mental health ex 1 tb q's
a student appears very nervous on the first day of clinical in a psychiatric setting. the student reviews the instructor's guidelines and appropriately takes which of the following actions? select all that apply
- discusses the anxious feelings iwth the instructor - builds rapport with the patient before asking personal questions - consults the instructor if a shocking situation arises
discharge planning from inpatient care for ppl with severe mental illness must address which of the following to be effective? sata
- finding housing for the client - finding transportation for the client SIMPLE INTERVENTION FOR SEVER MENTAL ILLNESS HOUSING AND TRANSPORTATION
a patient has just begun daily participation in a community based partial hospitalization program. the patient can expect the staff to assist with which of the following treatment goals? sata
- stabilizing psychiatric symptoms - improving activities of daily living - learning to structure time - developing social skills
the nurse is preparing to administer PRN medication to a client of japanese descent who is anxious the prescription reads alprazolam xanax 0.25-1.0 mg PO PRN the best dose for the nurse to give initially is
0.25 mg
psychiatric nursing became a requirement in nursing education in which year
1950
which element would be present in an assertive community treatment (ACT) program?
24 hour a day services ACT is twenty four hours because its assertive so its all the time in yo FACE
a nurse has invited a patient to sit down and have a conversation. the patient takes the first seat. the nurse pulls up another chair to sit with the patient approxamitely how far from the patient should the nusre place her chair
3-4 feet
the first training of nurses to work with persons with mental illness was in 1882 in which state?
Massachusetts
a patient reports a pattern of being suspicious and mistrusting of others, causing difficulty in sustaining lasting relationships. which stage according to erikson's psychosocial development was not successfuly completed?
Trust
group members are actively discussing a common topic. members are sharing that they identify with what others are saying. the nurse leader recognizes that the group is in which stage of group development?
Working the group members are working together
which of the following clients would most likely be mandated outpatient treatment
a client who is addicted to alcohol who has 2 dui offenses
an adult client is put in restraints after all other attempts to reduce aggression have failed. which of the following is required now that the restraints have been institutded?
a fae to face evaluation by a licensed independent practitioner within 1 hour of restraint.
which of the following losses are likely to result in disenfranchised grief? sata
a family whos longtime snake just died a nurse who has just witnessed the death of a patient a couple who has just experienced pregnancy loss the gay lover of a man whojust died from aids
which of the following situations would most likely provide social support to a client?
a friend who will share his or her perspective on an issue
a client is being evaluated for dementia. the nurse knows that a client who is able to complete very few tasks is most likely to have
a greater cognitive deficit
which of the following client situations most urgently requires the nurse to break confidentiality and warn a third party
a jealous man states, i am getting my gun and going to shoot my wife's lover!!
a filipino client meets the nurse for the first time. the client simply simles at the nurse who is introduced. the nurse interprets this behavior as
a typiacl greeitng for a filipino client
which statements are true of concrete and abstract messages? sata
abstract messages include figures of speech that are difficult to interpret concrete messages are clear, direct, and easy to understand
the phsyician has prescriped haldol 10 mg for a severely psychotic client. the client refuses the med. which nursing intervention is an appropriate response?
accept the clients decision
kubler ross developed a model of 5 stages to explain what ppl experiences as they grieve and mourn. which stage 5 of kubler ross stages of grieving?
acceptance
which of the following are critical components in assessment of a persons grief? sata
adequate perception regarding the loss adequate support w hile grieving for the loss adequate coping behaviors during the process perception support coping
which of the following are nontherapeutic techniques? sata
agreeing challenging giving approval nontherapeutic agreeing challenging approving or giving approval
a basic assumption of freud's psychoanalytic theory is that
all human behavior can be caused and can be explained
a holistic plan of recovery would be especially important to a client from which of the following cultural groups
american indian
one of the unforeseen effects of the movement toward community mental health services is
an increased number of admissions to available hospital services
the nurse should use clear concrete messages when working with patients displaying which of the following conditions? sata
anxiety dementia schizophrenia
a client from which of the following cultural groups is likely to prefer closeness in personal space
arab americans
patient says to the nurse i wonder whats playing at the movie tonight. the most therapeutic response would be
are you telling me you would like to go to the movies?
the nurse is assessing suicide potential in a patient who has expressed hopelessness. in what order does the nurse question the patient about suicidal thoughts
are you thinking of killing yourself do you have a plan to kill yourself how do you plan to kill yourself how would you carry out this plan
the most efective way for he nurse to provide culturally competent care to individuals who are grieving is which of the following
ask the client waht rituals are personally meaningful
the nurse uses a variety of therapetuic communication skills when working with patients which of the following is a therapeutic goal that can be accomplished thru the use of therapeutic communication skills
assess the patients perception of a problem
a psychiatric nurse is planning an educational program addressing primary prevention strategies in the community. the nurse explores current research regarding which health care need?
assisting high school students to effectively manage stress. primary prevention = stress management education secondary = early identification of mental health issues tertiary= monitoring and coordinating serviecs for mentally ill such as getting a job and performing well
a nurse is performing safety assessments on a client in mechanical restraints as required by policy. which action by the nurse demonstrates the ethical principle of nonmaleficence?
assuring that the restraints are not causing injury to the client
the major problems with large state institutions are: SATA
attendants were accused of abusing the residents clients were geographically isolated from family and community
a nurse makes the statemente in a treatment team meeting its not worth it to try to teach ghits patient how to make better choices he has been here many times before and goes back home and does the same thing the nurse is sharing which of the following
attitude
a nurse is questioning whether it is ethical to seclude a client beause of loud and intrusive behavior on the unit. what is the ethical principle that will best guide the decision on appropriate use of seclusion?
autonomy
ensuring that the client has informed consent before agreeing to treatment regimen displays which of the following ethical principles
autonomy
the nurse and patient are visiting about upcoming sporting events of which they both share an interest. this form of interaction has the potential to threaten the nurse patient relationship by
avoiding serious work that can help the patient change
a married couple has just received the news that the husband has terminal cancer. the wife tells the nurse maybe if we get another opinion and start treatment right away there is a chance of survival. the nurse documents that the wife is expressing signs of which of kubler ross stages of grief?
bargaining
the client says to the nurse i really want to see my first grandhcild born before i die is that too much to ask
bargaining
a client underwent a procedure before the nurse verified the clients signature on teh consent form. the client actually did not sign the form before the proceudure. if the client is dissatisfied with the outcome of the procedure and files a suit against the health care team which kind of case can the client file
battery
when preparing for the first clinical experience with patients on a forensic unit at a psychiatric hospital the nursing instructor discuesses students beliefs and fears surrounding forensic patients the primary reason for discussing personal beliefs is to
become aware of possible barriers to developing therapeutic relationships
which of the following is the best reason that many psychiatric care units have policies against clients touching one another or staff?
becuase some clients with mental illness have difficulty knowing when touch is or is not appropriate
which of the following terms is used to describe the process by which a person experiences the grief?
bereavment
which one of the following statements about the roles that biologic makeup plays in a clients emotional responses is most accurate
biologic differences can affect a clients response to treatment with psychotropic drugs
the nurse plans to assess a patients self concept in the admission assessment knowing that self concept influences which of the following? select all that apply
body image frequently expriienced emotions coping strategies
the nurse would recommend individual therapy for the patient who expresses a desire to
bring about personal changes
a client is fearful and reluctant to talk which of the following techniques is most effective when trying to engage the client in interaction?
broad opening
the nurse asks the patient what he would like to talk about this is an example of
broad opening
how can a nurse avoid the possibility of finding the clients behavior unacceetable or distasteful?
by being aware of the clients behavior and background before beginning the relationship; and exploring the possibiity of a conflict with a colleague.
which of the following behaviors by the nurse demonstrate postiive regards? SATA
calling the client by name spending time with the client responding openly considering the clients ideas when planning care
the client stated I was so upset about my sister ignoring me when i was talking about being ashamed. which nontherapeutic communication technique would the nurse be using it he nurse would satte, how are your stress reduction classes going?
changing the subject
The nurse is assessing the anxiety level of a young school age child. the nurse encourages the child to express feelings through the use of toys in a play situation. the purpose for this approach to assessment is largely related to which of the following?
children may not have developed the language to fully describe their feelings
during the admission assessment the nurse asks the client how are you feeling? the client responds, i was able to purchase gas for 7 cents a galllon less than yesterday which saved me a total of 84 cents. my car has a 12 gallon gas tank usually i am able to put in 11.7 gallons i am very happy to have saved so much money. the nurse recognizes this response as which of the following
circumstantial thinking answering a question after giving excessive unncessary detail.
a nurse is working with a middle eastern client being treated for major depression. the client is expressing feelings of guilt for not being able to SNAP out of it. a therapeutic response by the nurse would be
clinical depression is not something you have brought on yourself
which type of psychiatric rehabilitation relies on intentional communities and rehabilitation alliances?
clubhouse model clubhouse model = intentional communities and rehabiliation alliances
the term standards of care refers to expectations of nursing performance. standards of care are developed from which of the following? sata
code of ethics for nurses with interpretive statements state nurse practice acts agency job descriptions profesional nursing organizations everything NOT exam
a nurse is working with a patient with an eating disorder who refuses to eat a muffin. the nurse asks the patient is there any way that you could see the muffin as just flour and water, basic nutrients your body needs? in this statement, the nurse is using which type of therapy?
cognitive therapy
which approach to therapy is most effective when planning for a client with negative thinking?
cognitive therapy
which one of the following statements is most accurate regarding the cohesiveness of a group in group therapy
cohesiveness is a desirable group characteristic that is associated with positive group outcomes.
what is required for a transitional care model to be most effective in promoting the client's health and wellbeing and prevent relapse and rehospitalization? SATA
collaboration administrative support adequate funding collaboration administrative support adequate funding adequate funding collaboration administrative suport
which of the following cultural phenomena that should be assessed by the nurse includes preference such as touch and eye contact
communication
the primary goal of a psychiatric rehabilitation program is to promote
complete recovery from mental illness
the nurse asks a patient to list the days of the week in reverse order. the nurse is assessing which of the following?
concentration because it takes concentration to do so
discloser of client info beyond the interdisciplinary team without consent of the client is a breach of
confidentiality
a client who has depression is admitted to treatment on a voluntary basis. while in the hospital the client makes several comments about want to end it all. the client decides one day to leave against medical advice. which of the following would be most appropriate by nursing staff
contacting the psychiatrist for initiation of committment proceedings
a 22 year old has been manipulative of staff and disruptive in the milieu. although she is not dangerous to herslef or others she has created problems on the unit and clearly is not making progress the nurses offer prescribed medication but she consistently refuses any drugs the staff realizes that legally this client can
continue to refuse treatment
the nurse is caring for a hospice client whose death is imminent in preparing the family for the death of their loved one, the nurse prepares to assist the family in which of the following regardless of the familys cultural preferences? sata
dealing with the shock of losing a loved one efforts to stay connected to the client after death anger at the loss of a loved one
the patient expresses frustration that the doctor does not spend enough time with the patient when making rounds. the nurse replies, the doctors are very busy. what can i help you with? the nurse incorporated which nontherapeutic technique in this response?
defending
a client who has been in a substance abuse treatment program asks the nurse for a date after the client is discharged. the nurse talks to the client about the importance of a therapetuic relatinoship and its characteristics. the nurse is using which of the following techniques
defining boundaries
the goal of the 1963 community mental health centers act was to
deinstitutionalize state hospitals
a client is admitted to the psychiatric unit and states i am the president of the largest corporation in the world everyone comes to me for advice. the client is exhibiting which of the following
delusion
the patient states that he is 14 trillion yrs old and created the world. the nurse documents this statement as an example of which type of thinking displayed by the patient
delusional thinking
after being laid off from work a client becomes increasingly withdrawn and fatigued spends entire days in bed is unkempt and is eating and sleeping poorly. the nurse woudl recognize that the client is in which stage of grieving according to Kubler ross?
depression
a psychiatric nurse is planning activites aimed at secondary prevention of mental illness. which activity would be the most appropriate to develop?
depression screening in an assisted living facility
knowing that relationships with others are significant to mental health- the nurse effectively assesses a patients family relationships through which of the following
describe your relationships with your family
which of the following would best assess a clients judgment
discussing hypothetical situations
a woman has just had a therapetuic aboriton to end an unintended pregnancy. afterward the woman cries because although she wanted to have children in the future years this pregnancy was not well timed. which type of grief is this woman most likely to experience
disenfranchised grief
the primary advantage of an evolving consumer household is that clients
do not have to relocate as they become more independent evolving consumer household is a place that someone can live at permenantly
which of the following is a standard of professional performance?
education
a nurse suspects that a patient is abusing alcohol while taking presribed mediations. the nusre plans to educate the patient on the dangers of mixing medicine with alcohol. which of the following would be the most effective way for the nurse to approach this subject w the patient
emphasize the importane of truthful information using a nonjudgmental approach
the nurse asks the client what that experience was like. which comunication skill is the nurse usin
encouraging expression
during the working phase of a therapeutic relationship, which of the following actions by the nurse woudl best help the client explore problems?
encouraging the client to clarify feelings and behavior.
the nurse is mindful of maintaining relatoinsihps with patients that are therapeutic. certain characteristics of the relationships the nurse will foster include: SATA
establishing boundaries for both the nurse and patient maintaining a patient focus at all times avoiding concern wtih wether the patient like sthe nurse
which one of the following is the most common reason for ethical dilemmas being a challenge to nurses
ethical dilemmas are often charged with emotion
during the initial interview with a client in crises, the initial priority is to
evaluate the potential for self-harm
which of the following is defined as an advanced-level function in the practice area of psychiatric mental health nursing?
evaluation
a nurse is meeting with a crisis support group. in efforts to help patients identify with one another, the nurse explains which of hte following about the crisis experience?
even happy events can cause a crisis if the stress is overwhelming
which type of community residential treatment settingi s most likely to be permanent in any state?
evolving consumer household
which of the following is most essential when planning care for a client who is experiencing a crisis?
explore previous coping strategies
a patient states right before i got here i was doing alright. my job was going well. my wife and i were happy. we just moved into a new apt. the nurse responds you said you and your wife were happy tell me mroe about that this is an example of
exploring
the nurse has been working with a patient with an eating disorder for one week. during the morning treatment team meeting the treatment plan is updated. which of the following would be appropriate interventions at this time in the nurse and patient relationship? sata
exploring perceptions of reality promoting a positive self concept working through resistancei can sense
the nurse is meeting a client for thef irst time who has just spontaneously lost her unborn child. after establishing rapport the priority nursing intervension should focus on which of the following
exploring what this loss means for the client
the nurse is initating a therapeutic relationship w/ a client should explain purpose which is to
faciliate a postiive change
which one of the following goals of therapetuic communication would the nurse strive to attain first
facilitate the clients expression of emotions
which of the following are the types of roles that are usually included when assessing roles and relationships? sata
family hobbies occuptation activities
the family members of a patient with bipolar disorder express frustration with the unpredictable behaviors of their loved one. which group should the nurse suggest as most helpful to this family
family education group
it is recorded in the clients chart that the family is resilient. the nurse concludes which of the following characeristics about the family life of this client? sata
family members spend time together family members engage in recreational activities together they work togehther = resilient family
how might the nurse best provide culturally competent care?
find out as much as possible about a clients cultural values beliefs and health practices
a patient shows no facial expression when engaging in a game with peers during an outing at the park. the nurse uses which of the following terms when documenting the patients affect
flat affect flat affect is NO facial expression
a patient is being admitted to an inpatient unit for treatment of anorexia. of the following assessment data, which should the nurse place as highest priority in the plan of care?
frequent vomiting after meals
a patient is being transferred from a group home to an evolving consumer household. the goal of this transition is for the patient to eventually
fulfill daily responsibilities without supervision
the factor having the most influence on the current trend in treatment settings it he fact in recent years
funding for community programs has been inadequate
a patient asks the nurse what she should do about her cheating husband. the nurse replies you should divorce him you deserve better than that the nurse used which communication technique
giving advice
under which conditions would it be in the clients best interest for the court to appoint a conservator or legal guardian? sata
gravely disabled mentally incompetent unable to provide basic needs when resources exist
several family members arrive to visit an african american client. the nurse can best meet this clients neeed for socialization by providing the client and family which of the following
group gatherings and open conversation
a client is actively involved in community service activities. the benefit of involvement in meaningful daily activities iwll most directly contribute to which of the following attributes?
hardiness meaningful daily activities will lead us to hardiness
which of the following occurences is considered a breach of professional boundaries?
having a lengthy social conversation with a patient
a client was brought to the emerg. dept. by police after neighbors complained that he was loud and disruptive. the client is paranoid and upset and states noone can be trusted. which of the riteria for involuntary admission does the client meet?
he does not meet any of the necessary criteria.
the nurse fails to assess personal values surrounding homosexuality beforecaring for a patient who is openly gay the nurse is most at risk for which of the following when working with this patient
holding a prejudice towards this patient
the nurse is working with a client who lost her youngest child 2 months ago. when the nurse approaches, the client yells, i dont want to talk to you! you have no idea whats its like to lose a child. the nurse bases her response to the client on the understanding of which of the following
hostility is a common behavioral response to grief.
which of the following questions best encourages the client to disclose information the nurse must assess to provide culturally competent care?
how do you want me to help you ?
the nurse is working with a patient who has quit several jobs and no longer sends financial support to his two children living with thier mother this behavior is in conflict w/ the nurses values concerning responsible parenting when discussing family roles with the patient the nurse shows positive regard through which statement
how is not working right now affecting you
a woman has just been served divorced papers from her husband she has no financial resources and little social support she states hes not really leaving hell be back the most appropriate response by the nurse would be which of hte following
how is this affecting u right now?
a patient being discharged appears angry wit hthe nurse when the nurse attempts to review discharge instructions with the patient. the nurse can best assist the patient in this stage of the relationship with which of the following responses?
i can sense you are angry this morning tell me how you feeling about being discharged today
the nurse on an addictive disorders unit receives a phone call inquiring about the status of a client. the caller is not on the clients allowed contact list. which of the following is the appropriate response by the nurse to the caller
i cannot confirm nor deny the existance of any client here.
a young client tells the nurse that her husband died 3 months ago and she is feeling alone and vulnerable which statement by the lcient would indicate that her coping skills are adequate
i will find a support group
the client tells the nurse That new TV anchor is telling the world about me. this is an example of
ideas of reference ideas of reference (general events are personally directed to him)
the nurse has established a therapeutic relationship with a patient. the patient is beginning to share feelings openly with the nurse. the relationship has entered which phase according to peplau's theory?
identification
during the orientation phase of the nurse patient relationsihip the nurse directs the patient to do which of the following
identify problems to examine
2 nurses are discussing the rights of hospitalized psychiatric clients. which of the following statements is an error?
if a commited client is also found to be imcompetent, he loses his rights under the patients bill of rights
when is a nurse legally obligated to breach confidentiality
if threats are made to an identifiable third party
a patient states i hate spending time with my family. theyre alwasy on my back about somethingf! I wont do anything they ask me to do. which response by the nurse reflects a behavioral perspective?
if you agree to start doing what your parents request, then they have agreed to respect your privacy more.
which of the following questions is best to ask when assessing the clients judgment?
if you found yourself downtown without money or a car how would you get home?
an elderly woman who lives alone is beginning to have difficulty maintaing her household and performing daily tasks. the nurse asks her to identify someone who can help her. the woman replies i dont need help ive been managing for years. which of the following responses hleps the client shift form denial to consciously coping with her situtaiton
if you were to need help with your house who might you ask for help
a patient remarks you know its the same thing everytime. the nurse should respond by saying
im not sure what you mean please explain
during a regular home health visit to an elderly client the nurse observes that the client has feelings of hopelessness and despair. the client says im old and my life has no purpose anymore but promise me you wont tell anyone. how should the nurse respond>
im sorry but i cant keep that kind of secret.
a client has been making sexual comments when communicating with the nurse. the nurse wants to spend some time talking to the patient while respecting the patients right to privacy. which setting would be the most appropriate setting for the nurse to talk to the patient
in a quiet corner of the dayroom at least 4 feet away from others
which of the following are true regarding mental health and mental illness?
in most cases, mental health is a state of emotional, psychological, and social wellness evidenced by satisfying interpersonal relationships, effective behavior and coping, positive self-concept, and emotional stability.
a student nurse attends a self-help group as part of a class assignment. while there the student recognizes a family friend, upon returning home, the student talks about the experience with the family. the student's actions can be described as
inappropriate; most self-help groups have a rule of confidentiality
an adolescent on the unit is argumentative iwth staff and peers. the nurse tells the adolescent arguing is not allowed one more word and u will have to stay in your room for the rest of the day the nurses directive is
inappropriate; room restriction is not treatment in the least restrictive environment
a patient has just been referred to a psychosocial rehabilitation program. the nurse explains that the benefits of being involved in such a program include:
increased independence recovery from mental illness increased community integration
a nurse is teaching decision making skills to a client with dependent personality disorder. according ot erikson, the likely cause of the client developing dependent personality is failure to meet the critical task of which developmental stage?
industry (industry vs inferiority is building confidence in own abilities) so if you accomplish this stage youre better at not depending on others to make choices and take actions. INDUSTRY failed if a client is dependent on others to make decisions
a patient who has continuously experienced severe symptoms of schizoaffective disorder for the past 17 years is expeiencing an acute psychotic episode. which level of care is most appropriate for patient?
inpatient hospital treatment
the nurse is conducting a history and physical exam on a client who is griving the unwated loss of marriage by divorce. which of the following physical symptoms of grief would the nurse most likely expect to detect in the history?
insomnia
a client begins to take stock of his life and look into the future. the nurse assesses that this client is in which of erison's developmental stages?
integrity versus despair reflecting on life is what happens in integrity versus despair
the nurse asks the client what is similar about a cow and a horse? and what do a bus and an airplane have in common? these quetsions would best assess which of hte following areas
intellectual function
the nurse is assessing a client who is talking about her son's recent death but who shows no emotion of any kind. the nurse recognizes this behavior as which of the following defense mechanisms?
intellectualization is showing no emotions towards a situation intellectualization
which of the following are core skill areas that are needed of any effective team member of an interdisciplinary team? select all that apply
interpersonal skills teamwork skills communication skills risk assessment and risk management skills
which of the following distance zones is acceptable for people who mutually desire personal contact?
intimate
the nurse is preparing to conduct an admission assessment interview w/ a mexican american client. during the interview the nurse should respect the clients culture through which behavior
introduce self with a handshake
a patient has just been told she has cervical cancer. when asked about how this is impacting her she states its just an infection it will clear up. the statement indicates that this patient
is using denial to protect herself from an emotionally painful thought.
which of the following statements is true of the component of a theraputic relationship of accepteance?
it is avoiding judgments of the person no matter what the behavior is
which of the following are advantages of a crisis resolution team or home treatment team? sata
it is more likely to help a client to perceive his or her situation more accurately it is designed to assist clients in daeling with mental health crises without hospitalization the client may feel better about asking for help
which of the following statments is true of empathy SATA
it is the ability to place oneself into the experience of another for a moment in time it is developed by gathering information from the client
which of the following is the most compelling reason for the nurse to discuss matters of sexuality and suicide?
it is the nurses professional responsbiliity to keep safety needs first and foremost.
the client says to the nurse i have special powers because i am the mother of god. i can heal everyone in the hospital. the nurse's best response would be
it would be unusual for anyone to have that kind of power
in the space of 5 minutes the client has been laughing and euphoric then angry then crying for no reason that is apparent to the nurse. this behavior would be best described as
labile mood labile mood = moods that shift rapidly
which of the following individual factors can a person modify to improve mental and emotional health? sata
lack of exercise poor nutrition sleeplessness
culture has the most influence on a person's health beliefs and practices. african americans believe that the cause of mental illness occurs because of which of the following
lack of spiritual balance
a client who has agreed to be hospitalized for depression problems has decided that now she wnats to leave. the mental health staff caring for her realizes that at present she can legally
leave hospital after giving writting notice of her intent to do so
the nurse has completed the psychosocial assessment. which of the following is the best approach toward analysis of the data to identify nursing diagnoses and develop an appropriate plan of care?
look for patterns reflected in the overall assessment.
throughout the assessment the client displays disorganized thinking, jumping from one idea to another with no clear relationship between the thoughts. the nurse would asses the client as having which of the following?
loose associations not in connection to each other
a young couple just ended their relationsihpa fter a 9 month engagement. the one of the individauls is seeking short term counseling to assist in grieving this loss. which type ofloss best describes what this client is experiencing
loss of security and sense of belonging to the relationship and safe with the other person.
the nurse says to the client you become very anxious when we start talking about your drinking. which of the following techniques is the nurse using
making an observation
which one of the following is a result of federal legislation
making it more difficult to commit people for mental health treatment against their will
the staff on an inpatient psychiatric is very busy and fall behidn on preiodic assesssmnet of a severely depressed client during the rounds the client is discovered to have completed a suicide attempt in teh bathroom which type of lawsuit could the clients famiy file
malpractice
which of the following statements about spirituality are true? sata
many clients with mental disorders have disturbing religious delusions religious activities have been shown to be linked with better health and a sense of well-being hope and faith are 2 critical factors in psychiatric and physical rehabilitation spirituality may include a relatoinship with the environment
which of the following theories could be classified as humanistic theories? select all that apply
maslow's hierarchy of needs roger's client centered therapy roger and maslow are humans
a client diagnosed with a mild anxiety disorder has been referred to treatment in a community mental health center. treatment most likely provided at the center includes
medical management of symptoms
which of the following statements about mental illness are true? select all that apply
mental illness can cause significant distress, impaired functioning, or both individuals suffering from mental illness may experience dissatisfaction with relationships and self.
a nurse is meeting with the city council to advocate for mentally ill persons and the establishment of a group home in a neighborhood where the plans have been strongly opposed by the neighbors. the nurse can effetively educate the public on the realities of group home by citing research that indicates
most people with mental illness do not respresent a significant danger to others
which one of the following is an important characteristic of an effective therapist and client relationship in individual psychotherapy?
mutual benefit for the client and the therapist
which of the following are examples of adventitious crises? select all that apply.
natural disasters violent crimes war adventitious crises = unpredictable events that are completely unexpected like natural disasters, crimes, wars.
the nurse is attending an inservice training on safe take down techniques for agresive clients. preparation for safe physical handling prepares the nurse to practice which ethical principle
nonmalificence
which of the following statements about verbal and nonverbal communication skills is accurate
nonverbal communication is as important if not more than verbal communication
the nurse considers cultural variations pertaining to a clients nonverbal communication. which of the following is the primary rationale for considering alternative meanings of nonverbal communication?
nonverbal messages have diff meanings in varoius cultures
which one of the following statements about the nurse and ethnocentrism is true?
nurses as people may inwardly view their culture as superior to others
which of the following factors influencing assessment is under the nurses control
nurses attitude and approach
which of the following statements is true fo treatment of people with mental illness in the united states today?
only 25% of people needing mental health services are receiving those services.
patients on an inpatient psychiatric unit can earn off unit priveleges for daily use of socially appropriate behavior. this is an example of employing which concept of behavior modification
operant conditioning operant is when you operate a certain way you get a reward.
which of the following is a standard of practice?
outcome identification
which cognitive mode, according to harry stack sullivan, begins in eraly childhood as the child begins to connect experiences in sequence?
parataxic mode for tax, makes sense to a child
what are 2 essential components of transitional care discharge model that is used in canada and scotland?
peer support and bridging staff
a nurse is orienting to a new position working the infirmary in the state penitentiary. when working with prisoners who are also mentally ill, the nurse examins her own attitudes. which of the following beliefs should the nurse discuss wiht her supervisior before caring for incarcerated patients
people with mental illness are inherently violent
which of the following are critical components to assess in a grieving person? sata
perception of the loss support system coping behaviors
during the assesssment the nurse asks the client to describe his problems. the purpose of this quetsion is to obtain info about the clients
perception of the problem
a nurse notices a patient sitting quietly alone eyes downcast and looking sad the nurse says to the patient you look like something is bothering you which pattern of knowing did the nurse use to respond to the patient
personal knowing
which of the following statements about hope and symptoms of mental illness are true? sata
persons having more hope experienced fewer actual symptoms a possible way to help clients manage and decrease symptoms would be to support the development of hope
which one of the following statements is most accurate regarding the age at onset of a mental illness such as schizophrenia?
persons who are diagnosed at a younger age will more likely have a poorer outcome.
beliefs about the causes of pain and illness vary among cultures. in the united states western culture pain and illness are generally attributed to
physiologic causes
before the period of the englightenment, treatment of the mentally ill included
placing the mentally ill on display for the public's amusement
which of the following is most ilkely to prevent the client from experiencing complicated grief?
plaes trusts in familiar others
a couple came to the emergency dept with their 5 month old son. he was pronounced dead of sudden infant death syndrome. in the next day or two it will be important for this couple to
plan funeral arrangements for their son
a nurse has been caring for a gunshot victim who has just died. various family and friends are present. one of the visitors privately discloses to the nurse that she and the clietn were having an illicit affair. which of the following is the best action by the nurse after learningfg of this relationship?
privately offer support to the vistor who was having the affair witht he client
which is the orientation of assertive community treatment?
problem solving orientation
which is the orientation of assertive community treatment (ACT)?
problem solving orientation youre assertive if you try to solve problems.
a client is supposed to be ambulating ad lib. instead, he refuses to get out of bed, asks for a bed bathm and makes many demands of the nurses. he also yells that they are lazy and incompetent. the client's behavior is an example of which of the following defense mechanisms?
projection hes acting lazy but hes yelling that the other nurses are lazy and incompetent to avoid facing that part of himself.
the creation of asylums during the 1800's was meant to
provide food and shelter for the mentally ill
a patient has been started on antidepressants. the interdisciplinary team member most responsible for monitoring effectiveness and side effects of this new medication is the
psychiatric nurse
a patient with bipolar disorder taking lithium returns from a walk outside nad reports feeling shaky and dizzy. the nurse suspects the patient is experiencing a toxic reaction to the lithium and immediately notifes the
psychiatrist
The primary purpose for generalist nurses to develop skills with psychosocial interventions is
psychosocial interventions are needed in all nursing practice settings
the primary purpose for generalist nurses to develop skills with psychosocial interventions is
psychosocial interventions are needed in all nursing practice settings
a significant change in the treatment of people with mental illness occured in the 1950's when
psychotropic drugs became available for use
a college student decides to go to a party the night before a major exam instead of studying. after receiving a low score on the exam, the student tells a fellow student, i have to work too much and dont have time to study. it wouldnt matter anyway beause the teacher is so unreasonable. the defense mechanism the student is using are
rationalization and projection rationalization because excusing own behavior to avoid guilt responsibility and conflict anxiety or loss of self-respect. projecting blame of failing back onto teacher
placing a client in restraints before using other methods of intervention violates which of the clients rights?
receive treatment in the least restrictive environment
sexuality and self harm behaviors are often difficult areas for nurses to assess. an effective way for nurses to deal wtih discomfort includes
recognizing that these areas may also be uncomfortable fo the patient to discuss
a patient is encouraged to join in daily outdoor games with peers on the unit. the interdisciplinary team member who will monitor the patients involvement will be the
recreation therapist
which of the following is a major developmental task of middle adulthood?
reexamining life goals
some residential treatment settings are transitional. this means that clients are eventually expected to
relocate to another setting
a patient with bipolar disorder has a long history of both hospitalizations and incarcerations. the patient has no permanent residence and has infrequent contact with his family. upon admission to the inpatient psychiatric unit for stabilization, the nurse documents all the following in his record. which of hte following data suggest a most positive outcome for this patient?
reporting meeting w/ the same case manager monthly for the last 4 years
individuals who grow up in at risk environemnts but are able to become productive, successful citizens are believed to possess which of the following characteristics
resilience (having healthy responses to stressful situations or risky environments) hardiness = able to resist illness under stress
the appropriate action for a student nurse who says the wrong thing is to
restate it by saying, that didnt come out right. what i meant was...
a client made threats to harm his parents if they come too close to him the parents called 911 and the client is now held involuntarily for a psychaitric evaluation during this time of involuntary admission the client retains all client rights except for which of the following
right to freedom
direct eye contact is preferred by which of the cultures
russians
a child who has witnessed the murder of his classmate while at school would experience which kind of loss
safety loss; losing a safe environment
which of the following is the highest priorty for admission to inpatient care?
safety of self or others
which of the following statments is true about a nurses self disclosure
self disclosure on the nurses part should benefit the client
which of the following personal characteristics influence a clients response to stressors? sata
self efficacy spirituality hardiness resilience resourcefulness
the client says to the nurse i know i can learn to cope with my family istuation by getting help here at the clinic ill be able to deal with them more effectively and i wont be so stressed out all the time this client is demonstrating a high level of
self-efficacy this is a belief that personal abilites and efforts affect the events in our lives. if he believes his behavior will make a difference than is more likely to take action
genetics have been shown to play which of the following roles in a person's mental and emotional health
several mental disorders appear to run in families
What is meant by the term revolving door effecti in mental health care?
shorter and more frequent hospital stays for persons with severe and persistent mental illness
the client says to the nurse i feel really close to you you are the only true friend i have the most therapeutic response the nurse can make is
since ours is a professional relationship lets explore other opportunities in your life for frendship remind its professional
the nurse asks the patient whatw as it like for you when you first knew you had no place to go? the patient looks down and pauses for quite some time. which action by the nurse is most therapeutic?
sit quietly until the patient responds
the nurse is sitting down with a patient to begin a conversation which of the following positions should the nurse take to convey acceptance of the patient
sitting upright facing the patient with both feet on the floor
which one of the following is one of the american nurses association standards of practice for psychiatric mental health nursing?
some aspects of standard 5: implementation may only be carried out by psychiatric mental health advanced practice nurses.
females from which of the following cultures are most likely to be expected to move in with the husbands family
south asians
spirituality is especially important in helping people cope primarily for which of the following reasons?
spirituality guides beliefs about the meaning of life events
the nurse is making a cultural assessment of a client. the most important data about a client's cultural beliefs are
subjective data from the client
the priority of inpatient care for people with severe mental illness is
symptom management
a patient with depression is admitted to an inpatient hospital unit for treatment. the type of therapy most likely provided in this setting includes
talk therapy for depression
a nurse and patient have just completed reviewing the patient's take home meds. the nurse is exemplifying which role during this intervention
teacher
the nurse is trying to obtain some info about family relationships from the client which of the following statements is best?
tell me your feelings about your family situation
A nursing supervisor reprimands an employee for being chronically late for work. if the employee handles the reprimand using the defense mechanism of displacement, he would most likely do which of the following?
tell the unit housekeeper that his work is sloppy (displacement - take the blame off himself project to another weaker person)
a nurse documents that a patient has successfuly acquired a job performing janitorial services at a local manufacturing company. the goal of which of the following levels of prevention has been achieved?
tertiary prevention
the nurse is assessing the factors contributing to the well-being of a newly admitted client. which of the following would the nurse identify as having a positive impact on the individual's mental health?
the ability to effectively manage stress
a client who is depressed and suicidal is schedule for electroconvulsive therapy. which requires consent. legally who should sign the consent for this treatment?
the client
which of the following are criteriat hat must be adhred to when instituting the short term use of restraint or seclusion? sata
the client is aggressive the client is immimnently dangerous to himself or herelf or to others all other means of calming the client have been unsuccessful
a client's prognosis is said to be good due to a high degree of self-efficacy. which of the following is evidence of a high degree of self-efficacy?
the client is self motivated and asks for help when needed
the nurse is working with a client who has a history of inflicting spousal abuse. although the nurse does not condone domestic violence, the nurse treats the client with unconditional positive regard through which of the following?
the client is still viewed as someone worthy of respect and assistance.
a client with terminal cancer has been told he has 3 or 4 months to live which of the following would indicate to the nurse that further interventions are needed
the client sasy he is well and is making future plans
the nurse is establishing outcomes for a grieving client. which of the following is an appropriate outcome?
the client will develop a plan for cping with the loss
a nurse and a client of china are collaborating on treatment goals the nurse would document which of the following as the clients priority goal
the client will express a feeling of balance and harmony
a client reports feeling lik ehe belongs among his peers with whom eh shares a group home. the nurse incorporates this sense of belonging when formulating discharge plans because the nurse understands which?
the client will likely feel needed by his peers
when the nurse asks the client to restate the following in his or her own words, which sensorium and intellectual process is the nurse attempting to identify? the nurse states a stich in time saves nine.
the clients ability to use abstract thinking
which of the following considerations should have the most influence in the nurses choice of treatment for the client
the clients feelings and perceptions about his or her situation
a patient reported to the nurse that on his way to the clinic, a policeman in a patrol car turned on his lights and pulled him over. when asked what he did next the patient stated, i pulled over of course. which of the following was the nurse trying to assess?
the clients judgment
which of the following factors would be the most influential in determining a clients response to a particular stressor
the clients perception of the stressor
which of the following factors is primarily responsible for the changes in inpatient hospital treatment between the 1980's and the present?
the growth of managed care
a client comes to the physicians office for an annual chekcup. during the interview the nurse learns that the clients husband died unexpecteldy of a heart attack 2 months ago. the most appropriate response by hte nurse would be
the loss of your husband msut be very painful for you
a client is scheduled for a mastectomy for breast cancer. she is quiet shows little emotion and states that she has no quetsions. the nurses assessment would need to focus on
the meaning of the mastectomy to the client
a malpractice lawsuit was filed after a nurse restrained the client for screaming at and attempting to strike anyone who was within striking distance. the nurse followed agency procedures that were consistent with joint commision standards. for which reasons is this malpractie lawsuit most likely to be unsuccessful
the nurse did not breach duty
a nurse is using the johari window to identify the degree to which he feels comfortable ocmmunicating with others. after completing the exercise the nurse discovers that quadrant 1 has the longest list of qualities this indicates which about hte nurse
the nurse is open to others johari window 1 longest = open to others
a nurse openly admits to not being able to relate to a patients experience. according to munhall this will most likely have what influence on the therapeutic relatinoship
the nurse will avoid imposing any values on the patient
The nurse understands that crises are self-limiting. this implies that upon evaluation of crises intervention, the nurse should assess for which outcome?
the patient will resume the precrisis level of functioning.
a nurse assesses that a depressed patient is lethargic during the day and does not actively participate in unit activites. the notes from the night shift document that the patient did not sleep well. the most probable interpretation of these data is
the patients depressed mood is impairing restful sleep patterns
the nurse reviews the results of the minnesota multiphasic personality inventory MMPI recorded in a patient record. while considering the usefullness of these data, the nurse is mindful that the MMPi has which limitation?
the results of the MMPI could be culturally biased.
which of the following persons are most likely experiencing complicated grieving
the spouse of a person who died 7 years ago and visit the grave several tiems a day a driver whose spouse and children all died as a result of his driving drunk an adult woh insisted for many years that he or she hated his or her deceased parent the parent of a child who died after having left the child in a car on a hot day
which of the following are eventual outcomes of the emotional dimension of grieving? sata
the survivor begins to resestablish a sense of personal identity direction and purpose for living the survivor begins to gain independence and confidence the survivor develops new ways of managing life and new relatoinsihps
the legislation enacted in 1963 was largely responsible for which of the following shifts in care for the mentally ill?
the widespread use of community-based services
a delusion represents a problem in which of the folowing areas
thinking delusion in thinking
when assessing a patients mental health status which of the following describe the purpose of the psychosocial assessment? Sata
to assess the clients current emotional state to assess the clients mental capacity to assess the clients behavioral function
which is included in healthy people 2020 objectives?
to increase the number of people who are identified, diagnosed, treated, and helped to live healthier lives.
the nurse is sitting with a patient who is crying. after a few minutes the nurse places one hand on the patients shoulder. which of the following best describes the purpose of the nurses touch with this patient?
to offer comfort and support for the patient
what is an important role of the nurse with regard to residents opposing plans to establish a group home or residential facility in their neighborhood?
to provide information to correct misinformation related to stereotypes of persons with mental illness
the nurse consults the dsm for which of the following purposes?
to serve as a guide for client assessment
the client tells the nurse i dont think you can help me everytime i talk to you i am reminded of my mother and i hated her the nurse should recognize this as
transference transfering feelings towards a certian person to another person
which of the following is the priority of the healthy people 2020 objectives for mental health?
treatment of mental illness
one of the primary differences between social and therapeutic relationships is the
type of responsibility involved
which would be a reason for a student nurse to use the DSM?
understand the reason for the admission and the nature of psychiatric illnesses.
A nurse is assisting a patient who is working on the technique of systematic desensitization. when the patient feels anxious, the nurse can best use the principles of this technique by stating
use the deep breathing techniques we practiced yesterday
a new graduate nurse has accepted a staff position at an inpatient mental health facility. the graduate nurse can expect to be responsbile for basic-level functions including
using effective communication skills
a client being served in a busy inpatient psychiatric unit becomes very noisy and combative. the other clients are complaiinig about the noise and are afraid they will be hurt by the client. the nruse determines that the best course of action for all involved is to seclude the client until the client is able to regain control of his behaviors. on which ethical principle did the nurse base this decision
utilitarianism
the nurse must be alert to the nonverbal expressions of the client. becuase the meaning attached to nonverbal is subjective, it is important for the nurse to
validate the meaning of the nonverbal behavior
which is standard for establishing a code of conduct for living
values
a teenage patient defies the nurses repeated requests to turn off the video game and go to sleep. the teen says angrily - u sound just like my mother at home! and continues to play the video game. the nurse understands that this statement likely indicates
viewing the nurse as her mother.
a patient is known to express tangential thinking. the nurse would assess for which of the following when interacting with the patient
wandering off the topic and never answering the question going off tangient
a patient who has been working on controlling impulsive behavior shows a strengthening ego through which of the following behaviors?
weighing the advantages and disadvantages before making a decision
a nurse can best assess a patients ability to use abstract thinking by asking the patient which of the following q's
what do i mean when i say dont sweat the small stuff? abstract thinking is tested when you ask the patient to explain a phrase that is used commonly
a nurse is working with a paeint whose background is very diff from hers a good quetsion to ask herself to assure she can be effective working with this patient would be
what experiences do i have with people with similar backgrounds
during the mental status assessment the client expresses the belief that the CIA is stalking him and plans to kidnap him. the best response by the nurse would be
what kind of things have been happening?
a patient is blaming his impending divorce on the fact that his wife goes out frequently with her girlfriends. if using reality therapy, the nurse would help the patient with which of the following responses?
what role do you think you have played in the end of your marriage?
which of the following are components of the assessment of thought process and content? sata
what the client is thinking how the client is thinking clarity of ideas self harm or suicide urges
which of the following would be circumstances when a client could be subjected to involuntary hospitalization? sata
when a client states that he or she intends to commit suicide and is making plans to do so when a client states that he or she intends to harm others deliberate act when a client is unable to control his or her rage and is assaulting everyone around him or her
which of the following dilemmas involve the ethical principle of fidelity? select all that apply
when the nurse is unable to agree with teh policies or common practices on an agency when the nurse is faced with a decision to violate a policy that is harmful to the client
a nurse is assigned to care for a client whose sexual orientation differs from hers. when shoudl the nurse seek clinical supervision
when the nurse tries to assist the client to change values
which of the following statments correctly depict the problem of feeling sympathy toward the client? sata
when the nurses behavior is rooted in sympathy, the client finds it easier to manipulate the nurses feelings the client is discouraged from exploring his or her problems thoughts nad feelings the client is discouraged from growth the client feels dependent on the nurse
the client spoke of a current event in the national news and described it as it relates to the client. then the client spoke of a historical event and described it as it realtes to the client. which of the following questions might the nurse ask to determine if hte client is experiencing ideas of reference?
where were you when this happened
the nurse best assesses a patients memory by asking which of the following questions?
who is the current president?
friends of a teenage male recently killed in a car accident are discussing their sense of loss. which of the following comments best indicates that the firends are trying to make sense of the loss cognitively
why did he have to die so young?
a client who has been grieving the loss of his wife 2 weeks ago says to the nurse the best part of my day is when i am back at work. is that wrong? the nruse educates that work and other daily activites serve which purpose?
working is letting you take an emotional break from grieving theres nothign wrong iwth that.
a woman has just delivered a stillborn baby boy. which of hte following would be the most appropriate nursing response
would you like to hold your son?
the nurse is working with a woman who lost her partner nearly 3 weeks prior. the woman has become recently less emotional and expressed that few things in her life have meaning right now. which response by the nures is most appropriate this his time
you are just starting to accept that this loss is real
a client greiving the recent loss of her husband asks if she is becoming mentally ill because she is so sad. the nurse's best response would be
you are not mentally ill. this is an expected reaction to the loss you have experienced.
The nurse understands that empathy is essential to the therapeutic relationship. when a patient makes the statement i am just devastate that my marriage is falling apart; the nurse can best show empathy thourhg which response?
you feel like your world is falling apart right now??
a patient is sitting alone slouched with eyes closed the nurse approaches which statement is most likely to encourage the patient to talk?
you look like you are deep in thought
the nurse approahces a client who looks very sad and is sitting alone crying the best response b the nurse in this situation is
you look very sad what is happening?
which of the following statements would be an empathetic response in a client interaction
you must have been embarrased when your father yelled at you in the grocery store.
a patient states i feel fine its a good day. the nurse notes the patient is looking away and a decreasing pitch in his voice while speaking. which of the following is the most therapeutic response by the nurse
you say you feel fine but you dont really sound fine
a patient says its been so long since ive been with ym family which statement by the nurse is an example of restating
you say you havent seen your family in a while
a patient yells, ALL THE NURSES HERE ARE SO MEAN! none of you really care about us! the most therapeutic response would be
you seem very irritated
which is a positive aspect of treating clients with mental illness in a community based care?
you will be able to live in your own home while you still see a therapist regularly
during the admission interview the nurse asks the client what led to his hospitalization. the client responds, they lied about me they said i murdered my mother. youre the kiler. you all killed my mother. she died before i was born. the best initial response by the nurse would be
youre having very frightening thoughts.