CPNRE Mental Health Nursing Concepts 5 — Questions and Answers
Question 1: A nurse is working with a client who has borderline personality disorder. Which therapeutic approach is most effective for this population?
- Psychoanalytic therapy
- Dialectical behaviour therapy (DBT) (Correct answer)
- Electroconvulsive therapy (ECT)
- Systematic desensitization
Correct answer: Dialectical behaviour therapy (DBT)
Dialectical behaviour therapy (DBT) is the evidence-based treatment of choice for borderline personality disorder, focusing on emotion regulation, distress tolerance, and interpersonal effectiveness.
Question 2: A client refuses to take their prescribed antipsychotic medication. Under which circumstance may the nurse administer medication without consent?
- When the family requests it
- When the physician writes the order
- When the client poses an imminent danger to themselves or others (Correct answer)
- When the nurse believes it is in the client's best interest
Correct answer: When the client poses an imminent danger to themselves or others
Involuntary medication administration is legally and ethically justifiable only when a client presents an imminent risk of harm to themselves or others.
Question 3: A nurse observes a client with anorexia nervosa hiding food in napkins during mealtime. What is the most appropriate nursing response?
- Ignore the behaviour to avoid a power struggle
- Document the behaviour and report it to the treatment team (Correct answer)
- Reprimand the client in front of other clients
- Remove the client from the dining room immediately
Correct answer: Document the behaviour and report it to the treatment team
Documenting and reporting the behaviour ensures the treatment team can address it therapeutically as part of the client's care plan without punitive action.
Question 4: During a mental status examination, a client jumps rapidly from topic to topic with no apparent logical connection. The nurse documents this as:
- Circumstantiality
- Tangentiality
- Flight of ideas (Correct answer)
- Perseveration
Correct answer: Flight of ideas
Flight of ideas is characterized by rapidly shifting from one topic to another with minimal logical connection, commonly seen in mania.
Question 5: A nurse is implementing suicide precautions. Which environmental modification is the highest priority?
- Removing the television from the client's room
- Conducting room searches and removing sharp objects and ligatures (Correct answer)
- Limiting visiting hours to prevent overstimulation
- Placing the client in a single-occupancy room
Correct answer: Conducting room searches and removing sharp objects and ligatures
Removing all potentially lethal means, including sharps and ligatures, is the highest-priority environmental intervention to reduce suicide risk.
Question 6: A client with obsessive-compulsive disorder (OCD) spends three hours each morning performing hand-washing rituals. The nurse understands that the ritual functions primarily to:
- Gain attention from nursing staff
- Temporarily relieve the anxiety caused by obsessive thoughts (Correct answer)
- Express hostility toward family members
- Simulate symptoms for secondary gain
Correct answer: Temporarily relieve the anxiety caused by obsessive thoughts
Compulsive rituals in OCD temporarily reduce the intense anxiety generated by intrusive obsessive thoughts, reinforcing the compulsive behaviour cycle.
Question 7: A nurse is caring for a client who is experiencing grief after a significant loss. Which statement by the nurse is most appropriate?
- 'You'll feel better in a few weeks.'
- 'Everything happens for a reason.'
- 'I'm here with you. Tell me what you're experiencing.' (Correct answer)
- 'You should join a support group right away.'
Correct answer: 'I'm here with you. Tell me what you're experiencing.'
Offering presence and inviting the client to share their experience is the most therapeutic response, demonstrating empathy and active listening without minimizing grief.
CPNRE Mental Health Nursing Concepts 5
A nurse is working with a client who has borderline personality disorder.
Which therapeutic approach is most effective for this population?