Exam 1: NSG3450/ NSG 3450 V1 (NEW 2026/ 2027 Update) Nursing Practice – Mental Health Guide| Questions & Answers| Grade A| 100% Correct (Verified Solutions)- Galen

Exam 1: NSG3450/ NSG 3450 V1 (NEW 2026/ 2027 Update) Nursing Practice – Mental Health Guide| Questions & Answers| Grade A| 100% Correct (Verified Solutions)- Galen Q. The scope of practiced for an advanced nurse practitioner would include which intervention? a. Conducting a mental health assessment. b. Prescribing psychotropic medication. c. Establishing a therapeutic relationship. d. Individualizing a nursing care plan. ANSWER b. Prescribing psychotropic medication. Q. A nursing student expresses concerns that mental health nurses "lose all their clinical nursing skills." Select the best response by the mental health nurse. a. "Psychiatric nurses practice in safer environments than other specialties. Nurse-to client ratios must be better because of the nature of the clients' problems." b. "Psychiatric nurses use complex communication skills as well as critical thinking to solve multidimensional problems. I am challenged by those situations." c. "That's a misconception. Psychiatric nurses frequently use high technology monitoring equipment and manage complex intravenous therapies." d. "Psychiatric nurses do not have to deal with as much pain and suffering as medical- surgical nurses do. That appeals to me." ANSWER b. "Psychiatric nurses use complex communication skills as well as critical thinking to solve multidimensional problems. I am challenged by those situations." Q. When a new bill introduced in Congress reduces funding for care of persons diagnosed with mental illness, a group of nurses write letters to their elected representatives in opposition to the legislation. Which role have the nurses fulfilled? a. Recovery b. Attending c. Advocacy d. Evidence-based practice ANSWER c. Advocacy Q. A family has a long history of conflicted relationships among the members. Which family member's comment best reflects a mentally healthy perspective? a. "I've made mistakes but everyone else in this family has also." b. "I remember joy and mutual respect from our early years together." c. "I will make some changes in my behavior for the good of the family." d. "It's best for me to move away from my family. Things will never change." ANSWER c. "I will make some changes in my behavior for the good of the family." Q. Which assessment finding most clearly indicates that a client may be experiencing a mental illness? a. reporting occasional sleeplessness and anxiety. b. reporting a consistently sad, discouraged, and hopeless mood. c. being able to describe the difference between "as if" and "for real." d. experiencing difficulty making a decision about whether to change jobs. ANSWER b. reporting a consistently sad, discouraged, and hopeless mood. Q. Which finding best indicates that the goal "Demonstrate mentally healthy behavior" was achieved for an adult client? a. being willing to work towards achieving ideals and meeting demands. b. behaving without considering the consequences of personal actions. c. aggressively meeting personal needs without considering the rights of others. d. seeking help from others to avoid assuming responsibility for major areas of own life. ANSWER a. being willing to work towards achieving ideals and meeting demands. Q. A nurse encounters an unfamiliar psychiatric disorder on a new client's admission form. Which resource should the nurse consult to determine criteria used to establish this diagnosis? a. International Statistical Classification of Diseases and Related Health Problems (ICD-10) b. The ANA's Psychiatric-Mental Health Nursing Scope and Standards of Practice c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V) d. A behavioral health reference manual ANSWER c. Diagnostic and Statistical Manual of Mental Disorders (DSM-V) Q. A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource would have the most complete information? a. Nursing Outcomes Classification (NOC) b. DSM-V c. The ANA's Psychiatric-Mental Health Nursing Scope and Standards of Practice d. ICD-10 ANSWER b. DSM-V Q. Which individual behavior demonstrates resilience? a. Repress stressors associated with a divorce. b. Continuing to grieve the death of a spouse for 5 years. c. Continuing to live in a shelter for 2 years after the home is destroyed by fire. d. Taking a temporary job to maintain financial stability after loss of a permanent job. ANSWER d. Taking a temporary job to maintain financial stability after loss of a permanent job. Q. The relationship of the North American Nursing Diagnosis Association (NANDA) is to clinical judgment as Nursing Interventions Classification (NIC) is to what? a. client outcomes. b. nursing actions. c. diagnosis. d. symptoms. ANSWER b. nursing actions. Q. An adult says, "Most of the time I'm happy and feel good about myself. I have learned that what I get out of something is proportional to the effort I put into it." Which number on this mental health continuum should the nurse select? Mental Illness Mental Health 1 2 3 4 5 a. 1 b. 2 c. 3 d. 4 e. 5 ANSWER e. 5 Q. Which disorder is an example of a culture-bound syndrome? a. Epilepsy b. Schizophrenia c. Running amok d. Major depressive disorder ANSWER c. Running amok Q. What does the DSM-V classify? a. deviant behaviors b. present disability or distress c. people with mental disorders d. mental disorders ANSWER d) Mental disorders The DSM-V classifies disorders people have rather than people themselves. Q. A citizen at a community health fair asks the nurse, "What is the most prevalent mental disorder in the United States?" Select the nurse's correct response. a. Schizophrenia b. Bipolar disorder c. Dissociative fugue d. Alzheimer's disease ANSWER d. Alzheimer's disease Q. In the majority culture of the United States, which individual has the greatest risk to be labeled mentally ill? a. One who describes hearing God's voice speaking. b. One who is usually pessimistic but strives to meet personal goals. c. One who is wealthy and gives away $20 bills to needy individuals. d. One who always has an optimistic viewpoint about life ANSWER a. One who describes hearing God's voice speaking. Q. A client's relationships are intense and unstable. The client initially idealizes the significant other and then devalues him or her, resulting in frequent feelings of emptiness. This client will benefit from interventions to develop which aspect of mental health? a. Effectiveness in work b. Communication skills c. Productive activities d. Fulfilling relationships ANSWER d. Fulfilling relationships Q. Which belief will best support a nurse's efforts to provide client advocacy during a multidisciplinary client care planning session? a. All mental illnesses are culturally determined. b. Schizophrenia and bipolar disorder are cross-cultural disorders. c. Symptoms of mental disorders are unchanged from culture to culture. d. Assessment findings in mental illness reflect a person's cultural patterns. ANSWER d. Assessment findings in mental illness reflect a person's cultural patterns. Q. A nurse is part of a multidisciplinary team working with groups of depressed clients. One group of clients receives supportive interventions and antidepressant medication. The other group receives only medication. The team measures outcomes for each group. Which type of study is evident? a. Incidence b. Prevalence c. Comorbidity d. Clinical epidemiology ANSWER d. Clinical epidemiology Q. The spouse of a client diagnosed with schizophrenia says, "I don't understand how events from childhood have anything to do with this disabling illness." Which response by the nurse will best help the spouse understand the cause of this disorder? a. "Psychological stress is the basis of most mental disorders." b. "This illness results from developmental factors rather than stress." c. "Research shows that this condition more likely has a biological basis." d. "It must be frustrating for you that your spouse is sick so much of the time." ANSWER c. "Research shows that this condition more likely has a biological basis." Q. A category 5 tornado occurred in a community of 400 people. Many homes and businesses were destroyed. In the 2 years following the disaster, 140 individuals were diagnosed with post-traumatic stress disorder (PTSD). Which term best applies to these newly diagnosed cases? a. Prevalence b. Comorbidity c. Incidence d. Parity ANSWER c. Incidence Which component of treatment of mental illness is specifically recognized by Quality and Safety Education for Nurses (QSEN)? a. All genomes are unique. b. Care is centered on the client. c. Healthy development is vital to mental health. d. Recovery occurs on a continuum from illness to health. b. Care is centered on the client. What is the best response for the nurse to provide to a question from another health professional regarding the difference between a diagnosis in DSM-V and a nursing diagnosis. a. "There is no functional difference between the two. Both identify human disorders." b. "The DSM-V diagnosis disregards culture, whereas the nursing diagnosis takes culture into account." c. "The DSM-V diagnosis describes causes of disorders whereas a nursing diagnosis does not explore etiology." d. "The DSM-V diagnosis guides medical treatment, whereas the nursing diagnosis offers a framework for identifying interventions for issues a client is experiencing." d. "The DSM-V diagnosis guides medical treatment, whereas the nursing diagnosis offers a framework for identifying interventions for issues a client is experiencing." Which nursing intervention below is part of the scope of an advanced practice psychiatric/mental health nurse rather than a basic level registered nurse? a. Coordination of care b. Health teaching c. Milieu therapy d. Psychotherapy d. Psychotherapy An experienced nurse says to a new graduate, "When you've practiced as long as I have, you automatically know how to take care of clients experiencing psychosis." Which factors should the new graduate consider when analyzing this comment? (Select all that apply.) a. The experienced nurse may have lost sight of clients' individuality, which may compromise the integrity of practice. b. New research findings should be integrated continuously into a nurse's practice to provide the most effective care. c. Experience provides mental health nurses with the essential tools and skills needed for effective professional practice. d. Experienced psychiatric nurses have learned the best ways to care for mentally ill clients through trial and error. e. An intuitive sense of clients' needs guides effective psychiatric nurses. a. The experienced nurse may have lost sight of clients' individuality, which may compromise the integrity of practice b. New research findings should be integrated continuously into a nurse's practice to provide the most effective care. Which findings are signs of a person who is mentally healthy? (Select all that apply.) a. Says, "I have some weaknesses, but I feel I'm important to my family and friends." b. Adheres strictly to religious beliefs of parents and family of origin. c. Spends all holidays alone watching old movies on television. d. Considers past experiences when deciding about the future. e. Experiences feelings of conflict related to changing jobs. a. Says, "I have some weaknesses, but I feel I'm important to my family and friends." d. Considers past experiences when deciding about the future. e. Experiences feelings of conflict related to changing jobs. A client in the emergency department says, "Voices say someone is stalking me. They want to kill me because I developed a cure for cancer. I have a knife and will stab anyone who is a threat." Which aspects of the client's mental health have the greatest and most immediate concern to the nurse? (Select all that apply.) a. Happiness b. Appraisal of reality c. Control over behavior d. Effectiveness in work e. Healthy self-concept b. Appraisal of reality c. Control over behavior e. Healthy self-concept A parent says, "My 2-year-old child refuses toilet training and shouts 'No!' when given directions. What do you think is wrong?" What is the nurse's best reply? a. "Your child needs firmer control. It is important to set limits now." b. "This is normal for your child's age. The child is striving for independence." c. "There may be developmental problems. Most children are toilet trained by age 2." d. "Some undesirable attitudes are developing. A child psychologist can help you develop a plan." b. "This is normal for your child's age. The child is striving for independence." A nurse wants to find information on current evidence-based research, programs, and practices regarding mental illness and addictions. Which resource should the nurse consult? a. American Psychiatric Association b. American Psychological Association (APA) c. Clinician's Quick Guide to Interpersonal Psychotherapy d. Substance Abuse and Mental Health Services Administration (SAMHSA) d. Substance Abuse and Mental Health Services Administration (SAMHSA) A 26-month-old displays negative behavior, refuses toilet training, and often says, "No!" Which psychosocial crisis is evident? a. Trust versus mistrust b. Initiative versus guilt c. Industry versus inferiority d. Autonomy versus shame and doubt d. Autonomy versus shame and doubt A nurse supports a parent for praising a child who behaves in helpful ways to others. When this child behaves with politeness and helpfulness in adulthood, which feeling will most likely result? a. Guilt b. Anxiety c. Humility d. Self-esteem d. self-esteem An adult says, "I never know the answers," and "My opinion does not count." Which psychosocial crisis was unsuccessfully resolved for this adult? a. Initiative versus guilt b. Trust versus mistrust c. Autonomy versus shame and doubt d. Generativity versus self-absorption c. Autonomy versus shame and doubt Which statement by a client would lead the nurse to suspect unsuccessful completion of the psychosocial developmental task of infancy? a. "I know how to do things right, so I prefer jobs where I work alone rather than on a team." b. "I do not allow other people to truly get to know me." c. "I depend on frequent praise from others to feel good about myself." d. "I usually need to do things several times before I get them right." b. "I do not allow other people to truly get to know me." According to Erikson, the developmental task of infancy is the development of trust. A client is suspicious and is frequently sarcastic toward others. To which psychosexual stage do these traits relate? a. Oral b. Anal c. Phallic d. Genital a. Oral A client expresses a desire to be cared for by others and often behaves in a helpless fashion. Which stage of psychosexual development is most relevant to the client's needs? a. Latency b. Phallic c. Anal d. Oral d. Oral A nurse listens to a group of recent retirees. One says, "I volunteer with Meals on Wheels, coach teen sports, and do church visitation." Another laughs and says, "I'm too busy taking care of myself to volunteer to help others." Which psychosocial developmental task do these statements contrast? a. Trust and mistrust b. Intimacy and isolation c. Industry and inferiority d. Generativity and self-absorption d. Generativity and self-absorption An adult dies in a tragic accident. Afterward, the siblings plan a funeral service. Which statement by a sibling best indicates a sense of self-actualization? a. "Of all of us, I am the most experienced with planning these types of events." b. "Funerals are supposed to be conducted quietly, respectfully, and according to a social protocol." c. "This death was unfair, but I hope we can plan a service that everyone feels is a celebration of life." d. "This death was probably the consequence of years of selfish and inconsiderate behavior by our sibling." c. "This death was unfair, but I hope we can plan a service that everyone feels is a celebration of life." A student nurse says, "I don't need to interact with my clients. I learn what I need to know by observation." An instructor can best interpret the nursing implications of Sullivan's theory to this student by providing what response? a. "Interactions are required in order to help you develop therapeutic communication skills." b. "Nurses cannot be isolated. We must interact to provide clients with opportunities to practice interpersonal skills." c. "Observing client interactions will help you formulate priority nursing diagnoses and appropriate interventions." d. "It is important to pay attention to clients' behavioral changes, because these signify adjustments in personality." b. "Nurses cannot be isolated. We must interact to provide clients with opportunities to practice interpersonal skills." A nurse consistently encourages client to do his or her own activities of daily living. If the client is unable to complete an activity, the nurse helps until the client is once again independent. This nurse's practice is most influenced by which theorist? a. Betty Neuman b. Patricia Benner c. Dorothea Orem d. Joyce Travelbee c. Dorothea Orem A nurse uses Maslow's hierarchy of needs to plan care for a client diagnosed with mental illness. Which problem will receive priority? a. Refusal to eat or bathe. b. Reporting feelings of alienation from family. c. Reluctance to participate in unit social activities. d. Being unaware of medication action and side effects. a. Refusal to eat or bathe. Operant conditioning is part of the treatment plan to encourage speech in a child who is nearly mute. Which technique applies? a. Encourage the child to observe others talking. b. Include the child in small group activities. c. Give the child a small treat for speaking. d. Teach the child relaxation techniques. c. Give the child a small treat for speaking. The parent of a child diagnosed with schizophrenia tearfully asks the nurse, "What could I have done differently to prevent this illness?" What is the nurse's best response? a. "Although schizophrenia results from impaired family relationships, try not to feel guilty. No one can predict how a child will respond to parental guidance." b. "Schizophrenia is a biological illness resulting from changes in how the brain and nervous system function. You are not to blame for your child's illness." c. "There is still hope. Changing your parenting style can help your child learn to cope effectively with the environment." d. "Most mental illnesses result from genetic inheritance. Your genes are more at fault than your parenting." b. "Schizophrenia is a biological illness resulting from changes in how the brain and nervous system function. You are not to blame for your child's illness." A nurse influenced by Peplau's interpersonal theory works with an anxious, withdrawn client. What principle will the interventions be focused on? a. Rewarding desired behaviors. b. Using assertive communication. c. Changing the client's self-concept. d. Administering medications to relieve anxiety. b. Using assertive communication A client participated in psychotherapy weekly for 5 months. The therapist used free association, dream analysis, and facilitated transference to help the client understand conflicts and foster change. What is the term that applies to this method? a. Rational-emotive behavior therapy b. Psychodynamic psychotherapy c. Cognitive-behavioral therapy d. Operant conditioning b. Psychodynamic psychotherapy Consider this comment from a therapist: "The client is homosexual but has kept this preference secret. Severe anxiety and depression occur when the client anticipates family reactions to this sexual orientation." Which perspective is evident in the speaker? a. Theory of interpersonal relationships b. Classical conditioning theory c. Psychosexual theory d. Behaviorism theory a. Theory of interpersonal relationships A psychotherapist works with an anxious, dependent client. Which strategy is most consistent with psychoanalytic psychotherapy? a. Identifying the client's strengths and assets b. Praising the client for describing feelings of isolation c. Focusing on feelings developed by the client toward the therapist d. Providing psychoeducation and emphasizing medication adherence c. Focusing on feelings developed by the client toward the therapist A person says, "I was the only survivor in a small plane crash. Three business associates died. I got depressed and saw a counselor twice a week for 4 weeks. We talked about my feelings related to being a survivor, and I'm better now." Which type of therapy was used? a. Systematic desensitization b. Psychoanalysis c. Behavior modification d. Interpersonal psychotherapy d. Interpersonal psychotherapy Which technique is most applicable to aversion therapy? a. Punishment b. Desensitization c. Role modeling d. Positive reinforcement a. punishment A client says to the nurse, "My father has been dead for over 10 years but talking to you is almost as comforting as the talks he and I had when I was a child." Which term applies to the client's comment? a. Superego b. Transference c. Reality testing d. Countertransference b. Transference A college student received an invitation to attend the wedding of a close friend who lives across the country. The student is afraid of flying. Which type of therapy would be most helpful for this client? a. Psychoanalysis b. Aversion therapy c. Systematic desensitization d. Short-term dynamic therapy c. Systematic desensitization A client repeatedly stated, "I'm stupid." Which statement by that client would show progress resulting from cognitive-behavioral therapy? a. "Sometimes I do stupid things." b. "Things always go wrong for me." c. "I always fail when I try new things." d. "I'm disappointed in my lack of ability." a. "Sometimes I do stupid things." A client says, "All my life I've been surrounded by stupidity. Everything I buy breaks because the entire American workforce is incompetent." This client is experiencing what type of reaction? a. self-esteem deficit. b. cognitive distortion. c. deficit in motivation. d. deficit in love and belonging. b. cognitive distortion. A client is fearful of riding on elevators. The therapist first rides an escalator with the client. The therapist and client then stand in an elevator with the door open for 5 minutes and later with the elevator door closed for 5 minutes. Which technique has the therapist used? a. Classic psychoanalytic therapy b. Systematic desensitization c. Rational emotive therapy d. Biofeedback B. Systematic desensitization A client says, "I always feel good when I wear a size 2 petite." Which type of cognitive distortion is evident? a. Disqualifying the positive b. Overgeneralization c. Catastrophizing d. Personalization b. Overgeneralization Which comment best indicates a client is self-actualized? a. "I have succeeded despite a world filled with evil." b. "I have a plan for my life. If I follow it, everything will be fine." c. "I'm successful because I work hard. No one has ever given me anything." d. "My favorite leisure is walking on the beach, hearing soft sounds of rolling waves." d. "My favorite leisure is walking on the beach, hearing soft sounds of rolling waves." A nurse presents a community education program about mental illness. Which comment by a participant best demonstrates a correct understanding of mental illness from a biological perspective? a. "Some people experience life events so traumatic that they cannot be overcome." b. "Disturbed and conflicted family relationships are usually a starting place for mental illness." c. "My friend has had bipolar disorder for years and many problems have resulted. It's not her fault." d. "Mental illness is the result of developmental complications that cause a person not to grow to their full potential." c. "My friend has had bipolar disorder for years and many problems have resulted. It's not her fault." Which client is the best candidate for brief psychodynamic therapy? a. An accountant with a loving family and successful career who was involved in a short extramarital affair b. An adult with a long history of major depression who was charged with driving under the influence c. A woman with a history of borderline personality disorder who recently cut both wrists d. An adult male recently diagnosed with anorexia nervosa a. An accountant with a loving family and successful career who was involved in a short extramarital affair A client states, "I'm starting cognitive-behavioral therapy. What can I expect from the sessions?" Which responses by the nurse would be appropriate? (Select all that apply.) a. "The therapist will be active and questioning." b. "You will be given some homework assignments." c. "The therapist will ask you to describe your dreams." d. "The therapist will help you look at your ideas and beliefs about yourself." e. "The goal is to increase subjectivity about thoughts that govern your behavior." a. "The therapist will be active and questioning." b. "You will be given some homework assignments." d. "The therapist will help you look at your ideas and beliefs about yourself." Which comments by an elderly person best indicate successful completion of the individual's psychosocial developmental task? (Select all that apply.) a. "I am proud of my children's successes in life." b. "I should have given to community charities more often." c. "My relationship with my father made life more difficult for me." d. "My experiences in the war helped me appreciate the meaning of life." e. "I often wonder what would have happened if I had chosen a different career." a. "I am proud of my children's successes in life." d. "My experiences in the war helped me appreciate the meaning of life." Which comments by an adult best indicate self-actualization? (Select all that apply.) a. "I am content with a good book." b. "I often wonder if I chose the right career." c. "Sometimes I think about how my parents would have handled problems." d. "It's important for our country to provide basic health care services for everyone." e. "When I was lost at sea for 2 days, I gained an understanding of what is important." a. "I am content with a good book." d. "It's important for our country to provide basic health care services for everyone." e. "When I was lost at sea for 2 days, I gained an understanding of what is important." Which activities represent the caring foundation of nursing? (Select all that apply.) a. Administering medications on time to a group of clients b. Listening to a new widow grieve her husband's death c. Helping a client obtain groceries from a food bank d. Teaching a client about a new medication e. Holding the hand of a frightened client b. Listening to a new widow grieve her husband's death c. Helping a client obtain groceries from a food bank e. Holding the hand of a frightened client Which therapies involve electrical brain stimulation for treatment of mental illness? (Select all that apply.) a. Aversion therapy b. Operant conditioning c. Systematic desensitization d. Electroconvulsive therapy (ECT) e. Transcranial magnetic stimulation (TMS) d. Electroconvulsive therapy (ECT) e. Transcranial magnetic stimulation (TMS) In-client hospitalization for persons with mental illness is generally reserved for clients who demonstrate which characteristic? a. present a clear danger to self or others. b. are noncompliant with medication at home. c. have limited support systems in the community. d. develop new symptoms during the course of an illness. a. present a clear danger to self or others. A client was hospitalized for 24 hours after a reaction to a psychotropic medication. While planning discharge, the case manager learned that the client received a notice of eviction immediately prior to admission. What is the case manager's most appropriate action? a. Postpone the client's discharge from the hospital. b. Contact the landlord who evicted the client to further discuss the situation. c. Arrange a temporary place for the client to stay until new housing can be arranged. d. Determine whether the adverse medication reaction was genuine because the client had nowhere to live. c. Arrange a temporary place for the client to stay until new housing can be arranged. What action is an example of tertiary prevention? a. Helping a person diagnosed with a serious mental illness learn to manage money b. Restraining an agitated client who has become aggressive and assaultive c. Teaching school-age children about the dangers of drugs and alcohol d. Genetic counseling with a young couple expecting their first child a. Helping a person diagnosed with a serious mental illness learn to manage money A client diagnosed with schizophrenia had an exacerbation related to medication nonadherence and was hospitalized for 5 days. The client's thoughts are now more organized, and discharge is planned. The client's family says, "It's too soon for discharge. We will just go through all this again." What action should the nurse take? a. ask the case manager to arrange a transfer to a long-term care facility. b. notify hospital security to handle the disturbance and escort the family off the unit. c. explain that the client will continue to improve if the medication is taken regularly. d. contact the health care provider to meet with the family and explain the discharge rationale. c. explain that the client will continue to improve if the medication is taken regularly. A nurse inspects an inpatient psychiatric unit and finds that exits are free of obstructions, no one is smoking, and the janitor's closet is locked. What do these observations relate to? inating care of clients. b. management of milieu safety. c. management of the interpersonal climate. d. use of therapeutic intervention strategies. b. management of milieu safety. The psychiatric unit has one bed available. Which client should be admitted from the emergency department? The client a. The client feeling anxiety and a sad mood after separation from a spouse of 10 years. b. The client who self-inflicted a superficial cut on the forearm after a family argument. c. The client experiencing dry mouth and tremor related to taking antipsychotic medication. d. The client who is a new parent and hears voices saying, "Smother your baby." d. The client who is a new parent and hears voices saying, "Smother your baby." A suspicious, socially isolated client lives alone, eats one meal a day at a local shelter, and spends the remaining daily food allowance on cigarettes. What is the community psychiatric nurse's best initial action? a. Exploring ways to help the client stop smoking. b. Reporting the situation to the manager of the shelter. c. Assessing the client's weight; determine foods and amounts eaten. d. Arranging hospitalization for the client in order to formulate a new treatment plan. c. Assessing the client's weight; determine foods and amounts eaten. A nurse surveying medical records would find evidence suggesting which client's rights have been violated? a. A client was not allowed to have visitors. b. A client's belongings were searched at admission. c. A client with suicidal ideation was placed on continuous observation. d. Physical restraint was used after a client was assaultive toward a staff member. a. A client was not allowed to have visitors. Which principle has the highest priority when addressing a behavioral crisis in an inpatient setting? a. Resolve the crisis with the least restrictive intervention possible. b. Swift intervention is justified to maintain the integrity of a therapeutic milieu. c. Rights of an individual client are superseded by the rights of the majority of clients. d. Clients should have opportunities to regain control without intervention if the safety of others is not compromised. a. Resolve the crisis with the least restrictive intervention possible. Clinical pathways are used in managed care settings to accomplish what? a. stabilization of aggressive clients. b. identifying obstacles to effective care. c. relieving nurses of planning responsibilities. d. streamlining the care process to reduce costs. d. streamlining the care process to reduce costs. A nurse receives these three phone calls regarding a newly admitted client. · The psychiatrist wants to complete an initial assessment. . An internist wants to perform a physical examination. · The client's attorney wants an appointment with the client. The nurse schedules the activities for the client. Which role has the nurse fulfilled? a. Advocate b. Case manager c. Milieu manager d. Provider of care b. Case manager Which aspect of direct care is an experienced, inpatient psychiatric nurse most likely to provide for a client? a. Hygiene assistance b. Diversional activities c. Assistance with job hunting d. Building assertiveness skills d. Building assertiveness skills Which characteristic would be more applicable to a community mental health nurse than to a nurse working in an operating room? a. Kindness b. Autonomy c. Compassion d. Professionalism B. Autonomy Which client would be most appropriate to refer for assertive community treatment (ACT)? a. One diagnosed with a phobic fear of crowded places. b. One who experienced a single episode of major depressive disorder. c. One who experienced a catastrophic reaction to a tornado in the community. d. One diagnosed with schizophrenia who had four hospitalizations in the past year d. One diagnosed with schizophrenia who had four hospitalizations in the past year. The unit secretary receives a phone call from the health insurer for a hospitalized client. The caller seeks information about the client's projected length of stay. How should the nurse instruct the unit secretary to handle the request? a. Obtain the information from the client's medical record and relay it to the caller. b. Inform the caller that all information about clients is confidential. c. Refer the request for information to the client's case manager. d. Refer the request to the health care provider. c. Refer the request for information to the client's case manager. What is an example of primary prevention? a. Assisting a person diagnosed with a serious mental illness to fill a pill-minder b. Helping school-age children identify and describe normal emotions c. Leading a psychoeducational group in a community care home d. Medicating an acutely ill client who assaulted a staff person b. Helping school-age children identify and describe normal emotions Which level of prevention activities would a nurse in an emergency department employ most often? a. Primary b. Secondary c. Tertiary b. secondary How would the nurse assigned to ACT best explain the program's treatment goal? a. assisting clients to maintain abstinence from alcohol and other substances of abuse. b. providing structure and a therapeutic milieu for mentally ill clients whose symptoms require stabilization. c. maintaining medications and stable psychiatric status for incarcerated inmates who have a history of mental illness. d. providing services for mentally ill individuals who require intensive treatment to continue to live in the community. d. providing services for mentally ill individuals who require intensive treatment to continue to live in the community. Which scenario best depicts a behavioral crisis? a. A client is waving fists, cursing, and shouting threats at a nurse. b. A client is curled up in a corner of the bathroom, wrapped in a towel. c. A client is crying hysterically after receiving a phone call from a family member. d. A client is performing push-ups in the middle of the hall, forcing others to walk around. a. A client is waving fists, cursing, and shouting threats at a nurse. What is the initial action of a case manager who plans to discuss the treatment plan with a client's family? a. Determine an appropriate location for the conference. b. Support the discussion with examples of the client's behavior. c. Obtain the client's permission for the exchange of information. d. Determine which family members should participate in the conference. c. Obtain the client's permission for the exchange of information. A client usually watches television all day, seldom going out in the community or socializing with others. The client says, "I don't know what to do with my free time." Which member of the treatment team would be most helpful to this client? a. Psychologist b. Social worker c. Recreational therapist d. Occupational therapist c. Recreational therapist A client diagnosed with schizophrenia has been stable for 2 months. Today the client's spouse calls the nurse to report the client has not taken prescribed medication and is having disorganized thinking. The client forgot to refill the prescription. The nurse arranges a refill. What is the best outcome to add to the plan of care? a. The client's spouse will mark dates for prescription refills on the family calendar. b. The nurse will obtain prescription refills every 90 days and deliver to the client. c. The client will call the nurse weekly to discuss medication-related issues. d. The client will report to the clinic for medication follow-up every week. a. The client's spouse will mark dates for prescription refills on the family calendar. A community mental health nurse has worked for months to establish a relationship with a delusional, suspicious client. The client recently lost employment and could no longer afford prescribed medications. The client says, "Only a traitor would make me go to the hospital." What is the nurse's best initial intervention? a. With the client's consent, contact resources to provide medications without charge temporarily. b. Arrange a bed in a local homeless shelter with nightly on-site supervision. c. Hospitalize the client until the symptoms have stabilized. d. Ask the client, "Do you feel like I am a traitor?" a. With the client's consent, contact resources to provide medications without charge temporarily. Which activity is appropriate for a nurse engaged exclusively in community-based primary prevention? a. Medication follow-up b. Teaching parenting skills c. Substance abuse counseling d. Making a referral for family therapy b. Teaching parenting skills A health care provider prescribed long acting antipsychotic medication injections every 3 weeks at the clinic for a client with a history of medication nonadherence. For this plan to be successful, which factor will be of critical importance? a. The attitude of significant others toward the client b. Nutrition services in the client's neighborhood c. The level of trust between the client and nurse d. The availability of transportation to the clinic d. The availability of transportation to the clinic Which assessment finding for a client diagnosed with serious and persistent mental illness and living in the community merits priority intervention by the psychiatric nurse? a. The client receives social security disability income plus a small check from a trust fund every month. b. The client was absent from two of six planned Alcoholics Anonymous meetings in the past 2 weeks. c. The client lives in an apartment with two clients who attend partial hospitalization programs. d. The client has a sibling who was recently diagnosed with a mental illness. b. The client was absent from two of six planned Alcoholics Anonymous meetings in the past 2 weeks. The nurse should refer which of the following clients to a partial hospitalization program? a. One who has a therapeutic lithium level and reports regularly for blood tests and clinic follow-up. b. One who needs psychoeducation for relaxation therapy related to agoraphobia and panic episodes. c. One who spent yesterday in a supervised crisis care center and continues to have active suicidal ideation. d. One who cannot avoid using alcohol when their spouse goes to work every morning. d. One who cannot avoid using alcohol when their spouse goes to work every morning. After a Category 5 tornado hits a community and destroys many homes and businesses, a community mental health nurse encourages victims to describe their memories and feelings about the event. What does this action by the nurse best demonstrate? a. triage. b. primary prevention. c. psychosocial rehabilitation. d. psychiatric case management. b. Primary prevention A nurse makes an initial visit to a homebound client diagnosed with a serious mental illness. A family member offers the nurse a cup of coffee. What is the nurse's best response? a. "Thank you. I would enjoy having a cup of coffee with you." b. "Thank you, but I would prefer to proceed with the assessment." c. "No but thank you. I never accept drinks from clients or families." d. "Our agency policy prohibits me from eating or drinking in clients' homes." a. "Thank you. I would enjoy having a cup of coffee with you." A nurse performed these actions while caring for clients in an inpatient psychiatric setting. Which action violated clients' rights? a. Prohibited a client from using the telephone b. In client's presence, opened a package mailed to client c. Remained within arm's length of client with homicidal ideation d. Permitted a client with psychosis to refuse oral psychotropic medication a. Prohibited a client from using the telephone A nurse can best address factors of critical importance to successful community treatment by including making assessments focused on what? (Select all that apply.) a. housing adequacy. b. family and support systems. c. income adequacy and stability. d. early psychosocial development. e. substance abuse history and current use. a. housing adequacy. b. family and support systems. c. income adequacy and stability. e. substance abuse history and current use. The health care team at an inpatient psychiatric facility drafts these criteria for admission. Which criteria should be included in the final version of the admission policy? (Select all that apply.) a. Clear risk of danger to self or others b. Adjustment needed for doses of psychotropic medication c. Detoxification from long-term heavy alcohol consumption needed d. Respite for caregivers of persons with serious and persistent mental illness e. Failure of community-based treatment, demonstrating need for intensive treatment a. Clear risk of danger to self or others c. Detoxification from long-term heavy alcohol consumption needed e. Failure of community-based treatment, demonstrating need for intensive treatment A psychiatric nurse discusses rules of the therapeutic milieu and clients' rights with a newly admitted client. Which rights should be included? (Select all that apply.) a. The right to have visitors. b. The right to confidentiality. c. The right to a private room. d. The right to report inadequate care. e. The right to select the nurse assigned to their care. a. The right to have visitors. b. The right to confidentiality. d. The right to report inadequate care Which statements by clients diagnosed with a serious mental illness best demonstrate that the case manager has established an effective long-term relationship? (Select all that apply.) a. "My case manager talks in language I can understand." b. "My case manager helps me keep track of my medication." c. "My case manager gives me little gifts from time to time." d. "My case manager looks at me as a whole person with many needs." e. "My case manager let me do whatever I choose without interfering." a. "My case manager talks in language I can understand." b. "My case manager helps me keep track of my medication." d. "My case manager looks at me as a whole person with many needs." Which statements most clearly reflect the stigma of mental illness? (Select all that apply.) a. "Many mental illnesses are hereditary." b. "Mental illness can be evidence of a brain disorder." c. "People claim mental illness so they can get disability checks." d. "Mental illness results from the breakdown of American families." e. "If people with mental illness went to church, their symptoms would disappear." c. "People claim mental illness so they can get disability checks." d. "Mental illness results from the breakdown of American families." e. "If people with mental illness went to church, their symptoms would disappear." A person in the community asks, "People with mental illnesses went to state hospitals in earlier times. Why has that changed?" What are the accurate responses. (Select all that apply.) a. "Science has made significant improvements in drugs for mental illness, so now many persons may live in their communities." b. "There's now a better selection of less restrictive treatment options available in communities to care for people with mental illness." c. "National rates of mental illness have declined significantly. There actually is not a need for state institutions anymore." d. "Most psychiatric institutions were closed because of serious violations of clients' rights and unsafe conditions." e. "Federal legislation and payment for treatment of mental illness has shifted the focus to community rather than institutional settings." a. "Science has made significant improvements in drugs for mental illness, so now many persons may live in their communities." b. "There's now a better selection of less restrictive treatment options available in communities to care for people with mental illness." e. "Federal legislation and payment for treatment of mental illness has shifted the focus to community rather than institutional settings." A client diagnosed with schizophrenia lives in the community. On a home visit, the community psychiatric nurse case manager learns that the client: · wants to attend an activity group at the mental health outreach center. · is worried about being able to pay for the therapy. · does not know how to get from home to the outreach center. · has an appointment to have blood work at the same time an activity group meets. · wants to attend services at a church that is a half-mile from the client's home. Which tasks are part of the role of a community mental health nurse? (Select all that apply.) a. Rearranging conflicting care appointments b. Negotiating the cost of therapy for the client c. Arranging transportation to the outreach center d. Accompanying the client to church services weekly e. Monitoring to ensure the client's basic needs are met a. Rearranging conflicting care appointments c. Arranging transportation to the outreach center e. Monitoring to ensure the client's basic needs are met Which Western cultural feature may result in establishing unrealistic outcomes for clients of other cultural groups? a. Interdependence b. Present orientation c. Flexible perception of time d. Direct confrontation to solve problems d. Direct confrontation to solve problems A psychiatric nurse leads a medication education group for Hispanic clients. This nurse holds a Western worldview and uses pamphlets as teaching tools. Groups are short and concise. After the group, the clients are most likely to believe a. the nurse was uncaring. b. the session was effective. c. the teaching was efficient. d. they were treated respectfully. a. the nurse was uncaring. To provide culturally competent care, the nurse should focus on what action? a. accurately interpreting the thinking of individual clients. b. predicting how a client may perceive treatment interventions. c. formulating interventions to reduce the client's ethnocentrism. d. identifying strategies that fit within the cultural context of the client. d. identifying strategies that fit within the cultural context of the client. A black client, originally from Haiti, has a diagnosis of major depressive disorder. A colleague tells the nurse, "This client often looks down and is reluctant to share feelings. However, I've observed the client spontaneously interacting with other clients of color." Select the nurse's best response. a. "Clients of color depend on the church for support. Have you consulted the client's pastor?" b. "Encourage the client to talk in a group setting. It will be less intimidating than one- to-one interaction." c. "Don't take it personally. Clients of color often have a resentful attitude that takes a long time to overcome." d. "The client may have difficulty communicating in English. Have you considered using a cultural broker?" d. "The client may have difficulty communicating in English. Have you considered using a cultural broker?" A Haitian client diagnosed with major depressive disorder tells the nurse, "There's nothing you can do. This is a punishment. The only thing I can do is see a healer." The culturally aware nurse assesses that the client is demonstrating what? a. Delusions of persecution. b. A misdiagnosed of depression. c. The believe that distress is the result of a curse or spell. d. Feelings of hopeless and helpless related to an unidentified cause. c. The believe that distress is the result of a curse or spell. A group activity on an inpatient psychiatric unit is scheduled to begin at 1000. A client, who was recently discharged from U.S. Marine Corps, arrives at 0945. Which analysis best explains this behavior? a. The client wants to lead the group and give directions to others. b. The client wants to secure a chair that will be close to the group leader. c. The military culture values timeliness. The client does not want to be late. d. The behavior indicates feelings of self-importance that the client wants others to appreciate. c. The military culture values timeliness. The client does not want to be late. A nurse in the clinic has a full appointment schedule. A Hispanic American client arrives at 1230 for a 1000 appointment. A Native American client does not keep an appointment at all. What understanding about the clients will improve the nurse's planning? a. They are members of cultural groups that have a different view of time. b. They are immature and irresponsible in health care matters. c. They are acting-out feelings of anger toward the system. d. They are displaying passive-aggressive tendencies. a. They are members of cultural groups that have a different view of time. The sibling of an Asian American client tells the nurse, "My sister needs help for pain. She cries from the hurt." Which understanding regarding persons of an Asian American heritage will help the nurse contribute to culturally competent care for this client? a. They often express emotional distress with physical symptoms. b. They will probably respond best to a therapist who is impersonal. c. They will require prolonged treatment to stabilize these symptoms. d. They should be given direct information about the diagnosis and prognosis. a. They often express emotional distress with physical symptoms. Which communication strategy would be most effective for a nurse to use during an assessment interview with an adult Native American client? a. Open and friendly; ask direct questions; touch the client's arm or hand occasionally for reassurance. b. Frequent nonverbal behaviors, such as gestures and smiles; make an unemotional face to express negatives. c. Soft voice; break eye contact occasionally; general leads and reflective techniques. d. Stern voice; unbroken eye contact; minimal gestures; direct questions. c. Soft voice; break eye contact occasionally; general leads and reflective techniques. A Native American client sadly describes a difficult childhood. The client abused alcohol as a teenager but stopped 10 years ago. The client now says, "I feel stupid and good for nothing. I don't help my people." How should the treatment team focus planning for this client? a. Psychopharmacological and somatic therapies should be central techniques. b. Apply a psychoanalytical approach, focused on childhood trauma. c. Depression and alcohol abuse should be treated concurrently. d. Use a holistic approach, including mind, body, and spirit. d. Use a holistic approach, including mind, body, and spirit. A Native American client describes a difficult childhood and dropping out of high school. The client abused alcohol as a teenager to escape feelings of isolation but stopped 10 years ago. The client now says, "I feel stupid. I've never had a good job. I don't help my people." Which nursing diagnosis applies? a. Risk for other-directed violence b. Chronic low self-esteem c. Deficient knowledge d. Social isolation b. Chronic low self-esteem Which viewpoint of an Asian American family will most affect decision making about care? a. The father is the authority figure. b. The mother is head of the household. c. Women should make their own decisions. d. Emotional communication styles are desirable. a. The father is the authority figure Which intervention best demonstrates that a nurse correctly understands the cultural needs of a hospitalized Asian American client diagnosed with a mental illness? a. Encouraging the family to attend community support groups b. Involving the client's family to assist with activities of daily living c. Providing educational pamphlets to explain the client's mental illness d. Restricting homemade herbal remedies, the family brings to the hospital b. Involving the client's family to assist with activities of daily living A nurse speaks with family members of a Chinese American parent recently diagnosed with major depressive disorder. Which comment by the nurse will the family find most comforting? a. "The nursing staff will take good care of your parent." b. "The nursing staff will pray with your parent several times a day." c. "The nursing staff will teach your parent important self-care strategies." d. "The nursing staff will educate your parent about safety information regarding medication." a. "The nursing staff will take good care of your parent." A client in the emergency department shows a variety of psychiatric symptoms, including restlessness and anxiety. The client says, "I feel sad because evil spirits have overtaken my mind." Which worldview is most applicable to this individual? a. Eastern/balance b. Southern/holistic c. Western/scientific d. Indigenous/harmony d. Indigenous/harmony A nurse prepares to teach important medication information to a client of Mexican heritage. How should the nurse manage the teaching environment? a. Stand very close to the client while teaching. b. Maintain direct eye contact with the client while teaching. c. Maintain a neutral emotional tone during the teaching session. d. Sit 4 feet or more from the client during the teaching session. a. Stand very close to the client while teaching. A Chinese American client diagnosed with an anxiety disorder says, "My problems began when my energy became imbalanced." The nurse asks for the client's ideas about how to treat the imbalance. Which comment would the nurse expect from this client? a. "My family will bring special foods to help me get well." b. "I hope my health care provider will prescribe some medication to help me." c. "I think I would benefit from talking to other clients with a similar problem." d. "I would like to have a native healer perform a ceremony to balance my energy." a. "My family will bring special foods to help me get well." An experienced psychiatric nurse plans to begin a new job in a community-based medication clinic. The clinic sees culturally diverse clients. Which action should the nurse take first to prepare for this position? a. Investigate cultural differences in clients' responses to psychotropic medications. b. Contact the clinical nurse specialist for guidelines regarding cultural competence. c. Examine the literature on various health beliefs of members of diverse cultures. d. Complete an online continuing education offering about psychopharmacology. a. Investigate cultural differences in clients' responses to psychotropic medications. A psychoeducational session will discuss medication management for a culturally diverse group of clients. Group participants are predominantly members of minority cultures. Of the four staff nurses below, which nurse should lead this group? a. Very young registered nurse b. Older, mature registered nurse c. Newly licensed registered nurse d. A registered nurse who is very thin b. Older, mature registered nurse A nurse wants to engage an interpreter for a severely anxious 21-year-old male who immigrated to the United States 2 years ago. Of the four interpreters below who are available and fluent in the client's language, which one should the nurse call? a. 65-year-old female professional interpreter b. 24-year-old male professional interpreter c. A member of the client's family d. The client's best friend b. 24-year-old male professional interpreter A client who has been hospitalized for 3 days with a serious mental illness says, "I've got to get out of here and back to my job. I get 60 to 80 messages a day, and I'm getting behind on my email correspondence." What is this client's perspective about health and illness? a.Fateful, magical b. Eastern, holistic c. Western, biomedical d. Harmonious, religious c. Western, biomedical A client of German descent rocks back and forth, grimaces, and rubs both temples. What is the nurse's best action? a. Assess the client for extrapyramidal symptoms. b. Sit beside the client and rock in sync. c. Offer to pray with the client. d. Assess the client for pain. d. Assess the client for pain. A Vietnamese client's family reports that the client has wind illness. Which menu selection will be most helpful for this client? a. Iced tea b. Ice cream c. Warm broth d. Gelatin dessert c. Warm broth A Mexican American client puts a picture of the Virgin Mary on the bedside table. What is the nurse's best action? a. Move the picture so it is beside a window. b. Send the picture to the business office safe. c. Leave the picture where the client placed it. d. Send the picture home with the client's family. c. Leave the picture where the client placed it. A nurse begins work in an agency that provides care to members of a minority ethnic population. The nurse will be better able to demonstrate cultural competence by initially providing what intervention? a. identifying culture-bound issues. b. implementing scientifically proven interventions. c. correcting inferior health practices of the population. d. exploring commonly held beliefs and values of the population. d. exploring commonly held beliefs and values of the population. A nurse cares for a first-generation American whose family emigrated from Germany. Which worldview about the source of knowledge would this client likely have? a. Knowledge is acquired through use of affective or feeling senses. b. Science is the foundation of knowledge and proves something exists. c. Knowledge develops by striving for transcendence of the mind and body. d. Knowledge evolves from an individual's relationship with a supreme being. b. Science is the foundation of knowledge and proves something exists. The nurse administers medications to a culturally diverse group of clients on a psychiatric unit. What expectation should the nurse have about pharmacokinetics? a. Clients of different cultural groups may metabolize medications at different rates. b. Metabolism of psychotropic medication is consistent among various cultural groups. c. Differences in hepatic enzymes will influence the rate of elimination of psychotropic medications. d. It is important to provide clients with oral and written literature about their psychotropic medications. a. Clients of different cultural groups may metabolize medications at different rates. A nurse prepares to assess a newly hospitalized client who moved to the United States 6 months ago from Somalia. What should the nurse initially determine? a. if the client's immunizations are current. b. the client's religious preferences. c. the client's specific ethnic group. d. whether an interpreter is needed. d. whether an interpreter is needed. Which questions should the nurse ask to determine an individual's worldview? (Select all that apply.) a. What is more important: the needs of an individual or the needs of a community? b. How would you describe an ideal relationship between individuals? c. How long have you lived at your present residence? d. Of what importance are possessions in your life? e. Do you speak any foreign languages? a. What is more important: the needs of an individual or the needs of a community? b. How would you describe an ideal relationship between individuals? d. Of what importance are possessions in your life? Why is the study of culture so important for psychiatric nurses in the United States? (Sel