Psychology

2 years

A 33 year old client diagnosed with dysthymia asks the nurse to explain what the diagnosis means. When regarding the patient, the nurse should state that before dysthymia is diagnosed, depressed mood tends to be present for at least

Inclusion of family in the clients care plan

A Latino-American client is admitted in an aggravated, disheveled state to the Psych Unit. When developing an individual, culturally sensitive care plan, the nurse gives priority to:

Expressed thought of being "better off dead"

A Nurse is caring for a client with chronic obstructive pulmonary disease whose spouse died 3 weeks ago. Which of the following should the nurse address first?

Waxy Flexibility

A catatonic patient admitted in a stuporous condition begins to demonstrate increased motor activity. During his assessment, the psychiatrist raises the patient's arm above his head and releases it. The patient maintains the position his arm was placed in, immobile in that position for 15 minutes, moving only when the nurse gently lowers his arm. What symptom is demonstrated by this assessment technique?

CBT

A client diagnosed with an anxiety disorder tells a nurse that being in crowds make him anxious. What could the nurse recommend as a effective, non-pharmacological therapy for managing the client's symptoms of anxiety?

I have more control over my thoughts and behaviors

A client has OCD. Which of the following statements made by the client to the nurse would be the best indicator of improvement?

The right to leave the hospital against medical advice (AMA)

A client has been involuntarily committed to a hospital because he has been assessed as being dangerous to himself and others. The client has lost which of the following rights?

A compulsion

A client is admitted to the hospital for constant hand washing rituals. The act of hand-washing is considered:

Generalized Anxiety Disorder (GAD)

A client is admitted to your unit stated "I have been having excessive worry for the past 3 months" the nurse knows that the client most likely is suffering from:

Have you been thinking of hurting yourself?

A client recently diagnosed with terminal cancer states to the nurse, I wish I were dead.. I have no reason to live. Which of the following is the appropriate response by the nurse?

"I can help you look at the positives and negatives, so that you can make the decision"

A client says to the nurse, "I don't know what to do. I can't decide if I should tell my son to move out unless be stops drinking. What do you think I should do?

Please tell me about your medication concerns

A client tells you he is worried that his medication is not working. You should respond

tell the client that this must be reported to the staff because it concerns safety.

A client tells you, a student nurse, that he has been hoarding his pills in his drawer instead of swallowing them. He asks you to keep this confidential. You should:

"what has happened that is worrying you?"

A client who is experiencing anxiety disorder asks the nurse. "what will I do if I lose my job?" what is the most therapeutic response by the nurse?

Contact hospital services to request an interpreter

A client who speaks only mandarin is admitted. What action should the nurse take when admitting this client?

HTN Crisis

A nurse instructs a patient king a medication that inhibits the action of MAO to avoid certain foods and drugs because of the risk of:

Attending a partial hospitalization program

A nurse is an acute mental health is caring for a client who has severe mental illness and soon will be ready for discharge but still requires supervision much of the time. The client's wife works all day but is home by late afternoon. Which of the following would the nurse suggest as appropriate follow-up care?

I am no one and everyone is me

A nurse is caring for a client who has schizoaffective disorder. Which of these statements indicates the client is experiencing depersonalization?

Stay with the client and remain quiet

A nurse is caring for a client who is experiencing a panic attack. Which of the following is an appropriate nursing intervention?

A client who lives at home and keeps "forgetting to come in for his monthly antipsychotic

A nurse is caring for a group of clients. Which of the clients should a nurse consider for referral to an assertive community treatment (ACT) group?

Ask the client if family, a healer or cleric should be included in the decision-making process.

A nurse is caring for a patient from another culture. Which nursing action would be appropriate?

A client who says he is hearing a voice that tells him he is not worthy of living anymore.

A nurse is caring for several clients who are attending community-based mental health programs. Which of the following clients should the nurse plan to visit first?

Salami

A nurse is conducting discharge teaching for a client tranyleypromine (parnate) the nurse determines that the client understands the instructions given if the client says, "while I am on this medicine, is should not eat:

If I take these medications as prescribed, I should start to feel better

A nurse is educating a patient about the causes of depression. Which statement lets the nurse know the patient understands the neurobiological theory of depression?

• Difficultly sleeping for several days • Inability to concentrate on simple tasks • Finds no enjoyment in long-time hobby of gardening

A nurse is performing an admission assessment of a client. The nurse should recognize which of the following may meet criteria for a major depressive disorder and would require further questioning?

Tertiary prevention

A nurse is working on promotion of healthy coping skills with older adult clients who has all previously been hospitalized for severe depression and are now in a residential care facility. The nurse should recognize that this is an example of which of the following?

Attempt to reduce anxiety

A nurse observes a client who is OCD repeatedly applying, removing, and then reapplying makeup. The nurse identifies that repetitive behavior in a client who has OCD is due to the following?

Clang Association

A nurse performs a mental status examination of a new client. The nurse notes that the client uses rhyming words while speaking. How should the nurse document this finding?

A tort

A nurse puts a client with psychosis in seclusion overnight because the unit it short-staffed & the client frequently gets in trouble on the unit. This is an example of:

A patient was not allowed to have visitors

A nurse surveys medical records. Which finding signals a violation of patient's rights ?

Suicide potential

A nurse uses the SAD PERSONS scale to interview a patient. This tool provides data relevant to:

Sit with the client in silence

A nursing instructor is teaching a new student about establishing therapeutic relationships with mentally ill clients. What interventions should what intervention should be used to establish this relationship?

Pseudoparkinsonism

A patient diagnosed with schizophrenia has taken fluphenzaine (Prolixin) 5mg PO bid for 3 weeks. The nurse now observes a shuffling propulsive ga,t mask-like face, and drooling. Which term applies to these symptoms?

Paranoia

A patient diagnosed with schizophrenia says, "Contagious bacteria are everywhere. When they get in your body, you will be locked up with other infected people". Which problem Is evident?

Lorazepam (Ativan)

A patient experience a sudden episode of severe anxiety. Of these medications in the patients' medical record, which is the most appropriate to give as a prn anxiolytic?

Tell the patient, "Stop running and take a deep breath. I will help you"

A patient experiencing panic suddenly began running and shouting, "I'm going to explode!" select the nurses best action:

Tell me about what's been going on?

A patient is scared that she will lose her job. The nurse responds:

"Let's talking about what's happening"

A patient says that he is forgetful & might have Alzheimer's

Anhedonia

A patient says to the nurse, my life doesn't have any happiness in it anymore. I once enjoyed the holidays, but not they are just another day. The nurse documents this report as an example of:

Akathisia

A patient taking antipsychotic medication for treatment of schizophrenia reports feeling nervous. The nurse notices that the client is pacing the long hall-way and is unable to remain still, even when in conversation with other clients. What term should the nurse use to document this occurrence?

Denial

A patient undergoing diagnostic tests says, "nothing is wrong with me except a stubborn chest cold." The spouse reports the patient smokes, coughs daily, lost 15 pounds, and is easily fatigued. which defense mechanism is the patient using?

Compensation

A person who feels unattractive repeatedly says, "although im not beautiful, I am smart" this is an example of:

Performing ADL independently

A psychiatric unit uses a behavioral approach to determine client's privileges. Which factor should the nurse use to determine an increase in privileges?

"You sound worried, do you want to talk about it?"

A teen patient has difficulty sleeping. The nurse responds

Autonomy

According to Erickson, the developmental task for the toddler is:

Determining the goals and outcome criteria

After formulating the nursing diagnoses for a new patient, what is a nurse's next action?

The client is showing respect

An Arabic female client rarely makes eye contact with a male nurse when questioned. What is the most likely explanation for this behavior?

How does this situation make you feel?

An adolescent client who has a depressive disorder tells the nurse about a friend who started dating her former boyfriend. Which of the following is the appropriate nursing response?

Rationalization

An individual experiences sexual dysfunction and blames it on a partner by calling the person unattractive and unromantic. Which defense mechanism is evident?

A delusion

During an admission interview the client states that he believes that the news reporter on TV is talking about events that happened to the client. This is an example of:

Severe

During client assessment, the nurse finds that the client is trembling and restless, BP and HR are elevated, and the client reports dry mouth, SOB, inability to relax, loss of appetite, and an upset stomach. The nurse should conclude that the client is experiencing which level of anxiety?

A delusion

During the admission interview the client states that he believes that the news reporter on TV is talking about event that happened to the client. This is an example of:

Developing an awareness of self & the professional role in the relationship

For most nurses the most difficult part of the nurse-client relationship is:

Focusing on communication with the client

Hildegard Peplau nurse-client relationship is best promoted by which nursing intervention:

Can't remember past after travel

In a dissociative fugue, the patients experience the following:

Oneself and the desire to help

In psychiatric nursing, the most important tool the nurse brings to a helping relationship is:

Defense Mechanisms

In the process of development, the individual strives to maintain and protect the self. The nurse understands that this usually is accomplished through the use of

Present a clear danger to themselves or others

Inpatient hospitalization for person with mental illness is generally reserved for patients who

Helping school-age children identify and describe normal emotions

Select an example of primary prevention

Unwillingness to attend a wedding of a close family member

The client is seen in the clinic with social phobia anxiety. What behavior would the nurse expect the client to exhibit?

Is in imminent danger of harming herself or others, or the patient cannot properly care for his basic needs and cannot protect himself from harm

The criteria for admission to an inpatient psychiatric unit is that the patient

Word Salad

The following is an unusual speech pattern of clients with schizophrenia: "mountains, tigers, pie, blood ring." Select the correct usual pattern

SSRI's

The following is the first pharmacological line of treatment for OCD

Poor personal hygiene

The nurse assess a patient with schizophrenia. Which assessment finding would the nurse regard as a negative symptoms of schizophrenia?

Grooming

The nurse conducting a mini mental status examination documents what characteristics in the general appearance section?

Postpone assessment until the client is calmer

The nurse is assessing a client with severe anxiety. What technique shouldn't the nurse use:

Remind the client to go to the lab to have blood drawn for a WBC count

The nurse is planning discharge teaching for a client taking clozapine (Clozaril). Which following is essential to include?

The client reports hallucinations occur less frequently

The nurse is working with a client who has schizophrenia who has been taking (Thorazine) for 4 days. The nurse evaluates which of the following findings as therapeutic for this client?

Risk for self-directed violence

The nurse is working with a client who is anxious. Which nursing diagnosis has the highest priority at this time?

Channel unacceptable impulses into socially approved behavior

The nurse knows that sublimation is a defense mechanism that helps the individual:

States "I'm not sure I can avoid using alcohol when my spouse goes to work every morning"

The nurse should refer which for the following patients to a partial hospitalization program? A patient who:

"I want what I want"

The nursing instructor explain that the "id" is the part of the self that says:

2.5 mL

The order reads haloperidol 5mg/hour. The bottle is labeled haloperidol 2mg/ml. what amount will you give?

"you must be afraid, let's discuss this?

The patient think his roommate wants to kill him. Your response is:

How people see themselves

The self-concept is defined as

Phallic Stage

The stage of development most often concerned with "good me- bad me" is:

Provides care for people with present or potential mental health problems

The statement that best describes psychiatric nursing is:

"I understand that you're concerned, what concerns you specifically?"

When a family asks a nurse for reassurance about a client's condition. Which of the following is an appropriate response?

Ask open-ended questions

When assessing an anxious patient, the nurse should use which communication technique?

• Establish a rapport between the nurse and the patient • Assess for risk factors affecting the safety of the patient or others • Allow the nurse the chance to provide counseling to the patient • Formulate a plan of care

Which are the purposes of a thorough mental health nursing assessment? SATA

Seretonin deficiency

Which change in the brain's biochemical function is most associated with suicidal behavior?

Autonomy

Which characteristic would be more applicable to a community mental health nurse than to a nurse working in an operating room?

A 79 year old single, white male diagnosed recently with terminal cancer of the prostate

Which individual in the ED should be considered highest at risk for complete suicide?

Assure the safety of the client and others

Which is the nurses primary goal of seclusion for a client exhibiting violent behavior?

Olanzapine (Zyprexa)

Which medication from the medication administration record should a nurse administer to provide immediate intervention for a psychotic patient whose aggressive behavior continues to escalate despite verbal intervention?

The client expresses thoughts and feelings

Which of the following actions is present during the working phase of the nurse-client relationship?

Hallucinations, illusions, delusions

Which of the following are considered the positive signs of schizophrenia?

Offering advice

Which of the following is a barrier to communication?

Group and social interactions are formed

Which of the following is an emphasis of milieu therapy?

A client with psychosis who assaulted a homeless man with a metal rod

Which of the following is an example of a client who requires emergency admission to a mental health facility?

St. John's Wort

Which of the following is an over-the-counter herbal preparation used to relieve symptoms of depression?

Fluoxetine (Prozac)

Which of the following medications is most likely to cause sexual dysfunction?

Remain with the client

Which of the following would be the best nursing action for a client who is having a panic attack?

President JFK

Which president initiated the community mental health centers act-deinstitutionalization?

"the men you see are the house-keepers for our unit"

Which response is most therapeutic when talking to a paranoid patient?

"I hear evil voices that tell me to do bad things."

Which statement made b a patient during an initial assessment interview should serve as the priority focus for the plan of care?

Hallucinations

While the nurse is performing an admission assessment, the client keeps turning his head to the side and listening carefully. Which of the following is the client most likely experiencing?

Severe

While the nurse tries to give the client information about surgery, the client is sweating, pale & says" I don't understand what you're telling me." The nurse assesses the client's anxiety as:

"have you ever felt guilty about your drinking?"

a patient with a history of alcoholism is admitted for depression. Which is therapeutic?

Mild

the nurse teaches a client that the level of anxiety that best enhances an individual's power of perception is: