mental health practice questions

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a client admitted voluntarily for treatment of an anxiety problem demands to be released from the hospital. Which action would the nurse take initially? 1. contact HCP 2. call the clients family to arrange for transportation 3. attempt to persuade the client to stay for a few more days 4. tell the client that leaving would likely result in an involuntary commitment

1

a client experiencing disturbed thought processes believes that the food is being poisoned. Which communication technique would then urse use to encourage the client to eat 1. using open ended questions and silence 2. sharing personal preference regarding food choices 3. documenting reasons why the client does not want to eat 4. offering opinions about the necessity of adequate nutrition

1

a client is admitted to the mental health unit with a diagnosis of OCD. After the clinic intake assessment, the nurse observes that the client is repetitively wiping the furniture in her room with a facecloth and warm water. which action should the nurse take initially? 1. allow the client to perform the act 2. stop the client 3. help the client wipe the furniture while talking to her about the act 4. tell the client that the act is not necessary to do

1

a client is participating in a therapy group and focuses on viewing all team members equally important in helping the clients meet their goals. The nurse is implementing which therapeutic approach? 1. milieu 2. interpersonal 3. behavior modification 4. support group therapy

1

a client is preparing to attend a Gamblers Anon meeting for the first time. The nurse would plan to tell the client that which is the first step in the 12 step program? 1. admitting to having a problem 2. substituting other activities for gambling 3. stating that the gambling will be stopped 4. discontinuing relationships with people who gamble

1

a client is unwilling to go to church because the ex spouse goes there and the client feels that the ex spouse will laugh at the client. because of this hypersensitivity to a reaction from the spouse, the client remains homebound. The home care nurse develops a plan of care that addresses which personality disorder? 1. avoidant 2. borderline 3. schizotypal 4. obsessive compulsive

1

a client taking lithium reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and tremors. The lithium level is 2.5 mEq/L. The nurse plans care based on which representation of this level? 1. toxic 2. normal 3. slightly above normal 4. excessively below normal

1

a client with a paranoid disorder refuses to eat because he believes that the food being served in the mental health unit is poisoned. Which response is an appropriate way for the nurse to defuse the client's delusional thoughts 1. providing the client with food items in sealed containers 2. telling the client that he is safe now that he is in the hosp 3. setting firm limits and telling the client the food is not poisoned 4. ask the client if he would like to visit the kitchen to watch the food being prepared

1

the ED nurse is caring for an adult client who is a victim of family violence. Which priority information would be included in the discharge instructions? 1. shelters 2. calling the police 3. self defense classes 4. leaving the violent situation

1

the nurse employed in a mental health clinic is greeted by a neighbor in a local grocery store. The neighbor says to the nurse, "how is carol doing? carol is my best friend and is seen at your clinic every week". Which is the most appropriate response? 1. i cannot discuss any client situation with you 2. if you want to know about carol, you need to ask her yourself 3. only because you are worried about a friend, Ill tell you that Carol is improving 4. being a friend, you know that carol is having a difficult time and deserves privacy

1

the nurse has provided the family of a client with Alzeihmers disease with guidelines for caring for the client at home. Which statement indicates the education has been effective 1. family mentions encouraging physical activity during the day 2. the fam members indicate whether they will dress the client to prevent client frustration 3. will restrain at night if they wander 4. will feed client to ensure adequate nutrition

1

the nurse is conducting a group therapy session. During the session, a client diagnosed with mania consistently disrupts the group's interactions. Which intervention would the nurse initially implement? 1. setting limits on the client's behavior 2. asking the client to leave the group session 3. asking another nurse to escort the client out of the group session 4. telling the client that they will not be able to attend any future group sessions

1

the nurse is developing a plan of care for a client admitted to the mental health unit with a diagnosis of dissociative amnesia. which intervention should the nurse include in the plan 1. encouraging the client to perform self care activities 2. encourage the use of dissociation to cope with stress and anxiety 3. orienting the client and frequently reminding him of events in his past 4. making all decisions for the client to prevent him from feeling overwhelmed

1

the nurse is planning care for a client being admitted to the nursing unit who attempted suicide. Which priority intervention would the nurse include in the plan of care? 1. 1 to 1 suicide precautions 2. suicide precautions with 30 min checks 3. checking the whereabouts of the client Q 15 min 4. asking the client to report suicidal thoughts immediately

1

the nurse observes that a client is pacing, agitated and presenting aggressive gestures. The client's speech pattern is rapid, and affect is belligerent. Based on these observations, which is the nurse's immediate priority of care? 1. provide safety for the client and other clients on the unit 2. provide the clients on the unit with a sense of comfort and safety 3. assist the staff in caring for the client in a controlled environment 4. offer the client a less stimulating area in which to calm down and gain control

1

when reviewing the admission assessment, the nurse notes that a client was admitted to the mental health unit involuntarily. Based on this type of admission, the nurse would provide which intervention for this client? 1. monitor closely for harm to self or others 2. assist in completing an application for admission 3. supply the client with written information about their mental health problems 4. provide an opportunity for family members to discuss why they felt the admission was needed

1

the nurse in the mental health unit plans to use which therapeutic communication techniques when communicating with a client? select all that apply 1. restating 2. active listening 3. asking the client "why?" 4. maintaining neutral responses 5. providing acknowledgment and feedback 6. giving advice and approval/disapproval

1 2 4 5

which nursing interventions are appropriate for a hospitalized client with mania who is exhibiting manipulative behavior? Select all that apply 1. communicate expected behaviors to the client 2. ensure that the client knows that they are not in charge of the unit 3. assist the client in identifying ways of setting limits on personal behaviors 4. follow through about the consequences of behavior in a non punitive manner 5. enforce rules by informing the client that they will not be allowed to attend group sessions 6. have the client state consequences fro behaving in ways that are viewed as unacceptable

1 3 4 6

the nurse would plan which goals for the termination stage of group development? select all that apply 1. the group evaluates the experience 2. the real work of the group is accomplished 3. group interaction involves superficial conversation 4. group members become acquainted with one another 5. some structuring of group norms, roles, and responsibilities takes place 6. the group explores members feelings about the group and the impending separation

1 6

a client diagnosed eith delirium becomes disoriented and confused at night. Which intervention would the nurse implement initially? 1. move the client next to the nurses station 2. use an indirect light source and turn off the TV 3. keep the tv and soft light on during the night 4. play soft music during the night and maintain a well lit room

2

a client who has been taking buspirone for 1 month returns to the clinic for a follow up assessment. The nurse determines that the medication is effective if the absence of which manifestation has occurred? 1. paranoid though process 2. rapid heartbeat/anxiety 3. alcohol withdrawal syndrome 4. thought broadcasting/delusions

2

a client with depression who is scheduled to undergo ECT for the first time says to the nurse, "im nervous about this treatment. Someone told me there's a risk for electrocution" The nurse should make which response? 1. did you HCP talk to you about this when you signed the informed consent 2. electrocution is not a risk associated with this treatment. lets discuss your concerns 3. electrocution can only happen during a thunderstorm. Thats why we always check the weather report before treatment 4. the side effects of this treatment are minimal, so don't worry. Your HCP can talk to you about them in greater detail if you'd like

2

a client. arrives at the clinic, extremely upset and crying and asks to talk to someone. She tells the nurse that her husband has just told her that he wants a divorce because he is in love with someone else. The client says I dont know what im going to do or how im going to deal with this. he was my whole life" which type of crisis does the nurse determine the client is experiencing? 1. disaster 2. situational 3. maturational 4. adventitious

2

a female client with anorexia nervosa is transferred to the mental health unit from a medical unit after being treated for an electrolyte imbalance. Which action does the nurse in the mental health unit plan to take to ensure adequate nutritional intake 1. being supportive but feeding the client if she refuses to eat 2. staying with the client during mealtimes and encouraging to eat 3. telling the client that an IV line or nasogastric tube will be inserted if she does not eat 4. asking client to call the nurse when she is done eating to count calorie intake and fluid intake

2

the nurse in the ED is caring for a young victim of sexual assault. The client's physical assessment is complete and physical evidence has been collected. the nurse notes that the client is withdrawn, distracted, tremulous, and bewildered at times. how would the nurse interpret these behaviors? 1. signs of depression 2. reactions to a devastating event 3. evidence that the client is at a high risk for suicide 4. indicative of the need for hospital admission

2

the nurse is caring for a client diagnosed with paranoid personality disorder who is experiencing disturbed thought process. In formulating a nursing plan of care, which best intervention would the nurse include? 1. increase socialization of the client with peers 2. avoid using a whisper voice in front of the client 3. begin to educate the client about social supports in the community 4. have the client sign a release of information to appropriate parties for assessment purposes

2

the nurse is performing a follow up teaching session with a client discharged 1 month ago. the client is taking fluoxetine. which information would be important for the nurse to obtain during this client visit regarding specific side/adverse effects of the medication 1. renal dysfunctions 2. GI dysfunction 3. problems with mouth dryness 4. problems with excessive sweating

2

the nurse is reviewing the assessment data of a client admitted to the mental health unit. The nurse notes that the admission nurse documented that the client is experiencing anxiety as a result of a situational crisis. The nurse plans care for the client, determining that this type of crisis could be caused by which event? 1. witnessing a murder 2. death of a loved one 3. fire that destroyed the client's home 4. a recent rape episode experienced by the client

2

the nurse is teaching a client who is being started on imipramine about the medication. The nurse would inform the client to expect maximum desired effects at which time period following initiation of the medication? 1. in 2 months 2. in 2-3 weeks 3. during the first week 4. during the 6th week of administration

2

the nurse notes that a client with schizophrenia who is receiving an antipsychotic medication is moving the mouth, protruding the tongue and grimacing while watching TV. the nurse determines that the client is experiencing which medication complication? 1. parkinsonism 2. tardive dyskinesia 3. hypertensive crisis 4. neuroleptic malignant syndrome

2

the police arrive at the ED with a client who has lacerated both wrists. Which is the initial nursing action? 1. administer an anti anxiety agent 2. assess and treat the wound 3. secure and record a detailed history 4. encourage client to ventilate feelings

2

when planning the discharge of a client with chronic anxiety, which is the most appropriate maintenance goal? 1. suppressing feelings of anxiety 2. identifying anxiety producing situations 3. continuing contact with a crisis counselor 4. eliminating all anxiety from daily situations

2

which behavior observed by the nurse indicates suspicion that a depressed adolescent client may be suicidal? 1. client runs out of the therapy group swearing at the leader 2. gives away a DVD player and a cherished autographed pic of a performer 3. becomes angry while speaking on the telephone 4. gets angry with a roommate who borrowed their clothes without asking

2

a client who has been diagnosed as having an antisocial personality is hospitalized after being involved in a fight. Which interventions included in the plan of care are most crucial. SATA 1. encourage client to place bets and play poker with other clients 2. assess the client for thoughts of suicide and report these if they occur 3. explain that he will need to spend time in his room if he assaults others 4. discuss the need to refrain from hurting staff and other clients 5. encourage to find contact information for those he has injured and to apologize

2 3 4

the nurse has been closely observing a client who has been displaying aggressive behaviors. the nurse observes that the behavior displayed by the client is escalating. which nursing intervention is most helpful to this client at this time? select all that apply 1. initiate confinement measures 2. acknowledge the clients behavior 3. assist the client to an area that is quiet 4. maintain a safe distance from the client 5. allow the client to take control of the situation.

2 3 4

a client is admitted with a recent history of severe anxiety following a home invasion and robbery. During the initial assessment interview, which statement by the client would indicate the the nurse that possible diagnosis of PTSD? Select all that apply. 1. in afraid of spiders 2. i keep reliving the robbery 3. i see that face everywhere i go 4. i dont want anything to eat now 5. i might have died over a few dollars in my pocket 6. i have to wash my hands over and over again many times

2 3 5

the nurse calls security and has physical restraints applied to a client who was admitted voluntarily when the client becomes verbally abusive, demanding to be discharged from the hospital. Which represents the possible legal ramifications for the nurse associated with these interventions? Select all that apply 1. libel 2. battery 3. assault 4. slander 5. false imprisonment

2 3 5

the nurse is planning activities for a client diagnosed with bipolar disorder with aggressive social behavior. Which activity would be most appropriate for this client? 1. chess 2. writing 3. board games 4. group exercise

2`

a 6 y/o child brought to the school nurse's office because the child is complaining of abdominal pain. During assessment of the child, the nurse notes the presence of bruises in the child's abdomen and back, as well as several cigarette burns and suspects child abuse. which priority action should the nurse plan to take? 1. documenting the bruises 2. asking the child how long his parents have been abusing him 3. contacting child protective services and law enforcement 4. calling the parents to ask them how the child sustained the bruises and burn marks

3

a client diagnosed with terminal cancer says to the nurse, "I am going to die, and I wish my family would stop hoping for a cure. I get so angry when they carry on like this. After all, I am the one who is dying". Which response by the nurse is therapeutic? 1. have you shared your feelings with your family? 2. i think we should talk more about your anger with your family 3. it sounds as if you are feeling angry that your family continues to hope for you to be cured 4. you are probably very depressed, which is understandable with such diagnosis

3

a client is admitted to a medical nursing unit with a diagnosis of acute blindness after being involved in a hit and run accident. When diagnostic testing cannot identify any organic reason why this client cannot see, a mental health consult is prescribed. The nurse plans care based on which mental health condition? 1. Psychosis 2. Repression 3. Conversion disorder 4. dissociative disorder

3

a client is being admitted to the mental health unit after an attempted suicide by hanging. the nurse can best ensure client safety by taking which action? 1. requesting a peer stays with them at all times 2. removing the client's clothes and placing a hospital gown on 3. assigning the client a staff member who will remain with the client at all times 4. admitting the client to a seclusion room where all potentially dangerous articles are removed

3

a client receiving tricyclic antidepressants arrive at the mental health clinic. Which observation would indicate that the client is following the medication plan correctly? 1. client reports not going to work for the past week 2. client complains of not being able to do anything anymore 3. client arrives at the clinic neat and appropriate in appearance 4. client reports sleeping 12 hours per night and 3-4 hours during the day

3

a client says to the nurse, "the federal guards were sent here to kill me". which is the best response by the nurse to the clients concern? 1. i dont believe this is true 2. the guards are not out to kill you 3. do you feel afraid that people are trying to hurt you 4. what makes you think the guards were sent to hurt you

3

a manic client begins to make sexual advances toward visitors in the dayroom. When the nurse firmly states that this is inappropriate and will not be allowed. The client becomes verbally abusive and threatens physical violence to the nurse. Based on the analysis of this situation, which intervention would the nurse implement? 1. place the client in seclusion for 30 min 2. tell the client that the behavior is inappropriate 3. escort the client to their room, with the assistance of other staff 4. tell the client that their telephone privileges are revoked for 24 hours

3

a moderately depressed client who has been hospitalized 2 days ago suddenly begins smiling and reporting that the crisis is over. The client says to the nurse, " im finally cured". based on the clients behavior and statement, which intervention would the nurse include in the plan? 1. suggesting a reduction of medication 2. allowing increased in room activities 3. increasing the level of suicide precautions 4. allowing the client off unit privileges

3

a survivor of sexual assault is brought to the ED by a neighbor. The nurse assists the client into a private examining room and conducts an interview with the client. The nurse explains the procedure for physical exam, and the client refuses the exam. Which action should the nurse take next? 1. obtaining a court order for the exam 2. tell the client that the exam cannot be refused 3. encouraging the victim to discuss reasons for refusing the exam 4. telling the victim that the exam must be performed to obtain evidence of the rape

3

a victim of a sexual assault is being seen in the crisis center. The client states, " I still feel as though the rape happen yesterday" even though it has been a few months. which is the most appropriate response? 1. you need to try to be realistic, the rape did not just occur 2. it will take some time to get over these feelings about your rape 3. tell me more about the incident that causes you to feel as though the rape has just occurred 4. what do you think you can do to alleviate some of your fears about being raped again

3

police officers bring a victim of physical and emotional abuse to the ED. They tell the nurse that this is the clients 5th visit to the department in the last 4 months because of violent attacks by her husband. After assessing and treating the client's physical wounds, the nurse prepares to conduct an interview on the client. Which finding does the nurse expect to note while interviewing her? 1. client has self esteem 2. client is angry and aggressive 3. accepts the blame for the attack 4. talkative, energetic, anxious

3

the nurse is caring for a client just admitted to the mental health unit and diagnosed with catatonic stupor. The client is lying on the bed in a fetal position. Which is the most appropriate nursing intervention? 1. ask direct questions to encourage talking 2. leave the client alone to minimize external stimuli 3. sit beside the client in silence with simple open ended questions. 4. take the client into the dayroom with other clients to provide stimulation

3

the nurse is conducting an initial assessment of a client in a crisis. when assessing the client's perception of the precipitating event that led to the crisis. which is the most appropriate question? 1. with whom do you live with 2. who is available to help you 3. what leads you to seek help now 4. what do you do to usually feel better?

3

the nurse is preparing a client with schizophrenia and a history of command hallucinations for the discharge by providing instructions on interventions for managing hallucinations and anxiety. Which statement in response to these instructions suggests to the nurse that the client has a need for additional information 1. my medications will help my anxious feelings 2. ill go to support group and talk about what i am feeling 3. when i have command hallucinations, ill call a friend for help 4. i need to get enough sleep and eat well to help prevent feeling anxious

3

the nurse observes that a client with a potential for violence is agitated, pacing up and down the hallway, and making aggressive and belligerent gestures at other clients. Which statement would be most appropriate to make to this client? 1. you need to stop that behavior now 2. you will need to be placed in seclusion 3. you seem restless. tell me what is happening 4. you will need to be restrained if you do not change your behavior

3

A client with a diagnosis of depression who has attempted suicide says to the nurse "I should have died. Ive always been a failure. Nothing ever goes right for me". Which therapeutic response would the nurse make? 1. You have everything to live for 2. why do you see yourself as a failure 3. feeling like this is all part of being depressed 4. It sounds as if you've been feeling like a failure for a while

4

The nurse visits a client at home. The client states, "I haven't slept at all the last couple of nights." Which response by the nurse demonstrates therapeutic communication? 1. really? 2. why havent you been able to sleep 3. sometimes i have trouble sleeping too 4. tell me more about your sleep over the past few nights

4

a 16 y/o boy is brought to ED by ambulance. The mother of the client tells the nurse that she called the ambulance because her son's behavior was bizarre and violent and because he was having hallucinations. The mother says that she is concerned bc her son has been hanging out with the wrong crowd and suspects he has been doing cocaine. During the assessment, which sign of cocaine intoxication should the nurse expect to note? 1. lethargy 2. bradycardia 3. hypotension 4. dilated pupils

4

a client gives the home health nurse a bottle of clomipramine. The nurse notes that the medication has not been taken by the client in 2 months. Which behavior observed in the client would validate noncompliance with this medication? 1. complaints of insomnia 2. complaints of hunger and fatigue 3. pulse rate less than 60 bpm 4. frequent handwashing with hot soapy water

4

a client is admitted to the mental health unit with a diagnosis of depression. The nurse would develop a plan of care for the client that includes which intervention? 1. encouraging quiet reading and writing for the first few days 2. identification of physical activities that will provide exercise 3. no socializing activities until the client asks to participate in milieu 4. a structured program of activities in which the client can participate

4

a client who is an alcoholic is brought to the hospital by his family because he has begun to exhibit signs of confusion and mental deterioration. After a physical examination, the health care provider determines that the client has Korsakoff syndrome. ON the basis of this finding, what does the nurse expect the HCP to prescribe? 1. Gingko biloba 2. muscle relaxer 3. antiviral medication 4. Thiamine (vit B1)

4

a client who is hospitalized in a mental health unit becomes argumentative and agitated, pacing the hallway. He suddenly begins to glare at another client and makes verbal threats. Which initial action should the nurse take? 1. telling the client that if he continues to make threats, he will be placed in seclusion 2. approaching the client, putting an arm around his wrist, and asking what is bothering him. 3. obtaining assistance from other members of the nursing staff and taking him to his room 4. acknowledging the client's anger and providing the client options for dealing with his behavior

4

a depressed client on an inpatient unit says to the nurse, "my family would be better off without me", which is the best response? 1. have you talked to your family about this 2. everyone feels this way when they are depressed 3. you will feel better once your medication starts to work 4. you sound very upset. are you thinking of hurting yourself?

4

a female client is brought to the ED by a neighbor after experiencing sudden paralysis in both arms. On assessing the client, the nurse discovers that the paralysis developed 2 days after the clients husband told her he wanted a divorce. The client says "oh well i guess i will eventually learn to live without my arms working". during assessment the nurse learns that the client is a computer programmer and needs her hands to perform her work. which action by the nurse should she do FIRST 1. request a psychiatric consult 2. contact a crisis intervention team 3. conducting a thorough mental health assessment 4. assessing the client for any physical basis for the paralysis

4

an employee from the dietary department is stocking the kitchen of a mental health unit. A client who is nearby says to the nurse, "the terrorists are here and they are out to get me. they are putting anthrax in the sugar containers" which response should the nurse give 1. there are not any terrorists in the kitchen 2. no one is trying to hurt you. it is all in your mind 3. you will scare the other clients if they hear you talking that way 4. the person you saw is from the dietary department, he is here to stock the unit kitchen

4

during an interview a client reveals having an interest in sexual activity with others of the same sex. which nursing action is most appropriate 1. asking why it is perferred 2. asking how long it has been going on 3. encourage to discuss with a minister 4. encourage to discuss how this effects overall health

4

on review of the client's record, the nurse notes that the admission was voluntary. Based on this information, the nurse plans care, anticipating which client behvaior? 1. fearfulness regarding treatment measures 2. anger and aggressiveness directed towards others 3. an understanding of the patho and symptoms of the diagnosis 4. a willingness to participate in the planning of the care and treatment plan

4

the nurse is creating a plan of care for a client in a crisis state. When developing the plan, the nurse would consider which factor? 1. a crisis state indicates that the client has a mental illness 2. a crisis state indicates that the client has an emotional illness 3. presenting symptoms in a crisis situation are similar for all clients experiencing a crisis 4. a client's response to a crisis is individualized, and what constitutes a crisis for one client may not constitute a crisis for another client

4

the nurse is working with a client who, despite making a heroic effort, was unable to rescue a neighbor trapped in a house fire. Which client focused action would the nurse plan to engage in during the working phase of the nurse patient relationship? 1. exploring the clients ability to function 2. exploring the clients potential for self harm 3. inquiring about the clients perception or appraisal of why the rescue was unsuccessful 4. inquiring about and examining the clients feeling for any that may block adaptive coping

4

the nurse makes a routine scheduled visit to an older client and finds the client alone in his room while the son and daughter are enjoying a picnic in the back yard. When the nurse asks the client why he is not at the picnic w his family the client tearfully responds "my son told me to stay in my room because I make a mess of myself when i eat and i am a burden. which action by the nurse is most appropriate 1. telling that client that it is best to stay in his room 2. telling the client that she will stay with him for a while so he does not have to be alone 3. asking the client whether he would like to go home with her for the day 4. recognize that emotional abuse is taking place and contact the local agency for older adult protective services

4

the nurse, performing an assessment of a client, asks about the use of substances such as alcohol or drugs. The client tells the nurse that he has been using alcohol for a long time. Which question should the nurse as to determine whether the client is physically dependent on alcohol 1. do people criticize your drinking 2. have you ever felt guilty about drinking 3. have you ever felt as though you should try to cut down on your drinking 4. have you noticed that you have had to drink increasing amounts of alcohol

4

what is the most appropriate nursing action to help manage a manic client who is monopolizing a group therapy session? 1. ask the client to leave the group for this session only 2. refer the client to another group that includes manic clients 3. tell the client to stop monopolizing in a firm but compassionate manner 4. thank the client for the inout, but inform the client that others now need a chance to contribute

4

when a client is admitted to an inpatient mental health unit with the diagnosis of anorexia nervosa, a cognitive behavior approach is used as part of the treatment plan. The nurse plans care based on which purpose of this approach? 1. providing supportive environment 2. examining intrapsychic conflicts and past issues 3. emphasizing social interaction with the clients who withdraw 4. helping the client to examine dysfunctional thoughts and beliefs

4

a client admitted to the mental health unit has a diagnosis of moderate depression. The nurse formulating a care plan is concerned about the clients nutritional status. Which nursing interventions should be included in the care plan? Select all that apply 1. daily weight 2. filling out menu for the client 3. restricting visitors during mealtimes 4. including the dietitian in meal planning 5. providing small high calorie, high protein snacks throughout the day

4 5


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