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NUR 205 Final
| Term | Definition |
|---|---|
| The nurse knows that mental health issues are constantly changing. What is a standard of professional performance to keep in current practice? | Education |
| What is the universal definition of psychiatric-mental health? | There is no universal definition for psychiatric-mental health. |
| A client with schizophrenia has been non-compliant with medications. The client requires frequent admissions to the psychiatric unit for acute psychotic episodes. What is this process called? | revolving door |
| A new graduate nurse has accepted a staff position at an inpatient mental health facility. The graduate nurse can expect to be responsible for basic-level functions, including... | using effective communication skills. |
| A significant change in the treatment of people with mental illness occurred in the 1950s when... | psychotropic drugs became available for use |
| A student appears very nervous on the first day of clinical in a psychiatric setting. The student reviews the instructor's guidelines and appropriately takes which of the following actions? | Discusses the anxious feelings with the instructor Builds rapport with the patient before asking personal questions Consults the instructor if a shocking situation arises |
| Before the period of the enlightenment, treatment of the mentally ill included... | placing the mentally ill on display for the public's amusement. |
| Legislation enacted in 1963 was largely responsible for which of the following shifts in care for the mentally ill? | The widespread use of community-based services |
| The Geri-Psych nurse understands that the DSM-5 describes all mental disorders with specific criteria. The DSM-5 has the following purposes: Select all that apply. | to assist in identifying the underlying causes of disorders. to provide a standardized nomenclature and language for all mental health professionals. to present defining characteristics or symptoms that differentiate specific diagnoses. |
| The appropriate action for a student nurse who says the wrong thing is to... | restate it by saying, “That didn't come out right. What I meant was...” |
| The creation of asylums during the 1800s was meant to... | provide food and shelter for the mentally ill |
| The goal of the 1963 Community Mental Health Centers Act was to... | deinstitutionalize state hospitals |
| The newly licensed RN has been hired at the local hospital in the Geri-Psych unit. Today is her first day of orientation to this facility. What would be the nurse's priority action if a client becomes aggressive? | maintain a safe distance from the client |
| The nurse consults the DSM for which of the following purposes? | To serve as a guide for client assessment |
| The nurse is assessing the factors contributing to the well-being of a newly admitted client. Which of the following would the nurse identify as having a positive impact on the individual's mental health? | The ability to effectively manage stress |
| What is meant by the term "revolving door effect" in mental health care? | Shorter and more frequent hospital stays for persons with severe and persistent mental illness |
| What is a positive aspect of treating clients with mental illness in a community-based care? | “You will be able to live in your own home while you still see a therapist regularly.” |
| Which of the following is true regarding mental health and mental illness? | In most cases, mental health is a state of emotional, psychological, and social wellness evidenced by satisfying interpersonal relationships, effective behavior and coping, positive self-concept, and emotional stability. |
| Which of the following would be a reason for a student nurse to use the DSM-5? | Understand the reason for the admission and the nature of psychiatric illnesses. |
| Peplau | Interpersonal model |
| Freud | psychoanalysis-Id, Ego, Super ego |
| Erickson | not just for kids |
| Piaget | cognitive development |
| Id | pleasure principal |
| Ego | rational thought |
| Super Ego | perfection principle |
| A client who has been physically aggressive arrives at the emergency room for a psychiatric assessment. What would be the best approach for the nurse to use? | Use brief statements and questions to obtain information. |
| A malpractice lawsuit was filed after a nurse restrained the client for screaming at and attempting to strike anyone who was within striking distance. The nurse followed agency procedures that were consistent with Joint Commission Standards. For which reason is this malpractice lawsuit most likely to be unsuccessful? | The nurse did not breach duty. |
| A nurse in the emergency department is planning for a client with mental illness to be placed in an inpatient hospitalization. Which is a condition of this type of admission? | present a clear danger to self or others |
| A nurse is performing safety assessments on a client in mechanical restraints as required by policy. Which action by the nurse demonstrates the ethical principle of non-maleficence? | Assuring that the restraints are not causing injury to the client |
| A student nurse is assigned to administer oral medications to a client. Which of these actions should a student nurse take if a client refuses to take prescribed oral medications? | ask the client's reason for refusing and report it to the primary care nurse |
| An adolescent on the unit is argumentative with staff and peers. The nurse tells the adolescent, "Arguing is not allowed. One more word and you will have to stay in your room the rest of the day." The nurse's directive is... | inappropriate; room restriction is not treatment in the least restrictive environment. |
| An adult client is put in restraints after all other attempts to reduce aggression have failed. Which of the following is required now that restraints have been instituted? | A face-to-face evaluation by a licensed independent practitioner within 1 hour of restraint. |
| During rounds, the depressed client is discovered to have completed a suicide attempt in the bathroom. The staff on the inpatient psychiatric unit have been very busy and fell behind on periodic assessment for this client. Which type of lawsuit could the client's family file? | Malpractice |
| Ensuring that the client has provided informed consent for a treatment regimen displays which of the following ethical principles? | Autonomy |
| The client feels his rights have been violated. Placing a client in restraints before using other methods of intervention violates which of the client's rights? | Receive treatment in the least restrictive environment |
| Under which conditions would it be in the client's best interest for the court to appoint a conservator, or legal guardian? | Gravely disabled Mentally incompetent Unable to provide basic needs when resources exist |
| What nursing intervention constitutes false imprisonment? | The client has been “pesky,” seeking the attention of nurses in the nurses' station much of the day. Now the nurse escorts the client to the room and tells the client to stay there or be put into seclusion. |
| Which of the following are criteria for instituting the short-term use of restraint or seclusion? | The client is aggressive. The client is imminently dangerous to himself or herself or to others. All other means of calming the client have been unsuccessful. |
| Which of the following client situations most urgently requires the nurse to break confidentiality and warn a third party? | A jealous man states, "I am getting my gun and going to shoot my wife's lover!" |
| A client is observed pacing the hall with clenched fists and swearing at others. The nurse intervenes immediately in a calm manner to prevent the client from moving to which phase of the aggression cycle? | Crisis |
| A client lost control of his behavior, broke a window, and made verbal threats to staff and other clients. The client was placed in mechanical restraints by the nursing team. Which statement should the nurse make to explain the use of restraints to the client? | "This is a means of keeping you and others safe." |
| A nurse is working with a client who has frequent angry outbursts. Which of the following statements is most helpful when working with this client? | Anger is a normal feeling, and you can use it to solve problems." |
| An angry client has just thrown a chair across the room and is racing to pick up another chair to throw. The most appropriate action by the nurse would be which of the following? | Call for an emergency response from trained personnel. |
| As the nurse is performing an assessment on the client, the client's son is yelling and is hitting his hand with a rolled up newspaper. Which stage of aggression does the nurse identify that the client's son is exhibiting? | Escalation |
| The nurse in the psychiatric unit is aware the atmosphere can change at any time. At which point in the stages of aggressive incidents is intervention least likely to be effective in preventing physically aggressive behavior? | Crisis |
| The nurse should assess clients' risks for anger or aggression in the care of clients with which of the following psychiatric diagnoses? | Acute alcohol intoxication Schizophrenia Alzheimer's dementia |
| What client on the mental health unit should be assessed as being at highest risk for directing violent behavior toward others? | a client who has paranoid delusions and believes is being followed by members of the mafia |
| Which client should be assessed as demonstrating aggression? | a client who stomps away from the nurses' station, goes into the day room, and grabs a pool cue from another client standing at the pool table |
| Which of the following statements about anger, hostility, and aggression are accurate? | Anger is an emotional response to a real or perceived provocation. Physical aggression involves harming other persons or property. Hostility is also referred to as verbal aggression. |
| Which of the following statements about the crisis phase of aggression when the client becomes physically aggressive is true? | Four to six trained staff members are needed to restrain. |
| A client is seeking treatment for a specific phobia. The nurse in the anxiety disorders clinic documents that the client's anxiety is related to exposure to the phobic object. Which is a realistic outcome for anxiety self-control in this situation? | practice relaxation techniques and report decreased physiological sensations associated with thoughts of the feared object. |
| A client asks how his prescribed alprazolam helps his anxiety disorder. The nurse explains during teaching of medications, that antianxiety medications such as alprazolam affect the function of which neurotransmitter that is believed to be dysfunctional in anxiety disorders? | GABA |
| A client asks the nurse, "Why do I have to go to counseling? Why can't I just take medications?" The best response by the nurse would be... | "Medications combined with therapy help you change how well you function." |
| A client experiences panic attacks when confronted with riding in elevators. The therapist is teaching the client ways to relax while incrementally exposing the client to getting on an elevator. This technique is called which of the following? | systematic desensitization |
| A client is currently experiencing a panic attack. Which of the following is the most appropriate response by the nurse? | "You are safe. Take a deep breath." |
| A client says to the nurse, “I just can't talk in front of the group. I'm trembling and I feel like I'm going to pass out.” The nurse assesses the client's anxiety to be at which level? | Severe |
| A client who suffers from frequent panic attacks describes the attack as feeling disconnected from himself. The nurse notes in the client's chart that the client reports experiencing... | depersonalization |
| A nurse caring for a client with generalized anxiety disorder tells a supervisor “I find myself feeling uncomfortable and anxious when the client starts trembling and perspiring. I develop cold clammy hands and my pulse races." In such an interaction, the client will most likely develop which of the following? | increased anxiety |
| A nurse detects that a client is experiencing panic-level anxiety. Which intervention should be immediately implemented? | provide calm, brief, directive communication |
| A psychiatric nurse visits a client at home. The client tells the nurse that he or she experiences chest pain, shortness of breath, and sweating whenever leaving home. The client has been unable to go to work for six weeks. The nurse recognizes this problem as which behavior? | agoraphobia |
| A student is preparing to give a class presentation. A few minutes before the presentation is to begin, the student seems nervous and distracted. The student is looking at, and listening to, the peer speaker and occasionally looking at note cards. When the peer speaker asks a question of the group, the student is able to answer correctly in a high pitched voice. The professor understands that the student is likely experiencing which level of anxiety? | Moderate |
| The client has been defensive toward communication with the nurse today. Which one of the following can be a positive outcome of using defense mechanisms? | Defense mechanisms can help a person to reduce anxiety. |
| The nurse enters the client's room and finds the client anxiously pacing the floor. The client begins shouting at the nurse, "Get out of my room!" The best intervention by the nurse would be to... | Stand at the doorway and say, "You seem upset." |
| The nurse is caring for clients in the out-patient unit. Which of the following would be key points for the nurse to remember when working with persons who are suffering from anxiety disorders? | Remember to practice techniques to manage stress and anxiety in your own life. |
| The nurse is educating a client and family about managing panic attacks after discharge from treatment. The nurse includes which of the following in the discharge teaching? | Continued development of positive coping skills Continued practice of relaxation techniques Development of a regular exercise program |
| The nurse knows that which of the following are stages in Selye's general adaptation syndrome? | Alarm reaction stage Resistance stage Exhaustion stage |
| The nurse knows that which one of the following statements is true about stress and anxiety? | Stress is the wear and tear that life causes on the body. |
| True or False: Anxiety cannot be completely eliminated from life. | True |
| The student nurse correctly identifies that which one of the following statements applies to the parasympathetic nervous system? | It is activated at the end of the resistance stage. |
| When a client is experiencing a panic attack while in the recreation room, what interventions are the nurse's first priorities when considering the client's safety? Select all that apply. | Remain with the client to assess needs . Turn off any televisions or radios in the immediate area. |
| When teaching a client with generalized anxiety disorder, what is the highest priority for the nurse to teach the client to avoid? | Caffeine |
| Which are cognitive–behavioral therapy techniques that may be used effectively with anxious clients? | Positive reframing Decatastrophizing Assertiveness training |
| Which of the following statements about the assessment of persons with anxiety and anxiety disorders is most accurate? | When an elder person has an onset of anxiety for the first time in his or her life, it is possible that the anxiety is associated with another condition |
| match the level of anxiety | Mild-Motivational Moderate-Focus on solving the problem Severe-Focus on escaping the anxiety Panic-Unable to focus |
| A client with antisocial personality disorder is begging to use the phone to call his wife, even though it is against the unit rules. The client begs, "It is just this once, and she will be so hurt if I don't call her." Which would be the most appropriate response by the nurse? | "You may not use the phone to call your wife." |
| A client with borderline personality disorder says to the nurse, "I feel so comfortable talking with you. You seem to have a special way about you that really helps me." Which would be the most appropriate response by the nurse? | "I'm here to help you just as all the staff members are." |
| A client with dependent personality disorder has a goal to increase her problem-solving skills. Which client behavior would indicate progress toward meeting that goal? | Asking questions |
| A female client with borderline personality was formerly cooperative with the treatment regimen. Suddenly, the client believes the staff is working against her and is refusing all interaction and participation in treatment. The nurse feels very frustrated by this client's behavior. What is the best action for the nurse to take regarding personal frustration with this client? | Discuss the frustration with a colleague or supervisor in a private setting. |
| A nurse is caring for a client that does not want to participate in group therapy. Which behavior is supportive of a diagnosis of dependent personality disorder | believes he or she is incapable of functioning independently . |
| A nurse is teaching a client with borderline personality disorder to reshape thinking patterns. What is an example of a cognitive restructuring technique that would be helpful for this client? | Recognize negative thoughts and replace them with positive ones. |
| A person with temperament traits of high harm avoidance would most likely suffer from which personality disorder? | Avoidant |
| The client is talking to staff members individually and attempting to manipulate them. Which of the following are important in the limit-setting technique to deal with manipulative behavior? | Teach social skills. Provide factual feedback about behavior. |
| The client states that decisions that are made by him are superior to everyone else's. What would the nurse expect to assess in a client with narcissistic personality disorder? | Grandiose and superior self-concept |
| The nurse explains to the client that therapy will be a long process. What is a realistic outcome for the care of a person with a personality disorder? | Outcomes that focus on change in behavior |
| The nurse is planning the type of approach that will be most effective in developing a therapeutic relationship with the client. The nurse should use a matter-of-fact approach with clients with which types of personality disorders? | Antisocial Paranoid Narcissistic |
| The nurse is talking to a client with schizoid personality disorder about finding a job. Which suggestion by the nurse would be most helpful? | "There is a job posting at the hospital for a file clerk in medical records." |
| The nurse is teaching a client with paranoid personality disorder to validate ideas with another person before taking action on him. What is the best rationale for this intervention? | It will assist the client to start basing decisions and actions on reality. |
| The nurse teaches an antisocial client to take a time-out in his room when challenged by another person instigating an argument. What is the main reason for the time-out? | It allows an opportunity for the client to regain control of emotions. |
| The staff nurse that has a student assigned to her unit today notices that the nursing student appears to cooperate with the group but does not complete agreed upon tasks at the appropriate time repeatedly and then displays negativity. The nursing student may be showing signs of which personality disorder or behavior? | Passive-aggressive behavior |
| When analyzing the behaviors of a client who meets the criteria for antisocial personality disorder, the nurse recognizes that which nursing diagnoses would be pertinent to the client's care? | ineffective coping |
| When establishing a relationship with a client who has borderline personality disorder, what is most important for the nurse to do? | Respect the client's boundaries at all times. |
| Which challenges are posed when working with clients with personality disorders? | Clients with personality disorders challenge the ability of therapeutic staff to work as a team. It can take a long time to change their behaviors, attitudes, or coping skills. The nurse can easily but mistakenly believe the client simply lacks motivation or the willingness to make changes. Team members may have differing opinions about individual clients. |
| Which disorder is characterized by pervasive mistrust and suspiciousness of others? | Paranoid personality disorder |
| What is the main reason why the periodic team meetings are important when caring for a client with antisocial personality? | Team consistency is important to prevent manipulation by the client. |
| What observation by the nurse is supportive of a diagnosis of avoidant personality disorder? | Client fears criticism from others, including staff. |
| What is a psychosocial explanation for the development of personality disorders? | Failure to complete a developmental task jeopardizes future personality development. |
| What would most likely be a type of behavior that would be manifested by a client who has histrionic personality disorder? | Having a tantrum if not getting enough attention |
| A client with schizophrenia has returned to the clinic because of an increase in symptoms. The client reports he stopped taking his medication because he did not like the side effects. The nurse educates the client about managing uncomfortable side effects. What would be included in the teaching plan? | Maintain a balanced calorie-controlled diet. Use stool softeners as needed. Suck on hard candy as desired. |
| A client with schizophrenia is seen sitting alone and talking out loud. Suddenly, the client stops and turns as if listening to someone. The nurse approaches and sits down beside the client. What is the best initial response by the nurse? | "I don't hear or see anyone else; what are you hearing and seeing?" |
| A client with severe and persistent mental illness has been taking antipsychotic medication for 20 years. The nurse observes during their therapy session that the client's behavior includes repetitive movements of the mouth and tongue, facial grimacing, and rocking back and forth. The nurse recognizes these behaviors as indicative of the following? | Tardive dyskinesia |
| A person suffering from schizophrenia has little emotional expression when interacting with others. The nurse would document the client's affect as which of the following? | Inappropriate Blunt Flat |
| For a client taking clozapine, which of the following symptoms should the nurse report to the physician immediately as it may be indicative of a potentially fatal side effect? | Sore throat and malaise. |
| One week after beginning therapy with thiothixene, the client demonstrates muscle rigidity, a temperature of 103°F, an elevated serum creatinine phosphokinase level, stupor, and incontinence. The nurse should notify the physician because these symptoms are indicative of... | neuroleptic malignant syndrome. |
Created by:
shondell1971
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