Mental Health Exam 1
How does a democratic form of self-government in the milieu contribute to client
therapy? - Answer By setting community expectations wherein all clients are treated on
an equal basis
A client diagnosed with Bipolar I Disorder is exhibiting severe manic behaviors. A
physician prescribes lithium carbonate (Eskalith) and olanzapine (Zyprexa). The client's
spouse questions the Zyprexa order. Which is the appropriate nursing reply? - Answer
Zyprexa calms hyperactivity until the Eskalith takes effect."
A client diagnosed with Posttraumatic Stress Disorder is admitted to an inpatient
psychiatric unit for evaluation and medication stabilization. Which therapeutic
communication technique used by the nurse is an example of a broad opening? -
Answer "What would you like to talk about?"
Which tool should the nurse use to differentiate occasional spontaneous behaviors of
children from behaviors associated with bipolar disorder? - Answer FIND tool
A client diagnosed with Schizophrenia states, "Can't you hear him? It's the devil. He's
telling me I'm going to hell." Which is the most appropriate nursing reply? - Answer "I'm
sure the voices sound scary. I don't hear any voices speaking."
Which therapeutic communication technique is being used in this nurse-client
interaction?Client: "When I am anxious, the only thing that calms me down is alcohol."
Nurse: "Other than drinking, what alternatives have you explored to decrease anxiety?"
- Answer Formulating a plan of action
An angry client on an inpatient unit approaches a nurse, stating, "Someone took my
lunch! People need to respect others, and you need to do something about this now!"
The nurse's response should be guided by which basic assumption of milieu therapy? -
Answer Every interaction is an opportunity for therapeutic intervention.
Which indicates to the nurse a client is at risk for developing a mental disorder? -
Answer Demonstrates impaired daily functioning and maladaptive responses to stress
A client has been taking lithium for several years with good symptom control. The client
presents in the emergency department with blurred vision, tinnitus, and severe diarrhea.
Which lithium level should the nurse correlate with these symptoms? - Answer 1.7
mEq/L
A nurse is assessing a client diagnosed with Schizophrenia for the presence of
hallucinations. Which therapeutic communication technique used by the nurse is an
example of making observations? - Answer "You appear to be talking to someone I do
not see."
What is the purpose of a nurse providing appropriate feedback? - Answer To give the
client critical information
, Mental Health Exam 1
Which nursing intervention is most appropriate when caring for an acutely agitated client
with paranoia? - Answer Provide personal space to respect the client's boundaries.
A client diagnosed with Schizophrenia tells the nurse, "The 'Shopatouliens' took my
shoes out of my room last night." Which is the correct charting entry to describe this
client's statement? - Answer "The client is expressing a neologism."
A client diagnosed with Schizophrenia states, "My psychiatrist is out to get me. I'm sad
that the voice is telling me to stop him." Which symptom is the client exhibiting, and
what is the nurse's legal responsibility related to this symptom? - Answer Command
hallucinations; warn the psychiatrist.
A client with a history of three suicide attempts has been taking fluoxetine (Prozac) for 1
month. The client suddenly presents with a bright affect, is much more communicative,
and rates mood at 9/10. Which action should be the nurse's priority at this time? -
Answer Increase frequency of client observation.
Which nursing behavior will enhance the establishment of a trusting relationship with a
client diagnosed with Schizophrenia? - Answer Being reliable, honest, and consistent
during interactions
During the planning of care for a suicidal client, which correctly written outcome should
be the nurse's priority? - Answer The client will remain safe during the hospital stay.
A client diagnosed with Schizoaffective Disorder is admitted for social skills training.
Which information should be taught by the nurse? - Answer How to make eye contact
when communicating
A mental health technician asks the nurse, "How do psychiatrists determine which
diagnosis to give a patient?" Which is the nurse's best response? - Answer
"Psychiatrists use criteria from the APA's Diagnostic and Statistical Manual of Mental
Disorders."
A client is diagnosed with Schizophrenia. A physician orders haloperidol (Haldol), 50 mg
bid; benztropine (Cogentin), 1 mg prn; and zolpidem (Ambien), 10 mg HS. Which client
behavior would warrant the nurse to administer benztropine? - Answer Restlessness
and muscle rigidity
The nurse is assessing a client diagnosed with Schizophrenia. The nurse asks the
client, "Do you receive special messages from certain sources, such as the television or
radio?" Which potential symptom is the nurse assessing? - Answer Delusions of
reference
How does a democratic form of self-government in the milieu contribute to client
therapy? - Answer By setting community expectations wherein all clients are treated on
an equal basis
A client diagnosed with Bipolar I Disorder is exhibiting severe manic behaviors. A
physician prescribes lithium carbonate (Eskalith) and olanzapine (Zyprexa). The client's
spouse questions the Zyprexa order. Which is the appropriate nursing reply? - Answer
Zyprexa calms hyperactivity until the Eskalith takes effect."
A client diagnosed with Posttraumatic Stress Disorder is admitted to an inpatient
psychiatric unit for evaluation and medication stabilization. Which therapeutic
communication technique used by the nurse is an example of a broad opening? -
Answer "What would you like to talk about?"
Which tool should the nurse use to differentiate occasional spontaneous behaviors of
children from behaviors associated with bipolar disorder? - Answer FIND tool
A client diagnosed with Schizophrenia states, "Can't you hear him? It's the devil. He's
telling me I'm going to hell." Which is the most appropriate nursing reply? - Answer "I'm
sure the voices sound scary. I don't hear any voices speaking."
Which therapeutic communication technique is being used in this nurse-client
interaction?Client: "When I am anxious, the only thing that calms me down is alcohol."
Nurse: "Other than drinking, what alternatives have you explored to decrease anxiety?"
- Answer Formulating a plan of action
An angry client on an inpatient unit approaches a nurse, stating, "Someone took my
lunch! People need to respect others, and you need to do something about this now!"
The nurse's response should be guided by which basic assumption of milieu therapy? -
Answer Every interaction is an opportunity for therapeutic intervention.
Which indicates to the nurse a client is at risk for developing a mental disorder? -
Answer Demonstrates impaired daily functioning and maladaptive responses to stress
A client has been taking lithium for several years with good symptom control. The client
presents in the emergency department with blurred vision, tinnitus, and severe diarrhea.
Which lithium level should the nurse correlate with these symptoms? - Answer 1.7
mEq/L
A nurse is assessing a client diagnosed with Schizophrenia for the presence of
hallucinations. Which therapeutic communication technique used by the nurse is an
example of making observations? - Answer "You appear to be talking to someone I do
not see."
What is the purpose of a nurse providing appropriate feedback? - Answer To give the
client critical information
, Mental Health Exam 1
Which nursing intervention is most appropriate when caring for an acutely agitated client
with paranoia? - Answer Provide personal space to respect the client's boundaries.
A client diagnosed with Schizophrenia tells the nurse, "The 'Shopatouliens' took my
shoes out of my room last night." Which is the correct charting entry to describe this
client's statement? - Answer "The client is expressing a neologism."
A client diagnosed with Schizophrenia states, "My psychiatrist is out to get me. I'm sad
that the voice is telling me to stop him." Which symptom is the client exhibiting, and
what is the nurse's legal responsibility related to this symptom? - Answer Command
hallucinations; warn the psychiatrist.
A client with a history of three suicide attempts has been taking fluoxetine (Prozac) for 1
month. The client suddenly presents with a bright affect, is much more communicative,
and rates mood at 9/10. Which action should be the nurse's priority at this time? -
Answer Increase frequency of client observation.
Which nursing behavior will enhance the establishment of a trusting relationship with a
client diagnosed with Schizophrenia? - Answer Being reliable, honest, and consistent
during interactions
During the planning of care for a suicidal client, which correctly written outcome should
be the nurse's priority? - Answer The client will remain safe during the hospital stay.
A client diagnosed with Schizoaffective Disorder is admitted for social skills training.
Which information should be taught by the nurse? - Answer How to make eye contact
when communicating
A mental health technician asks the nurse, "How do psychiatrists determine which
diagnosis to give a patient?" Which is the nurse's best response? - Answer
"Psychiatrists use criteria from the APA's Diagnostic and Statistical Manual of Mental
Disorders."
A client is diagnosed with Schizophrenia. A physician orders haloperidol (Haldol), 50 mg
bid; benztropine (Cogentin), 1 mg prn; and zolpidem (Ambien), 10 mg HS. Which client
behavior would warrant the nurse to administer benztropine? - Answer Restlessness
and muscle rigidity
The nurse is assessing a client diagnosed with Schizophrenia. The nurse asks the
client, "Do you receive special messages from certain sources, such as the television or
radio?" Which potential symptom is the nurse assessing? - Answer Delusions of
reference
