Mental Health Exam Midterm

When the client says, "I met Joe at the dance last week," what is the best way for the nurse to ask the client to describe her relationship with Joe?

" Tell me about you and Joe."

A client says to the nurse, "the federal guards were sent to kill me." which is the best response by the nurse to the client's concern?

"Do you feel afraid that people are trying to hurt you?"

Which of the following is a concrete message?

"Help me put this pile of books on Marsha's desk."

The nurse employed in a mental health clinic is greeted by a neighbor in a local grocery store. The neighbor says to the nurse, "How is carol doing?" she is my best friend and is seen at your clinic every week." Which is the most appropriate nursing response?

"I cannot discuss any client situation with you."

Which of the following client statements would indicate self-efficacy?

"I know if I can learn to relax, I will feel better."

The nurse is teaching a client taking an MAOI about foods with tyramine that he or she should avoid. Which of the following statement indicates that the client needs further teaching?

"I'm so glad I can have pizza as long as I don't order pepperoni".

Which of the following statements would cause concern for achievement of developmental tasks of a 55-year-old woman?

"My children need me now just as much as when they were small."

A female victim of sexual assault is being seen in the crisis center. The client states that she still feels "as though the rape just happened yesterday," even though it has been a few months since the incident. Which is the most appropriate nursing response?

"Tell me more about the incident that causes you to feel like the rape just occurred"

The spouse of a client admitted to the mental health unit for alcohol withdrawal says to the nurse, "I should get out of this bad situation." Which is the most helpful response by the nurse?

"What do you find difficult about this situation?"

The nurse is conducting an initial assessment of a client in crisis. When assessing the client's perception of the precipitating event that led to the crisis, which is the most appropriate question?

"What leads you to seek help now?"

The nurse observes that a client with a potential for violence is agitated, pacing up and down the hallway, and is making aggressive and belligerent gestures at other clients. Which statement would be most appropriate to make to this client?

"You seem restless; tell me what is happening"

A depressed client on an inpatient unity says to the nurse, "My family would be better off without me." Which is the nurse's best response?

"You sound very upset. Are you thinking of hurting yourself?"

A client with a diagnosis of depression who has attempted suicide says to the nurse, "I should have died. I've always been a failure. Nothing ever goes right for me." which response by the nurse demonstrates therapeutic communication?

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

Statements that are examples of unacceptable behaviors under JCAHO standards for a culture of safety.

- "Don't page me again, I'm very busy." -"If you tell my supervisor, you'll never hear the end of it." - "I haven't seen such stupid behavior since grade school."

The nurse determines that the wife of an alcoholic client is benefiting from attending an Al-Anon group if the nurse hears the wife make which statement?

- "I no longer feel that I deserve the beatings my husband inflicts on me"

A nurse in an emergency mental health facility is caring for a group of clients. The nurse should identify that which of the following clients requires a temporary emergency admission?

- A client who has borderline personality disorder and assaulted a homeless man with a metal rod

A nurse wants to use democratic leadership with a group whose purpose is to learn appropriate conflict resolution techniques. The nurse is correct in implementing this form of group leadership when she demonstrates which of the following actions?

- Asks for group suggestions of techniques and then supports discussion

A client's medication sheet contains a prescription for sertraline. To ensure safe administration of the medication, how should the nurse administer the dose?

- At the same time each evening

A nurse in an acute mental health facility is assisting with discharge planning for a client who has a severe mental illness and requires supervision much of the time. The client's wife works all day but is home by late afternoon. Which of the following strategies should the nurse suggest as appropriate follow-up care?

- Attending a partial hospitalization program

Which of the following types of drugs requires cautious use with potentially aggressive clients?

- Benzodiazepines

Which of the following elements are essential in a clinician's duty to warn?

- Client makes threatening statements - Potential victim(s) are identifiable - Threat of harm is serious

A nurse is caring for a client who is in mechanical restraints. Which of the following statements should the nurse include in the documentation?

- Client was offered 8 oz of water every hour - Client shouted obscenities at assistive personnel -Client received chlorpromazins 15 mg by mouth at 1000

Which of the following is the best action for the nurse to take when assessing a child who might be abused?

- Consult with a professional member of the health team about making a report

A nurse is planning a peer group discussion about the diagnostic and statistical manual of mental health disorders 5th edition. Which of the following information is appropriate to include in the discussion?

- DSM-5 establishes diagnostic criteria for individual mental health - The DSM-5 assists nurses in planning care for client's who have mental health disorders - The DSM-5 indicates expected assessment findings of mental health disorders

A nurse is planning care for the termination phase of a nurse-client relationship. Which of the following actions should the nurse include in the plan of care?

- Discussing ways to use new behaviors

A nurse is working in a community mental health facility. Which of the following services does this type of program provide?

- Educational programs -Medication dispensing programs -Individual counseling programs -Family therapy

Which type of child abuse can be most difficult to treat effectively?

- Emotional

A nurse working on an acute mental health unit forms a group to focus on self management of medications. At each of the meetings, two of the members use the opportunity to discuss their common interest in gambling on sports. This is an example of which of the following concepts?

- Hidden Agenda

A nurse is providing teaching for a client who is scheduled to receive ECT for the treatment of major depressive disorder. Which of the following client statements indicates understanding of the teaching?

- I will receive a muscle relaxant to protect me from injury during ECT

A nurse in an outpatient mental health clinic is preparing to conduct an initial client interview. When conducting the interview, which of the following actions should the nurse identify as the priority?

- Identify client's perception of her mental health status

A charge nurse is discussing the characteristics of a nurse-client relationship with a newly licensed nurse. Which of the following characteristics should the nurse include in the discussion?

- It is goal-oriented -Behavioral change is encouraged - A termination date is established

A nurse is talking with a client who is at risk for suicide following the death of his spouse. Which of the following statements should the nurse make?

- Losing someone close to you must be very upsetting

The nurse is planning care for a client being admitted to the nursing unit who attempted suicide. Which priority nursing intervention should the nurse include in the plan of care?

- One-to-one suicide precautions

A nurse in the working phase of a therapeutic relationship with a client who has methamphetamine use disorder. Which of the following actions indicates transference behavior?

- The client accuses the nurse of telling him what to do just like his ex girlfriend

A client taking lithium reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and tremors. The lithium level is 2.4 mEq/L. the nurse plans care based on which representation of this level?

- Toxic

A nurse is orienting a new client to a mental health unit. When explaining the unit's community meetings, which of the following statements should the nurse make?

- You and the other clients will meet with staff to discuss common problems

Situations that are considered risk factors for complicated grief are

- death of a spouse or child, death by suicide, and sudden and unexpected death

The client who believes everyone is out to get him or her is experiencing a(n)

- delusion

The client's belief that a news broadcast has special meaning for him or her is an example of

- ideas of reference

Critical factors for successful integration of loss during the grieving process are

- the client's adequate perception, adequate support, and adequate coping

The nurse provides an educational sessions on client rights. Which statement by a member of the session demonstrates the best understanding of the nurses role regarding ensuring that each client's rights are respected?

-"Being respectful and concerned will ensure that i'm attentive to my clients rights."

Which of the following is an example of assertive communication?

-"I feel angry when you walk away when I'm talking."

A nurse in a pediatric clinic is caring for a preschool-age child who has a new diagnosis of ADHD. When teaching the parent about this disorder, whickh of the following statements should the nurse include in the teaching?

-Because of this disorder, your child is at an increased risk for injury."

A nurse is leading a peer group discussion about the indications for ECT. Which of the following indications should the nurse include in the discussion?

-Bipolar disorder with rapid cycling

A hospitalized client with a history of alcohol abuse tells the nurse, "I am leaving now. I have to go. I don't want any more treatment. I have things that I have to do right away." The client has not been discharged and is scheduled for an important diagnostic test to be performed in 1 hour. After the nurse discusses the client's concerns with the client, the client dresses and begins to walk out of the hospital room. What action should the nurse take?

-Call the nursing supervisor

Assessment data about the client's speech patterns are categorized in which of the following areas?

-General appearance and motor behavior

A client is participating in a therapy group and focuses on viewing all team members as equally important in helping the clients to meet their goals. The nurse is implementing which therapeutic approach?

-Milieu therapy

The client who is involuntarily committed to an inpatient psychiatric unit loses which of the following rights?

-Right to freedom

A client tells a nurse, "Don't tell anyone, but I hid a sharp knife under my mattress in order to protect myself from my roommate, who is always yelling at me and threatening me." Which of the following actions should the nurse take?

-Tell the client that this must be reported to the health care team because it concerns the health and safety of the clients and others

A nurse is told during change of shift report that a client is stuporous. When assessing the client, which of the following findings should the nurse expect?

-The client arouses briefly in response to a sternal rub

The nurse should plan which goals of the termination stage of group development? Select all that apply.

-The group evaluates the experience -The group explores members' feelings about the group and the impending separation.

Which of the following is an example of an open-ended question?

-What concerns you most about your health?

Which of the following is an example of a closed-ended question?

-Where are you employed?

A client has a prescription for Haloperidol, 5 mg orally two times a day, as ordered by the physician. The client is suspicious and refuses to take the medication. The nurse says, "If you don't take this pill, I'll get an order to give you an injection." The nurse's statement is an example of

-assault

Metaphors

A Phrase that describes an object or situation by comparing it to something familiar.

The nurse is creating a plan of care for a client in a crisis state. When developing the plan, the nurse should consider which factor?

A client's response to a crisis is individualized and what constitutes a crisis for one client may not constitute a crisis for one client may not constitute a crisis for another client.

The mentally ill homeless population benefits most from:

A combination of housing, rehabilitation services, and community support.

support group

A group leader explores member's thoughts and feelings, and creates an atmosphere of acceptance so that members feel comfortable expressing themselves

self-help group

A group made up of people with similar problems who help and support one another without the direct leadership of a clinician.

Asylum

A safe refuge or haven offering protection.

Compassion fatigue

A type of secondary traumatic stress or burnout that comes from working through traumatic experiences with clients.

A client is preparing to attend a Gamblers anonymous meeting for the first time. The nurse should tell the client that which is the first stop in this 12 step program?

Admitting to having a problem

A nurse is caring for an adult client who has injuries resulting from intimate partner abuse. The client does not wish to report the violence to law enforcement authorities. Which of the following nursing actions is the highest priority?

Advise the client about the location of women's shelters.

Which theorist believed that people make themselves unhappy by clinging to irrational beliefs?

Albert Ellis

Stimulant drugs

Amphetamines, used to treat psychiatric disorders in the late 1930's for effects on CNS stimulation.

Anxiolytic drugs

Anti-anxiety drugs, used to treat anxiety, anxiety disorders, insomnia, OCD, depression, PTSD, and alcohol withdrawal.

Benztropine

Anticholinergic

What is the drug classification for Benzotropine (Cogentin)?

Anticholinergic

Carbamazepine (Tegretol)

Anticonvulsant

Limbic system

Area of the brain located above the brain stem that includes the thalamus, hypothalamus, hippocampus, and amygdala.

A client is admitted to the mental health unit after an attempted suicide by hanging. The nurse can best ensure client safety by which action?

Assigning to the client a staff member who will remain with the client at all times

Hospitals established by Dorothea Dix were designed to provide which of the following?

Asylum

The emotional frame of reference by which one sees the world is created by:

Attitudes

What is the drug classification for Clozapine (Clozaril)

Atypical Antipsychotics

What is the drug classification for Quetiapine (Seroquel)?

Atypical antipsychotic

A client is unwilling to go to his church because his ex-girlfriend goes there and he feels that she will laugh at him if she sees him. because of this hypersensitivity to a reaction from her, the client remains homebound. The home care nurse develops a plan of care that addresses which personality disorder?

Avoidant

Which theorist believed behavior is learned from past experience that is reinforcing?

B.F. Skinner

Methylphenidate (Ritalin)

CNS stimulant

Orientation

Can you tell me today's date? (time) Can you tell me where you are? (place) Can you tell me your name? (person)

What theorist believed that the client is the key to his/her own healing?

Carl Rogers

Client: "I was so upset about my sister ignoring my pain when I broke my leg." Nurse: "When are you going to your next diabetes program?" This is a non therapeutic response because the nurse has:

Changed the topic

Neurotransmitter

Chemical substances manufactured in the neuron that aid in the transmission of information throughout the body. Can excite or inhibit action in the cells.

Direct eye contact may be considered disrespectful in which of the following cultures?

Chinese South Asian Vietnamese

Overt cues

Clear direct statements of intent

Psychiatric rehabilitation focuses on:

Client's strengths

Congruent message

Conveyed when content and process agree.

When a nurse develops feelings toward a client that are based on the nurse's past experience, it is called:

Countertransference

Which of the following is most influential in determining health beliefs and practices?

Cultural factors

A charge nurse is reviewing Kübler-Ross: Five Stages of Grief with a group of newly licensed nurses. Which of the following stages should the charge nurse include in the teaching? (Select all that apply)

Denial, Anger, Bargaining, Depression

Define mental illness

Disorders that affect mood, behavior, and thinking, such as depression, schizophrenia, anxiety disorders, and addictive disorders.

Who fought for moral treatment of the mentally ill?

Dorothea Dix

Psychotropic drugs

Drugs used to treat mental disorders.

Who formulated the classification of mental disorders according to symptoms?

Emil Krapelin

Which of the following assessments indicates positive growth and development for a 30-year-old adult?

Enjoys social activities with three or four close friends

Mental health parity laws ensure:

Equality in insurance coverage for mental illness.

What theorist believed that social and psychological factors influence development.

Erik Erikson

A client with anorexia nervosa is a member of a pre-discharge support group. The client verbalizes that she would like to buy some new clothes, but her finances are limited. Group members have brought some used clothes to the client to replace the client's old clothes. The client believes that the new clothes are much too tight and has reduced her calorie intake by 800 calories daily. How should the nurse evaluate this behavior?

Evidence of the client's disturbed body image

What is the result of achieving or failing to achieve a psychosocial development task, according to Erik Erikson

Failing to achieve a developmental task at a given stage results results in a negative outcome for that stage. It also slows successful completion of future tasks. Achieving is the opposite. Achieving a task, means your more likely to achieve other tasks later.

What is the result of achieving or failing to achieve a psychosocial developmental task, according to Erik Erikson?

Failure to successfully complete the developmental tasks at a given stage results in a negative outcome for that stage—such as mistrust rather than trust—and impedes successful completion of future tasks. Successful completion of tasks sets the stage for further success at the next developmental stage.

Attitudes

General feelings or a frame of reference around which a person organizes knowledge about the world.

Client: "I had an accident" Nurse: "Tell me about your accident" This is an example of which therapeutic communication technique?

General lead

Values

Give a person a set of right and wrong and establish a code of conduct for living.

Which of the following theorists believed that a corrective interpersonal relationship with the therapist was the primary mode of treatment.

HIldegard Peplau

A handshake is considered an acceptable greeting for anyone in which of the following cultures?

Haitian Mexican American White European American

When a client is admitted to an inpatient mental health unit with the diagnosis of anorexia nervosa, a cognitive behavioral approach is used as part of the treatment plan. The nurse plans care based on which purpose of this approach?

Helping the client to examine dysfunctional thoughts and beliefs

Four levels of anxiety were described by:

Hildegard Peplau

Who formulated the therapeutic nurse-client relationship?

Hildegard Peplau

Self-concept

How would you describe yourself as a person?

The nurse is monitoring a hospitalized client who abuses alcohol. Which findings should alert the nurse to potential for alcohol withdrawal delirium?

Hypertension, changes in level of consciousness, hallucinations

Beliefs

Ideas that one holds to be true,

When planning for the discharge of a client with chronic anxiety, the nurse directs the goals at promoting a safe environment at home. Which is the most appropriate maintenance goal?

Identifying anxiety-producing situations

Judgment

If you were lost downtown, what would you do?

Mood

In general, how are you feeling?

Research shows that scheduled intermittent hospital admissions result in which of the following?

Increased sense of control for the client

Inpatient psychiatric care focuses on all the following, except: a. Brief interventions b. Discharge planning c. Independent living skills d. Symptom management

Independent living skills

"How does Jerry make you upset?" is a non therapeutic communication technique because it:

Indicates an external source of the emotion.

A nurse is preparing a community education seminar about family violence. When discussing types of violence, the nurse should include which of the following?

Intentionally causing an older adult to fall is an example of physical violence

The nurse is caring for a female client who was admitted to the mental health unit recently for anorexia nervosa. The nurse enters the client's room and notes that the client is engaged in rigorous push-ups. Which nursing action is most appropriate?

Interrupt the client and offer to take her for a walk

Which theorist believed that behavior change occurs through conditioning with environmental stimuli?

Ivan Pavlov

Explain the kindling process as it relates to the manic episodes of bipolar affective disorder.

Just as kindling is used to start a larger fire, mild or small manic mood swings can eventually trigger a major, acute manic episode.

Who was the first American psychiatric nurse?

Linda Richards

Content

Literal words that a person speaks.

Managed care is designed to:

Maintain a balance between the quality and costs of health care

Briefly explain culturally competent nursing care:

Means being sensitive to issues related to culture, race, gender, sexual orientation, social class, economic situation, and other facts that affect client care. It means that the nurse promotes the client's practice of his/her beliefs (e.g. spiritual practices), and uses nonverbal communication that is congruent with the client.

When reviewing the admission assessment, the nurse notes that a client was admitted to the mental health unit involuntarily. Based on this type of admission, the nurse should provide which intervention for this client?

Monitor closely for harm to self and others

The primary purpose of the Community Mental Health Center Act of 1963 was:

Moving patients to their home community for treatment

Which team member focuses of functional abilities and work using arts and crafts?

Occupational therapist

Proverb

Old accepted sayings with generally accepted meanings.

Who formulated the concept of asylum as a safe haven?

Philippe Pinel and William Tuke

Social relationship

Primarily initiated for the purpose of friendship, socialization, companionship, or accomplishment of a task.

Self-awareness

Process of developing an understanding of one's own values, beliefs, thoughts, feelings, attitudes, motivations, prejudices, strengths, and limitations and how these qualities affect others.

Which of the following physician orders would the nurse question for a client who has stated "I'm allergic to phenothiazines?"

Prolixin, 5 mg. PO bid

The primary purpose of psychiatric rehabilitation is to:

Promote the recovery process

Managed care provides funding for psychiatric rehabilitation programs to:

Provide community skills training

Which team member works with families, community supports, and referrals?

Psychiatric social worker

Which team member makes diagnoses and prescribes treatment?

Psychiatrist

Dream analysis and free association are techniques in which of the following?

Psychoanalysis

The nurse in the emergency department is caring for a young female victim of sexual assault. The client's physical assessment is complete, and physical evidence has been collected. The nurse notes that the client is withdrawn, confused, and at times physically immobile. How should the nurse interpret these behaviors?

Reactions to a devastating event

Rando's "six Rs" of grieving

Recognize React Recollect and re-experience Relinquish Readjust Reinvest

Client teaching for lamotrigine (Lamictal) should include which of the following?

Report any rashes to your doctor immediately.

Serotonin syndrome

Results from taking an MAOI and an SSRI at the same time. - Symptoms can include agitation, sweating, fever, tachycardia, hypotension, rigidity, hyperreflexia, coma, and possible death.

Fluoxetine (Prozac)

SSRI

What is the drug classification for Fluoxetine (Prozac)?

SSRI antidepressant

All are characteristics of ACT except which of the following?

Services are provided by the client's case manager.

The nurse is conducting a group therapy session. During the session, a client diagnosed with mania consistently disrupts the groups interactions, which intervention should the nurse initially implement?

Setting limits on the client's behavior

The signs of lithium toxicity include which of the following?

Severe vomiting, diarrhea, weakness

The personality structures of id, ego, and superego were described by:

Sigmund Freud

The nurse is caring for a client just admitted to the mental health unit in diagnosed with catatonic stupor. The client is lying on the bed in a fetal position. Which is the most appropriate nursing intervention?

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

Kindling process

Snowball like effect seen when minor seizure activity seems to build up into more frequent and severe seizures.

The client tells the nurse "My biggest problem right now is trying to deal with a divorce. I didn't want a divorce and I still don't. But it is happening anyway!" Which of the following responses by the nurse will convey empathy?

Sounds like it has been a difficult time.

What is mental health?

State of complete physical, mental, and social wellness, not merely absence of disease or infirmity.

What is the drug classification for Methylphenidate (Ritalin)?

Stimulant

Proxemics

Study of distance zones between people during communication.

The nursing role that involves being a substitute for another, such as a parent, is called:

Surrogate

Amitriptyline (Elavil)

TCA

Incongruent message

The content and process disagree. When what the speaker says and does, doesn't align.

The nurse is reviewing the assessment data of a client admitted to the mental health unit. The nurse notes that the admission nurse documented that the client is experiencing anxiety as a result of a situational crisis. The nurse plans care for the client, determining that this type of crisis could be caused by which event?

The death of a loved one

A client who has been depressed and suicidal started taking a tricyclic antidepressant 2 weeks ago and is now ready to leave the hospital to go home. Which of the following is a concern for the nurse as discharge plans are finalized?

The nurse will evaluate the risk for suicide by overdose of the tricyclic antidepressant.

Building trust is important in:

The orientation phase of a relationship

Psychopharmacology

The use of medications to treat mental illness.

Circumstantiality

The use of words with long tedious descriptions.

Concrete message

The words are explicit and need no interpretation.

Hildegard Peplau is best known for her writing about which of the following?

Therapeutic nurse-client relationship

Intimate relationship

Two people who are emotionally committed to each other.

Abstract messages

Unclear patterns of words that often contain figures of speech that are difficult to interpret.

Positive regard

Unconditional non-judgemental attitude.

A client diagnosed with delirium becomes disoriented and confused at night. Which intervention should the nurse implement initially?

Use an indirect light source to turn off the television

Mood-stabilizing drugs

Used to treat bipolar disorder by stabilizing the client's mood, preventing or minimizing the highs and lows that characterize bipolar illness, and treating acute episodes of mania.

Covert cues

Vague, indirect messages needing interpretation

Active observation

Watching the speaker's nonverbal actions as he or she communicates.

Abstract thinking ability

What does the saying "A rolling stone gathers no moss" mean to you?

Insight

What led you to come to the clinic?

Therapeutic use of self

When a nurse understands herself and can begin to use aspects of her personality, experiences, values, feelings, intelligence, needs, coping skills, and perceptions to establish relationships with clients.

Congruence

When words and actions match.

Verbal communication

Words a person uses to speak to one or more listeners.

Clients taking which of the following types of psychotropic medications need close monitoring of their cardiac status?

antipsychotics

Clonzepam (Klonopin)

anxiolytic

Clozapine (Clozaril)

atypical antipsychotic

Spirituality

client's belief about life, health, illness, death, and one's relationship to the universe.

Advocacy

the process of acting on the client's behalf when he or she cannot do so.

Abstract standards that provide a person with his or her code of conduct are:

values

Rando's six R's of grieving tasks include:

-React -Readjust - Reinvest

Provide three concerns nursing students might have as they begin psychiatric nursing clinical experiences.

-What if I say the wrong thing? -How will I handle bizarre or inappropriate behavior? -Is my physical safety in jeopardy?

Physiologic responses of complicated grieving include

-impaired immune system, increased serum prolactin level, increased mortality rate from heart disease

A client with a diagnosis of anorexia nervosa, who is in a state of starvation, is in a 2-bed room. A newly admitted client will be assigned to this client's room. Which client would be the best choice as a roommate for the client with anorexia nervosa.

A client undergoing diagnostic tests

Ideas that one holds as true are:

Beliefs

What is the drug classification for Clonazepam (Klonopin)?

Benzodiazapine

The nurse is caring for a client with schizophrenia who is taking haloperidol (Haldol). the client complains of restlessness, cannot sit still, and has muscle stiffness. Of the following PRN medication, which would the nurse administer?

Benztropine (Cogentin), 2 mg

Correcting how one thinks about the world and oneself is the focus of:

Cognitive therapy

" Earlier today you said you were concerned that your son was still upset with you. When I stopped by your room about an hour ago, you and your son seemed relaxed and smiling as you spoke to each other. How did things go between the two of you?"

Consensual validation

A client admitted voluntarily for treatment of an anxiety disorder demands to be released from the hospital. Which action should the nurse take initially?

Contact the clients health care provider (HCP)

" Why do you always complain about the night nurse? She is a nice woman and a fine nurse and has five to support. You're wrong when you say she is noisy and uncaring." This example reflects which nontherapeutic technique?

Defending

A manic client begins to make sexual advances towards visitors in the day room. When the nurse firmly states that this is inappropriate and will not be allowed, the client becomes verbally abusive and threatens physical violence to the nurse. Based on the analysis of the situation, which intervention should the nurse implement?

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

Cliches

Expression that has become trite and generally conveys a stereotype.

Therapeutic relationship

Focuses on the needs, experiences, feelings, and ideas of the client only.

Which of the following is a concern for children taking stimulants for ADHD for several years?

Growth suppression

Which of the following interventions is an example of primary prevention implemented by a public health nurse?

Teaching effective problem-solving skills to high school students

What is the most appropriate nursing action to help manage a manic client who is monopolizing a group therapy session?

Thank the client for the input, but inform the client that others now need a chance to contribute.

Which team member emphasizes job-seeking and job-retention skills?

Vocational rehabilitation specialist

A group that was designed to meet weekly for 10 sessions to deal with feelings of depression would be a(n):

closed group

education group

provide information on a specific issue

A nurse is caring for a group of clients. Which of the following clients should a nurse consider for referral to an assertive community treatment group?

- A client who lives at home and keeps "forgetting" to come in for his monthly antipsychotic injection for schizophrenia

A nurse is caring for several clients who are attending community based mental health programs. Which of the following clients should the nurse plan to visit first?

- A client who says he is hearing a voice that tells him his is not worthy of living anymore

A female client comes to an urgent care clinic and says, "I've just been raped." What should the nurse do?

- Allow the client to express whatever she wants - Ask the client if staff can call a friend or family member for her -Stay with the client until someone else arrives to be with her

Which nursing interventions are appropriate for a hospitalized client with mania who is exhibiting manipulative behavior? Select all that apply.

- Communicate expected behaviors to the client. -This is the client in identifying ways of setting limits on personal behaviors. -Follow through about the consequences of behavior in a non punitive manner. -Have a client state the consequences for behaving in ways that are viewed as unacceptable

Which of the following is important for nurses to remember when administering psychotropic drugs to nonwhites?

- Lower doses may be used to produce desired effects

A nurse is planning care for a client who has a mental health disorder. Which of the following actions should the nurse include as a psychobiological intervention?

- Monitor the client for adverse effects of medications

A client is admitted with a recent history of severe anxiety following a home invasion and robbery. During the initial assessment interview, which statement by the client should indicate to the nurse the possible diagnosis of posttraumatic stress disorder? Select all that apply

-"I keep reliving the robbery" - "I see his face everywhere I go" -"I might have died over a few dollars in my pocket"

Select all that apply: Which of the following are examples of a therapeutic communication response?

-"Tell me more about your discharge plans." -"What might you do the next time you are feeling angry?"

A client is diagnosed with terminal cancer says to the nurse, "I'm going to die, and I wish my family would stop hoping for a cure! I get so angry when they carry on like this. After all, I'm the one who's dying." which response by the nurse is therapeutic?

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

The nurse visits a client at home. The client states, "I haven't slept at all the last couple of nights." Which response by the nurse demonstrates therapeutic communication?

-"You're having difficulty sleeping?"

Which of the following would indicate a duty to warn a third party?

-A client states, "If I can't have my girlfriend back, then no one can have her."

A nurse is working with an established group and identifies various member roles. Which of the following should the nurse identify as an individual role?

-A member who brags about accomplishments

On review of the client's record, the nurse notes that the admission was voluntary. Based on this information, the nurse plans care anticipating which client behavior?

-A willingness to participate in the planning of the care and treatment plan

Empathy

-Ability of the nurse to perceive the meanings and feelings of the client and to communicate that understanding to the client. -Helps to provide high-quality compassionate care.

The nurse has been closely observing a client who has been displaying aggressive behaviors. The nurse observes that the behavior displayed by the client is escalating. Which nursing intervention is most helpful to this client at this time? Select all that apply.

-Acknowledge the client's behavior - Assist the client to an area that is quiet -Maintain a safe distance from the client

A community health nurse is leading a discussion about rape with a neighborhood task force. Which of the following statements by a neighborhood citizen indicates an understanding of the teaching?

-Acquaintance rape often involves alcohol.

Nursing interventions that are helpful for the grieving client include:

-Allowing denial when it is useful -Correcting faulty assumptions -Providing attentive presence -Reviewing past coping behaviors

Which of the following statements about anger is true?

-Anger results from being frustrated, hurt, or afraid

The police arrive at the emergency department with a client who has lacerated both wrists. Which is the initial nursing action?

-Assess and treat the wound sites

A nurse is caring or a client who has a new prescription for disulfiram for treatment of alcohol abuse disorder. The nurse informs the client that this medication can cause nausea and vomiting if he drinks alcohol. Which of the following types of treatment is this method an example?

-Aversion Therapy

Which of the following elements are necessary to prove liability in a malpractice lawsuit?

-Client is injured -Failure to conform to standards of care - Injury caused by breach of duty -Recognized relationship between client and nurse

The nurse observes a client muttering to himself and pounding his fist in his other hand while pacing in the hallway. Which of the following principles should guide the nurse's action?

-Clients who can verbalize angry feelings are less likely to become physically aggressive

Assessment of sensorium and intellectual processes includes which of the following?

-Concentration -Memory -Orientation

Behaviors observed during the recovery phase of the aggression cycle.

-Decreased muscle tension - Lowered voice volume - Rational communication

A nurse is planning group therapy for clients dealing with bereavement. Which of the following activities should the nurse include in the initial phase?

-Define the purpose of the group -Discuss termination of the group -Establish an expectation of confidentiality within the group

The nurse is preparing to perform an admission assessment on a client with a diagnosis of bulimia nervosa. Which assessment findings should the nurse expect to note? Select all that apply

-Dental decay -Loss of tooth enamel -Electrolyte imbalances

A nurse is assisting the parents of a school-age child who has oppositional defiant disorder in identifying strategies to promote positive behavior. Which of the following is an appropriate strategy for the nurse to recommend Select all that apply.)

-Develop a reward system for acceptable behavior -Encourage the child to participate in school sports. -Be consistent when addressing unacceptable behavior

A nurse is assessing a client who experienced sexual assault. Which of the following findings indicate the client is experiencing an emotional reaction of rape-trauma syndrome? (Select all that apply)

-Emotional outbursts -Difficulty making decisions

Which of the following are specific tasks of the working phase of a therapeutic relationship?

-Encourage expression of feelings -Facilitate behavior change - Promote self-esteem

A client is pacing in the hallway with clenched fists and a flushed face. He is yelling and swearing. Which phase of the aggression cycle is he in?

-Escalation

A community mental health nurse is planning care to address the issue of depression among older adult clients in the community. Which of the following interventions should the nurse plan as a method of tertiary prevention?

-Establishing rehabilitation programs to decrease the effects of depression

A nurse decides to put a client who has a psychotic disorder in seclusion overnight because the unit is very short staffed, and the client frequently fights with other clients. The nurse's actions are an example of which of the following torts?

-False imprisonment

A nurse is assisting with systematic desensitization for a client who has an extreme fear of elevators. Which of the following actions should the nurse implement with this form of therapy?

-Gradually expose the client to an elevator while practicing relaxation techniques

A nurse is discussing normal grief with a client who recently lost a child. Which of the following statements made by the client indicates understanding? (Select all that apply.)

-I may experience feelings of resentment. will probably withdraw from others. -I can expect to experience changes in sleep.

A nurse is discussing free association as a therapeutic tool with a client who has major depressive disorder. Which of the following client statements indicates understanding of this technique?

-I should say the first thing that comes to my mind

A nurse is caring for the parents of a child who has demonstrated recent changes in behavior and mood. When the mother of the child asks the nurse for reassurance about her son's condition, which of the following responses should the nurse make?

-I understand you're concerned. Let's discuss what concerns you specifically

A nurse is discussing the care of a client following a sexual assault with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of teaching?

-I will administer prophylactic treatment for sexually transmitted infections, like chlamydia."

A charge nurse is discussing TMS with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

-I will schedule the client for daily TMS treatments for the first several weeks

Women in battering relationships often remain in those relationships as a result of faulty or incorrect beliefs. Which of the following beliefs is valid?

-If she tried to leave, she would be at increased risk for violence

Which of the following assessment findings might indicate elder self-neglect?

-Inability to manage personal finances

A moderately depressed client who was hospitalized 2 days ago suddenly begins smiling and reporting that the crisis is over. The client says to the nurse, "I am finally cured." How should the nurse interpret this behavior as a cue to modify the treatment plan?

-Increasing the level of suicide precautions

The emergency department nurse is caring for an adult client who is a victim of family violence. Which priority instruction should be included in the discharge instructions?

-Information regarding shelters

The nurse is working with a client who despite making a heroic effort was unable to rescue a neighbor trapped in a house fire. Which client focused action should the nurse engage in during the working phase of the nurse-client relationship?

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

Assessment of suicidal risk includes which of the following?

-Intent to die -Method -Plan -Reason

A nurse is working with a client who has recently lost his mother. The nurse recognizes that which of the following factors influence a client's grief and coping ability? (Select all that apply)

-Interpersonal relationships -Birth order -Religious beliefs -Prior experience with loss

A charge nurse is conducting a class on therapeutic communication to a group of newly licensed nurses. Which of the following aspects of communication should the nurse identify as a component of verbal communication?

-Intonation

A nurse is conducting a family therapy session. The adolescent son tells the nurse that he plans to make his sister look bad so his parents will think he's the better sibling, which he believes will give him more privileges. The nurse should identify this dysfunctional behavior as which of the following?

-Manipulation

A nurse is conducting chart reviews of multiple clients at a community mental health facility. Which of the following events is an example of client experiencing a maturational crisis?

-Marriage

group psychotherapy

-Members, through process of interaction, gain knowledge/insight into themselves for purpose of change. -The focus of group psychotherapy is treatment of pathology or illness.

A nurse is assessing a client immediately following an ECT procedure. Which of the following findings should the nurse expect?

-Memory loss - Nausea - Confusion

Which interventions are most appropriate for caring for a client in alcohol withdrawal? Select all that apply

-Monitor vital signs -Provide a safe environment -Address hallucinations therapeutically - Provide reality orientation as appropriate

The nurse gives the client quetiapine (Seroquel) in error when olanzapine (Zyprexa) was ordered. The client has no ill effects from the quetiapine. In addition to making a medication error, the nurse has committed which of the following? a. Malpractice b. Negligence c. Tort (unintentional) d. None of the above

-None of the above

A nurse is communicating with a client who was just admitted for treatment of a substance use disorder. Which of the following communication techniques should the nurse identify as a barrier to therapeutic communication?

-Offering advice

A nurse is caring for a client who is experiencing a crisis. Which of the following medications might the provider prescribe? (Select all that apply.)

-Paroxetine -Lorazepam

A charge nurse is leading a peer group discussion about family and community violence. Which of the following statements by a member of the group indicates an understanding of teaching?

-Pregnancy increases the risk for violence toward the intimate partner

A nurse is preparing to implement cognitive reframing techniques for a client who has an anxiety disorder. Which of the following techniques should the nurse include in the plan of care?

-Priority restructuring - Monitoring thoughts -Journal keeping

The nurse observes that a client is pacing, agitated, and presenting aggressive gestures. The client speech pattern is rapid, in affect is belligerent. Based on these observations which is the nurses immediate priority of care?

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

Which of the following is true about domestic violence between same-sex partners?

-Rates of violence are about the same as between heterosexual partners

To assess the client's ability to concentrate, the nurse would instruct the client to do which of the following?

-Repeat the days of the week backward

A nurse is assessing a 4-year-old child for indications of autism spectrum disorder. For which of the following manifestations should the nurse assess?

-Repetitive counting

A nurse in an acute mental health facility is communicating with a client. The client states. "I can't sleep. I stay up all night." The nurse responds "you are having difficulty sleeping?" Which of the following therapeutic communication techniques is the nurse demonstrating?

-Restating

The nurse in a mental health unit plans to use which therapeutic communication techniques when communicating with a client? Select all that apply

-Restating -Listening -Maintaining neutral responses -Providing acknowledgment and feedback

A nurse is preparing to assess an infant who has shaken baby syndrome. Which of the following is an expected finding? (Select all that apply)

-Retinal hemorrhage -Altered level of consciousness -Increase in head circumference -Respiratory Distress

A nurse working in an emergency department is assessing a preschool-age child who reports abdominal pain. When conducting a head-to-toe assessment, which of the following findings should alert the nurse to possible abuse? (Select all that apply.)

-Round burn marks on forearms -Areas of ecchymosis on torso

A nurse is caring for a client following the loss of her partner due a terminal illness. Identify the sequence of Engel's five stages of grief that the nurse should expect the client experience. the stages of grief in order of occurrence. All steps must be used.)

-Shock and disbelief - Developing awareness - Restitution -Resolution of the loss - Recovery

A nurse is performing an admission assessment on an adolescent client who has depression. Which of the following manifestations should the nurse expect? (Select all that apply)

-Substance Use -Irritability -Aggressiveness

A nurse is discussing silent rape reaction with a newly licensed nurse. The nurse should identify which of the following characteristics as expected for this type of reaction? (Select all that apply)

-Sudden development of phobias -Increased level of anxiety during interview -Unwillingness to discuss the sexual assault

A nurse hears a newly licensed nurse discussing a client's hallucinations in the hallway with another nurse. Which of the following actions should the nurse take first?

-Tell the nurse to stop discussing the behavior

Which behavior observed by the nurse indicates a suspicion that a depressed adolescent client may be suicidal?

-The adolescent gives away a DVD and a cherished autographed picture of a performer.

A nurse caring for a client who has anorexia nervosa. Which of the following examples demonstrates the nurse's use of interpersonal communication?

-The nurse asks the client about her body image perception

A nurse is teaching a client who has an anxiety disorder and is scheduled to begin classical psychoanalysis. Which of the following client statements indicates an understanding of this form of therapy?

-The therapist will focus on my past relationships during our sessions

When the nurse is assessing whether or not the client's ideas are logical and make sense, the nurse is examining which of the following?

-Thought process

Which of the following give cues to the nurse that a client may be grieving for a loss?

-Thoughts, feelings, behavior, and physiologic complaints

A nurse is obtaining a health history from the parents of a 12-year-old client who has conduct disorder. Which of the following findings should the nurse expect? (Select all that apply)

-Threats of suicide -Law-breaking activities -Bullying of others

A charge nurse is discussing mental status examinations with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

-To assess cognitive ability, I should ask the client to count backwards by sevens -To assess affect, I should observe the client's facial expression -To assess language ability, I should instruct the client to write a sentence

A client experiencing disturbed thought processes believes that his food is being poisoned. Which communication technique should the nurse use to encourage the client to eat?

-Using open-ended questions and silence

A nurse is planning care for a client following surgical implantation of a VNS device. The nurse should plan to monitor for which of the following adverse effects?

-Voice changes -Dysphagia - Neck pain

Provide three additional concerns nursing students might have as they begin psychiatric nursing clinical experiences.

-What if I recognize that I share similar problems or backgrounds with the clients? -What happens if a client asks me on a date or displays sexually aggressive or inappropriate behavior? -What if no one will talk to me?

The nurse is preparing a client with a history of command hallucinations for discharge by providing instructions on interventions for managing hallucinations and anxiety. Which statement in response to these instructions suggest to the nurse that the client has a need for additional information?

-When I have command hallucinations, I'll call a friend and ask him what I should do.

A nurse is caring for a client who was recently raped. The client states, "I never should have been out on the street alone at night." Which of the following responses should the nurse make?

-You believe this wouldn't have happened if you hadn't been out alone?

A nurse is caring for a client who lost his mother to cancer last month. The client states, ""I'd still have my mother if the doctor would have diagnosed her sooner." Which of the following responses should the nurse make?

-You sound angry. Anger is a normal feeling associated with loss"

Describe the teaching needed for a client who is scheduled for PET

-a radioactive substance will be into the bloodstream. The client will be asked to perform "thinking" tasks while the camera takes scans of the brain working. The procedure will take 2 to 3 hours.

Explain the rationale for tapering psychotropic medication doses before the client discontinues the drug.

-abrupt cessation results in a rebound effect, recurrence of the original symptoms, or possible withdrawal symptoms. -tapering gradually minimizes these problems.

Select all that apply: The advantages of assertive communication are:

-all persons rights are respected - It protects the speaker from being exploited. -The speaker can say "no" to another person's request. -The speaker can safely express thoughts and feelings.

Examples of child maltreatment include

-calling the child stupid for climbing on a fence and getting injure - spanking an infant who won't stop crying - watching pornographic movies in a child's presence -withholding meals as punishment for disobedience

Discuss three trends of mental health care in the United States.

-cost containment and managed care -cultural considerations -community based care

A hospitalized client is delusional, yelling, "The world is coming to an end. We must all run to safety!" When other clients complain that this client is loud and annoying, the nurse decides to put the client in seclusion. The client has made no threatening gestures or statements to anyone. The nurse's action is an example of

-false imprisonment

Discuss ideas for increasing the number of people receiving treatment for mental illness.

-move to community health -less restrictive treatment closer to home -decrease the rate of long term stays - income for disable persons (SSI) allowing for independence and less reliance on family for money -laws that make more difficult to commit an individual against their will.

Confidentiality means respecting the client's right to keep his or her information private. When can the nurse share information about the client?

-the client threatens to harm a family member -The client gives written permission. -The client's legal guardian asks for information.

A client is admitted to the mental health unit with a diagnosis of depression. The nurse should develop a plan of care for the client that includes which intervention?

A structured program of activities in which the client can participate

The nurse is caring for a client diagnosed with paranoid personality disorder who is experiencing disturbed thought process is. In formulating a nursing plan of care, which best intervention should the nurse include?

Avoid using a whisper voice in front of the client.

The nurse calls security and has physical restraints applied to a client who was admitted voluntarily when the client becomes verbally abusive, demanding to be discharged from the hospital. Which represents the possible legal ramifications for the nurse associated with these interventions? Select all that apply.

Battery Assault False imprisonment

Nonverbal communication

Behavior that accompanies verbal content such as body language, eye contact, facial expression, tone of voice, speed and hesitations in speech, grunts and groans, and distance from the listeners.

Briefly explain culturally competent nursing care.

Culturally competent nursing care means being sensitive to issues related to culture, race, gender, sexual orientation, social class, economic situation, and other factors that affect client care. It means that the nurse promotes the client's practice of his or her beliefs (e.g., spiritual practices), uses nonverbal communication that is congruent with the client, and so forth.

Preconceptions

Ways one person expects another to behave or speak.

Transference

When a client unconsciously transferes to the nurse, feelings they may have for a significant other.

Countertransference

When a nurse responds to the client based on personal unconscious needs and conflicts.

Quetiapine (Seroquel)

atypical antipsychotic

A client is admitted to the medical nursing unit with a diagnosis of acute blindness after being involved in a hit-and-run accident. When diagnostic testing cannot identify any organic reason why this client cannot see, a mental health consult is prescribed. The nurse plans care based on which condition that should be the focus of this consult?

conversion disorder

Which of the following states the naturalistic view of what causes illness?

llness is caused by cold, heat, wind, and dampness