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MENTAL HEALTH AND ILLNESS EXAM GUIDES
10 Items
Psychiatric-Mental Health Nursing 8th edition by Videbeck Test Bank.
Chapter 1 1. Th nurse is assessing th factors contributing to th well-being of a newly admitted client. Whchof th following would th nurse identify as hav... [Show More] ing a positive impact on th individual's mental health? A) Not needing othrs for companionship B) Th ability to effectively manage stress C) A family history of mental illness D) Striving for total self-reliance Ans: B Feedback: Individual factors influencing mental health include biologic makeup, autonomy, independence, self-esteem, capacity for growth, vitality, ability to find meaning in life, emotional resilience or hardiness, sense of belonging, reality orientation, and coping or stress management abilities. Interpersonal factors such as intimacy and a balance of separateness and connectedness are both needed for good mental health, and threfore a healthy person would need othrs for companionship. A family history of mental illness could relate to th biologic makeup of an individual, whchmay have a negative impact on an individual's mental health, as well as a negative impact on an individual's interpersonal and socialñcultural factors of health. Total self-reliance is not possible, and a positive social/cultural factor is access to adequate resources. 2. Whchof th following statements about mental illness are true? Select all that apply. A) Mental illness can cause significant distress, impaired functioning, or both. B) Mental illness is only due to social/cultural factors. C) Social/cultural factors that relate to mental illness include excessive dependency on or withdrawal from relationships. D) Individuals suffering from mental illness are usually able to cope effectively with daily life. E) Individuals suffering from mental illness may experience dissatisfaction with relationships and self. Ans: A, D, E Feedback: Mental illness can cause significant distress, impaired functioning, or both. Mental illness may be related to individual, interpersonal, or social/cultural factors. Excessive dependency on or withdrawal from relationships are interpersonal factors that relate to mental illness. Individuals suffering from mental illness can feel overwhelmed with daily life. Individuals suffering from mental illness may experience dissatisfaction with relationships and self. 3. Whchof th following are true regarding mental health and mental illness? A) Behavior that may be viewed as acceptable in one culture is always unacceptable in othr cultures. B) It is easy to determine if a person is mentally healthy or mentally ill. C) In most cases, mental health is a state of emotional, psychological, and social wellness evidenced by satisfying interpersonal relationships, effective behavior and coping, positive self-concept, and emotional stability. D) Persons who engage in fantasies are mentally ill. Ans: C Feedback: What one society may view as acceptable and appropriate behavior, anothr society may see that as maladaptive, and inappropriate. Mental health and mental illness are difficult to define precisely. In most cases, mental health is a state of emotional, psychological, and social wellness evidenced by satisfying interpersonal relationships, effective behavior and coping, positive self-concept, and emotional stability. Persons who engage in fantasies may be mentally healthy, but th inability to distinguish reality from fantasy is an individual factor that may contribute to mental illness. 4. A client grieving th recent loss of her husband asks if she is becoming mentally ill because she is so sad. Th nurse's best response would be, A) ìYou may have a temporary mental illness because you are experiencing so much pain.î B) ìYou are not mentally ill. This is an expected reaction to th loss you have experienced.î C) ìWere you generally dissatisfied with your relationship be4 your husband's death?î D) ìTry not to worry about that right now. You never know what th future brings.î Ans: B Feedback: Mental illness includes general dissatisfaction with self, ineffective relationships, ineffective coping, and lack of personal growth. Additionally th behavior must not be culturally expected. Acute grief reactions are expected and threfore not considered mental illness. False reassurance or overanalysis does not accurately address th client's concerns. 5. Th nurse consults th DSM for whchof th following purposes? A) To devise a plan of care for a newly admitted client B) To predict th client's prognosis of treatment outcomes C) To document th appropriate diagnostic code in th client's medical record D) To serve as a guide for client assessment Ans: D Feedback: Th DSM provides standard nomenclature, presents defining characteristics, and identifies underlying causes of mental disorders. It does not provide care plans or prognostic outcomes of treatment. Diagnosis of mental illness is not within th generalist RN's scope of practice, so documenting th code in th medical record would be inappropriate. 6. Whchwould be a reason for a student nurse to use th DSM? A) Identifying th medical diagnosis B) Treat clients C) Evaluate treatments D) Understand th reason for th admission and th nature of psychiatric illnesses. Ans: D Feedback: Although student nurses do not use th DSM to diagnose clients, thy will find it a helpful resource to understand th reason for th admission and to begin building knowledge about th nature of psychiatric illnesses. Identifying th medical diagnosis, treating, and evaluating treatments are not a part of th nursing process. 7. Th legislation enacted in 1963 was largely responsible for whchof th following shifts in care for th mentally ill? A) Th widespread use of community-based services B) Th advancement in pharmacothrapies C) Increased access to hospitalization D) Improved rights for clients in long-term institutional care Ans: A Feedback: Th Community Mental Health Centers Construction Act of 1963 accomplished th release of individuals from long-term stays in state institutions, th decrease in admissions to hospitals, and th development of community-based services as an alternative to hospital care. 8. Whchone of th following is a result of federal legislation? A) Making it easier to commit people for mental health treatment against thir will. B) Making it more difficult to commit people for mental health treatment against thir will. C) State mental institutions being th primary source of care for mentally ill persons. D) Improved care for mentally ill persons. Ans: B Feedback: Commitment laws changed in th early 1970s, making it more difficult to commit people for mental health treatment against thir will. Deinstitutionalization accomplished th release of individuals from long-term stays in state institutions. Deinstitutionalization also had negative effects in that some mentally ill persons are subjected to th revolving door effect, whchmay limit care for mentally ill persons. 9. Th goal of th 1963 Community Mental Health Centers Act was to A) ensure patients' rights for th mentally ill. B) deinstitutionalize state hospitals. C) provide funds to build hospitals with psychiatric units. D) treat people with mental illness in a humane fashion. Ans: B Feedback: Th 1963 Community Mental Health Centers Act intimated th movement toward treating those with mental illness in a less restrictive environment. This legislation resulted in th shift of clients with mental illness from large state institutions to care based in th community. Answer choices A, C, and D were not purposes of th 1963 Community Mental Health Centers Act. 10. Th creation of asylums during th 1800s was meant to A) improve treatment of mental disorders. B) provide food and shelter for th mentally ill. C) punish people with mental illness who were believed to be possessed. D) remove dangerous people with mental illness from th community. Ans: B Feedback: Th asylum was meant to be a safe haven with food, shelter, and humane treatment for th mentally ill. Asylums were not used to improve treatment of mental disorders or to punish mentally ill people who were believed to be possessed. Th asylum was not created to remove th dangerously mentally ill from th community. ...................................................................................................................................................................................................................CONTINUE. [Show Less]
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Mental Health and Mental Illness
MULTIPLE CHOICE 1. A staff nurse completes orientation to a psychiatric unit. This nurse may expect an advanced practice nurse to perform which addition... [Show More] al intervention? a. Conduct mental health assessments. b. Prescribe psychotropic medication. c. Establish therapeutic relationships. d. Individualize nursing care plans. ANS: B In most states, prescriptive privileges are granted to master’s-prepared nurse practitioners and clinical nurse specialists who have taken special courses on prescribing medication. The nurse prepared at the basic level is permitted to perform mental health assessments, establish relationships, and provide individualized care planning. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-23 TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment 2. A nursing student expresses concerns that mental health nurses “lose all their clinical nursing skills.” Select the best response by the mental health nurse. a. “Psychiatric nurses practice in safer environments than other specialties. Nurse-to-patient ratios must be better because of the nature of the patients’ problems.” b. “Psychiatric nurses use complex communication skills as well as critical thinking to solve multidimensional problems. I am challenged by those situations.” c. “That’s a misconception. Psychiatric nurses frequently use high technology monitoring equipment and manage complex intravenous therapies.” d. “Psychiatric nurses do not have to deal with as much pain and suffering as medical– surgical nurses do. That appeals to me.” ANS: B The practice of psychiatric nursing requires a different set of skills than medical–surgical nursing, though there is substantial overlap. Psychiatric nurses must be able to help patients with medical as well as mental health problems, reflecting the holistic perspective these nurses must have. Nurse–patient ratios and workloads in psychiatric settings have increased, just like other specialties. Psychiatric nursing involves clinical practice, not just documentation. Psychosocial pain and suffering are as real as physical pain and suffering. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 1-2, 21 TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment 3. When a new bill introduced in Congress reduces funding for care of persons diagnosed with mental illness, a group of nurses write letters to their elected representatives in opposition to the legislation. Which role have the nurses fulfilled? a. Recovery b. Attending c. Advocacy d. Evidence-based practice ANS: C An advocate defends or asserts another’s cause, particularly when the other person lacks the ability to do that for self. Examples of individual advocacy include helping patients understand their rights or make decisions. On a community scale, advocacy includes political activity, public speaking, and publication in the interest of improving the human condition. Since funding is necessary to deliver quality programming for persons with mental illness, the letter-writing campaign advocates for that cause on behalf of patients who are unable to articulate their own needs. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 1-26 TOP: Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment 4. A family has a long history of conflicted relationships among the members. Which family member’s comment best reflects a mentally healthy perspective? a. “I’ve made mistakes but everyone else in this family has also.” b. “I remember joy and mutual respect from our early years together.” c. “I will make some changes in my behavior for the good of the family.” d. “It’s best for me to move away from my family. Things will never change.” ANS: C The correct response demonstrates the best evidence of a healthy recognition of the importance of relationships. Mental health includes rational thinking, communication skills, learning, emotional growth, resilience, and self-esteem. Recalling joy from earlier in life may be healthy, but the correct response shows a higher level of mental health. The other incorrect responses show blaming and avoidance. PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 1-2, 3, 32 (Figure 1-1) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 5. Which assessment finding most clearly indicates that a patient may be experiencing a mental illness? The patient a. reports occasional sleeplessness and anxiety. b. reports a consistently sad, discouraged, and hopeless mood. c. is able to describe the difference between “as if” and “for real.” d. perceives difficulty making a decision about whether to change jobs. ANS: B The correct response describes a mood alteration, which reflects mental illness. The distracters describe behaviors that are mentally healthy or within the usual scope of human experience. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 1-2 to 4 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 6. Which finding best indicates that the goal “Demonstrate mentally healthy behavior” was achieved for an adult patient? The patient a. sees self as capable of achieving ideals and meeting demands. b. behaves without considering the consequences of personal actions. c. aggressively meets own needs without considering the rights of others. d. seeks help from others when assuming responsibility for major areas of own life. ANS: A The correct response describes an adaptive, healthy behavior. The distracters describe maladaptive behaviors. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 1-2 to 4 TOP: Nursing Process: Evaluation MSC: Client Needs: Psychosocial Integrity 7. A nurse encounters an unfamiliar psychiatric disorder on a new patient’s admission form. Which resource should the nurse consult to determine criteria used to establish this diagnosis? a. International Statistical Classification of Diseases and Related Health Problems (ICD-10) b. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V) d. A behavioral health reference manual ANS: C The DSM-V gives the criteria used to diagnose each mental disorder. It is the official guideline for diagnosing psychiatric disorders. The distracters may not contain diagnostic criteria for a psychiatric illness. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 1-18, 19 TOP: Nursing Process: Assessment MSC: Client Needs: Safe, Effective Care Environment 8. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource would have the most complete information? a. Nursing Outcomes Classification (NOC) b. DSM-V c. The ANA’s Psychiatric-Mental Health Nursing Scope and Standards of Practice d. ICD-10 ANS: B The DSM-V details the diagnostic criteria for psychiatric clinical conditions. It is the official guideline for diagnosing psychiatric disorders. The other references are good resources but do not define the diagnostic criteria. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 1-18, 19 TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment 9. Which individual is demonstrating the highest level of resilience? One who a. is able to repress stressors. b. becomes depressed after the death of a spouse. c. lives in a shelter for 2 years after the home is destroyed by fire. d. takes a temporary job to maintain financial stability after loss of a permanent job. ANS: D Resilience is closely associated with the process of adapting and helps people facing tragedies, loss, trauma, and severe stress. It is the ability and capacity for people to secure the resources they need to support their well-being. Repression and depression are unhealthy. Living in a shelter for 2 years shows a failure to move forward after a tragedy. See related audience response question. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 1-5, 6 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 10. Complete this analogy. NANDA: clinical judgment: NIC: a. patient outcomes. b. nursing actions. c. diagnosis. d. symptoms. ANS: B Analogies show parallel relationships. NANDA, the North American Nursing Diagnosis Association, identifies diagnostic statements regarding human responses to actual or potential health problems. These statements represent clinical judgments. NIC (Nursing Interventions Classification) identifies actions provided by nurses that enhance patient outcomes. Nursing care activities may be direct or indirect. PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 1-21, 22 TOP: Nursing Process: Evaluation MSC: Client Needs: Safe, Effective Care Environment .....................................................................................................................................................................................................................CONTINUE. [Show Less]
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ATI MENTAL HEALTH B
1. A nurse is caring for a school-aged child who has conduct disorder and is being physically aggressive toward other children in the unit. Which of the fo... [Show More] llowing actions should the nurse take first? a. Place the child in seclusion b. Use therapeutic hold technique c. Apply wrist restraints d. Administer risperidone 2. A nurse is caring for a client who has a new diagnosis of bulimia nervosa. Which of the following diagnosis procedures should the nurse anticipate the provider should describe during the medical evaluation? a. Chest x-ray b. ECG c. Coagulation studies d. Liver function test 3. A nurse is caring for a client who exhibits excessive compliance, passivity, and self-denial. The nurse should recognize that these findings are associated with which of the following personality disorders? a. Dependent b. Paranoid c. Borderline d. Histrionic 4. A nurse is caring for a client who is involuntarily admitted for major depressive disorder and refuses to take prescribed antianxiety medication. Which of the following actions should the nurse take? a. Inform the client that he does not have the right to refuse medication b. Administer the medication to the client via IM injection c. Offer the client the medication at the next scheduled dose time d. Implement consequences until the client take the medication 5. A nurse is caring for a client in the emergency department who states she was beaten and sexually assault by her partner. After a rapid assessment, which of the following actions should the nurse plan to take next? a. Conduct a pregnancy test b. Requests mental health consultation for the client c. Provide a trained advocate to stay with the client d. Offer prophylactic medication to prevent STI’s 6. A nurse is caring for a client who has major depressive disorder. After discussing the treatment with his partner, the client verbally agrees to electroconvulsive therapy (ECT) but will not sign the consent form. Which of the following actions should the nurse take? a. Request that the client’s partner sign the consent form b. Cancel the scheduled ECT procedure c. Proceed with the preparation for ECT based on implied consent d. Inform the client about the risks of refusing the ECT 7. A nurse is caring for a client who reports that he is angry with his partner because she thinks he is just trying to gain attention. When the nurse attempts to talk to the client, he becomes angry and tells her to leave. Which of the following defense mechanisms is the client demonstrating? a. Rationalization b. Denial c. Compensation d. Displacement 8. A nursing is advising an assistive personnel (AP) on the care of a client who has major depressive disorder. The AP states that he is irritated by the client’s depression. Which of the following statements by the nurse is appropriate? a. Please don’t take what the client said seriously when she is depressed b. It’s important that the client feel safe verbalizing how she is feeling c. Everybody feels that way about this client so don’t worry about it d. I’ll change your assignment to someone who doesn’t have depressive disorder 9. A nurse is assessing a child in the emergency department. Which of the following findings places the child at the greatest risk for physical abuse? a. The child is 10years old b. The child is homeschooled c. The has no siblings d. The child has cystic fibrosis 10. A nurse is providing behavioral therapy for a client who has obsessive-compulsive disorder. The client repeatedly checks that the doors are locked at night. Which of the following instructions should the nurse give the client when using thought stopping technique? a. Keep a journal of how often you check the locks each night b. Snap a rubber band on your wrist when you think about checking the locks c. Ask a family member to check the lock for you at night d. Focus on abdominal breathing whenever you go to check the locks ........................................................................................................................................................................................................................CONTINUE. [Show Less]
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Mental Health NUR2459 Module 4 EXAM 1 review guide 2022 updated.
• Role of the psychiatric Nurse o Work closely with treatment teams to develop individualized patient plans, aiming to maximize care and help patients l... [Show More] ive productive lives. They also provide individual counseling to patients and families to help them understand the illness. o Stranger ▪ Accepting the patient as he is ▪ Treating the patient as an emotionally able stranger and relating to him on this basis until evidence shows him to be otherwise. o Resource person ▪ In the role of resource person, the nurse explains, in language that the patient can understand, information related to the patient’s health care. o Teacher ▪ the nurse identifies learning needs and provides information required by the patient or family to improve the health situation. o Leader ▪ Autocratic leadership promotes overvaluation of the nurse and patients’ substitution of the nurse’s goals for their own. Laissez-faire leaders convey a lack of personal interest in the patient. o Surrogate ▪ Outside of their awareness, patients often perceive nurses as symbols of other individuals. They may view the nurse as a mother figure, a sibling, a former teacher, or another nurse who has provided care in the past. This perception occurs when a patient is placed in a situation that generates feelings similar to ones he or she has experienced previously. o Technical expert ▪ The nurse understands various professional devices and possesses the clinical skills necessary to perform interventions that are in the best interest of the patient. o Counselor ▪ The nurse uses “interpersonal techniques” to assist patients in adapting to difficulties or changes in life experiences. ▪ Counseling in nursing has to do with helping the patient to remember and to understand fully what is happening to him in the present situation, so that the experience can be integrated with, rather than dissociated from, other experiences in life. • Therapeutic use of self o strategic, useful tool for mental health professionals to improve empathy and identification with patients. o the ability to use one’s personality consciously and in full awareness in an attempt to establish relatedness and to structure nursing intervention.” o Use of the self in a therapeutic manner requires that the nurse possess self- awareness and self-understanding, which are achieved by developing a philosophical belief about life, death, and the overall human condition. • Phases of the therapeutic nurse patient relationship o Therapeutic relationships are always goal oriented. o Pre-interaction ▪ Obtaining valuable info about client from chart, SO, family, or healthcare team. ▪ Examining one’s feelings, fears, and anxieties about working with this patient. o Orientation ▪ Introduction ▪ Create environment of trust and rapport ▪ Establish boundaries ▪ Assess patient ➢ Identify strengths and limitations ▪ Formulate nursing diagnosis ▪ Set goals for patient ▪ Develop plan of action ▪ Explore feelings of both patient and nurse o Working phase ▪ Maintain trust and rapport ▪ Promote client insight and perception of reality. ▪ Problem-solving ▪ Overcome resistance behaviors ▪ Evaluate progress toward established goals. ▪ Transference: ➢ This occurs when the client unconsciously displaces or transfers to the nurse feelings formed toward another person from his/her past. ➢ These can be positive or negative feelings. ➢ Common phenomena that may occur during the working phase and can interfere with the therapeutic relationship. ▪ Countertransference: ➢ This refers to the nurse’s behavioral and emotional response to the client. ➢ The nurse is to recognize the occurrence of this phenomenon and remain professional at all times. ➢ Common phenomena that may occur during the working phase and can interfere with the therapeutic relationship. o Termination phase ▪ Progress has been made toward attainment of the goals. ▪ A plan of action for more adaptive coping with future stressful situations has been established. ▪ Feelings about termination of the relationship are recognized and explored. ..............................................................................................................................................................................................................................CONTINUE. [Show Less]
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Capstone Mental health assessment
1. A nurse is discussing discipline techniques with the parent of a preschooler. Which of the following statements by the parent indicates an understanding... [Show More] of time-out as a form of discipline? "I place my child in time-out for 15 minutes when they misbehave." "I send my child to their room for the time-out period." "I make use of time-out after giving three warnings." "I use a kitchen timer to mark the end of the time-out period." 2. A nurse in a well-child clinic receives a phone call from the parent of an adolescent client. The parent states, "I think my son might try to kill himself." Which of the following statements by the parent is the priority for the nurse to investigate further? "I can hear him crying in the middle of the night." "He spends most of his time locked in his room." "He refuses to go to the movies with his friends." "I noticed several cutting marks on both of his arms." 3. A nurse is caring for an adult client who is receiving treatment for alcohol use disorder. The client is upset because his partner has refused to visit him in the treatment facility. Which of the following actions by the client should indicate to the nurse that the client is using regression as a defense mechanism? The client states that he has developed sudden hearing loss. The client states that his partner will not visit because they are too busy with their job. The client yells obscenities at the nurse. The client stomps his feet and throws objects o his bedside table 4. A nurse is admitting a client who has posttraumatic stress disorder (PTSD) to a community mental health facility. Which of the following manifestations should the nurse expect when completing the admission assessment? Decreased startle response to loud noises Reports uninterrupted sleep of 10 to 12 hr each night Reluctance to discuss the event that precipitated the distress Reports feelings of acute distress that began 1 to 2 weeks ago 5. A nurse is conducting a child maltreatment screening of a family who has a toddler. Which of the following findings should the nurse identify as an indicator of possible child neglect? The child has a history of jaw factures. The child seems frightened of their parent. The child has had no immunizations since birth. The child rocks back and forth continually. 6. A nurse in an urgent-care clinic is caring for a school-age child who has several visible bruises. The child's parent states, "My partner got red today and came home angry. I don't think this will happen again." Which of the following responses should the nurse make? "I agree with you. I'm sure this will never happen again." "This is awful. You should le charges against your partner." "This is clearly child endangerment. I will have to call the police." "I'd like to know more about what happened. Let's sit and talk." 7. A nurse is caring for a client who has dementia and insists a doll is her infant child. Which of the following behavioral management techniques should the nurse use when interacting with the client? Cognitive reframing Thought stopping Validation therapy Operant conditioning 8. A nurse is planning care for a client who has major depressive disorder and is being admitted following a suicide attempt. Which of the following interventions is the nurse's priority? Initiate one-to-one observation. Encourage the client to participate in group activities. Administer an antidepressant. Set up a time for individual meetings with the client. 9. A nurse is caring for a client who is aggressive toward other clients and has been placed in wrist restraints. After obtaining a prescription for restraints from the provider, which of the following actions should the nurse take? Document the client's behavior once every hour. Keep the client in restraints until the prescription expires. Conduct a debrieng regarding the client with the unit staff. Request an evaluation of the client within 12 hr of application of restraints. 10. A nurse is providing teaching to a client who has a prescription for disulram. Which of the following client statements indicates an understanding of the teaching? "If I drink alcohol, I will become very sick." "If I drink alcohol, I will not be able to fall asleep." "If I drink alcohol, I will lose control of my inhibitions and say something I don't mean." "If I drink alcohol, I will have severe mood swings and exhibit belligerent behavior." ..........................................................................................................................................................................................................................CONTINUE. [Show Less]
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ATI Mental Health Proctored ATI Mental Health Proctored - ATI Mental Health.
1. A charge nurse is discussing mental status exams with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an... [Show More] understanding of the teaching? (Select all that apply) A. "To assess cognitive ability, I should ask the client to count backward by sevens." B. "To assess affect, I should observe the client's facial expression." C. "To assess language ability, I should instruct the client to write a sentence." D. "To assess remote memory, I should have the client repeat a list of objects." E. "To assess the client's abstract thinking, I should ask the client to identify our most recent presidents." 2. A nurse is planning care for a client who has a mental health disorder. Which of the following actions should the nurse include as a psychobiological intervention? A. Assist the client with systematic desensitization therapy. B. Teach the client appropriate coping mechanisms. C. Assess the client for comorbid health conditions. D. Monitor the client for adverse effects of the medications. 3. A nurse in an outpatient mental health clinic is preparing to conduct an initial client interview. When conducting the interview, which of the following actions should the nurse identify as the priority? A. Coordinate holistic care with social services. B. Identify the client's perception of her mental health status. C. Include the client's family in the interview. D. Teach the client about her current mental health disorder. 4. A nurse is told during change of shift report that a client is stuporous. When assessing the client, which of the following findings should the nurse expect? A. The client arouses briefly in response to a sternal rub. B. The client has a glasgow coma scale score less than 7. C. The client exhibits decorticate rigidity. D. The client is alert but disoriented to time and place. 5. A nurse is planning a peer group discussion about the DSM-5. Which of the following information is appropriate to include in the discussion? (Select all that apply) A. The DSM-5 includes client education handouts for mental health disorders. B. The DSM-5 establishes diagnostic criteria for individual mental health disorders. C. The DSM-5 indicates recommended pharmacological treatment for mental health disorders. D. The DSM-5 assists nurses in planning care for client's who have mental health disorders. E. The DSM-5 indicates expected assessment findings of mental health disorders. 6. A nurse in an emergency mental health facility is caring for a group of clients. The nurse should identify that which of the following clients requires a temporary emergency admission? A. A client who has schizophrenia with delusions of grandeur B. A client who has manifestations of depression and attempted suicide a year ago C. A client who has borderline personality disorder and assaulted a homeless man with a metal rod D. A client who has bipolar disorder and paces quickly around the room while talking to himself 7. A nurse decides to put a client who has a psychotic disorder in seclusion overnight because the unit is very short-staffed, and the client frequently fights with other clients. The nurse's actions are an example of which of the following torts? A. Invasion of privacy B. False imprisonment C. Assault D. Battery 8. A client tells a nurse, "Don't tell anyone but I hid a sharp knife under my mattress in order to protect myself from my roommate, who is always yelling at me and threatening me." Which of the following actions should the nurse take? A. Keep the client's communication confidential, but talk to the client daily, using therapeutic communication to convince him to admit to hiding the knife. B. Keep the client's communication confidential, but watch the client and his roommate closely. C. Tell the client that this must be reported to the health care team because it concerns the health and safety of the client and others. 9. D. Report the incident to the health care team, but do not inform the client of the intention to do so. 10.A A nurse is caring for a client who is in mechanical restraints. Which of the following statements should the nurse include in the documentation? (Select all that apply) A. "Client ate most of his breakfast." B. "Client was offered 8 oz of water every hr." C. "Client shouted obscenities at assistive personnel." D. "Client received chlorpromazine 15 mg by mouth at 1000." E. "Client acted out after lunch." ........................................................................................................................................................................................................................CONTINUE. [Show Less]
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ATI Mental Health/RETAKE
A nurse is providing teaching for a client who is scheduled to receive ECT for the treatment of major depressive disorder. Which of the following client st... [Show More] atements indicates understanding of the teaching? a. “It is common to treat depression with ECT before trying medications.” b. “I can have my depression cured if I receive a series of ECT treatments.” c. “I should receive ECT once a week for 6 weeks.” d. “I will receive a muscle relaxant to protect me from injury during ECT.” 2.) A charge nurse is discussing TMS with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? a. “TMS is indicated for clients who have schizophrenia spectrum disorders.” b. “I will provide postanesthesia care following TMS.” c. “TMS treatments usually last 5 to 10 minutes.” d. “I will schedule the client for daily TMS treatments for the first several weeks.” 3.) A nurse is assessing a client immediately following an ECT procedure. Which of the following findings should the nurse expect? (Select all that apply.) a. Hypotension. b. Paralytic ileus. c. Memory loss. d. Nausea. e. Confusion. 4.) A nurse is leading a peer group discussion about the indications for ECT. Which of the following indications should the nurse include in the discussion? a. Borderline personality disorder. b. Acute withdrawal related to a substance use disorder. c. Bipolar disorder with rapid cycling. d. Dysphoric disorder. 5.) A nurse is planning care for a client following surgical implantation of a VNS device. The nurse should plan to monitor for which of the following adverse effects? (Select all that apply.) a. Voice changes. b. Seizure activity. c. Disorientation. d. Dysphagia. e. Neck pain. Chapter 16 Personality Disorders 1.) A nurse manager is discussing the care of a client who has a personality disorder with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? a. “I can promote my client’s sense of control by establishing a schedule.” b. “I should encourage clients who have a schizoid personality disorder to increase socialization.” c. “I should practice limit-setting to help prevent client manipulation.” d. “I should implement assertiveness training with clients who have antisocial personality disorder.” 2.) A nurse is caring for a client who has avoidant personality disorder. Which of the following statements is expected from a client who has this type of personality disorder? a. “I’m scared that you’re going to leave me.” b. “I’ll go to group therapy if you’ll let me smoke.” c. “I need to feel that everyone admires me.” d. “I sometimes feel better if I cut myself.” 3.) A nurse is caring for a client who has borderline personality disorder. The client says, “The nurse on the evening shift is always nice! You are the meanest nurse ever!” The nurse should recognize the client’s statement as an example of which of the following defense mechanisms? a. Regression. b. Splitting. c. Undoing. d. Identification. 4.) A nurse is assisting with a court-ordered evaluation of a client who has antisocial personality disorder. Which of the following findings should the nurse expect? (Select all that apply.) a. Demonstrates extreme anxiety when placed in a social situation. b. Has difficulty making even simple decisions. c. Attempts to convince other clients to give him their belongings. d. Becomes agitated if his personal area is not neat and orderly. e. Blames others for his past and current problems. 5.) A charge nurse is preparing a staff education session on personality disorders. Which of the following personality characteristics associated with all of the personality disorders should the charge nurse include in the teaching? a. Difficulty in getting along with other members of a group. b. Belief in the ability to become invisible during times of stress. c. Display of defense mechanisms when routines are changed. d. Claiming to be more important than other persons. e. Difficulty understanding why it is inappropriate to have a personal relationship with staff. Chapter 21 Medications for Anxiety and Trauma- and Stressor-Related Disorders 1.) A nurse working in a mental health clinic is providing teaching to a client who has a new prescription for diazepam for generalized anxiety disorder. Which of the following information should the nurse provide? a. Three to six weeks of treatment is required to achieve therapeutic benefit. b. Combining alcohol with diazepam will produce a paradoxical response. c. Diazepam has a lower risk for dependence than other antianxiety medications. d. Report confusion as a potential indication of toxicity. .......................................................................................................................................................................................................................CONTINUE. [Show Less]
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ATI MENTAL HEALTH C 2020/2021 PROCTORED EXAM –LATEST STUDY GUIDE
1. A nurse is reviewing the medication administration record of a client who has major depressive disorder and a new prescription for selegiline. The nurse... [Show More] should recognize that which of the following client medications is contraindicated when taken with selegiline? a. Wafarin b. Fluoxetine c. Calcium carbonate d. Acetaminophen 2. A nurse in a long-term care facility is assessing a client who has dementia. Which of the following findings should the nurse identify as a risk for this client? a. Outside doors have locks b. The bed is in the low position c. Hallways are long distances d. The room has an area rug 3. A nurse is providing behavioral therapy for a client who has obsessive-compulsive disorder. The client repeatedly checks that the doors are locked at night. Which of the following instructions should the nurse give the client when using thought stopping technique? a. “Ask a family member to check the locks for you at night” b. “Keep a journal of how often you check the locks each night” c. “Snap a rubber band on your wrist when you think about checking the locks” d. “Focus on abdominal breathing whenever you go to check the locks” 4. A nurse in an inpatient mental health facility is assessing a client who has schizophrenia and is taking haloperidol. Which of the following clinical findings is the nurse’s priority? a. Insomnia b. Urinary hesitancy c. Headache d. High fever 5. A nurse is caring for a client who has Alzheimer’s disease. Which of the following findings should the nurse expect? a. Failure to recognize familiar objects b. Altered level of consciousness c. Excessive motor activity d. Rapid mood swings 6. A nurse in a mental health facility is interviewing a new client. Which of the following outcomes must occur if the nurse is to establish a therapeutic nurse-client relationship? a. The nurse is seen as an authority figure b. A written contract is established to clarify the steps of the treatment plan c. The nurse maintains confidentiality unless the client’s safety is compromised d. The nurse is seen as a friend 7. A nurse is teaching a client who has a new prescription for disulfiram. Which of the following statements by the client indicates an understanding of the teaching? a. “If I cut myself, I can clean the wound with isopropyl alcohol” b. “I can wear my cologne on special occasions” c. “When I bake my favorite cookies, I can use pure vanilla extract for flavoring” d. “I can continue to eat aged cheese and chocolate” 8. A nurse is planning care for a client who has narcissistic personality disorder. Which of the following actions is appropriate for the nurse to include in the plan of care? a. Ask the client to sign a no-suicide contract b. Remain neutral when communicating with the client c. Request an antipsychotic medication from the provider d. Provide the client with high-calorie finger foods 9. A nurse is reviewing the laboratory report of a client who is taking carbamazepine for bipolar disorder. Which of the following laboratory results should the nurse report to the provider? a. Urine specific gravity 1.029 b. Platelets 90,000/mm3 c. Urine pH 5.6 d. RBC 4.7/mm3 10. A nurse is providing teaching about relapse prevention to a client who has schizophrenia. Which of the following statements by the client indicates an understanding of the teaching? a. “I should avoid being around others if I think I’m having a relapse” b. “I should let my counselor know if I am having trouble sleeping” c. “I shouldn’t worry about the voices because they are a part of my illness” d. “I should increase my carbohydrate intake to maintain my energy level” ............................................................................................................................................................................................................................CONTINUE. [Show Less]
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ATI MENTAL HEALTH RETAKE GUIDE
A charge nurse is discussing mental status exams with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an un... [Show More] derstanding of the teaching? (Select all that apply) A. "To assess cognitive ability, I should ask the client to count backward by sevens." B. "To assess affect, I should observe the client's facial expression." C. "To assess language ability, I should instruct the client to write a sentence." D. "To assess remote memory, I should have the client repeat a list of objects." E. "To assess the client's abstract thinking, I should ask the client to identify our most recent presidents." A nurse is planning care for a client who has a mental health disorder. Which of the following actions should the nurse include as a psychobiological intervention? A. Assist the client with systematic desensitization therapy. B. Teach the client appropriate coping mechanisms. C. Assess the client for comorbid health conditions. D. Monitor the client for adverse effects of the medications. A nurse in an outpatient mental health clinic is preparing to conduct an initial client interview. When conducting the interview, which of the following actions should the nurse identify as the priority? A. Coordinate holistic care with social services. B. Identify the client's perception of her mental health status. C. Include the client's family in the interview. D. Teach the client about her current mental health disorder. A nurse is told during change of shift report that a client is stuporous. When assessing the client, which of the following findings should the nurse expect? A. The client arouses briefly in response to a sternal rub. B. The client has a glasgow coma scale score less than 7. C. The client exhibits decorticate rigidity. D. The client is alert but disoriented to time and place. A nurse is planning a peer group discussion about the DSM-5. Which of the following information is appropriate to include in the discussion? (Select all that apply) A. The DSM-5 includes client education handouts for mental health disorders. B. The DSM-5 establishes diagnostic criteria for individual mental health disorders. C. The DSM-5 indicates recommended pharmacological treatment for mental health disorders. D. The DSM-5 assists nurses in planning care for client's who have mental health disorders. E. The DSM-5 indicates expected assessment findings of mental health disorders. A nurse in an emergency mental health facility is caring for a group of clients. The nurse should identify that which of the following clients requires a temporary emergency admission? A. A client who has schizophrenia with delusions of grandeur B. A client who has manifestations of depression and attempted suicide a year ago C. A client who has borderline personality disorder and assaulted a homeless man with a metal rod D. A client who has bipolar disorder and paces quickly around the room while talking to himself A nurse decides to put a client who has a psychotic disorder in seclusion overnight because the unit is very short-staffed, and the client frequently fights with other clients. The nurse's actions are an example of which of the following torts? A. Invasion of privacy B. False imprisonment C. Assault D. Battery A client tells a nurse, "Don't tell anyone but I hid a sharp knife under my mattress in order to protect myself from my roommate, who is always yelling at me and threatening me." Which of the following actions should the nurse take? A. Keep the client's communication confidential, but talk to the client daily, using therapeutic communication to convince him to admit to hiding the knife. B. Keep the client's communication confidential, but watch the client and his roommate closely. C. Tell the client that this must be reported to the health care team because it concerns the health and safety of the client and others. D. Report the incident to the health care team, but do not inform the client of the intention to do so. ......................................................................................................................................................................................................................CONTINUE. [Show Less]
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ATI MENTAL HEALTH RETAKE EXAM- LATEST GUIDE
1. What are the phases of the cycle of violence that can occur between domestic partners and what may take place during each of these phases? -Tension-bui... [Show More] lding phase: The abuser has minor episodes of anger and can be verbally abusive and responsible for some minor physical violence. The vulnerable person is tense during this stage and tends to accept the blame for what is happening. -Acute battering phase: The tension becomes too much to bear, and serious abuse takes place. The vulnerable person can try to cover up the injury or try to get help. -Honeymoon phase: The situation is defused for a while after a violent episode. The abuser becomes loving, promises to change, and is sorry for the behavior. The vulnerable person wants to believe this and hopes for change. Eventually the cycle begins again. -Period of escalation and de-escalation usually continue with shorter and shorter periods of time between the two. Emotions for the abuser and vulnerable person (fear, anger) increase in intensity. Repeated episodes of violence lead to feelings of powerlessness. 2. A nurse is caring for a client hospitalized for opioid dependency. What manifestations should the nurse anticipate when abstinence syndrome begins? -Withdrawal manifestations are not life threatening, but suicidal ideation can occur. -Common findings include agitation, insomnia, flu-like manifestations, rhinorrhea, yawning, sweating and diarrhea. 3. The nurse is reviewing the admission information on a client being admitted with schizophrenia. The provider has indicated that the client has ‘schizophrenia with negative symptoms’. What would the nurse expect to notice in this client? How do negative symptoms differ from the positive symptoms of schizophrenia? -In a client that has schizophrenia with negative symptoms the nurse would expect to notice social withdrawal, lack of emotion, lack of energy, flattened affect, decreased motivation, and or decreased pleasure in activities. -In a client that has schizophrenia with positive symptoms are related to behavior thought, perception, and speech such as agitation, bizarre behavior, delusions, hallucinations, flight of ideas and or loose associations. 4. A nurse is caring for a client with a binge eating disorder. 1) What is binge-eating disorder? 2) What disorders is this client at increased risk for because of the weight gain associated with binge eating? -Binge eating disorder: Clients recurrently eat large quantities of food over a short period of time without the use of compensatory behaviors associated with bulimia nervosa. Excessive food consumption must be accompanied by a sense of lack of control at least once per week for 3 months. -The weight gain associated with binge eating disorder increases the client’s risk for other disorders, including type to diabetes mellitus, hypertension and cancer. 5. A nurse is reinforcing client education about the risk of hepatotoxicity with the drug valproic acid. What information should be included? -Determine baseline liver function, and monitor function regularly (minimum of every 2 months during the first 6 months of treatment) -Advise the client to observe for indications of hepatoxicity (nausea, dark colored urine, fever, loss of appetite, jaundice, fatigue) and to notify provider immediately if they occur. -Avoid in using in children younger than 2 years old. -Administer the lowest effective dose. 6. A client has been prescribed imipramine hydrochloride. What are some important aspects of teaching the nurse should reinforce before discharge? -Avoid concurrent use of tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) -Advise the client to avoid taking with other CNS depressants. -Practice good nutrition and exercise to decrease risk of weight gain. -Avoid hazardous activities, such as driving if sedation is excessive. -Take medication at bedtime to minimize daytime sleepiness and to promote sleep. Taking the medication at bedtime minimizes experiencing adverse effects during the day. -Change positions slowly to prevent orthostatic hypotension. Avoid dehydration, which increases risk for hypotension. 7. A client has been prescribed clonazepam. What is the likely reason this medication was prescribed and what lab values should be monitored by the nurse? -The likely reason this medication is prescribed is relief from anxiety. It is a first-line treatment for generalized anxiety disorder and panic disorder. -lab values that should be monitored are serum sodium, liver and kidney tests 8. A client has been prescribe Varenicline. What are some adverse effects the nurse should monitor for? -Neuropsychiatric effects (unpredictable behavior, mood changes, thoughts of suicide) -nausea -vomiting -insomnia -new onset depression -suicidal thoughts 9. A nurse is caring for a client who is taking haloperidol. The client has developed signs of infection. What potential complication may be occurring and what nursing actions should be taken related to the possibility of infection? -Agranulocytosis may be occurring -Advise for clients to observe for indications of infection (fever, sore throat, malaise) and to notify the provider if these flu-like manifestations occur -Nurse should obtain a CBC for client -Medication should be discontinued if laboratory test indicates the presence of an infection. 10. A client has been prescribed sertraline for generalized anxiety disorder. The nurse asks the client if he has any further questions after having spoken to the nurse and provider. The client states “Well, I really don’t understand why I am on this medication since I am not depressed.” How should the nurse reply? -SSRI antidepressants are the first line treatment for panic disorders and trauma and stressor related disorders. -SSRIs do not block uptake of dopamine or norepinephrine -Sertraline is indicated for social anxiety disorder, PTSD, OCD, and panic disorder ............................................................................................................................................................................................................................CONTINUE. [Show Less]
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