Mental Health Nursing Exam 1 Flashcards - Quizlet 2022
On admission to the mental health unit, a client tells the nurse she's afraid to leave the
house for fear of criticism. She informs the nurse, "My nose is so big. I know everyone is
looking at me and making fun of me. I had plastic surgery and it still looks awful!" These
symptoms are an indication of which disorder?
1. Paranoid personality disorder
2. Body dysmorphic disorder
3. Paranoid schizophrenia
4. Antisocial disorder - correct answer2. Body dysmorphic disorder
This disorder is characterized by a belief that the body is deformed or defective in a
specific way. Although elements of paranoia are evident, the focus on a defective body
part is the clue. There is some evidence of a thought disorder; however, paranoid
schizophrenia isn't likely. Antisocial personality is characterized by manipulative
behavior.
When should the nurse introduce information about the end of the nurse-client
relationship?
1. During the orientation phase
2. As the goals of the relationship are reached
3. At least one or two sessions before the last meeting
4. When the client can tolerate it - correct answer1. During the orientation phase
Preparation for ending the nurse-client relationship should begin during the orientation
phase, when realistic limits of the relationship are established. Termination should also
be discussed as goals are achieved and the relationship nears an end. Although the
nurse should remind the client that only one or two sessions are left, the nurse must not
wait until then to prepare the client for termination. The client's ability to tolerate the end
of a relationship shouldn't dictate its timing. Because many clients have had negative
experiences when ending relationships, the nurse can use termination of the nurse-
client relationship to prepare the client for and work the client through positive
termination experiences with others.
The nurse is explaining the Bill of Rights for psychiatric patients to a client who has
voluntarily sought admission to an inpatient psychiatric facility. Which of the following
rights should the nurse include in the discussion?
1. Right to select health care team members
2. Right to refuse treatment
3. Right to a written treatment plan
4. Right to obtain disability
5. Right to confidentiality
6. Right to personal mail - correct answer2. Right to refuse treatment
3. Right to a written treatment plan
5. Right to confidentiality
,6. Right to personal mail
An inpatient client usually receives a copy of the Bill of Rights for psychiatric patients,
where they would find options 2, 3, 5, and 6 in writing. However, a client in an inpatient
setting can't select health team members. A client may apply for disability as a result of
a chronic, incapacitating illness; however, disability isn't a patient right, and members of
a psychiatric institution don't decide who should receive it.
Which nursing intervention is most important when restraining a violent client?
1. Reviewing facility policy regarding how long the client can be restrained
2. Preparing an as-needed dose of the client's psychotropic medication
3. Checking that the restraints have been applied correctly
4. Asking if the client needs to use the bathroom or is thirsty - correct answer3.
Checking that the restraints have been applied correctly
The nurse must determine whether the restraints have been applied correctly to make
sure that the client's circulation and respiration aren't restricted and that adequate
padding has been used. The nurse should document the client's response and status
carefully after the restraints are applied. All staff members involved in restraining clients
should be aware of facility policy before using restraints. If an as needed medication is
ordered, it should be given before the restraints are in place and with the assistance of
other team members. The nurse should attend to the client's elimination and hydration
needs after the client is properly restrained.
An adolescent, age 17, rarely expresses feelings and usually remains passive.
However, when angry, her face becomes flushed and her blood pressure rises to
170/100 mm Hg. Her parents are passive and easygoing. The adolescent may be using
which defense mechanism to handle anger?
1. Displacement
2. Introjection
3. Projection
4. Sublimation - correct answer2. Introjection
The adolescent may be introjecting (assuming as her own) her parents' belief that anger
shouldn't be outwardly expressed. She may also be holding in and somatizing her angry
feelings, as evidenced by her increased blood pressure. (A blood pressure rise is a
common physiological reaction to the fight-or-flight response that may be brought on by
strong emotions. Habitual failure to express anger may contribute to hypertension.)
Displacement is the discharge of negative feelings onto another person or an object.
Projection is the attribution of one's own thoughts or impulses to another person.
Sublimation is the channeling of unbearable or socially unacceptable behaviors into
more socially acceptable outlets.
A client is brought to the facility in an agitated state and is admitted to the psychiatric
unit for observation and treatment. While putting personal items away, the client talks
rapidly and folds and unfolds garments several times. The client can't seem to settle
down. Which nursing diagnosis is most applicable at this time?
,1. Disturbed personal identity
2. Anxiety
3. Compromised family coping
4. Powerlessness - correct answer2. Anxiety
Anxiety is the most applicable nursing diagnosis at this time because the client's
behavior mimics some of the objective signs of anxiety, which include restlessness,
irritability, rapid speech, inability to complete tasks, and verbal expressions of tension.
The other options would be premature diagnoses because the nurse hasn't had an
opportunity to complete a thorough nursing assessment.
A busy attorney with a successful law practice is admitted to an acute care facility with
epigastric pain. Since admission, the client has called the nurse every 15 minutes with
one request or another. This client is most likely exhibiting:
1. repression.
2. somatization.
3. regression.
4. conversion. - correct answer3. regression.
The client is exhibiting the defense mechanism regression, a return to behavior that is
characteristic of an earlier developmental level. Dependent, attention-seeking behavior
is an attempt to relieve anxiety. Repression manifests as a denial of the symptoms.
Somatization is the channeling of anxiety into a preoccupation with physical complaints.
Conversion involves the transfer of a mental conflict into a physical symptom to relieve
anxiety.
A client in an acute care mental health program refuses his morning dose of an oral
antipsychotic medication and believes he's being poisoned. The nurse should respond
by taking which action?
1. Administering the medication by injection
2. Omitting the dose and trying again the next day
3. Crushing the medication and putting it in his food
4. Consulting with the physician about a care plan. - correct answer4. Consulting with
the physician about a care plan.
To determine a care plan for clients who are noncompliant with medications, the nurse
should consult with the physician. Unless the client presents a danger to himself or
others, medications can't be forced on a client. Crushing the medication and putting it in
food might make the client suspicious. The nurse shouldn't omit the dose and try again
the next day. The nurse should instead make another attempt to administer the drug to
avoid decreased drug levels.
When assessing a client's level of stress caused by significant life events, which of the
following would the nurse use?
1. Holmes and Rahe's theory
, 2. Selye's general adaptation syndrome theory
3. The general systems theory
4. Lazarus's theory - correct answer1. Holmes and Rahe's theory
Holmes and Rahe's theory suggests that all life events, whether positive or negative,
cause stress. Holmes and Rahe have created a readjustment scale that ranks life
events according to how much stress they cause. Selye's general adaptation syndrome
theory explains a person's organized response to stress in three stages. The general
systems theory takes a holistic view of the stress response, recognizing both internal
and external stimuli affecting the person's health. Lazarus's theory suggests that the
stress response occurs in three stages but it views each stage as a conscious
evaluation of the stimulus, not an automatic reaction.
A client changes topics quickly while relating past psychiatric history. This client's
pattern of thinking is called:
1. looseness of association.
2. flight of ideas.
3. tangential thinking.
4. circumstantial thinking. - correct answer2. flight of ideas.
Flight of ideas describes a thought pattern in which a client moves rapidly from one
topic to the next with some connection. Looseness of association describes a pattern in
which ideas lack an apparent logical connection to one another. Tangential thoughts
seem to be related but miss the point. A client who talks around the subject and
includes a lot of unnecessary information is exhibiting circumstantial thinking.
In the emergency department, a client reveals to the nurse a lethal plan for committing
suicide and agrees to a voluntary admission to the psychiatric unit. Which information
will the nurse discuss with the client to answer the question, "How long do I have to stay
here?"
1. "You may leave the hospital at any time unless you are suicidal."
2. "Let's talk more after the health team has assessed you."
3. "Once you've signed the papers, you have no say."
4. "Because you could hurt yourself, you must be safe before being discharged."
5. "You need a lawyer to help you make that decision."
6. "There must be a court hearing before you leave the hospital." - correct answer1.
"You may leave the hospital at any time unless you are suicidal."
2. "Let's talk more after the health team has assessed you."
4. "Because you could hurt yourself, you must be safe before being discharged."
A person who is admitted to a psychiatric hospital on a voluntary basis may sign out of
the hospital unless the health care team determines that the person is harmful to
himself or others. The health care team evaluates the client's condition before
discharge. If there is reason to believe that the client is harmful to himself or others, a
hearing can be held to determine if the admission status should be changed from
voluntary to involuntary. Option 3 is incorrect because it denies the client's rights; option
5 is incorrect because the client doesn't need a lawyer to leave the hospital; and option
On admission to the mental health unit, a client tells the nurse she's afraid to leave the
house for fear of criticism. She informs the nurse, "My nose is so big. I know everyone is
looking at me and making fun of me. I had plastic surgery and it still looks awful!" These
symptoms are an indication of which disorder?
1. Paranoid personality disorder
2. Body dysmorphic disorder
3. Paranoid schizophrenia
4. Antisocial disorder - correct answer2. Body dysmorphic disorder
This disorder is characterized by a belief that the body is deformed or defective in a
specific way. Although elements of paranoia are evident, the focus on a defective body
part is the clue. There is some evidence of a thought disorder; however, paranoid
schizophrenia isn't likely. Antisocial personality is characterized by manipulative
behavior.
When should the nurse introduce information about the end of the nurse-client
relationship?
1. During the orientation phase
2. As the goals of the relationship are reached
3. At least one or two sessions before the last meeting
4. When the client can tolerate it - correct answer1. During the orientation phase
Preparation for ending the nurse-client relationship should begin during the orientation
phase, when realistic limits of the relationship are established. Termination should also
be discussed as goals are achieved and the relationship nears an end. Although the
nurse should remind the client that only one or two sessions are left, the nurse must not
wait until then to prepare the client for termination. The client's ability to tolerate the end
of a relationship shouldn't dictate its timing. Because many clients have had negative
experiences when ending relationships, the nurse can use termination of the nurse-
client relationship to prepare the client for and work the client through positive
termination experiences with others.
The nurse is explaining the Bill of Rights for psychiatric patients to a client who has
voluntarily sought admission to an inpatient psychiatric facility. Which of the following
rights should the nurse include in the discussion?
1. Right to select health care team members
2. Right to refuse treatment
3. Right to a written treatment plan
4. Right to obtain disability
5. Right to confidentiality
6. Right to personal mail - correct answer2. Right to refuse treatment
3. Right to a written treatment plan
5. Right to confidentiality
,6. Right to personal mail
An inpatient client usually receives a copy of the Bill of Rights for psychiatric patients,
where they would find options 2, 3, 5, and 6 in writing. However, a client in an inpatient
setting can't select health team members. A client may apply for disability as a result of
a chronic, incapacitating illness; however, disability isn't a patient right, and members of
a psychiatric institution don't decide who should receive it.
Which nursing intervention is most important when restraining a violent client?
1. Reviewing facility policy regarding how long the client can be restrained
2. Preparing an as-needed dose of the client's psychotropic medication
3. Checking that the restraints have been applied correctly
4. Asking if the client needs to use the bathroom or is thirsty - correct answer3.
Checking that the restraints have been applied correctly
The nurse must determine whether the restraints have been applied correctly to make
sure that the client's circulation and respiration aren't restricted and that adequate
padding has been used. The nurse should document the client's response and status
carefully after the restraints are applied. All staff members involved in restraining clients
should be aware of facility policy before using restraints. If an as needed medication is
ordered, it should be given before the restraints are in place and with the assistance of
other team members. The nurse should attend to the client's elimination and hydration
needs after the client is properly restrained.
An adolescent, age 17, rarely expresses feelings and usually remains passive.
However, when angry, her face becomes flushed and her blood pressure rises to
170/100 mm Hg. Her parents are passive and easygoing. The adolescent may be using
which defense mechanism to handle anger?
1. Displacement
2. Introjection
3. Projection
4. Sublimation - correct answer2. Introjection
The adolescent may be introjecting (assuming as her own) her parents' belief that anger
shouldn't be outwardly expressed. She may also be holding in and somatizing her angry
feelings, as evidenced by her increased blood pressure. (A blood pressure rise is a
common physiological reaction to the fight-or-flight response that may be brought on by
strong emotions. Habitual failure to express anger may contribute to hypertension.)
Displacement is the discharge of negative feelings onto another person or an object.
Projection is the attribution of one's own thoughts or impulses to another person.
Sublimation is the channeling of unbearable or socially unacceptable behaviors into
more socially acceptable outlets.
A client is brought to the facility in an agitated state and is admitted to the psychiatric
unit for observation and treatment. While putting personal items away, the client talks
rapidly and folds and unfolds garments several times. The client can't seem to settle
down. Which nursing diagnosis is most applicable at this time?
,1. Disturbed personal identity
2. Anxiety
3. Compromised family coping
4. Powerlessness - correct answer2. Anxiety
Anxiety is the most applicable nursing diagnosis at this time because the client's
behavior mimics some of the objective signs of anxiety, which include restlessness,
irritability, rapid speech, inability to complete tasks, and verbal expressions of tension.
The other options would be premature diagnoses because the nurse hasn't had an
opportunity to complete a thorough nursing assessment.
A busy attorney with a successful law practice is admitted to an acute care facility with
epigastric pain. Since admission, the client has called the nurse every 15 minutes with
one request or another. This client is most likely exhibiting:
1. repression.
2. somatization.
3. regression.
4. conversion. - correct answer3. regression.
The client is exhibiting the defense mechanism regression, a return to behavior that is
characteristic of an earlier developmental level. Dependent, attention-seeking behavior
is an attempt to relieve anxiety. Repression manifests as a denial of the symptoms.
Somatization is the channeling of anxiety into a preoccupation with physical complaints.
Conversion involves the transfer of a mental conflict into a physical symptom to relieve
anxiety.
A client in an acute care mental health program refuses his morning dose of an oral
antipsychotic medication and believes he's being poisoned. The nurse should respond
by taking which action?
1. Administering the medication by injection
2. Omitting the dose and trying again the next day
3. Crushing the medication and putting it in his food
4. Consulting with the physician about a care plan. - correct answer4. Consulting with
the physician about a care plan.
To determine a care plan for clients who are noncompliant with medications, the nurse
should consult with the physician. Unless the client presents a danger to himself or
others, medications can't be forced on a client. Crushing the medication and putting it in
food might make the client suspicious. The nurse shouldn't omit the dose and try again
the next day. The nurse should instead make another attempt to administer the drug to
avoid decreased drug levels.
When assessing a client's level of stress caused by significant life events, which of the
following would the nurse use?
1. Holmes and Rahe's theory
, 2. Selye's general adaptation syndrome theory
3. The general systems theory
4. Lazarus's theory - correct answer1. Holmes and Rahe's theory
Holmes and Rahe's theory suggests that all life events, whether positive or negative,
cause stress. Holmes and Rahe have created a readjustment scale that ranks life
events according to how much stress they cause. Selye's general adaptation syndrome
theory explains a person's organized response to stress in three stages. The general
systems theory takes a holistic view of the stress response, recognizing both internal
and external stimuli affecting the person's health. Lazarus's theory suggests that the
stress response occurs in three stages but it views each stage as a conscious
evaluation of the stimulus, not an automatic reaction.
A client changes topics quickly while relating past psychiatric history. This client's
pattern of thinking is called:
1. looseness of association.
2. flight of ideas.
3. tangential thinking.
4. circumstantial thinking. - correct answer2. flight of ideas.
Flight of ideas describes a thought pattern in which a client moves rapidly from one
topic to the next with some connection. Looseness of association describes a pattern in
which ideas lack an apparent logical connection to one another. Tangential thoughts
seem to be related but miss the point. A client who talks around the subject and
includes a lot of unnecessary information is exhibiting circumstantial thinking.
In the emergency department, a client reveals to the nurse a lethal plan for committing
suicide and agrees to a voluntary admission to the psychiatric unit. Which information
will the nurse discuss with the client to answer the question, "How long do I have to stay
here?"
1. "You may leave the hospital at any time unless you are suicidal."
2. "Let's talk more after the health team has assessed you."
3. "Once you've signed the papers, you have no say."
4. "Because you could hurt yourself, you must be safe before being discharged."
5. "You need a lawyer to help you make that decision."
6. "There must be a court hearing before you leave the hospital." - correct answer1.
"You may leave the hospital at any time unless you are suicidal."
2. "Let's talk more after the health team has assessed you."
4. "Because you could hurt yourself, you must be safe before being discharged."
A person who is admitted to a psychiatric hospital on a voluntary basis may sign out of
the hospital unless the health care team determines that the person is harmful to
himself or others. The health care team evaluates the client's condition before
discharge. If there is reason to believe that the client is harmful to himself or others, a
hearing can be held to determine if the admission status should be changed from
voluntary to involuntary. Option 3 is incorrect because it denies the client's rights; option
5 is incorrect because the client doesn't need a lawyer to leave the hospital; and option
