NURS 224 - Psych Test 1 - Halter Questions
Of the following environments, which would be must conducive to a therapeutic session? a. A quiet section of the day room b. The utility room c. The nurses' station d. A table in the coffee shop
A quiet section of the day room
A nurse is providing care to a 28-year-old client diagnosed with bipolar disorder who was admitted in a manic state. According to Maslow's hierarchy of Needs theory, the nurse should identify which client symptom as having priority? a. Rapid, pressured speech b. Grandiose thoughts c. Lack of sleep d. Hyperactive behavior
Lack of sleep
Which theorist is associated with behavioral therapy? a. Sullivan b. Peplau c. Skinner d. Freud
Skinner
Which phase of the nurse-client relationship may cause client anxieties to reappear and past losses to be reviewed? a. Working phase b. Termination phase c. Orientation phase d. Preorientation phase
Termination phase
Consider both Sullivan's term security operations and Freud's term defense mechanisms. Which statement suggests that the client's specialized treatment goal has been successfully met? a. "I'm experiencing much less anxiety about school now." b. "I know that I'm not the only person who has a difficult time in school c. "Going back to school is hard and I'll need support." d. "I really think I can succeed in school now."
"I'm experiencing much less anxiety about school now."
A 43-year-old client being seen in the mental health clinic states, "I have always been a practicing Jew, but in the past few months I am questioning everything. I just don't know if I believe in it anymore." Which of the following nursing diagnoses best describes the client's comment? a. Ineffective coping b. Risk for self-harm c. Hoplessness d. Spiritual distress
Spiritual distress
Which response should the nurse provide a client who asks, "Why you need to conduct an assessment interview?" a. The assessment interview lets you express your feelings b. You are able to tell me in detail about your past so that we can determine why you are experiencing mental issues c. We will be able to form a relationship together where we can discuss current problems and come up with goals and a plan d. I need to find out more about you and the way you think in order to best help you
We will be able to form a relationship together where we can discuss current problems and come up with goals and a plan
What client assessment data demonstrates parity related to mental health care? a. Advance practice nurse can be certified as psychiatric nurse specialist b. The client is admitted for a 72-hour mental hygiene evaluation c. A client who has attempted suicide is hospitalized for a mental health evaluation d. A client's mental health coverage is equal to his/her medical/surgical coverage
A client's mental health coverage is equal to his/her medical/surgical coverage
The nurse planning care for a mentally ill client bases interventions on which concept? a. There are universal fears that are shared by all mentally healthy individuals b. Every client comes with experiences that contribute to their problem c. It is a client right to be treated respectfully d. Every client has a certain degree of resilience
Every client has a certain degree of resilience
How can a nurse best differentiate whether an Asian client is demonstrating a mental illness after having attempted suicide? a. Explain that suicide is often regarded as a desperate act b. Assess the client for other examples of depressive behaviors c. Identify the client's culture's view regarding suicide d. Ask the client whether he views himself as being depressed
Identify the client's culture's view regarding suicide
Which nursing diagnosis for a psychiatric client is correctly structured and worded? a. Hopelessness related to severe chronic depression b. Spiritual distress as evidenced by client stating "God has abandoned me because I'm a bad person" c. Defensive coping related to lack of insight associated with illicit drug use d. Imbalanced nutrition: less than body requirements related to poor self-concept as evidenced by reporting "I'm not worthy of eating
Imbalanced nutrition: less than body requirements related to poor self-concept as evidenced by reporting "I'm not worthy of eating
The mental health status of a particular client can best be assessed by considering which factor? a. The degree to which an individual is logical and rational b. Rate of demonstrated intellectual and emotional growth c. Position placement on a continuum for health to illness d. The degree of conformity of the individual to society's norms
Position placement on a continuum for health to illness
A client tells the nurse "I really feel close to you. You are like the friend I never had." The nurse can assess this statement as indicating the client may be experiencing which unconscious emotion? a. positive transference b. congruence c. empathetic feelings d. countertransference
Positive transference
The client's priority nursing diagnosis has been established as risk for self-directed violence: suicide related to multiple losses. The priority outcome would be that the client will: a. refrain from attempting suicide. b. be placed on suicide precautions. c. attend self-help group daily. d. state absence of feelings of powerlessness.
Refrain from attempting suicide.
Which nursing intervention demonstrates the theory behind operant conditioning? a. Showing the client how to be assertive without being aggressive b. Rewarding the client with a token for avoiding an argument with another client c. Explaining to the client the consequences of not following unit rules d. Demonstrating deep breathing techniques to a group of clients
Rewarding the client with a token for avoiding an argument with another client
A client states, "I will always be alone because nobody could ever love me." The nurse recognizes that the client is expressing what cognitive-behavioral concept? a. Actualization b. Aversion c. Schema d. Emotional consequence
Schema
The client makes the decision to sit about 5 feet away from the nurse during the assessment interview. The nurse can accurately make what assumption about the client's perception of the nurse? a. The nurse is a new friend b. They view the nurse as a peer c. They view the nurse as a stranger d. The nurse is a safe person to interact with
They view the nurse as a stranger
What is the primary difference between a social and a therapeutic relationship? a. Type of information exchanged b. Amount of motivation invested c. Amount of satisfaction felt d. Type of responsibility involved
Type of responsibility involved
What therapeutic communication technique is the nurse using by asking a newly admitted client, "Can you tell me what was happening to you that led to you being hospitalized here?" a. Using an open-ended question b. Paraphrasing c. Reflecting d. Using a minimal encourager
Using open-ended question
The nurse best assesses the client's spiritual life by asking which question? a. Do you practice a specific religion? b. To whom do you turn in times of crisis? c. Do you attend church regularly? d. What role does religion play in your life?
What role does religion play in your life?
The nurse is working with a client experiencing depression stemming from low self-esteem. The client is distrustful of unit staff and "just wants to go home." Initially what is the nurse's priority? a. Making the clint feel physically and emotionally safe b. Teaching the client effective coping skills c. Identifying the client's positive traits d. Focusing on preparing the client for a speedy discharge
Making the clint feel physically and emotionally safe
A patient who recently lost a parent begins crying in 1-on-1 session with nurse. What response illustrates empathy? a. That must have been such a hard situation for you b. You need to focus on yourself now, take time just for you c. I know that you will get over this, it just takes time d. I am so sorry, my father dies 2 years ago. I know how you are feeling
That must have been such a hard situation for you
Which nursing statement illustrates the concept of client advocacy? a. "I'd like you tell me more about your depression and your suicide attempt?" b. "Dr. Raye, during admission the client stated that there is a family history of three suicide attempts in the past." c. "Dr. Raye, during admission, the client stated they will refuse fluoxetine because of adverse effects they had previously." d. "I will take you on a tour of the unit and orient you to the rules so you can get adjus
"Dr. Raye, during admission, the client stated they will refuse fluoxetine because of adverse effects they had previously."
A 17-year-old client confides to the nurse that they have been thinking of ways to kill a peer. What should you respond when the client states, "You have to keep a secret, right?" a. "I will have to share this with the treatment team, but we won't tell your parents." b. "Yes, I will keep it confidential. We have laws to protect you." c. "I will keep it a secret, but we need to discuss a way to deal with this." d. "Issues of this kind have to be shared with the treatment team and parents."
"Issues of this kind have to be shared with the treatment team and parents."
A nurse's badge includes the term, "Psychiatric Mental Health Nurse." A client with a history of paranoia asks, "what does that title mean?" Keeping his diagnosis in mind, how should the nurse respond? a. "We have the specialized skills needed to care for those with mental illness." b. "Don't be afraid: it means I'm here to help, not hurt, you." c. "Psychiatric mental health nurses care for people with mental illnesses." d. "The nurses who work in mental health facilities have that title."
"We have the specialized skills needed to care for those with mental illness."
A registered nurse has accepted a position as staff nurse on a psychiatric unit. Which statement made by the nurse requires additional instructions regarding the therapies provided on the unit? a. "You will attend a psychotherapy group that I lead that will help you care for yourself." b. "You will be given a schedule daily of the groups we would like you to attend." c. "You will see your provider daily in a one-to-one session." d. "You will participate in unit activities and group
"You will attend a psychotherapy group that I lead that will help you care for yourself."
The nurse being aware that certain mental illnesses have a prevalence among a specific gender, will suspect which statement was made by a female client? (Select all that apply.) a. "I'm so anxious, about everything." b. "There is no way I could make a presentation to a group of people." c. "I freeze in panic when I see a spider." d. "I've been depressed most of my adult life." e. "I've been arrested 6 times in the last 15 years."
- "I've been depressed most of my adult life." - "I've been arrested 6 times in the last 15 years."
When a client states, "that nurse never seems comfortable being with me." How is the client characterizing the nurse? a. As transmitting fear of clients b. As being controlling c. As being unfriendly and aloof d. As not seeming genuine to the client
As not seeming genuine to the client
When asked about a rape, that happened 2 weeks ago, the client becomes very anxious and upset and begins to sob. How should the nurse respond? a. Tell the client that anything she says to you will be confidential b. Acknowledge that the topic of the rape is upsetting and reassure the client that it can be discussed at another time c. Use silence as a therapeutic tool and wait until the client is done to continue d. Push gently for more information about the rape, so it can be documented
Acknowledge that the topic of the rape is upsetting and reassure the client that it can be discussed at another time
Which statements are true regarding the difference between social and therapeutic relationships? (All that apply) a. In social, bother parties' needs are met. In therapeutic, only patient's needs are considered. b. Giving advice is normal in social, is not therapeutic c. Social's main purpose is exploring one person's feelings/issues, therapeutic purpose is friendship d. Social, both parties have solutions and problems, therapeutic solutions are only implemented by patient.
All but C
The nurse would address which of the following goals in attempting to establish a therapeutic nurse-client relationship? (All that apply) a. Facilitating communication of distressing thoughts and feelings b. Helping patients examine self-defeating behaviors and test alternatives c. Promoting self-care and independence d. Assisting patients with problem solving to help facilitate ADLs e. Providing client with opportunity to socialize
All but E
According to Freud, a client experiencing dysfunction of the conscious as part of the mind will have problems with which aspect of memory? a. Recent memory b. All memories c. Painful memories d. Long-term memory
All memories
During a clinical interview the client falls silent after disclosing that she was sexually abused as a child. The nurse should engage in which intervention in response to the client's silence? a. Allow the client to break the silence. b. Quickly break the silence and encourage the client to continue. c. Reassure the client that the abuse was not her fault. d. Reach out and gently touch the client's arm.
Allow the client to break the silence
Which communication techniques should the nurse use with a client who has been identified as having difficulty expressing thoughts and feelings? a. Offering opinions and avoiding periods of silence b. Asking open-ended questions and seeking clarification c. Asking closed-ended questions requiring "yes" or "no" answers d. Using emotionally charged words and gestures
Asking open-ended questions and seeking clarification
Using Maslow's model of needs, the nurse providing care for an anxious client identifies which intervention as being a priority? a. Assess the client for strengths upon which a nurse-client relationship can be based b. Assessing the client's ability to fulfill appropriate developmental level tasks c. Planning 1-on-1 time to assist in identifying the fears trigger the client's anxiety d. Evaluating the client's ability to learn and retain essential information regarding their current condition
Assess the client for strengths upon which a nurse-client relationship can be based
A term is a synonym for the characteristic of genuineness? a. Respect b. Empathy c. Authentic d. Positive regard
Authentic
What is the premise underlying behavioral therapy? a. Motives must change before behavior changes b. Behavior is determined by cognitions; change in cognitions produces new behavior c. Behavior is a product of unconscious drives d. Behavior is learned and can be modified
Behavior is learned and can be modified
According to current information what factor is associated with the most disabling mental disorders? a. Biological influences b. Learned ways of behaving c. Faulty patterns of early nurtuance d. Psychological trauma
Biological influences
The nurse is finding it difficult to provide structure and set limits for a client. The nurse should self-evaluate for which characteristic of a dysfunctional nurse-patient relationship? a. Boundary blurring b. Value dissonance c. Covert anger d. Empathy
Boundary blurring
A nurse is aware of state and national legislation affecting mental illness treatment. How can this nurse affect the climate for mental health treatment? a. By educating the public on the effects that stigma has on mental health clients b. By becoming active in politics leading to a political career c. Advocate for reduced mental health insurance benefits to discourage abuse of system d. Advocate for laws that make the involuntary long-term commitment process easier and faster for caregivers
By educating the public on the effects that stigma has on mental health clients
When discussing her husband, a client shares that "I would be better off alone. At least I would be able to come and go as I please and not have to be interrogated all the time." What therapeutic communication technique is the nurse using when responding, "Are you saying that things would be better if you left your husband? a. Reflection b. Focusing c. Clarification d. Restating
Clarification
After a client discusses a personal relationship with a parent, the nurse asks, "Tell me if I'm correct that you feel dominated and controlled by this person?" What is the purpose of the nurse's question? a. Verbalizing the implied b. Eliciting more information c. Clarifying the message d. Encouraging evaluation
Clarifying the message
What is the primary source for data collection during a psychiatric nursing assessment? a. client's nonverbal responses b. client's medical treatment records c. client's family and friends d. client's own words and actions
Client's own words and actions
The outcome of the nurse's expressions of the sympathy instead of empathy toward the client often leads to which outcome? a. Decreased client communication b. Lessening of client emotional pain c. Increased hope for client improvement d. Enhanced client coping
Decreased client communication
Freud believed that individuals cope with anxiety by implementing which mechanism? a. The superego b. Security operations c. Defense mechanisms d. Cognitive distortions
Defense mechanisms
Which client problem would be most suited to the use of interpersonal therapy? a. Disturbed sensory perception b. Impaired social interaction c. Medication noncompliance d. Dysfunctional grieving
Dysfunctional grieving
Which criterion is NOT essential when the nurse plans nursing interventions designed to meet a specific goal? a. Economical b. Safe c. Realistic d. Individualized e. Evidence based
Economical
The nurse is planning care for a 14-year-old. The nurse demonstrates an understanding of the developmental task appropriate for this client by providing which experience? a. Spending one-on-one time with staff to establish trust b. Assign them to help clean up the dayroom to develop a sense of industry c. Encouraging them to talk about their school plans to help achieve identity d. Providing them with the opportunity to select which unit activities they will participate in to gain autonomy
Encouraging them to talk about their school plans to help achieve identity
A recent immigrant to the United States from which country would tend to display little facial emotion when dealing with emotional stress? a. Japan b. Korea c. Mexico d. Germany
Germany
A nurse on a psychiatric unit has a past history of alcoholism and has regular meetings with a mentor. Which statement to the nurse's mentor would indicate the presence of countertransference? a. My patient, an elderly woman with depression, calls me by her daughter's name because I remind her of her. b. I told my patient, abusing alcohol, that the only way to quit is "cold turkey" get away from dysfunctional family now! c. Gave patient discharge instructions d. Patient relapsed, needs AA
I told my patient, abusing alcohol, that the only way to quit is "cold turkey" get away from dysfunctional family now!
The nurse providing anticipatory operant conditioning guidance to the mother of a toddler should advise that childhood temper tantrums are best handled by which intervention? a. Scolding the child when he/she displays tantrum behaviors b. Ignoring the tantrum and giving attention when the child acts appropriately c. Giving the child what he/she is asking for d. Spanking the child at the onset of the tantrum behaviors
Ignoring the tantrum and giving attention when the child acts appropriately
A nurse expresses an exclusive belief in the biological model for mental illness when stating "it's the only one I really believe." What conclusion can be made from this? a. The biological model has been proven to be successful in finding the cause of most symptoms of mental illness b. In believing only this model, other influences on mental heath are not taken into account c. The biological model is the most popular theory. d. It's the oldest and most reliable model.
In believing only this model, other influences on mental heath are not taken into account
Which statement made by the nurse reflects an accurate understanding of when termination should be discussed on inpatient psychiatric unit? a. Now that we've talked about why you are here, I would like to talk to you about discharge b. You are being discharged today, so I would like to discuss termination c. I haven't met my patient yet, but am working through anxiety in dealing with her d. Now that we are working on problem solving skills, I'd like to talk about termination
Now that we've talked about why you are here, I would like to talk to you about discharge
The mental status examination aids in the collection of what type of data? a. covert b. physical c. subjective d. objective
Objective
During what stage of the therapeutic nurse-client relationship is a formal or informal contract between the nurse and client established? a. Preorientation b. Orientation c. Working d. Termination
Orientation
What three structural components comprise a nursing diagnosis? a. Unmet need, goal, outcome criterion b. Problem, outcome, intervention c. Problem, probable cause, supporting data d. Presenting symptom, treatment, goal
Problem, probable cause, supporting data
During a therapeutic encounter the nurse remarks to a client, "I noticed anger in your voice when you spoke of your father. Tell me about that." What communication techniques is the nurse using? a. Clarify and suggesting collaboration b. Reflecting and exploring c. Presenting reality and encouraging planning d. Giving information and encouraging evaluation
Reflecting and exploring
An individual is found to consistently wear only a bathrobe and neglect the cleanliness of his apartment. When neighbors ask him to stop his frequent outbursts of operatic arias, he acts outraged and tells him he must sing daily and will not be quieter. This behavior shows what? a. The client is not conforming with social norms b. The client is engaging in egocentric behaviors c. The client is demonstrating symptoms of bipolar disorder d. The client is demonstrating socially deviant behavior
The client is not conforming with social norms
What is the focus during clinical supervision? a. Devising alternative strategies for client growth b. Assisting the client to develop increased independence c. The nurse's behavior in the nurse-client relationship d. Analysis of the client's motivation for tranferences
The nurse's behavior in the nurse-client relationship
A 26-year-old client is brought to the emergency room by a friend. The client is unable to give any history. Which response should the nurse provide to a client's friend giving info? a. Yes, however, we will have to get a release signed from the client b. There is no need for that, I will call his doc to get the info we need c. Yes, I will be happy to get any info and history that you can provide d. I can't take any info from you as it would violate confidentiality
Yes, I will be happy to get any info and history that you can provide
Which branch of epidemiology is the nurse involved in when seeking outcomes for patients whose depression was treated with electroconvulsive therapy (ECT)? a. experimental b. descriptive c. clinical d. analytic
clinical
What term is used to identify the quantitative study of the distribution of mental disorders in human populations? a. prevalence b. clinical epidemiology c. mortality d. epidemiology
epidemiology
Which client statement demonstrates the mental health concept of resilience? a. "My kids, happiness is worth any sacrifice I have to make." b. "My mother made decisions about my husband's funeral when I just couldn't do that." c. "Losing my job was hard but my skills will help me get another one." d. "In spite of all the treatment, I know I'll never be really healthy."
"Losing my job was hard but my skills will help me get another one."
What is the most helpful nursing response to a client who reports thinking of dropping out of college because it is too stressful? a. "School is stressful. What do you find most stressful?" b. "I know just what you are going through. The stress is terrible." c. "Don't let them beat you! Fight back!" d. "You have only two more semesters. You will be glad if you stick it out."
"School is stressful. What do you find most stressful?"
A cognitive therapist would help a client restructure the thoughts "I am stupid!" to which statement? a. "I am not as smart as others." b. "Things like this should not happen to anyone." c. "What I did was stupid." d. "Things usually go wrong for me."
"What I did was stupid."
With which client should the nurse make the assessment that not using touch probably be in the client's best interests? a. A deeply depressed client b. A tearful client reporting pain c. A very private client d. A recent immigrant from Russia
A very private client
How does Harry Stack Sullivan's Interpersonal Theory view anxiety? a. A sign of guilt in adults b. The result of trying to go beyond experiences of guilt and pain c. An emotional experience felt after the age of 5 years d. A painful emotion arising from social insecurity
A painful emotion arising from social insecurity
During a therapeutic encounter, the nurse makes an effort to ensure the use of two congruent levels of communication. What is the rationale for this? a. One statement may simultaneously convey conflicting messages b. Many of the client's remarks are not more than social phrases c. Content of messages may be contradicted by process d. The mental image of a word may not be the same for both nurse and client
Content of messages may be contradicted by process
A nursing diagnosis for a client with a psychiatric disorder serves what purpose when considering the plan of care? a. Justifying the use of certain psychotropic medication b. Providing data essential for insurance reimbursement c. Establishing a framework for selecting appropriate interventions d. Completing the medical diagnostic statement
Establishing a framework for selecting appropriate interventions
What principle forms the basis of nursing outcome planning? a. The goal of nursing action is to create a dependency between the client and the caregiver b. Nursing interventions are designed to solve individuals' problems for them c. Individuals have the right to outcomes that is reflective of their abilities d. Nurses have the best understanding of client problems and so they direct outcome selection
Individuals have the right to outcomes that is reflective of their abilities
Which tool can the novice nurse refer to when writing nursing outcomes? a. Nursing Interventions Classification (NIC) b. Joint Commission c. International Classification for Nursing Practice (ICNP) d. North American Nursing Diagnosis Association (NANDA)
International Classification for Nursing Practice (ICNP)
Which statement best describes the Diagnostic and Statistical Manual, fifth edition (DSM-5)? a. It suggests common interventions for mental disorders b. It is a compendium of treatment modalities c. It is a medical psychiatric assessment system d. It offers a complete list of nursing diagnoses
It is a medical psychiatric assessment system
The nurse is caring for an adult client who experienced severe physical abuse from the age of 2 through 12. What information should the nurse provide the client concerning the function of "id" and the ability to function? a. It provides an individual with the ability to differentiate experiences b. It has control over the emotional frustration felt as an adult c. It is severely damages by abuse experienced before the age of 5 years old d. It is the source of one's survival instincts
It is the source of one's survival instincts
Which severe mental illness has a prevalence of over 6% among the populace of the United States? (Select all that apply.) a. Major depressive disorder b. A personality disorder c. Generalized anxiety disorder d. Bipolar disorder e. Social phobia f. Alzheimer's Disease
Major depressive disorder A personality disorder Social phobia Alzheimer's Disease
Role playing is associated with which type of therapy? a. Psychoanalysis b. Modeling c. Operant conditioning d. Systematic desensitization
Modeling
A client tells the mental health nurse "I am terribly frightened! I hear whispering that someone is going to kill me." Which criterion of mental health can the nurse assess as lacking? a. Positive self-concept b. Rational thinking c. Learning and productivity d. Self-control
Rational thinking
The preferred seating arrangement for a nurse-client interview should incorporate which positioning? a. The client sitting in a chair and the nurse standing a few feet away b. The nurse and client sitting at a 90-degree angle to each other c. The nurse behind a desk and the client in a chair in front of the desk d. The nurse and client sitting facing each other
The nurse and client sitting at a 90-degree angle to each other
When a nurse and client meet informally or have an otherwise limited but helpful relationship, what term is used to identify this relationship? a. Crisis intervention b. Therapeutic encounter c. Autonomous interaction d. Preorientation phenomenon
Therapeutic encounter
A nurse is about to interview an older client whose glasses and hearing aid were placed in the bedside drawer for safe keeping. Before beginning the interview, which nursing intervention that will best facilitate data collection? a. Assist the client in putting on their glasses and hearing aid b. Give the client her glasses and hearing aid c. Ask the client if she needs her glasses and hearing aids d. Explain the importance of wearing glasses and hearing aids
Assist the client in putting on their glasses and hearing aid