Mental Health Review - Nursing

Which goal would be priority for the child with autism spectrum disorder who has frequent episodes of self-biting and head-banging and needs help with feeding and toileting?

Remaining safe from self-inflicted injury

Which initial action would the nurse take when a male toddler with autism spectrum disorder suddenly runs to the wall and starts banging his head on it?

Restrain the toddler to prevent head injury

Which benefit would a client expect from joining a self-help group after being discharged from a mental health facility?

Getting support from group members

Which feeling would the nurse anticipate a manic client with bipolar 1 disorder is likely experiencing?

Grandeur

Which technique would be appropriate for clients who exhibit mild neurocognitive impairment?

Reality orientation

Which age group of hospitalized children will have the most difficulty with separation anxiety?

6 to 30 months

Which statement best defines a crisis?

A threat to equilibrium

Which term describes a display of anger that is socially unacceptable?

Aggression

Which behavior is characteristic of panic during a crisis?

Being physically immobile

During group therapy, which behavior indicates that the working phase has begun?

Cohesiveness

A client verbalizes anger toward the staff after being denied an unaccompanied day pass to leave the psychiatric facility. Which feeling is most likely to be the client's source of the anger?

Powerlessness

Which psychotherapeutic theory uses hypnosis, dream interpretation, and free association as methods to release repressed feelings?

Psychoanalytic model

Which type of group is Alcoholics Anonymous (AA)?

Self-help group

A client says, "Sky, flower, angry, green, opposite, blanket." Which term describes this type of communication?

Word salad

Which of these questions is included on the CAGE screening test for alcoholism?

"Have you ever felt bad or guilty about your drinking?"

Which statements meet the criteria for involuntary hospitalization?

"I'd like to end it all with sleeping pills." "The voices say I should kill all prostitutes."

Which response would the nurse make to a depressed, crying client on the evening of admission?

"You're crying. Let's talk about it."

Which clinical manifestation would best indicate to the nurse that the mental status of a client with schizophrenia and paranoid delusions is improving?

Ability to function effectively in activities of daily living

Which action would the nurse take for a client who is a psychologist and has questioned the authority of the treatment team and advised other clients that their treatment plans are wrong?

Accept that the client is unable to control this behavior while setting appropriate limits

According to Kubler-Ross' theory of death and dying, which stage is a terminally ill client displaying by gradually moving towards resolution of feelings about impending death?

Acceptance stage

Which action would be required of the client with alcohol use disorder who attends Alcoholics Anonymous (AA) meetings?

Acknowledging an inability to control the alcoholism

At which point in the daily routine do clients who experience alterations in perception tend to have more problems with vivid hallucinations?

After going to bed

Which substance is considered addictive in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)?

Alcohol Caffeine Cannabis Gambling Hallucinogens Antianxiety medications

Which nursing intervention would help a client who exhibits physical symptoms when stressed?

Assisting the client in developing new coping mechanisms

Which type of hallucination is the most common?

Auditory

Which action would the nurse take for a client with a diagnosis of conversion disorder manifesting as paralysis of the legs?

Avoid focusing on the client's physical symptoms

Which behavior is most commonly used by an individual with a phobic disorder?

Avoidance

Which statement is accurate for adolescent suicide behavior?

Boys are more likely to use lethal methods than are girls

When planning for a client's care during the detoxification phase of early alcohol withdrawal, which action would the nurse take?

Check on the client frequently

According to Alcoholics Anonymous, which member of the health care team has the primary responsibility for the success of the therapy and rehabilitation?

Client

An older adult seems to make up stories to fill in for memory lapses. Which behavior is the client displaying?

Confabulating

Which side effect would the nurse monitor for in a severely depressed client who received electroconvulsive therapy (ECT)?

Confusion immediately after the treatment

Which assessment finding would the nurse observe in a client with bipolar disorder, manic phase?

Constant singing

Which strategy would the nurse use to help a depressed, withdrawn client who exhibits sadness through nonverbal behavior?

Cope with painful feelings by sharing them

Which term describes a client who drinks 2 drinks per day with no negative consequences?

Daily drinker

Which term would the nurse use to describe the processes of a male client that he is the commander of an alien spaceship despite repeated reality orientation?

Delusion

The objective of a therapy group is to assist the members to change behavior so they are able to participate in life in a more satisfying manner. Which leadership style is best to achieve this objective?

Democratic, guiding

Place the five stages of grieving identified and described by Elisabeth Kubler-Ross in order of progression from first to last.

Denial Anger Bargaining Depression Acceptance

Which term describes the disturbance in mood and affect seen in clients who are depressed?

Dysphoric

Which speech pattern is a disturbed client displaying when she or he starts to repeat phrases that others have just said?

Echolalia

Which characteristic is most essential for the nurse to have in caring for clients with mental health disorders?

Empathy

Which action is the priority when the nurse is establishing a therapeutic environment for a client?

Ensuring the client's safety

When the nurse revises the care plan because the goals have not been met, which phase of the nursing process is being applied?

Evaluation

Which characteristic of clients with antisocial personality disorder would the nurse consider when planning care?

Exhibits lack of empathy for others

Which primary purpose does the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) serve?

Facilitates classification of mental disorders and guides the determination of diagnosis

Which reason would be likely for a client's anger and acting out when the nurse interrupts the hand-washing ritual of a client with obsessive-compulsive disorder?

Has overwhelming feelings of anxiety

According to Erikson's developmental psychosocial theory, which is expected by 20 years of age?

Having a coherent sense of self and planning to accomplish future goals

Which intervention would the nurse add to the plan of care for a client who engages in ritualistic behavior?

Help the client understand that the behavior is caused by maladaptive coping with increased anxiety

For a newly admitted client, which aspect of the therapeutic contract is the most important?

Helping the client define treatment goals and expectations

Which disorder is defined as a preoccupation with the fear of having a serious disease?

Hypochondriac disorder

An older client states, "I've lived a good life. I don't want to die, but I accept it as a part of life." According to Erikson's psychosocial stages of development, which developmental task has the client achieved?

Integrity

Which term or phrase would the nurse chart about thought processes to describe a client with schizophrenia who says, "Yes, it's March. March is Little Women. That's literal, you know."?

Loose associations

Which behavior is the client displaying when pretending to be ill?

Malingering

Which factor would precipitate a client's use of confabulation?

Marked memory loss

Which term describes the expected outcomes for a client who is admitted for a recurrent mental health problem?

Measurable objectives

Which level of anxiety enhances the client's learning abilities?

Mild

Which term describes the client's use of made-up words that have no meaning to other people?

Neologisms

Which substance would pose the greatest risk of addiction for clients attending an alcohol rehabilitation program?

Nicotine

Which action by the nurse would be priority for a male client with a history of schizophrenia who comes to the emergency department accompanied by his spouse?

Observing and evaluating his behavior

A hostile client with the diagnosis of schizophrenia, says, "The voices are saying that they are going to poison me because I'm bad." Which type of schizophrenic behavior is the client displaying?

Paranoid

Which relationship is the most important to the formation of personality?

Parent-child relationships

Which primary symptom would the nurse assess for in a boy who has encopresis?

Passing feces either voluntarily or involuntarily into inappropriate places

Which type of delusion would the nurse chart about a client that says, "I've figured out how foreign agents have infiltrated the news media. Now they want to shut me up."?

Persecution

In the acute phase of bipolar disorder, manic episode, which biopsychosocial need is the priority?

Physical

An older adult client reports flashbacks related to his experiences in Vietnam; he exhibits startle reactions and poor concentration. Which mental health disorder is associated with these symptoms?

Post-traumatic stress disorder (PTSD)

The nurse hears a child who was not invited to a sleepover say, "I have better things to do than go to that sleepover." Which defense mechanism would the nurse conclude the child is using?

Rationalization

Which defense mechanism would be exhibited when a client with alcohol use disorder states, "I function better when I'm drinking than when I'm sober."?

Rationalization

Which action would the nurse take for an adolescent with a long history of drug abuse, stealing, and refusal to comply with rules?

Serve as a role model for mature behavior while providing a structured setting

Which information can be found in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)?

Signs and symptoms associated with mental disorders

Which action would the nurse take when caring for a severely depressed client?

Sit down next to the client at frequent intervals

Which characteristic can be observed in abusive parents?

Social isolation Poor coping skills Family authoritarianism Feeling of no control over life Inability to seek help from others Expects child to satisfy needs for love

Which strategy would the nurse include in a plan of care for a client with Alzheimer disease?

Structure the environment for safety

Which initial inference would the nurse make about a psychiatric client curled up in the fetal position in the corner of the dayroom?

The client is feeling more anxious today

Which assessment data are the most important to obtain from a client in crisis?

The client's perception of the circumstances related to the crisis

Which individual is coping with issues concerning dependence versus independence?

Toddler

According to Erikson's psychosocial stages of development, mastery of which task increases a child's ability to cope with separation or pending separation from significant others?

Trust

Place the levels of development in their order of achievement according to Erikson's psychosocial stages of development.

Trust vs Mistrust Industry vs Inferiority Identity vs Role confusion Intimacy vs Isolation Generativity vs Stagnation Integrity vs Despair

For a client with an obsessive-compulsive disorder, which rationale explains the function of obsessions and compulsions?

Unconscious control of unacceptable feelings

Which consistent approach would the nurse use for a client with an antisocial personality disorder?

Warm and firm without being punitive

Which response would the nurse make when a female client confides to the nurse that she enjoys engaging in sex with multiple male adult sex partners simultaneously?

"What are you using for birth control and protection from sexually transmitted infections?"

Which response would the nurse make to a client that says, "I feel so guilty. None of this makes any sense. Everyone must really think I'm crazy," after performing a complex ritual?

"You're concerned about what other people are thinking about you."

Which type of sexual disorder describes a client who has a sexual obsession with shoes?

Fetishistic

Which action would the nurse take for a client with an obsessive-compulsive disorder who continually walks up and down the hall, touching every other chair and becomes upset if interrupted?

Allow the behavior to continue for a specified time, letting the client help set the time limits to be imposed

When providing a change-of-shift report, which explanation would the nurse use to describe a schizophrenic client who is experiencing opposing emotions simultaneously?

Ambivalence

An older adult says, "I regret so many of the choices I made during my life." According to Erikson's psychosocial stages of development, which developmental conflict has the client failed to accomplish?

Ego integrity vs Despair

Which characteristic uniquely associated with psychophysiological disorders would differentiate them from somatic symptom disorders?

Underlying pathophysiology

Which term would the nurse use to describe a client with schizophrenia who is vacillating between being happy and sad about going home?

Ambivalence

A recently widowed client says, "His death has complicated my life even more than the hassles he caused when he was alive!" Which term would best describe the marital relationship?

Ambivalent

Which sign/symptom occurs in anorexia nervosa?

Amenorrhea

Which term would the nurse use to describe a female client who states that she no longer enjoys any of the activities that she once found fun and pleasurable?

Anhedonia

Which prescribed treatment would a nurse anticipate for a client with severe, persistent, intractable depression and suicidal ideation?

Electroconvulsive therapy

Which factor would the nurse identify as likely related to the sleeplessness of a schizophrenic client who was transferred from a private room to a room with a roommate 3 days ago?

Fear of the other client

To keep the client with Alzheimer's disease who has hyperorality safe, which parameter would the nurse have the staff closely monitor?

For attempts at eating inedible objects

Which initial action would the nurse take to provide a therapeutic environment for a client who is withdrawn and reclusive?

Foster a trusting relationship

Which primary feeling would the nurse anticipate that clients with bulimia nervosa experience after an episode of bingeing?

Guilt

Based on Erikson's psychosocial stages of development, which task must a 30-year-old work through?

Intimacy versus isolation

Which description is correct for Alzheimer's disease?

Is a slow, relentless deterioration of the mind

For a hyperactive, manic client who exhibits flight of ideas, which rationale explains why the client is not eating?

Is too busy to take time to eat

Which behavior would indicate that a client with a long history of alcohol use disorder is ready for treatment?

Verbalizing an honest desire for help

Which action would the nurse take for a withdrawn client who suddenly screams, bursts into tears, and runs from the room to the far end of the hallway?

Walk to the end of the hallway where the client is standing