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 the stabilization phase of drug therapy for a patient who is hospitalized with a psychiatric disorder, which action would be most appropriate?
A. Discussing the timing of tapering the medication
B. Instructing the patient about relapse prevention
C. Determining if the medication is losing its effect
D. Assessing the patient for target symptoms and side effects
Show answer and rationale
Correct answer: D — Assessing the patient for target symptoms and side effects
The correct answer is D because during the stabilization phase, assessing the patient for target symptoms and side effects is crucial to ensure the medication is working effectively without causing harm. This step allows healthcare providers to monitor the patient's progress, adjust the medication dosage if needed, and address any emerging side effects promptly.
A: Discussing the timing of tapering the medication is premature during the stabilization phase as the focus should be on monitoring the patient's response to the current medication regimen.
B: Instructing the patient about relapse prevention is important but more relevant during the maintenance phase rather than the stabilization phase.
C: Determining if the medication is losing its effect can be part of the assessment but is not the most appropriate action during the stabilization phase where the primary focus is on monitoring symptoms and side effects.
Question 2
Which one of the following positions is recommended for obtaining consistent blood pressure measurements?
A. Sitting with the arm in a horizontal, supported position at heart level
B. Supine position with arm resting comfortably on the chest
C. Sitting on the couch with arm resting comfortably by the side
D. Standing with arm by side and cuff positioned at heart level
Show answer and rationale
Correct answer: A — Sitting with the arm in a horizontal, supported position at heart level
The correct answer is A. Sitting with the arm in a horizontal, supported position at heart level is recommended for consistent blood pressure measurements because it helps reduce errors due to gravitational effects. Placing the arm at heart level minimizes the hydrostatic pressure changes, ensuring accurate readings. This position also allows for proper cuff placement and comfortable arm support, leading to more reliable results.
Summary:
Choice B (Supine position with arm resting comfortably on the chest) may lead to inaccurate readings due to the arm position not being at heart level. Choice C (Sitting on the couch with arm resting comfortably by the side) lacks the necessary arm support and heart level positioning, leading to potential errors. Choice D (Standing with arm by side and cuff positioned at heart level) may result in fluctuating readings due to the effect of gravity on blood pressure when standing.
Question 3
The nurse is reviewing the medical record of a client diagnosed with antisocial personality disorder. The nurse notes that the client has had numerous episodes involving irritability, aggressiveness, and impulsivity and has exhibited callousness toward others. Based on this information, which nursing diagnosis would the nurse most likely identify as a priority?
A. Risk for Other-Directed Violence
B. Risk for Self-Injury
C. Risk for Suicide
D. Risk for Self-Directed Violence
Show answer and rationale
Correct answer: A — Risk for Other-Directed Violence
The correct answer is A: Risk for Other-Directed Violence. This diagnosis is the priority because individuals with antisocial personality disorder often display behaviors such as irritability, aggressiveness, and callousness towards others. This places them at a higher risk for exhibiting violent behaviors directed towards others. It is crucial for the nurse to prioritize assessing and managing this risk to ensure the safety of both the client and others.
Summary of why the other choices are incorrect:
B: Risk for Self-Injury - Individuals with antisocial personality disorder are more likely to harm others rather than themselves.
C: Risk for Suicide - Antisocial personality disorder is not typically associated with an increased risk for suicide.
D: Risk for Self-Directed Violence - Individuals with antisocial personality disorder are more inclined towards externalizing behaviors rather than self-directed violence.
Question 4
When considering an eating disorder, what is a physical criterion for hospital admission?
A. A daytime heart rate of less than 50 beats per minute
B. An oral temperature of 100°F or more
C. 90% of ideal body weight
D. Systolic blood pressure greater than 130 mm Hg
Show answer and rationale
Correct answer: A — A daytime heart rate of less than 50 beats per minute
The correct answer is A: A daytime heart rate of less than 50 beats per minute. This criterion indicates severe bradycardia, which is a sign of cardiac compromise in individuals with eating disorders. Bradycardia is a serious medical complication associated with malnutrition and can lead to cardiac arrhythmias, heart failure, and even sudden death. Monitoring heart rate is crucial in assessing the severity of an eating disorder and the need for hospitalization.
Choice B (an oral temperature of 100°F or more) is not a specific criterion for hospital admission in eating disorders. Choice C (90% of ideal body weight) is an important indicator of malnutrition but does not directly reflect the severity of cardiac compromise. Choice D (systolic blood pressure greater than 130 mm Hg) is not typically a criterion for hospital admission in eating disorders unless it is extremely elevated and indicating hypertensive crisis.
Question 5
A male client who is admitted with delirium tremens is dehydrated and experiencing auditory hallucinations. He has a bruised, swollen tongue and is confused. In developing a plan of care, which action should the nurse include to ensure the client is physiologically stable?
A. Monitor vital signs.
B. Administer PRN antipsychotic medication.
C. Provide a quiet environment.
D. Encourage fluid intake.
Show answer and rationale
Correct answer: A — Monitor vital signs.
The correct answer is A: Monitor vital signs. This is crucial in managing a client with delirium tremens to ensure physiological stability. Monitoring vital signs such as blood pressure, heart rate, temperature, and respiratory rate can help identify any signs of deterioration or complications like dehydration, sepsis, or cardiovascular instability. By closely monitoring these parameters, the nurse can intervene promptly and prevent any further complications.
Summary:
- Option B is incorrect because administering antipsychotic medication is not the priority in managing delirium tremens.
- Option C is incorrect as providing a quiet environment may help with managing hallucinations, but it does not address the physiological stability of the client.
- Option D is incorrect as encouraging fluid intake is important for hydration but does not address the need for monitoring vital signs to ensure physiological stability.
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Question 6
A client on an inpatient psychiatric unit exhibits traits of borderline personality disorder. Which action by the nurse would initiate collaboration with the member of the mental health-care team who can best confirm this diagnosis?
A. Request an order from the psychiatrist for personality disorder medication.
B. Collaborate with the occupational therapist to meet this client's retraining needs.
C. Collaborate with the clinical psychologist to prepare the client for personality testing.
D. Meet with the recreational therapist to plan activities to relieve the client's anxiety.
Correct answer:
Correct Answer: C. Collaborate with the clinical psychologist to prepare the client for personality testing.
Rationale:
1. Borderline personality disorder (BPD) diagnosis requires comprehensive assessment, including personality testing.
2. Clinical psychologists are trained to administer and interpret psychological tests, including those for personality disorders.
3. Collaborating with the clinical psychologist ensures the client receives appropriate evaluation and diagnosis.
4. Requesting medication or focusing on occupational or recreational needs may not address the core issue of confirming a BPD diagnosis.
Summary:
A: Requesting medication is premature without confirming the diagnosis.
B: Occupational therapy focuses on retraining skills, not diagnosing personality disorders.
D: Planning recreational activities may help with anxiety but does not address the need for a formal diagnosis like personality testing.
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: ODD (Oppositional Defiant Disorder). This diagnosis fits because the child's behavior demonstrates a pattern of defiance, hostility, and disregard for authority figures. Loading a virus on the teacher's computer is a deliberate act of defiance, and the statement "Nobody can tell me what to do" reflects a persistent pattern of oppositional behavior.
Summary:
A: CD (Conduct Disorder) involves more severe and persistent antisocial behaviors, such as aggression towards people and animals, destruction of property, and serious rule violations.
C: Intermittent Explosive Disorder involves sudden and intense outbursts of aggression that are out of proportion to the stressor.
D: ADHD (Attention-Deficit/Hyperactivity Disorder) is characterized by inattention, hyperactivity, and impulsivity, but does not fully explain the deliberate and calculated behavior displayed by the child in the scenario.
A psychiatric-mental health nurse is working on developing cultural competence. Which of the following would be most appropriate for the nurse to do?
A. Research information about the cultures of the population being served after assessing the patients.
B. Recognize that one's own culture is the predominant way of addressing a patient's health care needs.
C. Assume that any individual of a racial or ethnic group is the same as another individual in that group.
D. Demonstrate an appreciation of and a genuine interest in the individual and his or her cultural beliefs.
Correct answer:
Step-by-step rationale for why answer D is correct:
1. Demonstrating appreciation and genuine interest in the individual and their cultural beliefs shows respect and empathy.
2. Building a therapeutic relationship based on understanding and valuing the patient's cultural background enhances trust.
3. Cultural competence involves recognizing and respecting diversity, which is exemplified by appreciating the patient's cultural beliefs.
4. By being genuinely interested in the individual's culture, the nurse can provide more individualized and effective care.
Summary:
Choice D is correct because it emphasizes the importance of appreciating and showing genuine interest in the individual and their cultural beliefs, which is essential for developing cultural competence. Choices A, B, and C are incorrect because they do not focus on the individual's unique cultural background and may perpetuate stereotypes or assumptions.
The RN leading a group session of adolescent clients gives the members a handout about anger management. One of the male clients is fidgety, interrupts peers when they try to talk, and talks about his pets at home. What nursing action is best for the RN to take?
A. Explore the client's feelings about his pets and home life.
B. Encourage his peers to help involve him in the activity.
C. Give the client permission to leave and return in 10 minutes.
D. Redirect him by encouraging him to read from the handout.
Correct answer:
The correct answer is D: Redirect him by encouraging him to read from the handout. This is the best nursing action because it addresses the client's disruptive behavior by redirecting his focus back to the topic at hand, which is anger management. By encouraging him to read from the handout, the RN is helping the client engage in the intended activity and stay on track with the group session's purpose. This approach helps maintain the group's cohesion and ensures that all members benefit from the session.
Exploring the client's feelings about his pets and home life (Choice A) may be relevant in a different context but is not the immediate priority in this scenario. Encouraging his peers to involve him in the activity (Choice B) may not effectively address his disruptive behavior. Giving the client permission to leave and return (Choice C) may disrupt the session and enable the client's avoidance of the activity.
A client is admitted to the mental health unit and sits in the corner of the dayroom. When the nurse begins the admission assessment interview, the client is guarded, suspicious, and resists talking. What action should the nurse implement?
A. Attempt to ask the client simple questions.
B. Postpone the client interview until the next day.
C. Ask another nurse to talk with the client.
D. Document the client's paranoid behavior.
Correct answer:
The correct action for the nurse to implement is to attempt to ask the client simple questions (Choice A). By asking simple questions, the nurse can start building rapport with the client and gradually gain their trust. This approach can help the client feel more comfortable and open up during the assessment interview. It is important for the nurse to demonstrate patience, empathy, and understanding towards the client's guarded and suspicious behavior.
Postponing the client interview until the next day (Choice B) may not address the client's current needs and may lead to further distrust. Asking another nurse to talk with the client (Choice C) may not necessarily be effective as the client may benefit from continuity of care with the same nurse. Documenting the client's paranoid behavior (Choice D) is important for the client's medical record but should not be the only action taken by the nurse in this situation.
A nurse assesses four patients between the ages of 70 and 80. Which patient has the highest risk for alcohol abuse? The patient who:
A. Consumes 1 glass of wine nightly with dinner.
B. Drank socially throughout adult life and continues this pattern, saying, “I’ve earned the right to do as I please.”
C. Began drinking alcohol daily after retirement and says, “A few drinks keep my mind off my arthritis.”
D. Abused alcohol between the ages of 25 and 40 but now abstains and occasionally attends Alcoholics Anonymous (AA).
Correct answer:
The correct answer is C because the patient who started drinking daily after retirement as a coping mechanism for arthritis has the highest risk for alcohol abuse. This behavior indicates a potential dependence on alcohol to manage physical and emotional discomfort, leading to increased consumption and potential addiction.
Choice A is not the correct answer because consuming 1 glass of wine nightly with dinner is generally considered moderate drinking and does not necessarily indicate alcohol abuse.
Choice B is also not the correct answer as social drinking throughout adult life, even if justified as a reward, does not inherently suggest alcohol abuse without further evidence of problematic drinking patterns.
Choice D is incorrect as the patient has a history of alcohol abuse but currently abstains and seeks support through AA, indicating active efforts to maintain sobriety and reduce the risk of alcohol abuse.
The school nurse has been alerted to the fact that an 8-year-old boy routinely playacts as a police officer 'locking up' other children on the playground to the point where the children get scared. The nurse recognizes that this behavior is most likely an indication of:
A. The need to dominate others
B. Inventing traumatic events
C. A need to develop close relationships
D. A potential symptom of traumatization
Correct answer:
The correct answer is D, as playacting as a police officer and causing fear in other children could be a potential symptom of traumatization. This behavior may stem from experiencing or witnessing traumatic events, leading the child to reenact them to make sense of their feelings and gain a sense of control. The child may be processing feelings of powerlessness or fear related to trauma through this play.
A: The need to dominate others - While the behavior may involve exerting control, it is more likely a coping mechanism for trauma rather than a desire to dominate.
B: Inventing traumatic events - There is no indication that the child is inventing traumatic events; rather, the behavior suggests a response to real trauma.
C: A need to develop close relationships - The behavior is not indicative of seeking close relationships but rather a way of expressing distress and trying to make sense of traumatic experiences.
The nurse is determining the success of a patient's plan of care by evaluating outcome indicators. The nurse understands that these indicators are usually determined initially at which time?
A. On the day of discharge
B. During the assessment process
C. At the initial interview
D. With goal-setting process
Correct answer:
The correct answer is B: During the assessment process. This is because outcome indicators are used to measure the effectiveness of the care plan and are typically established during the assessment phase to provide a baseline for comparison. By evaluating outcome indicators during the assessment process, the nurse can track progress, adjust interventions if needed, and ensure the patient's goals are being met.
A: On the day of discharge - This is incorrect because outcome indicators are typically determined before discharge to assess the overall success of the care plan.
C: At the initial interview - This is incorrect as outcome indicators are more closely related to the assessment process and ongoing evaluation.
D: With goal-setting process - This is incorrect because while outcome indicators are used to measure goal achievement, they are typically determined during the assessment to establish a starting point.
Nurse Stefan is caring for a ten-year-old client who has ASD. The client's mother is concerned that her child is not getting all his homework completed and she does not want him to get behind in school. Nurse Stefan educates the client's mother by offering several suggestions. What is the nurse's most appropriate response?
A. You should encourage your son to get all his work done in one sitting.'
B. Creating a quiet study corner in your home will help him to focus.'
C. Allow him to have the TV on in the background as this sometimes helps.'
D. Make him sit down and complete homework as soon as he gets home.'
Correct answer:
The correct answer is B: Creating a quiet study corner in your home will help him to focus. This option is the most appropriate because children with Autism Spectrum Disorder (ASD) often benefit from a quiet and structured environment to focus on tasks. The quiet study corner can minimize distractions and provide a dedicated space for the child to concentrate.
Incorrect choices:
A: Encouraging the child to get all his work done in one sitting may overwhelm him and lead to frustration, especially for a child with ASD who may need breaks and a structured routine.
C: Allowing the TV on in the background can be distracting for a child with ASD who may have sensory sensitivities and struggle to filter out background noise.
D: Forcing the child to sit down and complete homework as soon as he gets home may cause stress and resistance, as children with ASD often benefit from predictable routines and gradual transitions.
A patient receiving an antipsychotic agent develops acute extrapyramidal symptoms. Which response by the nurse would be most appropriate?
A. These symptoms are not real; the medication makes your brain think they are real.'
B. You have developed an allergy to the medication, so we need to change it.'
C. These are the results of the drug that can be treated; your illness is not getting worse.'
D. The sunlight together with the medication has caused these symptoms; just stay indoors.'
Correct answer:
The most appropriate response by the nurse is C: "These are the results of the drug that can be treated; your illness is not getting worse." This response acknowledges the side effects of the antipsychotic medication (extrapyramidal symptoms) while reassuring the patient that these symptoms can be managed without indicating a worsening of their condition. It demonstrates empathy, provides accurate information, and offers hope for improvement.
Explanation of other choices:
A: This response is dismissive and invalidates the patient's experience, which can be harmful to the therapeutic relationship.
B: Allergy is not the cause of extrapyramidal symptoms, so changing medication based on this assumption is incorrect and may lead to unnecessary changes.
D: Blaming sunlight for the symptoms is inaccurate and does not address the underlying issue of medication side effects, potentially causing confusion for the patient.
RN exams mental health practice questions, set 27 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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