Mid-Term Mental Heath
A Red Cross nurse is working with tornado victims. The nurse is interviewing a client whose house was totally destroyed during the night by the tornado. The client's cat died as a result of the tornado. Which statement by the client does the nurse expect to hear? A) "I don't know. I can't feel anything right now. Nothing seems real." B) "Devastated. . . . I just feel totally devastated. I don't know how I can go on living." C) "I just want my insurance man to get here so I can file a claim. Everything I had is gone." D) "I always thought my cat would die peacefully in my arms. Now I'll never be able to hold her again."
A) "I don't know. I can't feel anything right now. Nothing seems real."
A client with bipolar disorder, having experienced a depressive episode, is prescribed lamotrigine. After educating the client on this medication, the nurse determines that the education was successful when the client makes which statement? A) "I need to notify my physician if I develop a skin rash." B) "I need to have my blood tested about once a month." C) "I have to watch how much salt I use every day." D) "This drug can affect my liver function."
A) "I need to notify my physician if I develop a skin rash."
A client asks the nurse whether he needs to alter any of his activities because he is taking lithium carbonate. Which responses would be most appropriate? A) "Increase your salt intake if an activity causes you to perspire heavily." B) "Wear sunscreen when you are going to be outdoors in the summer." C) "Drink less fluid than usual now that you are taking this drug." D) "No changes are necessary for strenuous activities you do outdoors."
A) "Increase your salt intake if an activity causes you to perspire heavily."
A hospitalized client diagnosed with depression asks the nurse, "Should I go home this weekend?" Which response by the nurse uses the technique of Reflection? A) "Should you go home for the weekend?" B) "Home means what to you?" C) "It sounds as if you don't want to go home this weekend." D) "I doubt that you really should go home this weekend."
A) "Should you go home for the weekend?"
The nurse is working with a client who will be signing a commitment to treatment statement. After teaching the client about this statement, the nurse determines the need for additional instruction when the client makes which statement? A) "Signing this statement means that I will not commit suicide." B) "I am agreeing to get emergency treatment if I have suicidal thoughts." C) "I will be open and honest about my feelings about treatment." D) "I am agreeing to participate in the necessary treatment for my condition."
A) "Signing this statement means that I will not commit suicide."
A client with bipolar disorder is receiving divalproex sodium as part of the treatment plan. When monitoring the client's blood level for this drug, which level would alert the nurse to the need to change the dosage? A) 30 ng/mL B) 55 ng/mL C) 75 ng/mL D) 115 ng/mL
A) 30 ng/mL
During assessment, a client tells the nurse that he follows Buddhist beliefs. The nurse would integrate understanding of which statement when developing the client's plan of care? A) Desire is the cause of all human suffering and misery. B) Self-indulgence is necessary to reach nirvana. C) Present behavior is based on current unhappiness. D) Visions can be achieved through personal meditation and contemplation.
A) Desire is the cause of all human suffering and misery.
A client is being released from the inpatient psychiatric unit with a diagnosis of schizophrenia and treatment with antipsychotic medications. After teaching the client and family about managing the disorder, the nurse determines that the education was effective when they state which symptom should be reported immediately? A) Elevated temperature B) Tremor C) Decreased blood pressure D) Weight gain
A) Elevated temperature
When engaged in a non therapeutic relationship, which action would the nurse identify as occurring first? A) Failure to recognize the client as a person with a need B) Client avoiding the nurse C) The nurse being perceived as rude D) Client feeling hopeless and frustrated
A) Failure to recognize the client as a person with a need
A nursing student is to provide a class presentation about interpersonal and psychoanalytic theories. As part of this presentation, the student is planning to address the major way these two categories differ. Which aspect would the student include as key to interpersonal theories? A) Human relationships B) Instincts C) Drives D) Potential for goodness
A) Human relationships
When describing the influence of Harry Stack Sullivan on psychiatric-mental health nursing, which major concept would the instructor address? A) Interpersonal relations B) Harmony between the individual and society C) Collective unconscious D) Unconditional positive regard
A) Interpersonal relations
A client is scheduled for a challenge test. Which information would the nurse include when explaining this test to the client? A) Intravenous administration of a substance to induce symptoms B) Application of electrodes to the scalp for monitoring C) Evaluation of electrical impulses recorded on graph paper D) Exposure to a flashing strobe light to elicit abnormal activity
A) Intravenous administration of a substance to induce symptoms
A nurse is giving a presentation to colleagues about the actions of neurotransmitters. The nurse correctly identifies which chemical as a neuropeptide? A) Melatonin B) Serotonin C) Glutamate D) Gamma-aminobutyric acid
A) Melatonin
After educating a group of students on the beliefs associated with the world's major religions, the instructor determines that additional teaching is needed when the students identify which beliefs are associated with Confucianism? A) People are born good. B) People are assigned to castes. C) Authority figures are respected. D) Self-responsibility leads to improvement.
A) People are born good.
The nurse is caring for a hospitalized client who has a disorder of the hypothalamus. When developing the client's plan of care, in which area would the nurse anticipate a problem? A) Sleep B) Constipation C) Speech D) Motor activity
A) Sleep
The nurse is providing a presentation for a group of health professionals aboutsuicide. Which would the nurse address as a major contributing factor to the rising suicide rate among men? A) Substance abuse B) Media influences C) Lack of conflict resolution skills D) Parenting practices
A) Substance abuse
A client who is hospitalized with depression tells the nurse,"I don't want to take the medication because I'm afraid I'll become suicidal."Which response by the nurse would be most appropriate? A)"Have you ever thought about hurting yourself?" B)"It's important that you take this medication." C)"I agree with you. I wouldn't want to take this medication either." D)"Another client took that medication, and he really felt better."
A)"Have you ever thought about hurting yourself?"
The nurse has been providing regular care to a client diagnosed with an anxiety-related disorder for the past 2 weeks. Which statement made by the nurse suggests a possible professional boundary issue? A)"I am going to rearrange my schedule today so we can spend more time talking." B)"We can meet at 2:30PM today to practice stress management techniques." C)"It would be helpful if your family attended your next session with me." D)"It is good to see you smiling today."
A)"I am going to rearrange my schedule today so we can spend more time talking."
A client comes to the emergency department reporting a severe pounding headache in the temples and a stiff neck. The client is flushed and diaphoretic, and has a racing pulse. The client is taking selegiline to treat depression. Which question by the nurse would be most important to ask at this time? A) "When did you last have blood drawn to check your drug level?" B) "What have you had to eat or drink today?" C) "Are you having any chest pain?" D) "Do you use any herbal remedies?"
B) "What have you had to eat or drink today?"
The nurse is providing care to a client who is hospitalized with a diagnosis of schizophrenia. Which statement would be appropriate for the nurse to include in the client's medical record? A) "Client stated that they had a good night with no complaints." B) "Reported that they are unable to sleep because he heard voices throughout the night." C) "Had a typical night without incidence of insomnia or nightmares." D) "Acted crazily throughout the night; kept hearing voices and noises."
B) "Reported that they are unable to sleep because he heard voices throughout the night."
A client with schizophrenia is prescribed clozapine because other medications have been ineffective. After educating the client and family about the drug, the nurse determines that the education was successful when they make which statement? A) "The client needs to have an electrocardiogram periodically when taking this drug." B) "We'll need to make sure that the client's blood count is checked at least weekly." C) "Toxic levels of the drug might develop if the client smokes cigarettes." D) "We need to watch to make sure that the client doesn't lose too much weight."
B) "We'll need to make sure that the client's blood count is checked at least weekly."
A client is prescribed medication for a psychiatric disorder. After 3 days, the client reports being constipated. Which instruction should the nurse give the client? A) "You need to eat more high-protein foods such as meat and peanut butter." B) "You need to eat more fruits and vegetables and drink more water." C) "Ask your psychiatrist to prescribe a stool softener for you." D) "This side effect should disappear within a week or so."
B) "You need to eat more fruits and vegetables and drink more water."
A client is involuntarily committed without a court order. The nurse understands that the emergency, short-term hospitalization can occur for how long? A) A maximum of 24 hours B) 48 to 92 hours C) three to five days D) One week
B) 48 to 92 hours
When assessing a client with depression, the client states,"I just feel so sad and hopeless. I just don't care anymore. I don't even enjoy doing crossword puzzles like I used to." The nurse documents this finding as indicative of condition? A) Dysthymic disorder B) Anhedonia C) Delusion D) Psychosis
B) Anhedonia
A nurse is developing a plan of care for a client experiencing expressive aphasia. The nurse incorporates knowledge that the client most likely has sustained damage to which area of the brain? A) The postcentral gyrus B) Broca area C) Basal ganglia D) The hippocampus
B) Broca area
The nurse is caring for a client who has experienced damage to the parietal lobes of the brain. The nurse anticipates that the client will have difficulty with which activity? A) Perceiving sensory input B) Calculating a math problem C) Seeing objects in front of him D) Speaking fluently
B) Calculating a math problem
A psychiatric-mental health nurse is providing care for a client with a mental disorder. The client is participating in the decision-making process. The nurse interprets this as which component of recovery? A) Self-direction B) Collaborative C) Person-centered D) Holistic
B) Collaborative
The nurse is caring for a client with major depression. The client tells the nurse,"I'm just not sure that life is worth living." The nurse documents which nursing diagnosis as the priority? A) Self-esteem, Low, related to depressive episode B) Hopelessness related to symptoms of depression C) Anxiety related to lack of energy for self-care activities D) Thought Processes, Disturbed, related to memory loss and depression
B) Hopelessness related to symptoms of depression
A nurse is describing uncomplicated grief during a presentation. Which statement should the nurse include in the presentation? A) Uncomplicated grief differs from normal grief because it lasts longer. B) Most bereaved persons experience uncomplicated grief. C) Uncomplicated grief is primarily loss associated with death. D) This type of grief is less painful and disruptive than normal grief.
B) Most bereaved persons experience uncomplicated grief.
When engaged in therapeutic communication with a client who has a mental disorder, what is most important for the nurse to keep in mind? A) The nurse should self-disclose when indicated. B) The client is the primary focus of the interaction. C) The nurse should have an empathetic relationship with the client. D) The client's conversations should be recorded.
B) The client is the primary focus of the interaction.
The nurse is reviewing the electronic health records of several clients diagnosed with major depression. The nurse identifies which client is most likely to commitsuicide? A) Divorced man B) Widowed man C) Woman living with a roommate D) Married woman
B) Widowed man
The nurse is screening clients for risk factors associated with limited or no access to health care. Which client should the nurse identify as having the highest risk? A. The 5-year-old child who lives in the city and requires treatment for leukemia. B. The 10-year-old child who lives on a farm and requires treatment for depression. C. The 23-year-old client is a veteran and requires treatment for post-traumatic stress disorder (PTSD). D. The 20-year-old client who is homeless and requires treatment for diabetes mellitus.
B. The 10-year-old child who lives on a farm and requires treatment for depression.
A nurse is presenting a discussion for a local community group about suicide. Which comment from an audience member indicates the need to clarify the information? A) "Warning signs about the person's intention often occur." B) "People who are suicidal are undecided about living or dying." C) "Asking about suicide, may put the idea in people's heads." D) "People who talk about suicide need to be taken seriously."
C) "Asking about suicide, may put the idea in people's heads."
The nurse is caring for a 70-year-old client with a psychiatric disorder who has been prescribed a number of medications. When educating the client on the medications, which explanation would be most appropriate? A) "Your stomach empties more quickly as you age; therefore, you may feel the effect of your medications almost immediately." B) "Your entire GI system speeds up, so your medications are digested much more quickly. Therefore, it is important that you not drive after you take your medications." C) "Because of your age and related changes in liver functioning, you may have medication levels in your system with the potential to be toxic." D) "Because of age-related circulation changes, your body will be able to deliver therapeutic doses of your medication to select body sites more quickly."
C) "Because of your age and related changes in liver functioning, you may have medication levels in your system with the potential to be toxic."
A son brings his father to the clinic and tells the nurse that his father has begun to act strangely in the past few days, with unprovoked outbursts of anger. After the incidents, the father expresses remorse for his outburst. The son says,"I've never seen him act this way."Which question is most appropriate for the nurse to ask next? A) "Does your father have a history of an anxiety disorder, such as panic disorder?" B) "Has your father exhibited previous problems expressing anger appropriately?" C) "Has your father suffered any traumatic injury to his brain recently?" D) "Has your father injured the back of his head or neck in the past week?"
C) "Has your father suffered any traumatic injury to his brain recently?"
A nurse working on the psychiatric unit receives a telephone call from the employer of one of the clients on the unit. The employer asks to be sent a copy of Mr.Murray's latest laboratory work and psychological testing results so Mr. Murray's Medical records in employee health can be kept up-to-date. Based on the nurse's knowledge about issues surrounding breach of confidentiality, which response would be the most appropriate? A) "I'm sorry; we're not allowed to give out that information about our client." B) "I'll have to get the client's signed consent before we can send that information to you." C) "I am unable to acknowledge whether or not a Mr. Murray is a client on this unit." D) "Sure, give me your address, and I will see that the information is sent to you."
C) "I am unable to acknowledge whether or not a Mr. Murray is a client on this unit."
A psychiatric mental health nurse is working with a client who is being treated for depression. Which client statement would indicate that their spirituality is intact? A) "My church friends came to visit me this past Sunday afternoon." B) "Nothing will ever be the same again; my life is not worth living." C) "I know I am as well off as I can be under the circumstances." D) "I know God must be punishing me for all my sins."
C) "I know I am as well off as I can be under the circumstances."
A psychiatric client is talking to the nurse about why they are hospitalized. The client begins to discuss their relationship with their same-sex partner. The client describes the things in their relationship that cause discomfort, and the client asks the Nurse, "Should I break up with my partner?" Which response by the nurse would be most effective in building rapport between the client and nurse? A) "Of course you should; being gay is just not natural." B) "Yes, I think you should pursue building a relationship with someone of the opposite sex." C) "It sounds like you're beginning to be uncomfortable in this relationship." D) "You need to focus on yourself rather than the relationship right now"
C) "It sounds like you're beginning to be uncomfortable in this relationship."
A nurse is explaining recovery to the family of a client diagnosed with a mental disorder. Which statement would be most appropriate for the nurse to include about this process? A) "It is a step-by-step process from being ill to being well." B) "The client focuses mainly on the emotional aspects of their condition." C) "The client is helped to live a meaningful life to their fullest potential." D) "Although peer support is important, self-acceptance is essential."
C) "The client is helped to live a meaningful life to their fullest potential."
A migrant worker is brought to the emergency department because of an injury, and it soon becomes evident that the client cannot speak English. A nurse on duty offers to find an interpreter so the client can communicate with the medical staff. The a nurse's offer is an example of which type of nursing intervention? A) Milieu therapy B) Conflict resolution C) Cultural brokering D) Structured interaction
C) Cultural brokering
The nurse observes an adult client who has been taking antipsychotic medications for 8 months. The client is smacking their lips and blinking their eyes rapidly. The nurse also observes a protruding tongue. Which action by the nurse would be most appropriate? A) Ask whether the client has been experiencing side effects. B) Contact the client's physician for a different medication order. C) Document the client's symptoms of tardive dyskinesia. D) Instruct the client to begin tapering off the medication.
C) Document the client's symptoms of tardive dyskinesia.
The nurse is caring for a group of hospitalized clients with various psychiatric diagnoses. The nurse identifies which client as having the greatest risk for a suicideattempt? A) Man with bipolar I disorder B) Woman with acute stress disorder C) Man with major depressive disorder D) Woman with somatoform disorder
C) Man with major depressive disorder
A psychiatric-mental health client has an advance care directive on their medical record. A clinician provides treatment that disregards the client's directive. The clinician would be liable for which of the following? A) Assault B) Battery C) Medical battery D) False imprisonment
C) Medical battery
A nurse is presenting information about psychotic disorders to a client's family. The family demonstrates a need for more discussion when they make which statement about schizophreniform disorder? A) The duration of the illness is usually less than 6 months. B) Symptoms must be present for at least 1 month for the diagnosis. C) The majority of individuals with the disorder recover completely. D) The individual experiences hallucinations and/or delusions
C) The majority of individuals with the disorder recover completely.
A nurse is working as part of the multidisciplinary team and developing a plan of care for a client who is receiving recovery-oriented treatment. Which of the following would the nurse integrate into this plan? A) Focusing primarily on the mind B) Limiting support from others C) Using hope as motivation D) Avoiding underlying trauma
C) Using hope as motivation
The nurse is leading a support group on the mental health unit. Which action should the nurse take first? A. Empower each client to share as much or as little as desired within the group. B. Promote comfort by allowing each client to find a place to sit that makes the client comfortable within the room. C. Establish a connection by greeting each client by name and thanking each for joining the group. D. Encourage each client to invite a peer support person to come with him or her to the group sessions.
C. Establish a connection by greeting each client by name and thanking each for joining the group.
A 25-year-old legal secretary is seeking counseling because of a recent unexpected job loss. Which question would be most appropriate for the nurse to use in assessing the client's response to this loss? A) "What happened to cause you to lose your job?" B) "How did you feel immediately after being told you no longer had a job?" C) "How do you expect yourself to be able to handle this situation?" D) "How have you responded to previous stressful situations?"
D) "How have you responded to previous stressful situations?"
When assessing a client with a mental illness, the nurse determines that the client is experiencing label avoidance when the client states which of the following? A) "I'm the cause of my illness." B) "I'll never be able to function in the world." C) "I'm as crazy as everybody thinks I am." D) "I really don't need to see anyone."
D) "I really don't need to see anyone."
A client is being treated for prostate cancer; his prognosis is very poor. The client has a strong faith, and he has been active in his church for many years. He is concerned about his health and the challenges he faces as his cancer progresses.Which comment by the nurse reflects the Most appropriate spiritual nursing intervention for the client? A) "I'll take you to visit my church if you can get a pass." B) "You have to belong to the same church I do if you're going to go to heaven." C) "Would you like me to bring you a guided imagery audiotape?" D) "We can pray together if you'd like."
D) "We can pray together if you'd like."
A nurse administers a prescribed dose of lithium at 8PM. The nurse should schedule a specimen to be obtained for a blood level at which time? A) 10PM B) 12AM C) 4AM D) 8AM
D) 8AM
A client who has been taking clozapine for 6 weeks visits the clinic reporting fever, sore throat, and mouth sores. The nurse notifies the client's physician because the nurse suspects which condition? A) Severe anemia B) Neuroleptic malignant syndrome C) Encephalitis D) Agranulocytosis
D) Agranulocytosis
The nurse is reviewing the medical record of a client diagnosed with depression and notes that the client has been prescribed mirtazapine. The nurse identifies this agent as being in which drug category? A) Selective serotonin reuptake inhibitor B) Cyclic antidepressant C) Norepinephrine dopamine reuptake inhibitor D) Alpha-2 antagonist
D) Alpha-2 antagonist
A psychiatric-mental health nurse is integrating Carl Rogers' theory into the plan of care for a client with a mental illness. The nurse incorporates understanding of this theory by acknowledging that the therapist accomplishes which action? A) Provides validation of the terminology used during the session B) Focuses on the client's instinctual drives C) Recognizes an understanding of the client's basic needs D) Develops unconditional positive regard for the client
D) Develops unconditional positive regard for the client
A client's blood level of carbamazepine is increased. When reviewing the client's medication history, which medication would alert the nurse to a possible interaction? A) Phenobarbital B) Primidone C) Phenytoin D) Diltiazem
D) Diltiazem
A group of nursing students is reviewing information about Freud's personality structure. The students demonstrate understanding of this information when they identify the ability to form mutually satisfying relationships as a function of aspect? A) Defense mechanisms B) Unconscious C) Id D) Ego
D) Ego
Which behavior would be considered a "testing behavior" that usually happens during the "honeymoon phase" of the relationship? A) Talking nonstop and monopolizing the conversation. B) Sitting away from the group and not participating in the discussion. C) Accusing the nurse of being too controlling during the session. D) Expressing anger and accusing the nurse of breaking confidentiality.
D) Expressing anger and accusing the nurse of breaking confidentiality.
The nurse is caring for an older client in a residential care facility. The client has been extremely irritable the entire day. When modifying the client's plan of care, which snack is appropriate to offer the client in order to decrease the irritability? A) Chocolate candy bar B) Handful of raisins C) Granola bar D) Glass of milk
D) Glass of milk
A client has been diagnosed with memory dysfunction associated with Alzheimer disease. The nurse determines that damage to the client's brain includes deterioration of temporal lobe structures and the nerves of which structure? A) Basal ganglia B) Limbic system C) Frontal lobe D) Hippocampus
D) Hippocampus
Which area of the brain would a nursing instructor identify when describing its involvement with verbal language function, including areas for both receptive and expressive speech? A) Right hemisphere B) Parietal lobe C) Occipital lobe D) Left hemisphere
D) Left hemisphere
