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HESI and SAUNDERS NCLEX-PN COMPREHENSIVE Mental Health Exam Prep Questions & Knowledge Rev, Exams of Nursing

University of Oxford Nursing

HESI and SAUNDERS NCLEX-PN COMPREHENSIVE Mental Health Exam Prep Questions & Knowledge Review HESI and SAUNDERS NCLEX-PN COMPREHENSIVE Mental Health Exam Prep Questions & Knowledge Review

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HESI and SAUNDERS N CLEX-PN COMPREHENSIVE

Mental Health Exam Prep Questions & Knowledge

Review

A married male client with three children has lost his job and

states that he feels useless. He is tearful, upset, and

embarrassed. What is an appropriate objective of care for this

client?

1. Limiting tearfulness

2. Increasing self-esteem

3. Controlling feelings of sadness

4. Promoting acceptance by others - Correct answer 2. Increasing

self-esteem

The loss of a job can precipitate negative feelings about the self

and decrease self-esteem. Feelings should be expressed, not

limited; attempting to decrease a client's crying often ends up

worsening it. Crying is not necessarily an expression of sadness;

other feelings are involved. The focus should be on the client's

self-acceptance, not acceptance by others.

A 44-year-old client has been unable to function since her

husband asked for a divorce 2 weeks ago. She is brought to the

crisis intervention center by a friend. What type of crisis is this

situation?

1. Social

2. Situational

3. Maturational

4. Developmental - Correct answer 2. Situational

Situational crises involve an unanticipated loss, such as a divorce,

that is threatening to the client. Social crises involve multiple

Partial preview of the text

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HESI and SAUNDERS NCLEX-PN COMPREHENSIVE

Mental Health Exam Prep Questions & Knowledge

Review

A married male client with three children has lost his job and states that he feels useless. He is tearful, upset, and embarrassed. What is an appropriate objective of care for this client?

Limiting tearfulness
Increasing self-esteem
Controlling feelings of sadness
Promoting acceptance by others - Correct answer 2. Increasing self-esteem The loss of a job can precipitate negative feelings about the self and decrease self-esteem. Feelings should be expressed, not limited; attempting to decrease a client's crying often ends up worsening it. Crying is not necessarily an expression of sadness; other feelings are involved. The focus should be on the client's self-acceptance, not acceptance by others. A 44-year-old client has been unable to function since her husband asked for a divorce 2 weeks ago. She is brought to the crisis intervention center by a friend. What type of crisis is this situation?
Social
Situational
Maturational
Developmental - Correct answer 2. Situational Situational crises involve an unanticipated loss, such as a divorce, that is threatening to the client. Social crises involve multiple

losses such as those occurring during major disasters. Maturational crises occur in response to stress experienced as one struggles with developmental tasks. Developmental (maturational) crises are associated with developmental tasks; divorce is not a developmental task. A resident in a nursing home recently immigrated to the United States from Italy. How does the nurse plan to provide emotional support?

By offering choices consistent with the client's heritage
By ensuring that the client understands American beliefs
By assisting the client in adjusting to the American culture
By correcting the client's misconceptions about appropriate health practices - Correct answer 1. By offering choices consistent with the client's heritage Adherence to a plan of care is enhanced by the nurse's providing choices consistent with the client's cultural beliefs and practices. The nurse's cultural or personal beliefs and biases should not influence or interfere with the implementation of appropriate care. Helping the client adjust to the American culture is not the priority at this time; care should be adapted to the client's needs and culture. The person's cultural practices should not be addressed unless they are detrimental to the person's health. A nurse should reassess an older adult client's needs and current plan of care when the client's behavior indicates the development of what symptom?
Confusion
Hypochondriasis
Additional complaints
Increased socialization - Correct answer 1. Confusion

A nurse is planning to teach a client about self-care. What level of anxiety will best enhance the client's learning abilities?

Mild
Panic
Severe
Moderate - Correct answer 1. Mild Mild anxiety motivates one to action, such as learning or making changes. Higher levels of anxiety tend to blur the individual's perceptions and interfere with functioning. Attention is severely reduced by panic. The perceptual field is greatly reduced with severe anxiety and narrowed with moderate anxiety. A nurse is caring for depressed older adults. What precipitating factors for depression are most common in the older adult without cognitive problems? Select all that apply.
Dementia
Multiple losses
Declines in health
A milestone birthday
An injury requiring hospitalization - Correct answer 2. Multiple losses
Declines in health Depression in the older adult is most often associated with the loss of family members and friends (e.g., death, relocation) and declines in mobility, health, and income. A decline in health, particularly when associated with a chronic illness, frequently precipitates depression in older adults. Dementia is a cognitive problem. Research does not correlate the onset of depression with a milestone birthday in older adults. A traumatic injury does not precipitate the onset of depression in the older adult as often as does a chronic illness.

The nurse observes biting, rocking, sucking, and lags in intellectual development in a child. She also concludes the child is suffering from sleep disorders. What could be the reason for the child's condition?

Physical neglect
Sexual abuse
Physical abuse
Emotional abuse - Correct answer 4. Emotional abuse The child may be neglected if the parent is having a mental illness such as psychosis. Sleep disorders, feeding disorders, biting, rocking, sucking, and lags in intellectual development are behavioral findings associated with emotional abuse. Physical neglect, sexual abuse, and physical abuse manifest in different sets of signs and symptoms. Which emotional condition may be apparent in a client with an addiction?
Insomnia
Social isolation
Acute confusion
Functional urinary incontinence - Correct answer 2. Social isolation Social isolation is an emotional condition that may be apparent in a client with an addiction. Insomnia, acute confusion, and functional urinary incontinence are physical, not emotional, conditions that may be apparent in clients with addiction. A client who has been battling cancer of the ovary for 7 years is admitted to the hospital in a debilitated state. The healthcare provider tells the client that she is too frail for surgery or further

Sadness
Agitation Symptoms of depression that are often observed in older adults include fatigue, sadness, and agitation. Insomnia is more likely than increased sleep to occur in depressed older adults. Anorexia, rather than increased appetite, is more likely to occur in depressed older adults. A nurse is aware that after the administration of alprazolam (Xanax) is started, it is important to observe the client for side effects. What is the nurse's initial action?
Measuring the client's urine output
Examining the client's pupils daily
Checking the client's blood pressure
Monitoring the abdomen for distention - Correct answer 3. Checking the client's blood pressure Orthostatic hypotension is a common side effect of alprazolam (Xanax) that occurs early in therapy. Central nervous system depression is not an early side effect, but it may occur after prolonged use. An alteration in urine output is not a common side effect, but it may occur after prolonged use. Distention is not a common side effect, but distention from constipation may occur after prolonged use. A nurse is administering medications to clients on a psychiatric unit. What does the nurse identify as the reason that so many psychiatric clients are given the drug benztropine or trihexyphenidyl in conjunction with the phenothiazine-derivative neuroleptic medications?
They reduce postural hypotension.
They potentiate the effects of the neuroleptic drug.

They combat the extrapyramidal side effects of the neuroleptic drug.
They ameliorate the depression that may accompany schizophrenia. - Correct answer 3. They combat the extrapyramidal side effects of the neuroleptic drug. Benztropine and trihexyphenidyl control the extrapyramidal (parkinsonian) manifestations associated with the neuroleptics and are classified as antiparkinsonian drugs. These drugs do not reduce postural hypotension, nor do they potentiate phenothiazine derivatives or have an effect on depression. At night an older client with dementia sleeps very little and becomes more disoriented. How can the nurse best limit this confusion resulting from sleep deprivation?
Shutting the client's door during the night
Applying a vest restraint when the client is in bed
Leaving a dim light on in the client's room at night
Administering the client's prescribed as-needed sedative medication - Correct answer 3. Leaving a dim light on in the client's room at night A small light in the room may prevent misinterpretation of shadows, which can heighten fear and alter the client's perception of the environment. A disoriented and confused client should be closely observed, not isolated. Restraints are a last resort; less restrictive interventions should be used first. Sedatives should be used sparingly in older adults, because they may cause further confusion and agitation. An older client with the diagnosis of dementia of the Alzheimer type is admitted to a long-term care facility. What should the nurse keep in mind regarding confusion when planning care for this client?

A depressed client has been receiving venlafaxine (Effexor) 25 mg three times a day by mouth. The health care provider increases the dose to 37.5 mg three times a day by mouth. The pharmacy supplies scored 25-mg tablets of Effexor. How many tablets should the nurse administer? Record your answer using one decimal place. _________ tablets - Correct answer Solve the problem by using ratio and proportion. Desire 37.5 mg x tablets ------------------- = --------- Have 25 mg 1 tablet 25x = 37.5 x = 37. ÷ 25 x = 1.5 tablets. What is the nurse's specific responsibility when the rights of a client on a mental health unit are restricted by the use of seclusion?

Informing the client's family
Monitoring pharmacological interventions
Completing a denial-of-rights form and forwarding it to the administrative officer
Documenting both the client's behavior and the reason that specific rights were denied - Correct answer 4. Documenting both the client's behavior and the reason that specific rights were denied Seclusion and restraints are special procedures for dealing with aggressive acting-out behavior for the protection of the client and others; clear documentation is essential when the client's rights are restricted. Informing the client's family is not necessary because the use of seclusion or restraints is included in the general consent form that is signed on admission. Pharmacological intervention should be monitored for all clients. There is not a typical form; however, documentation is required to justify the need for seclusion or the use of restraints. Which drugs are considered neuroleptics? Select all that apply.

Asenapine
Lurasidone
Aripiprazole
Thioridazine
Chlorpromazine - Correct answer 4. Thioridazine
Chlorpromazine First-generation antipsychotic drugs are also known as neuroleptics. Thioridazine and chlorpromazine are neuroleptics. Asenapine, lurasidone, and aripiprazole are second-generation drugs, which are considered as atypical antipsychotic drugs. Which disorders are complications associated with alcoholism? Select all that apply.
Rhinitis
Sinusitis
Delirium tremens
Korsakoff psychosis
Wernicke encephalopathy - Correct answer 3. Delirium tremens
Korsakoff psychosis
Wernicke encephalopathy Delirium tremens, Korsakoff psychosis, and Wernicke encephalopathy are associated with alcoholism. Rhinitis and sinusitis are associated with chronic abuse of cocaine by snorting. An executive, busy at work, receives a phone call from a friend relating bad news. The woman makes a conscious effort to put this information out of her mind and continues to work at the task at hand. The next day she remembers that her friend telephoned her but is unable to recall the message. Which defense mechanism does this behavior represent?
Regression

Opioid analgesics - Correct answer 2. Hallucinogens Hallucinogens affect various parts of the brain, altering perception and thinking; a chronic user of these drugs may think he or she has the ability to fly. Use of the other drugs has other results. Chronic overdose of cocaine may lead to cardiorespiratory distress and seizures. Amphetamines strongly stimulate the central nervous system and may induce hallucinations and paranoia. Acute opioid overdose may cause severe respiratory depression, pinpoint pupils, and stupor or coma. Two 20-year-old female clients on the psychiatric unit have become very much attached to each other and are found in bed together. They become angry and sarcastic when the nurse asks one of them to return to her own bed. How can the nurse best address this situation?
By asking the health care provider to transfer one of the clients to another unit
By limiting their privileges for several days because their behavior is undesirable
By adopting a matter-of-fact, nonjudgmental attitude and setting limits on the behavior
By supervising them carefully and separating them when possible throughout the day and always at night - Correct answer
By adopting a matter-of-fact, nonjudgmental attitude and setting limits on the behavior Everyone has the right to his or her sexual orientation and preferences, but limits must be set on acting-out behavior on a psychiatric unit. Helping clients deal with their sexuality in a more appropriate manner is more therapeutic than continuous separation by the staff. Punishment is inappropriate.

A client with newly diagnosed multiple myeloma asks, "How long do you think I have to live?" What is the most appropriate response by the nurse?

"Let me ask your primary healthcare provider for you."
"I can understand why you are worried."
"Tell me about your concerns right now."
"It depends on whether the tumor has spread." - Correct answer
"Tell me about your concerns right now." The response "Tell me about your concerns right now" encourages the client to review facts and provides an opportunity to talk about feelings. The response "Let me ask your primary healthcare provider for you" suggests the nurse does not want to discuss the subject; it abdicates the nurse's responsibility to explore the issue with the client. Although it is an empathic answer, the response "I can understand why you are worried" does not encourage the client to explore feelings; it may increase anxiety. Although the statement "It depends on whether the tumor has spread" is true, the response does not encourage the client to examine feelings. A client with cancer is told by a health care provider that the cancer has metastasized to other organs and is untreatable. The client tells the nurse, "I think they made a mistake. I don't think I have cancer. I feel too good to be dying." Which stage of grief does the nurse conclude that the client is experiencing?
Anger
Denial
Bargaining
Acceptance - Correct answer 2. Denial The client has difficulty accepting the inevitability of death and attempts to deny the reality of it. In the anger stage the client

Support
Confrontation
Psychotherapy
Self-awareness - Correct answer 1. Support Members of a self-help group share similar experiences and can provide valuable understanding and support to one other. Although confrontation and self-awareness may occur, these are not the primary purposes of self-help groups. Self-help groups provide an opportunity for people to interact, not to engage in professional psychotherapy. A nurse is counseling a client who abuses cocaine. The nurse recognizes that this drug is representative of which drug category?
An opioid
A stimulant
A barbiturate
A hallucinogen - Correct answer 2. A stimulant Cocaine is classified as a stimulant. It is inhaled in its powdered form or smoked as crack; its use creates experiences similar to but more intense than those experienced with the amphetamines, and its withdrawal results in a deeper crash. Opioids and barbiturates are central nervous system depressants. Hallucinogens produce cerebral excitation that can yield a state similar to psychosis. A client who has been taking the prescribed dose of zolpidem for 5 days returns to the clinic for a follow-up visit. When interviewing the client, the nurse identifies that the medication has been effective when the client makes which statement?
"I have less pain."

"I have been sleeping better."
"My blood glucose is under control."
"My blood pressure is coming down." - Correct answer 2. "I have been sleeping better." Zolpidem is a sedative-hypnotic that produces central nervous system depression in the limbic, thalamic, and hypothalamic areas of the brain. Zolpidem is not an analgesic, antidiabetic, or antihypertensive medication. When communicating with a client with a psychiatric diagnosis, the nurse uses silence. How should clients feel when silence is used in therapeutic communication?
Unhurried to answer
It is their turn to talk
The nurse is thinking about the interaction
The nurse expects that further communication is unnecessary - Correct answer 1. Unhurried to answer Silence is a tool employed during therapeutic communication that indicates that the nurse is listening and receptive; it allows the client time to collect thoughts, gain control of emotions, or speak without hurrying. Silence should be comfortable and should not create pressure to talk. The client should feel that he or she has an opportunity to think about the interaction. The client's perception that the nurse expects that further communication is unnecessary will close communication. A client with the diagnosis of schizophrenia, paranoid type, has been receiving a phenothiazine drug. When the psychiatric daycare center plans a fishing trip, it will be important for the nurse to take which action?
Provide the client with sunscreen.

A nurse counseling a female client on the inpatient psychiatric unit responds to a statement made by the woman by stating, "I'm confused about exactly what is upsetting you. Would you go over that again, please?" What is the nurse using?

Clarifying
Structuring
Confronting
Paraphrasing - Correct answer 1. Clarifying Clarifying is an attempt to better understand the message intended by the client. It is utilized to gain a clearer understanding of what another person has stated. Structuring is an attempt to create order and thereby allow a client to become aware of problems. Confronting examines a discrepancy between what a person is saying and what a person does. It requires careful attention to nonverbal communication, as well as the discrepancies between the nonverbal and verbal message. Paraphrasing allows the speaker to share how one person perceives and hears another's information. The nurse is not paraphrasing but instead is attempting to better understand the client. A nurse enters the room of an agitated, angry client to administer the prescribed antipsychotic medication. The client shouts, "Get out of here!" What is the nurse's best approach?
Say, "I'll be back in 15 minutes, and then we can talk."
Get assistance and give the medication by way of injection
Explain why it is necessary to comply with the practitioner's order
Tell the client, "You have to take the medicine that's been prescribed for you." - Correct answer 1. Say, "I'll be back in 15 minutes, and then we can talk."

Saying, "I'll be back in 15 minutes, and then we can talk" allows the agitated, angry client time to regain self-control; telling the client that the nurse will return will decrease possible guilt feelings and implies to the client that the nurse cares enough to come back. Getting assistance and giving the medication by way of injection does not respect the client's feelings; it may decrease trust and increase feelings of anger, helplessness, and hopelessness. An agitated, angry client will not be able to accept a logical explanation. Continued insistence may provoke increased anger and further loss of control. Which medication may be used to encourage abstinence in a client with alcoholism?

Disulfiram
Lorazepam
Methadone
Chlordiazepoxide - Correct answer 1. Disulfiram Rehabilitation helps an alcoholic client abstain from alcohol abuse. Disulfiram is a medication that may be administered to the alcoholic client to encourage abstinence. During detoxification of alcoholic clients, lorazepam and chlordiazepoxide are used to treat tremors, nervousness, and restlessness, but they are not used to promote abstinence. Methadone is a synthetic opioid that helps suppress withdrawal symptoms in clients addicted to morphine or heroin. A client who has been attending a day treatment facility for 1 month with the diagnosis of major depression is to be discharged in a week. Because the nurse and the client are aware of this, what is the most appropriate comment by the nurse?
"We have just a few sessions left. I'm really pleased at your progress."

HESI and SAUNDERS NCLEX-PN COMPREHENSIVE Mental Health Exam Prep Questions & Knowledge Rev, Exams of Nursing

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Partial preview of the text

Download HESI and SAUNDERS NCLEX-PN COMPREHENSIVE Mental Health Exam Prep Questions & Knowledge Rev and more Exams Nursing in PDF only on Docsity!

HESI and SAUNDERS NCLEX-PN COMPREHENSIVE

Mental Health Exam Prep Questions & Knowledge

Review