SOC3 Exam 1 Mental Health End of Chapter Questions

Nancy says to the nurse, "I worked as a secretary to put my husband through college, and as soon as he graduated, he left me. I hate him! I hate all men!" Which is an empathetic response by the nurse? a. "You are very angry now. This is a normal response to your loss." b. "I know what you mean. Men can be very insensitive." c. "I understand completely. My husband divorced me, too." d. "You are depressed now, but you will feel better in time."

A

Some biological factors may be associated with the predisposition to suicide. Which of the following biological factors have been implicated? a. Genetics and decreased levels of serotonin b. Heredity and increased levels of norepinephrine c. Temporal lobe atrophy and decreased levels of acetylcholine d. Structural alterations of the brain and increased levels of dopamine

A) Genetics and decreased levels of serotonin

Which of the following behaviors suggest a possible breach of professional boundaries? (Select all that apply.) a. The nurse repeatedly requests to be assigned to a specific client. b. The nurse shares the details of her divorce with the client. c. The nurse makes arrangements to meet the client outside of the therapeutic environment. d. The nurse shares how she dealt with a similar difficult situation.

A B C

Anna has been a widow for 20 years. Her maladaptive grief response to the loss of her dog may be attributed to which of the following? (select all that apply) a. Unresolved grief over loss of her husband b. Loss of several relatives & friends over last few years c. Repressed feelings of guilt over the way in which Lucky died d. Inability to prepare in advance for the loss

A B C D

Susan, a depressed client who has been unkempt and untidy for weeks, today comes to group therapy wearing makeup and a clean dress and having washed and combed her hair. Which of the following responses by the nurse is most appropriate? a. "Nancy, I see you have put on a clean dress and combed your hair." b. "Nancy, you look wonderful today!" c. "Nancy, I'm sure everyone will appreciate that you have cleaned up for the group today." d. "Now that you see how important it is, I hope you will do this every day."

A) "Nancy, I see you have put on a clean dress and combed your hair."

Dan begins attendance at AA meetings. Which of the statements by Dan reflects the purpose of this organization? a. "They claim they will help me stay sober." b. "I'll dry out in AA, then I can have a social drink now and then." c. "AA is only for people who have reached the bottom." d. "If I lose my job, AA will help me find another."

A) "They claim they will help me stay sober."

Mrs. S. asks the nurse, "Do you think I should tell my husband about my affair with my boss?" Which is the most appropriate response by the nurse? a. "What do you think would be best for you to do?" b. "Of course you should. Marriage has to be based on truth." c. "Of course not. That would only make things worse." d. "I can't tell you what to do. You have to decide for yourself."

A) "What do you think would be best for you to do?"

Sandra is the nurse leader of a supportive/therapeutic group for individuals with anxiety disorders. Violet, who is beautiful but lacks self-confidence, states to the group, "Maybe if I became a blond my boyfriend would love me more." Larry responds, "Listen, dummy, you need more than blond hair to keep the guy around. A bit more in the brains department would help!" What type of member role is Larry assuming in this group? a. Aggressor. b. Monopolizer. c. Blocker. d. Seducer.

A) Aggressor

Anna, who is 72 years old, is of an age when she may have experienced many losses coming close together. What is this called? a) Bereavement overload b) Normal mourning c) Isolation d) Cultural relativity

A) Bereavement overload

Joe, a Native American, appears at the community health clinic with an oozing stasis ulcer on his lower right leg. It is obviously infected, and he tells the nurse that the shaman has been treating it with herbs. The nurse determines that Joe needs emergency care, but Joe state he will not go to the ED unless the shaman is allowed to help treat him. How should the nurse go about this? A. Contact the shaman & have him meet them at the ED to consult with attending physician B. Tell Joe that the shaman is not allowed in the ED C. Explain to Joe that the shaman is at fault for his leg being in the condition it is in D. Have the shaman try to talk to Joe into going without him

A) Contact the shaman & have him meet them at the ED to consult with attending physician

Mark, who has come to the mental health clinic with symptoms of depression, says to the nurse, "My father is dying. I have always hated my father. He physically abused me when I was a child. We haven't spoken for many years. He wants to see me now, but I don't know if I want to see him." With which spiritual need is Mark struggling? a. Forgiveness b. Faith c. Hope d. Meaning and purpose in life

A) Forgiveness

The nurse is using the nursing process to care for a suicidal client. Which of the following nursing actions is a part of the diagnosis step of the nursing process? a. Identifies nursing diagnosis: Risk for suicide. b. Notes client's family reports recent suicide attempt. c. Prioritizes the necessity for maintaining a safe environment for the client. d. Obtains a short-term contract from the client to seek out staff if feeling suicidal.

A) Identifies nursing diagnosis: Risk for suicide.

One of the goals of a therapeutic community is for clients to become more independent and accept self-responsibility. Which of the following approaches by staff best encourages fulfillment of this goal? a. Including client input and decisions into the treatment plan. b. Insisting that each client take a turn as "president" of the community meeting. c. Making decisions for the client regarding plans for treatment. d. Requiring that the client be bathed, be dressed, and attend breakfast on time each morning.

A) Including client input and decisions into the treatment plan.

The nurse is using the nursing process to care for a suicidal client. Which of the following nursing actions is a part of the planning step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the client. b. Determines if nursing interventions have been appropriate to achieve desired results. c. Obtains a short-term contract from the client to seek out staff if feeling suicidal. d. Establishes goal of care: Client will not harm self during hospitalization.

A) Prioritizes the necessity for maintaining a safe environment for the client.

Which of the following nursing diagnoses would be considered the priority in planning care for the child with severe autism spectrum disorder (ASD)? a. Risk for self-mutilation evidenced by banging head against wall b. Impaired social interaction evidenced by unresponsiveness to people c. Impaired verbal communication evidenced by absence of verbal expression d. Disturbed personal identity evidenced by inability to differentiate self from others

A) Risk for self-mutilation evidenced by banging head against wall

Mr. White is admitted to the hospital after an extended period of binge alcohol drinking. His wife reports he had been a heavy drinker for a number of years. Laboratory reports reveal he has a blood alcohol of 250 mg/dL. He is placed on the chemical addiction unit for detoxification. When would the first signs of alcohol withdrawal symptoms be expected? A. Several hours after the last drink B. 2-3 days after the last drink C. 4-5 days after the last drink D. 6-7 days after the last drink

A) Several hours after the last drink

J.J. is a staff nurse on a surgical unit. He has been selected as leader of a newly established group of staff nurses organized to determine ways to decrease the number of medication errors occurring on the unit. J.J. has definite ideas about how to bring this about. He has also applied for the position of Head Nurse on the unit and believes that, if he is successful in leading the group toward achievement of its goals, he can also facilitate his chances for promotion. At each meeting he addresses the group in an effort to convince the members to adopt his ideas. Which type of group and style of leadership is described in this situation? a. Task, autocratic. b. Teaching, autocratic. c. Self-help, democratic. d. Supportive/therapeutic, laissez-faire.

A) Task, autocratic.

A nurse who is helping a client in the preparation stage of the Psychological Recovery Model might include which of the following interventions? a. Teach about effects of the illness and how to recognize, monitor, and manage symptoms. b. Help the client identify "triggers" that cause distress or discomfort. c. Help the client establish a daily maintenance list. d. Listen actively while the client composes his or her personal story.

A) Teach about effects of the illness and how to recognize, monitor, and manage symptoms.

A polysubstance abuser makes the statement, "The green and whites do me good after speed." How might the nurse interpret the statement? a. The client abuses amphetamines and anxiolytics. b. The client abuses alcohol and cocaine. c. The client is psychotic. d. The client abuses narcotics and marijuana.

A) The client abuses amphetamines and anxiolytics.

The nurse identifies the primary nursing diagnosis for Theresa as Risk for Suicide related to feelings of hopelessness from loss of relationship. Which is the outcome criterion that would most accurately measure achievement of this diagnosis? a. The client has experienced no physical harm to herself. b. The client sets realistic goals for herself. c. The client expresses some optimism and hope for the future. d. The client has reached a stage of acceptance in the loss of the relationship with her boyfriend.

A) The client has experienced no physical harm to herself.

Which of the following describe advantages to electronic health records (EHRs)? (Select all that apply.) a. They reduce redundancy of information. b. They reduce issues regarding privacy. c. They decrease charting time. d. They facilitate communication between disciplines.

A) They reduce redundancy of information. C) They decrease charting time. D) They facilitate communication between disciplines.

Amanda's mobile home was destroyed by a tornado. Amanda received only minor injuries but is experiencing disabling anxiety in the aftermath of the event. This type of crisis is called a.crisis resulting from traumatic stress. b.maturational/developmental crisis .c.dispositional crisis. d.crisis of anticipated life transitions. The most appropriate crisis intervention with Amanda (from question above) would be to a. encourage her to recognize how lucky she is to be alive. b. discuss stages of grief and feelings associated with each. c. identify community resources that can help Amanda. d. suggest that she find a place to live that provides a storm shelter.

A) crisis resulting from traumatic stress. B) discuss stages of grief and feelings associated with each.

Dan, who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job, states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know. My boss is a jerk! I haven't missed any more days than my coworkers." The defense mechanism that Dan is using is: a. denial. b. projection. c. displacement. d. rationalization.

A) denial

A client states: "I refuse to shower in this room. I must be very cautious. The FBI has placed a camera in here to monitor my every move." Which of the following is the therapeutic response? a. "That's not true." b. "I have a hard time believing that is true." c. "Surely you don't really believe that." d. "I will help you search this room so that you can see there is no camera."

B

John tells the nurse, "I think lights out at 10 o'clock on a weekend is stupid. We should be able to watch TV until midnight!" Which of the following is the most appropriate response from the nurse on the milieu unit? a. "John, you were told the rules when you were admitted." b. "You may bring it up before the others at the community meeting, John." c. "Some people want to go to bed early, John." d. "You are not the only person on this unit, John. You must think of the others."

B

Theresa, who has been hospitalized following a suicide attempt, is placed on suicide precautions on the psychiatric unit. She admits that she is still feeling suicidal. Which of the following interventions is most appropriate in this instance? a. Obtain an order from the physician to place Theresa in restraints to prevent any attempts to harm herself. b. Check on Theresa every 15 minutes or assign a staff person to stay with her on a one-to-one basis. c. Obtain an order from the physician to give Theresa a sedative to calm her and reduce suicide ideas. d. Do not allow Theresa to participate in any unit activities while she is on suicide precautions.

B) Check on Theresa every 15 minutes or assign a staff person to stay with her on a one-to-one basis.

Which of the following medications is the physician most likely to order for a client experiencing alcohol withdrawal syndrome? a. Haloperidol (Haldol) b. Chlordiazepoxide (Librium) c. Methadone (Dolophine) d. Phenytoin (Dilantin)

B) Chlordiazepoxide (Librium)

Which of the following activities would be a responsibility of the psychiatric clinical nurse specialist on the IDT team? a. Manages the therapeutic milieu on a 24-hour basis. b. Conducts group therapies and provides consultation and education to staff nurses. c. Directs a group of clients in acting out a situation that is otherwise too painful for a client to discuss openly. d. Locates halfway house and arranges living conditions for client being discharged from the hospital.

B) Conducts group therapies and provides consultation and education to staff nurses.

Dan, who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job, states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know. My boss is a jerk! I haven't missed any more days than my coworkers." The nurse's best response is: a. "Maybe your boss is mistaken, Dan." b. "You are here because your drinking was interfering with your work, Dan." c. "Get real, Dan! You're a boozer and you know it!" d. "Why do you think your boss is a jerk, Dan?"

B) "You are here because your drinking was interfering with your work, Dan."

Carol, an adolescent, just returned from group therapy and is crying. She says to the nurse, "All the other kids laughed at me! I try to fit in, but I always seem to say the wrong thing. I've never had a close friend. I guess I never will." Which is the most appropriate response by the nurse? a. "What makes you think you will never have any friends?" b. "You're feeling pretty down on yourself right now." c. "I'm sure they didn't mean to hurt your feelings." d. "Why do you feel this way about yourself?"

B) "You're feeling pretty down on yourself right now."

Maria is an Italian American who is in the hospital after having suffered a miscarriage at 5 months' gestation. Her room is filled with relatives who have brought a variety of foods and gifts for Maria. They are all talking, seemingly at the same time, and some, including Maria, are crying. They repeatedly touch and hug maria and each other. How should the nurse handle this situation? a. Explain to the family that Maria needs her rest and they must all leave b. Allow the family to remain and continue their activity as described, as long as they do not disturb other clients. c. Explain that Maria will not get over her loss if they keep bringing it up and causing her to cry so much d. Call the family priest to come and take charge of this family situation

B) Allow the family to remain and continue their activity as described, as long as they do not disturb other clients.

Which of the following groups is most commonly used for drug management of the child with ADHD? a. CNS depressants (e.g., diazepam [Valium]) b. CNS stimulants (e.g., methylphenidate [Ritalin]) c. Anticonvulsants (e.g., phenytoin [Dilantin]) d. Major tranquilizers (e.g., haloperidol [Haldol])

B) CNS stimulants (e.g., methylphenidate [Ritalin])

Which of the following tasks are associated with the orientation phase of relationship development? (Select all that apply.) a. Promoting the client's insight and perception of reality. b. Creating an environment for the establishment of trust and rapport. c. Using the problem-solving model toward goal fulfillment. d. Obtaining available information about the client from various sources. e. Formulating nursing diagnoses and setting goals.

B) Creating an environment for the establishment of trust and rapport. E) Formulating nursing diagnoses and setting goals.

The nurse is using the nursing process to care for a suicidal client. Which of the following nursing actions is a part of the evaluation step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the client. b. Determines if nursing interventions have been appropriate to achieve desired results. c. Obtains a short-term contract from the client to seek out staff if feeling suicidal. d. Establishes goal of care: Client will not harm self during hospitalization.

B) Determines if nursing interventions have been appropriate to achieve desired results.

The nurse must give Frank, a Latino American, a physical examination. She asks him to remove his clothing and put on an examination gown. Frank refuses. What cultural norm among Latino Americans most likely explains Frank's response? a) Frank does not believe in taking orders from a woman b) Frank is modest and embarrassed to remove his clothes c) Frank does not understand why he must remove his clothes d) Frank does not think he needs a physical examination

B) Frank is modest and embarrassed to remove his clothes

Which of the following statements by Anna might suggest that she is achieving resolution of her grief over Lucky's death? a. I don't cry anymore when I think about Lucky b. It's true. Lucky didn't always mind me. Sometimes he ignored my commands. c. I remember how it happened now. I should have held tighter to his leash! d. I won't ever have another dog. It's just too painful to lose them.

B) It's true. Lucky didn't always mind me. Sometimes he ignored my commands.

Which of the following individuals is at highest risk for suicide? a. Nancy, age 33, Asian American, Catholic, middle socioeconomic group, alcoholic b. John, age 72, white, Methodist, low socioeconomic group, diagnosis of metastatic cancer of the pancreas c. Carol, age 15, African American, Baptist, high socioeconomic group, no physical or mental health problems d. Mike, age 55, Jewish, middle socioeconomic group, suffered myocardial infarction a year ago

B) John, age 72, white, Methodist, low socioeconomic group, diagnosis of metastatic cancer of the pancreas

Sandra is the nurse leader of a supportive/therapeutic group for individuals with anxiety disorders. In this group, Nancy talks incessantly. When someone else tries to make a comment, she refuses to allow him or her to speak. What type of member role is Nancy assuming in this group? a. Aggressor. b. Monopolizer. c. Blocker. d. Seducer.

B) Monopolizer

The nurse is using the nursing process to care for a suicidal client. Which of the following nursing actions is a part of the assessment step of the nursing process? a. Identifies nursing diagnosis: Risk for suicide. b. Notes client's family reports recent suicide attempt. c. Prioritizes the necessity for maintaining a safe environment for the client. d. Obtains a short-term contract from the client to seek out staff if feeling suicidal.

B) Notes client's family reports recent suicide attempt.

Anna's daughter notices that Anna appears to be listening to another voice when just the two of them are in a room together. When questioned, Anna admits that she hears someone telling her that she was a horrible caretaker for Lucky and did not deserve to ever have a pet. Which of the following best describes what Anna is experiencing? a) Neurosis b) Psychosis c) depression d) Bereavement

B) Psychosis

From which of the following symptoms might the nurse identify a chronic cocaine user? a. Clear, constricted pupils b. Red, irritated nostrils c. Muscle aches d. Conjunctival redness

B) Red, irritated nostrils

Anna, age 72, has been grieving the death of her dog, Lucky, for 3 years. She is not able to take care of her activities of daily living and wants only to make daily visits to Lucky's grave. What is the most likely reason her daughter has put off seeking help for Anna? a) Women are less likely than men to seek help for emotional problems b) Relatives often try to "normalize" the behavior rather than label it mental illness c) She knows that all older people are expected to be a little depressed d) She is afraid that the neighbors "will think her mother is crazy"

B) Relatives often try to "normalize" the behavior rather than label it mental illness

In the community meeting, which of the following actions is most important for reinforcing the democratic posture of the therapy setting? a. Allowing each person a specific and equal amount of time to talk. b. Reviewing group rules and behavioral limits that apply to all clients. c. Reading the minutes from yesterday's meeting. d. Waiting until all clients are present before initiating the meeting.

B) Reviewing group rules and behavioral limits that apply to all clients.

In an effort to help the child with mild to moderate intellectual disability develop satisfying relationships with others, which of the following nursing interventions is most appropriate? a. Interpret the child's behavior for others. b. Set limits on behavior that is socially inappropriate. c. Allow the child to behave spontaneously, for he or she has no concept of right or wrong. d. This child is not capable of forming social relationships.

B) Set limits on behavior that is socially inappropriate.

Sarah is an African American woman who receives a visit from the psychiatric home health nurse. A referral for a mental health assessment was made by the public health nurse, who noticed that Sarah was becoming exceedingly withdrawn. When the psychiatric nurse arrives, Sarah says to her, "No one can help me. I was an evil person in my youth, and now I must pay." How might the nurse assess this statement? a) Sarah is having delusions of persecution b) Some African Americans believe illness is God's punishment for their sins c) Sarah is depressed and just wants to be left alone d) African Americans do not believe in psychiatric help

B) Some African Americans believe illness is God's punishment for their sins

N.J. is the nurse leader of a childbirth preparation group. Each week she shows various films and sets out various reading materials. She expects the participants to utilize their time on a topic of their choice or practice skills they have observed on the films. Two couples have dropped out of the group, stating, "This is a big waste of time." Which type of group and style of leadership is described in this situation? a. Task, democratic. b. Teaching, laissez-faire. c. Self-help, democratic. d. Supportive/therapeutic, autocratic.

B) Teaching, laissez-faire.

Success of long-term psychotherapy with Theresa (who attempted suicide following a breakup with her boyfriend) could be measured by which of the following behaviors? a. Theresa has a new boyfriend. b. Theresa has an increased sense of self-worth. c. Theresa does not take antidepressants anymore. d. Theresa told her old boyfriend how angry she was with him for breaking up with her.

B) Theresa has an increased sense of self-worth.

Which of the following activities would be most appropriate for the child with attention deficit/hyperactivity disorder (ADHD)? a. Monopoly b. Volleyball c. Pool d. Checkers

B) Volleyball

Marie, age 56, is the mother of five children. Her youngest child, who had been living at home and attending the local college, recently graduated and accepted a job in another state. Marie has never worked out-side the home and has devoted her life to satisfying the needs of her husband and children. Since the departure of her last child from home, Marie has become more and more despondent. Her husband has become very concerned and takes her to the local mental health center. This type of crisis is called a.dispositional crisis. b.crisis of anticipated life transitions c.psychiatric emergency. d.crisis resulting from traumatic stress. The most appropriate nursing intervention with Marie (from question above) would be to a.refer her to her family physician for a complete physical examination. b.suggest she seek outside employment now that her children have left home. c.identify convenient support systems for times when she is feeling particularly despondent. d.begin grief work and assist her to recognize areas of self-worth separate and apart from her children.

B) crisis of anticipated life transitions D) begin grief work and assist her to recognize areas of self-worth separate and apart from her children.

In prioritizing care within the therapeutic environment, which of the following nursing interventions would receive the highest priority? a. Ensuring that the physical facilities are conducive to achievement of the goals of therapy. b. Scheduling a community meeting for 8:30 each morning. c. Attending to the nutritional and comfort needs of all clients. d. Establishing contacts with community resources.

C) Attending to the nutritional and comfort needs of all clients.

Judy has been in the hospital for 3 weeks. She has used Valium "to settle my nerves" for the past 15 years. She was admitted by her psychiatrist for safe withdrawal from the drug. She has passed the physical symptoms of withdrawal at this time, but states to the nurse, "I don't know if I will be able to make it without Valium after I go home. I'm already starting to feel nervous. I have so many personal problems." Which is the most appropriate response by the nurse? a. "Why do you think you have to have drugs to deal with your problems?" b. "Everybody has problems, but not everybody uses drugs to deal with them. You'll just have to do the best that you can." c. "Let's explore some things you can do to decrease your anxiety without resorting to drugs" d. "Just hang in there. I'm sure everything is going to be okay."

C) "Let's explore some things you can do to decrease your anxiety without resorting to drugs"

Theresa is hospitalized following a suicide attempt after breaking up with her boyfriend. Theresa says to the nurse, "When I get out of here, I'm going to try this again, and next time I'll choose a no-fail method." Which is the best response by the nurse? a. "You are safe here. We will make sure nothing happens to you." b. "You're just lucky your roommate came home when she did." c. "What exactly do you plan to do?" d. "I don't understand. You have so much to live for."

C) "What exactly do you plan to do?"

Theresa, age 27, was admitted to the psychiatric unit from the medical intensive care unit where she was treated for taking a deliberate overdose of her antidepressant medication, trazodone (Desyrel). She says to the nurse, "My boyfriend broke up with me. We had been together for 6 years. I love him so much. I know I'll never get over him." Which is the best response by the nurse? a. "You'll get over him in time, Theresa." b. "Forget him. There are other fish in the sea." c. "You must be feeling very sad about your loss." d. "Why do you think he broke up with you, Theresa?"

C) "You must be feeling very sad about your loss."

Which of the following is a correct assumption regarding the concept of crisis? a. Crises occur only in individuals with psychopathology. b. The stressful event that precipitates crisis is seldom identifiable. c. A crisis situation contains the potential for psychological growth or deterioration. d. Crises are chronic situations that recur many times during an individual's life.

C) A crisis situation contains the potential for psychological growth or deterioration.

A nurse who is helping a client with mental illness recovery using the WRAP Model says to the client, "First you must create a wellness toolbox." She explains to the client that a wellness toolbox is which of the following? a. A list of words that describe how the individual feels when he or she is feeling well b. A list of things the client needs to do every day to maintain wellness c. A list of strategies the client has used in the past that help relieve disturbing symptoms d. A list of the client's favorite health-care providers and phone numbers

C) A list of strategies the client has used in the past that help relieve disturbing symptoms

Which of the following activities would be a responsibility of the clinical psychologist member of the IDT team? a. Locates halfway house and arranges living conditions for client being discharged from the hospital. b. Manages the therapeutic milieu on a 24-hour basis. c. Administers and evaluates psychological tests that assist in diagnosis. d. Conducts psychotherapy and administers electroconvulsive therapy treatments.

C) Administers and evaluates psychological tests that assist in diagnosis.

When Anna's daughter expresses concern about her mother's behavior and recommends she see a counselor, Anna declares, "I'm fine. There is nothing wrong with me!" Which of the following best describes Anna's response? a.) Grief resolution b.) Somatic disorder c.) Anosognosia d.) Intellectualization

C) Anosognosia

The child with autism spectrum disorder (ASD) has difficulty with trust. With this in mind, which of the follow- ing nursing actions would be most appropriate? a. Encourage all staff to hold the child as often as possible, conveying trust through touch. b. Assign a different staff member each day so child will learn that everyone can be trusted. c. Assign same staff person as often as possible to promote feelings of security and trust. d. Avoid eye contact, because this is extremely uncomfortable for the child and may even discourage trust.

C) Assign same staff person as often as possible to promote feelings of security and trust.

Lucky sometimes refused to obey Anna, and indeed did not come back to her when she called to him on the day he was killed. But Anna continues to insist, "He was the very best dog. He always minded me. He always did everything I told him to do." This represents the defense mechanism: a) Sublimation b) Compensation c) Reaction formation d) Undoing

C) Compensation

Frank is a Latino American who has an appointment at the community health center for 1:00 p.m. The nurse is angry when Frank shows up at 3:30 p.m. stating, "I was visiting with my brother." How must the nurse interpret this behavior? a. Frank is being passive-aggressive by showing up late. b. This is Frank's way of defying authority. c. Frank is a member of a cultural group that is present-time oriented. d. Frank is a member of a cultural group that rejects traditional medicine.

C) Frank is a member of a cultural group that is present-time oriented.

In determining degree of suicidal risk with a suicidal client, the nurse assesses the following behavioral manifestations: severely depressed, withdrawn, statements of worthlessness, difficulty accomplishing activities of daily living, no close support systems. The nurse identifies the client's risk for suicide as: a. Low b. Moderate c. High d. Unable to determine

C) High

Henry is a member of an Alcoholics Anonymous group. He learned about the effects of alcohol on the body when a nurse from the chemical dependency unit spoke to the group. This is an example of which curative factor? a. Catharsis. b. Altruism. c. Imparting of information. d. Universality.

C) Imparting of information.

Nurse Jones is the leader of a bereavement group for widows. Nancy is a new member. She listens to the group and sees that Jane has been a widow for 5 years now. Jane has adjusted well and Nancy thinks maybe she can too. This is an example of which curative factor? a. Universality. b. Imitative behavior. c. Installation of hope. d. Imparting of information.

C) Installation of hope.

Nursing diagnoses are prioritized according to: a. Degree of potential for resolution. b. Legal implications associated with nursing intervention. c. Life-threatening potential. d. Client and family requests.

C) Life-threatening potential.

The nurse is using the nursing process to care for a suicidal client. Which of the following nursing actions is a part of the implementation step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the client. b. Determines if nursing interventions have been appropriate to achieve desired results. c. Obtains a short-term contract from the client to seek out staff if feeling suicidal. d. Establishes goal of care: Client will not harm self during hospitalization.

C) Obtains a short-term contract from the client to seek out staff if feeling suicidal.

Sarah is an African American woman who lives in the rural south. She receives a visit from the public health nurse. Sarah says to the nurse, "Granny told me to eat a lot of poke greens, and I would feel better." What cultural norm among African Americans most likely explains Sarah's response? a) Sarah's grandmother believes in the healing power of poke greens b) Sarah believes everything her grandmother tells her c) Sarah has been receiving health care from a folk practitioner d) Sarah is trying to determine if the nurse agrees with her grandmother

C) Sarah has been receiving health care from a folk practitioner

Dan has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job. Dan's drinking buddies come for a visit, and when they leave, the nurse smells alcohol on Dan's breath. Which of the following would be the best intervention with Dan at this time? a. Search his room for evidence. b. Ask, "Have you been drinking alcohol, Dan?" c. Send a urine specimen from Dan to the lab for drug screening. d. Tell Dan, "These guys cannot come to the unit to visit you again."

C) Send a urine specimen from Dan to the lab for drug screening.

Nurse Mary has been providing care for Tom during his hospital stay. On Tom's day of discharge, his wife brings a bouquet of flowers and box of chocolates to his room. He presents these gifts to Nurse Mary, saying "Thank you for taking care of me." What is a correct response by the nurse? a) I don't accept gifts from patients b) Thank you so much! It is so nice to be appreciated. c) Thank you. I will share these with the rest of the staff. d) Hospital Policy forbids me to accept gifts from patients.

C) Thank you. I will share these with the rest of the staff.

Which of the following is the desired outcome of working with an individual who has witnessed a traumatic event and is now experiencing panic anxiety? a. The individual will experience no anxiety b. The individual will demonstrate hope for the future c. The individual will identify that anxiety is at a manageable level d. The individual will verbalize acceptance of self as worth

C) The individual will identify that anxiety is at a manageable level

A nurse is assisting an individual with mental illness recovery using the Tidal Model. Which of the follow- ing is a component of this model? a. The wellness toolbox b. The daily maintenance list c. The individual's personal story d. Triggers

C) The individual's personal story

The nurse leader is explaining about group "curative factors" to members of the group. She tells the group that group situations are beneficial because members can see that they are not alone in their experiences. This is an example of which curative factor? a. Altruism. b. Imitative behavior. c. Universality. d. Imparting of information.

C) Universality

Symptoms of alcohol withdrawal include: a. euphoria, hyperactivity, and insomnia. b. depression, suicidal ideation, and hypersomnia. c. diaphoresis, nausea and vomiting, and tremors. d. unsteady gait, nystagmus, and profound disorientation.

C) diaphoresis, nausea and vomiting, and tremors.

Jenny reported to the high school nurse that her mother drinks too much. She is drunk every afternoon when Jenny gets home from school. Jenny is afraid to invite friends over because of her mother's behavior. This type of crisis is called a. crisis resulting from traumatic stress b. maturational/developmental crisis. c. dispositional crisis. d. crisis reflecting psychopathology. The most appropriate nursing intervention with Jenny (from question above) would be to a. make arrangements for her to start attending Al-Ateen meetings. b. help her identify the positive things in her life and recognize that her situation could be a lot worse than it is. c. teach her about the effects of alcohol on the body and that it can be hereditary. d. refer her to a psychiatrist for private therapy to learn to deal with her home situation.

C) dispositional crisis. A) make arrangements for her to start attending Al-Ateen meetings.

Three years ago, Anna's dog Lucky, whom she had for 16 years, was run over by a car and killed. Anna's daughter reports that since that time, Anna has lost weight, rarely leaves her home, and just sits and talks about Lucky. Anna's behavior would be considered maladaptive for which of the following reasons? A) it has been more than 3 years since Lucky died B) her grief is too intense just over the loss of a dog C) her grief is interfering with her functioning D) people in this culture would not comprehend such behavior

C) her grief is interfering with her functioning

Miss Lee is an Asian American on the psychiatric unit. She tells the nurse, "I must have the hot ginger root for my headache. It is the only thing that will help." What meaning does the nurse attach to this statement by Miss Lee? a. she is being obstinate and wants control over her care b. she believes that ginger root has magical qualities c. she subscribes to the restoration of health through the balance of yin and yang d. Asian Americans refuse to take traditional medicine for pain

C) she subscribes to the restoration of health through the balance of yin and yang

Andrew, a New York City firefighter, and his entire unit responded to the terrorist attacks at the World Trade Center. Working as a team, he and his best friend, Carlo, entered the area together. Carlo was killed when the building collapsed. Andrew was injured but survived. Since that time, Andrew has had frequent nightmares and anxiety attacks. He says to the mental health worker, "I don't know why Carlo had to die and I didn't!" This statement by Andrew suggests that he is experiencing a.spiritual distress. b.night terrors. c.survivor's guilt. d.suicidal ideation. Intervention with Andrew (from question above) would include a.encouraging expression of feelings. b.anti-anxiety medications. c.participation in a support group. d. a and c. e. all of the above.

C) survivor's guilt E)

Dorothy was involved in an automobile accident while under the influence of alcohol. She swerved her car into a tree and narrowly missed hitting a child on a bicycle. She is in the hospital with multiple abrasions and contusions. She is talking about the accident with the nurse. Which of the following statements by the nurse is most appropriate? a. "Now that you know what can happen when you drink and drive, I'm sure you won't let it happen again." b. "You know that was a terrible thing you did. That child could have been killed." c. "I'm sure everything is going to be okay now that you understand the possible consequence of such behavior." d. "How are you feeling about what happened?"

D) "How are you feeling about what happened?"

Client teaching is an important nursing function in milieu therapy. Which of the following statements by the client indicates the need for knowledge and a readiness to learn? a. "Get away from me with that medicine! I'm not sick!" b. "I don't need psychiatric treatment. It's my migraine headaches that I need help with." c. "I've taken Valium every day of my life for the last 20 years. I'll stop when I'm good and ready!" d. "The doctor says I have bipolar disorder. What does that really mean?"

D) "The doctor says I have bipolar disorder. What does that really mean?"

Paul is a member of an anger management group. He knew that people did not want to be his friend because of his violent temper. In the group, he has learned to control his temper and form satisfactory interpersonal relationships with others. This is an example of which curative factor? a. Catharsis. b. Altruism. c. Imparting of information. d. Development of socializing techniques.

D) Development of socializing techniques.

The nurse is using the nursing process to care for a suicidal client. Which of the following nursing actions is a part of the outcome identification step of the nursing process? a. Prioritizes the necessity for maintaining a safe environment for the client. b. Determines if nursing interventions have been appropriate to achieve desired results. c. Obtains a short-term contract from the client to seek out staff if feeling suicidal. d. Establishes goal of care: Client will not harm self during hospitalization.

D) Establishes goal of care: Client will not harm self during hospitalization.

S.T. is a 15-year-old girl who has just been admitted to the adolescent psychiatric unit with a diagnosis of anorexia nervosa. She is 55 tall and weighs 82 lb. She was elected to the cheerleading squad for the fall but states that she is not as good as the others on the squad. The treatment team has identified the following problems: refusal to eat, occasional purging, refusing to interact with staff and peers, and fear of failure. Which of the following nursing diagnoses would be the priority diagnosis for S.T.? a. Social Isolation. b. Disturbed Body Image. c. Low Self-Esteem. d. Imbalanced Nutrition: Less than body requirements.

D) Imbalanced Nutrition: Less than body requirements.

Miss Lee is an Asian American on the psych unit, says she is afraid that no one from her family will visit her. What belief does Miss Lee base her statement? A. Many asian americans do not believe in hospitals B. Many asian americans do not have close family support systems C. Many asian americans believe the body will heal itself if left alone D. Many Asian Americans view psych problems as bringing shame to the family

D) Many Asian Americans view psych problems as bringing shame to the family

An individual who is addicted to heroin is likely to experience which of the following symptoms of withdrawal? a. Increased heart rate and blood pressure b. Tremors, insomnia, and seizures c. Incoordination and unsteady gait d. Nausea and vomiting, diarrhea, and diaphoresis

D) Nausea and vomiting, diarrhea, and diaphoresis

Sandra is the nurse leader of a supportive/therapeutic group for individuals with anxiety disorders. On the first day the group meets, Valerie speaks first and begins by sharing the intimate details of her incestuous relationship with her father. What type of member role is Nancy assuming in this group? a. Aggressor. b. Monopolizer. c. Blocker. d. Seducer.

D) Seducer

Theresa is hospitalized following a suicide attempt after breaking up with her boyfriend. Freudian psychoanalytic theory would explain Theresa's suicide attempt in which of the following ways? a. She feels hopeless about her future without her boyfriend. b. Without her boyfriend, she feels like an outsider with her peers. c. She is feeling intense guilt because her boyfriend broke up with her. d. She is angry at her boyfriend for breaking up with her and has turned the anger inward on herself.

D) She is angry at her boyfriend for breaking up with her and has turned the anger inward on herself.

As a child, Mark was physically abused by his father. The father is now dying and has expressed a desire to see his son before he dies. Mark is depressed and says to the mental health nurse, "I'm so angry! Why did God have to give me a father like this? I feel cheated of a father! I've always been a good person. I deserved better. I hate God!" From this subjective data, which nursing diagnosis might the nurse apply to Mark? a. Readiness for enhanced religiosity b. Risk for impaired religiosity c. Readiness for enhanced spiritual well-being d. Spiritual distress

D) Spiritual distress

M.K. is a psychiatric nurse who has been selected to lead a group for women who desire to lose weight. The criterion for membership is that they must be at least 20 pounds overweight. All have tried to lose weight on their own many times in the past without success. At their first meeting, M.K. provides suggestions as the members determine what their goals will be and how they plan to go about achieving those goals. They decided how often they wanted to meet, and what they planned to do at each meeting. Which type of group and style of leadership is described in this situation? a. Task, autocratic. b. Teaching, democratic. c. Self-help, laissez-faire. d. Supportive/therapeutic, democratic.

D) Supportive/therapeutic, democratic.

A nurse is assisting an individual with mental illness recovery using the Psychological Recovery Model. The client says to the nurse, "I have schizophrenia. Nothing can be done. I might as well die." In which stage of the Psychological Recovery Model would the nurse assess this individual to be? a. The awareness stage b. The preparation stage c. The rebuilding stage d. The moratorium stage

D) The moratorium stage

Joe, a Native American, goes to the Ed because he has an oozing stasis ulcer on his leg. He is accompanied by the tribal shaman, who has been treating Joe on the reservation. As a greeting, the physician extends his hand to the shaman, who lightly touches the physician's hand, then quickly moves away. What cultural norm among Native Americans most likely explains the shaman's behavior? A. The shaman is snubbing the physician B. The shaman is angry at Joe for wanting to go to the ED C. The shaman does not believe in traditional med D. The shaman does not feel comfortable with touch

D) The shaman does not feel comfortable with touch

Crises occur when an individual a. is exposed to a precipitating stressor. b. perceives a stressor to be threatening. c. has no support systems. d. experiences a stressor and perceives coping strategies to be ineffective.

D) experiences a stressor and perceives coping strategies to be ineffective.

Anna states that Lucky was her closest friend, and since his death, there is no one who could ever replace the relationship they had. According to Maslow's hierarchy of needs, which level of need is not being met? A) Physiological Needs B) Self-esteem Needs C) Safety and security needs D) love and belonging needs

D) love and belonging needs

Ginger, age 19 and an only child, left 3 months ago to attend a college of her choice 500 miles away from her parents. It is Ginger's first time away from home. She has difficulty making decisions and will not undertake anything new without first consulting her mother. They talk on the phone almost every day. Ginger has recently started having anxiety attacks. She consults the nurse practitioner in the student health center. This type of crisis is called a. crisis resulting from traumatic stress. b. dispositional crisis. c. psychiatric emergency. d. maturational/developmental crisis. The most appropriate nursing intervention with Ginger (from question above) would be to a.suggest she move to a college closer to home. b.work with Ginger on unresolved dependency issues. c.help her find someone in the college town from whom she could seek assistance rather than calling her mother regularly. d.recommend that the college physician prescribe an anti-anxiety medication for Ginger.

D) maturational/developmental crisis. B) work with Ginger on unresolved dependency issues.

Anna's dog Lucky got away from her while they were taking a walk. He ran into the street and was hit by a car. Anna cannot remember any of these circumstances of his death. This is an example of what defense mechanism? a) rationalization b) suppression c) denial d) repression

D) repression

On the milieu unit, duties of the staff psychiatric nurse include which of the following? (Select all that apply.) a. Medication administration. b. Client teaching. c. Medical diagnosis. d. Reality orientation. e. Relationship development. f. Group therapy.

a. Medication administration. b. Client teaching. d. Reality orientation. e. Relationship development.

Sally was sexually abused as a child. She is a client on the milieu unit with a diagnosis of Borderline Personality Disorder. She has refused to talk to anyone. Which of the following therapies might the IDT team choose for Sally? (Select all that apply.) a. Music therapy. b. Art therapy. c. Psychodrama. d. Electroconvulsive therapy.

a. Music therapy. b. Art therapy. c. Psychodrama.

Which of the following interventions are appropriate for a client on suicide precautions? (Select all that apply.) a. Remove all sharp objects, belts, and other potentially dangerous articles from the client's environment. b. Accompany the client to off-unit activities. c. Obtain a promise from the client that she will not do anything to harm herself for the next 12 hours. d. Put all of the client's possessions in storage and explain to her that she may have them back when she is off suicide precautions.

a. Remove all sharp objects, belts, and other potentially dangerous articles from the client's environment. b. Accompany the client to off-unit activities. c. Obtain a promise from the client that she will not do anything to harm herself for the next 12 hours.

S.T. is a 15-year-old girl who has just been admitted to the adolescent psychiatric unit with a diagnosis of anorexia nervosa. She is 55 tall and weighs 82 lb. She was elected to the cheerleading squad for the fall but states that she is not as good as the others on the squad. The treatment team has identified the following problems: refusal to eat, occasional purging, refusing to interact with staff and peers, and fear of failure. Which of the following nursing diagnoses would be appropriate for S.T.? (Select all that apply.) a. Social Isolation. b. Disturbed Body Image. c. Low Self-Esteem. d. Imbalanced Nutrition: Less than body requirements.

a. Social Isolation. b. Disturbed Body Image. c. Low Self-Esteem. d. Imbalanced Nutrition: Less than body requirements

A client admitted to the emergency department smells strongly of alcohol, and his wife reports he has been a heavy drinker for the last 25 years. Which of the following assessment findings are consistent with long-term chronic alcohol abuse? Select all that apply. a. The client reports weak leg muscles, and his gait is unsteady b. The client's abdomen is distended c. The client reports he was coughing up some blood d. The client reports he has double vision e. Blood tests reveal a low WBC count

a. The client reports weak leg muscles, and his gait is unsteady b. The client's abdomen is distended c. The client reports he was coughing up some blood d. The client reports he has double vision e. Blood tests reveal a low WBC count

Which of the following are basic assumptions of milieu therapy? Select all that apply. a. the client owns his or her own environment b. each client owns his or her behavior c. peer pressure is useful and powerful tool d. inappropriate behaviors are punished immediately

a. the client owns his or her own environment b. each client owns his or her behavior c. peer pressure is useful and powerful tool

Which of the following is a true statement about mental health recovery? Select all that apply. a. Mental health recovery applies only to severe and persistent mental illnesses b. Mental health recovery serves to provide empowerment to the consumer c. Mental health recovery is based on the medical model d. Mental health recovery is a collaborative process

b. Mental health recovery serves to provide empowerment to the consumer d. Mental health recovery is a collaborative process