Ch 69 Mental Health Disorders

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The nurse is planning activities for a client diagnosed with bipolar disorder with aggressive social behavior. Which activity would be most appropriate for this client? 1. chess 2. writing 3. ping pong 4. basketball

2. writing

A client is unwilling to go to his church because his ex-girlfriend goes there and he feels that she will laugh at him if she sees him. Because of this hypersensitivity to a reaction from her, the client remains homebound. The home care nurse develops a plan of care that addresses which personality disorder? 1. avoidant 2. borderline 3. schizotypal 4. obsessive-compulsive

1. avoidant

Which nursing interventions are appropriate for a hospitalized client with mania who is exhibiting manipulative behavior? Select all that apply. 1. communicate expected behaviors to the client 2. ensure that the client knows that they are not in charge of the nursing unit 3. assist the client in identifying ways of setting limits on personal behaviors 4. follow through about the consequences of behavior in a nonpunitive manner 5. enforce rules by informing the client that he/she will not be allowed to attend therapy groups 6. have the client state the consequences for behaving in ways that are viewed as unacceptable

1. communicate expected behaviors to the client 3. assist the client in identifying ways of setting limits on personal behaviors 4. follow through about the consequences of behavior in a nonpunitive manner 6. have the client state the consequences for behaving in ways that are viewed as unacceptable

The nurse observes that a client is pacing, agitated, and presenting aggressive gestures. The client's speech pattern is rapid, and affect is belligerent. Based on these observations, which is the nurse's immediate priority of care? 1. provide safety for the client and other clients on the unit 2. provide the clients on the unit with a sense of comfort and safety 3. assist the staff in caring for the client in a controlled environment 4. offer the client a less stimulating area in which to calm down and gain control

1. provide safety for the client and other clients on the unit

The nurse is conducting a group therapy session. During the session, a client diagnosed with mania consistently disrupts the group's interactions. Which intervention should the nurse initially implement? 1. setting limits on the client's behavior 2. asking the client to leave the group session 3. asking another nurse to escort the client out of the group session 4. telling the client that they will not be able to attend any future group sessions

1. setting limits on the client's behavior

The nurse is caring for a client diagnosed with paranoid personality disorder who is experiencing disturbed thought processes. In formulating a nursing plan of care, which best intervention should the nurse include? 1. increase socialization of the client with peers 2. avoid using a whisper voice in front of the client 3. begin to educate the client about social supports in the community 4. have the client sign a release of information to appropriate parties for assessment purposes

2. avoid using a whisper voice in front of the client

When planning the discharge of a client with chronic anxiety, the nurse directs the goals at promoting a safe environment at home. Which is the most appropriate maintenance goal? 1. suppressing feelings of anxiety 2. identifying anxiety-producing situations 3. continuing contact with a crisis counselor 4. eliminating all anxiety from daily situations

2. identifying anxiety-producing situations

A client diagnosed with delirium becomes disoriented and confused at night. Which intervention should the nurse implement initially? 1. move the client next to the nurses' station 2. use an indirect light source and turn off the television 3. keep the television and a soft light on during the night 4. play soft music during the night, and maintain a well-lit room

2. use an indirect light source and turn off the television

A client says to the nurse, "the federal guards were sent to kill me." Which is the best response by the nurse to the client's concern? 1. "i don't believe this is true" 2. "the guards are not out to kill you" 3. "do you feel afraid that people are trying to hurt you?" 4. "what makes you think the guards were sent to hurt you?"

3. "do you feel afraid that people are trying to hurt you?"

A client is admitted to a medical nursing unit with a diagnosis of acute blindness after being involved in a hit-and-run accident. When diagnostic testing cannot identify any organic reason why this client cannot see, a mental health consult is prescribed. The nurse plans care based on which condition that should be the focus of this consult? 1. psychosis 2. repression 3. conversion disorder 4. dissociative disorder

3. conversion disorder

A manic client begins to make sexual advances toward visitors in the dayroom. When the nurse firmly states that this is inappropriate and will not be allowed, the client becomes verbally abusive and threatens physical violence to the nurse. Based on the analysis of this situation, which intervention should the nurse implement? 1. place the client in seclusion for 30 minutes 2. tell the client that the behavior is inappropriate 3. escort the client to their room, with the assistance of other staff 4. tell the client that their telephone privileges are revoked for 24 hours

3. escort the client to their room, with the assistance of other staff

The nurse is caring for a client just admitted to the mental health unit and diagnosed with catatonic stupor. The client is lying on the bed in a fetal position. Which is the most appropriate nursing intervention? 1. ask direct questions to encourage talking 2. leave the client alone so as to minimize external stimuli 3. sit beside the client in silence with occasional open-ended questions 4. take the client into the dayroom with other clients so that they can help watch them

3. sit beside the client in silence with occasional open-ended questions

The nurse is preparing a client with a history of command hallucinations for discharge by providing instructions on interventions for managing hallucinations and anxiety. Which statement in response to these instructions suggests to the nurse that the client has a need for additional information? 1. "my medications will help my anxious feelings" 2. "i'll go to support groups and talk about what i am feeling" 3. "i need to get enough sleep and eat well to help prevent feeling anxious" 4. "when i have command hallucinations, i'll call a friend and ask him what i should do"

4. "when i have command hallucinations, i'll call a friend and ask him what i should do"

A client is admitted to the mental health unit with a diagnosis of depression. The nurse should develop a plan of care for the client that includes which intervention? 1. encouraging quiet reading and writing for the first few days 2. identification of physical activities that will provide exercise 3. no socializing activities, until the client asks to participate in milieu 4. a structured program of activities in which the client can participate

4. a structured program of activities in which the client can participate


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