Test Bank For Foundations of Mental Health Care
8th Edition Morrison Valfre | 9780323810296 | All
Chapters with Answers and Rationals
An older client with the diagnosis of dementia of the Alzheimer type is admitted to a long-term care facility.
When planning care for this client, the nurse recalls that confusion:
1
Will be unchanged despite reality orientation
2
Is a common finding and is expected with aging
3
Results from brain changes that make interventions futile
4
Occurs with a transfer to new surroundings –
Correct Answer :4
P 1
, • Mental Health Care 09/15/2026
A change in environment and introduction of unfamiliar stimuli precipitate confusion in clients with dementia-
type disorders; with appropriate intervention, including frequent reorientation, confusion can be reduced.
Reality orientation can reduce confusion when these clients are confronted with unfamiliar surroundings. The
assertions that reality orientation is ineffective, that confusion is an expected finding in aging, and that brain
changes in dementia make interventions futile are all untrue.
During a nursing team conference, a mental health worker suggests that a client with schizophrenia, paranoid
type, be assigned to group therapy. What should the nurse manager explain about this type of therapy for this
client?
1
Individuals with this disorder respond well to small therapeutic groups.
2
Compliance with unit rules and medication regimens increases as therapeutic group involvement increases.
3
Involvement in small therapeutic groups may decrease the regression and dependency associated with
institutionalization.
4
Therapeutic group work tends to be threatening to individuals who are suspicious. –
Correct Answer :4Suspicious individuals do not do well in groups because they are unable to tolerate the give-
and-take that is necessary for successful group function. Suspicious individuals do not trust others enough to do
well in group therapy. The assertion that compliance with unit rules and medication regimens increases as
therapeutic group involvement increases may not be true for acutely ill psychiatric clients, who are not ready to
accept reality. Reducing problems related to institutionalization is not the purpose of group therapy. These
problems are addressed with remotivation therapy.
A nurse is caring for depressed older adults. What precipitating factors for depression are most common in the
older adult without cognitive problems? Select all that apply.
1
Dementia
2
Multiple losses
3
Declines in health
P 2
, • Mental Health Care 09/15/2026
4
A milestone birthday
5
An injury requiring hospitalization –
Correct Answer :23Depression in the older adult is most often associated with the loss of family members and
friends (e.g., death, relocation) and declines in mobility, health, and income. A decline in health, particularly
when associated with a chronic illness, frequently precipitates depression in older adults. Dementia is a cognitive
problem. Research does not correlate the onset of depression with a milestone birthday in older adults. A
traumatic injury does not precipitate the onset of depression in the older adult as often as does a chronic illness.
A client with schizophrenia is started on a regimen of chlorpromazine (Thorazine). After 10 days a shuffling gait,
tremors, and some rigidity are apparent. Benztropine mesylate (Cogentin) 2 mg by mouth daily is prescribed.
What should the nurse remember when administering these medications together?
1
Both medications are cholinesterase inhibitors.
2
The antipsychotic effects of chlorpromazine will be decreased.
3
The synergistic effect of these medications will cause drooling.
4
Both medications have a cholinergic blocking action. –
Correct Answer :4Both medications block central acetylcholine receptors. Neither medication inhibits
cholinesterase; neostigmine (Prostigmin) acts in this manner. Although benztropine mesylate (Cogentin) can
cause mental confusion when given in large doses, it does not reduce the antipsychotic effect of chlorpromazine
(Thorazine). Both medications cause dry mouth.
An older adult is brought to the clinic by a family member because of increasing confusion over the past week.
What can the nurse ask the client to do to assess orientation to place?
1
Explain a proverb.
2
P 3
, • Mental Health Care 09/15/2026
Give the state where she was born.
3
Recall what she ate for breakfast.
4
Identify the name of the clinic's town. –
Correct Answer :4Orientation to place refers to an individual's awareness of the objective world in its relation to
the self; orientation to time, place, and person is part of the assessment of cerebral functioning. Explaining a
proverb requires abstract thinking, which involves a higher integrative function than does orientation to place.
Having the client state where she was born helps the nurse assess remote memory, not orientation. Having the
client recalling what she had for breakfast helps assess recent memory, not orientation.
A male client with cyclothymic disorder with hypomanic symptoms is admitted to the psychiatric unit. He has
progressively lost weight and does not take the time to eat his food. How can the nurse best respond to this
situation?
1
By providing a tray for him in his room
2
By assuring him that he is deserving of food
3
By pointing out that he must replace the energy that he is burning up by eating
4
By ordering food that he can hold in his hand to eat while moving around –
Correct Answer :4The client with hypomanic symptoms cannot tolerate sitting still long enough to eat an
adequate meal; handheld foods will help meet the client's nutritional needs and do not require the client to sit
down. This client will most likely ignore the tray. Unworthy feelings are related to a depressive, not manic,
episode. It is unlikely that this client will understand or care about the need to replace energy with food.
A nurse who is assessing a recently hospitalized client with a diagnosis of opioid addiction should look for signs
of withdrawal. What are these signs? Select all that apply.
1
Seizures
P 4