HESI PN MENTAL HEALTH PROCTORED EXAM

HESI PN MENTAL HEALTH PROCTORED EXAM

VERSION 8

A nurse is admitting a new client on the mental health unit. During the conversation the nurse should be aware that countertransference can occur if the nurse display what feeling?Occurs when a health care team member displaces characteristics of people in her past onto a client.

Behaviors:

 Nurse overly identifies with client  Nurse competes with client  Nurse argues with client Example: a nurse may feel defensive and angry with a client for no apparent reason if the client reminds her of a friend who often elicited those feelings.Nursing implications: a nurse should be aware that clients who induce very strong personal feelings may become objects of countertransference.A client on the mental health unit is being discharge to a community base program referred to as Assertive Community Treatment. (ACT) What should the nurse explain to the client about this program? This includes nontraditional case management and treatment by an interprofessional team for clients who have severe mental illness and are noncompliant with traditional treatment. ACT helps to reduce reoccurrences of hospitalizations and provides crisis intervention, assistance with independent living, and information regarding resources for necessary support services.What are the legal rights of a person admitted to an inpatient mental health facility? Informed consent and the right to refuse treatment  Confidentiality  A written plan of care/treatment that includes discharge follow-up, as well as participation in the care plan and review of that plan  Communication with people outside the mental health facility, including family members, attorneys, and other health care professionals  Provision of adequate interpretive services if needed 1 / 2

 Care provided with respect, dignity, and without discrimination  Freedom from harm related to physical or pharmalogical restraint, seclusion, and any physical or mental abuse or neglect  A psychiatric advance directive that includes the client’s treatment preference in the event that an involuntary admission if necessary  Provision of care with the least restrictive interventions necessary to meet the client’s needs without allowing him to be a threat to himself or others

A nurse is caring for a client who is admitted to the unit for self-mutilation. What type of behavioral therapy would the nurse expect to be ordered for this client?Dialectical behavior therapy is a cognitive-behavioral therapy used for clients who exhibit self-injurious behavior. It focused on gradual behavior changes and provides acceptance and validation for these clients.

The client states that she is going through a divorce and her anxiety is extremely high. The nurse needs to assess the client’s ability to adapt and cope with this situation. What would this include?

Assessing the client’s ability to adapt and cope includes the following:

 Health status and functional abilities  Living arrangements and employability  Personality factors (e.g. attitudes)  Client, caregiver and family assessments  Levels of information (e.g. community programs)  Medication use and supplemental services

Evaluating whether client has successfully adapted includes the following:

 Able to state positive coping behaviors  Able to identify maladaptive coping behaviors  Able to participate in community resources  Able to list stress reduction techniques  Able to maintain housing and employment

A nurse is caring for a client in the manic phase of bipolar disorder. Identify five (5) clinical manifestations associated with this phase of the bipolar disorder. Labile mood with euphoria  Agitation and irritability  Restlessness  Dislike interference and intolerance of criticism  Increase in talking and activity  Flight of ideas: rapid, continuous speech with sudden and frequent topic change  Grandiose view of self and abilities (grandiosity)

 Impulsivity: spending money, giving away money or possessions

 Demanding and manipulative behavior  Distractibility and decreased attention span  Poor judgement

 Attention-seeking behavior: flashy dress and makeup, inappropriate behavior

 Impairment in social and occupational functioning  Decreased sleep

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