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 RN exams exam guide or more RN 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
During an assessment of an 80-year-old patient, the nurse notices the following: an inability to identify vibrations at her ankle and to identify the position of her big toe, a slower and more deliberate gait, and a slightly impaired tactile sensation. All other neurologic findings are normal. The nurse should interpret that these findings indicate:
A. CN dysfunction.
B. Lesion in the cerebral cortex.
C. Normal changes attributable to aging.
D. Demyelination of nerves attributable to a lesion.
Show answer and rationale
Correct answer: C — Normal changes attributable to aging.
Rationale for Choice C (Correct Answer - Normal changes attributable to aging):
1. As people age, it is common to experience a decrease in sensory perception and motor function due to changes in the nervous system.
2. The inability to identify vibrations and position of the big toe, slower gait, and impaired tactile sensation are typical age-related changes.
3. Since all other neurologic findings are normal, it suggests these findings are likely due to normal aging processes.
4. There are no signs of acute dysfunction or specific lesions, supporting the interpretation that these findings are part of the natural aging process.
Summary of other choices:
A: CN dysfunction - Not supported as there are no findings indicative of cranial nerve dysfunction.
B: Lesion in the cerebral cortex - Not supported as there are no signs of a specific lesion in the cerebral cortex.
D: Demyelination of nerves attributable to a lesion - Not supported as there is no evidence of demyelination or lesion causing nerve damage.
Question 2
A nurse caring for a patient taking a serotonin reuptake inhibitor (SSRI) will develop outcome criteria related to:
A. mood improvement
B. logical thought processes
C. reduced levels of motor activity
D. decreased extrapyramidal symptoms
Show answer and rationale
Correct answer: A — mood improvement
The correct answer is A: mood improvement. SSRI medications are primarily used to treat depression and anxiety disorders by increasing serotonin levels in the brain, which can lead to improved mood. Outcome criteria for a patient taking an SSRI should focus on monitoring and assessing mood changes to evaluate the effectiveness of the medication.
B: Logical thought processes is incorrect because SSRI medications do not directly target cognitive processes, so it is not a specific outcome criteria related to SSRI use.
C: Reduced levels of motor activity is incorrect because SSRI medications do not typically cause significant changes in motor activity as a primary effect, so it is not a relevant outcome criteria for monitoring patients on SSRIs.
D: Decreased extrapyramidal symptoms is incorrect because extrapyramidal symptoms are typically associated with antipsychotic medications, not SSRIs. Monitoring for extrapyramidal symptoms would not be a relevant outcome criteria for a patient taking an SSRI.
Question 3
An 80-year-old woman is visiting the clinic for a checkup. She states, 'I can't walk as much as I used to.' The nurse is observing for motor dysfunction in her hip and should ask her to:
A. Internally rotate her hip while she is sitting.
B. Abduct her hip while she is lying on her back.
C. Adduct her hip while she is lying on her back.
D. Externally rotate her hip while she is standing.
Show answer and rationale
Correct answer: B — Abduct her hip while she is lying on her back.
The correct answer is B: Abduct her hip while she is lying on her back. This action tests the strength and range of motion of the hip abductors, which are commonly affected in older adults leading to difficulty in walking. By asking the patient to abduct her hip while lying on her back, the nurse can assess if there is any weakness or limitation in her hip abduction movement, which can indicate underlying motor dysfunction. Additionally, this position minimizes the impact of gravity and stabilizes the pelvis, allowing for a more accurate assessment of hip abduction strength.
Incorrect options:
A: Internally rotate her hip while she is sitting - This does not specifically target the hip abductors, which are more relevant in assessing walking difficulty.
C: Adduct her hip while she is lying on her back - Adduction movement is not as relevant in assessing motor dysfunction related to walking difficulty in this context.
D: Externally rotate her hip while she is standing - Standing position and external
Question 4
During an assessment of a 32-year-old patient with a recent head injury, the nurse notices that the patient responds to pain by extending, adducting, and internally rotating his arms. His palms pronate, and his lower extremities extend with plantar flexion. Which statement concerning these findings is most accurate? This patient's response:
A. Indicates a lesion of the cerebral cortex.
B. Indicates a completely nonfunctional brainstem.
C. Is normal and will go away in 24 to 48 hours.
D. Is a very ominous sign and may indicate brainstem injury.
Show answer and rationale
Correct answer: D — Is a very ominous sign and may indicate brainstem injury.
The correct answer is D. These decerebrate posturing responses are indicative of dysfunction in the brainstem. Specifically, the abnormal posturing seen in the patient suggests damage to the midbrain or pons. This type of response is considered a more severe sign compared to decorticate posturing, which typically indicates damage to the cerebral cortex. Decerebrate posturing is associated with a poorer prognosis and can be a sign of significant neurological injury. The other choices are incorrect:
A: Indicates a lesion of the cerebral cortex - This is incorrect because the patient's response is indicative of brainstem, not cortical, dysfunction.
B: Indicates a completely nonfunctional brainstem - This is an extreme and inaccurate statement. The patient is exhibiting specific posturing responses, indicating some brainstem function.
C: Is normal and will go away in 24 to 48 hours - This is incorrect as the described response is a pathological sign, not a normal one, and requires medical attention.
Question 5
Which nursing intervention would help the client to meet desired outcomes when demonstrating behaviors and verbalizations indicating a lack of guilt feelings?
A. Provide external limits on client behavior.
B. Foster discussions of rationales for behavioral change.
C. Implement interventions consistently by only one staff member.
D. Encourage the client to involve self in care.
Show answer and rationale
Correct answer: A — Provide external limits on client behavior.
The correct answer is A because providing external limits on client behavior helps establish boundaries and consequences for inappropriate actions, promoting accountability and potentially reducing guilt-inducing behaviors. This intervention can guide the client towards more appropriate behaviors and reinforce the importance of adhering to set limits.
Explanation of why the other choices are incorrect:
B: Foster discussions of rationales for behavioral change - While discussing rationales for behavioral change can be beneficial, it may not directly address the lack of guilt feelings in the client.
C: Implement interventions consistently by only one staff member - Consistency in interventions is important, but limiting interventions to one staff member may not be sufficient to address the underlying lack of guilt feelings.
D: Encourage the client to involve self in care - Encouraging client involvement in care is important for empowerment but may not directly address the lack of guilt feelings.
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Question 6
A nurse is caring for a client who is preparing his advance directives. Which of the following statements by the client indicates an understanding of advanced directives?
A. I can't change my instructions once a minute
B. My doctor will need to approve my advance directives
C. I need an attorney to witness my signature on the advance directives
D. I have the right to refuse treatment
Correct answer:
The correct answer is D: I have the right to refuse treatment. This statement indicates an understanding of advance directives as it acknowledges the client's autonomy in making decisions about their healthcare, including the option to refuse treatment. This aligns with the purpose of advance directives, which is to allow individuals to express their healthcare preferences in advance.
Explanation of incorrect choices:
A: I can't change my instructions once a minute - This statement is incorrect because individuals have the right to update or change their advance directives at any time.
B: My doctor will need to approve my advance directives - This is incorrect as advance directives are the patient's own preferences and do not require approval from the doctor.
C: I need an attorney to witness my signature on the advance directives - While having a witness is recommended, it does not necessarily have to be an attorney. This choice implies a misunderstanding of the requirements for advance directives.
Emily is a 28-year-old nurse who works on a psychiatric unit. She is assigned to work with Jenna, a 27-year-old who was admitted with major depressive disorder. Emily and Jenna realize that they graduated from the same high school and each has a 2-year-old daughter. Emily and Jenna discuss getting together for a play date with their daughters after Jenna is discharged. This situation reflects:
A. Successful termination
B. Promoting interdependence
C. Boundary blurring
D. A strong therapeutic relationship
Correct answer:
The correct answer is C: Boundary blurring. This situation reflects boundary blurring because Emily, as a nurse, is crossing professional boundaries by engaging in a personal and social relationship with Jenna, her patient. This can lead to ethical concerns, compromised therapeutic effectiveness, and potential harm to both parties. It is important for healthcare professionals to maintain clear boundaries to uphold professionalism, trust, and the therapeutic nature of the nurse-patient relationship.
A: Successful termination is incorrect as it refers to the conclusion of the therapeutic relationship, which is not the case here.
B: Promoting interdependence is incorrect as it involves fostering mutual reliance and support between individuals, which is not the focus of the situation described.
D: A strong therapeutic relationship is incorrect as it describes a positive and therapeutic connection between a healthcare provider and patient, which is not the issue in this scenario due to boundary blurring.
The nurse is assessing a young adult and determines that the individual has achieved successful resolution of the previous stage of growth and development, evidenced by demonstrating which of the following?
A. Drive and hope
B. Direction and purpose
C. Devotion and fidelity
D. Production and care
Correct answer:
The correct answer is C: Devotion and fidelity. This indicates that the individual has successfully resolved the stage of growth and development according to Erikson's theory of psychosocial development. Devotion refers to the ability to form solid relationships and commitments, while fidelity means being able to maintain loyalty and trust in these relationships. These qualities show that the individual has successfully navigated the intimacy vs. isolation stage, which is characteristic of young adulthood.
Now, let's analyze why the other choices are incorrect:
A: Drive and hope - These qualities are more related to the stage of initiative vs. guilt in early childhood, not the young adulthood stage.
B: Direction and purpose - While important, these qualities are more reflective of the previous stage of identity vs. role confusion in adolescence.
D: Production and care - These qualities are more associated with the later stage of generativity vs. stagnation in middle adulthood, not young adulthood.
Which of the following statements are examples of the therapeutic communication technique of"focusing"? Select all that apply.
A. "You say you're angry, but I notice that you're smiling."
B. "Are you saying that you want to drive to Hawaii?"
C. "Tell me again about Vietnam and your feelings after you were wounded."
D. "I see you staring out the window. Tell me what you're thinking."
Correct answer:
The correct answer is C because it demonstrates focusing by redirecting the conversation back to a specific topic or issue, encouraging the client to elaborate on their thoughts and feelings. By asking the client to recount their experience in Vietnam and their emotions after being wounded, the therapist is helping the client concentrate on a particular aspect of their story.
Choices A, B, and D are incorrect:
A: This statement does not exemplify focusing as it points out a discrepancy between the client's words and body language, which may lead to defensiveness and does not encourage the client to delve deeper into their thoughts or feelings.
B: This statement does not involve focusing but rather reflects a literal interpretation of the client's words without guiding the conversation towards a specific topic or emotion.
D: While this statement acknowledges the client's behavior, it does not guide the conversation towards a specific topic or emotion, thus not demonstrating the focusing technique.
When the nurse focuses on a client's specific behavior rather than on the individuality of the client, the nurse is using a strategy of nonthreatening feedback. Which of the following nursing statements are examples of this strategy? Select all that apply.
A. "It's okay to be angry, but throwing the book was unacceptable behavior."
B. "I can't believe that you are always this manipulative."
C. "You are an irresponsible person regarding your life choices."
D. "Asking for meds every 2 hours proves that you are drug seeking."
Correct answer:
The correct answer is A because it focuses on the specific behavior (throwing the book) rather than making a general statement about the client. This approach acknowledges the client's emotions (anger) while addressing the behavior as unacceptable. This feedback is nonthreatening as it separates the behavior from the individual, allowing for constructive discussion without attacking the client's character or making sweeping judgments.
Explanation of why other choices are incorrect:
B: This statement makes a sweeping judgment about the client being manipulative without addressing specific behaviors, which can be threatening and unhelpful.
C: This statement generalizes the client as irresponsible without focusing on specific behaviors, which may be perceived as judgmental and threatening.
D: This statement assumes the client is drug-seeking based on a single behavior without exploring underlying reasons or addressing the behavior specifically, which can be perceived as accusatory and threatening.
The experience of being physically restrained can be traumatic. Which nursing intervention would best help the client deal with this experience?
A. Administering a tranquilizing medication before applying the restraints
B. Talking to the client at brief but regular intervals while the client is restrained
C. Decreasing stimuli by leaving the client alone most of the time
D. Checking on the client infrequently, in order to meet documentation requirements
Correct answer:
The most appropriate nursing intervention to help a client deal with the traumatic experience of being physically restrained is to talk to the client at brief but regular intervals while they are restrained (Option B). This intervention helps maintain communication and a sense of connection with the client, offering support and reassurance during a potentially distressing situation. By engaging with the client regularly, the nurse can provide comfort, monitor the client's well-being, and assess their needs. It also helps prevent feelings of isolation or abandonment that can exacerbate the trauma associated with being restrained. Administering tranquilizers before applying restraints (Option A) is not the best approach as it can have sedative effects that may not be necessary or beneficial for the client. Leaving the client alone most of the time (Option C) and checking on the client infrequently (Option D) are not recommended as they can increase feelings of distress and helplessness in the client.
A nursing assistant's responsibility for the resident during discharge ends
A. When the doctor writes the discharge order
B. When the resident's belongings are packed
C. When the resident is seated in the vehicle
D. When the vehicle's doors are closed
Correct answer:
The correct answer is C. A nursing assistant's responsibility for the resident during discharge ends when the resident is safely seated in the vehicle. This is because the nursing assistant's duty is to ensure the safe transfer of the resident from the facility to the vehicle. Once the resident is seated in the vehicle, the nursing assistant's direct responsibility for the resident's well-being ceases as the transportation process has been successfully completed.
Choice A is incorrect because the doctor writing the discharge order does not directly relate to the nursing assistant's responsibility for the resident's discharge process. Choice B is incorrect as the packing of the resident's belongings is not the main focus of the nursing assistant's duty during discharge. Choice D is incorrect because the closing of the vehicle's doors is not the key indicator for the completion of the nursing assistant's responsibilities; ensuring the resident's safe seating in the vehicle is the critical factor.
A 67-year-old female smoker with a family history of high blood pressure and heart disease presents with acute onset neck pain, headache, and a blood pressure of 175/100 mm Hg. What should the physical therapist do FIRST?
A. Refer the patient for assessment by a physician.
B. Assume that this is a 'white coat' effect and continue with the usual examination.
C. Continue the examination but modify the order and extent of the tests.
D. Modify the examination to avoid manual therapy and offer simple exercises.
Correct answer:
The correct answer is A: Refer the patient for assessment by a physician. Given the patient's age, smoking history, family history, and elevated blood pressure, there is a high likelihood of cardiovascular issues. As a physical therapist, it is crucial to prioritize patient safety and rule out any serious medical conditions before proceeding with any interventions. Referring the patient for immediate medical assessment allows for proper diagnosis and management of potential cardiovascular emergencies. This is the first and most important step to ensure the patient's well-being.
Other choices are incorrect because:
B: Assuming it is a 'white coat' effect overlooks the serious symptoms and risks associated with the patient's presentation.
C: Continuing the examination with modifications may delay necessary medical intervention and put the patient at risk.
D: Modifying the examination and avoiding manual therapy may not address the underlying cause of the symptoms and delay appropriate medical care.
Holly is a 53-year-old female with terminal breast cancer. Holly's nurse in the hospital brings up the subject of hospice care. Holly becomes upset and states, 'I am not ready to give up and die.' You respond that hospice is:
A. A model of healthcare that emphasizes quality of life for you and your family.
B. The end of curative treatments and pain management.
C. A multidisciplinary team providing curative and therapeutic treatment.
D. An aggressive medical plan to end suffering and hasten death.
Correct answer:
The correct answer is A because hospice care focuses on enhancing the quality of life for patients with terminal illnesses and their families. It provides holistic support, including pain management, emotional and spiritual care, and practical assistance. By bringing up hospice care, the nurse is offering a compassionate approach that aims to ensure comfort and dignity for Holly during her end-of-life journey.
Choice B is incorrect because hospice care does not necessarily mean the end of all treatments. It shifts the focus from curative treatments to palliative care, but it still provides medical support to manage symptoms and improve comfort.
Choice C is incorrect as hospice care does not provide curative treatment. It focuses on comfort care and symptom management rather than trying to cure the terminal illness.
Choice D is incorrect because hospice care is not about hastening death. It aims to provide support and comfort during the natural end-of-life process, not to aggressively end life.
A college-aged student and his friend arrive at the student health center. The friend reports that the patient has been having difficulties concentrating, remembering, and thinking. 'He's had quite a few research papers due this past week.' After ruling out other problems, the nurse determines that the patient is experiencing a culture-bound syndrome. Which of the following would the nurse most likely suspect?
A. Ataque de nervios
B. Brain fog
C. Mal de ojo
D. Shenjing shuairo
Correct answer:
The correct answer is B: Brain fog. The symptoms described by the friend, such as difficulties concentrating, remembering, and thinking, are characteristic of brain fog, a common term used to describe cognitive difficulties. This is not specific to any particular culture, making it a more likely explanation compared to the other choices.
A: Ataque de nervios is a culture-bound syndrome seen in Latino populations, characterized by symptoms like emotional distress and uncontrollable outbursts, which do not align with the symptoms described in the scenario.
C: Mal de ojo is another culture-bound syndrome, known as the evil eye, which is believed to cause harm through a malevolent glare. This does not align with the cognitive difficulties described in the scenario.
D: Shenjing shuairo is a culture-bound syndrome in Chinese populations, characterized by physical and psychological symptoms, such as weakness and fatigue, which are not consistent with the cognitive symptoms described in the scenario.
RN exams mental health practice questions, set 12 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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