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NURS661 Mental Health Practice Exam With Answers (188 Solved Questions)

Nursing
Walden University
32 pages
Shared May 2025

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NURS 661 Exam 1 The nurse in the community mental health clinic assesses a client and determines the presence of an Axis II diagnosis. What conclusions can the nurse draw? 1. The client is in need of further evaluation. 2. The client has a personality disorder. 3. The client will need a special diet. 4. The client is a candidate for the least restrictive environment. A female client disclosed to the nurse that she is in an abusive situation. This information will be used to contribute to: 1. Axis IV. 2. Axis III. 3. Nothing, since this is confidential information and should not be shared. 4. Axis I. The nurse on the inpatient unit is reviewing the record of a client admitted the previous day, and notes the client has an Axis I diagnosis. What inferenc es can the nurse make about the client? 1. The client has a clinical psychiatric disorder. 2. The client is in need of immediate medical attention. 3. The client has a chronic condition. 4. The client lacks a support system. A client is admitted with the following diagnosis: Axis I: 300.01 Panic disorder without agoraphobia Axis II: 301.83 Borderline personality disorder Axis III: No diagnosis Axis IV: Unemployment What conclusions can the nurse make relative to the clients Axis III information? 1. This client has problems with environment, but they are not related to mental disorder. 2. The client’s environment has not been evaluated. 3. The client’s health status has not been evaluated. 4. The client has no diagnosed physiological health problems r elevant to mental disorder at the time of admission. The school nurse, who must be familiar with mental health issues, will find child clinical disorders classified under: 1. Axis II.
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2. Axis I. 3. Axis X. 4. Axis VII. Answer: 2 After interviewing a client for admission, the nurse gives the client a score of 50 on the Global Assessment of Functioning Scale (GAF). The nurse selected this score based on the client’s level of functioning: 1. Since being given a psychiatric diagnosis . 2. Within the past week. 3. Since beginning the psychotropic medication. 4. Within the past year. Select the priority nursing diagnosis for a client with a Global Assessment of Functioning (GAF) score of 10. 1. Risk for Impaired Social Interaction 2. Risk for Injury 3. Knowledge Deficit 4. Risk for Communication Deficit The psychiatric home health nurse is evaluating whether a client’s level of functioning has improved since starting the prescribed psychotropic medication. What evidence does the nurse look for? 1. There is no change in the GAF score. 2. There is a significant decrease (by 10 or more points) in the clients GAF score. 3 . The client no longer qualifies for a GAF score. 4. There is an increase in the clients GAF score. The nurse is documenting observations of client interactions during a group session. The nurse strives to document the behaviors of the client interactions with: 1. Objectivity. 2. Serendipity. 3. Sympathy. 4. Empathy. The nurse is validating what was observed before documenting in the progress note. Validation is used as a mechanism to ensure which of the following? 1. The clients affect is appropriate t o the situation 2. The client’s perception of the response is communicated 3. The clients request is clarified 4. The clients need for further intervention is understood
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The nurse is developing a plan of care for a client. Which of the following interventions must the nurse be careful to avoid? 1. Discussing expectations with the client 2. Selecting interventions that conflict with the clients value system 3. Identifying the clients perception of the problem 4. Addressing issues related to the clients past experiences The student nurse asks why the nurse is documenting the client’s nonverbal responses in addition to verbal responses during the initial assessment. Which of the following statements made by the nurse reflects the rationale for doc umenting both verbal and nonverbal responses? 1. It is the hospital policy to document both. 2. It is important to be thorough when documenting. 3. Documenting both permits the reader to compare the behaviors for congruence. 4. Charting verbal and nonverbal helps me remain objective. During a group session, the clients are asked to make one positive statement about their home life. The nurse notices that one of the clients begins to fidget in the chair and interprets this behavior as: 1. A form of nonlanguage vocalization. 2. A therapeutic use of space. 3. An expression of discomfort. 4. An excuse to avoid answering the question. During a group session, a client expresses anger at the nurse. The nurse sits tensely with arms and legs crossed while verbally agreeing that the client’s point of view is correct. Which of the following messages is being sent by the nurse? 1. The nurse is expressing warmth toward the client 2. The nurse is being patient 3. The nurse is demonstrating empathy 4. The nurse is sending a mixed message The nurse observed that during a teaching session, the overall emotional tone of a client remained unchanged. The nurse documents this as: 1. Affect that has range. 2. Flat affect. 3. Incongruent verbal and nonverbal responses. 4. Muted behavior. The nurse is working with a teen admitted with a diagnosis of depression. Which of the following interventions demonstrates that the nurse is sensitive to the client’s needs?
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1. Avoiding the use of silence to decrease anxiety 2. Asking for details to demonstrate interest in the client 3. Using closed - ended questions 4. Listening to the clients feelings A working goal for the nurse client relationship is to achieve: 1. Facilitative intimacy. 2. Self - disclosure. 3. In terdependence. 4. Social superficiality During the first interaction with a client, the nurse makes an introduction and identifies the purpose of the interaction. This serves to accomplish which of the following in developing a trusting relationship? 1. Setting goals 2. Building 3. Initiating 4. Maintaining The nurse engaged in a therapeutic relationship with a client uses nonverbal communication to: 1. Enhance verbal messages. 2. Avoid the use of verbal messages. 3. Detract from verbal messages. 4. Terminate the therapeutic relationship. A nurse acknowledges feeling anxious about meeting new people. By acknowledging feelings to the client, the nurse is demonstrating: 1. Sympathy. 2. Genuineness. 3. Empathy. 4. Superficiality. Psychiatricmental hea lth nursing interventions occur at which of the following levels of communication? 1. Public 2. Intrapersonal 3. Interpersonal 4. International
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In planning care for a client who is gaining mental stability, the nurse develops measures to confirm the client’s view of self. Which of the following responses made by the nurse would be categorized as disturbed communication? 1. I do not understand what you are telling me. 2. You are wrong. 3. How might you go about that differently? 4. Do you want to tr y that again? Which of the following communication theories provides the most appropriate rationale for a nursing intervention to utilize the perceived strengths of the client in promoting effective communication? 1. Behavioral Effects and Human Communication Theory 2. Neurolinguistic Programming Theory 3. Theory of Communication Levels 4. Therapeutic Communication Theory Which of the following is not related to the theory of successful versus disturbed communication patterns during an admission assessment? 1. The appropriateness of the content of the message. 2. The quality of the feedback provided. 3. The language level of the assessment nurse. 4. How efficiently the client delivers a message A client asks the nurse about the doctors comment that he may have problems due to delayed synaptic transmission in his brain. The nurse explains that the best way to describe a synaptic transmission is which of the following? 1. An electrochemical process called neurotransmission 2. Where the axon is released 3. When the receptors bind to neurons 4. The space where neurotransmitters match up with receptors A client is admitted to the psychiatric unit exhibiting behaviors indicating a high level of anxiety following a personal crisis. Which of the following communication skills should the nurse utilize when interacting with this client? 1. Closed - ended questions 2. Providing reassurance 3. Open - ended questions 4. Providing the client with advice During a nurse client interaction, the client tells the nurse, I don’t think I can deal with feeling so sad much longer. The nurse’s best response is which of the following?
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1. Is there a history of depression in your family? 2. We all have times of sadness. 3. Are you saying you feel sad? 4. Tell me about your feelings of sadness. While reviewing therapeutic communication techniques, a nursing student made a list of things not to do or say to a client. Which of the following comments should be on the students list? 1. How d o you feel about being discharged today? 2. What happened when you quit taking your medications? 3. What are your concerns about your living situation? 4. Why do you think you will never get well? A client states, I just know my brother will not come back from the war. Which of the following examples would be used to encourage the client to explore this concern? 1. Maybe he will be one of the lucky ones. 2. How do you know this? 3. Where is your brother going? 4. What do you feel will happen to him? Which of the following is an example of clarifying a client’s verbal response? 1. Are you saying you feel the medicine is helping you? 2. See, the medicine does work. 3. I knew it would work; it just takes time. 4. Everything seems to work out eventually. A delusional client walks up to the nurse and says, I am the appointed overseer. Who are you and why are you here? The most therapeutic response is which of the following? 1. I am your nurse and I will be here to help you until suppertime. 2. You don’t know who I am? 3. You know who I am. 4. You are not the overseer; you are a client in the hospital. Which of the following interventions promotes mindful listening in any health care setting? 1. Telling the client to get off the phone 2. Encouraging the family to step outside before assessing the client 3. Turning off the television before interviewing a client 4. Asking clients what they would like to drink when taking medication
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In the immunization clinic, the nurse notices a client dis playing tense body posture. Which of the following is the most therapeutic response for the nurse to make? 1. This won’t hurt a bit. 2. You need to relax. 3. I can tell you’ve had a bad experience before. 4. I notice you are clenching your fists. The nurse gathering data from a client admitted to labor and delivery is overheard making the comment, you are lying. You need to tell me the truth so we can do what is best for your baby. The nurse’s communication is: 1. A perception check. 2. Nontherapeutic. 3. Necessary. 4. Therapeutic. When considering communication skills, the nurse caring for an older client anticipates that the client will: 1. Interrupt frequently. 2. Take longer to respond. 3. Answer questions with one - word responses. 4. Remain silent. The nurse is admitting a client from the emergency room. Which of the following would be used to clarify the nurses understanding of the client’s chief complaint? 1. If you are bleeding, where is the blood? 2. I feel your pain when I se e you hold your side. 3. Are you saying you feel that you are bleeding inside? 4. Don’t worry; we have the technology to take care of you. The nurse prepares to assess a patient diagnosed with major depression for disturbances in circadian rhythms. Which question should the nurse ask this patient? a. Have you ever seen or heard things that others do not? b. What are your worst and best times of the day? c. How would you describe your thinking? d. Do you think your memory is failing? The nurse is serving on a committee charged with reviewing the roles and responsibilities of the nurses on the psychiatric unit. Which publication should the nurse bring to the first meeting? 1. Diagnostic and Statistical Manual of Mental Disorders
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2. American Nurses Credenti aling Center certification requirements 3. American Nurses Association, Code of Ethics 4. Psychiatric Mental Health Nursing Standards of Practice The psychiatric mental health nurse reflecting on professional role activities is referred to the standards o f professional performance by a colleague. To which organization should the nurse look for guidance? 1. North American Nursing Diagnosis Association 2. American Nurses Credentialing Center 3. National League for Nursing 4. American Nurses Association The psychiatric mental health nurse is working with the new graduate nurse who is orienting to the psychiatric unit. Which comment by the new graduate indicates further clarification of the generalist - nursing role is needed? 1. I would feel better if you would look at my documentation that addresses progress toward treatment goals. 2. I will spend time each day evaluating the effectiveness of the therapeutic milieu. 3. I am a little nervous about conducting psychotherapy with clients. 4. I am doing some r eading on how to incorporate complementary interventions into treatment plans. The client on the psychiatric unit is asking questions about prevention of sexually transmitted diseases. Given the PsychiatricMental Health Nursing Standards of Practice, whic h action would be most appropriate for the nurse to take at this time? 1. Consult with the mental health care team. 2. Teach safer sexual practices. 3. Investigate the questions in individual psychotherapy. 4. Notify the attending psychiatrist. The client asks the nurse if certain changes can be made in the unit milieu. Which action by the nurse indicates understanding of the nursing role in the therapeutic milieu? 1. The nurse refers the clients requests to the psychiatric social worker. 2. The nur se discusses the desired changes with the client. 3. The nurse refers the clients requests to the psychosocial rehabilitation worker. 4. The nurse instructs the client that no changes can be made. Due to a staff members absence, the nurse is reviewing staff assignments for the day. Which task can the nurse delegate to the psychosocial rehabilitation worker? 1. Conflict resolution teaching to a small group of clients 2. Comparison of physicians orders with the medication records
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3. Routine medication administration to a stable client 4. Assessment of a long - term client If psychiatric nurses used Orems theory for structuring much of their nursing practice, a major focus area for assessment would be the clients ability to do which of the following? 1. Adapt and function to meet various role expectations. 2. Care about self and participate in self - healing. 3. Implement self - care to meet psychosocial needs. 4. Enter into a therapeutic one - to - one relationship with the nurse. The psychiatric mental health nurse is asked to develop an intervention for the nursing unit based on Watsons theory of ca ring. Given this assignment, which intervention is most appropriate for the nurse to implement? 1. One - to - one debriefing sessions each week with individual unit nurses and the unit manager 2. Clarification of values and cultural beliefs that might pose b arriers to caring for clients 3. Identification of additional coping skills for new nurses on the unit 4. Discussion of the impact of recent changes in hospital policy on the nursing staff The unit manager is consistently advocating for self - awareness among the psychiatric mental health nursing staff in order to promote quality care. From which theoretical base is the unit manager operating? 1. Jean Watsons theory of human caring 2. Dorothea Orems theory of self - care 3. Martha Rogerss principles of hom eodynamics 4. Sister Callista Roys adaptation theory Upon the client’s arrival on the patient care unit, the nurse begins implementation of the nursing process. Of which nursing theorist should the nurse’s practice be most reflective? 1. Ida Jean Orlando 2. Jean Watson 3. Dorothea Orem 4. Hildegard Peplau If the nurse is using the nursing theory that has shaped psychiatric mental health most directly, which nursing action is priority? 1. Assessing the clients abilities in areas of self - care 2. Teaching effective coping skills 3. Establishing a therapeutic nurse client relationship