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
A client on the mental health unit is becoming more agitated, shouting at the staff, and pacing in the hallway. When a PRN medication is offered, the client refuses the medication and defiantly sits on the floor in the middle of the unit hallway. What nursing intervention should the nurse implement first?
A. Transport the client to the seclusion room.
B. Quietly approach the client with additional staff members.
C. Take other clients in the area to the client lounge.
D. Administer medication to chemically restrain the client.
Show answer and rationale
Correct answer: C — Take other clients in the area to the client lounge.
The correct answer is C: Take other clients in the area to the client lounge. This intervention prioritizes the safety and well-being of both the agitated client and other clients in the unit. By removing other clients from the potentially escalating situation, the nurse can prevent further agitation or harm. This intervention also allows the client some space and privacy to calm down without an audience, potentially reducing their agitation.
Incorrect choices:
A: Transport the client to the seclusion room - This is a restrictive measure and should only be used as a last resort for safety reasons.
B: Quietly approach the client with additional staff members - Approaching an agitated client may escalate the situation, especially if the client is refusing medication.
D: Administer medication to chemically restrain the client - Chemical restraint should only be used as a last resort and must follow specific protocols and guidelines. It should not be the first intervention attempted.
Question 2
When obtaining a client's history, the nurse determines that the client has been experiencing delusions and hallucinations for the past 3 months, which has caused some problems in his ability to function on a daily basis at work. He also is exhibiting catatonic excitement, echopraxia, loose associations, and pressured speech. The nurse suspects which of the following?
A. Schizophrenia
B. Schizoaffective disorder
C. Brief Psychotic disorder
D. Schizophreniform disorder
Show answer and rationale
Correct answer: D — Schizophreniform disorder
The correct answer is D: Schizophreniform disorder. This disorder is characterized by symptoms similar to schizophrenia but lasting between 1 to 6 months. In this case, the client has been experiencing delusions, hallucinations, catatonic excitement, echopraxia, loose associations, and pressured speech for the past 3 months. This aligns with the timeframe and symptomatology of schizophreniform disorder.
A: Schizophrenia is a long-term mental disorder lasting for at least 6 months. The client's symptoms have been present for only 3 months, making schizophrenia less likely.
B: Schizoaffective disorder involves both psychotic symptoms and mood disturbances. There is no mention of mood disturbances in the client's presentation, making this choice less likely.
C: Brief Psychotic disorder involves sudden onset of psychotic symptoms lasting less than 1 month. The client's symptoms have been present for 3 months, ruling out this diagnosis.
In summary, the client's presentation of symptoms
Question 3
Which belief will best support a nurse's efforts to provide patient advocacy during a multidisciplinary patient care planning session?
A. All mental illnesses are culturally determined.
B. Schizophrenia and bipolar disorder are cross-cultural disorders.
C. Symptoms of mental disorders are unchanged from culture to culture.
D. Assessment findings in mental illness reflect a person's cultural patterns.
Show answer and rationale
Correct answer: D — Assessment findings in mental illness reflect a person's cultural patterns.
Step-by-step rationale for why answer D is correct:
1. Assessment findings in mental illness reflect a person's cultural patterns: This belief acknowledges the importance of cultural considerations in understanding and addressing mental health issues.
2. By recognizing cultural patterns in assessment findings, the nurse can provide more personalized and effective care.
3. Understanding cultural influences can help the nurse advocate for patient-centered care during multidisciplinary care planning.
4. This belief aligns with the principles of cultural competence and patient advocacy in healthcare.
Summary:
- Choice A is incorrect as mental illnesses can have biological, psychological, and social determinants in addition to cultural factors.
- Choice B is incorrect as it generalizes specific disorders without considering individual and cultural variations.
- Choice C is incorrect as symptoms can manifest differently across cultures due to various factors beyond just the disorder itself.
Question 4
A nurse is planning a support group for the families of patients with psychiatric disorders. The nurse integrates knowledge of which of the following as the primary underlying issue related to stress that the families experience?
A. Severity of the patient's symptoms
B. Barriers faced by the patient
C. Stigma associated with the diagnosis
D. Risk for relapse
Show answer and rationale
Correct answer: C — Stigma associated with the diagnosis
The correct answer is C: Stigma associated with the diagnosis. Stigma can lead to feelings of shame, isolation, and discrimination for families of patients with psychiatric disorders, causing significant stress. Families may struggle with societal judgment and misconceptions about mental illness, impacting their ability to seek support and cope effectively. Understanding and addressing stigma is crucial in supporting families.
Explanation of why the other choices are incorrect:
A: Severity of the patient's symptoms - While the severity of symptoms can be distressing for families, it is not the primary underlying issue related to stress.
B: Barriers faced by the patient - Although barriers faced by the patient can contribute to stress, it is not the primary underlying issue experienced by families.
D: Risk for relapse - While the risk for relapse can be a concern, it is not necessarily the primary underlying issue related to stress for families of patients with psychiatric disorders.
Question 5
When making a distinction as to whether an elderly patient has confusion related to delirium or another problem, what information would be of particular value?
A. Evidence of spasticity or flaccidity
B. The patient’s level of motor activity
C. Medications the patient has recently taken
D. Level of preoccupation with somatic symptoms
Show answer and rationale
Correct answer: C — Medications the patient has recently taken
The correct answer is C: Medications the patient has recently taken. This information is crucial because certain medications can cause symptoms of delirium or exacerbate confusion in elderly patients. By reviewing the patient's recent medications, healthcare providers can identify potential drug-induced causes of confusion and adjust the treatment accordingly.
Choice A (Evidence of spasticity or flaccidity) is incorrect because these symptoms are more related to neurological conditions such as stroke or spinal cord injury, not specifically delirium.
Choice B (The patient’s level of motor activity) is not as relevant in distinguishing delirium from other problems as medication history, as motor activity can be influenced by various factors.
Choice D (Level of preoccupation with somatic symptoms) is also less relevant compared to medication history in differentiating delirium, as somatic symptoms may not always directly indicate the underlying cause of confusion in elderly patients.
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Question 6
Shortly after the parents announced that they were divorcing, a 15-year-old became truant from school and assaulted a friend. The adolescent told the school nurse, 'I'd rather stay in my room and listen to music. It's easier than thinking about what is happening in my family.' Which nursing diagnosis is most applicable?
A. Chronic low self-esteem related to role within the family
B. Decisional conflict related to compliance with school requirements
C. Defensive coping related to adjustment to changes in family relationships
D. Disturbed personal identity related to self-perceptions of changing family dynamics
Correct answer:
The correct answer is C: Defensive coping related to adjustment to changes in family relationships. The adolescent's behavior of truancy and aggression towards a friend indicates they are using defensive coping mechanisms to avoid dealing with the stress of their parents' divorce. This diagnosis focuses on the maladaptive coping strategies being used by the individual.
A: Chronic low self-esteem is not the most applicable diagnosis in this case as the behavior described is more indicative of avoidance and coping mechanisms rather than self-esteem issues.
B: Decisional conflict related to compliance with school requirements does not address the underlying emotional distress the adolescent is experiencing due to the family situation.
D: Disturbed personal identity related to self-perceptions of changing family dynamics is not the most appropriate diagnosis as it does not directly address the defensive coping mechanisms being used by the adolescent in response to the family changes.
A child known as the neighborhood bully says, 'Nobody can tell me what to do.' After receiving a poor grade on a science project, this child secretly loaded a virus on the teacher's computer. These behaviors support a diagnosis of
A. CD.
B. ODD.
C. intermittent explosive disorder.
D. ADHD.
Correct answer:
The correct answer is B: Oppositional Defiant Disorder (ODD). ODD is characterized by a pattern of hostile and defiant behavior towards authority figures. In this scenario, the child's refusal to follow rules and defiance of authority by saying 'Nobody can tell me what to do' aligns with ODD. Additionally, the act of secretly loading a virus on the teacher's computer as a form of revenge is a manifestation of the vindictive and spiteful nature often seen in individuals with ODD.
Incorrect choices:
A: CD (Conduct Disorder) typically involves more serious and persistent antisocial behavior, such as aggression towards people or animals, destruction of property, and violation of rules.
C: Intermittent Explosive Disorder is characterized by recurrent outbursts of aggression that are disproportionate to the situation. This child's behavior is more planned and targeted.
D: ADHD (Attention-Deficit/Hyperactivity Disorder) does not account for the deliberate and calculated nature of the
Shortly after the parents announced that they were divorcing, a 15-year-old became truant from school and assaulted a friend. The adolescent told the school nurse, 'I'd rather stay in my room and listen to music. It's easier than thinking about what is happening in my family.' Which nursing diagnosis is most applicable?
A. Chronic low self-esteem related to role within the family
B. Decisional conflict related to compliance with school requirements
C. Defensive coping related to adjustment to changes in family relationships
D. Disturbed personal identity related to self-perceptions of changing family dynamics
Correct answer:
The correct answer is C: Defensive coping related to adjustment to changes in family relationships. The adolescent's behavior of truancy and assault is a coping mechanism to avoid dealing with the stress and turmoil caused by the parents' divorce. This choice addresses the underlying issue of struggling to adjust to the changes in family dynamics and using defensive coping mechanisms to deal with the emotional distress.
A: Chronic low self-esteem is not the most appropriate diagnosis in this case as the behavior exhibited is more related to coping with family changes rather than self-esteem issues.
B: Decisional conflict related to school compliance is not the best choice as the behavior is not primarily driven by conflicts related to school requirements.
D: Disturbed personal identity related to changing family dynamics is not the most suitable diagnosis as the primary issue lies in the coping mechanism and adjustment to family changes rather than personal identity disturbances.
When considering stress, what is the primary goal of making daily entries into a personal journal?
A. Providing a distraction from the daily stress
B. Expressing emotions to manage stress
C. Identifying stress triggers
D. Focusing on one's stress
Correct answer:
The correct answer is B: Expressing emotions to manage stress. By making daily entries in a personal journal, individuals can effectively express their emotions, thoughts, and feelings related to stress. This process helps in acknowledging and processing these emotions, leading to better stress management. Writing in a journal can serve as a cathartic outlet, allowing individuals to release pent-up emotions and gain clarity on their stressors. This practice promotes self-awareness, emotional regulation, and a sense of control over stressors.
Incorrect Choices:
A: Providing a distraction from the daily stress - Journaling is more about facing and processing stress rather than avoiding it.
C: Identifying stress triggers - While journaling may help in identifying stress triggers, the primary goal is to express emotions rather than solely focusing on triggers.
D: Focusing on one's stress - Journaling aims to manage stress by expressing emotions, not by fixating solely on stress itself.
Which person would the nurse assess as experiencing chronic sorrow?
A. The mother of a child diagnosed with asthma
B. The father of an adult son who is a schizophrenic
C. The daughter whose father experienced a hip replacement
D. The wife whose husband has recently requested a trial separation
Correct answer:
The correct answer is B because chronic sorrow is a continuous feeling of grief or sadness that occurs when there is a discrepancy between the reality of a situation and the individual's expectations or hopes. In this case, the father of an adult son who is schizophrenic is likely to experience chronic sorrow due to the ongoing challenges and difficulties associated with his son's mental illness. This long-term impact on his emotional well-being aligns with the concept of chronic sorrow.
Choices A, C, and D do not necessarily imply a long-term or continuous feeling of grief. The mother of a child with asthma may experience anxiety or distress during asthma attacks, but it may not necessarily lead to chronic sorrow. The daughter whose father had a hip replacement may experience temporary worry or concern but not chronic sorrow. The wife whose husband requested a trial separation may experience sadness and distress, but it is not a situation that inherently leads to chronic sorrow.
A client on the mental health unit is becoming more agitated, shouting at the staff, and pacing in the hallway. When a PRN medication is offered, the client refuses the medication and defiantly sits on the floor in the middle of the unit hallway. What nursing intervention should the nurse implement first?
A. Transport the client to the seclusion room.
B. Quietly approach the client with additional staff members.
C. Take other clients in the area to the client lounge.
D. Administer medication to chemically restrain the client.
Correct answer:
The correct answer is C: Take other clients in the area to the client lounge. This intervention prioritizes the safety and well-being of both the agitated client and other clients in the unit. By removing other clients from the potentially escalating situation, the nurse can prevent further agitation or harm. This intervention also allows the client some space and privacy to calm down without an audience, potentially reducing their agitation.
Incorrect choices:
A: Transport the client to the seclusion room - This is a restrictive measure and should only be used as a last resort for safety reasons.
B: Quietly approach the client with additional staff members - Approaching an agitated client may escalate the situation, especially if the client is refusing medication.
D: Administer medication to chemically restrain the client - Chemical restraint should only be used as a last resort and must follow specific protocols and guidelines. It should not be the first intervention attempted.
A client with major depressive disorder expresses feelings of hopelessness. Which nursing intervention should the nurse implement to address these feelings?
A. Encourage the client to engage in physical activity.
B. Provide opportunities for the client to make decisions.
C. Help the client identify positive aspects of their life.
D. Encourage the client to verbalize feelings of hopelessness.
Correct answer:
When a client with major depressive disorder expresses feelings of hopelessness, helping them identify positive aspects of their life can be an effective nursing intervention. This approach can assist in shifting their focus from negativity to positivity, promoting a sense of hope and potentially improving their overall outlook and well-being. By highlighting the positive aspects, the nurse can support the client in recognizing reasons for hope and encourage a more optimistic perspective, which can aid in addressing and alleviating feelings of hopelessness. Encouraging physical activity (Choice A) may be beneficial for overall well-being but may not directly address feelings of hopelessness. Providing opportunities for decision-making (Choice B) can empower the client but may not specifically target feelings of hopelessness. Encouraging verbalization of feelings (Choice D) is important but may not be as effective as helping the client shift their focus to positive aspects of life.
A child known as the neighborhood bully says, 'Nobody can tell me what to do.' After receiving a poor grade on a science project, this child secretly loaded a virus on the teacher's computer. These behaviors support a diagnosis of
A. CD.
B. ODD.
C. intermittent explosive disorder.
D. ADHD.
Correct answer:
The correct answer is B: Oppositional Defiant Disorder (ODD). ODD is characterized by a pattern of hostile and defiant behavior towards authority figures. In this scenario, the child's refusal to follow rules and defiance of authority by saying 'Nobody can tell me what to do' aligns with ODD. Additionally, the act of secretly loading a virus on the teacher's computer as a form of revenge is a manifestation of the vindictive and spiteful nature often seen in individuals with ODD.
Incorrect choices:
A: CD (Conduct Disorder) typically involves more serious and persistent antisocial behavior, such as aggression towards people or animals, destruction of property, and violation of rules.
C: Intermittent Explosive Disorder is characterized by recurrent outbursts of aggression that are disproportionate to the situation. This child's behavior is more planned and targeted.
D: ADHD (Attention-Deficit/Hyperactivity Disorder) does not account for the deliberate and calculated nature of the
A nursing instructor is integrating Piaget’s theory of cognitive development into the discussion of learning and mental health issues affecting adolescents. The instructor would identify this age group as in which stage?
A. Concrete operations
B. Preoperational
C. Formal operations
D. Sensorimotor
Correct answer:
The correct answer is C: Formal operations. During adolescence, individuals develop the ability to think abstractly and engage in hypothetical reasoning, which aligns with Piaget's Formal Operations stage. This stage typically occurs around ages 11 to adulthood. Adolescents can analyze complex problems, think about future possibilities, and consider multiple perspectives.
Now, let's review why the other choices are incorrect:
A: Concrete operations - This stage, typically occurring around ages 7 to 11, involves logical thinking about concrete events and objects but not abstract thinking like that seen in adolescents.
B: Preoperational - This stage, occurring around ages 2 to 7, involves symbolic thinking and egocentrism, which are not reflective of the cognitive abilities of adolescents.
D: Sensorimotor - This stage, occurring from birth to around 2 years old, focuses on sensory experiences and motor actions, which are not relevant to the cognitive development of adolescents.
A client of the local mental health clinic arrives for their appointment out of breath, hair a mess, and clothing askew. The receptionist tells the client, "You are fifteen minutes late. I will have to see if the doctor can still see you." The client responds, " know I am late. I can explain, my mother-in-law had a bad night. She lives with my husband and me. I am just so tired of taking care of her." This example falls under what category of risk factors?
A. genetic comorbidities
B. psychological factors
C. social factors
D. victimization
Correct answer:
The correct answer is C: social factors. The client's situation of being late due to caring for their mother-in-law highlights social factors as a risk factor. Social factors encompass relationships, support systems, living conditions, and societal influences. In this scenario, the client's caregiving responsibilities for their mother-in-law contribute to their stress and impact their ability to arrive on time. This situation reflects the influence of social dynamics on the client's behavior and well-being.
Incorrect options:
A: Genetic comorbidities are not relevant in this scenario as the client's late arrival is not attributed to any genetic factors.
B: Psychological factors may play a role in the client's stress related to caregiving, but the primary issue here is the social factor of caregiving responsibilities.
D: Victimization does not apply as the client is not being victimized in this situation; rather, they are experiencing stress due to caregiving responsibilities.
RN exams mental health practice questions, set 15 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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