Mental Heath Final Exam
QUESTIONS AND
CORRECT ANSWERS
GRADE A+
1. Which issues should a nurse address during the first interview with a patient diagnosed with a
psychiatric disorder?
a. Trust, congruence, attitudes, and boundaries
b. Goals, resistance, unconscious motivations, and diversion
c. Relationship parameters, the contract, confidentiality, and termination
d. Transference, countertransference, intimacy, and developing resources ANS: C
Relationship parameters, the contract, confidentiality, and termination are issues that should be
considered during the orientation phase of the relationship. The remaining options are issues that
are dealt with later.
Why is it important to talk about relationships with family members?
-To see what kind of support system they have
2.
A new staff nurse completes an orientation to the psychiatric unit. This nurse will expect to
ask an advanced practice nurse to perform which action for clients?
a. Perform mental health assessment interviews.
b. Prescribe psychotropic medication.
c. Establish therapeutic relationships.
d. Individualize nursing care plans. ANS: B
Prescriptive privileges are granted to master's-prepared nurse practitioners who have taken
special courses on prescribing medication. The nurse prepared at the basic level performs mental
health assessments, establishes relationships, and provides individualized care planning.
**Advanced practice nurses- must have a minimum of DMP, (masters), they have prescriptive
authority, diagnosis and can do psychiatric
3. Which client would be most appropriate to refer for assertive community treatment (ACT)?
,a. One diagnosed with a phobic fear of crowded places.
b. One who experienced a single episode of major depressive disorder.
c. One who experienced a catastrophic reaction to a tornado in the community.
d. One diagnosed with schizophrenia who had four hospitalizations in the past year. ANS:
D
ACT provides intensive case management for persons with serious persistent mental illness who
live in the community. Repeated hospitalization is a frequent reason for this intervention. The
distracters identify mental health problems of a more episodic nature.
How to demonstrate empathy?
- it must be very difficult for you to go through this
Best way to show patient that your listening?
- lean in when talking, RESTATE what he says
Verbal and non verbal communication?
Verbal- talking speaking
Nonverbal- posture and eye contact, not facing, clenching fist, not speaking at all
Which statement shows a nurse has empathy for a patient who made a suicide attempt?
a. "You must have been very upset when you tried to hurt yourself."
b. "It makes me sad to see you going through such a difficult experience."
c. "If you tell me what is troubling you, I can help you solve your problems."
d. "Suicide is a drastic solution to a problem that may not be such a serious matter." ANS:
A
Empathy permits the nurse to see an event from the patient's perspective, understand the patient's
feelings, and communicate this to the patient. The incorrect responses are nurse- centered
(focusing on the nurse's feelings rather than the patient's), belittling, and sympathetic.
9. While talking with a client diagnosed with major depressive disorder, a nurse notices the client
is unable to maintain eye contact. The client's chin lowers to the chest. The client looks at the
floor. Which aspect of communication has the nurse assessed?
a. Nonverbal communication
Test bank Varcarolis' Foundations of Psychiatric-Mental Health Nursing 9th Edition 97
b. A message filter
c. A cultural barrier
d. Social skills ANS: A
Eye contact and body movements are considered nonverbal communication. There are
insufficient data to determine the level of the client's social skills or an existing cultural barrier.
5. Which technique will best communicate to a client that the nurse is interested in listening?
a. Restating a feeling or thought the client has expressed.
b. Asking a direct question, such as "Did you feel angry?"
c. Making a judgment about the client's problem.
d. Saying, "I understand what you're saying." ANS: A
Restating allows the client to validate the nurse's understanding of what has been communicated.
Restating is an active listening technique. Judgments should be suspended in a nurse-client
, relationship. Close-ended questions such as "Did you feel angry?" ask for specific information
rather than showing understanding. When the nurse simply states that he or she understands the
client's words, the client has no way of measuring the understanding.
Thereputic communication-
**tell me what happened before you came to the hospital (open ended),
**Non judge mental and non accusatory
Transference; patient views you as someone they know and have opinion about
Countertransference; nurse views patient as someone they know and have opinions on, versed
Stages of Anxiety
Mild: restlessness, irritablity, and mild tension
Moderate: pounding heart, increase RR, and GI discomfort
Severe; headache, Nausia, dizziness, hyperventilation
Panic; pacing, running,shout and screaming
How to manage; deep breathing, medication, reducing stimuli
schizophrenia
positive symptoms; delusion and hallucinations, "bad symptoms" normal people don't have it
Negative symptoms;no pleasure, motivation or reduce speaking, Normal people have it
7. A client tells the nurse, "I don't think I'll ever get out of here." What is the nurse's most
therapeutic response?
a. "Don't talk that way. Of course, you will leave here!"
b. "Keep up the good work, and you certainly will."
c. "You don't think you're making progress?"
d. "Everyone feels that way sometimes."
ANS: C
By asking if the client does not believe that progress has been made, the nurse is reflecting or
paraphrasing by putting into words what the client is
19. A school age child tells the school nurse, "Other kids call me mean names and will not sit
with me at lunch. Nobody likes me." what is the nurse's most therapeutic response?
a. "Just ignore them and they will leave you alone."
b. "You should make friends with other children."
c. "Call them names if they do that to you."
d. "Tell me more about how you feel."
ANS: D
The correct response uses explo
1.
A client has had difficulty keeping a job because of arguing with co-workers and accusing them
of conspiracy. Today this client shouts, "They're all plotting to destroy me. Isn't that true?" what
is the nurse's most therapeutic response?
a. "Everyone here is trying to help you. No one wants to harm you."
b. "Feeling that people want to destroy you must be very frightening."
c. "That is not true. People here are trying to help you if you will let them."
QUESTIONS AND
CORRECT ANSWERS
GRADE A+
1. Which issues should a nurse address during the first interview with a patient diagnosed with a
psychiatric disorder?
a. Trust, congruence, attitudes, and boundaries
b. Goals, resistance, unconscious motivations, and diversion
c. Relationship parameters, the contract, confidentiality, and termination
d. Transference, countertransference, intimacy, and developing resources ANS: C
Relationship parameters, the contract, confidentiality, and termination are issues that should be
considered during the orientation phase of the relationship. The remaining options are issues that
are dealt with later.
Why is it important to talk about relationships with family members?
-To see what kind of support system they have
2.
A new staff nurse completes an orientation to the psychiatric unit. This nurse will expect to
ask an advanced practice nurse to perform which action for clients?
a. Perform mental health assessment interviews.
b. Prescribe psychotropic medication.
c. Establish therapeutic relationships.
d. Individualize nursing care plans. ANS: B
Prescriptive privileges are granted to master's-prepared nurse practitioners who have taken
special courses on prescribing medication. The nurse prepared at the basic level performs mental
health assessments, establishes relationships, and provides individualized care planning.
**Advanced practice nurses- must have a minimum of DMP, (masters), they have prescriptive
authority, diagnosis and can do psychiatric
3. Which client would be most appropriate to refer for assertive community treatment (ACT)?
,a. One diagnosed with a phobic fear of crowded places.
b. One who experienced a single episode of major depressive disorder.
c. One who experienced a catastrophic reaction to a tornado in the community.
d. One diagnosed with schizophrenia who had four hospitalizations in the past year. ANS:
D
ACT provides intensive case management for persons with serious persistent mental illness who
live in the community. Repeated hospitalization is a frequent reason for this intervention. The
distracters identify mental health problems of a more episodic nature.
How to demonstrate empathy?
- it must be very difficult for you to go through this
Best way to show patient that your listening?
- lean in when talking, RESTATE what he says
Verbal and non verbal communication?
Verbal- talking speaking
Nonverbal- posture and eye contact, not facing, clenching fist, not speaking at all
Which statement shows a nurse has empathy for a patient who made a suicide attempt?
a. "You must have been very upset when you tried to hurt yourself."
b. "It makes me sad to see you going through such a difficult experience."
c. "If you tell me what is troubling you, I can help you solve your problems."
d. "Suicide is a drastic solution to a problem that may not be such a serious matter." ANS:
A
Empathy permits the nurse to see an event from the patient's perspective, understand the patient's
feelings, and communicate this to the patient. The incorrect responses are nurse- centered
(focusing on the nurse's feelings rather than the patient's), belittling, and sympathetic.
9. While talking with a client diagnosed with major depressive disorder, a nurse notices the client
is unable to maintain eye contact. The client's chin lowers to the chest. The client looks at the
floor. Which aspect of communication has the nurse assessed?
a. Nonverbal communication
Test bank Varcarolis' Foundations of Psychiatric-Mental Health Nursing 9th Edition 97
b. A message filter
c. A cultural barrier
d. Social skills ANS: A
Eye contact and body movements are considered nonverbal communication. There are
insufficient data to determine the level of the client's social skills or an existing cultural barrier.
5. Which technique will best communicate to a client that the nurse is interested in listening?
a. Restating a feeling or thought the client has expressed.
b. Asking a direct question, such as "Did you feel angry?"
c. Making a judgment about the client's problem.
d. Saying, "I understand what you're saying." ANS: A
Restating allows the client to validate the nurse's understanding of what has been communicated.
Restating is an active listening technique. Judgments should be suspended in a nurse-client
, relationship. Close-ended questions such as "Did you feel angry?" ask for specific information
rather than showing understanding. When the nurse simply states that he or she understands the
client's words, the client has no way of measuring the understanding.
Thereputic communication-
**tell me what happened before you came to the hospital (open ended),
**Non judge mental and non accusatory
Transference; patient views you as someone they know and have opinion about
Countertransference; nurse views patient as someone they know and have opinions on, versed
Stages of Anxiety
Mild: restlessness, irritablity, and mild tension
Moderate: pounding heart, increase RR, and GI discomfort
Severe; headache, Nausia, dizziness, hyperventilation
Panic; pacing, running,shout and screaming
How to manage; deep breathing, medication, reducing stimuli
schizophrenia
positive symptoms; delusion and hallucinations, "bad symptoms" normal people don't have it
Negative symptoms;no pleasure, motivation or reduce speaking, Normal people have it
7. A client tells the nurse, "I don't think I'll ever get out of here." What is the nurse's most
therapeutic response?
a. "Don't talk that way. Of course, you will leave here!"
b. "Keep up the good work, and you certainly will."
c. "You don't think you're making progress?"
d. "Everyone feels that way sometimes."
ANS: C
By asking if the client does not believe that progress has been made, the nurse is reflecting or
paraphrasing by putting into words what the client is
19. A school age child tells the school nurse, "Other kids call me mean names and will not sit
with me at lunch. Nobody likes me." what is the nurse's most therapeutic response?
a. "Just ignore them and they will leave you alone."
b. "You should make friends with other children."
c. "Call them names if they do that to you."
d. "Tell me more about how you feel."
ANS: D
The correct response uses explo
1.
A client has had difficulty keeping a job because of arguing with co-workers and accusing them
of conspiracy. Today this client shouts, "They're all plotting to destroy me. Isn't that true?" what
is the nurse's most therapeutic response?
a. "Everyone here is trying to help you. No one wants to harm you."
b. "Feeling that people want to destroy you must be very frightening."
c. "That is not true. People here are trying to help you if you will let them."
