Mental Health Exam 2

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  • 1/118 Questions

    Which of the following is a correct assumption regarding the concept of crisis? 

    • A. Crises occur only in individuals with psychopathology.
    • B. The stressful event that precipitates crisis is seldom identifiable.
    • C. A crisis situation contains the potential for psychological growth or deterioration.
    • d. Crises are chronic situations that recur many times during an individual's life.
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About This Quiz

Mental Health Exam 2 explores crisis intervention through scenarios involving psychological growth, ineffective coping strategies, traumatic stress, and dispositional crises. It assesses understanding of appropriate interventions and support mechanisms in mental health nursing.

Mental Health Exam 2 - Quiz

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  • 2. 

    The most appropriate nursing intervention with Ginger (from question 7) would be to:

    • A. Suggest she move to a college closer to home.

    • B. Work with Ginger on unresolved dependency issues.

    • C. Help her find someone in the college town from whom she could seek assistance rather than calling her mother regularly.

    • D. Recommend that the college physician prescribe an antianxiety medication for Ginger.

    Correct Answer
    A. B. Work with Ginger on unresolved dependency issues.
    Explanation
    The most appropriate nursing intervention for Ginger would be to work with her on unresolved dependency issues. This suggests that Ginger may have underlying emotional or psychological issues that are causing her to rely heavily on her mother. By addressing these dependency issues, the nurse can help Ginger develop more independence and coping skills, which will ultimately benefit her in the long run. Suggesting that she move closer to home, finding someone else to seek assistance from, or recommending medication are not addressing the root cause of Ginger's dependency issues.

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  • 3. 

    Theresa is hospitalized following a suicide attempt after breaking up with her boyfriend. Theresa says to the nurse, “When I get out of here, I'm going to try this again, and next time I'll choose a no-fail method.” Which is the best response by the nurse?

    • A. “You are safe here. We will make sure nothing happens to you.”

    • B. “You're just lucky your roommate came home when she did.”

    • C. “What exactly do you plan to do?”

    • D. “I don't understand. You have so much to live for.”

    Correct Answer
    A. C. “What exactly do you plan to do?”
    Explanation
    The best response by the nurse is to ask Theresa what exactly she plans to do. This response shows concern for Theresa's safety and opens up a dialogue about her intentions. It allows the nurse to assess the seriousness of the situation and potentially intervene to prevent further harm.

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  • 4. 

    In determining degree of suicidal risk with a suicidal client, the nurse assesses the following behavioral manifestations: severely depressed, withdrawn, statements of worthlessness, difficulty accomplishing activities of daily living, no close support systems. The nurse identifies the client's risk for suicide as:

    • A. Low

    • B. Moderate

    • C. High

    • D. Unable to determine

    Correct Answer
    A. C. High
    Explanation
    The nurse identifies the client's risk for suicide as high because the client is exhibiting several behavioral manifestations that are commonly associated with a higher risk of suicide. These manifestations include severe depression, withdrawal from others, statements of worthlessness, difficulty completing daily activities, and lacking close support systems. These factors indicate that the client is experiencing significant distress and may be at a higher risk for suicidal thoughts and behaviors.

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  • 5. 

    Tony, age 21, has been diagnosed with schizophrenia. He has been socially isolated and hearing voices telling him to kill his parents. He has been admitted to the psychiatric unit from the emergency department. The initial nursing intervention for Tony is to:

    • A. Give him an injection of Thorazine.

    • B. Ensure a safe environment for him and others.

    • C. Place him in restraints.

    • D. Order him a nutritious diet.

    Correct Answer
    A. B. Ensure a safe environment for him and others.
    Explanation
    The initial nursing intervention for Tony, who has been diagnosed with schizophrenia and is experiencing auditory hallucinations and homicidal thoughts, is to ensure a safe environment for him and others. This is important to prevent harm to himself and others. Providing a safe environment may involve removing any potential weapons or harmful objects, closely monitoring his behavior, and implementing appropriate safety measures. Giving him medication or placing him in restraints may be considered later interventions depending on his condition and the recommendation of the healthcare team. Ordering him a nutritious diet is not the priority in this situation.

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  • 6. 

    The most appropriate crisis intervention with Amanda (from question 3) would be to:

    • A. Encourage her to recognize how lucky she is to be alive.

    • B. Discuss stages of grief and feelings associated with each.

    • C. Identify community resources that can help Amanda.

    • D. Suggest that she find a place to live that provides a storm shelter.

    Correct Answer
    A. B. Discuss stages of grief and feelings associated with each.
    Explanation
    The most appropriate crisis intervention with Amanda would be to discuss stages of grief and feelings associated with each. This would help Amanda understand and process her emotions and reactions to the traumatic event she experienced, allowing her to begin the healing process. It would also provide her with a framework for understanding her own journey through grief and help her feel supported and validated in her experiences. Additionally, discussing the stages of grief can help normalize her feelings and provide her with a sense of hope for the future.

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  • 7. 

    Ginger, age 19 and an only child, left 3 months ago to attend a college of her choice 500 miles away from her parents. It is Ginger's first time away from home. She has difficulty making decisions and will not undertake anything new without first consulting her mother. They talk on the phone almost every day. Ginger has recently started having anxiety attacks. She consults the nurse practitioner in the student health center. This type of crisis is called:

    • A. Crisis resulting from traumatic stress

    • B. Dispositional crisis

    • C. Psychiatric emergency

    • D. Maturational/developmental crisis

    Correct Answer
    A. D. Maturational/developmental crisis
    Explanation
    Ginger's situation can be categorized as a maturational/developmental crisis because she is experiencing anxiety attacks as a result of being away from home for the first time and facing new challenges in college. This type of crisis is common during major life transitions and milestones, such as leaving home for college. Ginger's difficulty in making decisions and her constant need for consultation with her mother further indicate that she is struggling with the developmental task of individuation and separation from her parents.

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  • 8. 

    The desired outcome of working with an individual who has witnessed a traumatic event and is now experiencing panic anxiety is:

    • A. The individual will experience no anxiety.

    • B. The individual will demonstrate hope for the future.

    • C. The individual will maintain anxiety at manageable level.

    • D. The individual will verbalize acceptance of self as worthy.

    Correct Answer
    A. C. The individual will maintain anxiety at manageable level.
    Explanation
    The desired outcome of working with an individual who has witnessed a traumatic event and is now experiencing panic anxiety is for the individual to maintain anxiety at a manageable level. This means that the goal is not to eliminate anxiety completely, as some level of anxiety may be normal and adaptive in certain situations. Instead, the focus is on helping the individual learn coping strategies and techniques to manage their anxiety so that it does not become overwhelming or interfere with their daily functioning. This approach recognizes that complete elimination of anxiety may not be realistic or necessary, but instead aims to help the individual develop skills to effectively manage and cope with their anxiety.

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  • 9. 

    Karen, age 23, graduated from nursing school with a 3.2/4.0 grade point average. She recently took the NCLEX exam and did not pass. Because of this, she had to give up her graduate nursing job until she can pass the exam. She has become very depressed and has sought counseling at the mental health clinic. Karen says to the psychiatric nurse, “I am a complete failure. I'm so dumb, I can't do anything right.” What is the most appropriate nursing diagnosis for Karen?

    • A. Chronic low self-esteem

    • B. Situational low self-esteem

    • C. Defensive coping

    • D. Risk for situational low self-esteem

    Correct Answer
    A. B. Situational low self-esteem
    Explanation
    The most appropriate nursing diagnosis for Karen is situational low self-esteem. This is because Karen's feelings of being a failure and not being able to do anything right are directly related to her recent failure in passing the NCLEX exam and having to give up her graduate nursing job. It is a situational issue that is causing her low self-esteem, rather than a chronic or ongoing problem.

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  • 10. 

    Which of the following outcome criteria would be most appropriate for the client described in question 1?

    • A. Karen is able to express positive aspects about herself and her life situation.

    • B. Karen is able to accept constructive criticism without becoming defensive.

    • C. Karen is able to develop positive interpersonal relationships.

    • D. Karen is able to accept positive feedback from others.

    Correct Answer
    A. A. Karen is able to express positive aspects about herself and her life situation.
    Explanation
    The most appropriate outcome criteria for the client described in question 1 would be that Karen is able to express positive aspects about herself and her life situation. This is because the question states that the client is described in question 1, and based on the options provided, expressing positive aspects about herself and her life situation would be the most relevant and appropriate outcome for the client.

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  • 11. 

    . Nancy tried out for the cheerleading squad in junior high, but was rejected. At age 15, she had looked forward to trying out for the cheerleading squad in high school. She took cheerleading classes and practiced for many hours every day. However, when tryouts were held, she was not selected. She has become despondent, and her mother takes her to the mental health clinic for counseling. Nancy tells the nurse, “What's the use of trying? I'm not good at anything!” Which of the following nursing interventions is best for Nancy's specific problem?

    • A. Encourage Nancy to talk about her feeling of shame over the second failure.

    • B. Assist Nancy to problem-solve her reasons for not making the team.

    • C. Help Nancy understand the importance of good self-care and personal hygiene in the maintenance of self-esteem.

    • D. Explore with Nancy her past successes and accomplishments.

    Correct Answer
    A. D. Explore with Nancy her past successes and accomplishments.
    Explanation
    Exploring Nancy's past successes and accomplishments can help her to recognize her strengths and build her self-esteem. By reminding her of her previous achievements, the nurse can help Nancy see that she is capable of success and that this recent failure does not define her abilities. This intervention can also help Nancy to regain her confidence and motivation to try again in the future.

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  • 12. 

    The psychiatric nurse encourages Nancy (the client in question 3) to express her anger. Why is this an appropriate nursing intervention?

    • A. Anger is the basis for self-esteem problems.

    • B. The nurse suspects that Karen was abused as a child.

    • C. The nurse is attempting to guide Karen through the grief process.

    • D. The nurse recognizes that Karen has long-standing repressed anger.

    Correct Answer
    A. C. The nurse is attempting to guide Karen through the grief process.
    Explanation
    The nurse encourages Nancy to express her anger because it is an appropriate nursing intervention to guide her through the grief process. Expressing anger can be a healthy way for Nancy to cope with her emotions and work through her grief. It allows her to acknowledge and process her feelings, leading to a healthier and more effective grieving process. By encouraging Nancy to express her anger, the nurse is providing her with a supportive and therapeutic environment to navigate her grief journey.

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  • 13. 

    Twins Jan and Jean still dress alike even though they are grown and married. This is an example of which of the following?

    • A. Rigid boundary

    • B. Enmeshed boundary

    • C. A boundary violation

    • D. Boundary pliancy

    Correct Answer
    A. B. Enmeshed boundary
    Explanation
    This is an example of an enmeshed boundary. Enmeshed boundaries occur when individuals have difficulty distinguishing their own thoughts, feelings, and identities from those of others. In this case, Jan and Jean continue to dress alike even though they are grown and married, indicating a lack of individuality and a strong sense of merging their identities with each other.

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  • 14. 

    Velma told Betty a secret that Mary had told her. This is an example of which of the following?

    • A. Too flexible boundary

    • B. A boundary violation

    • C. Rigid boundary

    • D. Enmeshed boundary

    Correct Answer
    A. B. A boundary violation
    Explanation
    Velma telling Betty a secret that Mary had told her is an example of a boundary violation. Boundaries are the limits and expectations we set in our relationships to protect our privacy and personal information. In this situation, Velma crossed a boundary by sharing a secret that Mary had entrusted to her, violating Mary's trust and privacy. This action demonstrates a lack of respect for boundaries and can lead to strained relationships.

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  • 15. 

    Tommy says to his friend, “I can't ever talk to my Daddy until after he has read his newspaper.” This is an example of which of the following?

    • A. Rigid boundary

    • B. A boundary violation

    • C. Enmeshed boundary

    • D. Too flexible boundary

    Correct Answer
    A. A. Rigid boundary
    Explanation
    This statement suggests that Tommy's father has a strict rule that he must read his newspaper before Tommy can talk to him. This indicates a rigid boundary, as there is a clear and inflexible rule about when communication can occur.

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  • 16. 

    Which of the following individuals is at highest risk for suicide? 

    • A. Nancy, age 33, Asian American, Catholic, middle socioeconomic group, alcoholic

    • B. John, age 72, white, Methodist, low socioeconomic group, diagnosis of metastatic cancer of the pancreas

    • C. Carol, age 15, African American, Baptist, high socioeconomic group, no physical or mental health problems

    • D. Mike, age 55, Jewish, middle socioeconomic group, suffered myocardial infarction a year ago

    Correct Answer
    A. B. John, age 72, white, Methodist, low socioeconomic group, diagnosis of metastatic cancer of the pancreas
    Explanation
    John, age 72, who has been diagnosed with metastatic cancer of the pancreas, is at the highest risk for suicide. Having a terminal illness like cancer can lead to feelings of hopelessness and despair, which can increase the risk of suicidal ideation. Additionally, being in a low socioeconomic group may limit access to quality healthcare and support services, further exacerbating feelings of distress. Age is also a risk factor, as older individuals may experience increased isolation and loss of social support. Therefore, John's combination of physical health condition, socioeconomic status, and age puts him at the highest risk for suicide.

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  • 17. 

    Some biological factors may be associated with the predisposition to suicide. Which of the following biological factors have been implicated?

    • A. Genetics and decreased levels of serotonin

    • B. Heredity and increased levels of norepinephrine

    • C. Temporal lobe atrophy and decreased levels of acetylcholine

    • D. Structural alterations of the brain and increased levels of dopamine

    Correct Answer
    A. A. Genetics and decreased levels of serotonin
    Explanation
    Genetics and decreased levels of serotonin have been implicated as biological factors associated with the predisposition to suicide. Serotonin is a neurotransmitter that plays a role in regulating mood, and lower levels of serotonin have been linked to an increased risk of depression and suicidal behavior. Additionally, genetic factors can influence an individual's susceptibility to mental health disorders, including depression and suicidal tendencies. Therefore, the combination of genetics and decreased levels of serotonin can contribute to an increased predisposition to suicide.

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  • 18. 

    Theresa, age 27, was admitted to the psychiatric unit from the medical intensive care unit where she was treated for taking a deliberate overdose of her antidepressant medication, trazodone (Desyrel). She says to the nurse, “My boyfriend broke up with me. We had been together for 6 years. I love him so much. I know I'll never get over him.” Which is the best response by the nurse?

    • A. “You'll get over him in time, Theresa.”

    • B. “Forget him. There are other fish in the sea.”

    • C. “You must be feeling very sad about your loss.”

    • D. “Why do you think he broke up with you, Theresa?”

    Correct Answer
    A. C. “You must be feeling very sad about your loss.”
    Explanation
    The best response by the nurse is "You must be feeling very sad about your loss." This response acknowledges Theresa's feelings and validates her emotions. It shows empathy and understanding towards Theresa's situation, allowing her to express her emotions and feel supported. The other options either minimize her feelings or focus on finding a reason for the breakup, which may not be helpful in the immediate moment.

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  • 19. 

    Theresa, who has been hospitalized following a suicide attempt, is placed on suicide precautions on the psychiatric unit. She admits that she is still feeling suicidal. Which of the following interventions is most appropriate in this instance? 

    • A. Obtain an order from the physician to place Theresa in restraints to prevent any attempts to harm herself.

    • B. Check on Theresa every 15 minutes or assign a staff person to stay with her on a one-to-one basis.

    • C. Obtain an order from the physician to give Theresa a sedative to calm her and reduce suicide ideas.

    • D. Do not allow Theresa to participate in any unit activities while she is on suicide precautions.

    Correct Answer
    A. B. Check on Theresa every 15 minutes or assign a staff person to stay with her on a one-to-one basis.
    Explanation
    The most appropriate intervention in this instance is to check on Theresa every 15 minutes or assign a staff person to stay with her on a one-to-one basis. This is because Theresa has admitted that she is still feeling suicidal, indicating that she is at high risk for self-harm. By regularly checking on her or assigning someone to stay with her, the healthcare team can closely monitor her and ensure her safety. Restraints should only be used as a last resort when all other interventions have failed and there is an immediate risk of harm. Sedatives may be considered, but the primary focus should be on ensuring her safety. Not allowing Theresa to participate in unit activities may further isolate her, which can exacerbate her feelings of distress.

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  • 20. 

    Sam, who has been hospitalized for ECT treatments, says to the nurse on admission, “I don't want to end up like McMurphy in One Flew Over the Cuckoo's Nest! I'm scared!” Which of the following statements would be most appropriate by the nurse in response to Sam's expression of concern?     

    • A. “I guarantee you won't end up like McMurphy, Sam.”

    • B. “The doctor knows what he is doing. There's nothing to worry about.”

    • C. “I know you are scared, Sam, and we're going to talk about what you can expect from the therapy.”

    • D. “I'm going to stay with you as long as you are scared.”

    Correct Answer
    A. C. “I know you are scared, Sam, and we're going to talk about what you can expect from the therapy.”
    Explanation
    The most appropriate response by the nurse would be option c because it acknowledges Sam's fear and offers reassurance by stating that they will discuss what he can expect from the therapy. This response shows empathy and understanding towards Sam's concerns, and it also indicates that the nurse is willing to address his fears and provide information to alleviate them.

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  • 21. 

    The nurse is interviewing a client on the psychiatric unit. The client tilts his head to the side, stops talking in midsentence, and listens intently. The nurse recognizes from these signs that the client is likely experiencing:

    • A. Somatic delusions

    • B. Catatonic stupor

    • C. Auditory hallucinations

    • D. Pseudoparkinsonism

    Correct Answer
    A. C. Auditory hallucinations
    Explanation
    The client's behavior of tilting his head to the side, stopping talking in midsentence, and listening intently suggests that he is experiencing auditory hallucinations. Auditory hallucinations involve hearing sounds or voices that are not actually present. The client's behavior indicates that he is focused on something that others cannot perceive, which is a common symptom of auditory hallucinations. This is different from somatic delusions, which involve false beliefs about the body, catatonic stupor, which is a state of unresponsiveness, and pseudoparkinsonism, which is a medication side effect causing Parkinson's-like symptoms.

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  • 22. 

    The nurse is interviewing a client on the psychiatric unit. The client tilts his head to the side, stops talking in midsentence, and listens intently. The nurse recognizes these behaviors as a symptom of the client's illness. The most appropriate nursing intervention for this symptom is to: 

    • A. Ask the client to describe his physical symptoms.

    • B. Ask the client to describe what he is hearing.

    • C. Administer a dose of benztropine.

    • D. Call the physician for additional orders.

    Correct Answer
    A. B. Ask the client to describe what he is hearing.
    Explanation
    The client's behavior of tilting his head to the side, stopping talking in midsentence, and listening intently suggests that he may be experiencing auditory hallucinations. Asking the client to describe what he is hearing is the most appropriate nursing intervention as it allows the nurse to gather more information about the client's symptoms and gain insight into his perception of reality. This can help in assessing the severity of the hallucinations and developing an appropriate care plan. Administering a dose of benztropine or calling the physician for additional orders may be necessary in certain situations, but the initial intervention should be focused on gathering more information from the client.

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  • 23. 

    The physician orders sertraline (Zoloft) 50 mg PO bid for Margaret, a 68-year-old woman with major depressive disorder. After 3 days of taking the medication, Margaret says to the nurse, “I don't think this medicine is doing any good. I don't feel a bit better.” What is the most appropriate response by the nurse?

    • A. “Cheer up, Margaret. You have so much to be happy about.”

    • B. “Sometimes it takes a few weeks for the medicine to bring about an improvement in symptoms.”

    • C. “I'll report that to the physician, Margaret. Maybe he will order something different.”

    • D. “Try not to dwell on your symptoms, Margaret. Why don't you join the others down in the dayroom?”

    Correct Answer
    A. B. “Sometimes it takes a few weeks for the medicine to bring about an improvement in symptoms.”
    Explanation
    The most appropriate response by the nurse is option b. It is important for the nurse to educate Margaret about the delayed onset of action for sertraline (Zoloft) in treating major depressive disorder. By explaining that it may take a few weeks for the medication to bring about an improvement in symptoms, the nurse provides reassurance and helps manage Margaret's expectations. This response also indicates that the nurse understands the medication and its expected effects, and does not dismiss Margaret's concerns or suggest alternative treatments without consulting the physician.

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  • 24. 

    The goal of cognitive therapy with depressed clients is to:

    • A. Identify and change dysfunctional patterns of thinking.

    • B. Resolve the symptoms and initiate or restore adaptive family functioning.

    • C. Alter the neurotransmitters that are creating the depressed mood.

    • D. Provide feedback from peers who are having similar experiences.

    Correct Answer
    A. A. Identify and change dysfunctional patterns of thinking.
    Explanation
    Cognitive therapy with depressed clients aims to identify and change dysfunctional patterns of thinking. This approach recognizes that negative thoughts and beliefs contribute to depression, and by challenging and replacing these thoughts with more realistic and positive ones, clients can experience relief from their symptoms. Cognitive therapy helps individuals recognize and reframe negative thought patterns, leading to improved mood and overall well-being. This approach does not involve resolving symptoms through family functioning, altering neurotransmitters, or providing peer feedback.

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  • 25. 

    A client with depression has just been prescribed the antidepressant phenelzine (Nardil). She says to the nurse, “The doctor says I will need to watch my diet while I'm on this medication. What foods should I avoid?” Which of the following is the correct response by the nurse?

    • A. Blue cheese, red wine, raisins

    • B. Black beans, garlic, pears

    • C. Pork, shellfish, egg yolks

    • D. Milk, peanuts, tomatoes

    Correct Answer
    A. A. Blue cheese, red wine, raisins
    Explanation
    The correct response is a. Blue cheese, red wine, raisins. This is because phenelzine is a monoamine oxidase inhibitor (MAOI), and certain foods containing high levels of tyramine can cause a dangerous increase in blood pressure when combined with MAOIs. Blue cheese, red wine, and raisins are all high in tyramine and should be avoided while taking phenelzine. Black beans, garlic, pears, pork, shellfish, egg yolks, milk, peanuts, and tomatoes do not contain high levels of tyramine and do not need to be avoided.

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  • 26. 

    Margaret, age 68, is diagnosed with bipolar I disorder, current episode manic. She is extremely hyperactive and has lost weight. One way to promote adequate nutritional intake for Margaret is to: 

    • A. Sit with her during meals to ensure that she eats everything on her tray.

    • B. Have her sister-in-law bring all her food from home because she knows Margaret's likes and dislikes.

    • C. Provide high-calorie, nutritious finger foods and snacks that Margaret can eat “on the run.”

    • D. Tell Margaret that she will be on room restriction until she starts gaining weight.

    Correct Answer
    A. C. Provide high-calorie, nutritious finger foods and snacks that Margaret can eat “on the run.”
    Explanation
    Providing high-calorie, nutritious finger foods and snacks that Margaret can eat "on the run" is a suitable approach to promote adequate nutritional intake for Margaret. Since she is extremely hyperactive and has lost weight, it implies that she may have a decreased appetite or difficulty sitting down for full meals. By offering high-calorie, nutritious finger foods and snacks that she can eat while remaining active, Margaret can consume sufficient calories and nutrients to support her health despite her manic episode.

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  • 27. 

    Which of the following is the most appropriate therapy for a client with agoraphobia?

    • A. 10 mg Valium qid

    • B. Group therapy with other agoraphobics

    • C. Facing her fear in gradual step progression

    • D. Hypnosis

    Correct Answer
    A. C. Facing her fear in gradual step progression
    Explanation
    The most appropriate therapy for a client with agoraphobia is facing her fear in gradual step progression. Agoraphobia is an anxiety disorder characterized by a fear of being in situations where escape might be difficult or embarrassing. Gradual exposure therapy helps the client confront their fears in a controlled and systematic manner, starting with less anxiety-provoking situations and gradually progressing to more challenging ones. This therapy helps the client build confidence and overcome their fear of being in public places or situations. Medication like Valium may be used to manage symptoms, but it is not the most appropriate therapy for agoraphobia. Group therapy and hypnosis may be helpful as adjunctive treatments, but they are not the primary therapy for agoraphobia.

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  • 28. 

    A client with OCD spends many hours each day washing her hands. The most likely reason she washes her hands so much is that it:

    • A. Relieves her anxiety

    • B. Reduces the probability of infection

    • C. Gives her a feeling of control over her life

    • D. Increases her self-concept

    Correct Answer
    A. A. Relieves her anxiety
    Explanation
    The most likely reason the client with OCD washes her hands so much is that it relieves her anxiety. Obsessive-Compulsive Disorder (OCD) is characterized by intrusive thoughts and repetitive behaviors aimed at reducing anxiety. In this case, the client's excessive hand washing is a compulsive behavior that provides temporary relief from the anxiety associated with her obsessions. This behavior becomes a cycle, as the relief reinforces the hand washing and perpetuates the OCD symptoms.

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  • 29. 

    The initial care plan for a client with OCD who washes her hands obsessively would include which of the following nursing interventions?

    • A. Keep the client's bathroom locked so she cannot wash her hands all the time.

    • B. Structure the client's schedule so that she has plenty of time for washing her hands.

    • C. Place the client in isolation until she promises to stop washing her hands so much.

    • D. Explain the client's behavior to her, since she is probably unaware that it is maladaptive.

    Correct Answer
    A. B. Structure the client's schedule so that she has plenty of time for washing her hands.
    Explanation
    The correct answer is b because structuring the client's schedule to allow for plenty of time to wash her hands is a nursing intervention that acknowledges and addresses the client's obsessive-compulsive behavior. This intervention recognizes the importance of allowing the client to engage in her compulsive behavior in a controlled and structured manner, rather than attempting to restrict or eliminate the behavior altogether. This approach is consistent with the principles of harm reduction and client-centered care.

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  • 30. 

    A client who is experiencing a panic attack has just arrived at the emergency department. Which is the priority nursing intervention for this client? 

    • A. Stay with the client and reassure of safety.

    • B. Administer a dose of diazepam.

    • C. Leave the client alone in a quiet room so that she can calm down.

    • D. Encourage the client to talk about what triggered the attack.

    Correct Answer
    A. A. Stay with the client and reassure of safety.
    Explanation
    The priority nursing intervention for a client experiencing a panic attack is to stay with the client and reassure them of safety. Panic attacks can be overwhelming and frightening for the client, so providing a calm and supportive presence is essential. By staying with the client, the nurse can help to prevent any harm that may occur during the panic attack and provide reassurance that they are not alone. Administering diazepam may be appropriate in some cases, but it is not the priority intervention. Leaving the client alone in a quiet room may increase their anxiety, and encouraging them to talk about what triggered the attack may be helpful but is not the priority intervention.

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  • 31. 

    Which of the following represents a nursing intervention at the primary level of prevention?

    • A. Teaching a class in parent effectiveness training

    • B. Leading a group of adolescents in drug rehabilitation

    • C. Referring a married couple for sex therapy

    • D. Leading a support group for battered women

    Correct Answer
    A. A. Teaching a class in parent effectiveness training
    Explanation
    Teaching a class in parent effectiveness training represents a nursing intervention at the primary level of prevention because it aims to prevent health problems from occurring in the first place. By educating parents on effective parenting techniques, the nurse is helping to promote healthy child development and prevent potential issues such as behavioral problems or neglect. This intervention focuses on promoting health and well-being rather than treating existing health problems, which is characteristic of primary prevention.

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  • 32. 

    . Marie, age 56, is the mother of five children. Her youngest child, who had been living at home and attending the local college, recently graduated and accepted a job in another state. Marie has never worked outside the home and has devoted her life to satisfying the needs of her husband and children. Since the departure of her last child from home, Marie has become more and more despondent. Her husband has become very concerned, and takes her to the local mental health center. This type of crisis is called:

    • A. Dispositional crisis

    • B. Crisis of anticipated life transitions

    • C. Psychiatric emergency

    • D. Crisis resulting from traumatic stress

    Correct Answer
    A. B. Crisis of anticipated life transitions
    Explanation
    The given scenario describes Marie experiencing a crisis after her youngest child leaves home. This crisis is known as a "crisis of anticipated life transitions." It refers to a period of distress or difficulty that occurs when an individual is faced with significant life changes or transitions, such as children leaving home, retirement, or other major life events. In this case, Marie's identity and purpose in life were closely tied to being a mother, and the sudden change of her children leaving has caused her to feel despondent.

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  • 33. 

    An elderly client says to the nurse, “I don't want to go to that crafts class. I'm too old to learn anything.” Based on knowledge of the aging process, which of the following is a true statement?

    • A. Memory functioning in the elderly most likely reflects loss of long-term memories of remote events.

    • B. Intellectual functioning declines with advancing age.

    • C. Learning ability remains intact, but time required for learning increases with age.

    • D. Cognitive functioning is rarely affected in aging individuals.

    Correct Answer
    A. C. Learning ability remains intact, but time required for learning increases with age.
    Explanation
    As individuals age, their learning ability remains intact, but the time required for learning increases. This is due to changes in cognitive processing speed and efficiency. While memory functioning may decline in the elderly, it is not necessarily limited to long-term memories of remote events. Intellectual functioning may also decline with age, but it is not the most accurate statement in this context. Cognitive functioning can be affected in aging individuals, although it varies from person to person.

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  • 34. 

    . Jenny reported to the high school nurse that her mother drinks too much. She is drunk every afternoon when Jenny gets home from school. Jenny is afraid to invite friends over because of her mother's behavior. This type of crisis is called:

    • A. Crisis resulting from traumatic stress

    • B. Maturational/developmental crisis

    • C. Dispositional crisis

    • D. Crisis reflecting psychopathology

    Correct Answer
    A. C. Dispositional crisis
    Explanation
    A dispositional crisis refers to a crisis that arises from an individual's internal characteristics or predispositions. In this scenario, Jenny's mother's excessive drinking and disruptive behavior create a crisis for Jenny, as it affects her daily life and social interactions. This crisis is not caused by traumatic stress, maturational/developmental factors, or psychopathology, but rather by her mother's disposition to drink excessively.

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  • 35. 

    Which of the following conditions is considered to be the only absolute contraindication for ECT?

    • A. Increased intracranial pressure

    • B. Recent myocardial infarction

    • C. Severe underlying hypertension

    • D. Congestive heart failure

    Correct Answer
    A. A. Increased intracranial pressure
    Explanation
    Increased intracranial pressure is considered to be the only absolute contraindication for ECT. ECT involves the administration of an electrical current to the brain, which can increase intracranial pressure. If a patient already has increased intracranial pressure, ECT could further exacerbate this condition and potentially lead to serious complications such as brain herniation. Therefore, it is crucial to avoid ECT in patients with increased intracranial pressure to ensure their safety.

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  • 36. 

    The most common side effects of ECT are: 

    • A. Permanent memory loss and brain damage

    • B. Fractured and dislocated bones

    • C. Myocardial infarction and cardiac arrest

    • D. Temporary memory loss and confusion

    Correct Answer
    A. D. Temporary memory loss and confusion
    Explanation
    ECT (Electroconvulsive Therapy) is a medical procedure used to treat severe depression and other mental illnesses. It involves passing electric currents through the brain to induce controlled seizures. The most common side effects of ECT are temporary memory loss and confusion. This is because the electrical stimulation disrupts the normal functioning of the brain, causing these temporary cognitive impairments. However, it is important to note that permanent memory loss and brain damage are not common side effects of ECT, contrary to popular belief.

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  • 37. 

    The priority nursing intervention before starting ECT therapy is to:

    • A. Take vital signs and record.

    • B. Have the patient void.

    • C. Administer succinylcholine.

    • D. Ensure that the consent form has been signed.

    Correct Answer
    A. D. Ensure that the consent form has been signed.
    Explanation
    Before starting ECT therapy, it is essential to ensure that the consent form has been signed. This is important because ECT therapy is an invasive procedure that carries potential risks and side effects. By ensuring that the consent form has been signed, the healthcare team can confirm that the patient has been fully informed about the procedure, its potential benefits, risks, and alternatives, and has given their voluntary consent to undergo the therapy. This ensures that the patient's autonomy and right to make decisions about their own healthcare are respected and upheld.

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  • 38. 

    Mrs. G, who has NCD due to Alzheimer's disease, says to the nurse, “I have a date tonight. I always have a date on Christmas.” Which of the following is the most appropriate response?

    • A. “Don't be silly. It's not Christmas, Mrs. G.”

    • B. “Today is Tuesday, Oct. 21, Mrs. G. We will have supper soon, and then your daughter will come to visit.”

    • C. “Who is your date with, Mrs. G?”

    • D. “I think you need some more medication, Mrs. G. I'll bring it to you now.”

    Correct Answer
    A. B. “Today is Tuesday, Oct. 21, Mrs. G. We will have supper soon, and then your daughter will come to visit.”
    Explanation
    The most appropriate response is option b because it acknowledges the patient's statement and provides her with accurate information about the current date and upcoming events. It also shows empathy by mentioning that her daughter will come to visit, which may help to reassure Mrs. G. and alleviate any confusion or anxiety she may be experiencing due to her Alzheimer's disease.

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  • 39. 

    A client says to the nurse: “I read an article about Alzheimer's and it said the disease is hereditary. My mother has Alzheimer's disease. Does that mean I'll get it when I'm old?” The nurse bases her response on the knowledge that which of the following factors is not associated with increased incidence of NCD due to Alzheimer's disease?

    • A. Multiple small strokes

    • B. Family history of Alzheimer's disease

    • C. Head trauma

    • D. Advanced age

    Correct Answer
    A. A. Multiple small strokes
    Explanation
    The nurse knows that multiple small strokes are not associated with an increased incidence of NCD (neurocognitive disorder) due to Alzheimer's disease. Alzheimer's disease is primarily caused by genetic factors (family history), head trauma, and advanced age. Multiple small strokes, on the other hand, can lead to a different type of dementia called vascular dementia. Therefore, the client's risk of developing Alzheimer's disease is not increased by multiple small strokes.

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  • 40. 

    The primary goal in working with an actively psychotic, suspicious client would be to:

    • A. Promote interaction with others.

    • B. Decrease his anxiety and increase trust.

    • C. Improve his relationship with his parents.

    • D. Encourage participation in therapy activities.

    Correct Answer
    A. B. Decrease his anxiety and increase trust.
    Explanation
    The primary goal in working with an actively psychotic, suspicious client would be to decrease his anxiety and increase trust. This is because individuals who are actively psychotic often experience high levels of anxiety and paranoia, which can hinder their ability to engage in therapy and build a therapeutic relationship. By decreasing anxiety, the client may feel more comfortable and open to participating in therapy activities. Increasing trust is also important as it can help establish a sense of safety and collaboration between the client and therapist, leading to better treatment outcomes.

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  • 41. 

    When a client suddenly becomes aggressive and violent on the unit, which of the following approaches would be best for the nurse to use first?

    • A. Provide large motor activities to relieve the client's pent-up tension.

    • B. Administer a dose of prn chlorpromazine to keep the client calm.

    • C. Call for sufficient help to control the situation safely.

    • D. Convey to the client that his behavior is unacceptable and will not be permitted.

    Correct Answer
    A. C. Call for sufficient help to control the situation safely.
    Explanation
    The best approach for the nurse to use first when a client suddenly becomes aggressive and violent on the unit is to call for sufficient help to control the situation safely. This is the most important step to ensure the safety of both the client and the staff. By calling for help, the nurse can ensure that there are enough staff members available to safely intervene and de-escalate the situation. This approach prioritizes the physical safety of everyone involved and allows for a more effective resolution of the situation.

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  • 42. 

    Education for the client who is taking MAOIs should include which of the following?

    • A. Fluid and sodium replacement when appropriate, frequent drug blood levels, signs and symptoms of toxicity

    • B. Lifetime of continuous use, possible tardive dyskinesia, advantages of an injection every 2 to 4 weeks

    • C. Short-term use, possible tolerance to beneficial effects, careful tapering of the drug at end of treatment

    • D. Tyramine-restricted diet, prohibitive concurrent use of over-the-counter medications without physician notification

    Correct Answer
    A. D. Tyramine-restricted diet, prohibitive concurrent use of over-the-counter medications without physician notification
    Explanation
    Education for clients taking MAOIs should include information about a tyramine-restricted diet, as MAOIs can interact with tyramine-rich foods and cause a hypertensive crisis. Clients should also be educated about the need to avoid concurrent use of over-the-counter medications without physician notification, as certain medications can interact with MAOIs and cause adverse effects. This education is important to ensure the safety and effectiveness of the medication.

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  • 43. 

    A client whose husband died 6 months ago is diagnosed with major depressive disorder. She says to the nurse, “I start feeling angry that Harold died and left me all alone; he should have stopped smoking years ago! But then I start feeling guilty for feeling that way.” What is an appropriate response by the nurse?

    • A. “Yes, he should have stopped smoking. Then he probably wouldn't have gotten lung cancer.”

    • B. “I can understand how you must feel.”

    • C. “Those feelings are a normal part of the grief response.”

    • D. “Just think about the good times that you had while he was alive.”

    Correct Answer
    A. C. “Those feelings are a normal part of the grief response.”
    Explanation
    The correct response by the nurse is c. “Those feelings are a normal part of the grief response.” This response acknowledges the client's feelings of anger and guilt and validates them as normal reactions to the loss of a loved one. It reassures the client that her feelings are valid and helps normalize her experience of grief.

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  • 44. 

    A newly admitted depressed client isolates herself in her room and just sits and stares into space. How best might the nurse begin an initial therapeutic relationship with this client?

    • A. Say, “Come with me. I will go with you to group therapy.”

    • B. Make frequent short visits to her room and sit with her.

    • C. Offer to introduce her to the other clients.

    • D. Help her to identify stressors in her life that precipitate crises.

    Correct Answer
    A. B. Make frequent short visits to her room and sit with her.
    Explanation
    The best way for the nurse to begin an initial therapeutic relationship with the depressed client is by making frequent short visits to her room and sitting with her. This approach shows the client that the nurse is available and supportive, without being intrusive. It allows the client to feel heard and understood, and provides an opportunity for the nurse to establish trust and rapport. By spending time with the client in her room, the nurse can also observe her behavior and mood, which can help in developing an appropriate care plan.

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  • 45. 

     John is a client at the mental health clinic. He is depressed, has been expressing suicidal ideations, and has been seeing the psychiatric nurse every 3 days. He has been taking 100 mg of sertraline daily for about a month, receiving small amounts of the medication from his nurse at each visit. Today he comes to the clinic in a cheerful mood, much different than he seemed just 3 days ago. How might the nurse assess this behavioral change?

    • A. The sertraline is finally taking effect.

    • B. He is no longer in need of antidepressant medication.

    • C. He has completed the grief response over loss of his wife.

    • D. He may have decided to carry out his suicide plan.

    Correct Answer
    A. D. He may have decided to carry out his suicide plan.
    Explanation
    The nurse should assess this behavioral change as a potential warning sign that John may have decided to carry out his suicide plan. Sudden shifts from a depressed state to a cheerful mood can sometimes indicate that an individual has made a decision to end their life. It is important for the nurse to carefully evaluate John's current mental state and ensure his safety.

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  • 46. 

    Margaret, a 68-year-old widow, is brought to the emergency department by her sister-in-law. Margaret has a history of bipolar disorder and has been maintained on medication for many years. Her sister-in-law reports that Margaret quit taking her medication a few months ago, thinking she didn't need it anymore. She is agitated, pacing, demanding, and speaking very loudly. Her sister-in-law reports that Margaret eats very little, is losing weight, and almost never sleeps. “I'm afraid she's going to just collapse!” Margaret is admitted to the psychiatric unit. The priority nursing diagnosis for Margaret is:

    • A. Imbalanced nutrition: less than body requirements related to not eating

    • B. Risk for injury related to hyperactivity

    • C. Disturbed sleep pattern related to agitation

    • D. Ineffective coping related to denial of depression

    Correct Answer
    A. B. Risk for injury related to hyperactivity
    Explanation
    The priority nursing diagnosis for Margaret is "Risk for injury related to hyperactivity." This is because Margaret is displaying symptoms of agitation, pacing, demanding behavior, and speaking loudly, which indicate hyperactivity. Additionally, her sister-in-law reports that Margaret eats very little, is losing weight, and almost never sleeps, which further supports the diagnosis of hyperactivity. The risk for injury is high due to Margaret's agitated and hyperactive state, making it important for the nurse to prioritize interventions to prevent any harm or accidents.

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  • 47. 

    The physician orders lithium carbonate 600 mg tid for a newly diagnosed client with Bipolar I Disorder. There is a narrow margin between the therapeutic and toxic levels of lithium. Therapeutic range for acute mania is:

    • A. 1.0 to 1.5 mEq/L

    • B. 10 to 15 mEq/L

    • C. 0.5 to 1.0 mEq/L

    • D. 5 to 10 mEq/L

    Correct Answer
    A. A. 1.0 to 1.5 mEq/L
    Explanation
    The therapeutic range for acute mania in a client with Bipolar I Disorder is 1.0 to 1.5 mEq/L. This means that the client's lithium levels should be maintained within this range in order to effectively manage their symptoms. It is important to closely monitor lithium levels as there is a narrow margin between the therapeutic and toxic levels. Levels below 1.0 mEq/L may not adequately control symptoms, while levels above 1.5 mEq/L can lead to toxicity and adverse effects. Therefore, maintaining lithium levels within the therapeutic range is crucial for optimal treatment outcomes.

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  • 48. 

    The most common comorbid condition in children with bipolar disorder is:

    • A. Schizophrenia

    • B. Substance disorders

    • C. Oppositional defiant disorder

    • D. Attention-deficit/hyperactivity disorder

    Correct Answer
    A. D. Attention-deficit/hyperactivity disorder
    Explanation
    The most common comorbid condition in children with bipolar disorder is attention-deficit/hyperactivity disorder (ADHD). Comorbidity refers to the presence of two or more disorders in the same individual. Bipolar disorder and ADHD often coexist in children, with studies showing a high prevalence of ADHD symptoms in children with bipolar disorder. This comorbidity can complicate the diagnosis and treatment of both disorders, as symptoms can overlap and interact with each other. Therefore, it is important for clinicians to carefully assess and address both bipolar disorder and ADHD symptoms in children to provide appropriate treatment and support.

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  • 49. 

    A client experiencing a manic episode enters the milieu area dressed in a provocative and physically revealing outfit. Which of the following is the most appropriate intervention by the nurse?

    • A. Tell the client she cannot wear this outfit while she is in the hospital.

    • B. Do nothing and allow her to learn from the responses of her peers.

    • C. Quietly walk with her back to her room and help her change into something more appropriate.

    • D. Explain to her that if she wears this outfit she must remain in her room.

    Correct Answer
    A. C. Quietly walk with her back to her room and help her change into something more appropriate.

Quiz Review Timeline (Updated): Mar 22, 2023 +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

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  • Mar 22, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Nov 18, 2016
    Quiz Created by
    Sarahnfitz
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