mental health nclex questions
1. A male patient in the psychiatric unit experiencing a state of mania is
walking the halls completely naked. How should the nurse respond
initially? (select all that apply)
Quietly escort the patient to his room.
Tell the patient he will be secluded if he does not get
dressed. Ask the other patients to go to their rooms.
Confront the patient and insist he get
dressed. Encourage the patient to get
dressed.
Withhold family visits due to inappropriate behavior.: Quietly escort the
patient to his room.
1/
,Encourage the patient to get
dressed. Explanation
• The nurse should take control of the situation without causing the
patient more anxiety. Walk the patient to his room and encourage
him to dress there.
• A manic patient often lacks good judgement and has poor impulse
control, but may respond well to non-threatening encouragement.
•A manic patient is more receptive to non-threatening direction than
confrontation, and walking with the patient to his room and encouraging
him to get dressed so that he can do something else he enjoys will get
better results than issuing an order.
•Confronting the patient or threatening the patient with seclusion or
2/
,restraint will often escalate the situation or lead to resistance.
•Asking the other patients to return to their rooms is not appropriate.
•Withholding visitation is not an appropriate response.
2. The home care nurse assesses an older adult client living with adult
chil- dren. The client is thin and frail, with bruising on the upper arms and
back.
3/
, Which circumstances alert the nurse to an increased risk of abuse?
Select all that apply.
Lower socioeconomic status of the older adult client's family.
The elderly client has a psychiatric diagnosis, such as dementia or
depres- sion.
The abuse of alcohol by the older adult client and/or a family member in
the home.
Physical or cognitive impairment making the client dependent on others
for activities of daily living.
Frequent emergency room visits for falls or unexplained illnesses.: The
elderly client has a psychiatric diagnosis, such as dementia or
depression.
4/
1. A male patient in the psychiatric unit experiencing a state of mania is
walking the halls completely naked. How should the nurse respond
initially? (select all that apply)
Quietly escort the patient to his room.
Tell the patient he will be secluded if he does not get
dressed. Ask the other patients to go to their rooms.
Confront the patient and insist he get
dressed. Encourage the patient to get
dressed.
Withhold family visits due to inappropriate behavior.: Quietly escort the
patient to his room.
1/
,Encourage the patient to get
dressed. Explanation
• The nurse should take control of the situation without causing the
patient more anxiety. Walk the patient to his room and encourage
him to dress there.
• A manic patient often lacks good judgement and has poor impulse
control, but may respond well to non-threatening encouragement.
•A manic patient is more receptive to non-threatening direction than
confrontation, and walking with the patient to his room and encouraging
him to get dressed so that he can do something else he enjoys will get
better results than issuing an order.
•Confronting the patient or threatening the patient with seclusion or
2/
,restraint will often escalate the situation or lead to resistance.
•Asking the other patients to return to their rooms is not appropriate.
•Withholding visitation is not an appropriate response.
2. The home care nurse assesses an older adult client living with adult
chil- dren. The client is thin and frail, with bruising on the upper arms and
back.
3/
, Which circumstances alert the nurse to an increased risk of abuse?
Select all that apply.
Lower socioeconomic status of the older adult client's family.
The elderly client has a psychiatric diagnosis, such as dementia or
depres- sion.
The abuse of alcohol by the older adult client and/or a family member in
the home.
Physical or cognitive impairment making the client dependent on others
for activities of daily living.
Frequent emergency room visits for falls or unexplained illnesses.: The
elderly client has a psychiatric diagnosis, such as dementia or
depression.
4/
