Post-study Quiz-mental Health-(VATI)

11. A nurse is caring for a client who has a new diagnosis of alcohol use disorder. The nurse should identify that which of the following is necessary before the client can begin participating in Alcoholics Anonymous (AA)? The client completely abstains from alcohol. The client has participated in an alcohol treatment program. The client acknowledges a higher power. The client expresses a desire to stop drinking.

D The nurse should identify that alcohol abstinence is the goal of AA, but it is not a requirement for participation in the program. The nurse should identify that participating in a past alcohol treatment program is not a requirement for going to AA. The nurse should identify that acknowledgment of a higher power is a component of AA, but it is not a requirement for participation in the program. The nurse should identify that a client must express a desire to stop drinking before participating in AA.

5. A nurse is caring for a client who has just been told that their mother has died in a motor-vehicle crash. The client is staring at the wall. Which of the following actions should the nurse take? Encourage the client to express their emotions. Ask the client if they would like something to eat or drink. Assure the client that everything is going to be ok. Tell the client their grief will diminish with time.

A By encouraging the client to express their emotions, the nurse is using therapeutic communication. Allowing the client to express their emotions demonstrates a desire by the nurse to understand what the client is thinking and feeling. Asking the client if they would like something to eat or drink is changing the subject. The nurse should use therapeutic communication techniques that invite the client to share their feelings. Assuring the client that everything will be ok is false reassurance. This negates the client's feelings. The nurse should use therapeutic communication techniques that invite the client to share their feelings. Telling the client their grief will diminish with time is making an assumption and minimizing the client's feelings by giving false reassurance. The nurse should use therapeutic communication techniques that invite the client to share their feelings.

4. A nurse is assisting with planning care for a client who has borderline personality disorder. Which of the following interventions should the nurse recommend? Establish clear boundaries and limits. Use bargaining with the client when establishing behavioral expectations. Provide consistency with the nurse assigned to care for the client. Ignore manipulative behavior.

A Clients who have borderline personality disorder can exhibit impulsive and manipulative behaviors. Therefore, the nurse should be consistent when establishing boundaries and setting limits with clients who have borderline personality disorder. The nurse should avoid using bargaining with the client when establishing behavioral expectations and consequences to reduce the risk for manipulation. Provide consistency with the nurse assigned to care for the client. The nurse should rotate staff assignments to minimize the risk for the client's development of dependency upon particular staff members. The nurse should discuss manipulative behavior with the client and enforce consequences.

16. A nurse is caring for a newly admitted client who has depression. The client states, "I feel so bad for my partner. They have to put up with so much." Which of the following is an appropriate response by the nurse? "Let's talk about how you might discuss this with your partner." "I will discuss your concerns with your partner." "Let's focus on you for now, and then we can consider your partner." "I think your partner understands and really loves you."

A The nurse is using the therapeutic technique of exploring to respectfully acknowledge the client's concerns about their partner and help the client work on those concerns. This is a nontherapeutic response and could violate the client's confidentiality. This is a nontherapeutic response in which the nurse changes the subject of the conversation. It does not address the client's immediate concern. This is a nontherapeutic response in which the nurse minimizes the client's immediate concern and makes statements that might not be true.

13. A nurse is caring for a client who has just been admitted with a new diagnosis of major depressive disorder. The client states, "I'm completely unlovable." Which of the following actions should the nurse take to help the client improve their self-esteem? Assist the client in identifying positive qualities about themselves. Relate to the client by sharing similar personal feelings. Change the subject to a more comfortable topic for the client. Assure the client that they have lovable qualities.

A The nurse should identify that assisting the client to identify positive qualities about themselves will help to improve their self-esteem. A client who has depression often exhibits cognitive distortions that contribute to negative thinking. The nurse should identify that sharing personal information is a nontherapeutic communication technique that redirects the focus of the conversation onto the nurse, rather than the client. The nurse should identify that changing the subject is a nontherapeutic communication technique that minimizes the client's feelings and discourages the client from sharing their thoughts. The nurse should identify that assuring the client that they are lovable is an example of false reassurance, which is a nontherapeutic communication technique that minimizes the client's concern.

3. A nurse in a mental health clinic is prioritizing care for a group of clients. Which of the following clients should the nurse see first? A client who has antisocial personality disorder and is angry with a group member A client who has schizophrenia and is exhibiting a flat affect A client who has depression and is crying about their partner's death A client who has bipolar disorder and is flirting with another client

A This client's behavior indicates that they are at risk for harming others. Clients who have antisocial personality disorder can be quick to anger and lash out, injuring themselves or others. Therefore, the nurse should see this client first. The nurse should check on a client who has schizophrenia and is exhibiting a flat affect. Flat affect is a negative manifestation associated with schizophrenia in which the client does not overtly express emotions. However, there is another client the nurse should see first. The nurse should encourage the client to express their feelings regarding the loss because it allows them an outlet for expression of feelings and emotions. However, there is another client the nurse should see first. The nurse should intervene to set limits on the client's behavior. A client who is experiencing a manic state has poor impulse control and can engage in activities that can be dangerous or embarrassing to the client following the manic episode. However, there is another client the nurse should see first.

1. A nurse is contributing to the plan of care for a newly admitted client who has obsessive-compulsive disorder (OCD). Which of the following interventions should the nurse include? Use detailed explanations when providing instructions to the client. Provide the client with a structured schedule of daily activities. Maintain a stimulating environment for the client. Limit time for rituals to 30 min each day.

B In a stressful situation, a client who has OCD cannot comprehend anything but simple communication. The nurse should provide the client who has OCD with a structured schedule of daily activities because it provides a feeling of security. In a stressful situation, a stimulating environment will increase anxiety for a client who has OCD. Anxiety is minimized when the client has time to perform ritualistic behaviors; therefore, setting a time limit for ritualistic behavior is not therapeutic for a client who has OCD.

15. A nurse is caring for a client who is experiencing sudden loss of vision and tests reveal no physiological reason for the blindness. Which of the following defense mechanisms is the client demonstrating? Repression Conversion Projection Reaction formation

B Repression is a defense mechanism in which a client pushes unpleasant or unwanted thoughts from awareness. The nurse should identify that the client is demonstrating conversion, which is the transferring of emotional or psychological problems into physical symptoms. Projection is a defense mechanism in which a client attributes unacceptable feelings about oneself to another person. Reaction formation is a defense mechanism in which a client demonstrates the emotion opposite of what they feel.

9. A nurse is caring for a client who has pedophilia. Which of the following is the priority action for the nurse? Review the state laws regarding pedophilia. Examine own attitudes toward pedophilia. Review the predisposing factors of pedophilia. Examine treatment approaches for pedophilia.

B The nurse should review state laws regarding pedophilia to provide safe, effective care. However, evidence-based practice indicates that the nurse should take a different action first. Pedophilia is a sexual preference for prepubescent children. Working with a client who has pedophilia might elicit strong emotions in the nurse. Using evidence-based practice, the first action the nurse should take is to examine their own attitudes toward pedophilia to enable them to advocate for the client and provide ethical care. The nurse should review the predisposing factors to help understand the client's disorder. However, evidence-based practice indicates that the nurse should take a different action first. The nurse should examine treatment approaches for pedophilia to effectively care for the client. However, evidence-based practice indicates that the nurse should take a different action first.

12. A nurse is caring for a client who is in the manic state of bipolar disorder. Which of the following is an appropriate activity to plan for the client? Playing a video game Taking part in a medication information group Going for a supervised walk Assisting with meal preparation

C A client experiencing mania lacks the focus necessary to concentrate on a high-stimulus activity such as a video game. Noise and the presence of other clients can agitate the client. The nurse should plan solitary activities for the client. information group A client experiencing mania lacks the ability to concentrate during a high-stimulus activity such as group therapy. The client's behavior could take the focus off the purpose of the group. Clients in the manic phase should participate in low-stimulus activities, such as walking, to provide an outlet for energy and decrease their manic behavior. The nurse should plan an activity that includes the client and a member of the health care team. Physical activity can reduce the client's stress level. A client experiencing mania lacks the ability to concentrate with a high-stimulus activity such as assisting with meal preparation. The nurse should take measures to reduce environmental stimuli for the client.

6. A nurse is collecting data from a client who has depression. The nurse should identify that which of the following findings is the priority? The client expresses feelings about their friend who died by suicide. The client reports misusing a controlled substance in the past. The client describes how their suicide will occur. The client acknowledges the abuse they endured as a child.

C Clients who have experienced a loss by suicide may have an increased risk for suicide and should be encouraged to express their feelings. However, this is not the priority finding. A history of substance use disorder is a risk factor for suicide and should be explored further by the nurse. However, this is not the priority finding. Evidence of a specific plan regarding how the suicide will occur is an imminent warning sign and increases the immediate risk of suicide; therefore, this is the priority finding for the nurse. The nurse should understand that the main elements of the lethality of a suicide plan include a detailed plan, how lethal the plan is, and whether or not the client has the means to carry out the plan. A history of abuse is a risk factor for suicide and should be explored by the nurse. However, this is not the priority finding.

8. A client is being discharged after being examined for physical abuse. Which of the following nursing interventions is the priority for this client? Provide information about available resources. Schedule an appointment with the client's provider. Assist the client to develop a plan of escape. Suggest the client attend a support group twice a week.

C Providing information about available resources is important so the client can obtain assistance. However, another action is the priority. Scheduling an appointment with the client's provider is important for ensuring that the client has follow-up care. However, another action is the priority. When using Maslow's hierarchy of needs, the nurse determines that the priority action to take is to assist the client in developing a plan of escape to ensure safety in the event of future abuse episodes. Suggesting that the client attend a support group is important so they can gain encouragement and assistance from others who have had similar experiences. However, another action is the priority.

14. A nurse is contributing to a behavior modification plan of care for a newly admitted client who has anorexia nervosa. Which of the following interventions should the nurse include? Weigh the client weekly at the same time. Bargain with the client regarding amount of caloric intake. Establish a reward system for when the client gains weight. Encourage daily participation in an exercise routine.

C The nurse should weigh the client daily to have accurate information to modify the treatment plan. The nurse should not bargain with the client who is resistant to treatment. A client who is denying a problem has a weak ego and will use manipulation to achieve control. Behavior modification is a strategy in which the client earns or loses rewards based on behavior. The nurse should not implement a supervised, planned exercise routine until the client has reached a goal weight. However, the goal weight has not been achieved because this client is newly admitted.

7. A nurse is caring for a client who recently witnessed the accidental death of their spouse and presents to an outpatient mental health clinic. The client is crying uncontrollably and pacing, and states to the nurse, "I don't know how to go on." Which of the following is the priority response the nurse should make? "Is there somebody available that I can call for you?" "Let's discuss methods you've used in the past to help you cope." "Would you like to talk about how the accident occurred?" "Are you thinking about harming yourself?"

D Offering to find support for the client is important to minimize the client's feeling of isolation. However, there is another response that is the priority for the nurse to make. Assisting the client to use past coping mechanisms is important to help them cope with the current crisis. However, there is another response that is the priority for the nurse to make. Giving the client the opportunity to talk about the accident allows the client to express their feelings. However, there is another response that is the priority. The client's behavior indicates they are at greatest risk for self-harm. Therefore, the priority response is for the nurse to determine if the client intends to hurt themselves.

2. A nurse is caring for a client who has persistent depressive disorder after experiencing a recent loss. Which of the following actions should the nurse plan to take first? Encourage the client to participate in physical exercise. Communicate to the client that crying is acceptable. Recommend spiritual support for the client. Determine the client's current stage of grief.

D Physical exercise can help a client who is depressed to relieve stress. However, there is another action the nurse should take first. Communicating to the client that crying is acceptable is therapeutic. However, there is another action the nurse should take first. Recommending spiritual support may provide comfort for a client who is depressed. However, there is another action the nurse should take first. Determining the client's current stage of grief is the first step in planning care for a client who is depressed.

10. A client who is admitted to a mental health unit states, "I can't even take care of myself. I don't want to have to worry anymore." The client appears anxious and cries easily. Which of the following is the priority nursing intervention? Assign one-to-one observation of the client. Administer an antidepressant medication. Encourage participation in unit activities. Identify if the client has thoughts of self-harm.

D The nurse should initiate suicide precautions for the client who has thoughts of suicide. Interventions include one-to-one observation of the client; however, there is another action the nurse should take first. The nurse should administer antidepressant medications, as prescribed by the provider, to alleviate manifestations of depression; however, there is another action the nurse should take first. The nurse should encourage the client to participate in unit activities to help elevate the client's mood and affect; however, there is another action the nurse should take first. The first action the nurse should take using the nursing process is to collect data from the client about thoughts of self-harm. The nurse should ask the client directly if they are thinking about suicide.