mental health exam 1 Flashcards


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1

select the correct etiology to complete this nursing diagnosis for a patient diagnosed with dissociative identity disorder. disturbed personal identity related to:

cognitive distortions associated with unresolved childhood abuse issues

2

an experienced charge nurse observes a novice nurse expressing irritability regarding a patient with a long history of alcoholism and suspects the new nurse is experiencing countertransference. which comment by the new nurse confirms this suspicion?

my parents were alcoholics and often neglected our family

3

select the most appropriate label to complete this nursing diagnosis_____related to feelings of shyness and poorly developed social skills as evidence by watching television alone at home every evening.

social isolation

4

when thinking about the prevalence of stigma related to mental health issues, which statement by a student nurse is most concerning?

patients who have irish heritage are most likely to develop alcoholism

5

when considering stigmatism, which statement made by the nurse demonstrates a need for immediate intervention by the nurse manager?

my experience has been that the irish have a problem with alcohol use

6

primary prevention

techniques and programs to improve the social environment so that new cases of mental disorders do not develop

7

secondary prevention

activities directed toward early diagnosis and prompt interventions, thereby lessening the severity of a condition and enabling the client to return to the highest level of health at the earliest possible point

8

tertiary prevention

activity aimed at restoring the individuals to the highest possible level of health and functioning

9

an experienced nurse says to a new graduate, when you've practiced as long i have, you automatically know how to take care of patients experiencing psychosis. which factors should the new graduate consider when analyzing this comment?

the experienced nurse may have lost sight of patients individuality, which may compromise the integrity of practice

new research findings should be integrated continuously into a nurses practice to provide the most effective care

10

which technique will best communicate to a patient that the nurse is interested in listening?

restating a feeling or thought the patient has expressed

11

a patient says, please dont share information about me with the other people. how should the nurse respond?

i will not share information with your family or friends without your permission, but i will share information about you with other staff

12

which principle should guide the nurse in determining the extent of silence to use during patient interview sessions?

silence can provide meaningful moments for reflection

13

which behavior shows that a nurse values autonomy? the nurse

discusses options and helps the patient weigh the consequences

14

a nurse works with a patient diagnosed with posttraumatic stress disorder who has frequent flashbacks as well as persistent symptoms of arousal. which intervention should be included in the plan of care?

explain that the physical symptoms are related to the psychological state

15

which action by a psychiatric nurse best applies the ethical principle of autonomy?

exploring the alternative solutions with the patients, who then makes a choice

16

as a patient diagnosed with a mental illness is being discharged from a facility, a nurse invites the patient to the annual staff picnic. what is the best analysis of this scenario?

the nurses action blurs the boundaries of the therapeutic relationship

17

a patient newly diagnosed as HIV-positive seeks the nurses advice on how to reduce the risk of infections. the patient says, I went to church years ago and I was in my best health then. maybe i should start going to church again. Which response with the nurse offer?

studies show that spiritual practices can enhance immune system function and coping abilities

18

a nursing student new to psychiatric mental health nursing asks a classmate what resources are best to use to understand which symptoms are present in a specific disorder. the resource is

diagnostic and statistical manual, fifth edition (DSM-V)

19

a native american patient describes a difficult childhood and dropping out of high school. the patient abused alcohol as a teenager to escape feelings of isolation but stopped 10 years ago. the patient now says, I feel stupid. I've never had a good job. I dont help my people. which nursing diagnosis applies?

chronic low self esteem

20

a native american patient describes a difficult childhood and dropping out of high school. the patient abused alcohol as a teenager to escape feelings of isolation but stopped 10 years ago. the patient now says, I feel stupid. I've never had a good job. I dont help my people. how should the treatment team focus planning for this patient?

use a holistic approach, including mind, body and spirit

21

a woman just received notification that her husband died. she approaches the nurse who cared for him during his last hours and says angrily. If you had given him your undivided attention, he would still be alive. How should the nurse analyze this behavior?

anger is an expected emotion in an adjustment disorder

22

the adult child of a patient diagnosed with major depressive disorder asks. Do you think depression and physical illness are connected? since my fathers death, my mother has has shingles and the flu, but shes usually not one who gets sick. which answer by the nurse best reflects current knowledge?

negative emotions and prolonged stress interfere with the bodys ability to protect itself and can increase the likelihood of illness

23

which issues should a nurse address during the first interview with a patient with a psychiatric disorder?

relationship parameters, the contract, confidentiality, and termination

24

which comment by the parents of young children best demonstrates support of development of resilience and effective stress management?

we spend daily family time talking about experiences and feelings

25

psychiatric mental health nurses can provide education about good nutrition, exercise, dangers of tobacco, alcohol, and drugs. this is an example of what type of prevention?

primary

26

which individual diagnosed with mental illness may need emergency of involuntary admission?

who takes 39 acetaminophen tablets after the persons stock portfolio becomes worthless

an individual with bipolar disorder, manic phase, who has not eaten in 4 days

throws a heavy plate at a waiter at the direction of command auditory hallucinations

reports ideas of hurting their mother while shes sleeping

27

when a new patient is hospitalized, a nurse takes the patient on a tour, explains rules of the unit, and discusses the daily schedule. the nurse is engaged in:

milieu management

28

termination of a therapeutic nurse-patient relationship has been successful when the nurse:

discusses with the patient changes that happened during the relationship and evaluates outcomes

29

maslows hierarchy of basic human needs is useful when planning and implementing nursing care as it provides a structure for:

establishing priorities of care

30

understanding the concept of countertransference is important for nurses to provide therapeutic care. countertransferance:

may result in strong negative or positive feelings for patients

refers to the unconscious feelings the nurse has for the patient

31

which comments by a nurse demonstrate use of the therapeutic techniques?

i noticed your hands trembling when you told me about your accident

im glad you were able to tell me how you felt about your loss

32

when considering the suggestions of hildegard peplau, the best way to ensure that the patient stays focus of therapeutic conversations is for student nurses to

reflecting on personal behaviors and personal needs

maintain awareness of personal behaviors/needs and reflect on these

33

which nursing intervention demonstrates false imprisonment?

a patient has been irritating and attention seeking much of the day. a nurse escorts the patient down to the hall saying. Stay in your room and don't come out.

34

the sibling of an asian american patient tells the nurse. My sister needs help for the pain. she cries from hurting. which understanding by the nurse will contribute culturally competent care for this patient? persons of an asian american heritage:

often expresses emotional distress with physical symptoms

35

assisted outpatient treatment and assertive community treatment are both community based psychiatric services. the difference is:

ACT helps with severe mental illness live safely in community settings. AOT is a court ordered outpatient treatment for non-compliant patients

36

a mexican american patient puts in a picture of the virgin mary on the bedside table what is the nurses best action?

understanding the religious beliefs may be of support to the patient and leave the picture where the patient placed it

37

a patient nervously says. financial problems are stressing my marriage. I've heard rumors about cutbacks at work. I am afraid I might get laid off. the patients pulse is 112/minute, respirations are 26/minute, and blood pressure is 166/88. which nursing intervention will the nurse implement?

direct the patient in slow and deep breathing using abdominal muscles

38

according to erik eriksons stages of development, which of the following statement best reflects an unsuccessful resolution of crisis?

a 29 yo states, I'm still single and theres no one out there for me

39

a nurse prepares to assess a new patient who moved to the united states from central america 3 years ago. after introduction, what is the nurses next comment?

are you comfortable conversing in english, or would you prefer to have a translator present?

40

of the following statements, which one is true of self-actualization?

the self-actualization process continues throughout life

41

an african american patient, originally from haiti, has a diagnosis of major depressive disorder. they tell the nurse, theres nothing you can do. this is a punishment. the only thing i can do is see a healer. the culturally aware nurse assesses that the patient

may believe the distress is the result of a curse or spell

42

a patient in the emergency department shows a variety of psychiatric symptoms including restlessness and anxiety. the patient says, i feel sad because evil spirits have overtaken my mind. which world view is most applicable to this individual?

indigenous/harmony

43

a patient tells the nurse, my doctor thinks my problems with stress relate to the negative way i think about things and suggested i learn new ways of thinking. which response by the nurse would support the recommendations?

teach the patient to recognize, reconsider, and reframe irrational thoughts

44

in a team meeting a nurse says, I'm concerned about whether we are behaving by using restraint to prevent one patient from self-mutilation, while the care plan to another self mutilating patient requires one on one supervision. which ethical principle most clearly applies to this situation?

justice

45

which entry in the medical record best meets the requirement for problem oriented charting?

s. states, I feel like im ready to blow up. O. pacing hall, mumbling to self. A. auditory hallucinations. P. offer haloperidol 2mg po. I. haloperidol 2mg po gram at 0900. E. returned to lounge at 0930 and quitly watched tv.

46

which component of treatment of mental illness is specifically recognized by quality and safety education for nurses?

care is centered on the patient

47

why is the study of culture so important for psychiatric nurses in the united states?

culture competence helps protect patients from prejudice and discrimination

patients should receive information a bout their illness and treatment in terms they understand

psychiatric nurses often interface with patients and their significant others over a long period of time

48

what is the legal significance of a nurses action when a patient verbally refuses medication and the nurse gives the medication over the patients objection? the nurse:

can be charged with battery

49

after formulating the nursing diagnoses for a new patient, what is the nurses next action?

determining the goals and outcome criteria

50

during the first interview with a patient whose child died in a car accident, the nurse feels empathetic and reaches out to take the patients hand. select the correct analysis of the nurses behavior

the gesture is premature. the patients cultural and individual interpretation of touch is unknown

51

two weeks ago, a soldier returned to the united states from active duty in a combat zone. the soldier was diagnosed with PTSD. which comment by the soldier requires immediate attention?

i saw my best friend get killed by a roadside bomb. i dont understand why it wasn't me

52

the miracle question is a useful technique in therapeutic communication, it helps patients

identify goals and gets to the source of the most important issue

53

as nurses we understand the promoting process of recovery is essential. according to SAMSHA recovery is defined as a process of

change through which individuals improve their health, and wellness, live a self-directed life and strive to reach their full potential

54

a patient is having difficulty making a decision. the nurse has mixed feelings about whether to provide advice. which principle usually applies? giving advice

is rarely helpful