Mental Health Nursing Exam 1 questions (Questions and Verified Answers)

Mental Health Nursing Exam 1 questions (Questions and Verified Answers) 1. 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 - ANS 2. 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. 2. 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 - ANS 1. 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. 3. 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 - ANS 2. 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. 4. 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 - ANS 3. 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. 5. 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 - ANS 2. 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. 6. 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 - ANS 2. 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. 7. 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. - ANS 3. 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. 8. 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. - ANS 4. Consulting with the physician about a care plan.