Mental Health Midterm Study Guide Exam
Questions And Answers
A nurse uses the SAD PERSONS scale to interview a patient. This tool provides data relevant
to
a. current stress level.
b. mood disturbance.
c. suicide potential.
d. level of anxiety.
Rationale: The SAD PERSONS tool evaluates 10 major risk factors in suicide potential: sex,
age, depression, previous attempt, ethanol use, rational thinking loss, social supports lacking,
organized plan, no spouse, and sickness. The tool does not have categories to provide
information on the other options listed. - ANS C
A male patient calls to tell the nurse that his monthly lithium level is 17 mEq/L. Which nursing
intervention will the nurse implement initially?
a. Reinforce that the level is considered therapeutic.
b. Instruct the patient to hold the next dose of medication and contact the prescriber.
c. Have the patient go to the hospital emergency room immediately.
d. Alert the patient to the possibility of seizures and appropriate precautions. - ANS B
Nurses have the opportunity to develop a therapeutic relationship with a patient, when the focus
of the interactions are based on
which concepts? (select all that apply)
A. Patient's support system
B. Patient concerns
C. Patient's psychiatric diagnosis
D. Patient experiences
E. Patient feelings
Rationale: The basis of the therapeutic relationship is when the nurse's interaction address the
patients needs, concerns, experiences and feelings. - ANS B, D, E
Which factors are essential for development of a therapeutic nurse-patient relationship? (Select
All That Apply)
,A. Sympathy
B. Genuineness
C. Empathy
D. Values clarification
E. Positive regard
Rationale: Vital components for establishing a therapeutic relationship is genuineness, empathy
and positive regard. - ANS B, C, E
Culturally competent care means that nurses adjust their practices to meet their patient's
cultural beliefs, practices, needs and preferences. Cultural competence consists of five
constructs: cultural awareness, cultural knowledge, cultural encounters, cultural skill, and
cultural desire. To provide culturally competent care, the nurse should
a. accurately interpret the thinking of individual patients.
b. predict how a patient may perceive treatment interventions.
c. formulate interventions to reduce the patient's ethnocentrism.
d. identify strategies that fit within the cultural context of the patient.
Rationale: The correct answer is the most global response. Cultural competence requires
ongoing effort. Culture is dynamic, diversified, and changing. The nurse must be prepared to
gain cultural knowledge and determine nursing care measures that patients find acceptable and
helpful. - ANS D
When considering culturally competent care for a Muslim patient diagnosed with cardiac
problems, which intervention is particularly important to implement initially when a low fat diet is
prescribed?
a. Requesting a dietary consult
b. Identifying dietary considerations
c. Explaining the importance of a low fat diet
d. Including the family in conversation about food preparation
Rationale: Interpreting the thinking of individual patients does not ensure culturally - ANS B
Which nursing actions demonstrate cultural competence? Select all that apply.
a. Planning mealtime around the patient's prayer schedule
b. Helping a patient to visit with the hospital chaplain
c. Researching foods that a lacto-ovo-vegetarian patient will eat
d. Providing time for a patient's spiritual healer to visit
e. Ordering standard meal trays to be delivered three times daily - ANS A, B, C, D
,Which intervention best demonstrates that a nurse correctly understands the cultural needs of a
hospitalized Asian American patient diagnosed with a mental illness?
a. Encouraging the family to attend community support groups
b. Involving the patient's family to assist with activities of daily living
c. Providing educational pamphlets to explain the patient's mental illness
d. Restricting homemade herbal remedies the family brings to the hospital
Rationale: The Asian community values the family in caring for each other. The Asian
community uses traditional medicines and healers, including herbs for mental symptoms. The
Asian community describes illness in somatic terms. The Asian community attaches a stigma to
mental illness, so interfacing with the community would not be appealing. - ANS B
When the nurse views the lab results, of an Asian patient's blood lithium level, it is noted the
lithium level is not within therapeutic
range. How can the results of the lab work be explained?
A. Patients of different cultural groups may metabolize medications at different rates.
B. The physician ordered the wrong dose.
C. Asians require smaller doses of psychotropic medications.
D. Asians' kidneys do not excrete psychotropic medications effectively.
Rationale: Genetic variations in culturally diverse patients can affect the pharmacokinetics
(metabolism) of drugs, regardless of ethnicity. - ANS A
The nurse administers medications to a culturally diverse group of patients on a psychiatric unit.
What expectation should the nurse have about pharmacokinetics?
a. Patients of different cultural groups may metabolize medications at different rates.
b. Metabolism of psychotropic medication is consistent among various cultural groups.
c. Differences in hepatic enzymes will influence the rate of elimination of psychotropic
medications.
d. It is important to provide patients with oral and written literature about their psychotropic
medications.
Rationale: Cytochrome enzyme systems, which vary among different cultural groups, influence
the rate of metabolism of psychoactive drugs. Renal function influences elimination of
psychotropic - ANS A
Which scenario best demonstrates a healthy family?
a. One parent takes care of children. The other parent earns income and maintains the home.
b. A family has strict boundaries that require members to address problems within the family.
c. A couple requires their adolescent children to attend church services three times a week.
, d. A couple renews their marital relationship after their children become adults. - ANS D
Which characteristic is indicative of a healthy and functional family?
A. Diffuse boundaries
B. Rigid boundaries
C. Mutual support
D. Equal distribution of power
Rationale: When family members emotional needs are met, they feel support from those around
them and are free to grow and explore new roles and facets of their personalities. - ANS C
A wife believes her husband is having an affair. Lately, he has been disinterested in romance
and working late. The husband has an important, demanding project at work. The mother asks
her teen, "What have you noticed about your father?" The teen later mentions this to the father,
who says, "Tell your mother that I can't deal with her insecurities right now." Which family
dynamic is evident?
a. Multigenerational dysfunction
b. Triangulation
c. Enmeshment
d. Blaming
Rationale: Triangulation is a family dynamic wherein a pair relationship (usually the parents) is
under stress and copes by drawing in a third person (usually a child) to align with one or the
other members of the pair relationship. Multigenerational dysfunction is any dysfunction that
exists within or across multiple generations of a family, such as child abuse or alcoholism.
Blaming is distracting attention from one's own dysfunction or reducing one's - ANS B
A 16-year-old wants to drive, but the parents will not allow it. A 14-year-old sibling was invited to
several sleepovers, but the parents found reasons to deny permission. Both teens are annoyed
because the parents buy clothes for them that are more suitable for younger children. The
parents say, "We don't want our kids to grow up too fast." Which term best describes this
family's boundaries?
a. Rigid
b. Clear
c. Enmeshed
d. Differentiated
Rationale: Rigid boundaries are those that do not change or flex with changing circumstances,
as indicated here by parents who are reluctant to revise their roles and expectations about their
children as the children mature. Enmeshed boundaries are those that have failed to differentiate
