Mental Health Midterm Review 1. The registered nurse has written an outcome statement of "Client will feel less anxious by the end of session" for a client with generalized anxiety disorder (GAD). Which interventions should the licensed practical nurse use to assist this client in meeting this goal? Select all that apply. a. Administer anxiolytics medications if prescribed. b. Ensure the client feels he/she is in a safe environment. c. Refrain from speaking until the client's anxiety is decreased. d. Stay with the client. e. Give many detailed directions to the client during the session 2. Which patient statement would lead a nurse to suspect that the developmental task of infant age was not successfully complete? a. “I’m afraid to let anyone really get to know me, I don't trust people.” b. “I have very warm and close friendships.” c. “I am always right, so I like to learn new tasks.” d. “I’m ashamed that I didn’t do it correctly in the first place.” 3. A therapist recently convicted of multiple counts of Medicare fraud says, "Sure I overbilled. Why not? Everyone takes advantage of the government, so I did too." These statements show: a. lack of guilt feelings, antisocial personality disorder. b. suspiciousness. c. superficial remorse. d. shame. 4. A patient tells the nurse, "I wanted my health care provider to prescribe alprazolam (Xanax) for my anxiety disorder, but buspirone (Buspar) was prescribed instead. Why? I want my Xanax" The nurse's reply should be based on the knowledge that buspirone: a. can be administered as needed (PRN for anxiety). b. it is only for short-term tratment c. is faster acting than diazepam. d. does not cause dependence and benzodiazepines cause dependence. 5. A patient is hospitalized for major depression. Of the medications listed, a nurse can expect to provide the patient with teaching about: a. olanzapine (Zyprexa), second generation antipsychotic b. fluoxetine (Prozac), SSRI c. haloperidol (Haldol) , first generation antipsychotic d. clonazepam ( Klonopin), benzodiazepine 6. A patient experiences an episode of severe acute anxiety. Of these medications in the patient's medical record, which is most appropriate to administer as an as-needed (PRN) anxiolytic medication? Mental Health Midterm Review a. fluoxetine (Prozac) b. risperidone (Risperdal) c. buspirone (Buspar) d. lorazepam (Ativan) 7. A female client who’s at high risk for suicide needs close supervision. To best ensure the client’s safety, the Registered Nurse should: a. Check the client frequently at irregular intervals throughout the night b. Check the client frequently at regular intervals throughout the night c. Disregard decreased communication by the client because this is common in suicidal clients d. assure the client that the nurse will hold in confidence anything the client says 8. Which of the following nursing interventions is MOST important when caring for a client who has just been placed in physical restraints? a. Check that the restraints have been applied correctly to avoid lack of circulation in the limbs b. Monitor the client’s needs for hydration and nutrition while restrained. c. Prepare PRN dose of psychotropic medication d. Review hospital policy regarding duration of restraints. 9. What is the desirable outcome for the orientation phase of a nurse-patient relationship? The patient will demonstrate behaviors that indicate: a. resolution of feelings of dependance. b. rapport and trust with the nurse. c. self-responsibility and making progress with mood disorders. d. great sense of autonomy. 10. Which physical characteristic is a nurse most likely to assess in a patient diagnosed with anorexia nervosa? a. Atrophic parotid glands b. Rigidity, perfectionism c. Open displays of emotion d. Very low weight 11. An involuntarily hospitalized patient tells the nurse, "Get me the forms for discharge against medical advice (AMA) so I can leave the hospital now." What is the nurse's best initial response? a. "I will get them for you, but let's talk about your decision to leave treatment." b. "Since you signed your consent for treatment, you may leave if you desire, it is ok for me" c. "I can't give you those forms without your health care provider's knowledge." d. "I'll get the forms for you right now and bring them to your room ." 12. The nurse in the mental health unit recognizes which as being therapeutic communication techniques? Select all that apply. a. Restating Mental Health Midterm Review b. Asking the client, "Why?" c. Providing acknowledgment and feedback d. Giving advice and approval or disapproval e. Providing false reassurance 13. A patient says, "I feel detached and weird all the time, like I'm looking at life through a cloudy window. Everything seems unreal. These feelings really interfere with my work and study." Which term should the nurse use to document this complaint? a. Dissociative identity disorder b. Depersonalization c. Factitious disorder d. Somatic Symptom Disorder 14. A woman is 5’8” tall, weighs 155 pounds, and wears a size 7.5 shoe. She says, “My feet are huge. I’ve asked tfour orthopedists to surgically reduce my feet, but they don't want.” The patient tries to buy shoes to make her feet look smaller, and in social settings conceals both feet under a table or chair. Which health problem is likely? a. Body dysmorphic disorder b. Dissociative amnesia with fugue c. Depersonalization disorder d. Prominent pain disorder 15. Which principle should guide the nurse in determining the extent of silence to use during patient interview sessions? a. Patients withdraw if silences are frequent b. Silence can provide meaningful moments for reflection and it is therapeutic c. Silence helps patients know that what they said is well understood . d. Nurses are responsible for breaking silences. 16. Which research evidence would most influence a group of nurses to change their practice? a. Expert committee report of recommendations for practice b. Descriptive study c. Meta-analysis d. Double-blind study 17. A nurse plans teaching for a patient diagnosed with generalized anxiety disorder (GAD) who takes lorazepam (Ativan). What information should be included? (Select all that apply.) a. Maintain consistent intake of salt. b. Allow only tyramine-free foods in diet. c. Avoid using alcohol and other sedatives. d. Take the medication in the morning. e. Use caution when operating machinery. Mental Health Midterm Review 18. A patient has symptoms of anxiety related to the death of a parent in an automobile accident 2 weeks ago. The nurse should anticipate administering a medication from which group in order to....? a. Benzodiazepines to increase the effect of GABA b. Atypical antipsychotics to block Dopamine effects c. Benzodiazepines to decrease GABA d. SSRI to decrease Serotonin action 19. Which assessment finding for a patient diagnosed with an eating disorder meets a criterion for hospitalization? a. Serum potassium: 3.8 mEq/L b. Urine output: 70 ml/2 hours c. Systolic blood pressure: 62 mm Hg d. Pulse rate: 56 beats/min 20. The most challenging nursing intervention for patients diagnosed with personality disorders, especially borderline personality disorder, who use manipulation to get their needs met is: a. supporting behavioral change. b. administering prescribed medications c. maintaining consistent limits. d. using aversive and systematic desensitization therapy. 21. The nurse is developing a comprehensive care plan for a young woman with an eating disorder. The nurse refers this client to assertiveness skills classes. The nurse knows that this is an appropriate intervention because this client may have problems with a. self-identity and self-esteem. b. family boundary intrusions c. aggressive behaviors and lack of guilt d. focusing on reality. 22. A patient with a high level of motor activity runs from chair to chair and cries, “They’re coming! They’re coming!” The patient is unable to follow staff direction or respond to verbal interventions. Which nursing diagnosis has the highest priority? a. Risk for infection b. Risk for injury c. Disturbed energy field d. Disturbed thought processes 23. Over the past six months, a woman has cooked gourmet meals for her family but eats only tiny servings. She wears layered, loose clothing and now has lanugo. Her current weight is 97 pounds, a loss of 32 pounds. Which medical diagnosis is most likely? a. Bulimia nervosa b. Binge eating disorder c. Polyphagia