Psychiatric Nursing

50 Questions  I  By Nursejbv21
Please take the quiz to rate it.

 Psychiatric Nursing
Welcome to Psychiatric Nursing (HESI EXAMINATION) Prepared by: Jeffrey Viernes Psychiatric Nursing or mental health nursing is the specialty of nursing that cares for people of all ages withmental illness or mental distress, such as schizophrenia,bipolar disorder, psychosis, depression or dementia. Nurses in this area receive more training in psychological therapies, building a therapeutic alliance, dealing with challenging behavior, and the administration of psychiatric medication. The most important duty of a psychiatric nurse is to maintain a positive therapeutic relationship with patients in a clinical setting. The fundamental elements of mental health care revolve around the interpersonal relations and i more

  
Changes are done, please start the quiz.


Questions and Answers

Removing question excerpt is a premium feature

Upgrade and get a lot more done!
  • 1. 
    The nurse is working with a client who has sought counseling after trying to rescue a neighbor involved in a house fire. In spite of the client's efforts, the neighbor died. Which action does the nurse engage in with the client during the working phase of the nurse-client relationship? 
    • A. 

      Exploring the client's ability to function

    • B. 

      Exploring the client's potential for self-harm

    • C. 

      Inquiring about the client's perception or appraisal of the neighbor's death

    • D. 

      Inquiring about and examining the client's feelings that may block adaptive coping


  • 2. 
    A client who has just been sexually assaulted is quiet and calm. The nurse analyzes this behavior as indicating which defense mechanism? 
    • A. 

      Denial

    • B. 

      Projection

    • C. 

      Rationalization

    • D. 

      Intellectualization


  • 3. 
    Laboratory work is prescribed for a client who has been experiencing delusions. When the nurse approaches the client to obtain a specimen of the client's blood, the client begins to shout “You're all vampires. Let me out of here!” The appropriate nursing response is which of the following? 
    • A. 

      “What makes you think that I am a vampire?”

    • B. 

      “I'll leave and come back later for your blood.”

    • C. 

      “I am not going to hurt you; I am going to help you.”

    • D. 

      “It must be frightening to think that others want to hurt you.”


  • 4. 
    Unresolved feelings related to loss most likely may be recognized during which phase of the therapeutic nurse-client relationship?
    • A. 

      Working

    • B. 

      Trusting

    • C. 

      Orientation

    • D. 

      Termination


  • 5. 
    A client with a diagnosis of major depression who has attempted suicide says to the nurse, “I should have died. I've always been a failure. Nothing ever goes right for me.” The therapeutic response to the client is: 
    • A. 

      “I don't see you as a failure.”

    • B. 

      “You have everything to live for.”

    • C. 

      “Feeling like this is all part of being ill.”

    • D. 

      “You've been feeling like a failure for a while?”


  • 6. 
    The community health nurse visits a client at home. The client states, “I haven't slept at all the last couple of nights.” Which response by the nurse illustrates a therapeutic communication technique for this client? 
    • A. 

      “Go on.”

    • B. 

      “Sleeping?”

    • C. 

      “You're having difficulty sleeping?”

    • D. 

      “Sometimes, I have trouble sleeping too.”


  • 7. 
    A client admitted to the mental health unit is experiencing disturbed thought processes and believes that the food is being poisoned. Which communication technique does the nurse plan to use to encourage the client to eat? 
    • A. 

      Using open-ended questions and silence

    • B. 

      Focusing on self-disclosure regarding food preferences

    • C. 

      Identifying the reasons that the client may not want to eat

    • D. 

      Offering opinions about the necessity of adequate nutrition


  • 8. 
    A client is admitted to a mental health unit for treatment of psychotic behavior. The client is at the locked exit door and is shouting, “Let me out. There's nothing wrong with me. I don't belong here.” The nurse analyzes this behavior as: 
    • A. 

      Denial

    • B. 

      Projection

    • C. 

      Regression

    • D. 

      Rationalization


  • 9. 
    The supervisor reprimands the nurse in charge of the nursing unit because the charge nurse has not adhered to the unit budget. Later that afternoon, the charge nurse accuses the nursing staff of wasting supplies. This behavior is an example of: 
    • A. 

      Denial

    • B. 

      Repression

    • C. 

      Suppression

    • D. 

      Displacement


  • 10. 
    The client says to the nurse, “I'm going to die, and I wish my family would stop hoping for a cure! I get so angry when they carry on like this. After all, I'm the one who's dying.” The therapeutic response by the nurse is: 
    • A. 

      “Have you shared your feelings with your family?”

    • B. 

      “I think we should talk more about your anger with your family.”

    • C. 

      “You're feeling angry that your family continues to hope for you to be cured?”

    • D. 

      “Well, it sounds like you're being pretty pessimistic. After all, years ago, people died of pneumonia.”


  • 11. 
    The nurse employed in a mental health unit is assigned to care for a client admitted to the unit 2 days ago. On review of the client's record, the nurse notes that the admission was a voluntary admission. Based on this type of admission, the nurse anticipates which of the following? 
    • A. 

      The client will resist treatment measures.

    • B. 

      The client will be angry and will refuse care.

    • C. 

      The client's family will resist treatment measures.

    • D. 

      The client will participate in the planning of the care and treatment plan


  • 12. 
    A nurse enters a client's room, and the client is demanding release from the hospital. The nurse reviews the client's record and notes that the client was admitted 2 days ago for treatment of an anxiety disorder and that the admission was a voluntary admission. Which of the following actions will the nurse take? 
    • A. 

      Contact the physician.

    • B. 

      Call the client's family.

    • C. 

      Persuade the client to stay a few more days.

    • D. 

      Tell the client that discharge is not possible at this time.


  • 13. 
    A client has been admitted to the mental health unit. On admission assessment, the nurse notes that the client was admitted by involuntary status. Based on this type of admission, the nurse would most likely expect that the client: 
    • A. 

      Presents a harm to self

    • B. 

      Requested the admission

    • C. 

      Consented to the admission

    • D. 

      Provided written application to the facility for admission


  • 14. 
    The nurse is preparing the client for the termination phase of the nurse-client relationship. The nurse prepares to implement which nursing task appropriate for this phase?
    • A. 

      Planning short-term goals

    • B. 

      Making appropriate referrals

    • C. 

      Developing realistic solutions

    • D. 

      Identifying expected outcomes


  • 15. 
    During the termination phase of the nurse-client relationship, the clinic nurse observes that the client has made several sarcastic remarks and has an angry affect. The most appropriate interpretation of the behavior is that the client: 
    • A. 

      Needs to be admitted to the hospital.

    • B. 

      Needs to be referred to the psychiatrist as soon as possible.

    • C. 

      Requires further treatment and is not ready to be discharged.

    • D. 

      Is displaying typical behaviors that can occur during termination.


  • 16. 
    The nurse is providing care to a client admitted to the hospital with a diagnosis of acute anxiety disorder. While conversing with the client, the client says to the nurse, “I have a secret that I want to tell you. You won't tell anyone about it, will you?” The appropriate nursing response is which of the following? 
    • A. 

      “No, I won't tell anyone.”

    • B. 

      “I cannot promise to keep a secret.”

    • C. 

      “If you tell me the secret, I will tell it to your doctor.”

    • D. 

      “If you tell me the secret, I will need to document it in your record.”


  • 17. 
    The nurse employed in a mental health clinic is greeted by a neighbor in a local grocery store. The neighbor says to the nurse, “How is Carol doing? She is my best friend and is seen at your clinic every week.” The appropriate nursing response is which of the following? 
    • A. 

      “I cannot discuss any client situation with you.”

    • B. 

      “If you want to know about Carol, you need to ask her yourself.”

    • C. 

      “I'm not suppose to discuss this, but because you are my neighbor, I can tell you that she is doing great!”

    • D. 

      “I'm not suppose to discuss this, but because you are my neighbor, I can tell you that she really has some problems!”


  • 18. 
    A home health nurse is talking to the spouse of a client taking an antidepressant. The spouse says, “Now that my husband is responding to the antidepressant, the suicidal risk is over and you can stop making these home visits.” After analyzing this statement, which of the following is the appropriate nursing response? 
    • A. 

      “I need to continue with my visits. Your comment reflects a lack of knowledge that this disease runs in families.”

    • B. 

      “I agree with you. Clients who want to kill themselves are only suicidal for a limited time. No one can feel self-destructive forever.”

    • C. 

      “I agree with you. The suicidal threats were really attention seeking. Continuing to visit would reinforce your husband's use of manipulation.”

    • D. 

      “I need to continue with my visits. Most suicides occur within 3 months after improvement begins because the client now has the energy to carry out the suicidal intentions.”


  • 19. 
    The nurse is caring for a client who is scheduled for electroconvulsive therapy. The nurse notes that an informed consent has not been obtained for the procedure. On review of the record, the nurse notes that the admission was an involuntary hospitalization. Based on this information, the nurse determines: 
    • A. 

      That the physician will provide the informed consent

    • B. 

      That an informed consent does not need to be obtained

    • C. 

      That an informed consent should be obtained from the family

    • D. 

      That an informed consent needs to be obtained from the client


  • 20. 
    The client was admitted involuntarily to the mental health unit because of episodes of extremely violent behavior. The client is demanding to be discharged from the hospital and the nurse does not allow the client to leave. Which of the following represents the legal ramifications associated with the nurse's behavior? 
    • A. 

      The nurse will be charged with assault.

    • B. 

      The nurse will be charged with slander.

    • C. 

      The nurse will be charged with imprisonment.

    • D. 

      No charge will be made against the nurse because the nurse's actions are reasonable.


  • 21. 
    The client asks the nurse about milieu therapy. The nurse responds, knowing that the primary focus of milieu therapy can best be described as which of the following?
    • A. 

      A form of behavior modification therapy

    • B. 

      A cognitive approach to changing behavior

    • C. 

      A living, learning, or working environment

    • D. 

      A behavioral approach to changing behavior


  • 22. 
    The nurse is caring for a client with a phobia who is being treated for the condition. The client is introduced to short periods of exposure to the phobic object while in a relaxed state. The nurse understands that this form of behavior modification can best be described as: 
    • A. 

      Milieu therapy

    • B. 

      Aversion therapy

    • C. 

      Self-control therapy

    • D. 

      Systematic desensitization


  • 23. 
    A client with an eating disorder is planning to attend group meetings with Overeaters Anonymous, and the nurse describes this group to the client. The nurse determines that the client needs additional information if the client states which of the following about this self-help group? 
    • A. 

      “The leader is a nurse or psychiatrist.”

    • B. 

      “The members provide support to each other.”

    • C. 

      “People who have a similar problem are able to help others.”

    • D. 

      “It is designed to serve people who have a common problem.”


  • 24. 
    The nurse is conducting a group therapy session, and a client with a manic disorder is monopolizing the group. The appropriate nursing action is which of the following?
    • A. 

      Ask the client to leave.

    • B. 

      Refer the client to another group.

    • C. 

      Tell the client to stop monopolizing

    • D. 

      Thank the client for the contribution and tell him or her to allow others a chance to contribute


  • 25. 
    A nurse employed in a mental health unit of a hospital is the leader of a group psychotherapy session. The nurse's role in the termination stage of group development is to:
    • A. 

      Encourage problem-solving.

    • B. 

      Encourage accomplishment of the group's work.

    • C. 

      Acknowledge the contributions of each group member.

    • D. 

      Encourage members to become acquainted with one another.


  • 26. 
    All treatment team members are seen as equally important in helping clients meet their treatment goals. This type of therapy approach is:
    • A. 

      Milieu therapy

    • B. 

      Interpersonal therapy

    • C. 

      Behavior modification

    • D. 

      Rational emotive therapy


  • 27. 
    An 18-year-old woman is admitted to an inpatient mental health unit with the diagnosis of anorexia nervosa. A cognitive behavioral approach is used as part of her treatment plan. The nurse understands that the purpose of this approach is to: 
    • A. 

      Provide a supportive environment.

    • B. 

      Examine intrapsychic conflicts and past issues.

    • C. 

      Emphasize social interaction with clients who withdraw.

    • D. 

      Help the client identify and examine dysfunctional thoughts and beliefs.


  • 28. 
    A client with major depression is considering cognitive therapy. The client asks the nurse, “How does this treatment work?” The nurse responds and tells the client that:
    • A. 

      “This type of treatment will help you relax and develop new coping skills.”

    • B. 

      “This type of treatment helps you confront your fears by gradually exposing you to them.”

    • C. 

      “This type of treatment helps you examine how your past life has contributed to your problems.”

    • D. 

      This type of treatment helps you examine how your thoughts and feelings contribute to your difficulties.”


  • 29. 
    The client is preparing to attend a Gambler's Anonymous meeting for the first time. The prototype used by this group is the 12-step program developed by Alcoholics Anonymous. The nurse tells the client that the first step in the 12-step program is which of the following? 
    • A. 

      Admitting to having a problem

    • B. 

      Substituting other activities for gambling

    • C. 

      Stating that the gambling will be stopped

    • D. 

      Discontinuing relationships with friends who are gamblers


  • 30. 
    Select the characteristics of the termination stage of group development. Select all that apply.
    • A. 

      The group evaluates the experience.

    • B. 

      The real work of the group is accomplished.

    • C. 

      Group interaction involves superficial conversation.

    • D. 

      Group members become acquainted with each other.

    • E. 

      Some structuring of group norms, roles, and responsibilities take place.

    • F. 

      The group explores members' feelings about the group and the impending separation.


  • 31. 
    The nurse assesses a client with the admitting diagnosis of bipolar affective disorder, mania. The symptom presented by the client that requires the nurse's immediate intervention is the client's:
    • A. 

      Outlandish behaviors and inappropriate dress

    • B. 

      Nonstop physical activity and poor nutritional intake

    • C. 

      Grandiose delusions of being a royal descendent of King Arthur

    • D. 

      Constant, incessant talking that includes sexual innuendoes and teasing the staff


  • 32. 
    A client who is delusional says to the nurse, “The federal guards were sent to kill me.” The nurse's best response is:
    • A. 

      “I don't believe this is true.”

    • B. 

      “The guards are not out to kill you.”

    • C. 

      “What makes you think the guards were sent to hurt you?”

    • D. 

      “I don't know anything about the guards. Do you feel afraid that people are trying to hurt you?”


  • 33. 
    A woman comes into the emergency room in a severe state of anxiety following a car accident. The appropriate nursing intervention is to:
    • A. 

      Remain with the client.

    • B. 

      Put the client in a quiet room.

    • C. 

      Teach the client deep breathing.

    • D. 

      Encourage the client to talk about their feelings and concerns.


  • 34. 
    A male client with delirium becomes disoriented and confused in his room at night. The best initial nursing intervention is to:
    • A. 

      Move the client next to the nurse's station.

    • B. 

      Use an indirect light source and turn off the television.

    • C. 

      Keep the television and a soft light on during the night.

    • D. 

      Play soft music during the night, and maintain a well-lit room.


  • 35. 
    The nurse is performing an assessment on a client with dementia. Which data gathered during the assessment indicate a manifestation associated with dementia?
    • A. 

      Confabulation

    • B. 

      Improvement in sleeping

    • C. 

      Absence of sundown syndrome

    • D. 

      Presence of personal hygienic care


  • 36. 
    The nurse is discharging a client with a history of command hallucinations to harm self or others. The nurse provides instructions to the client about interventions for hallucinations and anxiety and determines that the client understands the instructions if the client states:
    • A. 

      “My medications won't make me anxious.”

    • B. 

      “I'll go to support group and talk so that I don't hurt anyone.”

    • C. 

      “I won't get anxious or hear things if I get enough sleep and eat well.”

    • D. 

      “I can call my therapist when I'm hallucinating so that I can talk about my feelings and plans and not hurt anyone.”


  • 37. 
    The nurse develops a nursing diagnosis of self-care deficit for an older client with dementia. Which of the following is an appropriate goal for this client?
    • A. 

      The client will function at the highest level of independence possible.

    • B. 

      The client will complete all activities of daily living independently within a 1-hour time frame.

    • C. 

      The client will be admitted to a long-term care facility to have activities of daily living needs met.

    • D. 

      The nursing staff will attend to all the client's activities of daily living needs during the hospital stay.


  • 38. 
    The nurse is caring for a male client diagnosed with catatonic stupor. The client is lying on the bed with his body pulled into a fetal position. The appropriate nursing intervention is which of the following? 
    • A. 

      Ask direct questions to encourage talking.

    • B. 

      Leave the client alone and intermittently check on him.

    • C. 

      Sit beside the client in silence with occasional open-ended questions.

    • D. 

      Take the client into the dayroom with other clients so that they can help watch him.


  • 39. 
    The client is admitted to the mental health unit with a diagnosis of schizophrenia. A nursing diagnosis formulated for the client is thought processes, disturbed related to paranoia. In formulating nursing interventions with the members of the health care team, the nurse provides instructions to: 
    • A. 

      Increase socialization of the client with peers.

    • B. 

      Avoid laughing or whispering in front of the client.

    • C. 

      Begin to educate the client about social supports in the community.

    • D. 

      Have the client sign a release of information to appropriate parties so that adequate data can be obtained for assessment purposes.


  • 40. 
     A client is admitted to the mental health unit with a diagnosis of depression. The nurse develops a plan of care for the client and includes which appropriate activity in the plan?
    • A. 

      Reading and writing most of the day

    • B. 

      Several activities from which the client can choose

    • C. 

      Nothing, until the client asks to participate in milieu

    • D. 

      A structured program of activities in which the client can participate


  • 41. 
    When planning the discharge of a client with chronic anxiety, the nurse directs the goals at promoting a safe environment at home. The appropriate maintenance goal should focus on which of the following? 
    • A. 

      Ignoring feelings of anxiety

    • B. 

      Identifying anxiety-producing situations

    • C. 

      Continued contact with a crisis counselor

    • D. 

      Eliminating all anxiety from daily situations


  • 42. 
    he client is unwilling to go out of the house for fear of “doing something crazy in public.” Because of this fear, the client remains homebound, except when accompanied outside by the spouse. Based on this data, the nurse determines that the client is experiencing: 
    • A. 

      Agoraphobia

    • B. 

      Social phobia

    • C. 

      Claustrophobia

    • D. 

      Hypochondriasis


  • 43. 
    A nurse is conducting a group therapy session. During the session, a client with mania consistently talks and dominates the group session, and her behavior is disrupting group interactions. The nurse would initially: 
    • A. 

      Ask the client to leave the group session.

    • B. 

      Ask another nurse to escort the client out of the group session.

    • C. 

      Tell the client that she will not be able to attend any future group sessions.

    • D. 

      Tell the client that she needs to allow other clients in the group time to talk.


  • 44. 
    A client is admitted to a medical nursing unit with a diagnosis of acute blindness. Many tests are performed, and there seems to be no organic reason why this client cannot see. The nurse later learns that when a family of three was killed. The nurse suspects that the client may be experiencing a: 
    • A. 

      Psychosis

    • B. 

      Repression

    • C. 

      Conversion disorder

    • D. 

      Dissociative disorder


  • 45. 
    The manic client announces to everyone in the dayroom that a stripper is coming to perform this evening. When the nurse firmly states that this will not happen, the manic client becomes verbally abusive and threatens physical violence to the nurse. Based on the analysis of this situation, the nurse determines that the appropriate action would be to: 
    • A. 

      Orient the client to time, person, and place.

    • B. 

      Tell the client that the behavior is not appropriate.

    • C. 

      Escort the manic client to her room, with assistance.

    • D. 

      Tell the client that smoking privileges are revoked for 24 hours.


  • 46. 
    The nurse is planning activities for a client who has bipolar disorder with aggressive social behavior. Which of the following activities would be most appropriate for this client?
    • A. 

      Chess

    • B. 

      Writing

    • C. 

      Ping pong

    • D. 

      Basketball


  • 47. 
    A client is admitted to the hospital with a diagnosis of major depression, severe, single episode. The nurse assesses the client and identifies a nursing diagnosis of nutrition: less than body requirements, imbalanced related to poor nutritional intake. The appropriate nursing intervention related to this diagnosis is: 
    • A. 

      Weigh the client three times per week before breakfast.

    • B. 

      Explain to the client the importance of a good nutritional intake.

    • C. 

      Schedule brief nursing interactions with the client during several meals in which small portions are offered.

    • D. 

      Report the nutritional concern to the psychiatrist and obtain a nutritional consultation as soon as possible.


  • 48. 
    The depressed client verbalizes feelings of low self-esteem and self-worth typified by statements such as “I'm such a failure. I can't do anything right.” The best nursing response would be to:
    • A. 

      Tell the client that this is not true, that we all have a purpose in life.

    • B. 

      Identify recent behaviors or accomplishments that demonstrate the client's skills.

    • C. 

      Reassure the client that you know how the client is feeling and that things will get better.

    • D. 

      Remain with the client and sit in silence; this will encourage the client to verbalize feelings.


  • 49. 
    A client with a diagnosis of major depression, recurrent, with psychotic features, is admitted to the mental health unit. To create a safe environment for the client, the nurse most importantly devises a plan of care that deals specifically with the client's:
    • A. 

      Self-care deficit.

    • B. 

      Imbalanced nutrition.

    • C. 

      Deficient knowledge.

    • D. 

      Disturbed thought processes.


  • 50. 
    The nurse observes that a client is pacing, agitated, and presenting aggressive gestures. The client's speech pattern is rapid, and affect is belligerent. Based on these observations, the nurse's immediate priority of care is to: 
    • A. 

      Provide safety for the client and other clients on the unit.

    • B. 

      Provide the clients on the unit with a sense of comfort and safety.

    • C. 

      Assist the staff in caring for the client in a controlled environment.

    • D. 

      Offer the client a less stimulated area to calm down and gain control.


Back to top

Removing ad is a premium feature

Upgrade and get a lot more done!
Take Another Quiz
We have sent an email with your new password.