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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.  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.
2.  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.
3.  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.
B.
C.
D.
4.  A nurse is preparing to care for a dying client, and several family members are at the client's bedside. Select the therapeutic techniques that the nurse will use when communicating with the family. Select all that apply.
A.
B.
C.
D.
E.
F.
5.  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.
6.  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.
7.  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.
8.  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.
9.  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.
B.
C.
D.
10.  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.
11.  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.
12.  A hospitalized client with a history of alcohol abuse tells the nurse, “I am leaving now. I have to go. I don't want any more treatment. I have things that I have to do right away.” The client has not been discharged. In fact, the client is scheduled for an important diagnostic test to be performed in 1 hour. After the nurse discusses the client's concerns with the client, the client dresses and begins to walk out of the hospital room. The appropriate nursing action is to:
A.
B.
C.
D.
13.  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.
14.  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.
15.  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.
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.
B.
C.
D.
17.  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.
18.  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.
19.  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.
20.  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.
21.  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.
22.  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.
23.  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.
24.  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.
25.  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.
26.  Select the appropriate interventions for caring for the client in alcohol withdrawal. Select all that apply.
A.
B.
C.
D.
E.
F.
27.  The nurse is caring for a female client who was admitted to the mental health unit recently for anorexia nervosa. The nurse enters the client's room and notes that the client is engaged in rigorous push-ups. Which nursing action is appropriate?
A.
B.
C.
D.
28.  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.
29.  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.
B.
C.
D.
30.  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.
B.
C.
D.
31.  A male client with delirium becomes disoriented and confused in his room at night. The best initial nursing intervention is to:
A.
B.
C.
D.
32.  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.
33.  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.
B.
C.
D.
34.  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.
35.  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.
36.  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.
B.
C.
D.
37.  Unresolved feelings related to loss most likely may be recognized during which phase of the therapeutic nurse-client relationship?
A.
B.
C.
D.
38.   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.
39.  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.
40.  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.
B.
C.
D.
41.  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.
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.  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.
44.  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.
45.  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.
46.  A client who is delusional says to the nurse, “The federal guards were sent to kill me.” The nurse's best response is:
A.
B.
C.
D.
47.  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.
48.  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.
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.  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.
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