Mental Health & Culture
A nurse is assessing a client’s overall mental wellness. Which statement made by the client best reflects positive mental health?
A. “I try to avoid stress because I can’t handle it well.”
B. “I set goals for myself and adjust them when needed.”
C. “I often feel overwhelmed and unable to complete daily tasks.”
D. “I rarely talk about my feelings because it makes me uncomfortable.”
B. “I set goals for myself and adjust them when needed.”
Mental health is defined as a state of well‑being in which a person reaches their potential, copes with normal stressors, works productively, and contributes to the community.
Setting realistic goals and adapting to challenges reflects traits of a mentally healthy individual, including rational thinking, resilience, emotional growth, and healthy self‑esteem.
Which of the following is a boundary violation on the part of the Mental Health Nurse?
A. Accepting a box of candy to be shared by staff
B. Finding a pt attractive
C. Holding the hand of a frightened pt
D. Telling a pt about breaking up with a fiancé
D. Telling a pt about breaking up with a fiancé
When a PMHRN has difficulty setting limits on a pts behavior bc of an emotional response to a pt, this is an example of?
A. Transference
B. Countertransference
C. Magnification
D. Codependency
B. Countertransference
A nurse is teaching a client about the diathesis–stress model of mental illness. Which statement by the client shows correct understanding?
A. “Mental illness only develops when someone experiences extreme stress.”
B. “If I have a genetic vulnerability, stress can increase my risk of developing a mental illness.”
C. “Stress alone is enough to cause a mental illness in anyone.”
D. “If mental illness runs in my family, stress won’t affect me.”
B. “If I have a genetic vulnerability, stress can increase my risk of developing a mental illness.”
The diathesis–stress model explains that mental illness results from the interaction between a biological predisposition (diathesis) and environmental stress.
True or false?
Many medical illnesses can mimic mental illness
True
NEED TO RULE OUT MEDICAL ILLNESS FIRST
A nurse is educating a group of students about mental illness. Which statement indicates a correct understanding?
A. “Mental illness only occurs when someone experiences severe stress.”
B. “A mental illness involves significant dysfunction in thinking, emotions, or behavior that interferes with daily functioning.”
C. “Mental illness is diagnosed based solely on the client’s self‑report of symptoms.”
D. “Mental illness is always caused by a biological disorder.”
B. “A mental illness involves significant dysfunction in thinking, emotions, or behavior that interferes with daily functioning.”
Mental illness is defined as significant dysfunction in mental functioning, affecting thoughts, emotions, behaviors, and the ability to perform daily activities. It may arise from developmental, biological, or physiological factors, often triggered by stress, and requires meeting DSM‑5 diagnostic criteria. The diathesis‑stress model explains that both predisposition and environmental stress contribute.
During which stage of the therapeutic relationship does the nurse examine personal feelings about working with a pt?
A. Pre-interaction
B. Orientation
C. Working
D. Termination
A. Pre-interaction
A pt is upset that he hasn’t been able to complete a task successfully. Which of the following is an example of a non-therapeutic communication response?
A. I don’t think you need to worry about that
B. You re feeling frustrated
C. Perhaps we can work on this together
D. Lets talk about how you are feeling
A. I don’t think you need to worry about that
A nurse is meeting a client for the first time in an outpatient mental health clinic. Which action by the nurse is most appropriate during the orientation phase of the therapeutic relationship?
A. Assisting the client in developing new coping strategies for anxiety.
B. Reviewing the goals of the relationship and discussing when the relationship will end.
C. Encouraging the client to explore past trauma in depth.
D. Evaluating the client’s progress toward previously established goals.
B. Reviewing the goals of the relationship and discussing when the relationship will end.
During the orientation phase, the nurse and client:
Establish rapport
Clarify the parameters of the relationship
Create a formal or informal contract
Discuss the terms of termination from the beginning
Options A and C occur later in the working phase. Option D occurs in the termination phase.
A nurse is reviewing neurotransmitter function with a group of nursing students. Which statement made by a student indicates a need for further teaching?
A. “Low serotonin levels are associated with depression and can affect mood and appetite.”
B. “High dopamine levels are linked to symptoms of schizophrenia such as hallucinations.”
C. “Low GABA levels can contribute to increased anxiety and sleep disturbances.”
D. “High norepinephrine levels are responsible for depression and low energy.”
D is incorrect teaching. Depression is associated with low norepinephrine, not high. Norepinephrine regulates mood, alertness, concentration, and energy.
A is correct: Serotonin regulates mood, anxiety, and appetite, and low levels are seen in depression, bipolar disorder, and schizophrenia.
B is correct: Excess dopamine is linked to schizophrenia and affects motivation, reward, attention, and mood.
C is correct: Low GABA contributes to anxiety and affects sleep regulation.
The cultural group in the US that is most likely to attribute a psychiatric disease to a medical illness rather than a mental illness is?
A. African Americans
B. Native Americans
C. Asian Americans
D. Latinos
D. Latinos
A patient’s unresolved feelings related to loss would be most likely observed during which phase of the therapeutic nurse-patient relationship?
A. Pre-Orientation
B. Working
C. Orientation
D. Termination
D. Termination
In the termination phase, the relationship comes to a close. Ending treatment sometimes may be traumatic for patients who have come to value the relationship and the help. Because loss is an issue, any unresolved feelings related to loss may resurface during this phase.
A pt has undergone Electroconvulsive therapy (ECT) and is awakening from anesthesia. The initial pt response that is most expected is?
A. Sedation
B. Memory impairment
C. Agitation
D. Anger
B. Memory impairment
ECT works by triggering a controlled seizure.
Most people experience:
Trouble remembering conversations from the past few days
Forgetting what happened earlier the same day
Difficulty learning new information right after a session
These issues usually improve over days to weeks.
A nurse is caring for four clients. According to Maslow’s hierarchy of needs, which client should the nurse assess first?
A. A client who reports feeling lonely and states, “I don’t think anyone cares about me.”
B. A client who is anxious about starting a new job next week.
C. A client who has not voided in 12 hours and reports lower abdominal discomfort.
D. A client who says, “I don’t feel respected by my family anymore.”
C reflects a physiological need (urinary elimination), which must be addressed before safety, love/belonging, esteem, or self‑actualization.
Maslow’s hierarchy prioritizes physiological needs first, because they are essential for survival.
A reflects love/belonging needs.
B reflects safety or psychological security needs.
D reflects esteem needs.
Lower‑level needs must be met before higher‑level needs can be addressed.
A nurse is planning interventions for clients in a community mental health program. Which intervention is an example of primary prevention?
A. Teaching high school students how to manage stress and identify bullying behaviors.
B. Monitoring medication adherence for a client diagnosed with major depressive disorder.
C. Providing crisis stabilization for a client experiencing suicidal ideation.
D. Assisting a client with schizophrenia to return to their baseline functioning after a relapse.
A. Teaching high school students how to manage stress and identify bullying behaviors.
Primary prevention focuses on preventing mental illness before it occurs, such as teaching stress management, coping skills, and bullying prevention.
B is secondary prevention because the client already has a diagnosable illness and the goal is to minimize symptoms.
C and D are tertiary prevention, which involves caring for clients at their sickest point, preventing fatal outcomes, and helping them return to baseline functioning.
An Asian American adolescent is to be discharged from a psychiatric unit after a psychotic episode, but the parents who are immigrants from China are adamant that the pt cannot receive any out pt tx or follow up care, stating that his illness was caused by an infection. The probable reason for this is?
A. They are unfamiliar with Western tx for mental illness
B. They have poor language skills and misunderstand the dx
C. They have low health literacy
D. They are ashamed their child has a psychiatric condition
D. They are ashamed their child has a psychiatric condition
(Asian cultures believe that psychiatric illness is caused by poor behavior and it brings shame on the pt and family)
On the psychiatric unit, pts are rewarded for desired behaviors by receiving tokens that can be exchanged for privileges. This technique is used in?
A. Behavioral Therapy
B. Psychoanalytic therapy
C. Cognitive therapy
D. DBT Dialectical Behavioral therapy
A. Behavioral Therapy (Based on the idea that behavior is learned and can be unlearned or modified through structured interventions, Uses techniques like reinforcement, conditioning, exposure, and skills training.
Psychoanalytic Therapy (Rooted in Freud’s work and emphasizes unconscious conflicts, early childhood experiences, and internal drives.Uses techniques like free association, dream analysis, and exploring transference).
Cognitive Therapy (Developed by Aaron Beck; focuses on how thoughts influence emotions and behavior. Helps clients identify and challenge distorted or unhelpful thinking patterns).
DBT(reated for people with intense emotions or chronic instability.Teaches four core skill sets: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.)
A pt with severe tx resistant depression has had a device implanted in the chest wall for vagus nerve stimulation. When educating the pt about the tx the RN tells the pt to expect improvement in symptoms?
A. Almost immediately
B. Within a few days
C. Within a few weeks
D. Within a few months
D. Within a few months
-up to 9 mos it’s a slow progression.
Vagus nerve stimulation sends controlled electrical pulses to the vagus nerve, which then influences brain circuits involved in mood, seizures, and motor function. It can be done with an implanted device or a non‑invasive external stimulator.
Increase neurotransmitters like serotonin and norepinephrine (helpful for depression)
A client with severe, treatment‑resistant major depressive disorder is scheduled to undergo deep brain stimulation (DBS). Which statement by the client indicates a need for further teaching?
A. “This treatment targets specific areas of my brain involved in mood regulation.”
B. “I will still need ongoing therapy and medication even after the device is implanted.”
C. “I should avoid MRI machines unless my provider confirms it’s safe with my device.”
D. “This procedure will immediately cure my depression once the device is turned on.”
D. DBS does not provide an immediate cure for depression.
Mood improvement is gradual, often taking weeks to months as the device is adjusted.
Depression may still require medication and psychotherapy.
A, B, and C are correct statements:
DBS targets brain regions involved in mood.
Clients typically continue antidepressants and therapy.
Strong magnets (MRI) can interfere with the device unless specific safety protocols are followed.
A client with major depressive disorder has been prescribed fluoxetine. Which statement by the client indicates a need for further teaching?
A. “I know this medication may take several weeks before I start feeling better.”
B. “If I suddenly feel a big burst of energy or happiness, I should let my provider know.”
C. “It’s important that I take this medication every day, even if I start to feel better.”
D. “This medication will improve my depression within the next 24 to 48 hours.”
D is incorrect teaching. SSRIs take 4–6 weeks to reach full therapeutic effect. Early in treatment, clients are at increased suicide risk because energy may improve before mood does.
A is correct: SSRIs require several weeks to work.
B is correct: A sudden lifting of anhedonia or unexpected happiness can signal increased suicide risk and must be reported.
C is correct: Medication adherence is essential for therapeutic effect and relapse prevention.
The RN has accepted a position in an area with a large Native American population. The RN expects that native Americans are?
A. Comfortable being touched by healthcare providers
B. Comfortable with small personal space
C. Comfortable with direct eye contact
D. Comfortable with silence during conversation
D. Comfortable with silence during conversation
A pt has a severe phobia about heights and is unwilling to fly in an airplane or to ascend beyond the ground floor or a building. The most effective treatment approach is likely?
A. Aversion Therapy
B. Mindfulness meditation
C. Exposure therapy
D. Operant Conditioning
C. Exposure Therapy
(form of systemic desensitization, reduces fear by gradually exposing pt to the feared situation which decreases emotional response over time)
During times of Vagus Nerve Stimulation pts can expect to experience the following side effects? Select all that apply.
A. Hoarseness
B.Cough
C. Paresthesia
D. Dyspnea
E. Diaphoresis
A. Hoarseness
B. Cough
C. Paresthesia (pins and needles)
D. Dyspnea (SOB)
A client with treatment‑resistant depression is scheduled to begin repetitive transcranial magnetic stimulation (rTMS). Which statement by the client indicates a need for further teaching?
A. “I might feel a tapping sensation on my scalp during the procedure.”
B. “I will need someone to drive me home because I’ll be sedated afterward.”
C. “I may have a mild headache after the session.”
D. “The procedure is done while I’m awake and doesn’t require anesthesia.”
B. “I will need someone to drive me home because I’ll be sedated afterward.”
rTMS does not require sedation or anesthesia. Clients remain fully awake and alert, and they can safely drive themselves afterward.
A, C, and D are accurate statements:
A tapping or knocking sensation is expected.
Mild headache or scalp discomfort is common.
The procedure is noninvasive and performed without anesthesia.
A client prescribed phenelzine for major depressive disorder is reviewing dietary instructions. Which statement by the client indicates a need for further teaching?
A. “I will avoid foods like aged cheese and cured meats while taking this medication.”
B. “Drinking beer or red wine could be dangerous for me now.”
C. “I can still eat chocolate as long as I only have a small amount.”
D. “If I eat foods high in tyramine, I could have a severe increase in blood pressure.”
C is incorrect teaching. Clients taking MAOIs must avoid all tyramine‑containing foods, including chocolate, because they can trigger a hypertensive crisis, which can be fatal.
A is correct: Aged cheese and cured meats contain tyramine.
B is correct: Beer and chianti/red wine are high in tyramine.
D is correct: Tyramine + MAOIs = hypertensive crisis, a medical emergency.