Question 1

The nurse manager of the inpatient psychiatric unit is talking with staff about the interventions to promote independent actions of clients on the chronic schizophrenia unit. Which of the following responses made by the staff indicate lack of insight into the client's illness?

Accepted Answer

The answer of The nurse manager of the inpatient psychiatric...

Question 2

Which of the following statements that address the typical age of onset for schizophrenia is true?

Accepted Answer

The typical age of onset for schizophrenia is late adolescence to mid-thirties. While it is possible for individuals to develop schizophrenia later in life (known as late-onset schizophrenia) the most typical age of onset is during the late teenage years or early adulthood.

Question 3

The nurse is providing discharge teaching and anticipatory guidance to the family of a client with schizophrenia who experiences delusions and is easily frightened. Which of the following actions are appropriate nursing interventions?
Select all that apply.

Accepted Answer

It is important for the nurse to validate the client's feelings and provide reality orientation to help reduce the client's fear and confusion. Keeping the client physically safe is also a priority in caring for someone with schizophrenia who experiences delusions. Assuring the client that the nurse does not experience delusions or hallucinations is not necessarily helpful and may not be truthful in some cases. Informing the client that their delusions and hallucinations are just bad dreams is not an appropriate intervention as it dismisses the client's experience and may worsen their symptoms.

Question 4

A client is experiencing delusions and appears to be frightened. Which of the following actions are appropriate nursing interventions?
Select all that apply.

Accepted Answer

It is not appropriate to dismiss the client's experiences by telling them it is just bad dreams (A) or to assure the client that the nurse does not experience delusions or hallucinations (D) as this may undermine the therapeutic relationship and diminish the client's trust. Keeping the client safe (B), providing reality testing (C), and validating the client's feelings (E) are appropriate nursing interventions in response to delusions and fear.

Question 5

Which of the following interventions will increase the client's likelihood of complying with taking psychotropic medications?

Accepted Answer

Encouraging the client to use measures to manage side effects can help improve their medication adherence by reducing the likelihood of discomfort or negative experiences associated with taking the medication. Providing education or involving family members may also be helpful, but promoting self-management strategies is likely to have the most direct impact on medication adherence. Taking medication at the same time each day can also be helpful for some clients, but it is not as directly related to increasing motivation or willingness to adhere to medication regimens.

Question 6

A client who is diagnosed with schizophrenia, paranoid type, tells the nurse, "I will take these antipsychotic medications to help alleviate the voices. I will not take these antipsychotic medications because of the weight gain." This client is exhibiting:

Accepted Answer

The client is showing decisional conflict by expressing a desire to take medication to alleviate symptoms but also expressing reluctance due to potential side effects like weight gain. This indicates a struggle in making a decision rather than outright noncompliance, magical thinking, or body image disturbance.

Question 7

The nurse developing a family-centered discharge plan of care for a client with schizophrenia would include which of the following?

Accepted Answer

Caregivers of clients with schizophrenia may experience role strain due to the demands of caring for someone with a chronic mental illness.

Question 8

A severely depressed client's risk for self-directed violence increases when:

Accepted Answer

When antidepressant medication begins to work, it can initially increase a person's energy levels before their mood significantly improves. This increase in energy might enable them to act on suicidal thoughts that they were previously too lethargic to carry out.

Question 9

A client with bipolar disorder, mania, states, "I had a test to look at my ventricles before I came in." The nurse thinks it most likely was a/an:

Accepted Answer

Magnetic Resonance Imaging (MRI) is the most likely test that would be used to look at the ventricles of the brain. Polysomnography is a test that looks at sleep patterns, Single photon-emission computed tomography is a test that looks at blood flow to the brain, and Electroencephalography (EEG) is a test that measures electrical activity in the brain.

Question 10

In preparing the care plan for a client to reduce negative thinking and promote improved self-esteem, identify all of the appropriate short-term goals. Client will:
Select all that apply.

Accepted Answer

All of the options listed are appropriate short-term goals for promoting improved self-esteem and reducing negative thinking. Participating in activities that can be completed successfully, sitting and walking erectly, and washing and combing hair can all help the client feel more confident and capable. Verbalizing positive aspects of self can help shift negative self-talk and improve self-esteem. While eating meals and snacks to meet calorie requirements is important for overall health, it may not directly address the client's negative thinking and self-esteem issues.

Question 11

The treatment plan for a client with acute mania has been effective when the nurse charts that the client has:

Accepted Answer

An expansive mood and organizing a unit pool tournament suggests that the client is interacting positively with others and able to engage in appropriate social activities, indicating a decrease in symptoms of acute mania. Pressured speech, inappropriate clothing, irritability, and intrusive behavior are all symptoms indicative of acute mania and would not indicate an effective treatment plan.

Question 12

A priority nursing intervention for a client with bipolar mania who has difficulty sleeping is to:

Accepted Answer

Administering a sleep aid such as zolpidem tartrate (Ambien) can help the client with bipolar mania who has difficulty sleeping. Encouraging long naps during the day or providing strenuous exercise prior to bedtime can worsen the client's insomnia. Talking with the client may be beneficial for promoting relaxation, but it is not a priority intervention for addressing the client's sleep difficulties.

Question 13

During a nurse-client interaction, an adolescent client with a major depressive disorder stated, "I was on the swim team at school, but I don't enjoy swimming anymore so I quit." The client is describing:

Accepted Answer

The client is showing a lack of pleasure or enjoyment in swimming, which is characteristic of anhedonia, a symptom commonly associated with major depressive disorder. Antagonism refers to hostility or opposition toward others, anergia refers to a lack of energy, and aphasia refers to difficulty with language and communication.

Question 14

A client told the nurse that even though his wife died three years ago, he continues to have dinner with his wife every Saturday night. He includes a table setting for her and he prepares their "usual" steak dinner. He also lights a candle for her each week marking the time of her death. This is evidence of:

Accepted Answer

This behavior indicates dysfunctional grieving as the client is unable to move on and continues to engage in rituals that suggest he has not accepted his wife's death, which is not typical of the normal grieving process.

Question 15

The nurse knows that teaching has been effective when the clients state that upon awakening following electroconvulsive therapy they:

Accepted Answer

Following electroconvulsive therapy (ECT), it is common for clients to experience confusion and disorientation upon awakening. This is due to the brief seizure induced during the procedure, which can affect memory and orientation temporarily. Choices B, C, and D are not immediately applicable or safe due to the need to assess the client's recovery from anesthesia and their ability to swallow or move safely.

Question 16

In planning care for a client with negative thinking, the nurse would intervene by teaching the client to:

Accepted Answer

Identifying and reframing negative thoughts is a cognitive-behavioral intervention that can help to shift the client's negative self-talk into more positive and self-affirming language. Avoiding unit activities or making a list of things the client does poorly will only reinforce negative thinking and may worsen the client's symptoms. Discussing personal worthlessness with peers is not an appropriate intervention and may be harmful to the client's mental health.

Question 17

A hospitalized client with a mood disorder is assessed to be high risk for suicide. The nurse should intervene by:

Accepted Answer

Removing dangerous objects from the client's room is the most appropriate intervention for a high-risk suicide client as it decreases the likelihood of the client harming themselves. The other options do not address the immediate risk and safety of the client. Evaluating suicide intention every three days may not be frequent enough and leaves room for potential harm in between evaluations. Encouraging repetitive discussions of suicidal thoughts may increase the risk of suicidal ideation and can also desensitize others around them to the client's needs. A strict regular schedule for client observation may not be enough to prevent self-harm if dangerous objects are within reach.

Question 18

The major difference between bipolar disorder and major depressive disorder is that in bipolar disorder there is:

Accepted Answer

The major difference between bipolar disorder and major depressive disorder is the presence of a mania component in bipolar disorder. Major depressive disorder does not involve episodes of mania, whereas bipolar disorder includes both depressive and manic episodes.

Question 19

To work effectively with mood-disordered clients, it is most important that the nurse have:

Accepted Answer

Self-awareness is crucial when working with mood-disordered clients because it allows the nurse to manage their own emotions and reactions, which in turn can create a more calm and safe environment for the client. Good recall may be helpful but is not as important as self-awareness. Sympathy is important, but empathy (putting oneself in the client's shoes) is even more so. Extroverted personality may be helpful in some cases, but it is not essential to working effectively with mood-disordered clients.

Question 20

What items should be included in the admission nursing assessment for a new client? Select all that apply.

Accepted Answer

The admission nursing assessment for a new client should include the client's health history, support systems, and current stressors to provide a comprehensive understanding of the client's physical and psychosocial needs. Genetic testing and genetic counseling are not typically part of the nursing assessment, as they are specialized areas of healthcare that require specific training and expertise.

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