mental health nclex questions

A nurse is discharging a client from the mental health unit who has been treated for major depression. Which statement is most therapeutic at this time?

"Call the contact number we gave you if you have an emergency."

A client with a history of obsessive-compulsive behaviors has a marked decrease in symptoms and expresses a wish to obtain a part-time job. On the day of a job interview the client arrives at the mental health center with signs of anxiety. What is the most therapeutic response to the client's behavior by the nurse?

"Going for your interview triggered some feelings in you. Perhaps you could call a friend to drive you there."

The parents of an overweight 12-year-old bring their child to the mental health clinic. One parent says, "You've got to do something to help us—just look how huge he is." The child tells the nurse, "I hate school. The other kids tease me about my weight. I'm always last when they pick teams in gym." What is the most therapeutic response by the nurse?

"That hurts a lot when you want to be liked."

A client who has a history of a conversion reaction that involves weakness in the right arm that periodically progresses to paralysis is hospitalized on the mental health unit of the local community hospital. While listening to instructions for a group project, the client experiences a feeling of weakness and is unable to move the right arm. After evaluating the client, what should the nurse ask?

"What emotion were you feeling before you felt the weakness?"

A nurse on a mental health unit has developed a therapeutic relationship with a manipulative, acting-out client. One day as the nurse is leaving, the client says, "Please stay. I'm afraid that the evening staff doesn't like me. They're always punishing me." What is the nurse's most therapeutic response?

"You know I leave at this time. We'll talk about this in the morning."

After a week on the mental health unit, a client with the diagnosis of paranoid schizophrenia continues to say, "They're trying to kill me. They all are." What is the best response by the nurse?

"You're having very frightening thoughts."

A psychologist has been a client on a mental health unit for 3 days. The client has questioned the authority of the treatment team, advised other clients that their treatment plans are wrong, and been disruptive in group therapy. What is the most appropriate nursing intervention?

Accepting that the client is unable to control this behavior and setting appropriate limits

When being admitted to a mental health facility, a young male adult tells the nurse that the voices he hears frighten him. The nurse knows that clients tend to hallucinate more vividly at what point in their routine?

After going to bed

A primary health-care provider wants to assess the presence of stressors that could affect the mental health diagnosis in a client. In which axis of the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM-V) is this assessment finding made?

Axis IV

A nurse in a mental health facility is caring for a client with the diagnosis of borderline personality disorder. What should the nurse plan to do to maintain a therapeutic relationship?

Be firm, consistent, and understanding because there is a need for structure

A nurse in a mental health unit of the emergency department of a hospital frequently cares for adolescents who attempt suicide. What is important for the nurse to remember about adolescent suicide behavior?

Boys are more likely to use lethal methods than are girls.

Upon reviewing the mental health reports of four different clients, the nurse suspects that one client is experiencing obsessive thoughts. Which client's behavior supports the nurse's suspicion?

Client D; silently repeats the words germs, contagious, and filth frequently

A nurse is caring for a client admitted to a mental health unit because of suicidal ideation. Which intervention provides the greatest safety for this client?

Constant one-to-one supervision

An Asian client arrives at the mental health clinic with symptoms of anxiety and panic. While speaking with the client, the nurse notes that the client makes very little eye contact. What does this behavior suggest?

Cultural variation

A client has had repeated hospitalizations for aggressive, violent behavior. While on the mental health service, the client becomes very angry, starts screaming at the nurse, and pounds the table. What is the priority nursing assessment at this time?

Degree of control over the behavior

A male client in a mental health facility turns his head to the side during a unit meeting as if he hears something. When the nurse comments about it, the client replies, "You know, it's that microcomputer those foreign agents implanted in my ear." In light of this statement, what does the nurse determine that the client is experiencing?

Delusional thoughts

What is the nurse's specific responsibility when the rights of a client on a mental health unit are restricted by the use of seclusion?

Documenting both the client's behavior and the reason that specific rights were denied

It is most helpful to the nurse who is attempting to apply the principles of mental health to consider what?

Emotional health is promoted when there is a sense of mastery of self and the environment

What characteristic is most essential for the nurse caring for a client undergoing mental health care?

Empathy

The school health nurse is teaching a group of teachers about promoting the mental health of school-age children. Which action made by the teachers promotes a sense of industry among the children?

Giving grades and gifts for satisfactory performances

A health care provider refers a 52-year-old man to the mental health clinic. The history reveals that the man lost his wife to colon cancer 6 months ago and that since that time he has seen his health care provider seven times with the concern that he has colon cancer. All tests have had negative results. Recently the client stopped seeing friends, dropped his hobbies, and stayed home to rest. Which disorder should the nurse identify as consistent with the client's preoccupation with the fear of having a serious disease?

Hypochondriac disorder

A depressed client is admitted to the mental health unit. What factor should the nurse consider most important when evaluating the client's current risk for suicide?

Impending anniversary of the loss of a loved one

A college student is brought to the mental health clinic by his parents. The diagnosis is borderline personality disorder. Which factors in the client's history support this diagnosis? Select all that apply.

Impulsiveness Lability of mood Self-destructive behavior

The clients on a mental health unit go on a supervised day trip to a baseball game. When returning to the bus, a client with a narcissistic personality disorder insists on leaving the group to get an autograph from a player. What is the most appropriate response by the nurse?

Informing the client in a matter-of-fact tone that everyone must remain with the group

A client in the mental health clinic who has been seeing a therapist for more than 6 months begins to talk and act like a therapist who is analyzing coworkers. What defense mechanism does the nurse identify?

Introjection

A client with a history of sleeplessness, lack of interest in eating, and excessive purchases on charge accounts is seen in the mental health clinic. What is the adaptation that the nurse should expect the client to exhibit?

Intrusive involvement with environmental activities

An extremely agitated client hospitalized in a mental health unit begins to pace around the dayroom. What should the nurse do?

Let the client pace in the hall away from other clients.

A client with dementia has been cared for by the spouse for 5 years. During the last month, the client has become agitated and aggressive and is incontinent of urine and feces. Which is the priority while this client is in an inpatient mental health facility?

Managing the behavior

A client who attempted suicide by slashing her wrists is transferred from the emergency department to a mental health unit. What important nursing interventions must be implanted when the client arrives on the unit? Select all that apply.

Obtaining vital signs Assessing for suicidal thoughts Instituting continuous monitoring Initiating a therapeutic relationship Inspecting the bandages for bleeding

A client with recurrent episodes of depression comes to the mental health clinic for a routine follow-up visit. The nurse suspects that the client is at increased risk for suicide. What is a contributing factor to the client's risk for suicide?

Overwhelming feelings of guilt

A client with a diagnosis of bipolar disorder, manic episode, is admitted to the mental health unit. Because the environment is important, what should the nurse do?

Place the client in a private room to provide a quiet atmosphere

A client who is taking lithium arrives at the mental health center for a routine visit. The client has slurred speech, has an ataxic gait, and complains of nausea. The nurse knows that these signs and symptoms are what?

Probably associated with a toxic level of lithium

A client in the mental health clinic who has concerns about getting married says to the nurse, "I guess I'd better get married. All the plans are made and paid for, and the invitations have all been mailed." What defense mechanism is the client using?

Rationalization

A 13-year-old boy who recently was suspended from school for consistently bullying other children is brought to the pediatric mental health clinic by his mother. The child is assessed by the psychiatrist and referred to a psychologist for psychological testing. The day after the tests are completed, the mother returns to the clinic and asks the nurse for results of the tests. What should the nurse do?

Refer the mother to the psychiatrist

A client is admitted to the mental health unit after attempting suicide. When a nurse approaches, the client is tearful and silent. What is the best initial nursing intervention?

Saying, "I see that you're crying. Tell me what's going on in your life, and we can work on helping you."

An individual whose employment has been terminated because his company has been acquired by another company is brought by a family member to the mental health clinic because of extreme depression. While talking with the nurse the client says, "I'm a useless, worthless person. No wonder I lost my job." What type of delusion does the nurse identify?

Self-deprecation

A client in an acute mental health unit appears severely depressed. The client does not initiate conversations or perform personal care. Questions are answered with a barely audible one- or two-word response. The nurse sits with the client and makes no demands. On what premise is the nurse's intervention for this client based?

Spending time with depressed clients demonstrates that they are worthy of attention.

An acutely ill client with the diagnosis of schizophrenia has just been admitted to the mental health unit. What is the most therapeutic initial nursing intervention?

Spending time with the client to build trust and demonstrate acceptance

A client comes to a mental health center with severe anxiety, evidenced by crying, hand-wringing, and pacing. What should the first nursing intervention be?

Staying physically close to the client

A client with a history of methamphetamine use is admitted to the mental health unit because of aggressive, violent behavior. For what clinical manifestations of methamphetamine use should the nurse assess this client? Select all that apply.

Tachycardia Hyperthermia

A client is admitted to the mental health clinic for treatment of an obsessive-compulsive disorder that impairs ability to work outside the home. What should the nurse consider about the client's behavior when developing a plan of care?

The client knows that the behavior is illogical but is unable to stop it.

A teenager with anorexia nervosa is admitted to the adolescent unit of a mental health facility and signs a contract calling for her to gain weight or lose privileges. There is no weight gain after a week. What should the nurse explain to the client?

The prearranged consequences will go into effect.

How should a nurse intervene when a confused and anxious client voids on the floor in the sitting room of the mental health unit?

Toilet the client more frequently with supervision.

When does a nurse in the mental health clinic conclude that a client is using confabulation?

When imagination is used to fill in memory gaps

A nurse encourages a client to join a self-help group after being discharged from a mental health facility. What is the purpose of having people work in a group?

support

The nurse at the mental health clinic is counseling a client with obsessive-compulsive disorder who spends a lot of time each day engaged in handwashing and has trouble keeping appointments on time as a result. What is the most therapeutic initial intervention by the nurse?

Accepting the ritualistic behavior with a matter-of-fact attitude without displaying criticism

A client whose depression is beginning to lift remains aloof from the other clients on the mental health unit. How can a nurse help the client participate in an activity?

Invite another client to take part in a joint activity with the nurse and the client

A psychiatric nurse is hired to work in the psychiatric emergency department of a large teaching hospital. While reviewing the manuals, the nurse reads, "People with mental health emergencies shall be triaged within 5 minutes of entering the emergency department." What does the nurse consider this statement to represent?

Hospital policy