mental health wk2

A psychiatric-mental health nurse is engaged in communication with a client. Which nonverbal behavior by the nurse would convey a positive message? Select all that apply.

-Nurse sits at the same eye level as the client. -Nurse leans slightly forward in the chair.

Sensory deprivation in infancy and childhood can adversely affect brain development. Which characteristic of the brain is involved in this process?

Neuroplasticity

A client has a lithium level of 1.2 mEq/L. Which intervention by the nurse is indicated?

No intervention is necessary at this time.

A psychiatric-mental health nurse is attending a continuing education program on neurotransmitters and psychiatric disorders. The nurse demonstrates understanding of the information by identifying which neurotransmitter as being heavily concentrated in the terminal sites of sympathetic nerves?

Norepinephrine

Which antidepressant drug is a preferred drug for clients at high risk of suicide?

Sertraline

A nurse understands that giving positive regard to the client helps in building trust for the nurse. Which actions are appropriate while conveying positive regard? Select all that apply.

-The nurse should respond openly to the client. -The nurse should actively listen to the client. -The nurse should address the client by name.

A client suffers from low mood and disturbed sleep. This client is most likely experiencing a change in which neurotransmitter?

Serotonin

While interviewing a client, the nurse imagines what it would be like to be in the client's situation and how it would feel. The nurse is demonstrating:

empathy

A nurse is reviewing the role of neurotransmitters with mental illnesses. The nurse would identify Increased levels of which neurotransmitter as being primarily involved with mania?

Serotonin

Which behavior of the nurse indicates that the nurse has a therapeutic relationship with the client?

The nurse expresses empathy to a client who has recently lost the client's son in an accident.

A nurse is developing a therapeutic relationship with the client. To do this, the nurse must respect the client's religious and spiritual beliefs. Which will occur if the nurse does not show this respect?

eroding trust

Nurses develop empathy with their clients while gathering information about the client. Which of the following hinders the development of empathy?

interjecting personal experiences

The function of the thalamus and the hypothalamus is to coordinate:

internal and external responses.

The anatomy and physiology instructor is talking about the nervous system. What would the instructor tell the students about the cerebrum? Select all that apply.

-It has a parietal lobe. -It has a frontal lobe. -It has a temporal lobe. -It has an occipital lobe.

The nurse is working with a client who has quit several jobs and no longer sends financial support to the client's two children living with their other parent. This behavior is in conflict with the nurse's values concerning responsible parenting. When discussing family roles with the client, the nurse shows positive regard through which statement?

"How is not working right now affecting you?"

A client who is experiencing depression states, "I can't seem to do anything to take care of myself, how can I get going?" What is the nurse's best response?

"I notice it has been a while since you have had a shower."

Which statement by the nurse is an example of assertive communication?

"I understand that group can be difficult to attend but coming late is disruptive."

A client remarks, "You know, it's the same thing every time." The nurse should respond by stating:

"I'm not sure what you mean. Please explain."

A psychiatric-mental health nurse has been off of work for the past 4 days, as per the normal work schedule on the unit. On the nurse's first day back, a longterm client says, "I haven't seen you around here since Thursday. How was your time off?" What is the nurse's most appropriate response?

"I've been off for the past four days. What have you done since I last saw you?"

A client has been discharged from the hospital with a prescription for lorazepam. Which instruction should the nurse provide to this client?

"Make sure that you don't drink any alcohol when you're taking this medication."

A nurse and client are engaged in a discussion. The client says, "I feel really close to you. You are the only true friend I have." Which response by the nurse would be most therapeutic?

"Since ours is a professional relationship, let's explore other opportunities in your life for friendship."

The nurse is trying to obtain some information about family relationships from the client. Which statement is best?

"Tell me your feelings about your family situation."

During the mental status assessment, the client expresses the belief that the CIA is stalking the client and plans to kidnap the client. Which would be the best response by the nurse?

"What kinds of things have been happening?"

A nurse has been waiting for over an hour for the ancillary department of laboratory to draw blood on a non-critical client with bipolar disorder in the ED. Which response is an example of assertive communication from the nurse to the laboratory personnel?

"When you are late to draw blood the family gets upset, and I don't like having to repeat that you are on your way."

A client is sitting alone, slouched, with eyes closed. The nurse approaches. Which statement is most likely to encourage the client to talk?

"You look like you are deep in thought."

Which statement would be an empathetic response in a client interaction?

"You must have been embarrassed when your father yelled at you in the grocery store."

A nurse is speaking to a client who attempted suicide. The client says, "It is my dream to become a doctor, and I failed the entrance exam. I am so mad at myself." Which statement indicates genuine interest by the nurse?

"You must have been really upset."

The nurse is preparing a client for a functional magentic resonance imaging (fMRI) scan. When describing this procedure, which information would be most appropriate for the nurse to include?

"You'll have images taken of your brain to look at the blood flow through it."

When providing care to a client demonstrating aggressive behavior, the nurse integrates knowledge about potential biologic factors contributing to the condition. Which brain structure would the nurse identify as playing a role in the client's aggression? Select all that apply.

-Amygdala -Limbic system

During the admission interview, the nurse asks the client what led to the client's hospitalization. The client responds, "They lied about me. They said I murdered my mother. You're the killers. You all killed my mother. She died before I was born." What would be the best initial response by the nurse?

"You're having very frightening thoughts."

The nurse and the client are using therapeutic communication skills. Which statements are true of concrete and abstract messages? Select all that apply.

-Abstract messages include figures of speech that are difficult to interpret. -Concrete messages are clear, direct, and easy to understand.

A nurse is attending a review class on the neurologic basis of psychiatric disorders. The class also includes a review of the anatomy and physiology of the neurological system. The nurse demonstrates understanding of the information by identifying which structures ascomponents of the brain stem? (Select all that apply.)

-midbrain -pons -medulla

Which functions are controlled by the extrapyramidal motor system? Select all that apply.

-muscle tone -common reflexes -automatic voluntary motor functioning

Which is a major difference between the atypical antipsychotics (such as clozapine) and the typical antipsychotics (such as haloperidol)?

Atypical antipsychotics block both serotonin and dopaminergic receptors.

The body's first line of neurological defense against stressors involves what?

Autonomic nervous system

A client diagnosed with a stroke is exhibiting expressive aphasia. Which area in the frontal lobe is responsible for the motor function of speech?

Broca's area

A client is having difficulty standing without assistance and is exhibiting swaying. The client has a history of falls. Which area of the brain is most likely affected?

Cerebellum

The client has difficulty with motor coordination and walks with an unsteady gait. Of the following brain structures, which is most likely affected in the client's brain?

Cerebellum

What part of the brain would be responsible for activities such as walking and dancing?

Cerebellum

The nurse is assessing a client who suffered a head injury as a result of an altercation with two other individuals. The client has difficulty accurately recalling and reporting the events of the altercation and appears very emotional during the assessment. The nurse suspects which part of the brain received the greatest amount of injury?

Cerebrum

Neurotransmission is important in the function of the CNS. For neurotransmission to occur, how do neurons communicate with other cells?

Chemically

A client is experiencing acute stress leading to the stimulation of increased gastric acid. In this situation, which body system uses acetylcholine as a neurotransmitter?

Cholinergic

The client has seasonal affective disorder (SAD), in which depression parallels the shortening of the days during fall and winter. Which is most likely affected in the client?

Circadian rhythm

Despite best efforts, a nurse and client are engaged in a nontherapeutic relationship. Which client response would most likely occur?

Client leaves the unit, not being available for a scheduled meeting. (mutual Withdrawal)

Which is the primary role of neurotransmitters?

Communicate information from one cell or cell group to another

A professional boxer has suffered several concussions while boxing. Since retirement, the client has experienced periods of depression and suffers from short-term memory loss. Which provides the best explanation for the neurological basis of the client's symptoms?

Damage to the hippocampus

A client with diminished serotonin levels would likely experience which symptom?

Depression and impulsivity

A client has been diagnosed with Parkinson's disease. His symptoms of spasticity are related to a decrease in which neurotransmitter?

Dopamine

A client with Parkinson's disease is hospitalized on a medical unit. The nurse would be correct in identifying which neurotransmitter decreased in this disease?

Dopamine

During the working phase of a therapeutic relationship, which action by the nurse would best help the client to explore problems?

Encouraging the client to clarify feelings and behavior

Which goal of therapeutic communication would the nurse strive to attain first?

Establish a therapeutic nurse-client relationship.

A client states, "Right before I got here I was doing all right. My job was going well, my spouse and I were happy, and we just moved into a new apartment." The nurse responds, "You said you and your spouse were happy. Tell me more about that." This is an example of which therapeutic technique?

Exploring

A nursing instructor is teaching a class on empathy. The instructor determines that the class needs additional education when the students identify that empathy involves what?

Feeling the same emotions that the client is feeling at a given time

Abnormalities in which lobe is believed to be associated with schizophrenia?

Frontal

The nurse is educating the client and family members regarding schizophrenia. The nurse explains to them that schizophrenia is associated with an abnormality of which structure of the cerebrum?

Frontal lobe

The nurse is teaching the client with anxiety about the mechanisms of benzodiazepines. Which is increased with this medication?

GABA

A nurse is reading a journal article about neurotransmitters. The nurse demonstrates understanding of the information by identifying which substance as an inhibitory amino acid?

Glycine

The client cannot remember anything before an accident yesterday. Which brain structure might be injured?

Hippocampus

The nurse fails to assess personal values surrounding homosexuality before caring for a client who is openly gay. The nurse is most at risk for what when working with this client?

Holding a prejudice toward this client

A client is returning from military service and has been diagnosed with post-traumatic stress disorder (PTSD). Dysfunction in which brain structure contributes to the rage and fear experienced in PTSD?

Hypothalamus

A nurse is reviewing information about body distance zones between people during communication. Which zone would the nurse identify as being acceptable for people who desire personal contact?

Intimate

The parent of a child client holds the child close during the initial assessment. Which distance zone is acceptable for people who mutually desire personal contact?

Intimate

A client with a diagnosis of schizophrenia lacks insight into the illness. The client presents with significantly declined function and is consistently nonadherent with medications. Which medication administration route is best suited for optimal treatment of this client's condition?

Intramuscularly

Neuroplasticity influences psychiatric-mental health outcomes because it is or does what?

Is the ability of nervous tissue to change structure and functioning in response to new experiences

Which correctly describes the primary effect of a selective serotonin reuptake inhibitor (SSRI) antidepressant drug?

Its ability to block the reuptake of serotonin

While the nurse and client are in a therapy session, the nurse says to the client, "You become very anxious when we start talking about your drinking." Which technique is the nurse using?

Making an observation

The brain stem consists of which structure?

Midbrain

A client is brought to the emergency room following a motor vehicle accident in which he sustained head trauma. The client is complaining of blindness in the left eye. The nurse would be correct in documenting this abnormal finding as corresponding to which of the following cerebral lobes?

Occipital

A nurse and client are engaged in a therapeutic relationship. The nurse explains the boundaries of the relationship and clarifies expectations. The nurse and client are in which phase of the nurse-client relationship?

Orientation

A nurse is caring for a client on an inpatient mental health unit of a hospital. The nurse tells the client, "You are scheduled to attend therapy sessions every morning at 9:00 a.m. Please make sure that you complete your morning routine, such as using the restroom, bathing, and eating breakfast, before you come for the sessions." Which phase of the nurse-client relationship does this communication indicate, according to the Peplau's model?

Orientation phase

How should the nurse respond to a family member who asks how Alzheimer's disease is diagnosed?

Positron emission tomography (PET) scans can identify the amyloid plaques and tangles of Alzheimer's disease in living clients.

A client has been taking antidepressants for 2 years. The client tells the nurse that the medication no longer seems to be working. The nurse suspects that which situation is occurring?

Refractoriness

After attending an anatomy and physiology review class on the nervous system, a group of nurses demonstrate understanding of the information whe the group identifies which function as associated with the thalamus?

Relays sensory information to the central nervous system

A psychiatric-mental health nurse is working to develop a therapeutic relationship with a client. When doing so, which element would the nurse integrate as critical to building this relationship?

Self-awareness

A college student wakes up and notices a racing heart and dilated pupils. The student is scheduled to write an exam later that morning. Which system is responsible for this physiological response?

Sympathetic nervous system

The client is getting ready to be discharged from the psychiatry unit. A nurse and client has just completed reviewing the client's take-home medications. The nurse is exemplifying which role during this intervention?

Teacher

A client is seen for frequent exacerbation of schizophrenia due to nonadherence to medication regimen. The nurse should assess for which common contributor to nonadherence?

The client dislikes the weight gain associated with antipsychotic therapy.

A client experienced physical abuse by his father when he was a child. The client explains some of the intense financial and interpersonal stress that his father was experiencing at the time and describes the relationship between psychosocial stress and abuse. How should the nurse best interpret the client's statement?

The client is intellectualizing this traumatic event in order to deal with the emotions involved

A nurse is meeting a client for the first time. The nurse observes that the client smiles appropriately but is using rambling speech while answering the nurse's questions. Which would most likely be the reason for this behavior?

The client is nervous and insecure.

A psychiatric-mental health nurse has entered a client's room, made an introduction, and asked if the nurse and the client could speak for a few minutes. The clients states, "Yep. Glad to talk." However, the nurse observes that the client is looking at the floor and the client's arms and legs are crossed. How should the nurse best interpret this situation?

The client may be reluctant to dialogue despite the statement to the contrary

The mental health nurse instructs a client prescribed phenelzine to avoid aged foods, such as wine and cheese. For which reasons are these instructions important for client safety?

The foods contain tyramine, which may provoke hypertensive crisis.

A psychiatric-mental health nurse is developing a therapeutic relationship with a client. The nurse demonstrates acceptance by which action?

The nurse avoids judgments about the client, no matter what the behavior is.

A client expresses worry about the client's child's aggressive behavior. The nurse says "You are in a very challenging situation. Your child's aggressive behavior is very stressful for you, is this correct?" What does this nurse's statement indicate?

The nurse is empathizing with the client.

A client tells the nurse, "I'm afraid to quit my job at the day care center, even though its stressful. I don't think I have any marketable skills for another job." Previous interactions reveals that the client has a variety of skills in different areas and the nurse suspects that the client has difficulty with change. Which therapeutic communication technique would be most helpful to use in this situation?

Voicing doubt

A nurse is caring for a client with hemiplegia who has been depressed. The client tells the nurse, "I don't feel I would ever be independent again. I would be a burden to everybody in my house." The nurse responds by stating, "Your family misses you a lot and wants you home as soon as possible. The rehab team is very confident about your progress." Which phase of nurse-client relationship is occurring?

Working

A psychiatric-mental health nurse is experiencing problems in communication with a client. The nurse decides to complete a process recording. Which action would be most appropriate for the nurse to do?

Write up the interaction verbatim, exactly as it occurred.

A psychiatric-mental health nurse practitioner is conducting a review class for a group of nurses about emerging fields of study in psychiatric-mental health care. The nurse is describing the field of chronobiology and events that synchronize and set biologic rhythms. The nurse practitioner is correct in using which term to denote the synchronizing events?

Zeitgeber

Which is the primary cholinergic neurotransmitter found in greatest concentration in the peripheral nervous system?

acetylcholine

Two nursing students are giving a presentation on the limbic system. Which can they accurately include as actions of this brain structure?

behavior

In which way do neurons communicate through the use of synapses?

chemically

A nurse is communicating with a client who is highly anxious. During the conversation, the nurse notices that the nurse's speech is matching the fast pace of the client's speech, and the nurse's heart rate is increasing. The nurse identifies this as:

empathetic linkage.

The nurse initiating a therapeutic relationship with a client. Which information would the nurse most likely include when explaining the purpose of this relationship?

facilitating a positive change.

A client taking an antipsychotic is exhibiting manifestations of neuroleptic malignant syndrome (NMS). Which area of the brain is involved with the increased temperature noted with NMS?

hypothalamus

A college student decides to go to a party the night before a major exam instead of studying. After receiving a low score on the exam, the student tells a fellow student, "I have to work too much and don't have time to study. It wouldn't matter anyway because the teacher is so unreasonable." The defense mechanisms the student is using are:

rationalization and projection.

Which is often considered the most difficult yet most effective communication technique?

silence

A client diagnosed with borderline personality disorder is pitting one nurse against the other, calling one a best friend and declaring that the other is horrible. The client is using which defense mechanism?

splitting

The nurse must be alert to the nonverbal expressions of the client. Because the meaning attached to nonverbal behavior is subjective, it is important for the nurse to

validate the meaning of the nonverbal behavior.

An advanced practice nurse has chosen to apply motivational interviewing (MI) in the care of a client who will transition back to the community from inpatient treatment. The nurse should begin to apply this method by:

validating the client's ability to make decisions and effect change.

A nurse has interactions with several clients throughout the day. When would a formal setting for discussion be indicated?

when a client has difficulty maintaining boundaries

During which phase of the nurse-client relationship does the client identify and explore specific problems?

working