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 LPN exams exam guide or more LPN exams 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
A patient has anxiety, increased heart rate, and fear. The nurse would suspect the presence of a high concentration of which neurotransmitter?
A. GABA
B. Histamine
C. Acetylcholine
D. Norepinephrine
Show answer and rationale
Correct answer: D — Norepinephrine
The correct answer is D: Norepinephrine. In anxiety and fear, the body's "fight or flight" response is activated, leading to increased heart rate and heightened arousal. Norepinephrine is a neurotransmitter that plays a key role in this response by increasing heart rate, blood pressure, and alertness. A high concentration of norepinephrine is associated with these symptoms.
A: GABA is an inhibitory neurotransmitter that typically has a calming effect, so a high concentration of GABA would not produce symptoms of anxiety and increased heart rate.
B: Histamine is involved in allergic reactions and regulates sleep-wake cycles, not typically associated with anxiety and increased heart rate.
C: Acetylcholine is involved in muscle control and memory, not directly related to anxiety symptoms such as increased heart rate and fear.
In summary, the presence of anxiety, increased heart rate, and fear points towards a high concentration of norepinephrine due to
Question 2
A client tells a nurse, 'Don't tell anyone, but I hid a sharp knife under my mattress to protect myself from my threatening roommate.' Which of the following actions should the nurse take?
A. Keep the client's communication confidential, but talk to the client daily using therapeutic communication to convince them to admit to hiding the knife
B. Keep the client's communication confidential, but watch the client and their roommate closely
C. Tell the client that this must be reported to the health care team because it concerns the health and safety of the client and others
D. Report the incident to the health care team but do not inform the client of the intention to do so
Show answer and rationale
Correct answer: C — Tell the client that this must be reported to the health care team because it concerns the health and safety of the client and others
In this scenario, the nurse must prioritize the safety of the client and others. The client's disclosure of hiding a sharp knife under the mattress poses a significant risk. It is crucial for the nurse to inform the health care team about this situation to ensure immediate intervention and prevent any harm. Confidentiality is important in nursing care, but in cases where there is a clear threat to safety, the duty to protect overrides the duty of confidentiality. Reporting the incident to the health care team is essential to address the safety concerns and provide appropriate support and intervention for the client. Choices A and B are incorrect because while confidentiality is important, the immediate safety concern outweighs keeping the client's communication confidential or simply monitoring the situation. Choice D is incorrect as it does not involve informing the client, which can impact the therapeutic relationship and trust between the nurse and the client.
Question 3
A nurse is working with a patient who has bipolar disorder. The patient is currently in a manic episode. Which of the following interventions is most appropriate?
A. Encouraging the patient to engage in social activities
B. Providing a calm and structured environment
C. Reassuring the patient that their symptoms will improve with medication
D. Allowing the patient to express their feelings without limits
Show answer and rationale
Correct answer: B — Providing a calm and structured environment
The correct answer is B: Providing a calm and structured environment. During a manic episode, individuals with bipolar disorder may exhibit high energy levels, impulsivity, and decreased need for sleep. A calm and structured environment can help reduce stimuli that may exacerbate manic symptoms and promote stability. It can also help prevent impulsive behaviors and maintain a sense of safety.
Choice A (Encouraging the patient to engage in social activities) may not be appropriate during a manic episode as social interactions can be overwhelming and may lead to increased impulsivity. Choice C (Reassuring the patient that their symptoms will improve with medication) may not be effective during an acute manic episode as immediate symptom relief may not be achieved solely through medication. Choice D (Allowing the patient to express their feelings without limits) may not provide the necessary structure and boundaries needed to manage manic symptoms effectively.
Question 4
What is the best indicator of commitment to recovery for a client seen in the clinic for substance abuse treatment follow-up?
A. Rationalization and blaming
B. Continued abstinence
C. Recurrent lapses
D. Keeping scheduled appointments
Show answer and rationale
Correct answer: B — Continued abstinence
Continued abstinence Explanation: Continued use of a substance instead of making changes in behavior or using effective coping skills shows a lack of commitment to recovery. When clients avoid or even decrease substance use, this supports a sense of commitment to quit using, and this initial commitment leads to initiating behavior changes, and a sense of control to prepare them for facing high-risk situations. Signs of recovery include: Commitment and motivation to remain abstinent Initiating change Maintenance and effective coping Rationalization of drug use or assigning blame is not an effective coping strategy and does not support a commitment to recovery. Lapses resulting in substance use may occur and do not indicate a lack of commitment to recovery; however, repeated lapses increase the risk for relapse (uncontrolled use). Keeping appointments and making meetings indicates a commitment to a recovery, but continued abstinence is a more reliable indicator.
Question 5
A nurse is assessing a patient with bipolar disorder. The nurse observes signs of psychomotor agitation, racing thoughts, and tangentiality. What should the nurse document about the patient's thought process?
A. Coherence, logic, relevance, and organization
B. Flight of ideas, racing thoughts, and tangentiality
C. Themes, topics, beliefs, and perceptions
D. Signs of delusions, hallucinations, paranoia
Show answer and rationale
Correct answer: B — Flight of ideas, racing thoughts, and tangentiality
Choice A rationale: This choice is related to assessing the thought process, but it does not accurately address the specific signs described in the scenario: flight of ideas, racing thoughts, and tangentiality. Choice B rationale: This statement is correct. Flight of ideas, racing thoughts, and tangentiality are indicative of disorganized thought processes commonly seen in manic episodes of bipolar disorder. Flight of ideas refers to a rapid succession of thoughts that may be loosely connected, racing thoughts involve a constant stream of rapid thoughts, and tangentiality refers to veering off-topic during conversation. Choice C rationale: While understanding themes, topics, beliefs, and perceptions is important in a comprehensive psychiatric assessment, this choice does not address the specific signs mentioned. Choice D rationale: Delusions, hallucinations, and paranoia are not directly related to the disorganized thought processes described in the scenario.
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Question 6
Which factors are essential during the nursing assessment of child abuse?
A. Psychological evaluation of the caregiver only.
B. Collecting subjective and objective data only.
C. Assessing the child's developmental milestones only.
D. Collecting subjective and objective data, assessing developmental milestones, and ensuring the child's consent and comfort.
Correct answer:
Choice A rationale: 'Psychological evaluation of the caregiver only.' - This can provide valuable insights, but it is not a core component of the nursing assessment of child abuse. The focus should be on the child's well-being and safety. Choice B rationale: 'Collecting subjective and objective data only.' - While crucial, this alone is incomplete without considering developmental milestones and the child's comfort. Choice C rationale: 'Assessing the child's developmental milestones only.' - This is important but insufficient without data collection and ensuring comfort. Choice D rationale: 'Collecting subjective and objective data, assessing developmental milestones, and ensuring the child's consent and comfort.' - This combines all essential elements: gathering comprehensive data about the child's state, monitoring developmental progress to identify abuse indicators, and ensuring the child feels safe and respected, fostering trust and accurate information.
When performing a musculoskeletal assessment, the nurse knows that the correct approach for the examination should be:
A. Proximal to distal.
B. Distal to proximal.
C. Posterior to anterior.
D. Anterior to posterior.
Correct answer:
The correct approach for a musculoskeletal assessment is to examine from proximal to distal. This means starting closer to the body's center and moving towards the extremities. This approach helps to assess for overall strength, range of motion, and joint stability before focusing on specific areas. By starting proximally, the nurse can establish a baseline assessment and then progress methodically to evaluate each joint and muscle group. This systematic approach ensures a comprehensive evaluation of the musculoskeletal system.
Summary of Other Choices:
B: Distal to proximal - This approach may miss important information about overall strength and stability.
C: Posterior to anterior - This sequence is not ideal for a musculoskeletal assessment as it doesn't follow the natural flow of muscle and joint movements.
D: Anterior to posterior - This order may not provide a holistic view of the musculoskeletal system and may lead to missing relevant findings.
Which situation is an example of a nurse engaging in the Socio-Ecological Model to guide nursing care?
A. Administering insulin to a client with type 2 diabetes who has seen a worsening of their glycemic control despite taking metformin
B. Evaluating the causative factors of an observed increase in the number of grade-school children with newly diagnosed asthma
C. Evaluating the impact of lisinopril on a client's blood pressure 3 months after starting the medication
D. Planning an education session for a client following surgery with a goal of independently changing the surgical site dressing
Correct answer:
The correct answer is B because evaluating causative factors of an observed increase in newly diagnosed asthma in grade-school children aligns with the Socio-Ecological Model. This model examines multiple levels of influence on health outcomes, including individual, interpersonal, community, and societal factors. By evaluating causative factors, the nurse considers not only individual health behaviors but also environmental, social, and policy factors contributing to the health issue. This approach allows for a comprehensive understanding of the problem and guides nursing care interventions that address the root causes.
Choices A, C, and D focus more on individual-level care and management rather than examining broader factors influencing health outcomes. Administering insulin, evaluating medication impact, and planning education sessions are important aspects of nursing care but do not encompass the holistic view provided by the Socio-Ecological Model.
A 76-year-old patient who is determined to be a poor 2D6 metabolizer is being prescribed vortioxetine for his depression. What does the PMHNP need to remember when prescribing this drug?
A. The dosage of the drug will need to be increased
B. The dosage needs to begin at half then increase over a 2-week period
C. The dosage should not exceed ½ of the usual recommended dose
D. An adjunct medication will need to be prescribed until the dosage can be reduced
Correct answer:
The correct answer is C: The dosage should not exceed ½ of the usual recommended dose. Vortioxetine is primarily metabolized by the CYP2D6 enzyme. In poor 2D6 metabolizers, the metabolism of vortioxetine is significantly reduced, leading to higher drug levels in the body. Therefore, to prevent potential adverse effects or toxicity, the dosage should be reduced to avoid exceeding the usual recommended dose.
A: The dosage of the drug will need to be increased - Incorrect. Due to reduced metabolism in poor 2D6 metabolizers, increasing the dosage would lead to higher drug levels and increased risk of adverse effects.
B: The dosage needs to begin at half then increase over a 2-week period - Incorrect. Starting at half the dose is not sufficient for poor metabolizers as they may still experience increased drug levels.
D: An adjunct medication will need to be prescribed until the dosage can be reduced - Incorrect. Adding another medication is not necessary
A male patient reports to the nurse, 'I’m told I have memories of childhood abuse stored in my unconscious mind. I want to work on this.' Based on this statement, what information should the nurse provide the patient?
A. To seek the help of a trained therapist to help uncover and deal with the trauma associated with those memories.
B. How to use a defense mechanism such as suppression so that the memories will be less threatening.
C. Psychodynamic therapy will allow the surfacing of those unconscious memories to occur in just a few sessions.
D. Group sessions are valuable to identify underlying themes of the memories being suppressed.
Correct answer:
Correct Answer: A
Rationale: Seeking the help of a trained therapist is crucial for handling childhood abuse memories stored in the unconscious mind. A therapist can provide a safe space, guidance, and support to explore and process these traumatic memories. Working with a therapist trained in trauma therapy techniques can help the patient navigate the emotional challenges and develop coping strategies. Therapeutic intervention is essential for addressing the impact of childhood abuse on mental health and well-being.
Summary of Incorrect Choices:
B: Using defense mechanisms like suppression can lead to avoidance and may not address the root cause of the trauma.
C: Psychodynamic therapy takes time and multiple sessions to explore unconscious memories effectively, not just a few sessions.
D: Group sessions may not provide the individualized support and focus needed to address specific childhood abuse memories and their associated trauma effectively.
What is the most appropriate intervention for the school nurse to implement to promote a healthy school environment?
A. Advocate for nutritious school lunch programs
B. Provide care for children with asthma
C. Develop individualized health plans
D. Educate students and families about screening for scoliosis
Correct answer:
The correct answer is A: Advocate for nutritious school lunch programs. This intervention promotes a healthy school environment by ensuring students have access to nutritious meals, which are essential for their overall health and well-being. By advocating for nutritious school lunch programs, the school nurse can help improve students' physical health, cognitive functioning, and overall academic performance. This intervention also aligns with the school nurse's role in promoting preventive health measures.
Summary:
B: Providing care for children with asthma is important but does not address the broader goal of promoting a healthy school environment.
C: Developing individualized health plans is beneficial for specific students but may not impact the overall school environment.
D: Educating students and families about screening for scoliosis is important for early detection but does not directly contribute to creating a healthy school environment.
A 20 year old male is brought to the hospital approximately 30 minutes after being stabbed in the chest. There is a 3cm wound just medial to the left nipple. His BP is 70/33 and HR is 140. Neck and arm veins are distende Breath sounds are normal. Heart sounds are diminished, IV access has been established and warm crystalloid is infusing. The next most important aspect of immediate management is:
A. "CT scan of the chest"
B. "12 lead ECG"
C. "FAST exam"
D. "Begin infusion of RBCs"
Correct answer:
The correct answer is C: "FAST exam." In this scenario, the patient presents with signs of hypovolemic shock following a chest stab wound. The FAST exam (Focused Assessment with Sonography in Trauma) is crucial for rapid identification of intra-abdominal bleeding, which can occur concurrently with thoracic injuries. It is a quick and non-invasive bedside ultrasound assessment that can detect free fluid in the pericardial, pleural, and peritoneal spaces. Identifying intra-abdominal bleeding is important as it may require emergent surgical intervention to prevent further deterioration.
Choice A, "CT scan of the chest," would take more time and is not the immediate priority in a hemodynamically unstable patient. Choice B, "12 lead ECG," is important in assessing for cardiac injury but is not the most critical step in this scenario. Choice D, "Begin infusion of RBCs," may be necessary later but addressing the source of bleeding and volume status through
Some lifetime habits and hobbies affect postoperative respiratory function. If your client smokes 3 packs of cigarettes a day for the past 10 years, you will anticipate increased risk for:
A. perioperative anxiety and stress
B. delayed coagulation time
C. delayed wound healing
D. postoperative respiratory function
Correct answer:
The correct answer is D: postoperative respiratory function. Smoking 3 packs of cigarettes a day for 10 years can lead to respiratory issues such as decreased lung function, increased risk of respiratory infections, and impaired wound healing due to reduced oxygen levels in the blood. This will negatively impact postoperative respiratory function, making it harder for the client to recover and potentially leading to complications like pneumonia.
A: Perioperative anxiety and stress are not directly related to smoking habits but can be influenced by various factors such as fear of surgery or anesthesia.
B: Delayed coagulation time is more related to factors like medication use or underlying medical conditions affecting blood clotting, not smoking habit.
C: Delayed wound healing can be affected by smoking due to reduced blood flow and oxygen delivery, but it is not the primary concern in this scenario compared to postoperative respiratory function.
A client diagnosed with bipolar disorder has taken lithium carbonate (Lithane) for 1 year; this client presents in an emergency department with severe diarrhea, blurred vision, and tinnitus. The nurse should interpret these symptoms to be indicative of which of the following?
A. Consumption of foods high in tyramine
B. Common side effects of lithium carbonate
C. Lithium carbonate tolerance
D. Lithium carbonate toxicity
Correct answer:
The correct answer is D: Lithium carbonate toxicity. The symptoms of severe diarrhea, blurred vision, and tinnitus are indicative of lithium toxicity. Severe diarrhea can lead to dehydration, which can exacerbate lithium toxicity. Blurred vision and tinnitus are neurological symptoms associated with lithium toxicity. It is important for the nurse to recognize these symptoms as signs of lithium toxicity and take appropriate action.
A: Consumption of foods high in tyramine is not related to the symptoms described. Tyramine is not known to cause severe diarrhea, blurred vision, or tinnitus.
B: Common side effects of lithium carbonate typically include mild gastrointestinal upset, tremors, and increased thirst, not the severe symptoms described in the question.
C: Lithium carbonate tolerance refers to the body's ability to withstand higher doses of lithium over time. It does not present with the acute, severe symptoms described in the question.
A nurse is implementing nursing interventions for a child with DSED. Which intervention aims to protect the child from further harm?
A. Providing education about attachment and its types.
B. Administering psychological tests for diagnosis.
C. Referring the child and caregiver to a support group.
D. Reporting suspected cases of neglect or abuse.
Correct answer:
Choice A rationale: Educating the child and caregivers about attachment and its types is important, but it doesn't directly protect the child from further harm in the context of Disinhibited Social Engagement Disorder (DSED). Choice B rationale: Administering psychological tests for diagnosis is a valid step, but it's not an intervention aimed at protecting the child from harm. It's a diagnostic process, not a protective measure. Choice C rationale: Referring the child and caregiver to a support group can be beneficial for emotional support, but it doesn't directly address protection from harm, which is the primary concern in this scenario. Choice D rationale: Reporting suspected cases of neglect or abuse is crucial to ensure the child's safety. Children with DSED might engage with strangers without appropriate caution, which could expose them to potential danger. Reporting ensures that professionals can intervene to safeguard the child's well-being.
LPN exams mental health practice questions, set 7 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.
Keep going past these 15 questions
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