Correct Answers 2024/2025
A client who attempted suicide by overdosing with a very large number of
antidepressant pills has been admitted to the psychiatric unit. The nurse, being most
concerned with the client's safety, should take which action - ANS✔✔--Stay with the
client at all times.
The nurse is preparing a client for the termination phase of the nurse-client relationship.
Which task should the nurse appropriately plan for this phase? - ANS✔✔--Assist in
making appropriate referrals.
The nurse is caring for a client who received electroconvulsive therapy (ECT) for a
major depressive disorder. On data collection, the nurse notes that the client's blood
pressure is elevated at 160/100 mm Hg. Based on this finding, which nursing action
would be appropriate? - ANS✔✔--Notify the registered nurse.
The nurse is gathering data from a client with a phobia. The client tells the nurse that he
consistently avoids attending community functions because he fears that he will be
asked to speak publicly to the members. On the basis of this information, the nurse
determines that the client is experiencing which problem? - ANS✔✔--Social phobia
On data collection, which behavior should the nurse expect a client diagnosed with
agoraphobia to describe? - ANS✔✔--A fear of leaving the house
The wife of a client who abuses alcohol tells the nurse she cannot "do it alone" any
longer and asks the nurse about the availability of any free support services for "people
like me." The nurse refers the client's wife to which community group? - ANS✔✔--Al-
Anon
The nurse in the mental health unit reviews the therapeutic and nontherapeutic
communication techniques with a nursing student. Which are therapeutic
communication techniques? Select all that apply. - ANS✔✔--Restating
Listening
Maintaining neutral responses
Providing acknowledgment and feedback
The nurse is preparing a discharge plan for a client who attempted suicide. The nurse
understands that the plan of care should focus on which intervention? - ANS✔✔--
Contracts and immediate available crisis resources
, In planning activities for the depressed client, especially during the early stages of
hospitalization, which is best? - ANS✔✔--Encourage the client to participate in a
structured daily program of activities.
A female victim of a sexual assault is being seen in the crisis center. The client states
that she still feels "as though the rape just happened yesterday," even though it has
been a few months since the incident. Which nursing response is appropriate? -
ANS✔✔--"Tell me more about what causes you to feel like the rape just occurred."
The nurse has been caring for a client with a diagnosis of depression. The client says to
the nurse, "I wish you would just be my friend." The appropriate response by the nurse
is which? - ANS✔✔--"Our relationship is a therapeutic and helping one."
The day nurses in a psychiatric unit are receiving report from the night shift. During
report, a client approaches the nurses' station, becomes very loud and angry, and
demands to be seen by the health care provider immediately. Which nursing
intervention is appropriate? - ANS✔✔--Offer to assist the client to an examination
room until the health care provider is notified.
A client with moderate depression who was admitted to the mental health unit 2 days
ago suddenly begins smiling and reporting that the crisis is over. The client says to the
nurse, "I'm finally cured." The nurse interprets this behavior as a cue to modify the
treatment plan by taking which action? - ANS✔✔--Increasing the level of suicide
precautions
The nurse is having a therapeutic discussion with a client and knows that which
statements by the client should be immediately reported to the charge nurse? Select all
that apply. - ANS✔✔--"I hid my silverware from dinner last night."
"I know that by this time tomorrow all my troubles will be over."
A female client with anorexia nervosa is a member of a support group. The client has
verbalized that she would like to buy some new clothes, but her finances are limited.
Group members have brought some used clothes for the client to replace her old
clothes. The client believes that the new clothes were much too tight, so she has
reduced her calorie intake to 800 calories daily. The nurse identifies this behavior as
which? - ANS✔✔--Evidence of the client's altered and distorted body image
A client is scheduled to have electroconvulsive therapy (ECT). Which information would
the nurse tell the client? - ANS✔✔--Amnesia of events occurring near the period of
the therapy is common.
A client has just been admitted to the mental health unit with a diagnosis of obsessive-
compulsive disorder (OCD). The nurse observes the client for compulsive behavior that
denotes repetition in which? - ANS✔✔--Actions