Psychiatric Mental Health Nursing Practice Questions

Psychiatric Mental Health Nursing Practice Questions Related

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A physically and emotionally healthy client has just been fired. During a routine office visit he states to a nurse: Perhaps this was the best thing to happen. Maybe Ill look into pursuing an art degree. How should the nurse characterize the clients appraisal of the job loss stressor?

  • A. Irrelevant
  • B. Harm/loss
  • C. Threatening
  • D. Challenging
Correct Answer: D

Rationale: The correct answer is D: Challenging. The client's statement indicates a positive reframing of the job loss as an opportunity for personal growth. This suggests that the client views the situation as a challenge to adapt and pursue a new path. This perspective aligns with the concept of stress as a potential source of growth and development, known as the challenge appraisal.

Summary:
A: Irrelevant - The client's statement demonstrates relevance to his future plans, making this choice incorrect.
B: Harm/loss - The client's positive outlook does not reflect a perception of harm or loss, making this choice incorrect.
C: Threatening - The client's statement does not convey a perception of threat, making this choice incorrect.

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In the situation presented, which nursing intervention constitutes false imprisonment?

  • A. The client is combative and will not redirect, stating, No one can stop me from leaving. The nurse seeks the physicians order after the client is restrained.
  • B. The client has been consistently seeking the attention of the nurses much of the day. The nurse institutes seclusion.
  • C. A psychotic client, admitted in an involuntary status, runs off the psychiatric unit. The nurse runs after the client and the client agrees to return.
  • D. A client hospitalized as an involuntary admission attempts to leave the unit. The nurse calls the security team and they prevent the client from leaving.
Correct Answer: A

Rationale: The correct answer is A because false imprisonment occurs when a person is unlawfully restrained. In this scenario, the client is restrained without a physician's order, which is considered unlawful. Seeking a physician's order after the client is already restrained does not justify the action.

Choice B is incorrect because seclusion is a valid nursing intervention for managing disruptive behavior, as long as it is done in a safe and ethical manner.

Choice C is incorrect because the nurse's actions of running after the client and convincing them to return do not constitute false imprisonment.

Choice D is incorrect because preventing a client hospitalized as an involuntary admission from leaving with the help of security is a valid intervention to ensure the safety of the client and others.

A geriatric client is confused and wandering in and out of every door. Which scenario reflects the least restrictive alternative for this client?

  • A. The client is placed in seclusion.
  • B. The client is placed in a geriatric chair with tray.
  • C. The client is placed in soft Posey restraints.
  • D. The client is monitored by an ankle bracelet.
Correct Answer: D

Rationale: The correct answer is D - The client is monitored by an ankle bracelet. This option allows for monitoring and tracking the client's movements without physical restraint, promoting autonomy and freedom of movement. Seclusion (A) is restrictive and isolating. Placing the client in a geriatric chair with tray (B) limits mobility and can be degrading. Soft Posey restraints (C) restrict movement and can lead to physical and psychological harm. An ankle bracelet (D) is the least restrictive option as it allows for monitoring while still allowing the client some independence and mobility.

A client is prescribed alprazolam (Xanax) for acute anxiety. What client history should cause a nurse to question this order?

  • A. History of alcohol dependence
  • B. History of personality disorder
  • C. History of schizophrenia
  • D. History of hypertension
Correct Answer: A

Rationale: The correct answer is A: History of alcohol dependence. Alprazolam is a benzodiazepine and can be addictive, especially for individuals with a history of substance abuse like alcohol dependence. This client population is at higher risk for misuse, addiction, and overdose. It is important for the nurse to question this order to avoid potential harm. Choices B, C, and D are incorrect as they do not directly impact the safety or efficacy of alprazolam for acute anxiety.

During a group session, which client statement demonstrates that the group has progressed to the middle, or working, phase of group development?

  • A. Its hard for me to tell my story when Im not sure about the reactions of others.
  • B. I think Joes Antabuse suggestion is a good one and might work for me.
  • C. My situation is very complex, and I need professional, not peer, advice.
  • D. I am really upset that you expect me to solve my own problems.
Correct Answer: B

Rationale: The correct answer is B because it shows the client actively engaging in problem-solving and considering specific strategies, indicating progress to the working phase. Choice A reflects the initial phase where trust and sharing are still developing. Choice C suggests a dependency on professional advice, not group collaboration. Choice D demonstrates resistance and a lack of ownership over personal growth, indicating an earlier phase of group development.

A despondent client, who has recently lost her husband of 30 years, tearfully states, Ill feel a lot better if I sell my house and move away. Which nursing reply is most appropriate?

  • A. Im confident you know whats best for you.
  • B. This may not be the best time for you to make such an important decision.
  • C. Your children will be terribly disappointed.
  • D. Tell me why you want to make this change.
Correct Answer: B

Rationale: The correct answer is B because it acknowledges the client's emotions and gently suggests caution in making a big decision during a vulnerable time. It shows empathy and encourages the client to reconsider the decision later. Choice A lacks exploration of client's feelings, Choice C introduces unnecessary guilt, and Choice D focuses on the change rather than the emotional state.

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