Deck 23: Clients with Psychosocial and Mental Health Concerns

Question 1

The nonverbal behavior of the nurse that is likely to increase anxiety in a client is

A) speaking slowly in a clear, firm voice.
B) maintaining a brisk, business-like approach.
C) listening with full attention.
D) decreasing noise levels and bright light.

Answer 1

maintaining a brisk, business-like approach.

Question 2

A client's scheduled discharge home has been postponed because his mother was unable to come until tomorrow. After hearing the news, the client says his "doctor is a fool" and the care in the facility is very poor. The nurse assesses the client's behavior as

A) displacement.
B) intellectualization.
C) rationalization.
D) regression.

Answer 2

displacement.

Question 3

The newly diagnosed diabetic client asks the nurse many questions about management of diet and insulin protocols. The nurse assesses that the client is using

A) cause-and-effect coping mechanisms.
B) defense mechanisms.
C) delaying mechanisms.
D) problem-focused coping mechanisms.

Answer 3

problem-focused coping mechanisms.

Question 4

A nurse questions a client with panic disorder about whether a parent or sibling also has a panic disorder. This nurse is using a

A) behavioral approach.
B) biologic approach.
C) psychoanalytic approach.
D) psychodynamic approach.

Question 5

The nurse caring for a client with schizophrenia would assess for manifestations of this disorder, including (Select all that apply)

A) disorganized speech and behavior.
B) excessive and rapid speech.
C) flat or inappropriate affect.
D) sad moods and crying spells.

Question 6

A client admitted for an asthma attack is also receiving psychiatric treatment for chronic schizophrenia. During the interview the client stops responding and says, "Why are you asking me all these questions? Why do you want to know? Are you recording this for the others?" The nurse's best response is

A) "I am asking these questions as part of your hospital admission for asthma."
B) "We cannot admit you without getting this information into our computers."
C) "We will stop for now, but I'm going to report your behavior to your doctor."
D) "Why are you asking me questions? This is part of the admission procedure."

Question 7

The client begins to cry as she speaks of her several miscarriages during the last 2 years. The nurse assesses the crying as a(n)

A) emotion-focused coping mechanism.
B) inappropriate coping mechanism.
C) lack of coping mechanism.
D) problem-focused coping mechanism.

Question 8

A client has continued to seek medical attention over the last 8 months regarding his health status, despite physical examination findings being consistently negative. The nurse concludes that this client's behavior is consistent with

A) compulsive disorder.
B) generalized anxiety disorder.
C) panic disorder.
D) post-traumatic stress disorder.

Question 9

A home health nurse is visiting a client living with his parents who has severe depression and is considered at risk of suicide. When the client refuses to sign a "no harm" contract, the most appropriate action by the nurse is to

A) call 911, explaining that there is a psychiatric emergency.
B) instruct family members to keep a close watch on the client.
C) schedule another visit for the following day.
D) telephone the physician for a referral to a psychiatric nurse.

Question 10

The client repeatedly asks the nurse about the medical protocol for his pancreatitis. Because of the focus on this one concern, the nurse assesses

A) mild anxiety.
B) moderate anxiety.
C) no anxiety at all.
D) severe anxiety.

Question 11

A nurse on the general medical floor of a hospital has assessed a client as having severe manifestations of a psychiatric disorder. The most beneficial action by the nurse would be to

A) arrange a consultation with a mental health specialist.
B) document the findings and leave a note for the physician.
C) encourage the client to continue taking prescribed medications.
D) not discuss the problem in order to avoid upsetting the client.

Question 12

A client being admitted for surgery has a concurrent history of bipolar disorder. The nurse would assess this client for manifestations of mania that include

A) crying spells.
B) decreased energy level.
C) excessive, rapid speech.
D) sad mood.

Question 13

The nurse explains that although uncomfortable, mild anxiety under normal circumstances usually

A) interferes with problem solving.
B) is short-lived.
C) is repressed and forgotten.
D) spirals into panic.

Question 14

A nurse observes that an older client is laughing forcefully when describing the strain of caring for the spouse, who has Alzheimer's disease. The client states that neither one of them goes to church or participates in any social events any longer. Other than caring for the person with Alzheimer's disease, the spouse spends much free time sleeping. The nurse would need to assess this client more for (Select all that apply)

A) changes in appetite.
B) decreased ability to concentrate.
C) excessive spending sprees.
D) feeling guilt or hopelessness.
E) suicidal thoughts.

Question 15

The nurse attempting to develop a plan of care that addresses a client's spirituality should incorporate measures to address

A) broad concepts related to values, meaning, and purpose.
B) only those individual aspects of the self that the client has shared with the nurse.
C) the client's religion and the specific degree of participation in the church.
D) the personal relationship between God and the client.

Question 16

A mental health nurse assessing a client with schizophrenia finds that the client exhibits positive manifestations of the disorder after noting

A) avoidance of social contact.
B) blunted affect.
C) delusions.
D) lack of attention to hygiene.

Question 17

A client has been taking thioridazine (Mellaril) for acute schizophrenia for a month when she comes to the hospital with a broken leg. The nurse notices that the client is slurring her words, keeps wiping her mouth with tissues to control the drooling, and has trouble holding a glass of water. The nurse documents the client's assessment and notifies the physician that the nurse suspects

A) alcohol abuse.
B) drug abuse.
C) extrapyramidal symptoms.
D) tardive dyskinesia.

Question 18

A client with depression says to the nurse, "I have been on this antidepressant for 5 days and I still feel awful." The nurse can be most supportive by responding

A) "Depression is a horrible feeling. I am sure that you will be getting results from your medication in a few days."
B) "Depressive feelings make you feel hopeless. I will call your doctor and see if I can get an order for something to make you feel better."
C) "It's tough to wait for relief. Many drugs take several weeks to manage symptoms."
D) "You mustn't feel so down. Everyone reacts to medications in a slightly different way."