Mental Health B
A nurse is discussing a 12 step program with a client who has alcohol use disorder and is in an acute
care facility undergoing detox vacation. Which of the following information should the nurse include
in the teaching?
The client should obtain a sponsor before discharge for an increase chance of recovery
A client who has a recent diagnosis of bipolar disorder is placed in a room with a client who has
severe depression. The client who has depression reports to the nurse, "my roommate never sleeps,
and keeps me up, two". Which of the following action should the nurse take?
Move the client who has bipolar disorder to a private room
A nurse is caring for a child who is taking methylphenidate. The nurse and monitor the child for which
of the following findings as an adverse effect of methylphenidate?
Tachycardia
A nurse is preparing to administer diazepam, 7.5 mg IV. Bolus to a client for alcohol withdrawal.
Available is diazepam injection 5 mg/mL. How many mL should the nurse administer?
7.5mg / 5mg = 1.5mL
A nurse in the emergency department is caring for four clients. Which of the following clients is the
nurse required to report as a potential victim of abuse?
An older adult client who is bedbound and has a stage IV pressure ulcer.
A nurse is providing teaching to the partner of a client who is in a rehabilitation program for alcohol
use disorder. The nurse should identify that which of the following statements by the clients partner
indicates an understanding of teaching?
"I will not take charge of my partner's work responsibilities."
A nurse is caring for an older adult client who begins to cry and states, "I knew God would punish me,
and I deserve this horrible sickness!" Which of the following responses should the nurse make?
"Let's talk about what's upsetting you"
A nurse is caring for a client who is an abusive relationship and is assisting in the development of a
safety plan. Which of the following actions is the first component of a safety plan?
Identify signs of escalation of violence.
A nurse on a medical surgical unit is assessing a client who sustained injuries 12 hr ago following a
motor vehicle crash. The clients admission blood alcohol level was 325 mg/dL. Which of the following
finding should indicate to the nurse that the client is experiencing alcohol withdrawal?
Blood pressure 154/96
A nurse on a mental health unit observes a client who has acute mania hit another client. Which of
the following action should the nurse take first?
Call a team of staff members to help with the situation.
, A nurse observes a client on a mental health Unit pushing on the lock unit door. Which of the
following statements should the nurse make?
"It appears as though you would like to open the door"
A charge nurse on a mental health unit is discussing client rides with the newly licensed nurse. Which
of the following statements should the charge nurse make?
"Clients were admitted, involuntarily maintain the right to give informed consent for procedures."
A nurse on a mental health unit is caring for a group of clients. Which of the following actions by the
nurse is an example of the ethical principle of justice?
Spending adequate time with a client who is verbally abusive.
A nurse is assessing a client who has bulimia nervosa. The nurse should expect which of the following
findings?
Tooth erosion
A nurse is preparing to discharge to home and older adult client who attempted suicide. The client
lives alone and has difficulty performing ADLs. Which of the following referrals should the nurse
initiate?
•Occupational therapy
• meal delivery services
• physical therapy
• home health services
A nurse is creating a plan of care for a client who has been placed in seclusion after threatening to
harm others on the unit. Which of the following intervention should the nurse include in the plan?
Renew the prescription for the client every four hours (for a maximum of 24 hours)
.
A nurse in a community health center is working with a group of clients who have post-traumatic
stress disorder. Which of the following intervention should the nurse include to reduce anxiety among
the group members?
guided imagery
A nurse is assessing a family's dynamic during a counseling session. The nurse should recognize which
of the following findings as an indication of a boundary issue?
Older children who are responsible for their younger siblings
A nurse is planning care for a client who has generalized anxiety disorder. At which of the following
levels of anxiety, should the nurse plan to teach the client relaxation techniques?
Mild
-this is when the client will be able to concentrate and process information
A nurse is discussing a 12 step program with a client who has alcohol use disorder and is in an acute
care facility undergoing detox vacation. Which of the following information should the nurse include
in the teaching?
The client should obtain a sponsor before discharge for an increase chance of recovery
A client who has a recent diagnosis of bipolar disorder is placed in a room with a client who has
severe depression. The client who has depression reports to the nurse, "my roommate never sleeps,
and keeps me up, two". Which of the following action should the nurse take?
Move the client who has bipolar disorder to a private room
A nurse is caring for a child who is taking methylphenidate. The nurse and monitor the child for which
of the following findings as an adverse effect of methylphenidate?
Tachycardia
A nurse is preparing to administer diazepam, 7.5 mg IV. Bolus to a client for alcohol withdrawal.
Available is diazepam injection 5 mg/mL. How many mL should the nurse administer?
7.5mg / 5mg = 1.5mL
A nurse in the emergency department is caring for four clients. Which of the following clients is the
nurse required to report as a potential victim of abuse?
An older adult client who is bedbound and has a stage IV pressure ulcer.
A nurse is providing teaching to the partner of a client who is in a rehabilitation program for alcohol
use disorder. The nurse should identify that which of the following statements by the clients partner
indicates an understanding of teaching?
"I will not take charge of my partner's work responsibilities."
A nurse is caring for an older adult client who begins to cry and states, "I knew God would punish me,
and I deserve this horrible sickness!" Which of the following responses should the nurse make?
"Let's talk about what's upsetting you"
A nurse is caring for a client who is an abusive relationship and is assisting in the development of a
safety plan. Which of the following actions is the first component of a safety plan?
Identify signs of escalation of violence.
A nurse on a medical surgical unit is assessing a client who sustained injuries 12 hr ago following a
motor vehicle crash. The clients admission blood alcohol level was 325 mg/dL. Which of the following
finding should indicate to the nurse that the client is experiencing alcohol withdrawal?
Blood pressure 154/96
A nurse on a mental health unit observes a client who has acute mania hit another client. Which of
the following action should the nurse take first?
Call a team of staff members to help with the situation.
, A nurse observes a client on a mental health Unit pushing on the lock unit door. Which of the
following statements should the nurse make?
"It appears as though you would like to open the door"
A charge nurse on a mental health unit is discussing client rides with the newly licensed nurse. Which
of the following statements should the charge nurse make?
"Clients were admitted, involuntarily maintain the right to give informed consent for procedures."
A nurse on a mental health unit is caring for a group of clients. Which of the following actions by the
nurse is an example of the ethical principle of justice?
Spending adequate time with a client who is verbally abusive.
A nurse is assessing a client who has bulimia nervosa. The nurse should expect which of the following
findings?
Tooth erosion
A nurse is preparing to discharge to home and older adult client who attempted suicide. The client
lives alone and has difficulty performing ADLs. Which of the following referrals should the nurse
initiate?
•Occupational therapy
• meal delivery services
• physical therapy
• home health services
A nurse is creating a plan of care for a client who has been placed in seclusion after threatening to
harm others on the unit. Which of the following intervention should the nurse include in the plan?
Renew the prescription for the client every four hours (for a maximum of 24 hours)
.
A nurse in a community health center is working with a group of clients who have post-traumatic
stress disorder. Which of the following intervention should the nurse include to reduce anxiety among
the group members?
guided imagery
A nurse is assessing a family's dynamic during a counseling session. The nurse should recognize which
of the following findings as an indication of a boundary issue?
Older children who are responsible for their younger siblings
A nurse is planning care for a client who has generalized anxiety disorder. At which of the following
levels of anxiety, should the nurse plan to teach the client relaxation techniques?
Mild
-this is when the client will be able to concentrate and process information
