Mental Health Final Exam-with 100% verified solutions-2023-2024, Exams of Nursing

Download Mental Health Final Exam-with 100% verified solutions-2023-2024 and more Exams Nursing in PDF only on Docsity! Mental Health Final Exam-with 100% verified solutions-2023-2024 A nurse performed these actions while caring for patients in an inpatient psychiatric setting. Which action violated patients' rights? A. Prohibited a patient from using the telephone B. In patient's presence, opened a package mailed to patient C. Remained within arm's length of patient with homicidal ideation D. Permitted a patient with psychosis to refuse oral psychotropic medication. A. Prohibited a patient from using telephone A psychiatric nurse discusses rules of the therapeutic milieu and patient's rights with a newly admitted patient. Which rights should be included? (Select all that apply) The right to: A. Have visitors B. confidentiality C. A private Room D. complain about inadequate care E. select the nurse assigned to their care A. Have visitors B. Confidentiality D. Complain about inadequate care A nurse prepares to administer a scheduled injection of haloperidol to a patient with schizophrenia. As the nurse swabs the site, the patient shouts, "Stop! I don't want to take that medicine anymore. I hate the side effects." Select the nurse's best action. A. Assemble other stuff for a show of force and proceed with injection, using restrains if necessary. B. Stop the medication administration procedure and say to the patient, "Tell me more about the side effects you've been having." C. Proceed with the injection but explain to the patient that here are medications that will help reduce the unpleasant side effects. D. Say to the patient, "Since i've already drawn the medication in the syringe, I'm required to give it, but let's talk to the doctor about delaying next month's dose." B. Stop the medication administration procedure and say to the patient, "Tell me more about the side effects you've been having." An Adolescent hospitalized after a violent physical outburst tells the nurse, "i'm going to kill my father, but you can't tell anyone." Select the nurse's best response C. Management of interpersonal climate D. Use of therapeutic intervention strategies B. Management of milieu safety. An adolescent client is admitted to an acute care unity following an attempt to commit suicide. He hasn't said a word to anyone. Which of the following interventions should the nurse plan to implement first? A. Arrange one-to-one observation of the client. B. Encourage the client to interact with peers C. Teach the client about medication for depression. D. Obtain a medical history from the client and family. A. Arrange one-to one observation of the client. A nurse is told during change-of shift report that a client is stuporous. When assessing the client, which of the following findings should the nurse expect? A. the client arouses briefly in response to a sternal rub B. The client has a Glasgow coma scale score less than 5 C. The client exhibits decorticate rigidity. D. The client is alert but disoriented to time and place A. The client arouses briefly in response to a sternal rub Which statement about diagnosis of a mental disorder is true? A. The symptoms of each disorder are common among all cultures. B. Culture may cause variation in symptoms for each clinical disorder. C. All mental disorders listed in the DSM-5 seen in all other cultures D. Psychiatric diagnoses are listed in separately from other physical disorders in gives axes system. B. Culture may cause variations in symptoms for each clinical disorder. A cognitive therapist would help a client restructure the thought "I am stupid!" to A. "What i did was stupid." B. "I am not as smart as others." C. "Things usually go wrong for me." D. "Things like this should not happen to anyone." A. "What I did was stupid." The premise underlying behavioral therapy is A. Behavior is learned and can be modified B. Behavior is a product of unconscious drives. C. Motives must change before behavior changes D. Behavior is determined by a cognitions; change in conniptions produce new behavior A. Behavior is learned and can be modified Which of the following is the most vital element of therapeutic inpatient milieu? A. It creates an environment for safety and success B. It creates and environment for rest and recuperation C. It creates a structure that is easier for staff to manage D. It creates a structure that rewards the well-behaved A. It creates and environment for safety and sccess A client is admired for the third time to a psychiatric hospital with a diagnosis of schizophrenia. During the admission procedure, the nurse notices that the client is limping, quite dirty and unkempt, and seem to be actively hallucinating. Which of the following should the nurse's priority nursing assessment be? A. Perception of reality B. Support system/ Emergency contacts C. Physical Needs D. Mental Status C. Physical Needs Which of the following are documentation of client's affect? (Select all that apply) A. Crying B. Worthless C. Frowning D. Euphoric E. Blunted A: Crying C: Frowning E: Blunted A patient asks, "What are neurotransmitters? The doctor said mine are imbalanced." Select the nurse's best response. A. "What medications are you taking, are you experiencing side effects?" B. "They proceed us from harmful effects of free radicals, much like our nerves and white matter." C. "Neurotransmitters are substances we consume that influence memory and mood. D. "Neurotransmitters are natural chemicals that pass messages between brain cells." D. "Neurotransmitters are natural chemicals that pass messages between brain cells." The nurse administers a medication that potentiates the action of gamma-aminobutyric acid (GABA). Which effect would be expected? A. Reduce Anxiety B. Improved Memory C. More organize thinking D. Fewer sensory perceptual alteration A. Reduce Anxiety Exclusive use of Western psychological theories by nurses making client assessments will result in A. High level of care for all clients. B. Standardization of nomenclature for psychiatric disorders. C. Inadequate assessment of clients of diverse cultures. D. Greater ease in select appropriate treatment interventions C. Inadequate assessment of clients of diverse cultures. In which part of nursing care plan would the nurse expect to find this statement: Offer snacks and fingers foods frequently. A. Assessment B. Diagnosis C. Intervention D. Evaluation C. Intervention A patient diagnosed with schizophrenia tells the nurse, "the CIA is monitoring us through the fluorescent lights in this room. Be careful what you say." Which response by the nurse would be most therapeutic? A. "Let's talk about something other than the CIA." B. "It sounds like you're concerned about your privacy." C. "The CIA is prohibited from operating in health care facilities." D. "You have lost touch with reality, which is a symptoms of your illness." B. "It sounds like you're concerned about your privacy." A nurse interacts with a newly hospitalized patient. Select the nurse's comment act applies the communication technique of "offering self." A. "I've also had traumatic life experiences. Maybe it would help if i told you about them." B. "Why do you think you had so much difficulty adjusting to this change in your life?" C. "I hope you will feel better after getting accustomed to how this unit operates." D. "I'd like to sit with you for a while to help you get comfortable talking to me." D. "I'd like to sit with you for a while to help you get comfortable talking to me." A patient tells the nurse, "I don't think i'll ever get out of here." Select the nurse's most therapeutic response. A. "Don't talk that way. Of course you will leave here!" B. "Keep up the good work, and you certainly will." C. "You don't think you're making progress?" D. "Everyone feels that way sometimes." C. "You don't think you're making progress?" During the First interview with a parent whose child died in a car accident, the nurse felt empathic and reaches out to take the patient's hand. Select the correct analysis of the nurses behavior. A. It shows empty and compassion. It will encourage the patient to continue to express feelings. B. The gesture is premature. The patient's cultural and individual interpretation of touch is unknown . C. The patient will perceive the gesture as intrusive and overstepping boundaries. D. The action is inappropriate. Psychiatric patient should not be touched. B. The gesture is premature. The patient's cultural and individual interpretation of touch is unknown . During a One-on-One interaction with the nurse, a patient frequently looks nervously at the door. Select the best comment by the nurse regarding this nonverbal communication. A. "I notice you keep looking toward the door." B. "This is our time together. No one is going to interrupt us." C. "It looks as if you are eager to end out discussion for today. D. "If you are uncomfortable in this room, we can move someplace else." A. "I notice you keep looking toward the door." A school age child tells the school nurse, "Other kids call me mean names and will not sit with me at lunch. Nobody likes me." Select the nurse's most therapeutic response. A. "Just ignore them any they will leave you alone." B. "You should make friends with other children." C. "Call them names if they do that to you." D. "Tell me more about how you feel." D. "Tell me more about how you feel." A nurse is caring for an older client who begins to cry and states, "I knew God would punish me and I deserve this horrible sickness!" Which of the following responses should the nurse make? A. Why do you think you deserve this punishment? B. Don't worry about being punished by God. C. Let's talk about what is upsetting you D. You shouldn't say things that will upset you so much C. Let's talk about what is upsetting you Which food choice are best for a bipolar client in the manic phase? (Select all that apply) A. Roast beef and asparagus B. Spaghetti and meatballs C. Cheeseburger D. Ham and eggs E. Peanut butter and Jelly sandwich C. Cheeseburger E. Peanut Butter and Jelly Sandwich Which nursing charting entry is documentation of a behavioral symptom of mania? A. thoughts granted, flight of ideas noted B. Mood euphoric and expansive. Rates mood 10/10 C. Pacing halls throughout the day. Exhibits poor impulse control. D. Easily distracted, unable to focus on goals C. "Pacing halls throughout the day. Exhibits poor impulse control." A nurse on an in-patient psychiatric unit receives report at 1500 hours. Which client would need be assessed first? A. A client on a one to one status because of active suicidal ideations B. A client pacing the hall and experiencing irritability and flight of ideas. C. A client diagnosed with hypomania monopolizing time in the milieu. D. A client with a history of mania who is to be discharged in the morning. B. A client pacing the hall and experiencing irritability and flight of ideas. A client states to a nurse, "I feel as though I am the only one in the world feeling so depressed." The nurse responds, "I know what you mean." The nurse is obstructing communication in which of the following ways? A. Making value judgements B. Falsely reassuring the client C. Minimizing feelings D. Disapproving/Disagreeing C. Minimizing Feelings A newly admitted client diagnosed with bipolar I disorder is experiencing a manic episode. Which nursing diagnosis is a priority at the time? A. Risk for violence: Other-directed R/T poor impulse control B. Depressed mood C. Decreased peal sure in all or most activities E. Feelings of worthlessness and guilt The Nurse is evaluating a client who is suicidal. Which is a priority nursing intervention? A. Ask the client if any family members have mental illness B. Hospitalize that patine for further evaluation C. Assess for plan and ability to carry out plan D. Get a history of past suicide attempts C. Assess for plan and ability to carry out plan A manic client begins to make sexual advance towards visitors in the day room. When the nurse firmly states that this is inappropriate and will not be allowed, the client becomes verbally abusive and threatens physically violence to the nurse. Based on the analysis of this situation, which intervention should the nurse implement? A. Place the client in seclusion for 30 minutes B. Tell the client that the behavior is in appropriate C. Escort the client to their room, with the assistance of other staff. D. Tell the client that their telephone privileges are revoked for 24 hours. C. Escort the client to their room, with the assistance of other staff. Which nursing interventions are appropriate for a hospitalized client with mania who is exhibiting manipulative behavior? (Select all that apply) A. Communicate expected behaviors to the client B. Tell the client that they are not in charge of the nursing unit. C. Assist the client in identifying ways to setting limits on person behavior. D. Follow through with he consequences of behavior in a non-punitive manner. E. Enforce rules by informing the client that they will not be allowed to attend therapy groups. F. Have the client state the consequences for behaving in ways that are viewed as unacceptable A. Communicate expected behaviors to the client C. Assist the client in identifying ways to setting limits on person behavior. D. Follow through with the consequences of behavior in a non-punitive manner. F. Have the client state the consequences for behaving in ways that are viewed as unacceptable A nurse is meeting with a physician in the conference room and is approached by a depressed and withdrawn client. Which response by the nurse is most appropriate. A. Ask the client how she can help B. Ask the client if what she needs to urgent C. Tell the client that she will be available to talk with her in 5 minutes D. Tell the client that she will find her when she is finished helping the physician. A. Ask the client how she can help. Four individuals have given information about their suicide plans. Which plan evidences that greatest lethality? A. Turning on the oven and letting gas escape. B. Cutting the wrists in the bathroom C. Overdoing on aspiring with codeine D. Jumping from a high bridge at night D. Jumping from a high bridge at night A College student who failed two tests cried for hours and then tried to telephone a parent but got no answer. The student then gave several expensive sweaters to a roommate and asked to be left alone for a few hours. Which behavior provides the strongest clue of an impending suicide attempt? A. Calling parents B. Excessive crying C. Giving away sweaters D. Staying alone in dorm room C. Giving away sweaters A nurse assess a patient who reports a 3-week history of depression and period of uncontrolled crying. The patient says, "My business is bankrupt, and i was served with divorce papers." Which subsequent statement by the patient alerts the nurse to a concealed suicidal message? A. "I wish i were dead." B. "Life if not worth living." C. "I Have a plan that will fix everything." D. "My family will be better off without me." C. "I have a plan what will fix everything" Select the most critical questions for the nurse to ask an adolescent who has threatened to take an overdose of pills. A. "Why do you want to kill yourself?" B. "Do you have access to medications?" C. "have you been taking drugs and alcohol?" D. "Did something happen with your parents?" B. "Do you have access to medications? A client with chronic ongoing stress complains of physical symptoms. The nurse caring for him is aware that the most common chronic problem caused by stress is which of the following? A. Nausea B. Headaches C. Chest Pain D. Depressed Mood B. Headaches Stress reduction is likely to result in which of the following? (Select all that apply) A. Reduced pain B. Lower blood pressure C. Decreased cognitive functions D. Decreased Gastrointestinal problems A. Reduced pain B. Lower blood pressure D. Decreased gastrointestinal problems What would a client experience during a progressive relaxation session? A. Instruction in sequential tensing and relaxing of various muscle groups until the entire body is relaxed A. Regression B. Altruism C. Reaction Formation D. Undoing D. Undoing According to the attachment theory, relationship disorders are related to trauma associated with A. Insufficient food and/ or shelter B. Siblings and/ or strangers. C. Caregivers and/or parents D. Culture and/or religion C. Caregivers an/or patients A 22 year old patient complains of nightmares, flashbacks, and poor concentration. These symptoms are most consistent with which anxiety disorder? A. Panic Attack B. Phobic reaction C. OCD D. PTSD D. PTSD Which statement made by a client with PTSD would indicate improvement to the nurse? A. I exercise when those fears surface. B. I take valium to help me relax. C. I usually meet my friends for a beer when i feel upset D. I try to forget by blocking those thoughts from my mind. A. I exercise when those fears surface Lorazepam is prescribed for a client who has a generalized anxiety disorder. Which of the following instructions is most important for the nurse to give the client? A. Prolonged use can result in dependence. B. Take the medication 2 hours after eating. C. Take an additional dose if you don't obtain relief. D. Return once a month to have your blood level tested. A. Prolonged use can result in dependence. Which scenario demonstrates a dissociative fugue? A. After being caught in an extramarital affair, a man disappeared by then reappeared months later with no memory of what occurred while he was missing B. A man is extremely anxious about his problems and sometimes experiences dazed period of several minutes passing without conscious awareness of them. C. A woman finds unfamiliar clothes in her closet, is recognized whens he goes to new restaurants, and complains of "Blackouts" despite not drinking. D. A woman reports that when she feels tired or stressed, it seems like her body is not real and is somehow growing smaller. A. After being caught in an extramarital affair, a man disappeared by then reappeared months later with no memory of what occurred while he was missing What is a nurse's responsibility when a child is suspect of being abused or neglected? A. Report to CPS with a physician's order B. Parents must be informed before reporting to CPS C. Reporing of suspected abuse or neglect is required by law in each state. D. The nurse should consult a social worker before reporting to any authority C. Reporing of suspected abuse or neglect is required by law in each state. During an initial interview with parents, a nurse suspects child abuse. What behavior displayed by the parents would lead the nurse to be suspicious? A. Guilt B. Apathy C. Overconcern D. Ignoring the child C. Overconcern Which intervention is least appropriate for a nurse to use with a rape victim? A. Never leave the woman alone. B. Encourage expression of feelings C. Emphasize that she did the right thing in order to save her life D. Allow the client to shower and brush her teeth before an examination D. Allow the client to shower and brush her teeth before an examination A client presents in the ER after being sexually assaulted. She is physiologically table, but emotionally distraught. Which nursing action should receive priority? A. Assist with medical treatment B. Collect and prepare evidence for the police C. Attempt to reduce the client's anxiety level. D. Provide anticipatory guidance about normal responses to sexual assault. C. Attempt to reduce the client'a anxiety level Which nursing diagnosis is universally applicable for children diagnosed with autism spectrum disorders? A. Impaired social interaction related to disinterest in others B. Chornic low self-esteem related to excessive negative feedback C. Deficient fluid volume related to abnormal D. The child spins around the claps hands while walking A. Impaired social interaction related to disinterest in others which behavior indicates that the treatment plan for a child diagnosed with an autism spectrum disorder was effective? A. The child plays with one toy for 30 minutes B. The child repasts words spoken by a parent C. The child holds the parent's hand while walking. D. The child spins around and claps hands while walking C. The child holds the parent's hand while walking. A nurse will prepare teaching material for the parents of a child newly diagnosed with ADHD. Which medication will the information focus on? A. Paroxetine C. Attend psychotherapy sessions without encouragement. D. Be eager to discover the true reasons for physical symptoms B. Be resistant to accepting psychiatric help. To assist patients diagnosed with somatic symptoms disorders, nursing interventions of high priority: A. Explain the pathophysiology of symptoms B. Help these patients suppress feelings of anger C. Shift focus from somatic symptoms to feelings. D. Investigate each physical symptom as it is reported C. Shift focus from somatic symptoms to feelings. A patient with feats of serious corny artery disease was referred to the mental health center by a cardiologist. Extensive diagnostic evaluation showed no physical illness. The patient says, "My chest in tight, and my heart misses beats. I"m often absent from work. I don't go out much because i need to rest."" Which health problem is most likely? A. Conversion disorder B. Somatic symptoms disorder C. Antisocial personality disorder D. Illness anxiety disorder D. Illness anxiety disorder which treatment modality should a nurse recommend to help a patient diagnosed with a somatic symptom disorder to cope more effectively? A. Flooding B. Response prevention C. Relaxation techniques D. Systematic desensitization C. Relaxation techniques The information that is least relent when assessing a patient with a suspect somatization disorder is: A. Understanding coping mechanisms B. Results of diagnostic workups C. Potential for violence D. Limitations in actives of daily living C. Potential for violence When a couple in their early 40s tell the nurse that they ahem no had sexual relations in more than 5 years, the nurse should initially A. Mention that a lack of sexual desire is not an uncommon problem B. ask weather the couple finds this troublesome and are seeking help. C. Ask the couple about any medical conditions they have D. Remain noncommittal and allow them to take the lead B. ask weather the couple finds this troublesome and are seeking help. A client explains that he is not homosexual but that he prefers to dress in feminine clothing. This is a characters of A. Fetishism B. Exhibitionism C. Voyeurism D. Transvestism D. Transvestism A client with paraphilia tendencies tells the nurse that "I"m disgusted with my lifestyle." The nurse most appropriately. A. Assures him that his condition response well to treatment B. Tells him that the first step to managing his behavior is recognizing it as unhealthy C. Assess him for existence of suicidal ideations D. Recommends inpatient behavioral modification therapy. C. Assess him for existence of suicidal ideations When assessing for sexual dysfunction, which way of opening up the subject may increase the patient's comfort in discussing the topic? A. This is embarrassing for both of us, but i need to ask you about sexual problems. B. I have to ask you about sexual issues; don't fell uncomfortable discussing sexual issues with me C. Many people who have depression also experience sexual problems. Are there any problem you want to talk about? D. You may have sexual dysfunction, or similar problems. LEt's talk about it C. Many people who have depression also experience sexual problems. Are there any problem you want to talk about? A new staff nurse tells the clinical nurse specialist, "I am unsure about my role when patients bring up sexual problems." The lingual nurse specialist should give clarification by saying," All nurses: A. qualify as sexual counselors. Nurses have knowledge about the biopsychosocial aspected of sexuality through the life cycle B. Should be able to screen for sexual dysfunction and give basic information about sexual feelings, behaviors, and myths." C. Should defer questions about sex to other health care professional because of their limited knowledge of sexuality." D. Who are interested in sexual dysfunction can provide sex therapy for individuals and couples." B. Should be able to screen for sexual dysfunction and give basic information about sexual feelings, behaviors, and myths." Which of the following is most characteristic of cognitive disorders? A. Catatonia B. Depression C. Feeling of dread and doom D. Deficit in memory D. Deficit in memory The daughter of a 70-year old male client with dementia is attending a caretaker support meeting, and asks a nurse for a definition of dementia. The nurse responds: A. A personal neglect in self care B. Poor judgment, especially in social situations C. Memory loss occurring was a natural consequence of aging D. Loss of intellectual abilities sufficient to impair self-care D. Loss of intellectual abilities sufficient to impaired self-care A 70 year old client with alzheimer's disease becomes verbally abusive toward the nursing staff. What is the most appropriate action for the nurse to take? A. Administer lorazepam to calm the client B. Apply four point retardants to physically control the client in the ED. a patients vitals are BP 66/40, pulse 140, respiration 8 breaths and shallow. The nursing diagnosis is ineffective breathing pattern related to depression of respiratory center secondary to narcotic intoxication. Select the priority A. The patient will demonstrate effective coping skills and identify community resources for treated of substance abuse within 1 week of hospitalization B. Within 4 hours, vital signs will stabilize, with BP 90/60 pulse less than 100, and respiration at or above 12 C. The patient will correct describe a plan for home care and achieving a drug free state before release from the ED. D. Within 6 hours the patients breath sound will be clear bilaterally and throughout lung fields B. Within 4 hours, vital signs will stabilize, with BP 90/60 pulse less than 100, and respiration at or above 12 Family members of an individual undergoing a residential alcohol rehab program asks, "How can we help?" Select the nurses's best response A. It's important that you visit your family member every day B. Do not make any form of contact for the next few years C. Use random search and destroy tactics to keep the home alcohol free D. Empower your loved one to gain the responsibility and ownership of consequences A. It's important that you visit your family member every day Symptoms of withdrawal from opioids of which the nurse should asses include A. dilated pupils, tachycardia, elevated BP, and elation B. N/V, diaphoresis, anxiety, and hyperreflexia C. mood lability, incoordination, fever and drowsiness. D. excessive eating, constipation, and headache B. N/V, diaphoresis, anxiety, and hyperreflexia Select the priority outcome for a patient completing the fourth alcohol detoxification program in the past year. Prior to discharge the patient will A. state "I know i need long term treatment. B. Use denial and rationalization in healthy ways C. Identify constructive outlets for expression of anger D. Develop a trusting relationship with one staff member A. state "I know i need long term treatment. Which service would be expected to provide resources 24 hours a day, 7 days a week if need for persons with serious mental illness? A. Clubhouse model B. Cognitive Behavioral therapy C. Cognitive enhancement therapy D. Assertive community treatment D. Assertive community treatment A patient diagnosed with schizophrenia has had multiple relapses. The patient usually response quickly to antipsychotic medication but soon discontinues the medciation. Discharge plans include follow up at the mental health center, group home placement, and a psychosical day program. Which stargety should apply as the patient transisions from hospital to community? A. adminsier a second genration antipsychotic to help negative symptoms B. Use a quick dissolving medcaiotn formulation to reudce cheeking C. prescribe a long actin intramuscular antipsychotic medication D. Involve the patient in decisons aboutwhich medication is best D. Involve the patient in deciosn about which medications is the best A patient diagnosed with serious mental illens lives independently and attends a psychosial rehabilitation program. The patient prsents at the ER seeing hospitalzation. The patient has no acute asymtpoms by says, "I have no money to pay my rent or refull my prescription.". Select the nurse's best action A. Involve the patients case manager to provide crisis interveiton B. Send the patient to a homeless shelter until housing can be arranged C. Arrange for a shor tin patient admission and begin discharge planning D. Expaling that one must have active psychiatic symptoms to be admitted A. Invovle the patient case manager to provide crisis intervention The nurse wants to enroll a patient with poor social skills in a trianign prgoram for patients diagnosed with schizophrenia. Which description accraretly describe dsocial skill training? A. Patients learn social skill by practicing them in a supported employment setting B. Patient s learn to improve their attention and concerantion. C. Group leaders provide support without challenging patients to change. D. Complex interpersonal skills are taught by breaking them into simple behaviors D. Complex interpseronsal skilla re taught by btreaking them into simpel behaviors A nurse's neighbor says, "My sister has been daingose dwith bipolar disorder but will not take her meidcation. I have tried to help her for over 20 years, but it seems liek everything i do fails. Do you have any suggestion?". Select the nurse's best response A. "The national alliance on mental illness offers a family educaiton series that you might find helpful B. Since your sister is noncompliane, perhaps it's time for her ot be changed to injectable medication C. You have done all you can now its time to put yourself first and move on with your life. D. You cannot help her. WOuld you like to weigh th pros and cons discotinuing your relationship? A. The national alliance on mental illness offers a family education