Mental Health Nursing Exam #1
Question: When the nurse is working with a client in crisis, which nursing action is most important? A. Obtaining complete assessment of the client's past history B. Remaining focused on the client's immediate problem C. Determining the relationship of early life experiences and the crisis state D. Developing an action plan for the client
?
A nurse who will be providing care to a psychiatric -mental health patient is in the orientation phase of the relationship. The nurse would most likely assume which role? A. Counselor B. Teacher C. Stranger D. Surrogate
A. Counselor
In the FICA Model of Spiritual Assessment, which of the following questions would best assess the influence of a patient's beliefs? A. Does your spirituality impact your healthcare choices? B. Do you participate in a spiritual community? C. How would you like your spiritual beliefs to be addressed in your health care? D. Do you have spiritual values that help you cope with periods of stress?
A. Does your spirituality impact your healthcare choices?
A group of nursing students is reviewing risk factors for boundary violations in the therapeutic relationship. They demonstrate understanding of the concept when they select which of the following risk factors? (Select all that apply) A. Excessive focus on patient B. Setting consistent limits with the patient C. Feeling isolated among colleagues D. Frustration with job
A. Excessive focus on patient C. Feeling isolated among colleagues D. Frustration with job a.c.d. Focusing on a single, patient, poor interactions with coworkers, and feeling frustrated with job and role are risk factors for boundary violations.
A psychiatric-mental health nurse is engaged in a dialogue with a patient. The patient states, "My wife has left me. I feel like nobody wants me." Which of the following responses by the nurse would be most therapeutic? A. "Can you talk more about this feeling?" B. "These things happen all the time, things will get better." C. "My first husband left me, and I got over it." D. "What did you do wrong to cause this?"
A. "Can you talk more about this feeling?"
After teaching a group of students about risk and protective factors, the nursing instructor determines that additional teaching is needed when the students state which of the following about resilience? A. "Everyone is born with resilience, but not everybody uses it." B. "It is a protective factor that helps balance out the risk factors." C. "Individuals need time to develop resilience." D. "Resilience promotes better coping with trauma or stress."
A. "Everyone is born with resilience, but not everybody uses it."
A nursing student is reviewing thought processes and correctly identifies which statement as a flight of ideas? A. "The radio played that song I love. Love is blind. Three blind mice. Leaves of three, let it be." B. "Who is the question she asked my schedule before the coffee pot." C. "The car is blue because the man is six feet tall." D. "I'll you what I do for work but my father had a company that revolutionized the tech industry. It's amazing how fast technology is developing. Sometimes you wonder if all this technology is good for us."
A. "The radio played that song I love. Love is blind. Three blind mice. Leaves of three, let it be."
A group of nursing students is reviewing defense mechanisms. They will have demonstrated understanding when they identify which of the following definitions best describes sublimation? A. A teen who struggles with aggression channels the impulse by playing contact sports B. A mother refuses to believe her son has a drug problem C. A child who has recently moved to a different state and started at a new school begins to wet the bed D. An employee who was just reprimanded by his boss starts an argument with a coworker
A. A teen who struggles with aggression channels the impulse by playing contact sports
A nurse is developing a care plan for a patient with generalized anxiety disorder. She recognizes that several nursing interventions are appropriate for both mild and moderate anxiety. She also understands moderate anxiety decreases attention, perception and cognition. Which of the interventions below are most appropriate for patients experiencing moderate anxiety? (Select all that apply) A. Actively listening to the patient B. Prioritizing patient teaching C. Having a calm manner D. Reviewing previous coping strategies E. Ignoring the patient
A. Actively listening to the patient C. Having a calm manner D. Reviewing previous coping strategies
A patient is in therapy for anxiety and depression. He reports to his therapist that he is currently experiencing overwhelming stress after unexpectedly losing his job during the pandemic and falling behind on his mortgage payments. He confides that his house has gone into foreclosure and he is struggling with guilt that he was unable to see his mother who passed away in the hospital a few months ago. Which types of crisis is the patient experiencing? (Select all that apply) A. Adventitious crisis B. Maturational crisis C. Situational crisis D. Interpersonal crisis
A. Adventitious crisis C. Situational crisis
How did Dorothea Dix advance mental health care in the United States? A. Advocated for state hospitals to improve care for the mentally ill B. Introduced the concept of holistic nursing care C. Founded a school for psychiatric-mental health nurses D. Developed psychoanalytic theory around unconscious desires and their role in personality formation
A. Advocated for state hospitals to improve care for the mentally ill
The use of seclusion or restraint to control the behavior of a client who is at risk of harming self or others gives rise to conflict between the ethical principles of: A. Autonomy and beneficence B. Advocacy and confidentiality C. Veracity and fidelity D. Justice and humanism
A. Autonomy and beneficence Autonomy refers to self-determination and beneficence refers to doing good. When a client is restrained or secluded, the need to do good and prevent harm outweighs the client's autonomy.
A nurse is adequately representing the stated bioethical principle when valuing: A. Autonomy by respecting a client's right to decide to refuse cancer treatment. B. Justice by staying with a client who is suicidal C. Fidelity by informing the client about the negative side effects of a proposed treatment D. Beneficence when advocating for a client's right to enter into a clinical trail for a new medication
A. Autonomy by respecting a client's right to decide to refuse cancer treatment. Autonomy refers to self-determination. Self-determination can be exercised when one makes his or her own decisions without interference from others
A psychiatric-mental health nurse case manager occupies several different roles in the hospital, including all of the following EXCEPT: A. Caregiver B. Researcher C. Consultant D. Educator
A. Caregiver
During the identification phase of Peplau's nurse-patient relationship, the nurse focuses communication on which of the following? A. Clear understanding and identification of the problem B. The patient as a whole C. Expected routines D. Time frame for interaction
A. Clear understanding and identification of the problem
A nurse is charting at the nurse's station when she observes one of her patients has kicked a chair, is pacing in the dayroom and muttering to himself after being told he would not be able to make a phone call. Which response by the nurse best demonstrates her understanding of the therapeutic relationship? A. Exiting the nursing station, standing a few feet away from the patient and saying, "I see you're pacing. This must be very frustrating. If you like, we can go over the schedule together and review what times the phones are available so you can make your phone call at the next opportunity." B. Telling another nurse, "He did this yesterday too." C. Ignoring the patient and continuing to chart. D. Remaining seated and calling out to the patient, "I know that you're mad but you're not allowed to kick the furniture."
A. Exiting the nursing station, standing a few feet away from the patient and saying, "I see you're pacing. This must be very frustrating. If you like, we can go over the schedule together and review what times the phones are available so you can make your phone call at the next opportunity."
A nurse is providing primary prevention to a local community group about psychiatric-mental health disorders. Which of the following would the nurse include as a protective factor? Select all that apply. A. Flexibility B. High intelligence C. Limited social relationships D. Absence of recreational activities E. Adequate economic resources
A. Flexibility B. High intelligence E. Adequate economic resources
Which of the following options are qualities of a therapeutic relationship? (Select all that apply): A. Genuineness B. Offering support C. Respect D. Humor E. Maintaining boundaries
A. Genuineness B. Offering support C. Respect E. Maintaining boundaries
A nurse is establishing boundaries with a new patient who is coming to a community mental health center for treatment for the first time. Which of the following would be least appropriate to do during the orientation phase? A. Give the patient some information about the nurse's personal life B. Explain to the patient the reason for the nurse being there C. Describe what it is that the nurse can provide for the patient D. Discuss the time, place, and frequency for the meetings
A. Give the patient some information about the nurse's personal life
Deinstitutionalization occurred as a result of which of the following? A. Mental Retardation Facilities and Community Mental Health Centers Act B. National Mental Health Act C. Omnibus Budget Reconciliation Act (OBRA) D. Mental Health: A Report of the Surgeon General
A. Mental Retardation Facilities and Community Mental Health Centers Act
According to the American Nurses Association Standards of Practice for Psychiatric Mental Health Nurses, which specific intervention can be implemented by any psychiatric mental health nurse generalist? A. Milieu therapy B. Psychotherapy C. Consultation D. Prescriptive authority
A. Milieu therapy
The use of empathy and support begins in the stage of the nurse-client relationship termed the A. Orientation stage B. Working stage C. Identification stage D. Resolution stage
A. Orientation stage The use of empathy and support should begin in the orientation stage. These tools are helpful in building trust and furthering the relationship.
A patient newly admitted to an inpatient unit with a history of depression and substance use disorder is pounding on the nurse's station window, swearing at staff, and threatening violence if he is not discharged. What intervention is most appropriate during this aggressive episode? A. Setting limits on the patient's behavior B. Assessing the patient for a history of violent behavior C. Placing the patient in restraints D. Assessing the time of the patient's last drink
A. Setting limits on the patient's behavior
During the alarm stage in a stress response, the body undergoes a series of reactions to support the individual in assessing and responding to the threat. Select all the processes that occur in this stage. (Select all that apply): A. The adrenal cortex releases epinephrine and norepinephrine B. Decreased secretion of antidiuretic hormone [ADH] increases urine output C. Pupils dilate D. Food digestion speeds up E. Heart rate, blood pressure and cardiac output increase
A. The adrenal cortex releases epinephrine and norepinephrine C. Pupils dilate E. Heart rate, blood pressure and cardiac output increase
What is the primary nursing goal when establishing a therapeutic relationship with a client? A. To promote client growth B. To develop the nurse's personal identity C. To establish a purposeful social interaction D. To develop communication skills
A. To promote client growth
While interacting with a patient, the patient says, "How about we meet later after you are done with work and go grab a cup of coffee and talk?" Which response by the nurse would be most appropriate? A. "That sounds like fun, but I'm bust after work." B. "Remember, I'm here as a professional to help you." C. "Don't be silly. I can't meet you after work." "Okay, but this needs to be our secret."
B. "Remember, I'm here as a professional to help you."
A patient states, "You have been so helpful to me while I've been here, I'd like to take you to dinner after I get out to show my thanks." Which of the following would be the best response by the nurse? A. "Are you kidding, I would never go out with a mental patient." B. "That's very kind of you to offer. We have to remember, though, that our relationship is professional, not personal, so I will have to decline." C. "Sure, but we will have to keep it a secret or I could get into trouble." D. "Let me think about it and I'll get back to you before you are discharged."
B. "That's very kind of you to offer. We have to remember, though, that our relationship is professional, not personal, so I will have to decline."
When engaging in critical thinking, which of the following would the nurse ask first? A. "What would be the best course of action?" B. "What is the issue at hand?" C. "What could have been missed?" D. "What factors might be affecting the patient?"
B. "What is the issue at hand?"
A psychiatric-mental health nurse (PMHN) is preparing a presentation for a group of student nurses about psychiatric-mental health nursing. Which statement would the nurse include in the presentation about this specialty? A. A PMHN needs to obtain a graduate-level degree for practice B. Advanced practice PMHNs may practice psychotherapy C. Basic-level PMHNs mainly focus on the patient's medication compliance D. PMHNs work only in acute inpatient settings
B. Advanced practice PMHNs may practice psychotherapy
A nurse manager witnessed a nurse a gift from a discharging patient and speaks to her afterwards about the incident. What strategy would be most effective in helping the nurse in maintaining appropriate boundaries in the future? A. Asking other patients for feedback on her boundaries B. Asking for feedback from supervisors and peers on the unit C. Increasing emotional and mental distance from her patients D. Asking her patients to tell her if she makes them uncomfortable
B. Asking for feedback from supervisors and peers on the unit
What ethical principle is supported when a physician obtains informed consent for electroconvulsive therapy from a depressed client? A. Beneficence B. Autonomy C. Justice D. Fidelity
B. Autonomy Autonomy refers to self-determination. One way to exercise self-determination is to make decisions about one's care.
Cognitive-behavioral therapy (CBT) is one type of treatment for mental illness. Which of the following theories best describes the underlying framework for CBT? A. Mental illness is caused by a dysregulation of neurotransmitters in the brain B. Cognitive distortions lead to maladaptive behavior which causes poor mental health C. A person's environment and socially learned behaviors contribute to the development of mental illness D. Individuals are capable of achieving mental health with unconditional positive regard and patient-centered care
B. Cognitive distortions lead to maladaptive behavior which causes poor mental health
A public health nurse is developing a prevention plan in response to an increase in early adult schizophrenia cases in the community. Which of the following risk factors would be least effective to target in the prevention plan? A. Head injuries B. Gestational and birth complications C. Stress exposure D. Marijuana and substance use
B. Gestational and birth complications
Hildegard Peplau identified six roles that nurses take on during various stages of the interpersonal relationship. Which action is most appropriate for the leader role? A. Assisting the patient in recognizing differences between the nurse and previous caregivers B. Guiding patient in setting goals and accomplishing therapeutic tasks C. Mindfully employs the therapeutic use of self with patient D. Provides patient-specific information
B. Guiding patient in setting goals and accomplishing therapeutic tasks
A nurse is admitting a 36-year-old female with treatment-resistant depression to an inpatient unit following a suicide attempt. During the medical assessment, the patient reports that she experienced a severe concussion while playing college basketball, has been diagnosed with fibromyalgia and polycystic ovarian syndrome, drinks a bottle of wine most days of the week and has been unable to decrease this amount. She discloses that she experienced physical abuse and neglect in her childhood home, that both of her parents have substance-use disorders, and that her mother smoked during pregnancy. She states that she has been unable to afford her medications after falling behind on her student loan payments, which caused her wages to be garnished. Which of these disclosures is an individual risk factor for mental illness? (Select all that apply) A. Mother smoking throughout her pregnancy B. History of child abuse C. Poverty D. Her concussion E. Fibromyalgia diagnosis
B. History of child abuse D. Her concussion E. Fibromyalgia diagnosis
A patient with schizophrenia is experiencing delusional thinking. During an assessment with his nurse, the patient states, "Did you watch the news last night? That newscaster gave me a message in code. She told me that they're keeping her hostage at the news station." The nurse recognizes this as which type of thought process? A. Circumstantial thinking B. Ideas of reference C. Word salad D. Flight of ideas
B. Ideas of reference
When implementing secondary prevention strategies, which of the following would the psychiatric-mental health nurse do first? A. Conduct community screening B. Identify existence of risk factors C. Teach about coping skills D. Make referrals for immediate treatment
B. Identify existence of risk factors
A team of nurses is de-escalating a patient who is shouting and throwing items in the dayroom. The newest nurse tells the patient, "You say you're ready for discharge then you do something like this. You should apologize to all the other patients." This comment is an example of which type of nontherapeutic communication technique. (Select all that apply) A. Introducing an unrelated topic B. Judgmental comments C. Disapproving D. Advising
B. Judgmental comments D. Advising
The treatment team is reviewing the care plan for a patient with treatment-resistant depression, multiple inpatient admissions over the past six months, and who has been living independently in the community. What level of case management services would best support the patient in promoting optimal recovery? A. Level One B. Level Two C. Level Three D. No case management service are necessary
B. Level Two The patient is struggling to remain independent in the community as evidenced by the multiple readmissions over the previous six months. Level Two services support patients in their recovery and rehabilitation.
The nurse who provides therapeutic milieu management supports the clients best by: A. Allowing them to act out their fears and frustrations B. Providing a safe place for them to practice coping skills C. Meeting their physical as well as emotional needs D. Encouraging them to talk about their problems with others
B. Providing a safe place for them to practice coping skills A therapeutic milieu can serve as a real life training ground for learning about the self and practicing communication and coping skills in preparation for a return to the community.
For patients experiencing panic levels of anxiety, which nursing intervention is the most therapeutic? A. Providing patient teaching B. Providing reality orientation C. Encouraging the use of past coping strategies D. Encouraging the patient to talk about their anxiety
B. Providing reality orientation
When providing care to individuals involved in a community disaster, which of the following would be the priority? A. Food and water B. Safety C. Shelter D. Referrals
B. Safety
The therapist recognizes his patient is in crisis and understands that the goals of crisis intervention include all of the following except: A. The resolution of mental distress B. Solving the patient's problems C. The relief of acute distress D. Restoring the patient's previous level of functioning
B. Solving the patient's problems
Which of the following behaviors indicate the patient is experiencing aggression? (Select all that apply) A. The patient has a broad affect. B. The patient is walking around the unit and clenching his fists. C. The patient is reporting dizziness, palpitations, headache and confusion. D. The patient is arguing with staff and other patients.
B. The patient is walking around the unit and clenching his fists. D. The patient is arguing with staff and other patients.
A group of nursing students is reviewing culturally competent nursing care. The students will demonstrate understanding when they correctly identify enculturation as which of the following processes? A. Providing effective nursing care that incorporates the patient's cultural and spiritual background and beliefs B. The process of learning the dominant culture by growing up in it C. The process of assimilating to a new culture D. The ability to communicate effective with all people, including those with limited English proficiency
B. The process of learning the dominant culture by growing up in it
Which of the following rights is not included in the Bill of Rights for Mental Health Patients? A. The right to remain unrestrained B. The right for hospitals to override patient's refusal of medication C. The right to make grievances D. The right to access personal medical records
B. The right for hospitals to override patient's refusal of medication
Client reactions of intense hostility or feelings of strong affection toward the nurse are common forms of A. Resistance B. Transference C. Countertransference D. Emotional abreaction
B. Transference
During an interpersonal relationship, a patient identifies that a nurse reminds him of his sister and begins to respond to the nurse as he would his sister. The nurse recognizes this as which of the following? A. Boundary testing B. Transference C. Boundary crossing D. Counter-transference
B. Transference
When describing the results of integrating interpersonal models in psychiatric-mental health nursing, which of the following would be least appropriate to include? A. Therapeutic communication B. Milieu management C. Psychopharmacology D. Process groups
C. Psychopharmacology
A patient asks the nurse what physical symptoms may be caused by stress. What should the nurse share with the patient? A) Decreased respiratory rate B) Decreased blood pressure C) Increased heart rate D) Increased urine output
C) Increased heart rate OR D) Increased urine output
A nurse working in an intensive outpatient program recognizes her patient is currently experiencing an acute crisis. When evaluating the outcomes, which statement by the patient will indicate the crisis is resolving? A. "I tried those coping skills we talked about but they didn't help and my depression is worse than ever." B. "I just can't handle this on my own." C. "I meditated every day this week, I did all my therapy homework and when things were overwhelming, I was able to take some time and practice some self-care. I think I'm getting better at all this stuff." D. "I don't know what I would do if I had another panic attack like the last one."
C. "I meditated every day this week, I did all my therapy homework and when things were overwhelming, I was able to take some time and practice some self-care. I think I'm getting better at all this stuff."
A nurse is leading a meditation group on the milieu and wants to use self-disclosure to enhance patient education and develop rapport. Which of the following comments is an appropriate self-disclosure? A. "I have a hard time meditating but I have to do it because my doctor told me I need to lower my stress levels." B. "I'm sorry I'm yawning so much but I was out at the bar really late last night." C. "That siren was distracting for me too. That's okay. We can just allow the sound to come and go and then focus our attention back on our breath." D. "I really don't like meditation but I was assigned this group so let's just get started already."
C. "That siren was distracting for me too. That's okay. We can just allow the sound to come and go and then focus our attention back on our breath."
Two students fail their introductory nursing course. One student plans to seek tutoring and retake the course next fall. The second student attempts suicide. Which of the following factors would have been influential in the development of the second student's crisis? A. The time of year in which the event occurred B. The presence of support systems C. A lack of adequate coping mechanisms D. The individual's family birth order
C. A lack of adequate coping mechanisms
A nurse has developed a strong rapport with a patient on her unit. When she observes the patient crying after hearing some bad news, the nurse gives the patient a hug. The nurse later realizes she committed which of the following? A. Boundary Testing B. Boundary Violation C. Boundary Crossing D. Neglect
C. Boundary Crossing The nurse has committed a boundary crossing and performed an action that is not allowed in the therapeutic relationship. Boundary testing occurs when a patient tests the therapeutic relationship. A boundary violation is a serious breach of the nurse-patient relationship where the nurse's needs are met. Neglect is a form of boundary violation
A group of nursing students are reviewing information about Peplau's phases of the nurse-patient relationship and how they apply to the nursing process. The students demonstrate understanding of the information when they identify which of Peplau's phases as correlating to the implementation step of the nursing process? A. Orientation B. Identification C. Exploitation/working D. Resolution
C. Exploitation/working
The following phases associated with a crisis. Which of the following occurs first? A. Distress occurs as every method of coping fails B. Anxiety increases as past coping methods are ineffective C. Exposure to a stressor leads to use of past coping mechanisms D. New and different coping strategies are tried
C. Exposure to a stressor leads to use of past coping mechanisms
A group of nursing students in a psychiatric-mental health rotation are reviewing information on therapeutic communication. Which of the following do they correctly identify as a nontherapeutic communication technique? A. Using nonjudgmental language B. Asking open-ended questions C. Giving false reassurance D. Offering self
C. Giving false reassurance
A nurse is developing a care plan for a newly admitted 17-year-old patient diagnosed with panic disorder. She recognizes that the patient is in which of Erikson's stages of psychosocial development? A. Trust vs. Mistrust B. Initiative vs. Guilt C. Identity vs. Role Confusion D. Integrity vs. Despair
C. Identity vs. Role Confusion
While conducting a psychosocial assessment, the nurse observes the patient is smiling laughing while reporting severe depression and thoughts of suicide. The nurse understands that the patient is displaying which type of affect? A. Flat B. Broad C. Inappropriate D. Restricted
C. Inappropriate
A nursing instructor is preparing a class for a group of students about case management in psychiatric-mental health nursing. Which of the following would the instructor most likely include about psychiatric-mental health case management? A. It's a method of care delivery that's unique to psychiatric-mental health nursing B. It's a healthcare financing strategy aimed at reducing costs C. It involves multidisciplinary collaboration to achieve outcomes D. It involves reducing fragmentation of care during illness episodes
C. It involves multidisciplinary collaboration to achieve outcomes
A nurse is preparing to run a therapeutic group on an inpatient psychiatric unit. She understands that the high symptom acuity and short lengths of stay in the inpatient setting decrease group cohesion. What steps can the nurse take to increase cohesion in her group? A. Using an authoritarian style of leadership B. Discouraging patients from sharing their values C. Leading groups democratically and encouraging input from all members D. Demonstrating ambivalence about the group
C. Leading groups democratically and encouraging input from all members
A client diagnosed with dependent personality disorder states, "Do you think I should move from my parent's house and get a job?" Which nursing response is most appropriate? A. It would be best to do that in order to increase independence. B. Why would you want to leave a secure home? C. Let's discuss and explore all of your options. D. I'm afraid you would feel very guilty leaving your parents
C. Let's discuss and explore all of your options.
A group of nursing students are reviewing the various risk factors associated with psychiatric-mental health disorders. The students demonstrate understanding of the information when they identify which of the following as a family risk factor? A. Poverty B. High crime rate C. Marital discord D. Temperament
C. Marital discord
The nurse is performing an initial assessment on a newly admitted client who is oriented times four. Which of the following communication techniques would best facilitate obtaining accurate and complete client data? A. Close ended questions B. Requesting an explanation C. Open ended questions D. Interpreting
C. Open ended questions
Hildegard Peplau updated and condensed her model of interpersonal relationships. Select the correct order phases in the updated model. A. Orientation, Exploitation, Termination B. Identification, Exploitation, Resolution C. Orientation, Working, Termination D. Identification, Working, Resolution
C. Orientation, Working, Termination
When evaluating critical thinking, clinical decision making, the interpersonal relationship, and the nursing process, which of the following would be of primary importance? A. Nurse's self-awareness B. Setting for care C. Patient's needs D. Achievement of outcomes
C. Patient's needs
A nurse assesses a patient and determines that the patient is in the alarm stage of responding to stress. Which of the following would the nurse most likely note? A. Pupil constriction B. Decrease in heart rate C. Rapid respirations D. Dry skin
C. Rapid respirations
A nurse is admitting a 36-year-old female with treatment-resistant depression to an inpatient unit following a suicide attempt. During the interview, the patient states, "I am not going to let this beat me. I'll do whatever it takes but I want to be alive and I know I can get better." The nurse identifies this statement as evidence of which of the following? A. External protective factors B. Personal risk factor C. Resilience D. Defense mechanism
C. Resilience
A nursing student notices a patient is pacing in front of the nursing station, knocking on the glass, asking for medication and complaining of dizziness and extreme anxiety. She is able to follow nursing directions with difficulty and states, "I need medicine, I don't feel right. I feel like something bad is happening to me." The student recognizes the patient's presentation matches which level of anxiety? A. Mild B. Moderate C. Severe D. Panic
C. Severe
While interviewing a middle-aged woman who has come to the mental healthcare facility, the woman states "My oldest son just left for college last week. I'm so lost without him. The house seems so empty." The nurse would interpret the woman's statement as suggesting which type of crisis? A. Maturational B. Situational C. Social D. Adventitious
C. Social (according to book but I'm pretty sure it's A. Maturational)
A nurse who will be providing care to a psychiatric-mental health patient is in the orientation phase of the relationship. The nurse would most likely assume which role? A. Counselor B. Teacher C. Stranger D. Surrogate
C. Stranger
A nurse is admitting a patient with a limited English profiency and requires interpreter services. The nurse understands which of the following is the best way support the patient? A. Using medical terminology whenever possible B. Having a family member to interpret C. Supporting the interpreter in getting verbatim translations D. Using an interpreter of a different gender or age group
C. Supporting the interpreter in getting verbatim translations
The Community Mental Health Centers Act led to significant deinstitutionalization. Which of the following descriptions most closely defines deinstitutionalization: A. The development of medication targeting specific neurotransmitters B. The dismissal of individuals with mental health problems from the military C. The transition of psychiatric patients from long-term mental health facilities to the community D. The psychoanalytic theory that states a person's actions are motivated by unconscious desires
C. The transition of psychiatric patients from long-term mental health facilities to the community
When describing physical boundaries to a group of nursing students, which of the following would the instructor use as an example of this type of boundary? A. Feelings B. Choices C. Touching D. Spirituality
C. Touching
A nursing instructor is preparing a class discussion about the development of mental health care over time. Which of the following would the instructor include as occurring first? A. Development of psychoanalytic theory B. Establishment of the National Institute of Mental Health C. Use of medical treatments such as bloodletting and immobilization D. Emphasis on supportive, sympathetic care in a clean, quiet environment
C. Use of medical treatments such as bloodletting and immobilization
A patient with obsessive-compulsive disorder is recruited for a drug trial while on an inpatient unit. He asks the nurse if the medication has any side effects. By honestly reporting potential side effects to the patient, which ethical principle is the nurse demonstrating? A. Kantianism B. Fidelity C. Veracity D. Beneficence
C. Veracity
A basic-level psychiatric-mental health nurse is helping with intake screening in the emergency department. What other function could the nurse perform? A) Prescribing psychopharmacological agents B) Completing a comprehensive psychiatric and mental health evaluation C) Providing integrative therapy interventions D) Assisting with crisis intervention and stabilization
D) Assisting with crisis intervention and stabilization
A group of nursing students are reviewing information on boundaries, boundary crossings, and boundary violations. The students demonstrate understanding of the information when they state which of the following? A. "Most times, a boundary crossing will lead to a boundary violation." B. "Boundary violations can be therapeutic in some instances." C. "Boundaries are unnecessary if the patient and nurse view each other as equals." D. "Boundary crossings can result in a return to established boundaries."
D. "Boundary crossings can result in a return to established boundaries."
A nursing student is interviewing a patient when she observes the patient has started to cry. What response by the nursing student is the most therapeutic? A. "Are you upset? B. "Don't cry, it's going to be okay." C. "Why are you crying?" D. "I will sit here with you."
D. "I will sit here with you." Offering self to the patient and being available promotes trust and acceptance. Asking closed-ended questions, belittling the patient's feelings, and requesting explanations are examples of nontherapeutic communication.
The nurse best assesses the client's spiritual life by asking A. "Do you practice a specific religion?" B. "To whom do you turn to in times of crisis?" C. "Do you attend church regularly?" D. "What role does religion play in your life?"
D. "What role does religion play in your life?" Asking the client to define the role of religion in their life allows for discussion related to the other topics.
A nurse is preparing to run a therapeutic group on an inpatient psychiatric unit. She understands different phases of group call for different actions on the part of the group leader. Which task is most appropriate during the working phase of groups? A. Identifying the goals of group B. Planning for the end of the group meetings C. Facilitating introductions D. Accomplishing group tasks
D. Accomplishing group tasks
Role functions of psychiatric-mental health nurses include all of the following except: A. Managing the milieu B. Working with the interdisciplinary team C. Crisis intervention D. Clinical supervision
D. Clinical supervision
A public health nurse is developing a plan to prevent adverse childhood experiences (ACEs) in her community. Which strategy would be least effective to reduce ACEs? A. Educating community providers on ACEs and available community resources B. Starting a community mentoring program C. Developing a home visitation program for infants and toddlers D. Creating female-only violence prevention programs
D. Creating female-only violence prevention programs
A group of psychiatric-mental health nurses are preparing an in-service presentation about stress and crisis. Which of the following would the group most likely include in the presentation? A. Crisis can be a chronic situation due to stress B. An unknown stimulus is responsible for the crisis C. The stress associated with crisis must be real D. Crisis is not considered a mental illness
D. Crisis is not considered a mental illness
When describing the possibility of developing a psychiatric-mental health disorder related to a medical condition, which disorder would the nurse identify as the most common & problematic? A. Schizophrenia B. Acute stress disorder C. Personality disorder D. Depression
D. Depression
A nurse is in the resolution phase of the interpersonal relationship with a patient. The nurse would also be engaged in which step of the nursing process? A. Assessment B. Planning C. Implementation D. Evaluation
D. Evaluation
A client threatens to kill himself, his wife, and their children if the wife follows through with the divorce proceedings. During the pre-interaction phase of the nurse patient relationship, which interaction should the nurse employ? A. Acknowledging the client's actions and encouraging alternative behaviors. B. Establishing rapport and developing treatment goals C. Providing community resources on aggression management D. Exploring personal thoughts and feelings that may adversely impact the provision of care
D. Exploring personal thoughts and feelings that may adversely impact the provision of care
A group of nursing students are reviewing information related to the development of psychiatric-mental health nursing. The students demonstrate understanding of the information when they identify which person as emphasizing the use of the interpersonal process? A. Florence Nightingale B. Linda Richards C. Dorothea Dix D. Hildegard Peplau
D. Hildegard Peplau
Irving Yalom identified 11 curative factors or benefits of groups. Which of the following definitions best describes imitative behavior? A. Members offer and receive support from each other in groups B. Individuals copy the behavior of others and often try out new coping strategies of other members in groups C. Group members learn from lectures by the group leader and suggestions offered by other members D. Members may be reminded of unresolved conflicts in their early family experiences and be able to resolves them with group support and careful leader supervision
D. Members may be reminded of unresolved conflicts in their early family experiences and be able to resolves them with group support and careful leader supervision
A nursing instructor is teaching about the differences between therapeutic groups and group therapy. Her nursing students will have demonstrated understanding when they agree with which of the following statements? A. Psychiatric-mental health nurses can run group therapy sessions. B. Therapeutic groups feature psychotherapy sessions to improve interpersonal functioning in members C. Therapeutic groups are only led by group leaders with advanced degrees. D. Nurses can lead therapeutic groups to teach effective coping skills and provide patient education.
D. Nurses can lead therapeutic groups to teach effective coping skills and provide patient education.
Over the course of the pandemic, a patient has recently gone through the unexpected loss of his job, the death of his mother, and his house has been foreclosed on. He tells his therapist, "I feel so hopeless. My anxiety is constant and I can barely sleep. I don't know how I can go on like this. I don't know. I don't know." What phase of crisis is the patient currently in? A. Phase 1 B. Phase 2 C. Phase 3 D. Phase 4
D. Phase 4
When engaging in therapeutic communication for the first encounter with the patient who is upset, which of the following would be most appropriate for the nurse to do? A. Use silence. B. Sit next to the client and put your arm around them, offering them comfort. C. Say, "I know you are upset, but if you don't calm down, I will have to call the doctor for something to give you." D. Say, "You seem upset; can you begin to share with me what's going on so I can understand your situation better?"
D. Say, "You seem upset; can you begin to share with me what's going on so I can understand your situation better?"
A nurse wants to delineate the specific responsibilities for psychiatric-mental health nursing. Which of the following resources would they reference? A. Statement on Psychiatric Nursing Practice B. Healthy People 2030 C. Action for Mental Health D. Scope and Standards of Practice
D. Scope and Standards of Practice ??
In Travelbee's nurse-patient relationship, which phase is characterized by the wish to relieve the patient's suffering? A. Original encounter B. Empathy C. Rapport D. Sympathy
D. Sympathy
What activity occurs during the coordination function of the case management process? A. The case manager and treatment team implement the individualized treatment plan B. The case manager develops an evidence-based care plan with the treatment team C. The case manager assesses whether the goals of the treatment plan have been met D. The case manager works with other members of the care team to ensure the treatment plan is being implemented efficiently
D. The case manager works with other members of the care team to ensure the treatment plan is being implemented efficiently
A group of nursing students is studying the ethical principles of nursing care. They demonstrate understanding when they recognize which of the following options best describes the principle of nonmaleficence? A. A patient's ability to make decisions independently B. The right to fair treatment C. The obligation of the nurse to do what is best for the patient D. The obligation of the nurse to not harm the patient
D. The obligation of the nurse to not harm the patient
A group of nursing students is reviewing risk factors for aggression. They will demonstrate understanding when they recognize which of the following situations is associated with the highest risk of inpatient violence? A. The patient has a trauma history B. The patient is diagnosed with Major Depressive Disorder C. The patient is currently pacing the unit and swearing D. The patient has a history of previous violent episodes
D. The patient has a history of previous violent episodes
According to Peplau's theory of interpersonal relationships, the exploitation phase is when: A. The collaboration of the nurse and patient has resolved the patient's health care needs B. The nurse introduces themselves and the purpose of their relationship C. Mutually developed goals are established D. The patient takes responsibility for their health goals
D. The patient takes responsibility for their health goals
A nursing instructor is reviewing legal terms related to nursing. Her students will have demonstrated understanding when they correctly identify which of the following option as the duty to warn? A. Touching another person without their consent B. Sharing information about another person that damages their reputation C. Unjustified confinement of another person with the use of threat or force D. The responsibility of healthcare providers to warn an intended victim of potential harm or threats to their safety
D. The responsibility of healthcare providers to warn an intended victim of potential harm or threats to their safety
A client tells the nurse, "I feel bad because my mother does not want me to return home after I leave the hospital." Which nursing response is therapeutic? A. It is quite common for clients to feel that way after a lengthy hospitalization B. Why don't you talk to your mother? You may find out she doesn't feel that way. C. Your mother seems like an understanding person. I'll help you approach her D. You feel that your mother does not want you to come back home?
D. You feel that your mother does not want you to come back home?
