Mental Health Exam 1

A holistic plan of recovery would be especially important to a client from which of the following cultural groups? A) American Indian B) African American C) Mexican American D) Arab American

A

A nurse is assigned to care for a client whose sexual orientation differs from the nurse's sexual orientation. When should the nurse seek clinical supervision? A) When the nurse tries to assist the client to change values B) To discuss the nurse's feelings about the client with a supervisor C) When the nurse begins to empathize with the client D) When the nurse identifies anxieties regarding the client's values and sexuality

A

A nurse is assisting a patient who is working on the technique of systematic desensitization. When the patient feels anxious, the nurse can best use the principles of this technique by stating, A) "Use the deep breathing techniques we practiced yesterday." B) "What is the worst that will happen if you confront this fear?" C) "Tell me how you are feeling right now." D) "I can see you are anxious. Let's stop for a minute."

A

A nurse is meeting with a crisis support group. In efforts to help patients identify with one another, the nurse explains which of the following about the crisis experience? A) "Even happy events can cause a crisis if the stress is overwhelming." B) "Only people who have unfortunate life events will experience a crisis." C) "A person has no control over how a crisis will affect him or her." D) "People can prevent all crises if they develop good coping skills early."

A

A nurse is orienting to a new position working the infirmary in the state penitentiary. When working with prisoners who are also mentally ill, the nurse examines her own attitudes. Which of the following beliefs should the nurse discuss with her supervisor before caring for incarcerated patients? A) People with mental illness are inherently violent. B) The mentally ill can get better treatment in prison than in the community. C) People with mental illness are more vulnerable to victimization when incarcerated. D) Many mentally ill would not be in prison if they were stabilized on medication.

A

A nurse openly admits to not being able to relate to a patient's experience. According to Munhall, this will most likely have what influence on the therapeutic relationship? A) The nurse will avoid imposing any values on the patient. B) The patient will not trust the nurse's professional abilities. C) The nurse will more likely be manipulated by the patient. D) The patient will be less likely to self-disclose to the nurse.

A

A patient is being seen in the crisis unit reporting that poison letters are coming in the mail. The patient has no history of psychiatric illness. Which of the following medications would the patient most likely be started on? A) Aripiprazole (Abilify) B) Risperidone (Risperdal Consta) C) Fluphenazine (Prolixin) D) Fluoxetine (Prozac)

A

A patient reported to the nurse that on his way to the clinic, a policeman in a patrol car turned on his lights and pulled him over. When asked what he did next, the patient stated, "I pulled over, of course." Which of the following was the nurse trying to assess? A) The client's judgment B) The client's insight C) The client's concentration D) The client's self-concept

A

A patient reports a pattern of being suspicious and mistrusting of others, causing difficulty in sustaining lasting relationships. Which stage according to Erikson's psychosocial development was not successfully completed? A) Trust B) Autonomy C) Initiative D) Industry

A

A patient says, "Its' been so long since I've been with my family." Which statement by the nurse is an example of restating? A) "You say you haven't seen your family in a while." B) "Tell me when you last saw your family." C) "Go on. Tell me more." D) "When was the last time you saw your family?"

A

A patient with bipolar disorder has a long history of both hospitalizations and incarcerations. The patient has no permanent residence and has infrequent contact with his family. Upon admission to the inpatient psychiatric unit for stabilization, the nurse documents all of the following in the record. Which of the following data most suggests a positive outcome for this patient? A) Reporting meeting with the same case manager monthly for the last 3 years B) History of residential stays at several local homeless shelters C) Last contact with siblings 4 years ago D) Income from day labor for 10 days last month

A

A patient with bipolar disorder taking lithium returns from a walk outside and reports feeling shaky and dizzy. The nurse suspects the patient is experiencing a toxic reaction to the lithium and immediately notifies the A) psychiatrist. B) psychologist. C) nurse manager. D) recreation therapist.

A

Abstract standards that provide a person with his or her code of conduct are a. values. b. attitudes. c. beliefs. d. personal philosophy.

A

Building trust is important in a. the orientation phase of the relationship. b. the problem identification subphase of the relationship. c. all phases of the relationship. d. the exploitation subphase of the relationship.

A

During the admission assessment, the nurse asks the client, "How are you feeling?" The client responds, "I was able to purchase gas for 7 cents a gallon less than yesterday, which saved me a total of 84 cents. My car has a 12-gallon gas tank. Usually I am able to put in 11.7 gallons. I am very happy to have saved so much money." The nurse recognizes this response as which of the following? A) Circumstantial thinking B) Echolalia C) Flight of ideas D) Neologisms

A

During the orientation phase of the nurseñpatient relationship, the nurse directs the patient to do which of the following? A) Identify problems to examine B) Express needs and feelings C) Develop interpersonal skills D) Identify self-care strategies

A

"Earlier today you said you were concerned that your son was still upset with you. When I stopped by your room about an hour ago, you and your son seemed relaxed and smiling as you spoke to each other. How did things go between the two of you?" This is an example of which therapeutic communication technique? a. Consensual validation b. Encouraging comparison c. Accepting d. General lead

A

A basic assumption of Freud's psychoanalytic theory is that A) all human behavior can be caused and can be explained. B) human behavior is entirely unconscious. C) free association is the key to understanding. D) sexuality does not relate to behavior.

A

A client diagnosed with a mild anxiety disorder has been referred to treatment in a community mental health center. Treatment most likely provided at the center includes A) medical management of symptoms. B) daily psychotherapy. C) constant staff supervision. D) psychological stabilization.

A

A client from which of the following cultural groups is likely to prefer closeness in personal space? A) Arab Americans B) Chinese C) Cubans D) African Americans

A

A client is being evaluated for dementia. The nurse knows that a client who is able to complete very few tasks is most likely to have A) a greater cognitive deficit. B) A less precise mental status exam. C) more potential for agitation. D) no bearing on mental status.

A

A client is fearful and reluctant to talk. Which of the following techniques is most effective when trying to engage the client in interaction? A) Broad opening B) Focusing C) Giving information D) Silence

A

A client who had been in a substance abuse treatment program asks the nurse for a date after the client is discharged. The nurse talks to the client about the importance of a therapeutic relationship and its characteristics. The nurse is using which of the following techniques? A) Defining boundaries B) Defining therapy C) Letting the client down gently D) Reprimanding the client

A

A client's prognosis is said to be good due to a high degree of self-efficacy. Which of the following is evidence of a high degree of self-efficacy? A) The client is self-motivated and asks for help when needed. B) The client is able to resist illness when under stress. C) The client responds well in stressful situations. D) The client uses good problem-solving abilities.

A

A group that was designed to meet weekly for 10 sessions to deal with feelings of depression would be a(n) a. closed group. b. educational group. c. open group. d. support group.

A

Genetics have been shown to play which of the following roles in a person's mental and emotional health? A) Several mental disorders appear to run in families. B) Specific genes have been linked to certain mental disorders. C) Biologic factors can be modified to change the influence on emotional health. D) Psychiatric treatment is effective regardless of an individual's biologic influences.

A

Hospitals established by Dorothea Dix were designed to provide A) asylum. B) confinement. C) therapeutic milieu. D) public safety.

A

How can a nurse avoid the possibility of finding the client's behavior unacceptable or distasteful? A) By being aware of the client's behavior and background before beginning the relationship; and exploring the possibility of a conflict of a colleague. B) By using silence instead of verbal responses for all instance of the client describing their behavior C) By using facial expressions of annoyance if the client expresses behavior that the nurse disapproves of D) By turning away from the client when the nurse does not want the client to see his or her facial expression

A

Patient says to the nurse, "I wonder what's playing at the movie tonight." The most therapeutic response would be, A) "Are you telling me you would like to go to the movies?" B) "Why don't you look in the newspaper." C) "There's nothing worth watching." D) "Do you like to go to the movies?"

A

Psychiatric rehabilitation focuses on a. client's strengths. b. medication compliance. c. social skills deficits. d. symptom reduction.

A

Sexuality and self-harm behaviors are often difficult areas for nurses to assess. An effective way for nurses to deal with this discomfort includes A) recognizing that these areas may also be uncomfortable for the patient to discuss. B) share feelings of discomfort with the patient. C) defer assessing these areas to a more experienced nurse. D) develop a standard question to ask of all patients during this area of assessment

A

The client spoke of a current event in the national news and described it as it relates to the client. Then the client spoke of a historical event and described it as it relates to the client. Which of the following questions might the nurse ask to determine if the client is experiencing ideas of reference? A) "Where were you when this happened?" B) "Why do you think that?" C) "Are you sure?" D) "That is unbelievable!"

A

The client stated, "I was so upset about my sister ignoring me when I was talking about being ashamed." Which nontherapeutic communication technique would the nurse be using if the nurse would state, "How are your stress reduction classes going?" A) Changing the subject B) Offering advice C) Challenging D) Disapproving

A

The client tells the nurse, "That new TV anchor is telling the world about me." This is an example of A) ideas of reference. B) persecutory delusions. C) thought broadcasting. D) thought insertion.

A

The client who believes everyone is out to get him or her is experiencing a(n) a. delusion. b. hallucination. c. idea of reference. d. loose association.

A

The factor having the most influence on the current trend in treatment settings is the fact in recent years, A) funding for community programs has been inadequate. B) laws have enabled more people to be committed to treatment. C) state hospitals have expanded to meet the demand. D) community programs have been fully developed to meet treatment needs.

A

The legislation enacted in 1963 was largely responsible for which of the following shifts in care for the mentally ill? A) The widespread use of community-based services B) The advancement in pharmacotherapies C) Increased access to hospitalization D) Improved rights for clients in long-term institutional care

A

The nurse asks a patient to list the days of the week in reverse order. The nurse is assessing which of the following? A) Concentration B) Memory C) Orientation D) Abstract thinking

A

The nurse asks the client what that experience was like. Which communication skill is the nurse using? A) Encouraging expression B) Encouraging description of perceptions C) Exploring D) Requesting an explanation

A

The nurse asks the client, "What is similar about a cow and a horse?" and "What do a bus and an airplane have in common?" These questions would best assess which of the following areas? A) Intellectual function B) Insight C) Judgment D) Memory

A

The nurse asks the patient what he would like to talk about. This is an example of A) broad opening. B) encouraging expression. C) focusing. D) offering self.

A

The nurse fails to assess personal values surrounding homosexuality before caring for a patient who is openly gay. The nurse is most at risk for which of the following when working with this patient? A) Holding a prejudice toward this patient B) Neglecting to include the patient's desires in the plan of care C) Being manipulated by this patient D) Expressing shock when assessing the patient's history

A

The nurse is assessing a patient suffering a head injury as a result of an altercation with two other individuals. The patient has difficulty accurately reporting the events of the altercation and appears very emotional during the assessment. The nurse suspects which part of the brain received the greatest amount of injury? A) Cerebrum B) Cerebellum C) Medulla D) Amygdala

A

The nurse is preparing to administer PRN medication to a client of a Japanese descent who is anxious. The prescription reads, "Alprazolam (Xanax) 0.25 to 1.0 mg PO PRN." The best dose for the nurse to give initially is A) 0.25 mg. B) 0.5 mg. C) 0.75 mg. D) 1.0 mg.

A

The nurse is teaching a client taking an MAOI about foods with tyramine that he or she should avoid. Which statement indicates that the client needs further teaching? A) "I'm so glad I can have pizza as long as I don't order pepperoni." B) "I will be able to eat cottage cheese without worrying." C) "I will have to avoid drinking nonalcoholic beer." D) "I can eat green beans on this diet."

A

Which one of the following statements about the nurse and ethnocentrism is true? A) Nurses as people may inwardly view their own culture as superior to others. B) Ethnocentrism is a desirable trait in a nurse. C) Nurses must deny their ethnocentrism. D) A nurse must not think of his or her own attitudes and beliefs.

A

The nurse is working with a patient who has quit several jobs and no longer sends financial support to his two children living with their mother. This behavior is in conflict with the nurse's values concerning responsible parenting. When discussing family roles with the patient, the nurse shows positive regard through which statement? A) "How is not working right now affecting you?" B) "How do you expect your kids to be provided for?" C) "You need to somehow find a way to support your children." D) "Can the children's mother can get by for a while until you get better?"

A

The nurse would recommend individual therapy for the patient who expresses a desire to A) bring about personal changes. B) gain a sense of belonging. C) develop leadership skills. D) learn more about treatment.

A

The patient states that he is 14 trillion years old and created the world. The nurse documents this statement as an example of which type of thinking displayed by the patient? A) Delusional thinking B) Ideas of reference C) Word salad D) Hallucination

A

The personality structures of id, ego, and superego were described by a. Sigmund Freud. b. Hildegard Peplau. c. Frederick Perls. d. Harry Stack Sullivan.

A

What are the two essential components of transitional care discharge model that is used in Canada and Scotland? A) Peer support and bridging staff B) Collaboration and funding C) Relapse and hospitalization D) Poverty and entitlements

A

What is an important role of the nurse with regard to residents opposing plans to establish a group home or residential facility in their neighborhood? A) To provide information to correct misinformation related to stereotypes of persons with mental illnesses B) To persuade neighborhood residents that mentally ill people need safe, affordable, and desirable housing C) To provide for the safety and security of the neighborhood D) To ensure the security of persons in the group home

A

When a nurse develops feelings toward a client that are based on the nurse's past experience, it is called a. countertransference. b. role reversal. c. transference. d. unconditional regard.

A

When teaching a client about restrictions for tranylcypromine (Parnate), the nurse will tell the client to avoid which of the following foods? A) Broad beans B) Citrus fruit C) Egg products D) Fried foods

A

Which element would be present in an assertive community treatment (ACT) program? A) 24-hour-a-day services B) Infrequent contact with clients C) Many clients to each staff member D) Limited length of service

A

Which is most influential in determining health beliefs and practices? a. Cultural factors b. Individual factors c. Interpersonal factors d. All the above are equally influential.

A

Which of the following considerations should have the most influence in the nurse's choice of the treatment for the client? A) The client's feelings and perceptions about his or her situation B) The nurse's beliefs about the theories of psychosocial development C) The nurse's familiarity with the type of treatment D) Any approach to treatment should work with any client.

A

Which of the following cultural phenomena that should be assessed by the nurse includes preference such as touch and eye contact? A) Communication B) Social organization C) Environmental control D) Biologic variations

A

Which of the following is a concrete message? a. "Help me put this pile of books on Marsha's desk." b. "Get this out of here." c. "When is she coming home?" d. "They said it is too early to get in."

A

Which of the following is a neuromodulator? A) Neuropeptides B) Glutamate C) Dopamine D) GABA

A

Which of the following is most essential when planning care for a client who is experiencing a crisis? A) Explore previous coping strategies B) Explore underlying personality dynamics C) Focus on emotional deficits D) Offer a referral to a self-help group

A

Which of the following is the best reason that many psychiatric care units have policies against clients touching one another or staff? A) Because some clients with mental illness have difficulty knowing when touch is or is not appropriate B) Because clients often perceive being touched as a threat and may attempt to protect himself or herself by striking the staff person C) Because it can be threatening to both the client and the nurse D) Because touching always leads to more touching

A

Which of the following medications rarely causes extrapyramidal side effects (EPS)? A) Ziprasidone (Geodon) B) Chlorpromazine (Thorazine) C) Haloperidol (Haldol) D) Fluphenazine (Prolixin)

A

Which of the following questions best encourages the client to disclose information the nurse must assess to provide culturally competent care? A) "How do you want me to help you?" B) "Do you want me to contact your preacher?" C) "What special dietary preferences do you have?" D) "Which family members do you want to receive calls from?"

A

Which of the following situations would most likely provide social support to a client? A) A friend who will share his or her perspective on an issue B) The transportation service that provides access to daily rehabilitation services C) Fellow teammates participating in a community softball league D) The teacher assisting a client to obtain a GED

A

Which of the following statements would be an empathetic response in a client interaction? A) "You must have been embarrassed when your father yelled at you in the grocery store." B) "You really should find your own housing and get out of the situation with your father." C) "Well, it sounds like your father has difficulty controlling his temper." D) "Why do you think your father chose that time and place to yell at you?"

A

Which one of the following goals of therapeutic communication would the nurse strive to attain first? A) Facilitate the client's expression of emotions. B) Establish a therapeutic nurseñclient relationship. C) Teach the client and family necessary self-care skills. D) Implement interventions designed to address the client's needs.

A

Which of the following are components of the assessment of thought process and content? Select all that apply. A) What the client is thinking B) Abstract thinking abilities C) How the client is thinking D) Clarity of ideas E) Self-harm or suicide urges

A C D E

Which one of the following statements about the roles that biologic makeup plays in a client's emotional responses is most accurate? A) Biologic differences can affect a client's response to treatment with psychotropic drugs. B) Biologic differences do not affect a client's response to treatment with psychotropic drugs. C) Heredity and biologic factors are under voluntary control. D) Persons cannot change their health status and improve the ability to cope.

A

Which one of the following statements is most accurate regarding the age at onset of a mental illness such as schizophrenia? A) Persons who are diagnosed at a younger age will more likely have a poorer outcome. B) Persons who are diagnosed at a younger age will more likely have a better outcome. C) Age at diagnosis is not related to outcomes. D) Younger clients have more experiences that will help them.

A

Which type of psychiatric rehabilitation relies on intentional communities and rehabilitation alliances? A) Clubhouse model B) Assertive community treatment C) Group homes D) Respite housing

A

Clients taking which type of psychotropic medications need close monitoring of their cardiac status? A) Antidepressants B) Antipsychotics C) Mood stabilizers D) Stimulants

B

Which of the following personal characteristics influence a client's response to stressors? Select all that apply. A) Self-efficacy B) Sense of belonging C) Spirituality D) Hardiness E) Resilience F) Resourcefulness

A C D E F

Correcting how one thinks about the world and oneself is the focus of a. behaviorism. b. cognitive therapy. c. psychoanalysis. d. reality therapy.

B

The nurse plans to assess a patient's self-concept in the admission assessment knowing that self-concept influences which of the following?Select all that apply. A) Body image B) Cognitive processing C) Frequently experienced emotions D) Coping strategies E) Responsiveness to medications

A C D

The nurse should use clear concrete messages when working with patients displaying which of the following conditions? Select all that apply. A) Anxiety B) Anorexia C) Dementia D) Schizophrenia E) Hypochondriasis

A C D

The advantages of assertive communication are a. all persons' rights are respected. b. it gains approval from others. c. it protects the speaker from being exploited. d. the speaker can say no to another person's request. e. the speaker can safely express thoughts and feelings. f. the speaker will get his or her needs met.

A C D E

What is required for a transitional care model to be most effective in promoting the client's health and well-being and prevent relapse and rehospitalization? Select all that apply. A) Collaboration B) Administrative support C) Adequate funding D) Family support E) Completely different providers F) Isolation from peers who successfully live in the community

A B C

When assessing a patient's mental health status, which of the following describe the purpose of the psychosocial assessment? Select all that apply. A) To assess the client's current emotional state B) To assess the client's mental capacity C) To assess the client's behavioral function D) To assess the client's plan of care E) To assess the client's physical health status

A B C

Which of the following are the types of roles that are usually included when assessing roles and relationships? Select all that apply. A) Family B) Hobbies C) Occupation D) Activities E) Race F) Ethnicity

A B C D

Which of the following are core skill areas that are needed of any effective team member of an interdisciplinary team? Select all that apply. A) Interpersonal skills B) Teamwork skills C) Communication skills D) The ability to work independently E) Risk assessment and risk management skills

A B C E

The nurse has been working with a patient with an eating disorder for one week. During the morning treatment team meeting, the treatment plan is updated. Which of the following would be appropriate interventions at this time in the nurse patient relationship? Select all that apply. A) Exploring perceptions of reality B) Promoting a positive self-concept C) Explaining the boundaries of the relationship D) Working through resistance E) Assisting in identifying problems

A B D

Which of the following disorders are extrapyramidal symptoms that may be caused by antipsychotic drugs? Select all that apply. A) Akathisia B) Pseudoparkinsonism C) Neuroleptic malignant syndrome D) Dystonia E) Anticholinergic effects F) Breast tenderness in men and women

A B D

Which of the following statements about spirituality are true? Select all that apply. A) Many clients with mental disorders have disturbing religious delusions. B) Religious activities have been shown to be linked with better health and a sense of well-being. C) Spirituality only involves religion. D) Hope and faith are two critical factors in psychiatric and physical rehabilitation. E) Spirituality may include a relationship with the environment.

A B D E

Discharge planning from inpatient care for people with severe mental illness must address which of the following to be effective? Select all that apply. A) Finding housing for the client B) Finding a job for the client C) Finding transportation for the client D) Improving family support E) Identifying ideal recreational activities

A C

The major problems with large state institutions are: Select all that apply. A) attendants were accused of abusing the residents. B) stigma associated with residence in an insane asylum. C) clients were geographically isolated from family and community. D) increasing financial costs to individual residents.

A C

Which of the following statements is true of empathy? Select all that apply. A) It is the ability to place oneself into the experience of another for a moment in time. B) It involves interjecting the nurse's personal experiences and interpretations of the situation. C) It is developed by gathering information from the client. D) It results in negative therapeutic outcomes. E) The client must learn to develop empathy for the nurse.

A C

Confidentiality means respecting the client's right to keep his or her information private. When can the nurse share information about the client? a. The client threatens to harm a family member. b. Sharing the information is in the client's best interest. c. The client gives written permission. d. The client's legal guardian asks for information. e. The client is discharged to the parent's care. f. The client admits to domestic abuse.

A C D

A patient has just begun daily participation in a community-based partial hospitalization program. The patient can expect the staff to assist with which of the following treatment goals? Select all that apply. A) Stabilizing psychiatric symptoms B) Finding a better job C) Improving activities of daily living D) Learning to structure time E) Improved family support F) Developing social skills

A C D F

Assessment of sensorium and intellectual processes includes which? a. Concentration b. Emotional feelings c. Memory d. Judgment e. Orientation f. Thought process

A C E

Which statements are true of concrete and abstract messages? Select all that apply. A) Abstract messages include figures of speech that are difficult to interpret. B) Abstract messages are important for accurate information exchange. C) Concrete messages require the listener to interpret what the speaker says. D) Concrete messages are clear, direct, and easy to understand. E) Abstract messages are best used for persons who are anxious.

A D

Which of the following statements about mental illness are true? Select all that apply. A) Mental illness can cause significant distress, impaired functioning, or both. B) Mental illness is only due to social/cultural factors. C) Social/cultural factors that relate to mental illness include excessive dependency on or withdrawal from relationships. D) Individuals suffering from mental illness are usually able to cope effectively with daily life. E) Individuals suffering from mental illness may experience dissatisfaction with relationships and self.

A D E

Assessment of suicidal risk includes which? a. Intent to die b. Judgment c. Insight d. Method e. Plan f. Reason

A D E F

Which client statement would indicate self-efficacy? a. "I like to get several opinions before deciding a course of action." b. "I know if I can learn to relax, I will feel better." c. "I'm never sure if I'm making the right decision." d. "No matter how hard I try to relax, something always comes up."

B

Which cognitive mode, according to Harry Stack Sullivan, begins in early childhood as the child begins to connect experiences in sequence? A) Prototaxic mode B) Parataxic mode C) Bitaxic mode D) Syntaxic mode

B

"How does Jerry make you upset?" is a nontherapeutic communication technique because it a. gives a literal response. b. indicates an external source of the emotion. c. interprets what the client is saying. d. is just another stereotyped comment.

B

"Why do you always complain about the night nurse? She is a nice woman and a fine nurse and has five kids to support. You're wrong when you say she is noisy and uncaring." This example reflects which nontherapeutic technique? a. Requesting an explanation b. Defending c. Disagreeing d. Advising

B

A Filipino client meets the nurse for the first time. The client simply smiles at the nurse when introduced. The nurse interprets this behavior as A) a display of being shy and introverted. B) a typical greeting for a Filipino client. C) constricted verbal skills associated with the client's illness. D) a sign that the client may be suspicious of the nurse.

B

A client grieving the recent loss of her husband asks if she is becoming mentally ill because she is so sad. The nurse's best response would be, A) "You may have a temporary mental illness because you are experiencing so much pain." B) "You are not mentally ill. This is an expected reaction to the loss you have experienced." C) "Were you generally dissatisfied with your relationship before your husband's death?" D) "Try not to worry about that right now. You never know what the future brings."

B

A client is supposed to be ambulating ad lib. Instead, he refuses to get out of bed, asks for a bed bath, and makes many demands of the nurses. He also yells that they are lazy and incompetent. The client's behavior is an example of which of the following defense mechanisms? A) Introjection B) Projection C) Rationalization D) Reaction formation

B

Client: "I was so upset about my sister ignoring my pain when I broke my leg." Nurse: "When are you going to your next diabetes education program?" This is a nontherapeutic response because the nurse has a. used testing to evaluate the client's insight. b. changed the topic. c. exhibited an egocentric focus. d. advised the client what to do.

B

A client who has been depressed and suicidal started taking a tricyclic antidepressant 2 weeks ago and is now ready to leave the hospital to go home. Which is a concern for the nurse as discharge plans are finalized? A) The client may need a prescription for diphenhydramine (Benadryl) to use for side effects. B) The nurse will evaluate the risk for suicide by overdose of the tricyclic antidepressant. C) The nurse will need to include teaching regarding the signs of neuroleptic malignant syndrome. D) The client will need regular laboratory work to monitor therapeutic drug levels.

B

A college student decides to go to a party the night before a major exam instead of studying. After receiving a low score on the exam, the student tells a fellow student, "I have to work too much and don't have time to study. It wouldn't matter anyway because the teacher is so unreasonable." The defense mechanisms the student is using are A) denial and displacement B) rationalization and projection C) reaction formation and resistance D) regression and compensation

B

A new graduate nurse has accepted a staff position at an inpatient mental health facility. The graduate nurse can expect to be responsible for basic-level functions, including A) providing clinical supervision. B) using effective communication skills. C) adjusting client medications. D) directing program development.

B

A nurse and a client of Chinese heritage are collaborating on treatment goals. The nurse would document which of the following as the client's priority goal? A) The client will be free of pain and excess stress. B) The client will express a feeling of balance and harmony. C) The client will be free of physical symptoms of illness. D) The client will express gratefulness to God for recovery.

B

A nurse can best assess a patient's ability to use abstract thinking by asking the patient which of the following questions? A) "What would you do if you found a wallet containing $100 on the sidewalk?" B) "What do I mean when I say, 'Don't sweat the small stuff?'" C) "What are you going to do next time you hear voices?" D) "Can you begin with the number 100 and subtract 7, and then subtract 7 again?"

B

A nurse has invited a patient to sit down and have a conversation. The patient takes the first seat. The nurse pulls up another chair to sit with the patient. Approximately how far from the patient should the nurse place her chair? A) 1 to 2 feet B) 3 to 4 feet C) 6 to 8 feet D) 8 to 10 feet

B

A nurse is leading a medication education group for patients with depression. A patient states he has read that herbal treatments are just as effective as prescription medications. The best response is, A) "When studies are published they can be trusted to be accurate." B) "We need to look at the research very closely to see how reliable the studies are." C) "Your prescribed medication is the best for your condition, so you should not read those studies." D) "Switching medications will alter the course of your illness. It is not advised."

B

A nurse is working with a patient with an eating disorder who refuses to eat a muffin. The nurse asks the patient ìIs there any way that you could see the muffin as just flour and water, basic nutrients your body needs?î In this statement, the nurse is using which type of therapy? A) Rational emotive therapy B) Cognitive therapy C) Gestalt therapy D) Reality therapy

B

A nurse notices a patient sitting quietly alone, eyes downcast, and looking sad. The nurse says to the patient, "You look like something is bothering you." Which pattern of knowing did the nurse use to respond to the patient? A) Empirical knowing B) Personal knowing C) Ethical knowing D) Aesthetic knowing

B

A patient is encouraged to join in daily outdoor games with peers on the unit. The interdisciplinary team member who will monitor the patient's involvement will be the A) occupational therapist. B) recreation therapist. C) vocational rehabilitation therapist. D) psychiatric nurse.

B

A patient is sitting alone, slouched, with eyes closed. The nurse approaches. Which statement is most likely to encourage the patient to talk? A) "If you are sleepy, would you like me to help you back to your room?" B) "You look like you are deep in thought." C) "Is something wrong?" D) "Why are you sitting with your eyes closed?"

B

A patient who has been working on controlling impulsive behavior shows a strengthening ego through which of the following behaviors? A) Going to therapy only when there is nothing more desirable to do B) Weighing the advantages and disadvantages before making a decision C) Telling others in the group the right way to act D) Reporting having fun at a recent social event

B

A patient with depression has been taking paroxetine (Paxil) for the last 3 months and has noticed improvement of symptoms. Which of the following side effects would the nurse expect the patient to report? A) A headache after eating wine and cheese B) A decrease in sexual pleasure during intimacy C) An intense need to move about D) Persistent runny nose

B

A psychiatric nurse is planning an educational program addressing primary prevention strategies in the community. The nurse explores current research regarding which health-care need? A) Influencing schizophrenic patients to adhere to medication regimens B) Assisting high school students to effectively manage stress C) Coaching patients with depression to obtain employment D) Teaching parents the early signs of attention deficit disorder in children

B

All are characteristics of ACT except which? a. Services are provided in the home or community. b. Services are provided by the client's case manager. c. There are no time limitations on ACT services. d. All necessary support systems are involved in ACT.

B

An abnormality of which of the following structures of the cerebrum would be associated with schizophrenia? A) Parietal lobes B) Frontal lobe C) Occipital lobe D) Temporal lobes

B

Assessment data about the client's speech patterns are categorized in which of the following areas? a. History b. General appearance and motor behavior c. Sensorium and intellectual processes d. Self-concept

B

Client teaching for lamotrigine (Lamictal) should include which instructions? A) Eat a well-balanced diet to avoid weight gain. B) Report any rashes to your doctor immediately. C) Take each dose with food to avoid nausea. D) This drug may cause psychological dependence.

B

During a regular home health visit to an elderly client, the nurse observes that the client has feelings of hopelessness and despair. The client says, "I'm old, and my life has no purpose anymore. But promise me you won't tell anyone." How should the nurse respond? A) "Don't worry, I won't tell anyone else." B) "I'm sorry, but I can't keep that kind of secret." C) "Let's talk about something to cheer you up." D) "What can we do to help you feel better?"

B

During the admission interview, the nurse asks the client what led to his hospitalization. The client responds, "They lied about me. They said I murdered my mother. You're the killers. You all killed my mother. She died before I was born." The best initial response by the nurse would be, A) "I just saw your mother. She's fine." B) "You're having very frightening thoughts.l C) "We'll put you in a private room until you're in better control." D) "If your mother died before you were born, you wouldn't be here."

B

During the working phase of a therapeutic relationship, which of the following actions by the nurse would best help the client to explore problems? A) Comparing past and present coping strategies B) Encouraging the client to clarify feelings and behavior C) Identifying possible solutions for the client's problems D) Referring the client to a self-help group

B

How might the nurse best provide culturally competent care? A) Behave as appropriate for the nurse's culture. B) Find out as much as possible about a client's cultural values, beliefs, and health practices. C) Know what to expect from many cultural groups. D) Validate knowledge about culture through continuing education.

B

How should the nurse respond to a family member who asks how Alzheimer's disease is diagnosed? A) It is impossible to know for certain that a person has Alzheimer's disease until the person dies and his or her brain can be examined via autopsy. B) Positron emission tomography (PET) scans can identify the amyloid plaques and tangles of Alzheimer's disease in living clients. C) Alzheimer's disease can be diagnosed by using chemical markers that demonstrate decreased cerebral blood flow. D) It will be necessary for the patient to undergo positron emission tomography (PET) scans regularly for a long period of time to know if the patient has Alzheimer's disease.

B

Individuals who grow up in ìat-riskî environments but are able to become productive, successful citizens are believed to possess which of the following characteristics? A) Hardiness B) Resilience C) Social skills D) Tolerance

B

Mental health parity laws ensure A) better quality mental health treatment. B) equality in insurance coverage for mental illness. C) mental health treatment without stigma. D) that persons receiving treatment really need it.

B

Several family members arrive to visit an African American client. The nurse can best meet this client's need for socialization by providing the client and family which of the following? A) Individual visits to provide the client with a calm environment B) Group gatherings and open conversation C) Inclusion of ritualistic health practices with the family present D) A spiritual healer to remove the illness and protect the family

B

The appropriate action for a student nurse who says the wrong thing is to A) pretend that the student nurse did not say it. B) restate it by saying, ìThat didn't come out right. What I meant was...î C) state that it was a joke. D) ignore the error, since no one is perfect.

B

The client says to the nurse, "I have special powers because I am the mother of God. I can heal everyone in the hospital." The nurse's best response would be, A) "That sounds interesting. What can you do?" B) "It would be unusual for anyone to have that kind of power." C) "You could not heal everyone. No one has that much power." D) "Well, you can certainly try."

B

The client tells the nurse "I never do anything right. I make a mess of everything. Ask anyone; they'll tell you the same thing." The nurse recognizes these statements as examples of a. emotional issues. b. negative thinking. c. poor problem-solving. d. relationship difficulties.

B

The creation of asylums during the 1800s was meant to A) improve treatment of mental disorders. B) provide food and shelter for the mentally ill. C) punish people with mental illness who were believed to be possessed. D) remove dangerous people with mental illness from the community

B

The emotional frame of reference by which one sees the world is created by a. values. b. attitudes. c. beliefs. d. personal philosophy.

B

The family members of a patient with bipolar disorder express frustration with the unpredictable behaviors of their loved one. Which group should the nurse suggest as most helpful to this family? A) Family therapy group B) Family education group C) Psychotherapy group D) Self-help support group

B

The goal of the 1963 Community Mental Health Centers Act was to A) ensure patients' rights for the mentally ill. B) deinstitutionalize state hospitals. C) provide funds to build hospitals with psychiatric units. D) treat people with mental illness in a humane fashion.

B

The nurse and patient are visiting about upcoming sporting events of which they both share an interest. This form of interaction has the potential to threaten the nurse patient relationship by A) influencing whether the patient likes the nurse or not. B) avoiding serious work that can help the patient change. C) letting the patient know that the nurse is genuine with diverse interests. D) overstepping ethical boundaries that the nurse should maintain.

B

The nurse has completed the psychosocial assessment. Which of the following is the best approach toward analysis of the data to identify nursing diagnoses and develop an appropriate plan of care? A) Focus on each piece of information obtained from the patient. B) Look for patterns reflected in the overall assessment. C) Consider only the abnormal findings in the assessment. D) Present all data obtained in the treatment team meeting

B

The nurse has established a therapeutic relationship with a patient. The patient is beginning to share feelings openly with the nurse. The relationship has entered which phase according to Peplau's theory? A) Orientation B) Identification C) Exploitation D) Resolution

B

Which is an example of an open-ended question? a. Who is the current president of the United States? b. What concerns you most about your health? c. What is your address? d. Have you lost any weight recently?

B

The nurse is assessing the factors contributing to the well-being of a newly admitted client. Which of the following would the nurse identify as having a positive impact on the individual's mental health? A) Not needing others for companionship B) The ability to effectively manage stress C) A family history of mental illness D) Striving for total self-reliance

B

The nurse is caring for a client with schizophrenia who is taking haloperidol (Haldol). The client complains of restlessness, cannot sit still, and has muscle stiffness. Of the following prn medications, which would the nurse administer? A) Haloperidol (Haldol), 5 mg PO B) Benztropine (Cogentin), 2 mg PO C) Propranolol (Inderal), 20 mg PO D) Trazodone, 50 mg PO

B

The nurse is making a cultural assessment of a client. The most important data about a client's cultural beliefs are A) objective data about the culture. B) subjective data from the client. C) subjective data from the family. D) subjective data from society.

B

The nurse reviews results of the Minnesota Multiphasic Personality Inventory (MMPI) recorded in a patient record. While considering the usefulness of these data, the nurse is mindful that the MMPI has which limitation? A) The patient must be able to read to complete the MMPI. B) The results of the MMPI could be culturally biased. C) The MMPI assesses a narrow scope of functioning. D) The MMPI does not have established validity.

B

The nurse says to the client, "You become very anxious when we start talking about your drinking." Which of the following techniques is the nurse using? A) Confronting behavior B) Making an observation C) Translating into feelings D) Verbalizing the implied

B

The nurse understands that empathy is essential to the therapeutic relationship. When a patient makes the statement, "I am just devastated that my marriage is falling apart" the nurse can best show empathy through which of the following responses? A) "I feel so bad for what you are going through." B) "You feel like your world is falling apart right now." C) "I have been divorced too. I know how hard it is." D) "It will get better; let's talk about it."

B

The nurse uses a variety of therapeutic communication skills when working with patients. Which of the following is a therapeutic goal that can be accomplished through the use of therapeutic communication skills? A) Inform the patient of priority problems B) Assess the patient's perception of a problem C) Assist the patient to control emotions D) Provide the patient with a plan of action

B

The patient expresses frustration that the doctor does not spend enough time with the patient when making rounds. The nurse replies, "The doctors are very busy. What can I help you with?" The nurse incorporated which nontherapeutic technique in this response? A) Belittling B) Defending C) Disagreeing D) Introducing an unrelated topic

B

The primary advantage of an evolving consumer household is that clients A) are provided with adequate income to combat poverty. B) do not have to relocate as they become more independent. C) have on-site staff supervision 24 hours a day. D) receive on-site medical care

B

The primary purpose for generalist nurses to develop skills with psychosocial interventions is A) psychosocial interventions are included on the nursing licensure examinations. B) psychosocial interventions are needed in all nursing practice settings. C) nurses will be consulted to assist in the care of psychiatric patients in acute care settings. D) there are a growing number of nursing practice opportunities in mental health settings.

B

The primary purpose of the Community Mental Health Center Act of 1963 was to A) get better treatment in larger, more urban areas. B) move patients to their home communities for treatment. C) provide former patients with employment opportunities. D) remove the stigma of living in an institution.

B

What is meant by the term ìrevolving door effectî in mental health care? A) An overall reduction in incidence of severe mental illness B) Shorter and more frequent hospital stays for persons with severe and persistent mental illness C) Flexible treatment settings for mentally ill D) Most effective and least expensive treatment settings

B

What would be the most appropriate action by the student nurse when the client asked the student nurse to keep it secret that the client plans to kill a family member? A) The student nurse must respect the client's privacy and not tell anyone. B) The student nurse must tell the client that the student nurse cannot keep that secret and then report it to the instructor and/or staff members. C) The student nurse must tell the client that the student nurse will keep the secret and then tell the instructor and/or staff members. D) The student nurse must tell the instructor and then ask the instructor to keep it secret.

B

When the client asks the nurse how long it will take before the SSRI antidepressant medication will be effective, which of the following replies is most accurate and therapeutic? A) "This is a good medication! It will be effective within 20 minutes of the first dose." B) "You will have gradual improvement in symptoms over the next few weeks, but the changes may be so subtle that you may not notice them for a while. It is important for you to keep taking the medication." C) "It will probably take months for the medication to work. In the meantime, you should work on improving your attitude." D) "If you believe it will work, then it will. You have to have faith!"

B

When the client experiences facial flushing, a throbbing headache, nausea and vomiting after consuming alcohol while taking Disulfiram (Antabuse), the nurse is aware that this is due to which of the following? A) A mild side effect of the medication. B) The intended therapeutic result. C) An idiosyncratic reaction D) A severe allergy to the medication.

B

When the nurse is assessing whether the client's ideas are logical and make sense, the nurse is examining which of the following areas? a. Thought content b. Thought process c. Memory d. Sensorium

B

Which assessment indicates positive growth and development for a 30-year-old adult? a. Is dissatisfied with body image b. Enjoys social activities with three or four close friends c. Frequently changes jobs to "find the right one" d. Plans to move from parental home in near future

B

Which of the following is the highest priority for admission to inpatient care? A) Confusion or disorientation B) Need for medication changes C) Safety of self or others D) Withdrawal from alcohol or other drugs

C

Which is included in Healthy People 2020 objectives? A) To decrease the incidence of mental illness B) To increase the number of people who are identified, diagnosed, treated, and helped to live healthier lives C) To provide mental health services only in the community D) To decrease the numbers of people who are being treated for mental illness

B

Which of the following antidepressant drugs is a preferred drug for clients at high risk of suicide? A) Tranylcypromine (Parnate) B) Sertraline (Zoloft) C) Imipramine (Tofranil) D) Phenelzine (Nardil)

B

Which of the following distance zones is acceptable for people who mutually desire personal contact? A) Social B) Intimate C) Personal D) Public

B

Which of the following factors is primarily responsible for the changes in inpatient hospital treatment between the 1980s and the present? A) Progress in treatment options for mentally ill persons B) The growth of managed care C) Less stigma associated with mental illness D) The current use of milieu therapy

B

Which of the following factors would be the most influential in determining a client's response to a particular stressor? A) The client's experience with stress B) The client's perception of the stressor C) Duration of the stressor D) Severity of the stressor

B

Which of the following is a standard of practice? A) Quality of care B) Outcome identification C) Collegiality D) Performance appraisal

B

Which of the following is a standard of professional performance? A) Assessment B) Education C) Planning D) Implementation

B

Which of the following is a term used to describe the occurrence of the eye rolling back in a locked position, which occurs with acute dystonia? A) Opisthotonus B) Oculogyric crisis C) Torticollis D) Pseudoparkinsonism

B

Which of the following is an inhibitory neurotransmitter? A) Dopamine B) GABA C) Norepinephrine D) Epinephrine

B

Which of the following is the most compelling reason for the nurse to discuss matters of sexuality and suicide? A) It is required by the law by the federal government and in most states in the union. B) It is the nurse's professional responsibility to keep safety needs first and foremost. C) This is commonly required documentation for every encounter with every client. D) It allows the nurse to gain valuable experience in these kind of difficult discussions.

B

Which of the following is the most important skill the nurse must bring to the therapeutic nurse client relationship? A) Confrontation B) Empathy C) Humor D) Reframing

B

Which of the following questions is best to ask when assessing the client's judgment? A) "Can you describe your usual daily activities for me?" B) "If you found yourself downtown without money or a car, how would you get home?" C) "On a scale of 1 to 10, how stressed would you rate yourself?" D) "What problem would you like to work on while you're hospitalized?"

B

Which of the following statements about verbal and nonverbal communication skills is accurate? A) One third of meaning is transmitted nonverbally and two thirds is communicated verbally. B) Nonverbal communication is as important, if not more than, verbal communication. C) Verbal communication is most important because it is what the patient says. D) Verbal communication involves the unconscious mind.

B

Which of the following statements is true of the component of a therapeutic relationship "acceptance"? A) The nurse accepts the behavior of any inappropriate behavior. B) It is avoiding judgments of the person, no matter what the behavior is. C) It involves punishment for inappropriate behavior. D) It is the ability of the nurse to perceive the meanings and feelings of the client and to communicate that understanding to the client.

B

Which of the following would best assess a client's judgment? A) Counting by serial sevens B) Discussing hypothetical situations C) Interpreting proverbs D) Spelling words backward

B

Which one of the following is a result of federal legislation? A) Making it easier to commit people for mental health treatment against their will. B) Making it more difficult to commit people for mental health treatment against their will. C) State mental institutions being the primary source of care for mentally ill persons. D) Improved care for mentally ill persons.

B

Which one of the following is an important characteristic of an effective therapist client relationship in individual psychotherapy? A) Homogeneity between the client and the therapist. B) Mutual benefit for the client and the therapist. C) The client must adapt to the therapist's style of therapy and theoretical beliefs. D) Match between the theoretical beliefs and style of therapy and the client's needs and expectations of therapy

B

Which one of the following types of antipsychotic medications is most likely to produce extrapyramidal effects? A) Atypical antipsychotic drugs B) First-generation antipsychotic drugs C) Third-generation antipsychotic drugs D) Dopamine system stabilizers

B

Which role of the nurse is most likely to create difficulty for the nurse client relationship if the client confuses physical care with intimacy and sexual interest? A) Teacher B) Caregiver C) Advocate D) Parent surrogate

B

Which states the naturalistic view of what causes illness? a. Illness is a natural part of life and therefore unavoidable. b. Illness is caused by cold, heat, wind, and dampness. c. Only natural agents are effective in treating illness. d. Outside agents, such as evil spirits, upset the body's natural balance.

B

Which of the following is the primary consideration with clients taking antidepressants? A) Decreased mobility B) Emotional changes C) Suicide D) Increased sleep

C

The nurse is assessing suicide potential in a patient who has expressed hopelessness. In what order does the nurse question the patient about suicidal thoughts? A. "How would you carry out this plan?" B. "Do you have a plan to kill yourself?" C. "Are you thinking of killing yourself?" D. "How do you plan to kill yourself?"

C B D A

Which of the following are nontherapeutic techniques? Select all that apply. A) Silence B) Voicing doubt C) Agreeing D) Challenging E) Giving approval F) Accepting

C D E

Identify components of a cultural assessment. a. Communication b. Control of environment c. Family structure d. Language e. Socioeconomic status

C E F

Which are specific tasks of the working phase of a therapeutic relationship? a. Begin planning for termination. b. Build trust. c. Encourage expression of feelings. d. Establish a nurse-client contract. e. Facilitate behavior change. f. Promote self-esteem.

C E F

Which of the following individual factors can a person modify to improve mental and emotional health? Select all that apply. A) Serotonin deficiency B) Lack of exercise C) Poor nutrition D) Type I diabetes E) Sleeplessness

B C E

A client with bipolar disorder has been taking lithium, and today his serum blood level is 2.0 mEq/L. What effects would the nurse expect to see? A) Constipation and postural hypotension B) Fever, muscle rigidity, and disorientation C) Nausea, diarrhea, and confusion D) None; the serum level is in therapeutic range

C

It is recorded in the client's chart that the family is resilient. The nurse concludes which of the following characteristics about the family life of this client? Select all that apply. A) Family members are independent of one another. B) Family members spend time together. C) Family members engage in recreational activities together. D) Family members share the same personal goals. E) Family members allow individual members to develop unique daily routines.

B C

Which of the following are advantages of a crisis resolution team or home treatment team? Select all that apply. A) It is a residential treatment setting. B) It is more likely to help a client to perceive his or her situation more accurately. C) It is designed to assist clients in dealing with mental health crises without hospitalization. D) The client may feel better about asking for help. E) The client must meet multiple criteria to receive this type of care.

B C D

Which of the following are examples of adventitious crises? Select all that apply. A) Death of a loved one B) Natural disasters C) Violent crimes D) War E) Leaving home for the first time

B C D

Which of the following behaviors by the nurse demonstrate positive regard? Select all that apply. A) Communicating judgments about the client's behavior B) Calling the client by name C) Spending time with the client D) Responding openly E) Considering the client's ideas and preference when planning care

B C D E

Which of the following statements correctly depict the problem of feeling sympathy toward the client? Select all that apply. A) This can cause the nurse to feel sad and be unable to help the client. B) When the nurse's behavior is rooted in sympathy, the client finds it easier to manipulate the nurse's feelings. C) The client is discouraged from exploring his or her problems, thoughts, and feelings. D) The client is discouraged from growth. E) The client feels dependent on the nurse.

B C D E

The nurse is educating a patient and family about strategies to minimize the side effects of antipsychotic drugs. Which of the following should be included in the plan? Select all that apply. A) Drink plenty of fruit juice. B) Developing an exercise program is important. C) Increase foods high in fiber. D) Laxatives can be used as needed. E) Use sunscreen when outdoors. F) For missed doses, take double the dose at the next scheduled time.

B C E

The nurse is mindful of maintaining relationships with patients that are therapeutic. Certain characteristics of the relationships the nurse will foster include: Select all that apply. A) offering sound advice to the patient. B) establishing boundaries for both the nurse and patient. C) maintaining a patient-focus at all times. D) sharing personal feelings openly with the patient. E) avoiding concern with whether the patient likes the nurse.

B C E

Identify interpersonal factors of a client's response. a. Cultural beliefs b. Family support c. Sense of belonging d. Social networks e. Spirituality

B C F

Which of the following theories could be classified as humanistic theories? Select all that apply. A) Cognitive therapy B) Maslow's hierarchy of needs C) Gestalt therapy D) Rogers' client-centered therapy E) Rational emotive therapy F) Piaget's cognitive stages of development

B D

A patient has just been referred to a psychosocial rehabilitation program. The nurse explains that the benefits of being involved in such a program include: Select all that apply. A) continuous monitoring of symptoms. B) increased independence. C) increased involvement in treatment decisions. D) recovery from mental illness. E) increased community integration. F) greater opportunities for personal growth.

B D E

A student appears very nervous on the first day of clinical in a psychiatric setting. The student reviews the instructor's guidelines and appropriately takes which of the following actions? Select all that apply. A) Tells the client about personal events and interests B) Discusses the anxious feelings with the instructor C) Assumes that the client's unwillingness to talk to a student nurse is a personal insult or failure D) Builds rapport with the patient before asking personal questions E) Consults the instructor if a shocking situation arises F) Gravitates to clients that the student may know personally

B D E

Which of the following side effects of lithium are frequent causes of noncompliance? Select all that apply. A) Metallic taste in the mouth B) Weight gain C) Acne D) Thirst E) Lethargy

B E

Which of the following statements about hope and symptoms of mental illness are true? Select all that apply. A) Hope is not realistic and therefore is not related to mental well-being. B) Persons having more hope experienced fewer actual symptoms. C) Hope is a cause of mental illness. D) There is not a significant relationship between hopelessness and increased symptoms. E) A possible way to help clients manage and decrease symptoms would be to support the development of hope.

B E

A nurse and patient have just completed reviewing the patient's take-home medications. The nurse is exemplifying which role during this intervention? A) Advocate B) Caregiver C) Teacher D) Parent Surrogate

C

A client begins to take stock of his life and look into the future. The nurse assesses that this client is in which of Erikson's developmental stages? A) Identity versus role confusion B) Industry versus inferiority C) Integrity versus despair D) Generativity versus stagnation

C

A client is admitted to the psychiatric unit and states, ìI am president of the largest corporation in the world. Everyone comes to me for advice.î The client is exhibiting which of the following? A) Flight of ideas B) Thought broadcasting C) Delusion D) Loose associations

C

A client reports feeling like he belongs among his peers with whom he shares a group home. The nurse incorporates this sense of belonging when formulating discharge plans because the nurse understands which of the following? A) Living with a peer group often increases anxiety. B) Peers may alienate the client from daily living activities. C) The client will likely feel needed by his peers. D) Peer groups often do too much for each other causing dependency.

C

A client who is taking paroxetine (Paxil) reports to the nurse that he has been nauseated since beginning the medication. Which of the following actions is indicated initially? A) Instruct the client to stop the medication for a few days to see if the nausea goes away. B) Reassure the client that this is an expected side effect that will improve with time. C) Suggest that the client take the medication with food. D) Tell the client to contact the physician for a change in medication.

C

Which of the following is a major developmental task of middle adulthood? A) Developing intimacy B) Learning to manage conflict C) Reexamining life goals D) Resolving the past

C

A nurse assesses that a depressed patient is lethargic during the day and does not actively participate in unit activities. The notes from the night shift document that the patient did not sleep well. The most probable interpretation of these data is A) the patient's medications are ineffective. B) the patient is being kept awake at night due to noise on the unit. C) the patient's depressed mood is impairing restful sleep patterns. D) the patient is resisting treatment recommendations to participate in unit activities

C

A nurse documents that a patient has successfully acquired a job performing janitorial services at a local manufacturing company. The goal of which of the following levels of prevention has been achieved? A) Primary prevention B) Secondary prevention C) Tertiary prevention D) Community prevention

C

A nurse is meeting with the city council to advocate for mentally ill persons and the establishment of a group home in a neighborhood where the plans have been strongly opposed by the neighbors. The nurse can effectively educate the public on the realities of group home by citing research that indicates A) property values quickly rebound in neighborhoods that have group homes. B) police surveillance will be increased to avert any violence by residents. C) most people with mental illness do not represent a significant danger to others. D) neighborhoods that provide park areas provide children a centralized and safe place to play.

C

A nurse is using the Johari window to identify the degree to which he feels comfortable communicating with others. After completing the exercise, the nurse discovers that quadrant 1 has the longest list of qualities. This indicates which of the following about the nurse? A) The nurse conceals personal information about himself. B) The nurse needs to increase insight into his own characteristics. C) The nurse is open to others. D) The patient is sharing more than the nurse in the therapeutic relationship.

C

A nurse is working with a Middle-Eastern client being treated for major depression. The client is expressing feelings of guilt for not being able to "snap out of it." A therapeutic response by the nurse would be, A) "You have to keep trying to feel better." B) "What do you think could have caused your depression?" C) "Clinical depression is not something you have brought on yourself." D) "It will take several weeks for your medicine to start to help you feel better."

C

A nurse is working with a patient whose background is very different from hers. A good question to ask herself to assure she can be effective working with this patient would be, A) "Can this person understand me?" B) "Do I understand this patient's expectations of me?" C) "What experiences do I have with people with similar backgrounds?" D) "Is this person going to be able to relate to me?"

C

A nurse suspects that a patient is abusing alcohol while taking prescribed medications. The nurse plans to educate the patient on the dangers of mixing medicine with alcohol. Which of the following would be the most effective way for the nurse to approach this subject with the patient? A) Firmly inform the patient of the dangers of mixing medications with alcohol. B) Recommend a higher level of care, so the patient can be more closely supervised. C) Emphasize the importance of truthful information using a nonjudgmental approach D) Recognize the patient's right to self-determination and avoid addressing the subject.

C

A patient asks the nurse what she should do about her "cheating" husband. The nurse replies, "You should divorce him. You deserve better than that." The nurse used which communication technique? A) Giving information B) Verbalizing the implied C) Giving advice D) Agreeing

C

A patient being discharged appears angry with the nurse when the nurse attempts to review discharge instructions with the patient. The nurse can best assist the patient in this stage of the relationship with which of the following responses? A) "We have to go over these instructions before you can go. Please try to listen." B) "Would you rather not be discharged today?" C) "I can sense you are angry this morning. Tell me how you feel about being discharged today." D) "You should be able to regulate your feelings better by now. Why are you angry?"

C

A patient has been started on antidepressants. The interdisciplinary team member most responsible for monitoring effectiveness and side effects of this new medication is the A) pharmacist. B) psychiatrist. C) psychiatric nurse. D) psychologist.

C

A patient is being transferred from a group home to an evolving consumer household. The goal of this transition is for the patient to eventually A) meet with a therapist on a weekly basis. B) resolve crises within a shorter time period. C) fulfill daily responsibilities without supervision. D) use the increased emotional support of paid staff.

C

A patient is known to express tangential thinking. The nurse would assess for which of the following when interacting with the patient? A) Stopping abruptly in the middle of expressing himself B) Jumping from one idea to another C) Wandering off the topic and never answering the question D) Excessive and fast talking about an array of ideas

C

A patient is seen for frequent exacerbation of schizophrenia due to nonadherence to medication regimen. The nurse should assess for which of the following common contributors to nonadherence? A) The patient is symptom-free and therefore does not need to adhere to the medication regimen. B) The patient cannot clearly see the instructions written on the prescription bottle. C) The patient dislikes the weight gain associated with antipsychotic therapy. D) The patient sells the antipsychotics to addicts in the neighborhood.

C

A patient remarks, "You know, it's the same thing every time." The nurse should respond by stating, A) "I understand." B) "I'm sure everyone is doing their best." C) "I'm not sure what you mean. Please explain." D) "It's the same thing every time?"

C

A patient who has continuously experienced severe symptoms of schizoaffective disorder for the past 17 years is experiencing an acute psychotic episode. Which level of care is most appropriate for this patient at this time? A) Partial hospitalization B) Residential treatment C) Inpatient hospital treatment D) Clubhouse

C

A patient with bipolar disorder takes lithium 300 mg three times daily. The nurse evaluates that the dose is appropriate when the patient reports A) feeling sleepy and less energetic. B) weight gain of 7 pounds in the last 6 months. C) minimal mood swings. D) increased feelings of self-worth.

C

A student nurse attends a self-help group as part of a class assignment. While there the student recognizes a family friend. Upon returning home, the student talks about the experience with the family. The student's actions can be described as A) appropriate; persons familiar with group members are allowed self-help group membership. B) appropriate; self-help groups are not professional and therefore are open to public knowledge. C) inappropriate; most self-help groups have a rule of confidentiality. D) inappropriate; the student should not have been allowed to attend the group.

C

A teenage patient defies the nurse's repeated requests to turn off the video game and go to sleep. The teen says angrily, "You sound just like my mother at home!" and continues to play the video game. The nurse understands that this statement likely indicates A) the need of stricter discipline at home. B) early signs of oppositional defiant disorder. C) viewing the nurse as her mother. D) expression of developing autonomy.

C

Before the period of the enlightenment, treatment of the mentally ill included A) creating large institutions to provide custodial care. B) focusing on religious education to improve their souls. C) placing the mentally ill on display for the public's amusement. D) providing a safe refuge or haven offering protection.

C

Beliefs about the causes of pain and illness vary among cultures. In the United States (Western culture), pain and illness are generally attributed to A) economic class. B) psychological influences. C) physiologic causes. D) sociocultural factors.

C

Client: "I had an accident." Nurse: "Tell me about your accident." This is an example of which therapeutic communication technique? a. Making observations b. Offering self c. General lead d. Reflection

C

Direct eye contact is preferred by which of the following cultures? A) Native Americans B) Cambodians C) Russians D) Chinese

C

During the assessment, the nurse asks the client to describe his problems. The purpose of this question is to obtain information about the client's A) admitting diagnosis. B) communication skills. C) perception of the problem. D) personal needs.

C

During the mental status assessment, the client expresses the belief that the CIA is stalking him and plans to kidnap him. The best response by the nurse would be, A) "That makes no sense at all." B) "You can tell me about that after I finish asking these questions." C) "What kinds of things have been happening?" D) "Why would the CIA be interested in you?"

C

Females from which of the following cultures are most likely to be expected to move in with husband's family? A) African Americans B) Mexican Americans C) South Asians D) Haitians

C

Four levels of anxiety were described by a. Erik Erikson. b. Sigmund Freud. c. Hildegard Peplau. d. Carl Rogers.

C

Group members are actively discussing a common topic. Members are sharing that they identify with what others are saying. The nurse leader recognizes that the group is in which stage of group development? A) Planning B) Initial C) Working D) Termination

C

Ideas that one holds as true are a. values. b. attitudes. c. beliefs. d. personal philosophy.

C

In the space of 5 minutes, the client has been laughing and euphoric, then angry, and then crying for no reason that is apparent to the nurse. This behavior would be best described as A) flight of ideas. B) lack of insight. C) labile mood. D) tangential thinking

C

Inpatient psychiatric care focuses on all the following except a. brief interventions. b. discharge planning. c. independent living skills. d. symptom management.

C

Managed care provides funding for psychiatric rehabilitation programs to a. develop vocational skills. b. improve medication compliance. c. provide community skills training. d. teach social skills.

C

One of the unforeseen effects of the movement toward community mental health services is A) fewer clients suffering from persistent mental illnesses. B) an increased number of hospital beds available for clients seeking treatment. C) an increased number of admissions to available hospital services. D) Longer hospital stays for people needing mental health services.

C

One week after beginning therapy with thiothixene (Navane), the client demonstrates muscle rigidity, a temperature of 103∞F, an elevated serum creatinine phosphokinase level, stupor, and incontinence. The nurse should notify the physician because these symptoms are indicative of A) acute dystonic reaction. B) extrapyramidal side effects. C) neuroleptic malignant syndrome. D) tardive dyskinesia.

C

Psychiatric nursing became a requirement in nursing education in which year? A) 1930 B) 1940 C) 1950 D) 1960

C

The client says to the nurse, "I feel really close to you. You are the only true friend I have." The most therapeutic response the nurse can make is, A) "I am sure there are other people in your life who are your friends; besides, we just met." B) "It makes me feel good that you trust me so much; it is important for the work we are doing together." C) "Since ours is a professional relationship, let's explore other opportunities in your life for friendship." D) "We are not friends. This is strictly professional."

C

The client tells the nurse, "My biggest problem right now is trying to deal with a divorce. I didn't want a divorce and I still don't. But it is happening anyway!" Which of the following responses by the nurse will convey empathy? a. "Can you tell me about it?" b. "I'm so sorry. No wonder you're upset." c. "Sounds like it has been a difficult time." d. "You must be devastated."

C

The client's belief that a news broadcast has special meaning for him or her is an example of a. abstract thinking. b. flight of ideas. c. ideas of reference. d. thought broadcasting.

C

The first training of nurses to work with persons with mental illness was in 1882 in which state? A) California B) Illinois C) Massachusetts D) New York

C

Which of the following is defined as an advanced-level function in the practice area of psychiatric mental health nursing? A) Case management B) Counseling C) Evaluation D) Health teaching

C

The nurse has completed health teaching about dietary restrictions for a client taking a monoamine oxidase inhibitor. The nurse will know that teaching has been effective by which of the following client statements? A) "I'm glad I can eat pizza since it's my favorite food." B) "I must follow this diet or I will have severe vomiting." C) "It will be difficult for me to avoid pepperoni." D) "None of the foods that are restricted are part of a regular daily diet."

C

The nurse is assessing a client who is talking about her son's recent death but who shows no emotion of any kind. The nurse recognizes this behavior as which of the following defense mechanisms? A) Dissociation B) Displacement C) Intellectualization D) Suppression

C

The nurse is assessing the anxiety level of a young school-age child. The nurse encourages the child to express feelings through the use of toys in a play situation. The purpose for this approach to assessment is largely related to which of the following? A) The child has cognitive impairment and has limited vocabulary skills. B) The child has not been intellectually stimulated and can only express self through play. C) Children may not have developed the language to fully describe their feelings. D) Children will not express themselves openly unless instructed to do so by parents.

C

The nurse is sitting with a patient who is crying. After a few minutes the nurse places one hand on the patient's shoulder. Which of the following best describes the purpose of the nurse's touch with this patient? A) To express sympathy to the patient B) To assess the patient's skin temperature and circulation status C) To offer comfort and support for the patient D) To extend an offer of friendship to the patient

C

The nurse is working with a client who has a history of inflicting spousal abuse. Although the nurse does not condone domestic violence, the nurse treats the client with unconditional positive regard through which of the following? A) The nurse tries to understand the feelings that might have led to violent behavior. B) The nurse uses honest emotional expression in relating to client. C) The client is still viewed as someone worthy of respect and assistance. D) The nurse relates to the client as if he were her own spouse.

C

The nurse understands that crises are self-limiting. This implies that upon evaluation of crisis intervention, the nurse should assess for which outcome? A) The patient will identify possible causes for the crisis. B) The patient will discover a new sense of self-sufficiency in coping. C) The patient will resume the precrisis level of functioning. D) The patient will express anger regarding the crisis event.

C

The nursing role that involves being a substitute for another, such as a parent, is called a. counselor. b. resource person. c. surrogate. d. teacher.

C

The primary goal of a psychiatric rehabilitation program is to promote A) return to prior level of functioning. B) medication compliance. C) complete recovery from mental illness. D) stabilization and management of symptoms.

C

The primary purpose of psychiatric rehabilitation is to a. control psychiatric symptoms. b. manage clients' medications. c. promote the recovery process. d. reduce hospital readmissions.

C

Throughout the assessment, the client displays disorganized thinking, jumping from one idea to another with no clear relationship between the thoughts. The nurse would assess the client as having which of the following? A) Tangential thinking B) Ideas of reference C) Loose associations D) Word salad

C

To assess the client's ability to concentrate, the nurse would instruct the client to do which? a. Explain what "a rolling stone gathers no moss" means. b. Name the last three presidents. c. Repeat the days of the week backward. d. Talk about what a typical day is like.

C

When the client says, "I met Joe at the dance last week," what is the best way for the nurse to ask the client to describe her relationship with Joe? a. "Joe who?" b. "Tell me about Joe." c. "Tell me about you and Joe." d. "Joe, you mean that blond guy with the dark blue eyes?"

C

Which approach to therapy is most effective when planning for a client with negative thinking? A) Behavior modification B) Client-centered therapy C) Cognitive therapy D) Reality therapy

C

Which intervention is an example of primary prevention implemented by a public health nurse? a. Reporting suspected child abuse b. Monitoring compliance with medications for a client with schizophrenia c. Teaching effective problem-solving skills to high school students d. Helping a client apply for disability benefits

C

Which is a concern for children taking stimulants for ADHD for several years? A) Dependence on the drug B) Insomnia C) Growth suppression D) Weight gain

C

Which is a positive aspect of treating clients with mental illness in a community-based care? A) "You will not be allowed to go out with your friends while in the program." B) "You will have to have supervision when you want to go anywhere else in the community." C) "You will be able to live in your own home while you still see a therapist regularly." D) "You will have someone in your home at all times to ask questions if you have any concerns."

C

Which is a standard for establishing a code of conduct for living? A) Acceptance B) Empathy C) Values D) Positive regard

C

Which of the following are true regarding mental health and mental illness? A) Behavior that may be viewed as acceptable in one culture is always unacceptable in other cultures. B) It is easy to determine if a person is mentally healthy or mentally ill. C) In most cases, mental health is a state of emotional, psychological, and social wellness evidenced by satisfying interpersonal relationships, effective behavior and coping, positive self-concept, and emotional stability. D) Persons who engage in fantasies are mentally ill.

C

Which of the following factors influencing assessment is under the nurse's control? A) Client participation and feedback B) Client's health status C) Nurse's attitude and approach D) Client's ability to understand

C

Which of the following increases the risk for neuroleptic malignant syndrome (NMS)? A) Overhydration B) Intake of vitamins C) Dehydration D) Vegetarian diet

C

Which of the following statements is true of treatment of people with mental illness in the United States today? A) Substance abuse is effectively treated with brief hospitalization. B) Financial resources are reallocated from state hospitals to community programs and support. C) Only 25% of people needing mental health services are receiving those services. D) Emergency department visits by persons who are acutely disturbed are declining.

C

Which of the following was the first nonstimulant medication specifically designed and tested for ADHD? A) Methylphenidate (Ritalin) B) Amphetamine (Adderall) C) Atomoxetine (Strattera) D) Pemoline (Cylert)

C

Which one of the following drugs should the nurse expect the patient to require serum level monitoring? A) Anticonvulsants B) Wellbutrin C) Lithium D) Prozac

C

Which one of the following is one of the American Nurses Association standards of practice for psychiatricñmental health nursing? A) Prescriptive authority is granted to psychiatricñmental health registered nurses. B) All aspects of Standard 5: Implementation may be carried out by psychiatric mental health registered nurses. C) Some aspects of Standard 5: Implementation may only be carried out by psychiatric mental health advanced practice nurses. D) Psychiatric mental health advanced practice nurses are the only ones who may provide milieu therapy.

C

Which physician order would the nurse question for a client who has stated, "I'm allergic to phenothiazines?" A) Haldol, 5 mg PO bid B) Navane, 10 mg PO bid C) Prolixin, 5 mg PO tid D) Risperdal, 2 mg bid

C

Which statement would cause concern for achievement of developmental tasks of a 55-year-old woman? a. "I feel like I'm taking care of my parents now." b. "I really enjoy just sitting around visiting with friends." c. "My children need me now just as much as when they were young." d. "When I retire, I want a smaller house to take care of."

C

The mentally ill homeless population benefits most from a. case management services. b. outpatient psychiatric care to manage psychiatric symptoms. c. stable housing in a residential neighborhood. d. a combination of housing, rehabilitation services, and community support.

D

Which is an example of a closed-ended question? a. How have you been feeling lately? b. How is your relationship with your wife? c. Have you had any health problems recently? d. Where are you employed?

D

Which is the orientation of assertive community treatment (ACT)? A) Setting limits on mundane life issues B) Making a wide range of referrals C) Providing services in offices D) Problem-solving orientation

D

A client has a lithium level of 1.2 mEq/L. Which of the following interventions by the nurse is indicated? A) Call the physician for an increase in dosage. B) Do not give the next dose, and call the physician. C) Increase fluid intake for the next week. D) No intervention is necessary at this time.

D

A client has been making sexual comments when communicating with the nurse. The nurse wants to spend some time talking to the patient while respecting the patient's right to privacy. Which setting would be the most appropriate setting for the nurse to talk with the client? A) In the patient's room when the patient's roommate is present and 3 feet away B) At the nurse's station when other clients and visitors are less than 4 feet away C) In an interview room in a remote section of the unit with the nurse 1 foot away from the patient D) In a quiet corner of the dayroom at least 4 feet away from others

D

A client is actively involved in community service activities. The benefit of involvement in meaningful daily activities will most directly contribute to which of the following attributes? A) Self-efficacy B) Resilience C) Resourcefulness D) Hardiness

D

A client is seen in the clinic with clinical manifestations of an inability to sit still and a rigid posture. These side effects would be correctly identified as which of the following? A) Tardive dyskinesia B) Neuroleptic malignant syndrome C) Dystonia D) Akathisia

D

A client on the unit suddenly cries out in fear. The nurse notices that the client's head is twisted to one side, his back is arched, and his eyes have rolled back in their sockets. The client has recently begun drug therapy with haloperidol (Haldol). Based on this assessment, the first action of the nurse would be to A) get a stat. order for a serum drug level. B) hold the client's medication until the symptoms subside. C) place an urgent call to the client's physician. D) give a PRN dose of benztropine (Cogentin) IM.

D

A client with severe and persistent mental illness has been taking antipsychotic medication for 20 years. The nurse observes that the client's behavior includes repetitive movements of the mouth and tongue, facial grimacing, and rocking back and forth. The nurse recognizes these behaviors as indicative of A) extrapyramidal side effects B) loss of voluntary muscle control C) posturing D) tardive dyskinesia

D

A delusion represents a problem in which of the following areas? A) Memory B) Motivation C) Orientation D) Thinking

D

A nurse is teaching decision-making skills to a client with dependent personality disorder. According to Erikson, the likely cause of the client developing dependent personality is failure to meet the critical task of which developmental stage? A) Trust B) Autonomy C) Initiative D) Industry

D

A nurse makes the statement in a treatment team meeting, "It's not worth it to try to. teach this patient how to make better choices. He has been here many times before and goes back home and does the same thing." The nurse is sharing which of the following? A) Value B) Awareness C) Belief D) Attitude

D

A nursing supervisor reprimands an employee for being chronically late for work. If the employee handles the reprimand using the defense mechanism of displacement, he would most likely do which of the following? A) Argue with the supervisor that he is usually on time B) Make a special effort to be on time tomorrow C) Tell fellow employees that the supervisor is picking on him D) Tell the unit housekeeper that his work is sloppy

D

A patient has just been told she has cervical cancer. When asked about how this is impacting her, she states, ìIt's just an infection; it will clear up.î The statement indicates that this patient A) needs education on cervical cancer. B) is unable to express her true emotions. C) should be immediately referred to a cancer support group. D) is using denial to protect herself from an emotionally painful thought.

D

A patient is being admitted to an inpatient unit for treatment of anorexia nervosa. Of the following assessment data, which should the nurse place as highest priority in the plan of care? A) Weight 24% below normal for height B) Distorted body image C) Feelings of inadequacy D) Frequent vomiting after meals

D

A patient is blaming his impending divorce on the fact that his wife goes out frequently with her girlfriends. If using reality therapy, the nurse would help the patient with which of the following responses? A) "If you really love her, she should love you as well." B) "What does being divorced mean for you?" C) "How do you feel about your marriage ending?" D) "What role do you think you have played in the end of your marriage?"

D

A patient shows no facial expression when engaging in a game with peers during an outing at a park. The nurse uses which of the following terms when documenting the patient's affect? A) Blunt affect B) Restricted affect C) Broad affect D) Flat affect

D

A patient states, "I feel fine. It's a good day." The nurse notes the patient looking away, and a decreasing pitch in his voice while speaking. Which of the following is the most therapeutic response by the nurse? A) "I'm glad you are feeling good today." B) "I'm not sure I believe you." C) "Tell me what is good about today." D) "You say you feel fine, but you don't really sound fine."

D

A patient states, "I hate spending time with my family. They're always on my back about something! I won't do anything they ask me to do." Which response by the nurse reflects a behavioral perspective? A) "Let's play like I'm your parent, and we'll practice some better ways to communicate that won't result in an argument." B) "Some medicines really help with anger. Are you interested in talking to your physician about starting you on something?" C) "That's probably your way of getting back at them for being strict with you when you were younger." D) "If you agree to start doing what your parents request, then they have agreed to respect your privacy more."

D

A patient states, "Right before I got here I was doing alright. My job was going well, my wife and I were happy, and we just moved into a new apartment." The nurse responds, "You said you and your wife were happy. Tell me more about that." This is an example of which therapeutic technique? A) Encouraging comparison B) General lead C) Restating D) Exploring

D

Which of the following is the priority of the Healthy People 2020 objectives for mental health? A) Improved inpatient care B) Primary prevention of emotional problems C) Stress reduction and management D) Treatment of mental illness

D

A patient with bipolar disorder asks the nurse, "Why did I get this illness? I don't want to be sick." The nurse would best respond with, A) "People who develop mental illnesses often had very traumatic childhood experiences." B) "There is some evidence that contracting a virus during childhood can lead to mental disorders." C) "Sometimes people with mental illness have an overactive immune system." D) "We don't fully understand the cause, but mental illnesses do seem to run in families."

D

A patient with depression is admitted to an inpatient hospital unit for treatment. The type of therapy most likely provided in this setting includes A) leisure skills. B) self-monitoring of treatment. C) skills for daily living. D) talk therapy

D

A patient with schizophrenia is being treated with olanzapine (Zyprexa) 10 mg. daily. The patient asks the nurse how this medicine works. The nurse explains that the mechanism by which the olanzapine controls the patient's psychotic symptoms is believed to be A) increasing the amount of serotonin and norepinephrine in the brain. B) decreasing the amount of an enzyme that breaks down neurotransmitters. C) normalizing the levels of serotonin, norepinephrine, and dopamine. D) blocking dopamine receptors in the brain.

D

A patient yells, "All the nurses here are so mean. None of you really care about us!" The most therapeutic response would be, A) "I cannot allow you to yell like that." B) "We care about you." C) "Oh, really?" D) "You seem very irritated."

D

A psychiatric nurse is planning activities aimed at secondary prevention of mental illness. Which activity would be most appropriate to develop? A) Self-esteem building with a local after-school program B) Social skills training for chronic schizophrenics C) Parenthood classes at a local community center D) Depression screening in an assisted living facility

D

A significant change in the treatment of people with mental illness occurred in the 1950s when A) community support services were established. B) legislation dramatically changed civil commitment procedures. C) the Patient's Bill of Rights was enacted. D) psychotropic drugs became available for use.

D

An adolescent patient has just been found to have broken one of the unit rules. The nurse imposes the consequence of losing phone privileges. In this instance, the nurse is acting as A) advocate. B) caregiver. C) teacher. D) parent surrogate.

D

Culture has the most influence on a person's health beliefs and practices. African Americans believe that the cause of mental illness occurs because of which of the following? A) Lack of harmony of emotions B) Supernatural causes C) Heredity D) Lack of spiritual balance

D

Dream analysis and free association are techniques in which modality? a. Client-centered therapy b. Gestalt therapy c. Logotherapy d. Psychoanalysis

D

During the initial interview with a client in crisis, the initial priority is to A) assess the adequacy of the support system. B) assess for substance use. C) determine the precrisis level of functioning. D) evaluate the potential for self-harm.

D

For a client taking clozapine (Clozaril), which of the following symptoms should the nurse report to the physician immediately as it may be indicative of a potentially fatal side effect? A) Inability to stand still for 1 minute B) Mild rash C) Photosensitivity reaction D) Sore throat and malaise

D

Hildegard Peplau is best known for her writing about A) community-based care. B) humane treatment. C) psychopharmacology. D) therapeutic nurse-client relationship.

D

In planning for a client's discharge, the nurse must know that the most serious risk for the client taking a tricyclic antidepressant is which of the following? A) Hypotension B) Narrow-angle glaucoma C) Seizures D) Suicide by overdose

D

Knowing that relationships with others are significant to mental health, the nurse effectively assesses a patient's family relationships through which of the following? A) "Do you feel your family helps you?" B) "How many people are in your family?" C) "Whom are you closest to in your family?" D) "Describe your relationships with your family."

D

Managed care is designed to A) control health care costs by limiting access to care. B) keep health care costs from increasing over time. C) limit the amount of money paid to physicians and hospitals. D) maintain a balance between the quality and costs of health care.

D

One of the primary differences between social and therapeutic relationships is the A) amount of emotion invested. B) degree of satisfaction obtained. C) kind of information given. D) type of responsibility involved.

D

Patients on an inpatient psychiatric unit can earn off-unit privileges for daily use of socially appropriate behavior. This is an example of employing which concept of behavior modification? A) Systematic desensitization B) Negative reinforcement C) Classical conditioning D) Operant conditioning

D

Some residential treatment settings are transitional. This means that clients are eventually expected to A) become self-sufficient. B) find employment. C) no longer need medication. D) relocate to another setting.

D

Spirituality is especially important in helping people cope primarily for which of the following reasons? A) Spirituality helps people set personal goals. B) Spirituality gives people meaningful daily activities in which to participate. C) Spirituality provides a reliable support network. D) Spirituality guides beliefs about the meaning of life events.

D

The client says to the nurse, "I know I can learn to cope with my family situation. By getting help here at the clinic, I'll be able to deal with them more effectively, and I won't be so stressed out all the time." This client is demonstrating a high level of A) hardiness. B) resilience. C) sense of belonging. D) self-efficacy.

D

The client tells the nurse, "I don't think you can help me. Every time I talk to you, I am reminded of my mother, and I hated her." The nurse should recognize this as A) confrontation. B) countertransference. C) incongruence. D) transference.

D

The nurse asks the patient, "What was it like for you when you first knew you had no place to go?" The patient looks down and pauses for quite some time. Which action by the nurse is most therapeutic? A) Change the subject to something the patient will discuss B) Encourage the patient to express any unpleasant feelings C) Apologize for asking such a personal question D) Sit quietly until the patient responds

D

The nurse assesses fine hand tremors in a patient with a history of heavy alcohol use. If the nurse understands that the tremors are a direct result of alcohol use, the nurse is using which pattern of knowing, according to Carper? A) Aesthetic knowing B) Ethical knowing C) Personal knowing D) Empirical knowing

D

The nurse best assesses a patient's memory by asking which of the following questions? A) "Do you have any problems with memory?" B) "What did you have for lunch yesterday?" C) "Do you know where you are?" D) "Who is the current president?"

D

The nurse considers cultural variations pertaining to a client's nonverbal communication. Which of the following is the primary rationale for considering alternative meanings of nonverbal communication? A) The nurse must become expert at interpreting the client's gestures. B) Nonverbal signs indicative of certain mental illnesses transcend cultural differences. C) Mental illnesses impair a client's ability to express nonverbal messages. D) Nonverbal messages have different meanings in various cultures.

D

The nurse consults the DSM for which of the following purposes? A) To devise a plan of care for a newly admitted client B) To predict the client's prognosis of treatment outcomes C) To document the appropriate diagnostic code in the client's medical record D) To serve as a guide for client assessment

D

The nurse initiating a therapeutic relationship with a client should explain the purpose, which is to A) alleviate stressors in life. B) allow the client to know the nurse's feelings. C) establish relationships. D) facilitate a positive change.

D

The nurse is part of a group setting up a mobile crisis service in conjunction with the local police department. Community education on which of the following this team will focus includes? A) Teaching police officers counseling skills B) Crisis counseling services to be provided in the prison system C) Educating about the dangers of the mentally ill in the community D) Assisting police officers to recognize mental illness

D

The nurse is preparing a patient for an MRI scan of the head. The nurse should ask the patient, A) "Have you ever had an allergic reaction to radioactive dye?" B) "Have you had anything to eat in the last 24 hours?" C) "Does your insurance cover the cost of this scan?" D) "Are you anxious about being in tight spaces?"

D

The nurse is preparing to conduct an admission assessment interview with a Mexican American client. During the interview, the nurse should respect the client's culture through which behavior? A) Greet the client with a hug B) Encourage direct eye contact during questioning C) Prohibiting the next of kin to remain present D) Introduce self with a handshake

D

The nurse is sitting down with a patient to begin a conversation. Which of the following positions should the nurse take to convey acceptance of the patient? A) Leaning forward with arms on the table sitting directly across for the patient B) Turned slightly to the side of the patients with arms folded across the chest C) Leaning back in the chair next to the patient with legs crossed at the knees D) Sitting upright facing the patient with both feet on the floor

D

The nurse is trying to obtain some information about family relationships from the client. Which of the following statements is best? A) "Is it upsetting for you to talk about your family?" B) "Is your family ready for you to come home?" C) "So, how is your family?" D) "Tell me your feelings about your family situation."

D

The nurse knows that the client understands the rationale for dietary restrictions when taking MAOI when the client makes which of the following statements? A) "I am now allergic to foods that are high in the amino acid tyramine such as aged cheese, organ meats, wine, and chocolate." B) "Certain foods will cause me to have sexual dysfunction when I take this medication." C) "Foods that are high in tyramine will reduce the medication's effectiveness." D) "I should avoid foods that are high in the amino acid tyramine such as aged cheese, meats, and chocolate because this drug causes the level of tyramine to go up to dangerous levels."

D

The nurse must be alert to the nonverbal expressions of the client. Because the meaning attached to nonverbal behavior is subjective, it is important for the nurse to A) increase the client's awareness of nonverbal behavior. B) investigate the source of nonverbal behavior. C) validate the client's feelings. D) validate the meaning of the nonverbal behavior.

D

The priority of inpatient care for people with severe mental illness is A) family issues. B) insight into illness. C) social skills. D) symptom management.

D

The signs of lithium toxicity include which? A) Sedation, fever, and restlessness B) Psychomotor agitation, insomnia, and increased thirst C) Elevated WBC count, sweating, and confusion D) Severe vomiting, diarrhea, and weakness

D

When preparing for the first clinical experience with patients on a forensic unit at a psychiatric hospital, the nursing instructor discusses students' beliefs and fears surrounding forensic patients. The primary reason for discussing personal beliefs is to A) practice reflective communication skills in a role-play situation. B) assign the most compatible patients to the students. C) assess the appropriateness of the setting for implementing nursing skills. D) become aware of possible barriers to developing therapeutic relationships.

D

When the nurse asks the client to restate the following in his or her own words, which sensorium and intellectual process is the nurse attempting to identify? The nurse states, "A stitch in time saves nine." A) The client's orientation B) The client's memory C) The client's ability to concentrate D) The client's ability to use abstract thinking

D

Which drug classification is the primary medication treatment for schizophrenia? A) Anticoagulants B) Antidepressants C) Antimanics D) Antipsychotics

D

Which of the following occurrences is considered a breach of professional boundaries? A) Patient asking a nurse for her phone number B) Refusing a gift from a patient C) Changing the subject in response to a patient complement D) Having a lengthy social conversation with a patient

D

Which of the following statements about the neurobiologic causes of mental illness is most accurate? A) Genetics and heredity can explain all causes of mental illness. B) Viral infection has been proven to be the cause of schizophrenia. C) There is no evidence that the immune system is related to mental illness. D) Several mental disorders may be linked to genetic and nongenetic factors.

D

Which of the following statements is true about a nurse's self-disclosure? A) It is the basis for effective communication. B) Self-disclosure should be used with all clients to some degree. C) The more the nurse discloses, the more the client will disclose. D) Self-disclosure on the nurse's part should benefit the client.

D

Which of the following would not be included as a symptom of drug-induced parkinsonism? A) Stooped posture B) Cogwheel rigidity C) Drooling D) Tachycardia

D

Which one of the following statements is most accurate regarding the cohesiveness of a group in group therapy? A) It is commonly present in the first meeting of the group. B) It is necessary for the group to have maximum cohesiveness, the more the better. C) Group cohesiveness is the degree to which members think alike and many things are left unspoken. D) Cohesiveness is a desirable group characteristic that is associated with positive group outcomes.

D

Which theorist believed that a corrective interpersonal relationship with the therapist was the primary mode of treatment? a. Sigmund Freud b. William Glasser c. Hildegard Peplau d. Harry Stack Sullivan

D

Which type of community residential treatment setting is most likely to be permanent in any state? A) Halfway house B) Respite housing C) Independent living programs D) Evolving consumer household

D

Which would be a reason for a student nurse to use the DSM? A) Identifying the medical diagnosis B) Treat clients C) Evaluate treatments D) Understand the reason for the admission and the nature of psychiatric illnesses.

D

Which of the following are examples of a therapeutic communication response? a. "Don't worry; everybody has a bad day occasionally." b. "I don't think your mother will appreciate that behavior." c. "Let's talk about something else." d. "Tell me more about your discharge plans." e. "That sounds like a great idea." f. "What might you do the next time you're feeling angry?"

D F