SAUNDERS PN MENTAL HEALTH
questions well answered
The nurse is having a conversation with a depressed client in an inpatient psychiatric unit. The
client says to the nurse, "Things would be so much better for everyone if I just wasn't around."
Which response by the nurse would be appropriate at this time? - correct answer ✔✔ You
sound very unhappy. Are you thinking of harming yourself?
The nurse in the emergency department is assisting in caring for a young female victim of sexual
assault. The client's physical assessment is complete, and physical evidence has been collected.
The nurse notes that the client is withdrawn, confused, and at times physically immobile. Which
interpretation should the nurse make of these behaviors? - correct answer ✔✔ They are
expected reactions to a devastating event.
The nurse is caring for a client diagnosed with catatonic stupor. The client is lying on the bed,
with the body pulled into a fetal position. Which is the appropriate nursing intervention? -
correct answer ✔✔ Sit beside the client in silence and verbalize occasional open-ended
questions.
The spouse of a client admitted to the hospital for alcohol withdrawal says to the nurse, "I
should get out of this bad situation." The most helpful response by the nurse should be which
statement? - correct answer ✔✔ What do you find difficult about this situation?
The nurse employed in a psychiatric unit receives a client assignment for the day. Which client
assigned to the nurse is at the highest risk for committing suicide? - correct answer ✔✔ A client
with severe depression and terminal cancer
Which behaviors observed by the nurse might lead to the suspicion that a depressed adolescent
client could be suicidal? - correct answer ✔✔ The client gives away a DVD and a cherished
autographed picture of the performer.
,The nurse is preparing for the hospital discharge of a client with a history of command
hallucinations to harm self or others. The nurse instructs the client about interventions for
hallucinations and anxiety and determines that the client understands the interventions when
the client makes which statement? - correct answer ✔✔ "I can call my therapist when I'm
hallucinating so I can talk about my feelings and plans and not hurt anyone."
A client tells the nurse that he is feeling out of control. The nurse observes that the client is
pacing back and forth. Which approach by the nurse is appropriate to maintain a safe
environment? - correct answer ✔✔ Move the client to a quiet room and talk about his feelings.
The nurse is caring for an older depressed client whose son was killed in an armed robbery after
murdering two people. The client says, "I don't know what I did wrong. His dad died a hero in
Vietnam when he was only 2 years old, but he's had everything. When he threw the cat up
against the wall to see if it landed on its feet and stole money from me and denied it, his sister
covered for him." The nurse plans to make which therapeutic response to the client? - correct
answer ✔✔ "It seems as if you or your daughter feel regret?"
The nurse has been caring for a client with a diagnosis of depression. The client says to the
nurse, "I wish you would just be my friend." The appropriate response by the nurse is which? -
correct answer ✔✔ "Our relationship is a therapeutic and a helping one."
The nurse is working with an older client who has a diagnosis of depression. To work most
effectively with this client, the nurse recalls that which information is accurate regarding
depression and the older client? Select all that apply. - correct answer ✔✔ -Suicide is a frequent
cause of death among the older population.
-Some indications of dementia may actually originate as depression.
-Depression in an older person is likely to have physical manifestations.
, The nurse is assisting with the data collection on a client admitted to the psychiatric unit. After
review of the obtained data, the nurse should identify which as a priority concern? - correct
answer ✔✔ The client's report of self-destructive thoughts
The nurse is assessing a newly admitted client recently diagnosed with depression. Which data
best supports that the client is at risk for self-harm? - correct answer ✔✔ reported
hopelessness
A client who has just received a diagnosis of asthma says to the nurse, "This condition is just
another nail in my coffin." Which response by the nurse is therapeutic? - correct answer ✔✔
"You seem very distressed over learning you have asthma."
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? - correct answer ✔✔ The client will
be introduced to short periods of exposure to the phobic object while in a relaxed state.
A client with depression who has attempted suicide says to the nurse, "I should have died. I've
always been a failure. Nothing ever goes right for me." The nurse should make which
therapeutic response to the client? - correct answer ✔✔ "You've been feeling like a failure for a
while?"
The registered nurse has written an outcome statement of, "Client will feel less anxious by the
end of session," for a client with generalized anxiety disorder. Which interventions should the
licensed practical nurse use to assist this client in meeting this goal? Select all that apply. -
correct answer ✔✔ -Stay with the client
-Administer anxiolytics medications
-Ensure the client is in an environment...
The parents of a teenager diagnosed with anorexia nervosa ask the nurse what part they can
play during the long recovery period. The nurse accurately relates that which actions should the
parents take? - correct answer ✔✔ Planning a non-food related activity
questions well answered
The nurse is having a conversation with a depressed client in an inpatient psychiatric unit. The
client says to the nurse, "Things would be so much better for everyone if I just wasn't around."
Which response by the nurse would be appropriate at this time? - correct answer ✔✔ You
sound very unhappy. Are you thinking of harming yourself?
The nurse in the emergency department is assisting in caring for a young female victim of sexual
assault. The client's physical assessment is complete, and physical evidence has been collected.
The nurse notes that the client is withdrawn, confused, and at times physically immobile. Which
interpretation should the nurse make of these behaviors? - correct answer ✔✔ They are
expected reactions to a devastating event.
The nurse is caring for a client diagnosed with catatonic stupor. The client is lying on the bed,
with the body pulled into a fetal position. Which is the appropriate nursing intervention? -
correct answer ✔✔ Sit beside the client in silence and verbalize occasional open-ended
questions.
The spouse of a client admitted to the hospital for alcohol withdrawal says to the nurse, "I
should get out of this bad situation." The most helpful response by the nurse should be which
statement? - correct answer ✔✔ What do you find difficult about this situation?
The nurse employed in a psychiatric unit receives a client assignment for the day. Which client
assigned to the nurse is at the highest risk for committing suicide? - correct answer ✔✔ A client
with severe depression and terminal cancer
Which behaviors observed by the nurse might lead to the suspicion that a depressed adolescent
client could be suicidal? - correct answer ✔✔ The client gives away a DVD and a cherished
autographed picture of the performer.
,The nurse is preparing for the hospital discharge of a client with a history of command
hallucinations to harm self or others. The nurse instructs the client about interventions for
hallucinations and anxiety and determines that the client understands the interventions when
the client makes which statement? - correct answer ✔✔ "I can call my therapist when I'm
hallucinating so I can talk about my feelings and plans and not hurt anyone."
A client tells the nurse that he is feeling out of control. The nurse observes that the client is
pacing back and forth. Which approach by the nurse is appropriate to maintain a safe
environment? - correct answer ✔✔ Move the client to a quiet room and talk about his feelings.
The nurse is caring for an older depressed client whose son was killed in an armed robbery after
murdering two people. The client says, "I don't know what I did wrong. His dad died a hero in
Vietnam when he was only 2 years old, but he's had everything. When he threw the cat up
against the wall to see if it landed on its feet and stole money from me and denied it, his sister
covered for him." The nurse plans to make which therapeutic response to the client? - correct
answer ✔✔ "It seems as if you or your daughter feel regret?"
The nurse has been caring for a client with a diagnosis of depression. The client says to the
nurse, "I wish you would just be my friend." The appropriate response by the nurse is which? -
correct answer ✔✔ "Our relationship is a therapeutic and a helping one."
The nurse is working with an older client who has a diagnosis of depression. To work most
effectively with this client, the nurse recalls that which information is accurate regarding
depression and the older client? Select all that apply. - correct answer ✔✔ -Suicide is a frequent
cause of death among the older population.
-Some indications of dementia may actually originate as depression.
-Depression in an older person is likely to have physical manifestations.
, The nurse is assisting with the data collection on a client admitted to the psychiatric unit. After
review of the obtained data, the nurse should identify which as a priority concern? - correct
answer ✔✔ The client's report of self-destructive thoughts
The nurse is assessing a newly admitted client recently diagnosed with depression. Which data
best supports that the client is at risk for self-harm? - correct answer ✔✔ reported
hopelessness
A client who has just received a diagnosis of asthma says to the nurse, "This condition is just
another nail in my coffin." Which response by the nurse is therapeutic? - correct answer ✔✔
"You seem very distressed over learning you have asthma."
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? - correct answer ✔✔ The client will
be introduced to short periods of exposure to the phobic object while in a relaxed state.
A client with depression who has attempted suicide says to the nurse, "I should have died. I've
always been a failure. Nothing ever goes right for me." The nurse should make which
therapeutic response to the client? - correct answer ✔✔ "You've been feeling like a failure for a
while?"
The registered nurse has written an outcome statement of, "Client will feel less anxious by the
end of session," for a client with generalized anxiety disorder. Which interventions should the
licensed practical nurse use to assist this client in meeting this goal? Select all that apply. -
correct answer ✔✔ -Stay with the client
-Administer anxiolytics medications
-Ensure the client is in an environment...
The parents of a teenager diagnosed with anorexia nervosa ask the nurse what part they can
play during the long recovery period. The nurse accurately relates that which actions should the
parents take? - correct answer ✔✔ Planning a non-food related activity
