x x x
EXAM 2
x x x x
2024 x
x
A xcharge xnurse xis xdiscussing xmental xstatus xexams xwith xa xnewly xlicensed xnurse.
xWhich xof xthe xfollowing xstatements xby xthe xnewly xlicensed xnurse xindicates xan
xunderstanding xof xthe xteaching? x(Select xall xthat xapply) x
A) To xassess xcognitive xability, xI xshould xask xthe xclient xto xcount xbackward xby
xsevens. x
B) To xassess xaffect, xI xshould xobserve xthe xclient's xfacial xexpression x
C) To xassess xlanguage xability, xI xshould xinstruct xthe xclient xto xwrite xa xsentence. x
D) To xassess xremote xmemory, xI xshould xhave xthe xclient xrepeat xa xlist xof xobjects. x
E) To xassess xthe xclient's xabstract xthinking, xI xshould xask xthe xclient xto xidentify xour
xmost xrecent xpresidents. x- xA, xB, xC x
x
A xnurse xis xplanning xcare xfor xa xclient xwho xhas xa xmental xhealth xdisorder. xWhich
xof xthe xfollowing xactions xshould xthe xnurse xinclude xas xa xpsychobiological
xintervention? xA) xAssist xthe xclient xwith xsystematic xdesensitization xtherapy. x
B) Teach xthe xclient xappropriate xcoping xmechanisms. x
C) Assess xthe xclient xfor xcomorbid xhealth xconditions. x
D) Monitor xthe xclient xfor xadverse xeffects xof xthe xmedications. x- xD x
x
A xnurse xin xan xoutpatient xmental xhealth xclinic xis xpreparing xto xconduct xan xinitial
xclient
interview. xWhen xconducting xthe xinterview, xwhich xof xthe xfollowing xactions xshould
xthe x
x
nurse xidentify xas xthe
xpriority?
x
A) xCoordinate xholistic xcare xwith xsocial
xservices.
x
B) xIdentify xthe xclient's xperception xof xher xmental xhealth
xstatus.
x
C) xInclude xthe xclient's xfamily xin xthe
xinterview.
x
D) xTeach xthe xclient xabout xher xcurrent xmental xhealth xdisorder
x- xB
x
A xnurse xis xtold xduring xchange xof xshift xreport xthat xa xclient xis xstuporous.
xWhen xassessing xthe xclient, xwhich xof xthe xfollowing xfindings xshould xthe xnurse
xexpect? xA) xThe xclient xarouses xbriefly xin xresponse xto xa xsternal xrub. x
B) The xclient xhas xa xglasgow xcoma xscale xscore xless xthan x7. x
C) The xclient xexhibits xdecorticate xrigidity. x
D) The xclient xis xalert xbut xdisoriented xto xtime xand xplace. x- xA x
x
A xnurse xis xplanning xa xpeer xgroup xabout xthe xDSM-5. xWhich xof xthe xfollowing
xinformation xis xappropriate xto xinclude xin xthe xdiscussion? x(Select xall xthat xapply). x
,A) The xDSM-5 xincludes xclient xeducation xhandouts xfor xmental xhealth xdisorders. x
B) The xDSM-5 xestablishes xdiagnostic xcriteria xfor xindividual xmental xhealth
xdisorders. x
C) The xDSM-5 xindicates xrecommended xpharmacological xtreatment xfor xmental
xhealth xdisorders. x
D) The xDSM-5 xassists xnurses xin xplanning xcare xfor xclient's xwho xhave xmental
xhealth xdisorders. x
E) The xDSM-5 xindicates xexpected xassessment xfindings xof xmental xhealth
xdisorders. x- xB, xD, xE x
x
A xnurse xin xan xemergency xmental xhealth xfacility xis xcaring xfor xa xgroup xof xclients.
xThe xnurse xshould xidentify xthat xwhich xof xthe xfollowing xclients xrequires xa
xtemporary xemergency xadmission? x
A) A xclient xwho xhas xschizophrenia xwith xdelusions xof xgrandeur x
B) A xclient xwho xhas xmanifestations xof xdepression xand xattempted xsuicide xa xyear
xago. xC) xA xclient xwho xhas xborderline xpersonality xdisorder xand xassaulted xa
xhomeless xman xwith xa xmetal xrod. x
D) xA xclient xwho xhas xbipolar xdisorder xand xpaces xquickly xaround xthe xroom xwhile
xtalking xto xhimself. x- xC x
x
A xnurse xdecides xto xput xa xclient xwho xhas xa xpsychotic xdisorder xin xseclusion
xovernight xbecause xthe xunit xis xvery xshort-staffed, xand xthe xclient xfrequently xfights
xwith xother xclients. xThe xnurse's xactions xare xan xexample xof xwhich xof xthe xfollowing
xtorts? x
A) Invasion xof xprivacy x
B) False ximprisonment x
C) Assault x
D) Battery x- xB x
x
A xclient xtells xa xnurse, x"Don't xtell xanyone xbut xI xhid xa xsharp xknife xunder xmy
xmattress xin xorder xto xprotect xmyself xfrom xmy xroommate, xwho xis xalways xyelling xat
xme xand xthreatening xme." xWhich xof xthe xfollowing xactions xshould xthe xnurse xtake? x
A) Keep xthe xclient's xcommunication xconfidential, xbut xtalk xto xthe xclient xdaily,
xusing xtherapeutic xcommunication xto xconvince xhim xto xadmit xto xhiding xthe xknife. x
B) Keep xthe xclient's xcommunication xconfidential, xbut xwatch xthe xclient xand xhis
xroommate xclosely. x
C) Tell xthe xclient xthat xthis xmust xbe xreported xto xthe xhealthcare xteam xbecause xit
xconcerns xthe xhealth xand xsafety xof xthe xclient xand xothers. x
D) Report xthe xincident xto xthe xhealth xcare xteam, xbut xdo xnot xinform xthe xclient
xof xthe xintention xto xdo xso. x- xD x
x
A xnurse xis xcaring xfor xa xclient xwho xis xin xmechanical xrestraints. xWhich xof xthe
xfollowing xstatements xshould xthe xnurse xinclude xin xthe xdocumentation? x(Select xall
xthat xapply) x
A) Client xate xmost xof xhis xbreakfast x
B) Client xwas xoffered x8 xoz xof xwater xevery xhr x
C) Client xshouted xobscenities xat xassistive xpersonnel x
D) Client xreceived xchlorpromazine x15 xmg xby xmouth xat x1000 x
E) Client xacted xout xafter xlunch x- xB, xC, xD x
x
, A xnurse xhears xa xnewly xlicensed xnurse xdiscussing xa xclient's xhallucinations xin xthe
xhallway xwith xanother xnurse. xWhich xof xthe xfollowing xactions xshould xthe xnurse xtake
xfirst? x
A) Notify xthe xnurse xmanager x
B) Tell xthe xnurse xto xstop xdiscussing xthe xbehavior x
C) Provide xan xin-service xprogram xabout xconfidentiality x
D) Complete xan xincident xreport x- xB x
x
A xnurse xis xcaring xfor xthe xparents xof xa xchild xwho xhas xdemonstrated xchanges xin
xbehavior xand xmood. xWhen xthe xmother xof xthe xchild xasks xthe xnurse xfor
xreassurance xabout xher xson's xcondition, xwhich xof xthe xfollowing xresponses xshould
xthe xnurse xmake? x
A) xI xthink xyour xson xis xgetting xbetter. xWhat xhave xyou xnoticed x
x
B) xI'm xsure xeverything xwill xbe xokay. xIt xjust xtakes xtime xto
xheal
x
C) xI'm xnot xsure xwhat's xwrong. xHave xyou xasked xthe xdoctor xabout xyour
xconcerns?
D) xI xunderstand xyou're xconcerned. xLet's xdiscuss xwhat xconcerns xyou xspecifically
x- xD
x
A xnurse xis xcaring xfor xa xclient xwho xsmokes xand xhas xlung xcancer. xThe xclient
xreports, x"I'm xcoughing xbecause xI xhave xthat xcold xthat xeveryone xhas xbeen xgetting."
xThe xnurse xshould xidentify xthat xthe xclient xis xusing xwhich xof xthe xfollowing xdefense
xmechanisms? xA) xReaction xformation x
B) Denial x
C) Displacement x
D) Sublimation x- xB x
x
A xnurse xis xproviding xpreoperative xteaching xfor xa xclient xwho xwas xjust xinformed xthat
xshe x
requires xemergency xsurgery. xThe xclient xhas xa xrespiratory xrate x30/min xand xsays,
x"This x
is xdifficult xto xcomprehend. xI xfeel xshaky xand xnervous." xThe xnurse xshould xidentifyt x
xtha
x
the xclient xis xexperiencing xwhich xof xthe xfollowing xlevels xof
xanxiety?
x
A)
xMild
x
B)
xModerate
x
x
C)
xSevere
D) xPanic x-
xB
x
A xnurse xis xcaring xfor xa xclient xwho xis xexperiencing xmoderate xanxiety. xWhich xof xthe
xfollowing xactions xshould xthe xnurse xtrying xto xgive xnecessary xinformation xto xthe
xclient? x(Select xall xthat xapply) x