Psych Exam 1
The nurse and the client are using therapeutic communication skills. Which statements are true of concrete and abstract messages? Select all that apply.
Abstract messages include figures of speech that are difficult to interpret. —- Abstract messages are important for accurate information exchange. Concrete messages require the listener to interpret what the speaker says. Concrete messages are clear, direct, and easy to understand. —- Abstract messages are best used for persons who are anxious.
The nurse is providing care for a client with a diagnosis of depression. How can the nurse best address the client's needs in the biologic domain?
Administering the client's scheduled dose of citalopram ——- Evaluating the client's response to milieu therapy Teaching the client communication techniques Encouraging the client to join a support group
Client: "I was so upset about my sister ignoring me when I was talking about being ashamed."Nurse: "How are your stress reduction classes going?"This is a nontherapeutic response because the nurse has ...
Changed the topic. —— Offered advice Challenged the client Demonstrated disapproval
A client being discharged from a substance use disorder treatment program asks the nurse for a date. The nurse talks to the client about the importance of a therapeutic relationship and its characteristics. Which technique is the nurse using to manage this situation?
Defining boundaries. ——- Defining therapy Letting the client down gently Reprimanding the client
A male client comes to the emergency department and appears to be intoxicated. He fell and hit his head at home and has a minor laceration. The nurse asks when his last drink was. The client states that he didn't have a drink and "never touches the stuff." The client is exhibiting which defense mechanism?
Denial —— Devaluation Displacement Dissociation
The nurse and client are discussing discharge plans. Which statement should the nurse make that demonstrates empathy for the client's fear of returning to a group home environment?
Don't you think you're ready to be independent?" "It can be scary to leave a place that you trust and feel supported." —— "Just think of all of the things you can do in the home that you can't do here." "You are more than ready to get out of here. Have faith in your accomplishments."
The nurse provides care to a client who is diagnosed with bipolar disorder. Which statement indicates to the nurse that the client is experiencing empowerment?
I still need help remembering to take my medication." "My parents do my grocery shopping so that I have food to eat." "I independently set up my medication box each Sunday evening." ——- "My roommate reminds me to eat dinner because my thoughts are scattered."
A client with depression has been admitted to the mental health unit and is attending group therapy sessions as part of the treatment. The client asks the nurse leading the group if the nurse is married or has a girlfriend. The nurse responds, "I am curious what made you ask this question; however, what is important is how you are feeling today." The nurse's response is what?
Inappropriate, because the client was just making small talk about the nurse's personal situation to get to know the nurse better. Inappropriate, because the nurse should have answered to establish a therapeutic relationship. Appropriate, because the nurse is not in a relationship or married. Appropriate, because the focus of the therapeutic relationship is the client, not the nurse. ——
A key element in the definition of mental illness is that
The individual must have difficulties in functioning that cause distress and/or impairment of some type. —— The individual must need medications in order for the diagnosis to be of mental origin. The individual must acknowledge that he or she is having difficulties in functioning. The individual must have physiological symptoms that match with behaviors that are
Which observation should lead the nurse manager to recognize that countertransference is affecting the therapeutic effectiveness of an individual nurse on the unit?
The nurse frequently refers to an elderly, cognitively impaired client as "my granny". —- The nurse is referred to as being in a relationship with a client by that client, and the client wants the nurse to accompany the client to the prom The nurse begins to experience the symptoms of depression and calls out sick The nurse asks to be transferred to another unit to avoid burnout and to work with different disorders
When describing the effects of stigma by society on individuals with mental illness, which would a nurse most likely include?
The stigma is the same for any person with a mental illness. ——- The person being stigmatized is often considered part of the group. The stigma tends to increase the more the person's behavior differs from the norm. The person being stigmatized typically has a moderately high self-esteem.
While in the dayroom, the nurse observes a client begin to respond to visual hallucinations by shouting, "Keep those slimy monsters away from me!" A visitor on the unit is overheard saying, "It must be hard to work with crazy people like that." How should the nurse best advocate for this client?
The term 'crazy' is stigmatizing and should not be used to describe someone who is experiencing hallucinations." ——- "No one can control their hallucinations, and it is hurtful and unkind of you to call one of our clients 'crazy.' " "I appreciate that the behavior is unpleasant for you, so I will take the client somewhere private." "The client cannot be held responsible for the behavior; it is a result of a visual hallucination."
The nurse is creating a plan of care for a client that has been experiencing stress responses frequently. Which overall goal(s) of care are of the highest priority?
adaptive coping skills will be developed. —- positive social support will be received no further stress reactions will be experienced cognitive appraisal will be received
A psychiatric-mental health nurse is teaching the family members of a client about strategies for engaging with their family member who has recently been diagnosed with posttraumatic stress disorder (PTSD). The nurse should encourage the client's family to:
anticipate that the client is likely to be irritable and withdrawn at times. ——- expect that the client will sleep for short periods of time, several times per day. create social interaction for the client even if the client is actively opposed to socializing. ensure the client takes benzodiazepines at the same time each day.
A 22-year-old client has been manipulative of staff and disruptive in the milieu. Although she is not dangerous to herself or others, she has created problems on the unit and clearly is not making progress. The nurses offer prescribed medication, but she consistently refuses "any drugs." The staff realizes that legally this client can
be coerced to accept treatment be committed by her family to receive needed treatment have her family sign permission for treatment continue to refuse treatment ——-
The nurse is caring for a client with schizophrenia who has been stable on antipsychotics for several years and who now reports the desire to find employment. Which recovery oriented principle is this client demonstrating?
empowerment —— informed choice self-stigma advocacy
A nurse is conducting a presentation for a local community group about mental health and mental illness. One of the participants asks the nurse, "How do you know that a person is mentally healthy?" Which characteristic(s) would the nurse include when responding to the participant? Select all that apply.
functions in their role. —— has erratic behaviors adapts to changes. —— is irresponsible contributes to society —-
The nurse is demonstrating countertransference with a client with which behavior?
maintaining a professional demeanor with the client discussing the client's behavior with a family member explaining to the client that it is normal for the client to feel attachment relating to the client because the client resembles a favorite cousin ——
A nursing student is preparing to take an exam and is experiencing anxiety as a heightened sense of awareness. Which level of anxiety would this correspond with?
mild. —- moderate severe panic
What does desensitization refer to?
A systematic way to replace a panic response with a relaxation response. ——- A cognitive technique for replacing a worry with a positive statement Exposing the client to an anxiety-producing stimulus for 1 to 2 hours (flooding) Teaching the client to ignore or become immune to anxiety-producing situations
The advanced practice psychiatric mental health registered nurse is leading a support group for adolescents who have recently experienced disruptions in their life. What participant most warrants further assessment for posttraumatic stress disorder?
An adolescent who has committed uncharacteristic acts of violence since the death of the adolescent's mother —— An adolescent who often redirects the conversation to the subject of the adolescent's sister's death An adolescent who began smoking in the weeks after discovering a dead body in a park An adolescent who states "I've lost my soulmate" after the death of a boyfriend or girlfriend in an accident
The nurse is assisting a client with obsessive-compulsive disorder (OCD) during a behavior therapy session. How does the nurse assist the client with "response prevention"? Select all that apply.
Assist the client to confront situations that increase anxiety. Help the client to accept thoughts and related anxiety. —- Teach that anxiety will recede without disastrous consequences. —- Assist the client to take charge of thoughts and manage anxiety. —- Inform the client that the disorder is hereditary.
A client is being seen in the mental health clinic because of relapse. The client has been nonadherent with the medication regimen. The nurse reinforces the advantages of taking medications. The nurse is using which ethical principle?
Autonomy Justice Beneficence. —— Veracity
The nurse is taking care of a client from a culture different from the nurse's culture. How might the nurse best provide culturally competent care?
Behave as appropriate for the nurse's culture. Find out as much as possible about a client's cultural values, beliefs, and health practices. —— Know what to expect from many cultural groups. Validate knowledge about culture through continuing education.
Safe alcohol withdrawal usually is accomplished with the administration of which medication classification?
Benzodiazepines. —- Antipsychotics. Antidepressants Anticonvulsants
Which medication classifications used in the treatment of panic disorder can cause physical dependence?
Benzodiazepines. —- Selective serotonin reuptake inhibitors (SSRIs) Tricyclic antidepressants (TCAs) Serotonin-norepinephrine reuptake inhibitors (SNRIs)
When discussing a client's mental health condition with someone other than the health care team, the nurse must be aware of which of the following?
Breach of confidentiality. —- Assault Battery Neglect
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 ...
Confrontation Countertransference Incongruence Transference ——
A client seeks medical attention for injuries caused by intimate partner violence (IPV). Which information would the nurse provide to support open communication with the client? Select all that apply.
Ensure client confidentiality. —- Explain mandatory reporting requirements. —— Meet in a quiet private place for the interaction. — Ask for reasons the client stays in the relationship. Explain that refusing to talk about the situation will make it worse.
nurse is gathering information about a health history of a person who has experienced violence. Which are important caring behaviors a nurse should implement during the interview? Select all that apply.
Establish trustworthiness. —- Maintain a nonjudgmental attitude. — Ask questions regarding religious background and preference. Secure open communication. —- Discuss the nurse's personal feelings on victims of violence.
A nurse is gathering information about a health history of a person who has experienced violence. Which are important caring behaviors a nurse should implement during the interview? Select all that apply.
Establish trustworthiness. —- Maintain a nonjudgmental attitude. —- Ask questions regarding religious background and preference. Secure open communication. —- Discuss the nurse's personal feelings on victims of violence.
The nurse is caring for a client who has voiced reluctance to take prescribed antidepressant medication due to fear of side effects. When using the informed choice model, how should the nurse respond to the client's reluctance?
It is important for you to know all of the benefits and risks of taking this medication so you can make the right decision for your health. I can discuss this information with you and direct you to more resources." ——- "People are always trying to exert power over others. It is important that you feel comfortable making this decision, because the experts do not always know what is best for everybody." "Your doctor will have explained everything you need to know in order to to safely take this medicine. If you decide not to take it, you are likely going to end up in the hospital again." "I recommend that you talk it over with your family. They can help you make your decision about this medication."
Crisis theory holds that an imbalance exists between the client's problem and the immediate resources available to deal with it. Which of the following best describes the active crisis state?
It lasts for 2 to 3 months if left untreated. It lasts about 4 to 6 weeks. —- It is a pathological response to a normal problem. It is often remedied by the appropriate medication.
During an interview, a patient tells the nurse, "I walked into that room full of people and I felt like my heart was going to beat out of my chest." The nurse can best apply the communication technique of interpretation by providing what reply?
It sounds like going into that situation made you feel very anxious. ——- You felt that way because of your illness, not because of the people in the room. That feeling is likely rooted in the rejection you felt when you were a child. What would it take for you to feel differently in a situation like that?
Which ethical principle involves the right of the client to make his or her own decisions?
Justice Autonomy. —— Beneficience Nonmaleficence
A family member of a client diagnosed with a mental illness asks the nurse, "What is mental illness, really?" Which information would the nurse mostlikely integrate into the response? Select all that apply.
Mental illness can cause significant distress —- Mental illness is primarily due to social/cultural factors. Mental illness can interfere with a person's ability to function. —— Individuals suffering from mental illness are usually able to cope effectively with daily life. Individuals suffering from mental illness may experience dissatisfaction with relationships and self. ——
A nurse in the emergency department is planning for a client with mental illness to be placed in an inpatient hospitalization. Which is a criterion assessed by the nurse is condition of this type of admission?
Nonadherence with medication administration at home Presents a clear danger to self or others. —— Develops new symptoms of the illness Has no support systems in the community
A nurse is giving a presentation on mental health promotion to college students. One student asks the nurse to explain the difference between normal anxiety and an anxiety disorder. Which response is best?
People with anxiety disorders experience a fight-or-flight response when threatened." "People with anxiety disorders generally find that the anxiety interferes with daily activities." —- "Normal anxiety does not result in feelings of dread or restlessness." "Normal anxiety occurs in response to everyday stressors."
The nurse is developing the plan of care for a client with an opioid addiction using person-centered care. Which intervention should the nurse include in the plan of care?
Plan a meeting with the client and the client's family members. Teach client about newly prescribed medications. Discuss the client's feelings about support groups as part of treatment. —— Instruct the client about the possibility of restraints needed during withdrawal symptoms.
When caring for a client who is experiencing the symptomology of acute stress disorder, the nurse recognizes the importance of minimizing the client's risk for developing which condition?
Posttraumatic stress disorder. — Emotional numbness Dissociative amnesia Paranoia
client is seeking counseling due to difficulty coping with being a victim of a violent attack 16 months ago. Which will the nurse assess for when determining the major elements of posttraumatic stress disorder (PTSD)? Select all that apply.
Reexperiencing the trauma through dreams or recurrent and intrusive thoughts. —- Showing emotional numbing such as feeling detached from others —- Being on guard, irritable, or experiencing hyperarousal —— Feeling mildly anxious Occurring 2 weeks after the trauma
Which of the following rights could the psychiatric client lose when admitted to a locked, inpatient psychiatric treatment facility?
Right to communicate with an attorney Right to schedule his or her own time. ——— Right to send and receive mail without censorship Right to safety from harm
All of the following are civil rights afforded to all people receiving mental health care except which of the following?
Right to leave the hospital when involuntarily committed. —— Right to refuse treatment Right to send and receive sealed mail Right to have or refuse visitors
The nurse on the behavioral health unit reinforces to the clients that they can earn off-unit privileges for daily use of socially appropriate behavior. Which behavioral modification technique is the nurse employing?
Systematic desensitization Negative reinforcement Classical conditioning Operant conditioning —-
A client experiences panic attacks when confronted with riding in elevators. The nurse is teaching the client ways to relax while incrementally exposing the client to getting on an elevator. Which technique will the nurse employ to assist the client with overcoming the phobia?
Systematic desensitization —- Flooding Cognitive restructuring Combination therapy
The mental health nurse is interviewing a client of a different cultural background regarding the client's health care practices. The nurse understands that cultural competence is important in the care of this client. Cultural competence in health care can be bestdescribed as what?
The ability to understand and effectively interact with individuals or members of a community from diverse cultural or ethnic backgrounds. —— Knowing the characteristics of each individual cultural group in America A combination of a person's beliefs about cultural values and knowledge about his or her own culture The client's ability to tell the health care provider about his or her cultural beliefs and practices
The nurse is interviewing a client who has been diagnosed with posttraumatic stress disorder (PTSD) after being randomly attacked with a gun. The client describes a recent event where the client panicked and jumped for cover when a car backfired on the street. How should the nurse best interpret this event?
The client is experiencing hyperarousal. —— The client lacks effective coping strategies The client experienced an episode of derealization The client temporarily dissociated with the traumatic event
What assessment finding would suggest to the nurse that the client with posttraumatic stress disorder (PTSD) is experiencing dissociation?
The client is often "staring into space" and has no idea how much time has passed. ——- The client states that usual coping mechanisms are ineffective The client states that the client's mood is "alright" when appearing to be in some distress The client experiences awakenings during the night and is unable to fall asleep again
The nurse determines that Pavlov's theory of classical conditioning is demonstrated with which client behavior?
The client states "I need my pain medication" when the physical therapist comes for therapy. The client states "I can't stop crying every time I think about the death of my mother." The client states "My stomach is growling" with the sound of the food cart in the hallway. ——- The client states "I think my doctor is out in the hallway talking with my family members."
The nurse is assessing clients in the behavioral health unit. For which client will the nurse identify that a prn medication should be administered to control anxiety?
The client with a high anxiety level experiencing disorganized thoughts. —— A client that will be discharged home with a spouse today. A client that is experiencing mild anxiety prior to talking with the therapist. A client that is admitted and being oriented to the unit and states, "I am nervous."
The client has been admitted to the hospital involuntarily for the treatment of depression. Which criteria provides legal justification for the client's involuntary admission?
The client's treatment will require pharmacologic interventions. The client poses a threat to the self. —— The client's primary care provider is a psychiatrist. The client's family is unable to manage the client's care.
The psychological domain contains which theoretical bases? Select all that apply.
Thoughts. —- Relationships Feelings. — Culture Behavior. —-
A nurse is preparing a plan of care for a client with anxiety. Which elements would the nurse likely include? Select all that apply.
Using appropriate coping skills. —- Identifying treatment modalities. —- Involving family for support, if appropriate. — Providing supportive feedback. —- Using restraint when panic develops
The nurse is planning short-term goals to improve the client's self-esteem and treatment adherence. Which action by the nurse would assist the client in achieving these goals?
Using shared decision-making model to plan the client's care. —— Using the informed choice model to plan the client's care Referring the client for peer support after discharge Assisting the client in finding employment after discharge
The nurse is evaluating a group of clients who received person-centered care for mental health issues. Which client situation indicates that the outcomes were met?
client return the patient-satisfaction survey after being discharged. A client expresses the need to move out of the client's parents' house. A client who was homeless is living in a halfway house and maintaining a job. —- A client reports not having any suicidal ideations and is still feeling depressed.
The nurse is providing psychological first aid for a client after a hurricane who is exhibiting confusion. Which intervention is most appropriate for the client?
providing consolation administering an antianxiety medication giving clear communication. —- assisting with prioritization of resources
While interviewing a client, the nurse imagines what it would be like to be in the client's situation and how it would feel. What is the nurse demonstrating?
rapport empathy. —— self-awareness projection
A client describes herself as "mortified" that she has been diagnosed with bipolar disorder and states, "I don't know how I'll ever be able to face my family." The nurse should:
select interventions that address the client's self-stigma. ——- challenge the fact that the client is labeling herself. emphasize to the client that her disorder is curable. educate the client about the fact that she has an ethical responsibility to inform her family.
A client is being discharged from the hospital. After being out of work for several weeks, the client states, "I am ready to go back to work and be productive." The nurse determines this is a positive expression of which concept?
self-efficacy. —— modeling transference disconnection
What are characteristics of complicated grief? Select all that apply.
trouble accepting the death. —- excessive bitterness. —- increased trust of others feeling that life has meaning exacerbation of depression. —-
