PMH practice test 1

. On an inpatient unit, a client diagnosed with borderline personality disorder is challenging other clients and splitting staff. Which response by the nurse reflects the nurse's role of milieu manager? 1. Setting strict limits and communicating these limits to all staff members 2. Using role-play to demonstrate ways of dealing with frustration 3. Seeking orders from the physician to force medications 4. Holding a group session on relationship skills

1

Number, in a logical series, the skills that the nurse needs to interact therapeutically with clients ability to communicate ability to problem solve ability to recognize signs and symptoms ability to self-assess

2 ability to communicate 4 ability to problem solve 3 ability to recognize signs and symptoms 1 ability to self-assess

In the emergency department, the nurse assesses a client who is aggressive and experiencing auditory hallucinations. The client states, "The CIA is plotting to kill me." To which mental health setting would the nurse expect this client to be admitted? 1. Long-term inpatient facility 2. Day treatment 3. Short-term, inpatient, locked unit 4. Psychiatric case management

3

. A client admitted voluntarily for treatment of an anxiety problem demands to be released from the hospital. Which action should the nurse take initially? a. Contact the client's health care provider b. Call the client's family to arrange for transportation c. Attempt to persuade the client to stay "for only a few more days." d. Tell the client that leaving would likely result in an involuntary commitment

a

. A client taking lithium reports vomiting, abdominal pain, diarrhea. Blurred vision, tinnitus, and tremors. The lithium level is 2.5 mEq/L (2.5 mmol/L). The nurse plans care based on which representation of this level? a. Toxic b. Normal c. Slightly above normal d. Excessively above normal

a

A client experiencing disturbed thought processes believes that his food is being poisoned. Which communication technique should the nurse use to encourage the client to eat?" a. Using open-ended questions and silence b. Sharing personal preference regarding food choices c. Documenting reasons why the clients does not want to eat d. Offering opinions about the necessity of adequate nutrition

a

The nurse employed in a mental health clinic is greeted by a neighbor in a local grocery store. The neighbor says to the nurse, "How is Carol doing? She is my best friend and is seen at your clinic every week." Which is the most appropriate nursing response? a. "I cannot discuss any client situation with you." b. "If you want to know about Carol, you need to ask her yourself." c. "Only because you're worried about a friend, I'll tell you that she is improving." d. "Being her friend, you know she is having a difficult time and deserves privacy."

a

The nurse uses the click face assessment test to obtain which assessment data? a. Early signs of neurocognitive disorder b. Assessment rating of overall functioning c. Evidence of alcohol/substance use disorders d. Signs and symptoms of depression

a

When reviewing the admission assessment, the nurse notes that a client was admitted to the mental health unit involuntarily. Based on this type of admission, the nurse should provide which intervention for this client? a. Monitor closely for harm to self or others b. Assist in completing an application for admission c. Supply the client with written information about her or his mental problem d. Provide an opportunity for the family to discuss why they felt the admission was needed

a

Which of the following are reasons for the utilization of the DSM-5 in the mental health care system? Select all that apply. a. It is a convenient format for organizing and communicating clinical data b. It is a means for considering the complexity of clinical situations c. It is a means or describing the unique symptoms of psychiatric clients d. It is a format for evaluating the clients based on a regulated approach e. It is a means to better understand the etiology of many psychiatric disorders

a,b

The nurse in the mental health unit plans to use which therapeutic communication techniques when communicating with a client? Select all that apply. a. Restating b. Active listening c. Asking the client "Why?" d. Maintain neutral responses e. Providing acknowledgement and feedback f. Giving advice and approval or disapproval

a,b,d,e

Which of the following assessment information would be evaluated as objective data? Select all that apply a. Clinical institute withdrawal assessment score of 10 b. Client's' statement of generalized anxiety c. Complaints of anorexia d. Client state, "I can't keep my thoughts together." e. Clients' mood rating of 5 on a 10-point scale

a,e

. According to Maslow's hierarchy of needs, which situation on an inpatient psychiatric unit would require priority intervention? a. A client is disturbed that family can be seen only during visiting hours b. A client exhibits hostile and angry behaviors toward another client c. A client states, "I have no one who cares about me." d. A client states, "I have never my career goals."

b

. During a recent counseling session with a depressed client, the psychiatric nurse observes signs of transference. Which statement by the client would indicate that the nurse is correct? a. "Thanks for taking my side against the staff." b. "You sure do remind me of my mom." c. "Working on problem-solving together makes sense" d. "I won't stop drinking just to please my whole family."

b

A client's medication sheets contains a prescription for sertraline. To ensure safe administration of the medication, how should the nurse administer the dose? a. On an empty stomach b. At the same time each evening c. Evenly spaced around the clock d. As needed when the client complains of depression

b

A hospitalized client has begun taking bupropion as an antidepressant agent. The nurse determine that which is an adverse effect, indicating that the client is taking an excessive amount of medication? a. Constipation b. Seizure activity c. Increased weight d. Dizziness when sitting upright

b

A welder who recently lost high leg in a work-related accident is being admitted to an inpatient psychiatric unit. The client states, "I'm worried because I can't' support my family anymore!" Which nursing diagnosis is most reflective of the client's presenting problem" a. Ineffective coping related to poor self esteem b. Ineffective role performance r/t loss of job c. Impaired social interaction r/t altered body image d. Knowledge deficit r/t wound and skin care

b

On an inpatient psychotic unit, a client states, "I want to learn better ways to handle my anger." This interaction is most likely to occur in which phase of the nurse-client relationship? a. Pre-interaction phase b. Orientation phase c. Working phase d. Termination phase

b

The nurse explores any personal misconceptions or prejudices before caring for a client. This action is one of the tasks that occur in a phase of the nurse-client relationship. What is the nurse's major task in this phase? a. Determining why the client sought help b. Exploring self c. Assisting the patient in behavioral change d. Establishing and preparing the client for reality of separation

b

The nurse is describing the medication side effects to a client who is taking amitriptyline. Which information should the nurse incorporate in the discussion? a. Consume a low-fiber diet b. Increase fluids and bulk in the diet c. Rest if the heart begins to beat rapidly d. Walk if you have difficulty urinating because this is a normal side effect

b

The nurse is performing a follow-up teaching session with a client discharged 1 month ago. The client is taking fluoxetine. Which information would be important for the nurse to obtain during this client visit regarding the side and adverse effects of the medication? a. Cardiovascular symptoms b. Gastrointestinal dysfunction c. Problems with mouth dryness d. Problems with excessive sweating

b

The nurse is teaching a client who is being started on imipramine about the medication. The nurse should inform the client to expect maximum desired effects at which time period following initiation of this medication? a. In 2 months b. In 2 to 3 weeks c. During the first week d. During the sixth week of administration

b

Which is the goal for the orientation phase of the nurse-client relationship? a. Establish self-perception b. Establish trust c. Promote change d. Evaluate goal attainment

b

. An inpatient psychiatric client recently diagnosed with bipolar disorder has been prescribed lithium carbonate. When the nurse is functioning in the role of teacher, which of the following nursing interventions are appropriate? Select all that apply a. Teaching the neurochemical action of this medication b. Teaching the benefits of taking this medication as prescribed c. Teaching signs and symptoms of lithium toxicity d. Teaching dietary and fluid intake consideration e. Teaching reportable side effects

b,c,d,e

The nurse calls security and has physical restraints applied to a client who was admitted voluntarily when the client becomes verbally abusive, demanding to be discharged from the hospital. Which represents the possible legal ramifications for the nurse associated with these interventions? Select all that apply. a. Libel b. Battery c. Assault d. Slander e. False imprisonment

b,c,e

Which of the following are examples of primary prevention in a community mental health setting? Select all that apply a. Providing ongoing assessment of individuals at high risk for illness exacerbation b. Teaching physical and psychosocial effects of stress to elementary school students c. Referring for treatment those individuals in who illness symptoms have been assessed d. Monitoring effectives of aftercare services e. Teaching a class on child-rearing skills for a group of new parents

b,e

. A client receiving tricyclic antidepressant arrives at the mental health clinic. Which observation would indicate that the client is following the medication plan correctly? a. Client reports not going to work for the past week b. Client complains of not being able to "do anything" anymore. c. Client arrives at the clinic neat and appropriate in appearance d. Client reports sleeping 12 hours per night and 3 to 4 hours during the day

c

. The nurse visits a client at home. The client states. "I haven't slept at all the last couple of nights." Which response by the nurse demonstrates therapeutic communication? a. "I see." b. "Really?" c. "You're having difficulty sleeping?" d. "Sometimes I have trouble sleeping too."

c

. Which qualification are appropriate for the scope of practice of the psychiatric/mental health registered nurse generalist? a. The nurse generalist is qualified by meeting a minimum of a master's degree in nursing b. The nurse generalist is qualified to order client medications based on tests and laboratory vales c. The nurse generalist is qualified to implement crisis intervention d. The nurse generalist is qualified to assess, designative, and document a client's medical diagnosis

c

A 7-year-old boy is active in sports and has received a most-improved player award at his basketball tournament. According to Erickson, what describes the client's developmental task assessment? a. Autonomy b. Identity c. Industry d. Initiative

c

A client diagnosed with terminal cancer says to the nurse, "I'm going to die, and I wish my family would stop hoping for a cure! I get so angry when they carry on like this. After all, I'm the one who's dying." Which response by the nurse is therapeutic? a. "Have you ever shared your feelings with you family?" b. "I think we should talk more about your anger with your family." c. "You're feeling angry that your family continues to hope for you to be cured?" d. "You are probably very depressed, which is understandable with such a diagnosis.

c

The nurse is interviewing a client admitted to an inpatient psychiatric unit with a diagnosis of depressive disorder. Which is the primary goal in the assessment phase of the nursing process for this client? a. To build trust and rapport b. To identify goals and outcomes c. To collect and organize information d. To identify and validate the medical diagnosis

c

The nurse states to the client, "You say that you are sad, but you are smiling and laughing." Which describes the purpose of this therapeutic communication technique? a. To provide suggestions for coping strategies b. To redirect the client to an idea importance c. To bring incongruences or inconsistencies into awareness d. To provide feedback to the client

c

Which client situation is an example of normal ego development? a. A client continuously calls out to get his or her needs met b. A client complains of poor self-esteem because of punishments from his or her past c. A client exhibits the ability to assert himself or herself with anger or aggression d. A client feels guilty about wanting to have sexual relations outside of marriage

c

Which is the overall priority goal of inpatient psychiatric treatment? a. Maintenance of stability in the community b. Medication adherence c. Stabilization of the return to the community d. Better communication skills

c

. A hospitalized client is started on a monoamine oxidase inhibitor (MAOI) for the treatment of depression. The nurse should instruct the client that which foods are acceptable to consume while taking this medication? Select all that apply a. Figs b. Yogurt c. Crackers d. Aged cheese e. Tossed salad f. Oatmeal raisin cookies

c,e

. A client with schizophrenia has been started on medication therapy with clozapine. The nurse should assess the results of which laboratory study to monitor for adverse effects of this medication? a. Platelet count b. Blood glucose level c. Liver function studies d. White blood cell count

d

. On an inpatient psychiatric unit, a client who is anxious and distressed states "God has abandoned me." Which nursing action would initiate collaboration with the member of the mental health-care team who can assist this client with the assessed problem? a. Notify the psychiatrist to get an order for an anxiety medication prn b. Consult the social worker to provide community resources c. Notify the psychologist that testing is necessary d. Consult with the chaplain and describe the client's concerns

d

. The nurse is administering risperidone to a client with schizophrenia who is scheduled to be discharged. Before discharge, which instruction should the nurse provide to the client? a. Get adequate sunlight b. Continue driving as usual c. Avoid foods rich in potassium d. Get up slowly when changing positions

d

A client gives the home health nurse a bottle of clomipramine. The nurse notes that the medication has not been taken by the client in two months. Which behavior observed in the client would validate noncompliance with this medication? a. Complaints of insomnia b. Complaints of hunger and fatigue c. A pulse rate less than 60 beats per minute d. Frequent hand washing with hot, soapy water

d

A client with a diagnosis of depression who has attempted suicide says to the nurse, "I should have died. I've always been a failure. Nothing ever goes right for me." Which response by the nurse demonstrates therapeutic communication? a. You have everything to live for b. Why do you see yourself as a failure? c. Feeling like this is all part of being depressed d. You've been feeling like a failure for a while?

d

In which situation does a health-care worker have a duty to warn a potential victim? a. When clients manipulate and split the staff and are a danger to self b. When clients curse at family members during visiting hours c. When clients exhibit paranoid delusions and auditory or visual hallucinations d. When clients make specific threats toward someone who is identifiable

d

On review of the client's record, the nurse notes that the admission was voluntary. Based on this information, the nurse plans care anticipating which client behavior? a. Fearfulness regarding treatment measures b. Anger and aggressiveness directed toward others c. An understanding of the pathology and symptoms of the diagnosis d. A willingness to participate in the planning of the care and treatment plan

d

The nurse is working with a client who, despite making a heroic effort, was unable to rescue a neighbor trapped in a house fire. Which client-focused action should the nurse engage in during the working phase of the nurse-client relationship? a. Exploring the client's ability to function b. Exploring the client's potential for self-harm c. Inquiring about the client's' perception or appraisal of why the rescue was unsuccessful d. Inquiring about and examining the client's feelings for any that may block adequate coping

d

When a client is admitted to a inpatient unit with the diagnosis of anorexia nervosa, a cognitive behavioral approach is used as part of the treatment plan. The nurse plans care based on which purpose of this approach? a. Providing a supportive environment b. Examining intrapsychic conflicts and past issues c. Emphasizing social interaction with clients who withdraw d. Helping the clients to examine dysfunctional thoughts and belief

d

Which can be described as an example of an oversimplified or undifferentiated belief? a. Alcoholism is a disease b. A 12-step program may assist with recovery from alcohol use disorder c. Belief in a higher power assists client diagnosed with alcohol use disorder d. All alcoholics are skid-row bums

d

Which is an example of a behavioral response to a moderate level of anxiety? a. Narrowing perception b. Heart palpitations c. Limited attention span d. Restlessness

d

Which is an example of an interpersonal intervention for a client on an inpatient psychiatric unit? a. Assist the client to note common defense mechanisms and coping skills that are being used b. Discuss "acting-out" behaviors and assist the client in understanding why they occur c. Ask the client to record thoughts he or she is having before "acting- out" behaviors occur d. Ask the client to acknowledge one positive person in his or her life to assist the client after discharge

d

. Which of the following are examples of cognitive responses to mild levels of anxiety? Select all that apply a. Increased respirations b. Feelings of horror or dread c. Pacing the hall d. Increased concentration e. Heightened alertness

d,e

The nurse helps a client practice various technique of assertive communication by giving positive feedback for improvement of passive-aggressive interaction. This intervention would occur in which phase of the nurse-client relationship? e. Pre-interaction phase f. Orientation phase g. Working phase h. Termination phase

g