NCLEX Mental Health Practice
When upset, the client curls into a fetal position in bed. The nurse judges the client to be exhibiting which condition? fixation regression symbolization substitution
A client's behavior is best described as regression when it is typical of an earlier stage of development. Fixation means not progressing beyond a given level of development. Substitution means replacing unacceptable ideas with more acceptable ones. Symbolization occurs when one idea or object comes to stand for another.
A client with depression has been admitted to the mental health unit and is attending group therapy sessions as part of treatment. The client asks the nurse leading the group if he is married or has a girlfriend. The nurse responds, "I am curious what made you ask this question; however, what is important is how you are feeling today." The nurse's response is which of the following? Inappropriate, because the client was just making small talk about the nurse's personal situation to get to know the nurse better. Inappropriate, because the nurse should have answered to establish a therapeutic relationship. Appropriate, because the nurse is neither married nor has a girlfriend. Appropriate, because the focus of the therapeutic relationship is the client, not the nurse.
The nurse's response is appropriate, because the focus of the therapeutic relationship is the client. The other options do not place the focus of care on the client's needs or reflect a full understanding of the therapeutic relationship.
During the mental status examination, a client may be asked to explain such proverbs as "Don't cry over spilled milk." The purpose of this is to evaluate the client's ability to think: abstractly. tangentially. concretely. rationally.
Abstract thinking Its the ability to conceptualize and interpret meaning. It's a higher level of intellectual functioning than concrete thinking, in which the client explains the proverb by its literal meaning. Rational thinking involves the ability to think logically, make judgments, and be goal-directed. Tangential thinking is scattered, non-goal-directed, and hard to follow. Clients with such conditions as organic brain disease and schizophrenia typically can't conceptualize and comprehend abstract meaning. They interpret such statements as "Don't cry over spilled milk" in a literal sense, such as "Even if you spill your milk, you shouldn't cry about it."
One of the myths about sexual abuse of young children is that it usually involves physically violent acts. Which behavior is more likely to be used by the abusers? bribery with money coercion as a result of the trusting relationship asking for the child's consent for sex tying the child down
Coercion it's the most common strategy used because the child commonly trusts the abuser. Tying the child down usually is not necessary. Typically, the abusive person can control the child by his or her size and weight alone. Bribery usually is not necessary because the child wants love and affection from the abusive person, not money. Young children are not capable of giving consent for sex before they develop an adult concept of what sex is.
In group therapy, a client angrily speaks up and responds to a peer, "You're always whining, and I'm getting tired of listening to you! Here is the world's smallest violin playing for you." Which role is the client playing? Recognition seeker Monopolizer Blocker Aggressor
The aggressor it's negative and hostile and uses sarcasm to degrade others. The role of the blocker is to resist group efforts. The monopolizer controls the group by dominating conversations. The recognition seeker talks about accomplishments to gain attention.
The nurse is working with a client with depression in a mental health clinic. During the interaction, the nurse uses the technique of self-disclosure. In order for this technique to be therapeutic, which of the following steps must be a priority for the nurse? Allowing the client time to ask questions about the nurse's experience Asking for the client's perception of what the nurse has revealed Ensuring relevance to, and quickly refocusing upon, the client's experience Discussing the nurse's experience in detail
ensuring The nurse's self-disclosure should be brief and to the point so that the interaction can be refocused on the client's experience. Because the client is the focus of the nurse-client relationship, the discussion should not dwell on the nurse's own experience.
A client has been involuntarily committed to a hospital because he has been assessed as being dangerous to self or others. The client has lost which right? the right to send and receive uncensored mail the right to leave the hospital against medical advice the right to refuse medications and treatments freedom from seclusion and restraints
An involuntarily admitted client loses the right to leave the hospital until the condition is stable enough that the client no longer poses a danger to self or others. While hospitalized, the client retains all civil rights such as receiving mail, making phone calls, refusing treatment, and also receiving the least restrictive treatment. Should the involuntarily admitted client refuse treatment once admitted, he will be evaluated for the need to receive treatment against wishes in order to decrease the risk for self-harm or harm to others.
A nurse is counseling a married woman who has two children under 4 years of age and is a victim of spousal abuse. Before the client leaves the clinic, what is the most important thing the nurse should do? Teach the client about the cycle of violence. Discuss the abuser's behaviors with the client. Help the client develop a safety plan. Give the client the name of a domestic violence shelter.
It is most important for the nurse to help the client develop a safety plan because the abuse will occur again, and the client will need a plan to seek a safe environment for herself and her children. Teaching about the cycle of violence is not as important as the client's safety and the safety of her children. Discussing the abuser's behaviors is not as important as the client's safety and the safety of her children. Giving the client the name of a domestic violence shelter can be part of the safety plan, but the nurse needs to assure other safety measures are in place until the woman is ready to leave the abusive partner.
A client is admitted to the psychiatric unit following a suicide attempt. The client has suffered identity theft through the Internet and states, "My savings, checking, and retirement accounts are empty. I have nothing left to pay my bills or buy food and medicines. The only thing left is to die." After 1 week, the nurse would conclude that the client has been helped upon hearing which statements? Select all that apply. "I realize that I still can get monthly public assistance benefits." "I filed identity theft claims with the bank, my retirement account, and the government authorities." "With all the help I got here, I think I may be able to survive after all." "I know all the actions I can take, but they take so much time and energy. I am so tired." "The government has given me a lot of options, but I am not sure they are even pvossible."
I realized, I filed, with help Realizing financial resources and benefits will continue gives hope and decreases the risk of future suicide. Filing the claim forms may help regain some of the losses and shows the client is looking to the future. Lacking energy and motivation will inhibit taking positive actions and demonstrates the client has not been sufficiently helped as yet. Positive statements about survival also suggest the client has a new perspective. Not believing in the solutions will inhibit taking positive actions and demonstrates the client has not been sufficiently helped as yet.
The nurse is teaching unlicensed assistive personnel (UAP) about caring for a client who is withdrawing from alcohol and street drugs. Which communication technique when observed by the nurse indicates the UAP has understood the instructions? The UAP talks to the client using: cheerful tone of voice, using humor when appropriate. clear explanations in a quiet voice. loud voice and giving general comments. matter-of-fact manner and short sentences.
calm, matter-of-fact manner, using short sentences and a moderate tone of voice. This approach promotes orientation, reinforces cognitive-perceptual functions, and decreases anxiety. A cheerful tone and humor are inappropriate, possibly leading to misperceptions by the client with cognitive-perceptual impairment. Using general and abstract terms and a loud tone of voice increases anxiety and may lead to misunderstanding. Lengthy explanations delivered with a quiet voice will lead to frustration and increased anxiety.
