Psychiatric Nursing
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PSY EXAM
- 1.The nurse is working with a client who has sought counseling after trying to rescue a neighbor involved in a house fire. In spite of the client's efforts, the neighbor died. Which action does the nurse engage in with the client during the working phase of the nurse-client relationship?
- A.
Exploring the client's ability to function
- B.
Exploring the client's potential for self-harm
- C.
Inquiring about the client's perception or appraisal of the neighbor's death
- D.
Inquiring about and examining the client's feelings that may block adaptive coping
- 2.A client who has just been sexually assaulted is quiet and calm. The nurse analyzes this behavior as indicating which defense mechanism?
- A.
Denial
- B.
Projection
- C.
Rationalization
- D.
Intellectualization
- 3.Laboratory work is prescribed for a client who has been experiencing delusions. When the nurse approaches the client to obtain a specimen of the client's blood, the client begins to shout “You're all vampires. Let me out of here!” The appropriate nursing response is which of the following?
- A.
“What makes you think that I am a vampire?”
- B.
“I'll leave and come back later for your blood.”
- C.
“I am not going to hurt you; I am going to help you.”
- D.
“It must be frightening to think that others want to hurt you.”
- 4.A client with a diagnosis of major depression who has attempted suicide says to the nurse, “I should have died. I've always been a failure. Nothing ever goes right for me.” The therapeutic response to the client is:
- A.
“I don't see you as a failure.”
- B.
“You have everything to live for.”
- C.
“Feeling like this is all part of being ill.”
- D.
“You've been feeling like a failure for a while?”
- 5.The community health nurse visits a client at home. The client states, “I haven't slept at all the last couple of nights.” Which response by the nurse illustrates a therapeutic communication technique for this client?
- A.
“Go on.”
- B.
“Sleeping?”
- C.
“You're having difficulty sleeping?”
- D.
“Sometimes, I have trouble sleeping too.”
- 6.A client admitted to the mental health unit is experiencing disturbed thought processes and believes that the food is being poisoned. Which communication technique does the nurse plan to use to encourage the client to eat?
- A.
Using open-ended questions and silence
- B.
Focusing on self-disclosure regarding food preferences
- C.
Identifying the reasons that the client may not want to eat
- D.
Offering opinions about the necessity of adequate nutrition
- 7.A client is admitted to a mental health unit for treatment of psychotic behavior. The client is at the locked exit door and is shouting, “Let me out. There's nothing wrong with me. I don't belong here.” The nurse analyzes this behavior as:
- A.
Denial
- B.
Projection
- C.
Regression
- D.
Rationalization
- 8.The supervisor reprimands the nurse in charge of the nursing unit because the charge nurse has not adhered to the unit budget. Later that afternoon, the charge nurse accuses the nursing staff of wasting supplies. This behavior is an example of:
- A.
Denial
- B.
Repression
- C.
Suppression
- D.
Displacement
- 9.The client says to the nurse, “I'm going to die, and I wish my family would stop hoping for a cure! I get so angry when they carry on like this. After all, I'm the one who's dying.” The therapeutic response by the nurse is:
- A.
“Have you shared your feelings with your family?”
- B.
“I think we should talk more about your anger with your family.”
- C.
“You're feeling angry that your family continues to hope for you to be cured?”
- D.
“Well, it sounds like you're being pretty pessimistic. After all, years ago, people died of pneumonia.”
- 10.The nurse employed in a mental health unit is assigned to care for a client admitted to the unit 2 days ago. On review of the client's record, the nurse notes that the admission was a voluntary admission. Based on this type of admission, the nurse anticipates which of the following?
- A.
The client will resist treatment measures.
- B.
The client will be angry and will refuse care.
- C.
The client's family will resist treatment measures.
- D.
The client will participate in the planning of the care and treatment plan
- 11.A nurse enters a client's room, and the client is demanding release from the hospital. The nurse reviews the client's record and notes that the client was admitted 2 days ago for treatment of an anxiety disorder and that the admission was a voluntary admission. Which of the following actions will the nurse take?
- A.
Contact the physician.
- B.
Call the client's family.
- C.
Persuade the client to stay a few more days.
- D.
Tell the client that discharge is not possible at this time.
- 12.A client has been admitted to the mental health unit. On admission assessment, the nurse notes that the client was admitted by involuntary status. Based on this type of admission, the nurse would most likely expect that the client:
- A.
Presents a harm to self
- B.
Requested the admission
- C.
Consented to the admission
- D.
Provided written application to the facility for admission
- 13.The nurse is preparing the client for the termination phase of the nurse-client relationship. The nurse prepares to implement which nursing task appropriate for this phase?
- A.
Planning short-term goals
- B.
Making appropriate referrals
- C.
Developing realistic solutions
- D.
Identifying expected outcomes
- 14.During the termination phase of the nurse-client relationship, the clinic nurse observes that the client has made several sarcastic remarks and has an angry affect. The most appropriate interpretation of the behavior is that the client:
- A.
Needs to be admitted to the hospital.
- B.
Needs to be referred to the psychiatrist as soon as possible.
- C.
Requires further treatment and is not ready to be discharged.
- D.
Is displaying typical behaviors that can occur during termination.
- 15.The nurse is providing care to a client admitted to the hospital with a diagnosis of acute anxiety disorder. While conversing with the client, the client says to the nurse, “I have a secret that I want to tell you. You won't tell anyone about it, will you?” The appropriate nursing response is which of the following?
- A.
“No, I won't tell anyone.”
- B.
“I cannot promise to keep a secret.”
- C.
“If you tell me the secret, I will tell it to your doctor.”
- D.
“If you tell me the secret, I will need to document it in your record.”
- 16.The nurse employed in a mental health clinic is greeted by a neighbor in a local grocery store. The neighbor says to the nurse, “How is Carol doing? She is my best friend and is seen at your clinic every week.” The appropriate nursing response is which of the following?
- A.
“I cannot discuss any client situation with you.”
- B.
“If you want to know about Carol, you need to ask her yourself.”
- C.
“I'm not suppose to discuss this, but because you are my neighbor, I can tell you that she is doing great!”
- D.
“I'm not suppose to discuss this, but because you are my neighbor, I can tell you that she really has some problems!”
- 17.A home health nurse is talking to the spouse of a client taking an antidepressant. The spouse says, “Now that my husband is responding to the antidepressant, the suicidal risk is over and you can stop making these home visits.” After analyzing this statement, which of the following is the appropriate nursing response?
- A.
“I need to continue with my visits. Your comment reflects a lack of knowledge that this disease runs in families.”
- B.
“I agree with you. Clients who want to kill themselves are only suicidal for a limited time. No one can feel self-destructive forever.”
- C.
“I agree with you. The suicidal threats were really attention seeking. Continuing to visit would reinforce your husband's use of manipulation.”
- D.
“I need to continue with my visits. Most suicides occur within 3 months after improvement begins because the client now has the energy to carry out the suicidal intentions.”
- 18.The nurse is caring for a client who is scheduled for electroconvulsive therapy. The nurse notes that an informed consent has not been obtained for the procedure. On review of the record, the nurse notes that the admission was an involuntary hospitalization. Based on this information, the nurse determines:
- A.
That the physician will provide the informed consent
- B.
That an informed consent does not need to be obtained
- C.
That an informed consent should be obtained from the family
- D.
That an informed consent needs to be obtained from the client
- 19.The client was admitted involuntarily to the mental health unit because of episodes of extremely violent behavior. The client is demanding to be discharged from the hospital and the nurse does not allow the client to leave. Which of the following represents the legal ramifications associated with the nurse's behavior?
- A.
The nurse will be charged with assault.
- B.
The nurse will be charged with slander.
- C.
The nurse will be charged with imprisonment.
- D.
No charge will be made against the nurse because the nurse's actions are reasonable.
- 20.The client asks the nurse about milieu therapy. The nurse responds, knowing that the primary focus of milieu therapy can best be described as which of the following?
- A.
A form of behavior modification therapy
- B.
A cognitive approach to changing behavior
- C.
A living, learning, or working environment
- D.
A behavioral approach to changing behavior
- 21.The nurse is caring for a client with a phobia who is being treated for the condition. The client is introduced to short periods of exposure to the phobic object while in a relaxed state. The nurse understands that this form of behavior modification can best be described as:
- A.
Milieu therapy
- B.
Aversion therapy
- C.
Self-control therapy
- D.
Systematic desensitization
- 22.A client with an eating disorder is planning to attend group meetings with Overeaters Anonymous, and the nurse describes this group to the client. The nurse determines that the client needs additional information if the client states which of the following about this self-help group?
- A.
“The leader is a nurse or psychiatrist.”
- B.
“The members provide support to each other.”
- C.
“People who have a similar problem are able to help others.”
- D.
“It is designed to serve people who have a common problem.”
- 23.The nurse is conducting a group therapy session, and a client with a manic disorder is monopolizing the group. The appropriate nursing action is which of the following?
- A.
Ask the client to leave.
- B.
Refer the client to another group.
- C.
Tell the client to stop monopolizing
- D.
Thank the client for the contribution and tell him or her to allow others a chance to contribute
- 24.A nurse employed in a mental health unit of a hospital is the leader of a group psychotherapy session. The nurse's role in the termination stage of group development is to:
- A.
Encourage problem-solving.
- B.
Encourage accomplishment of the group's work.
- C.
Acknowledge the contributions of each group member.
- D.
Encourage members to become acquainted with one another.
- 25.All treatment team members are seen as equally important in helping clients meet their treatment goals. This type of therapy approach is:
- A.
Milieu therapy
- B.
Interpersonal therapy
- C.
Behavior modification
- D.
Rational emotive therapy
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