LPN MENTAL HEALTH EXAM
ATI LPN MENTAL HEALTH EXAM
Total Questions : 47
Showing 10 questions Sign up for moreA nurse is caring for a school-age client in an outpatient clinic.
The nurse should identify which of the client findings are manifestations of a factitious disorder? (Select all that apply.)
Explanation
A. Withdrawn: The child's withdrawn behavior, such as looking downcast and avoiding eye contact, may indicate emotional distress or a potential psychological issue, which can be associated with factitious disorder. Individuals with factitious disorder may exhibit emotional signs that reflect their internal struggles and manipulation of health-related situations.
B. Multiple hospitalizations: Frequent hospitalizations, especially without a clear medical diagnosis, can suggest factitious disorder. This pattern often reflects a behavior where an individual seeks medical attention and care, indicating a need to assume the sick role.
C. Unexplained abdominal pain: The presence of unexplained abdominal pain, particularly when combined with a history of seeking medical attention, aligns with factitious disorder. In this condition, individuals often feign or produce symptoms for psychological reasons, leading to repeated medical evaluations without a clear medical basis.
D. Excessive thinking about health: An intense preoccupation with health issues can be indicative of factitious disorder. This behavior demonstrates a focus on illness that may lead to manipulative behaviors in seeking attention or care.
E. Recent trauma: While trauma can contribute to various psychological conditions, it is not specifically indicative of factitious disorder. Many individuals may experience trauma without developing this disorder, making it less relevant in this context.
A nurse is caring for a client who has been diagnosed with schizophrenia. The client has been wearing the same clothes for the past week and appears unkept and unbathed. Which of the following statements should the nurse make to the client?
Explanation
A. "I'm going to ignore your lack of self-care because it is an aspect of the disorder." Ignoring the client’s hygiene neglect does not support their well-being or promote self-care. While poor self-care is a symptom of schizophrenia, the nurse should encourage hygiene rather than dismiss it.
B. "Do you really think it is ok not to bathe? What is going on with you?" This confrontational statement may make the client feel judged or defensive, potentially worsening their resistance to self-care. Clients with schizophrenia may have impaired insight and motivation, making supportive guidance more effective.
C. "It is now time for you to bathe. Do you want to wear the red or green shirt?" Providing a structured directive while offering a simple choice promotes autonomy and encourages adherence to hygiene. Clients with schizophrenia benefit from clear instructions and limited choices, reducing decision-making stress and increasing cooperation.
D. "This is it! You are getting a bath! There are three of us here to bathe you!" Using forceful or coercive language can cause distress and escalate resistance. Encouraging hygiene should be done through therapeutic communication and gentle prompts rather than threats or intimidation.
A nurse is caring for a client who frequently breaks their arms and other bones on purpose. The nurse understands that the client likely has which diagnosis?
Explanation
A. Factitious disorder. Factitious disorder involves intentionally faking, exaggerating, or inducing physical or psychological symptoms to assume the sick role. Clients may purposely injure themselves, such as breaking bones, to gain medical attention, even without external rewards like financial gain.
B. Illness anxiety disorder. This condition, previously known as hypochondriasis, involves excessive worry about having a serious illness despite minimal or no symptoms. Unlike factitious disorder, clients do not intentionally cause harm to themselves but rather misinterpret normal bodily sensations as signs of severe disease.
C. Functional neurological symptom disorder. Formerly called conversion disorder, this condition involves neurological symptoms, such as paralysis or seizures, that cannot be explained by medical findings. The symptoms are involuntary and not intentionally produced, unlike in factitious disorder.
D. Dissociative amnesia. Dissociative amnesia is characterized by sudden memory loss due to psychological stress or trauma, often affecting personal information or life events. It does not involve self-inflicted injuries or deliberate symptom fabrication, making it unrelated to this scenario.
A nurse is admitting a client who has anorexia nervosa. Which of the following statements should the nurse expect from this client?
Explanation
A. "I don't eat because I do not like the taste of food." Clients with anorexia nervosa typically avoid food due to intense fears of weight gain and body image concerns rather than a dislike for taste. Their restrictive eating is driven by psychological distress rather than a simple aversion to flavor.
B. "I restrict myself to 2,000 calories per day." Individuals with anorexia nervosa usually consume significantly fewer calories than recommended daily amounts. A restriction of 2,000 calories per day is within normal dietary guidelines and does not reflect the extreme caloric limitation seen in this disorder.
C. "I have certain foods, like pizza, that cause me a lot of fear." Clients with anorexia nervosa often develop strong food-related anxieties, especially about high-calorie or "forbidden" foods. Fear of specific foods is a hallmark feature of the disorder, making this the expected statement.
D. "I don't bother to track the number of calories I eat in a week." Individuals with anorexia nervosa are typically obsessive about tracking their calorie intake, often meticulously counting every calorie consumed. This level of control is a defining characteristic of the disorder.
A nurse on an inpatient unit is caring for a client who has somatic symptom disorder. The client comes to the nurse's station and reports chest pain. The nurse knows this is a new symptom for the client. Which of the following actions should the nurse take?
Explanation
A. Encourage the client to use relaxation techniques. While relaxation techniques can help manage symptoms in somatic symptom disorder, they should not be the first response to a new symptom like chest pain. The nurse must first rule out a medical cause before assuming the pain is psychological.
B. Reassure the client that pain is an expected part of their disorder. Assuming that the pain is purely psychosomatic without assessing for a potential medical emergency could lead to a delay in necessary treatment. Each new symptom should be evaluated independently.
C. Explain to the client that the pain is not real. The pain experienced by clients with somatic symptom disorder is real to them, even if a physical cause is not found. Dismissing their symptoms can damage trust and discourage them from reporting future concerns.
D. Assess the client's vital signs. Any new report of chest pain should be taken seriously, regardless of the client’s psychiatric history. Assessing vital signs ensures that a potential cardiac event or other medical issue is not overlooked before considering psychological factors.
A nurse is caring for a client who is crying and states they are depressed and feel like they are "going crazy." Which of the following client statements indicates the client is experiencing emotional abuse? (Select All that Apply.)
Explanation
A. "My ex-partner constantly makes fun of my weight." This statement reflects emotional abuse, as body-shaming can damage self-esteem and create feelings of worthlessness. Constant criticism about appearance is a form of psychological manipulation and control.
B. "My ex-partner tells me that I can't do anything right." Emotional abusers often undermine their victims’ confidence by making them feel incompetent or incapable. This type of verbal degradation can lead to self-doubt, anxiety, and depression.
C. "I recently was promoted at work but now I'm unable to work with the same coworkers I was used to working with." While workplace changes can be stressful, this does not indicate emotional abuse. There is no mention of manipulation, belittlement, or control by another person.
D. "I am newly divorced and a single parent." Divorce and single parenting can be challenging, but they do not inherently signify emotional abuse. Emotional abuse involves a pattern of controlling, belittling, or manipulative behavior from another individual.
E. "I suppose I really do need to be on medication, like my ex-partner said." This statement suggests that the ex-partner may have manipulated the client into doubting their own mental stability. Gaslighting—making someone question their own reality—is a common tactic in emotional abuse.
F. "My friend recently passed away." Grief can contribute to emotional distress, but the loss of a friend does not indicate emotional abuse. Emotional abuse involves deliberate psychological harm from another person.
A nurse is caring for a client who states, "When I get in the car to drive to work in the morning, my hands go numb. It is to the point where I can't grip the steering wheel." Which of the following conditions is the client likely experiencing?
Explanation
A. Dissociative amnesia. This condition involves memory loss of personal information or past events due to psychological stress or trauma. It does not cause physical symptoms like numbness or an inability to grip the steering wheel.
B. Depersonalization/derealization disorder. This disorder causes feelings of detachment from oneself (depersonalization) or the environment (derealization). While distressing, it does not typically result in sensory or motor deficits such as hand numbness.
C. Functional neurological symptom disorder. Formerly known as conversion disorder, this condition involves neurological symptoms, such as numbness or paralysis, that cannot be explained by a medical condition. The symptoms are often triggered by psychological stress, such as anxiety related to driving.
D. Factitious disorder. Factitious disorder involves deliberately fabricating or inducing symptoms to assume the sick role. In this case, the client is describing involuntary symptoms that appear to have a psychological basis rather than being intentionally produced.
A nurse is planning discharge for a client who has schizophrenia and reports "I don't have a place to live." Which of the following referrals should the nurse request from the provider?
Explanation
A. Employment assistance. While employment support is valuable for clients with schizophrenia, housing stability should be prioritized first. A client without a place to live may struggle to maintain a job, making housing support the more immediate concern.
B. Psychiatrist. A psychiatrist plays a crucial role in managing schizophrenia through medication and therapy. However, the client’s immediate need is housing, which falls outside the psychiatrist’s primary role and is better addressed by a social worker.
C. Social worker. A social worker can assist with housing placement, financial aid, and community resources for individuals experiencing homelessness. They are the most appropriate referral to help the client secure stable living arrangements.
D. Spiritual advisor. While spiritual guidance may provide emotional support, it does not directly address the client’s urgent need for housing. The primary intervention should focus on securing a safe and stable place to live.
A nurse is working with a client who is displaying disproportionate fear of having cancer. The nurse notes the client is seeking out medical care more frequently, has high anxiety, and believes they have cancer, despite no medical evidence to support this. Which of the following disorders is the client likely experiencing?
Explanation
A. Somatic symptom disorder. This disorder involves excessive concern over physical symptoms that are actually present, even if they are mild. In contrast, illness anxiety disorder is characterized by intense fear of having a serious illness despite the absence of significant physical symptoms.
B. Factitious disorder. Factitious disorder involves deliberately fabricating or inducing symptoms to assume the sick role. In illness anxiety disorder, the client genuinely believes they are ill but does not intentionally create symptoms.
C. Functional neurological symptom disorder. This condition, previously called conversion disorder, involves neurological symptoms (e.g., paralysis, blindness) that cannot be explained by medical findings. Unlike illness anxiety disorder, these symptoms are involuntary and not focused on a fear of disease.
D. Illness anxiety disorder. This disorder, formerly known as hypochondriasis, involves excessive worry about having a severe illness despite little or no medical evidence. The client’s persistent health-related anxiety and frequent medical visits align with this diagnosis.
A nurse is reviewing the medical record of a client who has somatic symptom disorder. Which of the following would be a likely comorbidity of somatic symptom disorder?
Explanation
A. Schizophrenia. Schizophrenia is a severe psychiatric disorder characterized by delusions, hallucinations, and disorganized thinking. While somatic symptom disorder (SSD) involves excessive focus on physical symptoms, it is not commonly linked to schizophrenia, which primarily affects perception and cognition.
B. Major depressive disorder. Depression is a common comorbidity of somatic symptom disorder. Clients with SSD often experience persistent sadness, hopelessness, and fatigue due to their distress over physical symptoms, which can contribute to or exacerbate depression.
C. Borderline personality disorder. While borderline personality disorder (BPD) is associated with emotional dysregulation and unstable relationships, it is not the most common comorbidity of SSD. BPD can co-occur with SSD, but depression and anxiety disorders are more frequently seen.
D. Bipolar disorder. Bipolar disorder involves mood fluctuations between mania and depression, whereas SSD is primarily characterized by excessive health-related concerns. While both conditions can co-exist, depression is more commonly associated with SSD.
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