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 male client with known auditory hallucinations begins talking loudly and gesturing wildly while in the unit's day room. What action should the nurse implement first?
A. Administer a PRN sedative.
B. Sit in the chair next to the client.
C. Escort the client to his room.
D. Listen to what the client is saying.
Show answer and rationale
Correct answer: D — Listen to what the client is saying.
When dealing with a client experiencing auditory hallucinations, it is crucial for the nurse to first listen to what the client is saying. Auditory hallucinations may hold significance to the client, and by actively listening, the nurse can gather information about the content and context of the hallucinations. This information helps the nurse assess the client's current state, emotional responses, and the potential triggers for the behavior. Administering a PRN sedative (Choice A) should not be the initial action as it may suppress important information and feelings the client is trying to communicate. Sitting next to the client (Choice B) may not be appropriate without understanding the situation better. Escorting the client to his room (Choice C) may escalate the situation without addressing the underlying cause of the behavior, which can be better understood through active listening.
Question 2
A client with post-traumatic stress disorder (PTSD) is struggling with flashbacks and nightmares. Which therapeutic approach should the nurse include in the care plan?
A. Cognitive-behavioral therapy.
B. Electroconvulsive therapy (ECT).
C. Medication management only.
D. Relaxation training and mindfulness.
Show answer and rationale
Correct answer: A — Cognitive-behavioral therapy.
Corrected Question: A client with post-traumatic stress disorder (PTSD) experiencing flashbacks and nightmares would benefit from cognitive-behavioral therapy (CBT) in the care plan. CBT is an evidence-based therapeutic approach that focuses on identifying and changing negative thought patterns and behaviors associated with PTSD symptoms. This helps the client learn coping strategies to manage distressing symptoms like flashbacks and nightmares.\nIncorrect Choices Rationale: B) Electroconvulsive therapy (ECT) is not indicated for PTSD and is typically used for severe depression that has not responded to other treatments. C) Medication management alone may not address the underlying cognitive and behavioral aspects of PTSD. D) Relaxation training and mindfulness can be helpful as adjunctive therapies but may not be as effective as CBT in specifically targeting and modifying PTSD symptoms.
Question 3
A client with complex somatic symptom disorder is complaining of significant pain in the joints. When providing care to this client, which of the following would be most important for the nurse to keep in mind?
A. Opioid analgesics are the primary mode of therapy.
B. The client's experience of pain is real.
C. Complementary therapies are usually of little benefit.
D. Outcomes need to reflect the biologic aspects of the pain.
Show answer and rationale
Correct answer: B — The client's experience of pain is real.
The correct answer is B: The client's experience of pain is real. In complex somatic symptom disorder, physical symptoms are real to the client even if there is no clear medical explanation. It is crucial for the nurse to validate the client's experience of pain to establish trust and promote therapeutic alliance. This approach can help address the underlying psychological factors contributing to the pain.
Incorrect choices:
A: Opioid analgesics are not always the primary mode of therapy for somatic symptom disorder as they may not address the underlying psychological factors contributing to the pain.
C: Complementary therapies can be beneficial in managing pain and promoting overall well-being in clients with somatic symptom disorder.
D: Outcomes need to consider not only the biologic aspects but also the psychosocial and environmental factors influencing the client's pain experience.
Question 4
A child drowned while swimming in a local lake 2 years ago. Which behavior best indicates the child's parents are mourning in an effective way? The parents
A. forbid their other children from going swimming.
B. keep a place set for the deceased child at the family dinner table.
C. sealed their child's room exactly as the child left it 2 years ago.
D. throw flowers on the lake at each anniversary date of the accident.
Show answer and rationale
Correct answer: D — throw flowers on the lake at each anniversary date of the accident.
The correct answer is D because throwing flowers on the lake at each anniversary date indicates a healthy way of mourning by honoring and remembering the child in a positive and symbolic manner. It shows an active and ongoing effort to pay tribute to the deceased child while also finding closure.
A: Forbidding other children from swimming may indicate overprotectiveness or fear rather than effective mourning.
B: Keeping a place set for the deceased child at the dinner table could be a constant reminder and hinder the mourning process by not allowing for acceptance and moving on.
C: Sealing the child's room exactly as it was could prevent the parents from processing their grief and moving forward in a healthy manner.
In summary, choice D is the most effective way of mourning as it allows for remembrance, closure, and honoring the deceased child without hindering the grieving process.
Question 5
A client who practices Orthodox Judaism is upset. The client's son has recently committed suicide. The client tearfully tells the nurse that the son may not be able to be buried with honors. Which intervention should the nurse implement?
A. Ask the client why the son won't be buried with honors.
B. Accept that the client is upset and just needs time alone.
C. Call the psychiatrist for an antianxiety medication.
D. Sit with the client and allow expression of loss and sorrow.
Show answer and rationale
Correct answer: D — Sit with the client and allow expression of loss and sorrow.
The correct answer is D: Sit with the client and allow expression of loss and sorrow. This intervention is appropriate as it demonstrates empathy, support, and active listening. By sitting with the client and allowing them to express their emotions, the nurse is providing a safe space for the client to grieve. This approach aligns with the principles of therapeutic communication and client-centered care.
A: Asking the client why the son won't be buried with honors may come off as insensitive and could potentially make the client feel judged or misunderstood.
B: Accepting that the client is upset and leaving them alone does not address the client's emotional distress or provide support during a difficult time.
C: Calling the psychiatrist for antianxiety medication does not address the client's immediate emotional needs and may not be the most appropriate intervention in this situation.
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Question 6
A client with generalized anxiety disorder (GAD) is being discharged. Which of the following instructions should the nurse include in the discharge teaching? Select one that does not apply.
A. Practice relaxation techniques daily
B. Avoid caffeine and alcohol
C. Engage in regular physical activity
D. Use benzodiazepines as the first line of treatment
Correct answer:
When discharging a client with GAD, it is important to provide instructions that promote holistic well-being and support without exacerbating the condition. Practicing relaxation techniques daily, avoiding caffeine and alcohol, and engaging in regular physical activity can help manage anxiety symptoms effectively. These strategies focus on self-care and healthy lifestyle choices. Seeking support from friends and family also plays a crucial role in maintaining mental health. However, using benzodiazepines as the first line of treatment is not recommended due to their potential for dependence and other associated risks. Non-pharmacological interventions and therapy are usually preferred as initial approaches in managing GAD. Therefore, the option 'D: Use benzodiazepines as the first line of treatment' is incorrect and should not be included in the discharge teaching for a client with GAD.
A client with borderline personality disorder is admitted to the psychiatric unit. Which intervention should the nurse implement to promote the client's safety?
A. Implement a no-harm contract with the client.
B. Monitor the client closely for signs of self-harm.
C. Encourage the client to participate in recreational activities.
D. Encourage the client to maintain a structured daily routine.
Correct answer:
When a client with borderline personality disorder is admitted to a psychiatric unit, implementing a no-harm contract is a crucial intervention to promote the client's safety. A no-harm contract is a formal agreement between the client and the healthcare provider stating that the client commits to not harm themselves or others. This intervention helps in establishing boundaries and promoting safety by enhancing communication and accountability between the client and the healthcare team. Monitoring the client closely for signs of self-harm (Choice B) is important but does not directly address promoting safety through a formal agreement. Encouraging participation in recreational activities (Choice C) and maintaining a structured daily routine (Choice D) are beneficial interventions but may not directly address the immediate safety concerns of a client with borderline personality disorder.
Kyle, a patient with schizophrenia, began taking the first-generation antipsychotic haloperidol (Haldol) last week. One day you find him sitting very stiffly and not moving. He is diaphoretic, and when you ask if he is okay, he seems unable to respond verbally. His vital signs are: BP 170/100, P 110, T 104.2°F. What is the priority nursing intervention? Select all that apply.
A. Hold his medication and contact his prescriber.
B. Wipe him with a washcloth wet with cold water or alcohol.
C. Administer a medication such as benztropine IM to correct this dystonic reaction.
D. Reassure him that although there is no treatment for his tardive dyskinesia, it will pass.
Correct answer:
The correct intervention is to administer a medication such as benztropine IM to correct this dystonic reaction. The presentation of stiffness, diaphoresis, inability to respond verbally, and vital sign changes suggest an acute dystonic reaction, which is an extrapyramidal side effect of antipsychotic medications like haloperidol. Benztropine is an anticholinergic medication commonly used to manage these acute dystonic reactions. Option A is incorrect because holding the medication without addressing the acute symptoms may lead to worsening of the condition. Option B is incorrect as wiping with cold water or alcohol does not address the underlying cause of the symptoms. Option D is incorrect because it mentions tardive dyskinesia, which is a different condition characterized by involuntary movements that occur with long-term antipsychotic use, not the acute dystonic reaction seen here.
A professional football player is seen in the emergency department after losing consciousness from an illegal block. Prior to discharge, the nurse assists the patient to schedule an outpatient computed tomography (CT) scan for the next day. Which strategy should the nurse use to ensure the patient remembers the appointment?
A. Write the appointment day, time, and location on a piece of paper and give it to the player.
B. Log the appointment day, time, and location into the playerâ„¢s cell phone calendar feature.
C. Ask the health care provider to admit the patient to the hospital overnight.
D. Verbally inform the patient of the appointment day, time, and location.
Correct answer:
The correct answer is B: Log the appointment day, time, and location into the player's cell phone calendar feature. This method utilizes technology to set a reminder for the appointment, increasing the likelihood of the patient remembering. By inputting the information directly into the player's cell phone calendar, it serves as a tangible reminder that the patient will frequently access. This strategy leverages the convenience and accessibility of smartphones, enhancing the chances of successful appointment attendance.
Choice A is less effective because a piece of paper can be lost or forgotten easily. Choice C is unnecessary as the patient does not require hospital admission for a routine CT scan appointment. Choice D relies solely on verbal communication which may not be as reliable as a digital reminder in a traumatic situation where the patient may be disoriented or forgetful.
Which initial information gathered by the nurse is most important when assessing Erikson's stages of development?
A. The chronological age of the individual.
B. The developmental age exhibited through behaviors.
C. The time frame needed to complete a successful outcome at a previous stage.
D. The implementation of interventions based on developmental age.
Correct answer:
The correct answer is B - The developmental age exhibited through behaviors. This is crucial because Erikson's stages of development focus on psychosocial milestones and individuals can exhibit behaviors that reflect their current stage, regardless of chronological age. Understanding the developmental age exhibited through behaviors provides insights into which stage the individual is in and helps tailor appropriate interventions.
The other choices are incorrect because:
A: The chronological age may not accurately reflect the individual's stage of development.
C: The time frame needed to complete a successful outcome at a previous stage is not directly relevant to assessing Erikson's stages.
D: The implementation of interventions based on developmental age is important but not as crucial as assessing the developmental age exhibited through behaviors in understanding Erikson's stages.
The nurse is caring for an older adult patient who has no history of violence but is agitated and appears ready to strike out at a staff member. The nurse would assess the patient for which of the following?
A. Panic disorder
B. Epilepsy
C. Bipolar disorder
D. Sensory losses
Correct answer:
The correct answer is D: Sensory losses. In this scenario, the older adult patient's agitation and readiness to strike out may be due to sensory losses such as hearing or vision impairment, leading to frustration and miscommunication. Assessing for sensory losses is crucial to understand the root cause of the patient's behavior and provide appropriate interventions.
A: Panic disorder - This choice is incorrect as panic disorder typically presents with sudden and intense episodes of fear or anxiety, not necessarily leading to physical aggression.
B: Epilepsy - This choice is incorrect as epilepsy is a neurological disorder characterized by seizures, not typically associated with sudden aggression.
C: Bipolar disorder - This choice is incorrect as bipolar disorder involves distinct episodes of mania and depression, which may not directly cause the patient's behavior in this situation.
As part of a community program on crisis prevention, a nurse is describing the phases of crisis. Which of the following would the nurse identify as occurring first?
A. Problem stimulating usual problem solving
B. Trial and error attempts to alleviate problem
C. Automatic relief behaviors take over
D. Serious personality disorganization
Correct answer:
The correct answer is A: Problem stimulating usual problem solving. In crisis intervention, the first phase is when the individual encounters a problem that triggers their usual problem-solving skills. This initial phase involves recognizing the crisis and attempting to assess and address the problem. This sets the stage for further crisis intervention strategies.
Choices B, C, and D are incorrect:
B: Trial and error attempts to alleviate problem - This typically occurs after the crisis has been recognized and initial problem-solving attempts have been made.
C: Automatic relief behaviors take over - This is more likely to be a coping mechanism employed after the crisis has escalated and the individual is seeking immediate relief.
D: Serious personality disorganization - This usually occurs in the later stages of a crisis when the individual's ability to cope is severely compromised.
A nurse is caring for a patient who has recently been diagnosed with diabetes. Which of the following interventions is most appropriate to help the patient manage their condition?
A. Encouraging the patient to follow a balanced diet and monitor blood glucose levels regularly
B. Recommending the patient take medication only when they feel unwell
C. Instructing the patient to avoid exercise to prevent fluctuations in blood sugar levels
D. Providing the patient with information on how to manage symptoms of diabetes only when they occur
Correct answer:
The correct answer is A: Encouraging the patient to follow a balanced diet and monitor blood glucose levels regularly. This is the most appropriate intervention because managing diabetes requires a combination of healthy eating habits and monitoring blood sugar levels. By following a balanced diet, the patient can regulate their blood sugar levels effectively. Regular monitoring helps the patient understand how their diet and lifestyle choices impact their condition.
Choice B is incorrect because taking medication only when feeling unwell does not address the need for consistent management of blood sugar levels. Choice C is incorrect as exercise is beneficial for managing diabetes by improving insulin sensitivity and reducing blood sugar levels. Choice D is incorrect because managing diabetes is not just about symptom management but also prevention through lifestyle modifications.
A client diagnosed with post-traumatic stress disorder (PTSD) is being assessed by a healthcare professional. Which symptom would the healthcare professional expect the client to exhibit?
A. Delusions of grandeur
B. Hypervigilance
C. Obsessive-compulsive behaviors
D. Periods of excessive sleeping
Correct answer:
In individuals with post-traumatic stress disorder (PTSD), hypervigilance is a common symptom. Hypervigilance refers to a state of increased alertness, awareness, and sensitivity to potential threats or danger. This heightened state of vigilance can manifest as being easily startled, having difficulty relaxing or sleeping, and constantly scanning the environment for signs of danger. It is an adaptive response to the trauma experienced and can significantly impact the individual's daily functioning. The other options are not typically associated with PTSD. Delusions of grandeur are more commonly seen in certain psychiatric disorders like bipolar disorder or schizophrenia. Obsessive-compulsive behaviors are characteristic of obsessive-compulsive disorder (OCD), not PTSD. Periods of excessive sleeping may be seen in conditions like depression, but they are not a hallmark symptom of PTSD.
During one-to-one session with the nurse, a female client who has been admitted for chronic depression and attempted suicide discloses her experience of sexual promiscuity and prostitution. When the nurse asks the client if she was ever sexually abused as a child, the client says, 'I don't remember, but my mother ran my father off when I was five.' The nurse should recognize that the client may be using which defense mechanism?
A. Repression.
B. Denial.
C. Projection.
D. Rationalization.
Correct answer:
The correct answer is A: Repression. Repression is a defense mechanism where painful or unacceptable memories are pushed into the unconscious mind to avoid conscious awareness. In this scenario, the client's inability to remember potential childhood sexual abuse could be a result of repressing those memories due to the distress they may cause. The client's response of not remembering but mentioning a significant event from childhood (mother running off father) suggests the possibility of repressed memories.
Summary:
- Choice B: Denial involves refusing to acknowledge reality, which is not evident in this scenario.
- Choice C: Projection involves attributing one's own thoughts or feelings to others, which is not applicable in this context.
- Choice D: Rationalization involves creating logical explanations to justify behaviors, which is not demonstrated in the client's response.
RN exams mental health practice questions, set 34 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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