Mental Health
D
1. A charge nurse is conducting a class on therapeutic communication to a group of newly licensed nurses. Which of the following aspects of communication should the nurse identify as a component of verbal communication? A. Personal space. B. Posture. C. Eye contact. D. Intonation.
A
3. A nurse is communicating with a client who was just admitted for treatment of substance use disorder. Which of the following communication techniques should the nurse identify as a barrier to therapeutic communication? A. Offering advice. B. Reflecting. C. Listening attentively. D. Giving information.
D
A charge nurse is discussing TMS with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? A. "TMS is indicated for clients who have schizophrenia spectrum disorders." B. "I will provide post-anesthesia care following TMS." C. "TMS treatments usually last 5 to 10 minutes." D. "I will schedule the client for daily TMS treatments for the first several weeks."
A B C
A charge nurse is discussing mental status examinations with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? (SATA) A. "To assess cognitive ability, I should ask the client to count backward by sevens." B. "To assess affect, I should observe the client's facial expressions." C. "To assess language ability, I should instruct the client to write a sentence." D. "To assess remote memory, I should have the client repeat a list of objects." E. "To assess the client's abstract thinking, I should ask the client to identify our most recent presidents."
C, D, E
A charge nurse is discussing the characteristics of a nurse-client relationship with a newly licensed nurse. Which of the following characteristics should the nurse include in the discussion? (SATA) 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
A client tells a nurse, "Don't tell anyone, but I hid a sharp knife under my mattress in order to protect myself from my roommate, who is always yelling at me and threatening me.' Which of the following actions should the nurse take? 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 the health care team because it concerns the health and safety of the client and others. D. Report the incident to the health care team, but do not inform the client of the intent to do so.
C
A community health nurse is planning care to address the issue of depression among older adult clients in the community. Which of the following interventions should the nurse plan as a method of tertiary prevention? A. Educating clients on health promotion techniques to reduce the risk of depression. B. Performing screenings for depression at community health programs. C. Establishing rehabilitation programs to decrease the effects of depression. D. Providing support groups for clients at risk for depression.
C
A nurse caring for a client who has anorexia nervosa. Which of the following examples demonstrates the nurse's use of interpersonal communication? A. The nurse discusses the client's weight loss during a health care team meeting. B. The nurse examines her own personal feelings about clients who have anorexia nervosa. C. The nurse asks the client about her body image perception. D. The nurse presents an educational session about anorexia nervosa to a group of adolescents.
B
A nurse decides to put a client who has a psychotic disorder in seclusion overnight because the unit is very short-staffed, and the client frequently fights with other clients. The nurse's actions are an example of which of the following torts? A. Invasion of privacy. B. False imprisonment. C. Assault. D. Battery.
B
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. Provide an in-service program about confidentiality. D. Complete an incident report.
B, C, E
A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients? (SATA) A. A client at 8 weeks gestation who asks for an influenza immunization. B. A client who takes prednisone and has a possible fungal infection. C. A client who has chronic liver disease and is taking hydrocodone/acetaminophen. D. A client who has peptic ulcer disease, takes sucralfate, and tells the nurse that she has started taking OTC aluminum hydroxide. E. A client who has a prosthetic heart valve, takes warfarin, and reports a suspected pregnancy.
C
A nurse in a provider's office is reviewing the medical record of a client who is pregnant and is at her first prenatal visit. Which of the following immunizations may the nurse administer safely to this client? A. Varicella vaccine B. Rubella vaccine C. Inactivated influenza vaccine D. Measles vaccine
C
A nurse in an acute mental health facility is assisting with discharge planning for a client who has a severe mental health illness and requires supervision most of the time. The client's wife works all day but is home by late afternoon. Which of the following strategies should the nurse suggest as appropriate follow-up care? 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.
D
A nurse in an acute mental health facility is communicating with a client. The client states, "I can't sleep. I stay up all night." The nurse responds, "You are having difficulty sleeping?" Which of the following therapeutic communication techniques in the nurse demonstrating? A. Offering general leads. B. Summarizing. C. Focusing. D. Restating.
c
A nurse in an emergency mental health facility is caring for a group of clients. The nurse should identify that which of the clients requires a temporary emergency admission? A. A client who has schizophrenia with delusions of grandeur. B. A client who has manifestations 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 around the room while talking to himself.
B
A nurse in an outpatient mental health clinic is preparing to conduct an initial client interview. When conducting the interview, which of the following actions should the nurse identify as the priority? A. Coordinate holistic care with social services. B. Identify the client's perception of her mental health status. C. Include the client's family in the interview. D. Teach the client about her current mental health disorder.
A, C, E
A nurse is admitting a client and completing a preassessment before administering medications Which of the following data should the nurse include in the preassessment? (SATA) A. Use of herbal teas B. Daily fluid intake C. Current health status D. Previous surgical history E. Food allergies
C, D, E
A nurse is assessing a client immediately following an ECT procedure. Which of the following findings should the nurse expect? (SATA) A. Hypotension B. Paralytic ileus C. Memory loss D. Nausea E. Confusion
A
A nurse is caring for a client who has a new prescription for disulfiram for treatment of alcohol use disorder. The nurse informs the client that this medication can cause nausea and vomiting if he drinks alcohol. Which of the following types of treatment is this method an example? A. Aversion therapy. B. Flooding. C. Biofeedback. D. Dialectical behavior therapy
C
A nurse is caring for a client who is taking oral oxycodone. The client states that he is also taking ibuprofen in three recommended doses daily. The nurse should identify that an interaction between these two medications will cause which of the following findings? A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication. B. A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication. C. An increase in the expected therapeutic effect of both medications. D. An increase in expected adverse effects for both medications.
B
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 deceased husband who has been dead for 3 months.
c
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 her antipsychotic medication be changed due to some new adverse 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 manifestations of severe anxiety before and during a job interview.
D
A nurse is caring for the parents of a child who has demonstrated recent changes in behavior and mood. When the mother of the child asks the nurse for reassurance about her son's condition, which of the following responses should the nurse make? A. "I think your son is getting better. What have you noticed? B. "I'm sure everything will be okay. It just takes some 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."
C
A nurse is completing discharge teaching for a client who has a new prescription for transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands the instructions? A. "I will clean the site with an alcohol swab before I apply the patch." B. "I will rotate the application sites weekly." C. "I will apply the patch to an area of skin with no hair." D. "I will place the new patch on the site of the old patch."
B
A nurse is conducting 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
D
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."
B
A nurse is in the working phase of a therapeutic relationship with a client who has methamphetamine use disorder. Which of the following actions 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 do just like an 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.
C
A nurse is leading a peer group discussing about the indications for ECT. Which of the following indications should the nurse include in the discussion? A. Borderline personality disorder B. Acute withdrawal related to a substance use disorder C. Bipolar disorder with rapid cycling D. Dysphoric disorder
C
A nurse is orienting a new client to a mental health unit. When explaining the unit's community meetings, which of the following statements should the nurse make? 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."
B, D, E
A nurse is planning a peer group discussion about the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Which of the following information is appropriate to include in the discussion? (SATA) A. The DSM-5 includes client education handouts for mental health disorders. B. The DSM-5 establishes diagnostic criteria for individual mental health disorders. C. The DSM-5 indicates recommended pharmacological treatment for mental health disorders. D. The DSM-5 assists nurses in planning care for client's who have mental health disorders. E. The DSM-5 indicates expected assessment findings of mental health disorders.
A, D, E
A nurse is planning care for a client following surgical implantation of a VNS device. The nurse should plan to monitor for which of the following adverse effects? (SATA) A. Voice changes B. Seizure activity C. Disorientation D. Dysphagia E. Neck pain
D
A nurse is planning care for a client who has a mental health disorder. Which of the following actions should the nurse include as a psychobiological intervention? A. Assist the client with systematic desensitization therapy. B. Teach the client appropriate coping mechanisms. C. Assess the client for comorbid health conditions. D. Monitor the client for adverse effects of medications.
A
A nurse is planning care for the termination phase of a nurse-client relationship. Which of the following actions should the nurse include in the plan of care? A. Discussing ways to use new behaviors. B. Practicing new problem solving skills. C. Developing goals. D. Establishing boundaries.
B, C, E
A nurse is planning group therapy for clients dealing with bereavement. Which of the following activities should the nurse include in the initial phase? (SATA) A. Encourage the group to work towards 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 confidentially within the group.
A, C, D
A nurse is preparing a client's medications. Which of the following actions should the nurse take in following legal practice guidelines? (SATA) A. Maintain skill competency. B. Determine the dosage. C. Monitor for adverse effects. D. Safeguard medications. E. Identify the client's diagnosis.
B
A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states that she took penicillin 3 years ago and developed a rash. Which of the following actions should the nurse take? A. Administer the prescribed dose. B. Withhold the medication. C. Ask the provider to change the prescription to an oral form. D. Administer an oral antihistamine at the same time.
B, D, E
A nurse is preparing to administer eye drops to a client. Which of the following actions should the nurse take? (SATA) A. Have the client lie on her side. B. Ask the client to look up at the ceiling. C. Tell the client to blink when the eye drops enter her eye. D. Drop the medication into the center of the client's conjunctival sac. E. Instruct the client to close her eye gently after instillation.
B, C, D
A nurse is preparing to administer medications to a 4-month old infant. Which of the following pharmacokinetic principles should the nurse consider when administering medications to this client? (SATA) A. Infants have a more rapid gastric emptying time. B. Infants have immature liver function. C. Infants' blood-brain barrier is poorly developed. D. Infants have an increased ability to absorb topical medications. E. Infants have an increased number of protein-binding sites.
A, B, D
A nurse is preparing to implement cognitive reframing techniques for a client who has an anxiety disorder. Which of the following techniques should the nurse include in the plan of care? (SATA) A. Priority restructuring. B. Monitoring thoughts. C. Diaphragmatic breathing. D. Journal keeping. E. Mediation.
D
A nurse is providing discharge instructions for a client who has a new prescription for an antihypertensive medication. Which of the following statements should the nurse give? A. "Be sure to limit your potassium intake while taking this medication." B. "You should check your blood pressure every 8 hours while taking this medication." C. "Your medication dose will be increased if you develop tachycardia." D. "Change positions slowly when you move from sitting to standing."
D
A nurse is providing teaching for a client who is scheduled to receive ECT for 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 should receive ECT once a week for 6 weeks." D. "I will receive a muscle relaxant to protect me from injury during ECT."
C
A nurse is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The nurse should recognize that the medication affected which of the following systems in the client? A. Cardiovascular B. Immune C. Central Nervous D. Gastrointestinal
d
A nurse is reviewing a new prescription for ondanestron 4 mg PO PRN for nausea and vomiting for a client who has hyperemesis gravidarum. The nurse should clarify which of the following parts of the prescription with the provider. A. Name B. Dosage C. Route D. Frequency
C
A nurse is talking with a client who is at risk for suicide following the death of his spouse. Which of the following statements should the nurse make? 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."
B
A nurse is teaching a client who has an anxiety disorder and is scheduled to begin classical psychoanalysis. Which of the following client statements indicates an understanding of this form of therapy? 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.
A
A nurse is told during change of shift report that a client is stuporous. When assessing the client, which of the following findings should the nurse expect? 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, B, C, E
A nurse is working in a community mental health facility. Which of the following services does this type of program provide? (SATA) A. Educational groups. B. Medication dispensing programs. C. Individual counseling programs. D. Detoxification programs. E. Family therapy.
C
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
A nurse on a medical-surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness? A. Reduced cardiac function B. First-pass effect C. Reduced hepatic function D. Increased gastric motility
B
A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands the process? A. "A second nurse enters the prescription into the client's medical record." B. "Another nurse should listen to the phone call." C. "The provider can clarify the prescription when he signs the health record." D. "I should omit the 'read back' if this is a one time prescription.
c
A nurse reviewing a client's health record notes a new prescription for Lisinopril 10 mg PO once every day. The nurse should identify this as which of the following types of prescriptions? A. Single B. Stat C. Routine D. Standing
A
A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the nurse take? A. Obtain a blood specimen immediately prior to administering the next dose of medication. B. Verify that the client has been taking the medication for 24 hr before obtaining the blood specimen. C. Ask the client to provide a urine specimen after the next dose of medication. D. Administer the medication, and obtain a blood specimen 30 min later
C
A nurse wants to use democratic leadership with a group whose purpose is to learn appropriate conflict resolution techniques. The nurse is correct in implementing this form of group leadership when she demonstrates which of the following actions? 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. Suggest techniques and asks group members to reflect on their use.
D
A nurse working on an acute mental health unit forms a group to focus on self-management of medications. At each of the meetings, two of the members use the opportunity to discuss their common interest in gambling on sports. This is an example of which of the following concepts? A. Triangulation B. Group process C. Subgroup D. Hidden agenda
C
A nursing is assisting with systematic desensitization for a client who has an extreme fear of elevators. Which of the following actions should the nurse implement with this form of therapy? 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.
B, C, D
A nursing is caring for a client who is in mechanical restraints. Which of the following statements should the nurse include in the documentation? (SATA) A. "Client ate most of his breakfast." B. "Client was offered 8 oz of water every hr." C. "Client shouted obscenities at assistive personnel." D. "Client received chlorpromazine 15 mg by mouth at 1000." E. "Client acted out after lunch."
A
A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication? A. One B. Two C. Three D. Four
C, E
A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer the lower medication dosages? (SATA) A. Increased renal excretion B. Increased medication-metabolizing enzymes C. Liver failure D. Peripheral vascular disease E. Concurrent use of medication the same pathway metabolizes