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exam 1 answers
Terms in this set (50)
1. A client 22 years of age with schizophrenia is refusing his antipsychotic medication. He states, "I don't like the dopey way it makes me feel. I feel like I'm walking underwater when I take it." The nurse explains to him, "Your schizophrenia is caused by a chemical imbalance in your brain, and this medication helps fix that chemical imbalance. You need to take it so your symptoms will get better." This conversation reflects a conflict between which two types of ethical principles?
Answer: Autonomy and Beneficence
2. A psychiatric-mental health nurse is documenting information in a client's medical record. Which of the following would be least likely to increase the nurse's legal liability?
Answer: "Administered haloperidol 10 mg IM stat as ordered for agitation."
3. A nursing student is reviewing journal articles about major depression. One of the articles describes the number of persons newly diagnosed with the disorder during the past year. The student interprets this as which of the following?
4. A client is involuntarily committed without a court order. The nurse understands that the emergency, short-term hospitalization can occur for how long?
Answer: 48 to 92 hours
5. After teaching a group of nursing students about the historical perspectives of mental health care, the instructor determines that the group has understood the information when they identify which of the following as a common belief about mental illness during the medieval period?
Answer: A person was removed from a contaminated environment to protect him or her.
6. During assessment, the nurse asks a client to explain what the following means: "A penny saved is a penny earned." The nurse is assessing which of the following?
Answer: Abstract reasoning
7. In a postclinical conference, a group of students is engaged in a discussion with their instructor. The instructor repeatedly has the students analyze and evaluate the nursing interventions implemented throughout the clinical experience. The students are engaged in which of the following?
Answer: Critical thinking
8. A psychiatric-mental health nurse determines that a client is competent when he is able to do which of the following?
Answer: Communicate his or her choices.
9. A psychiatric-mental health client has an advance care directive on his medical record. A clinician provides treatment that disregards the client's directive. The clinician would be liable for which of the following?
Answer: Medical battery
10. The nurse is determining the success of a client's plan of care by evaluating outcome indicators. The nurse understands that these indicators are usually determined initially at which time?
Answer: During the assessment process
11. A psychiatric-mental health nurse is adhering to the standards of practice. When engaging in clinical decision making, the nurse is integrating which of the following as the foundation?
Answer: Nursing Process
12. A nurse is caring for a client who is hospitalized for a mental disorder. The nurse is legally obligated to breach the client's confidentiality if the client states which of the following?
Answer: "When I get out of here, I'm going to kill my neighbor."
13. When providing care to a client, the psychiatric-mental health nurse is implementing the therapeutic use of self. The nurse is applying the concepts based on the work of which individual?
Answer: Hildegard Peplau
14. A nurse is preparing a presentation about the current status of mental health services in the United States. Which statement would the nurse include as the most reflective of this status?
Answer: "Mental health care services are inadequate and fragmented."
15. When describing the treatment of mental illness, which of the following would a nurse identify as the primary goal?
16. Based on assessment data, the nurse formulates the nursing diagnosis for a client as sleep pattern disturbance. After educating the client on how to relax before bedtime, the nurse determines that the education was effective by which outcome?
Answer: Within three days, client reports feeling rested upon awakening in the morning
17. A nursing instructor is describing the concept of evidence-based practice in psychiatric-mental health nursing. Which of the following would the instructor include as being important? Select all that apply.
Answer: Expert opinion, Research findings, Client data, Clinical experiences
18. Two nursing students are discussing psychiatric-mental health nursing and the role it has played in nursing's overall history. Which statement is most accurate?
Answer: The importance of using therapeutic communication was stressed by Nightingale.
19. A nurse working on the psychiatric unit receives a telephone call from the employer of one of the clients on the unit. The employer asks to be sent a copy of Mr. Murray's latest laboratory work and psychological testing results so Mr. Murray's medical records in employee health can be kept up-to-date. Based on the nurse's knowledge about issues surrounding breach of confidentiality, which response would be the most appropriate?
Answer: "I am unable to acknowledge whether or not a Mr. Murray is a client on this unit."
20. A client receives a court order for commitment. Which of the following best exemplifies the concept of "least restrictive environment?"
Answer: Involuntary commitment to an outpatient community mental health center
21. A psychiatric-mental health nurse is working on a committee that is developing programs that integrate the objectives for mental health and mental disorders, as identified in Healthy People 2020. Which type of program would be least appropriate?
Answer: Single substance abuse treatment programs
22. A nurse is assessing a client to evaluate the client's mental health and wellness. Applying the eight dimensions of wellness, which of the following would the nurse identify as reflecting emotional wellness?
Answer: Developing skills for dealing with stress
23. A group of students is reviewing information about mental health care after World War II. The students demonstrate understanding of this information when they identify which of the following as a result of the National Mental Health Act?
Answer: Establishment of the National Institute of Mental Health
24. A client is being admitted to the psychiatric unit. While explaining his reason for seeking admission, he describes how his 32-year-old son recently died of a heart attack. Which response by the nurse would enhance the effectiveness of this interview?
Answer: "This must be a very difficult time for you."
25. A nurse is assisting a client in using simple relaxation techniques. Which of the following would the nurse do first?
Answer: Ensure a quiet, nondisrupting environment.
26. A psychiatric nursing class is discussing current trends in mental health care. A student voices the opinion that there should be equitable access to mental health care and resources for those who live in rural areas, for those without health insurance, and for those with very little income. The student nurse's opinion most closely reflects which ethical principle?
27. A nursing student is assigned to care for a client diagnosed with schizophrenia. When talking about this client in a clinical postconference, the student would use which terminology when referring to the client?
Answer: Person with schizophrenia
28. A psychiatric-mental health nurse is asked to be a guest speaker at a community fund-raising event for mental health services. Which of the following would the nurse emphasize as the primary goal of mental health services?
Answer: Recovery from mental illness
29. A nurse identifies a nursing diagnosis of chronic low self-esteem. Which statement by a client would support this nursing diagnosis?
Answer: "I never do anything right."
30. A psychiatric-mental health nurse is preparing a presentation about recovery for a group of newly hired nurses at the mental health facility. Which of the following would the nurse identify as one of the most important concepts?
31. A nurse is explaining recovery to the family of a client diagnosed with a mental disorder. Which statement would be most appropriate for the nurse to include about this process?
Answer: "The client is helped to live a meaningful life to his fullest potential."
32. A nurse is reading a journal article about epidemiologic research and mental illness. Which of the following mental health conditions would the nurse expect to find as being projected as the leading burden of disease worldwide by the year 2030?
33. The nurse is assessing a client's immediate and short-term memory. Which of the following would be most appropriate?
Answer: Giving the client three words and asking him to recite them now and then in five minutes
34. When reviewing the evolution of mental health and illness care, which event is associated with mental disorders beginning to be viewed as illnesses requiring treatment?
Answer: Establishment of Pennsylvania Hospital in Philadelphia
35. Which of the following questions would be most helpful in beginning an initial assessment interview for a client who has just been admitted to a psychiatric inpatient unit?
Answer: "What brings you into the hospital today?"
36. The nurse is reviewing the assessment data of a client diagnosed with a mental illness. The client is to be prescribed medication to treat the illness. The nurse would identify changes in which laboratory values as being the least significant?
37. As part of a career day presentation to a group of nursing students, a psychiatric-mental health nurse plans to describe how this specialty developed. Which individual would the nurse describe as playing a major role in the development of specialty training programs for psychiatric nurses?
Answer: Hildegard Peplau
38. A psychiatric-mental health nurse is providing care for a client with a mental disorder. The client is participating in the decision-making process. The nurse interprets this as which component of recovery?
39. A nurse has developed a plan of care for a client with depression. Which nursing diagnosis would reflect the social domain?
Answer: Ineffective Role Performance related to inability to participate as family provider
40. A psychiatric-mental health nurse is implementing evidence-based practice. The nurse understands that this approach is developed by doing which of the following first?
Answer: Identifying a clinical question
41. After assessing a client, the nurse noted the following: "He was tearful, he tried to kill himself before coming into the hospital, he had no immediate plan for another suicide attempt, he was unable to concentrate, and he reported having trouble sleeping and having little or no appetite." The nurse also noted that the client's appearance was unkempt, that he spoke in a low monotone, and that he was unable to establish and maintain eye contact. Based on this information, which nursing diagnosis would be the most appropriate?
Answer: Risk for suicide
42. The nurse is providing care to a male client who is hospitalized with a diagnosis of schizophrenia. Which of the following would be appropriate for the nurse to include in the client's medical record?
Answer: "Complained of being unable to sleep because he heard voices throughout the night."
43. A nurse is preparing a presentation for a local community group about mental disorders and plans to include how mental disorders are different from medical disorders. Which statement would be most appropriate for the nurse to include?
Answer: "Clusters of behaviors, thoughts, and feelings characterize mental disorders."
44. After educating a group of students on mental health and mental illness, the instructor determines that the education was successful when the group identifies which of the following as reflecting mental disorders?
Answer: Alteration in mood or thinking
45. A nursing student is initiating a relationship with an assigned client. After meeting and spending approximately 20 minutes talking with the client, the student makes arrangements to visit again after lunch. After lunch, fellow classmates invite the student to go to the gym with them and a group of clients to play volleyball. The student starts to go with them but then remembers the promise to meet with the client. The student decides to forgo volleyball and talk with her client. The student's decision reflects which ethical principle?
46. A nurse is preparing to administer an as-needed (PRN) medication. Which of the following would the nurse need to keep in mind when documenting administration?
Answer: It requires a separate entry that includes reason for administration, dosage, route, and response to the medication every time it is administered to a client.
47. A nurse is engaged in exercises to develop self-awareness. The nurse is using which tool?
48. A nurse is explaining the distinction between confidentiality and privacy. Which of the following would the nurse include as reflecting privacy?
Answer: Part of personal life not governed by society's laws
49. While working in a community mental health treatment center, the nurse overhears one of the receptionists saying that one of the clients is "really psycho." Later in the day, the nurse talks with the receptionist about the comment. This action by the nurse demonstrates an attempt to address which issue?
Answer: Public Stigma
50. When applying the biopsychosocial model for a client with a mental health problem, the nurse addresses the psychological domain when assessing which of the following?
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