Chap. 4 review questions Flashcards
The concept of target symptom identification is best explained as:
A - Identification of the major clinical presentation of the client
B - Identification of specific, precise, and individualized symptoms reasonably expected to improve with medication
C - Identification of the secondary messenger system syndrome
D - Intentional modulation of synaptic pathways
B - Identification of specific, precise, and individualized symptoms reasonably expected to improve with medication.
Must have the target symptoms identified to determine patient outcomes to care.
Mr Johnson is a newly admitted client to an inpatient psychiatric hospital. The PMHNP on call at the facility plans to perform the initial intake assessment and diagnostic process. Mr Johnson asks to please talk in his room because, he says, “People make me nervous.” His room is at the end of the hallway and is the farthest away from the nursing station. The PMHNP’s action should be based on awareness that the best location to do the assessment is:
A - In Mr Johnson’s room, because it is the least noisy and most comfortable for him, thus facilitating data collection
B - In the dayroom, which is full of people, to observe his interactions with other individuals
C - In a quiet place but public enough to get assistance with client care should it be required during the assessment
D - In the treatment room with the door closed, a neutral location
C - In a quiet place but public enough to get assistance with client care should it be required during the assessment.
One PMHNP role is to control the milieu as an aspect of assessment.
In assessing a client, you ask him the meaning of the proverb “People who live in glass houses shouldn’t throw stones.” he replies, “Because it will break the windows.” The correct interpretation of this finding is:
A - Client has a probable mood disorder
B - Client has a probably anxiety disorder
C - Client has limited intellectual ability
D - Unable to interpret the finding without knowing the client’s age
D - Unable to interpret the finding without knowing the client’s age.
The answer demonstrates concrete thought processes, which are normal in individuals younger than age 12 but are abnormal after age 12. To interpret the finding, the PMHNP must know the age of the client.
The PMHNP is planning to work with a client using an individual therapy model of care. During the first session, the client makes the following statement: “This is the third time my son has run away. I’ve grounded him, taken away his bike, even tried cutting his allowance and locking him in his room. What should I do now?” The most therapeutic response is:
A - “I wonder if locking him in his room was abusive.”
B - “Maybe that depends on what you are trying to accomplish.”
C - “Perhaps talking to his friends and teachers would help.”
D - Remain silent.
B - “Maybe that depends on what you are trying to accomplish.”
This statement allows the client to be in a partnership with the clinician and an active participant in his/her own treatment. This is the MOST therapeutic response.
Mrs Shea has come to the mental health center seeking treatment for depression. She has a history of a suicide attempt by overdose 1 month ago. She was started on imipramine (TCA) after that event but stopped taking the medication 1 week later because “it did no good.” Which is the most appropriate initial action?
A - Asking Mrs Shea how to help her
B - Providing client teaching about the long time frame for TCAs to work
C - Contracting with Mrs Shea for six sessions of individual therapy
D - Providing Mrs Shea with feedback about how suicide might affect her family
A - Asking Mrs Shea how to help her.
An aspect of assessment - all other answers are aspects of interventions, which are not initial actions of the PMHNP.
