ATI Mental Health

A nurse is told during change-of-shift report that a client is stuporous. When collecting data from the client, which of the following is an expected finding? A. The client arouses briefly in response to a sternal rub. B. The client has a Glasgow Coma Scale score less than 7. C. The client exhibits decorticate rigidity. D. The client is alert but disoriented to time and place.

A A. CORRECT: A client who is stuporous requires vigorous or painful stimuli to elicit a response. B. INCORRECT: A GCS score of less than 7 indicates a comatose, rather than stuporous, level of consciousness. C. INCORRECT: Abnormal posturing is associated with a comatose, rather than stuporous, level of consciousness. D. INCORRECT: A client who is stuporous is not alert. CHAPTER 1 Basic Mental Health Nursing Concepts

A nurse is caring for a client who has acute stress disorder and is experiencing severe anxiety. Which of the following statements by the nurse is appropriate? A. "Tell me about how you are feeling right now." B. "You should focus on the positive things in your life to decrease your anxiety." C. "Why do you believe you are experiencing this anxiety?" D. "Let's discuss the medications your provider is prescribing to decrease your anxiety."

A A. CORRECT: Asking an open-ended question is therapeutic and assists the client in identifying anxiety. B. INCORRECT: Offering advice is nontherapeutic and can hinder further communication. C. INCORRECT: Asking the client a "why" question is nontherapeutic and can promote a defensive client response. D. INCORRECT: Postpone health teaching until after acute anxiety subsides. Clients experiencing severe anxiety are unable to concentrate or learn. CHAPTER 11 Anxiety Disorders Concepts

A nurse is caring for a client who has a prescription for disulfiram (Antabuse) for the treatment of his alcohol use disorder. The nurse informs the client that this medication can cause nausea and vomiting if he drinks alcohol. This form of treatment is an example of which of the following? A. Aversion therapy B. Flooding C. Biofeedback D. Dialectical behavior therapy

A A. CORRECT: Aversion therapy pairs a maladaptive behavior with unpleasant stimuli to promote a change in behavior. B. INCORRECT: Flooding is planned exposure to an undesirable stimulus in an attempt to turn off the anxiety response. C. INCORRECT: Biofeedback is a behavioral therapy to control pain, tension, and anxiety. D. INCORRECT: Dialectical behavior therapy is a cognitive-behavioral therapy for clients who have a personality disorder and exhibit self-injurious behavior. CHAPTER 7 Psychoanalysis, Psychotherapy, and Behavioral Therapies

A nurse is caring for a client who has avoidant personality disorder. Which of the following statements is expected from a client who has this type of personality disorder? A. "I'm scared that you're going to leave me." B. "I'll go to group therapy if you'll let me smoke." C. "I need to feel that everyone admires me." D. "I sometimes feel better if I cut myself."

A A. CORRECT: Clients who have avoidant personality disorder often have a fear of abandonment. This type of statement is expected. B. INCORRECT: This statement indicates manipulation, which is not expected from a client who has borderline personality disorder. C. INCORRECT: This statement indicates a need for admiration, which is expected from a client who has narcissistic personality disorder. D. INCORRECT: This statement indicates a risk for self-injury, which is expected from a client who has borderline personality disorder. CHAPTER 15 Personality Disorders

A nurse is reinforcing teaching to a client about stress-reduction techniques. Which of the following client statements indicates understanding of the teaching? A. "Cognitive reframing will help me change my irrational thoughts to something positive." B. "Progressive muscle relaxation uses a mechanical device to help me gain control over my pulse rate." C. "Biofeedback causes my body to release endorphins so that I feel less stress and anxiety." D. "Mindfulness allows me to prioritize the stressors that I have in my life so that I have less anxiety."

A A. CORRECT: Cognitive reframing helps the client look at irrational cognitions (thoughts) in a more realistic light and to restructure those thoughts in a more positive way. B. INCORRECT: Biofeedback, rather than progressive muscle training, uses a mechanical device to promote voluntary control over autonomic functions. C. INCORRECT: Physical exercise, rather than biofeedback, causes a release of endorphins that lower anxiety and reduce stress. D. INCORRECT: Priority restructuring, rather than mindfulness, teaches the client to prioritize differently to reduce the number of stressors. CHAPTER 9 Stress Management

A nurse is assisting with planning care for the termination phase of a nurse-client relationship. Which of the following actions is appropriate to include in the plan of care? A. Discussing ways to use new behaviors B. Practicing new problem-solving skills C. Developing goals D. Establishing boundaries

A A. CORRECT: Discussing ways for the client to incorporate new healthy behaviors into life is an appropriate task for the termination phase. B. INCORRECT: Practicing new problem-solving skills is an appropriate task for the working phase. C. INCORRECT: Developing goals is an appropriate task for the orientation phase. D. INCORRECT: Establishing boundaries is an appropriate task for the orientation phase. CHAPTER 5 Creating and Maintaining a Therapeutic and Safe Environment

A nurse is preparing to attend an educational seminar on stress. Which of the following should be expected to be included in the discussion? A. Excessive stressors cause the client to experience distress. B. The body's initial adaptive response to stress is denial. C. The absence of stressors results in homeostasis. D. Negative, rather than positive, stressors produce a biological response.

A A. CORRECT: Distress is the result of excessive or damaging stressors, such as anxiety or anger. B. INCORRECT: Denial is part of the grief process. The body's initial adaptive response to stress is known as the fight-or-flight mechanism. C. INCORRECT: Individuals need the presence of some stressors to provide interest and purpose to life. D. INCORRECT: Both positive and negative stressors produce a biological response in the body. CHAPTER 9 Stress Management

A nurse observes a client who is pacing and wringing his hands. The client states, "I don't know why, but I've worried every day for over a year that my son will die a horrible death." This finding is consistent with which of the following disorders? A. Generalized anxiety disorder B. Panic disorder C. Posttraumatic stress disorder D. Acute stress disorder

A A. CORRECT: Generalized anxiety disorder is characterized by uncontrollable, excessive worry for more than 3 months. B. INCORRECT: Panic disorder is associated with recurrent panic attacks rather than chronic worrying. C. INCORRECT: PTSD is associated with a specific traumatic event. D. INCORRECT: Acute stress disorder is associated with a specific traumatic event. CHAPTER 11 Anxiety Disorders Concepts

A charge nurse is discussing mirtazapine (Remeron) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates understanding? A. "This medication increases the release of serotonin and norepinephrine." B. "I will need to monitor the client for hyponatremia while taking this medication." C. "This medication is contraindicated for clients who have an eating disorder." D. "Sexual dysfunction is a common adverse effect of this medication."

A A. CORRECT: Mirtazapine provides relief from depression by increasing the release of serotonin and norepinephrine. B. INCORRECT: Hyponatremia is an adverse effect of venlafaxine, rather than mirtazapine. C. INCORRECT: Bupropion, rather than mirtazapine, is contraindicated in clients who have an eating disorder. D. INCORRECT: Sexual dysfunction is an adverse effect of SSRIs rather than mirtazapine. CHAPTER 20 Medications for Depressive Disorders

A nurse is communicating with a newly admitted client. Which of the following is a barrier to therapeutic communication? A. Offering advice B. Reflecting meaning C. Listening attentively D. Giving information

A A. CORRECT: Offering advice to a client is a barrier to therapeutic communication and should be avoided. Advice tends to interfere with the client's ability to make personal decisions and choices. B. INCORRECT: Reflection encourages the client to make choices and is therapeutic. C. INCORRECT: Listening is an important therapeutic technique. D. INCORRECT: Giving information informs the client of needed facts. CHAPTER 3 Effective Communication

A nurse is discussing the care of a client who has a personality disorder with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates a need for further teaching? A. "I can promote my client's sense of control by establishing a schedule." B. "Self-assessment will help me cope with emotional reactions to client care." C. "I should practice limit-setting to help prevent client manipulation." D. "Maintaining professional boundaries is a priority of client care."

A A. CORRECT: Rather than establishing a schedule, the nurse should ask for the client's input and offer realistic choices to promote the client's sense of control. B. INCORRECT: Caring for a client who has a personality disorder can evoke an intense emotional response by the nurse. Self-assessment assists the nurse to cope with these reactions. C. INCORRECT: When caring for a client who has a personality disorder, limit-setting is appropriate to help prevent client manipulation. D. INCORRECT: When caring for a client who has a personality disorder, the nurse should always maintain professional boundaries. CHAPTER 15 Personality Disorders

A nurse is discussing routine follow-up needs for a client who has a new prescription for valproic acid (Depakote). The nurse should inform the client of the need for routine monitoring of which of the following? A. AST/ALT and LDH B. Creatinine and BUN C. WBC and granulocyte counts D. Serum sodium and potassium

A A. CORRECT: Routine monitoring of liver function tests is necessary due to the risk for hepatotoxicity. B. INCORRECT: Baseline levels may be drawn. However, routine monitoring of creatinine and BUN is not necessary. C. INCORRECT: Baseline levels may be drawn. However, routine monitoring of WBC and granulocyte counts is not necessary. D. INCORRECT: Baseline levels may be drawn. However, routine monitoring of serum sodium and potassium is not necessary. CHAPTER 21 Medications for Bipolar Disorders

A nurse is discussing the care of a client who has major depressive disorder (MDD) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates a need for further reinforcement of teaching? A. "Care during the continuation phase focuses on treating continued manifestations of MDD." B. "The goal of treatment during the maintenance phase is prevention of future episodes of MDD." C. "The client is at greatest risk for suicide during the first weeks of an MDD episode." D. "Medication and psychotherapy are used to prevent a relapse of MDD."

A A. CORRECT: The focus of the continuation phase is relapse prevention. Treatment of manifestations occurs during the acute phase of MDD. B. INCORRECT: This statement does not indicate a need for further teaching. Prevention of future depressive episodes is the goal of the maintenance phase of treatment. C. INCORRECT: This statement does not indicate a need for further teaching. The client is at greatest risk for suicide during the acute phase of MDD. D. INCORRECT: This statement does not indicate a need for further teaching. Medication therapy and psychotherapy are used during the continuation phase to prevent relapse of MDD. CHAPTER 12 Depressive Disorders

A nurse working on an acute mental health unit is caring for a client who has major depressive disorder and comorbid anxiety disorder. Which of the following is the highest priority action by the nurse? A. Placing the client on one-to-one observation B. Assisting the client to perform ADLs C. Encouraging the client to participate in counseling D. Telling the client about medication adverse effects

A A. CORRECT: The greatest risk for a client who has MDD and comorbid anxiety is injury due to self‑harm. The highest priority intervention is placing the client on one-to-one observation. B. INCORRECT: The client who has MDD can require assistance with ADLs. However, this does not address the greatest risk to the client and is therefore not the priority intervention. C. INCORRECT: The nurse should encourage the client who has MDD to participate in counseling. However, this does not address the greatest risk to the client and is therefore not the priority intervention. D. INCORRECT: The nurse should tell the client who has MDD about medication adverse effects. However, this does not address the greatest risk to the client and is therefore not the priority intervention. CHAPTER 12 Depressive Disorders

A nurse is caring for an adolescent client who has anorexia nervosa with recent rapid weight loss and a current weight of 90 lb. Which of the following statements indicates the client is experiencing the cognitive distortion of catastrophizing? A. "Life isn't worth living if I gain weight." B. "Don't pretend like you don't know how fat I am." C. "If I could be skinny, I know I'd be popular." D. "When I look in the mirror, I see myself as obese."

A A. CORRECT: This statement reflects the cognitive distortion of catastrophizing because the client's perception of her appearance or situation is much worse than her current condition. B. INCORRECT: This statement reflects the cognitive distortion of personalization. C. INCORRECT: This statement reflects the cognitive distortion of overgeneralization. D. INCORRECT: This statement reflects a perception of distorted body image commonly experienced by the client who has anorexia nervosa. However, it is not an example of catastrophizing. CHAPTER 18 Eating Disorders

A nurse is working in a community mental health facility. Which of the following services are appropriate for clients to receive? (Select all that apply). A. Educational groups B. Medication dispensing programs C. Individual counseling programs D. Detoxification programs E. Crisis intervention

A, B, C A. CORRECT: Educational groups are services provided in a community mental health facility. B. CORRECT: Medication dispensing programs are services provided in a community mental health facility. C. CORRECT: Individual counseling programs are services provided in a community mental health facility. D. INCORRECT: Detoxification programs are services provided in a partial hospitalization program. E. INCORRECT: Crisis intervention is offered in an assertive community treatment (ACT) program. CHAPTER 6 Diverse Practice Settings

A nurse working in an acute mental health facility is caring for a 35-year-old female client who has clinical findings of depression. The client lives at home with her husband and two young children. She currently smokes and has a history of chronic asthma. The nurse should identify which of the following as risk factors for depression for this client? (Select all that apply.) A. Age of 35 years old B. Female gender C. History of chronic asthma D. Currently smokes E. Being married

A, B, C, D A. CORRECT: Depressive disorders are more prevalent in adults between the ages of 15 and 40. B. CORRECT: Depressive disorders are twice as common in females than in males. C. CORRECT: Depressive disorders are more common in clients who have a chronic medical illness. D. CORRECT: Depressive disorders are more common in clients who have a substance use disorder, such as nicotine use disorder. E. INCORRECT: Depressive disorders are more common in unmarried, rather than married, clients. CHAPTER 12 Depressive Disorders

A nurse is discussing acute vs. prolonged stress with a client. Which of the following should the nurse identify as an acute stress response? (Select all that apply.) A. Decreased appetite B. Depressed immune system C. Increased blood pressure D. Panic attacks E. Unhappiness

A, B, C, E A. CORRECT: Decreased appetite is an indicator of acute stress. B. CORRECT: A depressed immune system is an indicator of acute stress. C. CORRECT: Increased blood pressure is an indicator of acute stress. E. CORRECT: Unhappiness is an indicator of acute stress. D. INCORRECT: Panic attacks indicate a prolonged or maladaptive stress response. CHAPTER 9 Stress Management

A nurse is assisting a charge nurse with an admission assessment of a client who has bulimia nervosa with purging behavior. Which of the following are expected findings? (Select all that apply.) A. Hyponatremia B. Hypokalemia C. Mottling of the skin D. Slightly elevated body weight E. Presence of lanugo on the face

A, B, D A. CORRECT: Hyponatremia is an expected finding of purging-type bulimia nervosa. B. CORRECT: Hypokalemia is an expected finding of purging-type bulimia nervosa. D. CORRECT: Most clients who have bulimia nervosa maintain a weight within a normal range or slightly higher. C. INCORRECT: Mottling of the skin is an expected finding of anorexia nervosa rather than bulimia nervosa. E. INCORRECT: Lanugo is an expected finding of anorexia nervosa rather than bulimia nervosa. CHAPTER 18 Eating Disorders

A nurse is assisting an RN with preparing to implement cognitive reframing techniques for a client who has an anxiety disorder. Which of the following are appropriate to include in the plan of care? (Select all that apply.) A. Priority restructuring B. Monitoring thoughts C. Diaphragmatic breathing D. Journal keeping E. Meditation

A, B, D A. CORRECT: Priority restructuring is a cognitive reframing technique. B. CORRECT: Monitoring thoughts is a cognitive reframing technique. D. CORRECT: Journal keeping is a cognitive reframing technique. C. INCORRECT: Diaphragmatic breathing is a form of behavioral therapy, rather than a cognitive reframing technique. E. INCORRECT: Meditation is a form of behavioral therapy, rather than a cognitive reframing technique. CHAPTER 7 Psychoanalysis, Psychotherapy, and Behavioral Therapies

A nurse is assisting with the planning of a peer group discussion about the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Which of the following is appropriate to include in the discussion? (Select all that apply.) A. The DSM-5 is used to identify mental health disorders. B. The DSM-5 establishes diagnostic criteria. C. The DSM-5 indicates recommended pharmacological treatment. D. The DSM-5 is used to assist in the planning of care. E. The DSM-5 indicates expected data collection findings.

A, B, D, E A. CORRECT: The DSM-5 is used as a diagnostic tool to identify mental health diagnoses. B. CORRECT: The DSM-5 establishes diagnostic criteria for mental health disorders. D. CORRECT: Nurses use the DSM-5 to assist in the planning of care, and to implement and evaluate care. E. CORRECT: The DSM-5 identifies expected findings for mental health disorders. C. INCORRECT: The DSM-5 is a diagnostic tool for the diagnosis of mental health disorders but does not indicate pharmacological treatment. CHAPTER 1 Basic Mental Health Nursing Concepts

A nurse is caring for a client who takes paroxetine (Paxil) to treat posttraumatic stress disorder. The client states that he grinds his teeth during the night which causes pain in his mouth. The nurse should identify which of the following as possible measures to manage the client's bruxism? (Select all that apply.) A. Concurrent administration of buspirone B. Administration of a different SSRI C. Use of a mouth guard D. Changing to a different class of antianxiety medication E. Increasing the dose of paroxetine

A, C, D A. CORRECT: Concurrent administration of a low-dose of buspirone is an effective measure to manage the adverse effect of paroxetine. C. CORRECT: Using a mouth guard during sleep can decrease the risk for oral damage resulting from bruxism. D. CORRECT: Changing to different class of antianxiety medication that does not have the adverse effect of bruxism is an effective measure. B. INCORRECT: Other SSRIs also have bruxism as an adverse effect. Therefore, this is not an effective measure. E. INCORRECT: Increasing the dose of paroxetine can cause the adverse effect of bruxism to worsen. Therefore, this is not an effective measure. CHAPTER 19 Medications for Anxiety Disorders

A nurse is caring for a client who has substance-induced psychotic disorder and is experiencing auditory hallucinations. The client states, "The voices won't leave me alone!" Which of the following statements by the nurse are appropriate? (Select all that apply.) A. "When did you start hearing the voices?" B. "The voices are not real, or else we would both hear them." C. "It must be scary to hear voices." D. "Are the voices telling you to hurt yourself?" E. "Why are the voices talking to only you?"

A, C, D A. CORRECT: The nurse should ask the client directly about the hallucination. C. CORRECT: The nurse should focus on the client's feelings rather than agreeing with the client's hallucination. D. CORRECT: The nurse should collect data about the presence of command hallucinations and the client's risk for injury to self or others. B. INCORRECT: The nurse should not argue with the client's view of the situation. E. INCORRECT: The nurse should avoid asking a "why" question, which is nontherapeutic and can promote a defensive client response. CHAPTER 14 Psychotic Disorders

A nurse is collecting data on a client who has schizophrenia. Which of the following findings should the nurse document as positive symptoms? (Select all that apply.) A. Auditory hallucination B. Lack of motivation C. Use of clang associations D. Delusion of persecution E. Constantly waving arms F. Flat affect

A, C, D, E A. CORRECT: Hallucinations are an example of a positive symptom. C. CORRECT: Alterations in speech are an example of a positive symptom. D. CORRECT: Delusions are an example of a positive symptom. E. CORRECT: Bizarre motor movements are an example of a positive symptom. B. INCORRECT: Lack of motivation, or avolition, is an example of a negative symptom. F. INCORRECT: Flat affect is an example of a negative symptom. CHAPTER 14 Psychotic Disorders

A nurse is preparing to obtain a nursing history from a client who has a new diagnosis of anorexia nervosa. Which of the following questions are appropriate for the nurse to include in the data collection? (Select all that apply.) A. "What is your relationship like with your family?" B. "Why do you want to lose weight?" C. "Would you describe your current eating habits?" D. "At what weight do you believe you will look better?" E. "Can you discuss your feelings about your appearance?"

A, C, E A. CORRECT: A nursing history of a client who has anorexia nervosa should include information regarding of family and interpersonal relationships. C. CORRECT: A nursing history of a client who has anorexia nervosa should include the client's current eating habits. E. CORRECT: A nursing history of a client who has anorexia nervosa should include the client's perception of the issue. B. INCORRECT: Asking a "why" question promotes a defensive client response and is nontherapeutic. D. INCORRECT: This question promotes cognitive distortion, places the focus on weight, and implies that the client's current appearance is not acceptable. CHAPTER 18 Eating Disorders

A nurse is reinforcing teaching with a client who has a new prescription for imipramine (Tofranil) about how to minimize anticholinergic effects. Which of the following should the nurse include in the teaching? (Select all that apply.) A. Void just before taking the medication. B. Increase the dietary intake of potassium. C. Wear sunglasses when outside. D. Change positions slowly when getting up. E. Chew sugarless gum.

A, C, E A. CORRECT: Voiding just before taking the medication will help minimize the anticholinergic effects of urinary hesitancy or retention. C. CORRECT: Wearing sunglasses when outside will help minimize the anticholinergic effect of photophobia. E. CORRECT: Chewing sugarless gum will help minimize the anticholinergic effect of dry mouth. B. INCORRECT: The anticholinergic effects of imipramine do not affect the client's potassium level. D. INCORRECT: The client should change positions slowly to avoid orthostatic hypotension. However, this is not an anticholinergic effect. CHAPTER 20 Medications for Depressive Disorders

A nurse working on an acute mental health unit is caring for a client who has posttraumatic stress disorder (PTSD). Which of the following are expected findings? (Select all that apply.) A. Hallucinations B. Obsessive need to talk about the traumatic event C. Exaggerated displays of emotion D. Recurring nightmares E. Diminished reflexes

A, D A. CORRECT: Hallucinations associated with the traumatic event are an expected finding of PTSD. D. CORRECT: Recurring nightmares associated with the traumatic event are an expected finding of PTSD. B. INCORRECT: Avoidance of stimuli associated with the traumatic event is an expected finding of PTSD. C. INCORRECT: The inability to show feelings or emotions is an expected finding of PTSD. E. INCORRECT: Increased arousal, rather than diminished reflexes, is an expected finding of PTSD. CHAPTER 11 Anxiety Disorders Concepts

A nurse is making a home visit to a client who has Alzheimer's disease to collect data regarding home safety. Which of the following are appropriate suggestions to decrease the client's risk for injury? (SELECT ALL THAT APPLY) A. Install childproof door locks. B. Place rugs over electrical cords. C. Mark cleaning supplies with colored tape. D. Place the client's mattress on the floor. E. Install light fixtures above stairs.

A, D, E A. CORRECT: Door locks that are difficult to open are appropriate to reduce the risk of the client wandering outside without supervision. D. CORRECT: Placing the client's mattress on the floor reduces the risk for falls out of bed. E. CORRECT: Stairs should have adequate lighting to reduce the risk for falls. B. INCORRECT: Rugs create a fall risk hazard and should be removed. Electrical cords should be secured to baseboards rather than covered. C. INCORRECT: Cleaning supplies should be placed in locked cupboards. Marking the supplies with colored tape does not prevent the client's access to hazardous materials. CHAPTER 16 Cognitive Disorders

A nurse is assisting with the planning of care for a client following surgical implantation of a vagus nerve stimulation (VNS) device. The nurse should monitor for which of the following adverse effects? (Select all that apply.) A. Voice changes B. Seizure activity C. Disorientation D. Dysphagia E. Neck pain

A, D, E A. CORRECT: Voice changes are a common adverse effect of VNS due to the proximity of the implanted lead on the vagus nerve to the larynx and pharynx. D. CORRECT: Dysphagia is a potential adverse effect of VNS. However, this usually subsides with time. E. CORRECT: Neck pain is a potential adverse effect of VNS. However, this usually subsides with time. B. INCORRECT: Seizure activity is associated with ECT rather than VNS. C. INCORRECT: Disorientation is associated with ECT and TMS rather than VNS. CHAPTER 10 Brain Stimulation Therapies

A nurse is caring for a client on an acute mental health unit. The client reports hearing voices that are telling her to "kill your doctor." Which of the following is the priority action for the nurse to take? A. Use therapeutic communication to discuss the hallucination with the client. B. Initiate one-to-one observation of the client. C. Focus the client on reality. D. Notify the provider of the client's statement.

B B. CORRECT: A client who is experiencing a command hallucination is at risk for injury to self or others. Therefore, safety is the priority, and initiating one-to-one observation is the priority action. A. INCORRECT: It is appropriate for the nurse to use therapeutic communication to discuss the client's hallucination. However, this does not address the issue of client safety and is therefore not the priority action. C. INCORRECT: It is appropriate for the nurse to attempt to focus the client on reality. However, this does not address the issue of client safety and is therefore not the priority action. D. INCORRECT: It is appropriate for the nurse to notify the provider of the client's hallucination. However, this does not address the issue of client safety and is therefore not the priority action. CHAPTER 14 Psychotic Disorders

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 (ACT) group? A. A client in an acute care mental health facility who has fallen several times while running down the hallway B. A client who lives at home and keeps "forgetting" to come in for his monthly antipsychotic injection for schizophrenia C. A client in a day treatment program who says he is becoming more anxious during group therapy D. A client in a weekly grief support group who says she still misses her husband who has been dead for 3 months

B B. CORRECT: An ACT group works with clients who are nonadherent with traditional therapy, such as the client in a home setting who keeps "forgetting" his injection. A. INCORRECT: A client in acute care who has been running and falling should be helped by the treatment team on her unit. C. INCORRECT: A client who has anxiety might be referred to his counselor or mental health provider. D. INCORRECT: A client who is grieving for her husband who died 3 months ago is currently involved in an appropriate intervention. CHAPTER 6 Diverse Practice Settings

A nurse is caring for a client who is on lithium therapy. The client states that he wants to take ibuprofen for osteoarthritis pain relief. Which of the following statements by the nurse is appropriate? A. "That is a good choice. Ibuprofen does not interact with lithium." B. "Regular aspirin would be a better choice than ibuprofen." C. "Lithium decreases the effectiveness of ibuprofen." D. "The ibuprofen will make your lithium level fall too low."

B B. CORRECT: Aspirin is recommended as a mild analgesic, rather than ibuprofen, due to the risk for lithium toxicity. A. INCORRECT: Ibuprofen is not recommended for clients taking lithium. C. INCORRECT: Lithium does not decrease the effectiveness of ibuprofen. However, concurrent use is not recommended due to the risk of toxicity. D. INCORRECT: Ibuprofen increases the risk for a toxic, rather than low, lithium level. CHAPTER 21 Medications for Bipolar Disorders

A client says she is experiencing increased stress because her significant other is "pressuring me and my kids to go live with him. I love him, but I'm not ready to do that." She also states that her significant other "keeps nagging at my oldest son, which makes me mad, since he's my son, not his." Which of the following should the nurse recommend to promote a change in the client's situation? A. Learn to practice mindfulness. B. Use assertiveness techniques. C. Exercise regularly. D. Rely on the support of a close friend.

B B. CORRECT: Assertive communication allows the client to assert her feelings and then make a change in the situation. A. INCORRECT: Mindfulness is appropriate to decrease the client's stress. However, it does not change the client's situation. C. INCORRECT: Regular exercise is appropriate to decrease the client's stress. However, it does not change the client's situation. D. INCORRECT: Social support is appropriate to decrease the client's stress. However, it does not change the client's situation. CHAPTER 9 Stress Management

A nurse is reinforcing teaching with 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? A. "Even if my anxiety improves, I will need to continue this therapy for 6 weeks." B. "The therapist will focus on my past relationships during our sessions." C. "Psychoanalysis will help me reduce my anxiety by changing my behaviors." D. "This therapy will address my conscious feelings about stressful experiences."

B B. CORRECT: Classical psychoanalysis places a common focus on past relationships to identify the cause of the anxiety disorder. A. INCORRECT: Classical psychoanalysis is a therapeutic process that requires many sessions over months to years. C. INCORRECT: Classical psychoanalysis focuses on identifying and resolving the cause of the anxiety rather than changing behavior. D. INCORRECT: Classical psychoanalysis assesses unconscious, rather than conscious, thoughts and feelings. CHAPTER 7 Psychoanalysis, Psychotherapy, and Behavioral Therapies

A nurse in an outpatient mental health clinic is preparing to conduct an initial client interview. When conducting the interview, which of the following is the highest priority action? A. Respect the client's need for personal space. B. Identify the client's perception of her mental health status. C. Include the client's family in the interview. D. Reinforce teaching about the client's mental health disorder.

B B. CORRECT: Data collection is the priority action when taking the nursing process approach to client care. Identifying the client's perception of her mental health status provides important information about the client's psychosocial history. A. INCORRECT: It is appropriate to respect the client's need for personal space. However, it is not the highest priority action when taking the nursing process approach to client care. C. INCORRECT: If the client wishes, it is appropriate to include the client's family in the interview. However, it is not the highest priority action when taking the nursing process approach to client care. D. INCORRECT: It is appropriate to reinforce teaching for the client about her disorder. However, it is not the highest priority action when taking the nursing process approach to client care. CHAPTER 1 Basic Mental Health Nursing Concepts

A nurse is caring for a client who has Alzheimer's disease and is beginning to experience noticeable short-term memory loss. When discussing a new prescription for donepezil (Aricept), the nurse should include which of the following in the instructions? A. "You should avoid taking over-the-counter acetaminophen while on donepezil." B. "You can expect the progression of cognitive decline to slow with donepezil." C. "You will be screened for underlying kidney disease prior to starting donepezil." D. "You should stop taking donepezil if you experience nausea or diarrhea."

B B. CORRECT: Donepezil slows the cognitive deterioration of Alzheimer's disease. A. INCORRECT: Clients taking donepezil should avoid NSAIDs, rather than acetaminophen, due to risk for gastrointestinal bleeding. C. INCORRECT: Clients should be screened for underlying heart and pulmonary disease, rather than kidney disease, prior to treatment. D. INCORRECT: Gastrointestinal adverse effects are common with donepezil and can result in a dosage reduction. However, the client should not abruptly stop the medication without consulting his provider. CHAPTER 16 Cognitive Disorders

A nurse is participating in a family therapy session. The adolescent son tells the nurse that he plans ways 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? A. Placation B. Manipulation C. Blaming D. Distraction

B B. CORRECT: Manipulation is the dysfunctional behavior of using dishonesty to support an individual agenda. A. INCORRECT: Placation is the dysfunctional behavior of taking responsibility for problems to keep peace among family members. C. INCORRECT: Blaming is the dysfunctional behavior of blaming others to shift focus away from the individual's own inadequacies. D. INCORRECT: Distraction is the dysfunctional behavior of inserting irrelevant information during attempts at problem solving. CHAPTER 8 Group and Family Therapy

A nurse is obtaining informed consent for a client who has just learned she must have a breast biopsy. The client is perspiring and pale, has a respiratory rate 30/min, and says, "I don't quite understand what you're trying to tell me." The nurse should evaluate the client's anxiety as which of the following? A. Mild B. Moderate C. Severe D. Panic

B B. CORRECT: Moderate anxiety decreases problem-solving and can hamper one's ability to understand information. Vital signs can increase somewhat, and the person is visibly anxious. A. INCORRECT: In mild anxiety, the person's ability to understand information can actually increase. C. INCORRECT: Severe anxiety causes restlessness, decreased perception, and an inability to take direction. D. INCORRECT: During a panic attack, the person is completely distracted, unable to function, and can lose touch with reality. CHAPTER 4 Stress and Defense Mechanisms

A nurse is reinforcing teaching with a client who has a new prescription for amitriptyline. Which of the following client statements indicates understanding of the teaching? A. "While taking this medication, I'll need to stay out of the sun to avoid a skin rash." B. "I may feel drowsy for a few weeks after starting this medication." C. "I cannot eat my favorite pizza with pepperoni while taking this medication." D. "This medication will help me lose the weight that I have gained over the last year."

B B. CORRECT: Sedation is an adverse effect of amitriptyline during the first few weeks of therapy. A. INCORRECT: Skin rash is associated with SSRIs, rather than TCAs like amitriptyline. C. INCORRECT: Foods such as pepperoni should be avoided if the client is prescribed an MAOI, rather than a TCA like amitriptyline. D. INCORRECT: Weight gain, rather than weight loss, is expected with TCAs. CHAPTER 20 Medications for Depressive Disorders

A nurse is caring for a client who has borderline personality disorder. The client says, "The nurse on the evening shift is always nice! You are the meanest nurse ever!" The nurse should recognize the client's statement as an example of which of the following defense mechanisms? A. Regression B. Splitting C. Undoing D. Identification

B B. CORRECT: Splitting occurs when a person is unable to see both positive and negative qualities at the same time. The client who has borderline personality disorder tends to see a person as all bad one time and all good another time. A. INCORRECT: Regression refers to resorting to an earlier way of functioning, such as having a temper tantrum. C. INCORRECT: Undoing is a behavior that is intended to undo or reverse unacceptable thoughts or acts, such as buying a gift for a spouse after having an extramarital affair. D. INCORRECT: In identification, the person imitates the behavior of someone admired or feared. CHAPTER 15 Personality Disorders

A nurse is speaking with a client who has schizophrenia when he suddenly seems to stop focusing on the nurse's questions and begins looking at the ceiling and talking to himself. Which of the following actions should the nurse take? A. Stop the interview at this point, and resume later when the client is better able to concentrate. B. Ask the client, "Are you seeing something on the ceiling?" C. Tell the client, "You seem to be looking at something on the ceiling. I see something there, too." D. Continue the interview without comment on the client's behavior.

B B. CORRECT: The nurse should ask the client directly about the hallucination to identify client needs and check for a potential risk for injury. A. INCORRECT: The nurse should address the client's current needs related to the possible hallucination rather than stop the interview. C. INCORRECT: The nurse should avoid agreeing with the client, which can promote psychotic thinking. D. INCORRECT: The nurse should address the client's current needs related to the possible hallucination rather than ignoring the change in behavior. CHAPTER 14 Psychotic Disorders

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? A. Notify the nurse manager. B. Tell the nurse to stop discussing the behavior. C. Assist with providing an in-service program about confidentiality. D. Complete an incident report.

B B. CORRECT: The nurse should tell the newly licensed nurse to stop discussing the client's hallucinations in a public location. This is the priority action. A. INCORRECT: The nurse should notify the nurse manager, but this is not the first action the nurse should take. C. INCORRECT: The nurse should assist in providing an in-service program about confidentiality, but this is not the first action the nurse should take. D. INCORRECT: The nurse should complete an incident report, but this is not the first action the nurse should take. CHAPTER 2 Legal and Ethical Issues

A nurse is caring for a client who has schizoaffective disorder. Which of the following statements indicates the client is experiencing depersonalization? A. "I am a superhero and am immortal." B. "I am no one, and everyone is me." C. "I feel monsters pinching me all over." D. "I know that you are stealing my thoughts."

B B. CORRECT: This comment indicates the client is experiencing a loss of identity or depersonalization. A. INCORRECT: This comment indicates the client is experiencing delusions of grandeur rather than depersonalization. C. INCORRECT: This comment indicates the client is experiencing a tactile hallucination rather than depersonalization. D. INCORRECT: This comment indicates the client is experiencing thought withdrawal rather than depersonalization. CHAPTER 14 Psychotic Disorders

A nurse is caring for a client who smokes and has lung cancer. The client reports, "I'm coughing because I have that cold that everyone has been getting." Which of the following defense mechanisms is the client using? A. Reaction formation B. Denial C. Displacement D. Sublimation

B B. CORRECT: This is an example of denial, which is pretending the truth is not reality to manage the anxiety of acknowledging what is real. A. INCORRECT: This is not an example of reaction formation, which is overcompensating or demonstrating the opposite behavior of what is felt. C. INCORRECT: This is not an example of displacement, which is shifting feelings related to an object, person, or situation to another less threatening object, person, or situation. D. INCORRECT: This is not an example of sublimation, which is dealing with unacceptable feelings or impulses by unconsciously substituting acceptable forms of expression. CHAPTER 4 Stress and Defense Mechanisms

A nurse is caring for a client who has bipolar disorder. The client states, "I am very rich, and I feel I must give my money to you." Which of the following is an appropriate response by the nurse? A. "Why do you think you feel the need to give money away?" B. "I am here to provide care and cannot accept this from you." C. "I can request that your case manager discuss appropriate charity options with you." D. "You should know that giving away your money is inappropriate."

B B. CORRECT: This statement is matter-of-fact and concise and is an appropriate response to a client who has bipolar disorder. A. INCORRECT: Asking a "why" question is a nontherapeutic form of communication and can promote a defensive client response. C. INCORRECT: This statement does not recognize the possibility of poor judgment, which is associated with bipolar disorder. D. INCORRECT: This statement offers disapproval and can be interpreted by the client as aggressive, which can promote a defensive client response. CHAPTER 13 Bipolar Disorders

A nurse is discussing transcranial magnetic stimulation (TMS) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates a need for further teaching? A. "TMS is indicated for clients whose depression is not relieved by medication." B. "I will provide postanesthesia care following TMS." C. "TMS is usually performed as an outpatient procedure." D. "I will schedule the client for daily TMS treatments for the first several weeks."

B B. CORRECT: This statement requires further teaching. Postanesthesia care is not necessary after TMS because the client does not receive anesthesia and is alert during the procedure. A. INCORRECT: This statement does not require further teaching. TMS is indicated for the treatment of major depressive disorder that is not responsive to pharmacologic treatment. C. INCORRECT: This statement does not require further teaching. TMS is noninvasive and can be performed as an outpatient procedure. D. INCORRECT: This statement does not require further teaching. TMS is commonly prescribed daily for a period of 4 to 6 weeks. CHAPTER 10 Brain Stimulation Therapies

A nurse is in the working phase of a therapeutic relationship with a client who has methamphetamine use disorder. Which of the following indicates transference behavior? A. The client asks the nurse whether she will go out to dinner with him. B. The client accuses the nurse of telling him what to do just like his ex-girlfriend. C. The client reminds the nurse of a friend who died from a substance overdose. D. The client becomes angry and threatens harm to himself.

B B. CORRECT: When a client views the nurse as having characteristics of another person who has been significant to his personal life, such as his ex-girlfriend, this indicates transference. A. INCORRECT: This indicates the need to discuss boundaries but does not indicate transference. C. INCORRECT: This indicates countertransference rather than transference. D. INCORRECT: This indicates the need for safety intervention but does not indicate transference. CHAPTER 5 Creating and Maintaining a Therapeutic and Safe Environment

A nurse is caring for a client who has benzodiazepine toxicity due to an overdose. Which of the following is the priority nursing action? A. Assist with the administration of flumazenil. B. Identify the client's level of orientation. C. Administer a saline cathartic. D. Prepare the client for gastric lavage.

B B. CORRECT: When taking the nursing process approach to client care, the initial step is data collection. Therefore, identifying the client's level of orientation is the priority action. A. INCORRECT: Assisting with the administration of flumazenil is an appropriate action. However, it is not the priority when taking the nursing process approach to client care. C. INCORRECT: Administration of a saline cathartic is an appropriate action. However, it is not the priority when taking the nursing process approach to client care. D. INCORRECT: Gastric lavage is an appropriate action. However, it is not the priority when taking the nursing process approach to client care. CHAPTER 19 Medications for Anxiety Disorders

A nurse is caring for a client in restraints. Which of the following statements are appropriate documentation? (Select all that apply.) A. "Client ate most of his breakfast." B. "Client was offered 8 oz of water every hr." C. "Client shouted at assistive personnel." D. "Client received chlorpromazine 15 mg by mouth at 1000." E. "Client acted out after lunch."

B, C, D B. CORRECT: How much water was offered and how often it was offered is objective data that should be documented when a nurse is caring for a client in restraints. C. CORRECT: A description of the client's verbal communication is objective data and should be documented. D. CORRECT: The dosage and time of medication administration is objective data and should be documented when caring for a client in restraints. A. INCORRECT: The fact that the client ate most of his breakfast is subjective and should not be documented. E. INCORRECT: Acting out is subjective data and therefore should not be documented. CHAPTER 2 Legal and Ethical Issues

A nurse is participating in group therapy for clients dealing with bereavement. Which of the following should the nurse include in the initial phase? (Select all that apply.) A. Encourage the group to work toward goals. B. Define the purpose of the group. C. Discuss termination of the group. D. Identify informal roles of members within the group. E. Establish an expectation of confidentiality within the group.

B, C, E B. CORRECT: During the initial phase, the nurse should identify the purpose of the group. C. CORRECT: During the initial phase, the nurse should discuss termination of the group. E. CORRECT: During the initial phase, the nurse should set the tone of the group, including an expectation of confidentiality. A. INCORRECT: During the working phase, the group works toward goals. D. INCORRECT: During the working phase, the nurse should identify informal roles that other members in the group often assume. CHAPTER 8 Group and Family Therapy

A nurse is assisting with planning care for a client who has bipolar disorder and is experiencing a manic episode. Which of the following are appropriate nursing interventions? (Select all that apply.) A. Provide flexible client behavior expectations B. Offer concise explanations C. Establish consistent limits D. Disregard client complaints E. Use a firm approach with communication

B, C, E B. CORRECT: Offering concise explanations improves the client's ability to focus and comprehend the information. C. CORRECT: Establishing consistent limits decreases the risk for client manipulation. E. CORRECT: Using a firm approach with client communication promotes structure and minimizes inappropriate client behaviors. A. INCORRECT: The nurse should establish consistent client behavior expectations to decrease the risk for client manipulation. D. INCORRECT: The nurse should respond to valid client complaints to foster a trusting nurse-client relationship. CHAPTER 13 Bipolar Disorders

A nurse is assisting with data collection for a client who has delirium related to an acute urinary tract infection. Which of the following are expected findings? (Select all that apply.) A. History of gradual memory loss B. Family report of personality changes C. Hallucinations D. Unaltered level of consciousness E. Restlessness

B, C, E B. CORRECT: The client who has delirium can experience rapid personality changes. C. CORRECT: The client who has delirium can have perceptual disturbances, such as hallucinations and illusions. E. CORRECT: The client who has delirium commonly exhibits restlessness and agitation. A. INCORRECT: The client who has delirium can experience memory loss with sudden rather than gradual onset. D. INCORRECT: The client who has delirium is expected to have an altered level of consciousness that can rapidly fluctuate. CHAPTER 16 Cognitive Disorders

A nurse is collecting data from a client 4 hr after receiving an initial dose of fluoxetine (Prozac). Which of the following findings should the nurse report to the provider as an indication of serotonin syndrome? (Select all that apply.) A. Hypothermia B. Hallucinations C. Muscular flaccidity D. Diaphoresis E. Agitation

B, D, E B. CORRECT: Hallucinations are an indication of serotonin syndrome. D. CORRECT: Diaphoresis is an indication of serotonin syndrome. E. CORRECT: Agitation is an indication of serotonin syndrome. A. INCORRECT: Fever, rather than hypothermia, is an indication of serotonin syndrome. C. INCORRECT: Muscle tremors, rather than flaccidity, are an indication of serotonin syndrome. CHAPTER 19 Medications for Anxiety Disorders

A nurse is reinforcing teaching regarding relapse prevention with a client who has bipolar disorder. Which of the following should the nurse include in the discussion? (Select all that apply.) A. Use caffeine in moderation to prevent relapse. B. Difficulty sleeping can indicate a relapse. C. Begin taking your medications as soon as a relapse begins. D. Participating in psychotherapy can help prevent a relapse. E. Anhedonia is a clinical manifestation of a depressive relapse.

B, D, E B. CORRECT: The client should be alert for sleep disturbances, which can indicate a relapse. D. CORRECT: The client who has bipolar disorder can participate in psychotherapy to help prevent a relapse. E. CORRECT: The client who has bipolar disorder should be aware of clinical manifestations, including anhedonia, which is a depressive characteristic that can indicate a relapse. A. INCORRECT: The client who has bipolar disorder should avoid the use of caffeine because it can precipitate a relapse. C. INCORRECT: The client who has bipolar disorder should take prescribed medications to prevent and minimize a relapse. CHAPTER 13 Bipolar Disorders

A nurse is monitoring a client who has alcohol use disorder and is experiencing withdrawal. Which of the following is an expected finding? (Select all that apply.) A. Bradycardia B. Fine tremors of both hands C. Hypotension D. Vomiting E. Restlessness

B, D, E D. CORRECT: Vomiting is an expected finding of alcohol withdrawal. E. CORRECT: Restlessness is an expected finding of alcohol withdrawal. A. INCORRECT: An expected finding of alcohol withdrawal is tachycardia rather than bradycardia. C. INCORRECT: An expected finding of alcohol withdrawal is hypertension rather than hypotension. CHAPTER 17 Substance Use and Addictive Disorders

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. A client who recently burned her arm while using a hot iron at home B. A client who requests that her antipsychotic medication be changed due to some new side effects C. A client who says he is hearing a voice that tells him he is not worthy of living anymore D. A client who tells the nurse he experienced symptoms of severe anxiety before and during a job interview

C C. CORRECT: A client who hears a voice telling him he is not worthy is at greatest risk for self-harm, and the nurse should visit this client first. A. INCORRECT: This client has needs that should be met, but is not as high a priority as the client at risk for self-injury. B. INCORRECT: This client has needs that should be met, but is not as high a priority as the client at risk for self-injury. D. INCORRECT: This client has needs that should be met, but is not as high a priority as the client at risk for self-injury. CHAPTER 6 Diverse Practice Settings

A nurse is discussing candidates for emergency admission to a mental health facility with a newly licensed nurse. Which of the following is an example of a client who requires emergency admission to a mental health facility? A. A client who has schizophrenia and has frequent hallucinations B. A client who has symptoms of depression and attempted suicide a year ago C. A client who has borderline personality disorder and assaulted a homeless man with a metal rod D. A client who has bipolar disorder and paces quickly down the sidewalk while talking to himself

C C. CORRECT: A client who is a current danger to self or others is a candidate for emergency admission. A. INCORRECT: The presence of hallucinations does not constitute a clear reason for emergency commitment. B. INCORRECT: Clinical findings of depression do not constitute a clear reason for emergency commitment. D. INCORRECT: A client who is pacing does not constitute a clear reason for emergency commitment. CHAPTER 2 Legal and Ethical Issues

A nurse working in an outpatient clinic is reinforcing teaching to a client who has a new diagnosis of premenstrual dysphoric disorder (PMDD). Which of the following statements by the client indicates understanding of the teaching? A. "I can expect my problems with PMDD to be worst when I'm menstruating." B. "I will use light therapy 30 min a day to prevent further recurrences of PMDD." C. "I am aware that my PMDD causes me to have rapid mood swings." D. "I should increase my caloric intake with a nutritional supplement when my PMDD is active."

C C. CORRECT: A clinical finding of PMDD is emotional lability. The client can experience rapid changes in mood. A. INCORRECT: Clinical findings of PMDD are present during the luteal phase of the menstrual cycle, just prior to menses. B. INCORRECT: Light therapy is a first-line treatment for seasonal affective disorder, rather than PMDD. D. INCORRECT: PMDD increases the client's risk for weight gain due to overeating. It is not appropriate to increase caloric intake. CHAPTER 12 Depressive Disorders

A nurse in an acute mental health facility is caring for a client who has a severe mental illness and soon will be ready for discharge but still requires supervision much of the time. The client's partner works all day but is home by late afternoon. Which of the following should the nurse suggest as appropriate follow‑up care? A. Receiving daily care from a home health aide B. Having a weekly visit from a nurse case worker C. Attending a partial hospitalization program D. Visiting a community mental health center on a daily basis

C C. CORRECT: A partial hospitalization program can provide treatment during the day while allowing the client to spend nights at home, as long as a responsible family member is present. A. INCORRECT: Daily care provided by a home health aide will not provide adequate supervision for this client. B. INCORRECT: Weekly visits from a case worker will not provide adequate care and supervision for this client. D. INCORRECT: A weekly visit from a nurse case worker will not provide adequate care and supervision for this client. CHAPTER 6 Diverse Practice Settings

A nurse is reinforcing teaching to the family of a client who has a substance use disorder. Which of the following statements by a family member indicates a need for further teaching? A. "We need to understand that she is not responsible for her disorder." B. "Eliminating any codependent behavior will promote her recovery." C. "She should participate in an Al-Anon group to help her recover." D. "The primary goal of her treatment is abstinence from substance use."

C C. CORRECT: Al-Anon is a recovery group for the family of a client, rather than the client who has a substance use disorder. A. INCORRECT: Clients are not responsible for their disease but are responsible for their recovery. B. INCORRECT: Families should be aware of codependent behavior, such as enabling, that can promote substance use rather than recovery. D. INCORRECT: Abstinence is the primary treatment goal for a client who has a substance use disorder. CHAPTER 17 Substance Use and Addictive Disorders

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. A member who praises input from other members B. A member who follows the direction of other members C. A member who brags about accomplishments D. A member who evaluates the group's performance toward a standard

C C. CORRECT: An individual who brags about accomplishments is acting in an individual role that does not promote the progression of the group toward meeting goals. A. INCORRECT: An individual who praises the input of others is acting in a maintenance role. B. INCORRECT: An individual who is a follower is acting in a maintenance role. D. INCORRECT: An individual who evaluates the group's performance is acting in a task role. CHAPTER 8 Group and Family Therapy

A nurse is conducting therapy with a several clients and their families. Effective communication with clients and families is based on A. discussing in-depth topics with which the client feels comfortable. B. using silence to avoid unpleasant or difficult topics. C. attending to verbal and nonverbal behaviors. D. requiring the client and family to ask for feedback.

C C. CORRECT: Attending to verbal and nonverbal behaviors is necessary for effective communication. A. INCORRECT: In-depth conversations are not necessary for effective communication. Often, very brief conversations are most effective. B. INCORRECT: The purpose of effective silence is to allow the client time for reflection or to convey nonverbal support. It is not used to avoid unpleasant or difficult topics. D. INCORRECT: Requiring the client and family to ask for feedback is not an effective technique. CHAPTER 3 Effective Communication

A nurse observes a client who has OCD repeatedly applying, removing, and then reapplying makeup. Repetitive behavior in a client who has OCD is due to which of the following? A. Narcissistic behavior B. Fear of rejection from staff C. Attempt to reduce anxiety D. Adverse effect of antidepressant medication

C C. CORRECT: Clients who have OCD demonstrate repetitive behavior in an attempt to suppress persistent thoughts or urges. A. INCORRECT: Clients who have OCD demonstrate repetitive behavior but not narcissism, which can be associated with personality disorders. B. INCORRECT: Clients who have OCD demonstrate repetitive behavior but not fear of rejection, which can be associated with social phobias. D. INCORRECT: Clients who have OCD can take an antidepressant to help control repetitive behavior. CHAPTER 11 Anxiety Disorders Concepts

A nurse is orienting a new client to a mental health unit. When explaining the unit's community meetings, which of the following statements by the nurse is appropriate? A. "You and a group of other clients will meet to discuss your treatment plans." B. "Community meetings have a specific agenda that is established by staff." C. "You and the other clients will meet with staff to discuss common problems." D. "Community meetings are an excellent opportunity to explore your personal mental health issues."

C C. CORRECT: Community meetings are an opportunity for clients to discuss common problems or issues affecting all members of the unit. A. INCORRECT: Individual treatment plans are discussed during individual therapy rather than a community meeting. B. INCORRECT: Community meetings can be structured so that they are client-led with decisions made by the group as a whole. D. INCORRECT: Personal mental health issues are discussed during individual therapy rather than a community meeting. CHAPTER 5 Creating and Maintaining a Therapeutic and Safe Environment

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 demonstrating which of the following actions? A. Observes group techniques without interfering with the group process B. Discusses a technique and then directs members to practice the technique C. Asks for group suggestions of techniques and then supports discussion D. Suggests techniques and asks group members to reflect on their use

C C. CORRECT: Democratic leadership supports group interaction and decision-making to solve problems. A. INCORRECT: Laissez-faire leadership allows the group process to progress without any attempt by the leader to control the direction of the group. B. INCORRECT: Autocratic leadership controls the direction of the group. D. INCORRECT: Autocratic leadership controls the direction of the group. CHAPTER 8 Group and Family Therapy

A nurse is caring for a client who has alcohol use disorder. The client is no longer experiencing withdrawal manifestations. Which of the following medications should the nurse anticipate administering to assist the client with maintaining abstinence from alcohol? A. Chlordiazepoxide (Librium) B. Bupropion (Zyban) C. Disulfiram (Antabuse) D. Carbamazepine (Tegretol)

C C. CORRECT: Disulfiram (Antabuse) is administered to help clients maintain abstinence from alcohol. A. INCORRECT: Chlordiazepoxide (Librium) is indicated for acute alcohol withdrawal rather than to maintain abstinence from alcohol. B. INCORRECT: Bupropion (Zyban) is indicated for nicotine withdrawal rather than to maintain abstinence from alcohol. D. INCORRECT: Carbamazepine (Tegretol) is indicated for acute alcohol withdrawal rather than to maintain abstinence from alcohol. CHAPTER 17 Substance Use and Addictive Disorders

A nurse is assisting with conducting an in-service about the use of electroconvulsive therapy (ECT) for the treatment of bipolar disorder. Which of the following statements by a newly licensed nurse indicates understanding? A. "ECT is the recommended initial treatment for bipolar disorder." B. "ECT is contraindicated for clients who have suicidal ideation." C. "ECT is effective for clients who are experiencing severe mania." D. "ECT is prescribed to prevent relapse of bipolar disorder."

C C. CORRECT: ECT is appropriate for the treatment of severe mania associated with bipolar disorder. A. INCORRECT: Pharmacological intervention is the recommended initial treatment for bipolar disorder. B. INCORRECT: ECT is effective for clients who have bipolar disorder and suicidal ideation. D. INCORRECT: ECT is prescribed for clients experiencing an acute episode of bipolar disorder rather than for the prevention of relapse. CHAPTER 13 Bipolar Disorders

A nurse is leading a peer group discussion about the indications for electroconvulsive therapy (ECT). Which of the following is appropriate to include in the discussion? A. Borderline personality disorder B. Acute withdrawal related to a substance use disorder C. Bipolar disorder with rapid cycling D. Dysthymic disorder

C C. CORRECT: ECT is indicated for the treatment of bipolar disorder with rapid cycling. A. INCORRECT: ECT has not been found to be effective for the treatment of personality disorders. B. INCORRECT: ECT has not been found to be effective for the treatment of substance use disorders. D. INCORRECT: ECT has not been found effective for the treatment of dysthymic disorder. CHAPTER 10 Brain Stimulation Therapies

A nurse is making a home visit to a client who is in the late stage of Alzheimer's disease. The client's spouse, who is the primary caregiver, wishes to discuss concerns about the client's nutrition and the stress of providing care. Which of the following is an appropriate action by the nurse? A. Verify that a current power of attorney document is on file. B. Tell the client's spouse to offer finger foods to increase oral intake. C. Provide information on resources for respite care. D. Schedule the client for placement of an enteral feeding tube.

C C. CORRECT: Providing information on resources for respite care is an appropriate action to provide the client's spouse with a break from caregiving responsibilities. A. INCORRECT: A power of attorney document does not address the client's care or the concerns of the caregiver. B. INCORRECT: Clients in late-stage Alzheimer's disease are at risk for choking and are unable to eat without assistance. Therefore, offering finger foods is not an appropriate action. D. INCORRECT: Placement of an enteral feeding tube is appropriate only with a prescription from the provider following a discussion that includes the provider, nurse, the client's spouse, as well as possibly social services and additional family members. CHAPTER 16 Cognitive Disorders

A nurse is assisting with the preparation of a staff education program on substance use in older adults. Which of the following is appropriate for the nurse to include in the presentation? A. Older adults require higher doses of a substance to achieve a desired effect. B. Older adults commonly use rationalization to cope with a substance use disorder. C. Older adults are at a higher risk for substance use following retirement. D. Older adults develop substance use to mask signs of dementia.

C C. CORRECT: Retirement and other life change stressors increase the risk for substance use in older adults, especially if there is a prior history of substance use. A. INCORRECT: Requiring higher doses of a substance to achieve a desired effect is a result of the length and severity of substance use rather than age. B. INCORRECT: Denial, rather than rationalization, is a defense mechanism commonly used by substance users of all ages. D. INCORRECT: Substance use in the older adult can result in signs of dementia. CHAPTER 17 Substance Use and Addictive Disorders

A nurse is assisting with systematic desensitization for a client who has an extreme fear of elevators. Which of the following is appropriate when implementing this form of therapy? A. Demonstrate riding in an elevator, and then ask the client to imitate the behavior. B. Advise the client to say "stop" out loud every time he begins to feel an anxiety response related to an elevator. C. Gradually expose the client to an elevator while practicing relaxation techniques. D. Stay with the client in an elevator until his anxiety response diminishes.

C C. CORRECT: Systematic desensitization is the planned, progressive exposure to anxiety-provoking stimuli. During this exposure, relaxation techniques suppress the anxiety response. A. INCORRECT: Demonstration followed by client imitation of the behavior is an example of modeling, rather than systematic desensitization. B. INCORRECT: Instructing a client to say "stop" when anxiety occurs is an example of thought stopping, rather than systematic desensitization. D. INCORRECT: Exposing the client to a great deal of an undesirable stimulus in an attempt to turn off the anxiety response is an example of flooding, rather than systematic desensitization. CHAPTER 7 Psychoanalysis, Psychotherapy, and Behavioral Therapies

A nurse is working on promotion of healthy coping skills with older adult clients who all previously had been hospitalized for severe depression and are now in a residential care facility. The nurse should recognize that this is an example of which of the following? A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Mental status examination

C C. CORRECT: Tertiary prevention deals with prevention of further problems in clients already diagnosed with mental illness. A. INCORRECT: Primary prevention deals with preventing the initial onset of a mental health problem. B. INCORRECT: Secondary prevention deals with early detection of disease. D. INCORRECT: The mental status examination is a tool that the nurse could use to collect data regarding a client's problem, but it is not a type of prevention. CHAPTER 6 Diverse Practice Settings

A nurse is reviewing the medical record of a client who has a new prescription for bupropion (Wellbutrin) for depression. Which of the following findings is the priority for the nurse to report to the provider? A. The client has a family history of seasonal affective disorder. B. The client currently smokes 1.5 packs of cigarettes per day. C. The client had a motor vehicle crash last year and sustained a head injury. D. The client has a BMI of 25 and has gained 10 lb over the last year.

C C. CORRECT: The greatest risk to the client is development of seizures. Bupropion can lower the seizure threshold and should be avoided by clients who have a history of a head injury. This information is the priority to report to the provider. A. INCORRECT: The nurse should report family history information. However, this does not address the greatest risk to the client and is therefore not the priority. B. INCORRECT: The nurse should report the client's current smoking status. However, this does not address the greatest risk to the client and is therefore not the priority. D. INCORRECT: The nurse should report the client's BMI and change in weight. However, this does not address the greatest risk to the client and is therefore not the priority. CHAPTER 20 Medications for Depressive Disorders

A nurse is assisting with planning care for a client who is experiencing benzodiazepine withdrawal. Which of the following is the priority nursing intervention? A. Orient the client frequently to time, place, and person. B. Offer fluids and nourishing diet as tolerated. C. Implement seizure precautions. D. Encourage participation in group therapy sessions.

C C. CORRECT: The greatest risk to the client is injury. Therefore, implementing seizure precautions is the priority intervention. A. INCORRECT: Reorienting the client is an appropriate intervention. However, it is not the priority. B. INCORRECT: Providing hydration and nourishment is an appropriate intervention. However, it is not the priority. D. INCORRECT: Encouraging participation in therapy is an appropriate intervention. However, it is not the priority. CHAPTER 17 Substance Use and Addictive Disorders

A nurse is interviewing a 25-year-old client who has a new diagnosis of dysthymia. Which of the following findings should the nurse expect? A. Wide fluctuations in mood B. Report of five or more clinical findings of depression C. Presence of manifestations for at least 2 years D. Inflated sense of self-esteem

C C. CORRECT: The manifestations of dysthymic disorder last for at least 2 years in adults. A. INCORRECT: Wide fluctuations in mood are associated with bipolar disorder rather than dysthymia. B. INCORRECT: MDD, rather than dysthymic disorder, contains a minimum of five clinical findings of depression. D. INCORRECT: A decreased, rather than inflated, sense of self-esteem is associated with dysthymia. CHAPTER 12 Depressive Disorders

A client tells a student 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? A. Keep the client's communication confidential, but talk to the client daily, using therapeutic communication to convince him to admit to hiding the knife. B. Keep the client's communication confidential, but watch the client and his roommate closely. C. Tell the client that this must be reported to health care staff because it concerns the health and safety of the client and others. D. Report the incident, but do not inform the client of the intention to do so.

C C. CORRECT: This is a serious safety issue that must be reported to the staff. Using the principle of veracity, the student tells this client truthfully what must be done regarding the issue. A. INCORRECT: The information cannot be kept confidential. Daily therapeutic communication is not an appropriate action to correct the client's behavior. B. INCORRECT: The information cannot be kept confidential. Observing the client and his roommate is not an appropriate action. D. INCORRECT: The client should be aware that the information will be reported to the health care staff. CHAPTER 2 Legal and Ethical Issues

A nurse is caring for a client who has bulimia nervosa and who has stopped purging behavior. The client tells the nurse that she is afraid she is going to gain weight. Which of the following is an appropriate response by the nurse? A. "Many clients are concerned about their weight. However, the dietitian will ensure that you don't get too many calories in your diet." B. "Instead of worrying about your weight, try to focus on other problems at this time." C. "I understand you have concerns about your weight, but first, let's talk about your recent accomplishments." D. "You are not overweight, and the staff will ensure that you do not gain weight while you are in the hospital. We know that is important to you."

C C. CORRECT: This statement acknowledges the client's concern and then focuses the conversation on the client's accomplishments, which can promote client self-esteem and self-image. A. INCORRECT: This statement minimizes and generalizes the client's concern and is therefore a nontherapeutic response. B. INCORRECT: This statement minimizes the client's concern and is therefore a nontherapeutic response. D. INCORRECT: This statement minimizes the client's concern and is therefore a nontherapeutic response. CHAPTER 18 Eating Disorders

A nurse is talking with a client who is at risk for suicide following the death of his spouse. Which of the following statements by the nurse is appropriate? A. "I feel very sorry for the loneliness you must be experiencing." B. "Suicide is not the appropriate way to cope with loss." C. "Losing someone close to you must be very upsetting." D. "I know how difficult it is to lose a loved one."

C C. CORRECT: This statement is an empathetic response that attempts to understand the client's feelings. A. INCORRECT: This statement focuses on the nurse's feelings and is sympathetic rather than empathetic. B. INCORRECT: This statement implies judgment and is therefore not an empathetic or therapeutic response. D. INCORRECT: This statement focuses on the nurse's experiences rather than the client's and is therefore not therapeutic. CHAPTER 5 Creating and Maintaining a Therapeutic and Safe Environment

A nurse is caring for a client who is to begin taking fluoxetine (Prozac) for treatment of generalized anxiety disorder. Which of the following statements indicates the client understands the use of this medication? A. "I will take the medication at bedtime." B. "I will follow a low-sodium diet while taking this medication." C. "I will need to discontinue this medication slowly." D. "I will be at risk for weight loss with long-term use of this medication."

C C. CORRECT: When discontinuing fluoxetine, the client should taper the medication slowly according to a prescribed tapered dosing schedule to reduce the risk of withdrawal syndrome. A. INCORRECT: The client should take fluoxetine in the morning to minimize sleep disturbances. B. INCORRECT: The client is at risk for hyponatremia while taking fluoxetine. D. INCORRECT: The client is at risk for weight gain, rather than loss, with long-term use of fluoxetine. CHAPTER 19 Medications for Anxiety Disorders

A nurse is discussing the characteristics of a nurse-client relationship with a newly licensed nurse. Which of the following are appropriate to include in the discussion? (Select all that apply.) A. The needs of both participants are met. B. An emotional commitment exists between the participants. C. It is goal-directed. D. Behavioral change is encouraged. E. A termination date is established.

C, D, E C. CORRECT: A therapeutic nurse-client relationship is goal-directed. D. CORRECT: A therapeutic nurse-client relationship encourages positive behavioral change. E. CORRECT: A therapeutic nurse-client relationship has an established termination date. A. INCORRECT: A therapeutic nurse-client relationship focuses on the needs of the client. B. INCORRECT: An emotional commitment between the participants is characteristic of an intimate or social relationship rather than one that is therapeutic. CHAPTER 5 Creating and Maintaining a Therapeutic and Safe Environment

A nurse is monitoring a client immediately following an electroconvulsive therapy (ECT) procedure. Which of the following are expected findings? (Select all that apply.) A. Hypotension B. Paralytic ileus C. Memory loss D. Nausea E. Tachycardia

C, D, E C. CORRECT: Transient short-term memory loss is an expected finding immediately following ECT. D. CORRECT: Nausea is an expected finding immediately following ECT. E. CORRECT: Tachycardia is an expected finding immediately following ECT. A. INCORRECT: Immediately following ECT, the client's blood pressure is expected to be elevated. B. INCORRECT: Paralytic ileus is not an expected finding of ECT. CHAPTER 10 Brain Stimulation Therapies

A nurse is assisting with the preparation of a staff education session on personality disorders. Which of the following should be included as personality characteristics associated with all personality disorders? (Select all that apply.) A. Difficulty in getting along with other members of a group B. Belief in the ability to become invisible during times of stress C. Display of defense mechanisms when routines are changed D. Claiming to be more important than other persons E. Difficulty understanding why it is inappropriate to have a personal relationship with staff

C, E C. CORRECT: Maladaptive response to stress is a personality characteristic that can be seen with all personality disorder types. E. CORRECT: Difficulty understanding personal boundaries is a personality characteristic that can be seen with all personality disorder types. A. CORRECT: Difficulty with social and professional relationships is a personality characteristic that can be seen with all personality disorder types. B. INCORRECT: Clients who have schizotypal personality disorder can display magical thinking or delusions. However, this is not associated with all personality disorder types. D. INCORRECT: Clients who have narcissistic personality disorder can display grandiose thinking. However, this is not associated with all personality disorder types. CHAPTER 15 Personality Disorders

A nurse is reinforcing teaching with a client who is scheduled to receive electroconvulsive therapy (ECT) for the treatment of major depressive disorder. Which of the following client statements indicates understanding of the teaching? A. "It is common to treat depression with ECT before trying medications." B. "I can have my depression cured if I receive a series of ECT treatments." C. "I will have seizures lasting 1½ to 2 minutes during ECT." D. "I will receive a muscle relaxant to protect me from injury during ECT."

D D. CORRECT: A muscle relaxant, such as succinylcholine (Anectine), is administered to reduce the risk for injury during induced seizure activity. A. INCORRECT: ECT is indicated for clients who have major depressive disorder and who are not responsive to pharmacologic treatment. B. INCORRECT: ECT does not cure depression. However, it can reduce the incidence and severity of relapse. C. INCORRECT: Induced seizures during ECT typically last only 25 to 60 seconds. CHAPTER 10 Brain Stimulation Therapies

When a family asks a nurse for reassurance about a client's condition, which of the following is an appropriate response? A. "I think your son is getting better. What have you noticed?" B. "I'm sure everything will be okay. It just takes time to heal." C. "I'm not sure what's wrong. Have you asked the doctor about your concerns?" D. "I understand you're concerned. Let's discuss what concerns you specifically."

D D. CORRECT: A therapeutic response reflects upon and accepts the family's feelings, and it allows the members to clarify what they are feeling. A. INCORRECT: This interjects the nurse's opinion and can cause the family members to withhold their thoughts and feelings. B. INCORRECT: This interjects the nurse's opinion and can cause the family members to withhold their thoughts and feelings. C. INCORRECT: This interjects the nurse's opinion and can cause the family members to withhold their thoughts and feelings. CHAPTER 3 Effective Communication

A nurse working in a mental health clinic is reinforcing teaching with a client who has a new prescription for diazepam (Valium) for generalized anxiety disorder. Which of the following is appropriate for the nurse to include in the teaching? A. 3 to 6 weeks of treatment is required to achieve therapeutic benefit. B. Combining alcohol with diazepam will produce a paradoxical response. C. Diazepam has a lower risk for dependency than other antianxiety medications. D. Report confusion as a potential indication of toxicity.

D D. CORRECT: Confusion is a potential indication of diazepam toxicity that the client should report to the provider. A. INCORRECT: Buspirone, rather than diazepam, requires 3 to 6 weeks to achieve therapeutic benefit. B. INCORRECT: Combining alcohol with diazepam can produce CNS and respiratory depression, rather than a paradoxical response. C. INCORRECT: Diazepam is preferably used for short-term treatment because of the increased risk of dependency. CHAPTER 19 Medications for Anxiety Disorders

A nurse is caring for a client who is experiencing a panic attack. Which of the following is an appropriate nursing intervention? A. Discuss new relaxation techniques. B. Show the client how to change his behavior. C. Distract the client with a television show. D. Stay with the client, and remain quiet.

D D. CORRECT: During a panic attack, the nurse should quietly remain with the client. This promotes safety and reassurance without additional stimuli. A. INCORRECT: During a panic attack, the client is unable to concentrate on learning new information. B. INCORRECT: During a panic attack, the client is unable to concentrate on learning new information. C. INCORRECT: During a panic attack, the nurse should maintain a calm, quiet environment. Further stimuli can increase the client's level of anxiety. CHAPTER 11 Anxiety Disorders Concepts

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? A. "I will write down my dreams as soon as I wake up." B. "I may begin to associate my therapist with important people in my life." C. "I can learn to express myself in a nonaggressive manner." D. "I should say the first thing that comes to my mind."

D D. CORRECT: Free association is the spontaneous, uncensored verbalization of whatever comes to a client's mind. A. INCORRECT: Dream analysis and interpretation are therapeutic tools. However, they are not an example of free association. B. INCORRECT: Associating the therapist with significant persons in the client's life is an example of transference, rather than free association. C. INCORRECT: Learning to express feelings and solve problems in a nonaggressive manner is an example of assertiveness training, rather than free association. CHAPTER 7 Psychoanalysis, Psychotherapy, and Behavioral Therapies

A nurse is caring for a client who is experiencing moderate anxiety. Which of the following is an appropriate nursing intervention when trying to give necessary information to the client? A. Reassure the client that everything will be okay. B. Use a low-pitched voice and speak slowly. C. Ignore the client's anxiety so that she will not be embarrassed. D. Demonstrate a calm manner while using simple and clear language.

D D. CORRECT: Giving information simply and calmly will help the client grasp essential facts. A. INCORRECT: Providing false reassurance is not an appropriate nursing intervention. B. INCORRECT: Using a low-pitched voice and speaking slowly is not an appropriate nursing intervention. This is appropriate for the client who is experiencing severe to panic levels of anxiety. C. INCORRECT: Ignoring the client's anxiety to prevent embarrassment is not an appropriate intervention. CHAPTER 4 Stress and Defense Mechanisms

A nurse is conducting a class on therapeutic communication to a group of newly licensed nurses. Which of the following responses regarding nonverbal communication by a newly licensed nurse requires additional teaching? A. Personal space B. Posture C. Eye contact D. Intonation

D D. CORRECT: Intonation is the tone of one's voice and can communicate a variety of feelings. A. INCORRECT: Personal space is a part of nonverbal behavior and should be included in the teaching. B. INCORRECT: Posture is a part of nonverbal behavior and should be included in the teaching. C. INCORRECT: Eye contact is a part of nonverbal behavior and should be included in the teaching. CHAPTER 3 Effective Communication

A nurse in a long-term care facility is caring for a resident who has major neurocognitive disorder and attempts to wander out of the building. The client states, "I have to get home." Which of the following is an appropriate response by the nurse? A. "You have forgotten that this is your home." B. "You cannot go outside without a staff member." C. "Why would you want to leave? Aren't you happy with your care?" D. "I am your nurse. Let's walk together to your room."

D D. CORRECT: It is appropriate for the nurse to introduce herself with each new interaction and to promote reality in a calm, reassuring manner. A. INCORRECT: The nurse should avoid statements that can be interpreted as argumentative or demeaning. B. INCORRECT: The nurse should use positive rather than negative statements. C. INCORRECT: Using a "why" question can promote a defensive reaction and does not reinforce reality. CHAPTER 16 Cognitive Disorders

A nurse is assisting in the planning of care for a client who has a mental health disorder. Which of the following is appropriate to include as a psychobiological intervention? A. Assist the client with systematic desensitization therapy. B. Encourage the client to use appropriate coping mechanisms. C. Evaluate the client for comorbid health conditions. D. Monitor the client for adverse effects of medications.

D D. CORRECT: Monitoring for adverse effects of medications is an example of a psychobiological intervention. A. INCORRECT: Assisting with systematic desensitization therapy is a cognitive and behavioral, rather than psychobiological, intervention. B. INCORRECT: Encouraging appropriate coping mechanisms is a counseling or health teaching, rather than a psychobiological intervention. C. INCORRECT: Evaluating for comorbid health conditions is health promotion and maintenance, rather than a psychobiological intervention. CHAPTER 1 Basic Mental Health Nursing Concepts

A nurse in an acute mental health facility is caring for a client who is experiencing a mixed episode of bipolar disorder. Which of the following is the priority nursing action? A. Set consistent limits for expected client behavior. B. Administer prescribed medications as scheduled. C. Provide the client with step-by-step instructions during hygiene activities. D. Monitor the client for escalating behavior.

D D. CORRECT: Monitoring the client for escalating behavior addresses the client's priority need for safety and is therefore the priority nursing action. A. INCORRECT: Setting consistent limits for expected client behavior is appropriate. However, this does not address the client's priority need for safety and is therefore not the priority action. B. INCORRECT: Administering prescribed medications as scheduled is appropriate. However, this does not address the client's priority need for safety and is therefore not the priority action. C. INCORRECT: Providing the client with step-by-step instructions during hygiene activities is appropriate. However, this does not address the client's priority need for safety and is therefore not the priority action. CHAPTER 13 Bipolar Disorders

A nurse on an acute care unit is assisting with planning care for a client who has anorexia nervosa with binge-eating and purging behavior. Which of the following nursing actions is appropriate to include in the client's plan of care? A. Allow the client to select preferred meal times. B. Establish consequences for purging behavior. C. Provide the client with a high-fat diet at the start of treatment. D. Implement one-to-one observation during meal times.

D D. CORRECT: The nurse should closely monitor the client during and after meals to prevent purging. A. INCORRECT: The nurse should provide a highly structured milieu, including meal times, for the client requiring acute care for the treatment of anorexia nervosa. B. INCORRECT: The nurse should use a positive approach to client care that includes rewards rather than consequences. C. INCORRECT: The nurse should limit high-fat and gas-producing foods at the start of treatment. CHAPTER 18 Eating Disorders

A nurse is caring for a client who states, "I'm so stressed at work because of my coworker. He expects me to finish his work because he's too lazy!" When discussing appropriate communication, which of the following statements by the client to his coworker indicates client understanding? A. "You really should complete your own work. I don't think it's right to expect me to complete your responsibilities." B. "Why do you expect me to finish your work? You must realize that I have my own responsibilities." C. "It is not fair to expect me to complete your work. If you continue, then I will report your behavior to our supervisor." D. "When I have to pick up extra work, I feel very overwhelmed. I need to focus on my own responsibilities."

D D. CORRECT: This response demonstrates assertive communication, which allows the client to state her feelings about the behavior and then promote a change. A. INCORRECT: This statement is an example of disapproving/disagreeing, which can prompt a defensive reaction and is therefore nontherapeutic. B. INCORRECT: This statement uses a "why" question, which implies criticism and can prompt a defensive reaction and is therefore nontherapeutic. C. INCORRECT: This statement is aggressive and threatening, which can prompt a defensive reaction and is therefore nontherapeutic. CHAPTER 9 Stress Management

A nurse is discussing mental status examinations with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates a need for further teaching? A. "To check cognitive ability, I should ask the client to count backward by 7." B. "To check affect, I should observe the client's facial expression." C. "To check language ability, I should instruct the client to write a sentence." D. "To check remote memory, I should have the client repeat a list of objects."

D D. CORRECT: This statement requires further teaching. Asking the client to repeat a list of objects is appropriate to check immediate, rather than remote, memory. A. INCORRECT: This statement does not require further teaching. Counting backward by 7 is an appropriate technique to check a client's cognitive ability. B. INCORRECT: This statement does not require further teaching. Observing a client's facial expression is appropriate when checking affect. C. INCORRECT: This statement does not require further teaching. Writing a sentence is an indication of language ability. CHAPTER 1 Basic Mental Health Nursing Concepts

A nurse decides to put a client who has psychosis in seclusion overnight because the unit is very short‑staffed and the client frequently fights with other clients. This is an example of A. beneficence. B. a tort. C. a facility policy. D. justice.

B B. CORRECT: A civil wrong that violates a client's civil rights is a tort. In this case, it is false imprisonment. A. INCORRECT: Beneficence is doing good for a client. C. INCORRECT: If this were a facility policy, it would be a violation of federal and state statute, and the nurse could still be held responsible for following it. D. INCORRECT: Justice involves the fair and equal treatment of clients. CHAPTER 2 Legal and Ethical Issues

A nurse is caring for a client who is taking phenelzine (Nardil). For which of the following adverse effects should the nurse observe? (Select all that apply.) A. Elevated blood glucose level B. Orthostatic hypotension C. Priapism D. Headache E. Bruxism

B, D B. CORRECT: The nurse should observe for orthostatic hypotension, which is an adverse effect of phenelzine. D. CORRECT: The nurse should observe for a headache, which is an adverse effect of phenelzine. A. INCORRECT: An elevated blood glucose level is not an adverse effect of phenelzine. C. INCORRECT: Priapism is an adverse effect of trazodone, rather than phenelzine. E. INCORRECT: Bruxism is an adverse effect of SSRIs, rather than phenelzine. CHAPTER 20 Medications for Depressive Disorders

A nurse is assisting with a court-ordered evaluation of a client who has antisocial personality disorder. When collecting data on this client, which of the following are expected findings? (Select all that apply.) A. Demonstrates extreme anxiety when placed in a social situation B. Has difficulty making even simple decisions C. Attempts to convince other clients to give him their belongings D. Becomes agitated if his personal area is not neat and orderly E. Blames others for his past and current problems

C,E C. CORRECT: Exploitation and manipulation of others is an expected finding of antisocial personality disorder. E. CORRECT: Failure to accept personal responsibility is an expected finding of clients who have antisocial personality disorder. A. INCORRECT: Anxiety in social situations is an expected finding of clients who have avoidant rather than antisocial personality disorder. B. INCORRECT: Indecisiveness, due to a sensitivity to criticism, is an expected finding of clients who have narcissistic rather than antisocial personality disorder. D. INCORRECT: Perfectionism with a focus on orderliness and control is an expected finding of clients who have obsessive-compulsive rather than antisocial personality disorder. CHAPTER 15 Personality Disorders

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? A. Triangulation B. Group process C. Subgroup D. Hidden agenda

D D. CORRECT: A hidden agenda is when some group members have a different goal than the stated group goals. The hidden agenda is often disruptive to the effective functioning of the group. A. INCORRECT: Triangulation is when a third party is drawn into a relationship with two members whose relationship is unstable. B. INCORRECT: Group process is the verbal and nonverbal communication that occurs within the group during group sessions. C. INCORRECT: A subgroup is a small number of people within a larger group who function separately from that group. CHAPTER 8 Group and Family Therapy

A nurse is communicating with a client on the acute mental health facility. 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? A. Offering general leads B. Summarizing C. Focusing D. Restating

D D. CORRECT: Restating allows the nurse to repeat the main idea expressed. A. INCORRECT: Offering general leads allows the nurse to take the direction of the discussion. B. INCORRECT: Summarizing enables the nurse to bring together important points of discussion to enhance understanding. C. INCORRECT: Focusing concentrates the attention on a single point. CHAPTER 3 Effective Communication