Upgrade to remove ads
Only $2.99/month

MH Final

Terms in this set (175)

A nurse is explaining advance care directives, or ​living wills,​ to a patient and the patient's spouse. Which of the following would the nurse include in the description?
The document tells what treatment is to be omitted if the patient is unable to make the decision.
It requires that the patient sign the ​living will​ document while an attorney is present.
The patient's physician must act as a witness when the patient signs the document.
An attorney draws up the papers to be given to the patient and his or her family.
A
A psychiatric​mental health nurse determines that a patient is competent when he is able to do which of the following?
Speak coherent English. Communicate his or her choices. Write a ​living will.​
Comply with the medical regimen.
B
A patient receives a court order for commitment. Which of the following best exemplifies the concept of ​least restrictive environment?​
Involuntary commitment to an outpatient community mental health center
Medication administration for sedation so the patient cannot get out of bed
Placing the patient in a locked padded room in response to threats of self-harm
Allowing the patient to make the decision about whether treatment is necessary
A
A nurse is caring for a patient who is hospitalized for a mental disorder. The nurse is legally obligated to breach the patient's confidentiality if the patient states which of the following?
​I think that the federal government is spying on me.​
​I get really 'turned on' by your appearance.​
​That doctor I had today really made me angry.​
​When I get out of here, I'm going to kill my neighbor.​
D
Which patient would the nurse determine to be the most likely a candidate for involuntary commitment?
The client who refuses to take the prescribed medication
The client who is screaming in the street disturbing neighbors
The client who refuses to participate in the planned therapy
The client with a mental disorder who is homeless
B
The nurse is providing care to a male patient who is hospitalized with a diagnosis of schizophrenia. Which of the following would be appropriate for the nurse to include in the patient's medical record?
​Patient states that he had a good night with no complaints.​
​Complained of being unable to sleep because he heard voices throughout the night.​ ​
Had a typical night without incidence of insomnia or nightmares.​
​Acted crazily throughout the night; kept hearing voices and noises.​
B
A nurse working on the psychiatric unit receives a telephone call from the employer of one of the patients 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?
​I'm sorry; we're not allowed to give out that information about our patient.​
​I'll have to get the patient's signed consent before we can send that information to you.​ ​
I am unable to acknowledge whether or not a Mr. Murray is a patient on this unit.​ ​
Sure, give me your address, and I will see that the information is sent to you.​
C
A patient is going to be discharged this afternoon from the mental health unit. The patient asks the nurse if a copy of his medical record could be sent to the psychologist he will be seeing on an outpatient basis. Which response by the nurse would be most appropriate?
​Sure, we'll have that information sent out in today's mail.​
​You will need to sign written authorization for us before we can do this.​
​I think it would just be best if you just told your psychologist everything he needs to know.​ ​How are you feeling about being discharged this afternoon?​
B
A patient's psychiatrist informs her that he thinks she needs to participate in a 3-month outpatient aftercare program after her discharge. Which of the following would protect the patient's right to request a second opinion before agreeing to this suggestion?
Self-determinism
Least restrictive environment Confidentiality
Mandates to inform
A
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?
It requires a separate entry that includes reason for administration, dosage, route, and response to the medication the first time it is administered to a patient.
It requires a separate entry that includes reason for administration, dosage, route, and response to the medication every time it is administered to a patient.
It requires a separate entry that includes reason for administration, dosage, and route the first time it is administered to a patient.
It requires a separate entry that includes reason for administration, dosage, and route every time it is administered to a patient.
B
A group of nursing students are reviewing information about internal rights protection systems. The students demonstrate understanding of this information when they identify which of the following as an example?
American Hospital Association American Public Health Association State mental health provider
The Joint Commission
C
After teaching a class about competency and how it is assessed, the nursing instructor determines the need for additional instruction when the class identifies which ability as being evaluated?
Communication of choices
Understanding of relevant information
Appreciation for situation and consequences
Discussion of what is right and wrong
D
A patient is involuntarily committed without a court order. The nurse understands that the emergency short-term hospitalization can occur for which time frame?
A maximum of 24 hours
48 to 92 hours
3 to 5 days
One week
B
A nurse is explaining the distinction between confidentiality and privacy. Which of the following would the nurse include as reflecting privacy?
Part of personal life not governed by society's laws Ethical duty for nondisclosure
Involvement of two individuals
Knowledge of treatment costs and benefits
A
A psychiatric​mental health patient has an advance care directive on his medical record. A clinician provides treatment that disregards the patient's directive. The clinician would be liable for which of the following?
Assault
Battery
Medical battery
False imprisonment
C
A psychiatric​mental health nurse is documenting information in a patient's medical record. Which of the following would be least likely to increase the nurse's legal liability?
​Patient reported that he was feeling better today than yesterday.​ ​
Administered haloperidol 10 mg IM stat as ordered for agitation.​ ​
Patient was talking with another staff member and started screaming.​ ​
Applied restraints to all four patient extremities.​
B
After teaching a class of nursing students about the rights of persons receiving mental health services, the instructor determines a need for additional instruction when the students identify which of the following as a right?
Freedom from restraints or seclusion
Access to one's own mental health records on request
An individualized written treatment plan
Refuse treatment during an emergency situation
D
When applying the biopsychosocial model to client care, the nurse integrates the psychological domain when involved with which of the following?
Behavior therapy
Family support
Nutritional therapy
Sleep hygiene measures
A
A nursing instructor is describing the impact of technology and electronic health records on psychiatric​mental health care. Which of the following would the instructor identify as a major challenge associated with it?
Maintaining confidentiality
Establishing educational models
Decreasing fragmented care
Defining professional standards more clearly
A
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?
Nonmaleficence
Paternalism
Veracity
Justice
D
A nursing student is initiating a relationship with an assigned patient. After meeting and spending approximately 20 minutes talking with the patient, 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 patients to play volleyball. The student starts to go with them but then remembers the promise to meet with the patient. The student decides to stay behind and talk to with her patient. The student's decision reflects which ethical principle?
Autonomy
Beneficence
Fidelity
Veracity
C
Ina postclinical conference, a group of students are 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?
Therapeutic use of self
Critical thinking
Interdisciplinary care
Planning care
B
A group of students is reviewing the functions of psychiatric nurses. The students demonstrate understanding of the information when they identify which of the following as an advanced practice level function?
Milieu therapy
Promotion of self-care Psychopharmacology interventions
Health promotion activities
C
A nursing instructor has prepared a lecture about the scope and standards of practice of psychiatric nurses. The instructor determines that the teaching was effective when the students identify which of the following as common to both basic and advanced level practice?
Case management
Program development
Clinical supervision
Community interventions
A
A nurse is working on developing ways to meet the challenge of knowledge development. Which of the following would be most appropriate?
Access new information through continuing education programs. Improve access to community psychiatric care for all populations.
Reduce the burden of mental illness by fighting stigma.
Provide culturally competent, high-quality nursing care.
A
A 22-year-old patient 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 under water 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?
Autonomy and justice Paternalism and veracity
Justice and nonmaleficence
Autonomy and beneficence
D
A nurse is faced with an ethical dilemma involving a patient. Which question would be most important for the nurse to ask first when engaging in the process of ethical decision making?
What are my own feelings about the situation?
What assumptions am I making that need more data?
What do I know about the situation?
What do I know about the patient's values?
C
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?
Developmental issues
Nursing process
Commitment
Accountability
B
A group of nursing students are reviewing the standards of professional performance. The students demonstrate understanding when they identify which as a standard of professional performance?
Prescriptive authority Consultation
Planning
Collegiality
D
A psychiatric​mental health nurse is providing care to patients with a mental illness and is investigating factors related to the patient safety, delivery of care services, and cost effectiveness. The nurse is involved with which area of professional performance?
Education
Quality of practice
Resource utilization Collaboration
C
An instructor is preparing a class for a group of students about professional organizations and the leadership provided. Which of the following would the instructor include as an important function of the International Society of Psychiatric-Mental Health Nurses?
Advocating for mental health nursing practice through liaison activities
Advancing psychiatric​mental health nursing practice
Improving mental health care for culturally diverse individuals Providing a strong voice for psychiatric​mental health nurses
D
When applying the biopsychosocial model for a patient with a mental health problem, the nurse addresses the psychological domain when assessing which of the following?
Sleep patterns
Feelings
Family functioning
Cultural groups
B
A nurse had developed a plan of care for a patient with depression. Which nursing diagnosis would reflect the social domain?
Imbalanced Nutrition, Less Than Body Requirements related to lack of appetite.
Powerlessness related to feelings of lack of control over the situation.
Ineffective Role Performance related to inability to participate as family provider
Risk for Suicide related to depressed mood and feelings of oneself as a failure
C
A nurse is engaged in exercises to develop self-awareness. The nurse is using which tool? Interdisciplinary care
Reflection
Plan of care
Clinical reasoning
B
While caring for a family, the nurse determines that first-order changes have occurred with which of the following?
The children are all in school, and the parent returns to work.
The daughter leaves home to attend college.
The son marries his long-time sweetheart and moves into his own home.
The grandmother who has been living in the household dies.
A
The nurse is assessing a family system applying the family system framework model. Which assessment would be important for the nurse?
Acceptance of the family rules Adjustment to the family boundaries
Degree of enmeshment in the system
Interpersonal differentiation
D
While assessing a family system, the nurse uses the structural family system model by Minuchin. The nurse focuses the assessment on which of the following about the family members?
Boundaries
Emotional cutoff
Sibling position
Family projection process
A
A female patient is an adolescent who recently tried to overdose because her boyfriend broke up with her. Her father is a single parent, and he has been drinking excessively to cope with his stress. The patient tells the nurse that whenever she needs to talk to her father, he is always drunk or away drinking with his drinking buddies. Based on this information, which nursing diagnosis would be most appropriate for this patient's family?
Ineffective Family Therapeutic Regimen Management Compromised Family Coping
Ineffective Denial
Caregiver Role Strain
B
A family has recently lost all their belongings when their house burned down. They have been living in temporary housing. Although the parents were previously very supportive and able to help their young children with their homework in the evenings, they have been unable to do so under their present circumstances. Based on this information, which nursing diagnosis would be most appropriate for this family?
Interrupted Family Processes
Compromised Family Coping
Ineffective Family Therapeutic Regimen Management Caregiver Role Strain
A
A male patient has recently been diagnosed with type II diabetes. His family is having trouble incorporating the dietary and exercise regimen prescribed by his physician into their daily routines. They tell the nurse that they are all tired when they return home from school and work and that the last thing any of them want to do is go on a walk. In addition, the patient's wife discloses that she is unable to prepare any sugar-free or low-sugar foods that her husband enjoys eating. Based on this information, which nursing diagnosis would be most appropriate for this family?
Interrupted Family
Processes
Ineffective Denial
Caregiver Role Strain
Ineffective Family Therapeutic Regimen Management
D
A couple who have a 7-year-old son have been experiencing growing tension and anxiety in their relationship. However, the tension and anxiety between them lessened when the mother began focusing most of her attention on the son. When applying the family systems therapy model concept of triangulation, which of the following would the nurse expect to assess in the child?
Enjoying his mother's increasing attention and growing even closer to her
Growing distant from his father and blaming him for all of the family's problems
Developing problematic symptoms in response to his mother's increasing attention
Resenting mother for her suffocating attention and his father's growing distance
C
A nursing instructor is developing a teaching plan for a class about families. Which of the following would the instructor be most likely to include?
Families are primarily determined by blood.
New members are added by birth, marriage, or adoption.
In the United States, family size has been on the increase.
Families are less mobile today than in the past.
B
A group of nursing students is reviewing information about the changing family structure and its effect on mental health and illness. The students demonstrate understanding of this information when they identify which of the following?
Middle-aged childless adults are more vulnerable to loneliness and depression.
In stepfamilies, caring for the children often is a primary stressor to the marital partners.
Separation because of relocation provides additional support from extended family.
Same-sex families typically demonstrate lower rates for depression and stress.
B
A nurse is planning a support group for the families of patients with psychiatric disorders. The nurse integrates knowledge of which of the following as the primary underlying issue related to stress that the families experience?
Severity of the patient's symptoms
Barriers faced by the patient
Stigma associated with the diagnosis
Risk for relapse
C
A nurse is constructing a genogram of a family. Which of the following would the nurse do?
Use circles to represent the male members.
Use horizontal lines to connect the parents with children.
Use horizontal lines to show marriages.
Use asterisks to denote ages listed at the bottom.
C
Assessment of a family reveals that the youngest child has moved out of the family home to live by herself. One of the other two children is married, and the other child has just gotten engaged. The nurse interprets this family to be in which stage of the family life cycle?
Families with adolescents Launching children and moving on
Families in later life
Leaving home: single young adults
B
A group of nursing students is reviewing system models used in caring for families. The students demonstrate understanding of the information when they identify which of the following as characteristic of the Calgary Family Model?
Differentiation of self
Sibling position
Family development
Subsystems
C
A nurse is using a genogram as an intervention strategy based on the understanding of which of the following?
It provides information about appropriate methods for problem solving.
It allows the family to view its evolution over several generations.
It permits a subjective yet factual perspective of family relationships.
It provides a means for identifying the family's beliefs about mental illness.
B
A nurse is working with a family and using the Calgary Family Model. Problems have been identified, and the family being in which stage of the model?
Engagement
Assessment
Intervention
Termination
B
While caring for a family who lost a 10-year-old son in a car accident, the nurse should instruct the parents to tell the 4-year-old sister which of the following about her brother?
He died and is not coming back.
He passed on to the other side.
He departed on a long journey.
He has gone to see the Lord above.
A
The nurse is counseling a family with a 10-year-old child after the death of a favorite uncle. The nurse provides guidance to the parents, informing them that the child may exhibit which of the following as a response?
​Talk about scary, morbid novels all the time.​
​Complain of aches and pains, stomachaches, that sort of thing.​
​Suddenly become afraid of leaving home to go to school.​ ​
Become obsessed with religious rituals, Bible verses, and prayer.​
B
The nurse is counseling a family with two parents and two children, ages 8 and 10 years. The mother complains that the children are constantly fighting and have intense sibling rivalry. When statement would be most appropriate when advising the parents about how to respond to the sibling rivalry?
​Try reacting to each as unique individuals with talents and interests distinctly their own.​ ​
Be firm about telling the children they have to cooperate with one another.​
​Slowly decrease the amount of attention and control shown to the older child.​
​Make sure they have a quiet, subdued home environment to avoid stimulating conflict.​
A
A 3-year-old child has been admitted to the hospital after an automobile accident. Which statement by the nurse would be most appropriate when discussing the type of behavior the parents can expect their child to display while hospitalized?
​Your child may not be able to accept how the injury has changed your child's appearance.​ ​
Your child may seem unduly anxious in the presence of strangers.​
​Your child may experience some guilt feelings associated with the accident.​
​Your child will exhibit intermittent periodic mood swings, but these should be brief.​
B
A nurse is providing care to several chronically ill children. Which of the following would the nurse identify as having the greatest risk for developing a psychiatric problem?
12 year-old with diabetes mellitus
5 year-old with cerebral palsy
8 year-old who has chronic renal disease 10 year-old with a heart murmur
B
The nurse is planning a counseling session with a group of ​at-risk​ adolescents on the topic of drug abuse. Which teaching strategy would be most effective?
Handing out educational pamphlets and showing slides of car accidents related to teen drug use.
Showing informational videotapes and providing Internet addresses on the topic of drug addiction.
Giving information by lecturing and using pre- and posttest quizzing about the information.
Involving peers in teaching the effective group problem-solving skills.
D
The nurse is counseling a family with a child who has been abused by adult family friend in the past. When explaining about the child's needs, which of the following would be most important for the nurse to stress?
A supportive relationship with an adult Long-term psychotherapy
Antidepressant medications
Short-term separation from the parents
A
The nurse is planning an initial therapy session with a 20-year-old patient whose parents had alcoholism. The nurse anticipates that the patient would most likely exhibit symptoms of which of the following?
Delusions
Paranoid delusions
Low self-concept
Extroversion
C
A home-health nurse is working with a poverty-stricken family that has two small children, ages 2 and 3 years. The family lives in an isolated rural area. The family's home has a dirt floor, and there are chickens living in the house with the family. Because of a recent wind storm, there is a sizeable hole in the roof that lets rain and snow into the house. Which nursing intervention would be the highest priority in this situation?
Make immunization appointments for the children in a nearby town's public health clinic.
Help the family find funding and manpower to patch and repair the roof of their home. Determine the educational readiness of the two children.
Report the family for child abuse because of neglect.
B
While engaging in a discussion with a group of teens about risk behaviors, one of the teens says, ​That will never happen to me.​ The nurse interprets this as which of the following?
Invincibility fable
Formal operations
Egocentric thinking
Relational aggression
A
A nurse is working with a family in which the parents have just gotten divorced. After teaching the parents about measures to reduce the risk of emotional problems for the children, which statement by the parents indicates a need for additional teaching?
​We will try to alter their routines so they don't think about the past.​
​We will make sure that they understand that they did not cause the divorce.​ ​We will develop a regular and consistent schedule for visitation.​
​We will make sure that we are consistent in the limit that we set.​
A
A group of nursing students is reviewing information about the differences that occur with grieving in children, adolescents, and adults. The students demonstrate understanding of this information when they identify which of the following as characteristic of adolescents?
View death as reversible
Mourn by talking about the loss
Need repeated explanations to understand the loss
Express a time limit for socially acceptable grieving
B
A nurse is working with a child for which an out-of-home placement has occurred. Which of the following would the nurse anticipate as the child's initial response?
Despair
Withdrawal
Protest
Detachment
C
The nurse is working with a child who has engaged in bullying. Which of the following would be most effective for the nurse to implement?
Psychoeducation
Bibliotherapy
Early intervention program
Social skills training
D
A nurse is developing a plan of care for a family who is experiencing problems related to their child's chronic illness. The nurse plans to have the family read a group of short stories written by parents of children with chronic illnesses. The nurse will be using which technique?
Psychoeducation
Social skills training
Bibliotherapy
Assertiveness training
C
After teaching a class about childhood and adolescent mental health, the instructor determines that additional teaching is needed when the class identifies which of the following as promoting mental health in children?
Difficult temperament
Age-appropriate physical development Secure attachment
Normal psychosocial development
A
A nurse is providing teaching to a group of parents with children and adolescents who have experienced losses. The nurse determines that the teaching was successful when the group states which of the following?
​Children grieve in similar ways regardless of their age.​ ​
Children often use fantasy to fill in their gaps in understanding.​
​Families tend to grieve at similar times after the loss.​
​Children and adults grieve much in the same manner.​
B
The nurse is preparing to interview a 6-year-old girl and her mother in an outpatient psychiatric setting. To establish a treatment alliance with the child, the nurse should:
Tell the child she watches Sesame Street all the time.
Talk to the child while standing up and looking down at her.
Tell the child that this must be a bit scary for her.
Ask the parent if the child can be interviewed alone.
C
A nurse is interviewing a 12-year-old child in an outpatient psychiatric setting. Which of the following would be most appropriate for the nurse to say to establish a high degree of credibility?
​How would you describe your parents?​
​Tell me about your best friend.​
​I have several teddy bears; would you like one to hold?​
​You'd get along better with your parents if you'd follow their advice.​
B
To establish rapport with a 10-year-old child who is hospitalized in a psychiatric setting, which statement by the nurse would be most appropriate?
​Let's compare your situation to that of Cinderella's in the fairy tale.​
​I'm going to use the DECA tool to measure your self-control and initiative.​
​Let's have you draw a picture of yourself.​
​Would you like to play a game of checkers with me?​
D
The nurse is caring for an adolescent in the outpatient psychiatric setting. To help the adolescent feel more in control of the initial therapy sessions, which statement by the nurse would be most appropriate?
​I won't share anything that you don't want me to with your parents.​ ​
Adolescents often feel a distrust of authority figures. Is that true with you?​ ​
Your parents care a great deal about you. That's why you are here.​
​If something is uncomfortable for you, you don't have to talk about it.​
D
A child and the child's family visit a psychiatric outpatient setting because the parent is concerned about the child's behavior at school. The child scores 65 on the Global Assessment of Functioning (GAF) scale. The nurse interprets this finding as which of the following?
The child requires inpatient therapy.
The child is experiencing homicidal thoughts.
The child is functioning well in the area of school.
The child can be treated effectively as an outpatient.
D
The nurse is assessing an 8-year-old child's self-concept. Which of the following would be least appropriate for the nurse to ask?
​If you had three wishes, what would you wish for?​ ​
What would you like to be when you grow up?​ ​
What subjects do you like best in school?​
​What did you have for breakfast this morning?​
D
A nurse in an outpatient clinic is assessing a child, and the nurse will interview the child and the child's parents separately. Which of the following comments would the nurse anticipate the child making during the upcoming interview?
​I can't get along with my parents.​
​I yell at my parents a lot.​
​I'm sad a lot, and I have trouble sleeping.​
​I refuse to do what my parents tell me to.​
C
A nurse is performing an assessment interview of a 14-year-old boy who is being admitted to an adolescent substance abuse unit. His parents are concerned about their son's repeated problems at school that they associate with his drug use. The boy stalks into the office, abruptly sits down, crosses his arms, and says, ​Okay, ask your stupid questions, but don't expect me to cooperate!​ Which response by the nurse would be most appropriate?
​Your attitude is offensive; I can see why your parents brought you here.​ ​
Why don't we wait until you've calmed down a bit to start the interview?​
​Why are you so angry?​
​You seem pretty upset. Tell me about what is upsetting you.​
D
The nurse is beginning an assessment interview with an 8-year-old girl who has been brought in for counseling by her parents. When beginning the interview, which question would be most appropriate for the nurse to ask first?
​How are you feeling?​
​How old are you?​
​Has anyone told you about why you are here today?​
​Why do you think I'm talking to you alone without your parents here?
C
A nurse is interviewing a 12-year-old boy who has been diagnosed with depression. The client's depression was triggered by the death of his father 2 years ago. The nurse interprets which comment made by the boy as reflecting egocentrism?
​If I hadn't yelled at my dad and told him to go away, he never would have died.​ ​
I'm still sad because my dad died a couple of years ago.​
​I think I'm just experiencing normal grieving.​
​My father was the best friend I ever had; I still can't believe he's gone for good.​
A
A nurse is preparing to assess a 9-year-old child who has been sexually abused. Which of the following would be the priority for the nurse?
Finding out when the abuse occurred
Documenting the assessment for use in court
Using anatomically correct dolls to elicit information
Ensuring that the environment is safe and supportive
D
A group of nursing students is reviewing information about stress and coping in children. The students demonstrate a need for additional study when they identify which of the following as a stressful experience for a child?
Death of a pet
Chronic illness
Racial discrimination
Social support
D
A nurse is preparing to interview a 4-year-old preschooler. Which of the following would be most effective to use for the assessment?
A) Direct, simple questions
B) Play materials such as blocks
C) Pediatric anxiety rating scale
D) Children's Depression Inventory
B
The nurse is counseling a family whose 4-year-old child has mild mental retardation. The nurse is working with the family on realistic long-term goals. Which of the following would be most appropriate?
A) Locating suitable residential placement for the child
B) Finding a foster home for the child
C) Achieving independent functioning of the child as an adult
D) Preventing the onset of psychiatric disorders in the child
C
The nurse is counseling a family whose child has autism. When describing this condition, which of the following would the nurse most likely include?
A) Connection to ineffective parental practices
B) Detection after the child enters school
C) Onset before child is 2.5 years old
D) Girls are more frequently affected than boys
C
The nurse is caring for a family with a 3-year-old child who has autism disorders. When developing the teaching plan for the parents, which of the following would the nurse most likely include?
A) The child is at higher risk for seizure disorders as well.
B) The child's IQ will typically be higher than that of other children.
C) Dyslexia also may be a comorbid condition.
D) A structured physical environment is an important aspect.
D
The nurse is giving a presentation comparing and contrasting autism disorder and Asperger syndrome. Which of the following would the nurse include as differentiating Asperger syndrome from autism disorder?
A) ​Children typically do not engage in stereotypic behavior.​
B) ​They display age-appropriate intelligence.​
C) ​The children often reverse pronouns when speaking.​
D) ​They appear aloof and indifferent to others.​
B
The mother of a child with Asperger disorder tells the nurse that her child has few playmates. She states, ​He has such poor social skills with other children, and he strongly rejects any change in his routine by throwing a tantrum.​ Based on this information, the nurse identifies which nursing diagnosis as the priority?
A) Self-Care Deficits related to repeated tantrums
B) Risk for Injury related to Asperger disorder
C) Ineffective Family Coping related to having a child with Asperger disorder
D) Risk for Social Isolation related to poor social skills of the child
D
The nurse is caring for a 31⁄2-year-old child with autism who has been hospitalized. The child rocks continuously without any danger present to the child's safety. Which intervention by the nurse would be most appropriate?
A) Continue to monitor the child's behaviors.
B) Hold the child until the child stops rocking.
C) Ignore the child's rocking behavior.
D) Place the child in a ​time out​ area until the rocking stops.
C
A child diagnosed with autism is hospitalized in an inpatient mental health unit. When developing the plan of care for this child, which of the following would the nurse most likely include?
A) Ensuring that a variety of caregivers are available for the child
B) Providing a consistent, structured environment with predictable routines
C) Allowing the child frequent visits off the unit to provide stimulation
D) Sending the child to the ​time out" area if the child repeats phrases continually
B
The school nurse is caring for a 7-year-old child who has demonstrated a significantly lower-than- average score for mental age on standardized tests in reading. However, the child's IQ scores were within the average range. The nurse interprets this information as suggesting which of the following?
Communication disorder
Attention deficit hyperactivity disorder Asperger syndrome
Dyslexia
D
The nurse is counseling a parent whose child has a communication disorder. Which of the following would the nurse emphasize when teaching the parent about this disorder?
Providing the child with nonverbal activities
Initiating conversations with the child frequently
Stopping the child's conversation if stuttering begins
Asking the physician for medication to improve the child's speech
B
A nurse is assessing a child who is suspected of having attention deficit hyperactivity disorder. Which of the following would the nurse identify as reflecting impulsiveness in the child?
Inability to wait his turn
Restlessness
Difficulty completing a task
Risk-taking behavior
D
The history of a child newly diagnosed with ADHD reveals that the child is experiencing sleeping difficulties. Which agent would the nurse most likely use?
Methylphenidate
Atomoxetine
Bupropion
Clonidine
B
After teaching the parents of a child diagnosed with ADHD about the disorder and its treatment, the nurse determines that the teaching has been effective when the parents state which of the following?
​We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention.​
​We need to be careful so he doesn't develop a substance abuse problem as he grows older.​
​We should stop the medication after 2 months to see how effective it is in really controlling his symptoms.​
​We should set up regular routines for him but not worry if he violates the limits once in a while.​
A
A 10-year-old child with Tourette's disorder is receiving haloperidol as part of his treatment plan. When assessing the child at a follow up visit, which statement by the child would lead the nurse to suspect that he is experiencing a side effect of the drug?
​Sometimes I feel like I'm so sleepy.​
​I'm eating about the same amount as before.​
​My muscles seem pretty flexible lately.​
​I think I'm much more alert with this drug.​
A
A group of nursing students is reviewing information about disruptive behavior disorders. The students demonstrate understanding of the topic when they identify which of the following as an externalizing disorder?
Anxiety
Depression
Schizophrenia
Conduct disorder
D
A nurse is providing parent training for parents of a child diagnosed with a disruptive behavior disorder involving the use of time out. When describing how to implement this, which of the following would the nurse identify as the first step?
Having the child recount the reason for the time out
Clearly identifying what is required for the child
Informing the child what will happen because of the behavior
Placing the child in a designated area removed from others
B
The nurse is preparing to initiate a behavioral treatment program for a child with encopresis. Which of the following would the nurse most likely implement first?

Administration of mineral oil
Bowel cleansing
Low-fiber diet
Toilet sitting after each meal
B
A nurse is assessing an 8-year-old girl with a mood disorder. Which of the following would the nurse most likely expect to assess?
Statement from the child that she feels sad Behavioral problems
Recurrent obsessions
Ritualistic behavior
B
A group of nurses is reviewing medications used to treat attention deficit hyperactivity disorder. The students demonstrate understanding of the information when they identify methylphenidate as which of the following?
Selective serotonin reuptake inhibitor Psychostimulant
Noradrenergic reuptake inhibitor
Alpha agonist
B
The parents of a child with ADHD bring the child for a follow-up visit. During the visit, they tell the nurse that the child receives his first dose of methylphenidate (Ritalin) at about 7:30 AM every morning before leaving for school. The teacher and school nurse have noticed a return in the child's overactivity and distractibility just before lunch. The child's second dose is scheduled for about 12 noon. Which of the following might the nurse suggest as a possible solution to control the child's symptoms a bit more effectively?
Giving the second dose at 1 PM or later. Switching to a longer acting preparation. Splitting the early morning dose in half. Switching to another class of medication.
B
A nurse is caring for a 76-year-old patient with a hearing deficit caused by presbycusis. Which of the following would be most appropriate for the nurse to do when communicating with the patient?
Use a higher volume of speech.
Address the client's family members.
Ask if the client can use sign language.
Use lower pitched tones.
D
The nurse is caring for a 78-year-old client who is taking an anticholinergic medication and complains of dry mouth. Which of the following would be most appropriate for the nurse to suggest?
Chew hard candies.
Rinse the mouth with a mouthwash.
Use more seasonings on food.
Drink decaffeinated beverages often.
B
An elderly client tells the nurse that she had been constipated for the last few days and decided to use an over-the-counter fiber laxative that is dissolved in water. When reviewing the use of this laxative with the client, which of the following would the nurse include as a possible side effect?
Diarrhea
Nausea
Flatus
Stomach pain
C
An 80-year-old client visits the mental health clinic with her daughter. During the assessment process, the client tells the nurse that she is taking an antidepressant, an antibiotic, and an occasional aspirin. Which question would be most important for the nurse to ask?
​How much grapefruit juice do you drink on a daily basis?​ ​
How much orange juice do you drink on a daily basis?​ ​
How much tomato juice do you drink on a daily basis?​ ​
How much grape juice do you drink on a daily basis?​
A
While caring for an 88-year-old client suspected of having dementia, the nurse assesses the client for a common delusional thought. Which of the following would the nurse interpret as a common delusion?
​I am the king of the universe.​
​Creatures are living in my closet.​
​The government has people following me.​ ​My roommate keeps stealing my clothes.​
D
The nurse is assessing a 78-year-old client who lives alone in his own home. To assess the client's instrumental activities of daily living, which question would be most appropriate to ask?
​How often do you bathe or shower?​
​How many times do you change clothes during the day?​ ​How often do you cook meals for yourself?​
​How often do you go to the store to buy groceries?​
D
The nurse is assessing a client who has a history of heavy drinking and who lost his wife to cancer during the previous year. He reports that he isn't getting as much sleep as he used to when he was younger. Which question would be most appropriate to ask the client to determine if the change in his sleep pattern is related to normal aging or depression?
​How much did you sleep when you were younger?​
​Is it hard for you to fall asleep or remain asleep during the night?​
​Why do you think you continue to ingest so much alcohol?​ ​
What used to help you go to sleep?​
B
A couple is concerned that the husband's father may be developing depression. In questioning the couple, which of the following statements would support their concern?
​Dad has been crying off and on now for over 2 weeks since Mom died. He's also still having trouble sleeping.​
​Dad is agitated and anxious; he's been that way for a month now since Mom died.​
​It's been over 2 months now since Mom died, and Dad keeps crying; he can't eat or sleep.​ ​Mom's funeral was last week, and Dad hasn't been able to eat or sleep since then.​
C
A nurse is providing an in-service educational program for beginning nurses regarding mental health assessment needs of the older adult. One of the topics addressed is the importance of interviewing family members in addition to the older adult client. The nurse tells the audience that family members are sometimes able to give a more accurate history if the client has memory impairment. The nurse also emphasizes that interviewing family members provides which of the following?
A more accurate picture of the social support resources available Evaluation of the family's ability to effectively care for the older client Determination of the extent of the client's memory impairment
A much needed period of respite and support for the family members
B
Assessment of an older adult client reveals that the client is receiving psychiatric medications. The client states, ​I get dizzy periodically and have trouble walking.​ Which of the following should the nurse do first?
Compare the client's baseline blood pressure with the client's current blood pressure. Instruct the client to stop taking the psychiatric medications.
Interview the client's family about the client's coping skills and current stress level. Suggest the client periodically use an alcohol-based mouthwash several times a day.
A
A group of nursing students is reviewing information about age-related changes occurring in cognition and intellectual performance. The students demonstrate understanding of the information when they identify which of the following as a normal cognitive change?
Disorientation to time
Slowed information processing
Diminished executive functioning Restricted judgment
B
A nurse is assessing an older adult client. Which of the following would the nurse interpret as most indicative of mental health and wellness?
Keeping social contacts to a minimum Interacting with others in the environment Relying solely on family for assistance Experiencing bereavement
B
A nurse has used the Geriatric Depression Scale (short form) to assess an older adult client for
depression. Which score would lead the nurse to suspect that the client is mildly depressed?
A) 3
B) 5
C) 8
D) 13
C
An older adult client is brought to the emergency department after ingesting an unknown substance. The client, who appears to have dementia, has tremors, ataxia of the upper and lower extremities, depression, and confusion. The nurse suspects ingestion of which of the following?
Lead Aluminum Manganese Mercury
D
An adolescent client is seen in the emergency department with symptoms of dementia, tremors, and ataxia. The client had been sniffing glue with a friend. The nurse suspects the client's symptoms were caused by poisoning with which of the following?
Mercury Lead. Toluene Arsenic
C
The nurse is assessing a client who has received a tentative diagnosis of delirium. The nurse is explaining to the family about the major cause of the client's condition. Which statement by the nurse would be most appropriate?
​Basically, this diagnosis is based on the client's inability to talk normally.​
​Your report of gradually developing confusion over time was the basis for the diagnosis.​ ​His diagnosis is primarily based on the rapid onset of his change in consciousness.​
​The client's exposure to an infectious agent led us to determine the diagnosis.​
C
Thenurse is caring for a client diagnosed with delirium who has been brought for treatment by his son.
While taking the client's history, which question would be most appropriate for the nurse to ask the client's son?

​Has your father taken any medications recently?​
​Are you aware of your father falling or injuring his head in any way?​
​Has your father had a recent stroke?​
​Has your father experienced any major losses recently?
A
The nurse makes a home visit to a family caring for a client with Alzheimer's disease. The client's wife tells the nurse that she hasn't been out of the house for more than 2 weeks because her sister has been unable to help her care for the client. Which nursing diagnosis would the nurse identify as the priority?
Ineffective Family Coping related to care of a client with Alzheimer's disease Risk for Activity Intolerance related to Alzheimer's disease
Caregiver Role Strain related to social isolation
Powerlessness related to seclusion and long-term care of client
C
A daughter brings her mother, who has Alzheimer's disease, to the clinic. The client has been taking a cholinesterase inhibitor medication for 1 month. When assessing the client, the nurse would be alert for the possibility of which side effect?
Gastrointestinal distress Mild headache
Muscle tics
Blurred vision
A
A son brings his mother to the clinic for an evaluation. The son's mother has moderate Alzheimer's disease without delirium. The nurse assesses the client for which of the following as the priority?
Hearing deficits Mania
Strange verbalizations Catastrophic reactions
D
A client is admitted to the hospital with dementia related to Parkinson's disease. The client is being treated for a fractured tibia from a recent fall. The nurse should assess the client's history for use of which type of medication?
Anticholinergics Dopamine agonists Anxiolytics Benzodiazepines
A
While the nurse is caring for a hospitalized client in the advanced stages of Alzheimer's disease, the client begins to have a catastrophic reaction to feeding himself. Which of the following should the nurse do first?
Remain calm and reassuring.
Restrain the client temporarily.
Draw the curtains to darken the room. Offer to feed the client.
A
While reviewing the medical record of a client with moderate dementia of the Alzheimer type, the nurse notes that the client has been receiving memantine. The nurse identifies this drug as which type?
Atypical antipsychotic Cholinesterase inhibitor NMDA receptor antagonist Benzodiazepine
C
A group of nursing students is reviewing information about delirium and dementia. The students demonstrate a need for additional review when they identify which of the following as characteristics of dementia?
Fluctuating changes within a 24-hour period Possible hallucinations
Normal psychomotor activity
Globally impaired cognition
A
A nurse is assessing a client diagnosed with Alzheimer's disease. As part of the assessment, the nurse asks the client to identify common objects. The nurse is assessing for which of the following?
Aphasia
Apraxia
Agnosia
Executive functioning
C
A nursing instructor is preparing a presentation on the etiology of Alzheimer's disease. When discussing the role of neurotransmitters in the course of the disease, which of the following would the instructor most likely emphasize?
Serotonin Acetylcholine Dopamine Norepinephrine
B
When assessing a client with dementia, the nurse identifies that the client is experiencing hallucinations. Based on the nurse's understanding of this disorder, which type of hallucination would the nurse expect as most common?
Auditory Visual Gustatory Olfactory
B
A nurse is talking with the husband of a female client diagnosed with Alzheimer's disease. During the conversation, the husband tells the nurse that ​she often begins to scream and curse for no apparent reason​. The nurse interprets this as which of the following?
Hypersexuality Disinhibition Hypervocalization Apathy
C
After teaching a group of nursing students about Alzheimer's disease and appropriate nursing care, the instructor determines that the teaching was successful when the students identify which of the following as the foundation for providing care to the client and family?
Therapeutic relationship Medication therapy Injury prevention Functional independence
A
A nurse is providing care to a client with Alzheimer's disease who is exhibiting suspiciousness and delusional thinking. Which of the following would be most important for the nurse to do with this client?
Tell the client that he is experiencing delusions. Confront the client about his distorted thinking. Correct the client's interpretation of the situation. Determine the trigger for the distorted thinking.
D
A client with Alzheimer's disease is admitted to the acute care facility for treatment of an infection. Assessment reveals that the client is anxious. When developing the client's plan of care, which of the following would be least appropriate to include?
A) Frequently provide reality orientation.
B) Simplify the client's routines.
C) Limit the number of choices to be made.
D) Establish predictable routines.
A
The nurse is working in a shelter for homeless men. When planning the care for these clients, the nurse integrates understanding that men who have been homeless for a long period of time often feel a sense of which of the following?
Depersonalization Strong coping skills Self-efficacy
Fear of failure
A
A nurse is presenting a talk on homelessness and its effect on individuals. The nurse describes the resiliency of homeless individuals based on which of the following?
Strong community supports Available family resources Coping with extreme stressors Local governmental intervention
C
The nurse is caring for a homeless client who has been seen in the mobile clinic every week for the past month because of a foot infection. Which nursing diagnosis would the nurse most likely identify as the priority?
Social Isolation related to homelessness
Ineffective Health Maintenance related to homelessness
Chronic Low Self-Esteem related to foot disorder and homelessness Imbalanced Nutrition, less than body requirements, related to poor eating
B
A new graduate nurse is considering taking a job that focuses on meeting the mental health needs of homeless populations. During the graduate nurse's pre-employment interview, the graduate nurse asks the interviewer what characteristics are common in this population. Which response by the interviewer would be most likely?
​Most of them have very little education and, consequently, they work in menial jobs​when they can get them.​
​They come from a variety of backgrounds, and they often experience chronic illness and are unemployed.​
​They have often squandered their financial resources, and most are from poorer rural and urban backgrounds.​
​Most are frail elderly people, and many are mentally ill. However, very few are addicts or alcoholics.​
B
A nurse is assessing a 49-year-old homeless male client. The nurse fashions the assessment process based on the understanding that the client would most likely demonstrate which of the following?
Cooperation and talkativeness to share his ideas Agreement to allow a complete physical examination Desire for in-depth discussion of his condition Resistance and caution about the interaction
D
A nurse has formulated several nursing diagnoses for a homeless client after a thorough nursing assessment. Of these, which of the following would the nurse determine as the priority?
Anxiety
Powerlessness
Imbalanced nutrition Impaired social interaction
C
The nurse is helping a 56-year-old homeless woman develop a plan for after discharge. Which of the following would be most appropriate to include?
Contacting the woman's daughter as a possible source of support after the client's discharge Contacting the woman's parents as a possible source of support after the client's discharge Providing the woman with a three-ring binder full of resources that will promote independent living Providing the woman with telephone numbers of various local health care insurance companies
A
A nursing instructor is preparing a teaching plan for a group of nursing students who will be working with homeless populations. As part of the class, the instructor will be including information about barriers to successful treatment of homeless clients who are mentally ill. Which reason would the instructor include as contributing to lack of compliance with psychotropic medications?
Mistrust of medical personnel
Lack of proper medication storage
Chemical dependence on prescription medications Lack of motivation and literacy skills
B
A nurse is working for a mobile homeless treatment program. Which method would the nurse most likely use to provide follow-up care to clients?
Seeing them by appointment at a clinic office
Riding a bicycle to wherever the client happens to be
Meeting the client in a public place easily accessible by taxi Using the telephone to determine how well the clients are doing
B
A nurse is teaching an in-service education class about caring for homeless populations. When explaining the difference between the care provided by Safe Havens and Shelter Plus Care, which of the following would the nurse include?
​Shelter Plus Care offers more services to a larger population than does Safe Havens.​ ​Safe Havens provides shelter for as many as 100 people at a time.​
​Safe Havens provides traditional support services as well as short-term housing.​
​Shelter Plus Care offers a variety of supportive services in addition to long-term housing.​
D
After describing the various legislative efforts to address the issue of homelessness in the United States, a nursing instructor determines that the teaching was successful when the students identify which of the following as addressing the need for a continuum of care approach?
Bringing Home America Act
Affordable Care Act
American Recovery and Reinvestment Act
McKinney-Vento Homeless Assistance Act
D
A nurse working in an emergency homeless shelter is interviewing a woman who has just arrived with her two small children. When assessing this client, the nurse would expect the woman to report which of the following as the reason for seeking shelter?
Substance abuse Domestic violence Unemployment Imprisonment
B
A group of nurses is in a discussion about the homeless population in their community as a means for developing appropriate programs for this group. Which statement by one of the members indicates a need for the group to address the nurse's stereotypical thinking?
​Homeless individuals must be creative in figuring out ways to survive.​ ​People who are homeless come from all walks of life.​
​If the person lives on the street, he will not accept services.​
​Most people are homeless for a relatively short period of time.​
C
A nurse is developing a plan of care for a male client who is homeless. Which of the following would the nurse do first?
Refer the client to social services to access necessary benefits. Provide the client with a list of facilities that are safe.
Discuss how the client can maintain his privacy.
Stabilize the client's physical health status.
D
The nurse is preparing to assess a 78-year-old patient who has been diagnosed with major depression. Which of the following would the nurse expect to assess as a normal finding?
Decrease in body fat Increased muscle mass Dulled taste sensation Enhanced visual acuity
C
A group of nursing students is reviewing the physical changes that occur in older adults. The students demonstrate understanding of the information when they identify which of the following as contributing the patient's risk for drug toxicity?
Reduced liver function
Reduce brain gray matter volume
Lower metabolic rate at rest
Decreased body water
A
An older patient tells the nurse that she is becoming more forgetful. The nurse explains to the patient that this is most likely related to which of the following?
Anxiety
Organic brain syndrome Plaques in the brain tissue Medications
D
While assessing an older adult, the nurse allows ample time for the patient to respond based on the understanding of which of the following?
Ample time ensures that the correct answer is given.
The patient is most likely experiencing irreversible memory impairment.
The patient is experiencing decreased cerebral oxygen flow from reduced activity. Ample time is needed to weigh the pros and cons of the perceived risk for answering.
A
The nurse is planning a presentation to a group of older adults on the topic of suicide in the population. One of the group participants asks who has the highest risk of suicide. Which response by the nurse would be most appropriate?
​Older adults who have multiple prescriptions from a variety of different pharmacies.​ ​Older adults who are experiencing a deep and profound depression.​
​Older adult women who are divorced or widowed.​
​Men over the age of 75 years who are divorced or widowed.​
D
The nurse is working with a patient whose mobility is impaired secondary to a fall that resulted in a broken hip. In addition, the patient, who has diabetes, is developing problems with vision and hearing. The patient seems increasingly withdrawn and depressed. The nurse determines that the patient is at risk for spiritual distress. Which intervention would be most appropriate?
Encourage the patient to talk about significant childhood religious experiences.
Offer to take the patient to a revival the nurse's church is holding in the community. Read to the patient Bible passages that seem particularly relevant to the patient's case. Explore what the mobility, sight, and hearing changes mean to the patient.
D
After checking a patient's blood pressure, he asks the nurse what changes he should expect in himself as he grows older. Which response by the nurse would be most appropriate?
​You don't have anything to worry about; you will basically stay the same.​
​Your personality will stay the same, but your intelligence level will lessen somewhat.​
​Usually, you can anticipate that you will begin to react to things more slowly.​ ​
You will become increasingly childlike, and your personality will change.
C
A nurse is reviewing the medical records of several older adult patients. The nurse determines that which individual would have the least chance of developing mental health problems with aging?
A man who is single, has an eighth grade education, and walks to the mailbox and back every day A woman who is married with graduate education, eats nutritionally balanced meals, and exercises for 20 minutes each day
A man who is married, has a high school education, eats mostly fast food, and walks a mile each day
A woman who is single, has a college degree and watches what she eats but really does not exercise
B
The nurse is presenting a community educational program focusing on older adults and mental health protective factors. One of the participants asks what the influence of co-parenting one's grandchild has on the mental health of the grandparent. Which response by the nurse would be most appropriate?
​The well-being of grandmothers is statistically more significant when they co-parent their grandchildren.​
​Although there are stresses involved with grandparenting, the positive benefits appear to outweigh the negatives.​
​White grandmothers experience less well-being when they co-parent their grandchildren.​
​The perceived well-being of grandfathers who co-parent their grandchildren significantly changes in a positive direction.​
B
A nursing student is reading an article about protective factors for mental illness with older adults. The article mentions the individual's ability to adapt successfully to stress, trauma, or chronic adversity. The student identifies this as which of the following?
Functional status Gerotransendence Resilience
Empty nest
C
A nurse is reviewing the medical records of several older adult patients who have come to the clinic for evaluation. The nurse would classify a patient of which age as being in the middle-old stage?
66-year-old adult 70-year-old adult 78-year-old adult 86-year-old adult
C
While assessing an older adult patient for mental health issues, the nurse pays special attention to the patient's sensory function based on the understanding of which of the following?
Most older adults follow a specific pattern of decline in functioning leading to gradual onset of problems.
Sensory decline may affect the individual's ability to process information, possible influencing the findings of the mental status examination.
Diminished sensory function can lead to changes in other body systems that may affect the individual's reaction to prescribed medications.
Changes in the senses can result in changes in cognitive abilities that mimic the manifestations of mental disorders.
B
A group of nursing students is reviewing information about the course of aging in future older adults and qualities that contribute to successful aging. The students demonstrate understanding of this information when they identify which of the following as least important?
Capacity to adapt to change
Engagement in life
Stability with reliable social support Physical health
D
A nursing instructor is preparing for a class discussion on polypharmacy and older adults. Which of the following would the instructor expect to include?
The risk for drug abuse, although present, is fairly rare in this population.
Older adults often experience a greater risk for adverse reactions.
Medications are usually prescribed in higher doses initially and then gradually reduced. Age-related pharmacokinetic changes enhance the drug's therapeutic effectiveness.
B
A group of nursing students is reviewing risk and protective factors associated for mental disorders in the older adult population. The students demonstrate understanding of the information when they identify which of the following as a protective factor?
Poverty Education Loss
Chronic illness
B
The nurse is working as part of a team to help reduce the stigma attached to mental health treatment for the older adult population. Which of the following would be most appropriate to do to achieve this outcome?
Provide education about mental health and mental disorders. Initiate screening programs for symptoms.
Ensure older adults received integrated community care. Institute a wide range of social support services.
A
A nursing instructor is explaining the concept of the continuum of care to a group of students. Which of the following would the nurse include in this description?
Care provided in episodic intervals
System of care that focuses primarily on wellness
A single organization as responsible for care delivery Integrated system spanning illness to wellness states
D
The nurse is employed by a long-term residential treatment center that provides care to a variety of patients with chronic mental disorders. Which role would the nurse primarily assume when working with these patients?
Therapist
Medication administrator Mediator
Educator
D
A patient has threatened to kill his wife, and it is not anticipated that this crisis will resolve itself. The patient is to be admitted to an inpatient psychiatric unit on an involuntary basis. When explaining to the family about this plan, the nurse would identify which of the following as the focus of care?
Long-term therapy
Rehabilitative services
Acute symptom stabilization
24-hour supervision
C
A nurse is reviewing information about the various types of outpatient mental health care programs. The nurse demonstrates understanding of these types when identifying which of the following as involved in providing the most intensive outpatient nursing care?
Partial hospitalization programs Crisis intervention programs Outpatient detoxification programs Rehabilitation programs
A
A patient who has attempted suicide with a drug overdose has been released from an inpatient setting and has returned to school. The patient continues to need routine psychiatric services. The nurse anticipates that this patient will most likely be referred to which of the following?
Partial hospitalization program In-home mental health care Intensive outpatient program Crisis center in the community
C
The nurse is caring for a group of patients in a partial hospitalization program. The nurse would most likely be involved in which of the following activities?
Facilitating a drug abuse prevention group
Providing spiritual assessment and related interventions
Teaching patients how to plan a menu and to shop for groceries
Providing an educational group about the nutritional content of canned foods
C
A nurse is providing in-home mental health care and determines that the care was effective when the patient demonstrated which of the following?
A need for continued intensive monitoring in the home
A need for crisis intervention services on an ongoing basis
A decrease in admission frequency to inpatient psychiatric hospitals
A dependence on parents to participate in the patient's care
C
A patient with a psychiatric disorder is considering joining a clubhouse with other patients who have mental disorders. The patient asks the nurse to explain what services the clubhouses provide. Which response by the nurse would be most accurate?
​They are open 24 hours a day to provide care and support for the clubhouse members.​
​They are run entirely by psychiatric mental health nurses.​
​Their primary focus is on providing ongoing intensive psychotherapy for patients in a group setting.​ ​They are predominately run by psychiatric patients with minimal assistance from mental health staff.​
D
The nurse is working as part of the interdisciplinary staff of a psychiatric inpatient facility who are developing discharge plans for a patient who requires alternative housing arrangements. The patient will be referred to a personal care home. When explaining this housing arrangement to the patient, which of the following would the nurse include?
​You'll be living with a family in their home, and the family will help supervise and support you.​ ​You'll be living in an apartment with a roommate, and a staff member will come by to check on you.​
​You'll be living in a house with about 50 other people and receive 24-hour supervision and assistance.​
​You'll be living in a house with about six to 10 other people, and a health care attendant will provide 24-hour supervision.​
D
A nurse is developing a community education program for a local women's club on the topic of managed care in mental health. Which of the following would the nurse include as the main focus?
Cost savings
Consistent third-party reimbursement
Improved access to less costly services Individualized care for additional inpatient stays
C
When working within the continuum of care, which of the following occurs first? Referral
Transfer Assessment Discharge planning
C
A nurse who is working as part of an interdisciplinary team is looking at potential outpatient services for a patient. The patient requires a setting that provides a program of about 4 hours per day, three times per week with a 24-hour crisis and consultation service. The nurse would identify which of the following as appropriate?
Primary care setting
Ambulatory level one
Ambulatory level two
Multimodal outpatient setting
C
After teaching a group of students about the service and patient variables used when determining settings along the continuum of behavioral care, the instructor determines that the teaching was successful when the students identify which of the following as a service variable?
Signs and symptoms Milieu
Risk
Social support
B
The parents of a young adult diagnosed with schizophrenia are providing care for the patient in their home. During a home visit, the parents state, ​It's been so difficult taking care of our son. We need a break. But he needs constant supervision.​ Which of the following would be appropriate for the nurse to suggest?
Partial hospitalization
Acute inpatient care
Respite residential care Intensive outpatient program
C
A patient is referred to a psychosocial rehabilitation program. When explaining this type of care to the patient, the nurse would emphasize which of the following?
Intensive treatment that prepares the patient to live in the community Services that promote the patient's reintegration into the community Detoxification services for alcohol and drugs in an outpatient setting Frequent monitoring within a therapeutic milieu for relapse prevention
B
As part of an interdisciplinary team, a nurse is assisting with a patient assessment to determine the most appropriate setting for treatment. The team decides that an acute ambulatory setting would be most appropriate. Which of the following would support the team's decision?
The patient exhibits moderate to severe symptoms.
The patient demonstrates marked impairment in two areas of daily life The patient is unable to contract for treatment beyond initial care.
The patient demonstrates a limited ability to seek support.
C
THIS SET IS OFTEN IN FOLDERS WITH...