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
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.
Show answer and rationale
Correct answer: A — Proximal to distal.
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.
Question 2
A female patient is an adolescent who recently tried to overdose because her boyfriend broke up with her. Her father is a single parent, and he has been drinking excessively to cope with his stress. The patient tells the nurse that whenever she needs to talk to her father, he is always drunk or away drinking with his drinking buddies. Based on this information, which nursing diagnosis would be most appropriate for this patient's family?
A. Ineffective Family Therapeutic Regimen Management
B. Compromised Family Coping
C. Ineffective Denial
D. Caregiver Role Strain
Show answer and rationale
Correct answer: B — Compromised Family Coping
The correct answer is B: Compromised Family Coping. This choice is appropriate because the patient's family is struggling to cope effectively with the stressors they are facing. The father's excessive drinking and absence are impacting the patient's emotional well-being and ability to communicate with her father. This diagnosis reflects the family's inability to effectively manage the situation.
A: Ineffective Family Therapeutic Regimen Management does not directly address the family's coping mechanisms.
C: Ineffective Denial does not capture the family's overall coping ability and focuses more on individual denial behavior.
D: Caregiver Role Strain may not fully encompass the family's overall coping difficulties and the impact on the patient's well-being.
In summary, choice B is the most appropriate as it directly addresses the family's struggle to cope with the stressors, highlighting the need for nursing intervention to support their coping mechanisms.
Question 3
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
Show answer and rationale
Correct answer: C — The dosage should not exceed ½ of the usual recommended dose
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
Question 4
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
Show answer and rationale
Correct answer: B — Evaluating the causative factors of an observed increase in the number of grade-school children with newly diagnosed asthma
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.
Question 5
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.
Show answer and rationale
Correct answer: A — To seek the help of a trained therapist to help uncover and deal with the trauma associated with those memories.
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.
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Question 6
A patient diagnosed with opioid use disorder has expressed a desire to enter into a rehabilitation program. What initial nursing intervention during the early days after admission will help ensure the patient's success?
A. Restrict visitors to family members only.
B. Manage the patient's withdrawal symptoms well.
C. Provide the patient a low stimulus environment.
D. Advocate for at least 3 months of treatment.
Correct answer:
The correct answer is B: Manage the patient's withdrawal symptoms well. This is crucial as effective management of withdrawal symptoms is essential in the early days of rehabilitation to ensure the patient's success. By addressing withdrawal symptoms promptly and effectively, the patient is more likely to remain engaged in the treatment process and have a smoother transition into the rehabilitation program.
A: Restricting visitors to family members only may not be the most critical initial intervention and could potentially isolate the patient from important sources of support.
C: Providing a low stimulus environment is important but may not be as immediately impactful as managing withdrawal symptoms, which directly addresses the patient's physical and psychological discomfort.
D: Advocating for at least 3 months of treatment is important for long-term success, but managing withdrawal symptoms should take precedence in the initial days after admission.
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
Correct answer:
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
A psychiatric nurse is working in a community mental health center. They are completing an assessment on a 32-year-old pregnant female presenting with depression. They note that the client has not answered the questions about alcohol and tobacco use. Why is it important to gather this information?
A. This information is not a pertinent part of the assessment process for a community mental health client.
B. This information will help the health-care team in all aspects of caring for the client, especially since she is pregnant.
C. This information is not important as it will have no long-term effects on the client's unborn child.
D. This information is optional in relation to mental health care.
Correct answer:
The correct answer is B because assessing alcohol and tobacco use in a pregnant client with depression is crucial for providing comprehensive care. First, substance use can exacerbate mental health symptoms and impact treatment effectiveness. Second, substance use during pregnancy can harm both the mother and the unborn child, leading to adverse health outcomes. Third, this information is vital for developing a holistic care plan that considers both the mental health needs of the client and the safety of the unborn child.
Choices A, C, and D are incorrect because:
A: Failing to assess alcohol and tobacco use neglects essential information that can impact the client's well-being and treatment.
C: Substance use during pregnancy can have significant long-term effects on the unborn child's health and development.
D: Assessing alcohol and tobacco use is not optional, as it directly influences the client's mental health and the well-being of the unborn child.
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.
Which is the best nursing action when a client demonstrates transference toward a nurse?
A. Promoting safety and immediately terminating the relationship with the client
B. Encouraging the client to ignore these thoughts and feelings
C. Immediately reassigning the client to another staff member
D. Helping the client to clarify the meaning of the current nurseclient relationship
Correct answer:
When a client demonstrates transference toward a nurse, the best nursing action is to help the client clarify the meaning of the current nurse-client relationship. Transference occurs when a client's emotions and feelings from past relationships are unconsciously projected onto the nurse. It is a common occurrence in therapeutic relationships, and addressing it can lead to greater understanding and progress in the therapeutic process. By helping the client recognize and discuss these feelings, the nurse can facilitate insight, promote trust, and strengthen the therapeutic relationship. This approach allows for a more effective exploration of the client's emotions and experiences, leading to better outcomes in the nursing care provided. Terminating the relationship, encouraging the client to ignore these feelings, or immediately reassigning the client to another staff member would not address the underlying issues and could hinder the therapeutic process.
When a hospitalized patient dies, his wife stares blankly and states, "It can’t be." This indicates:
A. Despair and protest
B. Shock and disbelief
C. Anger and hostility
D. Disorganization and confusion
Correct answer:
Correct Answer: B (Shock and disbelief)
Rationale:
1. The wife's blank stare and statement "It can’t be" suggest a state of disbelief and being stunned by the news of her husband's death, indicating shock.
2. Shock is a common initial reaction to unexpected and distressing events, such as the sudden death of a loved one.
3. This choice is the most fitting based on the wife's reaction of disbelief and being unable to accept the reality of the situation.
Summary:
A: Despair and protest - Despair involves a sense of hopelessness, not evident in the wife's initial reaction. Protest implies a more active response, while the wife's reaction is passive.
C: Anger and hostility - There is no indication of anger or hostility in the wife's initial response; rather, it is characterized by disbelief.
D: Disorganization and confusion - While the wife may feel disorganized and confused later, her initial response reflects more shock and disbelief than disorganization
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.
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
A client has been diagnosed with histrionic personality disorder. Which of the following behaviors should the nurse expect?
A. Attention-seeking behavior
B. Dramatic expressions of emotion
C. Seductive behavior
D. Dependency on others
Correct answer:
Individuals with histrionic personality disorder often display attention-seeking behaviors as a way to draw focus and validation from others. This behavior may manifest as exaggerated emotions and dramatic expressions to maintain the spotlight. While seductive behavior and dependency on others are potential characteristics of histrionic personality disorder, attention-seeking behavior is the hallmark trait. Therefore, the correct answer is attention-seeking behavior (Choice A). Dramatic expressions of emotion (Choice B) can be a feature of histrionic personality disorder, but it is not as characteristic as attention-seeking behavior. Seductive behavior (Choice C) may also be present in individuals with histrionic personality disorder, but it is not the primary behavior to expect. Dependency on others (Choice D) is not a core feature of histrionic personality disorder, although individuals with this disorder may seek attention and validation from others.
A woman whose abusive husband was killed in an automobile accident 3 years earlier continues to idealize him and repeatedly talks about their “wonderful relationship.” Which outcome is most appropriate for the patient? Patient will:
A. Enlist the emotional support of both family and friends.
B. Keep a daily journal recording memories of time spent with her husband.
C. Express both positive and negative feelings about her husband and their life together.
D. Read information on the affects of physical abuse and the support groups available to her.
Correct answer:
Rationale:
Choice C is correct because it encourages the patient to express both positive and negative feelings about her husband and their relationship. This approach helps the patient process complex emotions and move towards a more realistic view of the past. It promotes emotional healing and growth by allowing the patient to acknowledge and work through conflicting feelings.
Summary of Incorrect Choices:
A: While emotional support is important, simply enlisting the support of family and friends may not address the underlying issues of idealization and unresolved emotions.
B: Keeping a daily journal may reinforce the idealization of the husband and could potentially hinder the patient's progress in coming to terms with the reality of the relationship.
D: Reading about abuse and support groups may provide information, but it does not directly address the patient's need to explore and express her own feelings about her husband and their relationship.
RN exams mental health practice questions, set 19 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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