You choose the therapeutic response, the safety priority, and the cue that means the patient is getting worse. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the NCLEX-RN exam guide or more NCLEX-RN practice questions.
Five mental health questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
One week after being told that she has terminal cancer with a life expectancy of 3 weeks, a female client tells the nurse, 'I think I will plan a big party for all my friends.' How should the nurse respond?
A. 'You may not have enough energy before long to hold a big party.'
B. 'Do you mean to say that you want to plan your funeral and wake?'
C. 'Planning a party and thinking about all your friends sounds like fun.'
D. 'You should be thinking about spending your last days with your family.'
Show answer and rationale
Correct answer: C — 'Planning a party and thinking about all your friends sounds like fun.'
Setting goals that bring pleasure is appropriate and should be encouraged by the nurse as long as the nurse does not perpetuate a client's denial. Option A is a negative response, implying that the client should not plan a party, which is not supportive. Option B is presumptive and may not reflect the client's true intentions. The correct response (Option C) acknowledges the client's positive plans and encourages her to enjoy her time with friends. Option D, while family is important, does not consider the client's wishes and choices, which should be respected and supported in this situation.
Question 2
The client is still unable to sleep despite following the progressive muscle relaxation technique routine taught by the nurse. Which action should the nurse take first?
A. Instruct the client to add regular exercise to their daily routine.
B. Determine if the client has been keeping a sleep diary.
C. Encourage the client to continue the routine until sleep is achieved.
D. Ask the client to describe the routine they are currently following.
Show answer and rationale
Correct answer: D — Ask the client to describe the routine they are currently following.
The nurse's initial step should be to assess the client's adherence to the original instructions. By asking the client to describe the routine they are following, the nurse gains more specific information than relying solely on a sleep diary. This information will help the nurse identify any deviations or areas needing adjustment in the technique. Encouraging the client to persist with an unsuccessful routine without evaluation is not beneficial. Adding regular exercise, although important for overall sleep health, should come after ensuring the correct execution of the relaxation technique.
Question 3
According to psychodynamic theory, what purpose do delusions serve?
A. Delusions are a defense against anxiety caused by real or imagined threats.
B. Magical thinking is a delusion that ensures desirable outcomes.
C. Delusions are a method of dealing with and interpreting external stimuli.
D. Subconsciously, delusions are a way to safely express anger and hostility.
Show answer and rationale
Correct answer: A — Delusions are a defense against anxiety caused by real or imagined threats.
According to psychodynamic theory, delusions serve as a defense mechanism against anxiety triggered by real or perceived threats. Delusions are the individual's unconscious way of protecting themselves from overwhelming feelings of anxiety. Magical thinking, on the other hand, involves believing that one's thoughts can influence external events. This is not the same as delusions. Delusions are not a way of interpreting external stimuli but rather a defense mechanism. Expressing anger and hostility is typically associated with defense mechanisms like displacement or projection, not delusions.
Question 4
While conducting an intake assessment of an adult male at a community mental health clinic, the nurse notes that his affect is flat, he responds to questions with short answers, and he reports problems with sleeping. He reports that his life partner recently died from pneumonia. Which action is most important for the nurse to implement?
A. Encourage the client to see the clinic's grief counselor.
B. Determine if the client has a family history of suicide attempts.
C. Inquire about whether the life partner was suffering from AIDS.
D. Consult with the health care provider about the client's need for antidepressant medications.
Show answer and rationale
Correct answer: A — Encourage the client to see the clinic's grief counselor.
The client is exhibiting normal grieving behaviors, so referral to a grief counselor is the most important intervention for the nurse to implement. Option B is relevant but is not a high-priority intervention compared to addressing the immediate grief support needs of the client. Option C is irrelevant at this time but might be important when determining the client's risk for contracting the illness. While antidepressant medication might be necessary based on further assessment, grief counseling is a more appropriate initial action as grief is a typical response to the loss of a loved one.
Question 5
An older woman has lived alone since the death of her husband 10 years ago, and she has a long list of vague complaints. Which assessment is the priority for the home health nurse to perform?
A. Assess for feelings of loneliness and isolation.
B. Determine if the client has unresolved grief.
C. Determine if there are safety issues.
D. Ask about the availability of support systems.
Show answer and rationale
Correct answer: C — Determine if there are safety issues.
The priority assessment for the home health nurse in this scenario is to determine if there are safety issues. The client is an older woman living alone with a long list of vague complaints, indicating several risk factors. Ensuring her safety should be the primary concern. While assessing for feelings of loneliness, isolation, or grief is important, ensuring the client's safety takes precedence due to her vulnerable situation. Although assessing the availability of support systems is essential in a home health assessment, safety issues must be addressed first given the client's profile.
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Question 6
While receiving a preoperative enema, a client starts to cry and says, 'I'm sorry you have to do this messy thing for me.' Which is the nurse's best response?
A. I don't mind it.'
B. 'You seem upset.'
C. 'This is part of my job.'
D. 'Nurses get used to this.'
Correct answer:
The nurse's best response in this situation is to acknowledge the client's emotional state, as it shows empathy and encourages further expression of feelings. Choice A, 'I don't mind it,' dismisses the client's emotions and does not address the underlying issue. Choice C, 'This is part of my job,' focuses on the task rather than the client's emotional needs. Choice D, 'Nurses get used to this,' minimizes the client's feelings and lacks empathy. By selecting choice B, 'You seem upset,' the nurse acknowledges the client's distress and opens the door for further communication and support.
A client who has undergone a mastectomy because of breast cancer is now undergoing chemotherapy, which has caused hair loss. The client states, 'I feel like I've lost my sense of power.' Which response would the nurse give?
A. 'Hair does not empower a person.'
B. 'Losing power seems important to you.'
C. Knowledge is power; I'll give you some pamphlets to read.'
D. 'Hair loss is common; it will grow back, so you should not worry.'
Correct answer:
The correct response is, 'Losing power seems important to you.' This response acknowledges the client's feelings and provides an opportunity for further discussion. Choice A is confrontational and dismissive, potentially shutting down communication. Choice C offers pamphlets, which may be seen as dismissing the client's concerns and avoiding engaging in a conversation. Choice D minimizes the client's feelings and may discourage further expression of emotions. By choosing option B, the nurse shows empathy and encourages the client to explore their emotions in a supportive environment.
Which action by a client who requires an above-the-knee amputation for peripheral arterial disease best indicates emotional readiness for the surgery?
A. Explains the goals of the procedure
B. Displays few signs of anticipatory grief
C. Participates in learning perioperative care
D. Verbalizes acceptance of permanent dependency needs
Correct answer:
Participating actively in learning self-care demonstrates emotional acceptance of the need for surgery and readiness for planning post-surgery. Explaining the goals of the procedure may reflect intellectual readiness but not necessarily emotional readiness. A client who shows few signs of anticipatory grief may be suppressing emotions or in denial, which can hinder the emotional readiness. Verbalizing acceptance of permanent dependency needs suggests the client may require further education and emotional support, as it may not reflect a healthy emotional readiness for the surgery.
The health care provider has changed a client's prescription from the PO to the IV route of administration. The nurse should anticipate which change in the pharmacokinetic properties of the medication?
A. The client will experience increased tolerance to the drug's effects and may need a higher dose.
B. The onset of action of the drug will occur more rapidly, resulting in a more rapid effect.
C. The medication will be more highly protein-bound, increasing the duration of action.
D. The therapeutic index will be increased, placing the client at greater risk for toxicity.
Correct answer:
When changing the route of administration from PO to IV, the absorption process is bypassed, leading to a more rapid onset of action of the medication and consequently a quicker effect. Choices A, C, and D are incorrect. Increased drug tolerance and higher doses are not typical outcomes of changing the route of administration. Protein binding does not increase with a change to IV administration; rather, it is the bioavailability and onset of action that are affected. Moreover, an increased therapeutic index reduces the risk of drug toxicity, contrary to what is stated in choice D.
When assessing an older adult, which vital sign changes would the nurse recognize as occurring with aging?
A. Increase in pulse rate
B. Widened pulse pressure
C. Increase in body temperature
D. Decrease in diastolic blood pressure
Correct answer:
When assessing an older adult, the nurse should be aware that with aging, systolic blood pressure tends to increase, resulting in widened pulse pressure. While in many older individuals both systolic and diastolic pressures increase, the pulse rate and body temperature typically do not increase with aging. Therefore, the correct answer is widened pulse pressure. Choices A, C, and D are incorrect because pulse rate does not necessarily increase with age, body temperature generally remains stable, and diastolic blood pressure may increase instead of decreasing in many older adults.
A client has just died, and their son states, 'She was the most wonderful mother. There was no one who was a better mother than she was. She was perfect.' Which stage of grief is this son experiencing?
A. Denial
B. Anger
C. Idealization
D. Shock
Correct answer:
The son is experiencing the idealization stage of grief. During this stage, individuals tend to idealize the deceased person and remember them in a highly positive light, overlooking any negative aspects. This idealization serves as a coping mechanism to deal with the loss. Choice A, Denial, is incorrect as denial involves refusing to accept the reality of the loss. Choice B, Anger, is incorrect as it involves feelings of resentment and frustration. Choice D, Shock, is incorrect as shock is the initial reaction to the loss and is different from idealizing the deceased individual.
The family of a child with cerebral palsy (CP) is at risk for difficult parenting issues. Which basis would the nurse conclude as the probable cause for this difficulty?
A. Lack of social support
B. Unrealistic expectations
C. Loss of the expected healthy child
D. Having a child with cognitive impairment
Correct answer:
The correct answer is 'Loss of the expected healthy child.' Parents of a child with cerebral palsy often grieve the loss of the healthy child they expected, mourning what could have been and what may never be. While lack of social support can contribute to parenting difficulties, it is not the primary basis in this case. Unrealistic expectations may play a role for some parents, but not all. Additionally, it is important to note that not all children with cerebral palsy experience cognitive impairment; around 30% to 50% of children with cerebral palsy have cognitive challenges.
The client is being instructed on the proper use of a metered-dose inhaler. Which instruction should the nurse provide to ensure the optimal benefits from the drug?
A. Fill your lungs with air through your mouth and then compress the inhaler.
B. Compress the inhaler while slowly breathing in through your mouth.
C. Compress the inhaler while inhaling quickly through your nose.
D. Exhale completely after compressing the inhaler and then inhale.
Correct answer:
To ensure optimal benefits from a metered-dose inhaler, the client should be instructed to compress the inhaler while slowly breathing in through the mouth. This technique facilitates the medication to reach deep into the lungs, allowing for an optimal bronchodilation effect. Option B is correct as it promotes the proper coordination of inhaler compression and inhalation, ensuring effective drug delivery. Options A, C, and D are incorrect as they do not support deep lung penetration of the medication, which is essential for its effectiveness in treating respiratory conditions.
Which mental health disorder is most likely to be treated with electroconvulsive therapy (ECT)?
A. Clinical depression
B. Substance abuse disorder
C. Antisocial personality disorder
D. Psychosis occurring in schizophrenia
Correct answer:
Electroconvulsive therapy (ECT) is commonly used to treat severe cases of clinical depression in individuals who have not responded well to psychotropic medications or when immediate intervention is necessary due to the severity of the depression. ECT is not typically a first-line treatment for substance abuse disorders, antisocial personality disorder, or psychosis occurring in schizophrenia. Clients with clinical depression who meet specific criteria and have not benefited from other treatments may be considered for ECT to alleviate symptoms and improve overall functioning.
In the care of a withdrawn, reclusive psychotic client, which goal is the priority?
A. Establish trust
B. Increase feelings of self-worth
C. Solidify sense of identity
D. Improve ability to socialize
Correct answer:
The priority goal in the care of a withdrawn, reclusive psychotic client is to establish trust. Trust is fundamental in building a therapeutic relationship, which is essential for effective care. Without trust, the client may not engage in therapy or interventions. Once trust is established, the nurse can then assess the client's feelings of self-worth, sense of identity, and ability to socialize. While these other goals are important in the overall care of the client, establishing trust forms the foundation for further progress in the therapeutic relationship and treatment.
NCLEX-RN mental health practice questions, set 18 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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The first five questions already include the rationale. Start full practice to unlock the remaining keys, missed-question review, and the rest of the bank.
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