MENTAL HEALTH (N243) EXAM QUESTIONS AND ANSWERS

MENTAL HEALTH (N243) EXAM QUESTIONS AND ANSWERS define CRISIS - Ans:-a threat to equilibrium Caplan's theory states that a crisis is an internal disturbance caused by a stressful event that alters the usual way of coping with a threat to the self; this temporarily disturbs the equilibrium of the person involved. What is a therapeutic nursing action in the care of a depressed client? - Ans:-Sitting down next to the client at frequent intervals Sitting down next to the client at frequent intervals gives the client the nonverbal message that someone cares and views the client as being worthy of attention and concern. A client is admitted to a psychiatric hospital after a month of unusual behavior that has included eating and sleeping very little, talking and singing constantly, and going on frequent shopping sprees. In the ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 2/22 hospital, the client is demanding, bossy, and sarcastic. Which disorder does the nurse associate with these behaviors? - Ans:-Bipolar disorder, manic phase This kind of hyperactive behavior is typical of the manic flight into reality associated with mood disorders. An older adult client is talking to the nurse about his Vietnam experiences and shares that he still has flashbacks. While assessing him the nurse notes that he is jumpy and exhibits startle reactions and poor concentration. With which mental health disorder does the nurse associate these symptoms? - Ans:- Posttraumatic stress disorder (PTSD) PTSD is a syndrome characterized by the development of symptoms after an extremely traumatic event. Symptoms include helplessness, flashbacks, intrusive thoughts, memories, images, emotional numbing, loss of interest, avoidance of any place that reminds the affected person of the traumatic event, poor concentration, irritability, startle reactions, jumpiness, and hypervigilance. A client who was involved in a near-fatal automobile collision arrives at the mental health clinic with complaints of insomnia, anxiety, and flashbacks. The nurse determines that the client is experiencing symptoms of crisis. What is the nurse's initial intervention? - Ans:-Focusing on the present ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 3/22 Crisis intervention deals with the here and now; the past is not important except in building on client strengths. The client is anxious and uncomfortable because of the current situation; the focus is on the present, not the past. A client has been unable to function since her husband asked for a divorce 2 weeks ago. She is brought to the crisis intervention center by a friend. What type of crisis is this situation? - Ans:-Situational Situational crises involve an unanticipated loss, such as a divorce, that is threatening to the client. Social crises involve multiple losses, such as those occurring during major disasters. Maturational crises occur in response to stress experienced as one struggles with developmental tasks. Developmental (maturational) crisis are associated with developmental tasks; divorce is not a developmental task. A client who has been attending a day treatment facility for 1 month with the diagnosis of major depression is to be discharged in a week. Because the nurse and the client are aware of this, what is the most appropriate comment by the nurse? - Ans:-"I understand that your discharge is set for next week. I'm wondering how you feel about that." Plans for termination that take emotional needs into account are best made after exploration of the client's thoughts and feelings about discharge. Noting that there are just a few sessions left and ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 4/22 expressing pleasure at the client's progress acknowledges the future termination but focuses on the nurse's, not the client's, feelings. Noting that the client's discharge date has been set for next week and calling this wonderful news acknowledges the future termination but suggests that the client should feel wonderful about the discharge, which may or may not be true. Although noting that the client and nurse have five sessions remaining and that the two need to start making plans to end the sessions acknowledges the future termination, plans for termination should be made after a discussion of the client's emotional response to the pending discharge. A nurse is preparing to care for a client who engages in ritualistic behavior. What is the most appropriate intervention to include in the plan of care? - Ans:-Helping the client understand that the behavior is caused by maladaptive coping with increased anxiety Helping clients understand that a behavior is being used to control anxiety usually makes them more amenable to psychotherapy. Treatment includes activities to help the client, not others. The client usually understands already that the behavior is not serving a realistic purpose. Administering antianxiety medications that block out the memory of internal fears will only mask symptoms and will not get at the root of what is bothering the client. A nurse is teaching a class about child abuse. What defense mechanism most often used by the physically abusive individual should the nurse include? - Ans:-Displacement ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 5/22 Displacement is a defense mechanism in which one's pent-up feelings toward a threatening person are discharged on those who are less threatening. Repression is the unintentional putting out of the mind unacceptable or troubling thoughts, desires, or experiences. Transference is a mechanism by which affects or emotional tones are shifted from one individual to another; it is unrelated to child abuse. Manipulation is a mechanism by which individuals attempt to manage, control, or use others to suit their own purpose or to gain an advantage; it is unrelated to child abuse. An older adult is being admitted to a nursing home with the diagnosis of dementia. The history reveals confusion, difficulty recognizing family members, and nighttime wandering. What should the nurse include in the client's plan of care? - Ans:-Assigning the client to a room near t