⭐️CM1 : Mental Health test 1 : evolve quizzes

which response would the nurse make while speaking to a client diagnosed with schizophrenia who keeps interjecting sentences that have nothing to do with the main thoughts being expressed? a. "you aren't making any sense, lets talk about something else" b. "you're so confused, I can't understand what you're saying" c. "I'd like to understand what you're saying but I'm having trouble following you" d. "Why don't you take a rest? we can talk again later this afternoon"

"I'd like to understand what you're saying but I'm having trouble following you"

which response would the nurse make to a client with schizophrenia who claims to be Joan of Arc about to be burned at the stake? a. "tell me more about being joan of arc" b. "it seems like the world is a pretty scary place for you" c. "we both know you aren't john of arc" d. " you're safe here now"

"it seems like the world is a pretty scary place for you"

In what order would the nurse intervene during a crisis for a client?

1. identify anxiety source 2. encourage deep breathing & relaxation 3. firm but kind directions

a client has paralysis of the leg r/t somatoform disorder - conversion type. Which explanation must be considered when formulating a plan of care? a. the illness is very real to the client & requires appropriate nursing care b. although they believe there is an illness theres no cause for concern c. there is no physiological basis for the illness, only emotional care is needed d. nursing intervention is needed even though the nurse understands the client is not ill

a. the illness is very real to the client & requires appropriate nursing care

What approaches would the nurse use during a crisis intervention interview? a. active b. passive c. reflective d. interpretive e. goal directed

active / goal directed

which role is most important for the nurse to assume when providing therapeutic crisis intervention? a. passive listener b. participant observer c. active participant d. friendly advisor

active participant

which finding would alert the nurse that a client with schizophrenia is experiencing positive symptoms? poverty of speech agitated behavior lack of motivation delusions of grandeur auditory hallucinations

agitated behavior delusions hallucinations

___________ makes decision making difficult if not impossible for clients with schizophrenia.

ambivalence

which s/s are classified as negative symptoms for a schizophrenia client? ideas of reference anhedonia anergy illogical speech agitated behavior

anergy anhedonia

which initial action should the nurse take for a client with schizophrenia who sits rocking in a corer for long periods & responds to voices with words the staff can't understand? a. include the client in a discussion group b. encourage the client to talk to others c. allow the client to be alone while observing from a distance d. arrange the client's day to allow for short periods to be spent with the nurse

arrange the client's day to allow for short periods to be spent with the nurse

clients with paranoid schizophrenia tend to experienced __________ & ____________ and have behavioral changes such as anger, hostility, or violence

grandiose delusions auditory hallucinations

which nurse statement defines boundaries in the orientation phase of peplau's model : when talking to a depressed client who has just been admitted a. tell me about your relationship with your parents b. what's the main thing you'd like to work on during therapy c. hi! im mollie. ill introduce you around and help you settle in d. i understand you have been depressed. what can you tell me about that?

hi! im mollie. ill introduce you around and help you settle in

when exploring alternative coping strategies during the working phase, which question would the nurse ask the depressed client who has a hx of suicide attempts? a. how have you managed your problems before? b. were there other things going on in your life that made you want to die c. what do you feel that you've learned from this suicide attempt? d. how will you manage the next time your problems start piling up?

how will you manage the next time your problems start piling up?

a young adult college student smiles and angrily says "if my girlfriend is pregnant ill drop out of school, marry her, and get a job". Which term would be used to document this behavior? a. double-bind message b. mixed message c. false reassurance d. incongruent message

incongruent message

which behaviors would the nurse expect the client to do during the working phase of a therapeutic relationships according to peplau's model? initiate topics of discussion focus the convo on the nurse repress emotionally charged material accept limits on unacceptable behavior expression emotions r/t transference

initiate topics of discussion, accept limits on unacceptable behavior, & expression emotions r/t transference

which response would be given by a nurse caring for a client receiving corticosteroid therapy who states "i have trouble controlling my temper, which is so unlike me, and I don't know what is happening" a. tell them theres nothing to worry about b. inquire about mood swings c. reassure that everyone does this at times d. instruct them to avoid situations that cause irritation

inquire about mood swings

which defense mechanism is a client with DM2 using when they discuss in detail the diabetic metabolic process while eating a piece of chocolate cake? a. projection b. dissociation c. displacement d. intellectualization

intellectualization

which action would the nurse take for a client diagnosed with schizophrenia who is paranoid, delusional, withdrawn, and negativistic? a. explain the benefits of group activity b. invite them to play cards with the nurse c. encourage them to make friends d. mention that the psychiatrist has prescribed increased activity

invite them to play cards with the nurse

are memory problems associated with somatoform disorders?

no

at which point would the nurse start to discuss terminating the nurse-client relationships? a. working phase -- initiated by client b. orientation phase -- when contract is made c. working phase -- when client progresses d. termination phase -- when discharge plans are being made

orientation phase -- when contract is made

Phases of Peplau's Theory

orientation, working, & resolution

a hostile client with schizophrenia says "the voices are saying they're going to poison me because i'm bad". Which type of schizophrenic behavior is this? a. residual b. catatonic c. paranoid d. disorganized

paranoid

which actions would the nurse follow in the orientation phase? prioritizing the client's problems evaluating goal achievement w/ the client talking action to meet goals set clarifying the client & nurse's role encouraging & helping the client with self-exploration

prioritizing the client's problems / clarifying the client & nurse's role

which defense mechanism is most commonly used by clients who are diagnosed with paranoid-schizophrenia? projection repression regression conversion

projection

which clinical finding assessed in a client with the diagnosis of paranoid schizophrenia increases the risk for harm to self or others? aloofness prominent delusions anxiety stilted interactions command hallucinations

prominent delusions comand hallucinations

which priority action will the nurse implement when caring for a client diagnosed with schizophrenia who is exhibiting s/s of impaired judgement, paranoia, & agitation? a. giving antipsychotics b. protecting other clients c. talking to the client in a calm way d. placing the client in seclusion

protecting other clients

somatoform disorder

psychological disorder in which the symptoms take a somatic form without apparent physical cause

which sequela would the nurse expect in a client with a conversion disorder experiencing leg paralysis? a. experience a spread of paralysis to other body parts b. require continuous psych treatment c. recovers use of the leg but under stress, experiences the same issue d. follows an unpredictable emotional course in the future

recovers use of the leg but under stress, experiences the same issue

which behavior is anticipated for a client with somatoform disorder? a. writes down convos to retain info b. monopolizes convos to describe anxiety c. redirects convos to physical symptoms d. starts convos to learn about palliative care

redirects convos to physical symptoms

which outcome is the priority for a client in crisis? a. learn new skills in OT b. long-term follow up therapy c. regains psychological equilibrium d. gains insight into the problem

regains psychological equilibrium

which defense mechanism is most commonly used by clients who are diagnosed with undifferentiated schizophrenia? projection repression regression conversion

regression

which defense mechanism is being used by a client who has amnesia after a car wreck that caused fatalities?

repression

a client with schizophrenia is apathetic & exhibits an inappropriate affect. Which behavior is the client likely to exhibit? a. logical deductions b. suicidal preoccupation c. absence of self-criticism d. response to internal stimulation

response to internal stimulation

what happens during the termination phase?

review accomplishments, reinforce new behaviors, and close the relationship

which topic would be most important for the nurse to address at a group session for 3 chronic schizophrenic clients? a. relaxation techniques b. social skills in group settings c. rational behavior therapy d. assertiveness in relationships

social skills in group settings

which action would the nurse take to assist a client diagnosed with schizophrenia who moves to the counter to choose food but is unable to decide what to do next? a. nonverbal communication b. ask basic questions requiring simple choices c. speak in simple, declarative statements d. reward client for each choice made

speak in simple, declarative statemetns

which nursing action best prepares a client for termination of the therapeutic relationship? a. reassuring them that the relationship may be extended for as long as needed b. periodically summarizing their progress during the working phase c. telling the client during the 1st meeting how long it will last d. encouraging expression of feelings about the relationship during the termination phase

telling the client during the 1st meeting how long it will last

what is intellectualization?

the avoidance of painful emotions with the use of rational explanations that removes the even from any personal significance

individuals with schizophrenia and paranoia do not respond to a ______________ approach, because they are not trusting of others.

authoritarian

which factor is most critical for a single mother of 2 who recently lost her job & doesn't know what to do? a. developmental hx of the kids b. available situational supports c. underlying unconscious conflict d. willingness to restructure lifestyle

available situation supports

why does the nurse need to assume a direct & active role during a client crisis?

because the client's ability to cope decreases and help is needed to solve problems

why is it NOT best practice to allow schizophrenia clients to be alone for long periods?

being alone will not relieve anxiety, instead it will foster further with-drawl

which characteristic of affect are expected for a client with somatoform disorder -- conversion type? calm cheerful depressed frightened matter of fact

calm matter of fact

which initial approach would the nurse use to establish a therapeutic 1-1 relationship with a guarded, suspicious client who has schizophrenia? a. warm and friendly b. permissive & distant c. casual & honest d. undemanding and watchful

casual and honest

which behavior would indicate to the nurse that a client diagnosed with schizophrenia is improving? a. avoids other clients b. expresses negative feelings freely c. describes delusions in a meticulous way d. communicates with others in a organized manner

communicates with others in a organized manner

during the termination phase of a therapeutic relationship, a client misses a series of appointments without any explanation which action would the nurse take? a. terminate the relationship b. plan to attend the remaining designated meetings c. explore personal feelings with supervisor d. contact the client to encourage another session

contact the client to encourage another session

client's in crisis need assistance with ____________ and the nurse must be involved with _________

coping / problem solving

what meds increase the excitability of the CNS which can cause labile emotions manifested as euphoria or depression

corticosteroids

which client-focused intervention would the nurse implement first when a client is clearly demonstrating crisis behavior? a. encourage deep breathing b. assure them they are safe c. determine their present state of mind d. ask if they can identify coping skills

determine their present state of mind

which intervention would the nurse include in the initial plan of care for a client with chronic OCD of hand washing a. determine the purpose of the ritual b. limit the time allowed for the ritual c. develop a routine schedule of activities d. suggest a symptom substitute

develop a routine schedule of activities

the working phase of peplau's model is focused on what?

developing client's problem solving skills while addressing the areas that are causing trouble

clients with schizophrenia have a increased level of ________ which produces ___________

dopamine / hallucinations

when would a reflective approach be appropriate for a crisis?

during long term therapy

which action would the nurse take FIRST when managing interpersonal relationships with a client who has schizophrenia? a. insist they join group meetings & activites b. allow them to be alone with quiet activities c. establish a 1:1 relationship then bring them to a group activity d. encourage dependence by the client initially, but set limits on the extent of it

establish a 1:1 relationship then bring them to a group activity

which nursing actions best promote communication when obtaining a nursing hx? establishing eye contact asking why & how questions using broad, open ended phrases asking yes or no questions reassuring the client there is no need for alarm paraphrasing the client's messages

establishing eye contact, using broad, open ended phrases, and paraphrasing the client's messages

which action would the nurse take for a client who is admitted with conversion disorder? a. talk about the physical problem b. explore ways to verbalize feelings c. explain how stress caused the physical symptoms d. focus on the client's concerns regarding the symptoms

explore ways to verbalize feelings

a client says "since my husband died, I've got nothing to live for. I just want to die". The UAP says "things will get better soon". Which error has occurred? a. advice offering b. false reassurance c. belittling the client d. changing the subject

false reassurance

what is repression as a defense mechanism?

the coping of overwhelming emotions by blocking awareness or memory of the stressful event

Peplau's Theory

the developing interaction between nurse and patient

in what phase of papleu's model should the client & nurse agree to work together, establish a contract, and discuss the length of the relationship?

the orientation phase

what phase of peplau's model does focusing the conversation on the nurse occur?

the orientation phase, before trust is established

in what phase does the nurse evaluate goal achievement with the client according to papule's theory?

the termination phase

what phase of peplau's model would recurring patterns of interaction with others throughout life -- based on things developed within the family emerge?

the working phase

when does the identification and clarification of problems take place in peplau's theory?

the working phase

which phase of peplau's model will most of the client's problem solving occur?

the working phase

what concern is most important after the initial crisis issue has been addressed in a client?

their potential to perform ADL's

in a crisis intervention what is the priority?

to identify personal internal strengths and support systems

An extremely anxious client asks a nurse for help. Which initial response best reflects the nurse's role in crisis intervention? 1 "Tell me what you've done to help yourself." 2 "I'll be here for you to help you figure things out." 3 "I understand that in the past you've had problems." 4 "Tell me about the things that are bothering you the most."

2

which response would the nurse make to a client who says "i'm a terrible, evil person. the voices are telling me that God needs to punish me" a. "Tell me what you're thinking about yourself" b. those voices are a fantasy c. God is loving and won't punish you d. you aren't wicked - both God and I love you

Tell me what you're thinking about yourself

What is cataonia?

a state where the client displays extreme psychomotor retardation to the point of not talking or moving

what is dissociation?

a temporary alteration of consciousness or identity used to handle conflict

a client is emotionally immobilized since her husband requested a divorce. Which assessment would be performed FIRST? a. what factors contributed to his decision b. what the divorce means to her c. whether she is receptive to suggestions d. how she plans to support herself $$

what the divorce means to her

what is la belle indefference?

when a client with somatoform demonstrates a lac of concern about the symptom

why would it be important to contact the client to encourage another session during the termination phase when a client starts missing sessions?

you want to determine if there is a problem or some other reason for the client's absence