1. A nurse is admitting a client who has schizophrenia. During the initial interview, the client takes off his belt and screams,
“A snake!” Which of
... [Show More] the following responses is appropriate?
a. “You know that is you belt and not a snake, don’t you?”
b. “Your belt doesn’t look like a snake.”
c. “Thisis your belt. I understand how thisisscary for you.”
d. “Why do you think your belt is a snake?”
2. A nurse working in the emergency department is assessing a client who has generalized anxiety disorder. Which of the
following actions should the nurse take first?
a. Move the client to a quiet area
b. Allow the client time to express hisfeelings
c. Instruct the client to use guided imagery
d. Assist the client to identify his coping skills
3. A nurse is caring for a client who has dementia. Which of the following is an appropriate nursing intervention? a. Encourage
the client to make choices regarding care.
b. Advise family to visit frequently as a group
c. Maintain a low-stimulation environment
d. Assign several tasks at the same time.
4. A nurse is counseling an adult client whose parent just died. The client states, “My son is 4, and I don’t know how he’ll react
when he finds out that his grandpa died.” The nurse should inform the client that the preschool-age child commonly has
which of the following concepts of death?
a. Death is contagious and can cause other people he loves to die
b. Death creates an interest in the physical aspects of dying
c. Death is not permanent and the loved one may come back to life.
d. Death is a part of life that eventually happensto everyone.
5. A nurse in the emergency department is admitting a client who has a history of alcohol use disorder. The client has a blood
alcohol level of 0.26 g/dL. The nurse should anticipate a prescription for which of the following medications? (p. 156)
a.
Chlordiazepoxide
b. Disulfram
c. Acamprosate
d. Naltrexone
6. A nurse is advising an assistive personnel (AP) on the care of a client who has major depressive disorder. The AP statesthat
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. “I’ll change your assignment to someone who doesn’t have depressive disorder.”
c. “It’simportant that the client feel safe verbalizing how she is feeling.”
d. “Everybody feelsthat way about this client, so don’t worry about it.”
7. A nurse is caring for a client who reports he is angry with his partner because she thinks he is trying to seek attention. When
the nurse questions the client, he becomes angry and tells her to leave. Which of the following defense mechanisms is
theclient demonstrating? (p. 30)
a. Compensation
b. Displacement
c. Denial
d. Rationalization
8. A nurse working in a mental health facility has just put a client in provider-prescribed seclusion. Which of the following is
the nurse required to document? (Select all that apply)
a. The client’s feelings about being secluded
b. The client’s behaviors that resulted in the need forseclusion
c. Previousinterventions used to prevent the need forseclusion
d. The client’s vital signs
e. The time the client entered seclusion
9. A nurse is assessing a client who has major depressive disorder. The client states, “I may as well be dead. I have always
been a failure.” Which of the following is an appropriate response by the nurse?
a. “Let’s discussthese feelings further.”
b. “why do you think you feel this way?”
c. “Feeling like a failure is expected with depression.”
d. “You have a great deal to offer in life.”
10. A nurse is planning care for a group of clients in an outpatient facility. For which of the following clients should the nurse
plan to provide assistance with ADLs?
a. A client who hasintense manifestations of agoraphobia
b. A client who has negative manifestations ofschizophrenia
c. A client who is in treatment for hypomania
d. A client who is in treatment for alcohol use disorder
11. A nurse Is planning care for a client who has anorexia nervosa and is admitted to an inpatient eating disorder unit. Which
of the following is an appropriate intervention? (p. 167)
a. Use systematic desensitization to addressthe client’sfears regarding weight gain
b. Allow the client to select meal times
c. Initiate a relationship built on trust with the client.
d. Negotiate with the client the opportunity to reweigh.
12.
A nurse is planning an inservice for new nurses about cultural beliefs and their impact on mental health care. The nurse
should identify that which of the following beliefs differs from the western perspective held by most nurses in the United
States? (Notsure)
a. Mental health isthe absence of a mental health disorder.
b. Clientsshouldmake independent decisions about their mental health care
c. Mental health care places value on veracity and confidentiality
d. Clients who have a mental health disordershould be passive in their care.
13. A nurse is caring for a client who is admitted to a mental health facility after attempting suicide. Which of the following
actions should the nurse take first? (p. 286)
a. Implement continuous one-to-one observation
b. Ask the client to sign a no-suicide contract
c. Encourage client to participate in group therapy
d. Establish a rapport to foster trust
14. A nurse is caring for a client in an out-patient mental health facility. The client tells the nurse that she wants to tell her a
secret and asks her to promise not to tell. Which of the following responses by the nurse is appropriate? (p. 37) a. “Go on.
Tell me more.”
b. “Why do you want to keep the information a secret?”
c. “Have you shared yoursecret with anyone else?”
d. “I can’t promise that I will keep your secret.” [Show Less]