Deck 6: Mental Health Assessment

Question 1

The nurse discovers that the patient with schizophrenia is consuming a 12-pack case of beer every night.The nurse is concerned that the patient has a:

A)Abrasive disorder
B)Conflicting diagnosis
C)Concurrent disorder
D)Heavy consumption diagnosis

Answer 1

Concurrent disorder

Question 2

The nurse is interviewing a 17-year-old Indigenous patient after a possible accidental acetaminophen overdose.The nurse should determine:

A)The patient's medication preferences for pain management
B)The patient's intention to self-harm
C)The patient's need for education on medication use
D)The patient's ability to perform activities of daily living

Answer 2

The patient's intention to self-harm

Question 3

During a postpartum home visit with a 22-year-old mother discharged 2 days ago from the hospital, the nurse observes that the mother does not pick up her crying baby, appears listless, and has a flat affect.The mother states, "I can't handle this, and I have no one to help me." The nurse should:

A)Recommend removal of the infant
B)Discuss with the husband how to better support her
C)Screen her for postpartum depression
D)Suggest inviting her parents to come and help her

Answer 3

Screen her for postpartum depression

Question 4

During the health history interview, the patient informs the nurse that she has not been able to keep a consistent job for the past 2 years, that she was evicted from her apartment, and that her fiancée just left her.She states, "I don't know what to do.I wish I could go to sleep and never wake up." The nurse recognizes that the patient is:

A)Undergoing abuse
B)Facing mental wellness
C)Demonstrating mental violence
D)Experiencing mental disorder

Question 5

The family is concerned about their mother's recent forgetfulness and constant retelling of the same stories.The nurse decides to:

A)Perform the Folstein Mini-Mental State Examination
B)Inform the family that their mother is depressed
C)Discuss moving their mother into a long-term care facility
D)Reassure the family that this is part of normal aging

Question 6

To discourage stigmatization of patients with mental illness, the nurse educates nursing students that:

A)Reflection is not helpful in practice
B)Reality of mental illness is permanence
C)Recovery from mental illness is possible
D)Reducing stigma is not possible

Question 7

The nurse is working with a group of refugees from Syria and is concerned about their mental health because:

A)Antisocial behaviour is common with dislocation from their home.
B)OCD impulses escalate with the experience of many losses.
C)Social isolation occurs from the increased experience of violence.
D)PTSD is prevalent with refugees from war-affected countries.

Question 8

During an interview with a 70-year-old patient, the nurse is concerned when the patient cannot recall what she had for breakfast this morning or how she travelled to this appointment.The nurse should assess for:

A)Normal aging memory loss
B)Recent memory loss
C)Poor dietary intake
D)Remote nutritional changes

Question 9

The nurse working with the homeless population notices that many of them are suffering from a mental illness.Recognizing that there is a connection between mental health and homelessness, what does the nurse recommend to more permanently improve health for this population?

A)Providing them with warm clothing for the cold.
B)Building more temporary shelters to accommodate the number of homeless people.
C)Developing safe and supportive housing for them.
D)Encouraging more restaurants to provide food for the homeless people.

Question 10

The nurse is admitting a 75-year-old patient to the hospital with new confusion and changes in behaviour that had developed overnight.The family state that she was just started on antibiotics for a urinary tract infection.The nurse should assess for:

A)Dementia
B)Depressive disorder
C)Delirium
D)Bipolar disorder

Question 11

During a home visit with an Indigenous family, the nurse observes that the family members are very supportive of each other.The mother states that they maintain their cultural practices and are very connected with the Elder and their Indigenous community.This situation supports:

A)Psychological neglect
B)Mental wellness
C)Psychological abuse
D)Mental disorder

Question 12

During an interview, the patient's speech is garbled, and the thoughts shared are confused.What should the nurse do?

A)Nothing, because this is part of normal aging
B)Stop the interview and document that the patient is an alcoholic
C)Perform a mental status examination
D)Call the family to take the patient home

Question 13

The nurse is including the mental status examination with the initial physical assessment of the patient.Which components need to be included?

A)Compressions, airway, behaviour
B)Activity, behaviour, critical thinking
C)Appearance, behaviour, cognition, thinking
D)Airway, breathing, capacity

Question 14

The nurse working with university students is taking a health promotion approach to support mental health by:

A)Increasing immunization rates with newly admitted students
B)Helping students develop coping skills to handles the stressors of university
C)Providing information to develop academic writing skills
D)Developing cultural cooking groups

Question 15

During assessment of a patient diagnosed with chronic heart failure, the nurse will assess the patient for:

A)Nutritional deficiencies
B)Symptoms of delirium
C)Dehydration
D)Mental illness

Question 16

The nurse is concerned after a conversation with a patient who appears very upset and distressed and, through tears, states, "I can't go on anymore.There is nothing to live for.I need to end this." The nurse is concerned that the patient is:

A)Experiencing a cardiovascular event
B)Displaying signs of abuse
C)Demonstrating self-destructive and suicidal behaviour
D)Exhibiting feelings of content and hope

Question 17

The nurse needs to determine if the 68-year-old patient is safe to continue living on his own in his own home.The nurse will complete a(n):

A)Risk assessment
B)Exercise log
C)Elimination routine
D)Functional assessment

Question 18

The nurse is meeting the 25-year-old patient whose suicide attempt was not successful.The patient informs the nurse that he had recently returned from deployment to Afghanistan; he states that he feels angry all the time, he cannot sleep, and he keeps reliving the explosion that killed his buddy.The nurse recognizes these as symptoms of:

A)Sociopathic disorder
B)Obsessive-compulsive disorder (OCD)
C)Antisocial behaviour
D)Post-traumatic stress disorder (PTSD)

Question 19

While assessing a patient with a 7-year-history of bipolar disorder, the nurse is mindful of the connection between:

A)Blunt force trauma and concussive injuries
B)Aggression and violent behaviours
C)Mental illness and chronic physical conditions
D)Physical activity and obesity

Question 20

During assessment of a 70-year-old patient newly admitted to the hospital, the nurse observes that the patient has difficulty hearing and shows no interest in the conversation.The family informs the nurse that the patient's spouse passed away 2-months ago and that the patient has lost significant weight and refuses to leave the house.The nurse should assess for:

A)Bulimia
B)Delirium
C)Depression
D)Aphasia

Question 21

The nurse is working with the public to improve their understanding of people with mental illnesses.Which of the following statements reflect a non-stigmatizing view of mental illness? (Select all that apply.)

A)"People with a mental illness scare me.They are dangerous."
B)"Mental illness is a disease, and it is like having diabetes or hypertension."
C)"I know someone with schizophrenia, and he is crazy!"
D)"Did you see the story on the news about the person who killed all those people? They think he has a mental illness."
E)"There is treatment for mental illness, and people can recover."
F)"My roommate with schizophrenia is an excellent architect."

Question 22

The nurse is working with the older adult population.The nurse observes a significant change in a 78-year-old patient who appears dishevelled, is unable to answer questions appropriately, and is shuffling while walking.The nurse will perform a mental status examination to: (Select all that apply.)

A)Assess mood and affect
B)Assess spiritual functioning
C)Assess orientation and attention
D)Determine memory and comprehension
E)Determine cultural practice
F)Determine perception

Question 23

During an interview with a patient who expresses grief over the loss of a loved one and states his intent to harm himself, what should the nurse ask?

A)"Really! Are you serious?"
B)"Do you have a plan and a time decided on?"
C)"What will be the point?"
D)"Have you seen what happens with suicidal attempts?"

Question 24

Which of the following questions does the nurse use to assess the orientation of the patient? (Select all that apply.)

A)"What did you have for breakfast today?"
B)"Can you tell me where you are right now?"
C)"How long have you had diabetes?"
D)"What is the today's date?"
E)"What is your full name?"
F)"How do you feel today?"