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
Which nursing intervention is best for facilitating communication with a psychiatric client who speaks a foreign language?
A. Rely on nonverbal communication.
B. Select symbolic pictures as aids.
C. Speak in universal phrases.
D. Use the services of an interpreter.
Show answer and rationale
Correct answer: D — Use the services of an interpreter.
The correct answer is D: Use the services of an interpreter. This is the best nursing intervention because it ensures accurate communication and understanding between the nurse and the psychiatric client who speaks a foreign language. Using an interpreter helps convey complex and nuanced information effectively, promotes trust and rapport, and ensures the client's needs are accurately addressed.
Rationale for why the other choices are incorrect:
A: Relying on nonverbal communication may lead to misunderstandings and misinterpretations, especially in a psychiatric setting where verbal communication is crucial.
B: Selecting symbolic pictures as aids may be helpful to some extent, but it may not fully address the client's communication needs and may limit the depth of conversation.
C: Speaking in universal phrases may be too simplistic and may not capture the complexity of the client's thoughts and emotions when addressing mental health issues.
Question 2
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"
Show answer and rationale
Correct answer: C — "FAST exam"
The correct answer is C: "FAST exam." In this scenario, the patient presents with signs of hypovolemic shock likely due to internal bleeding from the chest wound. FAST exam (Focused Assessment with Sonography in Trauma) is a rapid bedside ultrasound used to assess for free fluid in the abdomen or pericardium, which can help identify the source of bleeding. This is crucial for immediate management as it can guide further interventions such as surgery or angiography.
Choice A: "CT scan of the chest" is not the most immediate step as it takes time and may not provide rapid information needed for immediate management.
Choice B: "12 lead ECG" is not the priority in this situation as the patient is hemodynamically unstable and requires rapid assessment for potential life-threatening bleeding.
Choice D: "Begin infusion of RBCs" is important, but identifying the source of bleeding is crucial before deciding on the need for blood transfusion.
Question 3
A confused older adult patient in a skilled nursing facility was asleep when unlicensed assistive personnel (UAP) entered the room quietly and touched the bed to see if it was wet. The patient awakened and hit the UAP in the face. Which statement best explains the patient's action?
A. Older adult patients often demonstrate exaggerations of behaviors used earlier in life.
B. Crowding in skilled nursing facilities increases an individual's tendency toward violence.
C. The patient learned violent behavior by watching other patients act out.
D. The patient interpreted the UAP's behavior as potentially harmful.
Show answer and rationale
Correct answer: D — The patient interpreted the UAP's behavior as potentially harmful.
The correct answer is D because the patient's action can be explained by the concept of interpreting the UAP's behavior as potentially harmful. In this scenario, the patient was asleep and suddenly awakened by the UAP quietly entering the room and touching the bed. The patient's instinctive response of hitting the UAP in the face can be seen as a defensive reaction triggered by perceiving a potential threat or harm from the UAP's unexpected actions. This aligns with the idea that older adults in a vulnerable state may react aggressively when feeling threatened or unsafe.
Choice A is incorrect because it generalizes behavior without considering the specific context of the situation. Choice B is incorrect as it does not directly address the patient's perception of harm from the UAP's actions. Choice C is incorrect as there is no evidence provided in the scenario to support the idea that the patient learned violent behavior from other patients.
Question 4
A client who is being treated for chronic kidney disease complains to the health-care provider that he does not like the food available to him while hospitalized. The health-care provider insists that the client strictly adhere to the diet plan. What action can be expected if the client uses the defense mechanism of displacement?
A. The client assertively confronts the health-care provider.
B. The client insists on being discharged and goes for a long, brisk walk.
C. The client snaps at the nurse and criticizes the nursing care provided.
D. The client hides his anger by explaining the logical reasoning for the diet to his spouse.
Show answer and rationale
Correct answer: C — The client snaps at the nurse and criticizes the nursing care provided.
The correct answer is C: The client snaps at the nurse and criticizes the nursing care provided. Displacement is a defense mechanism where emotions are redirected from the original source to a less threatening target. In this case, the client's frustration towards the healthcare provider's diet plan is displaced onto the nurse, leading to snapping and criticizing the nursing care. This behavior allows the client to express their anger indirectly.
Incorrect choices:
A: The client assertively confronts the health-care provider. This is not an example of displacement; it is direct confrontation.
B: The client insists on being discharged and goes for a long, brisk walk. This choice does not demonstrate displacement but rather avoidance of the situation.
D: The client hides his anger by explaining the logical reasoning for the diet to his spouse. This choice does not involve displacement but rather rationalizing the situation to cope with anger.
Question 5
An 85-year-old client has become agitated and physically aggressive after having a stroke with right-sided weakness. The client is started on risperidone PO 0.5 mg qhs. Which is a priority nursing diagnosis for this client?
A. Risk for falls R/T right-sided weakness and sedation from risperidone.
B. Activity intolerance R/T right-sided weakness.
C. Disturbed thought processes R/T acting-out behaviors.
D. Anxiety R/T change in health status and dependence on others.
Show answer and rationale
Correct answer: A — Risk for falls R/T right-sided weakness and sedation from risperidone.
The correct answer is A: Risk for falls R/T right-sided weakness and sedation from risperidone. This is the priority nursing diagnosis because the client's physical aggression and right-sided weakness increase the risk of falls, which can lead to further injury. The sedative effect of risperidone can further impair the client's balance and coordination, exacerbating the risk. Addressing this risk is crucial to ensure the safety and well-being of the client.
Summary of other choices:
B: Activity intolerance R/T right-sided weakness - While this is a relevant concern, it is not the priority as the risk of falls takes precedence.
C: Disturbed thought processes R/T acting-out behaviors - While the client's behavior may be a concern, addressing the immediate risk of falls is more critical.
D: Anxiety R/T change in health status and dependence on others - While anxiety may be present, addressing the risk of falls is more urgent in this situation.
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Question 6
Which component of treatment of mental illness is specifically recognized by Quality and Safety Education for Nurses (QSEN)?
A. All genomes are unique.
B. Care is centered on the patient.
C. Healthy development is vital to mental health.
D. Recovery occurs on a continuum from illness to health.
Correct answer:
The correct answer is B: Care is centered on the patient. QSEN emphasizes patient-centered care in the treatment of mental illness. This approach involves understanding and addressing the patient's unique needs, preferences, and values to provide individualized and effective care. It focuses on fostering a therapeutic relationship between healthcare providers and patients to enhance treatment outcomes.
Explanation of why other choices are incorrect:
A: All genomes are unique - This statement is not directly related to the specific component of treatment recognized by QSEN.
C: Healthy development is vital to mental health - While healthy development may contribute to mental health, it is not the specific component highlighted by QSEN.
D: Recovery occurs on a continuum from illness to health - While recovery is an important aspect of mental health treatment, it is not the specific component emphasized by QSEN, which is patient-centered care.
A nurse prepares to assess a new patient who moved to the United States from Central America 3 years ago. After introductions, what is the nurse's next comment?
A. "How did you get to the United States?"
B. "Would you like for a family member to help you talk with me?"
C. "An interpreter is available. Would you like for me to make a request for these services?"
D. "Are you comfortable conversing in English, or would you prefer to have a translator present?"
Correct answer:
The correct next comment for the nurse is D: "Are you comfortable conversing in English, or would you prefer to have a translator present?" This is the best choice because it directly addresses the patient's language preference and ensures effective communication. By asking this question, the nurse demonstrates cultural sensitivity and respect for the patient's linguistic needs. It also shows a willingness to accommodate the patient's communication preferences, promoting trust and understanding in the healthcare setting.
Choice A is incorrect as it focuses on the patient's journey to the U.S., which is unrelated to the immediate healthcare assessment. Choice B assumes the patient needs help from a family member without first assessing the patient's language proficiency. Choice C, while offering an interpreter, does not directly inquire about the patient's language preference, potentially overlooking the patient's comfort level with English.
A client with a diagnosis of schizophrenia is exhibiting negative symptoms such as anhedonia and social withdrawal. Which intervention should be a priority for the nurse?
A. Encourage participation in group activities.
B. Administer prescribed antipsychotic medication.
C. Assist the client in setting realistic goals.
D. Promote engagement in social interactions.
Correct answer:
Encouraging participation in group activities is a priority intervention for a client with schizophrenia exhibiting negative symptoms like anhedonia and social withdrawal. Group activities provide structured social interactions and can help the client gradually re-engage with others, potentially reducing social withdrawal and improving social skills. Administering antipsychotic medication (Choice B) is essential in managing positive symptoms of schizophrenia such as hallucinations and delusions, not negative symptoms like anhedonia and social withdrawal. While assisting the client in setting realistic goals (Choice C) is important for overall care, addressing social withdrawal and anhedonia is more immediate. Promoting engagement in social interactions (Choice D) is beneficial, but encouraging participation in group activities provides a structured and supportive environment that can specifically target the negative symptoms being exhibited.
Upon taking the popliteal blood pressure of a patient with unilateral distal limb pain, the physical therapist notes that the popliteal pulse is easily palpable (compared to the nonsymptomatic side) and that the blood pressure is 95/65 mm Hg (upper limb reading 145/90 mm Hg). Which one of the following pathologies should be ruled out before proceeding with the rest of the physical examination?
A. Deep venous thrombosis
B. Restless leg syndrome
C. Popliteal aneurysm
D. Femoral artery occlusion
Correct answer:
The correct answer is C: Popliteal aneurysm. Popliteal aneurysm is a potentially serious condition that can lead to compression of surrounding structures, including the popliteal artery. In this case, the easily palpable popliteal pulse and the lower blood pressure in the affected lower limb suggest a potential obstruction or dilation of the popliteal artery, which could be indicative of a popliteal aneurysm. This condition needs to be ruled out urgently due to the risk of complications such as thrombosis or rupture.
Choice A: Deep venous thrombosis is unlikely in this case as there are no signs or symptoms suggestive of venous thrombosis, and the presence of a palpable pulse indicates arterial involvement.
Choice B: Restless leg syndrome is a neurological disorder characterized by an uncontrollable urge to move the legs, and it does not present with the physical findings described in the scenario.
Choice D: Femoral artery occlusion is
The parent of a child with attention deficit hyperactivity disorder (ADHD) tells the nurse that the child does not follow directions well. What strategy would be best for the nurse to recommend?
A. Consider developing a daily schedule plan with the child.
B. Try having the child repeat the instructions before starting the task.
C. Teaching the child to be assertive and not resist instructions by those in authority.
D. Place the child in time out for at least 20-30 minutes.
Correct answer:
The correct answer is B: Try having the child repeat the instructions before starting the task. This strategy, known as "active listening," can help children with ADHD improve their focus and understanding of directions. By repeating the instructions, the child reinforces the information in their memory and clarifies any confusion. This approach promotes better compliance with tasks.
Incorrect choices:
A: Developing a daily schedule plan may be helpful, but it doesn't specifically address improving the child's ability to follow directions.
C: Teaching assertiveness is not directly related to addressing the difficulty in following directions. It may not necessarily improve the child's compliance with instructions.
D: Placing the child in time out is a punitive measure and does not address the underlying issue of difficulty following directions. It may worsen the child's behavior and does not teach them how to improve their listening skills.
An adolescent diagnosed with a CD stole and wrecked a neighbor's motorcycle. Afterward, the adolescent was confronted about the behavior but expressed no remorse. Which variation in the central nervous system best explains the adolescent's reaction?
A. Serotonin dysregulation and increased testosterone activity impair one's capacity for remorse.
B. Increased neuron destruction in the hippocampus results in decreased abilities to conform to social rules.
C. Reduced gray matter in the cortex and dysfunction of the amygdala results in decreased feelings of empathy.
D. Disturbances in the occipital lobe reduce sensations that help an individual clearly visualize the consequences of behavior.
Correct answer:
The correct answer is C because reduced gray matter in the cortex and dysfunction of the amygdala can lead to decreased feelings of empathy.
1. The cortex is responsible for higher-order cognitive functions, including empathy.
2. The amygdala plays a crucial role in processing emotions, such as empathy and remorse.
3. Reduced gray matter in the cortex and dysfunction of the amygdala can result in deficits in recognizing and processing emotions like empathy and remorse.
Therefore, the adolescent's lack of remorse could be attributed to these neurological abnormalities.
Other choices are incorrect because:
A: Serotonin dysregulation and increased testosterone activity primarily affect mood regulation and aggression, not necessarily remorse.
B: Neuron destruction in the hippocampus affects memory and learning, not empathy or remorse.
D: Disturbances in the occipital lobe primarily impact vision and visual processing, not empathy or remorse.
A parent is worried about their adolescent who has been having angry outbursts for three weeks. The parent reaches out to the pediatrician's office asking about multisystemic treatment. How can the nurse explain it?
A. immediate assessment for oppositional defiant disorder'
B. very upsetting, but just typical for teenagers'
C. a combination of behavior therapy training that includes the child, the family, and the school'
D. a course of prescription medication'
Correct answer:
The correct answer is C: a combination of behavior therapy training that includes the child, the family, and the school. This is the most appropriate response because multisystemic treatment is a comprehensive approach involving various aspects of the adolescent's life. It targets behavior through therapy and involves not only the child but also the family and school to address underlying issues and promote positive change.
Incorrect options:
A: Immediate assessment for oppositional defiant disorder - This option focuses solely on a diagnosis and does not address the holistic approach of multisystemic treatment.
B: Very upsetting, but just typical for teenagers - This option dismisses the seriousness of the situation and does not provide a constructive solution.
D: A course of prescription medication - This option suggests a medical intervention, which is not typically the first-line approach for managing behavioral issues in adolescents.
Parents of an adolescent diagnosed with a CD say, 'We don't know how to respond when our child breaks the rules in our house. Is there any treatment that might help us?' Which therapy is likely to be helpful for these parents?
A. Parent–child interaction therapy (PCIT)
B. Behavior modification therapy
C. Multi-systemic therapy (MST)
D. Pharmacotherapy
Correct answer:
The correct answer is A: Parent-child interaction therapy (PCIT). PCIT focuses on improving parent-child relationships and teaching parents effective behavior management techniques. It helps parents develop positive communication skills and appropriate discipline strategies. This therapy is likely to be helpful for parents of an adolescent with CD as it addresses the specific challenges they are facing in managing their child's behavior.
Summary:
B: Behavior modification therapy focuses on changing specific behaviors through reinforcement and punishment, but may not address the underlying parent-child relationship issues.
C: Multi-systemic therapy (MST) targets multiple systems involved in the adolescent's life, but may not provide the direct skills and support needed for parents in managing their child's behavior at home.
D: Pharmacotherapy involves medication and is not designed to help parents develop effective parenting skills.
The client asks the nurse about the goal of treatment mental health programs. What would the nurse tell them?
A. The goal is to transition someone from treatment setting care to complete independence as quickly as possible.'
B. The goal is to provide safe, structured, and supportive care for people with mental health symptoms who can benefit from frequent treatment monitoring.'
C. The goal is to serve as a permanent home for the chronically mentally ill who can't exist out in the community.'
D. The goal is to provide close monitoring for clients who are a threat to themselves or others.'
Correct answer:
The correct answer is B because mental health programs aim to provide safe, structured, and supportive care for individuals with mental health symptoms who can benefit from frequent treatment monitoring. This goal emphasizes the importance of creating a therapeutic environment that offers necessary interventions and support to help individuals manage their symptoms and improve their well-being.
Choice A is incorrect because the goal is not solely about transitioning individuals to complete independence quickly, but rather about providing ongoing support and care. Choice C is incorrect as mental health programs are not intended to serve as permanent homes, but rather as treatment settings aimed at improving individuals' mental health. Choice D is incorrect because while close monitoring may be necessary for some clients, it is not the sole goal of mental health programs, which also focus on providing support and treatment interventions.
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 likely due to internal bleeding from the chest wound. FAST exam (Focused Assessment with Sonography in Trauma) is a rapid bedside ultrasound used to assess for free fluid in the abdomen or pericardium, which can help identify the source of bleeding. This is crucial for immediate management as it can guide further interventions such as surgery or angiography.
Choice A: "CT scan of the chest" is not the most immediate step as it takes time and may not provide rapid information needed for immediate management.
Choice B: "12 lead ECG" is not the priority in this situation as the patient is hemodynamically unstable and requires rapid assessment for potential life-threatening bleeding.
Choice D: "Begin infusion of RBCs" is important, but identifying the source of bleeding is crucial before deciding on the need for blood transfusion.
RN exams mental health practice questions, set 22 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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