NUR256 Mental Health Theory and Application Exam 4

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Ace Your Test with NUR256 Mental Health Theory and Application Exam 4 Actual Questions and Solutions - Full Set

Free NUR256 Mental Health Theory and Application Exam 4 Questions

1.

The nurse is caring for an adolescent client with an eating disorder. The treatment team calls for a family meeting, however the family becomes defensive. Which reply is the most therapeutic response?

  • "All clients are required to participate in two family sessions."

  • "Family dynamics are not linked to eating disorders. The meeting is to provide your child with family support."

  • "Family intervention and support are important in your child's recovery."

  • "Clients with eating disorders are part of the family system. Any alteration in family processes needs to be addressed."

Explanation

Explanation
Correct Answer:
(C) "Family intervention and support are important in your child's recovery." This response is therapeutic because it is honest, supportive, and non-blaming — it emphasizes the family's important role in the recovery process without accusing them of causing the disorder, which helps reduce defensiveness.
Why the other options are incorrect:
A. "All clients are required to participate in two family sessions." This is a rigid, policy-focused statement that does not address the family's emotional defensiveness or explain the therapeutic value of the meeting.
B. "Family dynamics are not linked to eating disorders. The meeting is to provide your child with family support." This statement is inaccurate, since family dynamics can play a role in eating disorders, and making an absolute claim like this could undermine trust in the nurse's expertise.
D. "Clients with eating disorders are part of the family system. Any alteration in family processes needs to be addressed." This statement is likely to increase the family's defensiveness, as it implies blame by suggesting the family system itself needs to be "altered."
2.

The nurse is discussing conduct disorder with the parent of a 12-year-old child who has been recently diagnosed. Which statement by the parent indicates understanding of the disorder?

  • "My child will grow out of this behavior once they reach adulthood, so treatment isn't necessary."

  • "As long as my child performs well in school, I don't need to address their behavior problems at home."

  • "Medication alone will cure my child's conduct disorder without the need for therapy."

  • "Early treatment and consistent structure at home can help improve my child's behavior."

Explanation

Explanation
Correct Answer:
(D) "Early treatment and consistent structure at home can help improve my child's behavior." This statement accurately reflects evidence-based understanding that early intervention combined with consistent structure and behavioral strategies at home are key components in improving outcomes for children with conduct disorder.
Why the other options are incorrect:
A. "My child will grow out of this behavior once they reach adulthood, so treatment isn't necessary." This is inaccurate; without treatment, conduct disorder can persist and even progress into antisocial personality disorder in adulthood, so intervention is necessary.
B. "As long as my child performs well in school, I don't need to address their behavior problems at home." This is incorrect; behavior problems at home still require intervention regardless of academic performance, as conduct disorder affects multiple areas of functioning.
C. "Medication alone will cure my child's conduct disorder without the need for therapy." This is inaccurate; conduct disorder is primarily treated with behavioral therapy and family interventions, not medication alone, as there is no medication that "cures" this disorder.
3.

The nurse teaches adolescent clients at a school about health promotion for purging type bulimia. The nurse should know to include teaching on which of the following?

  • Opioid Use Disorder and the effects on family structure.

  • Cyberbullying and the effects on the adolescent life.

  • Avenues for seeking assistance on dealing with peer pressure.

  • Additional ways that clients can feel in control of life.

Explanation

Explanation
Correct Answer:
(D) Additional ways that clients can feel in control of life. Purging behaviors in bulimia nervosa are often driven by an underlying need to gain a sense of control; teaching healthier alternative ways to achieve feelings of control directly addresses this psychological root cause and supports healthier coping strategies.
Why the other options are incorrect:
A. Opioid Use Disorder and the effects on family structure. This is unrelated to the core psychological drivers of purging-type bulimia and is not a relevant focus for this health promotion teaching.
B. Cyberbullying and the effects on the adolescent life. While cyberbullying can be a general adolescent stressor, it is not the most directly relevant topic tied to the core issue of purging behavior and control that should be prioritized in this teaching.
C. Avenues for seeking assistance on dealing with peer pressure. Peer pressure is a general adolescent concern but does not directly address the specific psychological need for control that drives purging behaviors in bulimia.
4.

A client with anorexia nervosa has just been admitted to a psychiatric facility that uses a system based on behavioral modification. The client is concerned about not having the privilege of using their cell phone. What is the best response by the nurse?

  • "You need to stop worrying about your cell phone and worry about getting well instead."

  • "Clients regain access to their cell phone once they have been here a minimum of one week."

  • "As you meet your weight gain goals, you may regain cell phone privileges."

  • "You need to realize that your own actions caused you to lose access to your cell phone."

Explanation

Explanation
Correct Answer:
C
Why the other options are incorrect:
A. "You need to stop worrying about your cell phone and worry about getting well instead." This dismisses the client's concern rather than explaining the therapeutic rationale of the program, and it does not answer the client's question.
B. "Clients regain access to their cell phone once they have been here a minimum of one week." This ties privilege restoration to an arbitrary timeframe rather than to the client's actual behavioral/treatment progress, which contradicts the purpose of a behavior modification system.
D. "You need to realize that your own actions caused you to lose access to your cell phone." This is a judgmental, blaming statement that does not support a therapeutic nurse-client relationship.
5.

What should the nurse understand about an adolescent with Tourette's disorder who suppresses their tics during a group therapy session?

  • This is manipulative behavior and should not be allowed.

  • The client may need 'tic time' privately after the session to vent the tics, feelings, and behaviors.

  • This is not possible and may indicate the child is faking the disorder.

  • Tics are usually much better during periods of acute stress. As long as the session is stressful, suppression should be easy.

Explanation

Explanation
Correct Answer:
(B) The client may need 'tic time' privately after the session to vent the tics, feelings, and behaviors. Clients with Tourette's disorder can often voluntarily suppress tics for a period of time (such as during a structured social situation like group therapy), but this suppression requires significant effort and is typically followed by a rebound increase in tics once the client is in a private, safe space to release them.
Why the other options are incorrect:
A. This is manipulative behavior and should not be allowed. This is incorrect and reflects a misunderstanding of the disorder; tic suppression is a genuine, effortful neurological coping mechanism, not manipulation.
C. This is not possible and may indicate the child is faking the disorder. This is factually incorrect; temporary voluntary tic suppression is a well-documented, real phenomenon in Tourette's disorder and does not indicate the child is faking symptoms.
D. Tics are usually much better during periods of acute stress. As long as the session is stressful, suppression should be easy. This is inaccurate; tics are typically worsened, not improved, by stress and anxiety, making this statement physiologically incorrect.
6.

A 10-year-old child with Tourette's disorder is struggling with severe motor tics that interfere with daily functioning. The nurse should expect the health care provider to prescribe which medication?

  • Sertraline

  • Lorazepam

  • Haloperidol

  • Methylphenidate

Explanation

Explanation
Correct Answer:
C
Why the other options are incorrect:
A. Sertraline. This SSRI is used to treat co-occurring anxiety or obsessive-compulsive symptoms in Tourette's disorder, but it is not effective for treating the motor tics themselves.
B. Lorazepam. This benzodiazepine is used for anxiety or acute agitation, but it is not a standard or effective treatment for tic suppression in Tourette's disorder.
D. Methylphenidate. This CNS stimulant, used to treat co-occurring ADHD, can actually exacerbate or worsen tics in some clients with Tourette's disorder, making it an inappropriate choice here.
7.

Which assessment finding for a client diagnosed with an eating disorder meets criteria for hospitalization?

Normal Reference Ranges: Potassium: 3.5–5.0 mEq/L

  • Serum potassium 3.4 mEq/L

  • Pulse rate 58 beats/min

  • Systolic blood pressure 62 mmHg

  • Urine output 40 mL/hr

Explanation

Explanation
Correct Answer:
(C) Systolic blood pressure 62 mmHg. Severe hypotension (systolic BP below approximately 70–80 mmHg or with hemodynamic instability) is a life-threatening finding indicating cardiovascular compromise from starvation, and it meets criteria for immediate hospitalization to prevent cardiac collapse.
Why the other options are incorrect:
A. Serum potassium 3.4 mEq/L. This value is only very slightly below the normal range (3.5–5.0 mEq/L) and, while it should be monitored, does not by itself represent the critical, immediately life-threatening abnormality that mandates hospitalization.
B. Pulse rate 58 beats/min. Mild bradycardia is common in eating disorders due to the body's adaptive response to malnutrition; hospitalization criteria typically require more severe bradycardia (e.g., below 40–50 beats/min).
D. Urine output 40 mL/hr. A urine output of 40 mL/hr is within an acceptable range (generally at or above 30 mL/hr is considered adequate), so this finding does not indicate a crisis requiring hospitalization.
8.

The nurse is assessing an adolescent client diagnosed with anorexia nervosa. The client is 165 cm (65 in) tall and weighs 40.8 kg (90 lb), with a BMI of 14.9. Which statement by the client is consistent with this disorder?

  • "I still need to lose more weight to look the way I want."

  • "I eat when I feel hungry, but I just get full really quickly."

  • "I don't worry too much about how I look or what I eat."

  • "My parents are overreacting; my weight is perfectly healthy."

Explanation

Explanation
Correct Answer:
A
Why the other options are incorrect:
B. "I eat when I feel hungry, but I just get full really quickly." This statement does not reflect the intentional restriction and body image distortion characteristic of anorexia nervosa; it suggests a more normal relationship with hunger cues.
C. "I don't worry too much about how I look or what I eat." This is inconsistent with anorexia nervosa, which involves a preoccupation with food, weight, and body image, not indifference toward them.
D. "My parents are overreacting; my weight is perfectly healthy." While denial can occur in anorexia nervosa, this statement lacks the specific hallmark feature of body image distortion and desire for further weight loss seen in option A, making A the better representation of the core diagnostic feature.
9.

The nurse is educating a group of parents about adolescent depression. Which statement should the nurse include in the education?

  • "Social isolation is uncommon in teenagers with depression."

  • "Adolescents with depression rarely experience academic difficulties."

  • "Depression in adolescents can sometimes be mistaken for normal mood swings."

  • "Teens with depression will always appear sad or withdrawn."

Explanation

Explanation
Correct Answer:
(C) "Depression in adolescents can sometimes be mistaken for normal mood swings." Adolescent depression can present atypically, with irritability, moodiness, or behavioral changes that overlap with normal developmental mood fluctuations, making it important for parents to understand this so depression is not overlooked or dismissed.
Why the other options are incorrect:
A. "Social isolation is uncommon in teenagers with depression." This is inaccurate; social withdrawal and isolation from friends and family are common signs of adolescent depression.
B. "Adolescents with depression rarely experience academic difficulties." This is inaccurate; declining academic performance is a common and important warning sign of depression in teens.
D. "Teens with depression will always appear sad or withdrawn." This is inaccurate and overly absolute; adolescent depression often presents as irritability, anger, or acting out rather than overt sadness, so it does not always look the same in every teen.
10.

The nurse is preparing to administer ceftriaxone 50 mg/kg/day to a child who weighs 24 kg. The total daily dose will be administered in two equally divided doses. The available concentration is ceftriaxone 250 mg/10 mL. How many mL should the nurse administer per dose? Round the answer to the nearest whole number.

Answer: 24 mL

  • 24 mL

Explanation

Explanation
Correct Answer Is:
24 mL
Total daily dose: 50 mg/kg/day × 24 kg = 1,200 mg/day
Dose per administration: 1,200 mg ÷ 2 doses = 600 mg/dose
Concentration: 250 mg/10 mL = 25 mg/mL
Volume per dose: 600 mg ÷ 25 mg/mL = 24 mL

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