Mental Health Exam 1 NCLEX GUARATEED DISTINCTION

Which statement about mental illness is true? a. mental illness is a matter of individual nonconformity with societal norms b. mental illness is present when individual irrational and illogical behavior occurs c. mental illness changes with culture, time in history, political system and group defining it d. mental illness is evaluated solely by considering individual control over behavior and appraisal of reality - ANSWERSc. mental illness changes with culture, time in history, political system and group defining it A new nursing student new to psychiatric nursing asks a peer what resource he/she can use to figure out which symptoms are part of the picture of a specific psychiatric disorder. The best answer would be: a. nursing intervention classifications b. nursing interventions outcomes c. NANDA nursing diagnosis d. DSM-V - ANSWERSd. DSM-V Why is it important for the nurse to be aware of the multiple factors that can influence an individual's mental health? a. rates of illness differ among various groups b. the DSM-V cannot be used without this information c. a holistic nursing assessment requires this awareness d. the nurse must contribute this data for epidemiological research - ANSWERSc. a holistic nursing assessment requires this awareness Which statement best describes a major difference between a DSM-V diagnosis and a nursing diagnosis? a. there is no functional difference between the two. Both serve to identify a human deviance. b. the DSM-V diagnosis regards culture, whereas the nursing diagnosis takes culture into account c. the DSM-V is associated with present distress or disability, whereas a nursing diagnosis considers past and present responses to actual mental health problems d. the DSM-V diagnosis impacts the choice of medical treatment, whereas the nursing diagnosis offers a framework for identifying interventions for phenomena a client is experiencing - ANSWERSd. the DSM-V diagnosis impacts the choice of medical treatment, whereas the nursing diagnosis offers a framework for identifying interventions for phenomena a client is experiencing Resilience, the capacity to rebound from stressors via adaptive coping, is associated with positive mental health. Your friend has just been laid off from his job. Which of the following responses on your part most likely contribute to enhanced resilience? a. using your connection to set up an interview with your employer b. connecting him with a friend with the family who owns his own business c. supporting him in arranging, preparing for, and completing multiple interviews d. helping him to understand that the layoff resulted from troubles in the economy and is not his fault - ANSWERSc. supporting him in arranging, preparing for, and completing multiple interviews Which of the following situations best supports the stress-diathesis model of mental illness development? a. the rate of suicide increases during times of national disaster and despair b. four of five siblings in the Jones family develop bipolar disorder by the age of 30 c. a man with no prior mental health problems experiences sadness after his divorce d. a man develops schizophrenia, but his identical twin remains free of mental illness - ANSWERSd. a man develops schizophrenia, but his identical twin remains free of mental illness After several therapeutic encounters with a client who recently attempted suicide, the behavior that would cause the nurse to consider the possibility of countertransference is that a. the client's reactions toward the nurse seem realistic and appropriate b. the client states the nurse is concerned about her, just like her father c. the nurse develops a trusting relationship with the client d. the nurse feels exceptionally happy when the client's mood begins to lift - ANSWERSb. the client states the nurse is concerned about her, just like her father Termination of the therapeutic nurse client relationship with a client has been handled successfully when the nurse a. gives the client his personal telephone number and permission to call after discharge b. avoids upsetting the client by focusing on other clients beginning 1 week before the client's discharge c. discusses with the client the changes that have happened during their time together and evaluates outcome attainment d. offers to meet the client for coffee and conversation three times a week for 2 weeks after discharge - ANSWERSc. discusses with the client the changes that have happened during their time together and evaluates outcome attainment During which phase of the nurse client relationship can the nurse anticipate that identified client issues will be explored and resolved? a. Working phase b. identifying phase c. dysfunctional phase d. termination phase - ANSWERSa. working phase At what point in the nurse client relationship should the nurse plan to first address the issue of termination? a. working phase b. termination phase c. orientation phase d. when the client initially brings up the topic - ANSWERSc. orientation phase The nurse introduces the matter of a contract during the first session because contracts a. specify what the nurse will do for the client b. are indicative of the feeling tone established between the participants c. are binding and prevent either party from prematurely ending the relationship d. spell out the participation and responsibilities of both parties - ANSWERSd. spell out the participation and responsibilities of both parties The remark by a client that would indicate passage into the working phase of the nurse client relationship is a. I don't have any problems b. it is so difficult for me to talk about problems c. I don't know how talking about things twice a week can help d. I think I would like to find a way to deal with my anger without blowing up - ANSWERSd. I think I would like to find a way to deal with my anger without blowing up The nurse attempts to explain to the family of a mentally ill client how the nurse client relationship differs from other interpersonal relationships. The best explanation is that a. the focus is on the client; problems are discussed by the nurse and client; and solutions are implemented by the client b. the focus shifts from nurse to client; advice is given by both parties; and solutions are implemented by each c. the focus is socialization; mutual needs are met; and feelings are shared d. the focus is creation of a partnership in which each member is concerned with growth and satisfaction of the other - ANSWERSa. the focus is on the client; problems are discussed by the nurse and client; and solutions are implemented by the client The nurse wishes to demonstrate genuineness within the context of the nurse client relationship with his client who has been diagnosed with schizophrenia. the nurse will need to a. use extensive self revelation in client interactions b. encourage the client to depend on him for support and reassurance c. consistently make value judgments about client behaviors d. be aware of his own feelings and use congruent communication strategies - ANSWERSd. be aware of his own feelings and use congruent communication strategies The nurse caring for a withdrawn, suspicious client finds himself feeling angry with the client. The nurse should: a. suppress the angry feelings b. express the anger openly and directly c. tell the nurse manager to assign the client to another nurse d. discuss the anger with a clinician during a supervisory session - ANSWERSc. tell the nurse manager to assign the client to another nurse A client says, "I've done a lot of cheating and manipulating in my relationships." A nonjudgmental response by the nurse would be a. how do you feel about that b. it's good that you realize this c. what a rotten way to behave d. have you outgrown that immature behavior - ANSWERSa. how do you feel about that The client mentions to the nurse "I'm still on restriction to the unit and I'd really like to start attending off unit activities. Would you ask the doctor to upgrade my privileges?" The best response for the nurse would be a. I'll be glad to mention it when I see the doctor later today b. That's a good topic for you to take up with the doctor. You'll be meeting at 2 PM c. Why are you asking me to do this when you're perfectly capable of speaking for yourself d. Do you think you are so unimportant that you can't speak to a doctor and that a nurse must intercede - ANSWERSb. that's a good topic for you to take up with the doctor. You'll be meeting at 2 PM While working with a client to establish outcomes for treatment, the nurse believes that an outcome suggested by the client is not in the client's best interest. The best action for the nurse would be to a. remain silent b. tell the client that the outcome is not realistic c. formulate a different, appropriate outcome for the client d. explore the consequences that might occur if the outcome is achieved - ANSWERSd. explore the consequences that might occur if the outcome is achieved Nursing behaviors associated with the implementation phase of the nursing process are concerned with a. gathering accurate and sufficient client centered data b. participating in mutual identification of client outcomes c. carrying out interventions and coordinating care d. comparing client responses and expected outcomes - ANSWERSc. carrying out interventions and coordinating care During the initial assessment interview the client becomes anxious and evasive when the nurse asks her if she has ever heard voices when no one else was around. the client asks, "what do you need to know that for?". the nurse should say a. please be honest about this, after repeating the questions b. sometimes questions seem highly personal, but we have our reasons for asking each one c. what purpose do you think we might have in asking about whether you hear voices d. I can see this subject makes you uncomfortable. we can discuss it at another time - ANSWERSc. what purpose do you think we might have in asking about whether you hear voices a 16 yr old client asks the nurse conducting the assessment interview "why should I tell you anything? you'll just run back and tell my mother whatever you find out." the best reply for the nurse would be a. that's not true. whatever you tell me will be held in the strictest confidence b. your mother may find out what you say, but is that really such a bad thing c. anything you say about feelings is confidential, but things like suicidal thinking must be reported to the treatment team d. it sounds as though you're not really ready to work on your problems and make changes - ANSWERSc. anything you say about feelings is confidential, but things like suicidal thinking must be reported to the treatment team which of the following statements is most true about the difference between delusions and hallucinations? a. delusions are false beliefs while hallucinations are false perceptions b. delusions are systems, hallucinations are beliefs c. delusions are always true and hallucinations are always false d. delusions are based on facts and hallucinations are based on beliefs - ANSWERSa. delusions are false beliefs while hallucinations are false perceptions the patient rushes up to you and says "they're after me. they want to torture me and kill me". This is an example of a. idea of reference b. auditory hallucinations c. delusions of persecution d. abstract thinking - ANSWERSc. delusions of persecution the nurse asks the patient: "what brought you to the hospital?" the patient replies: "a bus". this is an example of a. concreteness of thought b. blocking of thought c. irrelevant answer d. incoherence - ANSWERSa. concreteness of thought which nursing diagnosis for a psychiatric client is properly worded? a. hopelessness related to depression b. spiritual distress as evidenced by saying "God has abandoned me" c. defensive coping related to lack of insight associated with illicit drug use d. imbalanced nutrition: less than body requirements related to poor self concept as evidenced by reporting "I'm not worthy of eating" - ANSWERSd. imbalanced nutrition: less than body requirements related to poor self concept as evidenced by reporting "I'm not worthy of eating" as a client converses with the nurse, she states, "I dreamed I was stoned. when I woke up, I was feeling emotionally drained, as though I hadn't rested well." if the nurse needs clarification of "stoned" it would be appropriate to say a. it sounds as though you were quite uncomfortable with the content of your dream b. can you give me an example of what you leaned by stoned I understand what you're saying. bad dreams leave me feeling tired, too c. so, all in all, you feel as though you had a rather poor night's sleep - ANSWERSb. can you give me an example of what you leaned by stoned during the first interview with a restless young man, the nurse notices that he does not make eye contact throughout most of the interview. the nurse can correctly assume that a. he is not to be trusted in what he says because he is evasive b. he is feeling sad and cannot look the nurse in the eye c. he is shy and the nurse must move slowly d. more information is needed to draw a conclusion - ANSWERSd. more information is needed to draw a conclusion the client has disclosed several of his concerns and associated feelings. if the nurse wishes to seek clarification he could say a. what are the common element here b. tell me again c. am I correct in concluding that d. tell me everything from the beginning - ANSWERSc. am I correct in concluding that... a client tells the nurse "I don't think I'll ever get out of here." a therapeutic response would be a. you shouldn't talk that way. of course you'll leave here b. everyone feels that way sometimes c. you don't think you're making progress d. keep up the good work and you certainly will - ANSWERSc. you don't think you're making progress during a therapy session a client cries as the nurse explores the relationship of the client and her deceased mother. the client sobs "I shouldn't be blubbering like this." a response by the nurse that will hinder communication is a. the relationship with your mother is very painful for you b. I can see that you feel sad about this situation c. why do you think you are so upset d. crying is a way of expressing the hurt you're experiencing - ANSWERSc. why do you think you are so upset during the first interview with a woman who has just lost her son in a car accident, the nurse feels so sorry for the woman that she reaches out and touches her. the nurse's response a. is empathetic and will encourage the woman to continue express her feelings b. will be perceived by the client as intrusive and overstepping boundaries c. is inappropriate because a "no touch" rule should be applied to all psychiatric clients d. may be premature as the cultural and individual interpretation of touch is unknown - ANSWERSd. may be premature as the cultural and individual interpretation of touch is unknown during a nurse client interview the client attempts to shift the session focus from himself to the nurse by asking personal questions. the nurse should respond by saying a. you have no right to ask questions about my personal life b. nurses prefer to direct the interview c. you've turned the tables on me d. this time we spend together is for you to discuss your concerns - ANSWERSd. this time we spend together is for you to discuss your concerns a client seeks to elicit personal information about the nurse by asking several direct questions about the nurse's living arrangements. to refocus the interview the nurse should say a. I am uncomfortable when you ask me personal questions, so please stop b. it seems a bit odd that you are focusing on me rather than on yourself c. your questioning is manipulative and distracting us from our purpose d. this is your time to focus on your situation. tell me about your concerns - ANSWERSd. this is your time to focus on your situation. tell me about your concerns Maslow's theory of human needs has provided nursing with a framework for a. holistic assessment b. determining moral development c. identifying potential for success in therapy d. conducting nurse client interpersonal interactions - ANSWERSa. holistic assessment Sullivan viewed anxiety as a. emotional experience felt after the age of 5 years b. a sign of guilt in adults c. any painful feeling or emotion arising from social insecurity d. adults trying to go beyond experiences of guilt and pain - ANSWERSc. any painful feeling or emotion arising from social insecurity 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 - ANSWERSa. what I did was stupid one implication of Freud's theory of the unconscious on psychiatric mental health nursing is related to the consideration that conscious and unconscious influences can help better understand a. the root causes of client suffering b. the client's immature behavior c. the client's interpersonal interactions d. the client's psychological ability to reason - ANSWERSa. the root causes of client suffering which of the following contributions to modern psychiatric nursing practice was made by freud? a. the theory of personality structure and levels of awareness b. the concept of "a self actualized personality" c. the thesis that culture and society exert significant influence on personality d. provision of a developmental model that includes the entire life span - ANSWERSa. the theory of personality structure and levels of awareness the theory of interpersonal relationships developed by Peplau is based on the foundation provided by which of the following early theorists? a. freud b. piaget c. sullivan d. Maslow - ANSWERSc. sullivan the concept at the heart of sullivan theory of personality are a. needs and anxiety b. basic needs and meta-needs c. developmental tasks and psychosocial crises d. self esteem and self actualization - ANSWERSa. needs and anxiety the premise that an individual's behavior and affect are largely determined by the thoughts and assumptions the person has developed about the world underlies a. modeling b. milieu therapy c. cognitive therapy d. psychoanalytic psychotherapy - ANSWERSc. cognitive therapy providing a safe environment for clients with impaired cognition, referring an abused spouse to a "safe house", and conducting a community meeting are nursing interventions that address aspects of a. milieu therapy b. cognitive therapy c. psychoanalytic psychotherapy d. behavioral therapy - ANSWERSa. milieu therapy which goal should be evaluated as met prior to a client's discharge from an inpatient psychiatric unit? a. family members are ready to accept the client b. the client can return to productive work c. the admission crisis is resolved d. the client's illness is cured - ANSWERSc. the admission crisis is resolved a therapeutic milieu for an inpatient psychiatric unit is characterized by a. few rules b. staff control c. open communication d. conflict suppression - ANSWERSc. open communication for psychiatric nurses, a major difference between caring for clients in the community and caring for clients in the hospital is that: a. treatment is negotiated rather than imposed in the community setting b. fewer ethical dilemmas are encountered in the community settings c. cultural considerations are less important during treatment in the community d. the focus in the community setting is solely on managing symptoms of mental illness - ANSWERSa. treatment is negotiated rather than imposed in the community setting a significant influence allowing psychiatric treatment to move from the hospital to the community was: a. television b. the discovery of psychotropic medications c. identification of external causes of mental illness d. the use of collaborative approach by clients and staff focusing on rehabilitation - ANSWERSb. the discovery of psychotropic medications a typical treatment goal for a client with mental illness being treated in the community setting is that the client will: a. experience destabilization of symptoms b. take medications as prescribed c. learn to live with dependency and decreased opportunities d. accept guidance and structure of significant others - ANSWERSb. take medications as prescribed which action on the part of a community psychiatric nurse visiting the home of a client would be considered inappropriate: a. turning off an intrusive TV program without the client's permission b. facilitating the client's access to a community kitchen for 2 meals a days c. going beyond the professional role boundary to hang curtains for an elderly client d. arranging to demonstrate the use of public transportation to a mental health clinic - ANSWERSa. turning off an intrusive TV program without the client's permission when the wife of a client with schizophrenia asks which neurotransmitter is implicated in the development of schizophrenia, the nurse should state "the current thinking is that the thought disturbances are related to a. excess dopamine b. serotonin deficiency c. histamine decrease d. increased gamma-aminobutyric acid (GABA) - ANSWERSa. excess dopamine the nurse should provide ongoing assessment for a client receiving medication that potentiates the action of GABA relative to a. reduced anxiety b. improved memory c. more organized thinking d. fewer sensory perceptual alterations - ANSWERSa. reduced anxiety a nurse makes the assessment that the client demonstrates anxiety and a number of responses consistent with sympathetic nervous system stimulation. the nurse would suspect the presence of a high concentration of brain a. GABA b. histamine c. acetylcholine d. norepinephrine - ANSWERSd. norepinephrine a client is seen in the emergency department for symptoms of acute anxiety related to the death of her mother in an automobile accident 2 hours ago. to prepare a care plan, the nurse must correctly hypothesize that the client will need teaching about a drug from the group called a. tricyclic antidepressants b. antigenic drugs c. benzodiazepines d. neuroleptic drugs - ANSWERSc. benzodiazepines a client hospitalized with a mood disorder displays an elevated, unstable mood, aggressiveness, agitation, talkativeness, and irritability. the nurse can begin care planning based on the expectation that the psychiatrist is most likely to prescribe a medication classified as a(n) a. anticholinergic b. mood stabilizer c. psychostimulant d. antidepressant - ANSWERSb. mood stabilizer a client's husband is a chemist. he asks the nurse the action by which SSRIs lift depression. the nurse should explain that SSRIs a. make more serotonin available at the synaptic gap b. destroy increased amounts of neurotransmitter c. increase production of acetylcholine and dopamine d. block muscarininc and norepinephrine receptors - ANSWERSa. make more serotonin available at the synaptic gap the nurse caring for a college student who attempted suicide by overdose believes brain biochemical dysfunction contributes to suicidal behavior. the nurse will be better able to plan necessary health teaching if she identifies the probable neurotransmitter alteration of a. acetylcholine excess b. serotonin deficiency c. dopamine excess d. GABA deficiency - ANSWERSb. serotonin deficiency 20-year-old economics major became severely depressed after failing two examinations in economics. She cried for 2 hours, then called her parents who live in a neighboring state, planning to ask if she could return home. Her parents were in Europe. When her roommate went home for the weekend, the client gave her three expensive sweaters to keep. Later, the dormitory resident assistant returned a book to the client's room and found her unconscious on the floor, with an empty pill bottle nearby. The client behavior that provided a clue to the suicide attempt was: a. calling her parents b. staying in her dorm room c. giving away her sweaters d. excessive crying - ANSWERSc. giving away her sweaters the nurse uses the SAD PERSONS scale as he interviews a client who has expressed suicidal ideation. this tool provides data relevant to: a. mood disturbance