Mental Chapter Chapter 7-9

A nurse who provides care in a large, inner-city hospital is aware of the large influence of culture on health. The nurse recognizes that culture is best understood as a shared system that encompasses what? Beliefs, values, and behavioral expectations Dress, relationships, and diet Health behaviors, roles, and priorities Knowledge, skills, and norms

Beliefs, values, and behavioral expectations

A psychiatric nurse is assigned to perform observation of a client in restraints. The nurse knows that this client must be checked on how often? Every 4 hours Every shift Constantly for the first hour Every hour

Constantly for the first hour

Which component of hardiness encompasses the ability to make appropriate decisions in life activities? Control Commitment Challenge Change

Control

A nurse is aware that which of these represents a biochemical variation that may exist between clients of different cultures? Risk for osteoporosis Skin cancer Motor development Drug metabolism

Drug metabolism

Which state allows for an insanity defense? Iowa Idaho Montana Utah

Iowa

Which statement accurately describes the insanity defense? It is rarely successful It is commonly used It is accepted by the public It is viewed positively by the courts

It is rarely successful

Which culture believes that vigorous handshaking is aggressive? Native American Spanish French Asian

Native American

According to Purnell's model of cultural competence, which would not be included as a primary cultural characteristic? Age Race Color Occupation

Occupation

In which culture is touch uncommon and loudness considered disrespectful? Mexican American American Indian Native American South Asian women

South Asian women

A nurse understands the importance of protecting clients' rights of self-determinism. Self-determinism is similar to which ethical principle? autonomy veracity justice beneficence

autonomy

Which of the nurse's assessment questions would best identify whether the client has insight into the illness? "Has anyone ever spoken to you about having a mental illness?" "Do you think that your illness prevents you from functioning well?" "Has anything like this happened to you before?" "Do you ever hear voices or see things that other people do not see?"

"Do you think that your illness prevents you from functioning well?"

Which question would be best for the nurse to ask in order to assess recent memory? "When is your birthday?" "What did you eat for breakfast today?" "How are an orange and an apple different?" "Why are you at the health care clinic today?"

"What did you eat for breakfast today?"

Which statement made by the client demonstrates hardiness when faced with a health issue? "My father was diagnosed with this illness as well." "What do I need to do to manage this illness?" "I know my faith will get me through this illness." "Can you explain what caused this illness?"

"What do I need to do to manage this illness?"

The nurse is preparing to assess a client's remote memory. Which questions would be most appropriate for the nurse to ask? "Can you tell me what you have eaten in the last 24-hours?" "When did you get your first job?" "What did you do last evening?" "How are an apple and orange the same?"

"When did you get your first job?"

The nurse is explaining the responsibilities to a client's legal guardian. Which statements by the nurse are correct? Select all that apply. "You have to make the client stay with you." "You are supposed to write checks for the client." "You are supposed to monitor the client all the time." "You have to make health care decisions for the client." "You, not the client, should sign legal documents."

"You are supposed to write checks for the client." "You have to make health care decisions for the client." "You, not the client, should sign legal documents."

Which client of a forensic nurse has most likely been found not guilty but mentally ill (not guilty by reason of insanity) following the commission of a serious crime? A client who is being held involuntarily in a secure psychiatric setting A client with a history of mental illness who is serving a lengthy term in a federal prison A client who is receiving care involuntarily on a community hospital's psychiatric unit A client who has been released into the community with strict limits on activity

A client who is being held involuntarily in a secure psychiatric setting

As a result of the increasing severity of delusions and consequent unsafe behavior, a client has been admitted to a psychiatric facility and judged incompetent to make decisions. Who will now make decisions for the client? The client's primary nurse The client's psychiatrist A hospital-appointed interdisciplinary committee A guardian appointed by the court

A guardian appointed by the court

Which scenario conveys the application of cultural competence in the provision of nursing care? A new nurse has a client who speaks Spanish; the nurse has asked a Hispanic colleague to tell the new nurse about the culture, ideas for care, and how cultural beliefs might influence the client's response to health care interventions. An experienced nurse states during a nursing report meeting, "I just don't feel it is appropriate to allow the client to attend Mass when everyone else has to stay here." The nurse has independently formed a prayer group on the unit for all clients who are Catholic. The nurse has begun a client teaching group entitled "Understanding Your Medications."

A new nurse has a client who speaks Spanish; the nurse has asked a Hispanic colleague to tell the new nurse about the culture, ideas for care, and how cultural beliefs might influence the client's response to health care interventions.

The nurse is preparing to perform a psychosocial assessment of a client with schizophrenia. The client has a history of extreme aggression. What is the optimal setting for conducting an interview with the client? A table in the hospital cafeteria. A conference hall in the hospital. An isolated room outside the hospital premises. A physician's intake room with other medical personnel nearby.

A physician's intake room with other medical personnel nearby.

he nurse wants to ensure culturally competent care to a Black American who was born and raised on a Caribbean-speaking island. The nurse considers that a client from this culture may hold values and beliefs consistent with what? Discussing health problems with providers of the same sex Creating a balance between yin and yang to promote well-being Creating a balance between good and evil to promote well-being A spiritual approach and the use of rituals

A spiritual approach and the use of rituals

When the nurse asks, "How would you carry out this plan?" the nurse is questioning which component of a suicide assessment? Access Ideation Plan Method

Access

A client who recently immigrated from Eastern Europe comes to the clinic for an evaluation. During the assessment, the nurse notes that the client has adopted the local area's mannerisms and dress. The nurse interprets this as what? Acculturation Cultural identity Linguistic competence Cultural competence

Acculturation

A client with depression who is undergoing a colonoscopy tomorrow is receiving preoperative education regarding the procedure. Which nursing task best describes the explanation of the procedure and the associated risks and benefits? Ascertaining the client's privacy Acquiring informed consent Encouraging the client to be self-determined Acting in a beneficent manner

Acquiring informed consent

Which role of the nurse-client relationship is being exhibited when the nurse informs the client and then supports him or her in whatever decision he or she makes? Advocate Caregiver Teacher Parent surrogate

Advocate

While conducting an interview with a psychiatric-mental health client, the nurse is observing the client's facial expressions and nonverbal cues. What are these physical manifestations known as? Demeanor Temperament Mood Affect

Affect

The nurse working in the psychiatric unit observes that the African American clients experience more side effects from psychotropic drugs compared to the White clients. This is most likely for which reason? African Americans require higher dosages of psychotropic drugs to obtain a response. African Americans are less likely to follow the dosing schedule. African Americans are extremely sensitive to psychotropic drugs. African Americans metabolize psychotropic drugs more slowly.

African Americans metabolize psychotropic drugs more slowly.

A psychiatric-mental health nurse is assessing a client. Which statement by a client would the nurse recognize as evidence of an absence of insight? "I don't think any of those psychiatrists or psychologists or whatever have any clue what they're doing." "Sometimes I feel like the world would be better off if I were dead, but who doesn't feel like that from time to time?" "If things don't improve for me, I'll probably end up on the street." "I just feel these days like I'm in this black pit and there's no way I can get out of it."

"Sometimes I feel like the world would be better off if I were dead, but who doesn't feel like that from time to time?"

During assessment of a client with schizophrenia, the nurse notes the client has ideas of reference. Which statement of the client would have led the nurse to conclude this? "My dead friend is putting these ideas in my mind." "My family is taking my thoughts away. I am unable to think now." "I am sure you know what I am thinking. Everybody knows what I am thinking." "The news of the terrorist attack is directed to me. The terrorists are trying to warn me."

"The news of the terrorist attack is directed to me. The terrorists are trying to warn me."

When a client talks about the recent loss of a family member while laughing or smiling, this type of affect would be labeled as what? Inappropriate Blunted Restricted Flat

Inappropriate

When providing care for a cognitively impaired client who is strongly tied to the client's culture of origin, the nurse supports these expectations by doing what? Including family when discussing new medication treatment options Encouraging the family to consider enrolling the client in an adult day care center Being careful to discuss the client's condition only with the client's spouse Providing family members with information regarding appropriate long-term care facilities

Including family when discussing new medication treatment options

A mental health nurse is caring for a client with schizophrenia. The nurse observes the client laughing about the recent death of the client's father. The nurse would correctly document this mood as what? Blunted Incongruent Flat Labile

Incongruent

As a culture, what do African Americans believe is the cause of mental illness? Lack of spiritual balance Lack of harmony of emotions Supernatural causes Heredity

Lack of spiritual balance

A client has lived independently prior to being admitted to an inpatient unit. The client will be unable to return home following discharge. Which environment would be most appropriate for the client? Most restrictive Least restrictive Nursing home Transitional care unit

Least restrictive

A client with psychosis who was recently admitted to a psychiatric unit says to the nurse, "The car is red. Are you ready for lunch? My head is hurting. Dogs bark loud." The client is exhibiting which type of speech? Echolalia Clang association Neologism Loose associations

Loose associations

As the nurse is conducting an interview with a client with a diagnosis of schizophrenia, the client states, "Bunnies are cute as a button, buttons are on my shirt, shirts can be bought in a store." Which is a term used to describe this thought process? Magical thinking Neologisms Loose associations Ideas of reference

Loose associations

The nurse is assessing a client who recently immigrated to the United States. The client is experiencing a high level of stress and reports that nobody in the workplace is willing to work with or talk to the client. What is the most likely cause of stress in the client? Low hardiness Low self-efficacy Low resilience Low sense of belonging

Low sense of belonging

While performing the admission assessment of a new client, the nurse observed that the client brought a bottle of over-the-counter pain medication to the hospital. The nurse failed to document this or remove the medication from the room. Subsequently, the client experienced a serious adverse drug reaction as a result of the interaction between this drug and one of the drugs that the client was prescribed in the hospital. This nurse may be guilty of what? Assault Malpractice Failure of duty to warn Incompetence

Malpractice

Which stage of psychosocial development involves establishing the next generation? Adolescence Young adult Middle adult Maturity

Middle adult

Antisocial personality disorders are assessed with which tool? Tennessee Self-Concept Scale (TSCS) Milton Clinical Multiaxial Inventory (MCMI) Psychological Screening Inventory (PSI) Thematic Apperception Test (TAT )

Milton Clinical Multiaxial Inventory (MCMI)

A nurse is conducting an interview with a psychiatric-mental health client and notices the client is using made-up words. This is known as what? Neologisms Clangs Word themes Broadcasting

Neologisms

A client asks if the medication has any possible negative side effects. The nurse considers the client highly suggestible, believes the medication will benefit the client, and, since the client has no history of cardiovascular disease, does not tell the client of the potential for cardiac dysrhythmias. The nurse's actions involve a conflict between veracity and which other ethical principle? Justice Nonmaleficence Beneficence Fidelity

Nonmaleficence

When assessing if a procedural risk to a client is justified, the ethical principle underlying the dilemma is known as what? Nonmaleficence Informed consent Self-determination Pro-choice

Nonmaleficence

Which ethical principle focuses on the duty to do no harm? Nonmaleficence Autonomy Justice Beneficence

Nonmaleficence

Which ethical principle requires a nurse to prevent clients from harming themselves or others? Nonmaleficence Beneficence Autonomy Justice

Nonmaleficence

A client is being discharged but still needs close supervision. Which type of involuntary commitment would be appropriate for this client? Outpatient Emergency Extended Observational

Outpatient

When assessing a client who has been referred to the outpatient mental health clinic with symptoms of depression, the psychiatric nurse should closely observe the client's affect and which assessment component? Physical appearance Ability to describe the problem Recollection of the problem's related details Fine motor skills

Physical appearance

A South Asian client is being discharged from the hospital after knee surgery. The nurse is informing the client about the necessary follow-up appointment. Which should the nurse anticipate regarding the client's follow-up appointment? Plan to reschedule the appointment; the client will likely forget about it. Be on time with scheduled appointments for the day, the client will likely arrive early. Plan to see the client at the scheduled time, sharp. Offer extra time for the client to arrive to the appointment; the client will likely arrive late.

Plan to see the client at the scheduled time, sharp.

The Rorschach test is designed to provide what type of information about the client? Presence of depression Presence of a personality disorder Status of self-concept Preferred coping styles

Preferred coping styles

Which would not be included as a purpose of the psychosocial assessment? Previous compliance with treatment regimen Current emotional state Behavioral function Mental capacity

Previous compliance with treatment regimen

A nursing student identifies which as the most important tool of psychiatric nursing? Clinical reasoning Reflection Self Plan of care

Self

A nurse receives feedback from a colleague that the nurse tends to maintain direct eye contact while speaking to clients. Which client may interpret this nonverbal communication as disrespectful? Cubans Russians South Asians African Americans

South Asians

The nurse is looking to assess the client's ability to concentrate. Which task should the nurse ask the client to perform? Spell "America" backward. Interpret the meaning of a proverb. Explain the perception of inkblot cards. Write the names of family members.

Spell "America" backward.

The nurse notes that an older adult client is wearing layers of clothing on a warm, fall day. Which would be the priority assessment at this time? Asking whether the client often feels cold Assessing the client's developmental level Reviewing the client's culture for possible influence Observing the client's overall hygiene

Asking whether the client often feels cold

Which is the most important reason for psychiatric nurses to understand law, legislation, and legal processes that relate to professional nursing practice? Because only by lobbying can psychiatric nurses have an impact on the delivery of services on a national level. Because doing so gives the nurse the ability to provide quality care that will safeguard the rights and safety of clients. Because these activities are included in the Nursing Code of Ethics. Because doing so gives the nurse guidelines by which to use seclusion and restraint appropriately, when needed.

Because doing so gives the nurse the ability to provide quality care that will safeguard the rights and safety of clients.

A psychiatric treatment team is planning care for a client who was involuntarily admitted for treatment of depression and suicide ideation. When planning care, of what legal parameters of care must the nurse be aware? The client can refuse medication. The client can obtain release against medical advice. The client is in need of a public guardian. The client is considered incompetent.

The client can refuse medication.

A client with a diagnosis of depression has been referred to a support group led by an advanced practice psychiatric-mental health nurse. What action by the nurse best demonstrates the ethical principle of nonmaleficence? Discontinuing the client's participation in the group because it causes the client intense anxiety Informing the client that participation in the group is fully voluntary and that the client can withdraw at any time Assisting the client with investigating treatment options that will be covered by the client's health insurance plan Informing the client that many, but not all, clients benefit from participation in a support group

Discontinuing the client's participation in the group because it causes the client intense anxiety

Children learn cultural characteristics as they associate with others. Which entity has the most profound influence on the development of traditional values and practices? Community Church Family School

Family

When conducting a psycho-social assessment, the nurse inquires about the client's social supports. In order to effectively do this, which does the nurse need to explore? The number of networks Challenges faced with social networks The proximity of the networks to the client The length and quality of relationships

The length and quality of relationships

A client with a psychiatric illness has become extremely aggressive and the nurse decides that the client needs to be restrained. Which action would be considered human restraint? The nurse asks the client to calm down. The nurse sedates the client with morphine. The nurse ties the client's wrist using wrist restraints. The nurse and a group of paramedics hold the client.

The nurse and a group of paramedics hold the client.

On assessment, the nurse finds that a client has low self-esteem. Which intervention implies the nurse is facilitating improvement of the client's self-efficacy with the use of social modeling? The nurse convinces the client to believe in self. The nurse encourages the client to observe other people with high self-efficacy. The nurse teaches the client various techniques that would reduce stress. The nurse teaches the client to do various exercises to improve physical strength.

The nurse encourages the client to observe other people with high self-efficacy.

When it is discovered that a nurse did not act reasonably when providing care in accordance with the standards of professional practice, which factor would confirm the nurse has been negligent? The nurse was responsible for client injury The nurse was responsible for a client's injury and it was serious The nurse was responsible for a client injury that resulted in permanent disability The client's actions played a part in the nurse's reaction

The nurse was responsible for client injury

The nurse is assessing whether a room is fit for seclusion of clients. What are the requirements of a seclusion room? Select all that apply. The room should have pens or pencils. The room should not have any sharp objects. The room should not have locked doors. The room should have a bed that is bolted to the floor. The room should have facility for direct visual monitoring.

The room should not have any sharp objects. The room should have a bed that is bolted to the floor. The room should have facility for direct visual monitoring.

A psychiatric-mental health nurse is providing care to several clients. Some of the clients have been voluntarily admitted while others have been involuntarily admitted. Which description about voluntary admissions demonstrates that the nurse understands thedifferences between these two types of admissions? They can leave the hospital whenever they want. They have agreed to the hospitalization. They are not considered a danger to themselves or others. They cannot refuse treatment.

They have agreed to the hospitalization.

Which aspect of the mental status exam refers to information about how the client's thoughts connect to one another? Orientation Behavior Mood Thought process

Thought process

All except which problem stem from attitudes in which the focus is on the nurse's beliefs and values rather than those of the client? Holding preconceived judgement about cultural groups Developing a general belief system about all people from the same culture Treating the client as a source of cultural information Viewing a specific client population from a stigmatized view

Treating the client as a source of cultural information

In which culture is autonomy utilized in making health care decisions? Western Mexican Puerto Rican Vietnamese

Western

Which is the primary treatment sought in the Arab American culture? Western medicine Home remedies Faith healers Amulets

Western medicine

The nurse asks the client to explain the meaning of the proverb "a stitch in time saves nine." Which explanation given by the client indicates concrete thinking? One should always stitch before nine o'clock. You should not forget to sew up holes in your clothes. Fixing things on time would prevent bigger problems in future. If you solve one problem, you will prevent nine problems in future.

You should not forget to sew up holes in your clothes.

The nurse assesses a client with a history of bipolar disorder. The client tells the nurse that an intelligence agency has surveillance equipment set up in the client's bathroom. The nurse is observing which thought process or content? delusional thinking circumstantial thinking tangential thinking loose associations

delusional thinking

Which client behavior would the nurse document as being an automatism? drumming one's fingers on the table top frequently repeating his or her statements asking that the question be repeated staring off into space

drumming one's fingers on the table top

Which client would a nurse determine to be the most likely candidate for involuntary commitment? The client who: refuses to take the prescribed medication. is screaming in the street and disturbing neighbors. refuses to participate in the planned therapy. is homeless and has been diagnosed with a mental disorder.

is screaming in the street and disturbing neighbors.

Which ethical principles become an issue in mental health when a segment of a population does not have access to health care? justice nonmaleficence fidelity veracity

justice

During the assessment of a client who has a pattern of eating disordered behavior, the nurse asks, "What would you change about your body, if you could?" The nurse is assessing which component of the psychosocial assessment? self-concept sensory-perceptual alterations roles and relationships thought process and content

self-concept

When a nurse tells a coworker that an Asian client probably did not want any pain medication because "Asian women typically are stoic," the nurse is expressing a belief known as ... stigma. ethnic slur. bias. stereotype.

stereotype

When considering where to conduct a psychosocial assessment, the nurse can effectively interview which client in the unit's conference room? the anxious client the paranoid client the suicidal client the aggressive client

the anxious client

Which culture is more comfortable at distances greater than 2 or 3 feet? Asian Middle Eastern Latin American American

Asian

If the client provides a literal explanation of a proverb and cannot interpret its meaning, which thought process is lacking? Abstract thinking Concrete thinking Concentration Memory

Abstract thinking

The nurse begins an assessment of an older adult client who was brought to the hospital by her son. The client states, "I don't want your kind of help." What is the nurse's best response? "Have you had a bad experience in the hospital before?" "What makes you think you're not sick?" "What kind of help do you think you need?" "You don't think I know what I'm doing?"

"Have you had a bad experience in the hospital before?"

A nurse is performing a psychosocial assessment of the client. Which questions asked by the nurse can be identified as open ended? Select all that apply. "How can we help you?" "Are you feeling better today?" "How did your problems begin?" "Is there something wrong with you?" "When was your last visit in the psychiatric facility?"

"How can we help you?" "How did your problems begin?"

Which client statement best demonstrates a healthy relationship with family? "I feel better after I visit with my Mom." "I want to put on clean clothes for my sister's visit." My brother and I like to take a walk when he visits." "My family has always tried their best to help me."

"I feel better after I visit with my Mom."

The nurse has entered a hospital client's room and asked the client if the client plans to attend the morning's scheduled group life-skills session. Which response should signal the presence of thought blocking to the nurse? "Warning, warning, watch your back." "I might. I'll give it some..." "Well, that's certainly the end of that." The client makes eye contact with the nurse but does not respond verbally.

"I might. I'll give it some..."

A nurse is providing care to a male client who is hospitalized with a diagnosis of schizophrenia. Which would be appropriate for the nurse to include in the client's medical record? "Client states that he had a good night with no issues." "Reports being unable to sleep because the client heard voices throughout the night." "Had a typical night without incidence of insomnia or nightmares." "Acted crazily throughout the night; kept hearing voices and noises."

"Reports being unable to sleep because the client heard voices throughout the night."

Which statements made by the nurse demonstrate a limited understanding of the use of seclusion? Select all that apply. "Seclusion helps the client to be more active." "Seclusion reduces stimuli." "Seclusion helps protect the privacy of the client." "Seclusion helps in protecting other people from the client." "Seclusion minimizes the use of psychotropic drugs."

"Seclusion helps the client to be more active." "Seclusion minimizes the use of psychotropic drugs."

The nurse is providing information to the caregivers of the client who has been secluded. Which statements about the implementation of the seclusion are correct? Select all that apply. "The client will be removed from seclusion in 1 day." "The client will be assessed by the nurse every 1 to 2 hours." "The client can also be monitored by audio and video equipment." "The health care provider will review the seclusion order every 4 hours." "The client will be assessed by a specialized independent practitioner within the hour."

"The client will be assessed by the nurse every 1 to 2 hours." "The client can also be monitored by audio and video equipment." "The health care provider will review the seclusion order every 4 hours." "The client will be assessed by a specialized independent practitioner within the hour."

Which client statement indicates the most insight into his or her issue with auditory hallucinations? "The voices are telling me to hurt myself." "I can't remember a time when I didn't hear voices." "The voices aren't real but it's hard to ignore them." "I take medication so the voices will stop."

"The voices aren't real but it's hard to ignore them."

When assessing orientation, the nurse completes the assessment by asking which questions? Select all that apply. "What is your name?" "Can you tell me where you are?" "What day of the week is it?" "What did you eat for breakfast today?" "Would you count from 1 to 10 backward, please?"

"What is your name?" "Can you tell me where you are?" "What day of the week is it?"

Which question asked by the nurse indicates that the nurse is assessing the judgment of the client? "In which country do you live?" "Could you please repeat the days of the week backward?" "What would you do if you found $10 on the side of the road?" "Could you please explain the meaning of proverb 'barking dogs seldom bite'?"

"What would you do if you found $10 on the side of the road?"

When a 23-year-old client, after attempting suicide, asks to speak with the nurse but wants assurance that the conversation will remain confidential, the nurse responds how? "Will this conversation involve your desire to harm yourself?" "You know that I can't keep secrets from your health care team." "Without your permission I can't give any information to anyone." "Don't you trust me to respect your right to confidentiality?"

"Will this conversation involve your desire to harm yourself?"

The nurse is caring for a hospitalized client who is suspicious and guarded. The client tells the nurse that the client does not want anyone to tell the family about the client's condition. What is the nurse's best response when the family calls the hospital unit to inquire about the client's condition? "You are welcome to share any information that you think would be helpful." "Unfortunately, you are not permitted to call the hospital unit." "I am sorry, the client does not want you included in care." "It would be best if you came to visit the client here."

"You are welcome to share any information that you think would be helpful."

The nurse is speaking to a client with severe mania who has been physically restrained. The nurse is explaining the instructions for removing the restraints. What instructions given by the nurse are appropriate? Select all that apply. "You should be able to demonstrate appropriate behavior." "You should not verbally threaten anybody." "You should be able to communicate in a calm manner." "You should be willing to do the task I have given you." "You should take medications prescribed by your doctor."

"You should be able to demonstrate appropriate behavior." "You should not verbally threaten anybody." "You should be able to communicate in a calm manner.

A nurse is caring for a voluntary client in the health care facility. The client doesn't show signs of suicidal ideation or pose harm to others. The client states, "I would really like to leave tonight and sleep in my own bed." Although the client wants discharge tonight, the physician at this time. What is the most appropriate response of the nurse? "You will need to sign a written request for discharge." "I need to check with your family members if they think it would be okay." "You are free to leave at your will." "I will contact your landlord and let the landlord know you will be home."

"You will need to sign a written request for discharge."

Which mental health client meets criteria to be involuntarily committed? A client diagnosed with borderline personality disorder who is threatening to self-harm A client diagnosed with schizophrenia who is singing in the client's room A client diagnosed with mania who is pacing the hallways A client diagnosed with anxiety disorder who is fidgeting

A client diagnosed with borderline personality disorder who is threatening to self-harm

hich client most likely has the legal right to refuse treatment? A client who committed an assault while experiencing delusions A 20-year-old who has been admitted to the hospital for the treatment of depression after a suicide attempt A homeless person with schizophrenia who was admitted to the hospital with dehydration after refusing to eat for several days A client who voluntarily entered a substance abuse treatment facility to address an addiction to alcohol

A client who voluntarily entered a substance abuse treatment facility to address an addiction to alcohol

What is provided in the Code of Ethics for Nurses of the American Nurses Association (ANA)? A description of case studies featuring ethical dilemmas A guideline for nurses regarding ethical conduct Information about what to do when confronted with an ethical dilemma Pathways to follow for each of the ethical principles

A guideline for nurses regarding ethical conduct ...

After teaching a group of nursing students about the least restrictive environment, the instructor determines that the education was successful when the group identifies which as the most restrictive setting? Acute inpatient care Crisis intervention Residential services In-home detoxification

Acute inpatient care

For a client who belongs to an ethnic group that is known to have poor metabolism of psychotropic medications, the nurse should anticipate that the client may be at risk for which problem? Decreased therapeutic effect Paradoxical drug effects Adverse drug effects Increased drug resistance

Adverse drug effects

What action by a nurse best promotes the ethical principle of justice? Advocating for enhanced mental health services in an underserved neighborhood Informing a client who is competent that the client has the right to discontinue treatment Clearly describing the potential adverse effects of a client's new pharmacologic treatment Obtaining written, informed consent from a client who has agreed to be in a research study

Advocating for enhanced mental health services in an underserved neighborhood

A nurse working in an urban clinic is gathering data about the use of preventive mental health services by the clinic's clientele. The nurse is surprised that the data reveal more than 80% of the clients using this service are white, while the residential population in the surrounding area is predominantly African American and Asian American. Which statement most likely explains these data? The clinic's white clients value mental health services. African Americans and Asian Americans consider seeking mental health care to be a sign of weakness. African Americans and Asian Americans perceive the system as culturally insensitive The clinic's African American and Asian American client populations require mental health services less frequently than their white counterparts do.

African Americans and Asian Americans perceive the system as culturally insensitive

The nurse should anticipate that an individual's culture will have the most significant influence on which situation? An Asian American's physician has prescribed a new antipsychotic medication. An Arab American has begun grieving because her husband of several decades has just died. A Hispanic American will soon begin electroconvulsive therapy for the treatment of her depression. An African American client with schizophrenia has begun a new class on life skills.

An Arab American has begun grieving because her husband of several decades has just died.

The nurse recognizes that the difference between a voluntary and an involuntary commitment is what? An involuntarily committed client may not initiate his or her own discharge The voluntarily committed client is usually less aggressive An involuntarily committed client may refuse all treatment The voluntarily committed client usually has good insight into his or her mental health problem

An involuntarily committed client may not initiate his or her own discharge

When completing a physical assessment of an individual's response to stress, the nurse should observe and inquire about what? Appetite and sleep Mood Judgement and insight Concentration

Appetite and sleep

Which culture has a belief that mental illness is a planned attempt to manipulate others? Chinese Arab American Native American Vietnamese

Arab American

The nurse who is preparing a Native American client for surgery notes that the client is wearing a medicine bag. What intervention should the nurse implement to best address the client's spiritual needs with respect to presurgical care needs? Remove the medicine bag and give it to a family member for safe keeping. Ask the client to provide information about his or her personal spiritual belief system. Ask the client how the medicine bag can be respected while preparing for surgery. Explain to the client that the medicine bag must be removed in order to minimize the risk of infection during the surgical procedure.

Ask the client how the medicine bag can be respected while preparing for surgery.

An occupational health nurse is asked to see an employee who follows the Muslim faith. The client has been referred to the nurse because the client appears lethargic and has been noted to skip having lunch with other employees as the client had done formerly. Which step should the culturally competent nurse take next? Contact the client's spouse for an explanation. Ask the client if the client is participating in a religious or cultural ritual. Offer the client food to eat in the privacy of the nurse's office. Ask the client if the client has been receiving treatment from a traditional healer.

Ask the client if the client is participating in a religious or cultural ritual.

A physician would like to include a client with schizophrenia in a research study testing a new medication. The nurse's obligation is to do what? Assess the client's legal capacity when that client is asked to give consent. Talk the client out of revoking consent once the study has started. Obtain informed consent when the primary provider cannot be present. Persuade the client to consent, because the new drug has shown promising results.

Assess the client's legal capacity when that client is asked to give consent.

Which approach to care best reflects cultural competence? Always assign nurses of a specific ethnic background to clients with the same ethnic background. Learn all behaviors and values associated with people of specific ethnic backgrounds. Assess the culturally mediated beliefs of each client on an individual basis. Believe that people are more alike than they are different.

Assess the culturally mediated beliefs of each client on an individual basis.

A client is being admitted to an inpatient setting. It is important for the nurse to first obtain which information about the client? Educational level Social status Insurance information Assessment of history

Assessment of history

Which type of hallucination is the most common? Auditory Visual Gustatory Olfactory

Auditory

The depressed client is deciding which type of treatment would be beneficial. The nurse would document that the client is utilizing which ethical principle in this situation? Justice Beneficence Autonomy Veracity

Autonomy

A nurse recruiter is interveiwing a nurse for a psychiatric-mental health nursing position at the community clinic. When reviewing the applicant's educational background, the recruiter would identify which as the preferred level of preparation? Associate's degree Bachelor's degree Master's degree Doctoral degree

Bachelor's degree

A client was admitted for electroconvulsive therapy (ECT). The physician performing the procedure failed to obtain informed consent before the ECT was administered. The physician could be charged with what? Assault Battery Beneficence Fidelity

Battery

psychiatric mental health facility is undergoing a change from paper-based health records to electronic records. What action should the nurse prioritize in order to ensure client rights are protected? Being vigilant to identify any potential threats to client confidentiality Ensuring clients know that they have the right to opt out of the proposed system Educating clients and families about the potential benefits of the new system Teaching clients that they may lose the right to view their health records under the new system

Being vigilant to identify any potential threats to client confidentiality

A client is being seen in the mental health clinic because of relapse. The client has been nonadherent with the medication regimen. The nurse reinforces the advantages of taking medications. The nurse is using which ethical principle? Autonomy Justice Beneficence Veracity

Beneficence

A client who was deemed to be at high risk for suicide was ordered visual checks every 15 minutes. The nurse had been performing these checks since the beginning of a shift but neglected to pass off this responsibility to a colleague before leaving the unit for a scheduled break. As a result, the client made a suicide attempt while the nurse was off the unit. Which ethical principle has the nurse most clearly violated? Autonomy Beneficence Fidelity Veracity

Beneficence

A client with persistent depression is considering electroconvulsive therapy (ECT). The nurse has seen ECT be effective in other cases. When the client expresses fear and doubt about undergoing ECT, the nurse tries to talk the client into it, because the nurse truly believes it will help the client. Which two ethical concepts are in conflict? Beneficence and fidelity Fidelity and paternalism Justice and autonomy Beneficence and autonomy

Beneficence and autonomy

The nurse correctly differentiates race from ethnicity by noting that race is based on which characteristics? Biological Social Spiritual Religious

Biological

Which is the primary religion of Cambodians? Buddhism Judaism Christian Muslim

Buddhism

On meeting a client for the first time, the nurse pats the client on the shoulder. The client expresses discomfort with the nurse's behavior. To which culture does the client most likely belong? Cuban Chinese Haitian African American

Chinese

The nurse is assessing a client with psychiatric disorder. The nurse finds that when asked a question, the client gives excessive and unnecessary details followed by the answer. This is indicative of which impairment of thought content? Flight of ideas Loose associations Thought broadcasting Circumstantial thinking

Circumstantial thinking

A nurse is preparing an educational program identifying the major barriers experienced by culturally diverse populations when accessing mental health services. Which information should the nurse include? (Select all that apply.) Client and health care provider do not share a common language Health care beliefs are not shared by both client and health care provider Group value systems are not mutually accepted North American health care systems are biased against the culturally diverse client Cultural beliefs in people of varying ethinicities prevent people from accepting health care

Client and health care provider do not share a common language Health care beliefs are not shared by both client and health care provider Group value systems are not mutually accepted

Which is indicative of a voluntary admission? Client is a danger to self or others Client cannot care for self Client makes an autonomous decision to seek inpatient treatment Client can be committed against his or her will

Client makes an autonomous decision to seek inpatient treatment

Which must be addressed to establish a trusting working relationship before proceeding with the assessment? Client's feelings and perceptions Client's behavior Client's compliance Client's willingness to participate

Client's feelings and perceptions

The nurse is preparing a psychosocial assessment for use with clients with various mental health conditions. For which group of clients should the nurse include mostly closed-ended questions? Clients with depression Clients with post-traumatic stress disorder Clients with antisocial personality disorder Clients with adult attention deficit hyperactivity disorder

Clients with adult attention deficit hyperactivity disorder

A new nursing student correctly identifies which as most essential for guiding psychiatric-mental health nursing actions? Personal beliefs Code of Ethics for Nurses State laws Federal laws

Code of Ethics for Nurses

A nurse is assessing a hospitalized client who is hearing voices due to psychosis. The client is easily distracted, and this is creating a barrier to completing the assessment. What is the most effective way for the nurse to proceed? Use observation only to collect client information. Wait for psychiatric medication to take effect. Ask another nurse to attempt the assessment. Complete the assessment in several short interactions.

Complete the assessment in several short interactions.

Asking the client to complete serial sevens assesses what? Concentration Orientation Judgment Insight

Concentration

A nurse in a multicultural community knows that to give a client meaningful spiritual care within the health care context it must be what? Congruent with the client's beliefs Congruent with the client's societal standards Congruent with the client's family's wishes Congruent with cultural mores

Congruent with the client's beliefs

A nurse is assessing a client who immigrated from Russia. During the psychosocial assessment, the client describes himself as "sick." Which sign or symptom is most likely causing the client to feel this way? Too thin. Pale cheeks. Constipation. Low appetite.

Constipation

Which developmental task occurs in the middle adult growth area? Creation of a comfortable home Preparation for retirement Adjustment to health changes Maintenance of a maximal level of health

Creation of a comfortable home

Which statement about culture is true? Cultures are static. Cultural identity reflects what determines behavior. Culture is based solely on a common purpose. Acculturation eventually leads to the emergence of the dominant culture.

Cultural identity reflects what determines behavior.

Which represents the best brief definition of culture? Culture refers to a person's racial background. Culture refers to a person's religious beliefs. Culture is a shared structure for living. Culture is a society's social norms.

Culture is a shared structure for living.

Which client behavior would prompt the nurse manager to discuss the duty to warn with staff members? Suicidal ideation . Danger to others. Extremely aggressive. Unwilling to take medications.

Danger to others.

The nurse is conducting an admission interview with a psychiatric-mental health client. The nurse uses observational skills to identify that the client has a flat affect. The nurse is engaging in which part of the nursing process? Assessment Planning Evaluation Data collection

Data collection

A psychiatric-mental health nurse is working on developing cultural competence. Which would be most appropriate for the nurse to do? Research information about the cultures of the population being served after assessing the client. Recognize that one's own culture is the predominant way of addressing a client's health care needs. Assume that any individual of a racial or ethnic group is the same as another individual in that group. Demonstrate an appreciation of, and a genuine interest in, the individual and his or her cultural beliefs.

Demonstrate an appreciation of, and a genuine interest in, the individual and his or her cultural beliefs.

A culturally competent nurse can identify that some cultural and ethnic groups feel that mental illness is caused by what? Disruption of harmony Pretense The stars Fate

Disruption of harmony

Which intervention does not meet the standard of care for the client in seclusion? Documented assessment by the nurse every 30 minutes Face-to-face evaluation by a licensed independent practitioner within 1 hour of seclusion Close supervision of the client A physician's order given every 4 hours

Documented assessment by the nurse every 30 minutes

n elderly client in the hospital has not had a bowel movement for 3 days and the nurse planned to give the client a stool softener this morning. The client declined the medication, however, stating that the client's spouse will be bringing the client a herbal medication later in the day that is often used by members of their ethnic group. Which reaction demonstrates cultural care accommodation/negotiation? Documenting the client's wishes and informing the client's care team what the client will be taking Teaching the client about the risks associated with nonstandard doses of herbal remedies Teaching the client about the benefits of the medication that was ordered for the client Ensuring that the herbs are sent to the hospital pharmacy for clearance before the client is allowed to take them

Documenting the client's wishes and informing the client's care team what the client will be taking

A psychiatric-mental health nurse is conducting a review class about legal liability and psychiatric-mental health nursing. Which element would the nurse <b>most</b> likely include as being required to prove negligence on the part of a health care professional? Select all that apply. Duty Cause in fact Damages Cause in proximity Financial obligation Occurrence of a simple mistake

Duty Cause in fact Damages Cause in proximity

Malpractice is proven when certain criteria have been met. Which list includes the correct criteria? Duty of care, professional performance, injury related to the nurse's action, action foreseeably could have caused the injury, and proven injury Duty of care, professional performance, injury related to the nurse's action, failure to document injury, and proven injury Professional performance, injury related to the nurse's action, action foreseeably could have caused the injury, and proven injury Duty of care, professional performance, injury related to the nurse's action, and action foreseeably could have caused the injury

Duty of care, professional performance, injury related to the nurse's action, action foreseeably could have caused the injury, and proven injury

In order to help preserve and maintain a client's cultural belief regarding the need for "hot foods," which action should the culturally competent nurse take? Educate the staff to help them assist the client in selecting food choices from the client's menu that supports this belief Discuss the possibility of the family providing the appropriate foods Ask for a dietary consult with an understanding of the "hot and cold food" belief Assure the client that these needs will be considered by the staff

Educate the staff to help them assist the client in selecting food choices from the client's menu that supports this belief

Principles that serve as codes of conduct about right and wrong behaviors to guide actions are known as what? Ethics Beneficence Veracity Fidelity

Ethics

Which is the most effective way in which the nurse can assess the progress of a client's mental status based on the expected outcome of the therapeutic plan? Planning Evaluation Assessment Professional practice evaluation

Evaluation

A nurse has been asked to complete a mental status examination of a psychiatric-mental health client. Which is a necessary component of this assessment? A review of systems Evaluation of insight and judgment Questions regarding past behaviors Evaluation of medication compliance

Evaluation of insight and judgment

An agitated client has been put in restraints against the client's will because of inadequate staffing. The nurse determines this as which form of malpractice? Battery False imprisonment Defamation Assault

False imprisonment

The inappropriate use of restraints or seclusion is considered which form of intentional tort? False imprisonment Battery Assault Causation

False imprisonment

The nurse is teaching new parents about the developmental stages. When discussing trust vs. mistrust, which parenting skills should be included? Select all that apply. Feed the baby when hungry. Allow the infant play on his or her own. Use a car seat while travelling. Change diapers when wet or soiled. Keep the baby close.

Feed the baby when hungry. Use a car seat while travelling. Change diapers when wet or soiled. Keep the baby close.

A client's plan of care includes revoking privileges for inappropriate behavior, based on a contract between the client and the nurse who wrote the plan. Another nurse decides to ignore this because the client promises that the client will adhere to the contract in the future. The second nurse's behavior may have violated which ethical principle? Veracity Beneficence Autonomy Fidelity

Fidelity

Earlier in the shift, the nurse promised to help a client acquire some paper and a pen and draft a letter to a family member later in the day. The nurse became increasingly busy during the shift but has now taken some time to assist the client in this way. What ethical principle has the nurse best exemplified? Fidelity Veracity Nonmaleficence Beneficence

Fidelity

A client in a psychiatric facility has ideations about killing the client's spouse. This client requests to be discharged from the facility. Which represents the most appropriate action? The health care provider should: Allow the client to go home. Not accept the client's request. File for a civil commitment to detain. Ask the caregivers of the client for consent.

File for a civil commitment to detain.

Which type of affect is represented by showing no facial expression? Flat Blunted Inappropriate Restricted

Flat

While talking with a schizophrenic client, the nurse observes that the client is looking straight ahead, maintains no eye contact, and moves facial muscles very little, even though the client is telling the nurse about a very emotional episode the client just experienced with a roommate. When describing the client's affect, the nurse documents it as what? Labile Constricted Flat Blunted

Flat

A nurse assesses a 29-year-old client in the outpatient mental health clinic. The nurse notes the client is speaking very quickly and jumping from topic to topic very rapidly. There is some connection between ideas, but they are difficult to follow. Which term most accurately describes this thought process? Derailment Flight of ideas Circumstantiality Incoherence

Flight of ideas

During a conversation, the client states, "It's raining outside and raining in my heart. Did you know that St. Valentine used to visit jails? I've never been to jail." The nurse can correctly identify this thought process as what? Perseveration Circumstantiality Neologisms Flight of ideas

Flight of ideas

A 20-year-old client who has a diagnosis of schizophrenia frequently experiences delusions of persecution. At the prompting of the client's mother, the nurse attempts to determine the character and severity of these delusions on a particular day. In doing so, the nurse is conducting what type of assessment? Comprehensive Focused Screening Secondary

Focused

When promoting client safety on an inpatient psychiatric unit, which interventions would be used as the measure of last resort? Surveillance Seclusion Room restriction Four-point restraint

Four-point restraint

A young adult client is brought to the outpatient mental health clinic by the client's father. The client was diagnosed with schizophrenia 6 months ago and has been taking medication since. The father reports the client continues to hear voices despite adhering to the medication. Which term best describes the client's abnormality of perception? Illusion Hallucination Fugue state Perseveration

Hallucination

Which would play a role in a person's cultural identity? Select all that apply. Health beliefs Health practices Values Norms Behavior

Health beliefs Health practices Values Norms Behavior

Under which component of the psychosocial assessment should the nurse document observations concerning the client's cultural considerations? History Thought Process and Content Self-Concept Roles and Relationships

History

When addressing the issue of risk management, the mental health nurse acts on the foundational premise that Hospitalization and treatment are factors that can increase the client's risk for injury Identification of all client risks is a nursing responsibility Medication errors are the primary factor resulting in client injury There are many reasons a nurse may need to breach confidentiality

Hospitalization and treatment are factors that can increase the client's risk for injury

The nurse is providing care for a recent immigrant from India. When the client identifies as a member of the culture's lowest caste, what concern should the nurse address first with the client? When the client last received care for a serious health condition How the client feels about seeking medical and psychiatric care If the client can afford to pay for the health care required What chronic health conditions are present in his or her medical history

How the client feels about seeking medical and psychiatric care

When staff members physically control the client and move him or her to a seclusion room, what form of restraint is being implemented? Human Mechanical Short term Long term

Human

During an initial assessment, a client exhibits pressured speech and points to patterns on the wallpaper stating, "This is the writing about the tsunami. Thousands of people died because I read the writing." Which term should the nurse use to document this observation? Illusion Religious delusion Hallucination Ideas of reference

Ideas of reference

Which action is most effective in assisting the nurse to provide culturally competent care? Encouraging acculturation of non-American groups Working with only one cultural group so the nurse can get to know it more intimately Reinforcing segregation Identifying one's own biases and feelings about different cultural groups

Identifying one's own biases and feelings about different cultural groups

Which stage of Erikson's psychosocial development includes building confidence in one's own abilities? Industry versus inferiority Initiative versus shame and doubt Identity versus role confusion Generativity versus stagnation

Industry versus inferiority

The nurse is assessing a client and finds that the client has very low self-esteem. According to Erikson's stage of psychosocial development, this behavior may be an indication of failure in which stage? Trust vs. mistrust (infant) Industry vs. inferiority (school age) Identity vs. role diffusion (adolescence) Autonomy vs. shame and doubt (toddler)

Industry vs. inferiority (school age)

A client was admitted to a psychiatric facility because the client was found walking around naked and talking incoherently. The client has no known next of kin and has been adjudicated incompetent. The client refuses any antipsychotic medications but has not been harmful to the self or others. What action should the facility take? Initiate court proceedings to have a guardian named. Give the client medications by depot injection. Continue custodial care. Contact social services to find outpatient housing.

Initiate court proceedings to have a guardian named.

When determining the existence of malpractice, which factor is not considered? Intent Duty Injury Causation

Intent

A client receives a court order for commitment. Which best exemplifies the concept of "least restrictive environment"? Involuntary commitment to an outpatient community mental health center Medication administration for sedation so the client cannot get out of bed Placement of client in a secured padded room in response to threats of self-harm Admission of client to a locked inpatient psychiatric unit

Involuntary commitment to an outpatient community mental health center

The nurse is speaking to a group of high school students about health promotion. The nurse encourages the students to make friends and widen their social networks. What are the reasons the nurse might give this advice? Select all that apply. It helps to reduce stress. It helps to diminish illnesses. It has a positive influence on the ability to cope. It improves the hardiness of the individual. It improves the self-efficacy of the individual.

It helps to reduce stress. It helps to diminish illnesses. It has a positive influence on the ability to cope.

What is the most significant benefit of using Beck's Depression Inventory to the practice of evidence-based nursing practice? It identifies a client's level of depression. It has 21 focused questions to be asked of the client. It is easily graded by the nurse. It is a standardized, reliable depression tool.

It is a standardized, reliable depression tool.

A psychiatric-mental health nurse is feeling highly anxious before conducting an interview with a client. The nurse's experience of anxiety will impact the client assessment in which way? It will be beneficial to the interaction by increasing the nurse's focus and attention. It will be detrimental to the interaction by decreasing the nurse's focus and attention. It will be beneficial to the interaction by increasing the client's focus and attention. It will be detrimental to the interaction by decreasing the client's self-awareness.

It will be detrimental to the interaction by decreasing the nurse's focus and attention.

A client comes to the emergency department with severe depression and suicidal ideation. Staff members determine that the client does not have adequate insurance to cover inpatient psychiatric services at their facility, so they discharge the client with some prescriptions for medication. Which principle is being ignored by discharging this client? Veracity Justice Autonomy None of the above

Justice

The nurse is caring for a client who immigrated from Cambodia. What might the client perceive as the cause of the client's mental illness? Heredity Wrath of God Khmer Rouge brutalities Lack of spiritual balance

Khmer Rouge brutalities

Personal space and distance is a cultural perspective that can impact nurse-client interactions. What is the best way for the nurse to interact physically with a client who has a different cultural perspective on space and distance than the client? Know the client's cultural personal space preferences. Realize that sitting close to the client is an indication of warmth and caring. Sit 3 to 6 feet away from the client in an attempt to not offend. Remember not to intrude into the personal space of the elderly.

Know the client's cultural personal space preferences.

One way that nurses can protect themselves against liability from malpractice is to do what? Know the statutory and professional standards. Avoid documenting incriminating information. Carry individual malpractice insurance. Request legal consultation from the employer.

Know the statutory and professional standards.

The nurse has been asked to assess a Native American client. The nurse plans additional time to interview the client. Why has the nurse planned the additional time? Native Americans tend to speak in a rude manner. Native Americans tend to communicate by telling long stories. Native Americans do not understand the importance of the assessment. Native Americans tend to leave out important information while providing history.

Native Americans tend to communicate by telling long stories.

Racial bias is evident in mental health care treatment, as reflected by what? White clients are given access to better facilities within most mental health treatment centers. Nonwhite clients are institutionalized much more frequently than are whites. It is increasingly difficult to receive reimbursement for mental health services. Most nonwhite clients are grossly undermedicated when treated in inpatient facilities.

Nonwhite clients are institutionalized much more frequently than are whites.

What is one way in which nurses can develop cultural self-awareness? Ask peers and colleagues about practicing cultural competence. Objectively examine personal beliefs, values, and practices. Realize nothing can be done to change one's values and beliefs. Assert to others that personal biases cannot be changed.

Objectively examine personal beliefs, values, and practices.

A nurse is reviewing that standards of practice. Which component would the nurse identify as appropriate? Quality of practice Outcomes identification Collaboration Resource utilization

Outcomes identification

A client visits the clinic and tells the nurse about experiencing a great deal of stress on the job for the past 2 months. The nurse should instruct the client that two antecedents of the stress response are the person-environment relationship and which additional client factor? Physiologic status Perception Ethinicity Personality

Perception

A female nurse is conducting a family assessment of a Hispanic client. When the nurse asks questions about family problems, the nurse notices that the client is reluctant to answer. A possible cause for this behavior is that members of the Hispanic culture believe what? Personal matters are considered to be family problems. Information should not be shared with females. Females are cultural leaders to be revered and not burdened with personal matters. Imbalances in yin and yang result in problems and this information is not to be shared with those outside the culture.

Personal matters are considered to be family problems.

The nurse is working in a mental health facility. The nurse ensures that all able-bodied clients in the facility participate in the group exercise program every morning. For which reasons would this intervention be beneficial for the clients with mental illness? Select all that apply. Physical activity improves mood and lowers anxiety. Physical activity increases the efficacy of the psychotropic drugs. Physical activity prevents medical conditions. Physical activity can foster a sense of well-being. Physical activity decreases the need for psychotherapy.

Physical activity improves mood and lowers anxiety. Physical activity prevents medical conditions. Physical activity can foster a sense of well-being.

The delivery of culturally competent nursing care requires the incorporation of which concept into the planning? Planning and implementing care in a way that is sensitive to the needs of individuals, families, and groups from diverse cultural populations. Challenging the beliefs and values of clients from diverse cultures. Recognizing that the health care system is void of culture and cultural imposition must occur. Using ethnocentrism into the delivery of care.

Planning and implementing care in a way that is sensitive to the needs of individuals, families, and groups from diverse cultural populations.

A female nurse enters the room of a male Cambodian client who is about to undergo a procedure. When the nurse tries to apply cardiac monitoring leads to the client's chest, the client recoils and makes a disapproving facial expression. Which explains the client's reaction to the nurse's actions? Politeness is highly valued in the Cambodian culture Assimilation is common in the Cambodian culture Education regarding the use of touch in the North American culture is needed Family members should be present when the nurse completes any interventions

Politeness is highly valued in the Cambodian culture

The nurse in an psychiatric inpatient facility encourages clients to attend daily prayer sessions. What is the most likely reason for the nurse's action? Choose the best answer. Prayer helps in coping with stress. Prayer helps in curing illness. Prayer prevents the progression of the illness. Prayer helps in improving the effectiveness of therapy.

Prayer helps in coping with stress.

When interviewing a Native American client, the nurse avoids which behavior because it is deemed unacceptable by the client's culture? Sitting in the presence of an elder Prolonged eye contact Strict attention to time commitments Expression of emotion or affection

Prolonged eye contact

A Haitian American client has a history of not keeping follow-up appointments for necessary lab work. What intervention should the nurse implement to help the client keep the appointments? Provide an explanation about the importance of keeping the appointment Allow the client to pick the day and time of the appointment Be sure the client has transportation to the appointment Ask the primary health provider to discuss the issue with the client

Provide an explanation about the importance of keeping the appointment

The psychiatric nurse correctly identifies the client's form of communication as circumstantiality when the client does what? Provides long, irrelevant explanations when asked why the client abuses alcohol. Fails to complete what the client is saying as if distracted. Answers the question, "May we talk?" by responding, "Walk the walk." Repeats the phrase, "Mary had a little lamb," whenever feeling stressed.

Provides long, irrelevant explanations when asked why the client abuses alcohol.

A psychiatric-mental health nurse is practicing at the advanced level. Which function would this nurse be able to perform based on the nurse's advanced level of preparation? Health promotion Counseling Psychotherapy Intake screening

Psychotherapy

Which are functions of assertive community treatment? Select all that apply. Increases the likelihood of relapse Reduces inpatient service use Promotes continuity of outpatient care Increases the stability of people with serious mental illnesses Decreases availability of services

Reduces inpatient service use Promotes continuity of outpatient care Increases the stability of people with serious mental illnesses

A Native American client discusses cultural beliefs with the nurse providing care. In order to recognize any negative feelings or stereotypes the nurse has, which should the nurse do to ensure culturally competent nursing care can be provided? Reflect on how the client's beliefs are different from the nurse's own. Research Native American health care beliefs. Provide the client with written information on traditional medical principles. Agree to disagree on medical practices and beliefs.

Reflect on how the client's beliefs are different from the nurse's own.

The nurse is scheduled to begin a clinical rotation at an outpatient mental health clinic that is in a neighborhood with a large number of Asian residents. Since the nurse does not share this cultural background with the potential clients, which is the best way for the nurse to ensure cultural sensitivity in this setting? Reflect on, analyze, and foster awareness of the nurse's own culture Ask to be paired with a classmate who is of Asian descent Conduct research on various Asian subcultures that the nurse may encounter Expose himself or herself to as many different cultures as possible before the nurse's rotation begins

Reflect on, analyze, and foster awareness of the nurse's own culture

When asking a client to "tell me how having schizophrenia has affected your life," the nurse is assessing the client's capacity for what? Reflective insight Critical thinking Intellectual thought Concrete thinking

Reflective insight

After educating a class of nursing students about the rights of persons receiving mental health services, the instructor determines a need for additional instruction when the students identify which as a right? Freedom from restraints or seclusion Access to one's own mental health records upon request An individualized written treatment plan Refusal of treatment during an emergency situation

Refusal of treatment during an emergency situation

Which nonverbal cue should the nurse be especially alert for when caring for a Filipino client? Relying on facial expressions to convey various emotions Nodding and smiling even when the client does not understand what is being said Avoiding eye contact when frightened Generally silent when in the presence of health care providers

Relying on facial expressions to convey various emotions

Children of parents who abused alcohol and substances are able to develop self-esteem and self-efficacy by developing which characteristics? Resilience Hardiness Social skills Tolerance

Resilience

Evaluating the cultural practices of others according to the nurse's own culture can be counteracted by the nurse's use of which practice? Self-disclosure Self-discipline Self-esteem Self-analysis

Self-analysis

A client with a psychiatric disorder is scheduled to undergo a personality test. Which explanations can the nurse provide when the client asks why the test must be completed? Select all that apply. Self-concept Impulse control Cognitive abilities Defense mechanisms Intellectual functioning

Self-concept Impulse control Defense mechanisms

Which characteristic would be most prevalent in an individual demonstrating low self-efficacy? Self-doubt Personal goals Self-motivation Stress management

Self-doubt

Considering the nature of its content, which areas may be the most uncomfortable or difficult for the nurse to assess? Sexuality Mood Motor behavior Roles and relationships

Sexuality

When conducting an assessment with a client from another country, what can a nurse do to ensure the client receives culturally sensitive care? After the focused assessment, decide if a cultural assessment is necessary. Show genuine interest in the client's culture and personal life experiences. Develop a plan of care after talking to the client's family. Develop a plan of care based on the nurse's own knowledge of a client's culture.

Show genuine interest in the client's culture and personal life experiences.

The nurse is caring for a client who has recently developed psychomotor retardation. Based on this information, which behavior would the nurse expect to see in this client? Slowness of body movements Repeated tapping of the foot Speaking meaningless words Maintenance of an awkward posture for a long time

Slowness of body movements

A nurse is reading a journal article about spirituality, religion, and mental health. Which information would the nurse likely find? Select all that apply. Spirituality develops over time. Spirituality involves self-transcendence and transcendence beyond the self. Spirituality is the same as religiousness. Spirituality can be expressed through adherence to a particular religion. Religious beliefs often influence approaches to mental health.

Spirituality develops over time. Spirituality involves self-transcendence and transcendence beyond the self. Spirituality can be expressed through adherence to a particular religion. Religious beliefs often influence approaches to mental health.

The nurse caring for several clients on a surgical unit notes that one of the clients the nurse is caring for is Muslim. The nurse decides to remove all pork from the client's meal tray prior to delivering it to the room. What best describes the nurse's action? Stereotyping Racism Honoring rituals Transcultural nursing

Stereotyping

The nurse is performing a psychosocial assessment of a 30-year-old client who has recently moved back home. What developmental stressors may be noted in this client? Select all that apply. Stress related to health changes Stress related to career growth Stress related to moving out of parental home Stress related to the inability to look after self Stress related to reversing roles with parents

Stress related to career growth Stress related to moving out of parental home

The mental health nurse is interviewing a client of Asian descent regarding the client's health care practices. The nurse understands that cultural competence is important in the care of this client. Cultural competence in health care can be best described as what? Striving to achieve the ability to work within the cultural context of an individual or community from a diverse cultural or ethnic background Knowing the characteristics of each individual cultural group in America A combination of a person's beliefs about cultural values and knowledge about his or her own culture The client's ability to tell the health care provider about his or her cultural beliefs and practices

Striving to achieve the ability to work within the cultural context of an individual or community from a diverse cultural or ethnic background

A client's husband has asked that his wife be cared for exclusively by female nurses, a request that the client herself agrees with. Knowing that the couple is of Middle Eastern origin, what action should the care team take in response to this request? Take reasonable measures to accommodate the request. Assess the couple's rationale for making the request. Determine whether the request is rooted in culture or whether it is a personal preference. Teach the couple that the male nurses on the unit are empathetic, trustworthy, and competent.

Take reasonable measures to accommodate the request.

The interdisciplinary team is discussing the best approach to planning the care for a client with complex psychiatric-mental health needs. When determining which tasks can be performed by the psychiatric-mental health registered nurse (PMH-RN) and which must be performed by the psychiatric-mental health advanced practice registered nurse (PMH-APRN), the team should prioritize guidelines from what source? The American Nurses Association Standards of Practice The policies and procedures manual of the institution The recognized norms in the jurisdiction where the team is working The World Health Organization Guidelines for Nursing Practice

The American Nurses Association Standards of Practice

The nurse is performing a psychosocial assessment of a client with a mental illness. What information should the nurse gather while taking the history? Select all that apply. The age of the client The eating habits of the client The support systems of the client The spiritual beliefs of the client The client's view on personal attributes

The age of the client The spiritual beliefs of the client

The nurse is performing an assessment of a client with psychiatric illness. The nurse documents that the client has a restricted affect. Which behavior of the client is indicative of restricted affect? Choose the best answer. The client displays no facial expression. The client displays only one type of facial expression. The client displays a full range of emotional expressions. The client displays a facial expression that is incongruent with mood.

The client displays only one type of facial expression.

On assessment, the nurse finds that the client demonstrates low hardiness. Which can the nurse anticipate regarding the client based on this observation? Choose the best answer. The client has low self-esteem. The client is not spiritually inclined. T he client has reduced sense of belonging. The client has difficulty in problem solving under stress.

The client has difficulty in problem solving under stress.

Breaching a client's confidentiality is acceptable under which circumstance? The client works with your family member. The client is a close family friend. The client demonstrates antisocial personality. The client has discussed the intent to kill someone.

The client has discussed the intent to kill someone.

The nurse is assessing a client of Middle Eastern descent. The nurse finds that the client is standing at a distance of approximately 1.5 feet while speaking to the nurse. What should the nurse interpret from this behavior? The client is behaving in a manner that is culturally acceptable. The client is trying to invade the nurse's personal space. The client likes to be spoken to from a close distance. The client wants to develop a social relationship with the nurse.

The client is behaving in a manner that is culturally acceptable.

The nurse is performing a psychosocial assessment of a client. Which behavior would indicate that the client has a high self-efficacy? The client is extremely ambitious. The client has anxiety and depression. The client has an increased sense of self-doubt. The client does not believe that others would help the client if needed.

The client is extremely ambitious.

A nurse is meeting an older adult client for the first time. What may hinder the nurse's ability to effectively carry out the psychiatric assessment? (Select all that apply.) The client is not wearing a hearing aid. The nurse and the client speak different primary languages. The client has a cognitive impairment. The client is slow to respond to questions. The client is experiencing pain.

The client is not wearing a hearing aid. The nurse and the client speak different primary languages. The client has a cognitive impairment. The client is experiencing pain.

What findings would lead the nurse to conclude that the client needs a conservator? Select all that apply. The client has schizophrenia. The client is extremely aggressive. The client is not taking medications on time. The client is unable to act in the client's best interest. The client cannot provide food, clothing and shelter for self.

The client is unable to act in the client's best interest. The client cannot provide food, clothing and shelter for self.

Of the following clinical information, which one would be the most important in determining whether the client would be diagnosed with a mental disorder? The client is unable to continue school work and has been sitting on the client's bed for 3 days. The client has been receiving good grades in college and has a grade point average of 3.8. The client used cocaine up until 1 week ago. The client's father died in a tragic automobile accident when the client was 10 years old.

The client is unable to continue school work and has been sitting on the client's bed for 3 days.

A nurse is explaining assisted outpatient treatment to a client who is being discharged from the hospital. Which instructions should the nurse give the client regarding the assisted outpatient treatment? Select all that apply. The client must attend the follow-ups as per the schedule. The client must attend specific group therapy programs. The client must take prescribed medications as per the dosing schedule. The client must attend community health care lectures on the disorder. The client can decide whether to join the assisted outpatient treatment program.

The client must attend the follow-ups as per the schedule. The client must attend specific group therapy programs. The client must take prescribed medications as per the dosing schedule.

A nurse is reviewing a journal article about malpractice and the elements required to prove negligence. The nurse demonstrates a need for additional review when the nurse identifies which element as being necessary? The nurse professional had a duty of due care toward the plaintiff. The nurse's performance fell below the standard of care. The client must be injured physically as a result of the nurse's action. The client must prove the existence of injury.

The client must be injured physically as a result of the nurse's action.

A 22-year-old client has voluntarily sought treatment for an eating disorder at a rural residential facility. Despite a promising start, the client has been involved in recent conflicts with staff members and insists that the client wants to leave the facility. Staff members have refused to facilitate the client's transportation from the facility and have stated that they will not return the client's money and identification that were held when the client was admitted. Staff at the treatment facility may be guilty of false imprisonment due to what? The client's diagnosis is not terminal. The facility is in an inaccessible location. The client's diagnosis is not psychiatric in etiology. The client voluntarily admitted for treatment.

The client voluntarily admitted for treatment.

A nurse is teaching about assisted outpatient treatment to the caregivers of the client in the psychiatric facility. What are the benefits of this treatment program? Select all that apply. The client would require shorter inpatient stays. The client's risk of self harm would be reduced. The client would be accepting treatment voluntarily. The client would respond better to psychotropic drugs. The client would be protected from criminal victimization of others.

The client would require shorter inpatient stays. The client's risk of self harm would be reduced. The client would be protected from criminal victimization of others.

During a mental status exam, what conclusion should the nurse draw when the client is able to complete fewer than half of tasks accurately? The client's cognitive deficit is significant The test needs to be readministered The test environment was not appropriate The client did not understand the test instructions

The client's cognitive deficit is significant

The nurse has been asked to identify a location to conduct an interview with a psychiatric-mental health client. Which is an essential consideration when choosing a location? The amount of lighting in a given location The client's right to a stress-free environment The client's right to privacy The amount of distracters in a given location

The client's right to privacy

A client's estranged spouse has phoned the hospital unit several times seeking information about the client's admission and status. A nurse hears a colleague tell the client, "No, your spouse has not called as far as I know." When confronted by the nurse, the colleague states, "I'm just trying to look out for the client by protecting the client from stress." How should the colleague's actions be interpreted? The colleague had good motives but violated the principle of veracity The colleague was not justified in deceiving the client and contradicted the principle of fidelity The colleague's actions are a justifiable example of paternalism aimed at protecting the client's best interests The colleague was unjustified in allowing autonomy to override beneficence

The colleague had good motives but violated the principle of veracity

The nurse is assessing executives in the corporate sector. Which characteristic of the executives would indicate a higher hardiness? Choose the best answer. The executive has low stress and is less resistant to illnesses. The executive has high stress and is less resistant to illnesses. The executive has low stress and is more resistant to illnesses. The executive has high stress and is more resistant to illnesses.

The executive has high stress and is more resistant to illnesses.

The nurse finds that the client is constantly rubbing the hands. Under which component of psychosocial assessment should the nurse document this finding? The history component The mood and affect component The general assessment and motor behavior component The abnormal sensory experiences or misperceptions component

The general assessment and motor behavior component

The nurse is assessing an older adult client with lower back pain. In the course of assessment, the nurse learns that the client lost a spouse 10 weeks ago. The client laughs inappropriately and states, "My spouse just up and left me!" Which is the nurse's best response? The nurse should recognize the incongruity between content and behavior and find ways of exploring further. The nurse should recognize that the grieving process is highly individual, and responses need not match societal or cultural norms. The nurse should redirect the assessment toward mental status assessment. The nurse should recognize that the client is depersonalizing the death of the spouse.

The nurse should recognize the incongruity between content and behavior and find ways of exploring further.

A client with bipolar disorder has been following the prescribed medication regimen. The client indicates to the nurse a desire to stop the medication now that the client is feeling better. The nurse tells the client that most likely the client will have to remain on the medication for life to keep the condition under control. The nurse is practicing which principle? Autonomy Justice Veracity Fidelity

Veracity

An adolescent client has refused to wash or change clothes for several days. The client's hair is greasy, the client's clothes are stained, and the client has a strong malodor. Three male staff members approach the client to escort the client to the shower. The client resists and becomes combative with staff members. The client is placed in seclusion and is told the client will be released when the client is calm and willing to shower. Which is an accurate statement of the client's rights in this situation? Not violated, because hygiene is an important aspect of treatment Violated, primarily because showering is a personal preference Violated, primarily because of the inappropriate use of restraints Not violated, because the client's combative behavior warranted seclusion and restraint to protect others

Violated, primarily because of the inappropriate use of restraints

A nurse is seeing a client for a weekly therapeutic session in an outpatient psychiatric clinic. The client discloses to the nurse that the client often has thoughts about killing a neighbor. What should be the nurse's first response? Warn the client's neighbor and report to the authorities. Document the session thoroughly and meet with the client again the next day. Review the client's history to determine presence of past of violent behavior. Review coping strategies for anxiety and set new therapeutic goals.

Warn the client's neighbor and report to the authorities.

A nurse sitting with a client in a therapy session with the psychotherapist hears the client state, "I have had it with this marriage. I'm telling you, and not that I ever would do it, but I feel like hiring a hit man to kill my spouse!" Which action is the nurse obligated to take? Warn the client's spouse, based on the Tarasoff rule. Hold all psychotherapeutic content under strict confidence. Have the client sign a safety contract. Offer the client medication to help with anxiety and impulsive feelings.

Warn the client's spouse, based on the Tarasoff rule.

Which culture is comfortable with making direct eye contact? Western Native American Asian Chinese

Western

A nurse is reviewing material about assessing mental status. The nurse demonstrates a competent understanding of this assessment by identifying which area as a component of cognition? abstract reasoning posture speech mood

abstract reasoning

A nurse documents that "the client describes the recent breakup of a dating relationship with an emotionless tone and a flat facial expression." In which section of the mental status exam would the nurse have documented this statement? blocking feelings affect mood

affect

Which factor has the greatest impact on a person's ability to cope with illness? All of the following impair a person's ability to cope except: age. gender. occupation. financial status.

age

A client diagnosed with schizophrenia insists on stopping medication because it causes the client to gain weight. The client is exercising which ethical principle? autonomy beneficence justice veracity

autonomy

A 22-year-old client with schizophrenia is refusing antipsychotic medication. The client states, "I don't like the dopey way it makes me feel. I feel like I'm walking underwater when I take it." The nurse explains to the client, "Your schizophrenia is caused by a chemical imbalance in your brain, and this medication helps fix that chemical imbalance. You need to take it so your symptoms will get better." This conversation reflects a conflict between which two types of ethical principles? autonomy and justice paternalism and veracity justice and nonmaleficence autonomy and beneficence

autonomy and beneficence

Providing milieu therapy is an example of the use of which ethical principle? beneficence veracity fidelity autonomy

beneficence

A nursing student is initiating a relationship with an assigned client. After meeting and spending approximately 20 minutes talking with the client, the student makes arrangements to visit again after lunch. After lunch, fellow classmates invite the student to go to the gym with them and a group of clients to play volleyball. The student starts to go with them but then remembers the promise to meet with the client. The student decides to forgo volleyball and talk with the client. The student's decision reflects which ethical principle? autonomy beneficence fidelity veracity

fidelity

A nurse is conducting an assessment of a client with a suspected mental illness. Which component would the nurse most likely assess through observation? Select all that apply. hygiene posture unusual movements eye contact speech

hygiene posture unusual movements

A psychiatric nursing class is discussing current trends in mental health care. A student voices the opinion that there should be equitable access to mental health care and resources for those who live in rural areas, for those without health insurance, and for those with very little income. The student nurse's opinion most closely reflects which ethical principle? nonmaleficence paternalism veracity justice

justice

During an assessment of a client with bipolar disorder, the nurse observes the client laughing loudly, then sobbing immediately after. How should the nurse most accurately describe this observation? labile mood limited judgement lack of insight flat affect

labile mood

A psychiatric-mental health client has an advance care directive on the client's medical record. A clinician provides treatment that disregards the client's directive. The clinician would be liable for: assault. battery. medical battery. false imprisonment.

medical battery.