Mental Health Exam 1

When does the duty to warn legally override client confidentiality?

When a client makes a serious, specific threat toward an identifiable person.

How is mental illness defined in modern psychiatric nursing?

A clinically significant disturbance in mood, thought, behavior, or functioning; not a moral failure.

What is the most effective nursing strategy to reduce repeated emergency department use?

Coordinated, continuous community care and an individualized crisis plan.

When is involuntary hospitalization legally reserved for a client?

When there is imminent danger to self, others, or inability to meet basic needs.

What is the key difference between malpractice and an intentional tort?

Malpractice is unintentional standard-of-care failure; intentional torts are deliberate rights violations.

How is the ethical principle of autonomy defined?

The client's right to self-determination and independence.

How is the ethical principle of beneficence defined?

The duty to benefit others or promote good.

How is the ethical principle of nonmaleficence defined?

The duty to avoid or minimize harm.

How is the ethical principle of justice defined?

Fairness and equal treatment based on clinical need.

How is the ethical principle of veracity defined?

The duty to tell the truth.

How is the ethical principle of fidelity defined?

The duty to keep promises, commitments, and maintain boundaries.

What are the primary safety priorities when a client is in restraints?

Never restrain prone, protect airway, and monitor the client continuously.

How should a nurse therapeutically respond to a client resistant to therapy?

Use acceptance, reflection, and open-ended exploration without arguing or asking 'why'.

How should a nurse adapt teaching for a child in Piaget's concrete operational stage?

Use concrete demonstrations, visible examples, schedules, and step-by-step cause/effect.

What is the nursing priority for a client in severe anxiety or panic?

Reduce stimuli, stay with the client, use brief directions, and ensure safety.

How does a nurse prioritize client care using Maslow's hierarchy of needs?

Address physiological needs and immediate safety threats before higher-level needs.

What is the primary focus of existential therapy?

Exploring meaning, personal responsibility, freedom of choice, and authenticity.

What is the immediate nursing priority for a client experiencing acute dissociation?

Ensure safety and use sensory grounding techniques to orient the client.

What does Yalom's group therapeutic factor of universality mean?

The realization that one is not alone in their experiences.

How should a nurse handle a client's interest in complementary and alternative medicine?

Assess safety, respect autonomy, and collaborate on evidence-informed integrative options.

How should a nurse address a client in denial about substance use?

Use objective, nonjudgmental feedback and motivational interviewing to explore discrepancies.

What is the recommended interpersonal distance for most therapeutic conversations?

Maintain roughly 3 to 6 feet of personal space at eye level.

What does nonverbal congruence mean?

When a client's spoken words match their nonverbal behaviors.

How should a nurse initiate culturally competent care during assessment?

Ask the client about their cultural, spiritual, and communication preferences.

How should a nurse interpret a client's lack of eye contact?

As a culturally or individually variable behavior, not automatically as dishonesty.

What are the key tasks during the termination phase of a relationship?

Review progress, identify coping skills, discuss ending feelings, and maintain boundaries.

Why do two clients respond differently to the exact same stressor?

Response depends on cognitive appraisal—what the stressor means to the individual.

What is the primary goal of recovery-oriented community reintegration?

Achieving a meaningful, independent life in the community, not just symptom absence.

What is the most critical environmental factor for a client remaining in the community?

Safe, stable housing with access to essential resources and crisis support.

What is a major illness-related barrier to treatment in severe mental illness?

Anosognosia, or a lack of insight into one's own illness.

What is the nursing priority when a client experiences command hallucinations directing harm?

Treat it as an urgent safety risk and implement immediate monitoring.

What must occur before transferring a client from the emergency department to psychiatry?

Complete medical screening and achieve physiological stabilization of ABCs and vitals.

What are the primary functions of the frontal lobe?

Planning, judgment, impulse control, personality, and motor function.

What psychiatric symptoms are associated with excess dopamine in the mesolimbic pathway?

Positive psychotic symptoms, such as hallucinations and delusions.

What is the function of GABA, and what class enhances it?

It is the major inhibitory neurotransmitter; enhanced by benzodiazepines.

What parameters must be monitored for clients taking atypical antipsychotics?

Weight, BMI, blood pressure, fasting glucose, and lipid panels.

What is the major FDA warning associated with antidepressant use in youth?

An increased risk of suicidal thoughts and behaviors in young clients.

What are the essential client teaching points for lithium safety?

Maintain consistent hydration and sodium intake, and report toxicity symptoms.

What is the immediate nursing response to acute dystonia?

Hold medication, notify provider, protect airway, and give prescribed anticholinergics.

What is akathisia, and how is it clinically managed?

Inner restlessness; managed with dose adjustments, beta-blockers, or benzodiazepines.

What are the signs of tardive dyskinesia, and why are they reported?

Lip smacking, tongue protrusion, and grimacing; it can become irreversible.

What are the classic signs of Neuroleptic Malignant Syndrome (NMS)?

High fever, severe muscle rigidity, altered mental status, and autonomic instability.

What signs differentiate serotonin syndrome from other medication side effects?

Agitation, sweating, fever, tachycardia, hyperreflexia, clonus, and tremors.