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Module 3: Mental Health Concepts Questions With Complete Solutions The mother of a 3-year-old child tells the nurse that her child hit her doll after the mother scolded her for picking the neighbors' flowers. Which defense mechanism used by the child does the nurse identify in the mother's report? Displacement A client says to the nurse, "I've been following my diet and taking my medication. What else do you want to talk about today?" Which response would be most helpful during the working phase of the therapeutic alliance? "Some people have added exercise to diet and medication therapy and gotten positive results. Do you think that this would work for you? As the nurse prepares to interview a client being admitted to the mental health unit, the client says, "I asked my family to bring me in here to talk to someone, but now I don't know where to begin." Which response by the nurse would be most helpful? "Perhaps you can start by sharing some of your most recent concerns."
During a mental health intake interview, a young adult client who lives with his family rent free says, "I'm tired of not being able to offer my friends a beer just because my folks don't believe in taking a drink socially." Which nursing response would be therapeutic? "It seems that your parents expect you to follow their rules when you live under their roof." A nurse is participating in a care planning conference regarding care for a client whose spouse recently died. The registered nurse formulates a nursing diagnosis of dysfunctional grieving. Which priority intervention does the nurse expect to see incorporated into the plan? Determining the client's risk for violence toward self and others A client in the mental health unit tells the nurse, "My husband makes all the decisions about money, but I'm the one who's making the money now, not him. He needs to back off, but he's always directing every decision we make." Which nursing response would be the most therapeutic? "How do you feel the money decisions could best be handled in your household?" A nurse is attending a care planning conference for a client who recently received a diagnosis of acquired immunodeficiency syndrome and is experiencing difficulty adjusting to the illness.
"You seem to be saying no. Would you tell me more about your reluctance?" A single parent whose son was suspended from school for carrying a gun into the school says to the nurse, "I know he has no dad, but I've brought him up to know better, and anyway, where did he get the stupid gun? What should I do? He just won't listen to me." Which nursing response would be helpful at this time? "There is quite a bit that you can do. Let's talk about what you're already doing first." A client says to the nurse, "My health care provider says he thinks I'm ready to taper off my pain medication, but the new painkiller he prescribed doesn't relieve my pain the way the other pill did. I get pain when I try to do things." Which nursing response would be most supportive to the client? "Perhaps if I medicate you about a half-hour before you plan to start your daily activities, the medicine will be more effective." A client who was employed as a corporate manager before being laid off says to the nurse, "My wife thinks that I should work in a menial job to maintain our lifestyles until I find another job as a corporate manager, but I don't feel I should have to humiliate myself like that." Which nursing response would be therapeutic? "Have you shared your feelings with your wife?"
A young woman who has been divorced twice says to the nurse, "I've decided not to date men ever again! It never works out for me. Now I'm left with two children to bring up." Which nursing response would be therapeutic? "You talk about how the divorces affected you. Tell me how your children are dealing with the loss." A client says to the nurse, "What does my psychiatrist mean when she says that my illness is biologically based?" Which nursing statement would be the most informative? "There are many possible physical causes of mental illness, and they include problems in the brain." A nurse is caring for a 39-year-old client who has experienced a mild brain attack (stroke). The client is recently widowed, is very active physically, and has two young sons. The client says to the nurse, "I don't know what my sons will do if anything permanent happens to me. We have no other relatives, even on my late wife's side." Which nursing response would be therapeutic? "You seem to be feeling very troubled." A client who has been admitted to a surgical unit with a diagnosis of cancer is scheduled for surgery in the morning. When the nurse enters the room and begins the surgical preparation, the client states, "I'm not having surgery—you must have the wrong person! My test results were negative. I'll be
impending death. Which statement indicates to the nurse that this goal has been met? "I'd like to have my family here when I die." A client says to the nurse at the mental health clinic, "My husband and sister-in-law both have terminal illnesses, and my family thinks that because I'm a nurse I should be able to handle everything." Which nursing response would be therapeutic? "You've seen your loved ones dealing with some troubling events recently. Sounds as if you feel that your family expects more from you than from others in the family because you're a nurse." A 79-year-old client, recently widowed, says to the nurse, "My wife kept up our condominium single-handedly, and now my kids expect me to cook and clean for myself. I'm not lazy, but I don't know how to cook and I've burnt myself twice just frying up what was supposed to be bacon and eggs. I'm so frustrated and I've already lost 10 pounds this month." Which initial nursing statement should the nurse make to the client? "It seems as if you feel lost without your wife and maybe a bit ignored by your children." A physician tells a client that she has cancer, that her illness is terminal, and that she has a 6-month prognosis. After the physician leaves the client's room, which therapeutic statement should the nurse make to the client?
"What did your health care provider tell you about your condition? Can you tell me what you're thinking about?" The wife of a client who is dying says to the nurse, "I am able to take off the 6 months from work our health care provider feels that my husband will live, but what if he lives beyond that time?" Which therapeutic response should the nurse make? "Are there other options for you in taking work leave? What are your thoughts about reducing your work hours at first so that you can extend your compassionate leave?" The wife of a dying man is ignoring his rapid physiological decline and imminent death. She continues with her usual activities, exhibits inability to remember what others have just told her, and misses important appointments. Which therapeutic statement should the nurse make to the wife? "It isn't unusual for family to suffer from anticipatory grief when a loved one is dying." An older adult client who is dying says to the nurse, "My son is 40 years old, but he works in a very poorly paying job and is always borrowing money from me. I don't know how he's going to manage without me." Which response by the nurse would be therapeutic? "Could you share your feelings with your son just as you have with me?"
she would drink and drive when we told her over and over not to." Which statement by the nurse would be therapeutic? "Your sadness over losing your daughter is mixed with anger at her driving while intoxicated." A nursing student is assigned to work in the emergency department to assist victims after a tornado. The student says to the nurse in charge, "I don't know how to help these parents. Their son was just decapitated by a flying piece of glass, and they won't leave him. They did mention that they are Catholic." Which intervention does the nurse suggest for inclusion in a plan of immediate care for the family? Joining the family and, after they have been able to be with their son for some time, helping them relinquish their son's body to the nurses A nurse is caring for a bereaved man with acquired immunodeficiency syndrome who lost his twin brother in a rock-climbing accident a month ago. Which statement by the client should cause the nurse to be concerned? "Lately I've been feeling that life isn't that great." A client whose husband died 2 months ago says to the nurse, "After church, I visit my husband's grave and talk to him. It comforts me, but my daughter thinks I'm morbid and crazy and is upset with me because I don't want to meet her for coffee after
church like I used to." Which statement by the nurse would be therapeutic? "Sounds as if you have had difficulty letting your husband go from your life. What would happen if you visited his grave less frequently?" A nurse is talking to a client whose spouse died 10 months ago. Which statement by the client indicates successful mourning? "I'm planning a trip to England next fall to tour the mansions and their gardens." A 74-year-old widower of 3 months says to the nurse, "When my wife died, I lost my love and my best friend. Everyone I cared about is dead. We both were only children, and we had no kids. I'm more than ready to go when the time comes." Which nursing response should the nurse make? "Are you thinking of ending your life because your time has come?" A nurse coordinates the use of hospice care to visit a dying client who will be going home with his family. The nurse tells the family that which is one function of hospice services? Providing bereavement support to the family after the client's death A dying client with agoraphobia says to the nurse, "I've been unable to leave this house without tremendous effort for so long,
A client who is an attorney says to the clinic nurse, "I'm worried about my wife. She's been so distant and disorganized since our son died of leukemia 4 months ago. She never suggests that we go out or take our other children anywhere. Is this normal, or do I need to get her to a health care provider?" Which statement by the nurse would be therapeutic? "It's normal, but by the end of a year you can expect that your wife is improving and able to redirect her energy. Have you expressed your concerns to her?" A young nurse has just completed postmortem care of a 16-year- old client who died of cancer. The nurse says to the nurse manager, "I never get sick, and this client kept telling me that he couldn't remember not being ill. I feel terrible and so bad for him and about what he went through." Which statement by the nurse manager would be therapeutic? "Let's go for coffee and talk about this some more, shall we? We're both due for our coffee breaks." The 45-year-old husband of a client with breast cancer who just died says to the nurse, "If our health care provider had operated sooner, my wife would be alive now." Which statement by the nurse would be therapeutic? "Sounds as if you're feeling angry and pretty helpless right now."
During a one-to-one nurse-client session, the client plays with her pack of cigarettes and says, "I just get a couple of DVDs and watch movies so I won't have to look at my husband or talk to him." Which coping mechanism does the nurse recognize in the client's behaviors? Avoidance A 16-year-old client says, "My dad thinks I'm evil, but we get into fights because I let things build up. He never has any time for me because he's always glued to the TV. He doesn't even look at me when he talks." Which statement by the nurse encourages the client to use assertive behavior with his father? "Have you tried saying that directly to your dad? For example, you could say, 'I notice that you watch television when I'm telling you things that are important to me.'" A client who was formerly a workaholic has lost his job and is being supported financially by his wife. The client says to the nurse, "I know that my wife is disappointed in me, but I can't seem to get a job doing what I've done for 25 years. Why should I take a low-level job when she's able to support us financially?" Which response by the nurse would be therapeutic? "Can you tell me a little more about this?" A psychiatrist notes that a client being admitted to the inpatient mental health unit uses avoidance and denial to cope with stress.
"It seems that you feel that your husband could treat you well just as you treat him." A client says to the nurse, "My health care provider wants me to start keeping a journal every day about what's happening in my job." Which response by the nurse is appropriate? "Journal-keeping that identifies what seems to cause a strain in a person's life is a good way of improving one's health." A 62-year-old woman says, "Since my husband retired, 4 months ago, he's started playing golf 24/7, so after rearing our children alone while my workaholic husband ran his business, now I'm suddenly a golf widow." Which response by the nurse is appropriate? "Have you shared your feelings with your husband?" A client's son and daughter were killed during a fellow student's murderous rampage at their high school 9 months ago. The client says to the nurse, "My wife and I just feel empty and exhausted. I can't believe that I had a vasectomy after our son and daughter were born because we wanted to give them both whatever they needed. We have college funds for both of them that they'll never use now." The nurse should make which appropriate statement to the client? "Your loss touches me so. How truly devastated you both must be. Can you share what things you have been doing to grieve?"
The slightly overweight mother of a morbidly obese 11-year-old girl says, "My family physician is wild over my daughter's weight gain. He says she's not eating correctly and is too sedentary, and now she's at risk for diabetes. He says the sugar in her blood was up this month. It's all my fault because I eat the wrong things too, and I never get off the couch." Which statement by the nurse would be therapeutic in easing the client's self-blame? "Your daughter has a serious problem, but there are many successful programs that you can join with her to lose weight and improve your overall lifestyle." A client says to the nurse, "My health care provider tells me that I need to start progressive muscle relaxation (PMR) to ease my stress, but I just can't get the hang of it." Which response by the nurse would be most helpful? "PMR requires training sessions. Let's check into classes that you can attend to learn the technique." A nurse is teaching assertiveness training to a client with anger- management issues. Which instruction would the nurse give for helping the client assertively confront someone? Ask for private time to talk and point out the facts without being accusatory, then determine areas of mutual misunderstanding and request the changes you need.
grandchildren." Which response by the nurse would be therapeutic? "I am sorry you've had so many losses." The family of a client who is being discharged after trying to kill himself with one of his father's guns asks for a family meeting with the nurse to discuss their son's situation. Which statement by the nurse would be the most therapeutic start to the meeting? "I am going to begin by talking in general terms about your son's return home and some of the things that might happen. I can suggest measures that might be helpful, and then you can ask questions." A client with depression says to a nurse, "Why is my family meeting with you? Are you telling them about me?" Which response by the nurse would be therapeutic? "Your family is learning about depression and how best to help you so that they can be supportive of you. We do not talk about you or anything confidential about you." A client who has been referred for group therapy asks the nurse about the therapy. The nurse tells the client that this type of therapy is focused on which aspect(s)? The development of interpersonal skills, resolution of family problems, and effective use of community support
The parents of an adopted child schedule an appointment at a psychiatric clinic, and when they arrive, the nurse conducts an initial interview. One of the parents says to the nurse, "We need to speak to a psychiatrist about our adopted daughter. Could you please get one for us?" Which intervention by the nurse would be therapeutic? "The health care providers here feel that clients are best served when I conduct the initial interview after which the psychiatrist will see you with complete information." A 45-year-old fireman says to the nurse, "I've worked at some fires recently that were just devastating, but last week was the worst. I carried this little girl from a fire—she was badly burned and lived just a few minutes after I brought her out, and she said to me, 'Tell my mom and Rudy I love them both very much.' Her mom told me that Rudy is their dog, and he just mopes around the house since the little girl died. I keep thinking about her and just don't know if I can go on." Which response by the nurse would be therapeutic? "You're questioning your job because you're upset about the little girl you tried to save. Work stress can be treated and help you cope better. It is so important for you to seek treatment." A 68-year-old client whose husband died 2 months ago says to the nurse, "I'm having trouble sleeping lately, even though I don't nap in the daytime. I've been using warm milk without any results." Which statement by the nurse would be therapeutic?
