Exam 1 Mental Health (Questions and Answers) 2022

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Which statement about mental illness is true? - ANSWER Mental illness changes with culture, time in history, political systems, and the groups defining it. A nursing student new to psychiatric ment... al health nursing asks a peer what resources he can use to figure out which symptoms are present in a psychiatric disorder. The best answer would be: - ANSWER DSM - 5 Epidemiological studies contribute to improvements in care for individuals with mental disorders by: - ANSWER Identifying who in the general population will develop a specific disorder Which statement best describes a major difference between a DSM - 5 diagnosis and a nursing diagnosis - ANSWER The DSM-5 is associated with present symptoms, whereas a nursing diagnosis considers past, present, and potential responses to actual mental health problems. The intervention that can be practiced by an advanced practice registered nurse in psychiatric mental health but cannot be practiced by a basic level registered nurse is - ANSWER Psychotherapy Which contribution to modern psychiatric mental health nursing practice was made by Freud? - ANSWER The theory of personality structure and levels of awareness The theory of interpersonal relationships developed by Hildegard Peplau is based on the foundation provided by which early theorist? - ANSWER Sullivan The concepts at the heart of Sullivan's theory of personality are - ANSWER Needs and anxiety The premise that an individual's behavior and affect are largely determined by his or her attitudes and assumptions about the world underlies: - ANSWER Cognitive-behavioral therapy Providing a safe environment for patients with impaired cognition, planning unit activities to stimulate thinking, and including patients and staff in unit meetings are all part of: - ANSWER Milieu therapy A nurse administering a benzodiazepine should understand that the therapeutic effect of benzodiazepines results from potentiating the neurotransmitter: - ANSWER GABA Venlafaxine (Effexor) exerts its antidepressant effect by selectively blocking the reuptake of: - ANSWER Serotonin and norepinephrine The nurse administers each of the following drugs to various patients. The patient who should be most carefully assessed for fluid and electrolyte imbalances is the one receiving - ANSWER lithium Which drug group calls for nursing assessment for development of abnormal movement disorders among individuals who take therapeutic dosages - ANSWER antipsychotics Blockage of dopamine transmission can lead to increased pituitary secretions of prolactin. In women, this hyperprolactinemia can result in - ANSWER amenorrhea Which of the following factors contribute to the movement of patients out of large state institutions and into community-based mental health treatment - ANSWER a. States desire to save money by moving the patients to the community, where the federal government would pick up more of the cost, c. A system of coordinated and accessible community care was developed by forward-thinking communities and offered more effective treatment, the Community Mental Health d. Centers Act of 1963 required states to develop and offer care in community-based treatment programs, e. Patient advocates exposed deficiencies of state hospitals and took legal actions, leading to the identification of a right to treatment in the least restrictive setting, f. New psychotropic medications controlled symptoms more effectively, allowing many patient to live and receive care in less restrictive settings Levels of prevention strategies prominent in outpatient psychiatric care consist of primary prevention, secondary prevention, and ________ prevention. - ANSWER tertiary Anna, a patient at the community mental health center, tends to stop taking her medications at intervals, usually leading to decompensation. Which of the following interventions would most likely improve her adherence to her medications? - ANSWER Help Anna to understand her illness and share in decisions about her care. A friend recognizes that his depression has returned and tells you he is suicidal and afraid he will harm himself. He wishes to be hospitalized but does not have health insurance. Which of the following responses best meets his immediate care needs and reflects the options for care a person in his position typically has? - ANSWER Assist him in obtaining an outpatient counseling appointment at an area community mental health center, and call him frequently to assure he is safe until his appointment occurs. Which of the following nursing actions is appropriate in maintaining a safe therapeutic inpatient milieu? - ANSWER a. Interact frequently with both individuals and groups on the unit c. Initiate and support group interactions via therapeutic groups and activities d. Provide and encourage opportunities to practice social and other life skills f. Assess patient belongings and the unit for any dangerous items that could be used by patients to hurt themselves or others The criteria for admission to an in patient psychiatric unit is that the patient - ANSWER Is in imminent danger of harming himself or others, or the patient cannot properly care for his basic needs and cannot protect himself from harm In the DSM-5, a major change in how culture is viewed within each disorder is that - ANSWER Issues related to culture and mental illness are now integrated into the discussion of each disorder rather than separately discussing culture-bound syndromes Julio is a 31-year-old patient who comes to your mental health outpatient clinic. Which of the following would alert you to the potential for somatization? - ANSWER Julio presents with concerns involving headaches, dizziness, and fatigue You are caring for Maria, a patient who states that she has "ghost sickness." Which is the appropriate nursing response - ANSWER How does 'ghost sickness' make you feel? Which nursing actions demonstrate cultural competence? - ANSWER a. Planning mealtime around the patient's prayer schedule b. Advising a patient to visit with the hospital chaplain c. Researching foods that a lacto-ovo-vegetarian patient will eat d. Providing time for a patient's spiritual healer to visit The nurse is planning care for a patient of the Latin American culture. Which goal is appropriate? - ANSWER Patient will visit with spiritual healer once weekly A nurse makes a post on a social media page about his peer taking are of a patient with a crime-related gunshot wound during his shift in the emergency department. He does not use the name of the patient. It can be concluded that: - ANSWER The nurse has violated confidentiality laws and can be held liable Brian, a patient with schizophrenia, has been ordered an antipsychotic medication. The medication will likely benefit him, but there are side effects; in a small percentage of patients, it may cause a dangerous side effect. After medication teaching, Brian is unable to identify side effects and responds, "I won't have any side effects because I am iron and cannot be killed." Which response would be most appropriate under these circumstances? - ANSWER Petition the court to appoint a guardian as a substitute for Brian, as he is unable to comprehend the proposed treatment. A family who is worried that an adult female might hurt herself asks for her to be admitted to the hospital. An assessment indicates moderate depression with no risk factors for suicide other than a depressed mood. The patient denies any intent or thoughts about self-harm. The family agrees that the patient has not done or said anything to suggest that she might be a danger to herself. Which of the following responses is consistent with the concept of "least restrictive alternative" doctrine? - ANSWER Arrange for an outpatient counseling appointment the next day David has an overnight pass, and he plans to spend this time with his sister and her family. As you meet with the patient and his sister just prior to the pass, the sister mentions that she has missed her brother and needs him to babysit. You notice that the patient becomes visibly agitated when she says this. How do you balance safety and the patient's right to confidentiality? - ANSWER Meet with the patient's sister, sharing with her the patient's previous disclosure about his anger toward children and the resultant risk that his babysitting would present. Gina is admitted for treatment of depression with suicidal ideation triggered by marital discord. Her spouse visits one night and informs Gina that he has decided to file for divorce. The staff are aware of the visit and the husband's intentions regarding divorce but take no further action, feeling that the q15-minute suicide checks Gina is already on are sufficient. Thirty minutes after the visit ends, staff make rounds and discover Gina has hanged herself in her bathroom, using hospital pajamas she had tied together into a rope. Which of the following statements best describes this situation? - ANSWER The nurses have created liability for themselves and their employer by failing in their duty to protect Gina, The nurses have breached their duty to reassess Gina for increased suicide risk after her husband's visit, Given Gina's history, the nurses should have expected an increased risk of suicide after the husband's announcement, The nurses are subject to a tort of professional negligence for failing to prevent the suicide by increasing the suicide precautions in response to Gina's increased risk You are assessing a 6-year-old patient. When assessing a child's perception of a difficult issue, which methods of assessment are appropriate? - ANSWER a. Engage the child in a specific therapeutic game, b. Ask the child to draw a picture c. Provide the child with an anatomically correct doll to act out a story d. allow the child to tell a story Which are the purposes of a through mental health nursing assessment? - ANSWER a. Establish a rapport between the nurse and patient b. Assess for risk factors affecting the safety of the patient or others d. Identify the nurse's goals for treatment, e. formulate a plan of care (NOT COUNSELING) You are performing a spiritual assessment on a patient. Which patient statement would indicate that there is an experiential concern in the patient's spiritual life? - ANSWER "My sister will never forgive me for what I did." A patient states he has "given up on life." His wife left him, he was fired from his job, and he is four payments behind on his mortgage, meaning he will soon lose his house. Which nursing diagnosis is appropriate? - ANSWER Hopelessness related to multiple losses A 43-year-old female patient is brought to the emergency department with complaints of bizarre speech, visual hallucinations, and changes in behavior. She has no psychiatric history. Before ordering a psychiatric consultation, the emergency room physician orders a batter of blood tests as well as an MRI of the brain. The rationale for this is: - ANSWER Medical conditions and physical illnesses may mimic psychiatric illnesses; therefore, physical causes of symptoms must be ruled out. Which of the following actions best represents the basis or foundation of all other psychiatric nursing care? - ANSWER The nurse assesses the patient at regular intervals A male patient frequently inquires about the female student nurse's boyfriend, social activities, and school experiences. Which of the following initial responses by the student best addresses the issue raised by this behavior? - ANSWER She limits sharing personal information and stresses the patient-centered focus of the conversation Amanda was raised by a rejecting and abusive father and had a difficult childhood. As an inpatient, she frequently comments on how hard her nurse, Jane, works and on how other staff members do not seem to care as much about their patients as Jane does. Jane finds herself agreeing with Amanda. Jane appreciates her insightfulness, and realizes that the other staff members do not appreciate how hard she works and take her for granted. Jae enjoys the time she spends with Amanda and seeks out opportunities to interact with her. What phenomenon is occurring here, and which response by Jane would most benefit her and the patient? - ANSWER Amanda is experiencing transference; Jane should help Amanda to understand that she is emphasizing in Jane those qualities that were missing in her father A student nurse exhibits the following behaviors or actions while interacting with her patient. Which of these are appropriate as part of a therapeutic relationship. - ANSWER Sitting attentively in silence with a withdrawn patient until the patient chooses to speak. Emily is a 28-year-old nurse on the psychiatric unit. She has been working with Jenna, a 27-year-old who was admitted with depression. Emily and Jenna find they have much in common, including each having a 2-year-old daughter and each having graduated from the same high school. Emily and Jenna discuss getting together for lunch with their daughters after Jenna is discharged. This situation reflects: - ANSWER Boundary blurring You have been working closely with a patient for the past month. Today he tells you he is looking forward to meeting with his new psychiatrist but frowns and avoids eye contact while reporting this to you. Which of the following responses would most likely be therapeutic? - ANSWER "You say you look forward to the meeting, but you appear anxious or unhappy." Which student behavior is consistent with therapeutic communication? - ANSWER Summarizing the essence of the patient's comments in your own words Which statement about nonverbal behavior is accurate? - ANSWER The meaning of nonverbal behaviors varies with cultural and individual differences A nurse stops in to interview a patient on a medical unit and finds the patient lying supine in her bed with the head elevated at 10 degrees. Which initial response(s) would most enhance the chances of achieving a therapeutic interaction? - ANSWER locate a chair or stool that would place the nurse at approximately the level of the patient James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for day shift and anxiously reports, "Last night demons came to my room and tried to rape me." Which response would be most therapeutic? - ANSWER "You seem very upset; please tell me more about what you experienced last night." Mark, a 32-year-old patient with schizophrenia, is found in a closet with an empty 2-liter bottle of cola taken from the staff refrigerator. The bottle had been full. The patient has also been drinking more from the hallway water cooler and taking drinks from his peers' dinner trays. Recently, staff has noticed an increase in auditory hallucinations and the onset of confusion. Which response is most appropriate? - ANSWER Restrict his access to fluids, and evaluate for water intoxication via daily weights Jordan is a 21-year-old who was recently diagnosed with schizophrenia. He has had to drop out of college as the positive symptoms of his disease have made it impossible for him to pursue his dream of being an architect. He presents to the emergency department with flat affect, depressed mood, and having auditory hallucinations telling him he is "no good to anyone anymore." Which of the following statement is true regarding depression and schizophrenia? - ANSWER Assessing for depression and suicidal ideation in patients with schizophrenia is important since almost half of people with schizophrenia will attempt suicide Tony, a 45-year-old patient with schizophrenia, sometimes moves his lips silently or murmurs to himself when he does not realize others are watching. Sometimes when talking to others, he suddenly stops, appears distracted for a moment, and then resumes. Based on these observations, Tony most likely is experiencing - ANSWER Auditory hallucinations Julia, a 28-year-old diagnosed with schizophrenia, is encouraged to attend groups but stays in her room instead. Staff and peers encourage her participation, but without success. Her hygiene is poor despite encouragement to sower and brush her teeth. She does not seem concerned that others wish she would behave differently. Which is the most likely explanation for Julia's failure to respond to others' efforts to h [Show More]

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