Neeb Fundamentals of Mental Health Nursing 4th Edition- Linda M. Test Bank

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Neeb Fundamentals of Mental Health Nursing 4th Edition- Linda M. Test Bank

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WITH ANSWERS

Neebs Fundamentals of Mental Health Nursing 4th Edition- Linda M. Test Bank

 

Chapter 2: Basics of Communications

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   Which question by the nurse would gain the most information from a patient experiencing a marital crisis?

A. Do you hate your spouse?
B. Do you get along with your in-laws?
C. Do you talk out your problems with your spouse?
D. What is it like at home with your spouse?

 

 

____    2.   Mrs. R., the mother of a young schizophrenic patient, seeks you out and begins to cry. She expresses concern over her daughters behavior. Your best response to this woman is:

A. What is it that concerns you the most, Mrs. R.?
B. Well, you know, that is part of the illness.
C. Here is a book on schizophrenia. This will help you.
D. Are you afraid your daughter will always be like this?

 

 

____    3.   Linda is pacing the floor and appears extremely anxious. The day shift nurse approaches Linda in an attempt to lessen her anxiety. The most therapeutic statement by the nurse would be:

A. How about watching a football game?
B. Tell me how you are feeling today.
C. What do you have to be upset about now?
D. Ignore the client.

 

 

____    4.   A patient states, I dont know what the pills are for or why I am taking them, so I dont want them. What therapeutic communication would help this patient?

A. Ask for what you need
B. Silence
C. Using general leads
D. Giving information

 

 

____    5.   To practice effectively in mental health, the nurse should be able to:

A. Solve his or her own personal problems without assistance from others.
B. Comfortably point out the patient shortcomings and provide advice about how to improve.
C. Bring patients and coworkers into compliance with societal rules and norms.
D. Demonstrate therapeutic communication.

 

 

Completion

Complete each statement.

 

  1. The nurse plans to have a therapeutic communication with the client. To begin that therapeutic communication the nurse must first establish _________________ with the client.

 

  1. Communication has three parts: the sender, the message, and the _____________.

 

  1. When appropriate, the nurse can use _____________________ as part of an interaction when there is no talking. This can communicate support.

 

  1. A theory of communication that emphasizes the three ways to communicatehearing, seeing, and touchingis called _________________________

 

  1. Expressive, receptive, and global are types of _______________.

 

  1. Advising, asking closed-ended questions, and changing the subject are examples of ________________ to therapeutic communication.

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____  12.   A nurse is working with a patient and attempts to communicate effectively with him or her. Techniques the nurse can use to help communication include (select all that apply):

A. Clarifying terms.
B. Remaining silent.
C. Asking open-ended questions.
D. Offering false reassurance
E. Discouraging the person from expressing feelings that are unacceptable.

 

 

____  13.   The nurse may find that patients from other countries use different terminology than the nurse born in the United States. The difference in terminology may seem harmless to us but offensive to the foreign patient. Differences noted between different cultures are (select all that apply):

A. Eye contact.
B. Slang terms.
C. Hand gestures.
D. Gender references.

 

 

____  14.   The three components of communication are (select all that apply):

A. Impairment.
B. Message.
C. Sender.
D. Receiver.

 

 

____  15.   Nurses understand that when caring for patients with mental illnesses, a nurses communication is (select all that apply):

A. An active process that includes participating and listening and speaking.
B. A complex activity.
C. Exchanging information.
D. Verbal and nonverbal.
E. A one way path from nurse to patient.
F. Advising.

 

 

____  16.   The patient is concerned about his doctor and what the doctor has prescribed. The nurse making rounds notices the patient sitting on the side of the bed in deep thought. The nurse comes into the room and the patient begins to tell her his concerns about a new order. The nurse advises the patient, If I were you, I would find another doctor.

How does this statement by the nurse block communication (select all that apply)?

A. It tells the patient that his concerns are not valid.
B. It gives the idea that the nurses values are the correct ones.
C. It puts words in the patients mouth.
D. It hurts the nurses credibility if the solution doesnt help the patient.
E. It discourages yes or no answers.
F. It inhibits the patient from telling you what his concerns are.

 

 

____  17.   The following types of patients require adaptive communication techniques (select all that apply):

A. A patient who is blind.
B. A patient who has dysphasia.
C. A patient who is schizophrenic.
D. A patient who is elderly.
E. A patient with dysphagia.
F. A patient who has language differences from the staff.

 

 

____  18.   Which of the following are characteristics of assertive communication (select all that apply)?

A. Statements begin with the word you.
B. Statements deal with thoughts and feelings.
C. It is a form of blaming.
D. It puts responsibility for the interaction on the other person.
E. It is a technique of personal empowerment.
F. It is self-responsible.

 

Chapter 2: Basics of Communications

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  D

Encourages expression of feelings rather than a yes/no answer. Use of open-ended questions facilitates more open communication.

 

PTS:   1                    REF:   Chapter 2: Basics of Communication; Therapeutic Communication; page 21-25

KEY:  Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Therapeutic communication

 

  1. ANS:  A

The correct response is open ended to seek out more specifically why she is upset. Responses B and C shut down communication. Response D is making an assumption of why she is upset.

 

PTS:   1                    REF:   Chapter 2: Basics of Communication; Therapeutic Communication; page 24-25

KEY:  Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Psychotic disorders: Therapeutic nursing process | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

 

  1. ANS:  B

To keep open communication with the patient, the nurse should ask open-ended questions.

 

PTS:   1                    REF:   Chapter 2: Basics of Communication; Therapeutic Communication; page 24

KEY:  Integrated Processes: Caring | Content Area: Mental Health: Communication | Cognitive Level: Synthesis | Client Need: Psychosocial Integrity: Stress Management

 

  1. ANS:  D

Giving information can increase rapport, reduce patient anxiety, and suggest patient collaboration.

 

PTS:   1                    REF:   Chapter 2: Basics of Communication; Therapeutic Communication; page 25

KEY:  Integrated Processes: Teaching/Learning | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic Communication/Health Promotion and Maintenance: Principles of Teaching/Learning

 

  1. ANS:  A

Good communication skills are essential for working in mental health. Good communication skills center around being able to promote open communication with such techniques as good listening, use of open-ended questions, and appropriate use of silence to be therapeutic.

 

PTS:   1

REF:   Chapter 2: Basics of Communication; Techniques of Therapeutic/Helping Communication; page 23

KEY:  Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Nursing Process | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic Communication

 

COMPLETION

 

  1. ANS:

rapport

Rapport implies there is mutual understanding and trust. The communication can be both verbal and nonverbal.

 

PTS:   1                    REF:   Chapter 2: Basics of Communication; Therapeutic Communication; page 23

KEY:  Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Synthesis | Client Need: Psychosocial Integrity: Therapeutic Communication

 

  1. ANS:

receiver

Communication is not just about getting your message out, it also includes how the message is received.

 

PTS:   1                    REF:   Chapter 2: Basics of Communication; Communication Theory; page 16

KEY:  Integrated Processes: Communication and Documentation | Content Area: Mental Health: Communication | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Therapeutic Communication

 

  1. ANS:

silence

Silence allows the nurse and the patient time to collect their thoughts. It is a therapeutic technique of communication and demonstrates support and acceptance.

 

PTS:   1                    REF:   Chapter 2: Basics of Communication; Therapeutic Communication; page 26

KEY:  Integrated Processes: Caring/Communication and documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Therapeutic Communication

 

  1. ANS:

neurolinguistic programming

Neurolinguistic programming (NLP) was developed by Milton Erickson, John Grinder, and Richard Bandler. NLP can be used in conjunction with hypnosis and other treatment modalities giving insight into how one views the world.

 

PTS:   1                    REF:   Chapter 2: Basics of Communication; Types of Communication; page 18-19

KEY:  Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Therapeutic Communication

 

  1. ANS:

aphasia

Patients with speech difficulties or challenges have an aphasic disorder. Expressive is difficulty in verbal expression, receptive is difficulty with interpretation of written or verbal communication, and global is a combination of receptive and expressive.

 

PTS:   1

REF:   Chapter 2: Basics of Communication; Challenges to Communication; Table 2-1 Types of Aphasia; page 20

KEY:  Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Therapeutic Communication

 

  1. ANS:

blocks or barriers

These blocks to communication interfere with patient-nurse interaction to inhibit good communication.

 

PTS:   1

REF:   Chapter 2: Basics of Communication; Blocks to Therapeutic Communication; page 22-23

KEY:  Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Therapeutic Communication

 

MULTIPLE RESPONSE

 

  1. ANS:  A, B, C

Effective communication between the nurse and the patient includes approaches that give the patient opportunities to express himself or herself.

 

PTS:   1

REF:   Chapter 2: Basics of Communication; Techniques for Therapeutic Communication; page 24 and 26

KEY:  Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic Communication

 

  1. ANS:  A, B, C, D

Verbal and nonverbal communication doesnt always have the same meaning in other cultures. The same communication can be understood by another culture as offensive.

 

PTS:   1

REF:   Chapter 2: Basics of Communication; Nonverbal Communication ; Box 2-1 Examples of Communication with Cultural Implications; page 17

KEY:  Integrated Processes: Teaching/Learning | Content Area: Mental Health: Communication | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Therapeutic Communication

 

  1. ANS:  B, C, D

Communication with others requires these three components.

 

PTS:   1                    REF:   Chapter 2: Basics of Communication; Communication Theory; page 16

KEY:  Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Knowledge | Client Need: Psychosocial Integrity: Therapeutic Communication

 

  1. ANS:  A, B, C, D

Communication is important when determining the patients needs. It is not a passive process but an active, two-way activity between patient and nurse. Generally the nurses role is not to advise patients but to listen and support.

 

PTS:   1                    REF:   Chapter 2: Basics of Communication; Therapeutic Communication; page 24

KEY:  Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Application

 

  1. ANS:  B, C, D, F

Communication with patients should be purposeful and unbiased. Giving advice when the patient has not fully expressed his concerns inhibits and distracts the patient from what he is trying to communicate.

 

PTS:   1                    REF:   Chapter 2: Basics of Communication; Therapeutic Communication; page 21-22

KEY:  Integrated Processes: Communication and Documentation | Content Area: Mental Health: Communication | Cognitive Level: Evaluation

 

  1. ANS:  A, B, F

Although communication can be challenging, there may be temporary or permanent techniques to assist with communication. Patients with challenges to sight, sound, and speech require adaptive techniques. Those who speak a different language than the provider also need adaptive techniques.

 

PTS:   1

REF:   Chapter 2: Basics of Communication; Challenges to Communication; page 28-29

KEY:  Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Comprehension

 

  1. ANS:  B, E, F

Assertive communication begins with the word I. Other characteristics include speaking up for oneself in a respectful manner, verbalizing ones thoughts and feelings, and being honest.

 

PTS:   1                    REF:   Chapter 2: Basics of Communication; Types of Communication; page 18

KEY:  Integrated Processes: Communication and Documentation | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic Communication

 

Chapter 12: Bipolar Disorders

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   Your bipolar patient approaches you and says, I will be running this hospital someday. I know I can change everything. What is the best intervention?

A. Orient the patient by telling her that this would require multiple educational degrees that she does not have.
B. Ask the patient why she thinks she can do that.
C. Redirect the patient to what is going on around her now.
D. Contact the psychiatrist immediately.

 

 

____    2.   Your new patient admitted to the psychiatric unit is pacing and agitated. Which of the following is the most appropriate intervention?

A. Introduce the patient to all the other patients.
B. Direct him to a group therapy session.
C. Place him in a quiet area away from other patients.
D. Review the unit rules with the patient to distract him.

 

 

____    3.   Your patient in the psychiatric unit is still up at midnight playing cards. You tell him, Its time to get some sleep now. What is the purpose of this response?

A. Limit setting
B. Reality testing
C. Controlling patient so other patients will respond the same way
D. Enforcing rules

 

 

____    4.   Which statement is most likely to be from a patient in a manic episode?

A. I dont need to sleep.
B. I am Jesus Christ.
C. Leave me alone while I am reading this textbook.
D. I am worthless.

 

 

____    5.   Which diversional activity is most appropriate for a patient in a manic phase?

A. Bridge
B. Exercise class
C. Cross stitch
D. Computer game

 

 

____    6.   Lithium toxicity is most likely with which of the following patients?

A. Elderly man with diarrhea from food poisoning
B. Teenage girl on oral contraceptives
C. 40-year-old man who smokes marijuana on the weekend
D. All of the above are at high risk

 

 

____    7.   Your 28-year-old patient was admitted to the psychiatric unit with a diagnosis of major depression with symptoms of withdrawal and extreme sadness. After 2 weeks on the unit, the patient suddenly becomes more talkative, sleeps only 2 hours a night, and acts seductively with the male patients. What is the most likely explanation for this change?

A. The antidepressants are effective.
B. The patient was diagnosed incorrectly.
C. She is having a manic episode as part of her illness.
D. She is recovering from her depression.

 

 

____    8.   You are working with the RN to plan short-term goals for a 28-year-old hospitalized manic client. Which is the most important goal?

A. Protection from self-inflicted harm
B. Meals in excess of metabolic requirement
C. Strict participation in unit activities
D. Enforced medication compliance

 

 

____    9.   A 30-year-old male client is admitted to the psychiatric unit with a diagnosis of bipolar disorder. His family reports that for the past 2 months he has been in constant motion, sleeping very little, spending lots of money, and has been full of ideas. During the initial assessment with the client, the nurse would expect him to exhibit which of the following?

A. Short, polite responses to interview questions
B. Introspection related to his present situation
C. Exaggerated self-importance
D. Feelings of helplessness and hopelessness

 

 

____  10.   Lithium is most commonly used to treat which of the following disorders?

A. Dysthymia
B. Schizophrenia
C. Generalized anxiety disorder
D. Bipolar disorder

 

 

____  11.   Marnie is a 16-year-old patient with bipolar disorder. She is manic right now and is in the hallway naked, making sexual requests of the staff and other patients. What is your best course of action?

A. Quietly approach her, escort her to her room, and assist her in getting dressed.
B. Quietly approach her, escort her to her room, and explain to her the inappropriateness of her actions.
C. Approach her, confront her behavior as it is happening, and escort her to her room.
D. Confront her behavior in the hall, apologize to the other patients, and escort her to her room.

 

 

____  12.   Which activity would you select as best for your patient in a manic state?

A. Brown bag lunch at a book review group
B. Badminton
C. Paint by numbers class
D. Guided imagery

 

 

____  13.   Which of the following best describes bipolar I disorder?

A. Full manic cycles with possibility of depression.
B. Disturbance in mood that is a direct result of physiological effects of substance abuse.
C. Periods of mild mania followed by mild depression.
D. Intense depression followed by normal mood.

 

 

____  14.   Which of the following would present the greatest risk to develop bipolar disorder?

A. Use of stimulant medications as a child
B. History of anxiety disorder as a teenager
C. First-degree relative with the bipolar disorder diagnosis
D. History of conduct disorder

 

 

____  15.   Toni, diagnosed with bipolar disorder, is currently in the mania stage. The staff noted that Toni has placed her lipstick on in an exaggerated way. She is currently pacing the floor and is easily angered. The duty nurse approaches in an attempt to ease some of Tonis behaviors. The most therapeutic response by the nurse would be:

A. Would you like to watch TV?
B. Would you like me to talk with you?
C. Lets walk and talk
D. Avoid giving attention to the patient by not responding to her behavior

 

 

 

____  16.   For a patient diagnosed with bipolar disorder, what would be the drug of choice?

A. Lithium carbonate
B. Valium
C. Paxil
D. Haldol

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____  17.   Which of the following are signs of mania? (Select all that apply)

A. Pessimistic feelings
B. Increased sexual drive
C. Denial that anything is wrong
D. Decreased energy
E. Decreased need for sleep
F. Thoughts of death or suicide

 

 

____  18.   While assessing your patient, you realize the patient is experiencing a manic episode. You will most likely expect (select all that apply):

A. Decreased need for sleep.
B. Extreme irritability.
C. Extreme depression.
D. A surge of energy.
E. A loss of interest in ordinary activities.

 

Chapter 12: Bipolar Disorders

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  C

Rather than challenge the patients thinking or overreacting, it is best to acknowledge what she said and then distract her to more reality-based thoughts.

 

PTS:   1

REF:   Chapter 12: Bipolar Disorders; General Nursing Interventions for Bipolar Disorder; page 198-199

KEY:  Integrated Processes: Caring | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

 

  1. ANS:  C

Rather than adding more information and added stimuli, you are focusing on helping him cope.

 

PTS:   1

REF:   Chapter 12: Bipolar Disorders; General Nursing Interventions for Bipolar Disorder; page 198-199

KEY:  Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Coping | Cognitive Level: Application | Client Need: Psychosocial Integrity: Behavioral intervention

 

  1. ANS:  A

Limit setting is an important intervention that defines what is expected and what is not allowed. It is more therapeutic than just controlling or enforcing rules.

 

PTS:   1

REF:   Chapter 12: Bipolar Disorders; General Nursing Interventions for Bipolar Disorder; page 198-199

KEY:  Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

 

  1. ANS:  A

Manic patients usually have very little need for sleep. Response B is a delusion of grandeur that may be present but is not most likely. Manic patients are unable to concentrate on reading and less likely to make depressive statements in a manic state.

 

PTS:   1                    REF:   Chapter 12: Bipolar Disorders; Manic Phase; page 193-194

KEY:  Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Mood disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

 

  1. ANS:  B

Physical activity to discharge pent-up energy can be useful. The other activities are sedentary and require concentration, which would be difficult for the manic patient.

 

PTS:   1                    REF:   Chapter 12: Bipolar Disorders; General Nursing Interventions; page 198-199

KEY:  Integrated Processes: Nursing Process: Analysis

 

  1. ANS:  A

Diarrhea can precipitate dehydration, which is a common cause of lithium toxicity. Responses B and C are not indicators of high risk behaviors for toxicity.

 

PTS:   1                    REF:   Chapter 12: Bipolar Disorders; Treatment of Bipolar Disorders; page 197

KEY:  Integrated Processes: Nursing Process: Analysis | Content Area: Adult health: Pharmacology | Cognitive Level: Application | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration and adverse effects/contraindications/side effects/interactions

 

  1. ANS:  C

Sudden shifts to manic behavior after depression may indicate bipolar disorder I. Responses A and D are unlikely, given the rapid change in behavior. Depression diagnosis was accurate initially related to response B.

 

PTS:   1                    REF:   Chapter 12: Bipolar Disorders; Manic Phase; page 193-194

KEY:  Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

 

  1. ANS:  A

Safety is always the priority. The other goals may be part of the plan, but protection from self-inflicted harm is most important.

 

PTS:   1                    REF:   Chapter 12: Bipolar Disorders; General Nursing Interventions; page 198-199

KEY:  Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity

 

  1. ANS:  C

In the manic phase the client will be unable to control his response or be introspective. He will also not be in touch with feelings of helplessness or hopelessness unless he moves into the depressive phase.

Integrated process: Nursing process: Assessment | Content Area: Mental health: Mood disorder | Cognitive Level: Application | Client Need: Psychosocial integrity: Mental health concepts

 

PTS:   1                    REF:   Chapter 12: Bipolar Disorders; Manic Phase; page 193-194

KEY:  Integrated Processes: Nursing Process: Assessment | Content Area: Mental Health: Mood disorder | Cognitive Level: Application

 

  1. ANS:  D

Lithium is a drug commonly used to treat bipolar disorder and is not used to treat the other disorders.

 

PTS:   1                    REF:   Chapter 12: Bipolar Disorders; Treatment of Bipolar Disorders; page 197

KEY:  Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and parenteral therapies: Medication administration

 

  1. ANS:  A

With a patient in a manic state, the intervention should be calming with the emphasis on limit setting rather than confrontational and/or encouraging insight.

 

PTS:   1                    REF:   Chapter 12: Bipolar Disorders; General Nursing Interventions; page 198-199

KEY:  Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Mood disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

 

  1. ANS:  B

Physical activity is more effective than these other activities that require concentration.

 

PTS:   1                    REF:   Chapter 12: Bipolar Disorders; General Nursing Interventions; page 199

KEY:  Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Application | Client Need: Psychosocial Integrity: Mental health concepts

 

  1. ANS:  A

Bipolar I is a full syndrome of manic symptoms and may also have depression. Response B is bipolar disorder due to substance abuse.

 

PTS:   1

REF:   Chapter 12: Bipolar Disorders; Table 12-1, Forms of Bipolar Disorders; page 194

KEY:  Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

 

  1. ANS:  C

Family history is the strongest risk factor.

 

PTS:   1                    REF:   Chapter 12: Bipolar Disorders; Etiology; page 195-196

KEY:  Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

 

  1. ANS:  C

To reduce the level of anger and aggression the patient may be experiencing, the nurse should encourage the patient to discharge some energy by physical activity. Talking about feelings may be difficult. The patient may not be able to concentrate.

 

PTS:   1                    REF:   Chapter 12: Bipolar Disorders; General Nursing Interventions; page 193-195

KEY:  Integrated Processes: Caring | Content Area: Mental Health: Therapeutic Communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic Communication

 

  1. ANS:  A

Lithium is one of the major drugs that assist in mood stabilizing.

 

PTS:   1                    REF:   Chapter 12: Bipolar Disorders; Pharmacology Corner; page 196

KEY:  Integrated Processes: Teaching/Learning | Content Area: Mental Health: Pharmacology | Cognitive Level: Knowledge | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies: Expected Actions/Outcomes

 

MULTIPLE RESPONSE

 

  1. ANS:  B, C, E

The manic patient will have increased energy and drive and not exhibit insight into the maladaptive behavior.

 

PTS:   1                    REF:   Chapter 12: Bipolar Disorders; Manic Phase; page 193

KEY:  Integrated Processes: Analysis | Content Area: Mental Health: Mood disorders | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health concepts

 

  1. ANS:  A, B, D

Mania is part of the bipolar disorder. The patients moods shift from mania to depression, both in the extreme. The changes are noticeable and can be described as dramatic. During a manic episode the patient is hyperactive, irritable, reduced need for sleep without signs of depression.

 

PTS:   1                    REF:   Chapter 12: Bipolar Disorders; Manic Phase; page 193-194

KEY:  Integrated Processes: Teaching/Learning | Content Area: Mental Health: Mood Disorder | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Mental health Concepts

 

 

Chapter 22: Victims of Abuse and Violence

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____    1.   Your new patient in the ER states that she was been beaten and raped. What should you do first?

A. Ask for a psychiatric consult.
B. Stay with her and provide support.
C. Wash and dress her wounds before the rape kit is performed.
D. Encourage her to tell you the details of what happened.

 

 

____    2.   Who is the most likely perpetrator of child abuse?

A. Parent
B. Other relatives
C. Hired babysitter
D. Teacher

 

 

____    3.   What are safe surrender sites?

A. A place where a mother can safely give up her newborn with no questions asked.
B. A facility for teens who are unable to live with their parents.
C. A law enforcement action to give up guns in the home to reduce violence.
D. A place for teens with substance abuse problems to go to avoid arrest.

 

 

____    4.   Which of the following is NOT a risk factor for becoming a child abuser?

A. Abused as a child
B. Grew up in poverty
C. Heavy drinker
D. Poor coping mechanisms to deal with frustration

 

 

____    5.   Your new 90-year-old patient is admitted with a broken wrist and multiple bruises. The caregiver reports the patient falls when she wanders. Which of the following would lead you to suspect elder abuse?

A. Inconsistent explanations about the details of the falls.
B. The patient tells you she doesnt like the caregiver.
C. The patient begins crying when her daughter arrives.
D. The patient has a UTI.

 

 

____    6.   Nurses would expect that a nonthreatening form of therapy for a child who has been sexually abused would be:

A. Systematic desensitization.
B. Group therapy.
C. Art or play therapy.
D. Rational emotive therapy.

 

 

____    7.   Because a woman who is being hurt by her partner may try to keep the abuse private, which of the following is known to be an indirect source to identify the abuse?

A. Pediatric clinics
B. Emergency rooms
C. Womens shelters
D. Mental health clinics

 

 

____    8.   A battered woman in the womens shelter states that she is afraid to go home because he drinks. Thats when he gets violent and he beats me. Which of the following reflects accurate knowledge about domestic violence and alcohol use?

A. If you can get him to quit drinking, the beating will stop.
B. Alcohol use can increase the chances of abuse.
C. People who use alcohol almost always end up as abusers.
D. Hes just using the alcohol as an excuse to beat you.

 

 

____    9.   You are working nights in the free clinic. A woman is brought in by a female friend. According to the friend, the woman has been raped. The first nursing intervention for this patient is:

A. Reassure her that she is safe.
B. Get the rape kit and perform the examination.
C. Ask her who did this to her.
D. Call the police for her.

 

 

____  10.   Nurses must care for the abuser, as well as the abused person. You are caring for a middle-aged man who is under medical and psychiatric care for molesting a 7-year-old girl. You inform him that dinner is being served in the dining room. He tells you to leave and that he does not want anyone to see him or know what I did. You respond:

A. You will need to face people sooner or later.
B. You are here for treatment of an illness, not judgment of an action.
C. I guess I wouldnt want to been seen either. You may stay here.
D. Only the staff knows the reason for your admission.

 

 

____  11.   You are caring for a 6-year-old boy who allegedly has been abused by his mother. During his mothers visits, which of the following is most associated with her being an abuser?

A. A strong and loving relationship with her parents
B. Single parent home
C. A history of being abused as a child
D. Unemployed

 

 

____  12.   Which statement is NOT true about elder abuse?

A. Inappropriate misuse of patients funds by a caregiver is not considered abuse.
B. Inappropriate use of restraints is a form of abuse.
C. The abuser can be a hired caregiver or family.
D. Sexual contact with a woman with dementia is considered elder abuse.

 

 

____  13.   Your patient, who has reported domestic violence, now tells you she is going home with her husband because he has apologized and says he is taking her to Hawaii on a romantic vacation. Which statement best helps you understand her actions?

A. Her husband has received treatment for anger management.
B. This is the honeymoon phase of the abuse cycle.
C. This is the resolution phase of the family crisis.
D. She mistakenly reported domestic violence.

 

 

____  14.   The difference between child abuse and child neglect is:

A. Abuse is done on purpose; neglect is accidental.
B. Abuse is an act of commission; neglect is an act of omission.
C. Abuse is a crime; neglect is not.
D. Children are often afraid to report abuse, but are willing to report neglect.

 

 

____  15.   Shaken baby syndrome refers to:

A. The increasing rate of epilepsy and other seizure disorders in infants born to mothers with a history of psychiatric disorders.
B. A form of child abuse in which a baby is shaken hard enough to cause trauma and death.
C. The physical and developmental problems faced by infants of drug-addicted mothers.
D. The psychological trauma that children experience from perceived threats to their safety.

 

 

____  16.   Annie is a 5 year old who has been the victim of sexual abuse by a family member. Which of the following therapeutic techniques would be especially useful in helping Annie express her feelings?

A. Individual psychotherapy
B. Behavior modification
C. Family therapy sessions
D. Drawing

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____  17.   Which of the following are actions the nurse can take to help victims of abuse? (Select all that apply)

A. Reassure the patient that everything possible is being done to ensure his or her safety.
B. Dont show empathy to the abuser.
C. Know your own thoughts and feelings about abuse.
D. Take the burden of deciding about notifying authorities off the patient and do it yourself.
E. Remain nonjudgmental.
F. Know and follow agency policies.

 

 

____  18.   Which of the following statements about sexual abuse of children are true? (Select all that apply)

A. The abuser is most often someone the child knows and trusts.
B. The nurse must confront the abuse victim to make him or her admit to the abuse.
C. Abused children often act out the abuse in their own play behaviors.
D. The abused child is confused about whether the acts are right, but believes the abuser would not do anything wrong.
E. Because children are resilient, they tend to get over acts of sexual abuse fairly easily with minimal intervention.
F. One thing the nurse must do is reinforce that the child is not to blame for the abuse.

 

 

True/False

Indicate whether the statement is true or false.

 

____  19.   Purposely hurting a family pet is a warning sign of other types of abuse in the home.

 

Completion

Complete each statement.

 

  1. The misuse of a person, substance, or situation is called ________________.

 

 

Chapter 22: Victims of Abuse and Violence

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  B

Providing security and support are the best initial interventions. Response C is incorrect. Responses A and D may be needed later.

 

PTS:   1

REF:   Chapter 22: Victims of Abuse and Violence; General Nursing Interventions; page 362-363

KEY:  Integrated Processes: Nursing Process: Implementation | Content Area: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

 

  1. ANS:  A

The parent is the most likely child abuser.

 

PTS:   1                    REF:   Chapter 22: Victims of Abuse and Violence; Child Abuse; page 356

KEY:  Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Child abuse | Cognitive Level: Comprehension | Client Need: Psychosocial Integrity: Abuse/neglect

 

  1. ANS:  A

Safe surrender sites are available around the country to prevent abandonment of infants.

 

PTS:   1                    REF:   Chapter 22: Victims of Abuse and Violence; Child Abuse; page 357

KEY:  Integrated Processes: Nursing Process: Analysis | Content Area: Newborn at risk: Maternity: Newborn at risk | Cognitive Level: Comprehension | Client Need: Health Promotion and Maintenance: Ante/intra/postpartum and newborn care

 

  1. ANS:  B

Poverty by itself is not a risk factor though it may contribute to it in the presence of these other responses.  Child abuse occurs at all socioeconomic levels.

 

PTS:   1                    REF:   Chapter 22: Victims of Abuse and Violence; Child Abuse; page 356

KEY:  Integrated Processes: Nursing Process: Analysis | Content Area: Mental Health: Child abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Abuse/neglect

 

  1. ANS:  A

Inconsistent explanations of injuries are a common indicator of abuse. All of the other responses would not be indicators on their own, but with other factors may lead you to suspect abuse.

 

PTS:   1

REF:   Chapter 22: Victims of Abuse and Violence; Elder Abuse page 360 and Box 22-1 Common Warning signs of abuse; page 356

KEY:  Integrated Processes: Nursing Process: Analysis | Content Area: Geriatrics: Elder abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Abuse/neglect

 

  1. ANS:  C

Art and play therapy allow the child to work through feelings without having to have the words for them.

 

PTS:   1                    REF:   Chapter 22: Victims of Abuse and Violence; Treatment of Abuse; page 362

KEY:  Integrated Processes: Nursing Process: Analysis | Content Area: Child health: Abuse: Mental health: Child abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Abuse/neglect

 

  1. ANS:  A

Because a woman will seek medical care for her children, this is a common site for initial identification of the abuse.

 

PTS:   1                    REF:   Chapter 22: Victims of Abuse and Violence; Domestic Violence; page 358

KEY:  Integrated Processes: Nursing Process: Analysis | Content Area: Womens health | Cognitive Level: Application | Client Need: Psychosocial Integrity: Abuse/neglect

 

  1. ANS:  B

The other responses are inaccurate. Alcohol reduces inhibitions that can lead to aggressive behaviors.

 

PTS:   1                    REF:   Chapter 22: Victims of Abuse and Violence; The Abuser; page 354

KEY:  Integrated Processes: Nursing Process: Implementation | Content Area: Substance Abuse | Cognitive Level: Application | Client Need: Psychosocial Integrity: Abuse/neglect and Psychosocial Integrity: Chemical and other dependencies

 

  1. ANS:  A

Initial intervention should be focused on safety.

 

PTS:   1

REF:   Chapter 22: Victims of Abuse and Violence; Table 22-3 Nursing Interventions for Victims of Abuse; page 365

KEY:  Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

 

  1. ANS:  B

This response is professional and communicates support to this patient. Responses A and C are judgmental. Response D is true, but is not as supportive as response B.

 

PTS:   1

REF:   Chapter 22: Victims of Abuse and Violence; General Nursing Interventions; pages 362-3

KEY:  Integrated Processes: Nursing Process: Implementation | Content Area: Mental Health: Therapeutic communication | Cognitive Level: Application | Client Need: Psychosocial Integrity: Therapeutic communication

 

  1. ANS:  C

Continuing of the abuse cycle into adulthood remains a frequent pattern.

 

PTS:   1                    REF:   Chapter 22: Victims of Abuse and Violence; The Abuser; page 354

KEY:  Integrated Processes: Nursing Process: Analysis | Content Area

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