Mental health nursing Chapter 1-10
A 14-year-old who belongs to a neighborhood gang is found by her parents to lie and engage in
sexually promiscuous behavior. They bring her to the mental health center. The nurse
performing the assessment is told by the 14-year-old that she is happy, does well in school, and
sees herself as popular and well regarded by her group. She states her parents are just old
fashioned and don't understand her. The assessment the nurse will most likely make is that she:
A) is displaying deviant behavior.
B) cannot accurately appraise reality.
C) is seriously and persistently mentally ill.
D) should be considered for group home placement. - ANS-A) is displaying deviant behavior.
\A client comes to the clinic asking for help because his third fiancée has broken their
engagement. He states "I don't know what is wrong with me, but my friends tell me I am too
possessive." The type of therapy that might address his interpersonal deficit is
A) psychoanalysis.
B) cognitive therapy.
C) behavioral therapy.
D) interpersonal psychotherapy. - ANS-D) interpersonal psychotherapy.
\A client has begun to neglect her appearance, is withdrawn and stays in her room. Her mother
hears her seemingly talking to others, but no one is in the room with her. Last night she threw a
chair and broke the window of her bedroom. She tells the nurse nothing is wrong. The nurse
rating her current global assessment of functioning would probably assign the code
A) 100.
B) 70.
C) 40.
D) 0. - ANS-C) 40.
\A client is admitted to the behavioral health unit. Her husband comes to visit, and she tells the
nurse she does not wish to see him. The nurse tells the client's husband that
A) his wife has the right to refuse visitors if she wishes.
B) he is welcome to visit but may receive a cool reception.
C) the client's plan of care calls for limiting visitors for 2 days.
D) the client is acutely psychotic and not responsible for her present behavior. - ANS-A) his wife
has the right to refuse visitors if she wishes.
\A client is admitted to the hospital with severe depression. The nurse recognizes the possibility
that depression may be related to a stress induced hormonal imbalance associated with:
A) Luteinizing hormone
B) Cortisol
C) Gronadotropin
D) Clomipramine - ANS-B) Cortisol
\A client is being discharged after a short hospitalization. He will receive continuing care from a
community mental health nurse who will visit his home. Unlike in the hospital where the goal is
,the stabilization of the client and driven by the psychiatric staff, when in the community setting
the goals are:
A) client directed and focused on the individual's expressed wishes
B) society driven and focused on returning the client into the social community
C) determined by the care provider and focused on cost effective measures
D) negotiated by both client and staff and focused on long term functioning - ANS-D) negotiated
by both client and staff and focused on long term functioning
\A client receiving a psychotropic drug reports to the nurse that he is drowsy all the time and is
having difficulty focusing his attention. The nurse will correctly interpret this symptom as related
to the drug's effect on the brain's ability to regulate
A) mood.
B) thought.
C) memory.
D) sleep. - ANS-D) sleep.
\A client tells the mental health nurse "I am terribly frightened! I hear whispering that someone is
going to kill me." Which criterion of mental health can the nurse assess as lacking?
A) Control over behavior
B) Appraisal of reality
C) Effectiveness in work
D) Healthy self-concept - ANS-B) Appraisal of reality
\A client was admitted to the behavioral health unit for evaluation and diagnosis after being
found wandering the streets. His personal hygiene is poor and his responses to questions are
bizarre and inappropriate. The client's constitutional rights are violated when the nurse states:
A) "We will help you make decisions that will keep you safe."
B) "I am going to help you shower so you will not smell so bad."
C) "Your pocket knife and nail clippers will be kept in the nurses' station."
D) "You will be having a number of tests to help us learn about your condition." - ANS-B) "I am
going to help you shower so you will not smell so bad."
\A client with prolonged mental illness was readmitted when symptoms exacerbated after she
stopped taking prescribed medication. The client lives alone and has few outside activities. To
best prepare the client for discharge the nurse will focus on:
A) improving client-family relationships.
B) placing the client in a sheltered workshop.
C) psychoeducation to promote medication compliance.
D) involving the client in daily visits to a psychosocial club. - ANS-C) psychoeducation to
promote medication compliance.
\A client's communication is marked by loose associations and word salad. Dysfunction of which
portion of the brain is responsible for these symptoms?
A) Cerebrum
B) Cerebellum
C) Brainstem
D) Basal ganglia - ANS-A) Cerebrum
\A cognitive therapist would help a client restructure the thought "I am stupid!" to:
A) "What I did was stupid."
, B) "I am not as smart as others."
C) "Things usually go wrong for me."
D) "Things like this should not happen to anyone." - ANS-A) "What I did was stupid."
\A community mental health nurse is responsible for medication management for clients. Which
general approach can be anticipated to yield the best results?
A) Empowering clients to be responsible for medication compliance
B) Providing frequent oversight by nurse of daily medication ingestion
C) Establishing a system in which client support figures oversee medications
D) Scheduling monthly blood tests to determine serum levels of prescribed medications -
ANS-A) Empowering clients to be responsible for medication compliance
\A community mental health nurse whose culture is Hispanic is assigned to a mobile mental
health care unit in a locale where the majority culture is Vietnamese. A measure that will help
the nurse plan and implement culturally sensitive care for clients is
A) arranging for the services of an interpreter and cultural consultant.
B) reading about the predominant health beliefs held by members of Asian cultures.
C) to try to place self in the position of being an unassimilated member of a culture.
D) treat clients in the same manner that clients of the Hispanic culture find satisfying. - ANS-A)
arranging for the services of an interpreter and cultural consultant.
\A function shared by advanced practice and general practice psychiatric nurses is
A) prescriptive authority.
B) hospital privileges.
C) consultation services provided.
D) collaboration with a multidisciplinary team. - ANS-D) collaboration with a multidisciplinary
team.
\A man frequently bursts out by loudly singing operatic arias. The neighbors in the next
apartment find the noise disturbing. They go to his apartment to confront him and find that in he
is wearing only his bathrobe and his apartment is messy. He acts outraged and tells them he
must sing several hours daily and will not promise to be quieter. The conclusion that can be
drawn is:
A) The man is demonstrating symptoms of bipolar disorder.
B) The man is socially deviant.
C) The man is egocentric.
D) The man may or may not be mentally ill. - ANS-D) The man may or may not be mentally ill.
\A novice nurse is assigned to manage the milieu and provide for the safety of the other clients
when there is a behavioral crisis with a client in the dining room. The nurse shows a lack of
understanding of crisis management when he/she:
A) Insists that all clients go in their rooms
B) Move clients from the dining room to the day room/solarium
C) Encourage the clients to express their reactions to the incident
D) Reassure clients that staff will handle the agitated client - ANS-A) Insists that all clients go in
their rooms
\A nurse conducting research is seeking data about outcomes for depressed patients who have
been treated with electroconvulsive therapy. The nurse is engaged in the field of
A) experimental epidemiology.
A 14-year-old who belongs to a neighborhood gang is found by her parents to lie and engage in
sexually promiscuous behavior. They bring her to the mental health center. The nurse
performing the assessment is told by the 14-year-old that she is happy, does well in school, and
sees herself as popular and well regarded by her group. She states her parents are just old
fashioned and don't understand her. The assessment the nurse will most likely make is that she:
A) is displaying deviant behavior.
B) cannot accurately appraise reality.
C) is seriously and persistently mentally ill.
D) should be considered for group home placement. - ANS-A) is displaying deviant behavior.
\A client comes to the clinic asking for help because his third fiancée has broken their
engagement. He states "I don't know what is wrong with me, but my friends tell me I am too
possessive." The type of therapy that might address his interpersonal deficit is
A) psychoanalysis.
B) cognitive therapy.
C) behavioral therapy.
D) interpersonal psychotherapy. - ANS-D) interpersonal psychotherapy.
\A client has begun to neglect her appearance, is withdrawn and stays in her room. Her mother
hears her seemingly talking to others, but no one is in the room with her. Last night she threw a
chair and broke the window of her bedroom. She tells the nurse nothing is wrong. The nurse
rating her current global assessment of functioning would probably assign the code
A) 100.
B) 70.
C) 40.
D) 0. - ANS-C) 40.
\A client is admitted to the behavioral health unit. Her husband comes to visit, and she tells the
nurse she does not wish to see him. The nurse tells the client's husband that
A) his wife has the right to refuse visitors if she wishes.
B) he is welcome to visit but may receive a cool reception.
C) the client's plan of care calls for limiting visitors for 2 days.
D) the client is acutely psychotic and not responsible for her present behavior. - ANS-A) his wife
has the right to refuse visitors if she wishes.
\A client is admitted to the hospital with severe depression. The nurse recognizes the possibility
that depression may be related to a stress induced hormonal imbalance associated with:
A) Luteinizing hormone
B) Cortisol
C) Gronadotropin
D) Clomipramine - ANS-B) Cortisol
\A client is being discharged after a short hospitalization. He will receive continuing care from a
community mental health nurse who will visit his home. Unlike in the hospital where the goal is
,the stabilization of the client and driven by the psychiatric staff, when in the community setting
the goals are:
A) client directed and focused on the individual's expressed wishes
B) society driven and focused on returning the client into the social community
C) determined by the care provider and focused on cost effective measures
D) negotiated by both client and staff and focused on long term functioning - ANS-D) negotiated
by both client and staff and focused on long term functioning
\A client receiving a psychotropic drug reports to the nurse that he is drowsy all the time and is
having difficulty focusing his attention. The nurse will correctly interpret this symptom as related
to the drug's effect on the brain's ability to regulate
A) mood.
B) thought.
C) memory.
D) sleep. - ANS-D) sleep.
\A client tells the mental health nurse "I am terribly frightened! I hear whispering that someone is
going to kill me." Which criterion of mental health can the nurse assess as lacking?
A) Control over behavior
B) Appraisal of reality
C) Effectiveness in work
D) Healthy self-concept - ANS-B) Appraisal of reality
\A client was admitted to the behavioral health unit for evaluation and diagnosis after being
found wandering the streets. His personal hygiene is poor and his responses to questions are
bizarre and inappropriate. The client's constitutional rights are violated when the nurse states:
A) "We will help you make decisions that will keep you safe."
B) "I am going to help you shower so you will not smell so bad."
C) "Your pocket knife and nail clippers will be kept in the nurses' station."
D) "You will be having a number of tests to help us learn about your condition." - ANS-B) "I am
going to help you shower so you will not smell so bad."
\A client with prolonged mental illness was readmitted when symptoms exacerbated after she
stopped taking prescribed medication. The client lives alone and has few outside activities. To
best prepare the client for discharge the nurse will focus on:
A) improving client-family relationships.
B) placing the client in a sheltered workshop.
C) psychoeducation to promote medication compliance.
D) involving the client in daily visits to a psychosocial club. - ANS-C) psychoeducation to
promote medication compliance.
\A client's communication is marked by loose associations and word salad. Dysfunction of which
portion of the brain is responsible for these symptoms?
A) Cerebrum
B) Cerebellum
C) Brainstem
D) Basal ganglia - ANS-A) Cerebrum
\A cognitive therapist would help a client restructure the thought "I am stupid!" to:
A) "What I did was stupid."
, B) "I am not as smart as others."
C) "Things usually go wrong for me."
D) "Things like this should not happen to anyone." - ANS-A) "What I did was stupid."
\A community mental health nurse is responsible for medication management for clients. Which
general approach can be anticipated to yield the best results?
A) Empowering clients to be responsible for medication compliance
B) Providing frequent oversight by nurse of daily medication ingestion
C) Establishing a system in which client support figures oversee medications
D) Scheduling monthly blood tests to determine serum levels of prescribed medications -
ANS-A) Empowering clients to be responsible for medication compliance
\A community mental health nurse whose culture is Hispanic is assigned to a mobile mental
health care unit in a locale where the majority culture is Vietnamese. A measure that will help
the nurse plan and implement culturally sensitive care for clients is
A) arranging for the services of an interpreter and cultural consultant.
B) reading about the predominant health beliefs held by members of Asian cultures.
C) to try to place self in the position of being an unassimilated member of a culture.
D) treat clients in the same manner that clients of the Hispanic culture find satisfying. - ANS-A)
arranging for the services of an interpreter and cultural consultant.
\A function shared by advanced practice and general practice psychiatric nurses is
A) prescriptive authority.
B) hospital privileges.
C) consultation services provided.
D) collaboration with a multidisciplinary team. - ANS-D) collaboration with a multidisciplinary
team.
\A man frequently bursts out by loudly singing operatic arias. The neighbors in the next
apartment find the noise disturbing. They go to his apartment to confront him and find that in he
is wearing only his bathrobe and his apartment is messy. He acts outraged and tells them he
must sing several hours daily and will not promise to be quieter. The conclusion that can be
drawn is:
A) The man is demonstrating symptoms of bipolar disorder.
B) The man is socially deviant.
C) The man is egocentric.
D) The man may or may not be mentally ill. - ANS-D) The man may or may not be mentally ill.
\A novice nurse is assigned to manage the milieu and provide for the safety of the other clients
when there is a behavioral crisis with a client in the dining room. The nurse shows a lack of
understanding of crisis management when he/she:
A) Insists that all clients go in their rooms
B) Move clients from the dining room to the day room/solarium
C) Encourage the clients to express their reactions to the incident
D) Reassure clients that staff will handle the agitated client - ANS-A) Insists that all clients go in
their rooms
\A nurse conducting research is seeking data about outcomes for depressed patients who have
been treated with electroconvulsive therapy. The nurse is engaged in the field of
A) experimental epidemiology.
