MH 1
A client has been prescribed naltrexone (ReVia) for treatment of alcohol dependence. Which of the following statements is correct about the drug? A. Blocks opiate receptors that cause a "high" B. Produces the euphoria of alcohol C. Improves appetite and nutritional status D. Causes itching if alcohol is consumed
A
A client is being admitted to the psychiatric unit. While explaining his reason for seeking admission, he describes how his 32 year old son recently died of a heart attack. Which response by the nurse would facilitate an open discussion of his feelings? A. "This must be a very difficult time for you." B. "How is your wife handling your son's death?" C. "Do you have nay other living children that can help you cope with this loss?" D. "I know exactly how you're feeling; my 23 year old died unexpectedly last year."A
A
A client is prescribed disulfiram as part of his alcohol treatment program to prevent relapse. The client ask the nurse, "How will this drug help me?" Which response by the nurse would be most appropriate? A. "It can help to prevent you from drinking." B. "It will help to cure your alcoholism." C. "It makes the withdrawal symptoms less troublesome" D. "It helps to clear the alcohol out of your body."
A
A contribution of Linda Richards that remains part of contemporary psychiatric nursing practice is the idea that: A.Nurses should assess both the physical and the emotional needs of patients B. Psychiatric nurses should have advanced educational preparation C. Psychotic behavior must be controlled before psychotherapy begins D. Basic physical needs must be met before emotional needs are addressed
A
A nurse is faced with an ethical dilemma involving a client. Which question would be most important for the nurse to ask first when engaging in the process of ethical decision making? A. What do I know about the situation? B. What assumptions am I making that need more data? C. What do I know about the client's values? D. What are my own feelings about the situation?
A
A nurse voices the opinion that nurses and doctors know what is best for the patient who is irrational and confused. This opinion most closely reflects which ethical principle? A. Paternalism B. Justice C. Nonmaleficence D. Veracity
A
A psychiatric-mental health nurse is documenting information in a client's medical record. Which of the following would be LEAST likely to cause legal liability? A. "Administered haloperidol 10 mg IM stat as ordered for agitation." B. "Applied restraints to all four extremities as needed." C. Client reported that he was feeling better today than yesterday." D. "Client was talking with another staff member and started screaming."
A
After assessing a client, the nurse noted the following: "Client was tearful in discussing his suicide attempt before coming into the hospital. Denies immediate plan for another suicide attempt, unable to concentrate, report trouble sleeping and little to no appetite." The nurse also noted that the client's appearance was unkempt, he spoke in a low monotone, and he was unable to establish and maintain eye contact. Based on this information, which nursing diagnosis would be the MOST appropriate? A. Risk for suicide b. Risk of injury to others C. Risk for falling D. Risk for self-mutilation
A
Patient: "Some days I think it's just not worth it. I'd be better off alone. Maybe things would be calmer and simpler without him." Nurse: "Are you saying that things might be better if you left your husband?" Which therapeutic communication technique is used in this interaction between patient and nurse? A. Restatement B. Affirmation C. Reflection D. Summarization
A
When engaged in therapeutic communication with a client who has a mental disorder, which of the following is the most important for the nurse to keep in mind? A. The client is the primary focus of the interaction. B. The nurse should have a sympathetic relationship with the client C. The nurse should self-disclose when indicated D. The client's conversations should be recorded
A
Which of the following clients would be the MOST likely candidate for involuntary commitment? A. The client who is screaming incoherently in the street disturbing the neighbors B. The client who refuses to participate in the planned therapy C. The client who refuses to take the prescribed medication D. The client with a mental disorder who is homeless
A
Which of the following is NOT an example of nonverbal communication? A. Words to convey underlying emotion B. Body language C. Gestures D. Expressions
A
Which of the following statements BEST explains the personal right to privacy? A. Privacy refers to that part of personal life not governed by society's laws or government intrusion B. Privacy reflects a knowledge of treatment risks and benefits C. Privacy implies an ethical duty for nondisclosure when no one else is threatened D. Privacy involved nondisclosure between two individuals
A
Your patient tells you that he has entered the witness protection program and can't answer your questions because "my family would be harmed if any information gets out. For national security reasons, I need to watch my back." This is an example of a: A. Delusion of persecution B. Delusion of grandeur C. Somatic delusion D. Nihilistic delusion
A
The nurse is completing the admission of a client who is seeking treatment for alcoholism. He tells the nurse that the last time he had nay alcohol to drink was at 10 AM, before he left for the hospital. The nurse closley monitors the client. Which of the following would lead the nurse to suspect that the client is expereincing stage 1 of alcohol withdrawal syndrome? Select all that apply? A. Hand tremors B. Intermittent confusion C. Slight diaphoresis D. Heart rate of 135 beats/min E. Normal blood pressure
ACE
A client tells the nurse that "I'm depressed and I want to feel like my old self again." Which nursing response would be most therapeutic? A. "What do you mean by feeling like your old self again?" Tell me more." B. "I'm sorry you feel that way. Why are you depressed?" C. "don't worry, we're all here to help you get better." D. "What would you like for me to do for you?"
A`
A client is talking to the nurse about the recent death of her grandmother. She is sad, and tears roll down her cheeks as she talks. The nurse remembers how she felt when her own grandmother died the previous summer. The nurse puts her hand on the client's shoulder and says, "This must be very difficult for you." The nurse is demonstrating empathy based on which of the following? A. The nurse demonstrates understanding of how the client feels because of her own grandmother's death B. the nurse's response reflects an attempt to communicate understanding of the client's feelings. C. The nurse's statement expresses compassion and kindness toward the client. D. The nurse's response and use of reassuring touch reinforce the nurse'e concern for the client.
B
A female psychiatric client is talking to the nurse about her reasons for being hospitalized. She begins to discuss her relationship with her female significant other. The client is describing the things in her relationship that are making her uncomfortable, and she asks the nurse, " Should I break up with my partner?" Which response by the nurse would be most effective in building rapport between the client and nurse? A. "Yes, I think you should pursue building a relationship with a man." B. "It sounds like you're beginning to be uncomfortable in this relationship" C. "Of course you should; being a lesbian is just not natural" D. "You need to focus on yourself rather than the relationship right now."
B
A male client age 52 years who has a history of alcohol dependence is admitted to a detoxification unit. He has tremors, he is anxious, his pulse has risen from 98 to 110 beats/min, his blood pressure has risen from 140/88 to 152/100 mmHg, and his temperature is 0.6 degrees about normal. He is slightly diaphoretic. Which nursing diagnosis would be the priority? A. Disturbed thought processes B. Risk for injury C. Ineffective coping D. Ineffective denial
B
A nurse is caring for a client who is hospitalized for a mental disorder. The nurse is legally obligated to breach the client's confidentiality if the client states which of the following? A. "I think that the federal government is spying on me." B. "When I get out of here, I'm going to kill my neighbor." C. "That doctor I had today really made me angry." D. "I get really 'turned on' by your appearance."
B
A nurse is using motivational interviewing with a female client suffering from alcoholism. The client, who is unwilling to consider changing her drinking behavior, emphatically states, "I am not an alcoholic; you can't make me stop drinking." Which response by the nurse would be MOST appropriate? A. "You should consider what you are doing to your marital relationship" B. "You're the only one who can make yourself stop drinking." C. "You're right. You are not an alcoholic." D. "You have to stop drinking and driving. You could kill someone."
B
A nurse was sued for malpractice but was acquitted (proven not liable). Which fact from the case was decisive in determining its outcome? A. The nurse failed to give competent care B. No harm was actually suffered by the patient C. The nurse had a duty to the patient D. Negligence was implied
B
A patient is in the process of being involuntarily committed and demands to be evaluated by her own private psychiatrist. To preserve the patient's rights, the treatment team must A. Proceed with the commitment B. Allow her access to her own private psychiatrist C. Request she be seen by the hospital psychiatrist D. Release her, even if her psychiatrist agrees with the proceedings
B
After meeting and spending approximately 20 minutes talking with a client, the nurse makes arrangements to talk again after lunch. After lunch, the nurse prepares to take a group of clients to play volleyball. The nurse starts to go but then remembers the previous promise to meet with a client. The nurse decides to forgo volleyball and talk with the client. Their decision BEST reflects which ethical principle? A. Veracity B. Fidelity C. Autonomy D. Beneficence
B
During a mental status assessment, the nurse asks a client to explain what the following means: "A penny saved is a penny earned." The nurse is assessing which of the following? A. Attention B. Abstract reasoning C. Concentration D. Affect
B
During the termination phase of the therapeutic relationship, a client brings up previously resolved problems and presents them now as new issues toward which to work. The nurse interprets the client's action as indicating which of the following? A. The client is unhappy that the therapy was ineffective B. The client is attempting to prolong the nurse-client relationship C. The client is angry that the nurse is abandoning him D. The client require additional therapy
B
Mental disorders are characterized by which of the following? A. Capacity to perceive one's surroundings realistically B. Alterations in affect, cognition, or behavior C. Capacity to interact with others D. Ability to deal with ordinary stress
B
The nurse is assessing a client's immediate and short-term memory. Which of the following actions would be most appropriate? A. Giving the client a simple scenario and having him identify what would be the best response B. Giving the client three words and asking him to recite them now and then in five minutes C. Asking the client to tell the nurse the date, time, and current location D. Questioning the client about an event that has occurred within the past several months
B
The nurse is providing care to a male client who is hospitalized with a diagnosis of schizophrenia. Which of the following entries would be appropriate for the nurse to document in the client's medical record? A."Client had a good night with no complaints." B. "Complained of being unable to sleep because he heard voices throughout the night." C. "Had a typical night without incidence of insomnia or nightmares" D. Acted crazily throughout the night; kept hearing voices and noises.
B
When communicating with a client, which of the following would the nurse use to convey positive body language? A. Sitting in a chair with the feet tucked under the legs B. Sitting at the client's eye level C. Crossing the arms over the chest D. Sitting erect with back against the chair
B
When the nurse tries to intervene with a flirtatious, manic patient who is embarrassing others on the unit, the most therapeutic nursing intervention is to say: A. Please don't get fresh with me, or I'll put you in seclusion." B. "I know you thoughts are very rapid right now, let's sit down and talk about what you can do to relax." C. "You can look but not touch." D. "Do not speak to me or others like this. It is not appropriate and will not be tolerated.
B
Which of the following questions would be MOST helpful in beginning an initial assessment interview for a client who has just been admitted to a psychiatric inpatient unit? A. "How would you describe your relationship with your spouse?" B. "What brings you into the hospital today?" C. "Have you had any thoughts about trying to harm yourself?" D. "Have you had any previous psychiatric admissions?"
B
A client is considered competent and able to give informed consent when he or she is able to do which of the following? A. Comply with the medical regiment and cooperate with treatment. B. Write a "living will" or an advanced directive C. Use a logical thought process to understand the risks and benefits D. Speak coherent English and ask questions
C
A client receives a court order for involuntary commitment. Which of the following best exemplifies the concept of "least restrictive environment?" A. Administering medication to sedate the client and restraining them to the bed B. Placing the client in a locked seclusion room to protect them from threats of self-harm C. Committing the patient to an outpatient community mental health center D. Allowing the client to make the decision about whether admission to the hospital is necessary
C
A nurse is implementing a brief intervention with a client who is abusing alcohol. The nurse most likely would be involved with which of the following? A. Helping the client restructure his or her thoughts B. Asking about a substance use C. Negotiating a conversation with the client to cut down on drinking D. Pointing out the inconsistencies in thoughts, feelings, and action
C
A nurse working on the psychiatric unit receives a telephone call from the employer of one of the clients on the unit. The employer asks to be sent a copy of the client's latest lab work and psychological testing results so medical records in employee health can be kept up-to-date. Based on the nurse's knowledge about issues surrounding breach of confidentiality, which response would be the MOST appropriate? A. "I'm sorry; we're not allowed to give out that information about our client." B. "Okay, give me your address, and I will see that the information is sent to you." C. "I'm unable to acknowledge whether or not a client is on this unit." D. "I'll have to get the client's signed consent before we can send that information to you."
C
An involuntary patient is discharged from the hospital prior to the expiration of the commitment period, but is required to attend a day treatment program for the next 3 months. This is an example of A. Preventive commitment B. Temporary probation C. Conditional release D. Voluntary commitment
C
Which individual played a major role in the development of speciality training programs for psychiatric nurses? A. Harriet Bailey B. Linda Richards C. Hildegard Peplau D. Mary Adelaide Nutting
C
Which of the following impacted mental health care as a result of the National Mental Health Act of 1946 in the post WWII era? A. Discovery of psychopharmacology B. Development of community mental health centers C. Establishment of the National Institute of Mental Health D. Passage of the Hill-Burton Act
C
Which of the following is NOT a right guaranteed to patients receiving mental health services? A. Right to habeas corpus B. Right to outside communication C. Right to refuse treatment during an emergency situation D. Right to treatment in least restrictive setting
C
A client 22 years of age with schizophrenia is refusing his antipsychotic medication. He states, "I don't like the dopey way it makes me feel I feel like I'm walking underwater when I take it." The nurse explains to him, "Your schizophrenia is caused by a chemical imbalance in your brain, and this medication helps fix that chemical imbalance. You need to take it so your symptoms will get better." This conversation reflects a conflicts between which two ethical principles? A. Autonomy and justice B. Justice and nonmaleficence C. Paternalism and veracity D. Autonomy and beneficence
D
A client 57 years old who has been a heavy drinker for many years is being treated for alcoholisms, and this is her second week as an inpatient on the psychiatric unit. It's 5 AM, and the client has been having difficulty sleeping. The client is an orthopedic nurse, and although she is clothed in a hospital-issued gown and robe, she is wearing a stethoscope around her neck that the nurse recognizes as belonging to one of the staff nurses. When the nurses asks her why she is wearing the stethoscope and where she got it, the client gives her a long and involved reply that describes how her nursing supervisor came to visit and gave it to her to wear "so she'd remember to get well." The nurse suspects that the client may be experiencing which of the following?" A. Delirium tremens B. Malignant hyperthermia C. Wernicke's syndrome D. Korsakoff's psychosis
D
A client is voluntarily admitted to the psychiatric hospital without a court order. The nurse understands that voluntary hospitalization can occur for how long? A. 48-96 hours B. A minimum of 24 hours C. A maximum of three to five days D. As long as inpatient treatment is appropriate and necessary
D
A client who is hospitalized with depression tells the nurse, "I don't want to take the medication because i'm afraid I'll become suicidal." Which response by the nurse would be MOST appropriate? A. "Another client took that medication, and he really felt better." B. "I agree with you. I wouldn't want to take this medication either." C. "It's important that you take this medication." D. "Have you ever had thoughts about hurting yourself?"
D
A nurse has developed a plan of care for a client with depression. Which nursing diagnosis would be considered the highest priority? A. Imbalanced nutrition, less than body requirements related to lack of appetite B. Ineffective role performance related to inability to participate as family provider C. Powerlessness related to feelings of helplessness and lack of control D. Risk for suicide related to depressed mood and feelings of worthlessness
D
A psychiatric-mental health client has an advance care directive on his medical record. A clinician provides treatment that disregards the client's directive. The clinician would be liable for which of the following? A. False imprisonment B. Battery C. Assault D. Medical battery
D
A psychiatric-mental health nurse who adheres to the standards of practice, engages in clinical reasoning and decision making to identify appropriate outcomes while planning care for the client. Which of the following provides the foundation for these activities? A. Legal accountability B. Ethical standards C. Developmental theories D. Nursing process
D
Based on assessment data, the nurse formulates the nursing diagnosis for a client as Sleep pattern disturbance. After educating the client on how to relax before bedtime, the nurse determines that the education was effective by which outcome? A. Requests sleeping medication each night before bedtime B. Is able to sleep for short intervals throughout the night C. Discusses feelings about not being able to fall asleep D. Within three days, client reports feeling rested upon awakening in the morning
D
During post clinical conference, the nursing instructor repeatedly asks questions to encourage the students to analyze and evaluate the nursing interventions they implemented throughout the clinical experiences. The students are engaged in which of the following? A. interdisciplinary care B. implementation C. therapeutic use of self D. Critical thinking
D
The discovery of psychotropic medications such as Thorazine was especially important in the treatment of people with mental illness because A. Psychiatric patients became more sedated and were less irritable B. Psychiatric nurses could spend less time with patients in therapeutic activities C. Fewer psychiatric nurses were needed to treat larger numbers of patients D. Psychiatric patients became more treatable, requiring less physical restraint
D
The most influential legislation to give access to mental health care for patients resulting in deinstitutionalization was the: A. Americans with Disabilities Act of 1990 B. Social Security Act of 1935 C. Omnibus Budget Reconciliation Act of 1987 D. Community Mental Health Center Act of 1963
D
Which of the following mental disorders is characterized by rapidly fluctuating moods, delusions and hallucinations? A. Generalized Anxiety Disorder B. Chronic paranoid schizophrenia C. Bipolar Disorder, Type 2 D. Schizoaffective disorder
D
