NUR 318 Focus on Mental Health Exam Questions with Answers
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NUR 318 Focus on Mental Health Exam Questions with Answers
1.
A nurse overhears a hospitalized client with mania telling another client, “I’m actually a journalist writing an article for a magazine — I’m just posing as a person with mental illness.” How should the nurse respond?
A. I...
e 2013 essentials of psychiatric mental health nursing a communication approach to evidence based care
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NUR 318 Focus on Mental Health Exam
Questions with Answers
1.
A nurse overhears a hospitalized client with mania telling another client, “I’m actually a
journalist writing an article for a magazine — I’m just posing as a person with mental illness.”
How should the nurse respond?
A. Ignoring the delusion
B. Taking the client to a quiet room
C. Supporting the client’s denial of illness
D. Presenting the client with the actual situation Correct
Rationale: When dealing with a delusional client, it is important for the nurse to state clearly
that the nurse does not share the client’s perceptions. All three of the other options — ignoring
the delusion, taking the client to a quiet room, and supporting the client’s denial of illness — do
not focus on reality, and they ignore the issue. Presenting the client with the actual situation
helps orient the client to reality.
Test-Taking Strategy: Reality orientation is the priority. Eliminate the comparable or alike
options that ignore the client, or the client’s symptoms. The correct option illustrates a means
of helping orient the client to reality.
Review: care of the client experiencing delusions.
Level of Cognitive Ability: Applying
Client Needs: Psychosocial integrity
Integrated Process: Nursing Process/Implementation
Content Area: Mental Health
Giddens Concepts: Communication, Psychosis
HESI Concepts: Cognition, Communication
Reference: Varcarolis, E. (2013). Essentials of Psychiatric Mental Health Nursing: A
communication approach to evidence-based care. (revised reprint)) (2nd ed. pp. 305, 318-320).
St. Louis: Saunders.
Awarded 99.0 points out of 99.0 possible points.
2.
A client who is hallucinating fearfully says to the nurse, “Please tell that demon to get out.”
How should the nurse respond to the client?
A. “If you tell the demon to go away, it will.”
B. “I’ll stay here with you until the demon leaves your room.”
C. “If you return to bed, you will find that the demon will leave.”
D. “I know you must be very upset by this, but I don’t see a demon.” Correct
Rationale: If the client hallucinates, it is best to provide reality-based perceptions and not
negate the client’s experience, because this may lead to a regressive struggle with the client.
Giving advice or false reassurance is incorrect because such techniques indicate that demons
actually are present, which feeds into the client’s hallucination and reinforces the client’s
behavior.
Test-Taking Strategy: Use your knowledge of therapeutic communication techniques, noting
, that the client is hallucinating. Remember that it is most important to maintain reality with the
client. This will direct you to the correct option.
Review: communication techniques for the client who is hallucinating
Level of Cognitive Ability: Applying
Client Needs: Psychosocial Integrity
Integrated Process: Communication and Documentation
Content Area: Mental Health
Giddens Concepts: Communication, Psychosis
HESI Concepts: Cognition, Communication
References: Stuart, G. (2013). Principles & practice of psychiatric nursing (10th ed., pp. 25-29).
St. Louis: Mosby.
Varcarolis, E. (2013). Essentials of Psychiatric Mental Health Nursing: A
communication approach to evidence-based care. (revised reprint)) (2nd ed. p. 320). St.
Louis: Saunders. Awarded 99.0 points out of 99.0 possible points.
3.
The mother of a 3-year-old says, “My child hit his teddy bear after being scolded for picking the
neighbors’ flowers.” The nurse should explain the child is using which defense mechanism?
A. Projection
B. Sublimation
C. Displacement Correct
D. Identification
Rationale: The defense mechanism of displacement involves the discharge of intense feelings
for one person onto a less threatening substitute person or object to satisfy an impulse.
Projection involves attributing an attitude, behavior, or impulse to someone else, such as that
which occurs in blaming or scapegoating. Sublimation is rechanneling an impulse into a more
socially acceptable object. Identification involves modeling behavior after someone else's.
Test-Taking Strategy: Use knowledge of the subject, defense mechanisms, to assist with the
process of elimination. Focusing on the child’s behavior will direct you to the correct option.
Review: defense mechanisms.
Level of Cognitive Ability: Applying
Client Needs: Psychosocial Integrity
Integrated Process: Nursing Process/Analysis
Content Area: Mental Health
Giddens Concepts: Development, Coping
HESI Concepts: Developmental, Stress & Coping
Reference: Varcarolis, E. (2013). Essentials of Psychiatric Mental Health Nursing: A
communication approach to evidence-based care. (revised reprint)) (2nd ed. pp. 171, 173). St.
Louis: Saunders.
Awarded 99.0 points out of 99.0 possible points.
4.
A client says to the nurse, “Even though my husband and I keep telling them we don’t want to
have children, our parents are pressuring us to ‘start a family.’ What should we say to them?”
Which response by the nurse is therapeutic?
, A. “This must be very difficult for both of you.” Correct
B. “Maybe you should say you can’t have children.”
C. “How do you usually cope with that kind of interference?”
D. “Tell them to have more children if they want them so badly.”
Rationale: Childless families may elect not to have children or to postpone having them until
they have established themselves occupationally or financially. Telling the client to tell the
parents that the couple can’t have children is incorrect because the client is being encouraged to
lie about life decisions rather than helping the parents understand the couple’s choices. Asking
how they usually cope with such interference is incorrect because it indicates that the nurse is
judgmental and has decided that the parents are interfering with the client and spouse. Saying,
“Tell them to have more children if they want them so badly,” is incorrect because it is sarcastic
and ridicules the situation over which the client has expressed concerns.
Test-Taking Strategy: Use your knowledge of therapeutic communication techniques and
remember to focus on the client’s feelings. This will direct you to the correct option.
Review: therapeutic communication techniques.
Level of Cognitive Ability: Applying
Client Needs: Psychosocial Integrity
Integrated Process: Communication and Documentation
Content Area: Mental Health
Giddens Concepts: Communication, Family Dynamics
HESI Concepts: Communication, Developmental
Reference: Stuart, G. (2013). Principles & practice of psychiatric nursing (10th ed., p. 27). St.
Louis: Mosby.
Awarded 99.0 points out of 99.0 possible points.
5.
A young adult client says, “I just can’t seem to stop snapping at my parents. I know they work
hard to support me, but what do I do when they’re so overbearing?” Which responses by the
nurse is therapeutic?
A. “It’s important not to be rude to your parents.”
B. “You need to be more patient with your parents.”
C. “Snapping at your parents is childish. How could you?”
D. “Have you talked to your parents about your frustrations?” Correct
Rationale: The correct response is focused on the client’s concerns and encourages the
therapeutic technique of formulating a plan of action. “It’s important not to be rude to your
parents” and “You need to be more patient with your parents” are both nontherapeutic,
judgmental responses that do not encourage the client to further explore her feelings and
problem-solve. “Snapping at your parents is childish. How could you?” is incorrect because it is
sarcastic and condescending, which is nontherapeutic.
Test-Taking Strategy: Use your knowledge of therapeutic communication techniques and
remember to focus on the client’s feelings. This will direct you to the correct option.
Review: therapeutic communication techniques
Level of Cognitive Ability: Applying
Client Needs: Psychosocial Integrity
, Integrated Process: Communication and Documentation
Content Area: Mental Health
Giddens Concepts: Communication, Family Dynamics
HESI Concepts: Communication, Developmental
Reference: Stuart, G. (2013). Principles & practice of psychiatric nursing (10th ed., pp. 29, 31).
St. Louis: Mosby.
Awarded 99.0 points out of 99.0 possible points.
6.
A client says, “I have so much trouble caring for my husband’s child from his first marriage. I
resent the money we have to pay for child support because we have to deprive my own child of
things. How can I stop feeling this way?” Which response by the nurse is therapeutic?
A. “Your child benefits from having a sibling.”
B. “Have you shared your feelings with your husband?” Correct
C. “You need to take a second job to give your child what you think she deserves.”
D. “I wonder why you married him, knowing that he wouldn’t desert his biological
child.”
Rationale: Remarried individuals often encounter problems as a result of the stressors they
bring into a marriage without prior discussion with the new partner. Bonding sometimes does
not always occur when a child is not one’s biological offspring. The correct answer is focused
on the client’s feelings. “Your child benefits from having a sibling” is not facilitative. “I wonder
why you married him, knowing that he wouldn’t desert his biological child” is incorrect
because it prejudges the client. “You need to take a second job to give your child what you
think she deserves” is not open ended, does not facilitate feelings, and gives advice.
Test-Taking Strategy: Use your knowledge of therapeutic communication techniques and
remember to focus on the client’s feelings. This will direct you to the correct option.
Review: therapeutic communication techniques if you had difficulty with this question.
Level of Cognitive Ability: Applying
Client Needs: Psychosocial Integrity
Integrated Process: Communication and Documentation
Content Area: Mental Health
Giddens Concepts: Communication, Family Dynamics
HESI Concepts: Communication, Developmental
Reference: Stuart, G. (2013). Principles & practice of psychiatric nursing (10th ed., p. 27). St.
Louis: Mosby.
Awarded 99.0 points out of 99.0 possible points.
7.
A client says to the nurse, “My wife retired last year from a lucrative law practice, and I’m
really discouraged. I’ll be working until I die, even though I helped pay for her education.”
Which response by the nurse is supportive?
A. “That’s very unfair to you.”
B. “You sound very troubled by this.” Correct
C. “That’s such a tough break for you.”
D. “Why not ask your wife for some help?”
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