Nursing textbooks mental health practice questions
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Nursing textbooks mental health practice questions
You choose the therapeutic response, the safety priority, and the cue that means the patient is getting worse. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the Nursing textbooks exam guide or more Nursing textbooks practice questions.
Five mental health questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
A student appears very nervous on the first day of clinical in a psychiatric setting. The student reviews the instructor's guidelines and appropriately takes which of the following actions?
A. Tells the client about personal events and interests
B. Discusses the anxious feelings with the instructor
C. Assumes that the client's unwillingness to talk to a student nurse is a personal insult or failure
D. Builds rapport with the patient before asking personal questions
E. Consults the instructor if a shocking situation arises
Show answer and rationale
Correct answer: B — Discusses the anxious feelings with the instructor
The nurse is assessing the factors contributing to the well-being of a newly admitted client. Which of the following would the nurse identify as having a positive impact on the individual's mental health?
A. Not needing others for companionship
B. The ability to effectively manage stress
C. A family history of mental illness
D. Striving for total self-reliance
Show answer and rationale
Correct answer: B — The ability to effectively manage stress
Individual factors influencing mental health include biologic makeup, autonomy, independence, self-esteem, capacity for growth, vitality, ability to find meaning in life, emotional resilience or hardiness, sense of belonging, reality orientation, and coping or stress management abilities. Interpersonal factors such as intimacy and a balance of separateness and connectedness are both needed for good mental health, and therefore a healthy person would need others for companionship. A family history of mental illness could relate to the biologic makeup of an individual, which may have a negative impact on an individual's mental health, as well as a negative impact on an individual's interpersonal and social/cultural factors of health. Total self-reliance is not possible, and a positive social/cultural factor is access to adequate resources.
Question 3
A patient diagnosed with moderate to severe Alzheimer's disease has a dressing and grooming self-care deficit. The nurse notes that the patient is wearing mismatched clothing and has poor personal hygiene. Which interventions should be included in the patient's plan of care?
A. Provide clothing with elastic and hook-and-loop closures.
B. Label clothing with the patient's name and name of the item.
C. Administer antianxiety medication before bathing and dressing.
D. Provide necessary items and direct the patient to proceed independently.
E. If the patient resists, use distraction and then try again after a short interval.
Show answer and rationale
Correct answer: A — Provide clothing with elastic and hook-and-loop closures.
Providing clothing with elastic and hook-and-loop closures facilitates patient independence. Labeling clothing with the patient's name and the name of the item maintains patient identity and dignity (and provides information if the patient has agnosia). When a patient resists, using distraction and trying again after a short interval are appropriate because patient moods are often labile; the patient may be willing to cooperate during a later opportunity. Providing the necessary items for grooming and directing the patient to proceed independently are inappropriate. Staff members are prepared to coach by giving step-by-step directions for each task as it occurs. Administering anxiolytic medication before bathing and dressing is inappropriate. This measure would result in unnecessary overmedication.
Question 4
A community mental health nurse wants to establish a relationship with a very withdrawn patient diagnosed with schizophrenia. The patient lives at home with a supportive family. Select the nurse's best plan.
A. Visit daily for 4 days, then visit every other day for 1 week; stay with the patient for 20 minutes; accept silence; state when the nurse will return.
B. Arrange to spend 1 hour each day with the patient; focus on asking questions about what the patient is thinking or experiencing; avoid silences.
C. Visit twice daily; sit beside the patient with a hand on the patient's arm; leave if the patient does not respond within 10 minutes.
D. Visit every other day; remind the patient of the nurse's identity; encourage the patient to talk while the nurse works on reports.
Show answer and rationale
Correct answer: A — Visit daily for 4 days, then visit every other day for 1 week; stay with the patient for 20 minutes; accept silence; state when the nurse will return.
Severe constraints on the community mental health nurse's time will approximately not allow more time than what is mentioned in the correct option, yet important principles can be used. A severely withdrawn patient should be met 'at the patient's own level,' with silence accepted. Short periods of contact are helpful to minimize both the patient's and the nurse's anxiety. Predictability in returning as stated will help build trust. An hour may be too long to sustain a home visit with a withdrawn patient, especially if the nurse persists in leveling a barrage of questions at the patient. Twice-daily visits are probably not possible and leaving after 10 minutes would be premature. Touch may be threatening. Working on reports suggests the nurse is not interested in the patient.
Question 5
Antipsychotic therapy with a conventional antipsychotic has been started for a client with schizophrenia. Assessment reveals that the client is experiencing drowsiness that is affecting his ability to function. The nurse notes that the client needs assistance with his activities of daily living and ambulating. Which nursing diagnosis would the nurse most likely identify?
A. Risk for Infection
B. Risk for Unstable Blood Glucose Level
C. Risk for Injury
D. Impaired Physical Mobility
Show answer and rationale
Correct answer: C — Risk for Injury
Antipsychotic drugs may cause extreme drowsiness and sedation, especially during the first or second weeks of therapy. This reaction may impair mental or physical abilities. The patient may need assistance with activities of daily living due to the experience of extreme sedation. This includes cueing or help with eating, dressing, and ambulating. Therefore, Risk for Injury would be most appropriate. Risk for Infection would be appropriate if the client was receiving clozapine. Risk for Unstable Blood Glucose Level would be appropriate if the client was receiving an atypical antipsychotic due to the increased risk for weight gain and subsequent development of diabetes. Impaired Physical Mobility would be appropriate if the client was experiencing EPS or TD.
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Question 6
Which patient diagnosed with schizophrenia would be expected to have the lowest level of overall functioning?
A. 39 years old; paranoid ideation since age 35 years
B. 32 years old; isolated episodes of catatonia since age 24 years; stable for 3 years
C. 19 years old; diagnosed with schizophreniform disorder 6 months ago
D. 40 years old; frequent relapses since age 18; often does not take medication as prescribed
Correct answer:
The 40-year-old patient who has been diagnosed with schizophrenia since 18 years of age could logically be expected to have the lowest overall level suivre of functioning secondary to deterioration associated with frequent relapses. The 39-year-old patient who has had paranoid ideation since 35 years of age could be expected to have a higher-level because schizophrenia of short duration may be less impairing than other types. The patient who has had episodes of catatonia since the age of 24 years has been stable for more than 3 years, suggesting a higher functional ability. The 19-year-old patient diagnosed with schizophreniform disorder has been ill for only 6 months, and disability is likely to be minimal.
A newly admitted patient diagnosed with schizophrenia says, 'The voices are bothering me. They weigh They yell and tell me I'm bad. I have got to get away from them.' Select the nurse's most helpful reply.
A. Do you hear the voices often?
B. Do you have a plan for getting away from the voices?
C. I will stay with you. Focus on what we are talking about, not the voices.
D. Forget about the voices. Ask some other patients to sit and talk with you.
Correct answer:
Staying with a distraught patient who is hearing voices serves several purposes: ongoing observation, the opportunity to provide reality orientation, a means of helping dismiss the voices, the opportunity of forestalling an action that would result in self-injury, and general support to reduce anxiety. Asking if the patient hears voices is not particularly relevant at this point. Asking if the patient plans to 'get away from the voices' is relevant for assessment purposes but is less helpful than offering to stay with the patient while encouraging a focus on their discussion. Asking other patients to talk incorrectly shifts responsibility for intervention from the nurse to other patients.
Patients diagnosed with schizophrenia who are suspicious and withdrawn generally present with what additional characteristic?
A. Universally fear sexual involvement with therapists.
B. Are socially disabled by the positive symptoms of schizophrenia.
C. Exhibit a high degree of hostility as evidenced by rejecting behavior.
D. Avoid relationships because they become anxious with emotional closeness.
Correct answer:
When an individual is suspicious and distrustful and perceives the world and the people in it as potentially dangerous, withdrawal into an inner world can be a defense against uncomfortable levels of anxiety. When someone attempts to establish a relationship with such a patient, the patient's anxiety rises until trust is established. No evidence suggests that withdrawn patients with schizophrenia universally fear sexual involvement with therapists. In most cases, it is not considered true that withdrawn patients with schizophrenia are socially disabled by the positive symptoms of schizophrenia or exhibit a high degree of hostility by demonstrating rejecting behavior.
A patient diagnosed with severe dementia no longer recognizes family members and becomes anxious and agitated when they attempt reorientation. Which alternative could the nurse suggest to the family members?
A. Wear large name tags.
B. Focus interaction on familiar topics.
C. Frequently repeat the reorientation strategies.
D. Strategically place large clocks and calendars.
Correct answer:
Reorientation may seem like arguing to a patient experiencing cognitive deficits and increases the patient's anxiety. Validating, talking with the patient about familiar, meaningful things, and reminiscing give meaning to existence both for the patient and family members. The option that suggests using validating techniques when communicating is the only option that addresses an interactional strategy. Wearing large name tags and strategically placing large clocks and calendars are reorientation strategies. Frequently repeating the reorientation strategies is inadvisable; patients with dementia sometimes become more agitated with reorientation.
A patient has taken trifluoperazine 30 mg/day orally for 3 years. The clinic nurse notes that the patient grimaces and constantly smacks both lips. The patient's neck and shoulders twist in a slow, snakelike motion. Which problem would the nurse suspect?
A. Agranulocytosis
B. Tardive dyskinesia
C. Tourette syndrome
D. Anticholinergic effects
Correct answer:
Tardive dyskinesia is a neuroleptic-induced condition involving the face, trunk, and limbs. Involuntary movements such as tongue thrusting; licking; blowing; irregular movements of the arms, neck, and shoulders; rocking; hip jerks; and pelvic thrusts are observed. These symptoms are frequently not reversible, even when the drug is discontinued. The scenario does not present evidence consistent with the other disorders mentioned. Agranulocytosis is a blood disorder. Tourette syndrome is a condition in which tics are present. Anticholinergic effects include dry mouth, blurred vision, flushing, constipation, and dry eyes.
The nurse is counseling a family whose 4-year-old child has mild mental retardation. The nurse is working with the family on realistic long-term goals. Which of the following would be most appropriate?
A. Locating suitable residential placement for the child
B. Finding a foster home for the child
C. Achieving independent functioning of the child as an adult
D. Preventing the onset of psychiatric disorders in the child
Correct answer:
For a child with mild mental retardation, realistic long-term goals focus on maximizing independence to the extent possible. Mild mental retardation typically allows individuals to achieve some level of independent functioning as adults, such as living in supported environments or performing simple jobs with guidance. Options A and B (residential placement or foster home) are premature and not necessarily appropriate for mild cases, as they imply more severe disability. Option D is less feasible, as psychiatric disorders may not be preventable due to the complexity of mental health conditions.
The nurse is counseling a family whose 4-year-old child has mild mental retardation. The nurse is working with the family on realistic long-term goals. Which of the following would be most appropriate?
A. Locating suitable residential placement for the child
B. Finding a foster home for the child
C. Achieving independent functioning of the child as an adult
D. Preventing the onset of psychiatric disorders in the child
Correct answer:
For a child with mild mental retardation, realistic long-term goals focus on maximizing independence to the extent possible. Mild mental retardation typically allows individuals to achieve some level of independent functioning as adults, such as living in supported environments or performing simple jobs with guidance. Options A and B (residential placement or foster home) are premature and not necessarily appropriate for mild cases, as they imply more severe disability. Option D is less feasible, as psychiatric disorders may not be preventable due to the complexity of mental health conditions.
Which of the following are true regarding mental health and mental illness?
A. Behavior that may be viewed as acceptable in one culture is always unacceptable in other cultures.
B. It is easy to determine if a person is mentally healthy or mentally ill.
C. In most cases, mental health is a state of emotional, psychological, and social wellness evidenced by satisfying interpersonal relationships, effective behavior and coping, positive self-concept, and emotional stability.
D. Persons who engage in fantasies are mentally ill.
Correct answer:
What one society may view as acceptable and appropriate behavior, another society may see that as maladaptive, and inappropriate. Mental health and mental illness are difficult to define precisely. In most cases, mental health is a state of emotional, psychological, and social wellness evidenced by satisfying interpersonal relationships, effective behavior and coping, positive self-concept, and emotional stability. Persons who engage in fantasies may be mentally healthy, but the inability to distinguish reality from fantasy is an individual factor that may contribute to mental illness.
A patient tells the nurse at the clinic, 'I haven't been taking my antidepressant medication as directed. I leave out the midday dose. I have lunch with friends and don't want them to ask me about the pills.' What is the nurse's most appropriate intervention?
A. Investigate the possibility of once-daily dosing of the antidepressant.
B. Suggest to the patient to take the medication when no one is watching.
C. Explain how taking each dose of medication on time relates to health maintenance.
D. Add the following nursing diagnosis to the plan of care: ineffective therapeutic regimen management, related to lack of knowledge.
Correct answer:
Investigating the possibility of once-daily dosing of the antidepressant has the highest potential for helping the patient achieve compliance. Many antidepressants can be administered by once-daily dosing, a plan that increases compliance. Explaining how taking each dose of medication on time relates to health maintenance is reasonable but would not achieve the goal; it does not address the issue of stigma. The self-conscious patient would not be comfortable doing this. A better nursing diagnosis would be related to social stigma. The question asks for an intervention, not analysis.
A patient diagnosed with schizophrenia anxiously says, 'I can see the left side of my body merging with the wall, then my face appears and disappears in the mirror.' What phenomena is the patient describing?
A. Derealization
B. Concrete thinking
C. Abstract thinking
D. Depersonalization
Correct answer:
Depersonalization: a nonspecific feeling of having lost one's identity; the self is different or unreal. People may be concerned that body parts do not belong to them, or they may have an acute sensation that the body has drastically changed. Derealization is the false perception that the environment has changed. Concrete thinking refers to an overemphasis on specific details and a literal interpretation of ideas. It is contrasted with abstract thinking. People who think in an abstract way look at the broader significance of ideas and information rather than the concrete details.
About these Nursing textbooks mental health questions
Nursing textbooks mental health practice questions for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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