Mental Health Exam #2 (Ch. 14, 15, 18, 24,
& 25) Question And Answers
(A client who will not enter into a no-suicide contract should be placed on
the highest level of suicide watch.) - -A client with a history of repeated
suicidal attempts refuses to participate in a no-suicide contract. What
intensity of nursing observation should be instituted?
a) Constant 24-hour, one-to-one observation at arm's length
b) One-to-one observation while client is awake
c) Every 15-minute observation around the clock
d) Seclusion with 15-minute observation
a
(A depressed client usually has little energy. After even a short exercise
period, the client may feel exhausted and need rest.) - -The nurse has
developed a plan for a client with a severe sleep pattern disturbance to
spend 20 minutes in the gym exercising each afternoon. Which
intervention should be scheduled for upon returning to the unit?
a. Rest
b. Group therapy
c. A protein-based snack
d. Unstructured private time
a
(A number of ways to inspect items are possible.Taking all potentially
harmful gifts from visitors before allowing them to see clients, going
through client's belongings (with client present) and removing all
potentially harmful objects, ensuring that visitors do not leave potentially
harmful objects in the client's room, and searching clients for harmful
objects on return from pass are all effective methods to ensure a high rate
of client safety.) - -Unit practice requires inspection of all items being
brought onto the unit by visitors. This can be most effectively done by
a) having a staff member sit at the door and check packages as visitors
enter.
b) having a staff member make frequent rounds during visiting hours to
inspect gifts.
c) asking all visitors to report to the nurse's station before visiting a client.
d) asking clients to give staff any unsafe item that might have been left by
a visitor.
a
(Antisocial clients have no conscience. Their sense of right and wrong is
impaired, and they tend to do whatever serves them best without
,consideration for the rights or feelings of others.) - -Characteristics the
nurse will assess in the client diagnosed with antisocial personality
disorder are
a) deceitfulness, impulsiveness, and lack of empathy.
b) perfectionism, preoccupation with detail, and verbosit.
c) avoidance of interpersonal contact and preoccupation with being
criticized.
d) a need for others to assume responsibility for decision making and
seeking nurture.
a
(At this time in the United States, there are no specifically FDA-approved
medications for treating personality disorders. Prescribers are using the
medications "off- label" until evidence-based pharmacotherapies are
proven to be safe and effective. There is evidence that mood stabilizers,
antidepressants, and atypical antipsychotics are helpful in specific
personality disorders. Pharmacologic evidence is lacking for the treatment
of persons with narcissistic and obsessive-compulsive personality
disorders. Although patients with personality disorders usually do not like
taking medicine unless it calms them down and are fearful about taking
something over which they have no control, providers do attempt to
mediate symptoms with psychotropic agents for improved quality of life.) -
-Which is true of pharmacological therapies for treatment of personality
disorders?
a) Although there are no FDA-approved drugs specific to the treatment of
personality disorders, patients benefit from specific off-label uses of
antipsychotics, mood stabilizers, and antidepressants, depending on
which personality disorder is evident.
b) Research has shown that currently available psychotropic drugs have
not been shown to be effective in treating personality disorders.
c) Patients with narcissistic personality disorder and obsessive-compulsive
personality disorder have shown the most benefit from the use of
antianxiety medications along with use of selective serotonin reuptake
inhibitors.
d) Patients with personality disorders have been shown to be resistant to
accepting medication, and as a result most providers do not prescribe
psychotropic drugs to these patients.
a
(Ataque de nervios (attack of the nerves) is a culture-bound syndrome
that is seen in undereducated, disadvantaged females of Hispanic
ethnicity.) - -A cultural characteristic that may be observed in a teenage,
female Hispanic client in times of stress is to
a. suddenly tremble severely.
b. exhibit stoic behavior.
c. report both nausea and vomiting.
,d. laugh inappropriately.
a
(Because the client is not able to think through the problem and arrive at
an action that would lower anxiety, the nurse can assist by asking what
has worked in the past. Often what has been helpful in the past can be
used again.) - -A client who is demonstrating a moderate level of anxiety
tells the nurse, "I am so anxious, and I do not know what to do." A helpful
response for the nurse to make would be
a. "What things have you done in the past that helped you feel more
comfortable?"
b. "Let's try to focus on that adorable little granddaughter of yours."
c. "Why don't you sit down over there and work on that jigsaw puzzle?"
d. "Try not to think about the feelings and sensations you're experiencing."
a
(Because the razor is cordless, independent use is relatively safe.) - -The
morning after he was admitted, a suicidal client wishes to use the cordless
electric razor the staff took from his suitcase the night before. The nurse
should
a) allow him to use the razor under staff supervision.
b) tell him he must use a safety razor provided by the unit.
c) suggest that this would be a good time to grow a beard.
d) give him the razor and ask him to return it when he is finished.
a
(Borderline personality disorder has the central characteristic of instability
in affect, identity, and relationships. Borderline individuals desperately
seek relationships to avoid feeling abandoned, but they often drive others
away with excessive demands, impulsive behavior, or uncontrolled anger.
Their frequent use of the defense of splitting strains personal relationships
and creates turmoil in health care settings.) - -When providing care for a
client diagnosed with borderline personality disorder, the nurse will need
to consider strategies for dealing with the client's
a) mood shifts, impulsivity, and splitting.
b) grief, anger, and social isolation.
c) altered sensory perceptions and suspicion.
d) perfectionism and preoccupation with detail.
a
(Clients who must engage in compulsive rituals for anxiety relief are rarely
afforded relief for any prolonged period. The high anxiety level and need
to perform the ritual may interfere with sleep.) - -A potential problem for
a client diagnosed with severe obsessive-compulsive disorder is
a. sleep disturbance.
, b. excessive socialization.
c. command hallucinations.
d. altered state of consciousness.
a
(Clients with antisocial personality act out feelings without consideration
for the rights of others. They feel no remorse for their antisocial acts.) - -A
client arrested for an assault in which he savagely beat a classmate
states, "The guy deserved everything he got." The behaviors described
are most consistent with the clinical picture of
a) antisocial personality disorder.
b) borderline personality disorder.
c) schizotypal personality disorder.
d) narcissistic personality disorder.
a
(Cognitive distortions can be refuted by examining them, but to examine
them the nurse must gain the client's willingness to participate.) - -A
depressed, socially withdrawn client tells the nurse, "There is no sense in
trying. I am never able to do anything right!" The nurse can best begin to
attack this cognitive distortion by
a. suggesting, "Let's look at what you just said, that you can 'never do
anything right.'"
b. querying, "Tell me what things you think you are not able to do
correctly."
c. asking, "Is this part of the reason you think no one likes you?"
d. saying, "That is the most unrealistic thing I have ever heard."
a
(Denial of excessive thinness is the mainstay of the client with anorexia
nervosa.) - -A coping mechanism used excessively by clients with
anorexia nervosa is
a) denial.
b) humor.
c) altruism.
d) projection.
a
(Depressed clients think slowly and take long periods to formulate
answers and respond. The nurse must be prepared to wait for a reply.) - -
When the nurse remarks to a depressed client, "I see you are trying not to
cry. Tell me what is happening." The nurse should be prepared to
a. wait quietly for the client to reply.
b. prompt the client if the reply is slow.
c. repeat the question if the client does not answer promptly.
& 25) Question And Answers
(A client who will not enter into a no-suicide contract should be placed on
the highest level of suicide watch.) - -A client with a history of repeated
suicidal attempts refuses to participate in a no-suicide contract. What
intensity of nursing observation should be instituted?
a) Constant 24-hour, one-to-one observation at arm's length
b) One-to-one observation while client is awake
c) Every 15-minute observation around the clock
d) Seclusion with 15-minute observation
a
(A depressed client usually has little energy. After even a short exercise
period, the client may feel exhausted and need rest.) - -The nurse has
developed a plan for a client with a severe sleep pattern disturbance to
spend 20 minutes in the gym exercising each afternoon. Which
intervention should be scheduled for upon returning to the unit?
a. Rest
b. Group therapy
c. A protein-based snack
d. Unstructured private time
a
(A number of ways to inspect items are possible.Taking all potentially
harmful gifts from visitors before allowing them to see clients, going
through client's belongings (with client present) and removing all
potentially harmful objects, ensuring that visitors do not leave potentially
harmful objects in the client's room, and searching clients for harmful
objects on return from pass are all effective methods to ensure a high rate
of client safety.) - -Unit practice requires inspection of all items being
brought onto the unit by visitors. This can be most effectively done by
a) having a staff member sit at the door and check packages as visitors
enter.
b) having a staff member make frequent rounds during visiting hours to
inspect gifts.
c) asking all visitors to report to the nurse's station before visiting a client.
d) asking clients to give staff any unsafe item that might have been left by
a visitor.
a
(Antisocial clients have no conscience. Their sense of right and wrong is
impaired, and they tend to do whatever serves them best without
,consideration for the rights or feelings of others.) - -Characteristics the
nurse will assess in the client diagnosed with antisocial personality
disorder are
a) deceitfulness, impulsiveness, and lack of empathy.
b) perfectionism, preoccupation with detail, and verbosit.
c) avoidance of interpersonal contact and preoccupation with being
criticized.
d) a need for others to assume responsibility for decision making and
seeking nurture.
a
(At this time in the United States, there are no specifically FDA-approved
medications for treating personality disorders. Prescribers are using the
medications "off- label" until evidence-based pharmacotherapies are
proven to be safe and effective. There is evidence that mood stabilizers,
antidepressants, and atypical antipsychotics are helpful in specific
personality disorders. Pharmacologic evidence is lacking for the treatment
of persons with narcissistic and obsessive-compulsive personality
disorders. Although patients with personality disorders usually do not like
taking medicine unless it calms them down and are fearful about taking
something over which they have no control, providers do attempt to
mediate symptoms with psychotropic agents for improved quality of life.) -
-Which is true of pharmacological therapies for treatment of personality
disorders?
a) Although there are no FDA-approved drugs specific to the treatment of
personality disorders, patients benefit from specific off-label uses of
antipsychotics, mood stabilizers, and antidepressants, depending on
which personality disorder is evident.
b) Research has shown that currently available psychotropic drugs have
not been shown to be effective in treating personality disorders.
c) Patients with narcissistic personality disorder and obsessive-compulsive
personality disorder have shown the most benefit from the use of
antianxiety medications along with use of selective serotonin reuptake
inhibitors.
d) Patients with personality disorders have been shown to be resistant to
accepting medication, and as a result most providers do not prescribe
psychotropic drugs to these patients.
a
(Ataque de nervios (attack of the nerves) is a culture-bound syndrome
that is seen in undereducated, disadvantaged females of Hispanic
ethnicity.) - -A cultural characteristic that may be observed in a teenage,
female Hispanic client in times of stress is to
a. suddenly tremble severely.
b. exhibit stoic behavior.
c. report both nausea and vomiting.
,d. laugh inappropriately.
a
(Because the client is not able to think through the problem and arrive at
an action that would lower anxiety, the nurse can assist by asking what
has worked in the past. Often what has been helpful in the past can be
used again.) - -A client who is demonstrating a moderate level of anxiety
tells the nurse, "I am so anxious, and I do not know what to do." A helpful
response for the nurse to make would be
a. "What things have you done in the past that helped you feel more
comfortable?"
b. "Let's try to focus on that adorable little granddaughter of yours."
c. "Why don't you sit down over there and work on that jigsaw puzzle?"
d. "Try not to think about the feelings and sensations you're experiencing."
a
(Because the razor is cordless, independent use is relatively safe.) - -The
morning after he was admitted, a suicidal client wishes to use the cordless
electric razor the staff took from his suitcase the night before. The nurse
should
a) allow him to use the razor under staff supervision.
b) tell him he must use a safety razor provided by the unit.
c) suggest that this would be a good time to grow a beard.
d) give him the razor and ask him to return it when he is finished.
a
(Borderline personality disorder has the central characteristic of instability
in affect, identity, and relationships. Borderline individuals desperately
seek relationships to avoid feeling abandoned, but they often drive others
away with excessive demands, impulsive behavior, or uncontrolled anger.
Their frequent use of the defense of splitting strains personal relationships
and creates turmoil in health care settings.) - -When providing care for a
client diagnosed with borderline personality disorder, the nurse will need
to consider strategies for dealing with the client's
a) mood shifts, impulsivity, and splitting.
b) grief, anger, and social isolation.
c) altered sensory perceptions and suspicion.
d) perfectionism and preoccupation with detail.
a
(Clients who must engage in compulsive rituals for anxiety relief are rarely
afforded relief for any prolonged period. The high anxiety level and need
to perform the ritual may interfere with sleep.) - -A potential problem for
a client diagnosed with severe obsessive-compulsive disorder is
a. sleep disturbance.
, b. excessive socialization.
c. command hallucinations.
d. altered state of consciousness.
a
(Clients with antisocial personality act out feelings without consideration
for the rights of others. They feel no remorse for their antisocial acts.) - -A
client arrested for an assault in which he savagely beat a classmate
states, "The guy deserved everything he got." The behaviors described
are most consistent with the clinical picture of
a) antisocial personality disorder.
b) borderline personality disorder.
c) schizotypal personality disorder.
d) narcissistic personality disorder.
a
(Cognitive distortions can be refuted by examining them, but to examine
them the nurse must gain the client's willingness to participate.) - -A
depressed, socially withdrawn client tells the nurse, "There is no sense in
trying. I am never able to do anything right!" The nurse can best begin to
attack this cognitive distortion by
a. suggesting, "Let's look at what you just said, that you can 'never do
anything right.'"
b. querying, "Tell me what things you think you are not able to do
correctly."
c. asking, "Is this part of the reason you think no one likes you?"
d. saying, "That is the most unrealistic thing I have ever heard."
a
(Denial of excessive thinness is the mainstay of the client with anorexia
nervosa.) - -A coping mechanism used excessively by clients with
anorexia nervosa is
a) denial.
b) humor.
c) altruism.
d) projection.
a
(Depressed clients think slowly and take long periods to formulate
answers and respond. The nurse must be prepared to wait for a reply.) - -
When the nurse remarks to a depressed client, "I see you are trying not to
cry. Tell me what is happening." The nurse should be prepared to
a. wait quietly for the client to reply.
b. prompt the client if the reply is slow.
c. repeat the question if the client does not answer promptly.
