MH Exam 3 Quizzes

The nurse is preparing to perform an admission assessment on a client with a diagnosis of bulimia nervosa. Which assessment findings should the nurse expect to note? Select all

- dental decay -loss of tooth enamel -electrolyte imbalances

A hospitalized client with a history fo alcohol abuse tells the nurse, " I am leaving now. I have to go. I don't want any more treatment. I have things that I have to do right away." The client has not been discharged and is scheduled for an important diagnostic test to be performed in 1 hour. After the nurse discusses the clients concerns with the client. the client dresses and begins to walk out of the hospital room. What action should the nurse take?

Call the nursing supervisor

The nurse is monitoring a hospitalized client who abuses alcohol. Which findings should alert the nurse to the potential for alcohol withdrawal delirium?

Hypertension, changes in level of consciousness hallucinations

During postprandial monitoring, a female client with bulima nervosa tells the nurse. " you can sit with me, but you're just wasting your time. After you sat with me yesterday, I was still able to purge. Today, my goal is to do it twice. "what is the nurse's best response?"

I know it's importanat for you to feel in control, but I'll monitor you for 90 minutes after you eat

the nurse determines that the wife of an alcoholic client is benefiting from attending an AL-anon group if the nurse hears the wife make which statement?

I no longer feel that I deserve the beatings my husband inflicts on me

Nurse Tamara is caring for a client diagnosed with bulimia. The most appropriate initial goal for a client diagnosed with bulimia is to

Identify anxiety-causing situations

the nursing diagnosis that would be most appropriate for a 22 yo client who uses ritualistic behavior would be

Ineffective coping

The nurse caring for a female client who was admitted to the mental health unit recently for anorexia nervosa. The nurse enters the client's room and notes that the client is engaged in rigorous push-ups. Which nursing action is most appropriate?

Interrupt the client and offer to take her for a walk

The nurse is caring for a client with anorexia nervosa. Which behavior is characteristic of this disorder and reflects anxiety management?

Observing rigid rules and regulations

Nurse Rob has observed a co worker arriving to work drunk at least three times in the past month. Which action by nurse Rob would best ensure client safety and obtain necessary assistance for the co worker?

Report the coworker's behavior to the appropriate supervisor

For a female client with anorexia nervosa, Nurse Jimmy is aware that which goal takes the highest priority?

The client will establish adequate daily nutritional intake

For female client with anorexia nervosa, nurse Rose plans to include the parents in therapy sessions along with the client. what fact should the nurse remember to be typical of parents of clients with anorexia nervosa?

They tend to overprotect their children

The spouse of a client admitted to the mental health unit for alcohol with-drawl says to the nurse, "I should get out of this bad situation" Which is the most helpful response by the nurse?

What do you find difficult about this situation?

The home health nurse visits a client at home and determines that the client is dependent on drugs. During the assessment, which action should the nurse take to plan appropriate nursing care?

ask the client about the amount of drug and it effect

a hospitalized client, diagnosed with a borderline personality do, consistently breaks the unit's rules. This behavior should be confronted because it will help the client

become more self-aware

Which interventions are most appropriate for caring for a client in alcohol withdrawal? Select all

- monitor vital signs - provide reality orientation as appropriate - address hallucinations therapeutically - provide a safe environment

A client anorexia nervosa is a member of pre-discharge support group. The client verbalizes that she would like to buy some new clothes, but her finances are limited. Group members have brought some used clothes to the client to replace the client's old clothes. The client believes that the new clothes are much too tight and has reduced her caloric intake to 800 calories daily. How should the nurse evaluate this behavior?

Evidence of the client's disturbed body image

the nurse is caring for a client diagnosed with paranoid personality do who is experiencing disturbed thought processes. In formulating a nursing plan of care, which best intervention should the nurse include?

avoid using a whisper voice in front of the client

a client is unwilling to go to his church because his ex- girl goes there and he feels that she will laugh at him if she sees him because of his hypersensitivity to a reaction from her, the client remains home bound. The home care nurse develops a plan of care that addresses which personality disorder?

avoidant

Elsa is being treated in a chemical dependency unit. She tells the nurse that she only uses drugs when under stress and therefore does not have a substance problem. Which defense mechanism is the client using?

denial

a person with antisocial personality disorder has difficulty relating to others because of never having learned to

empathize with others

a client with a diagnosis of narcissistic personality disorder has been given a day pass from the psychiatric hospital. The client is due to return at 6pm. At 5 pm the client telephones the nurse in charge of the unit and says, " 6 o'clock is too early. I feel like coming back at 7:30" the nurse would be most therapeutic by telling the client to:

return on time or restrictions will be imposed

A client with a diagnosis of borderline personality DO has negative feelings toward the other lcients on the the unit and considers them all to be "bad". The nurse understands this defense is known as:

splitting