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 one of the following BEST describes the FIRST step that a physical therapist should take when integrating best evidence into clinical practice?
A. Identify current best evidence on the most successful interventions for the patient's diagnosis.
B. Mine the available data and critically appraise the evidence for its validity, level of evidence, and applicability.
C. Integrate the best evidence into clinical decision making after discussing it with the patient.
D. Identify a clinically relevant question that is important for the patient.
Show answer and rationale
Correct answer: D — Identify a clinically relevant question that is important for the patient.
Step-by-step rationale for why answer D is correct:
1. Identifying a clinically relevant question is crucial for guiding the integration of evidence into practice.
2. This step ensures that the evidence sought aligns with the specific needs and concerns of the patient.
3. By focusing on the patient's individual situation, the therapist can tailor the evidence-based interventions effectively.
4. It sets the foundation for a patient-centered approach to care, enhancing clinical decision-making.
5. Overall, starting with a clinically relevant question is the essential first step in evidence-based practice.
Summary:
A: Identifying current best evidence is premature without understanding the patient's specific needs.
B: Critically appraising evidence comes after identifying the question to ensure relevance.
C: Discussing evidence with the patient is important but should follow after identifying the relevant question.
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
A female client, who is wearing dirty clothes and has a foul body odor, comes to the clinic reporting feeling scared because she is being stalked. What action is most important for the nurse to take?
A. Assure the client that the healthcare provider will see her today.
B. Recommend that the client talk with a social worker.
C. Ask the client to describe why she is being stalked.
D. Offer the client a safe place to relax before interviewing her.
Show answer and rationale
Correct answer: D — Offer the client a safe place to relax before interviewing her.
The most important action for the nurse to take in this scenario is to offer the client a safe place to relax before interviewing her. The client's disheveled appearance and foul body odor suggest she may be in distress or facing challenging circumstances. By providing her with a safe and comfortable environment to relax, the nurse can help alleviate some of her distress and establish trust. This approach is crucial as the client is already feeling scared due to being stalked, indicating underlying mental health concerns. Assuring the client of a healthcare provider visit (choice A) may not address her immediate need for safety and comfort. Recommending she talk with a social worker (choice B) may be beneficial later but does not address the immediate need for a safe space. Asking the client to describe why she is being stalked (choice C) is not appropriate as the priority is ensuring her safety and comfort first.
Question 4
A patient undergoing diagnostic tests says, "Nothing is wrong with me except a stubborn chest col" The spouse reports the patient smokes, coughs daily, lost 15 pounds, and is easily fatigue Which defense mechanism is the patient using?
A. Displacement
B. Regression
C. Projection
D. Denial
Show answer and rationale
Correct answer: D — Denial
The correct answer is D: Denial. This defense mechanism involves refusing to acknowledge a stressful situation or reality. In this case, the patient is denying their serious health issues by attributing it to just a "stubborn chest cold." The patient's symptoms of smoking, daily coughing, weight loss, and fatigue indicate a more significant health concern that is being downplayed through denial.
A: Displacement involves redirecting emotions from the original source to a less threatening target, not applicable here.
B: Regression involves reverting to an earlier stage of development in the face of stress, not relevant to the scenario.
C: Projection involves attributing one's own unacceptable thoughts or feelings to others, not demonstrated in this situation.
In summary, denial is the most appropriate defense mechanism as it aligns with the patient's refusal to acknowledge the seriousness of their health issues.
Question 5
A patient presents to the emergency department with mixed psychiatric symptoms. The admission nurse suspects the symptoms may be the result of a medical problem. Lab results show elevated BUN (blood urea nitrogen) and creatinine. What is the nurse's next best action?
A. Report the findings to the health care provider.
B. Assess the patient for a history of renal problems.
C. Assess the patient's family history for cardiac problems.
D. Arrange for the patient's hospitalization on the psychiatric unit.
Show answer and rationale
Correct answer: B — Assess the patient for a history of renal problems.
The correct answer is B: Assess the patient for a history of renal problems. Elevated BUN and creatinine levels indicate possible renal dysfunction, which can manifest as psychiatric symptoms. By assessing the patient for a history of renal problems, the nurse can gather important information to help determine the underlying cause of the symptoms. This step is crucial in identifying and addressing any potential medical issues contributing to the psychiatric presentation.
Incorrect choices:
A: Reporting the findings to the health care provider is important, but assessing the patient for a history of renal problems should be done first.
C: Assessing the patient's family history for cardiac problems is not relevant to the elevated BUN and creatinine levels.
D: Hospitalization on the psychiatric unit may not address the underlying medical issue causing the symptoms; assessing for renal problems is more appropriate.
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Question 6
A nurse wants to find information about environmental threats that are present in the community. Which of the following would be the best source of data for the nurse?
A. Cumulative Index of Nursing and Allied Health (CINAHL) database
B. National Library of Medicine
C. State health department
D. Closest local library
Correct answer:
The correct answer is C: State health department. This is the best source of data for the nurse as it provides accurate and up-to-date information on environmental threats specific to the community. The state health department collects data from various sources, conducts surveillance, and monitors environmental factors that may pose a risk to public health. They have the expertise and resources to analyze and report on environmental threats, making them a reliable source for the nurse.
A: The CINAHL database is more focused on nursing and allied health research, not specifically on community environmental threats.
B: The National Library of Medicine is a valuable resource for medical information but may not have community-specific environmental threat data.
D: The closest local library may not have the specialized information needed on community environmental threats compared to the state health department.
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 patient living in community housing for the elderly says, “I don’t go to the senior citizens club. They play cards and talk about the past because that’s all they can do.” The nurse analyzes these remarks to represent:
A. Failure to achieve developmental tasks
B. Hypercritical behavior
C. Paranoid thinking
D. Thinking associated with ageism
Correct answer:
The correct answer is D: Thinking associated with ageism. This is because the patient's statement reflects a negative stereotype about older adults, assuming they are limited to playing cards and reminiscing about the past. Ageism involves discrimination or prejudice based on someone's age, which can lead to stereotyping and marginalization.
A: Failure to achieve developmental tasks - This choice does not directly relate to the patient's statement about ageism.
B: Hypercritical behavior - The patient's statement does not indicate hypercritical behavior, but rather a biased perspective on aging.
C: Paranoid thinking - The patient's statement does not demonstrate paranoid thinking, but rather a biased view of older adults based on ageist beliefs.
In summary, the correct answer is D as the patient's remarks reflect ageist thinking, while the other choices do not align with the content of the patient's statement.
A nurse is providing parent training for parents of a child diagnosed with a disruptive behavior disorder involving the use of time out. When describing how to implement this, which of the following would the nurse identify as the first step?
A. Having the child recount the reason for the time out
B. Clearly identifying what is required for the child
C. Informing the child what will happen because of the behavior
D. Placing the child in a designated area removed from others
Correct answer:
The correct answer is B: Clearly identifying what is required for the child. This is the first step in implementing time out as a behavioral intervention. By clearly identifying the expectations and rules for the child, the parents establish the criteria for when time out will be used, making the consequences of the behavior explicit. This helps the child understand the connection between their behavior and the consequence of time out.
Explanation for the other choices:
A: Having the child recount the reason for the time out - This would come after the child has been placed in time out, not as the first step.
C: Informing the child what will happen because of the behavior - This step comes after clearly identifying the rules and expectations for the child.
D: Placing the child in a designated area removed from others - This is the action taken after the child has been informed and understands the expectations.
Identical twins vary in their responses to stress. One twin may become anxious and irritable, while the other may withdraw and cry. How should the nurse explain these different reactions to stress to the parents?
A. Reactions to stress are relative rather than absolute; individual responses to stress vary.
B. It is abnormal for identical twins to react differently to similar stressors.
C. Identical twins should share the same temperament and respond similarly to stress.
D. Environmental influences weigh more heavily than genetic influences on reactions to stress.
Correct answer:
Individual responses to stress can vary significantly due to factors such as perception, past experiences, and environmental influences, in addition to genetic factors. It is not unusual for identical twins to exhibit different reactions to stress as their individual personalities and coping mechanisms play a significant role in how they respond to stressful situations. Choice A is the correct answer because it acknowledges the variability in responses to stress among individuals. Choice B is incorrect because it wrongly labels differing reactions in identical twins as abnormal, when in reality, it is a natural phenomenon. Choice C is incorrect as it assumes that identical twins should always have the same temperament and response to stress, which is not always the case. Choice D is incorrect because it oversimplifies the complex interplay between genetic and environmental factors in shaping responses to stress.
The head nurse in the ED has received word that a major fire in a high-rise office tower will result in many injured persons being brought to the hospital within the next few minutes. The head nurse tells the staff, 'You will need to assess for acute stress reactions as well as treating physical problems.' Which patient is exhibiting symptoms characteristic of acute stress reaction?
A. A male whose moods swing between mania and depression
B. A female who reports still hearing her daughter's pleas for help
C. A male who keeps repeating 'I don't understand what's going on?'
D. A female who is rocking her young son and repeating 'it will be okay.'
Correct answer:
The correct answer is B because the female reporting still hearing her daughter's pleas for help is exhibiting symptoms characteristic of acute stress reaction, a common response to traumatic events like a major fire. This symptom indicates a re-experiencing of the traumatic event, known as intrusion, which is a key feature of acute stress reactions. This can include vivid memories, flashbacks, or hearing sounds related to the traumatic event.
Choices A, C, and D do not align with acute stress reactions. A male with mood swings between mania and depression (Choice A) is more likely experiencing bipolar disorder. A male repeating 'I don't understand what's going on?' (Choice C) may indicate confusion or disorientation rather than acute stress reaction. A female rocking her young son and repeating 'it will be okay' (Choice D) may be demonstrating a coping mechanism rather than a symptom of acute stress reaction.
Nurse Simon has just completed a psychosocial assessment of his client Juan. During the assessment, Nurse Simon listens to Juan and tries to make Juan feel respected by showing compassion and empathy. What method is Nurse Simon using?
A. the therapeutic relationship
B. risk assessment
C. spiritual awareness
D. resilience strategy
Correct answer:
The correct answer is A: the therapeutic relationship. Nurse Simon is using the therapeutic relationship method by actively listening to Juan, showing compassion, and empathy. This method focuses on building trust, respect, and rapport with the client to facilitate effective communication and promote positive outcomes in the therapeutic process.
Summary of why the other choices are incorrect:
B: Risk assessment is not the method being used here as Nurse Simon is focused on building a therapeutic relationship, not assessing potential risks.
C: Spiritual awareness is not the method being used here as the scenario describes Nurse Simon showing compassion and empathy, not specifically focusing on spiritual beliefs or practices.
D: Resilience strategy is not the method being used here as Nurse Simon is focused on establishing a therapeutic relationship, not implementing strategies to build resilience in the client.
A nurse assesses a patient with a tentative diagnosis of generalized anxiety disorder. Which question would be most appropriate for the nurse to ask?
A. "Have you been a victim of a crime or seen someone badly injured or killed?"
B. "Do you feel especially uncomfortable in social situations involving people?"
C. "Do you repeatedly do certain things over and over again?"
D. "Do you find it difficult to control your worrying?"
Correct answer:
The correct answer is D: "Do you find it difficult to control your worrying?" This question is most appropriate because it directly assesses one of the key symptoms of generalized anxiety disorder, which is excessive and uncontrollable worrying. By asking this question, the nurse can gather crucial information to help confirm the diagnosis.
A: "Have you been a victim of a crime or seen someone badly injured or killed?" - This question is more relevant to assessing symptoms of post-traumatic stress disorder rather than generalized anxiety disorder.
B: "Do you feel especially uncomfortable in social situations involving people?" - This question is more indicative of social anxiety disorder rather than generalized anxiety disorder.
C: "Do you repeatedly do certain things over and over again?" - This question is more aligned with symptoms of obsessive-compulsive disorder rather than generalized anxiety disorder.
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.
During an interview, a patient tells the nurse that he was recently let go from his job. As the interaction continues, the patient states, 'I was really overqualified for that position anyway. It was definitely below my area of expertise.' The nurse interprets this information as reflecting which of the following?
A. Denial
B. Intellectualization
C. Projection
D. Passive aggression
Correct answer:
The correct answer is B: Intellectualization. Intellectualization is a defense mechanism where a person deals with emotional conflicts or stressors by focusing on the intellectual aspects of a situation rather than the emotional aspects. In this case, the patient is discussing their job loss in a detached, analytical manner by emphasizing their overqualification and expertise, which deflects from the emotional impact of losing the job.
A: Denial involves refusing to acknowledge or accept a reality. The patient is not denying the job loss but rather rationalizing it.
C: Projection involves attributing one's own thoughts, feelings, or motives to others. The patient is not projecting their own feelings onto someone else.
D: Passive aggression involves expressing negative feelings indirectly. The patient's statement does not reflect indirect hostility, but rather a coping mechanism through intellectualization.
RN exams mental health practice questions, set 28 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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