Review Practice Exercise

Introduction To Mental Health Nursing > Mental Health

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Practice Exercise

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Total Questions : 3

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Question 1:

Which phase of the nurse–patient relationship is characterized by establishing trust and defining the nurse’s role?

A. Working phase B. Orientation phase C. Termination phase D. Evaluation phase

Answer and Explanation

Choice A:

The working phase focuses on implementing care plans, not primarily on establishing trust or defining roles.

Choice B:

The orientation phase involves initial interactions where nurses establish trust and clarify their role. This sets the foundation for collaboration, addressing the patient’s immediate needs and expectations.

Choice C:

The termination phase centers on concluding the relationship, reviewing progress, not initiating trust.

Choice D:

The evaluation phase is not a standard phase; it may occur within others but does not focus on trust-building.

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Question 2:

A client expresses intent to harm another person. What is the nurse’s immediate legal responsibility?

A. Respect the client’s confidentiality B. Document the statement only C. Warn the intended victim and notify authorities D. Administer an anxiolytic medication

Answer and Explanation

Choice A:

Strictly maintaining confidentiality disregards the safety exception in cases of imminent harm to others, placing both the potential victim and the nurse at legal risk.

Choice B:

Solely documenting the statement fails to prevent danger, as it does not involve active steps to warn or protect the intended victim.

Choice C:

The nurse must act on the legal duty to protect others from foreseeable harm by alerting authorities and warning the threatened individual when a client makes a credible threat. This immediate action prioritizes safety over confidentiality.

Choice D:

Administering medication addresses possible agitation but does not fulfill the legal obligation to protect third parties from credible threats of harm.

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Question 3:

List two environmental safety measures in an acute psychiatric setting.

A. Securing sharp objects and removing potential weapons B. Locking patients in their rooms C. Turning off the ward lights during the day D. Allowing unrestricted visitor access

Answer and Explanation

Choice A:

Removing sharp objects and securing other potential weapons prevents impulsive acts of harm in high-acuity psychiatric units where patients may experience sudden agitation or psychosis.

Choice B:

Locking patients in rooms increases risk by restricting supervision, escalating agitation, and violating patient rights and therapeutic environment principles.

Choice C:

Turning off lights during the day disrupts orientation, increases confusion, and may worsen mood or psychotic symptoms in vulnerable patients.

Choice D:

Allowing unrestricted visitors introduces uncontrolled variables, increasing the chance of contraband entry or unsafe interactions that could jeopardize patient or staff safety.

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Total Questions : 3

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