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Mental health final
| Question | Answer |
|---|---|
| A client diagnosed with a mild anxiety disorder has been referred to treatment in a community mental health center. Treatment most likely provided at the center includes... | medical management of symptoms. |
| A client grieving the recent loss of her husband asks if she is becoming mentally ill because she is so sad. The nurse's best response would be... | “You are not mentally ill. )This is an expected reaction to the loss you have experienced.” Acute grief reactions are expected and therefore not considered mental illness.) |
| 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. (Basic-level functions include counseling, milieu therapy, self-care activities, psychobiologic interventions, health teaching, case management, and health promotion and maintenance) |
| 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? Select all that apply. | -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. |
| If a client states, "I carry this lucky rabbit's foot for luck, my dad did too, and it really works," which statement by the nurse reflects respect for the client's belief? | "I can accept that you feel it is lucky, so let's get to our activities for the day." |
| 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 |
| Nursing education has become broad in practice settings. The addition of Psychiatric nursing became a requirement in nursing education in 1950 by whom? | National League of Nursing (It was not until 1950 that the National League for Nursing, which accredits nursing programs, required schools to include an experience in psychiatric nursing. ) |
| One of the unforeseen effects of the movement toward community mental health services is... | an increased number of admissions to available hospital 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 provide a standardized nomenclature and language for all mental health professionals. -to present defining characteristics or symptoms that differentiate specific diagnoses. - to assist in identifying the underlying causes of disorders. |
| 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 case manager is providing an educational seminar for the nursing staff, she includes objectives from Healthy People 2020. Which of the following is the priority of the objectives for mental health? | Treatment of mental illness |
| The creation of asylums during the 1800s was meant to... | provide food and shelter for the mentally ill |
| The first training of nurses to work with persons with mental illness was in 1882 in which state? | Massachusetts |
| 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 |
| The nurse knows that mental health issues are constantly changing. Which of the following is a standard of professional performance to keep in current practice? | Education |
| There are many areas of practice in psychiatric mental health nursing. One of those is advanced-level practice. Which of the following is considered an advanced-level function? | Evaluation |
| 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 organization developed and maintains standards of practice that are used to determine safe quality care, and that can be used legally, if incorporated into the state practice act or nurse's rules and regulations, that guide the nursing profession? | ANA (American Nurses Association) |
| Which 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 is included in Healthy People 2020 objectives? | To increase the number of people who are identified, diagnosed, treated, and helped to live healthier lives |
| Which of the following is a major problem with large state institutions? Select all that apply. | -Attendants were accused of abusing the residents -Clients were geographically isolated from family and community -Clients were not given proper nutrition or clothed properly |
| Which of the following is a standard of practice? | Outcomes identification Standards of practice include assessment, diagnosis, outcomes identification, planning, implementation, coordination of care, health teaching and health promotion, and milieu therapy. |
| Which of the following is one of the American Nurses Association standards of practice for psychiatric–mental health nursing? | Some aspects of Standard 5: Implementation may only be carried out by psychiatric–mental health advanced practice nurses. |
| 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 statements by the nurse to the client's family is true of treatment of people with mental illness in the United States today? | Only one in four people needing mental health services are receiving those services. |
| 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. |
| Which one of the following is a result of federal legislation? | Making it more difficult to commit people for mental health treatment against their will. |
| A basic assumption of Freud's psychoanalytic theory is that... | all human behavior can be caused and can be explained. |
| A client begins to take stock of his life and look into the future. The nurse assesses that this client is in which of Erikson's developmental stages? | Integrity versus despair |
| Which of the following are complementary and alternative therapies? Select all that apply. | - massage and osteopathic therapy -aromatherapy - music and art therapy |
| A client has just been told she has cervical cancer. When asked about how this is impacting her, she states, "It's just an infection; it will clear up." The statement indicates that this patient… | is using denial to protect herself from an emotionally painful thought. |
| A client is supposed to be ambulating ad lib. He refuses to get out of bed, asks for a bed bath, and makes many demands of the nurses. He also yells that they are lazy and incompetent. This is which of the following defense mechanisms? | Projection |
| A client presents to the ED with a flat affect and disheveled appearance. The nurse objectively can see that the client has experienced an adventitious crisis. Which of the following are examples of adventitious crises? Select all that apply. | -Natural disasters - Violent crimes -War |
| A client reports a pattern of being suspicious of others, causing difficulty in sustaining lasting relationships. Which stage according to Erikson's psychosocial development was not successfully completed? | Trust vs. Mistrust |
| A client tells a nurse that he or she is using herbal supplements in addition to prescription medications. What would be the nurse's best response? | "Herbs have pharmacological effects on the body and can interact with some prescription medications." |
| "Herbs have pharmacological effects on the body and can interact with some prescription medications." | Weighing the advantages and disadvantages before making a decision |
| A student decides to go to a party the night before a exam instead of studying. After receiving a low score on the exam, the student tells a student, “I have to work too much and don't have time to study. It wouldn't matter anyway because the teacher is s | rationalization and projection |
| A mother is concerned about her child's development. The nurse knows which cognitive mode, according to Harry Stack Sullivan, begins in early childhood as the child begins to connect experiences in sequence? | Parataxic mode |
| A nurse has a difficult client has become frustrated. Which entry in nursing documentation is considered nonjudgmental in reporting findings? | The client does not recognize family members. |
| A nurse is assisting a patient who is working on the technique of systematic desensitization. When the patient feels anxious, the nurse can best use the principles of this technique by stating... | "Use the deep breathing techniques we practiced yesterday." |
| A nurse is meeting with a crisis support group. In efforts to help patients identify with one another, the nurse explains which of the following about the crisis experience? | "Even happy events can cause a crisis if the stress is overwhelming." |
| A nurse is participating in a group therapy session along with four clients. One client is experiencing moderate anxiety. Which of the following are indicators of moderate anxiety? Select all that apply. | -diaphoresis - higher pitched voice -increased pulse rate |
| A nurse is teaching decision-making skills to a client with dependent personality disorder. According to Erikson, the likely cause of the client developing dependent personality is failure to meet the critical task of which developmental stage? | -Industry |
| A nurse is working with a patient with an eating disorder who refuses to eat a muffin. The nurse asks the patient "Is there any you'd see the muffin as just flour and water, basic nutrients your body needs?" The nurse is using which type of therapy? | -Cognitive therapy |
| A nursing supervisor reprimands an employee for being chronically late for work. If the employee handles the reprimand using the defense mechanism of displacement, he would most likely do which of the following? | -Tell the unit housekeeper that his (the unit housekeeper's) work is sloppy |
| A patient is being admitted to an inpatient unit for treatment of anorexia nervosa. Of the following assessment data, which should the nurse place as highest priority in the plan of care? | -Frequent vomiting after meals |
| A patient is blaming his impending divorce on the fact that his wife goes out frequently with her girlfriends. If using reality therapy, the nurse would help the patient with which of the following responses? | "What role do you think you have played in the end of your marriage?" |
| A patient states, "I hate spending time with my family. They're always on my back about something! I won't do 'anything' they ask me to do." Which response by the nurse reflects a behavioral perspective? | "If you agree to start doing what your parents request, then they have agreed to respect your privacy more." |
| A student nurse attends a self-help group as part of a class assignment. While there the student recognizes a family friend. Upon returning home, the student talks about the friend's attendance with the family. The student's actions can be described as... | inappropriate; most self-help groups have a rule of confidentiality. |
| A teenage client defies the nurse's repeated requests to turn off the video game and go to sleep. The teen says angrily, "You sound just like my mother at home!" and continues to play the game. The nurse understands that this statement likely indicates… | the presence of transference. |
| According to Peplau, there are several roles of the nurse in a therapeutic relationship. These can be seen individually with the client or in a group setting. Which role would be used to offer direction to the client or group? | leader |
| During the initial interview with a client in crisis, the initial priority is to... | evaluate the potential for self-harm. |
| Group members are actively discussing a common topic. Members are sharing that they identify with what others are saying. The nurse leader recognizes that the group is in which stage of group development? | Working |
| The client asks the nurse how to select a therapist to help with support and understanding of mental illness. Which one of the following is an important characteristic of an effective therapist-client relationship in individual psychotherapy? | Match between the theoretical beliefs and style of therapy and the client's needs and expectations of therapy. |
| The family members of a patient with bipolar disorder express frustration with the proposed treatment plan of their loved one. Which group should the nurse suggest as most helpful to this family? | Family education group |
| The nurse has established a therapeutic relationship with a patient. The patient is beginning to share feelings openly with the nurse. The relationship has entered which phase according to Peplau's theory? | Identification |
| The nurse is assessing a client who is talking about her son's recent death but who shows no emotion of any kind. The nurse recognizes this behavior as which of the following defense mechanisms? | Intellectualization |
| The nurse is assisting a middle-age couple with marital counseling. Which of the following is a major developmental task of middle adulthood? | Reexamining life goals |
| The nurse is working with a client who has a history of inflicting spousal abuse. Although the nurse does not condone domestic violence, the nurse treats the client with unconditional positive regard through which of the following? | The client is still viewed as someone worthy of respect and assistance. |
| The nurse on the Psych unit reinforces to the clients that they can earn off-unit privileges for daily use of socially appropriate behavior. This is an example of employing which concept of behavior modification? | Operant conditioning |
| The nurse understands that crises are self-limiting. This implies that upon evaluation of crisis intervention, the nurse should assess for which outcome? | The patient will resume the precrisis level of functioning. |
| The nurse would recommend individual therapy for the client who expresses a desire to | bring about personal changes. |
| Which approach to therapy is most effective when planning for a client with negative thinking? | Cognitive therapy |
| Which of the following considerations should have the most influence in the nurse's choice of the treatment for the client | The client's feelings and perceptions about his or her situation |
| Which of the following is most essential when planning care for a client who is experiencing a crisis? | Explore previous coping strategies |
| Which of the following theories could be classified as humanistic theories? Select all that apply. | - Maslow's hierarchy of needs - Gestalt therapy - Rogers' client-centered therapy |
| Which one of the following statements is most accurate regarding the cohesiveness of a group in group therapy? | Cohesiveness is a desirable group characteristic that is associated with positive group outcomes. |
| A client has been started on antidepressants. The interdisciplinary team member most responsible for monitoring effectiveness and side effects of this new medication is the... | psychiatric nurse. |
| A client has just begun daily participation in a community-based partial hospitalization program. The patient can expect the nurse and staff to assist with which of the following treatment goals? Select all that apply. | -Stabilizing psychiatric symptoms -Improving activities of daily living - Learning to structure time -Developing social skills |
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