Foundation and practice of mental health nursing

A client has been taking escitalopram (Lexapro) for treatment of a major depressive episode. On the fifth day of therapy the client refuses the medication, stating, "It doesn't help, so what's the use of taking it?" What is the best response by the nurse? 1."It can take 1 to 4 weeks to see an improvement." 2."It takes 6 to 8 weeks for this medication to have an effect." 3."I'll talk to your doctor about increasing the dosage. That may help." 4."You should have felt a response by now. I'll notify the doctor right now."

1."It can take 1 to 4 weeks to see an improvement."

A client who has recently been found to be infected with HIV comments to the nurse, "There are so many terrible people around. Why couldn't one of them get HIV instead of me?" What is the best response by the nurse? 1."It seems unfair that you should have this disease." 2."I'm sure you really don't wish this on someone else." 3."It might be good for you to speak with your religious leader." 4."I'm sure you know that HIV infection is now considered a chronic illness."

1."It seems unfair that you should have this disease."

A child in the first grade is murdered, and counseling is planned for the other children in the school. What should a nurse identify first before evaluating a child's response to a crisis? 1.Developmental level of the child 2.Quality of the child's peer relationships 3.Child's perception of the crisis situation 4.Child's communication patterns with family members

1.Developmental level of the child

A practitioner prescribes Alprazolam (Xanax) 0.25 mg by mouth three times a day for a client with anxiety and physical symptoms related to work pressures. For what most common side effect of this drug should the nurse monitor the client? 1.Drowsiness 2.Bradycardia 3.Agranulocytosis 4.Tardive dyskinesia

1.Drowsiness

What characteristic is most essential for the nurse caring for a client undergoing mental health care? 1.Empathy 2.Sympathy 3.Organization 4.Authoritarianism

1.Empathy

The nurse anticipates that the medication that will be used to prevent symptoms of withdrawal in clients with a long history of alcohol abuse is: 1.Lorazepam (Ativan) 2.Phenobarbital (Luminal) 3.Chlorpromazine (Thorazine) 4.Methadone hydrochloride (Methadone)

1.Lorazepam (Ativan)

A client is receiving doxepin (Sinequan). For which most dangerous side effect of tricyclic antidepressants should a nurse monitor the client? 1.Mydriasis 2.Dry mouth 3.Constipation 4.Urine retention

1.Mydriasis

A woman who was sexually assaulted by a stranger in the elevator of her apartment building is brought by her husband to the emergency department. What is the priority nursing intervention? 1.Obtaining information about her perception of the incident 2.Notifying legal authorities that a sexual assault has occurred 3.Talking with the husband about his feelings concerning sexual assault 4.Teaching the client how to obtain a midstream clean-catch urine specimen

1.Obtaining information about her perception of the incident

A young client who has become a mother for the first time is anxious about her new parenting role. With the nurse's encouragement, she joins the new mothers' support group at the local YMCA. What kind of prevention does this activity reflect? 1.Primary prevention 2.Tertiary prevention 3.Secondary prevention 4.Therapeutic prevention

1.Primary prevention

According to Erikson, a child's increased vulnerability to anxiety in response to separation or pending separation from significant others results from failure to complete a developmental stage. What does the nurse call this stage? 1.Trust 2.Identity 3.Initiative 4.Autonomy

1.Trust

What should the nurse do to develop a trusting relationship with a disturbed child who acts out? 1.Ask the child's feelings about the parents 2.Implement one-on-one interactions every half hour 3.Offer support and encourage safety during play activities 4.Begin setting limits and explain the rules that must be followed

3.Offer support and encourage safety during play activities

What can the nurse do to help older adult to successfully complete Erikson's major task of this stage? 1.Invest creative energy in promoting social welfare 2.Develop a sense of satisfaction when considering past achievements 3.Develop deep and lasting relationships with other people or institutions 4.Recapture opportunities that the client did not take or those that were not fulfilled

2.Develop a sense of satisfaction when considering past achievements

According to Erikson, a young adult must accomplish the tasks associated with the stage known as: 1.Trust versus mistrust 2.Intimacy versus isolation 3.Industry versus inferiority 4.Generativity versus stagnation

2.Intimacy versus isolation

A 23-year-old woman is admitted to a psychiatric unit after several episodes of uncontrolled rage at her parents' home, and borderline personality disorder is diagnosed. While watching a television newscast describing an incident of violence in the home, the client says, "People like that need to be put away before they kill someone." The nurse concludes that the client is using: 1.Denial 2.Projection 3.Introjection 4.Sublimation

2.Projection

A client sits huddled in a chair and leaves it only to assume the fetal position in a corner. The nurse, observing this, identifies the behavior as: 1.Reactive 2.Regressive 3.Dissociative 4.Hallucinatory

2.Regressive

A nurse plans to use family therapy as a means of helping a family cope with their child's terminal illness. The nurse bases this choice on the principle that: 1.It is more efficient to interact with the whole family together 2.The entire family is involved because what happens to one member affects all 3.The nurse can control manipulation and alliances better by using this mode of intervention 4.It will prevent the parents from deceiving each other about the true nature of their child's condition

2.The entire family is involved because what happens to one member affects all

What developmental task should the nurse consider when caring for toddlers? 1.Trust 2.Industry 3.Autonomy 4.Identification

3.Autonomy

A parent whose daughter is killed in a school bus accident tearfully tells the nurse, "My daughter was just getting over the chickenpox and didn't want to go to school, but I insisted that she go. It's my fault that she's dead." How should the nurse anticipate that perceiving a death as preventable will likely influence the grieving process? 1.The loss may be easier to understand and accept. 2.The mourner may experience pathological grief. 3.Bereavement may be of greater intensity and duration. 4.The grieving process may progress to a psychiatric illness

3.Bereavement may be of greater intensity and duration.

When planning care for an older client, the nurse remembers that aging has little effect on a client's: 1.Sense of taste or smell 2.Muscle or motor strength 3.Capacity to handle life's stresses 4.Ability to remember recent events

3.Capacity to handle life's stresses

A client is admitted for treatment of obsessive-compulsive disorder that is interfering with activities of daily living. Which medication should the nurse anticipate the health care provider will prescribe? 1.Benztropine (Cogentin) 2.Amantadine (Symmetrel) 3.Clomipramine (Anafranil) 4.Diphenhydramine (Benadryl)

3.Clomipramine (Anafranil)

What is most important for the nurse to do to assist a couple to cope with their feelings about the husband's terminal illness? 1.Referring the husband to a psychotherapist for help in dealing with his anger 2.Placing the couple in a couple's therapy group that addresses terminal illness 3.Helping the couple express to each other their feelings about his terminal illness 4.Encouraging the wife to verbalize her feelings to a therapist during individual therapy sessions

3.Helping the couple express to each other their feelings about his terminal illness

A health care provider refers a 52-year-old man to the mental health clinic. The history reveals that the man lost his wife to colon cancer 6 months ago and that since that time he has seen his health care provider seven times with the concern that he has colon cancer. All tests have had negative results. Recently the client stopped seeing friends, dropped his hobbies, and stayed home to rest. Which disorder should the nurse identify as consistent with the client's preoccupation with the fear of having a serious disease? 1.Conversion disorder 2.Somatization disorder 3.Hypochondriac disorder 4.Body dysmorphic disorder

3.Hypochondriac disorder

Methylphenidate (Ritalin) is prescribed to treat a 7-year-old child's attention deficit-hyperactivity disorder (ADHD). The nurse understands that methylphenidate is used in the treatment of this disorder in children for its: 1.Diuretic effect 2.Synergistic effect 3.Paradoxical effect 4.Hypotensive effect

3.Paradoxical effect

A woman who is frequently physically abused tells the nurse in the emergency department that it is her fault that her husband beats her. What is the most therapeutic response by the nurse? 1."Maybe it was your husband's fault, too." 2."I can't agree with that—no one should be beaten." 3."Tell me why you believe that you deserve to be beaten." 4."You say that it was your fault—help me understand that."

4."You say that it was your fault—help me understand that."

How should a nurse at an assisted living facility encourage a client to effectively complete the tasks of older adulthood? 1.By redefining the resident's role in society 2.By investing the resident's energies into nurturing others 3.By trying to complete missed opportunities with significant others 4.By fostering a sense of contentment when the client looks back on her achievements

4.By fostering a sense of contentment when the client looks back on her achievements

A female nurse has been caring for a depressed 75-year-old woman who reminds her of her grandmother. The nurse spends extra time with her every day and brings her home-baked cookies. The nurse's behavior reflects: 1.Affiliation 2.Displacement 3.Compensation 4.Countertransference

4.Countertransference

Which goal specific to a client with impaired verbal communication related to a psychological barrier should be documented in the client's clinical record? 1.Freedom from injury 2.Engaging independently in solitary craft activities 3.Identifying the consequences of acting-out behavior 4.Interacting appropriately with others in the therapeutic milieu

4.Interacting appropriately with others in the therapeutic milieu

A client says, "Since my husband died I've got nothing to live for. I just want to die." The nurse hears the nursing assistant say, "Things will get better soon." The nurse identifies this response as: 1.Offering advice 2.Belittling the client 3.Changing the subject 4.Providing false reassurance

4.Providing false reassurance

A nurse is caring for several clients who have severe psychiatric disorders. What is the major reason that a health care provider prescribes an antipsychotic medication for these clients? 1.To improve judgment 2.To promote social skills 3.To diminish neurotic behavior 4.To reduce the positive symptoms of psychosis

4.To reduce the positive symptoms of psychosis

The parents of an adolescent who engages in self-injurious cutting behavior ask the nurse why their child self-mutilates. What should the nurse give as the reason for the cutting? 1.Cry for help 2.Suicide attempt 3.Attention-seeking behavior 4.Way to manage overwhelming feelings

4.Way to manage overwhelming feelings