Saunders mental health part 2
Comprehensive Questions and
Answers |Updated 2025.
A client diagnosed with schizophrenia is experiencing an acute dystonic reaction. Which
interventions should the licensed practical nurse (LPN) initiate? Select all that apply.
1.
Monitor airway.
2.
Notify the registered nurse (RN).
3.
Place the client in seclusion for safety.
4.
Remain with the client to provide support.
5.
Administer a prescribed antipsychotic medication.
6.
Administer a prescribed intramuscular (IM) antiparkinsonian medication.
1,2,4,6
The nurse in the mental health clinic hears a client yelling and threatening to hurt his sister. The
nurse reports this episode to the mental health therapist. Which should the nurse anticipate the
therapist to do? Select all that apply.
,1.
Identify the specific person being threatened.
2.
Tell the client that this behavior is not appropriate.
3.
Take appropriate action to protect the identified victim.
4.
Threaten the client that the police are going to be called.
5.
Have the client sign a document promising not to harm his sister.
6.
Assess and predict the client's danger of violence toward another.
1,3,6
The nurse is reviewing the record of a client admitted to the mental health unit and notes that the
client was admitted by voluntary status. The nurse makes which determination?
1.
The admission was mandated by a court order.
2.
The admission was made without the client's consent.
3.
The client has the right to demand and obtain release from the hospital.
,4.
The client was committed by a group of designated mental health professionals.
3
A client with a phobia will be treated for the condition using a behavior modification technique
known as systematic desensitization. The nurse describes the components of this form of therapy to
the client and reinforces which client instruction?
1.
The client will take medication daily to control the condition.
2.
The client will talk to self to control actions more effectively.
3.
The client will meet with others with the same problem in a support group.
4.
The client will be introduced to short periods of exposure to the phobic object while in a relaxed
state.
4
The nurse is assisting in conducting a group therapy session. A client who has shared with the group
at a previous session that she isolates herself when she feels depressed, suddenly gets up to leave.
Which nursing action is appropriate?
1.
Tell the client that it is not safe to leave.
2.
, Encourage the client to stay and ask the client what she is feeling.
3.
Tell the client that if she leaves, she cannot return to this therapy group.
4.
Lock the door so that the client cannot leave at this potentially vulnerable time.
2
A client with a potential for violence is exhibiting agitated behavior. The client is using aggressive
gestures and making belligerent comments to the other clients and is pacing continually in the
hallway. The nurse is considering seclusion and restraints for this client even though staffing is
lacking for close supervision and direct observation. Which are some contraindications to seclusion
and restraints without close supervision and observation? Select all that apply.
1.
Severe suicidal tendencies
2.
Immediate family's request
3.
Extremely unstable medical and psychiatric conditions
4.
Desire for punishment of client or convenience of staff
5.
Delirium or dementia leading to inability to tolerate decreased stimulation
6.
Comprehensive Questions and
Answers |Updated 2025.
A client diagnosed with schizophrenia is experiencing an acute dystonic reaction. Which
interventions should the licensed practical nurse (LPN) initiate? Select all that apply.
1.
Monitor airway.
2.
Notify the registered nurse (RN).
3.
Place the client in seclusion for safety.
4.
Remain with the client to provide support.
5.
Administer a prescribed antipsychotic medication.
6.
Administer a prescribed intramuscular (IM) antiparkinsonian medication.
1,2,4,6
The nurse in the mental health clinic hears a client yelling and threatening to hurt his sister. The
nurse reports this episode to the mental health therapist. Which should the nurse anticipate the
therapist to do? Select all that apply.
,1.
Identify the specific person being threatened.
2.
Tell the client that this behavior is not appropriate.
3.
Take appropriate action to protect the identified victim.
4.
Threaten the client that the police are going to be called.
5.
Have the client sign a document promising not to harm his sister.
6.
Assess and predict the client's danger of violence toward another.
1,3,6
The nurse is reviewing the record of a client admitted to the mental health unit and notes that the
client was admitted by voluntary status. The nurse makes which determination?
1.
The admission was mandated by a court order.
2.
The admission was made without the client's consent.
3.
The client has the right to demand and obtain release from the hospital.
,4.
The client was committed by a group of designated mental health professionals.
3
A client with a phobia will be treated for the condition using a behavior modification technique
known as systematic desensitization. The nurse describes the components of this form of therapy to
the client and reinforces which client instruction?
1.
The client will take medication daily to control the condition.
2.
The client will talk to self to control actions more effectively.
3.
The client will meet with others with the same problem in a support group.
4.
The client will be introduced to short periods of exposure to the phobic object while in a relaxed
state.
4
The nurse is assisting in conducting a group therapy session. A client who has shared with the group
at a previous session that she isolates herself when she feels depressed, suddenly gets up to leave.
Which nursing action is appropriate?
1.
Tell the client that it is not safe to leave.
2.
, Encourage the client to stay and ask the client what she is feeling.
3.
Tell the client that if she leaves, she cannot return to this therapy group.
4.
Lock the door so that the client cannot leave at this potentially vulnerable time.
2
A client with a potential for violence is exhibiting agitated behavior. The client is using aggressive
gestures and making belligerent comments to the other clients and is pacing continually in the
hallway. The nurse is considering seclusion and restraints for this client even though staffing is
lacking for close supervision and direct observation. Which are some contraindications to seclusion
and restraints without close supervision and observation? Select all that apply.
1.
Severe suicidal tendencies
2.
Immediate family's request
3.
Extremely unstable medical and psychiatric conditions
4.
Desire for punishment of client or convenience of staff
5.
Delirium or dementia leading to inability to tolerate decreased stimulation
6.
