MT & Q (Q & A)
A client approaches the nurse and loudly states, "I'm not putting up with this anymore!" The most appropriate response by the nurse would be which of the following?
"I can see you are angry. Tell me what's going on."
Which of the following questions is best to ask when assessing the client's judgment?
"If you found yourself downtown without money or a car, how would you get home?"
When the client says, "I met Joe at the dance last week," what is the best way for the nurse to ask the client to describe her relationship with Joe?
"Tell me about you and Joe."
A nurse is working with a client whose background is very different from hers. A good question to ask herself to assure she can be effective working with this client would be...
. "What experiences do I have with people with different backgrounds?"
Earlier today you said you were concerned that your son was still upset with you. When I stopped by your room about an hour ago, you and your son seemed relaxed and smiling as you spoke to each other. How did things go between the two of you?
. Consensual validation
The nurse asks the client to describe the quality of an experience. Which communication skill is the nurse using?
. Encouraging expression
A young couple just ended their relationship after a 9-month engagement. One of the individuals is seeking short-term counseling to assist in grieving this loss. Which type of loss best describes what this client is experiencing?
. Loss of security and sense of belonging
Nursing education has become broad in practice settings. The addition of Psychiatric nursing became a requirement in nursing education in 1950 by whom?
. National League of Nursing
A nurse has invited a client to sit down and have a conversation. The client takes the first seat. The nurse pulls up another chair to sit with the client. Approximately how far from the client should the nurse place her chair?
3 TO 6 FT
A client reports a pattern of being suspicious of others, causing difficulty in sustaining lasting relationships. Which stage according to Erikson's psychosocial development was not successfully completed? A Trust vs. Mistrust B.Autonomy vs. Shame and Doubt C.Initiative vs. Guilt D.Industry vs. Inferiority
A
An experienced nurse takes pride in the therapeutic use of self. Nurse-client relationships are meaningful to both the nurse and the client. Nurses that have use of self skills help clients do which of the following? A.grow, change, and heal B.participate in all aspect of care C.maintain skills after discharge D.serve as peer clients for new admissions
A
Building trust is important in A.the orientation phase of the relationship. B.the problem identification subphase of the relationship. C.all phases of the relationship. D.the exploitation subphase of the relationship.
A
The nurse is meeting with her client for the first time. During the orientation phase of the nurse-client relationship, the nurse directs the client to do which of the following? Identify problems to examine A.Identify problems to examine B.Express needs and feelings C.Develop interpersonal skills D.Identify self-care strategies
A
The creation of asylums during the 1800s was meant to... A. provide food and shelter for the mentally ill. B. improve treatment of mental disorders C. punish people with mental illness who were believed to be possessed. D. remove dangerous people with mental illness from the community
A Provide food and shelter
Which of the following clients would most likely be mandated outpatient treatment?
A client who is addicted to alcohol and has two driving under the influence (DUI) offenses.
An adult client is put in restraints after all other attempts to reduce aggression have failed. Which of the following is required now that restraints have been instituted
A face-to-face evaluation by a licensed independent practitioner within 1 hour of restraint
Which of the following client situations most urgently requires the nurse to break confidentiality and warn a third party?
A jealous man states, "I am getting my gun and going to shoot my wife's lover!
crisis is a turning point in an individual's life that produces an overwhelming response. Crises may be .. A. Maturational B. Situational C. Adventitious D. All the Above
ALL
The physician has prescribed haloperidol (Haldol) 10 mg oral tablet antipsychotic medication every morning for a severely psychotic client. The client refuses the medication. Which nursing intervention is an appropriate response?
Accept the client's decision
MATCHING STAGES
Achieving a sense of control and free will - Autonomy vs. shame and doubt Beginning development of a conscience: learning to manage conflict and anxiety - Initiative vs. guilt Emerging confidence in own abilities: taking pleasure in accomplishments. - Industry vs. inferiority Formulating a sense of self and belonging. - Identity vs. role confusion Forming adult, loving relationships, and meaningful attachment to others. - Intimacy v. isolation
A basic assumption of Freud's psychoanalytic theory is that...
All human behavior can be caused and can be explained.
What organization developed and maintains standards of practice that are used to determine safe quality care, and that can be used legally, if incorporated into the state practice act or nurse's rules and regulations, that guide the nursing profession?
American Nurses Association (ANA)
A nurse is assessing a newly-diagnosed depressed client. What question should the nurse prioritize?
Are you thinking about killing yourself
The most effective way for the nurse to provide culturally competent care to individuals who are grieving is which of the following?
Ask the client which rituals are most important and personally meaningful.
A nurse is performing safety assessments on a client in mechanical restraints as required by policy. Which action by the nurse demonstrates the ethical principle of nonmaleficence?
Assuring that the restraints are not causing injury to the client.
A client is supposed to be ambulating ad lib. Instead, he refuses to get out of bed, asks for a bed bath, and makes many demands of the nurses. He also yells that they are lazy and incompetent. The client's behavior is an example of which of the following defense mechanisms? A.Introjection B.Projection C.Rationalization D.Reaction formation
B
The nurse has established a therapeutic relationship with a patient. The patient is beginning to share feelings openly with the nurse. The relationship has entered which phase according to Peplau's theory? A.Orientation B.Identification C.Exploitation D.Resolution
B
Mental health parity laws ensure. A. better quality mental health treatment B.equality in insurance coverage for mental illness C. mental health treatment without stigma. D.that persons receiving treatment really need it.
B equality in insurance coverage for mental illness
The nurse fails to assess personal values surrounding homosexuality before caring for a client who is openly gay. The nurse is MOST at risk for which of the following when working with this client? A. Being manipulated by this client B.Holding a prejudice toward this client C.Expressing shock when assessing the client's history D.Neglecting to include the client's desires in the plan of care
B.Holding a prejudice toward this client
The nurse and client are visiting about upcoming sporting events of which they both share an interest. This form of interaction has the potential to threaten the nurse-client relationship by which of the following?
BOTH ANSWERS TAKEN: overstepping ethical boundaries that the nurse should maintain. avoiding serious work that can hinder the client from reaching set goals. ***
Which of the following terms is used to describe the process by which a person experiences the grief?
Bereavement
A client begins to take stock of his life and look into the future. The nurse assesses that this client is in which of Erikson's developmental stages? A. Identity versus Role Confusion B.Industry versus Inferiority C.Integrity versus Despair D.Generativity versus Stagnation
C
A teenage client defies the nurse's repeated requests to turn off the video game and go to sleep. The teen says angrily, "You sound just like my mother at home!" and continues to play the video game. The nurse understands that this statement likely indicates... A. The need for stricter discipline at home. B. Early signs of oppositional defiant disorder. C. The presence of transference. D. Expression of developing autonomy
C
Client: "I had an accident." Nurse: "Tell me about your accident." This is an example of which therapeutic communication technique? A.Making observations B.Offering self C.General lead D.Reflection
C
Group members are actively discussing a common topic. Members are sharing that they identify with what others are saying. The nurse leader recognizes that the group is in which stage of group development? A.Planning B.Initial C.Working D.Termination
C
The nurse understands that crises are self-limiting. This implies that upon evaluation of crisis intervention, the nurse should assess for which outcome? A.The patient will identify possible causes for the crisis. B.The patient will discover a new sense of self-sufficiency in coping C.The patient will resume the precrisis level of functioning. D.The patient will express anger regarding the crisis event.
C
A group that was designed to meet weekly for 10 sessions to deal with feelings of depression would be a(n)
CLOSED GROUP
An angry client has just thrown a chair across the room and is racing to pick up another chair to throw. The most appropriate action by the nurse would be which of the following?
Call for an emergency response from trained personnel, such as a crisis team.
During the admission assessment, the nurse asks the client, How are you feeling? The client responds, I was able to purchase gas for 7 cents a gallon less than yesterday, which saved me a total of 84 cents. My car has a 12-gallon gas tank. Usually I am able to put in 11.7 gallons. I am very happy to have saved so much money. The nurse recognizes this response as which of the following?
Circumstantial An example of circumstantial thinking is when a client eventually answers a question but only after giving excessive unnecessary detail.
Psychiatric rehabilitation focuses on
Client strength
A client has been making sexual comments when communicating with the nurse. The nurse wants to spend some time talking to the client while respecting the client's right to privacy. Which setting would be the most appropriate setting for the nurse to talk with the client? A.In the client's room when the client's roommate is present and 3 feet away. B.At the nurse's station when other clients and visitors are less than 4 feet away. C.In an interview room in a remote section of the unit with the nurse 1 foot away from the client. D.In a quiet corner of the dayroom at least 4 feet away from others.
D
A client has just been told she has cervical cancer. When asked about how this is impacting her, she states, "It's just an infection; it will clear up." The statement indicates that this patient... A Needs education on cervical cancer. B.Is unable to express her true emotions. C.Should be immediately referred to a cancer support group. D. Is using denial to protect herself from an emotionally painful thought.
D
A nurse is teaching decision-making skills to a client with dependent personality disorder. According to Erikson, the likely cause of the client developing dependent personality is failure to meet the critical task of which developmental stage? A.Trust B.Autonomy C.Initiative D.Industry
D
According to Peplau, there are several roles of the nurse in a therapeutic relationship. These can be seen individually with the client or in a group setting. Which role would be used to offer direction to the client or group? A.Resource person B.Teacher C.Counselor D.Leader
D
During the initial interview with a client in crisis, the initial priority is to... A.Assess the adequacy of the support system. B.Assess for substance use. C.Determine the precrisis level of functioning. D.Evaluate the potential for self-harm.
D
Which of the following would be a reason for a student nurse to use the DSM-5? A.Identifying the medical diagnosis B.Choose client's treatment C.Evaluate treatments D.Understand the reason for the admission and the nature of psychiatric illnesses.
D
A client who had been in a substance abuse treatment program asks the nurse for a date after the client is discharged. The nurse talks to the client about the importance of a therapeutic relationship and its characteristics. The nurse is using which of the following techniques?
Defining boundaries
The goal of the 1963 Community Mental Health Centers Act was to...
Deinstitutionalize state hospitals.
A woman has just had a therapeutic abortion to end an unintended pregnancy. Afterward, the woman cries because although she wanted to have children in future years, this pregnancy was not well-timed. Which type of grief is this woman most likely to experience?
Disenfranchised grief
An adult female patient who was raped is being assessed in the Emergency Room by the Forensic Nurse. In an attempt to obtain details of the incident, the patient states she cannot recall anything about the rape. A. Dissociation B. Rationalization C. Fixation D.Undoing
Dissociation
Which of the following interventions would assist the client with the appropriate expression of anger?
Encourage verbalization
A nurse is preparing to perform an assessment on a newly admitted client on the inpatient unit. The client is not cooperating, is yelling, clenching his fists, and is hitting his hand on the nurse's station demanding to know when he can leave. Which stage of aggression does the nurse identify that the client is exhibiting?
Escalation
TF A recently discharge client tells the nurse in his follow-up appointment he wishes he had a couch for his living room to be more comfortable. Concerned for the client, the nurse offers to sell her couch to him which he accepts. Her actions are NOT a warning sign that she may be abusing the nurse-client relationship.
FALSE
TF Close-ended questions elicit more descriptive information.
FALSE
TF In the staff lounge, Annie, a nurse, approaches her coworker, Julia, and mentions to Julia her concerns of her spending too much time with one particular male patient. Julia replies, "I didn't realize I was treating my patient differently from the others. I'll make sure to be more aware of the time I spend with him from now on." Julia's behavior may be an indication of abusing the nurse-client relationship.
FALSE
TF Self-awareness is the process by which the nurse refuses to believe that any of his/her beliefs or feelings impact a patient with mental illness.
FALSE
Assessment data about the client's speech patterns are categorized in which of the following areas?
General appearance and motor behavior
A client was brought to the emergency department by police after neighbors complained that he was loud and disruptive. The client is upset and states, "No one can be trusted." Which of the criteria for INVOLUNTARY admission does this client meet?
He does not meet any of the necessary criteria
The nurse on an addictive disorders unit receives a phone call inquiring about the status of an adult client. The caller is not on the client's allowed contact list. Which of the following is the appropriate response by the nurse to the caller?
I cannot confirm or deny the existence of any client here."
A nurse who is known to be open-minded and accepting of individuals belonging to the LGBT community has chosen to join her nurse manager, whom she has worked with for several years, in bashing homosexual patients.
INTROJECTION
What are the four (4) states cited in the textbook that DO NOT allow a verdict of guilty by insanity when the client has an insanity defense? All 4 states must be CORRECT.
Idaho, Kansas, Montana, and Utah
Which agency addressed workplace hostility and added standards that include any health-care organization must have a code of conduct that defines acceptable, disruptive, and inappropriate behaviors in the workplace?
Joint Commission on Accreditation of Healthcare Organizations
Which one of the following is a result of federal legislation? A.Improved care for mentally ill persons. B. State mental institutions being the primary source of care for mentally ill persons. C.Making it more difficult to commit people for mental health treatment against their will. D.Making it easier to commit people for mental health treatment against their will.
Making it more difficult to commit people for mental health treatment against their will.
Self-actualization, which takes place when a person who has achieved all the needs of the hierarchy and has developed his or her fullest potential in life was described by which Theorist?
Maslow
The first training of nurses to work with persons with mental illness was in 1882 in which state?
Massachusetts
the first training of nurses to work with persons with mental illness was in 1882 in which state?
Massachusetts
The nurse is attending an in-service training on safe take-down techniques for aggressive clients. Practicing these techniques help to reinforce the proper handling of this situation. Preparation for safe physical handling prepares the nurse to practice which ethical principle?
Nonmaleficence
This distance is comfortable between family and friends who are talking?
PERSONAL
Dream analysis and free association are techniques in which of the following?
Psychoanalysis
A significant change in the treatment of people with mental illness occurred in the 1950s when...
Psychotropic drugs became available for use.
A client with schizophrenia has been non-compliant with medications. The client requires frequent admissions to the psychiatric unit for acute psychotic episodes. What is this process called?
REVOLVING DOOR
The nurse is teaching a client to recognize early signs of anger and aggression. The nurse explores ways that the client can recognize which of the following?
Restlessness and irritability
A client made threats to harm his parents if they come too close to him. The parents called 911, and the client is now held involuntarily for a psychiatric evaluation. During this time of involuntary admission, the client retains all client rights except for which of the following?
Right to freedom
What is the name of the personality test that uses 10 stimulus cards of ink blots; client describes perceptions of ink blots; narrative interpretation discusses areas such as coping styles, interpersonal attitudes, characteristics of ideationi?
Rorschach test
When a nurse is tempted to use his break to smoke a cigarette, he goes to the hospital gym to run on the treadmill for 15 minutes instead.
SUBLIMATION
What is meant by the term "revolving door effect" in mental health care?
Shorter and more frequent hospital stays for persons with severe and persistent mental illness
Which Psychoanalytic Theorist believed that a person's dreams reflect his or her subconscious and has significant meaning, although the meaning is hidden or symbolic?
Sigmund Freud
The client tells the nurse "My biggest problem right now is trying to deal with a divorce. I didn't want a divorce and I still don't. But it is happening anyway!" Which of the following responses by the nurse will convey EMPATHY?
Sounds like it has been a difficult time.
The nursing role that involves being a substitute for another, such as a parent, is called what?
Surrogate
T/F - A crisis is a turning point in an individual's life that produces an overwhelming emotional response.
TRUE
TF A great leap in the treatment of mental illness began in about 1950 with the development of psychotropic drugs.
TRUE
TF Existential theorists believe that problems result when the person is out of touch with the self or the environment.
TRUE
TF Psychiatric nursing was recognized in the late 1800s, although it was not required in nursing education programs until 1950.
TRUE
TF The nurse is acting appropriately when he follows his Outpatient Facility policy when interacting with clients.
TRUE
TF When a nurse begins making more exceptions for one of her clients than she normally does, this may be a signal of inappropriate boundaries between the nurse and her client.,
TRUE
Anger energizes the body physically for self-defense, when needed by activating which response mechanism of the sympathetic nervous system?
The "fight or flight" response
The nurse is assessing the factors contributing to the well-being of a newly admitted client. Which of the following would the nurse identify as having a positive impact on the individual's mental health?
The ability to effectively manage stress
A nurse is discharging a client who is seriously mentally ill into a group home. What is a practical outcome for the client being treated in a community setting?
The ability to maintain stability in the community.
Which nursing intervention constitutes false imprisonment?
The client has been "pesky," seeking the attention of nurses in the nurses' station much of the day. Now the nurse escorts the client to the room, locks the door, and tells the client he will stay there for the rest of her shift.
A malpractice lawsuit was filed after a nurse restrained the client for screaming at and attempting to strike anyone who was within striking distance. The nurse followed agency procedures that were consistent with Joint Commission Standards. For which reason is this malpractice lawsuit most likely to be unsuccessful?
The nurse did not breach duty.
Hildegard Peplau is best-known for her writings about which of the following?
Therapeutic nurse-client relationship.
Which is included in Healthy People 2020 objectives?
To increase the number of people who are identified, diagnosed, treated, and helped to live healthier lives.
A nursing union representative who is stealing from the union he belongs to donates a large sum of money to the American Nurses Association.
UNDOING
Which of the following would be a reason for a student nurse to use the DSM-5?
Understand the reason for the admission and the nature of psychiatric illnesses.
A client being served in a busy inpatient psychiatric unit becomes very noisy and combative. The other clients are complaining about the noise and are afraid that they will be hurt by the client. The nurse determines that the best course of action for all involved is to seclude the client until the client is able to regain control of his behavior. On which ethical principle did the nurse base this decision?
Utilitarianism
Which Erickson's Stage of Psychosocial Development is the virtue of WISDOM?
WISDOM
A client is known to express tangential thinking. The nurse would assess for which of the following when interacting with the client?
Wandering off the topic and never answering the question
Concrete messages are important for accurate information exchange and require no interpretation. The speaker will use nouns instead of pronouns. Which question is clear and direct and a good example of a concrete message?
What health symptoms caused you to come to the hospital today?
A client who had been in a substance abuse treatment program asks the nurse for a date after the client is discharged. The nurse talks to the client about the importance of a therapeutic relationship and its characteristics. The nurse is using which of the following techniques? A.Defining boundaries B.Defining therapy C.Letting the client down gently D.Reprimanding the client
a
The client frequently attempts to touch the nurse and the nurse has explained the prohibition against this. Which of the following is the best reason that many psychiatric care units have policies against clients touching one another or staff? A.Because some clients with mental illness have difficulty knowing when touch is or is not appropriate. B.Because clients often perceive being touched as a threat and may attempt to protect himself or herself by striking the staff person. C.Because it can be threatening to both the client and the nurse. D.Because touching always leads to more touching.
a
The nurse fails to assess personal values surrounding homosexuality before caring for a client who is openly gay. The nurse is most at risk for which of the following when working with this client? A.Holding a prejudice toward this client. B.Neglecting to include the client's desires in the plan of care. C.Being manipulated by this client. D.Expressing shock when assessing the client's history.
a
The nurse using therapeutic communication asks the client what he would like to talk about. This is an example of which of the following? A.Broad opening B.Encouraging expression C.Focusing D.Offering self
a
Which client on the mental health unit should be assessed as being at highest risk for directing violent behavior toward others?
a client who has paranoid delusions and believes is being followed by members of the mafia
When the nurse asks the client to restate the following in his or her own words, which sensorium and intellectual process is the nurse attempting to identify? The nurse states, "A stitch in time saves nine."
abstract thinking abilities
Kubler-Ross developed a model of five stages to explain what people experience as they grieve and mourn. Which is stage five of Kubler-Ross's stages of grieving?
acceptance
A basic assumption of Freud's psychoanalytic theory is that...
all human behavior can be caused and can be explained
A student nurse is assigned to administer oral medications to a client. Which of these actions should a student nurse take if a client refuses to take prescribed oral medications?
ask the client's reason for refusing and report it to the primary care nurse.
The emotional frame of reference by which one sees the world is created by
attitudes.
A nurse is questioning whether it is ethical to seclude a client because of loud and intrusive behavior on the unit. What is the ethical principle that will best guide the decision on appropriate use of seclusion?
autonomy
"How does Jerry make you upset?" is a non-therapeutic communication technique because it A.gives a literal response B.indicates an external source of the emotion. C.interprets what the client is saying. D.is just another stereotyped comment.
b
A tool the nurse uses to learn more about his or her qualities and communication with others is called? A. Carper's Pattern B.Johari Window C.Peplau's Preconceptions D.Nursing Boundary Index
b
During a regular home health visit to an elderly client, the nurse observes that the client has feelings of hopelessness and despair. The client says, "I'm old, and my life has no purpose anymore. But promise me you won't tell anyone." How should the nurse respond? Answers:A."Don't worry, I won't tell anyone else." B."I'm sorry, but I can't keep that kind of secret." C."Let's talk about something to cheer you up." D."What can we do to help you feel better?
b
During the working phase of a therapeutic relationship, which of the following actions by the nurse would best help the client to explore problems? A.Comparing past and present coping strategies B.Encouraging the client to clarify feelings and behavior C.Identifying possible solutions for the client's problems D.Referring the client to a self-help group
b
The client expresses frustration that the doctor does not spend enough time with her when making rounds. The nurse replies, "The doctors are very busy. What can I help you with?" The nurse incorporated which nontherapeutic technique in this response? A.Belittling B.Defending C.Disagreeing D.Introducing an unrelated topic
b
The emotional frame of reference by which one sees the world is created by A.values B.attitudes C.beliefs D.personal philosophy
b
The nurse uses a variety of therapeutic communication skills when working with clients. Which of the following is a therapeutic goal that can be accomplished through the use of therapeutic communication skills? A.Inform the client of priority problems B.Assess the client's perception of a problem C.Assist the client to control emotions D.Provide the client with a plan of action
b
The nurse watches the expressions the client is making as group therapy is conducted. Which of the following statements about verbal and nonverbal communication skills is accurate? A.One third of meaning is transmitted nonverbally and two thirds is communicated verbally. B.Nonverbal communication is as important, if not more than, verbal communication. C.Verbal communication is most important because it is what the patient says. D.Verbal communication involves the unconscious mind.
b
Which of the following is the most important skill the nurse must bring to the therapeutic nurse-client relationship? A.Confrontation B.Empathy C.Humor D.Reframing
b
Which of the following statements is true of the component of a therapeutic relationship termed "acceptance"? A.The nurse accepts the presence of any inappropriate behavior. B.It is avoiding judging the person, no matter what the behavior is. C.It involves punishment for inappropriate behavior. D.It is the ability of the nurse to perceive the meanings and feelings of the client and to communicate that understanding to the client.
b
Ego is the Personality Component that
balances or mediates the force between the id and the superego
A client has just been informed of a diagnosis of terminal cancer. The client states, "God has to have mercy on me because my children need me. He knows I'll change if he gets me through this." The nurse documents that the wife is expressing signs of which of Kubler-Ross's stages of grief?
bargaining
When preparing for the first clinical experience with clients on a forensic unit at a psychiatric hospital, the nursing instructor discusses students' beliefs and fears surrounding forensic clients. The primary reason for discussing personal beliefs is to..
become aware of possible barriers to developing therapeutic relationships.
Ideas that one holds as true are
beliefs.
The nurse using therapeutic communication asks the client what he would like to talk about. This is an example of which of the following?
broad opening
A client says, "Its' been so long since I've been with my family." Which statement by the nurse is an example of restating? A."Go on. Tell me more." B."Tell me what happened when you last saw your family." C."You say you haven't seen your family in a while." D."When was the last time you saw your family?"
c
A nurse is using the Johari window to identify the degree to which he feels comfortable communicating with others. After completing the exercise, the nurse discovers that quadrant 1 has the longest list of qualities. This indicates which of the following about the nurse? A.The nurse conceals personal information about himself. B.The nurse needs to increase insight into his own characteristics. C.The nurse is open to others. D.The client is sharing more than the nurse in the therapeutic relationship.
c
Nursing education has become broad in practice settings. The addition of Psychiatric nursing became a requirement in nursing education in 1950 by whom? . A State Boards of Nursing. B.American Nurses Association. C. National League of Nursing. D.Nurse Practice Act
c
The nurse must be able to make decisions that are based on the principles of right and wrong. What is the standard for establishing such a code of conduct for living? A.Acceptance B.Empathy C.Values D.Positive regard
c
Client: "I was so upset about my sister ignoring my pain when I broke my leg." Nurse: "When are you going to your next diabetes education program?" This is a non-therapeutic response because the nurse has
changed topic
Correcting how one thinks about the world and oneself is the focus of what?
cognitive therapy
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 the client consistently refuses "any drugs." The staff realizes that legally this client can...
continue to refuse treatment.
A teenager who was forbidden to see an X-rated movie is tempted to do so by friends but develops blindness, and the teenager is unconcerned about the loss of the sight is an example of what Ego Defense Mechanism . A. Sublimation B. Conversion C. Resistance D. Introjection
conversion
The nurse tells another nurse, "I don't think I can care for Mr. Smith. Every time I hear his voice, it reminds me of my abusive father's voice." The nurse should recognize this as
countertranceference
When a nurse develops feelings toward a client that are based on the nurse's past experience, it is called
countertransference
The nurse in the psychiatric unit is aware the atmosphere can change at any time. At which point in the stages of aggressive incidents is intervention LEAST likely to be effective in preventing physically aggressive behavior?
crisis
During a session with a client, the client asks the nurse what she should do about her "cheating" husband. The nurse replies, "You should divorce him. You deserve better than that." The nurse used which non-therapeutic communication technique? A.Giving information B.Verbalizing the implied C.Agreeing D.Giving advice
d
The nurse asks the client, "What was it like for you when you first knew you had no place to go?" The client looks down and pauses for quite some time. Which action by the nurse is most therapeutic? A.Change the subject to something the patient will discuss. B.Encourage the patient to express any unpleasant feelings. C.Apologize for asking such a personal question. D.Sit quietly until the patient responds.
d
The nurse is sitting down with a client to begin a conversation. Which of the following positions should the nurse take to convey acceptance of the client? A.Leaning forward with arms on the table sitting directly across for the client. B.Turned slightly to the side of the clients with arms folded across the chest C.Leaning back in the chair next to the client with legs crossed at the knees. D.Sitting upright facing the client with both feet on the floor.
d
Situations that are considered risk factors for complicated grief are?
death of a spouse or child, death by suicide, and sudden and unexpected death.
"Why do you always complain about the night nurse? She is a nice woman and a fine nurse and has five kids to support. You're wrong when you say she is noisy and uncaring." This is an example of which non-therapeutic technique?
defending
A client is admitted to the psychiatric unit and states, "I am president of the largest corporation in the world. Everyone comes to me for advice." The nurse knows the client is exhibiting which of the following?
delusion
There are many areas of practice in psychiatric mental health nursing. One of those is advanced-level practice. Which of the following is considered an advanced-level function?
evaluation
TF The nurse does NOT need to consider a client's preferences, history or needs before using touch if the nurse believes touch will be supportive.
false
An adult client on the inpatient unit is dressed as a teenager and continues to attempt to open the locked door to the group therapy room, after being told multiple times that the group will begin in 15 minutes.
fixation
A client is showing no facial expression when playing a board game with other residents on an inpatient psychiatric unit. The nurse uses which of the following terms when documenting the client's affect?
flat affect
What type of touch is used when the nurse touches the hands of a patient with Bipolar Disorder to assess for fine tremors while prescribed Lithium, a mood stabilizer?
functional - professional
Client: "I had an accident." Nurse: "Tell me about your accident." This is an example of which therapeutic communication technique?
gen lead
Relationships with other people are important to one's social and emotional health. The nurse must assess the relationships in the client's life. Common questions to do this include which of the following?
have you been in a abusvie relationship
The client's belief that a news broadcast has special meaning for him or her is an example of
idea of reference
An adolescent on the unit is argumentative with staff and peers. The nurse tells the adolescent, "Arguing is not allowed. One more word and you will have to stay in your room the rest of the day." The nurse's directive is...
inappropriate; room restriction is not treatment in the least restrictive environment.
A nurse is teaching decision-making skills to a client with dependent personality disorder. According to Erikson, the likely cause of the client developing dependent personality is failure to meet the critical task of which developmental stage?
industry
The Id is the part of one's nature that reflects
innate desires such as sexual impulses.
Nurses develop empathy with their clients while gathering information about the client. Which of the following hinders the development of empathy?
interjecting personal experiences
In the space of 5 minutes, the client has been laughing and euphoric, then angry, and then crying for no reason that is apparent to the nurse. This behavior would be best described as...
labile mood.
Who is referred to as the first American psychiatric nurse?
linda richards
The newly licensed RN has been hired at the local hospital in the Geri-Psych unit. Today is her first day of orientation to this facility. What would be the nurse's PRIORITY action if a client becomes aggressive
maintain safe distance
During change of shift rounds, a depressed client on the inpatient psychiatric unit was discovered to have completed a suicide attempt in the bathroom. The assigned nurse has been very busy and fell behind on periodic assessment for this client. Which type of lawsuit could the client's family file?
malpractice
What would be considered an Unintentional Tort?
malpractice
The insurance program that is jointly funded by the federal and state governments and covers low-income individuals and families.
medicaid
A client diagnosed with a mild anxiety disorder has been referred to treatment in a community mental health center. Treatment most likely provided at the center includes...
medical management of symptoms
The primary purpose of the Community Mental Health Act of 1963 was
moving patients to their home community for treatment
The client tells the nurse "I never do anything right. I make a mess of everything. Ask anyone; they'll tell you the same thing." The nurse recognizes these statements are examples of A emotional issues B. negative thinking C. poor-problem solving D.relationship diffculties
negative thinking
A nurse is reviewing medical records to look for violations of client rights. What finding would signal a violation of client rights?
no documentation of benefits of treatment or treatment options
While the nurse and client are in a therapy session, the nurse says to the client, "You become very anxious when we start talking about your drinking." Which of the following techniques is the nurse using?
observation
Four levels of anxiety were described by who?
peplau
During the assessment, the nurse asks the client to describe his problems. The purpose of this question is to obtain information about which of the following?
perception of problem
Before the period of the enlightenment, treatment of the mentally ill included...
placing the mentally ill on display for the public's amusement
The creation of asylums during the 1800s was meant to.....
provide food and shelter for the mentally ill.
The nurse is assisting a middle-age couple with marital counseling. Which of the following is a major developmental task of middle adulthood?
reexamine life goals
To assess the client's ability to concentrate, the nurse would instruct the client to do which
repeat days of week backwards
An adult client says to her therapist, she has no childhood memories before age 8, when her parents were killed in a car accident.
repression
A patient diagnosed with a Substance Abuse Disorder who was charged with Driving While Under the Influence (DWI) was court-ordered to attend treatment for his alcoholism. The patient shows up for the group but refuses to participate in any of the group activities.
resistance
A child who has witnessed the murder of his classmate while at school would experience which kind of loss?
safety
The nurse decides to place an aggressive and violent client in mechanical restraints. The nurse bases this decision on which of the following?
safety of client
A client's prognosis is said to be good due to a high degree of self-efficacy. Which of the following best characterizes self-efficacy?
the client is self-motivated and asks for help when needed
Freud's personality component Superego involves
the part of a person's nature that reflects moral and ethical concepts.
When the nurse is assessing whether the client's ideas are logical and make sense, the nurse is examining which of the following?
thought process
TF Nonverbal communication can indicate the speaker's thoughts, feelings, needs, and values that he or she acts out mostly unconsciously.
tre
TF Abraham Maslow developed a hierarchy of needs stating that people are motivated by progressive levels of needs; each level must be satisfied before the person can progress to the next level.
true
TF Adventitious crises is sometimes called social crises and include natural disasters like floods, earthquakes, or hurricanes; war; terrorist attacks; riots; and violent crimes such as rape or murder.
true
TF Awareness of one's feelings, beliefs, attitudes, values, and thoughts, called self-awareness, is essential to the practice of psychiatric nursing.
true
TF Establishing a therapeutic relationship is one of the most important responsibilities of the nurse when working with clients.
true
TF No single universal definition of mental health exists.
true
TF Nurses, like others in helping professions, may experience compassion fatigue, a type of secondary traumatic stress or burnout that comes from working through traumatic experiences with clients.
true
TF Some of the positive aspects of community-based programs are that clients can remain in their communities, maintain contact with family and friends, and enjoy personal freedom that is not possible in an institution.
true
TF Therapeutic communication is an interpersonal interaction between the nurse and the client during which the nurse focuses on the client's specific needs to promote effective exchange of information.
true
Abstract standards that provide a person with his or her code of conduct are
values
Which is an example of an open-ended question?
what concerns you about your health
Which is an example of close-ended questions?
where are you employed