NURS661 Mental Health Practice Exam With Answers (188 Solved Questions)

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NURS 661 Exam 1The nurse in the community mental health clinic assesses a client and determines thepresence of an Axis II diagnosis. What conclusions can the nurse draw?1.The client is in need of further evaluation.2.The client has a personalitydisorder.3.The client will need a special diet.4.The client is a candidate for the least restrictive environment.A female client disclosed to the nurse that she is in an abusive situation. Thisinformation will be used to contribute to:1.Axis IV.2.Axis III.3.Nothing, since this is confidential information and should not be shared.4.Axis I.The nurse on the inpatient unit is reviewing the record of a client admitted the previousday, and notes the client has an Axis I diagnosis. What inferences can the nurse makeabout the client?1.The client has a clinical psychiatric disorder.2.The client is in need of immediate medical attention.3.The client has a chronic condition.4.The client lacks a support system.A client is admitted withthe following diagnosis:Axis I: 300.01 Panic disorder without agoraphobiaAxis II: 301.83 Borderline personality disorderAxis III: No diagnosisAxis IV: UnemploymentWhat conclusions can the nurse make relative to the clients Axis III information?1.This client has problems with environment, but they are not related to mentaldisorder.2.Theclient’senvironment has not been evaluated.3.Theclient’shealth status has not been evaluated.4.The client has no diagnosed physiological health problems relevant to mentaldisorder at the time of admission.The school nurse, who must be familiar with mental health issues, will find child clinicaldisorders classified under:1.Axis II.

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2.Axis I.3.Axis X.4.Axis VII.Answer: 2After interviewing a client for admission, the nurse gives the client a score of 50 on theGlobal Assessment of Functioning Scale (GAF). The nurse selected this score based ontheclient’slevel of functioning:1.Since being given a psychiatric diagnosis.2.Within the past week.3.Since beginning the psychotropic medication.4.Within the past year.Select the priority nursing diagnosis for a client with a Global Assessment ofFunctioning (GAF) score of 10.1.Risk for Impaired Social Interaction2.Risk for Injury3.Knowledge Deficit4.Risk for Communication DeficitThe psychiatric home health nurse is evaluating whether aclient’slevel of functioninghas improved since starting the prescribed psychotropic medication. What evidencedoes the nurse look for?1.There is no change in the GAF score.2.There is a significant decrease (by 10 or more points) in the clients GAF score.3.The client no longer qualifies for a GAF score.4.There is an increase in the clients GAF score.The nurse is documenting observations of client interactions during a group session.The nurse strives to document the behaviors of the client interactionswith:1.Objectivity.2.Serendipity.3.Sympathy.4.Empathy.The nurse is validating what was observed before documenting in the progress note.Validation is used as a mechanism to ensure which of the following?1.The clients affect is appropriate to the situation2.Theclient’sperception of the response is communicated3.The clients request is clarified4.The clients need for further intervention is understood

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The nurse is developing a plan of care for a client. Which of the followinginterventionsmust the nurse be careful to avoid?1.Discussing expectations with the client2.Selecting interventions that conflict with the clients value system3.Identifying the clients perception of the problem4.Addressing issues related to theclients past experiencesThe student nurse asks why the nurse is documenting theclient’snonverbal responsesin addition to verbal responses during the initial assessment. Which of the followingstatements made by the nurse reflects the rationale for documenting both verbal andnonverbal responses?1.It is the hospital policy to document both.2.It is important to be thorough when documenting.3.Documenting both permits the reader to compare the behaviors for congruence.4.Charting verbal andnonverbal helps me remain objective.During a group session, the clients are asked to make one positive statement abouttheir home life. The nurse notices that one of the clients begins to fidget in the chair andinterprets this behavior as:1.A form ofnonlanguage vocalization.2.A therapeutic use of space.3.An expression of discomfort.4.An excuse to avoid answering the question.During a group session, a client expresses anger at the nurse. The nurse sits tenselywith arms and legs crossed whileverbally agreeing that theclient’spoint of view iscorrect. Which of the following messages is being sent by the nurse?1.The nurse is expressing warmth toward the client2.The nurse is being patient3.The nurse is demonstrating empathy4.Thenurse is sending a mixed messageThe nurse observed that during a teaching session, the overall emotional tone of aclient remained unchanged. The nurse documents this as:1.Affect that has range.2.Flat affect.3.Incongruent verbal and nonverbalresponses.4.Muted behavior.The nurse is working with a teen admitted with a diagnosis of depression. Which of thefollowing interventions demonstrates that the nurse is sensitive to theclient’sneeds?

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1.Avoiding the use of silence to decreaseanxiety2.Asking for details to demonstrate interest in the client3.Using closed-ended questions4.Listening to the clients feelingsA working goal for thenurse clientrelationship is to achieve:1.Facilitative intimacy.2.Self-disclosure.3.Interdependence.4.Social superficialityDuring the first interaction with a client, the nurse makes an introduction and identifiesthe purpose of the interaction. This serves to accomplish which of the following indeveloping a trusting relationship?1.Setting goals2.Building3.Initiating4.MaintainingThe nurse engaged in a therapeutic relationship with a client uses nonverbalcommunication to:1.Enhance verbal messages.2.Avoid the use of verbal messages.3.Detract from verbal messages.4.Terminate the therapeutic relationship.A nurse acknowledges feeling anxious about meeting new people. By acknowledgingfeelings to the client, the nurse is demonstrating:1.Sympathy.2.Genuineness.3.Empathy.4.Superficiality.Psychiatricmental health nursing interventions occur at which of the following levels ofcommunication?1.Public2.Intrapersonal3.Interpersonal4.International

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In planning care for a client who is gaining mental stability, the nurse developsmeasures to confirm theclient’sview of self. Which of the following responses made bythe nurse would be categorized as disturbed communication?1.I do not understand what you are telling me.2.You are wrong.3.How might you go about that differently?4.Do you want to try that again?Which of the following communication theories provides the most appropriate rationalefor a nursing intervention to utilize the perceived strengths of the client in promotingeffective communication?1.Behavioral Effects and HumanCommunication Theory2.Neurolinguistic Programming Theory3.Theory of Communication Levels4.Therapeutic Communication TheoryWhich of the following is not related to the theory of successful versus disturbedcommunication patterns during an admissionassessment?1.The appropriateness of the content of the message.2.The quality of the feedback provided.3.The language level of the assessment nurse.4.How efficiently the client delivers a messageA client asks the nurse about the doctorscomment that he may have problems due todelayed synaptic transmission in his brain. The nurse explains that the best way todescribe a synaptic transmission is which of the following?1.An electrochemical process called neurotransmission2.Where theaxon is released3.When the receptors bind to neurons4.The space where neurotransmitters match up with receptorsA client is admitted to the psychiatric unit exhibiting behaviors indicating a high level ofanxiety following a personal crisis. Which ofthe following communication skills shouldthe nurse utilize when interacting with this client?1.Closed-ended questions2.Providing reassurance3.Open-ended questions4.Providing the client with adviceDuring anurse clientinteraction, the client tells the nurse, Idon’tthink I can deal withfeeling so sad much longer. Thenurse’sbest response is which of the following?

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1.Is there a history of depression in your family?2.We all have times of sadness.3.Are you sayingyou feel sad?4.Tell me about your feelings of sadness.While reviewing therapeutic communication techniques, a nursing student made a list ofthings not to do or say to a client. Which of the following comments should be on thestudents list?1.How do you feel about being discharged today?2.What happened when you quit taking your medications?3.What are your concerns about your living situation?4.Why do you think you will never get well?A client states, I just know my brother will not comeback from the war. Which of thefollowing examples would be used to encourage the client to explore this concern?1.Maybe he will be one of the lucky ones.2.How do you know this?3.Where is your brother going?4.What do you feel will happen to him?Which of the following is an example of clarifying aclient’sverbal response?1.Are you saying you feel the medicine is helping you?2.See, the medicine does work.3.I knew it would work; it just takes time.4.Everything seems to work outeventually.A delusional client walks up to the nurse and says, I am the appointed overseer. Whoare you and why are you here? The most therapeutic response is which of thefollowing?1.I am your nurse and I will be here to help you until suppertime.2.Youdon’tknow who I am?3.You know who I am.4.You are not the overseer; you are a client in the hospital.Which of the following interventions promotes mindful listening in any health caresetting?1.Telling the client to get off the phone2.Encouraging the family to step outside before assessing the client3.Turning off the television before interviewing a client4.Asking clients what they would like to drink when taking medication

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In the immunization clinic, the nurse notices a client displaying tense body posture.Which of the following is the most therapeutic response for the nurse to make?1.Thiswon’thurt a bit.2.You need to relax.3.I can tellyou’vehad a bad experience before.4.I notice you are clenching your fists.The nurse gathering data from a client admitted to labor and delivery is overheardmaking the comment,youare lying. You need to tell me the truth so we can do what isbest for your baby. Thenurse’scommunication is:1.A perception check.2.Nontherapeutic.3.Necessary.4.Therapeutic.When considering communication skills, the nurse caring for an older client anticipatesthat the client will:1.Interrupt frequently.2.Take longer to respond.3.Answer questions with one-word responses.4.Remain silent.The nurse is admitting a client from the emergency room. Which of the following wouldbe used to clarify the nurses understanding of theclient’schief complaint?1.If you are bleeding, where is the blood?2.I feel your pain when I see you hold your side.3.Are you saying you feel that you are bleeding inside?4.Don’tworry; we have the technology to take care of you.The nurse prepares to assess a patient diagnosed with major depression fordisturbances in circadian rhythms. Whichquestion should the nurse ask this patient?a. Have you ever seen or heard things that others do not?b. What are your worst and best times of the day?c. How would you describe your thinking?d. Do you think your memory is failing?The nurse is servingon a committee charged with reviewing the roles andresponsibilities of the nurses on the psychiatric unit. Which publication should the nursebring to the first meeting?1. Diagnostic and Statistical Manual of Mental Disorders

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2. American Nurses Credentialing Center certification requirements3. American Nurses Association, Code of Ethics4. Psychiatric Mental Health Nursing Standards of PracticeThe psychiatric mental health nurse reflecting on professional role activities is referredto the standards of professional performance by a colleague. To which organizationshould the nurse look for guidance?1.North American Nursing Diagnosis Association2.American Nurses Credentialing Center3.National League for Nursing4.American Nurses AssociationThe psychiatric mental health nurse is working with the new graduate nurse who isorienting to the psychiatric unit. Which comment by the new graduate indicates furtherclarification of the generalist-nursing role is needed?1.I would feel better if youwould look at my documentation that addresses progresstoward treatment goals.2.I will spend time each day evaluating the effectiveness of the therapeutic milieu.3.I am a little nervous about conducting psychotherapy with clients.4.I am doing some reading on how to incorporate complementary interventions intotreatment plans.The client on the psychiatric unit is asking questions about prevention of sexuallytransmitted diseases. Given thePsychiatricMental Health Nursing Standards ofPractice,which action would be most appropriate for the nurse to take at this time?1.Consult with the mental health care team.2.Teach safer sexual practices.3.Investigate the questions in individual psychotherapy.4.Notify the attending psychiatrist.Theclient asks the nurse if certain changes can be made in the unit milieu. Whichaction by the nurse indicates understanding of the nursing role in the therapeutic milieu?1.The nurse refers the clients requests to the psychiatric social worker.2.The nurse discusses the desired changes with the client.3.The nurse refers the clients requests to the psychosocial rehabilitation worker.4.The nurse instructs the client that no changes can be made.Due to a staff membersabsence, the nurse is reviewing staff assignments for the day.Which task can the nurse delegate to the psychosocial rehabilitation worker?1.Conflict resolution teaching to a small group of clients2.Comparison of physicians orders with the medicationrecords

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3.Routine medication administration to a stable client4.Assessment of a long-term clientIf psychiatric nurses used Oremstheory for structuring much of their nursing practice, amajor focus area for assessment would be the clients ability to do which of thefollowing?1.Adapt and function to meet various role expectations.2.Care about self and participate inself-healing.3.Implement self-care to meet psychosocial needs.4.Enter into a therapeutic one-to-one relationship with the nurse.The psychiatric mental health nurse is asked to develop an intervention for the nursingunit based on Watsons theory of caring. Given this assignment, which intervention ismost appropriate for the nurse to implement?1.One-to-one debriefing sessions each week with individual unit nurses and the unitmanager2.Clarification of values and cultural beliefs that might pose barriers to caring for clients3.Identification of additional coping skills for new nurses on the unit4.Discussion of the impact of recent changes in hospital policy on the nursing staffThe unit manager is consistently advocating for self-awarenessamong the psychiatricmental health nursing staff in order to promote quality care. From which theoretical baseis the unit manager operating?1.Jean Watsons theory of human caring2.Dorothea Orems theory of self-care3.Martha Rogerss principles of homeodynamics4.Sister Callista Roys adaptation theoryUpon theclient’sarrival on the patient care unit, the nurse begins implementation of thenursing process. Of which nursing theorist should thenurse’spractice be mostreflective?1.Ida JeanOrlando2.Jean Watson3.Dorothea Orem4.Hildegard PeplauIf the nurse is using the nursing theory that has shaped psychiatric mental health mostdirectly, which nursing action is priority?1.Assessing the clients abilities in areas of self-care2.Teaching effective coping skills3.Establishing a therapeuticnurse clientrelationship

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