Mental health assessment – history taking, MSE, Interview technique.
Time: 15:00
Which component of the mental status examination (MSE) assesses the client's observable emotional expression?
[a] Mood.
[b] Affect.
[c] Insight.
[d] Cognition.
A nurse asks a client, "Can you tell me more about what was happening when you started feeling this way?" This is an example of which type of interview technique?
[a] A closed-ended question.
[b] An open-ended question.
[c] Giving advice.
[d] A leading question.
During an MSE, a client's mood is their pervasive and sustained emotion, best assessed by asking:
[a] "Do you see things that others don't?"
[b] "Who is the current president?"
[c] "How have you been feeling lately?"
[d] "You seem happy today."
A client states, "The FBI is monitoring my thoughts through my television." This statement represents a disturbance in which area of the MSE?
[a] Thought process.
[b] Perception.
[c] Affect.
[d] Thought content.
In which part of the psychiatric history would a nurse document the client's educational background, work history, and marital status?
[a] History of present illness.
[b] Past psychiatric history.
[c] Personal and social history.
[d] Family history.
A client speaks very rapidly, jumping from one topic to another in a continuous, fragmented flow. This type of speech is known as:
[a] Poverty of speech.
[b] Flight of ideas.
[c] Circumstantiality.
[d] Mutism.
To assess a client's judgment, a nurse might ask:
[a] "Do you believe you have an illness?"
[b] "What would you do if you found a stamped, addressed envelope on the street?"
[c] "Can you repeat the names of these three objects for me?"
[d] "What does the saying 'people in glass houses shouldn't throw stones' mean?"
A client misinterprets a shadow on the wall as a frightening person. This is an example of a(n):
[a] Hallucination.
[b] Illusion.
[c] Delusion.
[d] Flashback.
The primary purpose of conducting a thorough mental health assessment is to:
[a] Immediately determine the correct medication.
[b] Fulfill a legal requirement for admission.
[c] Formulate a comprehensive plan of care based on the client's needs.
[d] Convince the client they need hospitalization.
A nurse observes that a client's affect is "labile." This means the client's emotional expression is:
[a] Severely reduced in intensity.
[b] Inappropriate to the situation.
[c] Rapidly and abruptly changing.
[d] Absent.
Asking a client to name the current month, year, and their current location assesses which cognitive function?
[a] Memory.
[b] Judgment.
[c] Orientation.
[d] Abstract thinking.
During an interview, a client states, "I'm not sure what you mean by that." The nurse responds, "I'm asking about how your mood has affected your sleep." The nurse is using which technique?
[a] Clarification.
[b] Reflecting.
[c] Summarizing.
[d] Restating.
Which of the following is the most crucial part of any mental health assessment, especially regarding safety?
[a] Assessment of educational level.
[b] Assessment of financial status.
[c] Assessment of suicidal or homicidal ideation.
[d] Assessment of past employment.
A client who gives excessive, unnecessary detail but eventually does answer the question is demonstrating:
[a] Tangentiality.
[b] Loose associations.
[c] Circumstantiality.
[d] Word salad.
The initial and most important task when beginning a client interview is to:
[a] Complete all required paperwork.
[b] Administer a standardized screening tool.
[c] Ask about suicidal thoughts.
[d] Establish rapport and a sense of trust.
Asking a client to interpret a proverb like "Don't cry over spilled milk" is used to assess:
[a] Insight.
[b] Memory.
[c] Orientation.
[d] Abstract thinking.
A client's awareness and understanding of their own illness and the need for treatment is defined as:
[a] Insight.
[b] Judgment.
[c] Cognition.
[d] Affect.
What is the primary reason for obtaining a medical history and a review of systems during a psychiatric assessment?
[a] To satisfy insurance company requirements.
[b] To assess the client's ability to pay for treatment.
[c] To rule out physical conditions that may cause or mimic psychiatric symptoms.
[d] To determine the client's genetic predispositions.
A nurse observes a client pacing, wringing their hands, and fidgeting. This is documented as a part of their:
[a] Mood.
[b] Thought content.
[c] Behavior and psychomotor activity.
[d] Perception.
When an interview is not progressing because a client is silent, what is an appropriate initial response from the nurse?
[a] End the interview and try again later.
[b] Ask a series of rapid, closed-ended questions.
[c] Comment on the silence or a non-verbal cue, e.g., "You've become very quiet. What are you thinking about?"
[d] Fill the silence by talking about your own experiences.
A client states, "I hear voices telling me I am worthless." This is an example of what type of perceptual disturbance?
[a] Visual hallucination.
[b] Auditory hallucination.
[c] Tactile hallucination.
[d] Delusion of persecution.
The "History of Present Illness" section of the assessment should primarily include:
[a] A list of all past hospitalizations.
[b] The client's family medical history.
[c] A chronological account of the symptoms that led to seeking care.
[d] The client's developmental milestones.
What is a key difference between an obsession and a compulsion?
[a] An obsession is a false belief, while a compulsion is a false sensory perception.
[b] An obsession is a recurrent thought, while a compulsion is a repetitive behavior performed in response to it.
[c] An obsession is a behavior, while a compulsion is a thought.
[d] There is no difference; the terms are interchangeable.
To maintain therapeutic boundaries during an interview, a nurse should avoid:
[a] Sitting at eye level with the client.
[b] Explaining the purpose of the interview.
[c] Sharing personal problems with the client.
[d] Taking notes discreetly.
Asking a client to remember three unrelated words and repeat them five minutes later is a test of:
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