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Mental Health - Exam 2

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Total Questions : 56

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Question 1:

A nurse is providing teaching to a client who is primigravid and is scheduled to have an abdominal ultrasound.

Which of the following statements by the client indicates an understanding of the teaching?

A. “I won’t apply perfumed lotion to my abdomen before the test.” B. “I can’t have anything to eat after midnight.” C. “I need to take a stool softener the night before the test.” D. “I will drink water before the test until my bladder feels full.”

Answer and Explanation

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Question 2:

A therapist recently convicted of multiple counts of Medicare fraud says, "Sure I overbilled. Why not? Takes advantage of the government, so I did too, it is not a problem."

These statements show:

Select one:

A. lack of remorse or guilt B. suspiciousness. C. shame. D. decreased empathy.

Answer and Explanation

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Question 3:

Which of the following individuals is at highest risk for committing suicide?

A. 75-year-Old Caucasian male, alcohol user, independent-minded. B. 51-year-Old female, depression, active in church. C. 42-year-old male, schizophrenic. Unemployed. D. 16-year-old female, diabetic, with 2 best friends.

Answer and Explanation

Choice C:

Schizophrenia is a severe mental illness associated with an increased risk of suicide. Individuals with schizophrenia are at a higher risk of suicide due to the presence of symptoms such as depression, hopelessness, and social isolation. Unemployment is also a risk factor for suicide as it can contribute to financial and social stress.

The other options do have some risk factors, but not as high as the individual in option c. Alcohol use and being independent-minded are not necessarily significant risk factors for suicide, and being active in church can be a protective factor. While depression is a significant risk factor for suicide, it is not the only factor, and having two best friends may be a protective factor. Diabetes, in and of itself, is not a risk factor for suicide.

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Question 4:

What is the nurse's priority assessment for a patient with borderline personality disorder?

A. Suicidal or homicidal ideations B. Sleep patern changes C. Impulsive behaviours D. Only support systems

Answer and Explanation

Choice A:

Borderline personality disorder is a serious mental illness characterized by instability in mood, behaviour, and self-image. Patients with borderline personality disorder are at a high risk of self-harm, suicide, and impulsive behaviours. Therefore, the nurse's priority assessment should be to identify any suicidal or homicidal ideations, as these can be life-threatening emergencies. Once identified, appropriate interventions should be initiated, such as suicide precautions, crisis management, and referral to mental health professionals for further evaluation and treatment.

While sleep patern changes, impulsive behaviours, and support systems are also important aspects to assess in patients with borderline personality disorder, they are not the priority when compared to suicidal or homicidal ideations.

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Question 5:

A nurse is communicating with a client who was just admited for treatment of a substance use disorder. Which of the following communication techniques should the nurse identify as a barrier to therapeutic communication?
Select one:

A. Reﬂecting B. Listening atentively C. Oﬀering advice D. Giving information

Answer and Explanation

Choice A:

Reﬂecting (option a) and listening attentively (option b) are both examples of eﬀective therapeutic communication techniques as they demonstrate active listening and empathy.

Choice B:

Reﬂecting (option a) and listening attentively (option b) are both examples of eﬀective therapeutic communication techniques as they demonstrate active listening and empathy.

Choice C:

Therapeutic communication involves actively listening to the client, demonstrating empathy, and using open-ended questions to encourage the client to express their thoughts and feelings.

However, oﬀering advice (option c) is a barrier to therapeutic communication because it implies that the nurse knows what is best for the client and can solve their problems for them.

Choice D:

This can create a power dynamic in the nurse-client relationship and may discourage the client from expressing their true thoughts and feelings. Giving information (option d) can be an important aspect of therapeutic communication, but it should be done in a way that respects the client's autonomy and involves collaboration rather than giving directives.

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Question 6:

A nurse is caring for a client following a recent suicide attempt. Which of the following actions should the nurse take?

A. Initiate one to one constant supervision around the clock. B. Ensure the client's hands are always visible. C. Tuck bedcovers over client's hands and arms. D. Inspect the client's personal belongings. E. Check the environment for possible hazards. F. Assign the client to a private room. G. Place only plastic utensils on the client's meal tray.

Answer and Explanation

Choice A:

Initiate one to one constant supervision around the clock: A client who has attempted suicide is at high risk for further harm, and close monitoring is necessary to prevent further attempts. Initiation of one-to- one constant supervision around the clock ensures that the client is continuously monitored, and any signs of suicidal ideation or behavior can be immediately addressed.

Choice B:

Ensure the client's hands are always visible: This action may be necessary if the client has a history of self-harm or aggressive behavior, but it is not specifically related to preventing suicide attempts.

Choice C:

Tuck bedcovers over client's hands and arms: This action may be necessary if the client has a history of self-harm, but it is not specifically related to preventing suicide attempts.

Choice D:

Inspect the client's personal belongings: While it may be important to inspect the client's personal belongings for any items that could be used for self-harm, this action is not as urgent as initiating constant supervision and checking the environment for hazards.

Choice E:

Check the environment for possible hazards: It is important to check the client's environment for potential hazards, such as sharp objects, cords, or other items that could be used to harm oneself. This step helps to ensure the client's safety and prevent further attempts.

Choice F:

Assign the client to a private room: While a private room may be beneficial for the client's comfort and privacy, it is not specifically related to preventing suicide attempts.

Choice G:

Place only plastic utensils on the client's meal tray: This action is not specifically related to preventing suicide attempts, unless there is concern that the client may harm themselves with utensils.

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Question 7:

After several therapeutic sessions with a client who recently attempted suicide, which occurrence should cause the nurse to consider the possibility of transference?
Select one:

A. The nurse develops a trusting relationship with the patient. B. The patient states,” Talking to you feels like talking to my parents and uncle." C. The patient's reactions toward the nurse seem realistic and appropriate. D. The nurse feels unusually and excessively happy when the patient's mood begins to lift.

Answer and Explanation

Choice B:

This statement by the patient suggests that they may be projecting their feelings, thoughts, and attitudes toward their parents and uncle onto the therapist. This projection is a common phenomenon in therapy and is known as transference. Transference occurs when a patient transfers emotions, desires, and expectations from one person to another, usually the therapist. It can be positive or negative and can aﬀect the therapeutic relationship.

Therefore, the statement "Talking to you feels like talking to my parents and uncle" is a clear indication of transference and should be carefully considered by the therapist in the ongoing therapy sessions. The therapist should explore the patient's feelings and experiences with their parents and uncle to better understand the nature of the transference and how it may be aﬀecting the therapeutic process.

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Question 8:

A patient cries as the nurse explores the patient's relationship with a deceased parent. The patient says, “I shouldn't be crying like this, it happened a long time ago.” Which responses by the nurse will facilitate communication? Select all that apply.
Select one or more:

A. “I can see that you feel sad about this situation.” B. "Don't be sad, everyone has to pass for something like this in the life.” C. I felt very sad when my mother died, it was horrible! D. "Let's talk about something else. this subject is upsetting you, don't worry about this." E. “The loss of your parent should be very painful for you."

Answer and Explanation

Choice A:

These responses by the nurse show empathy and validate the patient’s feelings. They also encourage the patient to continue expressing their emotions and facilitate communication.

Choice B:

Option b. “Don’t be sad, everyone has to pass for something like this in the life” is not a helpful response because it minimizes the patient’s feelings and may make them feel like their emotions are not valid.

Choice C:

Option c. “I felt very sad when my mother died, it was horrible!” is not a helpful response because it shifts the focus of the conversation away from the patient and onto the nurse’s personal experience.

Choice D:

Option d. “Let’s talk about something else. this subject is upsetting you, don’t worry about this” is not a helpful response because it dismisses the patient’s emotions and may make them feel like they are not allowed to express their feelings.

Choice E:

These responses by the nurse show empathy and validate the patient’s feelings. They also encourage the patient to continue expressing their emotions and facilitate communication.

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Question 9:

In a Behavioral Health Unit team meeting, a registered nurse Says, "l am concerned if we are behaving ethically by using restraint to prevent one patient from self-mutilation while the care plan for another patient who has also self-mutilated issues calls for one-on-one supervision."

Which ethical principle most clearly applies to this situation?

A. Veracity B. Non maleficence C. Autonomy D. Justice

Answer and Explanation

Choice A:

Option a. Veracity refers to the principle of truth-telling and honesty.

Choice B:

Option b. non-maleficence refers to the principle of doing no harm.

Choice C:

Option c. Autonomy refers to the principle of respecting an individual’s right to make their own decisions.

Choice D:

The ethical principle of justice refers to the fair and equal treatment of all individuals. In this situation, the nurse is concerned about whether the team is behaving ethically by using diﬀerent approaches to prevent self-mutilation in two patients. The nurse is questioning whether the team is treating both patients fairly and equally.

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Question 10:

A nurse is caring for several clients who are attending community-based mental health programs. Which Of the following clients should the nurse plan to visit first?
Select one:

A. A client who recently burned her arm by accident while using a hot iron at home. B. A client who tells the nurse he experienced manifestations of severe anxiety before and during a job interview. C. A client who requests that her antipsychotic medication be changed due to some new adverse eﬀects. D. A client that says he is hearing a voice that tells him he is not worthy of living anymore.

Answer and Explanation

Choice A:

Option a. A client who recently burned her arm by accident while using a hot iron at home may require wound care and education on safety, but this situation is not as urgent as the client experiencing auditory hallucinations.

Choice B:

Option b. A client who tells the nurse he experienced manifestations of severe anxiety before and during a job interview may benefit from interventions to manage anxiety, but this situation is not as urgent as the client experiencing auditory hallucinations.

Choice C:

Option c. A client who requests that her antipsychotic medication be changed due to some new adverse eﬀects may require medication adjustment and monitoring for side eﬀects, but this situation is not as urgent as the client experiencing auditory hallucinations.

Choice D:

This client is experiencing auditory hallucinations and may be at risk for self-harm or suicide. The nurse should prioritize visiting this client first to assess their safety and provide appropriate interventions.

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Total Questions : 56

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Mental Health - Exam 2

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