Mental Health
A client has been admitted to the inpatient psychiatric unit because the client has displayed violent behavior and is at risk for potentially harming others. Which of the following should the nurse avoid doing when caring for this client? Select one: a. Closing the door to the client's room when giving care to the client b. Arranging for a security officer to be available in the general area c. Facing the client while speaking and providing nursing care d. Admitting the client to a room near the nurses' station
a. Closing the door to the client's room when giving care to the client
The nurse is talking with a male client who is actively hallucinating. The client is fearful that the voices he hears will direct him to kill himself or will hurt him directly. Which of the following nursing statements would be therapeutic at this time? Select one: a. "I don't hear them, but it must be frightening to hear voices that others can't hear." b. "I know you believe they are going to cause you harm, but it's not true." c. "I can hear the voices too, but they are telling you to go to bed now." d. "I know whose voices you are hearing and told them not to hurt you."
a. "I don't hear them, but it must be frightening to hear voices that others can't hear."
A client who attempted suicide by hanging is brought to the emergency department by emergency medical services. The immediate nursing action is which of the following? Select one: a. Assess the client's respiratory status and for the presence of neck injuries. b. Perform a focused assessment, paying particular attention to the client's neurological status. c. Call the mental health crisis team and notify them that a client who attempted suicide is being admitted to the hospital. d. Take the client's vital signs.
a. Assess the client's respiratory status and for the presence of neck injuries.
An acutely depressed client is receiving cognitive-behavioral therapy. The nurse is developing a plan of care for the client and includes interventions that focus on this type of therapy. Which of the following interventions would the nurse include? Select all that apply. Select one or more: a. Assisting the client to develop alternative thinking patterns b. Assisting the client's family to participate in group therapy on a regular basis c. Assisting the client to participate in the treatment process d. Assisting the client with the administration of antidepressant medications e. Assisting the client to identify and test negative cognition f. Assisting the client to rehearse new cognitive and behavioral responses
a. Assisting the client to develop alternative thinking patterns c. Assisting the client to participate in the treatment process e. Assisting the client to identify and test negative cognition f. Assisting the client to rehearse new cognitive and behavioral responses
A client has recently been diagnosed with mild to moderate NCD due to Alzheimer's disease.Which medication would the nurse expect the physician to order for the client's cognitive impairment? Select one: a. Donepezil (Aricept) b. Zaleplon (Sonata) c. Nortriptyline (Pamelor) d. Quetiapine (Seroquel)
a. Donepezil (Aricept)
The client who is diagnosed with a borderline personality is admitted to the psychiatric unit. Based on a thorough understanding of personality disorders, the nurse would select which nursing diagnosis as the priority? Select one: a. Risk for self-mutilation b. Social isolation c. Ineffective coping d. Chronic low self-esteem
a. Risk for self-mutilation
The nurse is preparing a client for discharge who was hospitalized following a suicide attempt. The nurse evaluates that the client could benefit from further development of coping strategies if the client was overheard making which of the following statements prior to discharge? Select one: a. "I know now that I can't be all things to all people all the time." b. "I know that I won't become depressed again after the treatment I received here." c. "It's been good to learn better ways to deal with the stresses in my life." d. "It is important for me to take my medications just as prescribed."
b. "I know that I won't become depressed again after the treatment I received here."
A client admitted to the inpatient unit is being considered for electroconvulsive therapy (ECT). The client is calm, but the client's daughter is hypervigilant and anxious. The daughter says to the nurse, "My mother's brain will be shocked with electricity. How can the doctor even think about doing this to her?" Which of the following responses by the nurse would be therapeutic? Select one: a. "I think you need to speak directly to the psychiatrist." b. "It sounds as though you are very concerned about the procedure. Let's discuss the procedure." c. "Your mother has decided to have this treatment. You should support her." d. "Maybe you'll feel better if you see the ECT room and speak to the staff."
b. "It sounds as though you are very concerned about the procedure. Let's discuss the procedure."
Cognitive therapy was provided for a patient who frequently said, "I'm stupid." Which statement by the patient indicates the therapy was effective? Select one: a. "I'm disappointed in my lack of ability." b. "Sometimes I do stupid things." c. "Things always go wrong for me." d. "I always fail when I try new things."
b. "Sometimes I do stupid things."
A nurse is having a conversation with a depressed client on an inpatient psychiatric unit. The client says to the nurse, "Things would be so much better for everyone if I just weren't around." Which of the following responses by the nurse would be appropriate at this time? Select one: a. "Have you talked to anyone specifically about what is bothering you?" b. "You sound very unhappy. Are you thinking of harming yourself?" c. "I know what you mean; everyone gets that way when they are depressed." d. "Those feelings will go away when your medication really takes effect."
b. "You sound very unhappy. Are you thinking of harming yourself?"
The nurse is told that the result of a serum carbamazepine (Tegretol) level for a client who is receiving the medication for the control his mood swings is 10mcg/mL. Based on this laboratory result, the nurse anticipates that the physician will prescribe: Select one: a. A decrease of the dosage of the medication b. Continuation of the presently prescribed dosage c. An increase of the dosage of the medication d. Discontinuation of the medication
b. Continuation of the presently prescribed dosage
The nurse is working with a client who shows signs of benzodiazepine withdrawal. The nurse suspects that the client has suddenly discontinued taking which of the following prescribed medications? Select one: a. Sertraline (Zoloft) b. Diazepam (Valium) c. Haloperidol (Haldol) d. Fluoxetine (Prozac)
b. Diazepam (Valium)
For the last year, a college student continually and unrealistically worries about academic performance and love life performance. The student is irritable and suffers from severe insomnia.This behavior is associated with which diagnosis? Select one: a. Agoraphobia b. Generalized Anxiety Disorder (GAD) c. Obsessive-Compulsive Disorder (OCD) d. Social Phobia Disorder
b. Generalized Anxiety Disorder (GAD)
A mental health nurse is assigned to care for a client with a diagnosis of undifferentiated schizophrenia with acute exacerbation. The nurse uses which of the following approaches when planning care for this client? Select one: a. Repeatedly point out inconsistencies in the client's communication during initial treatment. b. Provide assistance with grooming and nutrition until the client's thinking has cleared. c. Let the client act out initially, and use the quiet room and restraints as needed. d. Allow the client to set the goals for the plan of care.
b. Provide assistance with grooming and nutrition until the client's thinking has cleared.
A nurse in the emergency department is preparing to care for a female client who has just been sexually assaulted. Which of the following client behaviors would demonstrate denial? Select one: a. The client is justifying unacceptable self-behaviors. b. The client is calm and quiet. c. The client is verbalizing generalizations about the incident. d. The client is blaming her sister for the incident.
b. The client is calm and quiet.
The nurse is assisting in developing a plan of care for a client with a psychotic disorder who is experiencing altered thought processes that include the belief that the food is being poisoned. The nurse develops strategies that will encourage the client to discuss feelings and plans to: Select one: a. Instruct the client about the need for adequate nutrition. b. Use open-ended questions and silence. c. Focus on the components of adequate nutrition. d. Focus on the fact that the client's beliefs are untrue.
b. Use open-ended questions and silence.
A client hates her mother because of childhood neglect. The nurse determines which client statement represents the use of the use of the defense mechanism of reaction formation? Select one: a. "My mom always loved my sister more than she loved me." b. "My mother hates me." c. "I have a very wonderful mother whom I love very much." d. "I don't like to talk about my relationship with my mother."
c. "I have a very wonderful mother whom I love very much."
A voluntarily hospitalized patient tells the nurse, "Get me the forms for discharge against medical advice so I can leave now." What is the nurse's best initial response? Select one: a. "Since you signed your consent for treatment, you may leave if you desire." b. "I can't give you those forms without your health care provider's knowledge." c. "I will get them for you, but let's talk about your decision to leave treatment." d. "I'll get the forms for you right now and bring them to your room."
c. "I will get them for you, but let's talk about your decision to leave treatment."
A client with a potential for violence is exhibiting aggressive gestures, making belligerent comments to the other clients, and is continuously pacing in the hallway. Which of the following comments by the nurse would be therapeutic at this time? Select one: a. "You are going to be restrained if you do not change your behavior." b. "Please stop so I don't have to put you in seclusion." c. "What is causing you to become agitated?" d. "Why are you intent on upsetting the other clients?"
c. "What is causing you to become agitated?"
The nurse is developing a care plan that will include goals that will help the client achieve an optimal level of functioning and appropriate resource utilization. When the nurse enters the client's room, the client asks the nurse, "Could you ask the physician to let me have a pass for the weekend?" The nursing response that assists the client in achieving these goals is: Select one: a. "I will call the doctor and find out if you can have a pass so that you can make your arrangements." b. "You can't have a pass for the weekend. You are not ready, and I'm sure that your doctor will say no." c. "When the physician arrives on the unit, I will let him or her know that you have a question." d. "When your doctor comes in, I will ask for a pass for the weekend."
c. "When the physician arrives on the unit, I will let him or her know that you have a question."
A mental health nurse who has been meeting with a client with a diagnosis of post-traumatic stress disorder is in the termination phase of the nurse-client relationship. The nurse notes that the client has been quiet and withdrawn and interprets the client's behavior as: Select one: a. An indication of the need for additional therapy sessions b. An inability of the client to terminate from the nurse c. A normal behavior that can occur during termination d. An indication of the need for antidepressants
c. A normal behavior that can occur during termination
A client is admitted to the psychiatric unit with a diagnosis of bipolar affective disorder and mania. The nurse would prioritize that which of the following symptoms or behaviors requires immediate intervention? Select one: a. Constant, incessant talking, with sexual innuendoes b. Outlandish behaviors and wearing odd and eccentric clothing c. Constant physical activity and poor oral intake d. Grandiose delusions of being a czar of Russia
c. Constant physical activity and poor oral intake
The client admitted to the mental health unit with major depression 3 days ago could hardly get out of bed without coaxing and needed constant encouragement to get dressed and participate in unit activities. Today, the client appears in the dayroom dressed and well-groomed, without any guidance from the staff. The client appears to be calm and relaxed, yet more energetic than before. The nurse should take which initial action after noting this client's behavior? Select one: a. Notify the staff of these observations at the team meeting, which will begin in 3 hours. b. Document that the client is adapting to the unit and is feeling safe. c. Speak to the client personally about the nurse's observations, and ask if the client is thinking about suicide. d. Continue to monitor the client's behavior from a distance.
c. Speak to the client personally about the nurse's observations, and ask if the client is thinking about suicide.
In the shift-change report, an off-going nurse criticizes a patient who wars heavy makeup. Which comment by the nurse who receives the report best demonstrates advocacy? Select one: a. "Your comments are inconsiderate and inappropriate. Keep the report objective." b. "This is a psychiatric hospital. Craziness is what we are all about." c. "Let's all show acceptance of this patient by wearing lots of makeup too." d. "Our patients need our help to learn behaviors that will help them get along in society."
d. "Our patients need our help to learn behaviors that will help them get along in society."
A client receiving long-term therapy with lithium carbonate (Lithobid) exhibits muscle tremors, confusion, vomiting, and diarrhea. The nurse anticipates that the results of the latest test of the serum lithium level will be between: Select one: a. 0.6 and 1.0 mEq/L b. 1.0 and 1.3 mEq/L c. 0 and 0.5 mEq/L d. 1.5 and 2.0 mEq/L
d. 1.5 and 2.0 mEq/L
Two students fail their introductory nursing course. One student plans to seek tutoring and retake the course next fall. The second student attempts suicide. Which of the following factors would have been influential in the development of the second student's crisis? Select one: a. The time of year in which the event occurred b. The individual's family birth order c. The presence of support systems d. A lack of adequate coping mechanisms
d. A lack of adequate coping mechanisms
The nurse in the pediatric unit is admitting a 2-year-old child. The nurse plans care, knowing that the child is in which stage of Erikson's psychosocial stages of development? Select one: a. Trust versus mistrust b. Industry versus inferiority c. Initiative versus guilt d. Autonomy versus shame and doubt
d. Autonomy versus shame and doubt
When caring for a client who is experiencing a panic attack, which of the following nursing actions should be implemented? Select one: a.Instruct the client regarding unit rules and regulations. b. Leave the client alone to maintain privacy. c. Sit with the client in the day room to provide comfort d. Communicate with simple words and brief message
d. Communicate with simple words and brief message
The nurse is describing medication side effects to a client who is taking a benzodiazepine. The nurse tells the client to take the medication only as prescribed because of the most serious risk of: Select one: a. Skin rashes b. Gastrointestinal side effects c. Headache d. Dependence
d. Dependence
In preparing for the orientation phase of the therapeutic relationship, the nurse suggests addressing which of the following subjects? Select one: a. Promoting self-esteem in the client b. Promoting problem solving skills in the client c. Facilitating behavioral change d. Establishing the parameters of the relationship
d. Establishing the parameters of the relationship
A client who has sustained severe injuries in a motorcycle accident was diagnosed with intensive care unit (ICU) psychosis. The nurse would be most likely to conclude that the client's status is improving if the client: Select one: a. Appears to be delirious but has stopped trying to pull out the nasogastric tube b. Keeps his eyes fixed on the nurses while they are working in the room but has stable vital signs c. Tells his wife, "I feel better, but the doctors want to give me a lethal injection." d. Increases the number of hours slept at one time and is increasingly alert
d. Increases the number of hours slept at one time and is increasingly alert
The nurse is preparing for the arrival of a new client at a drug abusers' residential treatment center and prepares to explain to the client that the emphasis of the center is on group and social interaction, and that rules and expectations are mediated by peer pressure. The most likely focus of therapy of this residential center is: Select one: a. Cognitive-behavioral therapy b. Systematic desensitization c. Aversion conditioning d. Milieu therapy
d. Milieu therapy
The goal for a patient is to increase resiliency. Which outcome should a nurse add to the plan of care? Within 3 days, the patient will: Select one: a. meet own needs without considering the rights of others. b. describe feelings associated with loss and stress. c. allow others to assume responsibility for major areas of own life. d. identify healthy coping behaviors in response to stressful events.
d. identify healthy coping behaviors in response to stressful events.
Psychotherapy involves all below except: Select one: a. positive expectancy b. neural plasticity c. none of the above d. a therapeutic relationship e. appropriate medications
e. appropriate medications
The nurse has been caring for a client with a diagnosis of depression. The client says to the nurse, "I wish you would just be my friend." The appropriate response by the nurse is: Select one: a. "I am your friend." b. "Our relationship is a therapeutic and helping one." c. "I can't be your friend. I'm the nurse, and you're the client." d. "You have plenty of friends. You don't need me to be your friend, too."
b. "Our relationship is a therapeutic and helping one."
Which nursing diagnosis is written correctly? Select one: a. Low self-esteem related to major depressive disorder evidenced by childhood abuse. b. Conduct disorder related to childhood sexual abuse evidenced by hostile and aggressive behaviors. c. Risk for social isolation related to low self-esteem evidenced by staying in room during the day. d. Imbalanced nutrition: less than body requirements related to suspiciousness evidenced by 20 lbs. weight loss.
d. Imbalanced nutrition: less than body requirements related to suspiciousness evidenced by 20 lbs. weight loss.
A nursing student is conducting a clinical conference and is describing the characteristics associated with milieu therapy. Which of the following statements, if made by the student, indicates an understanding of the focus of this form of therapy? Select one: a. "A living, learning, or working environment is the focus of milieu therapy." b. "Milieu therapy provides a cognitive approach to changing behavior." c. "A behavioral approach to changing behavior is the focus of milieu therapy." d. "Milieu therapy provides a behavior modification approach type of therapy."
a. "A living, learning, or working environment is the focus of milieu therapy."
The following patients are seen in the emergency department. Which of the following patients meets the severity of illness and intensity of care required for the admitting officer to recommend admission to the psychiatric unit? The patient who: Select one: a. who self inflicted a superficial cut on the forearm after a family argument. b. experiencing anxiety and a sad mood after a separation from a spouse of 10 years. c. who is a single parent and hears voices saying, "Smother your infant." d. experiencing dry mouth and tremor related to side effects of haloperidol (Haldol)
c. who is a single parent and hears voices saying, "Smother your infant."
The nurse is assigned to a client who is psychotic, pacing, agitated, and using aggressive gestures and rapid speech. The nurse determines that the priority of care at this time is which of the following? Select one: a. Providing the other clients on the unit with a sense of comfort and safety by isolating the client b. Assisting in caring for the client in a controlled environment, such as a quiet room c. Offering the client a less stimulated area in which to calm down and gain control d. Providing safety for the client and other clients on the unit
d. Providing safety for the client and other clients on the unit
A patient begins therapy with a phenothiazine medication. What teaching should a nurse provide related to the drug's strong dopaminergic effects? Select one: a. Arise slowly from bed. b. Increase dietary fiber. c. Chew sugarless gum. d. Report muscle stiffness.
d. Report muscle stiffness.
