SOC4: mental health

The nurse is planning activities for a client diagnosed with bipolar disorder with aggressive social behavior. Which activity would be most appropriate for this client? 1. chess 2. writing 3. ping pong 4. basketball

2. writing

When the community health nurse visits a client at home, the client states, "I haven't slept at all the last couple nights". Which response by the nurse illustrates a therapeutic communication response to this client? 1. "I see" 2. "Really?" 3. "You're having difficulty sleeping?" 4. "Sometimes, I have trouble sleeping too"

3. "You're having difficulty sleeping?"

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." what is the most appropriate nursing response? 1. "I cannot discuss any client with you" 2. "If you want to know about Carol, you need to ask her yourself" 3. "only because you are worried about a friend, I'll tell you she is improving" 4. "being her friend, you know she is having a difficult time and deserves her privacy"

1. "I cannot discuss any client with you"

Which nursing interventions are appropriate for a hospitalized client with mania who is exhibiting manipulative behavior? Select all that apply 1. communicate expected behaviors to the client 2. ensure that the client knows that they are not in charge of the nursing unit 3. assist the client in identifying ways of setting limits on personal behaviors 4. follow through about the consequences of behavior in a nonpunitive manor 5. enforce rules by informing the client that they will not be able to attend therapy groups 6. have the client state the consequences for behaving in ways that are viewed as unacceptable

1. communicate expected behaviors to the client 3. assist the client in identifying ways of setting limits on personal behaviors 4. follow through about the consequences of behavior in a nonpunitive manor 6. have the client state the consequences for behaving in ways that are viewed as unacceptable

A client admitted to a mental health unit for treatment of psychotic behavior spends hours at the locked exit door shouting, "Let me out. There's nothing wrong with me. I don't belong here." What defense mechanism is the client implementing? 1. denial 2. projection 3. regression 4. rationalization

1. denial

The nurse in the mental health unit recongnizes which as being therapeutic communication techniques? Select all that apply. 1. restating 2. listening 3. asking the client, "why?" 4. maintaining neutral responses 5. providing acknowledgement and feedback 6. giving advice and approval or disapproval

1. restating 2. listening 4. maintaining neutral responses 5. providing acknowledgement and feedback

A client says to the nurse, "the federal guards were sent to kill me". what is your best nursing response to the client's concern? 1. "I don't believe this is true" 2. ""the guards are not out to kill you" 3. " do you feel afraid that people are trying to hurt you?" 4. "what makes you think the guards were sent to hurt you?"

3. " do you feel afraid that people are trying to hurt you?"

A client is admitted to a medical nursing unit with a diagnosis of acute blindness after being involved in a hit-and-run accident. When diagnostic testing cannot identify any organic reason why this client cannot see, a mental health consult is prescribed. Which condition will be the focus of this consult? 1. psychosis 2. repression 3. conversion disorder 4. dissociative disorder

3. conversion disorder

A client with a diagnosis of major 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 demonstrates therapeutic communication? 1. "You have everything to live for." 2. "Why do you see yourself as a failure?" 3. "Feeling like this is all part of being depressed." 4. "You've been feeling like a failure for a while?"

4. "You've been feeling like a failure for a while?"

A client's unresolved feelings related to loss would be most likely observed during which phase of the therapeutic nurse-client relationship? 1. trusting 2. working 3. orientation 4. termination

4. termination

A client taking lithium carbonate reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and tremors. The lithium level is 2.5 mEq/L. This level is indicative of which finding? 1. Toxic 2. Normal 3. Excessively below normal 4. Slightly above normal

1. Toxic

The nurse is caring for a client diagnosed with catatonic stupor who is lying on the bed in a fetal position. What is the most appropriate nursing intervention? 1. Ask direct questions to encourage talking 2. Leave the client alone so as to minimize external stimuli. 3. Sit beside the client in silence with occasional open-ended questions. 4. Take the client into the dayroom with other clients so that they can help watch him.

3. Sit beside the client in silence with occasional open-ended questions.

A manic client begins to make sexual advance towards visitors in the dayroom. When the nurse firmly states that this is inappropriate and will not be allowed, the client becomes verbally abusive and threatens physical violence to the nurse. Based on the analysis of this situation, which intervention should the nurse implement? 1. Place the client in seclusion for 30 minutes 2. Tell the client that the behavior is inappropriate 3. Escort the client to their room, with the assistance of other staff. 4. Tell the client that their telephone privileges are revoked for 24 hours.

3. Escort the client to their room, with the assistance of other staff.

A client admitted voluntarily for treatment of an anxiety disorder demands to be released from the hospital. Which action should the nurse take initially? 1. Contact the client's health care provider (HCP). 2. Tell the client that leaving would likely result in an involuntary commitment. 3. Call the client's family to arrange for transportation. 4. Attempt to persuade the client to stay "for only a few more days."

1. Contact the client's health care provider (HCP).

A client being seen in the emergency department immediately after being sexually assaulted appears calm and controlled. The nurse analyzes this behavior as indicating which defense mechanism? 1. Denial 2. Projection 3. Rationalization 4. Intellectualization

1. Denial

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? 1. Monitor closely for harm to self or others 2. Assist in completing an application for admission 3. Supply the client with written information about their mental illness 4. Provide an opportunity for the family to discuss why they felt the admission was needed

1. Monitor closely for harm to self or others

The nurse observes that a client is pacing, agitated, and presenting aggressive gestures. The client's speech pattern is rapid, and affect is belligerent. Based on these observations, what is the nurse's immediate priority of care? 1. Provide safety for the client and other clients on the unit 2. Offer the client a less stimulating area to calm down in and gain control. 3. Assist the staff in caring for the client in a controlled environment. 4. Provide the clients on the unit with a sense of comfort and safety.

1. Provide safety for the client and other clients on the unit

The nurse is conducting a group therapy session. During the session, a client diagnosed with mania consistently disrupts the group's interactions. Which intervention should the nurse initially implement? 1. setting limits on client's behavior 2. asking the client to leave the group session 3. asking another nurse to escort the client out of the group session 4. telling the client that they will not be able to attend any further group sessions

1. setting limits on client's behavior

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? 1. using open-ended questions and silence 2. sharing personal preference regarding food choices 3. documenting reasons why the client does not want to eat 4. offering opinions about the necessity of adequate information

1. using open-ended questions and silence

The nurse is providing care to a client admitted to the hospital with a diagnosis of acute anxiety disorder. The client says to the nurse, "I have a secret that I want to tell you. You won't tell anyone about it, will you?" What is the most appropriate nursing response? 1. "No, I won't tell anyone." 2. "I cannot promise to keep a secret." 3. "It depends on what the secret is about." 4. "If you tell me the secret, I may need to document it."

2. "I cannot promise to keep a secret."

A client's medication sheet contains a prescription for sertraline (Zoloft). To ensure safe administration of the medication, how should the nurse administer the dose? 1. On an empty stomach 2. At the same time each evening 3. Evenly spaced around the clock 4. As needed when the client complains of depression

2. At the same time each evening

The nurse is caring for a client who is experiencing disturbed thought processes as a result of paranoia. In formulating nursing interventions with the members of the health care team, what best instruction should the nurse provide to the staff? 1. Increase socialization of the client with peers. 2. Avoid laughing or whispering in front of the client. 3. Begin to educate the client about social supports in the community. 4. Have the client sign a release of information to appropriate parties for assessment purposes

2. Avoid laughing or whispering in front of the client.

A hospitalized client has begun taking bupropion (Wellbutrin) as an antidepressant agent. The nurse understands that which is an adverse effect, indicating that the client is taking an excessive amount of medication? 1. Constipation 2. Seizure activity 3. Increased weight 4. Dizziness when getting upright

2. Seizure activity

The nurse calls security and has physical restraints applied when a client who was admitted voluntarily becomes both physically and verbally abusive while demanding to be discharged from the hospital. Which represents the possible legal ramifications for the nurse associated with these interventions? Select all that apply. 1. libel 2. battery 3. assault 4. slander 5. false imprisonment

2. battery 3. assault 5. false imprisonment

The nurse is performing a follow-up teaching session with a client discharged 1 month ago. The client is taking fluoxetine (prozac). What information would be important for the nurse to obtain during this client visit regarding the side/adverse effects of this medication? 1. cardiovascular symptoms 2. gastrointestional dysfunctions 3. problems with mouth dryness 4. problems with excessive sweating

2. gastrointestional dysfunctions

When planning the discharge of a client with chronic anxiety, the nurse directs the goals at promoting a safe environment at home. Which is the most appropriate maintenance goal? 1. suppressing feelings of anxiety 2. identifying anxiety-producing situations 3. continued contact with a crisis counselor 4. eliminating all anxiety from daily situations

2. identifying anxiety-producing situations

The nurse is teaching a client who is being started on imipramine (tofranil) about the medication. The nurse should inform the client to expect maximum desired effects at what time period following initiation of the medication? 1. in 2 months 2. in 2-3 weeks 3. during the first week 4. during the sixth week of administration

2. in 2-3 weeks

The nurse is describing the medication side and adverse effects to a client who is taking oxazepam (serax). What information should the nurse incorporate in the discussion? 1. consume a low-fiber diet 2. increase fluids and bulk in the diet 3. rest if the heart begins to beat rapidly 4. take antidiarrheal agents if diarrhea occurs

2. increase fluids and bulk in the diet

The nurse is preparing a client for the termination phase of the nurse-client relationship. The nurse prepares to implement which nursing task that is most appropriate for this phase? 1. planning short term goals 2. making appropriate referrals 3. developing realistic solutions 4. identifying expected outcomes

2. making appropriate referrals

A client who has been taking buspirone (buspar) for 1 month returns to the clinic for a follow up assessment. The nurse determines that the medication is effective if the absence of which manifestation has occurred? 1. paranoid thought process 2. rapid heartbeat or anxiety 3. alcohol withdrawal symptoms 4. though broadcasting or delusions

2. rapid heartbeat or anxiety

A client is unwilling to go out of the house for fear of "making a fool of myself in public". Because of this fear, the client remains homebound. Based on these data, which mental health disorder is the client experiencing? 1. agoraphobia 2. social phobia 3. claustrophobia 4. hypochondriasis

2. social phobia

The nurse notes that a client with schizophrenia and receiving an antipsychotic medication is moving her mouth, protruding her tongue, and grimacing as she watches television. The nurse determines that the client is experiencing which medication complication? 1. parkinsonism 2. tardive dyskinesia 3. hypertensive crisis 4. neuroleptic malignant syndrome

2. tardive dyskinesia

A client diagnosed with delirium becomes disoriented and confused at night. Which intervention should the nurse implement initially? 1. move the client next to the nurses station 2. use an indirect light source and turn off the television 3. keep the television and a soft light on during the night 4. play soft music during the night, and maintain a well-lit room

2. use an indirect light source and turn off the television

A client recieving tricyclic antidepressants arrives at the mental health clinic. Which observarion would indicate that the client is following the medication plan correctly? 1. client reports not going to work for this past week 2. client complains of not being able to "do anything" anymore 3. client arrives at the clinic neat and appropriate in apperance 4. client reports sleeping 12 hours per night and 3 to 4 hours during the day

3. client arrives at the clinic neat and appropriate in apperance

A hospitalized client is started on phenelzine (nardil) 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. 1. figs 2. yogurt 3. crackers 4. aged cheese 5. tossed salad 6. oatmeal raisin cookies

3. crackers 5. tossed salad

Which statement describes the best understanding of the nurse's role regarding ensuring that each client's rights are respected? 1. "autonomy is the fundamental right of each and every client" 2. "a client's rights are guaranteed by both state and federal laws" 3. "being respectful and concerned will ensure that I am attentive to my clients' rights" 4. "regardless of the client's condition, all nurses have the duty to respect client rights"

3. "being respectful and concerned will ensure that I am attentive to my clients' rights"

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? 1. "have you shared your feelings with your family?" 2. "I think we should talk more about your anger with your family" 3. "you're feeling angry that your family continues to hope for you to be cured?" 4. "you are probably very depressed, which is understandable with such a diagnosis"

3. "you're feeling angry that your family continues to hope for you to be cured?"

The nurse is preparing a client with a history of command hallucinations for discharge by providing instructions on interventions for managing hallucinations and anxiety. Which statement in response to these instructions suggests to the nurse that the client understands the instructions? 1. I'll go to support group and talk so that I don't hurt anyone." 2. "It's not likely that I'll get anxious or hear things if I get enough sleep and eat well." 3. "My medications aren't likely to make me anxious." 4. "When I begin to hallucinate, I'll call my therapist and talk about what I should do."

4. "When I begin to hallucinate, I'll call my therapist and talk about what I should do."

A client is admitted to the mental health unit with a diagnosis of depression. The nurse should develop a plan of care for the client that includes which intervention? 1. Encouraging quiet reading and writing for the first few days 2. Identification of physical activities that will provide exercise 3. No socializing activities, until the client asks to participate in milieu 4. A structured program of activities in which the client can participate

4. A structured program of activities in which the client can participate

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? 1. Exploring the client's ability to function 2. Exploring the client's potential for self-harm 3. Inquiring about the client's perception or appraisal of why the rescue was unsuccessful 4. Inquiring about and examining the client's feelings for any that may block adaptive coping

4. Inquiring about and examining the client's feelings for any that may block adaptive coping

On review of the client's record, the nurse notes that the admission was voluntary. Based on this information, the nurse anticipates which client behavior? 1. fearfulness regarding treatment measures 2. anger and aggressiveness directed toward others 3. an understanding of the pathology and symptoms of diagnosis 4. a willingness to participate in the planning of the care and treatment plan

4. a willingness to participate in the planning of the care and treatment plan

A client is scheduled for discharge and will be taking phenobarbital sodium (luminal) for an extended period. The nurse would place highest priority on teaching the client which point that directly relates to client saftey? 1. taking the medication only with meals 2. take the medication at the same time each day 3. use a dose container to help prevent missed doses 4. avoid drinking alcohol while taking this medication

4. avoid drinking alcohol while taking this medication

A client gives the home health nurse a bottle of climipramine (anafranil). The nurse notes that the medication has not been taken by the client in 2 months. Which behavior observed in the client would validate noncompliance with this medication? 1. complaints of insomnia 2. complaints of hunger and fatigue 3. a pulse rate of less than 60 bpm 4. frequent hand washing with hot soapy water

4. frequent hand washing with hot soapy water

The nurse is administering risperidone (risperdal) to a client who is scheduled to be discharged. Before discharge, which instruction should the nurse provide to the client? 1. get adequate sunlight 2. continue driving as usual 3. avoid foods rich in potassium 4. get up slowly when changing positons

4. get up slowly when changing positons

A client with schizophrenia has been started on medication therapy with clozapine (Clozaril). The nurse should assess the results of which laboratory study to monitor for adverse effects from this medication? 1. Platelet count 2. Blood glucose level 3. liver function studies 4. wbc count

4. wbc count