Psychiatric Mental Health Nursing

A nurse is assessing a client who experiences occasional feelings of sadness because of the recent death of a beloved pet. The client's appetite, sleep patterns, and daily routine have not changed. How would the nurse interpret the client's behaviors? 1. The client's behaviors demonstrate mental illness in the form of depression. 2. The client's behaviors are inappropriate, which indicates the presence of mental illness. 3. The client's behaviors are not congruent with cultural norms. 4. The client's behaviors demonstrate no functional impairment, indicating no mental illness. - ANS-- 4. The client's behaviors demonstrate no functional impairment, indicating no mental illness. At which point would the nurse determine that a client is at risk for developing a mental illness? 1. When thoughts, feelings, and behaviors are not reflective of the criteria for mental illness. 2. When maladaptive responses to stress are coupled with interference in daily functioning. 3. When a client communicates significant distress. 4. When a client uses defense mechanisms as ego protection. - ANS-- 2. When maladaptive responses to stress are coupled with interference in daily functioning. A client has been given a diagnosis of HIV. Which statement made by the client does the nurse recognize as the bargaining stage of grief? 1. "I hate my partner for giving me this disease I will die from!" 2. "If I don't do IV drugs anymore, God won't let me die." 3. "I am going to support groups and learning more about the disease." 4. "Can you please re-draw the test results; I think they may be wrong?" - ANS-- 2. "If I don't do IV drugs anymore, God won't let me die." A nurse notes that a client is extremely withdrawn, delusional, and emotionally exhausted. The nurse assesses the client's anxiety as which level? 1. Mild anxiety 2. Moderate anxiety 3. Severe anxiety 4. Panic anxiety - ANS-- 4. Panic anxiety A psychiatric nurse intern states, "This client's use of defense mechanisms should be eliminated." Which is a correct evaluation of this nurse's statement? 1. Defense mechanisms can be appropriate responses to stress and need not be eliminated. 2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and should always be eliminated. 3. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged and not completely eliminated. 4. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged. - ANS-- 1. Defense mechanisms can be appropriate responses to stress and need not be eliminated. During an intake assessment, a nurse asks both physiological and psychosocial questions. The client angrily responds, "I'm here for my heart, not my head problems." Which is the nurse's best response? 1. "It is just a routine part of our assessment. All clients are asked these same questions." 2. "Why are you concerned about these types of questions?" 3. "Psychological factors, like excessive stress, have been found to affect medical conditions." 4. "We can skip these questions, if you like. It isn't imperative that we complete this section." - ANS-- 3. "Psychological factors, like excessive stress, have been found to affect medical conditions." A client who is being treated for chronic kidney disease complains to the health-care provider that he does not like the food available to him while hospitalized. The health-care provider insists that the client strictly adhere to the diet plan. What action can be expected if the client uses the defense mechanism of displacement? 1. The client assertively confronts the health-care provider. 2. The client insists on being discharged and goes for a long, brisk walk. 3. The client snaps at the nurse and criticizes the nursing care provided. 4. The client hides his anger by explaining the logical reasoning for the diet to his spouse. - ANS-- 3. The client snaps at the nurse and criticizes the nursing care provided. A fourth-grade boy teases and makes jokes about a cute girl in his class. A nurse would recognize this behavior as indicative of which defense mechanism? 1. Displacement 2. Projection 3. Reaction formation 4. Sublimation - ANS-- 3. Reaction formation Which nursing statement regarding the concept of psychosis is most accurate? 1. Individuals experiencing psychoses are aware that their behaviors are maladaptive. 2. Individuals experiencing psychoses experience little distress. 3. Individuals experiencing psychoses are aware of experiencing psychological problems. 4. Individuals experiencing psychoses are based in reality. - ANS-- 2. Individuals experiencing psychoses experience little distress. When under stress, a client routinely uses alcohol to excess. When the client's husband finds her drunk, the husband yells at the client about her chronic alcohol abuse. Which action alerts the nurse to the client's use of the defense mechanism of denial? 1. The client hides liquor bottles in a closet. 2. The client yells at her son for slouching in his chair. 3. The client burns dinner on purpose. 4. The client says to the spouse, "I don't drink too much!" - ANS-- 4. The client says to the spouse, "I don't drink too much!" Devastated by a divorce from an abusive husband, a wife completes grief counseling. Which statement by the wife would indicate to a nurse that the client is in the acceptance stage of grief? 1. "If only we could have tried again, things might have worked out." 2. "I am so mad that the children and I had to put up with him as long as we did." 3. "Yes, it was a difficult relationship, but I think I have learned from the experience." 4. "I have a difficult time getting out of bed most days." - ANS-- 3. "Yes, it was a difficult relationship, but I think I have learned from the experience." According to Maslow's hierarchy of needs, which client action would demonstrate the highest achievement in terms of mental health? 1. Maintaining a long-term, faithful, intimate relationship 2. Achieving a sense of self-confidence 3. Possessing a feeling of self-fulfillment and realizing full potential 4. Developing a sense of purpose and the ability to direct activities - ANS-- 3. Possessing a feeling of self-fulfillment and realizing full potential According to Maslow's hierarchy of needs, which situation on an inpatient psychiatric unit would require priority intervention by a nurse? 1. A client rudely complaining about limited visiting hours 2. A client exhibiting aggressive behavior toward another client 3. A client stating that no one cares 4. A client verbalizing feelings of failure - ANS-- 2. A client exhibiting aggressive behavior toward another client Which describes neurosis? (Select all that apply.) 1. Neurosis is a unique category of mental disorder. 2. Neurosis is a psychological disturbance characterized by excessive anxiety. 3. Symptoms of neurosis include gross distortions of reality. 4. Neurosis may be expressed directly or altered through a defense mechanism. 5. A person experiencing neurosis is often aware that their behaviors are maladaptive. - ANS-- 2. Neurosis is a psychological disturbance characterized by excessive anxiety. 4. Neurosis may be expressed directly or altered through a defense mechanism. 5. A person experiencing neurosis is often aware that their behaviors are maladaptive. The nurse is reviewing the definition of a mental health disorder and notes the definition includes disturbance in which areas? (Select all that apply.) 1. Cognition 2. Physical 3. Emotional regulation 4. Behavior 5. Developmental - ANS-- 1. Cognition 3. Emotional regulation 4. Behavior 5. Developmental _______________________ is a diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness. - ANS-- Anxiety _______________________ is a subjective state of emotional, physical, and social responses to the loss of a valued entity. - ANS-- Grief Place in order the Kübler-Ross stages of grief from 1 to 5. (Enter the number of each step in the proper sequence, using comma and space format, such as 1, 2, 3, 4.) 1. Bargaining 2. Denial 3. Acceptance 4. Depression 5. Anger - ANS-- 2. Denial 5. Anger 1. Bargaining 4. Depression 3. Acceptance