MENTAL HEALTH PRACTICE EXAM
QUESTIONS AND CORRECT VERIFIED
ANSWERS
TheA2nurseA2isA2conductingA2dischargeA2teachingA2forA2aA2clientA2withA2schizophreniaA2w
hoA2plansA2toA2liveA2inA2aA2groupA2home.A2WhichA2statementA2isA2mostA2indicativeA2ofA2the
A2needA2forA2carefulA2follow-upA2afterA2discharge?
a.A2CricketsA2areA2aA2goodA2sourceA2ofA2protein.
b.A2IA2haveA2notA2heardA2anyA2voicesA2forA2aA2week.
c.A2OnlyA2myA2beliefA2inA2GodA2canA2helpA2me.
d.A2SometimesA2IA2haveA2aA2hardA2timeA2sittingA2stillA2-A2Ans--
*C.A2OnlyA2myA2beliefA2inA2GodA2canA2helpA2me.*
TheA2mostA2frequentA2causeA2ofA2increasedA2symptomsA2inA2psychoticA2clientsA2isA2non-
complianceA2withA2theA2medicationA2regimen.A2IfA2clientsA2believeA2thatA2"GodA2alone"A2is
A2goingA2toA2healA2themA2(C)A2thenA2theyA2mayA2discontinueA2theirA2medication,A2soA2(C)A
2wouldA2poseA2theA2greatestA2threatA2toA2thisA2client'sA2prognosis.A2(A)A2wouldA2requireA2f
urtherA2teaching,A2butA2isA2notA2asA2significantA2aA2statementA2asA2(C).A2(B)A2indicatesA2a
nA2improvementA2inA2theA2client'sA2condition.A2(D)A2mayA2beA2aA2signA2ofA2anxietyA2thatA2c
ouldA2improveA2withA2tx,A2butA2doesA2notA2haveA2theA2priorityA2ofA2(C).
AA2childA2isA2broughtA2toA2theA2ERA2withA2aA2brokenA2arm.A2BecauseA2ofA2otherA2injuries,A2
theA2nurseA2suspectsA2theA2childA2mayA2beA2aA2victimA2ofA2abuse.A2WhenA2theA2nurseA2tri
esA2toA2giveA2theA2childA2anA2injection,A2theA2child'sA2motherA2becomesA2veryA2loudA2andA2
shouts,A2"IA2won'tA2leaveA2myA2son!A2Don'tA2youA2touchA2him!
A2You'llA2hurtA2myA2child!"A2WhatA2isA2theA2bestA2interpretationA2ofA2theA2mother'sA2statem
ents?A2TheA2motherA2is
a.A2regressingA2toA2anA2earlierA2behaviorA2pattern.
b.A2sublimatingA2herA2anger.
c.A2projectingA2herA2feelingsA2ontoA2theA2nurse.
d.A2suppressingA2herA2fear.A2-A2Ans--*C.A2projectingA2herA2feelingsA2ontoA2theA2nurse.*
ProjectionA2isA2attributingA2one'sA2ownA2thoughts,A2impulses,A2orA2behaviorsA2ontoA2anoth
er--
itA2isA2theA2motherA2whoA2isA2probablyA2harmingA2theA2childA2andA2sheA2isA2attributingA2her
A2actionsA2toA2theA2nurseA2(C).A2TheA2motherA2mayA2beA2immature,A2butA2(A)A2isA2notA2the
A2bestA2descriptionA2ofA2herA2behavior.A2(B)A2isA2substitutingA2aA2sociallyA2acceptableA2fee
lingA2forA2anA2unacceptableA2one.A2TheseA2areA2notA2sociallyA2acceptableA2feelings.A2The
A2motherA2mayA2beA2suppressingA2herA2fearA2(D)A2byA2displayingA2anger,A2butA2suchA2anA
2interpretationA2cannotA2beA2concludedA2fromA2theA2dataA2presented.
,AnA2elderlyA2femaleA2clientA2withA2advancedA2dementiaA2isA2admittedA2toA2theA2hospitalA2
withA2aA2fracturedA2hip.A2TheA2clientA2repeatedlyA2tellsA2theA2staff,A2"TakeA2meA2home.A2IA2
wantA2myA2Mommy."A2WhichA2responseA2isA2bestA2forA2theA2nurseA2toA2provide?
a.A2OrientA2theA2clientA2toA2theA2time,A2place,A2andA2person.
b.A2TellA2theA2clientA2thatA2theA2nurseA2isA2thereA2andA2willA2helpA2her.
c.A2RemindA2theA2clientA2thatA2herA2motherA2isA2noA2longerA2living.
d.A2ExplainA2theA2seriousnessA2ofA2herA2injuryA2andA2needA2forA2hospitalization.A2-A2Ans--
*B.A2TellA2theA2clientA2thatA2theA2nurseA2isA2thereA2andA2willA2helpA2her.*
ThoseA2withA2dementiaA2oftenA2referA2toA2homeA2orA2parentsA2whenA2seekingA2securityA2a
ndA2comfort.A2TheA2nurseA2shouldA2useA2theA2techniquesA2ofA2"offeringA2self"A2andA2"talki
ngA2toA2theA2feelings"A2toA2provideA2reassuranceA2(B).A2ClientsA2withA2advancedA2dementi
aA2haveA2permanentA2physiologicalA2changesA2inA2theA2brainA2(plaquesA2andA2tangles)A2t
hatA2preventA2themA2fromA2comprehendingA2andA2retainingA2newA2information,A2soA2(A,A2
C,A2andA2D)A2areA2likelyA2toA2beA2ofA2littleA2useA2toA2thisA2clientA2andA2doA2notA2helpA2theA2
clientsA2emotionalA2needs.
AA227A2y/
oA2FA2clientA2isA2admittedA2toA2theA2psychiatricA2hospitalA2withA2aA2dxA2ofA2bipolarA2disorde
r,A2manicA2phase.A2SheA2isA2demandingA2andA2active.A2WhichA2interventionA2shouldA2theA
2nurseA2includeA2inA2thisA2client'sA2planA2ofA2care?
a.A2ScheduleA2herA2toA2attendA2variousA2groupA2activities.
b.A2ReinforceA2herA2abilityA2toA2makeA2herA2ownA2decisions.
c.A2EncourageA2herA2toA2identifyA2feelingsA2ofA2anger.
d.A2ProvideA2aA2structuredA2environmentA2withA2littleA2stimuli.A2-A2Ans--
*D.A2ProvideA2aA2structuredA2environmentA2withA2littleA2stimuli.*
ClientsA2inA2theA2manicA2phaseA2ofA2bipolarA2disorderA2requireA2decreasedA2stimuliA2andA2
aA2structuredA2environmentA2(D).A2PlanA2noncompetitiveA2activitiesA2thatA2canA2beA2carrie
dA2outA2alone.A2(A)A2isA2contraindicated;A2stimuliA2shouldA2beA2reducedA2asA2muchA2asA2p
ossible.A2ImpulsiveA2decision-
makingA2isA2characteristicA2ofA2clientsA2withA2bipolarA2disorder.A2ToA2preventA2futureA2com
plications,A2theA2nurseA2shouldA2monitorA2theseA2clients'A2decisionsA2andA2assistA2themA2i
nA2decision-
makingA2processA2(B).A2(C)A2isA2moreA2oftenA2associatedA2withA2depressionA2thanA2withA2
bipolarA2disorder.
AnA2adultA2maleA2clientA2whoA2wasA2admittedA2toA2theA2mentalA2hospitalA2unitA2yesterdayA
2tellsA2theA2nurseA2thatA2microchipsA2wereA2plantedA2inA2hisA2headA2forA2militaryA2surveilla
nceA2ofA2hisA2everyA2move.A2WhichA2responseA2isA2bestA2forA2theA2nurseA2toA2provide?
a.A2YouA2areA2inA2theA2hospital,A2andA2IA2amA2theA2nurseA2caringA2forA2you.
b.A2ItA2mustA2beA2difficultA2forA2youA2toA2controlA2yourA2anxiousA2feelings.
c.A2GoA2toA2occupationalA2therapyA2andA2startA2aA2project.
,d.A2YouA2areA2notA2inA2aA2warA2areaA2now;A2thisA2isA2theA2UnitedA2States.A2-A2Ans--
*A2C.A2GoA2toA2occupationalA2therapyA2andA2startA2aA2project.*
DelusionsA2oftenA2generateA2fearA2andA2isolation,A2soA2theA2nurseA2shouldA2helpA2theA2cli
entA2participateA2inA2activitiesA2thatA2avoidA2focusingA2onA2theA2falseA2beliefA2andA2encour
ageA2interactionA2withA2othersA2(C).A2DelusionsA2areA2oftenA2well-
fixed,A2andA2thoughA2(A)A2reinforcesA2reality,A2itA2isA2argumentativeA2andA2dismissesA2the
A2clientsA2fears.A2ItA2isA2oftenA2difficultA2forA2theA2clientA2toA2recognizeA2theA2relationshipA2
betweenA2delusionsA2andA2anxietyA2(B),A2andA2theA2nurseA2shouldA2reassureA2theA2clientA
2thatA2heA2isA2inA2aA2safeA2place.A2DismissingA2delusionalA2thinkingA2(D)A2isA2unrealisticA2b
ecauseA2neurochemicalA2imbalancesA2thatA2causeA2positiveA2symptomsA2ofA2schizophre
niaA2requireA2antipsychoticA2drugA2therapy.
AA238A2y/
oA2FA2clientA2isA2admittedA2withA2aA2dxA2ofA2paranoidA2schizophrenia.A2WhenA2herA2trayA2i
sA2broughtA2toA2her,A2sheA2refusesA2toA2eatA2andA2tellsA2theA2nurse,A2"IA2knowA2you'reA2tryi
ngA2toA2poisonA2meA2withA2thatA2food."A2WhichA2responseA2isA2mostA2appropriateA2forA2the
A2nurseA2toA2make?
a.A2I'llA2leaveA2yourA2trayA2here.A2IA2amA2availableA2ifA2youA2needA2anythingA2else.
b.A2You'reA2notA2beingA2poisoned.A2WhyA2doA2youA2thinkA2someoneA2isA2tryingA2toA2poiso
nA2you?
c.A2NoA2oneA2onA2thisA2unitA2hasA2everA2diedA2fromA2poisoning.A2You'reA2safeA2here.
d.A2IA2willA2talkA2toA2yourA2HCPA2aboutA2theA2possibilityA2ofA2changingA2yourA2diet.A2-
A2Ans--
*A.A2I'llA2leaveA2yourA2trayA2here.A2IA2amA2availableA2ifA2youA2needA2anythingA2else.*
(A)A2isA2theA2bestA2choiceA2cited.A2TheA2nurseA2doesn'tA2argueA2withA2theA2clientA2norA2de
mandA2thatA2sheA2eat,A2butA2offersA2supportA2byA2agreeingA2toA2"beA2thereA2ifA2needed",A2
e.g.,A2toA2warmA2theA2food.A2(BA2andA2C)A2areA2arguingA2withA2theA2client'sA2delusions,A2a
ndA2(B)A2asksA2"why"A2whichA2isA2usuallyA2notA2aA2goodA2questionA2forA2aA2psychoticA2clie
nt.A2(D)A2hasA2nothingA2toA2doA2withA2theA2actualA2problem;A2i.e.,A2theA2problemA2isA2notA2t
heA2dietA2(sheA2thinksA2anyA2foodA2givenA2toA2herA2isA2poisoned).
AA2homelessA2personA2whoA2isA2inA2theA2manicA2phaseA2ofA2bipolarA2disorderA2isA2admitte
dA2toA2theA2mentalA2healthA2unit.A2WhichA2labA2findingA2obtainedA2onA2admissionA2isA2mos
tA2importantA2forA2theA2nurseA2toA2reportA2toA2theA2HCP?
a.A2DecreasedA2TSHA2level.
b.A2ElevatedA2liverA2functionA2profile.
c.A2IncreasedA2WBCA2count.
d.A2DecreasedA2HctA2andA2HgbA2levels.A2-A2Ans--*A.A2DecreasedA2TSHA2level.*
HyperthyroidismA2causesA2anA2increasedA2levelA2ofA2serumA2thyroidA2hormonesA2(T3A2an
dA2T4),A2whichA2inhibitsA2theA2releaseA2ofA2TSHA2(A),A2soA2theA2client'sA2manicA2behaviorA
2mayA2beA2relatedA2toA2anA2endocrineA2disorder.A2(B,A2C,A2andA2D)A2areA2abnormalA2findin
, gsA2thatA2areA2commonlyA2foundA2inA2theA2homelessA2populationA2becauseA2ofA2poorA2sa
nitation,A2poorA2nutrition,A2andA2theA2prevalenceA2ofA2substanceA2abuse
TheA2nurseA2isA2planningA2dischargeA2teachingA2forA2aA2maleA2clientA2withA2schizophrenia
.A2TheA2clientA2insistsA2thatA2heA2isA2returningA2toA2hisA2apartment,A2althoughA2theA2HCPA2
informedA2himA2thatA2heA2willA2beA2movingA2toA2aA2boardingA2home.A2WhatA2isA2theA2most
A2importantA2nursingA2dxA2forA2dischargeA2planning?
a.A2IneffectiveA2denialA2r/tA2situationalA2anxiety.
b.A2IneffectiveA2copingA2r/tA2inadequateA2support.
c.A2SocialA2isolationA2r/tA2difficultA2interactions.
d.A2Self-careA2deficitA2r/tA2cognitiveA2impairment.A2-A2Ans--
*A.A2IneffectiveA2denialA2r/tA2situationalA2anxiety.*
TheA2bestA2nursingA2dxA2isA2(A)A2becauseA2theA2clientA2isA2unableA2toA2acknowledgeA2theA
2moveA2toA2aA2boardingA2home.A2(B,A2C,A2andA2D)A2areA2potentialA2nursingA2diagnoses,A2
butA2denialA2isA2mostA2importantA2becauseA2itA2isA2aA2defenseA2mechanismA2thatA2keepsA2
theA2clientA2fromA2dealingA2withA2hisA2feelingsA2aboutA2livingA2arrangements.
AA2clientA2whoA2hasA2beenA2admittedA2toA2theA2psychiatricA2unitA2tellsA2theA2nurse,A2"MyA2
problemsA2areA2soA2badA2thatA2noA2oneA2canA2helpA2me."A2WhichA2responseA2isA2bestA2for
A2theA2nurseA2toA2make?
a.A2HowA2canA2IA2help?
b.A2ThingsA2probablyA2aren'tA2asA2badA2asA2theyA2seemA2rightA2now.
c.A2Let'sA2talkA2aboutA2whatA2isA2rightA2withA2yourA2life.
d.A2IA2hearA2howA2miserableA2youA2are,A2butA2thingsA2willA2getA2betterA2soon.A2-A2Ans--
*A.A2HowA2canA2IA2help?*
OfferingA2selfA2showsA2empathyA2andA2caringA2(A),A2andA2isA2theA2bestA2ofA2theA2choicesA
2provided.A2CombiningA2theA2firstA2partA2ofA2(D)A2withA2(A)A2wouldA2beA2theA2bestA2respon
se,A2butA2thisA2isA2notA2aA2fill-in-the-blankA2orA2anA2essayA2test!
A2ChooseA2theA2bestA2ofA2thoseA2choicesA2providedA2andA2moveA2on.A2(B)A2dismissesA2th
eA2client,A2thingsA2areA2badA2asA2farA2asA2thisA2clientA2isA2concerned.A2(C)A2avoidsA2theA2cl
ientsA2problemsA2andA2promotesA2denial.A2"IA2hearA2howA2miserableA2youA2are"A2isA2anA2e
xampleA2ofA2reflectiveA2dialogueA2andA2wouldA2beA2theA2bestA2choiceA2ifA2itA2wereA2notA2fo
rA2theA2restA2ofA2theA2sentence--"butA2thingsA2willA2getA2better"A2whichA2isA2offeringA2falseA
2reassurance.
AA2youngA2adultA2maleA2client,A2diagnosedA2withA2paranoidA2schizophrenia,A2believesA2th
eA2worldA2isA2tryingA2toA2poisonA2him.A2WhatA2interventionA2shouldA2theA2nurseA2includeA2i
nA2thisA2client'sA2planA2ofA2care?
a.A2RemindA2theA2clientA2thatA2hisA2suspicionsA2areA2notA2true.
b.A2AskA2oneA2nurseA2toA2spendA2timeA2withA2theA2clientA2daily.
c.A2EncourageA2theA2clientA2toA2participateA2inA2groupA2activities.
QUESTIONS AND CORRECT VERIFIED
ANSWERS
TheA2nurseA2isA2conductingA2dischargeA2teachingA2forA2aA2clientA2withA2schizophreniaA2w
hoA2plansA2toA2liveA2inA2aA2groupA2home.A2WhichA2statementA2isA2mostA2indicativeA2ofA2the
A2needA2forA2carefulA2follow-upA2afterA2discharge?
a.A2CricketsA2areA2aA2goodA2sourceA2ofA2protein.
b.A2IA2haveA2notA2heardA2anyA2voicesA2forA2aA2week.
c.A2OnlyA2myA2beliefA2inA2GodA2canA2helpA2me.
d.A2SometimesA2IA2haveA2aA2hardA2timeA2sittingA2stillA2-A2Ans--
*C.A2OnlyA2myA2beliefA2inA2GodA2canA2helpA2me.*
TheA2mostA2frequentA2causeA2ofA2increasedA2symptomsA2inA2psychoticA2clientsA2isA2non-
complianceA2withA2theA2medicationA2regimen.A2IfA2clientsA2believeA2thatA2"GodA2alone"A2is
A2goingA2toA2healA2themA2(C)A2thenA2theyA2mayA2discontinueA2theirA2medication,A2soA2(C)A
2wouldA2poseA2theA2greatestA2threatA2toA2thisA2client'sA2prognosis.A2(A)A2wouldA2requireA2f
urtherA2teaching,A2butA2isA2notA2asA2significantA2aA2statementA2asA2(C).A2(B)A2indicatesA2a
nA2improvementA2inA2theA2client'sA2condition.A2(D)A2mayA2beA2aA2signA2ofA2anxietyA2thatA2c
ouldA2improveA2withA2tx,A2butA2doesA2notA2haveA2theA2priorityA2ofA2(C).
AA2childA2isA2broughtA2toA2theA2ERA2withA2aA2brokenA2arm.A2BecauseA2ofA2otherA2injuries,A2
theA2nurseA2suspectsA2theA2childA2mayA2beA2aA2victimA2ofA2abuse.A2WhenA2theA2nurseA2tri
esA2toA2giveA2theA2childA2anA2injection,A2theA2child'sA2motherA2becomesA2veryA2loudA2andA2
shouts,A2"IA2won'tA2leaveA2myA2son!A2Don'tA2youA2touchA2him!
A2You'llA2hurtA2myA2child!"A2WhatA2isA2theA2bestA2interpretationA2ofA2theA2mother'sA2statem
ents?A2TheA2motherA2is
a.A2regressingA2toA2anA2earlierA2behaviorA2pattern.
b.A2sublimatingA2herA2anger.
c.A2projectingA2herA2feelingsA2ontoA2theA2nurse.
d.A2suppressingA2herA2fear.A2-A2Ans--*C.A2projectingA2herA2feelingsA2ontoA2theA2nurse.*
ProjectionA2isA2attributingA2one'sA2ownA2thoughts,A2impulses,A2orA2behaviorsA2ontoA2anoth
er--
itA2isA2theA2motherA2whoA2isA2probablyA2harmingA2theA2childA2andA2sheA2isA2attributingA2her
A2actionsA2toA2theA2nurseA2(C).A2TheA2motherA2mayA2beA2immature,A2butA2(A)A2isA2notA2the
A2bestA2descriptionA2ofA2herA2behavior.A2(B)A2isA2substitutingA2aA2sociallyA2acceptableA2fee
lingA2forA2anA2unacceptableA2one.A2TheseA2areA2notA2sociallyA2acceptableA2feelings.A2The
A2motherA2mayA2beA2suppressingA2herA2fearA2(D)A2byA2displayingA2anger,A2butA2suchA2anA
2interpretationA2cannotA2beA2concludedA2fromA2theA2dataA2presented.
,AnA2elderlyA2femaleA2clientA2withA2advancedA2dementiaA2isA2admittedA2toA2theA2hospitalA2
withA2aA2fracturedA2hip.A2TheA2clientA2repeatedlyA2tellsA2theA2staff,A2"TakeA2meA2home.A2IA2
wantA2myA2Mommy."A2WhichA2responseA2isA2bestA2forA2theA2nurseA2toA2provide?
a.A2OrientA2theA2clientA2toA2theA2time,A2place,A2andA2person.
b.A2TellA2theA2clientA2thatA2theA2nurseA2isA2thereA2andA2willA2helpA2her.
c.A2RemindA2theA2clientA2thatA2herA2motherA2isA2noA2longerA2living.
d.A2ExplainA2theA2seriousnessA2ofA2herA2injuryA2andA2needA2forA2hospitalization.A2-A2Ans--
*B.A2TellA2theA2clientA2thatA2theA2nurseA2isA2thereA2andA2willA2helpA2her.*
ThoseA2withA2dementiaA2oftenA2referA2toA2homeA2orA2parentsA2whenA2seekingA2securityA2a
ndA2comfort.A2TheA2nurseA2shouldA2useA2theA2techniquesA2ofA2"offeringA2self"A2andA2"talki
ngA2toA2theA2feelings"A2toA2provideA2reassuranceA2(B).A2ClientsA2withA2advancedA2dementi
aA2haveA2permanentA2physiologicalA2changesA2inA2theA2brainA2(plaquesA2andA2tangles)A2t
hatA2preventA2themA2fromA2comprehendingA2andA2retainingA2newA2information,A2soA2(A,A2
C,A2andA2D)A2areA2likelyA2toA2beA2ofA2littleA2useA2toA2thisA2clientA2andA2doA2notA2helpA2theA2
clientsA2emotionalA2needs.
AA227A2y/
oA2FA2clientA2isA2admittedA2toA2theA2psychiatricA2hospitalA2withA2aA2dxA2ofA2bipolarA2disorde
r,A2manicA2phase.A2SheA2isA2demandingA2andA2active.A2WhichA2interventionA2shouldA2theA
2nurseA2includeA2inA2thisA2client'sA2planA2ofA2care?
a.A2ScheduleA2herA2toA2attendA2variousA2groupA2activities.
b.A2ReinforceA2herA2abilityA2toA2makeA2herA2ownA2decisions.
c.A2EncourageA2herA2toA2identifyA2feelingsA2ofA2anger.
d.A2ProvideA2aA2structuredA2environmentA2withA2littleA2stimuli.A2-A2Ans--
*D.A2ProvideA2aA2structuredA2environmentA2withA2littleA2stimuli.*
ClientsA2inA2theA2manicA2phaseA2ofA2bipolarA2disorderA2requireA2decreasedA2stimuliA2andA2
aA2structuredA2environmentA2(D).A2PlanA2noncompetitiveA2activitiesA2thatA2canA2beA2carrie
dA2outA2alone.A2(A)A2isA2contraindicated;A2stimuliA2shouldA2beA2reducedA2asA2muchA2asA2p
ossible.A2ImpulsiveA2decision-
makingA2isA2characteristicA2ofA2clientsA2withA2bipolarA2disorder.A2ToA2preventA2futureA2com
plications,A2theA2nurseA2shouldA2monitorA2theseA2clients'A2decisionsA2andA2assistA2themA2i
nA2decision-
makingA2processA2(B).A2(C)A2isA2moreA2oftenA2associatedA2withA2depressionA2thanA2withA2
bipolarA2disorder.
AnA2adultA2maleA2clientA2whoA2wasA2admittedA2toA2theA2mentalA2hospitalA2unitA2yesterdayA
2tellsA2theA2nurseA2thatA2microchipsA2wereA2plantedA2inA2hisA2headA2forA2militaryA2surveilla
nceA2ofA2hisA2everyA2move.A2WhichA2responseA2isA2bestA2forA2theA2nurseA2toA2provide?
a.A2YouA2areA2inA2theA2hospital,A2andA2IA2amA2theA2nurseA2caringA2forA2you.
b.A2ItA2mustA2beA2difficultA2forA2youA2toA2controlA2yourA2anxiousA2feelings.
c.A2GoA2toA2occupationalA2therapyA2andA2startA2aA2project.
,d.A2YouA2areA2notA2inA2aA2warA2areaA2now;A2thisA2isA2theA2UnitedA2States.A2-A2Ans--
*A2C.A2GoA2toA2occupationalA2therapyA2andA2startA2aA2project.*
DelusionsA2oftenA2generateA2fearA2andA2isolation,A2soA2theA2nurseA2shouldA2helpA2theA2cli
entA2participateA2inA2activitiesA2thatA2avoidA2focusingA2onA2theA2falseA2beliefA2andA2encour
ageA2interactionA2withA2othersA2(C).A2DelusionsA2areA2oftenA2well-
fixed,A2andA2thoughA2(A)A2reinforcesA2reality,A2itA2isA2argumentativeA2andA2dismissesA2the
A2clientsA2fears.A2ItA2isA2oftenA2difficultA2forA2theA2clientA2toA2recognizeA2theA2relationshipA2
betweenA2delusionsA2andA2anxietyA2(B),A2andA2theA2nurseA2shouldA2reassureA2theA2clientA
2thatA2heA2isA2inA2aA2safeA2place.A2DismissingA2delusionalA2thinkingA2(D)A2isA2unrealisticA2b
ecauseA2neurochemicalA2imbalancesA2thatA2causeA2positiveA2symptomsA2ofA2schizophre
niaA2requireA2antipsychoticA2drugA2therapy.
AA238A2y/
oA2FA2clientA2isA2admittedA2withA2aA2dxA2ofA2paranoidA2schizophrenia.A2WhenA2herA2trayA2i
sA2broughtA2toA2her,A2sheA2refusesA2toA2eatA2andA2tellsA2theA2nurse,A2"IA2knowA2you'reA2tryi
ngA2toA2poisonA2meA2withA2thatA2food."A2WhichA2responseA2isA2mostA2appropriateA2forA2the
A2nurseA2toA2make?
a.A2I'llA2leaveA2yourA2trayA2here.A2IA2amA2availableA2ifA2youA2needA2anythingA2else.
b.A2You'reA2notA2beingA2poisoned.A2WhyA2doA2youA2thinkA2someoneA2isA2tryingA2toA2poiso
nA2you?
c.A2NoA2oneA2onA2thisA2unitA2hasA2everA2diedA2fromA2poisoning.A2You'reA2safeA2here.
d.A2IA2willA2talkA2toA2yourA2HCPA2aboutA2theA2possibilityA2ofA2changingA2yourA2diet.A2-
A2Ans--
*A.A2I'llA2leaveA2yourA2trayA2here.A2IA2amA2availableA2ifA2youA2needA2anythingA2else.*
(A)A2isA2theA2bestA2choiceA2cited.A2TheA2nurseA2doesn'tA2argueA2withA2theA2clientA2norA2de
mandA2thatA2sheA2eat,A2butA2offersA2supportA2byA2agreeingA2toA2"beA2thereA2ifA2needed",A2
e.g.,A2toA2warmA2theA2food.A2(BA2andA2C)A2areA2arguingA2withA2theA2client'sA2delusions,A2a
ndA2(B)A2asksA2"why"A2whichA2isA2usuallyA2notA2aA2goodA2questionA2forA2aA2psychoticA2clie
nt.A2(D)A2hasA2nothingA2toA2doA2withA2theA2actualA2problem;A2i.e.,A2theA2problemA2isA2notA2t
heA2dietA2(sheA2thinksA2anyA2foodA2givenA2toA2herA2isA2poisoned).
AA2homelessA2personA2whoA2isA2inA2theA2manicA2phaseA2ofA2bipolarA2disorderA2isA2admitte
dA2toA2theA2mentalA2healthA2unit.A2WhichA2labA2findingA2obtainedA2onA2admissionA2isA2mos
tA2importantA2forA2theA2nurseA2toA2reportA2toA2theA2HCP?
a.A2DecreasedA2TSHA2level.
b.A2ElevatedA2liverA2functionA2profile.
c.A2IncreasedA2WBCA2count.
d.A2DecreasedA2HctA2andA2HgbA2levels.A2-A2Ans--*A.A2DecreasedA2TSHA2level.*
HyperthyroidismA2causesA2anA2increasedA2levelA2ofA2serumA2thyroidA2hormonesA2(T3A2an
dA2T4),A2whichA2inhibitsA2theA2releaseA2ofA2TSHA2(A),A2soA2theA2client'sA2manicA2behaviorA
2mayA2beA2relatedA2toA2anA2endocrineA2disorder.A2(B,A2C,A2andA2D)A2areA2abnormalA2findin
, gsA2thatA2areA2commonlyA2foundA2inA2theA2homelessA2populationA2becauseA2ofA2poorA2sa
nitation,A2poorA2nutrition,A2andA2theA2prevalenceA2ofA2substanceA2abuse
TheA2nurseA2isA2planningA2dischargeA2teachingA2forA2aA2maleA2clientA2withA2schizophrenia
.A2TheA2clientA2insistsA2thatA2heA2isA2returningA2toA2hisA2apartment,A2althoughA2theA2HCPA2
informedA2himA2thatA2heA2willA2beA2movingA2toA2aA2boardingA2home.A2WhatA2isA2theA2most
A2importantA2nursingA2dxA2forA2dischargeA2planning?
a.A2IneffectiveA2denialA2r/tA2situationalA2anxiety.
b.A2IneffectiveA2copingA2r/tA2inadequateA2support.
c.A2SocialA2isolationA2r/tA2difficultA2interactions.
d.A2Self-careA2deficitA2r/tA2cognitiveA2impairment.A2-A2Ans--
*A.A2IneffectiveA2denialA2r/tA2situationalA2anxiety.*
TheA2bestA2nursingA2dxA2isA2(A)A2becauseA2theA2clientA2isA2unableA2toA2acknowledgeA2theA
2moveA2toA2aA2boardingA2home.A2(B,A2C,A2andA2D)A2areA2potentialA2nursingA2diagnoses,A2
butA2denialA2isA2mostA2importantA2becauseA2itA2isA2aA2defenseA2mechanismA2thatA2keepsA2
theA2clientA2fromA2dealingA2withA2hisA2feelingsA2aboutA2livingA2arrangements.
AA2clientA2whoA2hasA2beenA2admittedA2toA2theA2psychiatricA2unitA2tellsA2theA2nurse,A2"MyA2
problemsA2areA2soA2badA2thatA2noA2oneA2canA2helpA2me."A2WhichA2responseA2isA2bestA2for
A2theA2nurseA2toA2make?
a.A2HowA2canA2IA2help?
b.A2ThingsA2probablyA2aren'tA2asA2badA2asA2theyA2seemA2rightA2now.
c.A2Let'sA2talkA2aboutA2whatA2isA2rightA2withA2yourA2life.
d.A2IA2hearA2howA2miserableA2youA2are,A2butA2thingsA2willA2getA2betterA2soon.A2-A2Ans--
*A.A2HowA2canA2IA2help?*
OfferingA2selfA2showsA2empathyA2andA2caringA2(A),A2andA2isA2theA2bestA2ofA2theA2choicesA
2provided.A2CombiningA2theA2firstA2partA2ofA2(D)A2withA2(A)A2wouldA2beA2theA2bestA2respon
se,A2butA2thisA2isA2notA2aA2fill-in-the-blankA2orA2anA2essayA2test!
A2ChooseA2theA2bestA2ofA2thoseA2choicesA2providedA2andA2moveA2on.A2(B)A2dismissesA2th
eA2client,A2thingsA2areA2badA2asA2farA2asA2thisA2clientA2isA2concerned.A2(C)A2avoidsA2theA2cl
ientsA2problemsA2andA2promotesA2denial.A2"IA2hearA2howA2miserableA2youA2are"A2isA2anA2e
xampleA2ofA2reflectiveA2dialogueA2andA2wouldA2beA2theA2bestA2choiceA2ifA2itA2wereA2notA2fo
rA2theA2restA2ofA2theA2sentence--"butA2thingsA2willA2getA2better"A2whichA2isA2offeringA2falseA
2reassurance.
AA2youngA2adultA2maleA2client,A2diagnosedA2withA2paranoidA2schizophrenia,A2believesA2th
eA2worldA2isA2tryingA2toA2poisonA2him.A2WhatA2interventionA2shouldA2theA2nurseA2includeA2i
nA2thisA2client'sA2planA2ofA2care?
a.A2RemindA2theA2clientA2thatA2hisA2suspicionsA2areA2notA2true.
b.A2AskA2oneA2nurseA2toA2spendA2timeA2withA2theA2clientA2daily.
c.A2EncourageA2theA2clientA2toA2participateA2inA2groupA2activities.
