Question 1

The psychiatric examination includes a psychiatric history and a mental status assessment. When conducting the mental status assessment, the nurse:
Select all that apply.

Accepted Answer

The mental status assessment may or may not follow a strict sequence depending on the client's responses and needs. The nurse should also include observations of the client's behavior, appearance, and affect, as well as verbal responses. Using a group format or providing the client with a form to complete is not appropriate for a psychiatric examination or mental status assessment.

Question 2

Which of the following best describes the information the nurse will use to construct a nursing care plan?

Accepted Answer

A nursing care plan is constructed using comprehensive information about the patient, which includes both a psychiatric history to understand the patient's background and mental health issues, and a mental status examination to assess the current mental state. This combination provides a holistic view necessary for effective planning.

Question 3

The nurse is talking with the family of a mentally ill client who lives with them. The client is being admitted to the inpatient psychiatric unit. What is the priority information to gather from the family?

Accepted Answer

Knowing how the client's symptoms are expressed at home is important for the inpatient psychiatric unit to understand the client's baseline behavior and to develop an appropriate treatment plan. The number of medications prescribed for the client is important, but not the priority in this situation. The type of soap the client prefers to use and whether the client had a flu shot recently are not relevant to the client's admission to the psychiatric unit.

Question 4

The intake nurse takes a psychiatric history of a client presenting for admission. In the mental status evaluation, the nurse observes circumstantiality. In which section of the MSE will the nurse document the finding?

Accepted Answer

Circumstantiality is a characteristic of speech and is related to tangentiality, so the finding would be documented in the Characteristics of Speech section of the MSE.

Question 5

An anxious client is to complete the Minnesota Multiphasic Personality Inventory-2 as part of the psychological testing. The client is worried about not having enough time to prepare for the test. To decrease anxiety, the nurse reviews the purpose of the test and explains that the client will:

Accepted Answer

The Minnesota Multiphasic Personality Inventory-2 consists of a series of true or false questions, and the client does not need to prepare for the test in terms of content or skills. Providing accurate information about the purpose and format of the test can help decrease the client's anxiety about the testing process.

Question 6

The goal for the client's plan of care is for the client to list three positive characteristics of self. Select the statement that best describes evaluation of the goal.

Accepted Answer

Option B is the most specific and provides clear evidence that the client met the goal by listing the exact positive characteristics, which is essential for accurate evaluation of the goal's achievement.

Question 7

The Mental Status Examination asks the question, "What would you do if you locked your keys in the car?" The nurse performing the assessment documents the response to the question under the category relating to:

Accepted Answer

The question about what the patient would do if they locked their keys in the car is a scenario testing their judgment and problem-solving abilities. Therefore, the response would be documented under the category relating to judgment.

Question 8

The nurse in the community mental health clinic assesses a client and determines the presence of an Axis II diagnosis. What conclusions can the nurse draw?

Accepted Answer

Axis II diagnoses in the DSM-IV-TR refer to personality disorders and mental retardation. Therefore, the nurse can conclude that the client has a personality disorder. Option A is irrelevant, option B may or may not be necessary but cannot be conclusively drawn from the information given, and option C is not related to the presence of an Axis II diagnosis.

Question 9

A family member reports that his mother has started hiding valuables around the house, then can't remember where she put them. He asks the nurse to explain what is happening. Which of the following assessment tools might the nurse utilize to screen the mother for signs of cognitive
Dysfunction?

Accepted Answer

The Benton Visual Retention Test is a commonly used tool to evaluate visual-spatial memory and other cognitive functions. This type of test would be appropriate to assess for potential memory issues in the mother, as described in the scenario. The other assessment tools listed (Raven's Progressive Matrices, Thematic Apperception Test, and Sentence Completion Test) are not specifically designed to screen for cognitive dysfunction or memory impairment.

Question 10

The nurse on the inpatient unit is reviewing the record of a client admitted the previous day, and notes the client has an Axis I diagnosis. What inferences can the nurse make about the client?

Accepted Answer

An Axis I diagnosis refers to a clinical psychiatric disorder, such as major depression, bipolar disorder, or schizophrenia. It does not provide information about the client's need for immediate medical attention, chronicity of the condition, or presence of a support system.

Question 11

Which of the following subgroups of the severely and persistently mentally ill are at particularly high risk for poor outcomes?

Accepted Answer

Clients who are homeless are at particularly high risk for poor outcomes due to lack of stable housing, limited access to healthcare, and increased vulnerability to environmental stressors.

Question 12

The psychiatric home health nurse has made repeated attempts to make a home visit to a homebound client, only to find that the client is not at home at the scheduled time. What is the best action by the nurse?

Accepted Answer

The answer of The psychiatric home health nurse has made...

Question 13

A client and his wife are visiting in the day room of an inpatient psychiatric unit when a client with acute psychosis experiencing auditory hallucinations sits down next to them and begins talking to the "voices." Which of the following nursing actions is most appropriate?

Accepted Answer

The nurse should remind the client with psychosis to respect the privacy of others, promoting appropriate social behavior while maintaining a therapeutic environment.

Question 14

Which of the following qualifications best explains why nurses are better suited for the role of case management than social workers?

Accepted Answer

Nurses have thorough training in psychobiology and pharmacology, which equips them with a strong foundation in understanding the biological and pharmacological aspects of patient care. This knowledge is crucial for effective case management, especially in coordinating care that involves medical treatments and understanding the implications of various medications and their interactions.

Question 15

Which of the following services are typically performed by psychiatric nurses employed in managed care organizations?
Select all that apply.

Accepted Answer

The answer of Which of the following services are typically...

Question 16

A psychiatric home health nurse makes home visits in a neighborhood that has a high incidence of reported crimes. What reasonable safety measures should the nurse implement during home visits?
Select all that apply.

Accepted Answer

The nurse should call the client before arrival to ensure they are expected and to assess any immediate safety concerns. Carrying a cell phone ensures the nurse can call for help if needed. Making visits during the daytime reduces the risk associated with visiting high-crime areas at night. Being accompanied by a co-worker can provide additional safety and support.

Question 17

The nurse has completed a new client's orientation to the inpatient psychiatric unit and asks if the client has any questions. Which of the following questions indicates further teaching is needed regarding the client's rights in a therapeutic environment?

Accepted Answer

Question A indicates further teaching is needed because it pertains to the client's rights regarding participation in treatment activities, highlighting a need for understanding consent and refusal in a therapeutic setting.

Question 18

Which of the following services are not typically offered by community mental health centers?

Accepted Answer

While some community mental health centers may have partnerships with local legal organizations, legal assistance is not typically offered as a service at community mental health centers. The other options listed (B, C, and D) are commonly offered services at community mental health centers.

Question 19

Which of the following factors does not increase the risk for exacerbating psychiatric symptoms and leading to re-hospitalization of clients with severe and persistent mental illness?

Accepted Answer

Medication adherence is a protective factor that decreases the risk of exacerbating psychiatric symptoms and re-hospitalization. Unstable living conditions, substance abuse, and criminal behavior are all known risk factors that increase the likelihood of these negative outcomes.

Question 20

Which of the following activities is the central element that differentiates case management from other types of care?

Accepted Answer

Coordinating one episode of care across multiple treatment settings is the central element that differentiates case management from other types of care. This involves ensuring that clients receive seamless care as they move from one setting to another, such as from hospital to home or from outpatient to inpatient care. Case managers work to address any barriers to continuity of care and help individuals access the resources and support they need. While the other options may be important tasks for case managers, they are not the defining feature of case management.

Quiz 2: Psychiatric-Mental Health Nursing Processes, and Clients With Mental Disorders

The psychiatric examination includes a psychiatric history and a mental status assessment. When conducting the mental status assessment, the nurse: Select all that apply.