Mental Health exam #1

If a person's behaviors interfere with daily activities, impair her judgment, or alter her perception of reality, this person is considered to be: a Confused b Disoriented c Mentally healthy d Mentally ill

d

Psychotherapeutic drug therapy works primarily by: a Causing vasodilatation within the nervous system b Disrupting blood flow within the brain c Opening major nerve pathways within the brain d Altering chemical balances within the nervous system

d

The nurse documents in a male client's records that he displayed a "flat affect." The client's behavior most likely would consist of: 1. Rapid, dramatic changes in emotion 2. Sadness and hopelessness 3. Lack of agreement of affect and mood 4. Unresponsive emotions

4

A female client with severe depression is about to be discharged from an inpatient mental health unit. The client's highest level of education is seventh grade, and she reads at a fifth-grade level. The nurse is giving her discharge instructions. Which instruction is most appropriate for this client? 1. "Your MAOI should be taken once a day at the same time each day." 2. "This is the medicine for your depression, and you will take it every morning after you get up." 3. "Your MAOI should be taken q.d." 4. "Your antidepressant should be taken in the morning or in the evening at the same time each day."

2

a nonviolent client on the psychiatric unit suddenly refuses to take the prescribed antipsychotic medication. what should the nurse do? a honor the client's decision and document the behavior and all interventions b use an authoritarian approach to induce the client to take prescribed medication c call the health care provider and request that the client be discharged against medical advice d start proceedings to have the client declared incompetent and seek a court order permitting medication

a

What percentage of U.S. citizens have no health insurance? 1. 5% 2. 15% 3. 25% 4. 35%

2

The rights of the care provider include the right to: 1. Fair pay 2. Fair benefits from employers 3. Refuse to care for individuals who may cause harm to the care provider 4. Respect as individuals

3

Which type of community setting involves care for individuals with mental health issues in a protected and supervised environment within the community? 1. Psychiatric home care 2. Community mental health centers 3. Residential programs 4. Partial hospitalization

3

The nurse states to a client," What would you like to eat for your mid-morning snack?" The client responds, "My favorite snack is fizpopofluff. It's so quepsy." What speech pattern is this client exhibiting? 1. Echolalia 2. Mutism 3. Pressured speech 4. Neologism

4

A nursing supervisor sends an unlicensed assistive personnel (UAP) to help relieve the burden of care on a short-staffed medical-surgical unit. Which tasks can be delegated to the UAP? Select all that apply. a Taking routine vital signs b Applying a sterile dressing c Answering clients' call lights d Administering saline infusions e Changing linens on an occupied bed f Assessing client responses to ambulation

ace

which behaviors are most likely to be observed in a client who is a victim of sexual abuse? select all that apply a acting out b promiscuity c attention seeking d public masturbation e wariness of physical contact with adults

bd

a nurse delegates care for clients affected by flooding. which qualities are crucial for the nurse to have in order to accomplish this task thoroughly and on time? select all of that apply a treat each staff member as an adult b experience handling crisis conditions c adapt to the needs of the work group d quick in making decisions and taking actions e firm in assigning the defined tasks to the staff

bde

A nursing team leader identifies that a nurse is coming to work after drinking alcohol. What is the most appropriate way for the team leader to approach this ethical situation? a Counsel the nurse about the problem b Ignore the problem until it happens again c Notify the nurse manager about the problem d Resolve the problem by sending the nurse home

c

visitor from a room adjacent to a client asks the nurse what disease the client has. The nurse responds, "I will not discuss any client's illness with you. Are you concerned about it?" This response is based on the nurse's knowledge that to discuss a client's condition with someone not directly involved with that client is an example of what? a libel b negligence c breach of confidentiality d defamation of character

c

while addressing the group a nurse placed an emphasis on team building. the nurse also specifies that the individuals within the team will be credited based on their behavior and performance during the decisions making process. which type of leadership qualities does the nurse have? a situational leadership b autocratic leadership c democratic d free run style

c

what stage of kolhberg's theory of moral development define "right" by the decision of the conscience? a social contract orientation b society maintaining orientation c instrumental relativist orientation d universal ethical principle orientation

d

In the early 1900s, the neurophysiologist Sigmund Freud is credited with introducing which concept? a Psychoanalysis b Insanity c Lunacy d Mental illness

a

The concept of recidivism is prevalent among individuals with chronic psychiatric problems. Which is the most accurate description of this concept? 1. Relapse of symptoms of a client's mental health disease, resulting in frequent readmission to facilities 2. Coordination and cooperation between community mental health agencies and hospitals, resulting in continuity of care 3. Providing mental health care services to a client who lives on his own in his own home 4. Limited supervision in a community setting with emphasis on individual responsibility for care

1

When assessing the recent memory of a client, the nurse may ask questions regarding events that occurred within the past __________. 1. 2 weeks 2. 3 weeks 3. 4 weeks 4. 5 weeks

1

During an admission assessment, a male client states that he has been having auditory hallucinations and difficulty concentrating at work. This type of data is referred to as: 1. Objective 2. Subjective 3. Measured 4. Shared

2

The nurse observes the client as he paces the floor and talks to himself. The nurse documents, "Client confused and agitated." This is an example of: 1. Objective data 2. A judgment 3. Subjective data 4. An observation

2

When using physical restraints for client safety, the nurse must follow the guidelines of observing, assessing, and monitoring the client every __________ minutes; the restraint must be removed from one limb at a time, and each limb must be exercised every __________ hours. 1. 5; 2 2. 15; 2 3. 5; 4 4. 15; 4

2

A female client tells the care provider that she feels very depressed about her recent divorce. Which is the care provider's best response? 1. "I know exactly how you feel." 2. "Most people experience depressed feelings after a divorce." 3. "I know this must be difficult for you." 4. "Look on the bright side. You will be glad you divorced him in a couple of years."

3

Because many individuals in the United States do not seek health care for mental illness until late into the illness, many end up being seen in: 1. Hospitals and nursing homes 2. Outpatient and community services 3. Emergency rooms and jails 4. Physicians' offices

3

A nurse is caring for a client who had a nephrectomy because of cancer of the kidney. which factor will influence the client's ability to deep breathe and cough postoperatively? a location of surgical incision b increased anxiety about the prognosis c inflammatory process associated with surgery d pulmonary congestion from preoperative meds

a

A nurse is providing postoperative care for a client one hour before the client had an adrenalectomy. Maintenance steroid therapy has not begun yet. The nurse should monitor the client for which complication? a hypotension b hyperglycemia c sodium retention d potassium excretion

a

which acid base imbalance results in excretion of carbon dioxide by the lungs in a compensatory attempt to raise pH levels? a metabolic acidosis b metabolic alkalosis c respiratory acidosis d respiratory alkalosis

a

which assessment finding on a newborn's skin would need further investigation? a sclerema b acrocyanosis c cutis maromrata d edema around the eyes and face

a

According to the concept of the health-illness continuum, which actions can mentally healthy individuals do? Select all that apply. a Avoid stressors during activities of daily living. b Respond to stress with effective behaviors. c Develop effective coping mechanisms. d Set realistic goals for themselves. e Take no responsibility for own actions.

abc

which statement regarding certificates of need are true? select all that apply. a they consider the cost of running and starting a home care agency b they consider the availability of personnel and need for the services c they are granted by the state in accordance with rules and formulas set forth by state regulators d they constitute governmental recognition of an individual or educational program for meeting predetermined standards e they represent the process of granting recognition to a professional association that has demonstrated ability in a special are of practice

abc

a nurse is caring for a client who has had a thyroidectomy. what clinical symptoms will lead the nurse to suspect the client has developed post surgical hypothyroidism? select all that apply a dry skin b lethargy c insomnia d tachycardia e sensitive to cold

abe

A visiting nurse association is providing public health services under the governance of a community based board of directors. Which sources of funding would support this agency? select all that apply a grants b county revenues c fees from all sources d charitable contributions e tax-deductible contributions

ace

A client has cholelithiasis with possible obstruction of the common bile duct. What should be determined about the client's nutritional status before surgery is scheduled? a to determine if follows a high fatty diet b to determine id deficient in vitamins a, d, k c to determine if eats adequate amounts of dietary fiber d to determine if consumes excessive amounts of protein

b

A client on the psychiatric unit is undergoing a pretreatment evaluation for electroconvulsive therapy (ECT). Because of the client's profoundly depressed behavior, the nurse doubts that the client can provide informed consent. What should the nurse's initial intervention be? a Consulting with the hospital's legal staff and following their recommendation b Having the client verbalize her understanding and the outcomes of the procedure c Asking the client to sign the consent form because the client has not been declared incompetent d Suggesting to the health care provider that a family member sign the consent form for the client

b

A nurse is caring for a client w a diagnosis of cushing syndrome. What is the most common cause of cushing syndrome that the nurse should consider before assessing this client for physiological responses? a pituitary hypoplasia b hyperplasia of adrenal cortex c deprivation fo adrenocortical hormones d insufficient acth production

b

A nurse's coworker approaches the nurse to inquire about the test results of a friend who is being cared for by the nurse. How should the nurse respond? a Answer the questions softly so other people will not hear b Decline to discuss the friend's medical condition c Give the coworker the name of the client's primary healthcare provider, so the coworker can contact the provider instead d To provide reassurance, tell the coworker of the friend's test results that are within normal limits.

b

A woman arrives at the prenatal clinic stating that her pregnancy test is positive. she asks the nurse for information about an abortion. after verifying that the woman is at 8 weeks' gestation, the nurse counsels her that having an abortion is controversial and that many women have long lasting feelings of guilt after an abortion. what is the nurse's legal responsibility? a to share her own thoughts on abortion with the client b to provide the client with correct unbiased information c to ask why the client wants information about abortion d to notify the health care provider because this is beyond the scope of nursing practice

b

After assessing a client who is addicted to drugs, the nurse suspects that the client is at increased risk for sinusitis and rhinitis. Which statement of the client's may have led the nurse to suspect this risk? a "I freebase cocaine" b "I snort the powder form of cocaine" c "I dissolve the phencyclidine in alcohol and take it orally" d "I mix methamphetamine with marijuana and smoke it"

b

During a home visit the nurse observes the children and concludes that the family is democratic. Which behavior of the family lead to this conclusion? a the child's aunt cooks b the child is respected as an individual c the child's father makes all the decisions d the child is bound to strict rules and expectations

b

During a home visit, the nurse communicates w the family and understands that the family is establishment stage. what would lead the nurse to this conclusion? a the family has adopted their 1st child b the family is planning for birth of their first child c the family is taking decisions on childbirth methods d the family has announced they are engaged to be married

b

During the Dark Ages, demonic exorcisms were performed as a result of the belief that mental illness was punishment for sins, the result of witchcraft, or caused by: a Imbalance of fundamental elements b Possession by the devil c Rational soul controlling the irrational soul d Chemical imbalances within the body

b

In all states of the United States, what is the professional nurse's legal responsibility regarding child abuse? a Honor the request of the parents not to report the suspected abuse b Report any suspected abuse to local law enforcement authorities c Return the child to the legal parent even if he or she is suspected of abuse d Provide the parents with a copy of the child's medical record.

b

a health agency is providing private nursing care to a client with Alzheimer disease. a paid board of directors appointed by the owner governs this agency. how is this agency classified? a public nonprofit freestanding b private for-profit freestanding c private for-profit institution based d private nonprofit institution based

b

after ordinary physical activity, a client with cardiac insufficiency reports fatigue and dyspnea that is relieved by rest. according to the new York heart association heart failure classification, into which category of heart failure does this client fit? a class I b class II c class III D class IV

b

A client is admitted voluntarily to a psychiatric unit. Later, the client develops severe pain in the right lower quadrant and is diagnosed as having acute appendicitis. How should the nurse prepare the client for the appendectomy? a Have two nurses witness the client signing the operative consent form b Ensure that the primary healthcare provider and the psychiatrist sign for the surgery because it is an emergency procedure c Ask the client to sign the operative consent form after the client has been informed of the procedure and required care d Inform the client's next of kin that it will be necessary for one of them to sign the consent form because the client is on a psychiatric unit.

c

A client is admitted with ahead injury. The nurse identifies that the client's urinary catheter is draining large amounts of clear, colorless urine. What does the nurse identify as most likely cause? a increased serum glucose b decicient renal perfusion c inadequate aintidiuretic hormone secretion d excess amounts of iv fluid

c

A client with hemoglobin of 6 gm/dL is refusing blood because of religious reasons. What is the most appropriate action by the nurse? a call the chaplain to convince the client to receive the blood transfusion b discuss the case with coworkers c notify the primary health care provider of the client's refusal of blood products d explain to the client that they will die without blood transfusion

c

A hospital has threatened to refuse the discharge of a newborn until the parents pay part of the hospital bill. The nurse is aware that the legal term that best describes this situation is: a false threats b assault and battery c False imprisonment d breach of confidentiality

c

A nurse cares for a client with terminal pancreatic cancer. the client tells the nurse ' i have some spiritual questions and would like to talk to someone. which member of the care interdisciplinary hospice team should be contacted? a social worker b hospice volunteer c spiritual coordinator d bereavement coordinator

c

A nurse is collecting a health history from a client with thromboangiitis obliterans. What symptoms are most likely to be associated with this disorder? a General blanching of skin b Easy fatigue of extremities c Burning pain after exposure to cold d Presence of Homans sign when ambulating

c

A nurse is teaching staff members about the legal terminology used in child abuse. What definition of battery should the nurse include in the teaching? A. Maligning a person's character while threatening to do bodily harm B. A legal wrong committed by one person against property of another C. The application of force to another person without lawful justification D. Behaving in a way that a reasonable person with the same education would not

c

A primary health care provider asks a nurse to encourage bed rest and to plan care to prevent fatigue in a client. What condition might the client have? a pain related to ischemia b respiratory distress related to cardiac dysrhythmia c decreased cardiac output related to cardiac insufficiency d gastrointestinal complaints related to cardiac dysrhythmia

c

A staff member is planning to start a new job but is worried about the impact it might have on future growth opportunities. The nurse leader is helping the staff member understand all the implications. Which ethical principle is the nurse manager as a leader following a Justice b Veracity c Paternalism d Non-maleficence

c

During a home visit a nurse discovers that a child in the household has a disability and has been experiencing seizures. In addition the child's parent is unresponsive to the child's physical, emotional, or medical needs and seems to provoke seizure episodes by harsh verbal exchanges with the child. The nurse believes that the intervention by an appropriate community resource is indicated. Where should the nurse make a referral? a outpatient clinic b hospital pediatric unit c child protective services d bureau of the handicapped

c

It is determined that a staff nurse has drug abuse problem. what should happen as an initial intervention? a the staff nurse should be counseled by the staff psychiatrist b the staff nurse should be dismissed from the job immediately c the staff nurse should be referred to the employee assistance program d the staff nurse should be forced to promise to abstain from drugs in the future

c

The nurse is having difficulty understanding a client's decision to have hospice care rather than an extensive surgical procedure. Which ethical principle does the client's behavior illustrate? a Justice b Veracity c Autonomy d Beneficence

c

The nurse is reviewing the client's health history. with which diagnosis is a client most likely to exhibit hemoptysis? a anemia b pneumonia c tb d leukocytosis

c

a nurse is assessing a middle aged female client for the presence of risk factors associated with coronary heart disease. which risk factor carries a greater risk for women than men? a obesity b hypertension c diabetes mellitus d cigarette smoking

c

An adolescent is taken to the emergency department of the local hospital after stepping on a nail. The puncture wound is cleansed and a sterile dressing applied. The nurse asks about having had a tetanus immunization. The adolescent responds that all immunizations are up to date. Penicillin is administered, and the client is sent home with instructions to return if there is any change in the wound area. A few days later, the client is admitted to the hospital with a diagnosis of tetanus. Legally, what is the nurse's responsibility in this situation? a The nurse's judgment was adequate, and the client was treated accordingly b The possibility of tetanus was not foreseen because the client was immunized c Nurses should routinely administer immunization against tetanus after such an injury d Data collection by the nurse was incomplete, and as a result the treatment was insufficient

d

An adult client with schizophrenia is involuntarily admitted to the psychiatric unit. While off the unit for needed testing, the client runs away. Legally, who should the nurse notify immediately? a Probate judge b Client's family c Client's psychiatrist d Law enforcement officer

d

Refusing to follow the prescribed treatment regimen, a client plans to leave the hospital against medical advice. The nurse recognizes that it is important to inform the client that he or she: a Is acting irresponsibly b Is violating the hospital policy c Must obtain a new healthcare provider for future medical needs d Must accept full responsibility for possible undesirable outcomes

d

The nurse prepares to give a prescribed capsule of hydroxyzine to a client. The client begins to vomit, so the nurse holds the oral medication. The nurse has not opened the medication package. What does proper and safe disposal of the capsule of hydroxyzine require the nurse to do?Return the capsule to the pharmacy a Drop the capsule into the sharps container b crush the capsule and flush it into the sewer system c Place the capsule into a red biohazard bag and tie it shut d return the capsule to the pharmacy

d

What should the nurse do initially when obtaining consent for surgery?aDescribe the risks involved in the surgery bExplain that obtaining the signature is routine for any surgery cWitness the client's signature, which the nurse's signature will document dDetermine whether the client's knowledge level is sufficient to give consent.

d

Which action by a home care nurse would be considered an act of euthanasia? a Implementing a "do not resuscitate" order in the home health setting b Abiding by the decision of a living will signed by the client's family c Encouraging a client to consult an attorney to document and assign a power of attorney d Knowing that a dying client is overmedicating and not acting on this information

d

Which statement is true regarding the PPS developed secondary to the Balanced Budget ACT of 1997? a the pps imposed an intermin payment system to control home health expenditures b the pps implemented a new payment system to home health agencies to increase payments to clients c the pps imposed new limits on home health payments through a provision of bba d the pps provided incentives to home health providers to deliver home health services more efficiently

d

The brother of a male mental health client is concerned because he works during the day and has no one to care for his brother, who requires almost constant supervision. He wants to keep his brother at home but is unsure of what resources are available in the community. What is the nurse's best response? 1. "Have you considered a residential group home?" 2. "Let me give you some information on a community day treatment center." 3. "Psychiatric home care might be an option." 4. "A community mental health center would be good for your brother."

2

A client requires emergency cardiac surgery. The leader nurse wants to make the client aware of the situation and wants the client to decide what should be done. Which ethical model does the leader nurse follow here? a Autonomy model b paternalistic model c social justice model b patient benefit model

a

A female client is taking an antipsychotic medication for her schizophrenia. The nurse monitors this client for the peripheral nervous system side effects of: a Dry mouth, photophobia, and hypotension b Hypertension, photophobia, and bradycardia c Elevated blood glucose levels d Tremors and inability to sit still

a

which factors should the nurse consider when assessing an individual for a predisposition to violence, injury, or death? select all that apply. a poverty b education c work history d drug involvement e history of physical abuse

ade

A nurse is teaching a group of parents about child abuse. What definition of assault should the nurse include in the teaching plan? a Assault is a threat to do bodily harm to another person b It is a legal wrong committed by one person against the property of another c It is a legal wrong committed against the public that is punishable by state law d Assault is the application of force to another person without lawful justification

a

After a gastroscopy, how does the nurse assess the client for the return of the gag reflex? a Touching the pharynx with a tongue depressor b Giving a small amount of water using an oral syringe c Observing the client's swallowing ability d Instructing the client to breathe deeply and cough gently

a

An emancipated older adult with dementia develops a large pressure ulcer after refusing to change position for extended periods of time. the family blames the nurses for the client's condition. what is considered when deterring the source of blame fir the pressure ulcer? a the client should have been turned regularly b older clients frequently develop pressure ulcers c the nurse is not responsible to the client's family d nurses should respect a client's right not to be moved

a

The nurse prepares to give a prescribed capsule of hydroxyzine to a client. The client begins to vomit, so the nurse holds the oral medication. The nurse has not opened the medication package. What does proper and safe disposal of the capsule of hydroxyzine require the nurse to do? a Return the capsule to the pharmacy b Drop the capsule into the sharps container c Place the capsule into a red biohazard bag and tie it shut d Have another nurse witness the disposal of the medication.

a

A nurse applies a heating pad to a client's buttocks. Upon removal of the heating pad, the nurse discovers that the client has received burns due to incorrect settings when use of the heating pad was initiated. Which principle would legally apply? a No one could be held liable for new equipment b The nurse could be held liable for the injury that occurred c the nurse did what a reasonable, prudent nurse would do d The manufacturer is liable for new equipment.

b

The care provider is completing the general description portion of the mental status examination tool. One of the primary focuses of this portion of the tool is the client's: 1. Level of consciousness 2. Motor activity, gestures, and posture 3. Level of concentration and judgment 4. Perceptions

2

The caregiver observes a male client who is sitting in a chair, staring out the window for a long time. The caregiver asks the client whether he is okay. The client says that he is trying to talk himself into telling his wife about his gambling addiction and the money he has lost. He says that he is playing the scenario in his head and is thinking about how he wants to present the news to her and how she will respond. The client's behavior is an example of: 1. Hallucinations 2. Interpersonal communication 3. Delusions 4. Interpersonal communication

2

While dining in a restaurant, the nurse overhears two coworkers in the next booth discussing a client who is being cared for on the mental health unit in which they work. What action have the nurse's coworkers committed for which they could be held liable? 1. Libel 2. Slander 3. Invasion of privacy 4. Assault

3

Which patient right may clients with mental health disorders lose during treatment? 1. Confidentiality of records 2. Freedom from restraint or seclusion 3. Humane treatment environment 4. Referral to other mental health providers on discharge

2

In the early 1800s, Dr. Benjamin Rush wrote the first psychiatric text, Diseases of the Mind, in which he advocated which conditions for the mentally ill? Select all that apply a. Kindness b Clean condition c Good air, lighting, and food d Proper administration of psychotherapeutic drugs e Tranquilizing chairs

abc

Several hours after administering insulin, the nurse is assessing a client for an adverse response to the insulin. Which client responses are indicative of hypoglycemic reaction? select all that apply a confusion b tremors c anorexia d glycosuria e diaphoresis

abe