Comprehensive Mental Health and Psychiatric Nursing NCLEX Practice Quiz #2: 75 Questions

Comprehensive Mental Health and Psychiatric Nursing NCLEX Practice Quiz #2: 75 QuestionsComprehensive Mental Health and Psychiatric Nursing NCLEX Practice Quiz #2: 75 Questions 1. 1. Question Which nursing intervention is best for facilitating communication with a psychiatric client who speaks a foreign language? o A. Rely on nonverbal communication o B. Select symbolic pictures as aids o C. Speak in universal phrases o D. Use the services of an interpreter Incorrect Correct Answer: D. Use the services of an interpreter An interpreter will enable the nurse to better assess the client’s problems and concerns. Language barriers pose challenges in terms of achieving high levels of satisfaction among medical professionals and patients, providing high- quality healthcare and maintaining patient safety. To address these challenges, many larger healthcare institutions offer interpreter services to improve healthcare access, patient satisfaction, and communication. • Option A: Nonverbal communication is important; however for the nurse to fully determine the client’s problems and concerns, the assistance of an interpreter is essential. Language barriers have negative implications for the delivery of healthcare and patient satisfaction. One study showed that among patients who received treatment from nurses who did not speak the local language, 30% had difficulty understanding medical instructions, 30% had a problem with the reliability of information, and 50% believed that the language barrier contributed to errors. • Option B: Online translation tools such as Google Translate and MediBabble present possible solutions for overcoming these challenges. Further studies on the implications of language barriers and the effectiveness of online translation tools are recommended. Furthermore, new updates with more medical phrases for Google Translate and with more languages included for MediBabble application are recommended. • Option C: The use of universal phrases may assist the nurse in understanding the basic needs of the client; however these are insufficient to assess the client with a psychiatric problem. Some healthcare organizations use online translation tools such as Google Translate and MediBabble to address the challenges of language barriers. These tools are free and easy to access, and they contribute to improving healthcare delivery, patient safety, and increase (up to 92%) the satisfaction of both medical professionals and patients. 2. 2. Question The nurse explains to a mental health care technician that a client’s obsessive-compulsive behaviors are related to an unconscious conflict between id impulses and the superego (or conscience). On which of the following theories does the nurse base this statement? • A. Behavioral theory • B. Cognitive theory • C. Interpersonal theory • D. Psychoanalytic theory Incorrect Correct Answer: D. Psychoanalytic theory Psychoanalytic is based on Freud’s beliefs regarding the importance of unconscious motivation for behavior and the role of the id and superego in opposition to each other. Psychoanalysis is defined as a set of psychological theories and therapeutic methods which have their origin in the work and theories of Sigmund Freud . The primary assumption of psychoanalysis is the belief that all people possess unconscious thoughts, feelings, desires, and memories. The aim of psychoanalysis therapy is to release repressed emotions and experiences, i.e., make the unconscious conscious. It is only having a cathartic (i.e., healing) experience can the person be helped and “cured.” • Option A: Behaviorism, also known as behavioral psychology, is a theory of learning based on the idea that all behaviors are acquired through conditioning. Conditioning occurs through interaction with the environment. Behaviorists believe that our responses to environmental stimuli shape our actions. According to this school of thought, behavior can be studied in a systematic and observable manner regardless of internal mental states. According to this perspective, only observable behavior should be considered—cognitions, emotions, and moods are far too subjective. • Option B: Cognitive theory is an approach to psychology that attempts to explain human behavior by understanding your thought processes. For example, a therapist is using principles of cognitive theory when they teach you how to identify maladaptive thought patterns and transform them into constructive ones. The assumption of cognitive theory is that thoughts are the primary determinants of emotions and behavior. Information processing is a common description of this mental process. Theorists compare the way the human mind functions to a computer. • Option C: Interpersonal theory emphasizes the importance of various developmental stages—infancy, childhood, the juvenile era, preadolescence, early adolescence, late adolescence, and adulthood. Like Freud and Jung, Sullivan (1953b) saw personality as an energy system. Energy can exist either as tension (potentiality for action) or as actions themselves (energy transformations). Energy transformations transform tensions into either covert or overt behaviors and are aimed at satisfying needs and reducing anxiety. 3. 3. Question The nurse observes a client pacing in the hall. Which statement by the nurse may help the client recognize his anxiety? • A. “I guess you’re worried about something, aren’t you? • B. “Can I get you some medication to help calm you?” • C. “Have you been pacing for a long time?” • D. “I notice that you’re pacing. How are you feeling?” Incorrect Correct Answer: D. “I notice that you’re pacing. How are you feeling?” By acknowledging the observed behavior and asking the client to express his feelings the nurse can best assist the client to become aware of his anxiety. Recognition acknowledges a patient’s behavior and highlights it without giving an overt compliment. A compliment can sometimes be taken as condescending, especially when it concerns a routine task like making the bed. However, saying something like “I noticed you took all of your medications” draws attention to the action and encourages it without requiring a compliment. • Option A: The nurse is offering an interpretation that may or may not be accurate; the nurse is also asking a question that may be answered by a “yes” or “no” response, which is not therapeutic. Therapeutic communication is often most effective when patients direct the flow of conversation and decide what to talk about. To that end, giving patients a broad opening such as “What’s on your mind today?” or “What would you like to talk about?” can be a good way to allow patients an opportunity to discuss what’s on their mind. • Option B: The nurse is intervening before accurately assessing the problem. By using nonverbal and verbal cues such as nodding and saying “I see,” nurses can encourage patients to continue talking. Active listening involves showing interest in what patients have to say, acknowledging that you’re listening and understanding, and engaging with them throughout the conversation. Nurses can offer general leads such as “What happened next?” to guide the conversation or propel it forward. • Option C: This statement encourages a “yes” or “no” response, avoids focusing on the client’s anxiety, which is the reason for his pacing. Observations about the appearance, demeanor, or behavior of patients can help draw attention to areas that might pose a problem for them. Observing that they look tired may prompt patients to explain why they haven’t been getting much sleep lately; making an observation that they haven’t been eating much may lead to the discovery of a new symptom. 4. 4. Question A client with obsessive-compulsive disorder is hospitalized in an inpatient unit. Which nursing response is most therapeutic? • A. Accepting the client’s obsessive-compulsive behaviors. • B. Challenging the client’s obsessive-compulsive behaviors. • C. Preventing the client’s obsessive-compulsive behaviors. • D. Rejecting the client’s obsessive-compulsive behaviors. Incorrect Correct Answer: A. Accepting the client’s obsessive-compulsive behaviors A client with obsessive-compulsive behavior uses this behavior to decrease anxiety. Accepting this behavior as the client’s attempt to feel secure is therapeutic. When a specific treatment plan is developed, other nursing responses may also be acceptable. Obsessive-compulsive disorder (OCD) is often a disabling condition consisting of bothersome intrusive thoughts that elicit a feeling of discomfort. To reduce the anxiety and distress associated with these thoughts, the patient may employ compulsions or rituals. These rituals may be personal and private, or they may involve others to participate; the rituals are to compensate for the ego-dystonic feelings of the obsessional thoughts and can cause a significant decline in function. • Option B: In The Diagnostic and Statistical Manual of Mental Disorders (DSM)-5, which was published by the American Psychiatric Association (APA) in 2013, Obsessive-Compulsive Disorder sits under its own category of Obsessive-Compulsive and Related Disorders. Obsessions are defined as intrusive thoughts or urges that cause significant distress; the patient attempts to neutralize this distress by diverting thoughts or performing rituals. Compulsions are actions the patient feels pressured to do in response to the anxiety/distress producing obsessions or to prevent an uncomfortable situation from occurring. These compulsions may be illogical or excessive. • Option C: The most common obsessions include fears of contamination, fears of aggression/harm, sexual fears, religious fears, and need to make things “just right.” The compensatory compulsions for these obsessions include washing and cleaning, checking, reassurance-seeking, repeating, and ordering, and arranging. As OCD has the possibility of hindering one’s social growth and development, the WHO lists OCD as one of the ten most disabling conditions by financial loss and a decrease in quality of life. • Option D: Those who have OCD have a 7% risk of Tourette syndrome and a 20% chance of developing tics. As the treatment for OCD involves selective serotonin reuptake inhibitors (SSRIs) and possible antipsychotics, adverse effects of these medications including but not limited to weight gain, tardive dyskinesia, and dystonia, must also be monitored. 5. 5. Question