Exam 1 MH Practice Question

Which statement reflects a student nurse's accurate understanding of the concepts of mental health and mental illness? A. "The concepts are rigid and religiously based." B. "The concepts are multidimensional and culturally defined." C. "The concepts are universal and unchanging." D. "The concepts are unidimensional and fixed."

ANS: B

Which nursing statement reflects the nontherapeutic communication technique of minimizing? a) "If I were you, I would take the medication." b) "Don't feel badly. Everything will work out fine." c) "Why do you feel so depressed all the time?" d) "I think your sister is right about how bad of a temper you have."

ANS: B

List 3 components/aspects of the Recovery movement:

ANS: 1. President's New Freedom Commission, 2003 (United States) Cited a need for transforming mental health service delivery with recovery as the goal of this transformation. 2. Robert Whitakers'; work/book: Anatomy of an Epidemic--made a major impact with his book 3. The Substance Abuse and Mental Health Services Administration (SAMHSA) used the recovery and stated mental health recovery is a journey

At what point should the nurse determine that a client is at risk for developing a mental disorder? A. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria B. When maladaptive responses to stress are coupled with interference in daily functioning C. When the client communicates significant distress D. When the client uses defense mechanisms as ego protection

ANS: B

During an interpersonal relationship, a patient identifies that a nurse reminds him of his grandmother and begins to respond to the nurse as he would his grandmother. The nurse recognizes this as which of the following? a. Boundary testing b. Transference c. Boundary crossing d. Counter-transference

ANS: B

Number the logical series of skills that the nurse needs to interact therapeutically with clients. a)________Ability to communicate therapeutically. b)________Ability to problem solve. c)________Ability to recognize signs and symptoms. d)________Ability to self-assess.

ANS: A C B D

Number the following nursing interventions as they would proceed through the phases of the nurse-client relationship. a) _______Plan for continued care. b) _______Promote client's care. c)_______Examine personal bias. d)_______Formulate nursing diagnosis.

ANS: C D B A

_____________ is considered the founder of modern psychiatric-mental health nursing. A. Peplau B. Travelbee C. Nightingale D. Mahoney

ANS: A

Which statement is most accurate regarding the assessment of clients diagnosed with psychiatric problems? A. Medical history is of little significance and can be eliminated from the nursing assessment. B. Assessment provides a holistic view of the client, including biopsychosocial aspects. C. Comprehensive assessments can be performed only by advanced practice nurses. D. Psychosocial evaluations are gained by subjective reports rather than objective observations.

ANS: B

A boundary violation results: A. When there is confusion between the needs of the nurse and those of the patient B. There is a brief transient excursion across a professional boundary C. When a nurse decides to set limits on clients testing behavior D. In assisting the patient understand therapeutic relationships

ANS: A

A nurse is communicating with a client who is admitted for substance use disorder. Which of the following communication techniques should the nurse identify as a barrier to therapeutic communication? A. Offering advice B. Reflecting C. Listening attentively D. Giving information.

ANS: A

In accepting a job on an inpatient unit, a nurse learns that the work environment emphasizes milieu management to facilitate treatment. Which of the following can the nurse expect? A. Nurses will be responsible for adjusting light and noise levels to create a less stressful environment B. Nurses will facilitate therapeutic group meetings C. Nurses will work within a self-managed team framework D. Nurses will devote most of their time to working one-on-one with patients

ANS: A

With which one of the following statements is a nurse showing an awareness of self-conducive to establishing a therapeutic relationship with a patient? A. "I come from a cultural background and have had previous experiences that influence my perception and expectations of the therapeutic relationship." B. "I have the appropriate credentials to perform my role and am very knowledgeable about this patient's diagnosis." C. "I can convey a strong sense of my personality and values to the patient so that the patient knows what to expect from me." D. "I am able to eliminate all my biases and never be affected by clients."

ANS: A

Which of the following are activities that promote the therapeutic use of self *(select all that apply)?* A. Engaging in reflection with other nurses about the work of nursing B. Integrating theory with experience and knowledge of self to structure interventions for patients C. Monitoring and acknowledging one's reactions to the patient and exploring the experiences and values that inform those reactions D. Compartmentalizing one's reactions to the patient; so that they do not interfere with patient care E. Finding common ground with the patient so that friendship level of relationship can ensue, helping the patient feel more comfortable

ANS: A B C

Which of the following behaviors suggest a possible breach of professional boundaries? *Select all that apply.* a) The nurse repeatedly requests to be assigned to a specific patient. b) The nurse shares the details of her divorce with the patient. c) The nurse makes arrangements to meet the patient outside of the therapeutic environment. d) The nurse shares how she dealt with a similar difficult situation.

ANS: A B C

A nurse is working in a community mental health facility. Which of the following services does the program provide? *Select all that apply.* A. Educational groups B. Medication dispensing programs C. Individual counseling programs D. Detoxification programs E. Family therapy

ANS: A B C E

Which of the following are cultural aspects of mental illness? *Select all that apply.* A. Local or cultural norms define pathological behavior. B. The higher the social class the greater the recognition of mental illness behaviors. C. Psychiatrists typically see patients when the family can no longer deny the illness. D. The greater the cultural distance from the mainstream of society, the greater the likelihood that the illness will be treated with sensitivity and compassion.

ANS: A C

To develop a working relationship with a client in a psychiatric setting, the nurse knows that goal setting is vital. To ensure that the goal is attainable, it must: ____. *Select all that apply.* a) Have observable outcomes. b) Be set by the nurse and agreed to by the patient. c) Be rigid and unchangeable d) Be mutually set by the client and nurse. e) Be agreed to be all members of the treatment team.

ANS: A D

Institutional guidelines that support appropriate nurse−patient boundaries would appropriately include which of the following *(select all that apply)?* A. Nurses should wear clothing that is unlikely to be construed as sexually suggestive. B. Nurses should give patients small gifts on the patients' birthdays and other holidays. C. If the patient uses profanity, the nurse should respond in kind to speak the same language as the patient. D. Nurses should meet with patients only at the clinic or another designated therapeutic environment. E. Nurses should cautiously engage in self-disclosure after self-reflection that it is only for the intentional purpose of furthering the therapeutic relationship for the patient's benefit.

ANS: A D E

A nurse is working in a community mental health facility. Which of the following services are appropriate for clients to receive in this setting? *Select all that apply.* a) Education groups b) Crisis intervention c) Detoxification programs d) Medication dispensing programs e) Group therapy sessions

ANS: A E

A client has a history of excessive drinking, which has led to multiple arrests for driving under the influence (DUI). The client states, "I work hard to provide for my family. I don't see why I can't drink to relax." The nurse recognizes the use of which defense mechanism? A. Projection B. Rationalization C. Regression D. Sublimation

ANS: B

A nurse decides to put a client who has a delusional disorder in seclusion overnight because the unit is short staffed and the client frequently fights with other clients. The nurse is trying to keep the unit safe. The nurses' actions are an example of which of the following torts? A. Invasion of privacy B. False imprisonment C. Assault D. Battery

ANS: B

A nurse is preparing a presentation on health care careers for a group of prospective nursing students. The presentation should state that a nurse with a bachelor's degree can perform all of the following tasks EXCEPT: A. Patient intake screening B. Psychotherapy C. Administration of medication D. Milieu management

ANS: B

A patient describes having lost his job several months ago, feeling very worried about money, and being ashamed about being unemployed. His girlfriend also recently broke up with him due to his financial problems. The patient has been sending out resumes and plans to attend a professional conference next week, but is so nervous about going he feels panicked. Which level on Travelbee's continuum of suffering most closely describes this patient? A. Transitory feeling of displeasure B. Extreme anguish C. Malignant phase of despairing D. Terminal phase of apathetic indifference

ANS: B

As a result of nurse theorists such as Peplau and Travelbee, ________________ was now considered an important part of the patient's recovery. A. Medication B. Therapeutic communication C. Physical therapy D. Activities therapy

ANS: B

During the 1990s there was a major shift in psychiatric-mental health treatment in that: A. Patients now had complete control over their care B. Medication became the first line of treatment and therapy became secondary C. Nurses now conducted most of the therapy groups on psychiatric units D. Psychiatric inpatient stays lengthened to accommodate insurance requirements

ANS: B

Excessive use of self-disclosure with patients puts the nurse at risk for A. Boundary crossing B. Boundary violation C. Burnout D. Over involvement with peers

ANS: B

When engaging in therapeutic communication for the initial encounter with the patient, which of the following would be most appropriate for the nurse to use? A. Silence B. "What would you like to discuss?" C. "Are you having any problems with anxiety?" D. "Why do you think you came here today?"

ANS: B

The nurse-client therapeutic relationship includes which of the following characteristics? *Select all that apply.* A. Meeting the psychological needs of the nurse and the client B. Ensuring therapeutic termination C. Promoting client insight into problematic behavior D. Collaborating to set appropriate goals E. Meeting both the physical and psychological needs of the client

ANS: B C D E

A nurse is discussing acute vs prolonged stress with a client. Which of the following effects should the nurse identify as an acute stress response? *Select all that apply* A. Chronic pain B. Depressed immune system C. Increased blood pressure D. Panic attacks E. Unhappiness

ANS: B C E

A nurse is discussing the early signs of lithium toxicity. Which of the following should the nurse include in her educational presentation? *Select all that Apply* A. Constipation B. Polyuria C. Rash D. Muscle weakness E. Tinnitus

ANS: B D

A nurse is interviewing a 25 year-old client who has a new diagnosis of dysthymic disorder. Which of the findings should the nurse expect? A. Wide fluctuations in mood. B. Report of a minimum of five findings of depression C. Presence of signs and symptoms of a mood disorder for at least 2 years D. Inflated sense of self-esteem

ANS: C

Which of these plans indicates the nurse understands the characteristics of a therapeutic nurse-patient relationship? a) Establishing priorities and goals for the patient. b) Utilizing the nursing process to establish patient goals. c) Collaborating to establish mutually agreed upon goals and priorities. d) Directing interactions to assist the patient to meet needs.

ANS: C

A nurse is assessing a client immediately following an ECT procedure. Which of the following findings should the nurse expect? *Select all that apply* A. Hypotension B. Paralytic ileus C. Memory loss D. Nausea E. Confusion

ANS: C D E

A nurse emphasizes holistic care of the patient that considers health of mind, body, and spirit and emphasizes freely finding purpose in life as a means to recovery. This nurse is most likely working in which of the following traditions? A. Social theories B. Behavioral theories C. Cognitive theories D. Humanist theories

ANS: D

A nurse in an acute mental health facility is caring for a client diagnosed with bipolar disorder, Which of the following is the priority nursing action? A. Set consistent limits for expected behavior B. Administer prescribed medications as scheduled. C. Provide the client with step-by-step instructions during hygiene activities D. Monitor the client for escalating behavior

ANS: D

A patient shares that she has been raped and has suffered debilitating panic attacks since the assault. The nurse, who has never had a similar experience, should ________________________: A. Focus the therapeutic session on other issues B. Work with the health care team to assign a different nurse to this patient C. Work with the patient on the basis of theoretical models of recovery D. Listen empathetically and convey a desire to engage with the patient

ANS: D

In thinking about Travelbee's continuum of suffering, you can reason that a client is most potentially dangerous for self-harm once they have reached: A. Transitory feeling of displeasure B. Extreme anguish C. Malignant phase of despairful not caring D. Terminal phase of apathetic indifference

ANS: D

The Mini-Mental Status Exam measures: a) The meaning of neologisms. b) Flight of ideas c) Ego strength d) Orientation to time and place

ANS: D

Which statement is true as it relates to psychiatric treatment outcomes? a) Custodial care has proved to minimize signs and symptoms of mental illness. b) Mental illness is caused by "spirits" and the devil. c) Insulin therapy, wet sheet packs, ice baths, and psychosurgery are still in use today. d) Psychotropic medications help relieve symptoms but do not resolve emotional problems.

ANS: D