Mental health test 1

The RN is educating a nursing student about dopamine. Which statement made by the nursing student indicates a need for further education?

"Dopamine is a neurotransmitter that is released by the pituitary." -Dopamine is released by the hypothalamus. This statement indicates a need for further education.

common responses that can be observed in a client with general adaptation syndrome

1. Alarm 2. Resistance 3. Exhaustion

The nursing instructor is explaining the role of the psychiatrist to a group of student nurses. Which statement made by a student nurse needs correction?

"A psychiatrist performs the ongoing assessment of the client's condition." - Performing the ongoing assessment of the client's condition is the responsibility of the psychiatric nurse. This statement by the student nurse requires correction.

Which client behavior noted by the nurse is indicative of using projection?

A client blaming his or her boss after getting fired from his or her job

Which neurotransmitter is decreased in clients with schizophrenia?

Glutamate and aspartate are decreased in clients with schizophrenia.

The nurse is caring for a client with anxiety. The client asks the nurse, "Will I be normal?" Which nurse's statement reassures the client?

"Don't worry about it. We can work on that as a team." - The nurse reassures the client that there is no need to worry, thereby reassuring the client's feelings and discouraging further anxiety.

After undergoing an abortion, a teenager asks the nurse, "Can you provide me with some information regarding birth control pills?" Which response from the nurse indicates ethical egoism?

"I am sorry. Providing information about birth control pills to teenagers will pose a risk for my job." - If the nurse refuses to provide information about birth control pills to avoid risk of losing his or her job, it indicates ethical egoism. The decision made by the nurse is beneficial only to him or her, but not to the teenager.

Which statement made by the nurse while interacting with a client helps to develop a trusting relationship?

"I will listen to you if you want to discuss your feelings." - This statement of the nurse indicates that the nurse is encouraging the client to share his or her feelings. Helping the client to express feelings may foster the development of a trusting relationship with the client.

The registered nurse is teaching a group of student nurses about the effects of psychotropic medications on neurotransmitters. Which statement made by the registered nurse needs correction?

"Increased sweating, insomnia, and tremors are the side effects associated with selective serotonin reuptake inhibitors." - Selective serotonin reuptake inhibitors (SSRIs) are the potent inhibitors of serotonin reuptake. Sweating, insomnia, and tremors are the side effects associated with the blockade of norepinephrine reuptake. Therefore, these side effects are not associated with SSRIs as they do not block norepinephrine reuptake.

The psychiatrist is explaining to the team members about the conditions that promote therapeutic community. Which statement made by a team member indicates effective teaching?

"It is important to set forth the norms, rules, and behavioral limits of the treatment setting." -Setting forth the norms and rules and behavioral limits of the treatment setting will reinforce the democratic posture of the treatment setting, thereby promoting therapeutic community. This statement by the team member is valid and indicates effective learning.

The registered nurse is teaching a student nurse about skills for active listening. Which statement made by the student nurse needs correction?

"Maintain constant eye contact while listening to others." - The eye contact of the nurse should be intermittently directed, which shows the willingness of the nurse to listen. Thus, this statement needs correction.

Which statements made by the student nurse indicates effective learning about restraints?

"Restraints should only be used if the client's behavior poses a risk to his or her physical safety." -When the student nurse says that restraints are only used if the client's behavior poses a risk to his or her physical safety, it indicates effective learning. Restraints control the client's behavior during psychotic episodes and help prevent the risk of physical injury. "Restraints can also include a medication that causes sedation and controls the client's behavior." -Restraints include medications like tranquilizers that are used to control the behavior of a client with agitation. This statement by the student nurse indicates effective learning.

A client's spouse presents a bouquet of flowers and chocolates to the nurse for taking care of the client. What is the most appropriate response of the nurse?

"Thank you. I will share your gift with my colleagues." - Accepting small gifts as a token of appreciation from the client may be considered appropriate. If the nurse responds, "Thank you. I will share it with my colleagues," it would be more appropriate because the nurse is acknowledging the effort of other staff members involved in caring for the client.

A client asks the nurse, "Do you think I should tell my mother about my brother's drinking habits?" What would be the best response by the nurse?

"What do you think you should do with this information?" - This response is the best one for the nurse. Questions and feelings should be referred back to the client, so that he or she recognizes that his or her point of view has value.

A client with depression says, "I feel like I am alone out in the ocean." What would the nurse say in response to this statement using a therapeutic communication technique?

"You must be feeling very lonely." -In response to the client's statement, the nurse should try to desymbolize the statement and find an underlying clue in it. This statement is attempting to do so.

Which important criteria must be first met in order for a client to achieve a higher level of functioning?

. Basic physiological needs -The basic requirements of life are food, clothes, and shelter. Therefore, basic physiological needs are the most important criteria that must be met first in a client in order to pursue a higher level of functioning.

The registered nurse is teaching a group of student nurses about the basic assumptions of therapeutic community. Which statement made by one of the student nurses needs correction?

. Restrictions and punishments for inappropriate behaviors should be a priority. - Inappropriate behaviors in a therapeutic community should be dealt with as they occur. However, restrictions and punishments should be avoided in a therapeutic community.

The nurse is caring for a client who unconsciously transfers his or her feelings for a person in the client's past towards the nurse because the nurse's appearance reminds the client of that person. Which outcome in the client would indicate the effectiveness of the nursing care?

. The client will assume responsibility for his or her own behavior. When the client assumes responsibility for his or her own behavior, it indicates that the client no longer shows the transference behavior and that the nursing care is effective.

A client suffering from a psychiatric disorder tells the nurse, "I am going to kill my girlfriend. She cheated on me." Which interventions followed by the nurse are valid in this situation?

1. Documenting the situation in a written format 2. Conveying the information to the primary health-care provide 3. Discussing the client's situation with other members of the health-care team

What is the responsibility of the psychiatric nurse in a therapeutic community?

1. Performing ongoing assessment of client's condition -The psychiatric nurse will perform ongoing physical and mental assessment of the client's condition and manages the therapeutic milieu on a 24-hour basis.

Which actions in the nursing practice can result in the nurse being accused of false imprisonment?

2. Taking the clothes of a depressed client against his or her wishes 3. Restraining the extremities of a voluntary competent client demanding release 4. Locking the client in a room for the nurse's convenience

The nurse is teaching a group of nursing students about the feedback method of communication. Which statements made by the student nurse indicates effective teaching? Select all that apply.

3. "Feedback allows the client to take in information, if given using an objective description." 4. "Feedback should focus on the behavior rather than on the client."

Which factors will influence the chances of lawsuit being brought against the nurse?

3. Insensitivity of the nurse to the client's complaints -The insensitive behavior of the nurse to the client's complaints may provoke the client to file a lawsuit against the nurse.. Failure of the nurse to meet the client's emotional needs -Defensive behavior of the nurse during an unfavorable event may cause the client to file a lawsuit against the nurse.

The nurse is managing a support group for clients who have lost spouses. Which client is demonstrating behaviors of acceptance?

A client who has found hobbies and interests with others

Which psychiatric client requires the nurse to obtain informed consent from the closest relative before treatment?

A client who is scheduled for electroconvulsive therapy -

Which member of a psychiatric care unit assists clients in the fulfillment of their activities of daily living?

A mental health technician is the member of the psychiatric care unit who assists clients in the fulfillment of their activities of daily living.

Which of the following medications would be an appropriate prn medication for an individual with anxiety symptoms? A. Buspirone B. Alprazolam C. Fluoxetine D. Sertraline

A. Buspirone

The nurse informs a client that his/her spouse was killed in an automobile accident. The client begins to scream "No, no, that's a lie!" while covering her ears and rocking back and forth. Which stage of grief would the nurse anticipate next?

Anger

When working in the therapeutic milieu, what technique should the nurse teach the client to improve confidence and communication?

Assertive techniques -The nurse includes assertive techniques in client education in order to improve confidence and communication by reducing anger in the client. Assertive techniques will make the client express his or her emotions, thereby promoting better communication.

The nurse finds that a client with schizophrenia is aggressive and attempted suicide. On inquiry, the nurse learns that the client harmed the caregiver while the caregiver tried to rescue the client. Which ethical principle should the nurse break in this situation?

Autonomy - Since the client with schizophrenia has impaired cognitive abilities, the client cannot make independent choices. The mentally ill aggressive client can cause harm to other individuals. Therefore, the nurse should not allow the client to exercise his or her autonomy.

A nursing instructor tells a group of nursing students, "You have to treat clients with the same respect and dignity with which you would expect to be treated." Which ethical theory is the nursing instructor teaching the students?

Christian ethics - The nursing instructor is teaching the group of students about the theory of Christian ethics, which states that the nurse should treat clients with the same respect and dignity with which they would expect from others.

Which members of the interdisciplinary treatment team can conduct individual, group, and family therapy? Select all that apply.

Clinical psychologist --The clinical psychologist has a doctorate degree in clinical psychology and can conduct individual, group, and family therapy Psychiatric social worker -- The psychiatric social worker has a master's degree in social work and can conduct individual, group, and family therapy. Psychiatric clinical nurse specialist --The psychiatric clinical nurse specialist has a master's degree in psychiatry. Therefore, he or she can conduct individual, group, and family therapy.

The nurse knows which is an important characteristic of the therapeutic relationships?

Collaborative -Ideally, the nurse and client decide together what the goal of the therapeutic relationship will be.

Which biological responses occur at the sustained stage of stress during the "fight or flight" syndrome?

Decreased immune response -Glucocorticoids are released by the adrenal cortex during stress. These glucocorticoids decrease immune responses. Decreased inflammatory response -Inflammatory response decreases during stress due to the release of glucocorticoids from the adrenal cortex.

A client is admitted to the psychiatric unit for the fourth time in a month after being found face down in parking lot with an extremely high blood alcohol level. While speaking with the nurse, the client explains he drinks alcohol to ease the pain of losing his family. What ego defense mechanism is the client exemplifying?

Denial -Denial involves refusing to acknowledge the existence of a real situation or the feelings associated with it. Drinking heavily to avoid coping with a loss is an example of this defense mechanism.

A client who developed an alcohol problem after the death of her baby tells the nurse, "No I do not have a drinking problem. I do not drink in excess; I can stop before I get to that point. That open container in the car was the only reason I got a DUI in the a couple of months ago." Which defense mechanism does the nurse suspect from the client's statement?

Denial The client is showing denial because she is not acknowledging that she has a drinking problem.

The student nurse is assigned to care for a client with severe mental illness. Which action of the student nurse violates the Health Insurance Portability and Accountability Act (HIPAA)?

Discussing the client's health information at the reception desk -The student nurse should not disclose the client's health information to others on the health-care team who are not directly involved in the client's care. In addition, the student nurse should not discuss the client's health information in any public areas. This action of the student nurse violates HIPAA.

The nurse is in the first phase of relationship development with a client who is an alcoholic. What should be the goal of the nurse during this phase?

Exploring self-perceptions -The first phase is the preinteraction phase, where the nurse prepares for the first encounter with the client. Everyone brings attitudes and feelings from their own experiences to the clinical setting. Therefore, it is necessary to be aware of self-perceptions so as to not let them affect providing care to clients.

The nurse begins a session with the client by saying, "What would you like to discuss today?" This is an example of which communication technique?

Giving broad openings

The nurse is caring for a client who is in the isolation room. Which statement made by the nurse indicates that the nurse is trying to increase the client's feeling of self-worth?

I'll sit in here with you for a while."

When can the nurse disclose a client's information to others without obtaining consent from the client?

If the client is in a life-threatening situation -The nurse can disclose the client's information when the client is in a life-threatening situation. In this case, the nurse's primary priority is to save the life of the client rather than protect the client's right to confidentiality.

Which biological response occurs at the initial stage of stress during "fight or flight" syndrome?

Increase in lacrimal secretions

Which physiological activity occurs at sustained stress during the "fight or flight" syndrome?

Increased gluconeogenesis Adrenocorticotropic hormone released by the pituitary gland stimulates the adrenal cortex to release glucocorticoids. These glucocorticoids increase gluconeogenesis.

What is the nurse's best approach to encourage the client to become more independent and accept self-responsibility?

Insisting each client take the lead in community meetings - Insisting each client take the lead in community meetings provides the client the opportunity to assume roles and responsibilities. This makes the client more independent and self-reliant.

Which theory of ethical decision-making suggests that nursing actions should be bound by a sense of duty?

Kantianism theory states that nursing actions should be bound by a sense of moral duty. An action can be deemed right or wrong depending on the principle or motivation on which the action is based.

The nurse is caring for a client who is having difficulty achieving satisfactory interpersonal relationships. Which level of Maslow's Hierarchy of needs would the nurse conclude the client is attempting to achieve?

Love and belonging

The nurse tells an angry client, "I see you have been walking back and forth frequently." Which therapeutic communication technique should the nurse follow while communicating with the client?

Making observations - Making observations or verbalizing the perceived behavior encourages the client to recognize specific behavior and evaluate the observation with the nurse. This gives the client an opening to discuss issues.

Which interdisciplinary treatment team member uses creative activities and therapeutic skills to enhance self-esteem of clients?

Occupational therapist - An occupational therapist uses the creative abilities and therapeutic skills of the client to enhance self-esteem in the client.

While assessing a client, the nurse learns that client has been diagnosed with anxiety in the past. The client also he or she is afraid of "going crazy." Which level of anxiety will the nurse expect to see when reviewing the client's previous history?

Panic anxiety is associated with a feeling of terror, and individuals may be convinced that they have a life-threatening illness and/or fear that they are "going crazy."

The primary health-care provider instructs the nurse to seclude a psychotic client showing aggressive behaviors. What should the nurse do in this situation?

Place the client alone in a closed, minimally furnished room. -

What is the priority nursing intervention for a newly admitted client in a psychiatric unit?

Providing notice of privacy policies to the client and the client's representative The notice of privacy policies ensure protected health information (PHI). The priority nursing intervention is to provide notice of privacy policies to the client and the client's representative.

Which interdisciplinary treatment team member focuses on one-to-one relationship development with the client?

Psychiatric nurse - A psychiatric nurse has the responsibility of focusing on one-to-one relationship development with the client. Apart from the psychiatric nurse, the mental health technician may also focus on the same function.

Which task would a client with moderate anxiety need assistance from the nurse to complete?

Putting together a puzzle - The client with moderate anxiety will need assistance with problem solving, so the nurse may need to help with putting together a puzzle.

The hypothalamus is located just above the pituitary gland. Which is a major function of this region of the forebrain?

Regulates the appetite - The hypothalamus regulates the appetite.

The hypothalamus is located just above the pituitary gland. Which of the following would be considered major functions of this region of the forebrain?

Regulation of the pituitary gland -The hypothalamus regulates the pituitary gland.

A client tells the nurse, "I can't concentrate on anything. My mind keeps wandering." How should the nurse respond to convey to the client that he or she has understood the client's statement?

Repeating the main idea of what the client has said - The nurse should repeat the main idea of what the client has said to make the client know that the statement is understood. Repeating the main idea will help both the client and the nurse to validate the statement.

The nurse is caring for a client who has been raped. The client says, "I don't remember anything after I entered my apartment building." Which ego defense mechanism should the nurse conclude the client is exhibiting?

Repression - Repression is the involuntary act of blocking unpleasant experiences from one's awareness.

The nurse accepts a client unconditionally and regards him or her as a worthy person. Which characteristic is exhibited by the nurse?

Respect is to acknowledge the client's dignity, value, and worth. Therefore, if the nurse accepts the client unconditionally and regards him or her as a worthy person, it is a characteristic of respect exhibited by the nurse.

he nurse is preparing a care plan for a client who is experiencing the second Kubler-Ross stage of grief. Which intervention in the care plan will help to reduce these symptoms in the client?

Secluding the client for some time - Anger is the second stage of Kubler-Ross stages of grief. Therefore, secluding the client for some time will be helpful to reduce the anger in the client.

A client with bipolar disorder is scheduled for neurosurgery. Which action should the nurse undertake in this situation?

Secure informed consent from the family member. -The client with bipolar disorder cannot make decisions on his or her own. Therefore, the nurse should secure informed consent from the client's family member.

Which basic need is at the top of Maslow's hierarchy of needs?

Self-fulfillment

What does milieu therapy emphasize?

Social skills -Milieu therapy maintains the client's environment in order to produce a behavioral change. This is done with the help of interpersonal interactions. Therefore, the emphasis is on social skills.

Which action may place a nurse at risk of being charged with slander?

Spreading oral defamation of the client by malicious or false information -When the nurse orally defames a client's image by spreading malicious or false information, then he or she could have committed slander.

The physician orders a computed tomography scan for a client that is having problems with short-term memory loss. On which lobe of the cerebrum will the study focus?

Temporal - The primary functions of the temporal lobe are hearing, short-term memory, sense of smell, and expression of emotions through connection with limbic system.

While caring for a client with posttraumatic stress disorder, the art therapist uses the creative abilities of the client to encourage the expression of feelings and emotions through artwork. Which action of the client indicates the effectiveness of the treatment?

The client will analyze his or her own work to recognize and resolve underlying conflict. -When the therapist uses the client's creative abilities to express emotions to encourage the expression of feelings and emotions through artwork, it will help the client to analyze his or her own work to recognize and resolve underlying conflict. It indicates the effectiveness of the therapy.

While caring for a client with acute stress disorder, the therapist uses recreational activities as a part of the therapy. Which outcome in the client will indicate effectiveness of the therapy?

The client will learn skills that can be used in leisure time. - Recreational activities redirect the client's thinking about the trauma. When the therapist uses recreational abilities, the client will learn skills which can be used in leisure time to redirect the client's thought process.

The nurse is caring for a client during an anger-management program. Which action represents the working phase of therapeutic relationship management?

The nurse helping the client practice various adaptive procedures to control anger. -In the working phase, the therapeutic work of the relationship between the nurse and client is carried out. Therefore, the nurse helping the client practice various adaptive procedures to control anger represents the working phase.

Which phase of the nurse-client relationship development deals with creating an environment for the establishment of trust and rapport with the client?

The orientation phase -The orientation phase is the introductory phase where the nurse and client get acquainted. Therefore, if the nurse is creating an environment to establish trust and rapport with the client, then it is the orientation phase.

During evaluation, the registered nurse concludes that a new trainee nurse is implementing the ethical principle of justice effectively. Which action of the trainee nurse supports the registered nurse's conclusion?

Treating both married and unmarried clients equally - The nurse should treat all clients equally irrespective of sex, race, marital status, or socioeconomic status to implement justice effectively in his or her profession.

The client becomes angered when a nurse comes in wearing a hat that reminds the client of the his abusive mother used to wear. Which term describes this emotion?

Transference -Transference occurs when the client unconsciously displaces (or "transfers") feelings formed toward a person from his or her past onto another.

Which ethical principle indicates that a nurse should always be truthful in his or her profession?

Veracity refers to the ethical principle that the nurse should always be truthful to clients and not intentionally deceive or mislead them.

The nurse is caring for a client who experienced a cerebral vascular accident (CVA) in the occipital lobe of the brain. Which deficit will the nurse find when doing an assessment?

Vision -Damage to the occipital lobe will lead to problems with vision.

. A client in the milieu unit tells the nurse, "I think it's stupid to close the front gate at 10 pm. We should be allowed to be out until midnight." How should the nurse respond to this client?

You are not the only person in the unit. Decisions are made as a group." - Reminding the client that his or her behavior affects the other clients in the community is an appropriate response by the nurse in this scenario. This will help the client understand the situation.