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 client who will be receiving electroconvulsive therapy (ECT) must provide informed consent. Which situation should cause a nurse to question the validity of the informed consent?
A. The client is paranoid.
B. The client is 87 years old.
C. The client incorrectly reports his or her spouses name, the date, and the time of day.
D. The client relies on his or her spouse to interpret the information.
Show answer and rationale
Correct answer: A — The client is paranoid.
Informed consent is a crucial component of the healthcare process, ensuring that clients are fully aware of the treatment or procedure they will undergo and have the capacity to make decisions regarding their care. In this scenario, the client being paranoid raises significant concerns about their ability to provide valid informed consent. Paranoia may impact the individual's ability to understand the information presented to them, assess the risks and benefits of ECT, and make a decision based on their own free will. Clients must be able to comprehend the information provided to them, weigh the potential consequences, and communicate their decision without any significant impairments that could affect their judgment. Therefore, a nurse should question the validity of informed consent when a client is paranoid, as it may indicate a lack of capacity to make an informed decision.
Question 2
An African American youth, growing up in an impoverished neighborhood, presents in the emergency department with bruises to his face, chest, and arms. He appears to be upset, is speaking in a dialect that is difficult for the nurse to understand, and is standing within 6 inches of the nurses personal space. What cultural consideration should a nurse identify as playing a role in this youths behavior?
A. African Americans frequently speak in different tongues when they are upset.
B. Most African Americans have learned to be aggressive when they have to see a health professional.
C. African Americans tend to use dialects and invasion of personal space to intimidate others.
D. Some African Americans speak in a dialect that is different from standard English and tend toward smaller personal space than that of the dominant culture.
Show answer and rationale
Correct answer: D — Some African Americans speak in a dialect that is different from standard English and tend toward smaller personal space than that of the dominant culture.
The correct cultural consideration that the nurse should identify as playing a role in this youth's behavior is that some African Americans speak in a dialect that is different from standard English and tend toward smaller personal space than that of the dominant culture. It is important for healthcare providers to recognize and respect cultural differences, such as variations in language and personal space preferences, when interacting with patients from diverse backgrounds. In this case, the youth's use of a dialect the nurse finds difficult to understand and standing within close proximity may be reflective of his cultural norms and should not be misinterpreted as aggression or intimidation. Understanding and acknowledging cultural differences can help build trust and rapport between healthcare providers and patients, leading to more effective and culturally competent care.
Question 3
The nurse is caring for a family in which the elderly mother has been a victim of abuse and neglect by her 48-year-old son. Which of the following would be most important for the nurse to keep in mind before interviewing the family?
A. A top nursing priority will be to legally remove the son from the home.
B. The main focus of the nurse's actions should be on improving the elderly mother's self-esteem.
C. The nurse must allow the elderly mother to decide if she wants to leave the situation or not.
D. Placement for the elderly woman in a nursing home within the community is crucial.
Show answer and rationale
Correct answer: C — The nurse must allow the elderly mother to decide if she wants to leave the situation or not.
The correct answer is C: The nurse must allow the elderly mother to decide if she wants to leave the situation or not. This is important because it respects the elderly mother's autonomy and empowers her to make decisions about her own well-being. By allowing her to decide, the nurse promotes her sense of control and dignity in a situation where she may feel powerless. It also aligns with the principles of patient-centered care and informed consent.
Choice A is incorrect because legally removing the son should not be the immediate priority without considering the elderly mother's wishes. Choice B is incorrect as solely focusing on improving self-esteem may not address the safety and protection concerns of the elderly mother. Choice D is incorrect as placement in a nursing home should be a decision made collaboratively with the elderly mother, not imposed without her consent.
Question 4
A young adult says to the nurse, I go to sleep without any problem, but I often wake up during the night because it feels like there are rubber bands in my legs. Which assessment question should the nurse ask to assess for restless legs syndrome (RLS)?
A. What type of birth control do you use?
B. How much caffeine do you use every day?
C. How much exercise do you get in a typical day?
D. Does anyone else in your family have this problem?
Show answer and rationale
Correct answer: D — Does anyone else in your family have this problem?
The correct answer is D: "Does anyone else in your family have this problem?" This question is crucial for assessing restless legs syndrome (RLS) because RLS can have a genetic component. By asking if anyone else in the family has experienced similar symptoms, the nurse can determine if there is a familial pattern of RLS, which can help in diagnosing and managing the condition.
A: "What type of birth control do you use?" This question is unrelated to RLS and does not provide relevant information for assessing the client's symptoms.
B: "How much caffeine do you use every day?" While caffeine consumption can potentially impact sleep, it is not directly related to RLS symptoms involving sensations of rubber bands in the legs.
C: "How much exercise do you get in a typical day?" While exercise can influence sleep patterns, it is not a key assessment question for RLS specifically.
Question 5
You are called to assist an adult female with a possible allergic reaction. You arrive to find a 22-year-old patient who is just beginning to have difficulty breathing. She has itching, urticaria, and hives after a bee-sting. During the possible allergic reaction, what is occurring at the cellular level?
A. The mast cells are retaining the vasoactive amines, resulting in a localized response to the sting
B. The cells begin a hypermetabolic state associated with the patient's increased activity level after the sting
C. An anaerobic metabolism has begun at the local level and is now moving into the vasculature
D. The mast cells have degranulated, releasing serotonin and histamines into the general circulation
Show answer and rationale
Correct answer: D — The mast cells have degranulated, releasing serotonin and histamines into the general circulation
Rationale:
1. Mast cells play a key role in allergic reactions by releasing histamines and other inflammatory mediators.
2. When triggered by an allergen like a bee-sting, mast cells degranulate, releasing histamines and serotonin.
3. Histamines cause vasodilation and increased vascular permeability, leading to itching, hives, and urticaria.
4. Serotonin contributes to smooth muscle contraction and bronchoconstriction, leading to difficulty breathing.
5. Therefore, choice D is correct as it accurately describes the cellular events in an allergic reaction.
Summary:
A, B, and C are incorrect because they do not accurately depict the cellular processes involved in an allergic reaction. A does not mention degranulation, B focuses on a hypermetabolic state unrelated to allergies, and C refers to anaerobic metabolism which is not the primary mechanism in allergic reactions.
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Question 6
A new patient at the sleep disorders clinic tells the nurse, I have not slept well in a year, so I never feel good. I do not expect things will ever improve or be any different. Interventions the nurse should consider include (Select all that apply)
A. suggesting use of alcohol as a sedative.
B. providing instruction in relaxation techniques.
C. counseling the patient to address cognitive distortions.
D. health teaching regarding factors that influence sleep.
Correct answer:
The correct answer is B: providing instruction in relaxation techniques. This is the most appropriate intervention because teaching relaxation techniques can help the patient manage stress and anxiety, which are common contributors to sleep disturbances. By learning to relax, the patient may improve their ability to fall asleep and stay asleep.
Choice A is incorrect because suggesting the use of alcohol as a sedative can lead to dependence, disrupt sleep patterns, and worsen the patient's overall health.
Choice C is incorrect because while addressing cognitive distortions may be beneficial, it is not the most immediate intervention for improving sleep quality.
Choice D is incorrect because providing health teaching on factors that influence sleep is important, but focusing solely on this aspect may not directly address the patient's immediate need for better sleep.
A group of nursing students are reviewing information about the various nursing theorists and their application to psychiatric-mental health nursing. The students demonstrate understanding when they identify which theorist as responsible for developing the theory of cultural care diversity and universality?
A. Madeleine Leininger
B. Sister Calista Roy
C. Hildegard Peplau
D. Dorothea Orem
Correct answer:
Step-by-step rationale:
1. Madeleine Leininger is known for developing the theory of cultural care diversity and universality.
2. Leininger emphasized the importance of understanding and integrating cultural beliefs and practices into nursing care.
3. This theory is particularly relevant in psychiatric-mental health nursing to provide culturally sensitive care.
4. Sister Calista Roy developed the Adaptation Model, Hildegard Peplau the Interpersonal Relations Model, and Dorothea Orem the Self-Care Deficit Theory, which are not directly related to cultural care diversity and universality.
Summary:
Choice A is correct as Madeleine Leininger is the nursing theorist responsible for the theory of cultural care diversity and universality. Choices B, C, and D are incorrect as they are associated with different nursing theories not focused on cultural care diversity and universality.
A nurse is providing care to a client just recently diagnosed with schizophrenia during an inpatient hospital stay. Throughout the day, the nurse observes the client drinking from the water fountain quite frequently as well as carrying cans of soda and bottles of water with him wherever he goes. Upon entering the client's room, the nurse sees numerous empty cups that had been filled with fluids on his table and in the trash can. The room has an odor of urine. The nurse suspects which of the following?
A. Diabetes mellitus
B. Disordered water balance
C. Tardive dyskinesia
D. Orthostatic hypotension
Correct answer:
The correct answer is B: Disordered water balance. The client's excessive fluid intake, frequent use of the water fountain, carrying cans of soda and bottles of water, and presence of numerous empty cups suggest polydipsia, a common symptom in schizophrenia due to disordered water balance. This can lead to dilutional hyponatremia and subsequent urinary incontinence, explaining the odor of urine in the room.
A: Diabetes mellitus is unlikely as there are no symptoms of hyperglycemia mentioned.
C: Tardive dyskinesia is a movement disorder associated with long-term antipsychotic use, not related to excessive fluid intake.
D: Orthostatic hypotension is characterized by a drop in blood pressure upon standing, not related to the client's symptoms.
In summary, the client's behavior and symptoms point towards disordered water balance, specifically polydipsia, as the likely cause.
Adam has antisocial personality disorder. He says to the nurse, 'I'm not crazy. I'm just fun-loving. I believe in looking out for myself. Who cares what anyone thinks? If it feels good, do it!' Which of the following describes the psychoanalytical structure of Adam's personality?
A. Weak id, strong ego, weak superego
B. Strong id, weak ego, weak superego
C. Weak id, weak ego, punitive superego
D. Strong id, weak ego, punitive superego
Correct answer:
The correct answer is B: Strong id, weak ego, weak superego. This is because Adam's statement reflects characteristics of a person with strong id, prioritizing immediate gratification and pleasure without considering consequences. His lack of concern for societal norms or moral values indicates a weak superego. Additionally, his statement suggests a weak ego, as he lacks the ability to balance the demands of the id and superego, resulting in impulsive and self-centered behavior.
Summary of other choices:
A: Weak id, strong ego, weak superego - This is incorrect as Adam's statement reflects a strong id, not a weak one.
C: Weak id, weak ego, punitive superego - This is incorrect as Adam's statement does not suggest a punitive superego.
D: Strong id, weak ego, punitive superego - This is incorrect as Adam's statement does not indicate a punitive superego but rather a weak one.
A female client who is wearing dirty clothes and has foul body odor comes to the clinic reporting feeling scared because she is being stalked. What action is most important for the RN to take?
A. Offer the client a safe place to relax before interviewing her.
B. Ask the client to describe why she is being stalked.
C. Recommend that the client talk with a social worker.
D. Assure the client that the HCP will see her today.
Correct answer:
The correct answer is A: Offer the client a safe place to relax before interviewing her. This is important because the client is feeling scared and may be in a vulnerable state. Providing a safe and comfortable environment first helps establish trust and rapport with the client, allowing her to feel more at ease to discuss her concerns. It also shows empathy and understanding towards her current situation.
Choice B is incorrect because asking the client to describe why she is being stalked may not be appropriate at this initial stage and could further distress her. Choice C is incorrect as recommending the client talk with a social worker may be premature without understanding the full scope of the situation. Choice D is incorrect as assuring the client that the healthcare provider will see her today does not address her immediate need for a safe and calming environment.
Which individual in the emergency department should be considered at highest risk for completing suicide?
A. An adolescent Asian American girl with superior athletic and academic skills who has asthma.
B. A 38-year-old single, African American female church member with fibrocystic breast disease.
C. A 60-year-old married Hispanic man with 12 grandchildren who has type 2 diabetes.
D. A 79-year-old single, white male diagnosed recently with terminal cancer of the prostate.
Correct answer:
The correct answer is D because the 79-year-old single, white male diagnosed with terminal cancer of the prostate is at the highest risk for completing suicide. This individual is facing a terminal illness, which can lead to feelings of hopelessness and despair, increasing the risk of suicide. The other choices do not present such high-risk factors for suicide.
A: While the adolescent Asian American girl may face pressures from high achievements and asthma, these factors do not inherently place her at the highest risk for suicide.
B: The 38-year-old single, African American female church member with fibrocystic breast disease may face challenges, but they do not indicate a high risk for suicide.
C: The 60-year-old married Hispanic man with 12 grandchildren who has type 2 diabetes has family support and does not have as severe risk factors as the individual in choice D.
Epidemiological studies contribute to improvements in care for individuals with mental disorders by:
A. Providing information about effective nursing techniques.
B. Identifying risk factors that contribute to the development of a disorder.
C. Identifying individuals in the general population who will develop a specific disorder
D. Identifying which individuals will respond favorably to a specific treatment.
Correct answer:
The correct answer is B: Identifying risk factors that contribute to the development of a disorder. Epidemiological studies help to identify factors that increase the likelihood of developing mental disorders, leading to better prevention strategies. This is crucial for improving care by targeting interventions early on.
Incorrect choices:
A: Providing information about effective nursing techniques. This is not the primary role of epidemiological studies, which focus on identifying risk factors at a population level.
C: Identifying individuals in the general population who will develop a specific disorder. Epidemiological studies look at populations rather than predicting individual outcomes.
D: Identifying which individuals will respond favorably to a specific treatment. This is more related to clinical trials and personalized medicine rather than epidemiological studies.
The nurse is caring for a client with schizophrenia. Orders from the physician include 100 mg chlorpromazine IM STAT and then 50 mg PO bid; 2 mg benztropine PO bid prn. Because benztropine was ordered on a prn basis, which of the following assessments by the nurse would convey a need for this medication?
A. The client's level of agitation increases.
B. The client complains of a sore throat.
C. The client's skin has a yellowish cast.
D. The client develops tremors and a shuffling gait.
Correct answer:
The correct answer is D: The client develops tremors and a shuffling gait. Benztropine is an anticholinergic medication commonly used to treat extrapyramidal symptoms (EPS) such as tremors and shuffling gait that can occur as side effects of antipsychotic medications like chlorpromazine. Therefore, the presence of these symptoms indicates a need for benztropine to manage the EPS.
A: The client's level of agitation increasing does not directly relate to the need for benztropine.
B: The client complaining of a sore throat is not a typical indication for benztropine.
C: The client's skin having a yellowish cast is not associated with EPS or a need for benztropine in this context.
In summary, the development of tremors and a shuffling gait in the client with schizophrenia receiving chlorpromazine is a clear indication of EPS and the need for benztropine as a treatment option
A patient is taking tranylcypromine sulfate for depression. What advice should the nurse include in the teaching plan for this medication?
A. Warn the patient about severe hypotension.
B. Instruct the patient to avoid beer and cheddar cheese.
C. Encourage the patient to take ginseng and ephedra.
D. Encourage the patient to eat fruit such as bananas.
Correct answer:
The correct answer is B: Instruct the patient to avoid beer and cheddar cheese. Tranylcypromine sulfate is a monoamine oxidase inhibitor (MAOI), and consuming foods high in tyramine, such as beer and cheddar cheese, can lead to a hypertensive crisis due to the interaction with MAOIs. It is crucial for the nurse to advise the patient to avoid these foods to prevent serious complications.
Incorrect choices:
A: Warn the patient about severe hypotension - This is incorrect because MAOIs are known to cause hypertensive crises, not hypotension.
C: Encourage the patient to take ginseng and ephedra - This is incorrect because ginseng and ephedra can interact with MAOIs and lead to an increased risk of hypertensive crisis.
D: Encourage the patient to eat fruit such as bananas - This is incorrect because while a healthy diet is important, there is no specific indication for bananas
The highest priority for assessment by nurses caring for older adults who self-administer medications is:
A. Use of multiple drugs with anticholinergic effects.
B. Overuse of medications for erectile dysfunction.
C. Missed doses of medications for arthritis.
D. Trading medications with acquaintances.
Correct answer:
The correct answer is A: Use of multiple drugs with anticholinergic effects. This is the highest priority as anticholinergic medications can have severe side effects in older adults, including confusion, constipation, and increased risk of falls. Nurses need to assess for potential harm caused by these medications.
Choice B (Overuse of medications for erectile dysfunction) is not the highest priority as it may not pose an immediate threat to the health and safety of older adults compared to anticholinergic effects.
Choice C (Missed doses of medications for arthritis) is important but not as critical as assessing for the potential harm caused by anticholinergic medications.
Choice D (Trading medications with acquaintances) is concerning but not as urgent as assessing for the harmful effects of anticholinergic medications, which can lead to serious health complications.
RN exams mental health practice questions, set 37 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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