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.

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.

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2.

Crises occur when an individual:
- A. Is exposed to a precipitating stressor
- B. Perceives a stressor to be threatening
- C. Has no support systems
- D. Experiences a stressor and perceives coping strategies to be ineffective
Correct Answer

A. D. Experiences a stressor and perceives coping strategies to be ineffective

Explanation

Crises occur when an individual experiences a stressor and perceives coping strategies to be ineffective. This means that when a person is faced with a difficult situation or event (stressor) and they feel that their usual methods of dealing with it are not working, they may enter a crisis. In this state, the individual may feel overwhelmed and unable to effectively manage or resolve the stressor, leading to increased distress and potential negative outcomes.

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3.

. Amanda's mobile home was destroyed by a tornado. Amanda received only minor injuries, but is experiencing disabling anxiety in the aftermath of the event. This type of crisis is called:
- A. Crisis resulting from traumatic stress
- B. Maturational/developmental crisis
- C. Dispositional crisis
- D. Crisis of anticipated life transitions
Correct Answer

A. A. Crisis resulting from traumatic stress

Explanation

Amanda's experience of her mobile home being destroyed by a tornado has resulted in her experiencing disabling anxiety. This type of crisis is called a crisis resulting from traumatic stress because the traumatic event of the tornado has caused significant distress and anxiety for Amanda.

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4.

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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5.

. 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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6.

The most appropriate nursing intervention with Jenny (from question 5) would be to:
- A. Make arrangements for her to start attending Alateen meetings.
- B. Help her identify the positive things in her life and recognize that her situation could be a lot worse than it is.
- C. Teach her about the effects of alcohol on the body and that it can be hereditary.
- D. Refer her to a psychiatrist for private therapy to learn to deal with her home situation.
Correct Answer

A. A. Make arrangements for her to start attending Alateen meetings.

Explanation

The most appropriate nursing intervention with Jenny would be to make arrangements for her to start attending Alateen meetings. Alateen meetings are specifically designed to provide support and guidance to teenagers who have been affected by someone else's alcoholism. By attending these meetings, Jenny will have the opportunity to connect with others who are going through similar experiences, share her feelings, and learn coping strategies. This intervention can help Jenny feel supported and understood, and provide her with the tools she needs to navigate her situation more effectively.

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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 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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9.

. 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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10.

The most appropriate nursing intervention with Marie (from question 9) would be to:
- A. Refer her to her family physician for a complete physical examination.
- B. Suggest she seek outside employment now that her children have left home.
- C. Identify convenient support systems for times when she is feeling particularly despondent.
- D. Begin grief work and assist her to recognize areas of self-worth separate and apart from her children.
Correct Answer

A. D. Begin grief work and assist her to recognize areas of self-worth separate and apart from her children.

Explanation

The most appropriate nursing intervention for Marie would be to begin grief work and assist her in recognizing areas of self-worth separate from her children. This intervention acknowledges Marie's feelings of loss and helps her navigate through the grieving process. By helping her identify her own self-worth, the nurse can support Marie in finding new sources of fulfillment and purpose in her life. This intervention promotes Marie's emotional well-being and helps her cope with the changes in her life.

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11.

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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12.

Andrew, a New York City firefighter, and his entire unit responded to the terrorist attacks at the World Trade Center. Working as a team, he and his best friend, Carlo, entered the area together. Carlo was killed when the building collapsed. Andrew was injured, but survived. Since that time, Andrew has had frequent nightmares and anxiety attacks. He says to the mental health worker, “I don't know why Carlo had to die and I didn't!” This statement by Andrew suggests that he is experiencing:
- A. Spiritual distress
- B. Night terrors
- C. Survivor's guilt
- D. Suicidal ideation
Correct Answer

A. C. Survivor's guilt

Explanation

The statement made by Andrew, "I don't know why Carlo had to die and I didn't!" suggests that he is experiencing survivor's guilt. Survivor's guilt is a common psychological response to surviving a traumatic event while others did not. It is characterized by feelings of guilt, self-blame, and questioning why one survived while others did not. Andrew's statement reflects his struggle with understanding why he survived while his best friend did not, leading to feelings of guilt and questioning his own worthiness of survival.

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13.

Intervention with Andrew (from question 12) would include:
- A. Encouraging expression of feelings
- B. Antianxiety medications
- C. Participation in a support group
- D. a and c
- E. All of the above
Correct Answer

A. E. All of the above

Explanation

Intervention with Andrew would include encouraging expression of feelings, as this can help him process and cope with his emotions. Participation in a support group can provide Andrew with a supportive community and the opportunity to share experiences with others who may be going through similar challenges. Additionally, antianxiety medications may be prescribed to help manage any anxiety symptoms that Andrew may be experiencing. Therefore, all of the options (a, b, and c) are correct and would be part of the intervention plan for Andrew.

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14.

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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15.

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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16.

. 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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17.

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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18.

A nursing school graduate failing the NCLEX exam and a 15-year-old high school girl not being selected for the cheerleading squad are examples of which of the following?
- A. Focal stimuli
- B. Contextual stimuli
- C. Residual stimuli
- D. Spatial stimuli
Correct Answer

A. A. Focal stimuli

Explanation

A nursing school graduate failing the NCLEX exam and a 15-year-old high school girl not being selected for the cheerleading squad are examples of focal stimuli. Focal stimuli refer to specific events or situations that have a significant impact on an individual's behavior or emotions. In both cases, the individuals experience a negative outcome that can influence their future actions and decisions. These events stand out and have a direct impact on the individuals involved, making them examples of focal stimuli.

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19.

The husband says to the wife, “What do you want to do tonight?” and the wife responds, “Whatever you want to do.” This is an example of which of the following?
- A. Rigid boundary
- B. A boundary violation
- C. Too flexible boundary
- D. Showing respect for the boundary of another
Correct Answer

A. C. Too flexible boundary

Explanation

This is an example of a too flexible boundary because the wife is not expressing her own desires or preferences, but instead deferring to the husband's wishes. This lack of assertiveness and self-expression can indicate a boundary that is too flexible and can lead to potential issues in the relationship.

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20.

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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21.

Karen's counselor asked her if she would like a hug. This is an example of which of the following?
- A. Rigid boundary
- B. A boundary violation
- C. Enmeshed boundary
- D. Showing respect for the boundary of another
Correct Answer

A. D. Showing respect for the boundary of another

Explanation

This scenario demonstrates showing respect for the boundary of another because the counselor asked Karen if she would like a hug, allowing her to make a decision about her personal space and physical boundaries. This shows an understanding and consideration for Karen's autonomy and comfort level.

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22.

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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23.

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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24.

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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25.

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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26.

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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27.

The nurse identifies the primary nursing diagnosis for Theresa as Risk for Suicide related to feelings of hopelessness from loss of relationship. Which is the outcome criterion that would most accurately measure achievement of this diagnosis?
- A. The client has experienced no physical harm to herself.
- B. The client sets realistic goals for herself.
- C. The client expresses some optimism and hope for the future.
- D. The client has reached a stage of acceptance in the loss of the relationship with her boyfriend.
Correct Answer

A. A. The client has experienced no physical harm to herself.

Explanation

The outcome criterion that would most accurately measure achievement of the nursing diagnosis "Risk for Suicide related to feelings of hopelessness from loss of relationship" is option a, "The client has experienced no physical harm to herself." This criterion indicates that the client has not engaged in any self-harming behaviors, which is a significant indicator of progress in addressing the risk for suicide. It shows that the client has been able to maintain her physical safety and well-being, which is a positive outcome in managing the identified risk.

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28.

Theresa is hospitalized following a suicide attempt after breaking up with her boyfriend. Freudian psychoanalytic theory would explain Theresa's suicide attempt in which of the following ways?
- A. She feels hopeless about her future without her boyfriend.
- B. Without her boyfriend, she feels like an outsider with her peers.
- C. She is feeling intense guilt because her boyfriend broke up with her.
- D. She is angry at her boyfriend for breaking up with her and has turned the anger inward on herself.
Correct Answer

A. D. She is angry at her boyfriend for breaking up with her and has turned the anger inward on herself.

Explanation

Freudian psychoanalytic theory suggests that Theresa's suicide attempt can be explained by her anger towards her boyfriend for breaking up with her, which she has internalized and directed towards herself. This theory focuses on the unconscious mind and the influence of unresolved conflicts and repressed emotions on behavior. According to Freud, individuals may turn their anger inward in the form of self-destructive behaviors, such as self-harm or suicide attempts, as a way to cope with their feelings of anger and frustration.

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29.

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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30.

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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31.

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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32.

Which of the following interventions are appropriate for a client on suicide precautions? (Select all that apply.)
- A. Remove all sharp objects, belts, and other potentially dangerous articles from the client's environment.
- B. Accompany the client to off-unit activities
- C. Obtain a promise from the client that she will not do anything to harm herself for the next 12 hours.
- D. Put all of the client's possessions in storage and explain to her that she may have them back when she is off suicide precautions.
Correct Answer(s)

A. A. Remove all sharp objects, belts, and other potentially dangerous articles from the client's environment.
A. B. Accompany the client to off-unit activities
A. C. Obtain a promise from the client that she will not do anything to harm herself for the next 12 hours.

Explanation

The appropriate interventions for a client on suicide precautions include removing all sharp objects, belts, and other potentially dangerous articles from the client's environment to ensure their safety. Accompanying the client to off-unit activities helps to provide supervision and support. Obtaining a promise from the client that they will not do anything to harm themselves for the next 12 hours is important to assess their immediate risk. Putting all of the client's possessions in storage and explaining that they may have them back when they are off suicide precautions is not an appropriate intervention as it may increase their distress and feelings of isolation.

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33.

Success of long-term psychotherapy with Theresa (who attempted suicide following a breakup with her boyfriend) could be measured by which of the following behaviors?
- A. Theresa has a new boyfriend.
- B. Theresa has an increased sense of self-worth.
- C. Theresa does not take antidepressants anymore.
- D. Theresa told her old boyfriend how angry she was with him for breaking up with her.
Correct Answer

A. B. Theresa has an increased sense of self-worth.

Explanation

The success of long-term psychotherapy with Theresa, who attempted suicide following a breakup with her boyfriend, could be measured by her increased sense of self-worth. This indicates that therapy has helped her develop a more positive perception of herself, which is crucial for her overall mental well-being and resilience. It suggests that she has gained confidence, self-acceptance, and a healthier self-image, which can contribute to her ability to cope with challenges and maintain a stable emotional state.

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34.

Electroconvulsive therapy is most commonly prescribed for:
- A. Bipolar disorder, manic
- B. Paranoid schizophrenia
- C. Major depression
- D. Obsessive-compulsive disorder
Correct Answer

A. C. Major depression

Explanation

Electroconvulsive therapy (ECT) is most commonly prescribed for major depression. ECT involves passing electric currents through the brain to induce a controlled seizure. It is typically used when other treatments, such as medication and therapy, have not been effective in treating severe depression. ECT has been shown to be particularly effective in cases where depression is accompanied by suicidal tendencies, psychotic features, or a lack of response to other treatments. It is not typically used as a first-line treatment for bipolar disorder, paranoid schizophrenia, or obsessive-compulsive disorder.

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35.

Which of the following best describes the average number of ECT treatments given and the timing of administration?
- A. One treatment per month for 6 months
- B. One treatment every other day for a total of 6 to 12 treatments
- C. One treatment three times per week for a total of 20 to 30 treatments
- D. One treatment every day for a total of 10 to 15 treatments
Correct Answer

A. B. One treatment every other day for a total of 6 to 12 treatments

Explanation

The best description for the average number of ECT treatments given and the timing of administration is option b. One treatment every other day for a total of 6 to 12 treatments. This means that the patient will receive ECT treatments every other day, with a total of 6 to 12 treatments in total. This schedule allows for regular treatment over a period of time, providing the necessary therapy while allowing for recovery between sessions.

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36.

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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37.

Electroconvulsive therapy is thought to effect a therapeutic response by:
- A. Stimulation of the CNS
- B. Decreasing the levels of acetylcholine and monoamine oxidase
- C. Increasing the levels of serotonin, norepinephrine, and dopamine
- D. Altering sodium metabolism within nerve and muscle cells
Correct Answer

A. C. Increasing the levels of serotonin, norepinephrine, and dopamine

Explanation

Electroconvulsive therapy (ECT) is a treatment that involves passing electric currents through the brain to induce a controlled seizure. It is believed to have a therapeutic response by increasing the levels of serotonin, norepinephrine, and dopamine. These neurotransmitters play a crucial role in regulating mood, emotions, and overall mental well-being. By increasing their levels, ECT may help alleviate symptoms of depression and other mental disorders. Stimulation of the CNS (option a) is a general effect of ECT, but it does not specifically explain the therapeutic response. Decreasing the levels of acetylcholine and monoamine oxidase (option b) and altering sodium metabolism within nerve and muscle cells (option d) are not supported by current understanding of ECT's mechanism of action.

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38.

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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39.

Sam has a diagnosis of major depression. After an unsuccessful trial of antidepressant medication, Sam's physician has hospitalized Sam for a course of ECT treatments. Sam 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!” Sam's priority nursing diagnosis at this time would be:
- A. Anxiety related to deficient knowledge about ECT
- B. Risk for injury related to risks associated with ECT
- C. Deficient knowledge related to negative media presentation of ECT
- D. Acute confusion related to side effects of ECT
Correct Answer

A. A. Anxiety related to deficient knowledge about ECT

Explanation

Sam's priority nursing diagnosis at this time would be anxiety related to deficient knowledge about ECT. This is because Sam expresses fear and concern about the treatment, indicating a lack of understanding about what to expect. By addressing Sam's anxiety and providing education about ECT, the nurse can help alleviate Sam's fears and increase their understanding of the treatment, ultimately promoting a more positive experience.

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40.

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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41.

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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42.

Atropine sulfate is administered to a client receiving ECT for what purpose?
- A. To alleviate anxiety
- B. To decrease secretions
- C. To relax muscles
- D. As a short-acting anesthetic
Correct Answer

A. B. To decrease secretions

Explanation

Atropine sulfate is administered to a client receiving ECT in order to decrease secretions. ECT (electroconvulsive therapy) can cause excessive salivation and bronchial secretions, and atropine sulfate is a medication that helps to reduce these secretions. It works by blocking the action of acetylcholine, a neurotransmitter that stimulates secretions. By decreasing secretions, atropine sulfate can help to prevent complications such as aspiration pneumonia during ECT.

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43.

Succinylcholine is administered to a client receiving ECT for what purpose?
- A. To alleviate anxiety
- B. To decrease secretions
- C. To relax muscles
- D. As a short-acting anesthetic
Correct Answer

A. C. To relax muscles

Explanation

Succinylcholine is administered to a client receiving ECT (Electroconvulsive therapy) to relax their muscles. ECT involves the induction of a controlled seizure in order to treat severe depression, mania, or catatonia. The muscle relaxation caused by succinylcholine helps to prevent injury during the seizure and allows for a smoother procedure.

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1
44.

Which of the following is a true statement about mental health recovery? (Select all that apply.)
- A. Mental health recovery applies only to severe and persistent mental illnesses.
- B. Mental health recovery serves to provide empowerment to the client.
- C. Mental health recovery is based on the medical model.
- D. Mental health recovery is a collaborative process.
Correct Answer(s)

A. B. Mental health recovery serves to provide empowerment to the client.
A. D. Mental health recovery is a collaborative process.

Explanation

Mental health recovery serves to provide empowerment to the client as it focuses on helping individuals regain control over their lives and make informed decisions about their mental health. It is a collaborative process as it involves a partnership between the individual and their healthcare providers, family, friends, and community to support their recovery journey. The statement a is false as mental health recovery can apply to a range of mental illnesses, not just severe and persistent ones. The statement c is false as mental health recovery is not solely based on the medical model but also takes into account social, psychological, and environmental factors.

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45.

A nurse is assisting an individual with mental illness recovery using the Tidal Model. Which of the following is a component of this model?
- A. The wellness toolbox
- B. The daily maintenance list
- C. The individual's personal story
- D. Triggers
Correct Answer

A. C. The individual's personal story

Explanation

The Tidal Model is a framework used by mental health professionals to assist individuals with mental illness recovery. One of the components of this model is the individual's personal story. This refers to the unique experiences, beliefs, and values of the individual, which are important in understanding their mental health journey and tailoring appropriate interventions. By acknowledging and exploring the personal story, the nurse can gain insight into the individual's perspective and work collaboratively towards their recovery goals.

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46.

A nurse is assisting an individual with mental illness recovery using the Psychological Recovery Model. The client says to the nurse, “I have schizophrenia. Nothing can be done. I might as well die.” In which stage of the Psychological Recovery Model would the nurse assess this individual to be?
- A. The awareness stage
- B. The preparation stage
- C. The rebuilding stage
- D. The moratorium stage
Correct Answer

A. D. The moratorium stage

Explanation

The client's statement, "I have schizophrenia. Nothing can be done. I might as well die," suggests a sense of hopelessness and resignation. This aligns with the moratorium stage of the Psychological Recovery Model. In this stage, individuals may feel overwhelmed by their illness and believe that there is no possibility for improvement or recovery. They may be stuck in a state of inaction and lack motivation to seek help or make changes. The nurse would assess the client to be in the moratorium stage based on their negative beliefs and lack of hope for the future.

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47.

A nurse who is helping a client in the preparation stage of the Psychological Recovery Model might include which of the following interventions?
- A. Teach about effects of the illness and how to recognize, monitor, and manage symptoms.
- B. Help the client identify “triggers” that cause distress or discomfort.
- C. Help the client establish a daily maintenance list.
- D. Listen actively while the client composes his or her personal story.
Correct Answer

A. A. Teach about effects of the illness and how to recognize, monitor, and manage symptoms.

Explanation

In the preparation stage of the Psychological Recovery Model, the nurse focuses on providing education and information to the client about the effects of their illness and how to recognize, monitor, and manage symptoms. This is important as it helps the client develop a better understanding of their condition and empowers them to take an active role in their own recovery. By teaching about the effects of the illness and symptom management, the nurse is helping the client build knowledge and skills necessary for their recovery journey.

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48.

A nurse who is helping a client with mental illness recovery using the WRAP Model says to the client, “First you must create a wellness toolbox.” She explains to the client that a wellness toolbox is which of the following?
- A. A list of words that describe how the individual feels when he or she is feeling well
- B. A list of things the client needs to do every day to maintain wellness
- C. A list of strategies the client has used in the past that help relieve disturbing symptoms
- D. A list of the client's favorite health-care providers and phone numbers
Correct Answer

A. C. A list of strategies the client has used in the past that help relieve disturbing symptoms

Explanation

The nurse explains to the client that a wellness toolbox is a list of strategies the client has used in the past that help relieve disturbing symptoms. This means that the client can refer to this list whenever they are experiencing symptoms and use the strategies that have worked for them in the past to help alleviate those symptoms. It allows the client to have a personalized set of tools to manage their mental illness and promote their recovery.

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49.

An example of a treatable (reversible) form of neurocognitive disorder (NCD) is one that is caused by which of the following? (Select all that apply.)
- A. Multiple sclerosis
- B. Multiple small brain infarcts
- C. Electrolyte imbalances
- D. HIV disease
- E. Folate deficiency
Correct Answer(s)

A. C. Electrolyte imbalances
A. E. Folate deficiency

Explanation

Electrolyte imbalances and folate deficiency are both examples of treatable forms of neurocognitive disorder (NCD). Electrolyte imbalances can disrupt normal brain function, leading to cognitive impairment, but can be corrected through proper management of electrolyte levels. Folate deficiency can also cause cognitive impairment, but can be reversed through folate supplementation or dietary changes. Multiple sclerosis and multiple small brain infarcts are not treatable or reversible causes of NCD, while HIV disease can be managed but not completely reversed.

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Mental Health Exam 2

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

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Crises occur when an individual:

. Amanda's mobile home was destroyed by a tornado. Amanda received only minor injuries, but is experiencing disabling anxiety in the aftermath of the event. This type of crisis is called:

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

. 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:

The most appropriate nursing intervention with Jenny (from question 5) would be to:

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

The most appropriate nursing intervention with Marie (from question 9) would be to:

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

Intervention with Andrew (from question 12) would include:

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

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

A nursing school graduate failing the NCLEX exam and a 15-year-old high school girl not being selected for the cheerleading squad are examples of which of the following?

The husband says to the wife, “What do you want to do tonight?” and the wife responds, “Whatever you want to do.” This is an example of which of the following?

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

Karen's counselor asked her if she would like a hug. This is an example of which of the following?

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

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?

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

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

The nurse identifies the primary nursing diagnosis for Theresa as Risk for Suicide related to feelings of hopelessness from loss of relationship. Which is the outcome criterion that would most accurately measure achievement of this diagnosis?

Theresa is hospitalized following a suicide attempt after breaking up with her boyfriend. Freudian psychoanalytic theory would explain Theresa's suicide attempt in which of the following ways?

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?

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?

Which of the following interventions are appropriate for a client on suicide precautions? (Select all that apply.)

Success of long-term psychotherapy with Theresa (who attempted suicide following a breakup with her boyfriend) could be measured by which of the following behaviors?

Electroconvulsive therapy is most commonly prescribed for:

Which of the following best describes the average number of ECT treatments given and the timing of administration?

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

Electroconvulsive therapy is thought to effect a therapeutic response by:

The most common side effects of ECT are:

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?

The priority nursing intervention before starting ECT therapy is to:

Atropine sulfate is administered to a client receiving ECT for what purpose?

Succinylcholine is administered to a client receiving ECT for what purpose?

Which of the following is a true statement about mental health recovery? (Select all that apply.)

A nurse is assisting an individual with mental illness recovery using the Tidal Model. Which of the following is a component of this model?

A nurse who is helping a client in the preparation stage of the Psychological Recovery Model might include which of the following interventions?

A nurse who is helping a client with mental illness recovery using the WRAP Model says to the client, “First you must create a wellness toolbox.” She explains to the client that a wellness toolbox is which of the following?

An example of a treatable (reversible) form of neurocognitive disorder (NCD) is one that is caused by which of the following? (Select all that apply.)