Mental Health Practice Questions EXAM 2

Brittany is caring for a patient with bulimia. She recognizes which of the following nursing interventions as being most appropriate? a. monitor the patient on bathroom trips after eating b. allow the patient extensive private time with family members c. provide meals whenever the patient requests them d. encourage the patient to select foods that she likes

b. allow the patient extensive private time with family members

While on an inpatient unit, you are caring for newly admitted Alyssa, a 16 year old diagnosed with anorexia nervosa. Number the following nursing interventions in order of priority: a. initiate a therapeutic relationship b. promote caloric consumption c. assess for suicidal ideation d. review accomplishments made during treatment e. explore feelings of underlying anxiety and low self-esteem

A = 1 B = 3 C = 2 D = 5 E = 4

What assessment question should you should the nurse ask when attempting to determine if A teenager's mental health resilience? Select all that apply. A. How did you cope when your father deployed with the army for a year in Iraq? B. Who did you go to for advice when your father was away for a year in Iraq how do you feel about talking to a mental health counselor D. where do you see yourself in 10 years or E. do you like the school you go to?

A b d

Pam, the nurse educator, is teaching a new nurse about seclusion and restraint. Order the following interventions from least (one) to most (five) restricted: A. With the patient, identified behaviors that are acceptable and consequences associated with harmful behaviors B. place the patient and physical restraints C. allow the patient to take a time out and sit in his or her room D. offer the PRN medication by mouth E. place the patient in Alex seclusion room

A, d, c, e, b

Andy is a patient anxiously waiting for his turn to speak with you. As you are very busy, you ask Andy if he can wait a few minutes for you to finish your task. Unfortunately, the task takes longer than anticipated, and you're delayed in getting back to Andy. I'm seeing you approach him, Andy accuses you of lying and refuses to speak to you. Which response is most therapeutic at this time? A. "You're angry that I didn't speak with you when I promised I would." B. "I'm sorry I'm late, but screaming at me isn't the best way to handle it." C. "You're too angry to talk right now. I'll come back in 20 minutes, and we can talk about it then. D. "Why are you angry? I told you I was busy and I'd get to you as soon as I could."

A. "You're angry that I didn't speak with you when I promised I would."

The nurse educator is teaching a new nurse about seclusion and restraint. Order the following interventions from least (1) to most (4) restrictive. A. Allowing the patient to sit in the sensory room B. Placing the patient in physical restraints C. Placing the patient in a locked seclusion room D. Offering a PRN medication by mouth

A. 1 B. 4 C. 3 D. 2

Which statement about crisis theory will provide a basis for nursing intervention? A. A crisis is an acute, time-limited phenomenon experienced as an overwhelming emotional reaction to a problem perceived as unsolvable. B. A person in crisis has always had adjustment problems and has coped in adequately in his or her usual life situations. C. Crisis is precipitated by an event that enhances a person's self-concept and self-esteem. D. Nursing intervention in crisis situations rarely has an effect of ameliorating a crisis.

A. A crisis is an acute, time-limited phenomenon experienced as an overwhelming emotional reaction to a problem perceived as unsolvable.

Which belief would be the least helpful for a Nurse working in crisis intervention? A. A person in crisis is incapable of making decisions B. a crisis counseling relationship is one between partners C. Crisis counseling helps the patient to refocus to gain new perspectives on the situation D. anxiety-reduction techniques are used to the patient and her resources can be assessed

A. A person in crisis is incapable of making decisions

In pediatric mental health there is a lack of sufficient numbers of community based researchers and providers, and there are long waiting list for services. This has resulted in: select all that apply. A. Children of color or poor economic conditions being underserved B. increased stress and family units C. markedly increased funding D. premature termination of the patient's psychiatric services

A. B. D

The nurse is preparing to assess a child who primarily speaks Spanish but is fluent in English. Which is the appropriate method for gathering information? A. Begin the assessment in English. B. Utilize a Spanish dictionary to ask questions of the child. C. Asked the child if he understands English. D. Obtain an interpreter who is fluent in Spanish.

A. Begin the assessment in English.

Kyle, a 23-year-old patient with schizophrenia, has been admitted to the psychiatric unit for one week. He has begun to take the first generation antipsychotics haloperidol (Haldol.) One day you find him sitting very stiffly and not moving. He is diaphoretic, and when you ask him if he is okay he seems unable to turn towards you or to respond verbally. You obtain vital signs, which are as follows: BP 170/100, pulse 110, temperature 103. What are the priority nursing invite interventions? Select all that apply. A. Begin to wipe him with a washcloth wet with cold water. B. Hold his medication, and contact his provider stat. C. Administer a medication such as benztropine IM to correct his dystonic reaction. D. Reassure him that although there is no treatment for his tardive dyskinesia, it will pass. E. Explain that he has anticholinergenic toxicity, hold his meds, and administer physostigmine IM. F. Hold his medication

A. Begin to wipe him with a washcloth wet with cold water. B. Hold his medication, and contact his provider stat.

Which statement demonstrates a well-structured attempt at limiting settings? A. Hitting me when you're angry is unacceptable. B. I expect you to behave yourself during dinner. C. Come here, right now! D. Good boys don't bite.

A. Hitting me when you're angry is unacceptable.

Alisha, 31-year-old patient, is flirting with a peer. She's overheard asking him to convince staff to give her privileges to leave the inpatient mental health unit. Later she offers you a back rub in exchange for receiving her 10 PM Xanax an hour early. Which response(s) to behaviors would be the most therapeutic? Select all that apply. A. Label the behavior as undesirable, and explore with Alisha more effective ways to meet her needs. B. By role-playing, demonstrate other approaches Alisha could use to meet her needs. C. Advise the other patients that Alisha is being manipulative and that they should ignore her when she behaves this way. D. Bargain with Alisha to determine a reasonable compromise regarding how much of such behavior is acceptable before she crosses the line. E. Explain that such behavior is unacceptable, and give Alisha specific examples of consequences that will be enacted if behavior continues. F.

A. Label the behavior as undesirable, and explore with Alisha more effective ways to meet her needs. B. By role-playing, demonstrate other approaches Alisha could use to meet her needs. E. Explain that such behavior is unacceptable, and give Alisha specific examples of consequences that will be enacted if behavior continues.

The nurse is planning care for a patient with a binge eating disorder. What outcomes are appropriate? Select all that apply: A. Pt will identify triggers that lead to binge eating B. Pt will identify 4 alternative coping skills C. Pt will increase dietary intake D. Pt will experience satisfaction in eating alone

A. Pt will identify triggers that lead to binge eating B. Pt will identify 4 alternative coping skills

You respond in to a loud, Angry voice coming from the day room, where you find that Alex is pacing and shouting that he isn't "going to take this (bleeeep) anymore." Which if the following responses is most likely to deescalate Alex? Select all that apply: A. Remain calm, quiet, and in control B. The Alex that his actions are unacceptable and that he must go to his room C. Match Alex's volume level so that he is able to hear you over his own shouting D. Ask Alex if he can tell you what is upsetting him so you may be able to help E. Stand close to Alex so you can intervene physically if needed to help others F. Tell Alex that he could be placed in seclusion if he cannot control himself, so that the patient is aware of negative consequences

A. Remain calm, quiet, and in control D. Ask Alex if he can tell you what is upsetting him so you may be able to help

Julia, a 28-year-old diagnosed with schizophrenia, is encouraged to attend groups but stays in her room instead. Staff and peers encourage her participation, without success. Her hygiene is poor despite encouragement to shower and brush her teeth. She does not seem concerned that others wish she would behave differently. Which is/are the most likely explanation(s) for Julia's failure to respond to others efforts to help her behave in a more adaptive fashion? Select all that apply. A. She is displaying avolition. B. She is displaying anergia. C. She is displaying negativism. D. She is being resistant and oppositional. E. She is experiencing paranoid delusions. F. She is apathetic due to her schizophrenia.

A. She is displaying avolition. B. She is displaying anergia. F. She is apathetic due to her schizophrenia.

You are caring for Gabby, a 12-year-old patient diagnosed with oppositional defiant disorder (ODD.) Gabby's mother asks you what type of medication is usually prescribed for this diagnosis. Your answer is based on the knowledge that: A. Treatment of this disorder does not usually involve any specific medication but focuses on adaptive coping mechanisms. B. Interventions for this disorder usually include treatment with mood stabilizers or "off-label" uses for other classifications of medications. C. A care plan may include medication, but the patient will outgrow the behavioral problems without any specific treatment. D. Psychiatric medications have not been proven to work in the child and adolescent population.

A. Treatment of this disorder does not usually involve any specific medication but focuses on adaptive coping mechanisms.

Which individuals are most at risk for displaying aggressive behavior? Select all that apply. A. an adolescent embarrassed in front of friends. B. a young male who feels rejected by a social group C. a young adult depressed after the death of a friend. D. a middle aged adult who feels that concerns are going unheard. E. a patient who was discovered telling a lie.

A. an adolescent embarrassed in front of friends. B. a young male who feels rejected by a social group D. a middle aged adult who feels that concerns are going unheard. E. a patient who was discovered telling a lie.

The highest priority goal in crisis intervention is: A. patient safety B. anxiety reduction C. identification of situational support D. Teaching specific coping skills that are lacking

A. patient safety

Lily, a single mother of four, comes to the crisis center 24 hours after an apartment fire in which all the families household goods and clothing were lost. Lily has no other family in the area. Her efforts to mobilize assistance have been disorganized, and she is still without shelter. She is distraught and confused. When responding to Lily, the intervention that takes priority is to: A. reduce anxiety B. arrange shelter C. contact out-of-area family D. hospitalize and placed patient on suicide precautions

A. reduce anxiety

First generation antipsychotics are used to treat: (select all that apply) A. delusions B. hallucinations C. apathy D. disorganized speech E. disorganized behavior F. depression

AB DE

Which factors tend to increase the difficulty of diagnosing young children who demonstrate behaviors associated with mental illness? Select all that apply. Limited language skills level of cognitive development level of emotional development parental denial that a problem exists severity of the typical mental illness is observed in young children

ABC

Comorbidities of Schizophrenia include: (Select all that apply.) A. Substance use disorder B. Polydipsia (abnormal lab values) C. Physical illness D. Anxiety E. Mania F. Depression G. Polyuria (abnormal lab values) H. Shorter life expectancy

ABCDFH

Ian makes the following statements to you while admitting him. Which statement indicates an increased likelihood of violent behavior? A "When I get mad, I want to be left alone." B "Last time I was in here, I ended up in seclusion for punching my roommate." C "My old man was meek and mild and I've always said I'm not going to be like him." D "My girlfriend says I yell way too much and she's threatened to leave me."

B "Last time I was in here, I ended up in seclusion for punching my roommate."

A newly admitted patient has a history of aggressive behavior towards staff. Which statement by the nurse demonstrates the need for more information? A. "If his behavior warrants restraints, someone will stay with him the entire time he's restrained." B. "I'll call the primary care provider to get an as needed (prn) seclusion/restraint order" C. If he is restrained, make sure he is offered food and fluids regularly" D. "Remember that physical restraints are our last resort"

B. "I'll call the primary care provider to get an as needed (prn) seclusion/restraint order"

Joshua, a 17-year-old outpatient, has been diagnosed with intermittent explosive disorder. As you care for Joshua, you anticipate this psychiatric care provider may prescribe which of the following? A. A benzodiazepine B. An anticonvulsant C. A psychostimulant D. An anticholinesterase inhibitor

B. An anticonvulsant

Josie, a 27-year-old patient, complains that most of the staff do not like her or care what happens to her, but you are special and she can tell that you are a caring person. She talks with you about being unsure of what she wants to do with her life and her "mixed up feelings about relationships." When you tell her that you will be on vacation next week, she becomes angry. Two hours later, she's found using a curling iron to burn her under arms and explains that "it makes the numbness stop." Given this presentation, which personality disorder would you suspect? A. Obsessive-compulsive B. Borderline C. Antisocial D. Schizotypal

B. Borderline

The nurse is caring for a patient with ADHD. The child has been prescribed methylphenidate (Ritalin.) Which of the following symptoms are side effects the nurse will monitor for? (Select all that apply.) A. Hypotension B. Decreased appetite C. Sedation D. Insomnia E. Headache F. Seizure

B. Decreased appetite D. Insomnia E. Headache

Which of the following are true regarding feeding disorders in children? Select all that apply: A. Feeding disorders usually reflect poor parenting B. Feeding disorders are often manifested in children with developmental delays C. Feeding disorders are most often treated with the punishment/reward system D. In many cases, toddler mealtime disturbances spontaneously resolve without additional intervention E. Behavior modification has been found to be effective in treating feeding disorders

B. Feeding disorders are often manifested in children with developmental delays D. In many cases, toddler mealtime disturbances spontaneously resolve without additional intervention E. Behavior modification has been found to be effective in treating feeding disorders

Mark, a 32-year-old patient with schizophrenia, is found in a closet with an empty 2 L bottle of cola taken from the staff refrigerator. The bottle had been full. The patient also has been drinking more from the hallway water cooler and taking drinks from his peers' dinner trays. Recently, staff has noticed an increase in auditory hallucinations and the onset of confusion. Which response is most appropriate? A. Please mark on every-15-minute checks to identify any further deterioration. B. Restrict his access to fluids, and evaluate for water intoxication via daily weights. C. Attempt distract the patient from excess fluid intake and other bizarre behavior. D. Request an increase in antipsychotic medication, owing to the worsening of his psychosis.

B. Restrict his access to fluids, and evaluate for water intoxication via daily weights.

Which statement about persons with personality disorders is accurate? A. They, unlike those with mood or psychotic disorders, are very low risk of suicide. B. They tend not to perceive themselves as having problems but instead believe their problems are caused by how others behave toward them. C. They are believed to be purely psychological disorders, that is, disorders arising from psychological rather than neurological or other physiological abnormalities. D. Their symptoms are not as disabling as most other mental disorders; therefore, they are Kara tends to be less challenging and complicated for staff.

B. They tend not to perceive themselves as having problems but instead believe their problems are caused by how others behave toward them.

Lily, a single mother of four, comes to the crisis center 24 hours after an apartment fire in which all the families household goods and clothing were lost. Lily has no other family in the area. Her efforts to mobilize assistance have been disorganized, and she is still without shelter. She is distraught and confused. You assess the situation as: A. maturational crisis B. a situational crisis C. an adventitious crisis D. an existential crisis

B. a situational crisis

Jordan is a 21-year-old who has recently been diagnosed with schizophrenia. He has to drop out of college as a positive symptoms of his disease have made it impossible for him to pursue his dream of being an architect. He presents to the emergency department with flat affect, depressed mood, and having auditory hallucinations telling him he is "no good to anyone anymore." Which of the following statements is true regarding depression and schizophrenia? A. Anxiety and substance abuse or comorbid with schizophrenia, but not depression or dysphoria. B. It is important to assess for depression in patients with schizophrenia, but suicide rarely occurs in this population of clients. C. Assessing for depression and suicidal ideation and patients with schizophrenia is important, since almost half of the people with schizophrenia will attempt suicide. D. The medications that will be given to control the positive symptoms of s

C. Assessing for depression and suicidal ideation and patients with schizophrenia is important, since almost half of the people with schizophrenia will attempt suicide.

The nurse is developing a care plan for an in-patient teenager with ADHD who is at high risk for self harm due to poor judgement, high risk-taking behaviors, and impulsivity. Which is the priority nursing intervention? A. Schedule a regular nurse-patient session daily, and encourage her to explore stressors that may worsen her depressed mood B. Develop a "no harm" contract with the patient, and encourage her to engage in all unit activities. C. Assign a staff member one-on-one close observation until the treatment team determines she is no longer a risk for self harm. D. The patient is to wear hospital issue clothing (pajamas) and sit/sleep within view of staff until the position determines she is no longer a risk or self harm.

C. Assign a staff member one-on-one close observation until the treatment team determines she is no longer a risk for self harm.

Tony, a 45-year-old patient with schizophrenia, sometimes moves his lip silently or murmurs to himself when he does not realize others are watching. Sometimes when talking to others, he suddenly stops, appears distracted for a moment, and then resumes. Based on these observations, Tony most likely is experiencing: A. Illusions B. Delusional thinking C. Auditory hallucinations D. Impaired reality testing

C. Auditory hallucinations

______________ disorder is one of the most frequently diagnosed disorders in children and adolescents. It is a problem in the adult population, as well, with adults experiencing the same type of symptoms. It is characterized by disregard of the rights of others and disdain for social rules. A. Autism Spectrum B. Oppositional defiance disorder C. Conduct D. Intermittent explosive

C. Conduct

Which statement about violence and nursing is accurate? A. Unless working in psychiatric mental health settings, nurses are unlikely to experience patient violence B. To date, there is no legislation that exists that addresses workplace violence against nurses C. Emergency, psychiatric, and step-down units have the highest rates of violence towards staff D. Violence primarily affects inexperienced or unskilled staff who cannot calm their patients

C. Emergency, psychiatric, and step-down units have the highest rates of violence towards staff

The nurse is admitting a patient who weighs 100 pounds, is 66 inches, and is below ideal body weight. The patients blood pressure is 130/80, pulse is 72 bpm, potassium is 2.5 mmol/L, and ECG is normal. Her teeth enamel is eroded, her hands are shaking, and her parotid gland is enlarged. The patient states, "I'm really nervous about coming to this unit." What is the priority nursing diagnosis? A. Powerlessness B. Risk for injury C. Imbalanced nutrition: less than body requirement D. Anxiety

C. Imbalanced nutrition: less than body requirement

Blake is a 15-year-old patient admitted for emergency observation after stealing a car and being pulled over by the police for reckless driving. He also has a history of pyromania. Which of the following is the priority assessment? A. Illegal behaviors in the past six months B. Assessment of childhood development and family interactions C. Suicide risk D. Feelings of remorse

C. Suicide risk

You are caring for Malcolm, and 83-year-old African American patient with Alzheimer's disease. Malcolm exhibits agitated behavior at times, especially when he feels he is missing work, and he attempts to leave the unit to "get to school where I teach." Which of the following is appropriate to deescalate Malcolm's agitation? A. Medicare Malcom with prn medication at regular intervals to prevent agitation B. Repeatedly explain to Malcolm that he's retired and no longer teaches, as repetition will reinforce patient orientation C. Use validation therapy and ask Malcolm about his job D. Reduce stimulation in the environment by having Malcom sit in his room by himself in his room until agitation has passed

C. Use validation therapy and ask Malcolm about his job

April, a 10-year-old admitted to inpatient pediatric care, has been getting more and more wound up and is losing self-control in the day room. Timeout does not appear to be effective tool for April to engage in self-reflection. April's mother admits to putting her in timeouts up to 20 times a day the nurse recognizes that: A. timeout is an important part of Aprils baseline discipline B. time out is no longer an effective therapeutic measure C. April enjoys timeouts and ask out to get some alone time or D. time out will need to be replaced with seclusion and restraint

C. resilience

Child protective services has removed a 10-year-old, Christopher, from his parents home for neglect. Christopher reveals to the nurse that he considers the woman next-door his "nice mom," that he loves school, and he gets above average grades. The strongest explanation of this response is: A. temperament B. genetic factors C. resilience D. paradoxical effects of neglect

C. resilience

Lacey, a 19-year-old patient, shows you multiple fresh, serious (but not life-threatening) self-inflicted cuts on her forearm. Which response would be most therapeutic? A. I'm sorry you felt so bad that you cut yourself! Let's discuss what led up to this action while I take care of your wounds. B. I will take care of the wounds first, then you will have to be searched for anything else you could injure yourself with. C. I can give you some Band-Aids for you to put on your cuts, but you need to stop this attention seeking behavior. D. After I care for your wounds, I'd like you to write down what you were thinking and feeling before you cut yourself; then we will discuss it.

D. After I care for your wounds, I'd like you to write down what you were thinking and feeling before you cut yourself; then we will discuss it.

A seven-year-old male without any other diagnosed a problem engages in jaw clenching and rocking back-and-forth. Which medical condition should the nurse anticipate being diagnosed? A. ADHD B. Tourette's disorder C. Stereotypic movement disorder D. Autism spectrum disorder

D. Autism spectrum disorder

A patient becomes frustrated and angry when trying to get his bluetooth headset to function properly and angrily throws it across the room, nearly hitting a peer with it. Which intervention would be the most therapeutic? Select all that apply. A. Place the patient in restraints for one hour to allow him to deescalate. B. Tell the patient that any further outbursts will result in a loss of privileges. C. Offer to help the patient learn how to operate his Bluetooth headset. D. Explore with the patient how he was feeling as he worked with the headset. E. Point out the consequences of such behavior and note that it cannot be tolerated. F. Limit the patient's exposure to frustrating experiences until he attains appropriate coping skills. G. Encourage the patient to recognize signs of mounting tension and to seek assistance.

D. Explore with the patient how he was feeling as he worked with the headset. E. Point out the consequences of such behavior and note that it cannot be tolerated. G. Encourage the patient to recognize signs of mounting tension and to seek assistance.

When working on an inpatient adolescent mental health unit, staff may be able to maintain safety and a calm environment when they interact with patients using: A. High expressed emotion - "you must stop that immediately!" - Using a stern tone B. Strict rule adherence - "there are no snacks after 10 PM. No exceptions!" - Using an authoritarian tone C. Suppressed emotions - "hey, let's talk about something else that doesn't upset you." - Using a late, friendly tone D. Low expressed emotion - "please go to your room for quiet time now." - Using a neutral, calm tone

D. Low expressed emotion - "please go to your room for quiet time now." - Using a neutral, calm tone

Which activity is most appropriate for a child with ADHD? A. Reading an adventure novel B. monopoly C. checkers D. tennis

D. tennis