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Worksheetsmental health Rn nursing midterm study guide
Total questions: 77
Worksheet time: 39mins
What is a 'milieu'?
A) A type of medication for mental health disorders
B) Therapy focused on modifying/controlled environment to develop life and social skills disrupted by mental health disorder
C) A legal term for patient rights
D) A type of physical exercise
Which of the following is NOT a component of milieu therapy?
A) Orient patient to physical setting
B) ID rules and boundaries
C) Safe environment
D) Administering medication
Nonmaleficence means _________.
do no harm
do good always
respect autonomy
seek justice
Which ethical principle refers to being truthful and authentic?
Autonomy
Fidelity
Veracity
Beneficence
Intentional tort implies that the person knowingly performed unsafe, unlawful actions or an act of omission.
True
False
Which of the following is an example of assault in nursing?
Physical harm to a client
Verbal harm that causes fear or anxiety
Breaking confidence
Confinement without legal grounds
Battery in nursing does NOT require which of the following?
A) A threat
B) Physical contact
C) Client awareness of contact
D) Offensive or unwanted contact
False imprisonment is the confinement of a client when there are no legal grounds to do so.
True
False
Invasion of privacy in nursing can include breaking confidence by sharing photos without patient permission.
True
False
Negligence is defined as _________.
providing inadequate care in a professional setting
following all professional guidelines
delivering exceptional care consistently
ensuring patient safety at all times
Which of the following is NOT one of the five elements of malpractice?
Breach of duty
Cause in fact
Damages
Informed consent
Duty
What is informed consent in mental health care?
Voluntary agreement to treatment or procedures, must know treatment description, risk vs benefit, consequences of no treatment and alternatives.
A legal document signed by the patient before any treatment.
A mandatory procedure for all patients regardless of their understanding.
A verbal agreement between patient and doctor without any explanation.
What does parity mean in the context of health insurance?
Equal coverage for mental and physical health accessibility to health insurance.
Coverage only for physical health conditions.
A discount on health insurance premiums.
Insurance that only covers prescription drugs.
Which of the following is NOT a type of involuntary admission?
Danger to self
Request of client
Danger to others
Unable to meet basic self-care needs
What is the purpose of psychiatric advanced directives?
Legal documents that allow clients with mental illness to state treatment preferences ahead of time in case they lose decision-making capacity.
A form of therapy used to treat severe depression.
A medication regimen for managing schizophrenia.
A support group for individuals with anxiety disorders.
Who makes decisions for a person with loss of capacity according to the health care power of attorney?
The health care power attorney portion person (health care proxy).
The person's neighbor.
The hospital janitor.
The local police officer.
What is the difference between capacity and competency in mental health care?
Capacity is understanding information and consequences assessed by provider; competency is determined in a court of law and providers do not determine competency.
Capacity is a legal term, while competency is a medical diagnosis made by providers.
Capacity and competency are both determined solely by mental health providers.
Competency is about understanding treatment options, while capacity is about following provider instructions.
Which of the following is a release criterion for restraint use?
Continuous monitoring
Release based on client's response
Restraints removed by registered nurses
All of the above
Who is responsible for diagnosing and managing medications in a psychiatric interdisciplinary team?
Psychiatrist
Psychologist
Social Worker
Occupational Therapist
Which professional is responsible for coordinating care discharge planning and community resources?
Psychologist
Social worker
Occupational therapist
Psychiatric pharmacist
What is one of the responsibilities of a mental health RN?
Conduct assessment
Prescribe medication
Perform surgery
Diagnose physical illnesses
Fill in the blank: The scope of practice of a mental health RN includes conducting assessment, monitoring safety, administering medication, providing therapeutic communication, teaching coping strategies, and ________ responses.
documenting
ignoring
delaying
exaggerating
A nurse should assist or advocate for a client who is angry and demanding by:
Listening actively and addressing concerns respectfully.
Ignoring the client's complaints to avoid escalation.
Telling the client to calm down and wait their turn.
Responding with equal anger to show authority.
Parity means equal coverage for mental and physical health in accessibility to health insurance for clients who have mental illness or substance use related illness.
True
False
According to the Affordable Care Act, can insurance companies deny coverage or charge higher rates for pre-existing conditions, including mental illness?
Yes
No
Compassion fatigue is:
a state of emotional exhaustion from caring for others
a physical injury caused by overwork
a type of contagious disease
a method of stress management
Fill in the blank: Incivility includes rude or disrespectful, disruptive ________ behavior.
dismissive
encouraging
supportive
cooperative
When should policy/procedure be discussed with patients?
At the end of the stay
At the beginning of the stay to set boundaries
Only if there is a problem
Never
It is a best practice to inform clients on admission about the seclusion and restraint policy to avoid any misunderstandings.
True
False
What is a physical restraint?
A drug used to calm a patient
Manual/mechanical device that reduces movement ability or arm legs or body
Involuntary confinement
A type of comfort measure
What is seclusion?
Giving medication to a patient
Involuntary confinement preventing the client from leaving (only to be used in case of self/ or other directed harm)
Allowing the patient to leave the facility
Setting boundaries at the beginning of the stay
Fill in the blank: Least restrictive measures include ________, distraction, comfort measures, PRN meds.
verbal de-escalation
physical restraints
seclusion
chemical sedation
Which of the following is an example of an adaptive behavior?
Exercise
Panic
Seclusion
Restraint
Maladaptive behaviors are those that prevent coping with a situation.
True
False
An anxiety response that matches the situation is called ________.
Justified
Irrational
Excessive
Unrelated
An anxiety response that is disproportionate to the situation is called ________.
Unjustified
Expected
Mild
Temporary
What are some neurophysiologic manifestations of anxiety?
Increased adrenaline, dry mouth, sweating, increased heart rate and respiratory rate
Fatigue, exhaustion, difficulty concentrating
GI disturbance, sleep disruptions, fight or flight response, sleep troubles
All of the above
The role of vulnerability gene in anxiety can be genetic, biological, physiological, cognitive, and personality, making individuals predisposed to mental health disorders like anxiety.
True
False
Panic level anxiety is characterized by which of the following?
Feels terror, exhausted, no longer responding to stimuli
Panic attacks occur unexpectedly for no apparent reason
Fight, flight, freeze, fawn
All of the above
Transdiagnostic anxiety refers to psychological processes or vulnerabilities that are common across multiple mental health disorders. Which of the following sets of disorders share these features?
Generalized Anxiety Disorder, Major Depressive Disorder, Obsessive-Compulsive Disorder
Schizophrenia, Anorexia Nervosa, Tourette's Syndrome
Bipolar Disorder, Autism Spectrum Disorder, Narcolepsy
Dissociative Identity Disorder, Insomnia, Conduct Disorder
What are adverse childhood experiences?
Adverse childhood experiences
Positive childhood experiences
Neutral childhood experiences
Supportive childhood experiences
What are positive childhood experiences? (Does not cancel out ACE but can be protective)
Positive childhood experiences
Adverse childhood experiences
Negative peer influences
Chronic stress in childhood
Identify two protective factors for adverse/positive childhood experiences.
Supportive family relationships and community involvement
Lack of supervision and social isolation
Exposure to violence and neglect
Unstable housing and frequent relocations
Which of the following is NOT a risk factor for anxiety related disorders?
Family history
Male gender
No social support
Inconsistent discipline
What is generalized anxiety disorder? Fill in the blank: Generalized anxiety disorder is characterized by excessive worry most days for ___ months, difficult to control, and symptoms such as restlessness, fatigue, poor concentration, irritability, muscle tension, and sleep disturbance.
6+ months
1 month
3 months
12 months
What is selective mutism? Fill in the blank: Selective mutism is the __________, and not being able to speak during school even when spoken to, which affects achievement academically or socially and interferes with regular communication.
consistent failure to speak in some social situations
inability to understand language
tendency to speak excessively in all situations
desire to avoid all social contact
Which of the following is a characteristic of phobia?
A) Fear/anxiety upon exposure to a specific object or situation
B) Excessive grooming
C) Pulling one's hair
D) Setting clear boundaries
What is separation anxiety? Fill in the blank: Separation anxiety is excessive fear/anxiety without their person/people, often resulting in ____.
nightmares
hunger
laughter
excitement
What is body dysmorphia? Fill in the blank: Body dysmorphia is the preoccupation with perceived defects or flaws in appearance, often leading to behaviors such as mirror checking, excessive grooming, skin picking, reassurance seeking, and _____?
eating disorder
increased sleep
improved memory
better vision
What is trichotillomania? Fill in the blank: Trichotillomania is a pattern of behavior by serially or intentionally pulling one's hair, often due to boredom or anxiety, resulting in reduced tension, gratification, pleasure, or a sense of _____
release
confusion
anger
dizziness
Which of the following best describes a nurse/patient boundary violation?
A) Setting clear boundaries
B) Avoiding misunderstandings
C) Crossing established boundaries between client and nurse
D) Using best current evidence
What is evidence-based practice? Fill in the blank: Evidence-based practice involves using best current evidence, clinical experience, and ____ values.
client
financial
organizational
technological
Which of the following are considered priority assessment findings in mental health nursing? (Select all that apply)
Suicidal ideation
Homicidal ideation
Psychosis
Withdrawal symptoms
Severe anxiety/panic
What does the 'O' stand for in the ADPIE framework of the 6 Standards of Practice?
Outcome identification
Observation
Order entry
Objective assessment
Client-centered care planning includes which of the following?
Accessibility
Collaboration
Quality across patient goals
Preference and culture/decision making
All of the above
Which of the following is NOT a component of the trauma-informed care framework?
Safety
Compassion and trustworthiness
Empowerment
Medication management
Holistic care involves treating the client as a whole in all areas of ADPIE. Which of the following is NOT one of these areas?
A) Physical
B) Emotional and psychological
C) Financial
D) Spiritual
Therapeutic relationships in mental health nursing should include which of the following?
Use of empathy
Active listening
Avoiding judgement
Asking open-ended questions
All of the above
Therapeutic communication should be conducted in a way that benefits clients' mental health.
True
False
Name two techniques used in building trusting therapeutic communication.
Empathy and active listening
Judgment and criticism
Interrupting and ignoring
Sarcasm and confrontation
Neurotransmission involves which of the following?
Hormones
Neurotransmitters
Enzymes
Vitamins
What is a neurotransmitter? Fill in the blank: A neurotransmitter is a chemical messenger that sends signals from one nerve cell/neuron to another or to muscles and gland cells.
A chemical messenger that sends signals from one nerve cell/neuron to another or to muscles and gland cells.
A type of electrical impulse that travels through the bloodstream.
A protein that provides structural support to neurons.
A hormone that regulates blood sugar levels.
What is the process called when neurotransmitters send signals from one neuron to another?
Neurotransmission
Photosynthesis
Osmosis
Transcription
Which neurotransmitter is associated with mood, sleep, appetite, and sexual desire, and decreases in depression and anxiety?
Serotonin
Dopamine
Acetylcholine
GABA
Dopamine is involved in which of the following?
Reward
Movement
Memory
Learning
Fill in the blank: Norepinephrine is associated with ______ and arousal. Decrease in depression, increase in anxiety/mania.
fight/flight
digestion
sleep
memory
Acetylcholine is associated with parasympathetic activation and is decreased in which diseases?
Alzheimer’s, Huntington’s, Parkinson’s
Multiple sclerosis, ALS, Myasthenia gravis
Schizophrenia, Bipolar disorder, Depression
Diabetes, Hypertension, Asthma
GABA has a calming effect, while Glutamate is associated with excitation.
True
False
How does genetics affect mental illness and medication response? Fill in the blank: Genetics affect what medications, receptor densities, and metabolism in the liver. Some meds work for some people and others don’t; meds are _______.
individual
universal
predictable
identical
What is a key teaching point for benzodiazepine use regarding dependency?
Do not use chronically for more than 6 months as high rates of dependency make it near impossible to get people off them long term.
Benzodiazepines are not associated with any risk of dependency.
Benzodiazepines can be stopped abruptly without any withdrawal symptoms.
Long-term use of benzodiazepines is recommended for all patients with anxiety.
What is a dangerous manifestation of alcohol withdrawal?
Manifestations of withdrawal symptoms are lethal.
Mild headache and fatigue are always fatal.
Increased appetite is the most dangerous symptom.
Improved sleep quality is a warning sign.
What are some symptoms of alcohol withdrawal?
Seizures
Hallucinations
Tremors
Diaphoresis
Tachycardia
Fill in the blank: Early alcohol withdrawal symptoms can include shaking headaches, which stop as ________ is released before alcohol is consumed.
dopamine
serotonin
adrenaline
cortisol
Opiate withdrawal: When do acute physical symptoms typically develop after the last dose?
1-2 hours
12-24 hours
2-3 days
1 week
Fill in the blank: Post-acute (protracted) opiate withdrawal can last for _______ after the last dose.
2 weeks or months
2-3 days
24 hours
6-8 hours
Fill in the blank: Methadone is a _______ acting opioid agonist used in opiate withdrawal.
long
short
rapid
intermediate
Fill in the blank: Naltrexone is used to prevent _______ and block opioid effects.
relapse
infection
withdrawal
addiction
