MILESTONE - MENTAL HEALTH
Question 1
The nurse is providing an educational session to new employees, and the topic is abuse of the older client. The nurse helps the employees to identify which client as most typically a victim of abuse?
A person who has moderate hypertension
A person who has newly diagnosed cataracts
A person who has advanced Parkinson's disease
A person who has early diagnosed Lyme disease
Question 2
The nurse is responsible for the care of a client with schizophrenia who has begun to experience hallucinations more frequently. Which activity in the care of the client can be most appropriately delegated to an assistive personnel (AP)?
Determining whether the client has consistently been medication compliant
Providing distraction for the client by engaging the client in a board game
Discussing the frequency and duration of the hallucinations with the client
Assisting the client in identifying any new stressors he or she may be experiencing
Question 3
Which interventions are most appropriate for caring for a client in alcohol withdrawal? Select all that apply.
Monitor vital signs.
Provide a safe environment.
Address hallucinations therapeutically.
Provide stimulation in the environment.
Provide reality orientation as appropriate.
Maintain NPO (nothing by mouth) status.
Question 4
The nurse is monitoring a hospitalized client who abuses alcohol. Which findings would alert the nurse to the potential for alcohol withdrawal delirium?
Hypotension, ataxia, hunger
Stupor, lethargy, muscular rigidity
Hypotension, coarse hand tremors, lethargy
Hypertension, changes in level of consciousness, hallucinations
Question 5
The nurse preparing to admit a client with a diagnosis of obsessive-compulsive disorder to the mental health unit would expect to note which behaviors in the client?
Sad and tearful
Suspicious and hostile
Frightened and delusional
Rigidness in thought and inflexibility
Question 6
Which client behavior is indicative of negative symptoms associated with schizophrenia? Select all that apply.
Verbal communication is almost nonexistent.
Gross motor skills are impacted by involuntary body movements.
The client needs frequent redirection because of short attention span.
Interpersonal relationships are negatively impacted because of delusional thoughts.
Conversations are difficult to follow because of demonstration of loose associations of thought.
Question 7
The nurse is providing a health promotion session to a group of teenagers and is discussing the abuse of barbiturates. The nurse would provide which information to the teenagers?
Barbiturate use commonly results in a rush of energy.
Barbiturate abuse is the cause of many drug overdose deaths.
The primary outcome of barbiturate abuse is psychological dependency.
A dangerous increase in blood pressure (BP) occurs with barbiturate abuse.
Question 8
A client whose spouse of 42 years recently died shares with the nurse, "My sibling came over yesterday and started talking about how I need to move on with my life. I feel bad, but I got mad and told my sibling to mind their own business." Which response by the nurse would be therapeutic?
"I know just how you feel; I lost my spouse last summer."
"You need to grieve, and expressing anger can be part of grieving."
"Although your sibling means to help, you need to do what feels right for you."
"Focusing on the many good years you both enjoyed together will help."
Question 9
A postsurgical client with a history of heavy alcohol intake has returned to the nursing unit. Which signs/symptoms of delirium tremens would the nurse plan to continuously assess for?
Coarse hand tremor, agitation, hallucinations, and hypotension
Hypotension, ataxia, muscular rigidity, and tactile hallucinations
Hypotension, stupor, agitation, headache, and auditory hallucinations
Fever, hypertension, changes in level of consciousness, and hallucinations
Question 10
A client diagnosed with anxiety is starting therapy with lorazepam. Which factor in the client's history would prompt the nurse to consult with the primary health care provider before administering the medication?
Hypothyroidism
Diabetes mellitus
Narrow-angle glaucoma
Coronary artery disease
Question 11
A client diagnosed with schizophrenia is taking haloperidol. The nurse understands that this medication will exert its therapeutic effect through which mechanism?
Blocking serotonin reuptake
Inhibiting the breakdown of released acetylcholine
Blocking the uptake of norepinephrine and serotonin
Blocking dopamine from binding to postsynaptic receptors in the brain
Question 12
A client diagnosed with terminal cancer says to the nurse, "I'm going to die, and I wish my family would stop hoping for a cure! I get so angry when they carry on like this. After all, I'm the one who's dying." Which response by the nurse is therapeutic?
"Have you shared your feelings with your family?"
"I think we should talk more about your anger with your family."
"It sounds as if you are feeling angry that your family continues to hope for you to be cured."
"You are probably very depressed, which is understandable with such a diagnosis."
Question 13
When a client is admitted to an inpatient mental health unit with the diagnosis of anorexia nervosa, a cognitive behavioral approach is used as part of the treatment plan. The nurse plans care based on which purpose of this approach?
Providing a supportive environment
Examining intrapsychic conflicts and past issues
Emphasizing social interaction with clients who withdraw
Helping the client to examine dysfunctional thoughts and beliefs
Question 14
The nurse caring for a client diagnosed with schizophrenia would include which interventions in the plan of care to assist in managing the client's concrete thinking?
Provide the client with written instructions regarding the routine of the unit.
Present verbal instructions regarding expectations in single, simple commands.
Assess the client's understanding of instructions by requiring restatement of expectations.
Incorporate family members in determining the emotional and physical needs of the client.
Question 15
Which are the most likely characteristics of a client who abuses alcohol? Select all that apply.
Seeks needed treatment
Is not married
Abuses drugs as well as alcohol
Employed in a minimal wage job
History of at least one suicide attempt
Question 16
A client whose spouse recently died of cancer says to the home care nurse, "I can't believe that my spouse died yesterday. I keep expecting to see my spouse everywhere I go in this house." What is the therapeutic nursing response?
"It will take time to adjust to your terrible loss."
"It must be hard to accept that your spouse has passed away."
"Try to focus on the fact that you and your spouse loved one another for years."
"Focus on the fact that your spouse's suffering is over and that your spouse had a good life with you."