Mental Health EVOLVE FOUNDATIONS AND MODES OF CARE QUESTIONS.
Mental Health EVOLVE FOUNDATIONS AND MODES OF CARE QUESTIONS.
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Mental Health EVOLVE FOUNDATIONS AND MODES OF CARE QUESTIONS 1. A primary gain is always the reduction of anxiety. Gaining benefits from others is related to a secondary gain. Fulfillment of unconscious desires is unrelated to primary gains. Control of unacceptable impulses is unrelated to primary ...
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Mental Health EVOLVE FOUNDATIONS AND MODES OF CARE QUESTIONS
1. A primary gain is always the reduction of anxiety. Gaining benefits from others is related to a
secondary gain. Fulfillment of unconscious desires is unrelated to primary gains. Control of
unacceptable impulses is unrelated to primary gains.
2. Mental healthy person SATA
One who accepts aging
One who engages available strengths
One who sustains positive relationships
3. A mother and her three young children arrive at the mental health clinic. The woman says
that she is seeking help in leaving her husband. She reports that he has been beating her for
years but just started hitting the children. What is the best initial action by the nurse?
A: Arranging for a staff member to watch the children so the mother
and nurse can talk.
4. A nurse counseling a client on the inpatient psychiatric unit responds to a statement made by
the client by stating, "I'm confused about exactly what is upsetting you. Would you go over
that again, please?" What is the nurse using?
A: Clarifying
R: Clarifying is an attempt to better understand the message intended by the client. It is utilized
to gain a clearer understanding of what another person has stated. Structuring is an attempt to
create order and thereby allow a client to become aware of problems. Confronting examines a
discrepancy between what a person is saying and what a person does. It requires careful
attention to nonverbal communication, as well as the discrepancies between the nonverbal and
verbal messages. Paraphrasing allows the speaker to share how one person perceives and hears
another's information. The nurse is not paraphrasing, but instead is attempting to better
understand the client.
5. Deaths that are perceived as preventable cause more guilt for the mourners and therefore
increase the intensity and duration of the grieving process. Perceiving a death as
preventable will not necessarily result in a pathological reaction, but it will usually make it
harder to understand and accept the death.
6. A nurse working in a crisis center understands that a crisis can best be defined as what?
A: A threat to equilibrium
R: Caplan's theory states that a crisis is an internal disturbance caused by a stressful
event that alters the usual way of coping with a threat to the self; this temporarily disturbs
the equilibrium of the person involved
7. What does a psychiatric nurse identify as the primary purpose of the Diagnostic and
Statistical Manual of Mental Disorders, fifth edition (DSM-5)?
, A: Provide a classification of types of mental disorders and guidelines to aid in making a
diagnosis.
R: The prime purpose of the DSM-5 is to serve the clinician as a guide in identifying a
client’s mental health or psychiatric diagnosis. Although the DSM-5 is useful in facilitating
communication, the teaching of psychopathology, and the collection of accurate public
health statistics, none of these are the primary purpose of this publication.
8. A client who is to be discharged from an inpatient mental health facility is referred to a mental
health daycare center in the community. What should the nurse identify as
the primary reason for this referral?
A: MAINTAINING GAINS ACHIEVED DURING HOSPITALIZATION
R: The daycare center provides the client with a therapeutic setting for a few hours each
day during the transitional stage between hospital and total discharge. The goal is to
maintain and enhance progress made during inpatient treatment. Daycare treatment may
improve social skills or allow the client to get out of the house for a few hours, but neither
is its primary purpose. Avoiding direct confrontation with the community may help during
the transition stage, but it is not the primary goal of daycare.
9. What can the nurse do to help and older adult successfully complete erikson major task of
this stage?
A: DEVELOP A SENSE OF SATISFACTION WHEN CONSIDERING PAST
ACHIEVEMENTS.
R: Feeling a sense of satisfaction when considering past achievements allows the client to
accept what life is or was and helps prevent feelings of despair. Investing creative energies
in promoting social welfare is the major task of middle adulthood (30 to 65 years).
Developing deep, lasting relationships with other people or institutions is the major task of
the young adult (20 to 30 years). Feeling a need to make up for past failings is a negative
resolution of the major task of the older adult.
10. POWERELESSNESS Anger is a common feeling when people do not have control over decisions
that affect them. There is no information to indicate that the client is feeling hopeless, indecisive,
or worthless.
11. An inpatient therapy group on a psychiatric unit has as its goal helping clients
participate in life more fully by gaining insight and changing behavior. The nurse
leader can best help the group achieve this goal by using a leadership style that is
what?
A: DEMOCRATIC AND GUIDING
R: A democratic and guiding leader stimulates and directs the group to assist it in
developing its maximal potential by facilitating and balancing the group's forces. An
autocratic and directing leader makes most of the decisions and controls the group,
thereby limiting group growth potential. A laissez-faire, observing leader allows group
members to take over the group; if there are no members with leadership skills, little is
gained from the group. A passive and nonconfrontational leader does not provide adequate
leadership to make the group effective.
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, 12. Priority outcome in the planning of care for a client in crisis?
A: RESTORING THE CLIENTS PSYCHOLOGICAL EQUILIBRIUM
R: Crisis intervention is short-term therapy with the major outcome of restoring the client
to the precrisis state. Referring the client for occupational therapy is not an outcome, but
an action to help achieve an outcome; it is not part of crisis intervention. Scheduling the
client for follow-up counseling is not an outcome, but rather an intervention that may be
necessary if psychological equilibrium cannot be restored. Having the client gain insight
into the problem is not always necessary for a client to be able to function effectively.
13. What should a nurse consider about the past experiences of clients who have immigrated to
this country?
A: IT IS IMPORTANT THAT THEIR VALUES BE ASSESESD FIRST
R: Past experiences are important and must be recognized because they help set the individual's values
throughout life. Past experiences will not affect inherited traits. Past experiences play an important role in
an individual's life. Nothing establishes how an individual responds forever; new experiences continue to
influence future responses.
14. Personality disorders are identified in the DSM-V in clusters. How should the nurse describe
the behaviors of an individual with a cluster A personality disorder?
A: ODD AND ECCENTRIC
R: Cluster A includes paranoid, schizoid, and schizotypal personality disorders. These
clients are odd and eccentric and use strange speech, are angry, and have impaired
relationships. Cluster C includes avoidant, dependent, and obsessive-compulsive personality
disorders. These clients are anxious, fearful, tense, and rigid. Cluster B includes antisocial,
borderline, histrionic, and narcissistic personality disorders. These clients are dramatic, erratic,
labile, impulsive, hostile, and manipulative.
15. A nurse is conducting a therapy group whose objectives are to assist the members to gain
insight and to change behavior so they are able to participate in life in a more satisfying
manner. What leadership style will best help the nurse achieve these objectives?
A: DEMOCRATIC, GUIDING
R: A democratic, guiding type of leader stimulates, directs, and assists the group to develop its
maximum potential by facilitating and balancing group forces. A hierarchal, directing type of
leader makes most of the decisions and controls the group, thus limiting group growth potential.
An autocratic, controlling type of leader makes most of the decisions and controls the group, thus
limiting group growth potential. A laissez-faire, observing type of leader allows group members to
take over the group; if the group has no leader or leaders, little is gained from the group.
16. A client in the mental health clinic who has been seeing a therapist for more than 6 months
begins to talk and act like a therapist who is analyzing coworkers. What defense mechanism
does the nurse identify?
A: INTROJECTION
R: Introjection is treating something outside the self as if it is actually inside the self; it is
unconsciously incorporating the wishes, values, and attitudes of another as if they were one’s
own. Undoing is taking some action to counteract or make up for a wrongdoing. Projection is
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, attributing to another person or group one’s own unacceptable attitudes or characteristics.
Intellectualization is using logical explanations without feelings or an affective component.
17. A situational crisis involves an unanticipated loss that is apparent to others. Examples include
loss of a job, death of a loved one, and a change in health status such as an amputation. A
subjective (internal) crisis threatens a person's well-being but is not obvious to others. Examples
of subjective crises include aging, lack of independence, and loss of faith. An adventitious crisis
involves natural (e.g., hurricane, tsunami) or man-made (e.g., arson, terrorist attack) traumatic
events. These crises often involve numerous losses. A maturational crisis occurs in response to
stress as a person experiences a predictable change. Examples of maturational crises include
adolescence, marriage, parenthood, and retirement.
18. A crisis occurs when usual methods of coping are no longer effective and the individual
is so overwhelmed that emotional distress and cognitive impairment result. A crisis is precipitated
by a known acute situation, not by a situation that comes and goes. Feelings of uneasiness,
tension, and irritability are associated with anxiety. However, feelings associated with a crisis
cause such severe disequilibrium that the individual is unable to concentrate or function.
A: NOTHING I TRY WORKS, EVERYTHING JUST KEEPS GETTING WORSE
19.The nurse is scheduled to be the co-leader of a therapy group being
formed in the mental health clinic. When planning for the first meeting,
it is of primary importance that the nurse consider what?
A: NEEDS OF THE CLIENT BEING INCLUDED
R: When planning a group, the nurse must ensure that clients have similar needs to
promote relationships and interactions; diverse needs do not foster group process.
Although important, the number of clients is not a primary consideration. Behavior and
needs, rather than diagnoses, are of primary importance. The socioeconomic status of the
clients in the group has little effect on group process
20. A client is presented with the treatment option of electroconvulsive therapy (ECT). After
discussion with staff members, the client requests that a family member be called to help
make the decision about this treatment. What ethical principle does the nurse consider when
supporting the client’s request?
A:AUTONOMY
Autonomy is the ethical principle of respecting the independence and right to self-determination of
others. In this situation the nurse focuses on helping the client make a choice. Justice is the
ethical principle that requires all people to be treated fairly, regardless of sex, age, religion,
diagnosis, marital status, or socioeconomic level. Veracity is the ethical principle that requires
truthfulness. Beneficence is the duty to do good and promote the welfare of others.
21. Clients who have experienced childhood sexual abuse will have difficulty being aware of their
personal boundaries and maintaining appropriate boundaries for themselves and others. Clients
who have experienced childhood sexual abuse tend to have decreased, not increased, libidos.
Phobic behavior, the irrational fear of an object or situation, is not necessarily a concern that the
nurse should have for this client more than for other clients. Clients who have experienced
childhood sexual abuse can exhibit aggressive behavior, but it does not directly address the
identification of inappropriate touching.
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