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NUR 2488 / NUR2488 MENTAL HEALTH NURSING EXAM 1 CORRECTED

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NUR 2488 / NUR2488 MENTAL HEALTH NURSING EXAM 1 CORRECTED A fully developed outcome for a client goal would include: (SATA) The nurse understands a client could be at risk for serotonin syndrome when taking which of the following medications in addition to over the counter medications or herbal supplements? A 4-year-old child grabs toys from siblings, saying, “I want that toy now!” The siblings cry and the child’s parent becomes upset with the behavior. Using Freudian theory, a nurse can interpret the child’s behavior as a product of impulses originating in the: Selected Which expected client outcome should a nurse identify as being correctly formulated? A voluntarily hospitalized patient tells the nurse, “Get me the forms for 1 out of 1 points discharge against medical advice so I can leave now.” Which is the nurse’s best response? The client is being admitted to the inpatient psychiatric unit. The nurse 0 out of 1 points conducts a mental status examination. Which of the following items are included in this examination? (Select all that apply) A client with schizophrenia has recently begun a new medication, 1 out of 1 points clozapine (Clozaril). Which signs and symptoms of a potentially fatal side effect will the nurse teach the client about? Which information suggests that caution is necessary in prescribing a benzodiazepine to an anxious client? A brother calls to speak to his sister who has been admitted to the 0 out of 1 points psychiatric unit. The nurse connects him to the community phone and the sister is summoned. Later the nurse realizes that the brother was not on the client’s approved call list. What law has the nurse broken? The client attempted suicide by overdosing on pain medication. Once the client ingested the medication, she decided that she did not want to die and she sought immediate treatment. Once the client recovered from the physical effects of overdose, the client voluntarily sought inpatient mental health treatment. Which of the following statements is true of voluntary admission? A nurse says to a client, “Things will look better tomorrow after a good night’s sleep.” This is an example of which communication technique? A patient is involuntarily admitted to a psychiatric unit after calling a 1 out of 1 points friend and saying, “I’ve got a gun and I’m going to shoot myself.” Which of the following rights has the patient lost temporarily? Selected A depressed client states, “I have a chemical imbalance in my brain. I have no control over my behavior. Medications are my only hope to feel normal again.” Which nursing response is appropriate? During an intake interview, which question would assist the nurse in gathering data about the client’s judgment? A nursing instructor asks a student to describe the nursing process when initiating care of a client. The student nurse understands the nursing process order to be correctly identified as: During an intake assessment, a nurse asks both physiological and psychosocial questions. The client angrily responds, “I’m here for my heart, not my head problems.” Which is the nurse’s best response? A mother rescues two of her four children from a house fire. In an emergency department, she cries, “I should have gone back in to get 0 out of 1 points them. I should have died, not them.” Which of the following responses by the nurse is an example of reflection? An entry level registered nurse works with patients in a community setting. Which groups should this nurse expect to lead? (Select all that apply.) 1 out of 1 points Selected A client has been involuntarily admitted to an inpatient behavioral health unit. During this admission, which of the following rights does the client still retain? (Select all that apply.) A mother who is notified that her child was killed in a tragic car accident states, “I can’t bear to go on with my life.” Which nursing statement conveys empathy? During the implementation phase of the nursing process, a nurse is teaching an adult depressed patient with a cochlear implant about 1 out of 1 points medications. Which modification in the teaching plan would be the most appropriate for this client? A 22 year old college student is admitted to a hospital following a suicide attempt and states, “No one will ever love a loser like me.” According to Erikson’s theory of personality development, a nurse should recognize a deficit in which developmental stage? A nursing instructor is teaching about the monoamine category of 0 out of 1 points neurotransmitters. Which student statement indicates that learning about the function of norepinephrine has occurred?

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NUR 2488 / NUR2488 MENTAL HEALTH
NURSING EXAM 1 CORRECTED

0 out of 1 points
 Question 1

A fully developed outcome for a client goal would include:
(SATA)
Selected
Answers: Time sensitive

Measurable
terms
Initial
assessment
Attainable for
client
Answers: Time sensitive
Measurable
terms
Initial
assessment
Identifying data
Attainable for
client
Response
Feedback: No. Outcomes need to take into account the patient's culture,
values, and ethical beliefs. Specifically, outcomes are stated in
attainable and measurable terms and include a time estimate
for attainment".
 Question 2
0 out of 1 points
The nurse understands a client could be at risk for serotonin
syndrome when taking which of the following medications in addition
to over the counter medications or herbal supplements?
Selected
Answer: Haloperid
ol
Answers: Sertraline

, Haloperid
ol
Trazadon
e
Venlafaxi
ne
Response No. Sertraline (Zoloft) is an SSRI, and when combined with
Feedback: over the counter medications or herbal supplements could
increase the clients risk for developing serotonin syndrome.
 Question 3
0 out of 1 points
A 4-year-old child grabs toys from siblings, saying, “I want that toy
now!” The siblings cry and the child’s parent becomes upset with the
behavior. Using Freudian theory, a nurse can interpret the child’s
behavior as a product of impulses originating in the:
Selected
Answer: Ego
Answers: Id
Ego
Superego
Preconsci
ous
Response
Feedback No. The id operates on the pleasure principle, seeking
: immediate gratification of impulses. The ego acts as a
mediator of behavior and would weigh the consequences of
the action, perhaps determining that taking the toy is not worth
the parent’s wrath. The superego would oppose the impulsive
behavior as “not nice.” The preconscious is a level of
awareness.
 Question 4
1 out of 1 points
Which expected client outcome should a nurse identify as being correctly
formulated?
Selected
Answer: Client will initiate interaction with one peer during free
time within 2 days.
Answers: Client will feel happier by discharge.
Client will demonstrate two relaxation techniques.
Client will verbalize triggers to anger by end of session.

, Client will initiate interaction with one peer during free
time within 2 days.
Response Yes. The statement “Client will initiate interaction with one peer
Feedback
during free time within 2 days” is an example of a correctly
:
formulated expected outcome. Outcomes should be
measurable, realistic, client-focused goals that include a time
frame. Appropriate nursing interventions are guided by client
outcomes.
 Question 5
1 out of 1 points
A voluntarily hospitalized patient tells the nurse, “Get me the forms for
discharge against medical advice so I can leave now.” Which is the
nurse’s best response?
Selected
Answer: “I will get them for you, but let’s talk about your decision to
leave treatment.”
Answers: “I can’t give you those forms without your health
care provider’s knowledge.”
“I’ll get the forms for you right now and bring them to
your room.”
“Since you signed your consent for treatment, you
may leave if you desire.”
“I will get them for you, but let’s talk about your decision
to leave treatment.”
Response
Feedback Yes. A patient who has been voluntarily admitted as a
: psychiatric inpatient has the right to demand and obtain
release in most states. However, as a patient advocate, the
nurse is responsible for weighing factors related to the
patient’s wishes and best interests. By asking for
information, the nurse may be able to help the patient
reconsider the decision. The statement that discharge forms
can’t be given without the health care provider’s knowledge
is not true. Facilitating discharge without consent is not in the
patient’s best interests before exploring the reason for the
request.
 Question 6
0 out of 1 points
The client is being admitted to the inpatient psychiatric unit. The nurse
conducts a mental status examination. Which of the following items are
included in this examination? (Select all that apply)
Selected
Answers:
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