1.
When the mental health nurse assesses her client, who has been admitted to an inpatient psychiatric unit for depression, she takes into account that the family will not have income while the client is hospitalized. This assessment by the nurse regarding the impact of client's hospitalization on...
, 1. On the first day of a psychiatric-mental health nursing clinical, a student nurse is
assigned to work with a 24-year-old male client who is being treated for major
depression due to a recent diagnosis of AIDS. Which of the following questions of the
nurse would reflect prejudice regarding the client?
A) “Does depression often occur when young people get a diagnosis of AIDS?”
B) “What is the physiological reason that depression might happen in conjunction with this
diagnosis?”
C) “Does the client's family know he is depressed and in treatment? I haven't seen any
visitors since he was admitted.”
D) “Why do gay men seem to get depressed more often? Could it be related to IV drug
abuse?”
Ans: D
Feedback:
Prejudice is a judgment or opinion (“preconceived notion”) that has been made or
formed before any knowledge or facts have been gathered. In option D, the student has
already assumed that because the client has AIDS, he is gay and also may use IV drugs,
and therefore, the student's question reflects prejudice. Asking a question regarding the
development of depression following a diagnosis of AIDS in young people,
investigating the physiologic reason for depression occurring in a client diagnosed with
AIDS, and determining if the client's family has knowledge of the depression are all
relevant questions posed by the student nurse.
2. Which of the following would be the most therapeutic student nurse response to the
client's question, “Hi. What is your name?”
A) “My name is Dorothy, and I am a student nurse at Oakdale University School of
Nursing.”
B) “Why do you ask?”
C) “It is interesting that you would ask about my name. What is your name?”
D) “I would like to tell you; however, it is against the policy at Oakdale Hospital to reveal
personal information.”
Ans: A
Feedback:
There are clinical situations in which it is unadvisable to provide personal information
about oneself. However, other situations merit the cautious sharing of personal
information; this is one. Providing her name gives the student credibility and establishes
trust. To withhold this type of information would make the client uncomfortable and
possibly suspicious of the student.
3. The student nurse is beginning her first day of clinical in a mental health unit. The nurse
realizes that therapeutic communication can occur even if the nurse is not certain of how
to initiate the conversation. This is because?
A) It does not matter what you say to the client.
B) Sincerity, honesty, respect, and caring are the most important elements in communication
and will overcome anything you may say that could be nontherapeutic.
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,C) Psychiatric-mental health clients do not really understand what you say most of the time
anyway.
D) Clients in most mental health settings are cognitively impaired.
Ans: B
Feedback:
Sincerity, honesty, respect, and caring are hallmarks of being an effective psychiatric-
mental health care provider. If the student nurse is sincere and honest, shows respect for
the client, and displays a caring attitude, the staff and clients will give the student their
trust.
4. A Hispanic man employed as a sales representative goes into a local department store to
pick up a gift for his wife. As he walks around the store, the security guard appraises the
man's race, comes up to him, and says, “You need to leave the store because of your
suspicious behavior.” This is an example of
A) Cultural isolation
B) Dislocation
C) Prejudice
D) Discrimination
Ans: D
Feedback:
Discrimination occurs when there is treatment or consideration that is based on class or
category rather than on individual merit. In this case, the man has been treated
differently (asked to leave) based on his race, because there is no other defining
characteristic or behavior that he is exhibiting that would lead to his expulsion from the
store.
5. A mental health nurse has been assigned to a client diagnosed with schizophrenia. Upon
entering the room, the client yells, “Get out of here, you little brat! You're bigger than
my kid sister, who is horrible!” The initial action of the nurse would include which of
the following?
A) Sit down on the client's bed and initiate a conversation.
B) Run out of the client's room yelling, “I need some help here!”
C) Tell the client that her behavior is not acceptable and will not be tolerated.
D) Slowly back out of the client's room, and summon for help.
Ans: D
Feedback:
Nursing staff and clinicians are experienced in assessing the client's potential for
violence and have specific protocols to utilize when this occurs. The nurse should be
familiar with these protocols. The nurse should neither try to confront the client nor
create a disruption. Initiating any type of conversation when the client is confrontational
would not be appropriate. Running from the room and yelling may cause increased
agitation in this client. Telling the client that her behavior is unacceptable does not
resolve the current situation. The most appropriate nursing action in this situation would
be to leave the client's room and summon help.
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, 6. Which of the following is a characteristic of an introvert?
A) Outgoing personality
B) Relates easily to people
C) Exhibits leadership qualities
D) Prefers to be a follower
Ans: D
Feedback:
An introvert is a quiet individual who relates better to the inner world of ideas, thoughts,
and feelings. He or she prefers to be a follower and usually lets other initiate and direct
interactions. An extrovert is an outgoing person who relates more easily to people and
things in the environment, likes to take charge of situations, and has little difficulty
socializing.
7. When caring for a depressed client, the nurse made a comment that all depressed people
are weak. This is categorized as which type of attitude displayed by the nurse?
A) Affective incongruence
B) Judgmental
C) Jealous
D) Open-minded
Ans: B
Feedback:
Persons who display judgmental attitudes are often inflexible and run the risk of
neglecting the perception of others, possibly arriving at an opinion based on their values
without enough facts or enough regard for what other people may feel or think.
Affective incongruence occurs when the client's mood is not congruent with the
situation. The nurse in this instance is not being open-minded or conveying jealousy.
8. One of the students completing her mental health clinical states that “All those people
seem very crazy.” It is important that the student display which type of attitude when
dealing with mentally ill clients?
A) Biased
B) Judgmental
C) Introverted
D) Open-minded
Ans: D
Feedback:
Individuals who display an open-minded attitude do not make decisions until they are
aware of all the facts of the situation. It is especially important to be open-minded when
dealing with clients from various cultures and ethnic backgrounds. The student is
displaying a judgmental or biased opinion of the mentally ill. Introversion is a
personality trait.
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