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Psychiatric Nursing

50 Questions  I  By [email protected]
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 interperson
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1.  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.
B.
C.
D.
2.  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.
B.
C.
D.
3.  Select the characteristics of the termination stage of group development. Select all that apply.
A.
B.
C.
D.
E.
F.
4.  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.
B.
C.
D.
5.  A client begins to experience extrapyramidal side effects from an antipsychotic medication. The nurse anticipates that the physician will prescribe which of the following to treat this condition?
A.
B.
C.
D.
6.  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.
B.
C.
D.
7.  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.
B.
C.
D.
8.  A client who has just been sexually assaulted is quiet and calm. The nurse analyzes this behavior as indicating which defense mechanism? 
A.
B.
C.
D.
9.  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.
B.
C.
D.
10.  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.
B.
C.
D.
11.  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.
B.
C.
D.
12.  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.
B.
C.
D.
13.  The nurse is caring for a client with anorexia nervosa. The nurse is monitoring the behavior of the client and understands that the client with anorexia nervosa manages anxiety by:
A.
B.
C.
D.
14.  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.
B.
C.
D.
15.  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.
B.
C.
D.
16.  The client with a diagnosis of anorexia nervosa, who is in a state of starvation, is in a two-bed room. A newly admitted client will be assigned to this client's room. Which of the following clients would be an appropriate choice as this client's roommate? 
A.
B.
C.
D.
17.  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.
B.
C.
D.
18.  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.
B.
C.
D.
19.  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.
B.
C.
D.
20.  The home health nurse visits a client at home and determines that the client is dependent on drugs. Which of the following assessment questions would assist the nurse to provide appropriate nursing care?
A.
B.
C.
D.
21.  The client with schizophrenia has been started on medication therapy with clozapine (Clozaril). The nurse assesses the results of which laboratory study to monitor for adverse effects from this medication?
A.
B.
C.
D.
22.  The nurse is preparing to perform an admission assessment on a client with a diagnosis of bulimia nervosa, and a nursing student will be observing the nurse. The nurse asks the student about the expected assessment findings and determines that the student needs to research the disorder further if the student states that which of the following is a characteristic finding?
A.
B.
C.
D.
23.  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.
B.
C.
D.
24.  Select the appropriate interventions for caring for the client in alcohol withdrawal. Select all that apply.
A.
B.
C.
D.
E.
F.
25.  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.
B.
C.
D.
26.  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.
B.
C.
D.
27.  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.
B.
C.
D.
28.  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.
B.
C.
D.
29.  The client with schizophrenia has been started on medication therapy with clozapine (Clozaril). The nurse assesses the results of which laboratory study to monitor for adverse effects from this medication?
A.
B.
C.
D.
30.  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.
B.
C.
D.
31.  The nurse determines that the wife of an alcoholic client is benefiting from attending an Al-Anon group when the nurse hears the wife say:
A.
B.
C.
D.
32.  A female client with anorexia nervosa is a member of a predischarge support group. The client verbalizes that she would like to buy some new clothes, but her finances are limited. Group members have brought some used clothes to the client to replace the client's old clothes. The client believes that the new clothes were much too tight and has reduced her calorie intake to 800 calories daily. The nurse analyzes this behavior as: 
A.
B.
C.
D.
33.  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.
B.
C.
D.
34.  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.
B.
C.
D.
35.  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.
B.
C.
D.
36.  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.
B.
C.
D.
37.  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.
B.
C.
D.
38.  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.
B.
C.
D.
39.  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.
B.
C.
D.
40.  The nurse is performing an assessment on a client with dementia. Which data gathered during the assessment indicate a manifestation associated with dementia?
A.
B.
C.
D.
41.  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.
B.
C.
D.
42.  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.
B.
C.
D.
43.  he spouse of a client admitted to the mental health unit for alcohol withdrawal says to the nurse, “I should get out of this bad situation.” The most helpful response by the nurse would be:
A.
B.
C.
D.
44.  A hospitalized client is started on phenelzine sulfate (Nardil) for the treatment of depression. The nurse instructs the client to avoid consuming which foods while taking this medication? Select all that apply.
A.
B.
C.
D.
E.
F.
45.  All treatment team members are seen as equally important in helping clients meet their treatment goals. This type of therapy approach is:
A.
B.
C.
D.
46.  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.
B.
C.
D.
47.  A woman comes into the emergency room in a severe state of anxiety following a car accident. The appropriate nursing intervention is to:
A.
B.
C.
D.
48.   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.
B.
C.
D.
49.  The nurse is monitoring a client who abuses alcohol for signs of alcohol withdrawal. Which of the following would alert the nurse to the potential for withdrawal delirium?
A.
B.
C.
D.
50.  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.
B.
C.
D.
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