The History of Mental Illness
What is the practice of burring (cutting) a hole through the skull to release evil spirits known as?
A: Trephining
B: Cathartic
C: Purging
D: Lunacy
Answer: A. Trephining
The nursing student hears one of the nurses say to a newly admitted client, "Jay, you're back again? You were just here two weeks ago! And before that, it was two months ago! You're here all the time!" The student recognizes that what is occurring?
A: Retrieval
B: Retrials
C: Repeat offenders
D: Recidivism
Answer: D: Recidivism
The client is feeling very anxious and has requested that a anti-anxiety medication be ordered. The nurse informs the client that the medication can be administered only every 4 hours and was given 3 hours ago. The nurse promises to give the client the medication as soon as it is due, but the nurse goes to lunch 1 hour later without giving the client the medication. Which ethical principle did the nurse violate:
A: Fidelity
B: Privacy
C: Confidentiality
D: Justice
Answer: A: Fidelity
According to Erik Erikson, what is the appropriate developmental task for a 45-year-old adult?
A: Integrity versus despair
B: Industry versus inferiority
C: Generativity versus stagnation
D: Initiative versus guilt
Answer: C: Generativity versus stagnation
The nursing student is sitting in the nurses' station of the psychiatric unit as a client continues to pace the hall over and over and over again. One nurse who is sitting in the nurses' station says, "I think he's just really anxious." Another says, "I think he's just attention-seeking." The student, knowing that the client is receiving the first-generation antipsychotic medication haloperidol, states that he believes that the pacing is probably more likely due to:
A: Akinesia
B: Unwillingness to sit down long enough to talk with a staff member
C: Akathisia
D: Dyskinesia
Answer: C: Akathisia
: What are things that influence who we are as a person?
A: attitudes
B: genetics
C: autonomy
D: fraud
Answer: A: attitudes
The Mental Health Status Exam takes place in what step of the nursing process?
A: Nursing diagnosis
B: Evaluation
C: Intervention
D: Assessment
Answer: D: Assessment
The client tells the nurse that he was "set free" from a state psychiatric hospital in 1988. How will the nurse document this information?
A: Early release
B: Rapid discharge
C: Deinstitutionalization
D: Discharge against medical advice
Answer: C: Deinstitutionalization
In the United States, which factors determine whether a client requires inpatient rather than outpatient care? (Select all that apply.)
A. Severity of the illness
B. Level of dysfunction
C. Suitability of the setting for treating the problem
D. Anticipated diagnosis
E. Level of client cooperation
F. Ability to pay
Answers: A, B, C, E, and F
These options are the determining factors for inpatient mental health care. If a client meets the criteria, the diagnosis does not matter in the determination of whether the client requires inpatient or outpatient care.
The nurse encounters a client crying in her room. Upon talking to the client, it is discovered that she is upset because a new nursing assistant made her go out for a walk with the group even though the client informed her that she waits for her daughter to go for her walk. This is a potential violation of which ethical principle?
A: Veracity
B: Autonomy
C: Confidentiality
D: Nonmaleficence
Answer: B: Autonomy
Which individual therapy is designed to help the client identify and correct distorted thinking and dysfunctional beliefs?
A: electroconvulsive therapy
B: cognitive therapy
C: somatic therapy
D: milieu therapy
Answer: B: cognitive therapy
The client is taking phenelzine (Nardil), a potent monoamine oxidase inhibitor (MAOI) antidepressant. Which food would the client need to avoid?
A: Green leafy vegetables
B: Lean ground beef
C: Aged cheese
D: Whole milk
Answer: C: Aged cheese
What is the primary goal of crisis intervention?
A: Provide emotional support and ensure safety
B: Stabilizing the individual to prevent unrest with residents
C: Learn more about the client's short and long-term goals
D: Encourage the building of a therapeutic relationship
Answer: A: Provide emotional support and ensure safety
The client is in the process of being admitted to a mental health facility. The client believes that the nurse is a police officer, despite the nurse repeatedly reinforcing the role of nurse. What is this client experiencing?
A: Delusions
B: Flight of ideas
C: Acute confusion
D: Hallucinations
Answer: A: Delusions
During the latter part of the 18th century, psychiatry became a separate branch of medicine, and inhumane treatment was greatly diminished by the French hospital director:
A. Dix
B. Beers
C. Pinel
D. Carter
Answer: Pinel
Philippe Pinel advocated acceptance of the mentally ill, as well as proper treatment. Dorothea Dix crusaded for construction of mental health hospitals. Clifford Beers wrote the book A Mind That Found Itself. President Jimmy Carter established the President’s Commission on Mental Health in 1978.
There are 23 states that have enacted mental health parity laws. The most accurate description of these laws is that they require insurance companies to:
A: Include coverage of mental illness.
B: Include coverage for substance abuse treatment.
C: Include coverage for mental illness that is equal to coverage for physical illness.
D: Include coverage for outpatient therapy for individuals with substance abuse
Answer: C: Include coverage for mental illness that is equal to coverage for physical illness
The landlord of a building was aware of a mold problem. The landlord failed to get rid of the mold and multiple tenants got sick. What is this an example of?
A: malpractice
B: negligence
C: libel
D: battery
Answer: B: negligence
Which type of theory views the person as a multidimensional person who adapts to stress within a dynamic environment while striving for self-fulfillment?
A: Humanistic
B: Hereditary
C: Cognitive
D: Psychoneuroimmunologic
Answer: A: Humanistic
: The client being medicated with haloperidol (Haldol) for over four weeks has started to display symptoms of involuntary movements of the mouth that resemble chewing and sucking. What is the client demonstrating?
A: extrapyramidal side effects
B: anaphylactic reaction
C: anhedonia
D: anticholinergic side effects
Answer: A: extrapyramidal side effects
A newly admitted 17-year-old female client says to the student nurse, "I'm terrified all the time. I don't know what it is. I'm really afraid of something, but I don't know what! I don't know what to do!" The nursing student knows that the client is experiencing which of these emotional responses?
A: Exalation
B: Depression
C: Anxiety
D: Ambivalence
Answer: C: Anxiety
The nurse is working with a client who appears to have several mental health issues. The nurse is aware that the main therapeutic tool of mental health care providers is:
A: a balance of psychotherapeutic medication
B: the optimal use of psychoanalytic techniques
C: the therapeutic use of self
D: the use of rules, boundaries, and limitations
Answer: C: the therapeutic use of self
During the 1930s, what common treatment for schizophrenia caused clients to fall into a coma that could last as long as 50 hours?
A. Electroconvulsive therapy
B. Insulin therapy
C. Humoral therapy
D. Amphetamine therapy
Answer: Insulin therapy
Insulin therapy was believed to successfully treat schizophrenia in the early 1900s. Amphetamines were used to treat depression, and electroconvulsive therapy was used for severe depression. Humoral therapy, which originated in ancient Greece and Rome, was a belief that mental illness resulted from an imbalance of the humors of air, fire, water, and earth.
Which client populations are at greater risk for the development of mental health disorders? (Select all that apply.)
A. Homeless
B. Clients infected with HIV or AIDS
C. Those in crisis
D. Nurses
E. Clients living in rural areas
F. Older adults
G. Psychiatrists
H. Children
Answers:
A. Homeless
B. Clients infected with HIV or AIDS
C. Those in crisis
E. Clients living in rural areas
F. Older adults
H. Children
: The client informs the nurse of their intention to physically harm their landlord. The nurse's priority action is guided by which principle?
A: Informed consent laws
B: Rule of restraint
C: Duty to warn regulations
D: Family Educational Rights and Privacy Act (FERPA)
Answer: C: Duty to warn regulations
The first comprehensive theory of mental illness based on observation (psychoanalysis) was developed by which theorist?
A: Abraham Maslow
B: Sigmund Freud
C: Hildegard Peplau
D: Erik Erikson
Answer: B: Sigmund Freud
Antipsychotic (neuroleptic) medications treat which disorders? Select all that apply.
A: substance abuse
B: acute mania
C: schizophrenia
D: insomnia
E: resistant bipolar disorder
Answers: B, C, and E
B: acute mania
C: schizophrenia
E: resistant bipolar disorder
An important component of providing good care is for health caregivers to take care of, or nurture, themselves. Which of the following are ways that effectively assist health caregivers to nurture themselves? (Select all that apply.)
A. Be supportive of colleagues.
B. Recognize and accept one’s own limitations and strive to improve.
C. Take pride in oneself.
D. Accept all challenges presented.
E. Be responsible and accountable for one’s own actions.
Answers:
A. Be supportive of colleagues.
B. Recognize and accept one’s own limitations and strive to improve.
C. Take pride in oneself.
E. Be responsible and accountable for one’s own actions.
: The nurse is preparing to interview a client in the client's room begins to move newspapers off a chair to sit down. The client requests that the nurse sit in another chair and leave the newspapers where they were. What is the client demonstrating?
A: Assault.
B: Paranoia.
C: Manipulation.
D: Territoriality.
Answer: D: Territoriality.
In the 1930s, what mental health disorder was electroconvulsive therapy (ECT) most often used to treat?
A. Schizophrenia
B. Bipolar disorder
C. Severe depression
D. Violent behavior
Answer: Severe depression
ECT was found to be an effective treatment for severe depression in the 1930s. During this period, schizophrenia was treated with insulin therapy, and violent behavior was treated with a lobotomy. In 1949, lithium carbonate was discovered as a treatment for bipolar disorder.
The client reports to the nurse case manager, "I can't do this anymore. I am going to end things on my terms. I have a bottle of oxycodone and I am going to take them right now." What community mental health care setting would be most appropriate for this client?
A: Emergency care
B: Residential program
C: Partial hospitalization
D: Psychiatric home care
Answer: A: Emergency care
The nurse is aware a client was admitted to the mental health unit on an involuntary status. What could be the possible cause for this type of admission?
A: The client scheduled this admission.
B: The client has a history of bipolar disorder for the past 10 years.
C: The client is experiencing extrapyramidal side effects.
D: The client attempted to do harm to himself.
Answer: D: The client attempted to do harm to self.
In the 1800s, asylums, jails, and almshouses sent mentally ill people to cages, closets, cells, stalls, and pens. Which individual used this data to lead the reformation of mental health care during this time?
A: Abraham Maslow
B: John Cade
C: Florence Nightingale
D: Dorothea Dix
Answer: D: Dorothea Dix
Which class of medications is used for treatment of mental health disorders? Select all that apply.
A: Antianxiety medications
B: Mood stabilizers
C: Mineralocorticoids
D: Anesthetics
E: Antipsychotics
Answers: A, B, and E
A: Antianxiety medications
B: Mood stabilizers
E: Antipsychotics
Identify the stages experienced by a person in a crisis. (Select all that apply.)
A. Recovery
B. Adaptation
C. Disorganization
D. Crisis
E. Denial
F. Reorganization
G. Perception
H. Exhaustion
Answers: A, C, D, E, F, and G.
A. Recovery
C. Disorganization
D. Crisis
E. Denial
F. Reorganization
G. Perception
These are the typical stages that a person in crisis experiences. The stages usually occur in the order of perception, denial, crisis, disorganization, recovery, and reorganization.
The nurse is interviewing a 70-year-old woman who is accompanied to the clinic by her son. He says, "I don't know what's going on with her! You ask her what the problem is! She doesn't even know where she was yesterday, and then she just showed up at my house for no reason!" The client says, "I don't know what he's talking about! I had a party to go to next door to him, so I just came for a visit! The people next door to him are my friends!" The nurse recognizes that the client is displaying which type of thinking?
A: Confabulation
B: Amnesia
C: Perseveration
D: Preoccupation
Answer: A: Confabulation