Psych Midterm Review Quiz
A nursing student is conducting a clinical conference and is describing the characteristics associated with milieu therapy. Which of the following statements, if made by the student, indicates an understanding of the focus of this form of therapy?
"A living, learning, or working environment is the focus of milieu therapy."
The nurse is talking with a male client who is actively hallucinating. The client is fearful that the voices he hears will direct him to kill himself or will hurt him directly. Which of the following nursing statements would be therapeutic at this time?
"I don't hear them, but it must be frightening to hear voices that others can't hear."
A client hates her mother because of childhood neglect.The nurse determines which client statement represents the use of the use of the defense mechanism of reaction formation?
"I have a very wonderful mother whom I love very much."
The nurse is preparing a client for discharge who was hospitalized following a suicide attempt. The nurse evaluates that the client could benefit from further development of coping strategies if the client was overheard making which of the following statements prior to discharge?
"I know that I won't become depressed again after the treatment I received here."
A voluntarily hospitalized patient tells the nurse, "Get me the forms for discharge against medical advice so I can leave now." What is the nurse's best initial response?
"I will get them for you, but let's talk about your decision to leave treatment."
A client admitted to the inpatient unit is being considered for electroconvulsive therapy (ECT). The client is calm, but the client's daughter is hypervigilant and anxious. The daughter says to the nurse, "My mother's brain will be shocked with electricity. How can the doctor even think about doing this to her?" Which of the following responses by the nurse would be therapeutic?
"It sounds as though you are very concerned about the procedure. Let's discuss the procedure."
In the shift-change report, an off-going nurse criticizes a patient who wars heavy makeup. Which comment by the nurse who receives the report best demonstrates advocacy?
"Our patients need our help to learn behaviors that will help them get along in society."
The nurse has been caring for a client with a diagnosis of depression. The client says to the nurse, "I wish you would just be my friend." The appropriate response by the nurse is:
"Our relationship is a therapeutic and helping one."
Cognitive therapy was provided for a patient who frequently said, "I'm stupid." Which statement by the patient indicates the therapy was effective?
"Sometimes I do stupid things."
A nurse is having a conversation with a depressed client on an inpatient psychiatric unit. The client says to the nurse, "Things would be so much better for everyone if I just weren't around." Which of the following responses by the nurse would be appropriate at this time?
"You sound very unhappy. Are you thinking of harming yourself?"
A client receiving long-term therapy with lithium carbonate (Lithobid) exhibits muscle tremors, confusion, vomiting, and diarrhea. The nurse anticipates that the results of the latest test of the serum lithium level will be between:
1.5 and 2.0 mEq/L
Two students fail their introductory nursing course. One student plans to seek tutoring and retake the course next fall. The second student attempts suicide. Which of the following factors would have been influential in the development of the second student's crisis?
A lack of adequate coping mechanisms
A mental health nurse who has been meeting with a client with a diagnosis of post-traumatic stress disorder is in the termination phase of the nurse-client relationship. The nurse notes that the client has been quiet and withdrawn and interprets the client's behavior as:
A normal behavior that can occur during termination
A client who attempted suicide by hanging is brought to the emergency department by emergency medical services. The immediate nursing action is which of the following?
Assess the client's respiratory status and for the presence of neck injuries
The nurse in the pediatric unit is admitting a 2-year-old child. The nurse plans care, knowing that the child is in which stage of Erikson's psychosocial stages of development?
Autonomy versus shame and doubt
The client who is diagnosed with a borderline personality is admitted to the psychiatric unit. Based on a thorough understanding of personality disorders, the nurse would select which nursing diagnosis as the priority?
Risk for self-mutilation
A client has been admitted to the inpatient psychiatric unit because the client has displayed violent behavior and is at risk for potentially harming others. Which of the following should the nurse avoid doing when caring for this client?
Closing the door to the client's room when giving care to the client
When caring for a client who is experiencing a panic attack, which of the following nursing actions should be implemented?
Communicate with simple words and brief message
A client is admitted to the psychiatric unit with a diagnosis of bipolar affective disorder and mania. The nurse would prioritize that which of the following symptoms or behaviors requires immediate intervention?
Constant physical activity and poor oral intake
The nurse is told that the result of a serum carbamazepine (Tegretol) level for a client who is receiving the medication for the control his mood swings is 10mcg/mL. Based on this laboratory result, the nurse anticipates that the physician will prescribe:
Continuation of the presently prescribed dosage
The nurse is describing medication side effects to a client who is taking a benzodiazepine. The nurse tells the client to take the medication only as prescribed because of the most serious risk of:
Dependence
The nurse is working with a client who shows signs of benzodiazepine withdrawal. The nurse suspects that the client has suddenly discontinued taking which of the following prescribed medications?
Diazepam (Valium)
A mental health nurse is assigned to care for a client with a diagnosis of undifferentiated schizophrenia with acute exacerbation. The nurse uses which of the following approaches when planning care for this client?
Provide assistance with grooming and nutrition until the client's thinking has cleared.
The nurse is assigned to a client who is psychotic, pacing, agitated, and using aggressive gestures and rapid speech. The nurse determines that the priority of care at this time is which of the following?
Providing safety for the client and other clients on the unit
A patient begins therapy with a phenothiazine medication. What teaching should a nurse provide related to the drug's strong dopaminergic effects?
Report muscle stiffness
The client admitted to the mental health unit with major depression 3 days ago could hardly get out of bed without coaxing and needed constant encouragement to get dressed and participate in unit activities. Today, the client appears in the dayroom dressed and well-groomed, without any guidance from the staff. The client appears to be calm and relaxed, yet more energetic than before. The nurse should take which initial action after noting this client's behavior?
Speak to the client personally about the nurse's observations, and ask if the client is thinking about suicide.
A nurse in the emergency department is preparing to care for a female client who has just been sexually assaulted. Which of the following client behaviors would demonstrate denial?
The client is calm and quiet.
The nurse is assisting in developing a plan of care for a client with a psychotic disorder who is experiencing altered thought processes that include the belief that the food is being poisoned. The nurse develops strategies that will encourage the client to discuss feelings and plans to:
Use open-ended questions and silence.
A client with a potential for violence is exhibiting aggressive gestures, making belligerent comments to the other clients, and is continuously pacing in the hallway. Which of the following comments by the nurse would be therapeutic at this time?
What is causing you to become agitated?
Psychotherapy involves all below except:
appropriate medications
The goal for a patient is to increase resiliency. Which outcome should a nurse add to the plan of care? Within 3 days, the patient will:
identify healthy coping behaviors in response to stressful events.
The following patients are seen in the emergency department. Which of the following patients meets the severity of illness and intensity of care required for the admitting officer to recommend admission to the psychiatric unit? The patient who:
who is a single parent and hears voices saying, "Smother your infant"
The nurse is developing a care plan that will include goals that will help the client achieve an optimal level of functioning and appropriate resource utilization. When the nurse enters the client's room, the client asks the nurse, "Could you ask the physician to let me have a pass for the weekend?" The nursing response that assists the client in achieving these goals is:
"When the physician arrives on the unit, I will let him or her know that you have a question."
An acutely depressed client is receiving cognitive-behavioral therapy. The nurse is developing a plan of care for the client and includes interventions that focus on this type of therapy. Which of the following interventions would the nurse include? Select all that apply.
-Assisting the client to identify and test negative cognition -Assisting the client to rehearse new cognitive and behavioral responses -Assisting the client to develop alternative thinking patterns -Assisting the client to participate in the treatment process
A client has recently been diagnosed with mild to moderate NCD due to Alzheimer's disease.Which medication would the nurse expect the physician to order for the client's cognitive impairment?
Donepezil (Aricept)
In preparing for the orientation phase of the therapeutic relationship, the nurse suggests addressing which of the following subjects?
Establishing the parameters of the relationship
For the last year, a college student continually and unrealistically worries about academic performance and love life performance. The student is irritable and suffers from severe insomnia.This behavior is associated with which diagnosis?
Generalized Anxiety Disorder (GAD)
Which nursing diagnosis is written correctly?
Imbalanced nutrition: less than body requirements related to suspiciousness evidenced by 20 lbs. weight loss.
A client who has sustained severe injuries in a motorcycle accident was diagnosed with intensive care unit (ICU) psychosis. The nurse would be most likely to conclude that the client's status is improving if the client:
Increases the number of hours slept at one time and is increasingly alert
The nurse is preparing for the arrival of a new client at a drug abusers' residential treatment center and prepares to explain to the client that the emphasis of the center is on group and social interaction, and that rules and expectations are mediated by peer pressure. The most likely focus of therapy of this residential center is:
Milieu therapy
