PSYCHIATRIC-MENTAL HEALTH NURSING EXAM
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Mental Health Nursing Exam 1
Unit 1: Foundations of the Nurse-Client Relationship,
Unit 2: Milieu Management & Behavioural Limits
Unit 3: Legal, Ethical, and Documentation Concepts
Unit 4: Psychopharmacology & Psychological Theories
The basis for building a strong, therapeutic nurse-client relationship begins
with the nurse's:
1. sincere desire to help others.
2. acceptance of others.
3. self-awareness and understanding.
4. sound knowledge of psychiatric nursing.
3. self-awareness and understanding.
Although all of the options are desirable, knowledge of self is the basis for building a
strong, therapeutic nurse-client relationship. Being aware of and understanding
personal feelings and behavior are prerequisites for understanding and helping
clients.
Critical pathways of care refer to:
1. a care plan that provides outcome-based guidelines with a designated
length of stay.
2. a care plan designed for physicians to prescribe medications.
3. a design of treatment that includes approved therapies.
4. a technique in therapy to care for the client holistically.
1. a care plan that provides outcome-based guidelines with a designated length of
stay.
Critical pathways are defined as a provision of care in a case management system.
The pathways provide outcome-based guidelines for goal achievement within a
designated length of stay. Critical pathways are to be used by the treatment team,
not just by the physician. Pathways are designated lengths of stay, not therapies.
A client with antisocial personality disorder smokes where it's prohibited and
refuses to follow other unit and facility rules. The client gets others to do the
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laundry and other personal chores, splits the staff, and will work only with
certain nurses. The care plan for this client should focus primarily on:
1. consistently enforcing unit rules and facility policy.
2. isolating the client to decrease contact with easily manipulated clients.
3. engaging in power struggles with the client to minimize manipulative
behavior.
4. using behavior modification to decrease negative behavior by using
negative reinforcement.
1. consistently enforcing unit rules and facility policy.
Firmness and consistency regarding rules are the hallmarks of a care plan for a
client with a personality disorder. Isolation is inappropriate and violates the client's
rights. Power struggles should be avoided because the client may try to manipulate
people through them. Behavior modification usually fails because of staff
inconsistency and client manipulation.
The nurse has been caring for a client with chronic paranoid schizophrenia for
several months, including several one-on-one sessions. During one session,
the client seems more anxious than usual, speaking rapidly and loudly as the
session starts. This behavior indicates a possible change in which form of
communication?
1. Appearance
2. Kinesics
3. Paralanguage
4. Proxemics
3. Paralanguage
Paralanguage is the use of vocal effects, such as tone and tempo, to convey a
message. Appearance refers to the way a person looks. Kinesics involves body
language or movement. Proxemics is the use of spatial relationships (the distance
between people) during interaction to communicate meaning.
Nursing implications for a client taking central nervous system (CNS)
stimulants include monitoring the client for which of the following conditions?
1. Hyperpyrexia, slow pulse, and weight gain
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2. Tachycardia, weight loss, and mood swings
3. Hypotension, weight gain, and listlessness
4. Increased appetite, slowing of sensorium, and arrhythmias
2. Tachycardia, weight loss, and mood swings
Stimulants produce mood swings, anorexia and weight loss, and tachycardia. The
other symptoms indicate CNS depression.
A client is admitted to an inpatient psychiatric unit. After the assessment and
admission procedures are completed, the nurse states, "I'll try to be available
to talk with you when needed and will spend time with you each morning from
10:00 until 10:30 in the corner of the dayroom." What is the main rationale for
communicating these planned nursing interventions?
1. To attempt to establish a trusting relationship
2. To provide a structured environment for the client
3. To instill hope in the client
4. To provide time for completing nursing responsibilities
1. To attempt to establish a trusting relationship
Availability, reliability, and consistency are critical factors in establishing trust with a
client. Being specific about the time and place of meetings helps establish trust,
which is initially the main objective. Although important, structuring the environment
and instilling hope aren't the primary tasks at this time. Arranging a regular meeting
with the client allows the nurse to plan the workload but isn't the major reason for
such scheduling.
The nurse documents, "The client described her husband's abuse in an
emotionless tone and with a flat facial expression." This statement describes
the client's:
1. feelings.
2. blocking.
3. mood.
4. affect.
4. affect.
Affect refers to a person's emotional expression (in this case, the manner in which
the client talks about her experiences). Feelings are emotional states or perceptions.