mental health exam 1

According to Maslow's hierarchy of needs, the most basic needs category for nurses to address is: a. physiological b. safety c. love and belonging d. self-actualization

a

When discussing therapy options, the nurse should provide information about interpersonal therapy to which patient? Select all that apply. a. The teenager who is the focus of bullying at school b. The older woman who has just lost her life partner to cancer c. The young adult who has begun demonstrating hoarding tendencies d. The adolescent demonstrating aggressive verbal and physical tendencies e. The middle-aged adult who recently discovered her partner has been unfaithful

a, b, e

A client is preparing to attend a Gamblers Anonymous meeting for the first time. The nurse should tell the client that which is the first step in this 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

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 provides an educational session on client rights. Which statement by a member of the session demonstrates the best understanding of the nurse's role regarding ensuring that each client's rights are respected? 1. "Autonomy is the fundamental right of each and every client." 2. "A client's rights are guaranteed by both state and federal laws." 3. "Being respectful and concerned will ensure that I'm attentive to my clients' rights." 4. "Regardless of the client's condition, all nurses have the duty to value client rights."

3

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 other manic clients. 3. Tell the client to stop monopolizing in a firm but compassionate manner. 4. Thank the client for the input, but inform the client that others now need a chance to contribute.

4

The nurse administers each of the following drugs to various patients. The patient who should be most carefully assessed for fluid and electrolyte imbalance is the one receiving: a. lithium (Eskalith) b. clozapine (Clozaril) c. diazepam (Valium) d. amitriptyline

a

Which nursing assessments are directed at monitoring a patient's fight-or-flight response? Select all that apply. a. Blood pressure b. Heart rate c. Respiratory rate d. Abdominal pain e. Dilated pupils

a, b, c, e

Based on Maslow's hierarchy of needs, physiological needs for a restrained patient include: Select all that apply. a. Private toileting, oral hydration b. Checking the tightness of the restraints c. Therapeutic communication d. Maintaining a patent airway

a, b, d

Implied consent occurs when no verbal or written agreement takes place prior to a caregiver delivering treatment. Which of the following examples represents implied consent? a. The mother of an unconscious patient saying okay to surgery b. Care given to a heroin overdose victim c. Immobilizing a patient who has refused to take medication d. Signing general intake paperwork with specific parameters

b

Recognizing the frequency of depression among the American population, the nurse should advocate for which mental health promotion intervention? a. Including discussions on depression as part of school health classes b. Providing regular depression screening for adolescent and teenage students c. Increasing the number of community-based depression hotlines available to the public d. Encouraging senior centers to provide information on accessing community depression resources

b

Which statement about mental illness is true? a. Mental illness is a matter of individual nonconformity with societal norms. b. Mental illness is present when irrational and illogical behavior occurs. c. Mental illness changes with culture, time in history, political systems, and the groups defining it. d. Mental illness is evaluated solely by considering individual control over behavior and appraisal of reality.

b

A patient is telling a tearful story. The nurse listens empathically and responds therapeutically with: a. "The next time you find yourself in a similar situation, please call me." b. "I am sorry this situation made you feel so badly. Would you like some tea?" c. "Let's devise a plan on how you will react next time in a similar situation." d. "I am sorry that your friend was so thoughtless. You should be treated better."

c

When considering the suggestions of Hildegard Peplau, which activity should the nurse regularly engage in to ensure that the patient stays the focus of all therapeutic conversations? a. Assessing the patient for unexpressed concerns and fears b. Evaluating the possible need for additional training and education c. Reflecting on personal behaviors and personal needs d. Avoiding power struggles with the manipulative patient

c

A client admitted voluntarily for treatment of an anxiety disorder demands to be released from the hospital. Which action should the nurse take initially? 1. Contact the client's health care provider (HCP). 2. Call the client's family to arrange for transportation. 3. Attempt to persuade the client to stay "for only 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 his food is being poisoned. Which communication technique should the nurse 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

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? She is my best friend and is seen at your clinic every week." Which is the most appropriate nursing 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're worried about a friend, I'll tell you that she is improving." 4. "Being her friend, you know she is having a difficult time and deserves her privacy."

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 should 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 his or her mental illness. 4. Provide an opportunity for the family 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. Listening 3. Asking the client "Why?" 4. Maintaining neutral responses 5. Providing acknowledgment and feedback 6. Giving advice and approval or disapproval

1, 2, 4, 5

A client diagnosed with delirium becomes disoriented and confused at night. Which intervention should the nurse implement initially? 1. Move the client next to the nurses' station. 2. Use an indirect light source and turn off the television. 3. Keep the television and a soft light on during the night. 4. Play soft music during the night, and maintain a well-lit room.

2

A client diagnosed with terminal cancer says to the nurse, "I'm 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'm the one who's 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. "You're feeling angry that your family continues to hope for you to be cured?" 4. "You are probably very depressed, which is understandable with such a diagnosis."

3

A client says to the nurse, "The federal guards were sent to kill me." Which is the best response by the nurse to the client's concern? 1. "I don't 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

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. "I see." 2. "Really?" 3. "You're having difficulty sleeping?" 4. "Sometimes I have trouble sleeping too."

3

A client is admitted to the mental health unit with a diagnosis of depression. The nurse should 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 with a diagnosis of depression who has attempted suicide says to the nurse, "I should have died. I've always been a failure. Nothing ever goes right for me." Which response by the nurse demonstrates therapeutic communication? 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. "You've been feeling like a failure for a while?"

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 behavior? 1. Fearfulness regarding treatment measures 2. Anger and aggressiveness directed toward others 3. An understanding of the pathology and symptoms of the diagnosis 4. A willingness to participate in the planning of the care and treatment plan

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 should the nurse engage in during the working phase of the nurse-client relationship? 1. Exploring the client's ability to function 2. Exploring the client's potential for self-harm 3. Inquiring about the client's perception or appraisal of why the rescue was unsuccessful 4. Inquiring about and examining the client's feelings for any that may block adaptive coping

4

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

4

A male patient reports to the nurse, "I'm told I have memories of childhood abuse stored in my unconscious mind. I want to work on this." Based on this statement, what information should the nurse provide the patient? a. To seek the help of a trained therapist to help uncover and deal with the trauma associated with those memories. b. How to use a defense mechanism such as suppression so that the memories will be less threatening. c. Psychodynamic therapy will allow the surfacing of those unconscious memories to occur in just a few sessions. d. Group sessions are valuable to identify underlying themes of the memories being suppressed.

a

In an outpatient psychiatric clinic, a nurse notices that a newly admitted young male patient smiles when he sees her. One day the young man tells the nurse, "You are pretty like my mother." The nurse recognizes that the male is exhibiting: a. Transference b. Id expression c. Countertransference d. A cognitive distortion

a

Which statement made by a patient demonstrates a healthy degree of resilience? Select all that apply. a. "I try to remember not to take other people's bad moods personally." b. "I know that if I get really mad I'll end up being depressed." c. "I really feel that sometimes bad things are meant to happen." d. "I've learned to calm down before trying to defend my opinions." e. "I know that discussing issues with my boss would help me get my point across."

a, d, e

What assessment question is focused on identifying a long-term consequence of chronic stress on physical health? a. "Do you have any problems with sleeping well?" b. "How many infections have you experienced in the past 6 months?" c. "How much moderate exercise do you engage in on a regular basis?" d. "What management techniques to you regularly use to manage your stress?"

b

When considering stigmatization, which statement made by the nurse demonstrates a need for immediate intervention by the nurse manager? a. "Depression seems to be a real problem among the teenage population." b. "My experience has been that the Irish have a problem with alcohol use." c. "Women are at greater risk for developing suicidal thoughts then acting on them." d. "We've admitted several military veterans with posttraumatic stress disorder this month."

b

Which drug group calls for nursing assessment for development of abnormal movement disorders among individuals who take therapeutic dosages? a. SSRIs b. antipsychotics c. benzodiazepines d. tricyclic antidepressants

b

Which question should the nurse ask when assessing for what Sullivan's Interpersonal Theory identifies as the most painful human condition? a. "Is self-esteem important to you?" b. "Do you think of yourself as being lonely?" c. "What do you do to manage your anxiety?" d. "Have you ever been diagnosed with depression?"

b

You realize that your patient who is being treated for a major depressive disorder requires more teaching when she makes the following statement: a. "I have been on this antidepressant for 3 days. I realize that the full effect may not happen for a period of weeks." b. "I am going to ask my nurse practitioner to discontinue my Prozac today and let me start taking a monoamine oxidase inhibitor tomorrow." c. "I may ask to have my medication changed to Wellbutrin due to the problems I am having being romantic with my wife." d. "I realize that there are many antidepressants and it might take a while until we find the one that works best for me."

b

Epidemiological studies contribute to improvements in care for individuals with mental disorders by: a. Providing information about effective nursing techniques. b. Identifying risk factors that contribute to the development of a disorder. c. Identifying individuals in the general population who will develop a specific disorder. d. Identifying which individuals will respond favorably to a specific treatment.

b, d

A nurse makes a post on a social media page about his peer taking care of a patient with a crime-related gunshot wound in the emergency department. He does not use the name of the patient. The nurse: a. Has not violated confidentiality laws because he did not use the patient's name. b. Cannot be held liable for violating confidentiality laws because he was not the primary nurse for the patient. c. Has violated confidentiality laws and can be held liable. d. Cannot be held liable because postings on a social media site are excluded from confidentiality laws.

c

Besides antianxiety agents, which classification of drugs is also commonly given to treat anxiety and anxiety disorders? a. Antipsychotics b. Mood stabilizers c. Antidepressants d. Cholinesterase inhibitors

c

When considering facility admissions for mental healthcare, what characteristic is unique to a voluntary admission? a. The patient poses no substantial threat to themselves or to others b. The patient has the right to seek legal counsel c. A request in writing is required before admission d. A mental illness has been previously diagnosed

c

When considering stress, what is the primary goal of making daily entries into a personal journal? a. Providing a distraction from the daily stress b. Expressing emotions to manage stress c. Identifying stress triggers d. Focusing on one's stress

c

Which nursing intervention demonstrates the ethical principle of beneficence? a. Refusing to administer a placebo to a patient. b. Attending an in-service on the operation of the new IV infusion pumps c. Providing frequent updates to the family of a patient currently in surgery d. Respecting the right of the patient to make decisions about whether or not to have electroconvulsive therapy

c

Which statement demonstrates the nurse's understanding of the effect of environmental factors on a patient's mental health? a. "I'll need to assess how the patient's family views mental illness." b. "There is a history of depression in the patient's extended family." c. "I'm not familiar with the patient's Japanese's cultural view on suicide." d. "The patient's ability to pay for mental health services needs to be assessed."

c

A nurse is assessing a patient who graduated at the top of his class but now obsesses about being incompetent in his new job. The nurse recognizes that this patient may benefit from the following type of psychotherapy: a. Interpersonal b. Operant conditioning c. Behavioral d. Cognitive-behavioral

d

Linda is terrified of spiders and cannot explain why. Because she lives in a wooded area, she would like to overcome this overwhelming fear. Her nurse practitioner suggests which therapy? a. Behavioral b. Biofeedback c. Aversion d. Systematic desensitization

d

Which action reflects therapeutic practices associated with operant conditioning? a. Encouraging a parent to read to their children to foster a love for learning b. Encouraging a patient to make daily journal entries describing their feelings c. Suggesting to a new mother that she spend time cuddling her newborn often during the day d. Acknowledging a patient who is often verbally aggressive for complimenting a picture another patient drew

d