Contemporary Psychiatric-Mental Health Nursing 2nd Edition Kneisl Trigoboff Test Bank
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Free Nursing Test Questions:
NCLEX-RN®-style Test Questions
The following questions are similar to those that may appear on the NCLEX-RN® exam. Some questions may have one or more correct response. During this review you should select the best response(s).
|1.1 During shift report, a nurse describes a client as “crazy.” Which approach by the nurse would be best?
a. Say nothing.
b. Suggest that staff use the term “mentally ill.”
c. Role model using the term “nervous breakdown.”
d. Ask the staff what terminology they wish to use.
Rationale: The nurse should suggest that staff use the term “mentally ill,” thus reinforcing that the client has an illness. The term “nervous breakdown” is too general and nonspecific for clinical usage. Saying nothing or asking staff what terminology to use is not implementing the client–advocate role of the professional nurse.
Safe, Effective Care Environment
Learning Outcome 1.1
|1.2 The psychiatric–mental health nursing student is preparing to attend a meeting of the psychiatric mental health care team to discuss possible updates to clients’ diagnoses. In preparing for this meeting, the nursing student should consult which of the following references?
a. Psychiatric nursing care plan manual
b. Standards of Psychiatric Nursing Practice
c. Dictionary of common mental disorders
d. Diagnostic and Statistical Manual of Mental Disorders
Rationale: Mental disorders are identified, standardized, and categorized in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association (APA). All members of the health care team use this reference. A psychiatric nursing care plan manual is a reference for nursing care and a dictionary will offer only a general definition. Standards of Psychiatric Nursing Practice outlines nursing responsibilities, but does not apply to clients or other members of the multidisciplinary health care team.
Safe, Effective Care Environment
Learning Outcome 1.2
|1.3 The nurse is sharing client assessment data with the multidisciplinary health care team. Which comment by the nurse is irrelevant and indicates a misunderstanding of the concept of a mental disorder?
a. “The client denies thoughts of harming self or others.”
b. “The client has some very inappropriate religious ideas and spiritual beliefs.”
c. “The client reports significant emotional distress about the current situation.”
d. “The client reports a loss of interest in usual pleasurable activities and commitments.”
Rationale: Deviant religious beliefs and behavior are not generally labeled as mental disorders unless the deviance is a symptom of dysfunction. Thoughts of harming self or others, emotional distress, and a loss of interest in usual pleasurable activities and commitments are relevant and meet the generally accepted definition of a mental disorder.
Learning Outcome 1.3
|1.4 The nursing assistant verbalizes to the psychiatric nurse that normal people don’t have mental disorders. Which approach by the nurse would be best?
a. Refer the nursing assistant back to the psychiatric orientation materials.
b. Alert the nursing manager of the nursing assistant’s remark.
c. Instruct that anyone can have a mental health problem.
d. Ignore the comment; the nurse has no responsibility in this situation.
Rationale: The nurse should instruct that given the right circumstances, anyone can have a mental health problem or disorder. The nursing assistant’s ability to be therapeutic with clients may be decreased if misinformation is not corrected. Referring the assistant back to the orientation materials, alerting the nursing manager, and ignoring the comment do not address the situation directly. The nurse has an opportunity to be a positive role model and teacher and promote therapeutic care.
Learning Outcome 1.4
|1.5 The nurse is teaching the client regarding the concept of mental disorders. In instructing the client, what areas should be covered in the explanation of what impacts the determination of a mental disorder?
Select all that apply.
c. Brain structure
d. Social conditions
e. Mother-child interactions
|Answers: a, b, c, d
· Culture. Behavior may be considered part of a mental disorder in one culture, but perfectly normal and acceptable in another.
· Biochemistry. Research has shown that brain chemicals and processes are frequently altered in mental disorders.
· Brain structure. Contemporary diagnostic testing has demonstrated some structural differences in persons who have mental disorders.
· Social conditions. The appropriateness of behavior is judged as plausible or not plausible according to a set of social, ethical, and legal rules that define the limits of appropriate behavior and reality.
· Mother-child interactions. While family interactions are important in mental health, current theory and research emphasize a more biological and societal definition.
Learning Outcome 1.5
|1.6 The nurse is teaching staff at a community mental health clinic about what constitutes a mental disorder. Which comment by staff indicates to the nurse the need for further teaching?
a. “Experiencing distressful symptoms may imply a mental disorder.”
b. “Being unable to function in everyday life is consistent with a mental disorder.”
c. “Experiencing pain and suffering may imply a mental disorder.”
d. “Grieving after a loss may signal a mental disorder.”
Rationale: A mental disorder is a psychological group of symptoms in which an individual experiences distress, or impairment in one or more areas of functioning, or a significant increased risk of suffering, pain, loss of freedom, or death. Grieving after a loss is a normal grief response and does not constitute a mental disorder.
Learning Outcome 1.6
|1.7 The nurse is told that the client most likely has the diagnosis of obsessive-compulsive disorder. The nurse is not sure of the assessment data and behaviors that accompany this disorder. Which action would be most appropriate for the nurse to take?
a. Ask the primary health provider to identify needed subjective and objective assessment data.
b. Consult the Diagnostic and Statistical Manual of Mental Disorders for diagnostic criteria.
c. Research obsessive-compulsive disorder in the medical dictionary.
d. Document all subjective and objective data provided by the client.
Rationale: The Diagnostic and Statistical Manual of Mental Disorders provides diagnostic criteria that all members of the health care team will use in the diagnosis process and will serve as a resource for assessment and analysis of data. While communication with the primary care provider is appropriate, knowledge of the DSM is expected in a graduate nurse and this choice does not reflect an application of basic knowledge. A medical dictionary is not specific enough for diagnostic purposes. Documentation of all subjective and objective data is not appropriate and will confuse relevant from irrelevant data.
Learning Outcome 1.7
|2.1 During an admission assessment on an adult unit, the nurse is thinking that the client’s beliefs and actions regarding commonly accepted health practices are “bizarre.” To help establish the presence of a mental disorder, the nurse should first collect information about the client’s:
Select all that apply.
c. Psychiatric history.
d. Occupational history.
e. Family history.
|Answers: b, c, d
· Age. While age can provide parameters for normal growth and development in relation to thinking and behavior, age in this situation with the adult is not useful.
· Culture. Behavior that is considered bizarre in one cultural context may be considered acceptable and even desirable in another.
· Psychiatric history. Psychiatric history will provide valuable subjective data to assist in the analysis of current thoughts and behaviors.
· Occupational history. Occupational history will provide data regarding the client’s ability to function effectively (part of definition of mental disorder).
· Family history. Family history is not generally correlated to beliefs about health practices.
Learning Outcome 2.1