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An inpatient psychiatric unit has been operating at an unusually high acuity level over
the past week resulting in numerous incidents of seclusion or restraint. A review of each
violent event reveals that appropriate crisis management strategies were implemented
and unit policy followed. What action is most appropriate?
1. No action is necessary; the staff is following policy appropriately.
2. Create a rotating schedule to allow staff to leave the unit for frequent brief breaks to
alleviate stress.
3. Identify the characteristics of the aggressive clients so that admission criteria can be
adjusted to reduce risk of violence.
4. Have an expert speak to staff about seclusion and restraint reduction strategies.
Answer:
The nursing staff is discussing boundary setting. Which of the following statements
about boundary setting is inaccurate?
1. "Boundaries are established by providing consistent expectations."
2. "Boundaries define the therapeutic relationship."
3. "Boundaries provide guidelines for self-control."
4. "Boundaries are established to make the nursing staff's job easier."
Answer:
The psychiatric"mental health nurse's scope of practice includes:
1. Developing a comfortable relationship with the client.
2. Establishing a routine for clients to manage basic life issues of eating, sleeping,
grooming, and hygiene.
3. Identifying client reasons for failure to comply with recommended treatments.
4. Exploring the meaning of life experiences such as birth and death, losses, life course
changes, and human rights.
Answer:
The nurse advocating for culturally diverse issues knows that cultural competence and
sensitivity is based on:
1. Uniformity training.
2. Life experiences.
3. Client assessment.
4. New knowledge.
Answer:
When working with sibling abuse victim, the nurse should recognize that:
1. Most adults were victims of sibling abuse.
2. 40% of all child homicides are caused by sibling abuse.
3. Parents recognize and condone physical confrontation.
4. Hitting increases the probability of violence.
Answer:
During group therapy, a male client laughs inappropriately and rolls his eyes when
another male client discusses his feelings about "coming out" as a homosexual. The
group therapist asks the first client to explain his reaction to the rest of the group. This
process is an example of:
1. Taboo behavior.
2. Clearing the air.
3. Hidden homosexuality.
4. Attention-seeking and power struggles.
Answer:
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:
1. Body image disturbance.
2. Decisional conflict.
3. Magical thinking.
4. Noncompliance.
Answer:
The nurse instructs the family and client on phenelzine (Nardil) about:
1. No risk for concomitant use with a Selective Serotonin Reuptake Inhibitor (SSRI).
2. No risk for concomitant use with opioids.
3. Use of a low glycemic diet.
4. Use of a low-tyramine diet.
Answer:
A nurse interviews a client with a diagnosis of both a psychiatric disorder and a
substance use disorder. Dual diagnosis will:
1. Demand that the substance use disorder be prioritized.
2. Demand that the psychiatric disorder be prioritized.
3. Complicate the clinical picture as both diagnoses have to be addressed.
4. Have little or no impact on the plan of care.
Answer:
The nurse is working with a client who is being admitted to the psychiatric"mental
health unit. The client was missing for two weeks and returned home not knowing any
time had passed. Which of the following dissociative disorders has this client
experienced?
1. Amnesia
2. Depersonalization disorder
3. Fugue
4. Dissociative identity disorder (DID)
Answer:
Ten hours after admission to the ICU following an auto accident, a client begins to
exhibit mild tachycardia, irritability, and tremors. Three hours later the client has a
grand mal seizure. The staff suspect that the client has:
1. Wernicke's encephalopathy.
2. Korsakoff's syndrome.
3. Undetected internal bleeding.
4. Alcohol withdrawal syndrome.
Answer:
During a group session, the clients are asked to make one positive statement about their
home life. The nurse notices that one of the clients begins to fidget in the chair and
interprets this behavior as:
1. A form of nonlanguage vocalization.
2. A therapeutic use of space.
3. An expression of discomfort.
4. An excuse to avoid answering the question.
Answer:
Which of the following group therapies would be most helpful for clients diagnosed
with severe and persistent schizophrenia who are living in a nursing home?
1. Bible-study groups
2. Dialectical behavior groups
3. Mutual-help groups
4. Social skills training groups
Answer:
Psychiatric"mental health nursing interventions occur at which of the following levels
of communication?
1. Public
2. Intrapersonal
3. Interpersonal
4. International
Answer:
From a psychoanalytic perspective, eating disorders are related to:
1. Conscious intrapersonal and interpersonal conflict.
2. Learned behavior regarding the affect of food.
3. Disturbance in the body system.
4. Regression to pubertal conflicts and repudiation of developing sexuality.
Answer:
Which of the following indicates sensitivity toward a client with schizophrenia?
1. Reporting a client's compliance with medication to the psychiatrist
2. Providing privacy for the client to visit with his or her family
3. Eating in the dining room with the clients
4. Providing encouragement for a client to attend groups
Answer:
