N3381 - Psychiatric Mental Health Exam 2
1. The nurse is reviewing the assessment data of a client admitted to the mental
health unit. The nurse notes that the admission nurse documented the client is
experiencing anxiety as a result of a situational crisis.The nurse plans care for the
client, determining that this type of crisis could be caused by which event?
1. Witnessing a murder
2. The death of a loved one
3. A fire that destroyed the client's home
4. A recent rape episode experienced by the client <Ans> The death of a loved one
Rationale <Ans>A situational crisis arises from external rather than internal
sources. External situations that could precipitate a crisis include loss or change
of a job, the death of a loved one, abortion, change in financial status, divorce,
addition of new family members, pregnancy, and severe illness. Options 1, 3, and
4 identify adventitious crises. An adventitious crisis refers to a crisis of disaster, is
not a part of everyday life, and is unplanned and accidental. Adventitious crises
may result from a natural disaster (e.g., floods, fires, tornadoes, earthquakes), a
national disaster (e.g., war, riots, airplane crashes), or a crime of violence (e.g.,
rape, assault, murder in the workplace or school, bombings, or spousal or child
abuse).
2. The nurse is conducting an initial assessment of a client in crisis. When
assessing the client's perception of the precipitating event that led to the
crisis, which is the most appropriate question?
,1. "With whom do you live?"
2."Who is available to help you?"
3."What leads you to seek help now?"
4."What do you usually do to feel better?" <Ans> "What leads you to seek help now
Rationale <Ans>The nurse's initial task when assessing a client in crisis is to
assess the individual or family and the problem. The more clearly the problem
can be defined, the better the chance a solution can be found. The correct option
would assist in determining data related to the precipitating event that led to the
crisis. Options 1 and 2 assess situational supports. Option 4 assesses personal
coping skills.
3. The nurse is creating a plan of care for a client in a crisis state. When
developing the plan, the nurse should consider which factor?
1. A crisis state indicates that the client has a mental illness.
2. A crisis state indicates that the client has an emotional illness.
,3. Presenting symptoms in a crisis situation are similar for all clients experi-
encing a crisis.
4. A client's response to a crisis is individualized and what constitutes a crisis for
one client may not constitute a crisis for another client. <Ans> A client's response
to a crisis is individualized and what constitutes a crisis for one client may not
constitute a crisis for another client.
Rationale <Ans> Although each crisis response can be described in similar terms
as far as presenting symptoms are concerned, what constitutes a crisis for one
client may not constitute a crisis for another client, because each is a unique
individual. Being in the crisis state does not mean that the client has a mental or
emotional illness.
4. A newly admitted client is exhibiting signs and symptoms associated with a
loss of physical functioning, although no such loss can be confirmed medically.
This situation supports which mental health diagnosis?
1. Depression
2. Somatization disorder
3. Post-traumatic stress disorder
4. Obsessive-compulsive disorder <Ans> Somatization disorder
Rationale <Ans> Emotional turmoil expressed in physical signs is the hallmark of
somatiza- tion disorder. None of the other options are associated with loss of
physical function.
5. A client who has recently lost her spouse says, "No one cares about me
, anymore. All the people I loved are dead." Which response demonstrates an
understanding of therapeutic communication when dealing with a grieving client?
1. "I certainly care about you."
2. "You must be feeling all alone at this point."
3. "I don't believe that and neither should you."
4. "It isn't unusual to feel alone when you are grieving." <Ans> "You must be
feeling all alone at this point."
Rationale <Ans>The client is experiencing loss and is feeling hopeless. The
therapeutic response by the nurse is the one that attempts to translate words into
feelings. None of the remaining options encourage the client to discuss feelings
but rather minimize and/or trivialize the feelings expressed.
6. A depressed client who appeared sullen, distraught, and hopeless a few days
ago now suddenly appears calm, relaxed, and more energetic. Which is
1. The nurse is reviewing the assessment data of a client admitted to the mental
health unit. The nurse notes that the admission nurse documented the client is
experiencing anxiety as a result of a situational crisis.The nurse plans care for the
client, determining that this type of crisis could be caused by which event?
1. Witnessing a murder
2. The death of a loved one
3. A fire that destroyed the client's home
4. A recent rape episode experienced by the client <Ans> The death of a loved one
Rationale <Ans>A situational crisis arises from external rather than internal
sources. External situations that could precipitate a crisis include loss or change
of a job, the death of a loved one, abortion, change in financial status, divorce,
addition of new family members, pregnancy, and severe illness. Options 1, 3, and
4 identify adventitious crises. An adventitious crisis refers to a crisis of disaster, is
not a part of everyday life, and is unplanned and accidental. Adventitious crises
may result from a natural disaster (e.g., floods, fires, tornadoes, earthquakes), a
national disaster (e.g., war, riots, airplane crashes), or a crime of violence (e.g.,
rape, assault, murder in the workplace or school, bombings, or spousal or child
abuse).
2. The nurse is conducting an initial assessment of a client in crisis. When
assessing the client's perception of the precipitating event that led to the
crisis, which is the most appropriate question?
,1. "With whom do you live?"
2."Who is available to help you?"
3."What leads you to seek help now?"
4."What do you usually do to feel better?" <Ans> "What leads you to seek help now
Rationale <Ans>The nurse's initial task when assessing a client in crisis is to
assess the individual or family and the problem. The more clearly the problem
can be defined, the better the chance a solution can be found. The correct option
would assist in determining data related to the precipitating event that led to the
crisis. Options 1 and 2 assess situational supports. Option 4 assesses personal
coping skills.
3. The nurse is creating a plan of care for a client in a crisis state. When
developing the plan, the nurse should consider which factor?
1. A crisis state indicates that the client has a mental illness.
2. A crisis state indicates that the client has an emotional illness.
,3. Presenting symptoms in a crisis situation are similar for all clients experi-
encing a crisis.
4. A client's response to a crisis is individualized and what constitutes a crisis for
one client may not constitute a crisis for another client. <Ans> A client's response
to a crisis is individualized and what constitutes a crisis for one client may not
constitute a crisis for another client.
Rationale <Ans> Although each crisis response can be described in similar terms
as far as presenting symptoms are concerned, what constitutes a crisis for one
client may not constitute a crisis for another client, because each is a unique
individual. Being in the crisis state does not mean that the client has a mental or
emotional illness.
4. A newly admitted client is exhibiting signs and symptoms associated with a
loss of physical functioning, although no such loss can be confirmed medically.
This situation supports which mental health diagnosis?
1. Depression
2. Somatization disorder
3. Post-traumatic stress disorder
4. Obsessive-compulsive disorder <Ans> Somatization disorder
Rationale <Ans> Emotional turmoil expressed in physical signs is the hallmark of
somatiza- tion disorder. None of the other options are associated with loss of
physical function.
5. A client who has recently lost her spouse says, "No one cares about me
, anymore. All the people I loved are dead." Which response demonstrates an
understanding of therapeutic communication when dealing with a grieving client?
1. "I certainly care about you."
2. "You must be feeling all alone at this point."
3. "I don't believe that and neither should you."
4. "It isn't unusual to feel alone when you are grieving." <Ans> "You must be
feeling all alone at this point."
Rationale <Ans>The client is experiencing loss and is feeling hopeless. The
therapeutic response by the nurse is the one that attempts to translate words into
feelings. None of the remaining options encourage the client to discuss feelings
but rather minimize and/or trivialize the feelings expressed.
6. A depressed client who appeared sullen, distraught, and hopeless a few days
ago now suddenly appears calm, relaxed, and more energetic. Which is
