Psychiatric and Mental Health Nursing D449
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Free Psychiatric and Mental Health Nursing D449 Questions
A client with a major depressive disorder is admitted to the inpatient psychiatric unit. Which intervention should the nurse use to demonstrate support of the client?
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Incorporate animated communication techniques.
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Recommend journaling and time taken in self-reflection.
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Assist the client to identify symptoms of depression.
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Schedule regular periods of time for interaction with client.
Explanation
Explanation
Clients with major depression often feel isolated and may lack motivation to initiate social interaction. Scheduling consistent, brief interactions demonstrates availability, support, and interest from the nurse. Regular contact helps build trust and encourages the client to engage in communication and therapeutic relationships.Correct Answer Is:
D. Schedule regular periods of time for interaction with client.A client is admitted to the mental health unit and sits in the corner of the day room. When the nurse begins the admission assessment interview, the client is guarded, suspicious, and resists talking. Which action should the nurse implement?
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Document the client's paranoid behavior.
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Ask another nurse to talk with the client.
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Postpone the client interview until the next day.
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Attempt to ask the client simple questions.
Explanation
Explanation
When a client appears guarded and suspicious, the nurse should use simple, nonthreatening communication to build trust and encourage interaction. Asking simple questions allows the client to respond at their comfort level and helps establish rapport. Postponing the interview or transferring responsibility to another nurse does not promote therapeutic communication, and documentation alone does not address the client's immediate needs.Correct Answer Is:
D. Attempt to ask the client simple questions.A nurse who is co-leading group therapy recognizes that a client is beginning to experience severe levels of anxiety. Which intervention is best for the nurse to implement?
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Assist the client with relaxation techniques in the group.
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Escort the client from the group to reduce stimuli.
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Provide education about ways to cope with anxiety.
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Ask the client to describe and identify the source of the feelings.
Explanation
Explanation
When a client reaches severe anxiety levels, the ability to concentrate and process information decreases significantly. Reducing environmental stimuli helps lower anxiety and regain emotional control. Escorting the client to a quieter area allows the nurse to provide support while minimizing overstimulation from the group setting.Correct Answer Is:
B. Escort the client from the group to reduce stimuli.The mother of an infant with profound mental and physical disabilities tells the nurse how depressed she is because she realizes that her child will never achieve normal growth and development milestones. How should the nurse respond to this mother?
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Encourage the mother to write thoughts and feelings in a journal.
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Reassure the mother that her child will achieve some growth and development milestones.
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Ask the mother if she has ever thought about harming herself or her child.
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Determine if the mother has other children who do not have developmental disabilities.
Explanation
Explanation
When a client expresses severe depression or distress, the priority is to assess for risk of harm to self or others. Directly asking about thoughts of harming herself or her child helps determine safety risks and allows the nurse to intervene promptly if needed.Correct Answer Is:
C. Ask the mother if she has ever thought about harming herself or her child.A client who has agoraphobia (a fear of crowds) is beginning desensitization with the therapist, and the nurse is reinforcing the process. Which intervention has the highest priority for this client's plan of care?
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Encourage deep breathing when anxiety escalates in a crowd.
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Establish trust by providing a calm, safe environment.
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Encourage substitution of positive thoughts for negative ones.
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Progressively expose the client to larger crowds.
Explanation
Explanation
Establishing a calm and safe environment is the priority because clients with severe anxiety or phobias need to feel secure before engaging in therapeutic interventions. Building trust helps reduce anxiety and increases the client's willingness to participate in treatments such as desensitization and gradual exposure.Correct Answer Is:
B. Establish trust by providing a calm, safe environment.The nurse is teaching a client about the initiation of a prescribed abstinence therapy using disulfiram. Which information should the client provide to acknowledge understanding?
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Completely abstain from heroin or cocaine use.
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Admit to others that he is a substance abuser.
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Attend monthly meetings of Alcoholics Anonymous.
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Remain alcohol free for 12 hours prior to the first dose.
Explanation
Explanation
Disulfiram is used to support abstinence in individuals with alcohol use disorder. Alcohol must be avoided before starting the medication because combining disulfiram with alcohol can cause a severe reaction, including flushing, nausea, vomiting, and hypotension. Clients should remain alcohol free for at least 12 hours before the first dose.Correct Answer Is:
D. Remain alcohol free for 12 hours prior to the first dose.During a one-to-one session, the nurse begins to become angry with the client. Which action should the nurse take?
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Terminate the session before the feelings escalate.
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Resolve the feelings with the client after discharge.
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Share similar experiences the nurse has had in the past.
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Identify the client's transference of feelings of annoyance.
Explanation
Explanation
When a nurse begins to experience strong emotions toward a client, this reflects countertransference. The appropriate action is to stop the interaction before the feelings interfere with therapeutic communication. Ending the session allows the nurse to regain emotional control and maintain professional boundaries, preventing harm to the therapeutic relationship.Correct Answer Is:
A. Terminate the session before the feelings escalate.An adolescent who was arrested a month ago for gang-related activities has a court order to attend weekly group therapy sessions at the mental health clinic. Today the adolescent’s mother calls the clinic nurse to report that her child became angry last night and put a fist through a window. Which intervention is most important for the nurse to implement?
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Tell the mother to describe her feelings of helplessness to her child.
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Advise the mother to call the police if violent behavior occurs again.
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Refer the mother for psychiatric evaluation for anxiety and depression.
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Reinforce the need for the adolescent to attend group therapy sessions.
Explanation
Explanation
The adolescent has been ordered by the court to attend therapy to address behavioral problems and aggression. Reinforcing the importance of attending these sessions helps ensure the client receives ongoing treatment aimed at improving behavior and coping skills. Continued participation in therapy is essential for managing anger and preventing further violent behavior.Correct Answer Is:
D. Reinforce the need for the adolescent to attend group therapy sessions.A client with bipolar disorder tells the nurse about the need to make some deals to improve a retirement savings. Based on this information, which client outcome should the nurse include in the care?
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Seek legal counsel when making business decisions.
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Identify the feelings associated with the behavior.
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Delay business decisions until mania subsides.
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Describe feelings of fear about finances.
Explanation
Explanation
Clients experiencing mania often demonstrate poor judgment, impulsive decision-making, and excessive involvement in risky financial activities. Encouraging the client to delay important financial or business decisions until mood stabilization occurs helps prevent harmful consequences and supports safer decision-making.Correct Answer Is:
C. Delay business decisions until mania subsides.The charge nurse of the psychiatric unit observes clients in the day area. Which client is exhibiting symptoms of a conversion disorder?
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An adolescent who becomes extremely anxious about going outside.
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A middle-aged man who is troubled with shortness of breath and is diaphoretic.
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An older adult who is continuously troubled by a headache and back pain.
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A young woman who suddenly goes blind with no indication of organic pathology.
Explanation
Explanation
Conversion disorder involves neurological symptoms that cannot be explained by a medical condition. These symptoms may include blindness, paralysis, or loss of sensation without an identifiable physical cause. Sudden blindness without organic pathology is a classic example of conversion disorder, where psychological stress manifests as physical symptoms.Correct Answer Is:
D. A young woman who suddenly goes blind with no indication of organic pathology.How to Order
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