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
The nurse is caring for a client who has been taking clozapine (Clozaril) for 2 weeks. The client tells the nurse, 'My throat is sore, and I feel weak.' The nurse assesses the client's vital signs and finds that the client has a fever. The nurse notifies the physician, expecting an order to obtain which laboratory test?
A. A white blood cell count
B. Liver function studies
C. Serum potassium level
D. Serum sodium level
Show answer and rationale
Correct answer: A — A white blood cell count
The correct answer is A: A white blood cell count. Clozapine can cause agranulocytosis, a serious condition characterized by a severe decrease in white blood cells. The client's symptoms of sore throat, weakness, fever, and recent initiation of clozapine raise suspicion for agranulocytosis. A white blood cell count is crucial to monitor for this adverse effect.
B: Liver function studies are not the priority in this case, as the symptoms and findings are more indicative of a potential hematologic issue than liver dysfunction.
C: Serum potassium level is not the most relevant test to order in this scenario, as the client's symptoms and history are more concerning for a hematologic issue rather than a potassium imbalance.
D: Serum sodium level is not the most appropriate test to request, as the client's symptoms and history do not suggest a primary issue related to sodium imbalance.
Question 2
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 player™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.
Show answer and rationale
Correct answer: B — Log the appointment day, time, and location into the player™s cell phone calendar feature.
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.
Question 3
A nurse is talking with a 57-year-old client who has been a heavy drinker for many years. The client is being treated for alcoholism, and this is her second week as an inpatient on the psychiatric unit. It is 5:00 AM, and the client has been having difficulty sleeping. The client is an orthopedic nurse, and although she is clothed in a hospital-issued gown and robe, she is wearing a stethoscope around her neck that the nurse recognizes as belonging to one of the staff nurses. When the nurse asks her why she is wearing the stethoscope and where she got it, the client gives her a long and involved reply that basically describes how her nursing supervisor came to visit and gave it to her to wear 'so she'd remember to get well.' The nurse suspects that the client may be experiencing which of the following?
A. Wernicke's syndrome
B. Delirium tremens
C. Korsakoff's psychosis
D. Malignant hyperthermia
Show answer and rationale
Correct answer: C — Korsakoff's psychosis
Rationale: The correct answer is C: Korsakoff's psychosis. This is because the client's long and involved reply with false information about receiving the stethoscope from her nursing supervisor is indicative of confabulation, a common symptom of Korsakoff's psychosis. This condition is typically associated with chronic alcohol abuse and thiamine deficiency, leading to memory issues and confabulation.
Incorrect options:
A: Wernicke's syndrome is characterized by a triad of symptoms including confusion, ataxia, and ophthalmoplegia, not confabulation.
B: Delirium tremens is a severe form of alcohol withdrawal that presents with hallucinations, tremors, and autonomic instability, not confabulation.
D: Malignant hyperthermia is a rare but life-threatening reaction to certain medications used during anesthesia, not related to the client's behaviors or symptoms described in the scenario.
Question 4
Nurse Sheila makes adjustments to the client's plan of care after talking with the client. This is most likely an example of what component of the EBP model?
A. best available research
B. client preferences
C. nursing expertise
D. review of evidence
Show answer and rationale
Correct answer: B — client preferences
The correct answer is B: client preferences. In the EBP model, client preferences play a crucial role in decision-making. When Nurse Sheila adjusts the client's plan of care after talking with them, she is considering the client's individual needs, values, and preferences. This aligns with the client-centered approach of EBP, where decisions are made collaboratively with the client.
Incorrect choices:
A: Best available research - While research is important in EBP, in this scenario, the focus is on the client's preferences rather than solely relying on research evidence.
C: Nursing expertise - While nursing expertise is valuable, in this case, the emphasis is on incorporating the client's input into the plan of care.
D: Review of evidence - While reviewing evidence is a component of EBP, in this scenario, the main focus is on the client's preferences rather than the evidence alone.
Question 5
While working in a community mental health treatment center, the nurse overhears one of the receptionists saying that one of the patients is `really psycho.? Later in the day, the nurse talks with the receptionist about the comment. This action by the nurse demonstrates an attempt to address which issue?
A. Lack of knowledge
B. Public stigma
C. Label avoidance
D. Self-stigma
Show answer and rationale
Correct answer: B — Public stigma
The correct answer is B: Public stigma. This is because the nurse is addressing the negative stereotype and discrimination associated with mental health conditions by engaging in a conversation with the receptionist about the derogatory term "psycho." This action aims to challenge and educate the receptionist about the harmful impact of stigmatizing language on individuals with mental health issues.
Incorrect choices:
A: Lack of knowledge - This choice does not align with the scenario as the nurse is not addressing a lack of knowledge but rather addressing a stigma-related issue.
C: Label avoidance - This choice is not relevant to the scenario as the nurse is directly confronting the stigmatizing language used by the receptionist.
D: Self-stigma - This choice is not applicable as the scenario involves the nurse addressing the stigma perpetuated by the receptionist, not self-stigma.
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Question 6
A patient with major depressive disorder is started on venlafaxine. Which class of antidepressant does this medication belong to?
A. Selective serotonin reuptake inhibitors (SSRIs)
B. Tricyclic antidepressants (TCAs)
C. Monoamine oxidase inhibitors (MAOIs)
D. Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Correct answer:
Venlafaxine is classified as a serotonin-norepinephrine reuptake inhibitor (SNRI). SNRIs work by increasing the levels of both serotonin and norepinephrine in the brain, which helps alleviate symptoms of depression. This mechanism of action distinguishes SNRIs from other classes of antidepressants like SSRIs, TCAs, and MAOIs, making venlafaxine an effective choice for patients with major depressive disorder. Therefore, the correct answer is D. Choice A, SSRIs, primarily target serotonin reuptake only. Choice B, TCAs, work by inhibiting the reuptake of norepinephrine and serotonin, but they are not as selective as SNRIs. Choice C, MAOIs, inhibit the enzyme monoamine oxidase, leading to increased levels of various neurotransmitters, including serotonin and norepinephrine, but they are typically used as second- or third-line agents due to dietary restrictions and potential side effects.
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 is being treated for obsessive-compulsive disorder (OCD). Which intervention should be included in the care plan?
A. Discourage the client from performing rituals.
B. Allow the client to perform rituals in the early stages of treatment.
C. Encourage the client to focus on their compulsions.
D. Isolate the client to prevent performance of rituals.
Correct answer:
Allowing the client to perform rituals in the early stages of treatment is a common therapeutic approach for obsessive-compulsive disorder (OCD). Allowing the client to engage in rituals can help reduce anxiety by providing temporary relief. It is a part of exposure therapy, where the individual is gradually exposed to anxiety-provoking situations. As treatment progresses, the focus shifts to gradually reducing the frequency and intensity of rituals through interventions like exposure and response prevention therapy. Discouraging the client from performing rituals (Choice A) is not recommended as it may increase anxiety and resistance to treatment. Encouraging the client to focus on their compulsions (Choice C) may reinforce the behavior rather than helping to decrease it. Isolating the client (Choice D) is not therapeutic and can lead to feelings of abandonment and worsen symptoms.
A group of nursing students is reviewing information about open and closed groups. The students demonstrate understanding of the information when they identify which of the following as an example of an open group?
A. Outpatient smoking cessation group
B. Community clinic psychoeducation group
C. Ambulatory psychotherapy group
D. Inpatient anger management group
Correct answer:
The correct answer is D: Inpatient anger management group. An open group allows members to join or leave at any time, and new members can be added throughout the group's duration. In an inpatient setting, such as an anger management group, individuals may come and go due to varying lengths of stay. This flexibility in membership aligns with the characteristics of an open group.
Choice A (Outpatient smoking cessation group) is incorrect because outpatient groups typically have a set start and end date, making them more closed in nature. Choice B (Community clinic psychoeducation group) is incorrect as these groups usually have a defined curriculum and limited spots, making them closed groups. Choice C (Ambulatory psychotherapy group) is also incorrect as these groups often have a set number of sessions with the same members attending each session, making them more closed than open.
A patient receives a court order for commitment. Which of the following best exemplifies the concept of `least restrictive environment??
A. Involuntary commitment to an outpatient community mental health center
B. Medication administration for sedation so the patient cannot get out of bed
C. Placing the patient in a locked padded room in response to threats of self-harm
D. Allowing the patient to make the decision about whether treatment is necessary
Correct answer:
The correct answer is A because involuntary commitment to an outpatient community mental health center provides treatment while allowing the patient to remain in the community and maintain some level of freedom. This option aligns with the principle of the least restrictive environment by balancing the patient's need for treatment with their rights and autonomy.
Option B is incorrect as sedating a patient to prevent them from getting out of bed is overly restrictive and limits their freedom unnecessarily. Option C is also incorrect as placing a patient in a locked padded room is highly restrictive and does not promote autonomy or community integration. Option D is incorrect because allowing the patient to decide on treatment, while important, may not always align with their best interests in cases of severe mental illness requiring involuntary commitment for safety and treatment.
A client diagnosed with bipolar disorder: depressive episode intentionally overdoses on sertraline (Zoloft). Family reports that the client has experienced anorexia, insomnia, and recent job loss. Which should be the priority nursing diagnosis for this client?
A. Risk for suicide R/T hopelessness
B. Anxiety: severe R/T hyperactivity
C. Imbalanced nutrition: less than body requirements R/T refusal to eat
D. Dysfunctional grieving R/T loss of employment
Correct answer:
The priority nursing diagnosis for a client diagnosed with bipolar disorder who intentionally overdoses on sertraline is "A: Risk for suicide R/T hopelessness." This is because the client's actions indicate a high risk for self-harm, which takes precedence over other diagnoses. The client's depressive episode, anorexia, insomnia, and recent job loss all contribute to feelings of hopelessness and can increase the risk of suicide.
Choice B, anxiety related to hyperactivity, is not the priority because the client's intentional overdose is a more immediate concern than anxiety symptoms. Choice C, imbalanced nutrition due to refusal to eat, is not the priority because the risk of suicide is a more urgent and life-threatening issue. Choice D, dysfunctional grieving related to job loss, is not the priority as the client's immediate safety from self-harm takes precedence over grieving.
A client visits the emergency department after she was raped in her apartment. The nurse assesses the client's ability to adapt to the trauma by assessing her social support systems and which of the following?
A. Ability to effectively activate coping strategies
B. Evidence of body image disturbance
C. Type of affect reflected in nonverbal communication
D. Degree of fear response reflected in nonverbal communication
Correct answer:
The correct answer is A: Ability to effectively activate coping strategies. This is crucial in assessing the client's ability to adapt to trauma. Coping strategies help individuals manage stress and trauma effectively. By assessing the client's coping strategies, the nurse can determine how well the client is able to deal with the psychological impact of the rape.
Choices B, C, and D are incorrect because they do not directly assess the client's ability to adapt to the trauma through coping strategies. Body image disturbance (B) may be a concern but is not the primary focus immediately after a traumatic event. The type of affect reflected in nonverbal communication (C) and the degree of fear response (D) are important but do not directly measure the client's coping abilities. Therefore, A is the most relevant choice for assessing the client's adaptation to trauma in this context.
Which therapeutic approach is considered most effective for treating posttraumatic stress disorder (PTSD)?
A. Cognitive processing therapy
B. Psychoanalysis
C. Medication management
D. Group therapy
Correct answer:
Cognitive processing therapy is a specialized form of cognitive-behavioral therapy that has been shown to be highly effective in treating posttraumatic stress disorder (PTSD). This therapy focuses on helping individuals process and make sense of their traumatic experiences, leading to symptom reduction and improved coping mechanisms. Psychoanalysis, medication management, and group therapy can be beneficial in some cases, but cognitive processing therapy is specifically tailored for addressing the symptoms and underlying causes of PTSD. Psychoanalysis may not be as effective for PTSD due to its focus on unconscious conflicts rather than trauma processing. Medication management can be useful as an adjunct to therapy but does not address the core issues of PTSD. Group therapy can provide support but may not offer the individualized approach that cognitive processing therapy provides.
A Red Cross nurse is working with tornado victims. The nurse is interviewing a woman whose house was totally destroyed during the night by the tornado; the woman's pet poodle died as a result of the tornado. Which of the following would the nurse most likely expect to hear from the woman?
A. I don't know. I can't feel anything right now. Nothing seems real.
B. Devastated. . . . I just feel totally devastated. I don't know how I can go on living.
C. I just want my insurance man to get here so I can file a claim. Everything I had is gone.
D. I always thought my dog would die peacefully in my arms. Now I'll never be able to hold her again.
Correct answer:
The correct answer is A. The nurse would most likely expect to hear the woman express shock and numbness due to the traumatic event. This response aligns with the concept of psychological numbing, which is a common immediate reaction to severe trauma. The woman's statement of not being able to feel anything and nothing seeming real indicates a dissociative response, which is a typical initial coping mechanism in such situations.
Choices B, C, and D are incorrect because they primarily focus on emotional devastation, practical concerns (insurance claim), and grief over the loss of the pet poodle, respectively. While these responses are valid emotional reactions, they do not reflect the typical immediate psychological response to a traumatic event like the one described. In contrast, choice A captures the expected initial shock and numbness often experienced in such circumstances.
A nurse is working with a client who is a survivor of violence on developing a safety plan. Which of the following would the nurse address first?
A. Devising an escape route
B. Recognizing the signs of danger
C. Identifying a safe place to hide
D. Identifying a signal to indicate it is safe to leave
Correct answer:
The correct answer is B, recognizing the signs of danger, as it is crucial to be able to identify potential threats before devising an escape plan or identifying safe places. By recognizing signs of danger, the client can proactively assess risky situations and take necessary precautions. This step is vital in ensuring the client's safety and preventing harm.
Option A, devising an escape route, would be ineffective if the client cannot recognize the signs of danger to know when to use the route. Option C, identifying a safe place to hide, is not as effective as recognizing signs of danger since hiding may not always be a viable solution. Option D, identifying a signal to indicate it is safe to leave, would not be effective if the client cannot accurately assess when it is safe to leave. Recognizing signs of danger is the foundational step in creating a comprehensive safety plan.
RN exams mental health practice questions, set 35 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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