NR 326 Psychiatric Mental Health Nursing Test Part 1

NR 326 Psychiatric Mental Health Nursing Test Part 1

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Chamberlain University

NR-326: Mental Health Nursing

Prof. Name

Date

Psychiatric Mental Health Nursing Test – Part 1

The following section contains the quiz questions and answers with explanations. Each item includes the correct answer and rationale.

1. Your patient is very dependent and submissive. There are times that the patient is very clingy. This behavior reflects what type of personality disorder?

Answer: b. Dependent Personality

Dependent personality disorder is characterized by dependence, submission, and clinginess. Antisocial personality is impulsive, aggressive, and manipulative, whereas manic behavior and anxiety disorder do not reflect this behavioral pattern.

2. The appropriate therapeutic distance between you and a psychiatric patient is?

Answer: d. 4 feet

Therapeutic distance is ideally 3–6 feet to maintain boundaries and effective communication.

3. Nurse Anna is instructing the new nurse to the psychiatric set-up. She also reminded her to use her therapeutic communication skills in dealing with clients. Which of the following techniques enlaces therapeutic communication?

Answer: a. What are you thinking about?

This uses the therapeutic technique of broad opening, which allows the client to introduce a topic.

4. Mr. Juan is diagnosed with Alzheimer’s disease. The nurse’s intervention should focus on helping the client be oriented with the physical set-up and daily events. Which of the following is the most effective nursing intervention in orienting patients who has Alzheimer’s disease?

Answer: b. Provide simple and easily understood directions

Daily routines and simple instructions help orient clients with Alzheimer’s disease more effectively.

5. A therapy that focuses on the remotivation of clients by directing their attention outside themselves to relieve preoccupation with personal thoughts, feelings, and attitudes is known as:

Answer: d. Recreational therapy

Recreational therapy directs attention away from internal preoccupations and encourages coping through activities such as bowling, picnics, or group games.

6. The 12-year old male patient looks like the nurse’s younger brother who is missing for years. During assessment and in the implementation of nursing care the nurse prioritizes this client. One day, when she found the boy crying in his room she hugged him and cried with him. This is an example of:

Answer: a. Counter-transference

Counter-transference occurs when the nurse displays emotions toward a client based on personal feelings.

7. A schizophrenic client is under your care. In reinforcing the functional behavior of this client what will the nurse do?

Answer: c. Compliment the client for cessation of acting out behaviors

According to B.F. Skinner’s behavior modification techniques, reinforcing positive behaviors with praise encourages desirable actions.

8. A client was brought to the ER. Based on the significant others, the client had a history of shop stealing. However, no self-mutilating activities are committed by the client. During the interview, the client is very manipulative and aggressive and impulsive. What personality disorder most likely the client has?

Answer: a. Antisocial

Antisocial personality disorder is marked by manipulation, aggression, and impulsivity. Other disorders have different hallmark traits.

Client Rights and Medication Refusal

The client has the right to refuse medication. Instead of ordering the client to take it (Option A), the nurse should provide the necessary information so the client can make an informed decision. Attempting to induce guilt (Option C) or threatening the client (Option D) may only heighten anxiety.

Question 9

After seeking help at an outpatient mental health clinic, a client who was raped while walking her dog is diagnosed with posttraumatic stress disorder (PTSD). Three months later, the client returns to the clinic, complaining of fear, loss of control, and helpless feelings. Which nursing intervention is most appropriate for this client?

The most appropriate intervention for a client with PTSD is encouraging the exploration of the meaning of the traumatic event. This approach helps the client understand their losses and reduces the risk of worsening symptoms, depression, or self-destructive behaviors.

Question 10

Jane is admitted to an inpatient psychiatric unit for treatment of obsessive-compulsive symptoms. Obsessive-compulsive disorder (OCD) is associated with:

OCD is defined by repetitive, uncontrollable thoughts and irresistible impulses. In contrast, somatoform disorders involve physical symptoms without physiological cause, while anxiety disorders are linked with apprehension and poor concentration.

Question 11

A client with obsessive-compulsive disorder and ritualistic behavior must brush the hair back from his forehead 15 times before carrying out any activity. Nurse Leo notices that the client’s hair is thinning and the skin on the forehead is irritated — possible effects of this ritual. When planning the client’s care, the nurse should assign highest priority to:

Client safety takes the highest priority. Setting consistent limits on harmful ritualistic behavior is necessary before addressing secondary aspects, such as motivation or coping skills.

Question 12

During alprazolam (Xanax) therapy, nurse Rachel should be alert for which dose-related adverse reaction?

Alprazolam can cause dose-related reactions, including ataxia, drowsiness, confusion, and dizziness. Hepatomegaly, rash, or urticaria are rare and not dose-related.

Question 13

A client is admitted to the psychiatric unit with a diagnosis of conversion disorder. Since witnessing the beating of his wife at gunpoint, he has been unable to move his arms, complaining that they are paralyzed. When planning the client’s care, nurse Jay should focus on:

For conversion disorder, the nurse should focus on helping the client identify and verbalize underlying emotional conflicts, rather than challenging or ignoring the symptoms.

Question 14

A male client with borderline personality disorder tells nurse Valerie, “You’re the only nurse who really understands me. The others are mean.” The client then asks the nurse for an extra dose of antianxiety medication because of increased anxiety. How should the nurse respond?

The appropriate response focuses on acknowledging the client’s feelings while maintaining professional consistency. This prevents staff splitting and addresses the emotional content rather than the medication request.

Question 15

Angel, is admitted to the unit visibly anxious. When assessing her, the nurse would expect to see which of the following cardiovascular effects produced by the sympathetic nervous system?

The sympathetic nervous system response to stress includes increased heart rate, blood pressure, cardiac output, and vasoconstriction. Syncope is associated with parasympathetic stimulation.

Question 16

A male client with Alzheimer’s disease has a nursing diagnosis of Risk for injury related to memory loss, wandering, and disorientation. Which nursing intervention should appear in this client’s plan of care to prevent injury?

The best intervention is removing environmental hazards such as chemicals or unsafe objects. Sedation and restraints are inappropriate unless absolutely necessary, and detailed instructions may confuse the client further.

Question 17

Rudy was found wandering in a local park, unable to state who or where he is or where he lives. He is brought to the emergency department, where his identification is eventually discovered. The client’s wife states that he was diagnosed with Alzheimer’s disease 3 years ago and has had increasing memory loss. She tells nurse Angelie she is worried about how she’ll continue to care for him. Which response by the nurse would be most helpful?

The most helpful response is to determine the wife’s specific concerns so the care plan can be tailored to her and her husband’s needs.

Question 18

Nurse Agnes is aware that nursing action most appropriate when trying to diffuse a male client’s impending violent behavior is:

Violence can often be prevented by helping the client verbalize feelings of anger and anxiety. Seclusion or diversion may be used later, but verbal intervention is the safest first step.

Question 19

A male client has been taking imipramine (Tofranil), 125 mg by mouth daily, for 1 week. Now the client reports wanting to stop taking the medication because he still feels depressed. At this time, what is the best response of nurse Charlyn?

Imipramine requires 2–3 weeks to reach therapeutic levels. Clients must be encouraged to continue therapy before making decisions about discontinuation.

Question 20

A male client with Alzheimer’s disease mumbles incoherently and rambles in a confused manner. To help redirect the client’s attention, nurse Mark should encourage the client to:

Simple, familiar tasks such as folding towels help redirect attention and provide a sense of accomplishment. Complex tasks are unsuitable for confused clients.

Question 21

Nurse Francis is aware that the nursing preparations for a client undergoing electroconvulsive therapy (ECT) resemble those used for:

Preparation for ECT is similar to general anesthesia: NPO status for 8 hours, voiding before the procedure, and removal of dentures or jewelry.

Question 22

Nurse Hershey must administer activated charcoal before administering certain other drugs to a client who’s taken an overdose. Which drug is rendered inactive when administered concomitantly with activated charcoal?

Activated charcoal renders ipecac syrup inactive, making it ineffective in cases of overdose.

Question 23

Dr. Tan orders electroconvulsive therapy (ECT) for a severely depressed client who fails to respond to drug therapy. When teaching the client and family about this treatment, nurse Bernadeth should include which most important point about ECT?

The most important point to stress is that ECT induces a seizure, which alters neurotransmitter activity. Although it may reduce depression, it does not cure it.

Question 24

Julius, an adolescent becomes increasingly withdrawn, is irritable with family members, and has been getting lower grades in school. After giving away a stereo and some favorite clothes, the adolescent is brought to the community mental health agency for evaluation. This adolescent is at risk for:

Withdrawal, irritability, poor performance, and giving away possessions are major warning signs of suicide risk.

Question 25

Nurse Bea is aware that when preparing a client for electroconvulsive therapy (ECT), she should make sure that:

Psychiatric Nursing Practice Test (with Answers and Rationales)

1. Prescribe which medication for this client?

• a. Chlorpromazine (Thorazine)

• b. Imipramine (Tofranil)

• c. Lithium carbonate (Lithane)

• d. Fluphenazine decanoate (Prolixin Decanoate)

Answer: The correct medication is Fluphenazine decanoate (Prolixin Decanoate). This long-acting injectable antipsychotic lasts for four weeks, making it especially useful for clients with a history of noncompliance. Chlorpromazine must be taken daily, requiring strict adherence. Imipramine, a tricyclic antidepressant, and lithium carbonate, a mood stabilizer, are not standard treatments for chronic schizophrenia.

2. Which of the following medications would the nurse in-charge expect the doctor to order to reverse a dystonic reaction?

• a. Prochlorperazine (Compazine)

• b. Diphenhydramine (Benadryl)

• c. Haloperidol (Haldol)

• d. Midazolam (Versed)

Answer: The correct choice is Diphenhydramine (Benadryl). Administering 25–50 mg intramuscularly or intravenously rapidly reverses dystonia. Prochlorperazine and haloperidol can cause dystonia, while midazolam induces drowsiness but does not address the underlying issue.

3. A nurse places a female client in full leather restraints. How often must the nurse check the client’s circulation?

• a. Once per hour

• b. Once per shift

• c. Every 10 to 15 minutes

• d. Every 2 hours

Answer: The correct frequency is Every 10 to 15 minutes. Circulatory, skin, and nerve damage can occur quickly, within 15 minutes. Restraints should be removed every two hours, allowing for range-of-motion exercises.

4. The client tells the nurse he was involved in a car accident while he was intoxicated. What would be the most therapeutic response from the nurse?

• a. “Why didn’t you get someone else to drive you?”

• b. “Tell me how you feel about the accident.”

• c. “You should know better than to drink and drive.”

• d. “I recommend that you attend an Alcoholics Anonymous meeting.”

Answer: The correct therapeutic response is “Tell me how you feel about the accident.” This open-ended statement fosters expression, shows empathy, and avoids judgment or advice-giving, which could create defensiveness or dependency.

5. A client is being admitted to the substance abuse unit for alcohol detoxification. As part of the intake interview, the nurse asks him when he had his last alcoholic drink. He says that he had his last drink 6 hours before admission. Based on this response, the nurse should expect early withdrawal symptoms to:

• a. begin after 7 days.

• b. not occur at all because the time period for their occurrence has passed.

• c. begin anytime within the next 1 to 2 days.

• d. begin within 2 to 7 days.

Answer: The correct choice is begin anytime within the next 1 to 2 days. Alcohol withdrawal can begin six hours after cessation and peaks within 24–48 hours. Delirium tremens may occur 2–7 days after the last drink.

6. Which is the highest priority in the post ECT care?

• a. Observe for confusion

• b. Monitor respiratory status

• c. Reorient to time, place and person

• d. Document the client’s response to the treatment

Answer: The correct answer is Monitor respiratory status. Respiratory arrest is the most life-threatening complication following ECT. Confusion and disorientation are common but not as critical.

7. Which of the following medical conditions is commonly found in clients with bulimia nervosa?

• a. Allergies

• b. Cancer

• c. Diabetes mellitus

• d. Hepatitis A

Answer: The correct choice is Diabetes mellitus. Bulimia nervosa can cause serious complications such as diabetes, hypertension, and cardiovascular disease.

8. A client tends to be insensitive to others, engages in abusive behaviors and does not have a sense of remorse. Which personality disorder is he likely to have?

• a. Narcissistic

• b. Paranoid

• c. Histrionic

• d. Antisocial

Answer: The correct diagnosis is Antisocial personality disorder. This disorder is characterized by lack of remorse, disregard for others, and abusive behavior. Narcissistic disorder involves grandiosity, paranoid personality shows distrust, and histrionic personality demonstrates attention-seeking.

9. The client on Haldol has pill rolling tremors and muscle rigidity. He is likely manifesting:

• a. Tardive dyskinesia

• b. Pseudoparkinsonism

• c. Akinesia

• d. Dystonia

Answer: The correct manifestation is Pseudoparkinsonism. This side effect of antipsychotics is marked by pill-rolling tremors, rigidity, and mask-like facies. Tardive dyskinesia presents with lip-smacking, akinesia with fatigue, and dystonia with involuntary muscle contractions.

10. A client has approached the nurse asking for advice on how to deal with his alcohol addiction. The nurse should tell the client that the only effective treatment for alcoholism is:

• a. Psychotherapy

• b. Total abstinence

• c. Alcoholics Anonymous (AA)

• d. Aversion therapy

Answer: The correct treatment is Total abstinence. While psychotherapy, AA, and aversion therapy support recovery, abstinence is the only proven effective treatment.

11. The nurse is caring for a male client with schizophrenia. Which outcome is the least desirable?

• a. The client spends more time by himself

• b. The client doesn’t engage in delusional thinking

• c. The client doesn’t harm himself or others

• d. The client demonstrates the ability to meet his own self-care needs

Answer: The least desirable outcome is The client spends more time by himself. Social withdrawal is common in schizophrenia, but increasing isolation is not a goal. The other options reflect desirable outcomes.

12. The client says to the nurse “Pray for me” and entrusts her wedding ring to the nurse. The nurse knows that this may signal which of the following:

• a. Anxiety

• b. Suicidal ideation

• c. Major depression

• d. Hopelessness

Answer: The correct indication is Suicidal ideation. Giving away possessions and making direct statements are warning signs. While depression and hopelessness are linked to suicide, the direct clue here indicates active suicidal thoughts.

13. The nurse asks a client to roll up his sleeves so she can take his blood pressure. The client replies, “If you want I can go naked for you.” The most therapeutic response by the nurse is:

• a. “You’re attractive but I’m not interested.”

• b. “You wouldn’t be the first that I will see naked.”

• c. “I will report you to the guard if you don’t control yourself.”

• d. “I only need access to your arm. Putting up your sleeve is fine.”

Answer: The correct response is “I only need access to your arm. Putting up your sleeve is fine.” This matter-of-fact approach addresses the behavior without judgment or confrontation.

14. Diana Gil is a 45-year-old mother of three, a patient on a burn unit. She received full thickness burn on 20% of her body in a house fire in which two of her children died. Which behavior would most suggest that Mrs. Gil is still in the earliest stage of the grief process?

• a. Outburst of anger toward her family and the staff

• b. Questions about job retraining

• c. Statements that “it’s a dream” and “it didn’t really happen”

• d. Wanting to be left alone in a dark and quiet room

Answer: The correct answer is Statements that “it’s a dream” and “it didn’t really happen.” This indicates denial, the first stage of grief. Anger, depression, or acceptance occur later.

15. Shortly after midnight, Mrs. Gil is awakened by the sound of an arriving ambulance. She screams, cries, attempts to get out of bed, and speaks incoherently. These manifestations are most suggestive of which level of anxiety?

• a. Mild

• b. Moderate

• c. Panic

• d. Severe

Answer: The correct answer is Panic. Extreme behaviors, disorganized speech, and exaggerated reactions indicate panic anxiety.

16. During this episode, which nursing intervention is most appropriate?

• a. Discuss appropriate coping mechanisms with Mrs. Gil.

• b. Encourage Mrs. Gil to express her feelings about the event.

• c. Have Mrs. Gil remain in bed and apply soft restraints.

• d. Stay with Mrs. Gil and provide assurance and safety.

Answer: The most appropriate action is Stay with Mrs. Gil and provide assurance and safety. During panic, the priority is presence, safety, and reassurance, not teaching or restraining.

17. A 26-year-old unemployed woman seeks help because she feels depressed and abandoned. She has quit her last five jobs due to perceived dislike from coworkers. Recently, her boyfriend broke up with her after she crashed his car during an argument. The initial diagnosis is borderline personality disorder. Which nursing observations support this?

• a. Flat affect, social withdrawal, and unusual dress

• b. Suspiciousness, hypervigilance, and emotional coldness

• c. Lack of self-esteem, strong dependency needs, and impulsive behavior

• d. Insensitivity to others, sexual acting out, and violence

Answer: The correct choice is Lack of self-esteem, strong dependency needs, and impulsive behavior. These are hallmarks of borderline personality disorder, along with unstable relationships and poor self-image.

18. How soon after chlorpromazine administration should the nurse in charge expect delusional thoughts and hallucinations to be eliminated?

• a. Several minutes

• b. Several hours

• c. Several days

• d. Several weeks

Answer: The correct answer is Several weeks. While immediate calming effects may appear in hours, the antipsychotic effects require weeks.

19. Dolores Moreno, a 21-year-old mother of a premature newborn with respiratory distress, expresses guilt for smoking during pregnancy. Which aspect of the nursing role is most important in addressing her guilt?

• a. Empathy

• b. Guidance

• c. Role modeling

• d. Teaching

Answer: The correct approach is Empathy. Demonstrating understanding builds trust and encourages self-expression.

20. While pacing in the hall, a patient with paranoid schizophrenia tells the nurse, “Why are you poisoning me? You work for central thought control! You can keep my thoughts. Give me back my soul!” How should the nurse respond?

• a. “I’m a nurse, I’m not poisoning you. It’s against the nursing code of ethics.”

• b. “I’m a nurse, and you’re a patient in the hospital. I’m not going to harm you.”

• c. “I’m not poisoning you. And how could I possibly steal your soul?”

• d. “I sense anger, Are you feeling angry today?”

Answer: The correct response is “I’m a nurse, and you’re a patient in the hospital. I’m not going to harm you.” This reorients the client to reality without reinforcing delusions.

21. Conditions necessary for the development of a positive sense of self-esteem include:

• a. Consistent limits

• b. Critical environment

• c. Inconsistent boundaries

• d. Physical discipline

Answer: The correct condition is Consistent limits. Structure and acceptance promote security. Critical, inconsistent, or punitive environments harm self-esteem.

22. During which phase of alcoholism is loss of control and physiologic dependence evident?

• a. Prealcoholic phase

• b. Early alcoholic phase

• c. Crucial phase

• d. Chronic phase

Answer: The correct answer is Crucial phase. This stage is marked by dependence and loss of control.

23. A client tells the nurse that he is having suicidal thoughts every day. What is the best recommendation to the treatment team?

• a. A no-suicide contract

• b. Weekly outpatient therapy

• c. A second psychiatric opinion

• d. Intensive inpatient treatment

Answer: The best recommendation is Intensive inpatient treatment. Daily suicidal ideation requires immediate and structured care.

24. A client with borderline personality disorder shows self-inflicted lacerations and asks the nurse to keep it a secret. What is the best response?

• a. “That’s it! You’re on suicide precautions.”

• b. “I’m going to tell your physician. Do you want to tell me why you did that?”

• c. “Tell me what instrument you used. I’m concerned about infection.”

• d. “The team needs to know when something important occurs in treatment. I need to tell the others, but let’s talk about it first.”

Answer: The correct response is “The team needs to know… let’s talk about it first.” This balances transparency with therapeutic discussion.

NR 326 Psychiatric Mental Health Nursing Test Part 1

25. Flumazenil (Romazicon) has been ordered for a client who overdosed on oxazepam (Serax). Which adverse effect should the nurse expect?

• a. Seizures

• b. Shivering

• c. Anxiety

• d. Chest pain

Answer: The correct effect is Seizures. This is the most common and serious reaction to flumazenil, especially in combined overdoses.

1. What is the primary neurotransmitter associated with schizophrenia?

A. Serotonin
B. Norepinephrine
C. Dopamine
D. Acetylcholine

2. Which of the following is considered a positive symptom of schizophrenia?

A. Flat affect
B. Avolition
C. Delusions

3. Which of the following is a negative symptom of schizophrenia?

A. Hallucinations
B. Delusions
C. Affective flattening
D. Disorganized speech

4. When assessing a client for risk of suicide, which factor is most critical?

A. Family history of mental illness
B. Existence of a suicide plan
C. History of substance abuse
D. Previous hospitalization

5. Rapists are believed to act out which underlying feeling through the act of rape?

A. Hostility toward women
B. Desire for power and control
C. Lack of sexual satisfaction
D. Need for intimacy

6. A child who is sexually abused may show ambivalence toward the abuser primarily because:

A. The child identifies with the abuser
B. The child feels powerless and has needs met by the abuser
C. The child seeks approval from the abuser
D. The child has repressed anger

7. A client who has had an abortion directs anger at the staff and hospital. This reaction is an example of:

A. Displacement
B. Projection
C. Reaction formation
D. Denial

8. Which factor is most important in helping an individual cope with crisis?

A. Personal internal strength and supportive individuals
B. Professional counseling
C. Financial resources
D. Religious beliefs

9. Crisis intervention groups are designed to:

A. Provide long-term therapy
B. Focus on exploring unconscious conflict
C. Offer medication management
D. Reestablish psychological equilibrium through problem solving

10. Which nursing observation best indicates that a client feels comfortable discussing problems?

A. Client avoids eye contact
B. Client changes the subject frequently
C. Client verbalizes the problems motivating the behavior
D. Client remains withdrawn

11. Which therapy is most effective for clients with phobias?

A. Psychoanalysis
B. Cognitive therapy
C. Behavior modification using desensitization
D. Medication therapy

12. Which clinical finding is a key indicator of anxiety level?

A. Increased appetite
B. Narrowed perceptual field
C. Increased libido
D. Clear concentration

13. One of the symptoms of autism is:

A. Excessive attachment to others
B. Strong interest in social interactions
C. Heightened awareness of environment
D. Lack of responsiveness to others

14. Which type of delusion is most often seen in clients who believe their body is diseased or abnormal?

A. Delusions of grandeur
B. Somatic delusions
C. Persecutory delusions
D. Nihilistic delusions

15. Andy is admitted to the psychiatric unit with a diagnosis of borderline personality disorder. Nurse Hilary should expects the assessment to reveal:

A. Coldness, detachment and lack of tender feelings
B. Somatic symptoms
C. Inability to function as responsible parent
D. Unpredictable behavior and intense interpersonal relationships

16. PROPRANOLOL (Inderal) is used in the mental health setting to manage which of the following conditions?

A. Antipsychotic – induced akathisia and anxiety
B. Obsessive – compulsive disorder (OCD) to reduce ritualistic behavior
C. Delusions for clients suffering from schizophrenia
D. The manic phase of bipolar illness as a mood stabilizer

17. Which medication can control the extra pyramidal effects associated with antipsychotic agents?

A. Clorazepate (Tranxene)
B. Amantadine (Symmetrel)
C. Doxepin (Sinequan)
D. Perphenazine (Trilafon)

18. Which of the following statements should be included when teaching clients about monoamine oxidase inhibitor (MAOI) antidepressants?

A. Don’t take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)
B. Have blood levels screened weekly for leucopenia
C. Avoid strenuous activity because of the cardiac effects of the drug
D. Don’t take prescribed or over the counter medications without consulting the physician

19. Kris periodically has acute panic attacks. These attacks are unpredictable and have no apparent association with a specific object or situation. During an acute panic attack, Kris may experience:

A. Heightened concentration
B. Decreased perceptual field
C. Decreased cardiac rate
D. Decreased respiratory rate

20. Initial interventions for Marco with acute anxiety include all except which of the following?

A. Touching the client in an attempt to comfort him
B. Approaching the client in calm, confident manner
C. Encouraging the client to verbalize feelings and concerns
D. Providing the client with a safe, quiet and private place

21. Nurse Jessie is assessing a client suffering from stress and anxiety. A common physiological response to stress and anxiety is:

A. Uticaria
B. Vertigo
C. Sedation
D. Diarrhea

22. When performing a physical examination on a female anxious client, nurse Nelli would expect to find which of the following effects produced by the parasympathetic system?

A. Muscle tension
B. Hyperactive bowel sounds
C. Decreased urine output
D. Constipation

23. Which of the following drugs have been known to be effective in treating obsessive-compulsive disorder (OCD)?

A. Divalproex (Depakote) and Lithium (Lithobid)
B. Chlordiazepoxide (Librium) and Diazepam (Valium)
C. Fluvoxamine (Luvox) and Clomipramine (Anafranil)
D. Benztropine (Cogentin) and Diphenhydramine (Benadryl)

24. Tony with agoraphobia has been symptom-free for 4 months. Classic signs and symptoms of phobia include:

A. Severe anxiety and fear
B. Withdrawal and failure to distinguish reality from fantasy
C. Depression and weight loss
D. Insomnia and inability to concentrate

25. Which nursing action is most appropriate when trying to diffuse a client’s impending violent behavior?

A. Place the client in seclusion
B. Leaving the client alone until he can talk about his feelings
C. Involving the client in a quiet activity to divert attention
D. Helping the client identify and express feelings of anxiety and anger

26. Rosana is in the second stage of Alzheimer’s disease who appears to be in pain. Which question by Nurse Jenny would best elicit information about the pain?

A. “Where is your pain located?”
B. “Do you hurt? (pause) Do you hurt?”
C. “Can you describe your pain?”
D. “Where do you hurt?”

27. Nursing preparation for a client undergoing electroconvulsive therapy (ECT) resemble those used for:

A. General anesthesia
B. Cardiac stress testing
C. Neurologic examination
D. Physical therapy

NR 326 Psychiatric Mental Health Nursing Test Part 1

28. Jose who is receiving monoamine oxidase inhibitor antidepressant should avoid tyramine, a compound found in which of the following foods?

A. Figs and cream cheese
B. Fruits and yellow vegetables
C. Aged cheese and Chianti wine
D. Green leafy vegetables

29. Erlinda, age 85, with major depression undergoes a sixth electroconvulsive therapy (ECT) treatment. When assessing the client immediately after ECT, the nurse expects to find:

A. Permanent short-term memory loss and hypertension
B. Permanent long-term memory loss and hypomania
C. Transitory short-term memory loss and permanent long-term memory loss
D. Transitory short and long term memory loss and confusion

30. Barbara with bipolar disorder is being treated with lithium for the first time. Nurse Clint should observe the client for which common adverse effect of lithium?

A. Polyuria
B. Seizures
C. Constipation
D. Sexual dysfunction

31. Nurse Fred is assessing a client who has just been admitted to the ER department. Which signs would suggest an overdose of an antianxiety agent?

A. Suspiciousness, dilated pupils and incomplete BP
B. Agitation, hyperactivity and grandiose ideation
C. Combativeness, sweating and confusion
D. Emotional lability, euphoria and impaired memory

32. Discharge instructions for a male client receiving tricyclic antidepressants include which of the following information?

A. Restrict fluids and sodium intake
B. Don’t consume alcohol
C. Discontinue if dry mouth and blurred vision occur
D. Restrict fluid and sodium intake

33. Important teaching for women in their childbearing years who are receiving antipsychotic medications includes which of the following?

A. Increased incidence of dysmenorrhea while taking the drug
B. Occurrence of incomplete libido due to medication adverse effects
C. Continuing previous use of contraception during periods of amenorrhea
D. Instruction that amenorrhea is irreversible

34. A client refuses to remain on psychotropic medications after discharge from an inpatient psychiatric unit. Which information should the community health nurse assess first during the initial follow-up with this client?

A. Income level and living arrangements
B. Involvement of family and support systems
C. Reason for inpatient admission
D. Reason for refusal to take medications

35. The nurse understands that the therapeutic effects of typical antipsychotic medications are associated with which neurotransmitter change?

A. Decreased dopamine level
B. Increased acetylcholine level
C. Stabilization of serotonin
D. Stimulation of GABA

36. Which of the following best explains why tricyclic antidepressants are used with caution in elderly patients?

A. Central Nervous System effects
B. Cardiovascular system effects
C. Gastrointestinal system effects
D. Serotonin syndrome effects

37. A client with depressive symptoms is given prescribed medications and talks with his therapist about his belief that he is worthless and unable to cope with life. Psychiatric care in this treatment plan is based on which framework?

A. Behavioral framework
B. Cognitive framework
C. Interpersonal framework
D. Psychodynamic framework

38. A nurse who explains that a client’s psychotic behavior is unconsciously motivated understands that the client’s disordered behavior arises from which of the following?

A. Abnormal thinking
B. Altered neurotransmitters
C. Internal needs
D. Response to stimuli

39. A client with depression has been hospitalized for treatment after taking a leave of absence from work. The client’s employer expects the client to return to work following inpatient treatment. The client tells the nurse, “I’m no good. I’m a failure.” According to cognitive theory, these statements reflect:

A. Learned behavior
B. Punitive superego and decreased self-esteem
C. Faulty thought processes that govern behavior
D. Evidence of difficult relationships in the work environment

40. The nurse describes a client as anxious. Which of the following statement about anxiety is true?

A. Anxiety is usually pathological
B. Anxiety is directly observable
C. Anxiety is usually harmful
D. Anxiety is a response to a threat

41. A client with a phobic disorder is treated by systematic desensitization. The nurse understands that this approach will do which of the following?

A. Help the client execute actions that are feared
B. Help the client develop insight into irrational fears
C. Help the client substitutes one fear for another
D. Help the client decrease anxiety

42. Which client outcome would best indicate successful treatment for a client with an antisocial personality disorder?

A. The client exhibits charming behavior when around authority figures
B. The client has decreased episodes of impulsive behaviors
C. The client makes statements of self-satisfaction
D. The client’s statements indicate no remorse for behaviors

43. The nurse is caring for a client with an autoimmune disorder at a medical clinic, where alternative medicine is used as an adjunct to traditional therapies. Which information should the nurse teach the client to help foster a sense of control over his symptoms?

A. Pathophysiology of disease process
B. Principles of good nutrition
C. Side effects of medications
D. Stress management techniques

44. Which of the following is the most distinguishing feature of a client with an antisocial personality disorder?

A. Attention to detail and order
B. Bizarre mannerisms and thoughts
C. Submissive and dependent behavior
D. Disregard for social and legal norms

45. Which nursing diagnosis is most appropriate for a client with anorexia nervosa who expresses feelings of guilt about not meeting family expectations?

A. Anxiety
B. Disturbed body image
C. Defensive coping
D. Powerlessness

46. A nurse is evaluating therapy with the family of a client with anorexia nervosa. Which of the following would indicate that the therapy was successful?

A. The parents reinforced increased decision making by the client
B. The parents clearly verbalize their expectations for the client
C. The client verbalizes that family meals are now enjoyable
D. The client tells her parents about feelings of low-self esteem

47. A client with dysthymic disorder reports to a nurse that his life is hopeless and will never improve in the future. How can the nurse best respond using a cognitive approach?

A. Agree with the client’s painful feelings
B. Challenge the accuracy of the client’s belief
C. Deny that the situation is hopeless
D. Present a cheerful attitude

48. A client with major depression has not verbalized problem areas to staff or peers since admission to a psychiatric unit. Which activity should the nurse recommend to help this client express himself?

A. Art therapy in a small group
B. Basketball game with peers on the unit
C. Reading a self-help book on depression
D. Watching movie with the peer group

49. The home health psychiatric nurse visits a client with chronic schizophrenia who was recently discharged after a prolong stay in a state hospital. The client lives in a boarding home, reports no family involvement, and has little social interaction. The nurse plan to refer the client to a day treatment program in order to help him with:

A. Managing his hallucinations
B. Medication teaching
C. Social skills training
D. Vocational training

50. Which activity would be most appropriate for a severely withdrawn client?

A. Art activity with a staff member
B. Board game with a small group of clients
C. Team sport in the gym
D. Watching TV in the dayroom