NCLEX Review Questions - Mental Health

Patients diagnosed with BPD exhibit negative effect, which includes rapidly moving from one emotional extreme to another. What term is used to describe this characteristic? Lability Impulsivity Splitting Denial

Lability

Based on the current understanding of brain physiology, which neurotransmitter would be the expected target of medication prescribed to manage depression? (Select all that apply.) Dopamine γ-aminobutyric acid (GABA) Serotonin Norepinephrine Acetylcholine

Dopamine γ-aminobutyric acid (GABA) Serotonin Norepinephrine

Which medication is FDA approved for treatment of anxiety in children? Sertraline Fluoxetine Clomipramine Duloxetine

Duloxetine

A nurse is providing care to a 28-year-old patient diagnosed with bipolar disorder who was admitted in a manic state. According to Maslow's Hierarchy of Needs theory, the nurse should identify which patient symptom as having priority? Rapid, pressured speech Grandiose thoughts Lack of sleep Hyperactive behavior

Lack of sleep

A prescription for which medication would require the nurse to monitor the client for potential development of the side effect of hypothyroidism? Fluoxetine Bupropion Lithium Imipramine

Lithium

A nurse, active in local consumer mental health groups and in local and state mental health associations, keeps aware of state and national legislation affecting mental illness treatment. How can this nurse positively affect the climate for effective, mental health treatment? "By becoming active in politics leading to a potential political career." "By educating the public on the effects that stigmatizing has on mental health clients." "Advocating for laws that would make the involuntary long-term commitment process easier and faster for caregivers of mentally ill persons." "Advocating for reduced mental health insurance benefits to discourage abuse of the system by inappropriate psychiatric admissions."

"By educating the public on the effects that stigmatizing has on mental health clients."

A 29-year-old patient has been admitted following a suicide attempt. Which nursing statement illustrates the concept of patient advocacy? "Dr. Raye, I notice you ordered fluoxetine for this patient. During the admission interview, the client stated they will refuse the medication because of adverse effects they experienced previously." "Dr. Raye, during the admissions interview the patient stated that there is a family history of three other suicide attempts in the past." "I'd like you tell me more about your depression and your suicide attempt?" "I will take you on a tour of the unit and orient you to the rules so you can get adjusted here."

"Dr. Raye, I notice you ordered fluoxetine for this patient. During the admission interview, the client stated they will refuse the medication because of adverse effects they experienced previously."

Ali is a 17-year-old patient with bulimia coming to the outpatient mental health clinic for counseling. Which of the following statements by Ali indicates that an appropriate outcome for treatment has been met? "I purge only once a day now instead of twice." "I feel a lot calmer lately, just like when I used to eat four or five cheeseburgers." "I am a hard worker and I am very compassionate toward others." "I always purge when I'm alone so that I'm not a bad role model for my younger sister."

"I am a hard worker and I am very compassionate toward others."

Which statement by a patient who has been taught cognitive reframing indicates that the teaching was successful? "I do not have the ability to handle that job." "I can be successful if I do all the things required to learn the job." "I may be fired from the job but eventually I will find something else to do with my life." "I can never learn all there is to know for the job."

"I can be successful if I do all the things required to learn the job."

A 38-year-old patient is admitted with major depression. Which statement made by the patient alerts the nurse to a common accompaniment to depression? "I still pray and read my Bible every day." "My mother wants to move in with me, but I want to independent." "I still feel bad about my sister dying of cancer. I should have done more for her!" "I've heard others say that depression is a sign of weakness."

"I still feel bad about my sister dying of cancer. I should have done more for her!"

You are working on an adolescent psychiatric unit. A 16 year old being treated on an adolescent psychiatric unit has become angry and is in the hallway yelling, "It's not fair! You all hate me! I hate this place!" When the client begins pounding his/her fists on the wall the nurse should attempt to de-escalate the situation by providing which response? "I will help you calm down. Do you want to go to your room and talk or go to the quiet room?" "You may yell and bang your fists but you must do it in your own room so you don't upset the other patients." "Stop that right now! I will not allow you to behave like that!" "You will have to go into seclusion and restraints right now in order to be safe."

"I will help you calm down. Do you want to go to your room and talk or go to the quiet room?"

A client prescribed fluoxetine demonstrates an understanding of the medication teaching when making which statement? "I will make sure to get plenty of sunshine and not use sunscreen to avoid a skin reaction." "I will not take any over-the-counter medication while on the fluoxetine." "I will report any symptoms of high fever, fast heartbeat, or abdominal pain to my provider right away." "I will report increased thirst and urination to my provider."

"I will report any symptoms of high fever, fast heartbeat, or abdominal pain to my provider right away."

Consider both Sullivan's term security operations and Freud's term defense mechanisms. Which statement suggests that the client's specialized treatment goal has been successfully met? "I really think I can succeed in school now." "I'm experiencing much less anxiety about school now." "Going back to school is hard and I'll need support." "I know that I'm not the only person who has a difficult time in school."

"I'm experiencing much less anxiety about school now."

A client diagnosed with schizophrenia states to the nurse, "My, oh my. My mother is brother. Anytime now it can happen to my mother." Your best response would be: "You are having problems with your speech. You need to try harder to be clear." "You are confused. I will take you to your room to rest a while." "I will get you a prn medication for agitation." "I'm sorry, I didn't understand that. Do you want to talk more about your mother as we did yesterday?"

"I'm sorry, I didn't understand that. Do you want to talk more about your mother as we did yesterday?"

A 17-year-old patient confides to the nurse that they have been thinking of ways to kill a peer. What response should the nurse give when the patient states, "you have to keep it a secret because its confidential information"? "I will keep it a secret, but you and I need to discuss ways to deal with this situation appropriately without committing a crime." "Yes, I will keep it confidential. We have laws to protect patients' confidentiality." "Issues of this kind have to be shared with the treatment team and your parents." "I will have to share this with the treatment team, but we will not share it with your parents."

"Issues of this kind have to be shared with the treatment team and your parents."

A client being prepared for discharge tells the nurse, "Dr. Jacobson is putting me on some medication called naltrexone. How will that help me?" Which response is appropriate teaching regarding naltrexone? "It helps your mood so that you don't feel the need to do drugs." "It will keep you from experiencing flashbacks." "It is a sedative that will help you sleep at night so you are more alert and able to make good decisions." "It helps prevent relapse by reducing drug cravings."

"It helps prevent relapse by reducing drug cravings."

A patient is presenting with behaviors that indicate anger. When approached, the patient states harshly, "I'm fine! Everything's great." Which response should the nurse provide to the patient? "Okay, but we are all here to help you, so come get one of the staff if you need to talk." "I'm glad everything is good. I am going to give you your schedule for the day and we can discuss how the groups are going." "I don't believe you. You are not being truthful with me." "It looks as though you are saying one thing but feeling another. Can you tell me what may be upsetting you?"

"It looks as though you are saying one thing but feeling another. Can you tell me what may be upsetting you?"

A 24-year-old patient diagnosed with borderline personality disorder (BPD) is admitted to the inpatient psychiatric unit following a suicide attempt. Which client statements illustrate a primary coping style of persons with BPD? "My provider says I might get out of here tomorrow. Do you think I'm ready to go?" "Last night the nurse let me go outside and smoke. I can't believe you aren't letting me. I used to think you were the best nurse here." "I will never again speak to any of my messed up family members. I know that this will help me to be more functional." "I promise I am not feeling suicidal. I won't hurt myself."

"Last night the nurse let me go outside and smoke. I can't believe you aren't letting me. I used to think you were the best nurse here."

Resilience is characteristic of mental health that allows people to adapt to tragedies, trauma, and loss. Which client behavior demonstrates this characteristic? "My mother made decisions about my husband's funeral when I just couldn't do that." "Losing my job was hard but my skills will help me get another one." "In spite of all the treatment, I know I'll never be really healthy." "My kids, happiness is worth any sacrifice I have to make."

"Losing my job was hard but my skills will help me get another one."

A nurse on the psychiatric unit has a past history of alcoholism and has regular meetings with a mentor. Which statement made to the nurse's mentor would indicate the presence of countertransference? "My patient is being discharged tomorrow. I provided discharge teaching and stressed the importance of calling the help line number should she become suicidal again." "My patient has been abusing alcohol. I told her that the only way to recover was to go 'cold turkey' and to get away from her dysfunctional family and to do it now!" "My patient started drinking after 14 years of sobriety. We are focusing on his treatment plan of attending AA (Alcoholics Anonymous) meetings five times a week after discharge." "My patient, is an elderly woman with depression. She calls me by her daughter's name because she says I remind her of her daughter."

"My patient has been abusing alcohol. I told her that the only way to recover was to go 'cold turkey' and to get away from her dysfunctional family and to do it now!"

A 38-year-old patient diagnosed with major depression states, "my provider said something about the medicine I've been prescribed will affect my neurotransmitters. What exactly are neurotransmitters?" What is the nurse's best response to the patient's question? "Neurotransmitters are chemical messengers in the brain that help regulate specific functions such as depression." "Neurotransmitters are too complicated to explain easily. Just know that the medication will help your mood and make you less depressed." "Neurotransmitters are chemicals in the brain that are the reason you are depressed." "I will ask your provider to give you a more in-depth explanation about why this medication will help your depression."

"Neurotransmitters are chemical messengers in the brain that help regulate specific functions such as depression."

Consider the nurse-patient relationship on an inpatient psychiatric unit. Which of the following statements made by the nurse reflects an accurate understanding of when the issue of termination should first be discussed? "You are being discharged today, so I'd like to bring up the subject of termination—discussing your time here and summarizing what coping skills you have attained." "I haven't met my new patient yet, but I am working through my feelings of anxiety in dealing with a patient who wanted to kill herself." "Now that we are working on your problem-solving skills and behaviors you'd like to change, I'd like to bring up the issue of termination." "Now that we've discussed your reasons for being here and how often we will meet, I'd like to talk about what we will do at the time of your discharge."

"Now that we've discussed your reasons for being here and how often we will meet, I'd like to talk about what we will do at the time of your discharge."

Which statement, made by a client diagnosed with dissociative identity disorder, demonstrates effective understanding in response to the question, "What exactly are the 'alters'? your provider told you about?" illustrates that the education you provided has been effective? "So, alters are based in mysticism and religiosity, such as demons." "So, alters are separate personalities with their own characteristics that take over during stress." "So, alters are never aware of each other." "So, alters are just like me, but they have no memory of the trauma I went through."

"So, alters are separate personalities with their own characteristics that take over during stress."

The mother of a 3-year-old boy just diagnosed with autism spectrum is tearful and states, "The doctor said we need to start therapy right away. I just don't understand how helpful it will be—he's only 3 years old!" What response should the nurse provide to the mother's statement? "You are right, 3 years old is very young to start therapy, but it will make you feel better to be doing something." "Starting him on treatment now gives Taylor a much greater chance for a productive life." "If your child starts therapy now, he will be able to stop therapy sooner." "If you have questions, its best to ask the doctor."

"Starting him on treatment now gives Taylor a much greater chance for a productive life."

A patient admitted with anxiety asks, "What exactly are stressors?" What is the nurse's best response to the patient's question? "Stressors are events that happen that threaten your current functioning and require you to adapt." "Stressors are complicated neuro stimuli that cause mental illness." "It's best if you ask questions like that of your provider for a complete answer." "Instead of focusing on what stressors are, let's explore your coping skills."

"Stressors are events that happen that threaten your current functioning and require you to adapt."

When considering the duty to warn and protect third parties, which client statement should the nurse report to the treatment team members? "That judge is going to really regret putting me in here." "All politicians need to be shot." "When I'm elected president, I'll make them all pay for doubting me." "The man out there who is laughing at me is going to die."

"That judge is going to really regret putting me in here."

A patient who recently loss a parent begins crying during a one-to-one session with the nurse. Which of the following responses by the nurse illustrates empathy? "I'm so sorry. My father died 2 years ago, so I know how you are feeling." "You need to focus on yourself right now. You deserve to take time just for you." "That must have been such a hard situation for you to deal with." "I know that you will get over this. It just takes time."

"That must have been such a hard situation for you to deal with."

Which response should the nurse provide a client who asks, "Why you need to conduct an assessment interview"? "I need to find out more about you and the way you think in order to best help you." "The assessment interview lets you have an opportunity to express your feelings." "You are able to tell me in detail about your past so that we can determine why you are experiencing mental health alterations." "We will be able to form a relationship together where we can discuss the current problems and come up with goals and a plan for treatment."

"We will be able to form a relationship together where we can discuss the current problems and come up with goals and a plan for treatment."

Which of the following statements represent a nontherapeutic communication technique? (select all that apply) "Why didn't you attend group this morning?" "From what you have said, you have great difficulty sleeping at night." "What did your boyfriend do that made you leave? Are you angry at him? Did he abuse you in some way?" "If I were you, I would quit the stressful job and find something else." "I'm really proud of you for the way you stood up to your brother when he visited today." "You mentioned that you have never had friends. Tell me more about that." "It sounds like you have been having a very hard time at home lately."

"Why didn't you attend group this morning?" "What did your boyfriend do that made you leave? Are you angry at him? Did he abuse you in some way?" "If I were you, I would quit the stressful job and find something else." "I'm really proud of you for the way you stood up to your brother when he visited today."

A 26-year-old patient is brought to the emergency room by a friend. The patient is unable to give any coherent history. Which response should the nurse provide when the patient's friend offers to provide information regarding the patient? "I'm sorry, but I cannot take any information from you as it would violate confidentiality laws." "There is no need for that as I will call his primary care provider to obtain the information we need." "Yes, I will be happy to get any information and history that you can provide." "Yes, however, we will have to get a release signed from the patient for you to be able to talk with me."

"Yes, I will be happy to get any information and history that you can provide."

The nurse in an emergency department notices a patient's husband, pacing in the hallway, muttering to himself, and looking angrily around the emergency department. Which statement should the nurse make to the spouse to help prevent escalation and/or violence? "You need to stay with your wife. She needs you." "Hey, what's up? You look out of control." "I am calling security to deal with your behavior." "You appear upset. Can I help you with anything?"

"You appear upset. Can I help you with anything?"

A client has been admitted to your inpatient psychiatric unit with suicidal ideation. In a one-to-one session with the nurse, he shares the terrible guilt he feels over sexually abusing his stepdaughter and wanting to die because of it. Which of the following responses you could make reflects a helpful trait in a therapeutic relationship? "It's good that you feel guilty. That means you still have a chance of being helped." "Of course you feel guilty. You did a horrendous thing. You shouldn't even forget what you did." "The biggest question is, will you do it again? You will end up having even worse guilt feelings because you hurt someone again." "You are suffering with guilt over what you did. Let's talk about some goals we could work on that may make you want to keep living."

"You are suffering with guilt over what you did. Let's talk about some goals we could work on that may make you want to keep living."

A new nurse has accepted a position as staff nurse on a psychiatric unit. Which statement made by the new nurse requires additional instructions regarding the therapies provided on the unit? "You will participate in unit activities and groups daily." "You will be given a schedule daily of the groups we would like you to attend." "You will attend a psychotherapy group that I lead that will help you care for yourself." "You will see your provider daily in a one-to-one session."

"You will attend a psychotherapy group that I lead that will help you care for yourself."

Which hospitalized patient should the nurse identify as being a candidate for the appropriate use of a release from hospitalization known as against medical advice (AMA)? A 37-year-old patient scheduled for discharge in 24 hours wishes to be discharged immediately A 75-year-old patient with dementia who demands to be allowed to go back to his own home A 21-year-old actively suicidal patient who wants to be discharged to home and do outpatient counseling A 32-year-old female patient who wishes to stay in the hospital but whose husband demands that she be discharged into his care

A 37-year-old patient scheduled for discharge in 24 hours wishes to be discharged immediately

Which client behavior illustrates eustress? A college student fails an exam. A bride is planning for her wedding. A man is laid off from his job. An adolescent gets into a fight at school.

A bride is planning for her wedding.

Which scenarios describe a HIPAA violation associated with a nurse's behavior? An ED (Emergency Department) nurse gives the intensive care unit nurse a client report from a telephone at the nurse's station. A nurse on the medical-surgical floor calls a patient's primary care provider to obtain a list of current medications. A nurse on the cardiac unit gives report to the nurse on the step-down unit while transporting a client in the staff elevator. A nurse on the psychiatric unit gives discharge information to the counseling office regarding a client's outpatient treatment.

A nurse on the cardiac unit gives report to the nurse on the step-down unit while transporting a client in the staff elevator.

The nurse is conducting an admission interview with a client who was raped 2 weeks ago. When asked about the rape, the client becomes very anxious and upset and begins to sob. What should be the nurse's response to the client's reaction? Push gently for more information about the rape because the information needs to be documented. Acknowledge that the topic of the rape is upsetting and reassure the client that it can be discussed at another time when she feels more comfortable. Use silence as a therapeutic tool and wait until the client is done sobbing to continue discussing the rape. Reassure the client that anything she says to you will remain confidential.

Acknowledge that the topic of the rape is upsetting and reassure the client that it can be discussed at another time when she feels more comfortable.

A client's daughter states, "My mother lives with me since my dad died 6 months ago. For the past couple of months, every time I need to leave the house for work or anything else, Mom becomes extremely anxious and cries that something terrible is going to happen to me. She seems OK except for these times, but it's affecting my ability to go to work." This information supports that the client may be experiencing which anxiety-related disorder? Panic disorder Adult separation anxiety disorder Agoraphobia Social anxiety disorder

Adult separation anxiety disorder

Which statement is true of pharmacological therapies associated with the treatment of personality disorders? Although there are no FDA-approved drugs specific to the treatment of personality disorders, patients benefit from specific off-label uses of antipsychotics, mood stabilizers, and antidepressants, depending on which personality disorder is evident. Research has shown that currently available psychotropic drugs have not been shown to be effective in treating personality disorders. Patients with narcissistic personality disorder and obsessive-compulsive personality disorder have shown the most benefit from the use of antianxiety medications along with use of selective serotonin reuptake inhibitors. Patients with personality disorders have been shown to be resistant to accepting medication, and as a result most providers do not prescribe psychotropic drugs to these patients.

Although there are no FDA-approved drugs specific to the treatment of personality disorders, patients benefit from specific off-label uses of antipsychotics, mood stabilizers, and antidepressants, depending on which personality disorder is evident.

A client admitted with major depression and suicidal ideation with a plan to overdose is preparing for discharge and asks you, "Why did I get a prescription for only 7 days of amitriptyline?" The nurse's response is based on what fact? Amitriptyline is very expensive, so the patient may have to buy fewer at a time. The goal is to see how the client responds to the first week of medication to evaluate its effectiveness. The health care provider wants to see whether any side effects occur within the first week of administration. Amitriptyline is lethal in overdose.

Amitriptyline is lethal in overdose.

A 12-year-old male patient diagnosed with Tourette's disorder is visiting his provider. The nurse will prepare medication teaching on which class of medication to help manage the tics associated with this disorder? (Select all that apply.) Mood stabilizers Antianxiety agents Anticholinesterase inhibitors First-generation antipsychotics Second-generation antipsychotics

Antianxiety agents First-generation antipsychotics Second-generation antipsychotics

Which of the following classifications of medication may be prescribed in intermittent explosive disorder? Anticonvulsants Psychostimulants Antianxiety agents such as benzodiazepines Monoamine oxidase (MAO) inhibitors

Anticonvulsants

A 16-year-old patient being treated for anorexia, has been prescribed medication to reduce compulsive behaviors regarding food now that ideal weight has been reached. Which class of medication is prescribed for this specific issue associated with eating disorders? Mood stabilizers Antidepressants Anxiolytics Atypical antipsychotics

Antidepressants

Assessment for oppositional defiant disorder should include which interventions? Assessing the history, frequency, and triggers for violent outbursts Assessing moral development, belief system, and spirituality for the ability to understand the impact of hurtful behavior on others, to empathize with others, and to feel remorse Assessing issues that result in power struggles and triggers for outbursts Assessing sibling birth order to understand the dynamics of family interaction

Assessing issues that result in power struggles and triggers for outbursts

The nurse is caring for a patient on day 1 post surgical procedure. The patient becomes visibly anxious and short of breath, and states, "I feel so anxious! Something is wrong!" What action should the nurse take initially in response to the patient's actions? Reassure the patient that what they are feeling is normal anxiety and do deep breathing exercises with her. Use the call light to inquire whether the patient has been prescribed prn anxiety medication. Call for staff help and assess the client's vital signs. Reassure the patient that you will stay until the anxiety subsides.

Call for staff help and assess the client's vital signs.

A 19-year-old college sophomore who has been using cocaine and alcohol heavily for 5 months is admitted for observation after admitting to suicidal ideation with a plan to the college counselor. What would be an appropriate priority outcome for this client's treatment plan while in the hospital? Client will return to a predrug level of functioning within 1 week. Client will be medically stabilized while in the hospital. Client will state within 3 days that they will totally abstain from drugs and alcohol. Client will take a leave of absence from college to alleviate stress.

Client will be medically stabilized while in the hospital.

Which statement is true regarding substance addiction and medical comorbidity? Most substance abusers do not have medical comorbidities. There has been little research done regarding substance addiction disorders and medical comorbidity. Conditions such as hepatitis C, diabetes, and HIV infection are common comorbidities. Comorbid conditions are thought to positively affect those with substance addiction in that these patients seek help for symptoms earlier.

Conditions such as hepatitis C, diabetes, and HIV infection are common comorbidities.

Which statement concerning syndromes seen in other cultures but not seen in our own, such as piblokto, Navajo frenzy witchcraft, and amok should be considered true? Dissociative disorders such as dissociative identify disorders Physical disorders, not mental disorders Culture-bound syndromes that are not dissociative disorders Myths, or rumors, because they have not been sufficiently studied to be classified as real.

Culture-bound syndromes that are not dissociative disorders

A client hospitalized for a psychotic relapse is being discharged home to family. Which topic is important to address when teaching both the patient and the family to recognize possible signs of impending mania? Increased appetite Decreased social interaction Increased attention to bodily functions Decreased sleep

Decreased sleep

Which of the following statements about dissociative disorders is true? Dissociative symptoms are under the person's conscious control. Dissociative symptoms are not under the person's conscious control. Dissociative symptoms are usually a cry for attention. Dissociative symptoms are always negative.

Dissociative symptoms are not under the person's conscious control.

The nurse is providing teaching to a preoperative patient just before surgery. The patient is becoming more and more anxious and begins to report dizziness and heart pounding. The patient also appears confused and is trembling noticeably. Considering the scenario, what decision should the nurse make? To reinforce the preoperative teaching by restating it slowly. Have the patient read the teaching materials instead of providing verbal instruction. Have a family member read the preoperative materials to the patient. Do not attempt any further teaching at this time.

Do not attempt any further teaching at this time.

According to current theory, which statement regarding eating disorders is accurate? Eating disorders are psychotic disorders in which patients experience body dysmorphic disorder. Eating disorders are frequently misdiagnosed. Eating disorders are possibly influenced by sociocultural factors. Eating disorders are rarely comorbid with other mental health disorders.

Eating disorders are possibly influenced by sociocultural factors.

Which nursing intervention is appropriate for the management of intermittent explosive disorder? Providing intensive family therapy Establishing a trusting relationship with the patient Setting up loose boundaries so the patient will feel relaxed Limiting decision-making opportunities to avoid frustration

Establishing a trusting relationship with the patient

Which of the following describe the symptoms of the manic phase of bipolar disorder? (Select all that apply.) Excessive energy Fatigue and increased sleep Low self-esteem Pressured speech Purposeless movement Racing thoughts Withdrawal from environment Distractibility

Excessive energy Pressured speech Purposeless movement Racing thoughts Distractibility

A 17-year-old patient is admitted to the psychiatric unit after threatening his mother during an argument and is diagnosed with conduct disorder. Which of the following would be an appropriate short-term outcome for this patient? Engages in appropriate coping skills to manage stressors Expresses feelings Maintains self-control during hospitalization Mother will improve communication skills to interact with Eli.

Expresses feelings

Which of the following symptoms would lead a provider to suspect that a client is experiencing PTSD? (Select all that apply.) Visiting the scene of the accident over and over Talking with strangers about the events of the accident Flashbacks of the accident Hypervigilance Irritability Difficulty concentrating Mania

Flashbacks of the accident Hypervigilance Irritability Mania

A 31-year-old patient admitted with acute mania tells the staff and the other patients that he is on a secret mission for the President of the United States. He states, "I am the only one he trusts, because I am the best!" What term will the nurse use when documenting this behavior? Unpredictability Rapid cycling Grandiosity Flight of ideas

Grandiosity

When approaching a client who is acting out aggressively, what interventions should the nurse implement to assure personal safety? Stand close to the client for reassurance and to convey caring. Have other staff as backup, and stay out of the client's personal space. Take the client to his/her room so that his/her privacy will be protected. Call security and wait until they arrive before approaching the client.

Have other staff as backup, and stay out of the client's personal space.

A 36 year old comes to the crisis clinic with reports of not sleeping, anxiety, and excessive crying. After a tornado devastated his hometown, the client was suddenly unemployed and homeless. Which of the following statements regarding crisis accurately describes the client's situation? He is experiencing low self-esteem from the job loss, as well as anger because of the loss of his home. He is experiencing a situational crisis that is associated with both a natural disaster and a personal event. He is experiencing ineffective coping and should be hospitalized for intensive therapy. He is experiencing a situational crisis with the added stress of financial burden.

He is experiencing a situational crisis that is associated with both a natural disaster and a personal event.

Nico, a 22-year-old patient, is diagnosed with schizophrenia. Which of the following symptoms would alert a provider to a possible diagnosis of schizophrenia in a 22-year-old male client? Excessive sleeping with disturbing dreams Hearing voices telling him to hurt his roommate Withdrawal from college because of failing grades Chaotic and dysfunctional relationships with his family and peers

Hearing voices telling him to hurt his roommate

Which of the following statements are true regarding childhood-onset conduct disorder? (Select all that apply.) It is more commonly diagnosed in males. It is characterized by feelings of remorse and regret. It is usually diagnosed in late teen years. It is characterized by disregard for the rights of others. Those with conduct disorder rationalize their aggressive behaviors. It is usually outgrown by early adulthood.

It is more commonly diagnosed in males. It is characterized by disregard for the rights of others. Those with conduct disorder rationalize their aggressive behaviors.

According to the DSM-V, which statement made by an adult client supports the criteria for generalized anxiety disorder? (select all that apply) I've been really anxious for at least 2 years now. My anxiety has to be genetic; my mom was a terrible worrier too. My marriage is in trouble because I'm always so irritable. I've had a good physical and my health care provider says I'm in good health. Its hard falling asleep and even harder staying asleep; I'm restless all night.

I've been really anxious for at least 2 years now. My marriage is in trouble because I'm always so irritable. I've had a good physical and my health care provider says I'm in good health. Its hard falling asleep and even harder staying asleep; I'm restless all night.

Which of the following statements are true regarding the differences between a social relationship and a therapeutic relationship? (Select all that apply.) In a social relationship, both parties' needs are met; in a therapeutic relationship, only the patient's needs are to be considered. A social relationship is instituted for the main purpose of exploring one member's feelings and issues; a therapeutic relationship is instituted for the purpose of friendship. Giving advice is done in social relationships; in therapeutic relationships giving advice is not usually therapeutic. In a social relationship, both parties come up with solutions to problems and solutions may be implemented by both (a friend may lend the other money, etc.); in a therapeutic relationship, solutions are discussed but are only implemented by the patient. In a social relationship, communication is usually deep and evaluated; in a therapeutic relationship, communication remains on a more superficial level, allowing patients to feel comfortable.

In a social relationship, both parties' needs are met; in a therapeutic relationship, only the patient's needs are to be considered. Giving advice is done in social relationships; in therapeutic relationships giving advice is not usually therapeutic. In a social relationship, both parties come up with solutions to problems and solutions may be implemented by both (a friend may lend the other money, etc.); in a therapeutic relationship, solutions are discussed but are only implemented by the patient.

A nurse expresses an exclusive belief in the biological model for mental illness when stating "it's the only one I really believe." What conclusion should be drawn from this statement? The biological model is the oldest and most reliable model for explaining mental illness. The biological model has been proven to be successful in finding the cause of most symptoms of mental illness. The biological model is the most popular theory among leading psychiatrists and therefore the one that should be fully embraced. In believing only in the biological model, other influences on mental health including cultural, environmental, social, and spiritual influences are not taken into account.

In believing only in the biological model, other influences on mental health including cultural, environmental, social, and spiritual influences are not taken into account.

When educating a client diagnosed with bulimia nervosa about the medication fluoxetine, the nurse should include what information about this medication? It will reduce the need for cognitive therapy. It will be prescribed at a higher than typical dose. There are a variety of medications to prescribe if fluoxetine proves to be ineffective. Long-term management of symptoms is best achieved with tricyclic antidepressants.

It will be prescribed at a higher than typical dose.

An 8-year-old patient is newly diagnosed with attention deficit hyperactivity disorder (ADHD). It is important that the parents be educated to the fact that symptoms will take which form? (Select all that apply). of, inattention, and impulsivity have to be apparent: (Select all that apply.) Low frustration tolerance Poor school performance Impulsive behaviors Easily intimidated Mood swings

Low frustration tolerance Poor school performance Impulsive behaviors Mood swings

A 49-year-old patient diagnosed with schizophrenia at 22 years old is prescribed risperidone. Which nursing assessment is the priority for this patient? Monitoring blood levels to avoid toxicity Monitoring for abnormal involuntary movements Observing for secondary mania Observing for memory changes

Monitoring for abnormal involuntary movements

A patient is sitting with arms crossed over his or her chest, his or her left leg is rapidly moving up and down, and there is an angry expression on his or her face. When approached by the nurse, the patient states harshly, "I'm fine! Everything's great." Which statement related to communication should the nurse focus on when working with this patient? Verbal communication is always more accurate than nonverbal communication. Verbal communication is more straightforward, whereas nonverbal communication does not portray what a person is thinking. Nonverbal and verbal communication may be different; nurses must pay attention to the nonverbal communication being presented to get an accurate message. Nonverbal communication is about 10% of all communication, and verbal communication is about 90%.

Nonverbal and verbal communication may be different; nurses must pay attention to the nonverbal communication being presented to get an accurate message.

Which statement is true of the eating disorder referred to as bulimia? Patients with bulimia often appear at a normal weight. Patients with bulimia binge eat but do not engage in compensatory measures. Patients with bulimia severely restrict their food intake. One sign of bulimia is lanugo.

Patients with bulimia often appear at a normal weight.

The nurse is planning long-term goals for a 17-year-old male client recently diagnosed with schizophrenia. Which statement should serve as the basis for the goal-setting process? If treated quickly following diagnosis, schizophrenia can be cured. Schizophrenia can be managed by receiving treatment only at the time of acute exacerbations. Patients with schizophrenia often do not fully respond to treatment and have residual symptoms and varying degrees of disability. If patients with schizophrenia stay on their drug regimen, they usually lead fully productive lives with no further symptoms.

Patients with schizophrenia often do not fully respond to treatment and have residual symptoms and varying degrees of disability.

Jacob is a college student whose friend recently committed suicide. Jacob rates his stress as low. Melissa was also friends with the person who committed suicide, but she rates her stress as high. The difference in how Jacob and Melissa rate their stress may be explained by which coping mechanism? Projection Denial Perception Repression

Perception

Two 16-year-old students were both involved in serious car accident. Both students have spoken with a counselor about the incident. One student has been able to move forward with little dysfunction as a result of the accident while the other has been experiencing anxiety and an inability to concentrate in school even after numerous counseling sessions. The difference in the way the accident affected both boys may be explained primarily by what factor? Personal perception of the event. Individual personality. Existence of previous, unresolved emotion trauma. One student received ineffective counseling.

Personal perception of the event.

Which statement is true regarding antisocial personality disorder (APD)? (Select all that apply.) It is the least studied of the personality disorders. It is characterized by rigidity and inflexible standards of self and others. Persons with APD display magical thinking. Persons with APD are concerned with personal pleasure and power. It is characterized by deceitfulness, disregard for others, and manipulation. Persons with APD usually present for treatment because of awareness of how their behavior is affecting others. Frontal lobe dysfunction is a brain change identified in APD.

Persons with APD are concerned with personal pleasure and power. It is characterized by deceitfulness, disregard for others, and manipulation. Frontal lobe dysfunction is a brain change identified in APD.

A 4 years old is referred to the outpatient mental health clinic after being in a severe car accident during which the child mother died. The father states that the child is withdrawn, not sleeping, having nightmares, and acts out the car accident over and over again when playing. The child states, "It's my fault because I'm bad." What trauma induced disorder does this data support? Adjustment disorder Dissociative identity disorder Posttraumatic stress disorder (PTSD) Acute stress disorder (ASD)

Posttraumatic stress disorder (PTSD)

What is the highest nursing priority for a client experiencing a situational crisis? Reduction of expressed anxiety. Development of new coping skills. Prevention of boundary blurring. Promoting client safety.

Promoting client safety.

The treatment team meets to discuss a client's plan of care. Which of the following factors will be priorities when planning interventions? Readiness to change and support system Current college performance Financial ability Availability of immediate family to come to meetings

Readiness to change and support system

The nurse is caring for an admitted client with a history of becoming aggressive when angry and has caused physical injury to another client and two staff members. When this client begins to demonstrate signs of anger while in the day room what intervention should the nurse implement to address the safety of the milieu? Alert security to come to the unit for a show of strength Request that the client accompany the nurse to the client's room Inform the client that restraints will be used if the behavior continues Prepare to administer a prn chemical restraint to the client

Request that the client accompany the nurse to the client's room

What are the foundational concerns regarding the use of restraint and seclusion when providing care to children? (Select all that apply.) Parents may initiate a lawsuit if injury occurs. Staff have conflicted feelings leading to ineffectiveness. Research suggests both are psychologically and physically harmful. Staff tends to be undertrained in use of restraints in children. The principle of least restrictive intervention is a primary concern.

Research suggests both are psychologically and physically harmful. The principle of least restrictive intervention is a primary concern.

Which nursing intervention demonstrates the theory behind operant conditioning? Rewarding the client with a token for avoiding an argument with another client Showing the client how to be assertive without being aggressive Demonstrating deep breathing techniques to a group of clients Explaining to the client the consequences of not following unit rules

Rewarding the client with a token for avoiding an argument with another client

A teenaged client is being discharged from the psychiatric unit with a prescription for risperidone. The nurse providing medication teaching to the client's mother should provide which response when asked about the risk her son faces for extrapyramidal side effects (EPSs)? All antipsychotic medications have an equal chance of producing EPSs. Newer antipsychotic medications have a higher risk for EPSs. Risperidone is a newer antipsychotic medication and has a lower risk of EPSs than older antipsychotics. Advise the mother to ask the provider to change the medication to clozapine instead of risperidone.

Risperidone is a newer antipsychotic medication and has a lower risk of EPSs than older antipsychotics.

A client states, "I will always be alone because nobody could ever love me." The nurse recognizes that the client is expressing what cognitive-behavioral concept? Emotional consequence Schema Actualization Aversion

Schema

A 37-year-old patient, referred to the mental health clinic with a suspected personality disorder, is withdrawn and suspicious and states, "I've always preferred to be alone" and then adds, "I can read your thoughts whenever I want to." This presentation supports which psychiatric diagnosis? Obsessive-compulsive personality disorder Narcissistic personality disorder Avoidant personality disorder Schizotypal personality disorder (STPD)

Schizotypal personality disorder (STPD)

A 43-year-old client being seen in the mental health clinic states, "I have always been a practicing Jew, but in the past few months I am questioning everything. I just don't know if I believe in it anymore." Which of the following nursing diagnoses best describes the client's comment? Ineffective coping Spiritual distress Risk for self-harm Hopelessness

Spiritual distress

What is the major reason for the hospitalization of a depressed patient? Inability to go to work Suicidal ideation Loss of appetite Psychomotor agitation

Suicidal ideation

Which of the following is true of the relationship between bipolar disorder and suicide? Patients need to be monitored only in the depressed phase because this is when suicides occur. Suicide is a serious risk because nearly 20% of those diagnosed with bipolar disorder commit suicide. Patients with bipolar disorder are not considered high risk for suicide. As long as patients with bipolar disorder adhere to their medication regimen, there is little risk for suicide.

Suicide is a serious risk because nearly 20% of those diagnosed with bipolar disorder commit suicide.

A client, whose friend recently committed suicide, asks the nurse about some ways to help cope with the stress regarding the event. Which option should the nurse discuss with the client? Isolation for a short time so that the pain isn't reinforced by explaining her feelings over and over Antianxiety medication to help her relax Starting a hobby to keep her mind off the troubling event Talking with friends and attending a loss support group

Talking with friends and attending a loss support group

Tara and Aaron are twins who are both diagnosed with schizophrenia. Aaron was diagnosed at 23 years old and Tara at 31 years old. Based on your knowledge of early and late onset of schizophrenia, which of the following is true? Tara and Aaron have the same expectation of a poor long-term prognosis. Tara will experience more positive signs of schizophrenia such as hallucinations. Aaron will be more likely to hold a job and live a productive life. Tara has a better chance for positive outcomes because of later onset.

Tara has a better chance for positive outcomes because of later onset.

Which assessment data describes a client in phase IV of Caplan's phases of crisis? The client reports experiencing increased anxiety and feelings of extreme discomfort the day after the tornado. The client comes to the crisis clinic reporting depression and expresses that he does not want to go on living. The client reports experiencing a panic attack. The client reports experiencing anxiety symptoms the day after being fired.

The client comes to the crisis clinic reporting depression and expresses that he does not want to go on living.

A 72-year-old patient diagnosed with Parkinson's disease is demonstrating behaviors associated with anxiety and has had several falls lately and is reluctant to take medications as prescribed. When his provider orders lorazepam, 1 mg PO bid, the nurse questions the prescription based primarily on what fact? The client may become addicted faster than younger patients. The client is at risk for falls. The client has a history of nonadherence with medications. The client should be treated with cognitive therapies because of his advanced age.

The client is at risk for falls.

When the nurse asks whether a client is having any thoughts of suicide, the client becomes angry and defensive, shouting, "I'm sick of you people! Are you ever do is ask me the same question over and over. Get out of here!" The nurse's response is based on what fact concerning hostility? The client is getting better and is able to be assertive. The client may be at high risk for self-harm. The client is probably experiencing transference. The client may be angry at someone else and projecting that anger to staff.

The client may be at high risk for self-harm.

When considering client rights, which client can be legally medicated against his or her wishes? The client has accepted the medication in the past. The client may cause imminent harm to himself or others. The client's primary provider orders the medication. The client's mental illness may relate to cognitive impairment.

The client may cause imminent harm to himself or others.

What is the expected outcome for an individual who has successful resolved all the maturational crises they have been presented with? (Select all that apply.) The development of basic human qualities The elimination of future maturational crises The development of new, effective coping mechanisms The elimination to specific barriers to psychosocial growth The ability to pass through subsequent developmental stages

The development of basic human qualities The development of new, effective coping mechanisms The ability to pass through subsequent developmental stages

A 21-year-old client asks the nurse, "What's wrong with my brain causing me to be so angry and aggressive?" The nurse's response should be grounded on what research-supported basis? The diminishment of stress hormones causes anger and aggression. No abnormalities of the brain have been identified that correlate with anger and aggression. The limbic system, the prefrontal cortex, and neurotransmitters have been implicated in playing a part in aggression. Personality type plays a much greater part in anger and aggression than physical factors.

The limbic system, the prefrontal cortex, and neurotransmitters have been implicated in playing a part in aggression.

When preparing to hold an admission interview with a client, the nurse pulls up a chair and sits facing the client with his or her knees almost touching. When the nurse leans in close to speak, the client becomes visibly flustered and gets up and leaves the room. What is the most likely explanation for client's behavior? The nurse violated the client's personal space by physically being too close. The client has issues with sharing personal information. The nurse failed to explain the purpose of the admission interview. The client is responding to the voices by ending the conversation.

The nurse violated the client's personal space by physically being too close.

A 55-year-old patient recently came to the United States from England on a work visa. The patient was admitted for severe depression following the death of a life partner weeks ago. While discussing the death and its effects the patient shows little emotion. Which of the following explanations is most plausible for this lack of emotion? The patient in denial. The response may reflect cultural norms. The response may reflect personal guilt. The patient may have an antisocial personality.

The response may reflect cultural norms.

Which assessment should the nurse perform to evaluate the pharmacokinetic affect of a monoamine oxidase inhibitors (MAOIs) antidepressant medication? The status of the client's appetite The results of the liver function test The level of depression exhibited by the client The client's current sleeping patterns

The results of the liver function test

A 26-year-old patient who abuses heroin states to you, "I've been using more heroin lately because I've begun to need more to feel the effect I want." What effect does this statement describe? Intoxication Tolerance Withdrawal Addiction

Tolerance

What older concept of care is being used currently to help in violence reduction in disruptive clients? Aired grievances Trauma-informed care Shared governance Learned helplessness

Trauma-informed care

A 9-year-old patient has been diagnosed with an intellectual development disorder (IDD). Which assessment findings support this diagnosis? (Select all that apply.) Unable to explain the phrase, "Raining cats and dogs" Reads below age level Is capable of providing effective oral self care Enjoy interacting with developmentally similar peers Physically lashes out when frustrated

Unable to explain the phrase, "Raining cats and dogs" Reads below age level Physically lashes out when frustrated

A 72-year-old patient is hospitalized diagnosed with pneumonia and experiencing delirium. When the client points to the IV pole and screams, "Get him out of here! He's going to hurt me!", the nurse recognizes the response as a(n) hallucination. delusion. illusion. confabulation.

illusion.