    B. Orthostatic hypotension, urinary retention, constipation, and blurred vision
    C. Dizziness, lethargy, headache, and nausea
    D. Alterations in mental status, restlessness, tachycardia, labile blood pressure, and diaphoresis
    D. Alterations in mental status, restlessness, tachycardia, labile blood pressure, and diaphoresis
    (this multiple choice question has been scrambled)
  87. Which medication would be classified as a tricyclic antidepressant?

    A. Citalopram (Celexa)
    B. Mirtazapine (Remeron)
    C. Nortriptyline (Pamelor)
    D. Bupropion (Wellbutrin)
    C. Nortriptyline (Pamelor)
    (this multiple choice question has been scrambled)
  88. Atropine sulfate is administered to a client receiving ECT for what purpose?

    A. To decrease secretions
    B. To relax muscles
    C. As a short-acting anesthetic
    D. To alleviate anxiety
    A. To decrease secretions
    (this multiple choice question has been scrambled)
  89. Succinylcholine is administered to a client receiving ECT for what purpose?

    A. As a short acting anesthetic
    B. To decrease secretions
    C. To alleviate anxiety
    D. To relax muscles
    D. To relax muscles
    (this multiple choice question has been scrambled)
  90. Which symptom is an example of an affective alteration exhibited by clients diagnosed with severe depression?

    A. Social isolation
    B. Apathy
    C. Difficulty falling asleep
    D. Somatic delusion
    B. Apathy
    (this multiple choice question has been scrambled)
  91. Major depressive disorder would be most difficult to detect in which of the following clients?

    A. A 75-year old man
    B. A 13-year old boy
    C. A 5-year old girl
    D. A 25-year old woman
    B. A 13-year old boy
    (this multiple choice question has been scrambled)
  92. Which nursing diagnosis takes priority for a client immediately after ECT?

    A. Chronic confusion r/t side effect of ECT
    B. Impaired social interaction r/t confusion
    C. Activity intolerance r/t weakness
    D. Risk for injury r/t altered mental status
    D. Risk for injury r/t altered mental status
    (this multiple choice question has been scrambled)
  93. A clients outcome states, "The client will make a plan to control of one life situation by discharge." Which nursing diagnosis documents the client's problem that this outcome addresses?

    A. Impaired social interaction
    B. Knowledge deficit
    C. Dysfunctional grieving
    D. Powerlessness
    D. Powerlessness
    (this multiple choice question has been scrambled)
  94. A client admitted with major depressive disorder has a nursing diagnosis of ineffective sleep pattern r/t aches and pains. Which is an appropriate short-term outcome for this client?

    A. This client will express feeling rested on awakening
    B. The client will sleep 6 to 8 hours at night by day 5
    C. The client will rate pain level at or below a 4/10
    D. The client will maintain a steady sleep pattern while hospitalized
    B. The client will sleep 6 to 8 hours at night by day 5
    (this multiple choice question has been scrambled)
  95. A client diagnosed with major depressive disorder is being considered for ECT. Which client teaching should the nurse prioritize?

    A. Inform the client that injury r/t seizure commonly occurs
    B. Discuss with the client and family expected short-term memory loss
    C. Monitor for any cardiac alterations to avoid possible negative outcomes
    D. Empathize with the client about fears regarding ECT
    B. Discuss with the client and family expected short-term memory loss
    (this multiple choice question has been scrambled)
  96. The client presents in the emergency room with constricted pupils, slurred speech, drowsiness, and respirations of 8/min. The person who accompanied the client to the ER reports the client had taken an unknown quanity of meperidine (Demerol) tablets 30 mins earlier. Which medication should the nurse anticipate giving the client?

    A. Methadone
    B. Diazepam (Valium)
    C. Phenytoin (Dilantin)
    D. Naloxone (Narcan)
    D. Naloxone (Narcan)
    (this multiple choice question has been scrambled)
  97. The nurse is completing an admission assessment for a client admitted to the medical unit with a diagnosis of Acute Alcohol Intoxication. When asked to describe his drinking pattern and amount, the client states, "I only drink when I am under a lot of stress." The clients response indicated what defense mechanism?

    A. Rationalization
    B. Regression
    C. Projection
    D. Denial
    A. Rationalization
    (this multiple choice question has been scrambled)
  98. A graduate nurse is assigned to work on a unit with mentally ill chemically abusing (MICA) clients. Which of the following statements by the nurse is reason for concern?

    A. "I never really understood what the clients were going through until I attended a counseling group session."
    B. "It must be very frightening for the client who experiences hallucinations while withdrawing from using alcohol."
    C. "The client should be complimented for maintaing 1 week of sobriety."
    D. "These clients have more excuses for their problems than anyone I know."
    D. "These clients have more excuses for their problems than anyone I know."
    (this multiple choice question has been scrambled)
  99. The client with paranoid schizophrenia and cocaine abuse is at risk for:

    A. increased psychiatric symptoms
    B. increased response to pscyhiatric medications
    C. decreased tardive dyskinesia
    D. decreased frequency and length of psychiatric hospitalizations
    A. increased psychiatric symptoms
    (this multiple choice question has been scrambled)
  100. A client diagnosed with bipolar I disorder is experiencing auditory hallucinations and flight of ideas. Which medication combination would the nurse expect to be prescribed to treat these symptoms?

    A. Lithium carbonate (Eskalith) and clonazepam (Klonopin)
    B. Verapamil (Calan) and topiramate (Topamax)
    C. Amitriptyline (Elavil) and divalproex sodium (Depakote)
    D. Risperidone (Risperdal) and Lamotrigine (Lamictal)
    D. Risperidone (Risperdal) and Lamotrigine (Lamictal)
    (this multiple choice question has been scrambled)
  101. A client prescribed lithium carbonate (Eskalith) is experiencing an excessive output of dilute urine, tremors, and muscular irritability. These symptoms would lead the nurse to expect that the clients lithium serum level would be which of the following?

    A. 1.5 mEq/L
    B. 3.5 mEq/L
    C. 2.6 mEq/L
    D. 0.6 mEq/L
    C. 2.6 mEq/L
    (this multiple choice question has been scrambled)
  102. The physician orders lithium carbonate 600 mg tid for a newly diagnosed client with Bipolar I Disorder. There is a narrow margin between the therapeutic and toxic levels of lithium. Therapeutic range for acute mania is:

    A. 0.5 to 1.0 mEq/L
    B. 1.0 to 1.5 mEq/L
    C. 10 to 15 mEq/L
    D. 5 to 10 mEq/L
    B. 1.0 to 1.5 mEq/L
    (this multiple choice question has been scrambled)
  103. Although historically lithium has been the drug of choice for mania, several other drugs have been used with good results. Which of the following are used in the treatment of bipolar disorder? (Select all that apply)

    a. Olanzepine (Zyprexa)
    b. Paroxetine (Paxil)
    c. Carbamazepine (Tegretol)
    d. Gabapentin (Neurontin)
    e. Tranylcypromine (Parnate)
    • a. Olanzepine (Zyprexa)
    • c. Carbamazepine (Tegretol)
    • d. Gabapentin (Neurontin)
  104. A nurse is educating a client about his lithium therapy. She is explaining signs and symptoms of lithium toxicity. For which of the following would she instruct the client to be on the alert?

    A. Occipital headache, palpations, chest pain
    B. Skin rash, marked rise in BP, bradycardia
    C. Fever, sore throat, malaise
    D. Tinnitus, severe diarrhea, ataxia
    D. Tinnitus, severe diarrhea, ataxia
    (this multiple choice question has been scrambled)
  105. A client diagnosed with bipolar mania enters the milieu area dressed in a provocative and physically revealing outfit. Which of the following is the most appropriate intervention by the nurse?

    A. Quietly walk with her back to her room and help her change into something more appropriate
    B. Explain to her that, if she wears this outfit, she must remain in her room
    C. Tell the client she cannot wear this outfit while she is in the hospital
    D. Do nothing and allow her to learn form the responses of her peers
    A. Quietly walk with her back to her room and help her change into something more appropriate
    (this multiple choice question has been scrambled)
  106. A nurse on an in-patient psychiatric unit receives report at 1500 hours. Which client would need to be assessed first?

    A. A client on one-to-one status because of active suicidal ideations
    B. A client pacing the hall and experiencing irritability and flight of ideas
    C. A client diagnosed with hypomania monopolizing time in the milieu
    D. A client with a history of mania who is to be discharged in the morning
    B. A client pacing the hall and experiencing irritability and flight of ideas
    (this multiple choice question has been scrambled)
  107. A nurse is planning to teach about appropriate coping skills. The nurse would expect which client to be at the highest level of readiness to participate in this instruction?

    A. A newly admitted client with an anxiety level of 8/10 and racing thoughts
    B. A client admitted 6 days ago for a manic episode refusing to take medications
    C. A newly admitted client experiencing suicidal ideations with a plan to overdose
    D. A client admitted 6 days ago for suicidal ideations following a depressive episode
    D. A client admitted 6 days ago for suicidal ideations following a depressive episode
    (this multiple choice question has been scrambled)
  108. Which nursing charting entry is documentation of a behavioral symptom of mania?

    A. "Thoughts fragmented, flight of ideas."
    B. "Mood euphoric and expansive. Rates mood a 10/10."
    C. "Pacing halls throughout the day. Exhibits poor impulse control."
    D. "Easily distracted, unable to focus on goals."
    C. "Pacing halls throughout the day. Exhibits poor impulse control."
    (this multiple choice question has been scrambled)
  109. The nurse is reviewing expected outcomes for a client diagnosed with Bipolar I disorder. Number the outcomes presented in order in which the nurse would address them.

    __The client exhibits no evidence of physical injury
    __The client eats 70% of all finger foods offered
    __The client is able to access available out-patient resources
    __The client accepts responsibility for own behaviors
    • 1. The client exhibits no evidence of physical injury
    • 2. The client eats 70% of all finger foods offered
    • 3. The client accepts responsibility for own behaviors
    • 4. The client is able to access available out-patient resources
  110. A client diagnosed with bipolar II disorder has nursing diagnosis of impaired social interactions r/t egocentrism. Which short-term outcome is an appropriate expectation for this client problem?

    A. The client will verbalize the desire to interact with peers by day 2
    B. The client will exchange personal information with peers at lunchtime
    C. The client will have an appropriate one-on-one interaction with a peer by day 4
    D. The client will initiate an appropriate social relationship with a peer
    C. The client will have an appropriate one-on-one interaction with a peer by day 4
    (this multiple choice question has been scrambled)
  111. A client newly admitted to an in-patient psychiatric unit who is experiencing a manic episode. The client's nursing diagnosis is imbalanced nutrition, less than body requirements. Which meal is most appropriate for this client?

    A. Grilled chicken and a baked potato
    B. Chili and crackers
    C. Chicken fingers and french fries
    D. Spaghetti and meatballs
    C. Chicken fingers and french fries
    (this multiple choice question has been scrambled)
  112. A provocatively dressed client diagnosed with bipolar I disorder is observed laughing loudly with peers in the milieu. Which nursing action is a priority in this situation?

    A. Administer PRN antianxiety medication to calm the client
    B. Join the milieu to assess the appropriateness of the laughter
    C. Redirect clients in the milieu to structured social activities, such as cards
    D. Privately discuss with the client the inappropriateness of provocative dress during hospitalization
    D. Privately discuss with the client the inappropriateness of provocative dress during hospitalization
    (this multiple choice question has been scrambled)
  113. A client diagnosed with bipolar I disorder in the manic phase is yelling at another peer in the milieu. Which nursing intervention takes priority?

    A. Calmly redirect and remove the client from the milieu
    B. Obtain an order for seclusion to help decrease external stimuli
    C. Notify the client to lower voice
    D. Administer prescribed PRN intramuscular injection for agitation
    A. Calmly redirect and remove the client from the milieu
    (this multiple choice question has been scrambled)
  114. A competent, voluntary client has stated he wants to leave the hospital. The nurse hides his clothes in an effort to keep him from leaving. With which of the following legal actions might the nurse be charged because of this nursing action?

    A. Battery
    B. Breach of confidentiality
    C. False imprisonment
    D. Assault
    C. False imprisonment
    (this multiple choice question has been scrambled)
  115. Joe is very restless and is pacing a lot. The nurse says to Joe, "If you dont sit down in the chair and be still, I'm going to put you in restraints!" With which of the following legal actions might the nurse be charged because of this nursing action?

    A. Battery
    B. Defamation of character
    C. Assault
    D. Breach of confidentiality
    C. Assault
    (this multiple choice question has been scrambled)
  116. An individual may be considered gravely disabled for which of the following reasons? (Select all that apply)

    a. A person, because of mental illness, cannot fufill basic needs
    b. A mentally ill person is in danger of physical harm based on inability to care for self
    c. A mentally ill person lacks the resourse to provide the necessities of life
    d. A mentally ill person is unable to make use of available resources to meet daily living requirements
    • a. A person, because of mental illness, cannot fufill basic needs
    • b. A mentally ill person is in danger of physical harm based on inability to care for self
    • d. A mentally ill person is unable to make use of available resources to meet daily living requirements
  117. Which of the following statements is (are) correct regarding the use of restraints? (Select all that apply)

    a. Restraints may never be initiated without a physicians order
    b. Orders for restraints must be reissued by a physician every 2 hours for children and adolescents
    c. Clients in restraints must be observed and assessed every hour for issues regarding circulation, nutrition, respiration, hydration, and elimination
    d. An in-person evaluation must be conducted within 1 hour of initiating restraints
    • b. Orders for restraints must be reissued by a physician every 2 hours for children and adolescents
    • d. An in-person evaluation must be conducted within 1 hour of initiating restraints
  118. Guidelines relating to "duty to warn" state that a therapist should consider taking action to warn a third party when his or her client: (Select all that apply)

    a. Threatens violence toward another individual
    b. Identifies a specific intended victim
    c. Is having command hallucinations
    d. Reveals paranoid delusions about another individual
    • a. Threatens violence toward another individual
    • b. Identifies a specific intended victim
  119. Attempting to calm an angry client by using "talk therapy" is an example of which of the following clients' rights?

    A. The right to refuse medication
    B. The right to confidentiality
    C. The right to privacy
    D. The right to the least-restrictive treatment alternative
    D. The right to the least-restrictive treatment alternative
    (this multiple choice question has been scrambled)
  120. Which would be a cue to an increased risk of a person becoming violent in the workplace?

    A. Poor on the job relationships
    B. Periods of sadness and crying
    C. Remains productive at work
    D. A sense of self-responsiblity
    A. Poor on the job relationships
    (this multiple choice question has been scrambled)
  121. The nurse is caring for a woman who states she was beaten and sexually assualted by a male friend. What should the nurse do first?

    A. Ask for a psychiatry consult
    B. Stay with the client during the physical exam
    C. Encourage the client to call her family lawyer
    D. Wash and dress the client's wounds before the physical exam
    B. Stay with the client during the physical exam
    (this multiple choice question has been scrambled)
  122. Which is the best action for the nurse to take when assessing a child who might be abused?

    A. Ask the child which of his parents caused this injury
    B. Confront the parents with the facts and ask them what happened
    C. Consult with a professional member of the health team and making a report
    D. Say or do nothing; the nurse has only suspicions, not evidence
    C. Consult with a professional member of the health team and making a report
    (this multiple choice question has been scrambled)
  123. Which is true about domestic violence between same-sex partners?

    A. Rates of violence are about the same as between heterosexual partners
    B. The frequency and intensity of violence are greater than between heterosexual partners
    C. Such violence is less common than that between heterosexual partners
    d. None of the above
    A. Rates of violence are about the same as between heterosexual partners
    (this multiple choice question has been scrambled)
  124. The nurse is designing an in-service for the ED staff as victims of partner abuse. It would be particularly important to include which factor?

    A. The victim will need to stay with a relative until it is safe to return home
    B. Staff members should include the abuser in the assessment and referral processes
    C. Leaving an abusive partner is a process over time. Returing to the abuser is typical
    D. Once the abuse is reported to the police, the abuser will no longer risk being abusive
    C. Leaving an abusive partner is a process over time. Returing to the abuser is typical
    (this multiple choice question has been scrambled)
  125. A high risk factor for childhood sexual abuse includes:

    A. multiple siblings
    B. undereducated parents
    C. low-income families
    D. parents who were sexually abused as children
    D. parents who were sexually abused as children
    (this multiple choice question has been scrambled)
  126. Which type of child abuse can be most difficult to treat effectively?

    A. physical
    B. emotional
    C. sexual
    D. neglect
    B. emotional
    (this multiple choice question has been scrambled)
  127. Women in battering relationships often remain in those relationships as a result of faulty or incorrect beliefs. Which of the following beliefs is valid?

    A. She often does things that provoke the violent episodes
    B. No one else would put up with her dependent, clinging behavior
    C. If she would do a better job of meeting his needs, the violence would stop
    D. If she tried to leave, she would be at increased risk for violence
    D. If she tried to leave, she would be at increased risk for violence
    (this multiple choice question has been scrambled)
  128. A client with a long history of alcoholism presents in the ED with a sudden onset of muscle pain, swelling, and weakness, and reddish-tinged urine. What lab value would the nurse evaluate as evidence of this clients disorder?

    A. Increase in CPK
    B. Decrease in AST
    C. Increase in LDL
    D. Decrease in FBS
    A. Increase in CPK
    (this multiple choice question has been scrambled)
  129. A client has been diagnosed with Wernicke-Korsakoff syndrome. Which is an example of this client's use of confabulation?

    A. The client clearly discussed a field trip, when in reality no field trip occurred
    B. The client jumps from one topic to another
    C. The client lies about anxiety level rating to receive more anxiolytics
    D. The client has difficulty keeping thoughts focused and on topic
    A. The client clearly discussed a field trip, when in reality no field trip occurred
    (this multiple choice question has been scrambled)
  130. A client with a long history of alcohol dependence comes to the ED with SOB and an enlarged abdomen. Which complication of alcoholism is this client experiencing, and what is the probable cause?

    A. Gastritis resulting from inflammation of the stomach lining
    B. Malnutrition resulting from thiamine deficiency
    C. Ascities resulting from cirrhosis of the liver
    D. Enlarged liver resulting from alcoholic hepatitis
    C. Ascities resulting from cirrhosis of the liver
    (this multiple choice question has been scrambled)
  131. A client with a long history of alcohol dependence comes to the ED with frank hemopytsis. Which life-threatning complication of alcoholism is this client experiencing, and what is the probably cause?

    A. Ascites resulting from impaired protein metabolism
    B. Hepatic encephalopathy resulting from the inability of the liver to convert ammonia to urea for excretion
    C. Thombocytopenia resulting from the inability of the diseased liver to produce adequate amounts of prothrombin and fibrinogen
    D. Hemorrhage of esophageal varices resulting from portal HTN
    D. Hemorrhage of esophageal varices resulting from portal HTN
    (this multiple choice question has been scrambled)
  132. A client with a history of alcoholism is seen in the ED 2 days after a binge of excessive alcohol consumption. The nurse suspects pancreatitis. Which symptoms would support the nurses suspicion?

    A. Constant, severe epigastric pain; nausea and vomiting; and abdominal distension
    B. Parlysis of the ocular muscles, diplopia, and ataxia
    C. Confusion, loss of recent memory, and confabulation
    D. Elevated creatine phosphokinase and signs and symptoms of congestive heart failure
    A. Constant, severe epigastric pain; nausea and vomiting; and abdominal distension
    (this multiple choice question has been scrambled)
  133. What substance stimulates the CNS?

    A. Crack
    B. Traizolam (Halcion)
    C. Vodka
    D. Lorazepam (Ativan)
    A. Crack
    (this multiple choice question has been scrambled)
  134. The nurse is educating a client about how to avoid sources of stimulation. What produces the least signifcant stimulation to the CNS?

    A. Excedrin Migraine
    B. Tequila shooter
    C. Filtered cigarettes
    D. Brewed coffee
    B. Tequila shooter
    (this multiple choice question has been scrambled)

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