Psych questions for test 5

How could each of these situations influence the milieu? (Discussion) 1. Staff member is on the desk phone arguing loudly with a roommate about a phone bill. The clients clearly see and hear the conversation. 2. The nurse takes report from admissions about a patient being admitted soon and announces to other staff: "We've got another incoming hit! Man your battle stations!" 3. A client has been physically restrained; unit activities get cancelled.

(discussion)

A client asks the nurse for medication because she is feeling nervous. With a therapeutic milieu, which of the following would the nurse do INITIALLY? a. Talk with the client about her feelings. b. Suggest that the client play a game with another client. c. Advise the client to lie down in her room until she feels better. d. Administer lorazepam (Ativan) 1 mg PO PRN as ordered for anxiety.

a. Talk with the client about her feelings.

A psychiatric treatment team is planning care for a client who was involuntarily admitted for treatment of depression and suicide ideation. One understanding utilized in planning client care is that the client is: a. able to refuse medication. b. able to demand and obtain release. c. in need of a guardian. d. considered to be incompetent.

a. able to refuse medication

A client in a long-term care facility refuses to take his oral medications. The nurse threatens the client and tells him that, if the medication isn't taken, restraints will be applied and the medication will be given by injection. The nurse's statement constitutes which legal tort? a. Assault b. Battery c. Negligence d. Right to refuse care

a. assault

The premise underlying behavioral therapy is: a. Behavior is learned and can be modified. b. Behavior is a product of unconscious drives. c. Motives must change before behavior changes. d. Behavior is determined by cognitions. Change in cognitions produces new behavior.

a. behavior is learned and can be modified

Which nursing intervention is likely to be part of the care of a psychiatric client on day 1 of hospitalization? a. Provide a safe environment b. Assign therapeutic activities c. Order admission labs d. Educate the client about medications

a. provide a safe environment

In the stages of grief which statement would be evidence of denial? a. "I should have made him go to the doctor earlier." b. "I can't believe it, I am too young to die." c. "I cannot stop crying." d. "I have gotten used to sleeping in the bed alone."

b. "I can't believe it, I am too young to die."

Which technique would be an example of operant conditioning for a mute child? a. Spanking the child for silence b. Giving the child a reward for speaking c. Having the child observe others who are talking d. Teaching the child relaxation and guided imagery

b. Giving the child a reward for speaking

Which of the following statements is true about milieu therapy? a. Punishments are used to eliminate negative behaviors. b. Interpersonal therapy is the foundation for the treatment. c. Staff perform all activities of care for the clients. d. The environment is structured so that stresses are used as opportunities for learning.

b. Interpersonal therapy is the foundation for the treatment.

A nurse is planning a peer group discussion about the Diagnostic and Statistical Manual Disorders, 5th edition (DSM-5). Which of the following information is appropriate to include in the discussion? SELECT ALL THAT APPLY a. The DSM-5 includes client education handouts for mental health disorders. b. The DSM-5 establishes diagnostic criteria for individual mental health disorders. c. The DSM-5 indicates recommended pharmacological treatment for mental health disorders. d. The DSM-5 assists nurses in planning care for client's who have mental health disorders. e. The DSM-5 indicates expected assessment findings of mental health disorders.

b. The DSM-5 establishes diagnostic criteria for individual mental health disorders. d. The DSM-5 assists nurses in planning care for client's who have mental health disorders. e. The DSM-5 indicates expected assessment findings of mental health disorders.

A client was seen in the ED for acute mania (bipolar disorder). The mental health worker assessed that the client was not able to consent for admission to behavioral health. The magistrate then ordered the patient to be admitted. Which term describes the status of this client? a. Admitted with consent (voluntary) b. Emergency involuntary commitment (TDO) c. Competent d. Legally incompetent

b. emergency involuntary commitment (TDO)

A nurse decides to put a client who has a psychotic disorder in seclusion overnight because the unit is very short-staffed, and the client frequently fights with other clients. The nurse's actions are an example of which of the following torts? a. Invasion of privacy b. False imprisonment c. Assault d. Battery

b. false imprisonment

The client is 4 years old. He sometimes grabs toys away from his brother stating "i want that!" Freud would interpret this behavior as a product of impulses originating from the: a. ego b. id c. superego d. preconscious

b. id

Which client problem would be most suited to the use of interpersonal therapy? a. Altered sensory perceptions b. Impaired social interactions c. Medication noncompliance d. Dysfunctional grieving

b. impaired social interactions

The client just lost his wife of 40 years. He tells the nurse, "I cannot live without her." The most therapeutic response would be: a. "Remember, she is no longer suffering." b. "Each day will get a little better." c. "Her death is a terrible loss for you." d. "Your friends will help you cope."

c. "Her death is a terrible loss for you."

What is done to reinforce the democratic form of self-government on a milieu unit? a. Clients are allowed to set forth the type of punishment for a peer who violates the rules. b. Clients may choose whether or not to attend daily community meetings. c. Clients participate in decision making that affects management of the unit. d. Professional staff do not attend community meetings.

c. Clients participate in decision making that affects management of the unit.

For the nurse managing the therapeutic milieu, which factor is significant to determine the need for a PRN medication? a. Is the client willing to accept the medication? b. Have less restrictive alternatives been tried without success? c. Does the client's behavior indicate possible danger to self, others, or the environment? d. Will administration of the medication make the work of the staff easier or safer?

c. Does the client's behavior indicate possible danger to self, others, or the environment?

Which theorist identified the need to belong and beloved? a. Peplau b. Beck c. Maslow d. Erikson

c. Maslow

The nurse is reviewing medical records to look for violations of client's rights. Which would signal a possible violation? a. Lack of treatment plan in the chart b. Client's belongings searched at admission c. Physical restraint used to prevent possible harm to self d. Client was placed on a continuous 1:1 observation

c. Physical restraint used to prevent possible harm to self

A client tells a nurse, "Don't tell anyone, but I hid a sharp knife under my mattress in order to protect myself from my roommate, who is always yelling at me and threatening me." Which of the following actions should the nurse take? a. Keep the client's communication confidential, but talk to the client daily, using therapeutic communication to convince him to admit to hiding the knife. b. Keep the client's communication confidential but watch the client and his roommate closely. c. Tell the client that this must be reported to the health care team because it concerns the health and safety of the client and others. d. Report the incident to the health care team, but do not inform the client of the intention to do so.

c. Tell the client that this must be reported to the health care team because it concerns the health and safety of the client and others.

A client admitted under an involuntary commitment order became physically aggressive and assaulted another client on the unit. The doctor ordered seclusion and restraints for 24 hours and a one-time intramuscular injection of haloperidol stat. Which of the following statements is INCORRECT? a. The client has the right to humane treatment. b. The client has the right to an attorney. c. The client has the right to be released against medical advice. d. The client has the right to request another doctor be in charge of his care.

c. The client has the right to be released against medical advice.

Which statement is true concerning informed consent? a. Minors are permitted to give informed consent. b. The professional nurse and physician may both obtain informed consent. c. The client must be fully informed regarding treatment, tests, surgery, and the risks and benefits prior to giving informed consent. d. Mentally competent and incompetent clients can legally give informed consent.

c. The client must be fully informed regarding treatment, tests, surgery, and the risks and benefits prior to giving informed consent.

In which circumstance may the nurse legally and ethically disclose confidential information about a client? a. The human immunodeficiency virus (HIV) status of a single male client to his family members. b. The diagnosis of pancreatic cancer to the client's significant other. c. The diagnosis of an uncontrolled seizure disorder of a taxi driver to a state agency. d. The client is 32 weeks pregnant with twins and is legally separated.

c. The diagnosis of an uncontrolled seizure disorder of a taxi driver to a state agency.

Which concept refers to the role of the professional nurse in client advocacy? a. The nurse makes decisions for clients who can't make decisions for themselves. b. The nurse follows the basic standards of care and hospital policies and procedures for providing care for clients. c. The nurse promotes and protects the client's interests and rights. d. The nurse adapts a paternalistic approach to the care for clients.

c. The nurse promotes and protects the client's interests and rights.

The client tells the nurse that after a year and a half since her husband died she feels like being around other people. This is evidence of: a. denial b. anger c. acceptance d. bargaining

c. acceptance

The nurse planning care for a 14-year-old needs to take into account that the developmental task of adolescence is to: a. establish trust. b. gain autonomy. c. achieve identity. d. develop a sense of industry.

c. achieve identity

The client tells the nurse they went to therapy following an accident in which they were the only survivor. "I feel better after talking about my thoughts regarding being the only survivor." This is an example of: a. Milieu therapy b. Behavior modification c. Cognitive therapy d. Interpersonal therapy

c. cognitive therapy

The nurse recognizes which strategy as a cognitive approach? a. reveal their dreams b. take prescribed medications c. examine their thoughts about their disease d. choosing an applicable diagnosis from the DSM V

c. examine their thoughts about their disease

The nurse recognizes that the overall goal of inpatient psychiatric treatment is: a. maintenance of stability in the community. b. medication compliance. c. stabilization and return to the community. d. better communication skills.

c. stabilization and return to the community

A cognitive therapist would help a client restructure the thought, "I'm stupid!" to: a. "I'm not as smart as others." b. "Things usually go wrong for me." c. "Things like this shouldn't happen to anyone." d. "What I did was stupid."

d. "what i did was stupid"

The client's fiancé died in an automobile accident several days ago. The client is crying and experiencing feelings of guilt and anger. The nurse assesses this behavior as: a. reorganization b. denial c. acceptance d. depression

d. depression

Peplau believed that when assessing a patient, it is important to assess for: a. Sleep patterns b. Defense mechanisms c. Cognitive Distortions d. Level of anxiety

d. level of anxiety

Peplau believed that within the nurse-patient relationship, the nurse must exercise: a. Good physical assessment skills b. Sound Ethics c. Self Actualization d. Self Awareness

d. self awareness