Mental Health Exam 1 : Evolve Questions

Which of the following is considered a primary behavioral theorist? Freud Skinner Sullivan Peplau

B. F. Skinner (1904-1990) represented the second wave of behavioral theorists and is recognized as one of the prime movers behind the behavioral movement.

You are caring for Alyssa, a 28-year-old patient with bipolar disorder who was admitted in a manic state. According to Maslow's Hierarchy of Needs theory, which of the following symptoms needs to be the first priority in caring for this patient? Rapid, pressured speech Grandiose thoughts Lack of sleep Hyperactive behavior

Based on Maslow's theory, physiological needs such as food, water, air, sleep, etc., are the priority and must be taken care of first. The other options are symptoms of mania but not as critical as lack of sleep.

If a client is placed in seclusion and held there for 24 hours without a written order or examination by a physician, the client has experienced battery. defamation of character. false imprisonment. assault.

false imprisonment. False imprisonment is the arbitrary holding of a client against his or her will. When seclusion is ordered, it is not invoked arbitrarily, but after other less restrictive measures have failed. If the client is secluded without the medical order, the measure cannot be proven as instituted for medically sound reasons.

The Eastern world view can be identified by the belief that one's identity is found in individuality. holds responsibility to family as central. time waits for no one. disease is a lack of harmony with the environment.

holds responsibility to family as central. The Eastern traditional world view is sociocentric. Individuals experience their selfhood and their lives as part of an interdependent web of relationships and expectations.

The psychiatric nurse planning and implementing care for culturally diverse clients should understand holistic theory. systems theory. adaptation theory. political power theory.

holistic theory In most cultures a holistic perspective prevails, one without separation of mind and body.

In order to best differentiate whether an Asian client is demonstrating a mental illness when attempting suicide is to ask the client whether he views himself as being depressed. identify his culture's view regarding suicide. explain to him that suicide is often regarded as a desperate act. assess the client for other examples of depressive behaviors.

identify his culture's view regarding suicide.

The charge nurse shares with the psychiatric technician that negligence of a patient is an act or failure to act in a way that a responsible employee would act. applies only when the client is abandoned or mistreated. is an action that puts the client in fear of being harmed by the employee. means the employee has given malicious false information about the client.

is an act or failure to act in a way that a responsible employee would act. Behaving as a wise and prudent person would act under the same circumstances is one way of judging whether the standard of care has been violated. Employers typically hope that staff will prevent clients from striking each other.

The nurse responsible for the care of a client prescribed clonazepam (Klonopin) would evaluate treatment as being successful when the client demonstrates less anxiety. normal appetite. improved sleep pattern. reduced auditory hallucinations.

less anxiety. γ-Aminobutyric acid is thought to modulate neuronal excitability and anxiety. A drug that increases the effectiveness of γ-aminobutyric acid would result in anxiety reduction.

The nurse caring for a client taking risperidone (Risperidal) observes the client carefully for napping during the day, a weight gain, and reports of dizziness. reports of falls, heartburn, and nausea. a rapid heartbeat, red rash, and hives. dry mouth, poor urinary output, and constipation.

napping during the day, a weight gain, and reports of dizziness. H1 blockade has the potential to produce sedation, weight gain, and hypotension.

The pre-orientation phase of the nurse-client relationship is characterized by the nurse's focus on self-analysis of strengths, limitations, and feelings. clarification of the nursing role. changing the client's dysfunctional behavior. incorporating coping skills into client's routine.

self-analysis of strengths, limitations, and feelings. During the preorientation phase the nurse prepares for a relationship with a client by engaging in self-examination.

The orientation phase of the nurse-client relationship focuses on the nurse identifying personal biases. the nurse and client identifying client needs. overcoming resistance to changing behavior. reviewing situations that occurred in previous meetings.

the nurse and client identifying client needs. The orientation phase is the first stage of the nurse-client relationship and focuses on, among other things, the identification of client needs.

A client was admitted to the behavioral health unit for evaluation and diagnosis after being found wandering the streets. His personal hygiene is poor, and his responses to questions are bizarre and inappropriate. The client's constitutional rights are violated when the nurse states: "We will help you make decisions that will keep you safe." "I am going to help you shower, so you will not smell so bad." "Your pocket knife and nail clippers will be kept in the nurses' station." "You will be having a number of tests to help us learn about your condition."

"I am going to help you shower, so you will not smell so bad." Every client has the right to be treated with dignity. This statement is demeaning.

A client being medicated for both hallucinations and delusions reports being drowsy. The nurse will correctly interpret this symptom as related to the drug's effect on the brain's ability to regulate mood. thought. memory. sleep.

A number of psychotropic drugs have side effects that interfere with the brain's ability to regulate sleep alertness. These side effects range from lethargy to extreme drowsiness. As the client's body becomes accustomed to the drug, the drowsiness should dissipate.

A suspicious client who smokes several packs of cigarettes daily and drinks large quantities of coffee and soda as he is able to afford reacts to every nursing intervention with sarcasm. When asking for advice, the nurse manager's most helpful response is "You are dealing with a very difficult and resistant client; just keep with your plan." "If you haven't been able to establish client trust by now, ask for a change of assignment." "Remember that sarcasm represents the oral-stage fixation of development." "You are attempting to work with a client who likes to keep others off-balance."

According to Freud's psychosexual stages of development, this client is exhibiting the oral (0-1 year) personality traits: fixation at the oral stage is associated with passivity, gullibility, and dependence; the use of sarcasm; and the development of orally focused habits (e.g., smoking, nail biting).

Which class of drugs for: depression schizophrenia & Parkinson's anxiety disorders Alzheimer's, Huntington's, Parkinson's

Antidepressant medication targets serotonin and norepinephrine. Dopamine is implicated in schizophrenia (increase) and Parkinson's disease (decrease). GABA is implicated in anxiety disorders. Acetylcholine is implicated in Alzheimer's disease as well as Huntington's disease and Parkinson's disease.

The psychiatric mental health nurse working with depressed clients of the Eastern culture must realize that a useful outcome criterion might be if client reports increased somatic expressions of distress. disruption of energy balance. appeasement of the spirits. increased anxiety.

Appeasement of the spirits Appeasement of spirits might be a viable outcome criterion if the client believes the illness was caused by angry spirits. In each of the other options useful outcomes would be decreased somatic symptoms, reinstatement of energy balance, and decreased anxiety.

Which source of healing might be most satisfactory to a client who believes his illness is caused by spiritual forces? Acupuncture Dietary change Cleansings Herbal medicine

Cleansings Rituals, cleansings, prayer, and even witchcraft may be the treatment expectation of a client who believes his illness is caused by spiritual forces.

During a therapeutic encounter, the nurse makes an effort to ensure the use of two congruent levels of communication. What is the rationale for this? The mental image of a word may not be the same for both nurse and client. One statement may simultaneously convey conflicting messages. Many of the client's remarks are no more than social phrases. Content of messages may be contradicted by process.

Content of messages may be contradicted by process. Verbal messages may be contradicted by the nonverbal message that is conveyed. The nonverbal message is usually more consistent with the client's feelings than the verbal message.

A client admitted to the behavioral health unit with a diagnosis of schizophrenia tells the nurse that she does not wish to see her husband if he visits. The nurse tells the client's husband that his wife has the right to refuse visitors if she wishes. he is welcome to visit but may receive a cool reception. the client's plan of care calls for limiting visitors for 2 days. the client is acutely psychotic and not responsible for her present behavior.

The client has the right to choose or refuse visitors.

On the basis of the current understanding of neurotransmitters, the nurse can view a client's symptoms of profound depression as likely related in part to increased dopamine level. decreased serotonin level. increased norepinephrine level. decreased acetylcholine level.

decreased serotonin level. A lowered serotonin level is highly supported as being related to depression; however, depression is more probably influenced by a number of neurotransmitter abnormalities.

According to Freud, the nurse recognizes that a client experiencing dysfunction of the conscious as part of the mind will have problems with only recent memory. both recent and long-term memory. all material that the person is aware of at any one time. only material that should be easily retrieved.

Freud described the conscious part of the mind as the tip of the iceberg. It contains all of the material that the person is aware of at any one time.

Which symptomatology has priority for admission to an inpatient behavioral health unit? Severe anxiety and feeling as though one is suffocating Profound grieving over the recent death of one's identical twin Hearing voices that proclaim one to be "the exalted ruler of the universe" History of seizures and an elevated lithium level

History of seizures and an elevated lithium level This modification requires careful titration and observation that would be difficult to provide on an outpatient basis. (Lithium toxicity can proceed to death.)

When assessing and planning treatment for a client who has recently arrived in the United States from China, the nurse should be alert to the possibility that the client's explanatory model for his illness reflects supernatural causes. negative forces. inheritance. imbalance.

Imbalance Many Eastern cultures explain illness as a function of imbalance.

You and Jack are two of the nurses working on the psychiatric unit. Jack mentions to you that the biological model for mental illness is the one he embraces, and states "it's the only one I really believe." Which of the following statements is true regarding believing in only the biological model? The biological model is the oldest and most reliable model for explaining mental illness. The biological model does not explain every symptom of mental illness. The biological model is the most popular theory among leading psychiatrists and therefore the one that should be fully embraced. In believing only the biological model, other influences on mental health including cultural, environmental, social, and spiritual influences are not taken into account.

In believing only in the biological model to the exclusion of other theories and perspectives, influences such as educational, social, spiritual, cultural, environmental, and economic are not considered, and these have also been proven to play a part in mental health and mental illness. The other options are untrue.

Role-playing is associated with which type of therapy? Psychoanalysis Modeling Operant conditioning Systematic desensitization

In modeling, the therapist provides a role model for specific identified behaviors, and the client learns through imitation. The therapist may do the modeling, provide another person to model the behaviors, or present a video for the purpose. Some behavior therapists use role-playing in the consulting room for modeling therapy.

Julie, a 49-year-old patient diagnosed with schizophrenia at 22 years old, is taking risperidone (Risperdal). Which of the following nursing assessments is the priority assessment with Julie? Monitoring blood levels to avoid toxicity Incorrect Monitoring for abnormal involuntary movements Observing for secondary mania Observing for memory changes

Monitoring for abnormal involuntary movements Risperidone has the highest rate of extrapyramidal side effects (EPSs) of the second-generation antipsychotic medications, thus making it imperative to monitor for EPSs. Risperidone is not monitored with blood levels and does not cause mania or memory changes.

Ms. Wong, aged 52 years, comes to the emergency room with severe anxiety. She was raised in China but immigrated to the United States at age 40 years. She was recently fired from her job because of a major error in the accounting department that she managed. Ms. Wong's aged parents live with her. Ms. Wong states, "I am a failure." Which of the following statements may accurately assess the basis for Ms. Wong's anxiety and feelings of failure? Ms. Wong may feel that she has let herself down since she did not achieve her personal goals in the workplace. Ms. Wong may feel that she has shamed the family by being fired and may no longer be able to provide for them. Ms. Wong may feel personally inadequate since she failed in her quest for independence and self-reliance. Ms. Wong may be feeling anxiety because in her family's traditions her failure may result in a changed fate.

Ms. Wong may feel that she has shamed the family by being fired and may no longer be able to provide for them.

Which of the following patients would need monitoring for potential development of the side effect of hypothyroidism? Janelle, who is taking Prozac Travis, who is taking Depakote Shelly, who is taking lithium Anna, who is taking Risperdal

Shelly, who is taking lithium Long-term use of lithium may cause hypothyroidism. The other options refer to drugs whose long-term use do not cause hypothyroidism.

A nursing assistant shares with the nurse that a client with schizophrenia is as difficult to communicate with as "someone with Alzheimer's." The nurse offers the following advice: "Try talking to him early in the day to get the best results. Fatigue disorganizes his thinking." "Schizophrenia and Alzheimer's disease both cause irreversible brain damage, so keep your conversations short when you talk to a client with either disorder." "His medication targets his disturbed thought and speech patterns. To maximize improvement he will need positive interactions and support." "Make sure he eats the comfort foods he is served because they increase serotonin production and will help normalize his thoughts and speech."

This response will help the nursing assistant understand that improvement can be expected in the client's condition and that this improvement can be maximized by therapeutic interactions with staff. It establishes the expectation that the nursing assistant will interact in a therapeutic manner.

Using Maslow's model of needs, the nurse providing care for an anxious client identifies the priority intervention to be assessing the client's success at fulfilling her appropriate developmental level tasks. assessing the client for her strengths upon which a nurse-client relationship can be based. planning one-on-one time with the client to assist in identifying the fears behind her anxiety. evaluating the client's ability to learn and retain essential information regarding her condition.

assessing the client for her strengths upon which a nurse-client relationship can be based. The value of Maslow's model in nursing practice is twofold. First, the emphasis on human potential and the client's strengths is key to successful nurse-client relationships. The second value lies in establishing what is most important in sequencing of nursing actions in the nurse-client relationship.

When interviewing an adolescent client, the nurse can expect the client to be most concerned about the issue of confidentiality. sexual orientation. substance use or abuse. family mental problems.

confidentiality Adolescents are often concerned that what they reveal to the nurse or health care team will be shared with parents. Confidentiality should be explained at the outset of the interview.

A client reports that her mother-in-law is very intrusive. The nurse responds, "I know how you feel. My mother-in-law is nosy, too." The nurse is demonstrating self-disclosure in an appropriate way. to the client permission to continue. countertransference. empathy to establish trust.

countertransference. Countertransference refers to the stirring up of feelings in the nurse by the client.

The outcome of the nurse's expressions of sympathy instead of empathy toward the client often leads to enhanced client coping. lessening of client emotional pain. increased hope for client improvement. decreased client communication.

decreased client communication. Sympathy and the resulting projection of the nurse's feelings limits the client's opportunity to further discuss the problem.