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Test Bank Foundations Mental Health Care 5th Edition, Morrison
Chapter 1: The History of Mental Health Care
1. The belief of the ancient Greek philosopher Plato that the rational soul controlled the irrational soul could be compared with the belief of the more recent psychological theorist:
2. During the mid-1500s, behaviors associated with mental illness were more accurately recorded by professionals. This practice led to ______________ for different abnormal behaviors.
3. During the latter part of the eighteenth century, psychiatry became a separate branch of medicine, and inhumane treatment was greatly diminished by the French hospital director:
4. In 1841, _______________ surveyed asylums, jails, and almshouses throughout the United States, Canada, and Scotland and is credited with bringing about public awareness and reform for the care of the mentally ill.
a. Sigmund Freud
b. John Cade
c. Florence Nightingale
d. Dorothea Dix
5. As a direct result of Clifford Beers work and book, A Mind That Found Itself, the Committee for Mental Hygiene was formed in 1909 with a focus on prevention of mental illness and:
a. Early detection of symptoms of mental illness
b. Education of caregivers
c. Current treatment options
d. Removing the stigma attached to mental illness
6. During the 1930s, what common treatment for schizophrenia caused clients to fall into a coma that could last as long as 50 hours?
a. Electroconvulsive therapy
b. Insulin therapy
c. Humoral therapy
d. Amphetamine therapy
7. In the 1930s, what mental health disorder was electroconvulsive therapy (ECT) most often used to treat?
b. Bipolar disorder
c. Severe depression
d. Violent behavior
8. In the early twentieth century, a frontal lobotomy was a common treatment for violent behaviors. Which description of this procedure is accurate?
a. A procedure that delivers an electrical stimulus to the frontal lobes of the brain
b. A surgical procedure that drills holes in the front of the skull to drain fluid
c. A surgical procedure that severs the frontal lobes of the brain from the thalamus
d. A surgical procedure that inserts implants into the frontal lobes of the brain
9. Which class of drugs was introduced in the 1930s for the treatment of depression?
b. Tricyclic antidepressants
10. In 1937, Congress passed the Hill-Burton Act, which was significant for the treatment of mental health because it funded:
a. Research on drugs for the treatment of mental health disorders
b. Training of mental health professionals
c. Construction of psychiatric units in facilities throughout North America
d. Development of community mental health clinics
Chapter 2: Current Mental Health Care Systems
1. Because mental health care is not covered in Australia under the basic health plan, which citizens are more likely to receive mental health care?
2. Mental health care is available under the universal health care system in Britain, which is funded primarily by:
b. Private donations
c. Small businesses
d. Tax revenues
3. The __________ model views clients holistically with the goal of creating a support system designed to encourage independence in the client with a mental health disorder.
a. Community support systems
b. Case management
c. Multidisciplinary health care team
d. Client population
4. The home mental health nurse visits a female client to assess her ability to care for herself at home after discharge from an inpatient setting. Which component of the case management system does this demonstrate?
b. Crisis intervention
c. Resource linkage
d. Psychosocial rehabilitation
5. A client with a severe, treatment-resistant mental illness has been assigned to an assertive community treatment (ACT) team. An ACT treatment strategy that helps to prevent recurrent hospitalizations for mental health reasons is to meet with the client in the community setting _____ per week.
b. Two to four times
c. Five to six times
d. Seven to eight times
6. Which member of the multidisciplinary mental health care team is primarily responsible for evaluating the family of the client, as well as the environmental and social surroundings of the client, and plays a major role in the admission of new clients?
a. Psychiatric nurse
b. Clinical psychologist
d. Psychiatric social worker
7. It is estimated that approximately __________ of adults experience some form of mental or emotional disorder.
8. A male client with a diagnosis of bipolar disorder is admitted to an inpatient unit during a severe manic episode. As a result of guidelines implemented by the Health Care Financing Administration in 1983, the clients Medicare will pay for his stay in this unit for:
a. The length of time necessary for his condition to be stabilized
b. Up to 6 months with appropriate documentation
c. A predetermined length of time based on the diagnosis
d. 2 to 4 weeks
9. A female client was given the diagnosis of schizophrenia and recently has lost her job. She tells the nurse that she has enough money for only two more house payments, and if she does not find a job, she fears she will become homeless. The nurse knows that this client falls in the group of nearly __________ of U.S. citizens who live below poverty level.
10. Addiction to recreational drugs, such as crack, cocaine, and heroin, combined with use of psychotherapeutic drugs is associated with:
a. Permanent psychotic states
b. Bipolar disorder
c. Generalized anxiety disorder
d. Obsessive-compulsive disorder
Chapter 3: Ethical and Legal Issues
1. A male teenage client tells the nurse that his friends like to drink alcohol occasionally to get drunk. The clients friends see nothing wrong with their drinking habits. The client states that he was taught by his parents and agrees that underage drinking is not acceptable. Also, he has never seen his parents drunk; therefore, he refuses to drink with his friends. Which mode of transmission best describes how this clients particular value was formed?
2. A female client becomes combative when the nurse attempts to administer routine medications. The nurse would like to ignore the client but chooses to talk with the client to calm her. The nurse is successful in calming the client, and the client takes her medications. What process best describes how the nurse decided on the course of action taken?
a. Values clarification
b. Nurses rights
3. Twenty-three states have enacted mental health parity laws. The most accurate description of these laws is that they require insurance companies to include coverage for:
a. Mental illness
b. Substance abuse treatment
c. Mental illness that is equal to coverage for physical illness
d. Outpatient therapy for individuals with substance abuse
4. The client is feeling very anxious and has requested that a p.r.n. antianxiety medication be ordered. The nurse informs the client that the medication can be administered only every 4 hours and was given 3 hours ago. The nurse promises to give the client the medication as soon as it is due, but the nurse goes to lunch 1 hour later without giving the client the medication. Which ethical principle did the nurse violate?
5. A male client is seeking help in a mental health clinic for anger management problems. He voices that he is fearful that his wife may divorce him because of his anger problem, and he is willing to do whatever it takes to control his anger. Later in the week, the clients wife also seeks assistance because she is going to divorce her husband. The nurse who is caring for both of these clients tries to decide the correct action to take. The nurse is experiencing:
a. A moral dilemma
b. Value clarification
c. An ethical conflict (or dilemma)
d. A breach of confidentiality
6. The psychiatrist asks the nurse to perform a procedure that she is not familiar with, and the nurse is unsure whether this is something within the scope of practice. Where can the nurse find the answer to her question?
a. National nurse practice act
b. State nurse practice act
c. Regional nurse practice act
d. Community nurse practice act
7. An order written by a physician is reviewed by the nursing staff, and no one is familiar with the treatment instructions. A nurse who was recently hired knows that this treatment is covered by the states nurse practice act. What is the nurses best course of action?
a. Call the physician to ask for clarification.
b. Check the states nurse practice act again.
c. Contact the nursing supervisor for approval to carry out the treatment.
d. Refer to the facilitys policy and procedure to determine the course of action.
8. Standards of nursing practice for mental health can best be described as helping to ensure:
a. That certain clients receive care
b. Quality and effectiveness of care
c. Proper documentation
d. Proper medication administration
9. If a client is involuntarily committed to a mental health care facility indefinitely, the law requires that the case must be reviewed every _____ months.
10. A male client is being argumentative during a group therapy session. The male psychiatric technician warns the client that if he does not cooperate with the nurse, he will physically restrain him and take the client to his room for the remainder of the day. For which action could the technician be held liable?
Chapter 4: Sociocultural Issues
1. An older Asian female with a diagnosis of depression is cared for by her granddaughter. Her granddaughter is very attentive to the clients needs, attends every therapy session, and is active in the planning and implementing of the treatment plan. The granddaughters valuing of her grandmother is most likely due to her:
b. Cultural beliefs
2. A traditional Arab female client is brought to the emergency room by her husband. She complains of feeling very anxious and short of breath and has chest pain. What would likely be a hindrance to the care of this client?
a. The emergency room physician is female.
b. Her husband asks if he can stay with his wife.
c. One of the emergency room nurses is of Arab descent.
d. The only caregivers available in the emergency room are male.
3. Disease is defined as _____ dysfunction.
4. The nurse is caring for a 20-year-old woman from Puerto Rico. The client speaks English, but she is accompanied by her mother who does not. The client has a history of mental illness, and through the interpreter, the nurse learns that the mother, who has traditional Puerto Rican cultural beliefs, believes that the clients mental illness is caused by:
c. Chemical imbalances
d. A trance
5. A client is continually late for his appointment at the mental health clinic. What is a likely reason for his lack of punctuality?
a. Need for environmental control
b. Time orientation
c. Space comfort zone
d. Territorial needs
6. Which client communication problem can the nurse most easily correct?
a. Age differences
b. Altered cognition
c. Cultural differences
d. Gender differences
7. What is the social orientation among most middle-class American families?
c. Significant others
8. It is important for the nurse to be familiar with the religious practices of clients cared for most often in a particular region because attitudes toward health and illness, death and burial, food, and procreation have a strong impact on a clients beliefs and practices. The nurse knows that the religion practiced most often around the world is:
b. Jehovahs Witness
9. The metabolism of psychotropic medications is most likely to be affected by:
10. A male Hmong client from Laos is a client at an outpatient mental health clinic who is being seen for his diagnosis of bipolar disorder. The importance of lithium testing was stressed in his discharge plans; however, it is discovered that he has had his lithium level checked only once, rather than the three scheduled times. What is the nurses best action?
a. Remind the client about the importance of lithium level testing.
b. Make scheduled appointments for the client to get his lithium level tested.
c. Give the client written information regarding the importance of lithium level testing and written instructions on how to make appointments for testing.
d. Talk with the client to see if there is a reason that he is not getting his lithium levels checked as outlined in his discharge plans.
Chapter 5: Theories and Therapies
1. A male client who has a diagnosis of generalized anxiety disorder (GAD) is seen in the emergency room with complaints of chest pain, shortness of breath, and inability to concentrate, along with feelings of overwhelming anxiety. The nurse uses Maslows theory to triage the clients complaints, knowing that which complaint must be addressed first?
a. Inability to concentrate
b. Shortness of breath
c. Overwhelming anxiety
d. Chest pain
2. According to Freuds theory, a baby who is crying in response to wanting to be held by his mother is an example of which part of the personalitys control over behavior?
3. According to the theorist Erik Erikson, an individual strives to actualize his identity, is most productive, and demonstrates guidance of and concern for others with a core task of caring during which stage of psychosocial development?
a. Young adulthood (18 to 25 years)
b. Maturity (65 years to death)
c. Middle adulthood (25 to 65 years)
d. Puberty (12 to 18 years)
4. During a therapy session, a client is asked to respond to a word with the first word or phrase that comes to mind. What term is commonly used to refer to this technique?
a. Transference relationship
b. Dream analysis
c. Free association
5. Carl Jung was the founder of analytical psychotherapy; he differed from Freud in that he believed that the mind was divided into three levels: the conscious ego, the personal unconscious, and the:
a. Extroverted personality
b. Introverted personality
d. Collective unconscious
6. Jean Piagets theory of cognitive development identifies an interrelationship between the __________ and the __________ functions in the development of ones personality.
a. Id; ego
b. Intellectual; emotional
c. Anxiety; affective
d. Personified; cognitive
7. How many stages of the human life cycle did Erik Erikson identify?
8. A 4-year-old client in a pediatric unit is imitating the actions of the nurse. The nurse knows, according to Erik Eriksons theory, that this child is displaying a characteristic seen during which developmental stage?
9. Humanistic theories are important to health care because these theories serve as the foundation for the concept of:
a. Assertiveness training
c. Holistic care
d. Behavior modification
10. During a conversation with a male client, he voices that he really appreciates his family, likes his job, and enjoys groups in which he volunteers. According to Maslows theory, what is this client experiencing?
Chapter 6: Complementary and Alternative Therapies
1. For a client with a sleep disorder, which CAM therapy could be used safely without interference with any allopathic methods of treatment?
a. Progressive relaxation
b. Dietary supplements
c. Herbal supplements
2. A female client would like to use biofield therapy for her addiction to nicotine. Which form of therapy would she most likely choose?
c. Nicotine patches
d. Group therapy
3. A male client experiences a phobia of enclosed spaces (claustrophobia) and is seeking an energy-based therapy that he can practice and initiate on his own when he experiences symptoms. Which therapy will the nurse recommend?
a. Music and sound therapy
b. Relaxation and visualization
c. Hypnosis therapy
d. Spiritual healing
4. Which theory best describes energy medicine?
a. There is a harmony within the body, nature, and the world.
b. The body has a natural ability to heal itself.
c. There is a vital, life-force energy that flows through an individuals body.
d. The mind and spirit affect body functions and influence illness.
5. A female client is receiving therapy for severe depression that consists of repetitive transcranial magnetic stimulation. This form of therapy is considered to be:
a. Energy medicine
b. Illegal according to FDA regulations
c. A form of expressive therapy
d. A biofield therapy
6. A 70-year-old male client tells the nurse that he is using chelation therapy to prevent Alzheimers disease. Which adverse effect is the client most likely to experience?
a. Allergic reactions
b. Low potassium levels
c. Elevated blood glucose levels
d. Interactions with other medications
7. A male client of Indian origin practices meditation and yoga, uses herbs and follows specific diet practices, and practices controlled breathing and exposure to sunlight. Which type of CAM therapy is this individual practicing?
a. Traditional Chinese medicine
8. What is the main function of the National Center for Complementary and Alternative Medicine (NCCAM)?
a. To seek scientific validation of CAM and also be a resource for the public for CAM therapies
b. To investigate and develop new CAM therapies
c. To produce a monthly newsletter on new CAM therapies
d. To monitor the production of dietary and herbal supplements used in CAM therapies
9. The Food and Drug Administration (FDA) does not impose the same guidelines on __________ as it does on prescription drugs.
a. Chiropractic treatment
b. Dietary supplements
c. Homeopathic treatments
d. Hypnotic therapy
10. A 45-year-old male client uses a treatment method that focuses on the relationship between an individuals body structure and its function. This mode of treatment is:
Chapter 7: Psychotherapeutic Drug Therapy
1. During client teaching, the nurse must inform the client prescribed a tricyclic antidepressant (TCA) to not expect to see a difference in mood or anxiety level for up to:
a. 5 days
b. 2 to 3 weeks
c. 4 to 5 weeks
d. 6 weeks
2. A male client with the diagnosis of depression is taking a monoamine oxidase inhibitor (MAOI). Which is the most important teaching point the nurse must include in his care plan?
a. Avoid foods high in sodium content.
b. Avoid alcoholic beverages.
c. Ensure that protein intake is 60 grams per day.
d. Take a potassium supplement.
3. A female client is 3 days postoperative and has been receiving meperidine (Demerol) for pain control. The family mentions to the nurse that the client has been taking phenelzine (Nardil) for years for her depression. The client did not list this medication on admission. What signs and symptoms should the nurse look for in case of reaction between these two medications?
a. Increased pulse and respirations
b. Hyperactivity and difficulty concentrating
c. Increased tearing and increased urinary output
d. Sedation, disorientation, and hallucinations
4. The nurse is aware that he or she may be administering the new antianxiety medication pregabalin (Lyrica) to clients without an anxiety disorder for the purpose of treating:
b. Psychotic episodes
c. Neuropathic pain
d. Bipolar disorder
5. Selective serotonin reuptake inhibitors (SSRIs) are most health care providers drug of choice for the treatment of depression because:
a. Side effects are more manageable than with most antidepressants.
b. They are the only class safe for long-term therapy.
c. This is the oldest class of antidepressants.
d. They are fast-acting medications.
6. In preparing discharge planning for a client who has been prescribed lithium for the treatment of bipolar disorder, the nurse must be sure that the client demonstrates an understanding of the need to monitor his or her diet for intake of:
7. A female client calls the clinic for advice after forgetting to take her morning dose of twice-daily lithium 5 hours ago. Which instructions should the nurse give the client?
a. Take the dose immediately, and then take the second dose 3 hours late.
b. Take half of a dose now, and then take the second dose at the normal time.
c. Eliminate the dose missed, and take the second dose at the normal time.
d. Immediately take the missed dose, and take the second dose at the normal time.
8. A female client who has had bipolar disorder for several years decides to stop all of her medications because she is tired of the side effects. She also cancels all appointments with her therapist, stating that it is just too difficult to plan the visits in her hectic schedule. This client is considered:
c. Suffering from an anxiety disorder
d. Possessing obsessive-compulsive tendencies
9. A male client with schizophrenia lives in an assisted-living complex for individuals with mental health disorders. He is tired of the Parkinson-like symptoms he experiences with his antipsychotic medication and therefore stops taking his medication after much discussion with his treatment team. He is progressively withdrawing from reality but is not a safety risk at this point to himself or others. What is the best response of the nurse and treatment team?
a. Try to coerce him into taking his medication.
b. Ensure that the client and those around him are safe, and monitor for additional symptoms of his schizophrenia while maintaining trust with the client.
c. Crush his antipsychotic medications and put them in his food to stop the process of his withdrawal from reality.
d. Speak to his family about seeking an involuntary emergency hold in a mental health facility to get him back on his medications.
10. An adult female client has been diagnosed recently with mild depression but opts not to take the medication prescribed by her physician after talking with the physician about the benefits, risks, possible outcomes, and side effects. She decides to investigate alternative treatments. This client is making this decision based on the premise of:
a. Informed consent
c. Client education
d. Right to privacy
Chapter 8: Skills and Principles of Mental Health Care
1. An adult female client becomes combative with the nurse during routine medication administration. What is the nurses primary responsibility in this situation?
a. To ensure that the client takes her medications
b. To ensure that the client is placed in physical restraints to protect the safety of the staff and other clients
c. To ensure that chemical restraints are used in the future until the client displays more appropriate and compliant behavior
d. To ensure that the client is kept safe while trying to protect staff safety and to reason with the client to try to de-escalate the combative behavior
2. A nurse is trying to develop trust with a client on an inpatient mental health unit. Which action by the nurse is going to best promote development of a mutually trusting relationship?
a. At the beginning of the shift, the nurse promises to play a game of cards with the client at some point during that day and does so before the end of the shift.
b. The nurse promises to play a game of cards with the client on the following day.
c. The nurse leads a group discussion with clients about ways to develop trust in a relationship.
d. The nurse gives the client written information about the medications he is taking.
3. An adult female client is exhibiting behavior that the nurse interprets as anger toward another client. What is the nurses best action?
a. Continue to monitor the clients behavior and document it as anger directed toward another client.
b. Talk with the client about the observations made, and ask whether she was displaying anger toward the other client.
c. Ask the other client if she felt that the client was angry with her.
d. Ask the client to write in a journal the emotions she was feeling at that time.
4. A nurse and an adolescent female client develop a plan of care together that addresses the clients difficult relationship with her parents. The client says that her parents just dont understand her, and she is always getting privileges taken away for not doing things that she is supposed to do. What is the nurses best action?
a. Talk with the client about how important it is that she carry through with actions that her parents feel are important.
b. Identify two priority responsibilities that are agreed upon between the client and her parents, and monitor her ability to comply with the plan for 1 week.
c. Discuss with the parents what responsibilities they feel are important, to determine what actions should be planned with the client.
d. Identify what the client feels are reasonable responsibilities.
5. __________ coping mechanisms are means of successfully solving a problem or reducing ones stress level.
6. A married woman, who is the mother of two children, has been in an abusive relationship for 4 years. She decides to leave her husband after suffering an episode of severe physical abuse. She and her children, ages 7 and 9, arrive at a crisis intervention center. What is the nurses priority intervention?
a. Offer immediate emotional support.
b. Refer her to a womans domestic abuse center.
c. Begin to develop a treatment plan for the client and her children.
d. Thoroughly assess the situation from most recent to 2 weeks prior to this incident.
7. A male client with the diagnosis of depression has not attended his last two group meetings. The nurse provides a printed schedule of meeting dates and times to the client the next time she sees him. The nurses actions can be described as:
d. Client advocacy
8. An adolescent female client continually displays a negative attitude toward everyone she comes into contact with and toward life in general. Which action should the nurse implement first that will be helpful in assisting this client to develop a more positive attitude?
a. Helping the client recognize negative thoughts, emotions, and attitudes
b. Pointing out every negative behavior that the client displays
c. Assisting the client to replace negative thoughts by frequently repeating positive statements
d. Praising positive behavior exhibited by the client
9. A caregiver is said to be practicing __________ care not only when she takes into consideration the clients actual or potential problems but also when she considers the clients family, work responsibilities, and social aspects of life.
10. A client is believed to have adapted to a situation when he or she exhibits which characteristic?
a. The client has become accustomed to his or her surroundings.
b. The client has shown improvement in behavior as evidenced by the ability to carry out activities normal to his or her life.
c. The client has accepted his or her current behavior patterns.
d. The client has established a trusting relationship with the caregivers who are providing care.
Chapter 9: Mental Health Assessment Skills
1. The nurse asks the client a series of questions upon entry into a mental health care system. This action is an example of which phase of the nursing process?
2. A nurse administers antidepressant medication to a client in an assisted-living facility. This is an example of which phase of the nursing process?
3. Following completion of a male clients series of group therapy sessions, the nurse periodically talks with the client to determine whether he has any signs of relapse of his previous problems. This action by the nurse is an example of:
4. During a session with a female client with a diagnosis of social phobia, she talks about how proud she is of herself because she was finally able to shop at the grocery store. The nurse documents the events and knows that this would be considered which phase of the nursing process?
5. The treatment team meets with a client for the first time and determines, with the clients input, a nursing diagnosis, goal, and steps to reach this goal. In addition to a nursing diagnosis, the treatment team has completed which phase of the nursing process?
6. Without assessment of six specific aspects of an individuals being, the mental health nurses scope of care is narrow and limited in effectiveness. These aspects include social, physical, cultural, intellectual, emotional, and spiritual areas of a persons life, known as a(n) __________ assessment.
7. The nurse is reviewing information regarding a female client that was obtained with the psychiatric assessment tool. The clients ability to provide food and shelter for herself is included in which area of the assessment?
a. Appraisal of health and illness
b. Coping responses, discharge planning needs
c. Knowledge deficits
d. Previous psychiatric treatment
8. During an interview with a 15-year-old female client admitted for depression, the nurse expresses her disappointment when she to learns that the client recently became pregnant and then had an abortion. The nurse is contradicting the effective interview guideline of:
a. Paying close attention to the clients nonverbal communication
b. Avoiding making assumptions
c. Avoiding ones personal values that may cloud professional judgment
d. Setting clear client goals
9. A male client with a history of schizophrenia was admitted to the mental health facility after he was found on the street in a confused state and was uncooperative when approached by the police. One of the first assessments that should be performed on this client upon admission is a _____ assessment.
10. During the mental status examination, the nurse observes that the client rapidly changes from one idea to another related thought. Which disordered thinking process is the client displaying?
d. Flight of ideas
Chapter 10: Therapeutic Communication
1. A male client with a diagnosis of schizophrenia begins to have hallucinations during a conversation with the nurse; this prevents him from receiving the message that the nurse is trying to communicate to him. According to Rueschs theory of communication, this unsuccessful interaction is called _____ communication.
2. The theorist Eric Berne theorized that an individuals three ego states of parent, child, and adult make up ones:
c. Thought processes
d. Ability to communicate
3. The nursing student is assigned a client to interview and is asked to practice the therapeutic communication technique of sharing perceptions. Which statement made by the student nurse best describes this technique?
a. I noticed that you pace the halls, and you have a tense look on your face. I sense that you are anxious about something.
b. Can you tell me more about how you feel when you are arguing with your daughter?
c. I would like to talk with you about your plan of care.
d. Tell me if I understand you correctly.
4. The nurse is talking with a male client regarding his recent relapse of alcohol addiction. The client alludes to the fact that he started to drink again after a fight with his wife. The nurse uses clarification to ensure an accurate understanding of the client. Which statement is the best example of clarification?
a. You said that the fight you had with your wife caused you to start drinking again?
b. Lets discuss what made you feel the need to drink.
c. Could you tell me again when and what happened that you feel caused you to start drinking again?
d. Tell me what your childhood was like.
5. A female client discusses her feelings of jealousy regarding the relationship between her mother and her daughter. The nurse responds in a nontherapeutic way by making a statement that is defensive and challenging. Which statement is the best example of a defensive and challenging nontherapeutic response?
a. Tell me more about the feelings you have regarding their relationship.
b. I think that you should tell them how you feel.
c. Lets not talk about that right now.
d. Dont you think that you should be thankful that your daughter has a good relationship with her grandmother?
6. A female client has been attending group therapy for support regarding an abusive relationship with her husband. The client voices concern about her 10-year-old daughter growing up in this environment but states that she just cant find the strength to leave her husband. The nurse responds by using the nontherapeutic technique of reassuring. Which statement is the best example of this nontherapeutic technique?
a. I cant believe that you would want your daughter to grow up in this environment.
b. I understand your concern. Let me give you some information on our local council for domestic abuse.
c. Im sure it wont be that bad to be out on your own. I know you can do it.
d. I think you should not think about leaving and should just do it.
7. Therapeutic communication techniques support effective communication between the client and the nurse. Which group of therapeutic techniques is most likely to be effective when one is conversing with a client?
a. Broad openings, restating, and advising
b. Clarification, focusing, and confrontation
c. Listening, silence, and reflection
d. Humor, informing, and reassuring
8. While the nurse is talking with a female client, the client becomes silent for several seconds. Which is the nurses best response?
a. To interpret this action as an indication that the client is finished with the conversation
b. To ask the client a question so the interaction can continue
c. To remain silent and be attentive to the clients nonverbal communication
d. To tell the client that help can be more effective if she shares her feelings
9. A client who usually is very active in her therapy group tells the nurse that she really does not feel well today and would rather not attend the group therapy session. Which is the nurses most appropriate response?
a. You dont feel like attending the group therapy today?
b. I will just stay with you for a while.
c. Its okay to skip a session every once in a while.
d. Why dont you want to attend group therapy?
10. The nurse is talking with a male client with a diagnosis of schizophrenia who often experiences auditory hallucinations. For this communication to be most effective, the nurse should:
a. Sit with the client and encourage him to not verbalize.
b. Do most of the talking.
c. Discuss several different topics to keep the clients attention.
d. Use simple, concrete language.
Chapter 11: The Therapeutic Relationship
1. The nurse is attempting to develop trust with a newly admitted female client for the purpose of establishing a therapeutic relationship. The nurse is currently administering medications to all clients on the unit. The newly admitted client asks the nurse to sit and talk with her for a while. What is the nurses best response?
a. I am busy right now, but I will come back later.
b. Give me just a few more minutes to finish passing medication to the other clients.
c. I will return in 20 minutes so we can talk.
d. I have to finish giving all the clients their medications, but I will then come back so we can talk.
2. A nurse is working with a male client in a mental health outpatient clinic. The client voices a desire to become more autonomous. Which goal will assist the client in becoming more autonomous?
a. The client will check his calendar each night to plan for commitments scheduled on the following day.
b. The nurse will remind the client weekly of his appointment at the clinic for the following week.
c. The client will ask the nurse to call him to remind him of his appointment.
d. The nurse will complete the clients calendar of daily commitments scheduled for the week.
3. An important aspect of developing a therapeutic relationship with a mental health client is for the nurse to show that she cares about the client. The nurse who is working on an inpatient unit can show signs of caring by:
a. Telling a client several times a day that he or she cares about him or her
b. Asking a client what his or her favorite movie is, then showing that movie during a movie night on the unit
c. Giving a client a card that has a sentiment that says the nurse cares about him or her
d. Telling a client that he or she is the favorite client
4. The nurse is caring for a female client with a diagnosis of severe bipolar disorder. Out of many treatment methods, the one treatment that the client and the team have found to be most effective is the medication lithium. The client voices concern about her future with this diagnosis. Which nurse response best represents the concept of hope?
a. You need to take your lithium unless you want to relapse.
b. You are doing so well that there is nothing you cant do if you put your mind to it.
c. You are doing very well since we found that lithium helps. You should do well as long as you continue your therapy and medication.
d. A lot of people are much worse off than you are, so you should be thankful that you are doing as well as you are.
5. A male client with schizophrenia has lost his job and home and has been living in a homeless shelter. He voluntarily admits himself into a mental health treatment facility. The clients current living situation and lack of a job at this time likely will contribute to his having difficulty with which dimension of hope?
6. A female client with obsessive-compulsive disorder is undergoing treatment in an outpatient setting and is attending group therapy sessions. She is working on controlling the compulsion of touching her head three times every time she talks. To maintain the therapeutic relationship established with the client, by which action can the nurse show acceptance?
a. Ignoring the compulsion during the group therapy session and talking with the client privately about the behavior
b. Asking the group to remind the client every time she touches her head to help her consciously stop the compulsion
c. Pointing out the compulsion to the group each time the client exhibits the behavior
d. Asking the client to stop talking during the group session until she has learned to control her compulsion
7. The characteristic of genuineness helps in establishing a therapeutic relationship with a client. Which nurse response is the best example of a display of genuineness to a client who is going through a difficult divorce?
a. I know exactly how you feel. My husband and I divorced 2 years ago because of his infidelity.
b. Divorcing my husband was the best thing I ever did.
c. I have friends who have gone through a divorce. It must be difficult for you.
d. I am sorry that you have to go through this difficult time.
8. During the preparation phase of a therapeutic relationship with a client, what is the main task to be completed by the nurse?
a. To establish with the client the purpose of the relationship
b. To gather and review all possible information regarding the client
c. To build trust with the client
d. To obtain agreement from the client to work in conjunction with the nurse
9. When should the nurse begin preparations for the termination phase of a therapeutic relationship?
a. During the orientation phase
b. Prior to the last meeting
c. During the last meeting
d. After all goals have been met
10. The nurse is preparing an adult male client, who has been successfully treated for a social phobia, for the termination phase of the therapeutic relationship. During their last meeting, the client told the nurse that he noticed he has developed a nervous habit that started a few days ago of checking his door at home several times a day to be sure it is locked. This client is exhibiting the client response to termination known as:
Chapter 12: The Therapeutic Environment
1. Crisis stabilization provides care to clients in treatment settings with the purpose of reestablishing homeostasis; it usually lasts for _____ days.
a. 1 to 2
b. 2 to 4
c. 4 to 6
d. 6 to 8
2. Which is an accepted criterion for inpatient admission to a mental health facility?
a. The client likes the security and comfort of the mental health facility.
b. The client feels that he is no longer able to cope with life stressors or maintain control of his behavior.
c. A clients behavior becomes unusual.
d. The client suffers from depression.
3. A male client with a diagnosis of schizophrenia refuses to take his medication because of his paranoia that the medication may be poisoned. Frequent inpatient readmissions to the facility occur as a result. Which term is given to repeated inpatient admissions?
4. An adult female inpatient client with a diagnosis of paranoid schizophrenia will not take her medications from the nurse. She states, I know you are poisoning that medicine. Which nursing action is most appropriate?
a. Promise the client that the staff would not do anything to harm her.
b. Let the client watch the medication preparation process.
c. Administer medications to her in unit dose packages so that she can open the packages herself.
d. Allow the client to retrieve the medications out of the medication cart with supervision.
5. A male inpatient client who is experiencing depression has no interest in eating. He skips meals frequently and has been losing weight. What is the best nursing action in this situation?
a. Ask the client to Please eat one meal for me.
b. Leave food with him at mealtime and offer snacks frequently.
c. Give the client information on the benefits of good nutrition.
d. Remove client privileges every time he doesnt eat.
6. Encouragement for clients to practice good hygiene habits not only meets basic physiological needs, it also meets the hierarchal need of:
a. Love and belonging
b. Safety and security
c. Infection control
7. With regard to the environment, it is important for the nurse to be aware of lighting for some clients. Clients with a diagnosis of schizophrenia may be bothered by lights that are flickering because this may trigger:
c. Aggressive behaviors
8. A female client on the mental health unit experiences periods of psychosis at intervals. She often asks what day she came to the facility and what day it is now, and she seems never to be aware of the time. Which nursing intervention would help this client the most?
a. Remind her of the time of day every time she asks.
b. Assist her to keep a written schedule, including her day of admission, on a calendar posted in her room and a clock beside the calendar.
c. Tell her it doesnt really matter what day she came to the facility; what matters is what day and time it is now.
d. Instruct the staff to not answer her repetitive questions because she has been told numerous times her day of admission, and there is a clock on the wall.
9. A 15-year-old female client is noted to often sit alone in the activity room of the facility while watching television. She often begins to join in activities on the unit but then retreats back to her room. Which intervention is most appropriate in this situation?
a. Encourage her to join in on a group activity and actively participate in the activity with her until she feels more comfortable on her own.
b. Keep encouraging her to participate in the group activity.
c. Offer her rewards, such as extended television privileges, for joining in a group activity.
d. Offer her support as she tries to become more involved in activities.
10. The nurse can assist a client best in meeting his or her needs for self-esteem and/or self-actualization by:
a. Setting rules and regulations
b. Allowing the client to set rules and regulations for the inpatient unit
c. Informing the client of what the treatment team has decided regarding the plan of care
d. Allowing the client to make choices involving his or her care when appropriate
Chapter 13: Problems of Childhood
1. Social and emotional development occurs at a more simple level in the child who is _____ years old.
2. A 10-year-old male client is 20 pounds overweight. Which intervention by the nurse is the most effective in this situation?
a. Place the client on a strictly controlled calorie-restricted diet.
b. Talk to the client about why he is so overweight.
c. Teach the client and his parents about healthy eating habits and choices.
d. Make a list of foods that are to be restricted in the clients diet.
3. A couple comes to the sleep disorder clinic because their 3-year-old daughter has problems falling asleep every night. The parents say that it takes their daughter 1 to 2 hours each night to fall asleep, and one of the parents ends up having to lie down with her. Which intervention should the nurse first suggest?
a. The parents should trade each night who tries to put her to bed.
b. The daughter could start falling asleep in the parents bed, then could move to her own bed.
c. Place the child in bed at the same time each night, and dont allow her to get out of bed.
d. Follow a bedtime ritual each night, such as reading one book.
4. The parents of a 2-year-old boy seek assistance at a family therapy clinic because their son throws a temper tantrum every time he is not allowed to throw his food on the floor during meals. Which therapeutic intervention does the nurse suggest?
a. Leave him during the tantrum, so that he feels isolated from others as a result of his behavior.
b. Try to distract him when he becomes frustrated, and reward him for positive behavior.
c. Hold the child down until the tantrum stops.
d. Put him in the corner for punishment while he is having the tantrum.
5. Poverty influences the growth and development of children and is often a precursor to mental health disorders in children. Nearly _____ of children in the United States come from families that live at the poverty level.
6. During the interview process with a homeless client, which is an appropriate nursing action?
a. Wait until later in the interview to ask questions such as address or nearest relative.
b. Ask the client early in the interview what is his or her highest education level.
c. Ask the client where he or she planned to sleep that night.
d. Encourage the client to bathe as soon as possible.
7. Adult disorders such as chronic anxiety and depression often are associated with childhood:
8. For children older than 4 years, separation anxiety should last for no longer than:
a. A few days
b. A few weeks
c. A few months
d. 1 year
9. The parents of a 9-year-old girl with mental retardation voice concerns to the nurse regarding their childs eating insects and leaves. The parents report that this behavior has been occurring for almost 4 months. From what is this child most likely suffering?
b. Rumination disorder
10. As the caregiver for a male client whose mental retardation level is classified at a moderate level, the nurses most appropriate action is to:
a. Encourage him to work in a supervised setting at a fast food restaurant.
b. Persuade him to look for an apartment in which he can live on his own.
c. Find a group home that he would adjust well to.
d. Seek placement for him in a long-term setting for clients with cognitive disabilities.
Chapter 14: Problems of Adolescence
1. The child in early adolescence experiences developmental issues with his or her identity as evidenced by:
a. Feeling stable with his or her self-esteem
b. Conforming to group norms
c. Being very self-centered
d. Being idealistic
2. Internal developmental problems are seen as a causative factor for some behavioral and family problems during adolescence. Psychological developmental issues that can lead to problems during late adolescence (17 to 20 years old) include:
a. Wide mood swings
b. Tendency to withdraw when upset
c. Intense daydreaming
d. Concealing of anger
3. A male adolescent client tells the nurse that he is almost positive that he is homosexual. This realization most likely has occurred during the developmental period of:
a. Late childhood
b. Early adolescence
c. Middle adolescence
d. Late adolescence
4. Environmental problems often lead to mental health problems among adolescents. Approximately _____ million children and adolescents must cope with the issue of having a parent in jail or on parole.
5. The nurse is working with a 15-year-old girl and her parents on a treatment plan for her diagnosis of attention-deficit/hyperactivity disorder (ADHD). The nurse should be sure to:
a. Encourage the parents to seek teachers for their daughter who are going to be lenient with assignment schedules because of her diagnosis.
b. Remind the parents to determine ahead of time consequences/punishment that they will give their daughter when she is not listening to them and/or teachers.
c. Teach the parents how to structure and enforce limits on their daughters behavior that are appropriate to her condition.
d. Inform the client and her parents that medications typically used for ADHD are very safe and have few side effects.
6. The nurse is working with a teen in whom conduct disorder was diagnosed and his family on developing a plan of care for treatment. What is the nurses first intervention?
a. Assessing and/or stabilizing the home environment
b. Teaching effective communication skills to the client and family members
c. Advocating behavior modification for the client to gain self-control
d. Teaching effective discipline techniques
7. Adolescents and young adult women account for ______% of Americans affected by eating disorders.
a. 25 to 30
b. 55 to 60
c. 70 to 75
d. 85 to 90
8. In a research study of eating disorders, it was found that the most frequent weight loss method used by female high school students was:
b. Skipping meals
c. Using diet pills
9. A 15-year-old girl is being admitted to an inpatient mental health clinic with the diagnosis of anorexia nervosa. The nurse knows that the most common personality characteristic of teens affected with this disorder is:
a. Excessive cooperation
c. Normal body weight
d. Positive self-esteem
10. When one is developing the care plan for a female adolescent with an eating disorder, the primary issue to consider as the underlying cause is:
b. Body image
d. Coping skills
Chapter 15: Problems of Adulthood
1. The nurse is caring for an adult male client who lacks a strong sense of personal identity. With which area of development will this client most likely struggle the most?
2. __________ is a major challenge for adults because energies are not concentrated on the self, and the demands can create feelings of anxiety, isolation, inadequacy, and helplessness.
3. An adult male client is admitted to a mental health facility with the diagnosis of depression following the breakup of a long-term engagement. He states that he couldnt commit to marriage. In conducting his admission assessment, the nurse learns that during his childhood he did not feel guided, nurtured, or accepted by his parents. One of the goals for this client is to help him develop a positive personal identity. Which intervention should the nurse implement to meet this goal?
a. Improve his strength in the ability to adapt to new situations.
b. Develop the ability to establish and maintain an intimate relationship.
c. Discern his feelings about relationship choices and level of commitment.
d. Outline his lifes dream.
4. The term sandwich generation best describes adults:
a. Caught between adulthood and late adulthood
b. Caring for their children and aging parents
c. Caring for their children and grandchildren
d. Caught between young adulthood and adulthood
5. An increasing number of are the head of the household of families in the United States.
a. Married couples
b. Single women
c. Single men
6. The nurse is caring for a client who is a single mother of two young children, has no financial or parental support from her ex-husband, is troubled by her financial circumstances and future, and works at a local fast-food restaurant. She is seeking help for depression. What is the nurses best action?
a. Assist the client in seeking educational and/or vocational programs for single parents.
b. Encourage the client to explore her feelings related to the reasons for her divorce.
c. Persuade the client to contact her ex-husband for financial and parental support.
d. Share information with the client regarding support groups for single mothers.
7. An adult female calls a crisis hotline stating that she moved a few months ago to seek a new job in a big city. She is crying and says that she doesnt think she can stand being so lonely anymore but doesnt want to move back to her small home town and face her family and friends as a failure. What is the nurses first response?
a. Would you like me to call your family to assist you in deciding what is best for you to do?
b. I am sure you will make friends once you find a steady job that you like.
c. Can you tell me what you mean by your statement that you dont think you can stand being lonely anymore?
d. Let me give you a list of some social groups that might be of interest to you.
8. AFRAIDS is a condition that most likely would be seen in:
a. The homosexual population
b. Sexually promiscuous heterosexuals
c. Individuals in a heterosexual monogamous relationship
d. Persons who have a chemical dependency on illegal intravenous drugs
9. How many people in the United States have a severe mental illness?
b. 1.3 million
c. 5.4 million
d. 10 million
10. When the nursing care plan for a client with a mental health disorder is developed, what is the most likely reason that interventions are ineffective and goals are not met?
a. The client sees his goals as less important.
b. The clients family is not supportive.
c. The clients disorder is difficult to treat.
d. The clients medications are being adjusted.
Chapter 16: Problems of Late Adulthood
1. _____% of older adults are living at the poverty level.
c. Twenty six
d. Twenty three
2. A 55-year-old man is extremely fearful of the effects of growing old. He is experiencing:
c. An age phobia
d. Elder phobia
3. Physical signs of aging usually begin in the late 30s. Physical signs of aging begin to slow after one reaches the age of approximately:
4. An elderly man has serious vision problems and is no longer allowed to obtain a drivers license. He has been very independent until this time. Which nursing diagnosis is most appropriate for this situation?
a. Confusion, chronic
b. Coping, ineffective
c. Self-esteem, risk for situational low
d. Grieving, dysfunctional
5. The home health nurse is caring for a 79-year-old man with the diagnosis of hypertension who is on a fixed income. He was discharged from the hospital a few weeks ago with his newly prescribed medication to keep his BP under control. His BP measurements have been gradually increasing over the last few visits, with no other changes in status assessed. Which nurse statement would be most appropriate?
a. Have you been taking your medication as often as you are supposed to?
b. I dont understand why your BP is up.
c. Maybe I should check your BP at another time.
d. I hope you are taking your medication. Otherwise, I am wasting my time.
6. A 2006 survey indicates a ____% increase in elder abuse.
7. Which intervention will be most effective when one is teaching a client about his or her medications and their administration?
a. Pointing out the colors of the medications for easier identification
b. Referring to medications by name and providing written instructions
c. Quizzing the client on each medications purpose, side effects, and drug interactions
d. Encouraging the client to hold all questions until the end of the discussion so the nurse will not have to repeat information
8. The nurse is caring for a 79-year-old client with dementia. The client worked as an obstetrics nurse before retiring. Despite her dementia, she still remembers terms and procedures and basic nursing care interventions from her past career. This is an example of:
a. Working memory
c. Information processing
d. Crystallized intelligence
9. An elderly client states that she paid $10,000 to a nice repairman for fixing her broken window and fence. This is an example of elder abuse known as:
a. Violation of rights
c. Psychological abuse
10. The nurse must be aware of physical signs and symptoms of depression because these are often the first, sometimes overlooked, signs of the disorder. Physical signs and symptoms of depression include:
a. Decreased or slowed memory
c. Changes in appetite
d. Abdominal pain
Chapter 17: Cognitive Impairment, Alzheimers Disease, and Dementia
1. A 75-year-old male client is brought to the clinic by his son. The son states, Ever since Mom died, Dad hasnt been the same. At first he just seemed sad, but now he seems to get mixed up about everything. The nurse is aware that based on the clients history, the source of confusion is most likely:
b. Depression from the loss of his wife
c. Hypoxia of the brain
d. Delirium from medications
2. Vascular dementia is more common in individuals living in:
a. The United States
3. A newly admitted elderly client seems to become confused and agitated every evening after dinner. This client most likely is suffering from:
a. Alzheimers disease
b. Acute dementia
c. Sundown syndrome
4. The elderly spouse of a 74-year-old male client states that she has noticed that her husband doesnt remember as well as he used to. She explains that he has been putting on his coat before his shirt, and that he can never get their checkbook to balance as it did in the past. The client is exhibiting signs and symptoms typical of:
a. Vascular dementia
b. Alzheimers disease
c. Acute delirium
5. The affective losses of Alzheimers disease refer to losses noticed in the individuals:
b. Thought processes
c. Ability to make and carry out plans
6. The average time that a person with Alzheimers disease lives after diagnosis is _____ years.
7. For those family members who desire to care at home for loved ones who have been given a diagnosis of Alzheimers disease, it is important for the nurse to ensure that the family is aware of which caregiver skills and responsibilities will be necessary. What is one of the responsibilities of the caregiver during the middle stage of the disease?
a. Helping the loved one with memory and communication problems
b. Providing a stable, routine environment
c. Providing complete assistance with physical care
d. Adapting to the changing personality and behavior of the loved one
8. The nurse is answering questions from a client and his family regarding a recent diagnosis of Alzheimers disease. The client asks how effective medication is in treating the disease. What is the nurses best response?
a. There is no cure or treatment for Alzheimers disease.
b. Medications have shown little improvement in symptoms.
c. Medications for the disease have been found to improve thinking abilities, behavior, and daily functioning in some clients.
d. Alternative therapies, such as co-enzyme Q-10 and ginkgo biloba, are more effective than any of the prescription medications used to treat the symptoms.
9. Which of the following is an effective communication technique that should be included in the teaching plan for the family members of a woman in whom Alzheimers disease has been diagnosed recently?
a. Use simple, familiar words, along with short and simple sentences.
b. If the client tends to pace a lot, be sure to encourage her to sit during interactions.
c. If she doesnt understand the communication, change key words.
d. Use hand gestures when speaking to try to explain what is being said.
10. The elderly spouse of a female Alzheimers client states that his wife seems to wander aimlessly from room to room looking for th
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