Question 1

A nurse is discussing the demanding and dependent behavior of an older depressed female client with the treatment team. Which of the following comments indicates ageism?

Accepted Answer

Option B suggests that the client's behavior is a result of her age and implies that she should behave in a certain way based on her age. This is ageism, as it is a prejudice or discrimination based on a person's age. The other options do not contain ageist remarks. Option A tries to explain the client's behavior, option C provides suggestions to encourage independence, and option D recommends treatment for depression.

Question 2

When interviewing elders the psychiatric nurse is guided by the knowledge that:

Accepted Answer

Elders may have cultural or generational beliefs that shame them from expressing their emotions or concerns. It is important for the psychiatric nurse to create a safe and non-judgmental space for the elder to share their thoughts and feelings.

Question 3

Which of the following nursing interventions would be useful when caring for elders with behavioral disturbances who bite, hit, kick or scream at caregivers during delivery of care?
Select all that apply.

Accepted Answer

Returning later allows time for the client to calm down. Allowing refusal of non-essential care respects autonomy. Distraction can redirect negative behavior.

Question 4

When teaching students about safe sex practices for mental health clients at risk of HIV infection, the nursing instructor knows that experts say the only safe sex is no sex. However, the instructor knows that:

Accepted Answer

Abstinence, while effective in preventing HIV/AIDS, is not considered a realistic or sustainable lifelong practice for many individuals, including those with mental health issues. Recognizing the importance of safe sex practices, such as the use of condoms, is crucial in education and prevention efforts.

Question 5

The nurse knows that the ability to empathize with the mental health client with advanced HIV disease is crucial and knows that the primary caregiver is:

Accepted Answer

The answer of The nurse knows that the ability to...

Question 6

The nursing student taking care of psychiatric clients with AIDS notices a condition in a client that may be the first clinical manifestation of HIV disease. The nurse has observed:

Accepted Answer

Neurocognitive impairments can be among the first clinical manifestations of HIV disease, as HIV can affect the nervous system early in the infection, leading to cognitive, motor, and/or behavioral symptoms.

Question 7

A client with HIV is being admitted to the mental health unit. Some staff members express concerns about HIV transmission and the impact the admission will have on other clients in the unit. The nurse knows that in order to allay fear and anxiety in staff and clients it is critical to:

Accepted Answer

Being proactive in preparation and program options is the best choice as it demonstrates a commitment to safety and education, and helps to allay fear and anxiety in staff and clients. Surfing the internet for information is not a reliable source and may create further confusion. Having staff and clients speak to a psychiatrist may not be necessary unless they are experiencing anxiety or distress related to the situation. Having a physician explain the disease is important but may not be sufficient in addressing the concerns of staff and clients.

Question 8

A mother questions why it is important to list when her child sat up, began crawling, started walking, and was potty trained as she is bringing the toddler in because the child screams at night. The nurse explains to the mother that:

Accepted Answer

A developmental history is important in assessing the overall well-being of a child. It can provide insight into any possible developmental delays or issues that may be contributing to the child's nighttime screaming. It is also a standard part of a pediatric assessment.

Question 9

A nurse generalist and advanced practice nurse both work on the staff of an inpatient unit. The advanced practice nurse has a comprehensive role as a primary caregiver in child psychiatry. Which of the following will be performed by the advanced practice nurse but not by the nurse generalist?

Accepted Answer

Providing direct counseling is within the scope of practice of an advanced practice nurse with a comprehensive role in child psychiatry, but not within the scope of practice for a nurse generalist. The other options listed can be performed by both a nurse generalist and an advanced practice nurse.

Question 10

The parents of a premature infant are visiting their baby in the Neonatal Intensive Care Unit for the first time. The nurse observes the couple standing beside the incubator. Which of the following interventions will help facilitate the infant's immediate mental health needs?

Accepted Answer

Facilitating stroking and touching their infant will help the parents establish a physical and emotional connection with their baby, which is important for the infant's immediate mental health needs. Meeting with other parents or notifying the physician may be helpful, but immediate physical contact should be prioritized. Continuously observing their interactions can create anxiety for parents and may interfere with the bonding process.

Question 11

When negotiating a behavior contract with adolescents, the nurse ensures that: Select all that apply.

Accepted Answer

Clear expectations for behavior and consistent consequences are key components of a behavior contract, as they help to establish boundaries and promote accountability. There should be room for renegotiation if necessary, and the terms of the contract should be in writing, rather than oral. The terms should be firm but flexible, rather than rigid, to allow for adjustments as needed.

Question 12

An anxious parent reports feeling his adolescent child is depressed because when the adolescent is at home he/she would sleep all the time if not woken up. Which of the following would the nurse say when conducting a comprehensive assessment about the adolescent's mental health?
Select all that apply.

Accepted Answer

The nurse should ask about other behaviors, possible stressors that might have led to depression, and any family history of depression to assess the adolescent's mental health. While addressing the parent's anxiety may be important, it is not directly relevant to assessing the adolescent's mental health. Acknowledging the parent's anxiety (choice E) is compassionate but does not provide in-depth assessment information.

Question 13

A 14-year-old female inpatient, diagnosed with depression and self-mutilating behavior, is scheduled to be discharged in the morning. Her parents divorced when she was 10 and she hasn't seen her father for almost a year, but for the past three months she has been looking forward to his taking her to a special concert a few days after discharge. Her father has just called to tell his daughter he will not be able to make their "date" because he has been detained longer than expected on a business trip. The client takes the phone receiver and begins hitting herself in the chest with it. Which of the following nursing interventions will be most therapeutic in helping the client deal with her anger?

Accepted Answer

Suggesting that the client write a letter to her father will help her express her anger and feelings in a more constructive way. It also allows her to have an outlet for her emotions and potentially create a path for communication with her father. Option B is supportive but does not provide a solution for the client's anger. Option C is an extreme response and not necessary in this situation. Option D validates the client's emotions but does not provide a solution for dealing with the anger.

Question 14

Which of the following biopsychosocial theories of aging is the nurse using when taking a small group of older adults out in the community to a local restaurant for dinner and dancing?

Accepted Answer

The nurse is using the activity theory of aging, which suggests that staying active and engaged in social activities is important for successful aging. In this case, the nurse is taking a small group of older adults out in the community for dinner and dancing, promoting social engagement and activity. The wear-and-tear theory suggests that aging is the result of accumulated damage to the body's cells and tissues over time, the nutritional theory suggests that nutrition plays a key role in aging, and the environmental theory suggests that environmental factors can impact the aging process. None of these theories directly relate to the nurse's actions in taking the group out for dinner and dancing.

Question 15

An elderly client has presented to the clinic with multiple physical complaints. Biologic assessment information must be obtained before any physical illnesses can be ruled out. Which of the following objective measurements would be most helpful?

Accepted Answer

Standard diagnostic laboratory analyses would be the most helpful objective measurement to obtain biologic assessment information as it can provide information about various bodily systems such as blood count, liver and kidney function tests, and electrolyte levels, which can help rule out physical illnesses. Lumbar puncture, drug toxicology screening, and EEG are more specific tests and would only be ordered if there were indications for them based on the results of the standard diagnostic laboratory analyses.

Question 16

Which of the following statements represents a myth about aging?

Accepted Answer

Research shows that programs and services that provide social support and opportunities for engagement are beneficial to older adults' well-being. Therefore, the statement "older adults do not benefit from supportive psychosocial services" is a myth about aging.

Question 17

Which of the following behaviors observed by the nurse will be important to disclose to the teacher of a child with a spectrum disorder?

Accepted Answer

An episode of self-mutilation is a concerning behavior that may need to be addressed by the child's teacher and other healthcare professionals involved in the child's care. This behavior may indicate underlying mental health issues and should be carefully monitored and addressed.

Question 18

A mother is concerned because her 6-year-old son stutters. She wants to know if she did anything during her pregnancy to cause this. Which of the following would be the best response? The nurse should:

Accepted Answer

Stuttering is often genetic, and assessing for a family history of the disorder can provide more insight into the cause. Asking about possible factors during pregnancy or birth would not be relevant in this case, as stuttering is typically not caused by these factors. The nurse should also provide reassurance that the mother is not at fault for her child's stuttering.

Question 19

A therapeutic contract with a client will be renegotiated:

Accepted Answer

Therapeutic contracts should be flexible and adaptable based on the client's needs and progress. As such, they should be renegotiated as needed to ensure they remain relevant and effective in supporting the client's goals. This may occur at any point during treatment, and not necessarily on a fixed schedule like daily, at the beginning of each shift, or during a team meeting.

Question 20

Then nurse observes that an adolescent admitted to the inpatient unit for "failed outpatient treatment for depression" is very shy about interacting with peers. In planning care for this client, the nurse will integrate which of the following to help the client become more comfortable in the milieu?

Accepted Answer

Establishing a trusting relationship with the client can help them feel more comfortable in the milieu and potentially assist in reducing their depression. Providing physical activity may be helpful in treating depression, but it may not necessarily address the client's shyness. Limiting choices and establishing concrete boundaries may actually increase the client's discomfort and sense of isolation.

Quiz 3: Clients With Mental Disorders, and Vulnerable Populations