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Mental Health Exam 1
- A fully developed outcome for a client goal would include: (SATA)
Attainable for client, measurable terms and time sensitive
- The nurse understands a client could be at risk for serotonin syndrome when taking which of the following medications in addition to over the counter medications or herbal supplements?
-Sertraline
- A 4-year-old child grabs toys from siblings, saying “I want that toy now!”. The siblings cry and the child’s parents become upset with the behavior. Using Freudian theory, a nurse can interpret the child behavior as a product of impulses originating in the:
-Id
- Which expected client outcome should a nurse identify as being correctly formulated?
- Client will initiate interaction with one peer during free time within 2 days.
- A voluntarily hospitalized patient tells the nurse, “Get me the forms for discharge against medical advice so I can leave now. “Which is the nurse’s best response?
-I will get them for you, but lets talk about your decision to leave treatment
- The client is being admitted to the inpatient psychiatric unit. The nurse conducts a mental status examination. Which of the following items are included in this examination?
-Appearance, mood and effect, thought and cognition
- A client with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which signs and symptoms of a potentially fatal side effect will the nurse teach the client about?
-blurring vision and muscular weakness
- Which information suggests that caution is necessary in prescribing a benzodiazepine to an anxious client?
-The client has a history of alcohol dependence
- A brother calls to speak to his sister who has been admitted to the psychiatric unit. The nurse connects home to the community phone and the sister is summoned. Later the nurse realizes that the brother was not on the client’s approved call list. What law has the nurse broken?
-The Health Insurance Portability and Accountability Act (HIPPA)
- The client attempted suicide by overdosing on pain medication. Once the client ingested the medication, she decided that she did not want to die and she sought immediate treatment. Once the client recovered from the physical effects of overdoes, the client voluntarily sought inpatient mental health treatment. Which of the following statements is true of voluntary admission?
-The client retains the right to request release
- A nurse says to the client, “Things will look better tomorrow after a good nights sleep.” This is an example of which communication technique?
-The nontherapeutic technique of giving reassurance
- A patient is involuntarily admitted to a psychiatric unit after calling a friend and saying, “I’ve got a gun and I’m going to shoot myself.” Which of the following rights has the patient lost temporarily?
- The right to leave the hospital without medical approval
- A depressed client states, “I have a chemical imbalance in my brain. I have no control over my behavior. Medications are my only hope to feel normal again. “Which nursing response is appropriate?”
-Medications are one way to address chemical imbalances. Environmental and interpersonal factors can also have an impact on biological factors.
- During an intake interview, which question would assist the nurse in gathering data about the clients judgement?
- “If you found a stamped, addressed envelope in the street, what would you do?”
- A nursing instructor asks a student to described the nursing process when initiating care of a client. The student nurse understands the nursing process order to be correctly identified as:
-Assessment, Nursing Diagnoses, Outcomes, Planning, Implementation, Evaluation
- During an intake assessment, a nurse asks both physiological and psychosocial questions. The client angrily responds, “I’m here for my heart, not my head problems.” Which is the nurse’s best response?
-Psychological factors, like excessive stress, have been found to affect medical conditions
- A mother rescues two of her four children from a house fire. In an emergency department, she cries, “I should have gone back in to get them. I should have died, not them.” Which of the following responses by the nurse is an example of reflection?
- You’re feeling guilty because you weren’t able to save your children
Why can’t they be added to what I am on now? Wouldn’t adding one help?” Which is the appropriate nursing response?
-Combined use can lead to a life-threatening condition called a hypertensive crisis
- A 29 year old client living with parents has few interpersonal relationships. The client states, “I have trouble trusting people.” Based on Erikson’s developmental theory, which should the nurse recognize as true statements about the client?
- A patient discloses several concerns and associated feelings. If the nurse wishes to seek clarification, which comment would be most appropriate?
-Am I correct in understanding that…
- The health care provider prescribes an antidepressant for an elderly client, but the nurse notices that the dosage is greater than the usual adult dosage. Which of the following best describes what action the nurse should take?
-Hold the medication until clarified with the health care provider
- Which interventions by a psychiatric nurse best utilizes the ethical principle of autonomy? The nurse:
- Explores alternative solutions with a patient, who then makes a choice
- Which of the following should the nurse plan to include in the assessment of an older adult client?
-Identify physical needs and necessary accommodations for this client
- A patient is about to be released and tells the staff nurse “I’m glad I’m getting out of here; I swear the first things I’ll do is kill my ex wife and that stupid boyfriend of hers. “Which of the following is the staff nurse’s legal duty?
-Report the threat to the treatment team and document the statement
- A client tells a nurse that he hates his doctor and plans to hurt the doctor, but she did not report this prior to leaving. When the nurse returns to work the next day, she finds that the physician has been brutally beaten by the client and the physician is hospitalized. Which of the following best represents the nurses failure to act by not reporting the client’s intent?
-Negligence
- A newly admitted patient is hyperactive, restless and disorganized. The patient goes to the dining room and begins to throw food. Verbal intervention is ineffective. Seclusion is instituted for the primary purpose of:
-Reducing environmental stimuli that negatively affect the patient
- A Mexican American patient puts a picture of the Virgin Mary on the bedside table. Under which section of the assessment should the nurse document this behavior?
-Culture
- Which one of the following best represents a potential liability issue for the professional nurse?
-Placing a patient who talks constantly and loudly into a secluded room alone.
- A researcher tells the nurse that she would like a patient to participate in a study on the effects of new medications. The nurse’s responsibility in regard to this study is:
-To assess whether the patient has the ability and legal right to give informed consent.
- A nurse is performing a mental health assessment on an adult client. According to Maslow’s hierarchy of needs, which client action would demonstrate the highest achievement in terms of mental health?
-Possessing a feeling of self fulfillment and realizing full potential
- A nurse explains to the family of a mentally ill patient how the nurse-patient relationship differs from other interpersonal relationships. Which is nurses best explanation?
-The focus is on the patient. Problems are discussed by the nurse and patient: but solutions are implemented by the patient.
- A client who is very dirty and has an offensive odor refused to take a shower when he was admitted to the psychiatric inpatient unit of the hospital. He yelled, “No, no, no bath!” when two staff members carried him into the shower and made him was himself thoroughly before allowing him to leave the shower area. Which of these statements is correct regarding this patients’ rights?
-This was a violation of patient rights because the patient was restrained by force
- The nurse is assessing a client who has a diagnosis of schizophrenia and takes a typical antipsychotic agent daily. Which assessment finding should alert the nurse to a potential adverse effect of typical antipsychotic medications?
-Temperature of 101 F
- Using Erickson’s theory of personality development, which of the following task occur with teenagers during puberty?
-Identifying oneself from one’s parents
