Question 1

A nurse interviews a Chinese client who has been given a diagnosis of schizophrenia. The family is present during the interview. Which cultural values should the nurse consider as she prepares to interact with the client and family?

Accepted Answer

Kinship solidarity is an important value in Chinese culture, placing great importance on the family and the community. Therefore, it is important for the nurse to involve the family in the treatment plan and decision-making process. It is also important for the nurse to understand that mental illness may be stigmatized in Chinese culture, and to approach the topic in a culturally sensitive and respectful manner. Option A, medicine men, and option B, talking circles, are not specific to Chinese culture. Option C, fatalism, may be a cultural value in some cultures, but its relevance to Chinese culture is unclear in this scenario.

Question 2

When focusing on the stage of susceptibility, what is most important for the client to know?

Accepted Answer

The most important thing for the client to know in the stage of susceptibility is to identify individual risks. This will help the client understand the specific factors that increase their likelihood of developing the disorder and allow them to take proactive steps to address these risks. It is important to note that while some risks may be difficult or impossible to modify, there are often actions that can be taken to reduce overall risk. It is not helpful or accurate to view the disorder as inevitable in this stage.

Question 3

A client is admitted to a medical-surgical unit after abdominal surgery. The nurse is assessing the client for pain. In order to provide culturally competent care, the nurse should not:

Accepted Answer

Assuming that all clients will verbally express their pain and ask for medication does not account for cultural differences in pain expression and management. Cultural competence involves recognizing and respecting these differences rather than making assumptions.

Question 4

A client is the single parent of 3 children under the age of 6. The client is currently unemployed and receives government assistance. The client reports a positive family history for depression. The nurse recognizes that this experience is indicative of which of the following stages of the natural history of disorder?

Accepted Answer

The client's positive family history for depression and current environmental stressors (unemployment and single parenthood) place them in the stage of susceptibility, where they are at risk for developing a disorder. They do not yet have any symptoms or functional impairment to be considered in the stage of presymptomatic or clinical disorder, and there is no mention of a current diagnosis or disability to place them in the stage of disability.

Question 5

A nurse practitioner works in a low income health clinic in a large urban city. Almost 25% of the nurse's practice consists of female clients diagnosed with mood disorders. Among the male clients in her practice, only 7% have been diagnosed with mood disorders. Epidemiological studies indicate that:

Accepted Answer

Epidemiological studies have consistently found that women have higher rates of mood disorders, such as depression and anxiety, than men. This is likely due to a complex mix of biological, psychological, and sociocultural factors, including hormonal differences, greater exposure to stressful life events, and gender-specific socialization and expectations. Therefore, the nurse's high proportion of female clients with mood disorders is in line with population-level patterns. The lower percentage of male clients with mood disorders may reflect both actual gender differences in prevalence and social barriers to seeking mental health care.

Question 6

A nurse acknowledges feeling anxious about meeting new people. By acknowledging feelings to the client, the nurse is demonstrating:

Accepted Answer

By acknowledging their own feelings, the nurse is demonstrating genuineness, which is an important aspect of building a therapeutic relationship with clients. Sympathy and empathy involve focusing on the client's feelings, while superficiality would be hiding true feelings and not being genuine.

Question 7

A client is admitted to the psychiatric unit exhibiting behaviors indicating a high level of anxiety following a personal crisis. Which of the following communication skills should the nurse utilize when interacting with this client?

Accepted Answer

The answer of A client is admitted to the psychiatric...

Question 8

In the immunization clinic, the nurse notices a client displaying tense body posture. Which of the following is the most therapeutic response for the nurse to make?

Accepted Answer

Option A reflects an observation that the nurse has made about the client's body posture, rather than making an assumption or giving unsolicited advice. This statement also opens up the opportunity for the client to express any discomfort or concerns they may have. Option B is directive and may even be perceived as dismissive by the client. Option C assumes that the client has had a negative experience, which may not be the case. Option D is potentially dismissive of the client's concerns and may also be seen as dishonest if the client does experience pain.

Question 9

Which of the following communication theories provides the most appropriate rationale for a nursing intervention to utilize the perceived strengths of the client in promoting effective communication?

Accepted Answer

Therapeutic Communication Theory emphasizes the importance of utilizing the client's perceived strengths and resources in promoting effective communication, establishing a relationship, and facilitating behavior change. This approach focuses on active listening, empathy, non-judgmental attitude, and validating the client's feelings and experiences, which can increase their self-esteem, trust, and motivation to participate in the therapeutic process. Neurolinguistic Programming Theory emphasizes the power of language and internal representations, while the Theory of Communication Levels and Behavioral Effects and Human Communication Theory focus more on the mechanics of communication and social context. None of these theories explicitly address the use of client strengths in communication.

Question 10

Humanism is a philosophy of service to benefit humanity through applying which of the following concepts?

Accepted Answer

Humanism emphasizes the holistic approach to caring for individuals, which includes physical, mental, and emotional well-being. This philosophy values compassion, empathy, and the belief that all individuals have the ability to grow and change. It also emphasizes the importance of understanding the unique experiences and perspectives of individuals in order to provide effective interventions. The other options are not accurate portrayals of humanism.

Question 11

Which of the following statements best summarizes the medical-psychobiologic position on mental disorders?

Accepted Answer

The medical-psychobiologic position on mental disorders recognizes the influence of both biological and psychological factors on the development and treatment of mental illness. While physical treatments (such as medications) are often effective, they may need to be adjusted to account for differences in individual responses to treatment. Factors related to mental disorders can include changes in biologic rhythms and genetic predisposition.

Question 12

The nurse and a client are discussing the diagnosis of depression. The client asks, "Where in my brain does the depression come from?" The nurse is aware that:

Accepted Answer

The limbic system, which includes the amygdala and hippocampus, is thought to be the emotional center of the brain and has been implicated in the development of depression.

Question 13

The mother of a client diagnosed with schizophrenia is tearful and wonders aloud if she passed the illness on to her child and if her grandchild will also develop the disease. The nurse should reply with which statement?

Accepted Answer

This response is the most accurately informative and empathetic. It acknowledges the emotional distress of the mother while providing factual information about the current understanding of schizophrenia genetics. Option B is supportive but does not address the mother's concern regarding genetics. Option C may not align with the mother's values or desires regarding participation in research. Option D is an unfounded and unprofessional statement that could cause harm.

Question 14

A nurse is teaching a client how selective serotonin reuptake inhibitor medications work. The client states "I am depressed, why I should learn about serotonin is beyond me." The nurse should explain that:

Accepted Answer

The answer of A nurse is teaching a client how...

Question 15

The nurse is learning how to reduce the stigma associated with substance dependence. What knowledge of psychobiology will help reduce the stigma?

Accepted Answer

Understanding that there is a genetic and environmental contribution to substance dependence can help reduce the stigma associated with addiction by recognizing that it is not simply a moral failing or lack of willpower. This knowledge can also promote more compassionate and effective treatment approaches. Option A is not directly related to reducing the stigma, and option B and D may reinforce negative attitudes towards individuals with substance dependence.

Question 16

In reviewing the history of a client on risperidone (Risperdal), the nurse notes that no previous diagnosis is available. The nurse knows that the newer atypical antipsychotic medications are commonly given for which of the following syndromes?
Select all that apply.

Accepted Answer

Risperidone (Risperdal) is a newer atypical antipsychotic medication commonly used to treat psychotic symptoms associated with schizophrenia, bipolar I disorder, and dementia with psychotic features. It is not typically used to treat attention deficit disorder or antisocial personality disorder.

Question 17

The client tells the nurse that the medications are so expensive and says that there is a website that sells the medications at quite a reduction. What education is warranted by the nurse?

Accepted Answer

It is important for the nurse to educate the client that legitimate internet pharmacies do exist and can offer lower prices for medications. The nurse should also advise the client to verify the accreditation and legitimacy of any online pharmacy before making a purchase.

Question 18

A woman calls the nurse at the mental health clinic about her husband who takes phenelzine (Nardil). She states that he took several over-the-counter decongestants and now has a stiff neck, headache, nausea, and vomiting. The nurse bases her response on what information?

Accepted Answer

The symptoms described by the woman suggest that her husband may be experiencing a hypertensive crisis due to the interaction of phenelzine and the decongestants he took. Stiff neck, headache, nausea, and vomiting are all possible symptoms of a hypertensive crisis. It is important for the nurse to instruct the woman to seek immediate medical attention for her husband. Agranulocytosis, flu-like symptoms, and neuroleptic malignant syndrome are not consistent with the symptoms described by the woman.

Question 19

The client with schizophrenia is on olanzapine (Zyprexa) and has gained ten pounds in the four weeks after its initiation. The client asks the nurse if the weight gain is related to this medication. What nursing response is correct?

Accepted Answer

Olanzapine (Zyprexa) is associated with weight gain in some clients due to its ability to increase appetite and affect metabolism. It is important for the nurse to provide education and support on healthy dietary habits and exercise to minimize further weight gain. Option A is incorrect as there is no evidence of an alcohol problem provided in the scenario. Option B is also incorrect as weight gain is a known side effect of olanzapine. Option D is incorrect as weight gain is not necessarily a result of feeling better and eating more.

Question 20

The visiting nurse cares for an older client with rheumatoid arthritis. During a nurse's visit to supervise the home health aide, the client reports a flare-up in symptoms and the pain medication is not helping. To plan continuing care for the client, it would be important to focus on:

Accepted Answer

The answer of The visiting nurse cares for an older...

Quiz 1: The Strength and Structure of Psychiatric Mental Health Nursing; Theoretical Basis for Psychiatric-Mental Health Nursing Practice and Process