Mental Health Exam IV Review 1

After an assault by a patient, a nurse has difficulty sleeping, startles easily, and is preoccupied with the incident. The nurse said, “That patient should not be allowed to get away with that behavior.” Which response poses the greatest barrier to the nurse’s ability to provide therapeutic care?

• Startle reactions

• Difficulty sleeping

• A wish for revenge

• Preoccupation with the intention

Which referral will be most helpful for a woman who was severely beaten by an intimate partner, has no relatives or friends in the community, is afraid to return home, and has limited financial resources?

• A women's shelter

• A mental health center

• Vocational counseling

• A support group

Which clinical scenario predicts the highest risk for directing violent behavior toward others?

• Completed alcohol withdrawal; beginning a rehabilitation program

• Paranoid delusions of being followed by alien monsters

• Major depressive disorder with delusions of worthlessness

• Obsessive-compulsive disorder; perform many rituals

Family members describe the patient as “a difficult person who finds fault with others.” The patient verbally abuses nurses for their poor care. The most likely explanation lies in…

• Poor childbearing that did not teach respect to others

• A personality style that externalizes problems

• Delusions that others wish to deliver harm

• Automatic thinking leading to cognitive distortions

The staff development coordinator plans to teach physical management techniques when patients become assaultive. Which topic should the coordinator emphasize?

• Diversion and physical outlets

• Practice & teamwork

• Spontaneity & surprise

• Caution & superior size

A survivor of physical spousal abuse was treated in the ED for a broken wrist. This patient said, “I've considered leaving, but I made a vow and I must keep it no matter what happens.” Which outcome should be met before discharge? The patient will…

• Reexamine cultural beliefs about marital commitment

• Demonstrate insight into the abusive relationship

• Name two community resources for help

• Facilitate counseling for the abuser

Which comment by the nurse would best support relationship building with a survivor of intimate partner abuse?

• “Abusers often target people who are passive. I will refer you to an assertiveness class.”

• “You are feeling violated because you thought you could trust your partner.”

• “I’m here for you. I want you to tell me about the bad things that happened to you.”

• “I was very worried about you. I knew you were living in a potentially violent situation.”

An older adult diagnosed with Alzheimer's disease lives with a family in a rural area. During the week, this adult attends a daycare center while the family is at work. In the evenings, members of the family provide care. Which factor makes this adult most vulnerable to abuse?

• Multiple caregivers

• living in a rural area

• Alzheimer's disease

• Being a part of a busy family

A woman was found confused and disoriented after being abducted and raped at gunpoint by an unknown assailant. The emergency department nurse makes these observations about the woman: talking rapidly in disjointed phrases, unable to concentrate, and indecisive when asking to make simple decisions. What is the woman’s level of anxiety?

• MIld

• Weak

• Severe

• Moderate

A rape victim tells the nurse, “I should not have been out on the street alone.” Select the nurse’s most therapeutic response.

• Rape can happen anywhere

• You are right. You should not have been alone on the street at night

• You feel as though this would not have happened if you had not been alone?

• Blaming yourself increases your anxiety and discomfort