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NSG 3450. Mental Health Exam 1 Multiple Choice
Questions and Correct Answers
A 26-month-old displays negative behavior, refuses toilet training, and often says, "No!" Which psychosocial crisis is evident? a. Trust versus mistrust b. Initiative versus guilt c. Industry versus inferiority d. Autonomy versus shame and doubt - CORRECT ANSWER d. Autonomy versus shame and doubt A black client, originally from Haiti, has a diagnosis of major depressive disorder. A colleague tells the nurse, "This client often looks down and is reluctant to share feelings.
However, I've observed the client spontaneously interacting with other clients of color." Select the nurse's best response. a. "Clients of color depend on the church for support. Have you consulted the client's pastor?" b. "Encourage the client to talk in a group setting. It will be less intimidating than one- to-one interaction." c. "Don't take it personally. Clients of color often have a resentful attitude that takes a long time to overcome." d. "The client may have difficulty communicating in English. Have you considered using a cultural broker?" - CORRECT ANSWER d. "The client may have difficulty communicating in English. Have you considered using a cultural broker?" A category 5 tornado occurred in a community of 400 people. Many homes and businesses were destroyed. In the 2 years following the disaster, 140 individuals were diagnosed with post-traumatic stress disorder (PTSD). Which term best applies to these newly diagnosed cases? a. Prevalence b. Comorbidity c. Incidence d. Parity - CORRECT ANSWER c. Incidence
c. The psychiatrist has no obligation concerning the client's confidentiality. d. The psychiatrist is immune from charges of malpractice. - CORRECT ANSWER b. The psychiatrist demonstrated the duty to warn and protect. A client diagnosed with schizophrenia had an exacerbation related to medication nonadherence and was hospitalized for 5 days. The client's thoughts are now more organized, and discharge is planned. The client's family says, "It's too soon for discharge. We will just go through all this again." What action should the nurse take? a. ask the case manager to arrange a transfer to a long-term care facility. b. notify hospital security to handle the disturbance and escort the family off the unit. c. explain that the client will continue to improve if the medication is taken regularly. d. contact the health care provider to meet with the family and explain the discharge rationale. - CORRECT ANSWER c. explain that the client will continue to improve if the medication is taken regularly. A client diagnosed with schizophrenia has been stable for 2 months. Today the client's spouse calls the nurse to report the client has not taken prescribed medication and is having disorganized thinking. The client forgot to refill the prescription. The nurse arranges a refill. What is the best outcome to add to the plan of care? a. The client's spouse will mark dates for prescription refills on the family calendar. b. The nurse will obtain prescription refills every 90 days and deliver to the client. c. The client will call the nurse weekly to discuss medication-related issues.
d. The client will report to the clinic for medication follow-up every week. - CORRECT ANSWER a. The client's spouse will mark dates for prescription refills on the family calendar. A client diagnosed with schizophrenia lives in the community. On a home visit, the community psychiatric nurse case manager learns that the client: · wants to attend an activity group at the mental health outreach center. · is worried about being able to pay for the therapy. · does not know how to get from home to the outreach center. · has an appointment to have blood work at the same time an activity group meets. · wants to attend services at a church that is a half-mile from the client's home. Which tasks are part of the role of a community mental health nurse? (Select all that apply.) a. Rearranging conflicting care appointments b. Negotiating the cost of therapy for the client c. Arranging transportation to the outreach center d. Accompanying the client to church services weekly e. Monitoring to ensure the client's basic needs are met - CORRECT ANSWER a. Rearranging conflicting care appointments c. Arranging transportation to the outreach center e. Monitoring to ensure the client's basic needs are met
Physically - CORRECT ANSWER d. Client pacing, shouting. Haloperidol 5 mg given PO at
- No effect by 1315. At 1415 client yelled, "I'll punch anyone who gets near me," and struck another client with fist. Physically placed in seclusion at 1420. Seclusion order obtained from Dr. Smith at 1430 A client expresses a desire to be cared for by others and often behaves in a helpless fashion. Which stage of psychosexual development is most relevant to the client's needs? a. Latency b. Phallic c. Anal d. Oral - CORRECT ANSWER d. Oral A client in alcohol rehabilitation reveals to the nurse, "I feel terrible guilt for sexually abusing my 6-year-old before I was admitted." What is the nurse's most appropriate, initial action? a. Reporting the abuse to the local child protection agency. b. Reply, "I'm glad you feel comfortable talking to me about it." c. File a written report with the agency's ethics committee. d. Respect nurse-client relationship confidentiality. - CORRECT ANSWER a. Reporting the abuse to the local child protection agency. A client in the emergency department says, "Voices say someone is stalking me. They want to kill me because I developed a cure for cancer. I have a knife and will stab anyone who is a threat." Which aspects of the client's mental health have the greatest and most immediate concern to the nurse? (Select all that apply.)
a. Happiness b. Appraisal of reality c. Control over behavior d. Effectiveness in work e. Healthy self-concept - CORRECT ANSWER b. Appraisal of reality c. Control over behavior e. Healthy self-concept A client in the emergency department shows a variety of psychiatric symptoms, including restlessness and anxiety. The client says, "I feel sad because evil spirits have overtaken my mind." Which worldview is most applicable to this individual? a. Eastern/balance b. Southern/holistic c. Western/scientific d. Indigenous/harmony - CORRECT ANSWER d. Indigenous/harmony A client is fearful of riding on elevators. The therapist first rides an escalator with the client. The therapist and client then stand in an elevator with the door open for 5 minutes and later with the elevator door closed for 5 minutes. Which technique has the therapist used? a. Classic psychoanalytic therapy
a. Rational-emotive behavior therapy b. Psychodynamic psychotherapy c. Cognitive-behavioral therapy d. Operant conditioning - CORRECT ANSWER b. Psychodynamic psychotherapy A client repeatedly stated, "I'm stupid." Which statement by that client would show progress resulting from cognitive-behavioral therapy? a. "Sometimes I do stupid things." b. "Things always go wrong for me." c. "I always fail when I try new things." d. "I'm disappointed in my lack of ability." - CORRECT ANSWER a. "Sometimes I do stupid things." A client says to the nurse, "My father has been dead for over 10 years but talking to you is almost as comforting as the talks he and I had when I was a child." Which term applies to the client's comment? a. Superego b. Transference c. Reality testing d. Countertransference - CORRECT ANSWER b. Transference
A client says, "All my life I've been surrounded by stupidity. Everything I buy breaks because the entire American workforce is incompetent." This client is experiencing what type of reaction? a. self-esteem deficit. b. cognitive distortion. c. deficit in motivation. d. deficit in love and belonging. - CORRECT ANSWER b. cognitive distortion. A client says, "I always feel good when I wear a size 2 petite." Which type of cognitive distortion is evident? a. Disqualifying the positive b. Overgeneralization c. Catastrophizing d. Personalization - CORRECT ANSWER b. Overgeneralization A client states, "I'm starting cognitive-behavioral therapy. What can I expect from the sessions?" Which responses by the nurse would be appropriate? (Select all that apply.) a. "The therapist will be active and questioning." b. "You will be given some homework assignments." c. "The therapist will ask you to describe your dreams." d. "The therapist will help you look at your ideas and beliefs about yourself."
A client who has been hospitalized for 3 days with a serious mental illness says, "I've got to get out of here and back to my job. I get 60 to 80 messages a day, and I'm getting behind on my email correspondence." What is this client's perspective about health and illness? a.Fateful, magical b. Eastern, holistic c. Western, biomedical d. Harmonious, religious - CORRECT ANSWER c. Western, biomedical A client's relationships are intense and unstable. The client initially idealizes the significant other and then devalues him or her, resulting in frequent feelings of emptiness. This client will benefit from interventions to develop which aspect of mental health? a. Effectiveness in work b. Communication skills c. Productive activities d. Fulfilling relationships - CORRECT ANSWER d. Fulfilling relationships A college student received an invitation to attend the wedding of a close friend who lives across the country. The student is afraid of flying. Which type of therapy would be most helpful for this client? a. Psychoanalysis b. Aversion therapy
c. Systematic desensitization d. Short-term dynamic therapy - CORRECT ANSWER c. Systematic desensitization A community mental health nurse has worked for months to establish a relationship with a delusional, suspicious client. The client recently lost employment and could no longer afford prescribed medications. The client says, "Only a traitor would make me go to the hospital." What is the nurse's best initial intervention? a. With the client's consent, contact resources to provide medications without charge temporarily. b. Arrange a bed in a local homeless shelter with nightly on-site supervision. c. Hospitalize the client until the symptoms have stabilized. d. Ask the client, "Do you feel like I am a traitor?" - CORRECT ANSWER a. With the client's consent, contact resources to provide medications without charge temporarily. A family has a long history of conflicted relationships among the members. Which family member's comment best reflects a mentally healthy perspective? a. "I've made mistakes but everyone else in this family has also." b. "I remember joy and mutual respect from our early years together." c. "I will make some changes in my behavior for the good of the family." d. "It's best for me to move away from my family. Things will never change." - CORRECT ANSWER c. "I will make some changes in my behavior for the good of the family."
b. A misdiagnosed of depression. c. The believe that distress is the result of a curse or spell. d. Feelings of hopeless and helpless related to an unidentified cause. - CORRECT ANSWER c. The believe that distress is the result of a curse or spell. A health care provider prescribed long acting antipsychotic medication injections every 3 weeks at the clinic for a client with a history of medication nonadherence. For this plan to be successful, which factor will be of critical importance? a. The attitude of significant others toward the client b. Nutrition services in the client's neighborhood c. The level of trust between the client and nurse d. The availability of transportation to the clinic - CORRECT ANSWER d. The availability of transportation to the clinic A Mexican American client puts a picture of the Virgin Mary on the bedside table. What is the nurse's best action? a. Move the picture so it is beside a window. b. Send the picture to the business office safe. c. Leave the picture where the client placed it. d. Send the picture home with the client's family. - CORRECT ANSWER c. Leave the picture where the client placed it.
A Native American client describes a difficult childhood and dropping out of high school. The client abused alcohol as a teenager to escape feelings of isolation but stopped 10 years ago. The client now says, "I feel stupid. I've never had a good job. I don't help my people." Which nursing diagnosis applies? a. Risk for other-directed violence b. Chronic low self-esteem c. Deficient knowledge d. Social isolation - CORRECT ANSWER b. Chronic low self-esteem A Native American client sadly describes a difficult childhood. The client abused alcohol as a teenager but stopped 10 years ago. The client now says, "I feel stupid and good for nothing. I don't help my people." How should the treatment team focus planning for this client? a. Psychopharmacological and somatic therapies should be central techniques. b. Apply a psychoanalytical approach, focused on childhood trauma. c. Depression and alcohol abuse should be treated concurrently. d. Use a holistic approach, including mind, body, and spirit. - CORRECT ANSWER d. Use a holistic approach, including mind, body, and spirit. A new antidepressant is prescribed for an elderly client diagnosed with major depressive disorder, but the dose is more than the usual geriatric dose. What action should the nurse take? a. Consult a reliable drug reference b. Teach the client about possible side effects and adverse effects.
A nurse can best address factors of critical importance to successful community treatment by including making assessments focused on what? (Select all that apply.) a. housing adequacy. b. family and support systems. c. income adequacy and stability. d. early psychosocial development. e. substance abuse history and current use. - CORRECT ANSWER a. housing adequacy. b. family and support systems. c. income adequacy and stability. e. substance abuse history and current use. A nurse cares for a first-generation American whose family emigrated from Germany. Which worldview about the source of knowledge would this client likely have? a. Knowledge is acquired through use of affective or feeling senses. b. Science is the foundation of knowledge and proves something exists. c. Knowledge develops by striving for transcendence of the mind and body. d. Knowledge evolves from an individual's relationship with a supreme being. - CORRECT ANSWER b. Science is the foundation of knowledge and proves something exists. A nurse consistently encourages client to do his or her own activities of daily living. If the client is unable to complete an activity, the nurse helps until the client is once again independent. This nurse's practice is most influenced by which theorist?
a. Betty Neuman b. Patricia Benner c. Dorothea Orem d. Joyce Travelbee - CORRECT ANSWER c. Dorothea Orem A nurse encounters an unfamiliar psychiatric disorder on a new client's admission form. Which resource should the nurse consult to determine criteria used to establish this diagnosis? a. International Statistical Classification of Diseases and Related Health Problems (ICD-10) b. The ANA's Psychiatric-Mental Health Nursing Scope and Standards of Practice c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V) d. A behavioral health reference manual - CORRECT ANSWER c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V) A nurse finds a psychiatric advance directive in the medical record of a client currently experiencing psychosis. The directive was executed during a period when the client was stable and competent. What is the appropriate nursing action? a. review the directive with the client to ensure it is current. b. ensure that the directive is respected in treatment planning. c. consider the directive only if there is a cardiac or respiratory arrest.
