Chapter 21. The Psychiatric-Mental Health Client in Nonpsychiatric Settings
MULTIPLE CHOICE
1. The nurse in the emergency department (ED) is assessing a client with a long history of
depression. The nurse finds that the client has gained weighatb,irhb.acosmd/treyst skin, and has cold
sensitivity. The nurse determines the client’s depression is exacerbating; further examination and
testing reveal the client has hypothyroidism. Which phenomenon occurred?
1. Depression screening
2. Social distancing
3. Trauma-informed caring
4. Diagnostic overshadowing
ANS: 4
Chapter: Chapter 21, Caring for Clients with Mental Illness and Substance Use Disorders in
General Practice Settings
Objective: Recognize the impact of inadequate assessment, treatment, and referral for the client
with mental health and substance use disorders.
Page: 334
Heading: The Need for Education of Health-Care Providers
Integrated Processes: Nursing Process
Client Need: Reduction of Risk Potential
Cognitive Level: Comprehension [Understanding]
Concept: Mood
Difficulty: Easy
Feedback abirb.com/test
1. This is incorrect. The nurse did not screen for depression; rather, the nurse assessed
inadequately and incorrectly.
2. This is incorrect. The nurse did not use social distancaibnirgb,.caomt/tepset of
stigmatization in which health-care workers and others avoid clients with mental
illness or addiction.
3. The
Thisnurse made aThe
is incorrect. premature, inaccurate
nurse did decision.
not use trauma-informed caring, care that assesses
for and demonstrates sensitivity to the impact of trauambiarbh.ciosmt/tersyt (violence,
abuse,
trauma) on current behavior and relationships. The nurse inadequately assessed the
4. This is correct. The nurse used diagnostic overshadowabiirnbg.c,oma /ptehstenomenon in
which clients’ physical symptoms are attributed to their mental illness. The nurse
attributed the weight gain, dry skin, and cold sensitivity to the depression rather than
to hypothyroidism.
2. The client arrives to the ED complaining of severe abdominal pains. The attending health-care
provider determines that the client is in labor. Upon further investigation, the nurse discovers that
the client uses illegal substances and did not seek prenatal caabirreb..coWm/hteiscth of the following
would best explain this lack of prenatal care?
1. Many states consider substance use during pregnancy as child abuse.
2. The client was never educated about the need for prenatal care.
3. The client had children at home and considered prenatal care unnecessary.
4. The client did not have the financial resources to obtain prenatal care.
ANS: 1
Chapter: Chapter 21, Caring for Clients with Mental Illness and Substance Use Disorders in
General Practice Settings
Objective: Analyze barriers that influence the screening, intervention, and referral process for
clients with mental health and substance use concerns.
Page: 338
Heading: Substance Use Disorders
Integrated Processes: Nursing Process
Client Need: Management of Care
Cognitive Level: Application [Applying]
Concept: Collaboration
Difficulty: Easy
Feedback
1. This is correct. Many states consider substance use daubriirbn.gcompr/tegstnancy to be
child
abuse with legal consequences, and health-care professionals are required to report
suspected
2. This prenatalDespite
is incorrect. drug use.
no education for the need foabrirpb.rceonma/tteaslt care,
this is not the best explanation for lack of care.
3. This is incorrect. Each pregnancy is unique, and prenatal care is paramount for the
well-being of both mother and infant.
4. This is incorrect. Although prenatal care can be costlayb,irtbh.ceorme/taesrte resources to
help the
mother obtain adequate prenatal care.
CON: Addictions and Behaviors
3. The client with a myocardial infarction tells the intensiveabcirabr.ceomn/utersste, “You won’t
have to care for me pretty soon. I will not be a burden to you or others.” Which initial action
should the nurse take?
1. Screen the client for suicide.
2. Transfer the client to the medical unit.
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