Foundations and Practice of Mental Health Nursing

Which individual is coping with issues concerning dependence versus independence? 1.Infant 2.Toddler 3.School-aged child 4.Preschool-aged child

2.Toddler

A client who is being treated in a mental health clinic is to be discharged after several months of therapy. The client anxiously tells the nurse, "I don't know what I'll do when I can't see you anymore." The nurse determines that the client is: 1.Expressing thanks to the nurse 2.Reacting to the planned discharge 3.Attempting to manipulate the nurse 4.Indicating a need for further treatment

2.Reacting to the planned discharge

In response to a question posed during a group meeting, the nurse explains that the superego is that part of the self that says: 1."I like what I want." 2."I want what I want." 3."I shouldn't want that." 4."I can wait for what I want."

3."I shouldn't want that."

A male college student who is smaller than average and unable to participate in sports becomes the life of the party and a stylish dresser. What defense mechanism does the nurse determine that the client is using? 1.Introjection 2.Sublimation 3.Compensation 4.Reaction formation

3.Compensation

When a person who is nonathletic and uncoordinated is successful in a musical career, it may be related to the defense mechanism of: 1.Sublimation 2.Transference 3.Compensation 4.Rationalization

3.Compensation

A health care provider prescribes divalproex (Depakote). What does the nurse consider an appropriate indication for the use of this drug? 1.Control of acute agitation of schizophrenia 2.Treatment of the agitated phase of a paranoid state 3.Management of manic episodes of bipolar disorder 4.Modification of the depressive phase of major depression

3.Management of manic episodes of bipolar disorder

What statement by a 45-year-old woman scheduled for an abdominal hysterectomy and bilateral salpingo-oophorectomy should alert the nurse to the potential for postoperative coping difficulties? 1."I'm not the least bit worried." 2."I don't want any more children." 3."I get along very well with my husband." 4."I'll be glad not to have any more periods."

1."I'm not the least bit worried."

One afternoon a nurse sees a client rushing down the hall of the mental health unit, rapidly tapping his fingers against the wall. What is the most appropriate nursing action at this time? 1.Approaching the client in a nonthreatening manner to determine the cause of the agitation 2.Summoning additional staff members to forcefully subdue the client and stop the acting-out behavior 3.Observing the client to see whether the behavior escalates and whether it may pose a risk to other clients or staff 4.Immediately obtaining staff assistance to enable administration of medication prescribed for the client's agitatio

1.Approaching the client in a nonthreatening manner to determine the cause of the agitation

The nurse explains to a nursing assistant that behavior usually is viewed and accepted as normal if it: 1.Fits within standards accepted by one's society 2.Helps the person reduce the need for coping skills 3.Expresses the individual's feelings and thoughts accurately 4.Allows achievement of short-term and long-term goals by the individua

1.Fits within standards accepted by one's society

A client with the diagnosis of schizophrenia, paranoid type, has been receiving a phenothiazine drug. The daycare center is planning a fishing trip. It is important that the nurse: 1.Provide the client with sunscreen 2.Caution the client to limit exertion during the trip 3.Give the client an extra dose of medication to take after lunch 4.Take the client's blood pressure before allowing him to participate in the outing

1.Provide the client with sunscreen

What should a nurse ensure when creating an environment that is conducive to psychological safety? 1.Realistic limits are set. 2.Passive acceptance is promoted. 3.The client's physical needs are met. 4.The physical environment is kept in order.

1.Realistic limits are set.

Antipsychotic drugs can cause extrapyramidal side effects. Which responses should the nurse document as indicating pseudoparkinsonism? (Select all that apply.) 1.Rigidity 2.Tremors 3.Mydriasis 4.Photophobia 5.Bradykinesia

1.Rigidity 2.Tremors 5.Bradykinesia

What is the basic therapeutic tool used by the nurse to foster a client's psychological coping? 1.Self 2.Milieu 3.Helping process 4.Client's intellect

1.Self

For which adverse effect should the nurse continually observe a client who is receiving valproic acid (Depakene)? 1.Yellow sclerae 2.Motor restlessness 3.Ringing in the ears 4.Torsion of the neck

1.Yellow sclerae

A health care provider writes a prescription of "Restraints PRN" for a client who has a history of violent behavior. What is the nurse's responsibility in regard to this order? 1.Asking that the order indicate the type of restraint 2.Recognizing that PRN orders for restraints are unacceptable 3.Implementing the restraint order when the client begins to act out 4.Ensuring that the entire staff is aware of the order for the restraints

2.Recognizing that PRN orders for restraints are unacceptable

A client with type 1 diabetes is found to have a psychosis and is to receive haloperidol (Haldol). Which response should a nurse anticipate with this drug combination? 1.Depressed respiration 2.Intensified action of both drugs 3.Decreased control of the diabetes 4.Increased danger of extrapyramidal side effects

3.Decreased control of the diabetes

A client with schizophrenia who has type II (negative) symptoms is prescribed risperidone (Risperdal). Which outcomes indicate that the medication has minimized these symptoms? (Select all that apply.) 1.There is less agitation. 2.There are fewer delusions. 3.More interest is shown in unit activities. 4.The client reports that the hallucinations have stopped. 5.The client performs activities of daily living independently

3.More interest is shown in unit activities. 5.The client performs activities of daily living independently

Three days after a stressful incident a client can no longer remember why it was stressful. The nurse, in relating to this client, can be most therapeutic by identifying that the inability to recall the situation is an example of the defense mechanism of: 1.Denial 2.Regression 3.Repression 4.Dissociation

3.Repression

How long after the last dose should the nurse schedule to have a client's blood drawn to evaluate the serum lithium level? 1. 2 to 4 hours 2. 4 to 6 hours 3. 6 to 8 hours 4. 8 to 12 hours

4. 8 to 12 hours

A client is extremely depressed, and the practitioner prescribes a tricyclic antidepressant, imipramine (Tofranil). The client asks the nurse what the medication will do. The nurse responds: 1."It will help you forget why you are depressed." 2."It will help keep you alert and cure your insomnia." 3."It will help you feel better after taking it for several days." 4."It will help increase your appetite and make you feel better."

4."It will help increase your appetite and make you feel better."

A client on the psychiatric unit who has suicidal ideas says to the nurse, "I signed myself in. I'll sign myself out." What concept provides the basis for the nurse's response? 1.Voluntary clients may sign out at any time. 2.Voluntary clients may sign out by following unit procedures. 3.Suicidal clients may sign out if they are able to contract for their safety. 4.Suicidal clients may not sign out even if they voluntarily admitted themselves

4.Suicidal clients may not sign out even if they voluntarily admitted themselves

The practitioner prescribes valproic acid (Depakene) 750 mg daily to be administered in two divided doses. The medication is supplied as a syrup of 250 mg/5 mL. How many milliliters of solution should the nurse administer per dose? Record your answer using one decimal place. __________ mL

7.5 mL

A parent of four is remanded to the psychiatric unit by the court for observation. The client was arrested and charged with abusing a 2-year-old son, who is in the pediatric intensive care unit in critical condition. The nurse approaches the client for the first time. How should the nurse anticipate that the client will likely respond? (Select all that apply.) 1.By denying beating the son 2.By avoiding talking about the situation 3.By expressing excessive concern for the son 4.By asking where the other three children are 5.Emotional response is inconsistent with degree of injury

1.By denying beating the son 2.By avoiding talking about the situation 5.Emotional response is inconsistent with degree of injury

Which nursing intervention involves providing, structuring, and maintaining a safe and therapeutic environment in collaboration with patients, families, and other health care providers? 1.Milieu therapy 2.Coordination of care 3.Health teaching and health maintenance 4.Pharmacologic, biologic, and integrative therapies

1.Milieu therapy

What is the priority goal in the planning of care for a client in crisis? 1.Referring the client for occupational therapy 2.Arranging follow-up counseling for the client 3.Restoring the client's psychological equilibrium 4.Having the client work to gain insight into the problem

3.Restoring the client's psychological equilibrium

A 19 year-old, arrested for assault and robbery, has a history of truancy and prostitution but is unconcerned that her behavior has caused emotional distress to others. The diagnosis of antisocial personality disorder is made. According to psychoanalytical theory, the client's lack of remorse and repetitive behavior probably are related to an underdeveloped: 1.Id 2.Ego 3.Superego 4.Limbic system

3.Superego

An older man is widowed suddenly when his wife is killed in an automobile accident. What should the nurse in the emergency department do first to best help the client at this time? 1.Ask a member of the clergy to visit him 2.Have the practitioner prescribe a sedative for him 3.Refer him to a support group that meets near his home 4.Assure him that everything possible was done for his wife

4.Assure him that everything possible was done for his wife

Thirty minutes after administering fluphenazine (Prolixin) to a client, the nurse notes that the client's jaw is rigid, the client is drooling, and her speech is slurred. There are a number of as-needed prescriptions in the client's chart. What should the nurse administer? 1.Diazepam (Valium), 10 mg by mouth 2.Trihexyphenidyl (Artane), 1 mg by mouth 3.Haloperidol (Haldol), 2 mg intramuscularly 4.Benztropine (Cogentin), 2 mg intramuscularly7

4.Benztropine (Cogentin), 2 mg intramuscularly7

A nurse is teaching a client about side effects of medications. Which drug will cause a heightened skin reaction to sunlight? 1.Lithium 2.Sertraline 3.Methylphenidate 4.Chlorpromazine

4.Chlorpromazine

Doxepin (Sinequan) is prescribed for a 74-year-old man for treatment of a depressive episode that has not responded to several other medications. The nurse in the outpatient clinic reviews with the client the side effects of doxepin. The identification of which side effects by the client as needing to be reported to the health care provider allows the nurse to conclude that the teaching has been effective? (Select all that apply.) 1.Diarrhea 2.Loss of appetite 3.Photosensitivity 4.Retention of urine 5.Thoughts of suicide

4.Retention of urine 5.Thoughts of suicide