MH Theories/ Therapies
MH Fundamentals
Ethical Considerations
Psychopharmacology
Neurotransmitters
Grief/ Loss
Trauma, Crisis, Disasters
Somatic disorders
100
A nurse is participating in a team review on a client's progress. Which if the following is an example of transference?
A.The therapist views the client like a daughter.
B.The client views the therapist as a mother figure.
C. The client expresses to the therapist how they feel about marriage.
B. This is an example of transference. The concept of transference can occur when the client develops feelings toward the therapist in relation to someone similar who was significant in their childhood.
100
A nurse is reviewing ethical principles with a newly licensed nurse. The nurse should include which of the following as an ethical principle?
A. Bias
B. Duty to Warn
C. Justice
C. Justice
Rational:
In mental health there are ethical principles that guide how nurses should act regarding ethical issues. Ethical principles can include beneficence, autonomy, and justice. The American Nurses Association has a code of ethics that assists in guiding nurse in how to make ethical decisions in health care.
100
A nurse is discussing torts with a newly licensed nurse. Which of the following information should the nurse include?
A. Assault is a tort that only occurs if a client is physically harmed.
B. Negligence is the most common unintentional tort.
C. False imprisonment does not apply to use of chemical restraints.
B. Negligence is the most common unintentional tort and can be committed by anyone. For example, negligence can occur when a guardian does not provide adequate nutrition for their minor child.
100
A nurse is caring for a client who is experiencing delusions, hallucinations, and alterations in speech. Which of the following medications should the nurse anticipate the provider to prescribe?
A. Mood stabilizer
B. Dopamine antagonist
C. Benzodiazepine
B. The nurse should identify that dopamine antagonists, such as antipsychotics, are used to manage manifestations of psychosis, including hallucinations.
100
A nurse is providing education to the family of a client who has Alzheimer's disease. Which of the following statements should the nurse make when explaining the role of acetylcholine in this disease process?
A. "Acetylcholine regulates the release of histamine and glutamate."
B."Acetylcholine plays a central role in findings of Alzheimer's disease."
C."Acetylcholine is an excitatory neurotransmitter that is responsible for learning and memory."
B. The nurse should identify that individuals with Alzheimer’s disease are found to have a decreased number of neurons that excrete acetylcholine, resulting in lower levels of acetylcholine. Acetylcholine regulates the sleep-wake cycle and is responsible for muscle functioning and helps with arousal, short-term memory, and learning.
100
A nurse is caring for a client who has cancer and is terminally ill. The nurse should recognize that the client and their family might be experiencing which of the following types of grief?
A. Anticipatory
B. Traumatic
C. Complicated
A. Anticipatory grief might be experienced by clients and their families when a client has a terminal illness and is still alive.
100
A nurse is caring for an adolescent who has experienced abuse and neglect since early childhood. The nurse should understand that this is an example of which of the following types of trauma?
A. Historical Trauma
B. Chronic Trauma
C. Vicarious trauma
B. Chronic trauma refers to multiple and/or persistent traumatic events that a client experiences over time, including long-term abuse and neglect. This type of trauma could also include ongoing isolation, poverty, or hunger.
100
A newly licensed nurse asks the charge nurse about functional neurological symptom disorder. Which of the following responses should the charge nurse make?
A. "The manifestations of this disorder are worse during times of increased stress."
B. “Clients who have this disorder consciously control the manifestations.”
C. “Feeling outside of one’s body is a primary manifestation of this disorder.”
A. The manifestations of neurological symptom disorder often worsen or become more apparent when a client is experiencing a stressful situation. Also called conversion disorder.
200
The nurse should include that which of the following client relationships should be a part of family therapy?
A.The client's maternal grandparent who watches the client daily after school
B.The client's babysitter who watches them once a month
C. The client's aunt/uncle who visit every holiday
A. Grandma/ Grandpa!
Rational:The client's maternal grandparent who watches the client daily is a part of the immediate family. Family therapy involves those who have a relationship where members are engaged with each other. Families can be traditional or nontraditional.
200
A charge nurse is instructing a newly licensed nurse about mental health disorders. Which of the following statements by the nurse indicates an understanding of mental health disorders?
A. "Mental Health Disorders are preventable."
B. "Mental health disorders are broken down by their manifestations."
C."Mental health disorders are primarily caused by biological factors."
B. Mental health disorders can be broken down into a variety of categories, often by their manifestations.
200
A nurse on a mental health unit is preparing to document an incident that occurred involving a client. Which of the following considerations by the nurse will ensure competency in the documentation?
A. The nurse includes the client's own words when describing what happened.
B. The nurse describes what happened subjectively.
C. The nurse describes what happened by providing general and broad details.
A. Using the client's own words in the form of a quotation is important and demonstrates attention to detail and reflection of the client's thoughts and condition.
200
A nurse is caring for a client who is taking fluphenazine and is experiencing tardive dyskinesia. Which of the following medications should the nurse anticipate the provider to prescribe for this client?
A. Diphenhydramine
B. Naloxone
C. Valbenazine
C. The nurse should anticipate the provider to prescribe valbenazine to treat the manifestations of tardive dyskinesia.
200
A nurse is providing education to a group of clients about the process of neurotransmission. Which of the following statements about neurotransmission should the nurse make?
A. "Neurotransmitters are activated by the enzyme transferase."
B. "Neurotransmitters function by inhibiting the production of glucose."
C."Neurotransmitters are found throughout the body."
C. The body has a vast system of nerves composed of neurons, and this is where neurotransmitters are found. Neurotransmitters play a role in nearly every function of the body, including the brain. Specifically, neurotransmitters are chemical communicators carrying specific messages from one nerve cell to another and function as one of the main components of how the body communicates with itself.
200
A nurse is providing care for a client who has recently returned from active combat and experienced the loss of a close friend during combat. Which of the following client statements indicates that the client is experiencing traumatic grief?
A. "I can't cry when I talk about my friend because soldiers aren't supposed to show emotions."
B. "I should have been the one who had been killed instead of my friend."
C. "When I have flashbacks, it feels like my heart is going to beat through my chest."
B. This statement indicates self-blame or guilt, which is a manifestation of traumatic grief. A client's response is often intensified by disbelief or shock, feelings of anger or numbness, self-blame or guilt, a sense of fear or danger, loss of meaning.
200
A nurse is providing care to a client who has acute stress disorder. Which of the following client statements is consistent with this disorder?
A. "I was in a car crash 2 weeks ago and I have nightmares when I sleep."
B. "I was in a terrible car crash 2 years ago and I have been unable to drive a car since then."
C. "I was physically abused when I was a child and have frequent flashbacks since then."
A. This client's symptoms are consistent with acute stress disorder, which lasts between 3 days and 1 month after the traumatic event. If symptoms last beyond 1 month, then a mental health provider may consider a diagnosis of post-traumatic stress disorder.
200
A nurse is discussing treatment options with the guardian of a child who has been diagnosed with dissociative identity disorder. The guardian asks, "How is nursing care different for children diagnosed with dissociative identity disorder compared to adults?" How should the nurse best respond?
A. "Nursing interventions for this diagnosis are very limited, regardless of age."
B. "Assessing for thoughts of self-harm is important, regardless of age."
B. Regardless of the client's age, assessing for thoughts of self-harm or suicidal ideation is a priority.
300
A charge nurse is reviewing Freud's psychoanalytical theory with a group of newly hired nurses. One of the nurses states, "I remember from school that the conscious mind is what determines right from wrong." Which of the following statements should be the charge nurse's reply?
A. Yes, that is correct.
B. I think you are referring to the Ego.
C. You are thinking of the superego, which focuses on morals
C. SuperEgo!
Rational: The charge nurse should reply with this statement. The superego is the personality part that is concerned with morals and following rules and is frequently referred to as the conscience.
300
A nurse is speaking with a newly licensed nurse who reports that they fear a client might be dangerous to others due to the client's diagnosis of schizophrenia. Which of the following types of stigma should the nurse identify as being associated with this fear?
A. Public
B. Cultural
C. Self
A. Public
Rational: Public stigma occurs when there is a negative attitude toward those who have a mental illness. It can be expressed in discriminatory attitudes or actions.
300
A nurse on a mental health unit is discussing restraints and seclusion with a group of newly hired nurses. At which of the following times should a nurse discuss the restraint and seclusion policy with a client?
A. When a client becomes agitated
B. While administering chemical or physical restraints
C. Upon admission
C. The nurse should discuss the restraint and seclusion policy with a client upon admission, when the client is usually calm.
300
A nurse is caring for a client who is experiencing periods of hyperactivity, impulsivity, and inattentiveness. Which of the following medications should the nurse anticipate the provider to prescribe?
A. Dopamine antagonist
B. Benzodiazepine
C. Central nervous system stimulant
C. The nurse should identify that central nervous system (CNS) stimulants, such as methylphenidate, are primarily used to treat manifestations of attention deficit hyperactivity disorder (ADHD) and narcolepsy.
300
A nurse is caring for a client who has sleep dysregulation, poor memory, and poor concentration. Which of the following neurotransmitters should the nurse identify as being responsible for the client's manifestations?
A. Dopamine
B. Norepinephrine
C. Serotonin
B. The nurse should identity that norepinephrine is an excitatory neurotransmitter that is responsible for learning, sleep, mood, memory, and attention.
300
A nurse is preparing for a home visit with a client whose partner recently died by suicide. Which of the following actions should the nurse take first when preparing to provide client-centered care?
A. Read the client's progress notes.
B. Review current provider prescriptions.
C. Perform self-reflection
C. Performing self-reflection allows the nurse to consider their own beliefs, values, personal losses or grief, and any bias they might have. This is an important first step in preparing for client-centered care.
300
A nurse assigned to a mental health hotline receives a call from a nurse who has been working on a Covid-19 unit. The caller states, "I just don't think I can be a nurse anymore." Which of the following types of trauma should the nurse recognize this person is experiencing?
A. Complex trauma
B. Chronic trauma
C. Secondary Trauma
C. Nurses and other health care professionals are at risk for secondary trauma due to the repeated witnessing of client trauma and death. Incidents of secondary trauma have increased during the Covid-19 pandemic.
300
A nurse is caring for an adolescent client who was sexually assaulted. The client is having difficulty remembering events related to the assault. Which of the following is the client likely experiencing?
A. Dissociative amnesia
B. Depersonalization/derealization
C. Factitious disorder
A. With dissociative amnesia, the client would be unable to recall events related to their history in a way that is not consistent with ordinary forgetfulness.
400
A nurse is describing cognitive therapy to a new nurse. Which of the following is the correct explanation as to how cognitive therapy works?
A."Cognitive therapy is based on the concept that problems can begin in the past and are guided by what is currently occurring with the patient."
B."Cognitive therapy is based on the concept that problems are based on a person's childhood and guides their reaction in the present."
C. "Cognitive therapy is based on the concept that all problems are based on the client's current state."
A. Cognitive therapy is based on the concept that problems can be based or initially begin in a person's past but are guided and maintained by what is going on in the present.
https://www.aafp.org/pubs/afp/issues/2006/0101/p83.html
400
A nurse is discussing mental health parity and policy with a newly licensed nurse. Which of the following statements should the nurse include in the discussion about the Mental Health Parity and Addiction Equity Act?
A. The act requires that there is insurance coverage for mental health conditions.
B. The act requires that all employers offer mental health coverage regardless of the type of insurance.
C. The act requires that all insurance plans cover 100% of mental illness hospitalizations.
A. MHPAEA requires MH conditions be covered by insurance.
400
A nurse on a mental health unit is discussing the concepts of competency and capacity with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the concepts?
A. "Capacity and competency are the same thing and can be used interchangeably."
B. "A client who has been deemed legally incompetent can provide informed consent for treatment."
C. "Competency and capacity are often discussed as being the same thing, but they are different."
C. While often used interchangeably, competency and capacity are two distinct concepts. Capacity is a client's ability to comprehend information, use rational thought processing, communicate their wishes, and understand consequences of their choices. Competence is a legal term and can only be determined following a hearing where a judge reviews evidence concerning the client's condition.
400
A nurse is caring for a client who has psychosis and is prescribed chlorpromazine. The client reports feelings of restlessness. The nurse should identify that the client should be monitored for which of the following adverse effects?
A. Suicidal ideation
B. Shuffling walk
C. Abnormal movements of the tongue and face
A. The nurse should identify that chlorpromazine is a first-generation antipsychotic (FGA) that can cause akathisia, or feelings of restlessness not relieved by movement. Clients can develop suicidal ideation when experiencing akathisia.
400
A nurse is speaking with the parent of a client who is experiencing manifestations of psychosis. The parent states, "I don't understand how a child can experience psychosis." Which of the following responses should the nurse make?
A. "Psychosis may be experienced when an individual has excessive amounts of glutamate in the brain."
B. "Low levels of acetylcholine in the brain may cause manifestations of psychosis."
C. "Recreational drugs that block histamine receptors cause manifestations of psychosis."
A. Glutamate
The nurse should identify that high levels of glutamate could serve as a precursor for an individual developing manifestations of psychosis.
400
A nurse is assessing a client who is experiencing grief. The nurse should identify which of the following findings as an indication that the client has developed clinical depression?
A. Loss of appetite
B. Loss of interest in pleasurable activities
C. Has intense moments of sadness
B. Manifestations of clinical depression include prolonged or marked functional impairment, fixed emotions (low mood), and anhedonia.
400
A nurse is reviewing assessment findings for a 9-year-old child whose family home was destroyed in a wildfire. The nurse should identify that which of the following behaviors is related to the traumatic experience?
A. The child is found making small fires in the backyard.
B. The child is rude to their siblings when things do not go their way.
C. The child insists on having their own way when playing with friends.
A. Children often reenact trauma through play; this is a clinical manifestation of trauma. The parents should seek follow-up care and further education on clinical manifestations of trauma.
400
A nurse is caring for a client who describes extreme fear of having or acquiring a disease. The client is also exhibiting behaviors like repeated body checking. The nurse should identify that the client is exhibiting manifestations of which of the following disorders?
A. Factitious disorder
B. Somatic symptom disorder
C. Illness anxiety disorder
C. Illness anxiety disorder, previously called hypochondriasis, occurs when a client experiences constant thoughts and worry about having an illness.
500
A nurse is caring for a group of children. Give an example of a child (to include age estimate) who is in Piaget's sensorimotor stage of development?
A 9-month-old child who cries when they are hungry
Rational: The first stage, called sensorimotor, is based on fulfilling a child's basic needs and comfort needs.
500
A nurse is discussing the diathesis-stress model with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the model?
A."The diathesis-stress model assists the client in identifying their level of stress or anxiety."
B. "The diathesis-stress model assists in telling me how stressed a client is."
C. "The diathesis-stress model assists in identifying risk factors or vulnerabilities for stress."
C. A person's predisposition, which can be related to stress or illness, can be viewed as a vulnerability. Those who have a vulnerability are more likely to have maladjustment to stress.
500
A nurse on a mental health unit is reviewing the Code of Ethics for Nurses. Which of the following are examples of the provisions that help guide nurses throughout their practice?
Give Two Examples
Nurses should practice with compassion and respect is correct. Nurses should respect clients who have a mental illness and their families. The nurse should avoid labeling and making derogatory remarks.
A nurse's primary commitment should be to the client is correct. Nurses should honor a client's decisions regarding treatment and non treatment, and support clients in their decision-making process.
Nurses are responsible for taking action to support social justice is correct. Nurses in the mental health setting should seek to improves access to mental health services.
Nurses should support and establish an ethical environment is correct. Nurses should strive to improve ethical practice in the workplace while ensuring the work setting is conducive to safe and quality care.
500
A nurse is reviewing laboratory results for a client and notes a serum lithium level of 1.6 mEq/L. Which of the following manifestations should the nurse expect the client to report?
A. Blurred vision and jerking motor movements
B. GI discomfort and poor coordination
C. Fever and fluctuating blood pressure
B. GI discomfort and poor coordination are associated with early lithium toxicity, at a level of 1.5 to 2.0 mEq/L.
Blurred vision and jerking motor movements are associated with advanced lithium toxicity levels of 2.0 to 2.5 mEq/L.
500
A nurse is preparing a presentation on neurotransmission. Which of the following statements about the neurotransmitter histamine should the nurse include?
A. "Histamine is responsible for affective and cognitive functioning."
B. Histamine is essential to sleep and muscle functioning."
C. "Histamine is partially responsible for level of consciousness."
C. The nurse should identify that histamine regulates the release of histamine, glutamate, serotonin, and gamma amino butyric acid (GABA), which have an effect on alertness and wakefulness.
500
500
A nurse is caring for a client who has posttraumatic stress disorder (PTSD). The nurse anticipates the provider might prescribe which of the following medications?
A. Tramadol
B. Zaleplon
C. Paroxetine
C. The first treatment for PTSD is a selective serotonin reuptake inhibitor (SSRI), such as paroxetine.
500
A nurse is reviewing the medical record of a client who reports severe pain in their head and abdomen. The client's blood toxicology test reveals ingestion of a common insect poison. The client states, "I like to feel like I am the center of a TV show medical drama. That is why I took the poison." The client denies suicidal intent or ideation. Which of the following disorders best describes the client's condition?
Factitious disorder
This behavior is indicative of factitious disorder, whereby a person consciously pretends to be ill or acts in a way to intentionally cause illness or injury. This disorder was previously known as Munchausen syndrome.