Mental Health Chap 8

An adult female client becomes combative with the nurse during routine medication administration. What is the nurses primary responsibility in this situation?

a. To ensure that the client takes her medications

b. To ensure that the client is placed in physical restraints to protect the safety of the staff and other clients

c. To ensure that chemical restraints are used in the future until the client displays more appropriate and compliant behavior

d. To ensure that the client is kept safe while trying to protect staff safety and to reason with the client to try to de-escalate the combative behavior

d

A nurse is trying to develop trust with a client on an inpatient mental health unit. Which action by the nurse is going to best promote development of a mutually trusting relationship?

a. At the beginning of the shift, the nurse promises to play a game of cards with the client at some point during that day and does so before the end of the shift.

b. The nurse promises to play a game of cards with the client on the following day.

c. The nurse leads a group discussion with clients about ways to develop trust in a relationship.

d. The nurse gives the client written information about the medications he is taking.

a

An adult female client is exhibiting behavior that the nurse interprets as anger toward another client. What is the nurses best action?

a. Continue to monitor the clients behavior and document it as anger directed toward another client.

b. Talk with the client about the observations made, and ask whether she was displaying anger toward the other client.

c. Ask the other client if she felt that the client was angry with her.

d. Ask the client to write in a journal the emotions she was feeling at that time.

b

A nurse and an adolescent female client develop a plan of care together that addresses the clients difficult relationship with her parents. The client says that her parents just dont understand her, and she is always getting privileges taken away for not doing things that she is supposed to do. What is the nurses best action?

a. Talk with the client about how important it is that she carry through with actions that her parents feel are important.

b. Identify two priority responsibilities that are agreed upon between the client and her parents, and monitor her ability to comply with the plan for 1 week.

c. Discuss with the parents what responsibilities they feel are important, to determine what actions should be planned with the client.

d. Identify what the client feels are reasonable responsibilities.

b

__________ coping mechanisms are means of successfully solving a problem or reducing ones stress level.

a. Defensive

b. Maladaptive

c. Constructive

d. Individual

c

A married woman, who is the mother of two children, has been in an abusive relationship for 4 years. She decides to leave her husband after suffering an episode of severe physical abuse. She and her children, ages 7 and 9, arrive at a crisis intervention center. What is the nurses priority intervention?

a. Offer immediate emotional support.

b. Refer her to a womans domestic abuse center.

c. Begin to develop a treatment plan for the client and her children.

d. Thoroughly assess the situation from most recent to 2 weeks prior to this incident.

a

A male client with the diagnosis of depression has not attended his last two group meetings. The nurse provides a printed schedule of meeting dates and times to the client the next time she sees him. The nurses actions can be described as:

a. Insight

b. Self-awareness

c. Empathy

d. Client advocacy

d

An adolescent female client continually displays a negative attitude toward everyone she comes into contact with and toward life in general. Which action should the nurse implement first that will be helpful in assisting this client to develop a more positive attitude?

a. Helping the client recognize negative thoughts, emotions, and attitudes

b. Pointing out every negative behavior that the client displays

c. Assisting the client to replace negative thoughts by frequently repeating positive statements

d. Praising positive behavior exhibited by the client

a

A caregiver is said to be practicing __________ care not only when she takes into consideration the clients actual or potential problems but also when she considers the clients family, work responsibilities, and social aspects of life.

a. Competent

b. Complete

c. Holistic

d. Crisis

c

A client is believed to have adapted to a situation when he or she exhibits which characteristic?

a. The client has become accustomed to his or her surroundings.

b. The client has shown improvement in behavior as evidenced by the ability to carry out activities normal to his or her life.

c. The client has accepted his or her current behavior patterns.

d. The client has established a trusting relationship with the caregivers who are providing care

b

One of the goals of therapy established with a client on a mental health unit who has been given a diagnosis of obsessive-compulsive disorder (OCD) is to improve his feelings of stability in his environment. Much of his OCD behavior manifests as cleanliness and control of germs. Which nursing intervention most likely would help this client to feel more stable in his environment?

a. Encouraging visits from family members and friends

b. Rewarding him for acceptable behavior by increasing the number of times he is allowed to clean his bathroom daily

c. Encouraging him to participate in group activities

d. Allowing him to wash his hands only for an agreed upon number of times daily

d

Which is the best way that a nursing unit manager can assist his or her staff in maintaining a professional commitment to their job and profession?

a. Frequently offering and requiring a specific number of hours of in-service training on new care modalities within the facility

b. Requiring out-of-facility continuing education hours twice a year

c. Encouraging staff to subscribe to nursing journals to keep up-to-date on new information

d. Keeping nursing journals on the unit for easy access to staff

a

The nurse is working with a male client to instill a feeling of self-commitment to improve his self-esteem. From which of the following interventions would the client most benefit?

a. Having the client promise himself that he will do the best he can in a particular situation, knowing that failure is a possibility

b. Encouraging the client to do the best he can in any given situation, while reminding him that failure is a possibility

c. Ensuring that the client limits activities to those in which he is sure to be successful

d. Allowing the client to set goals that are nearly impossible to achieve but giving him the opportunity to try his best to meet these goals

a

The nurse is working with a health care team with that believes in the philosophy of reality therapy. The nurse is aware that the teams belief is centered around:

a. Reorientation of the client to his or her environment

b. Describing clients as irresponsible rather than mentally ill

c. Looking at the clients past in determining how it has affected present behavior

d. Accepting the clients perceptions of right and wrong behavior in the development of his treatment plan

b

A busy community mental health center treats a client who is in crisis. The client is provided with instruction on relaxation exercises, but throws them away. Two weeks later the staff is dismayed when the client returns with her condition worsened. This lack of success after the previous visit is due to which of the following factors?

a. Disorganization

b. Pseudoresolution

c. Self-awareness

d. Lack of commitment

b

A client is monopolizing a group session, not allowing other members to participate. What is the most appropriate way to address the client?

a. You are not allowed to speak for the remainder of the session.

b. You are selfish and must leave now.

c. You are very rude when you act this way.

d. You need to stop this behavior. Lets see what others have to say.

d

The night before her final exam, the nursing student cannot sleep, and is convinced she will fail. Which of the following actions will help to promote a more positive outlook?

a. Continue to study rather than continue attempting to sleep.

b. Accept the possibility of failure and plan to repeat the course.

c. Use the negative thoughts as motivation.

d. Visualize staying relaxed during the exam and successfully passing

d

A client with frequent re-admissions to the inpatient unit refuses to eat or participate in activities. The nurse functions as the client advocate by which of the following actions?

a. Respecting the clients wishes by taking food away and leaving the room door closed

b. Scolding the client as a way to motivate a change in behavior

c. Providing consistent encouragement to attend activities and having food available

d. Ignoring the client and encouraging other health care team members to do the same

c

Identify the stages experienced by a person in a crisis. (Select all that apply.)

a. Recovery

b. Adaptation

c. Disorganization

d. Crisis

e. Denial

f. Reorganization

g. Perception

h. Exhaustion

a, c, d, e, f, g

Which of the following are signs that indicate that the mental health nurse is becoming overly involved with a clients care? (Select all that apply.)

a. Knowing when to help and when not to help a client

b. Showing greater levels of concern for one client over all other clients

c. Feeling that the nurse is the only caregiver who understands the client

d. Being committed to providing competent health care at all times

b, c

An important component of providing good care is for health caregivers to take care of, or nurture, themselves. Which of the following are ways that effectively assist health caregivers to nurture themselves? (Select all that apply.)

a. Be supportive of colleagues.

b. Recognize and accept ones own limitations, and strive to improve.

c. Take pride in oneself.

d. Accept all challenges presented.

e. Be responsible and accountable for ones own actions.

a, b, c, e

A recently widowed 74-year-old male is seen in the mental health clinic for sleep disorders and depression. Which of the following nursing actions demonstrate caring? (Select all that apply.)

a. Providing a private place to interview the client

b. Delegating other tasks to a colleague while speaking to the client

c. Addressing the client as honey to provide comfort

d. Asking about his daily activities and hobbies during the interview

e. Listening intently to his responses and not being distracted by his nonverbal communication

a, b, d