PN Mental Health Online Practice 2020 A
A nurse is reinforcing teaching with a client whose provider has prescribed
electroconvulsive therapy (ECT). Which of the following information should
the nurse include?
a. The client will receive continuous oxygen during the electrical stimulation
intervals. Incorrect
(The client will receive oxygen throughout the procedure. However, the
oxygen will be removed during the brief electrical stimulation intervals.)
b. A benzodiazepine will be administered prior to the procedure. Incorrect (A
benzodiazepine should not be administered because it interferes with the
seizure process. A short-acting anesthetic, such as propofol, will be
administered.)
c. ECT is an option for clients after medication has been unsuccessful.
d. Confusion is expected for the first 2 days after treatment. (Clients who
receive ECT can have confusion and disorientation for several hours after
treatment.)
C. ECT is an option for clients after medication has been unsuccessful.
(Medication is the first-line of treatment for depression. ECT is prescribed
when medication has been unsuccessful.)
A nurse is assisting with discharge planning for a client who needs to attend
a day treatment center ad has limited community and financial support.
Which of the following referrals should the nurse recommend including in the
client's discharge plan?
A. Social worker
B. Recreational therapist(Although recreational therapists can promote
therapies, such as art and music, to help enhance and preserve mental
health, they do not usually address issues regarding financial support and
community resources.)
C. Psychologist (Although psychologists can provide individual or family
therapy for clients, they do not usually address issues regarding financial
support and community resources.)
D. Pharmacist (Pharmacists prepare prescribed medications and dispense
medications in acute care and community settings. They coordinate with the
provider and nurses regarding the client's medication regime. However, they
do not address issues regarding financial support and community resources.)
,A. Social worker (Social workers can assist clients with building a support
structure to help promote and preserve mental health, including contacting
day treatment centers and arranging for financial and other community
resources.)
A nurse is developing countertransference toward a client during the working
phase of the nurse-client relationship. To correct the situation, which of the
following actions should the nurse take?
A. Tell the client how to change their behaviors. (This action places
responsibility on the client to correct the situation. When dealing with
countertransference, it is the nurse's responsibility to find an appropriate
solution.)
B. Talk to the client about the developing feelings. (The nurse should avoid
disclosing personal feelings because these feelings can interfere with the
nurse-client relationship. When dealing with countertransference, it is the
nurse's responsibility to find an appropriate solution, not the client's.)
C. Ask to be reassigned to a different client. (In order to achieve personal and
professional growth, the nurse should work through the issue of
countertransference by caring for this client, rather than asking for a new
assignment.)
D. identify personal response to the client.
D. identify personal response to the client.
(Countertransference is an emotional response toward the client by the
nurse. This response might be related to the nurse's past unresolved feelings
or relationships. These feelings can interfere with the nurse-client
therapeutic relationship. In order to correct the situation of
countertransference, the nurse must recognize personal reactions to the
client in an attempt to work through these feelings.)
A nurse is collecting data from a client who has bipolar and a history of
mania. Which of the following findings should the nurse identify as an
indication that the client is relapsing?
A. Weight gain (Weight loss, rather than weight gain, can indicate relapse in
a client who has a history of mania.)
B. Pressured speech
C. Ritualistic behavior (Ritualistic behavior is an indication of obsessive-
compulsive disorder, not mania.)
D. Anhedonia (Anhedonia is a negative symptom of schizophrenia.
Anhedonia is defined as a loss of interest in daily activities and the inability
or lack of capacity to experience pleasure in general. This is not an indication
of relapse in a client who has a history of mania.)
, B. Pressured speech (The nurse should identify that rapid or pressured
speech, provocative behavior, and insomnia are indications of potential
relapse in a client who has bipolar disorder and a history of mania.)
History and Physical
Subjective: Client states, "My stomach hurts."; "I feel sadder and more alone
every day."
Client's adult child stated to the nurse upon dropping the client off today,
"I've been meaning to tell you, I started giving my dad St. John's wort several
weeks ago to improve his mood."
Objective: Episodes of speech incoherency, rapid mood swings, 3 episodes of
vomiting in the past 40 min
Moderate Alzheimer's disease.
Provider Prescriptions
Fluoxetine 20 mg PO daily
Trazodone 50 mg PO daily at bedtime
Omeprazole 20 mg PO daily
Diagnostic Results
Blood pressure 172/94 mm Hg
Temperature 38.2° C (100.8° F)
Pulse rate 110/min
Respiratory rate 24/min
A nurse is caring for a client in a day treatment program. Which of the
following actions should the nurse take? (Click on the exhibit tabs for
additional information about the client. There are three tabs that contain
separate categories of data)
A. Request transport for the client to an emergency department.
B. Place a hypothermia blanket on the client. (There is no indication that a
hypothermia blanket is necessary for this client.)
C. Discontinue the client's fluoxetine therapy immediately. (Fluoxetine should
not be discontinued abruptly because this can cause the client to exhibit
manifestations of withdrawal.)
D. Implement droplet precautions for the client. (There is no indication for
the implementation of droplet precautions for this client. Droplet precautions
are used for clients who have diseases that are transmitted by large droplets
that are expelled into the air.)
A nurse is reinforcing teaching with a client whose provider has prescribed
electroconvulsive therapy (ECT). Which of the following information should
the nurse include?
a. The client will receive continuous oxygen during the electrical stimulation
intervals. Incorrect
(The client will receive oxygen throughout the procedure. However, the
oxygen will be removed during the brief electrical stimulation intervals.)
b. A benzodiazepine will be administered prior to the procedure. Incorrect (A
benzodiazepine should not be administered because it interferes with the
seizure process. A short-acting anesthetic, such as propofol, will be
administered.)
c. ECT is an option for clients after medication has been unsuccessful.
d. Confusion is expected for the first 2 days after treatment. (Clients who
receive ECT can have confusion and disorientation for several hours after
treatment.)
C. ECT is an option for clients after medication has been unsuccessful.
(Medication is the first-line of treatment for depression. ECT is prescribed
when medication has been unsuccessful.)
A nurse is assisting with discharge planning for a client who needs to attend
a day treatment center ad has limited community and financial support.
Which of the following referrals should the nurse recommend including in the
client's discharge plan?
A. Social worker
B. Recreational therapist(Although recreational therapists can promote
therapies, such as art and music, to help enhance and preserve mental
health, they do not usually address issues regarding financial support and
community resources.)
C. Psychologist (Although psychologists can provide individual or family
therapy for clients, they do not usually address issues regarding financial
support and community resources.)
D. Pharmacist (Pharmacists prepare prescribed medications and dispense
medications in acute care and community settings. They coordinate with the
provider and nurses regarding the client's medication regime. However, they
do not address issues regarding financial support and community resources.)
,A. Social worker (Social workers can assist clients with building a support
structure to help promote and preserve mental health, including contacting
day treatment centers and arranging for financial and other community
resources.)
A nurse is developing countertransference toward a client during the working
phase of the nurse-client relationship. To correct the situation, which of the
following actions should the nurse take?
A. Tell the client how to change their behaviors. (This action places
responsibility on the client to correct the situation. When dealing with
countertransference, it is the nurse's responsibility to find an appropriate
solution.)
B. Talk to the client about the developing feelings. (The nurse should avoid
disclosing personal feelings because these feelings can interfere with the
nurse-client relationship. When dealing with countertransference, it is the
nurse's responsibility to find an appropriate solution, not the client's.)
C. Ask to be reassigned to a different client. (In order to achieve personal and
professional growth, the nurse should work through the issue of
countertransference by caring for this client, rather than asking for a new
assignment.)
D. identify personal response to the client.
D. identify personal response to the client.
(Countertransference is an emotional response toward the client by the
nurse. This response might be related to the nurse's past unresolved feelings
or relationships. These feelings can interfere with the nurse-client
therapeutic relationship. In order to correct the situation of
countertransference, the nurse must recognize personal reactions to the
client in an attempt to work through these feelings.)
A nurse is collecting data from a client who has bipolar and a history of
mania. Which of the following findings should the nurse identify as an
indication that the client is relapsing?
A. Weight gain (Weight loss, rather than weight gain, can indicate relapse in
a client who has a history of mania.)
B. Pressured speech
C. Ritualistic behavior (Ritualistic behavior is an indication of obsessive-
compulsive disorder, not mania.)
D. Anhedonia (Anhedonia is a negative symptom of schizophrenia.
Anhedonia is defined as a loss of interest in daily activities and the inability
or lack of capacity to experience pleasure in general. This is not an indication
of relapse in a client who has a history of mania.)
, B. Pressured speech (The nurse should identify that rapid or pressured
speech, provocative behavior, and insomnia are indications of potential
relapse in a client who has bipolar disorder and a history of mania.)
History and Physical
Subjective: Client states, "My stomach hurts."; "I feel sadder and more alone
every day."
Client's adult child stated to the nurse upon dropping the client off today,
"I've been meaning to tell you, I started giving my dad St. John's wort several
weeks ago to improve his mood."
Objective: Episodes of speech incoherency, rapid mood swings, 3 episodes of
vomiting in the past 40 min
Moderate Alzheimer's disease.
Provider Prescriptions
Fluoxetine 20 mg PO daily
Trazodone 50 mg PO daily at bedtime
Omeprazole 20 mg PO daily
Diagnostic Results
Blood pressure 172/94 mm Hg
Temperature 38.2° C (100.8° F)
Pulse rate 110/min
Respiratory rate 24/min
A nurse is caring for a client in a day treatment program. Which of the
following actions should the nurse take? (Click on the exhibit tabs for
additional information about the client. There are three tabs that contain
separate categories of data)
A. Request transport for the client to an emergency department.
B. Place a hypothermia blanket on the client. (There is no indication that a
hypothermia blanket is necessary for this client.)
C. Discontinue the client's fluoxetine therapy immediately. (Fluoxetine should
not be discontinued abruptly because this can cause the client to exhibit
manifestations of withdrawal.)
D. Implement droplet precautions for the client. (There is no indication for
the implementation of droplet precautions for this client. Droplet precautions
are used for clients who have diseases that are transmitted by large droplets
that are expelled into the air.)
