mental health modules 8-11
A university student presents to the ED after having a panic attack at school during an exam. Which of the following identifies the type of crisis that the patient is experiencing?
Anticipated life transition
Which nursing intervention has highest priority for a patient with bulimia nervosa? Assist the patient to identify triggers to binge eating. Provide remedial consequences for weight loss. Assess for signs of impulsive eating. Explore needs for health teaching
Assist the patient to identify triggers to binge eating.
The nurse is running a psychoeducational group on anger management . The form of leadership style for this type of group is: lasseiz-faire democratic authoritative universal
Authoritative
Which remark would the nurse expect to hear during the working stage of group therapy? "My problems are very personal and private; how do I know you people will not tell others what you hear in group?" "I have enjoyed this group; hard to believe that only a few weeks ago I couldn't even bring myself to talk here." "One thing everyone seems to have in common is that sometimes it's hard to be truly honest with those you love most." "I don't think I agree with that; it might help you, but it seems like it would upset your family."
"I don't think I agree with that; it might help you, but it seems like it would upset your family."
A patient, Mary, has talked constantly throughout the group therapy session. She has repeated the same material several times. Other members were initially attentive then became bored, inattentive, and finally sullen. Which intervention would be most effective for the nurse leader to take? "Most of you have become quiet. I'm wondering if it might be related to concerns you may have about how the group is progressing today." "Mary has been doing most of the talking. I think it would be helpful for everyone to tell Mary how that has affected your experience of the group." "I noticed that as the group went on, most members became quiet, then disinterested, and now seem almost angry. What is going on?" "Mary, you have been doing most of the talking, and others have not had much chance to speak as a result. Could you please yield to others now
"Most of you have become quiet. I'm wondering if it might be related to concerns you may have about how the group is progressing today."
A patient referred to the eating disorders clinic lost 35 pounds over 3 months. To assess eating patterns, the nurse should ask: "Do you often feel fat?" "Who plans the family meals?" "What do you eat in a typical day?" "What do you think about your present weight?"
"What do you eat in a typical day?"
A young female member in a therapy group relates to an older female patient as one might to a mother, accusing her of trying to control her whenever the older member offers observations or suggestions to her. Which therapeutic factor of a group is represented by this behavior? Instillation of hope Existential resolution Development of socializing techniques Corrective recapitulation of the primary family
Corrective recapitulation of the primary family
An 80 year old client admitted to the ED is experiencing fever, urinary frequency, and dysuria. The client is combative and seeing things that others do not see. Which nursing diagnosis reflects this client's problem? Disturbed sensory perception R/T infection AEB visual hallucinations Risk for violence: self directed R/T disorientation Self care deficit R/T decreased perceived need AEB disheveled appearance Social isolation R/T decreased self esteem
Disturbed sensory perception R/T infection AEB visual hallucinations
In working with a client with late state AD, which is priority intervention? Assist the client to consume fluids and food to prevent electrolyte imbalance Reorient the client to place and time frequently to reduce confusion and fear Encourage the client to participate in own ADLs to promote self esteem Assist with ambulation to prevent injury from falls
Help client consume fluids and food to prevent electrolyte imbalance
A client presents to the emergency department with an acute decrease in cognitive ability. The nurse's assessment should include which of the following? Select all that apply. Slow progression of symptoms Impaired attention and concentration Diminished appetite Symptoms diminish as the day progresses Oriented to time and place with no wandering
Impaired attention and concentration Orientated to time and place with no wandering
A nurse conducts group therapy on the eating disorders unit. Sessions are scheduled immediately after meals. What is the rationale? Provide a forum for journaling about foods eaten. Shift the patients' focus from food to psychotherapy. Promote processing of anxiety associated with eating. Focus on weight control mechanisms and food preparation
Promote processing of anxiety associated with eating
Countertransference
Refers to the nurse's behavioral and emotional response to the client
Which of the following interventions is appropriate for the nurse to use on clients with either delirium or dementia? For safety, use physical restraints with an aggressive client Approach quietly and touch the client before speaking Speak in a loud, firm voice to the client Reorient the client to the nurse with each contact
Reorient the client to the nurse with each contact
A patient has recently been under significant stress and worked long hours. At home, the patient watches television and eats until going to bed. The patient is too tired to exercise and has gained 25 pounds in 1 month. A desired outcome for the patient is to recognize anxiety that precedes binge eating and reduce it. Which intervention addresses the outcome? Teach stress-reduction techniques such as relaxation and imagery. Encourage the patient to design and implement an exercise program. Explore ways in which the patient may feel more in control of the environment. Encourage the patient to attend a support group such as Overeaters Anonymous.
Teach stress-reduction techniques such as relaxation and imagery.
A young man presents to the university health services complaining of symptoms of depression with anxiety. He reveals that his family has disowned him because he has decided to go to school in another town. The nurse's assessment would be that the family is most likely enmeshed and reacting to the patient's independence. true False
True
A patient in a group therapy session listens for a time and then remarks, "I used to think I was the only one who felt afraid. I guess I'm not as alone as I thought." This is an example of:
Universality
On discharge, a client diagnosed with dementia is prescribed donepezil hydrochloride (Aricept). Which of the following would the nurse include in the teaching plan for the client's family? Aricept is a sedative/hypnotic used for short term insomnia Aricept is an Alzheimer's treatment used for mild to moderate dementia Aricept is an antipsychotic used for clients diagnosed with dementia Aricept is an Antianxiety agent used to help with the anxiety of early stage dementia
Used for mild to moderate dementia
A client is admitted to an acute care facility with delirium caused by a serious urinary tract infection. Which of the following assessment data should the nurse expect to find? Select all that apply. Disorientation to time, place, person Ability to perform most self-care activities Normal and stable vital signs Wandering attention Perceptual disturbances Change in level of consciousness
Wandering attention Perceptual disturbances Change in level of consciousness
A client who is delirious yells out to the nurse: You are an idiot. Get me your supervisor" Which is the best nursing response in this situation? You need to calm down and listen to what I am saying You're very upset, I'll call my supervisor You're going through a difficult time. I'll stay with you. Why do you feel that my calling my supervisor will help anything?
You're going through a difficult time. I'll stay with you.
Transference
in psychoanalysis, the patient's transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent)