The client describes being uncomfortable as a male since kindergarten. “I liked playing
with dolls and playing dress-up in my mom’s prom dress and high heels.” The client is
relating an example of:
1. Cross-dressing.
2. Fetishism.
3. Gender dysphoria.
4. Androgyny.
Answer:
During a nurse”client interaction, an adolescent client with a major depressive disorder
stated, “I was on the swim team at school, but I don”t enjoy swimming anymore so I
quit.” The client is describing:
1. Anhedonia.
2. Aphasia.
3. Anergia.
4. Antagonism.
Answer:
A 13-year-old client was admitted for giving a younger sister a black eye and throwing
a cat out the window. Which neurotransmitter imbalance is not likely to be associated
with this behavior?
1. Dopamine excess
2. Serotonin deficit
3. Gamma-aminobutyric acid (GABA) deficit
4. Acetylcholine excess
Answer:
The nurse knows that because people with mental illness continue to be ostracized by
mainstream society, families must cope with the burden of:
1. Dementia.
2. Shame.
3. Isolation.
4. Stigma.
Answer:
A common symptom of dementia is difficulty in recalling words. This is called:
1. Apraxia.
2. Agnosia.
3. Aphasia.
4. Dysphagia.
Answer:
When planning a new children’s mental health clinic, the nurse understands the
importance of including a play area. Play and toys are used to assess children with
suspected mental disorders because:
1. Children do not usually relate to adults.
2. Children express themselves through play.
3. Only toys that are developmentally appropriate and specific to the child’s biological
age are used.
4. Play enables the nurse to assess cognitive ability.
Answer:
A client tells the nurse, “I refuse to take quetiapine (Seroquel) because it is
manufactured by Al Qaeda. If I take it, I”ll die.” This is an example of:
1. A negative symptom of schizophrenia called alogia.
2. A negative symptom of schizophrenia called avolition.
3. A positive symptom of schizophrenia called delusion.
4. A characteristic of schizophrenia called ambivalence.
Answer:
The nurse and a client talk about the signs and symptoms of acute mania. The client
states, “When I am feeling really good and don”t need to sleep, I am manic, but the last
thing I want is treatment.” The nurse recognizes that this experience is indicative of the
need for:
1. Competency.
2. Psychiatric advance directive (PAD).
3. Right to treatment.
4. Informed consent.
Answer:
A nurse is leading an inpatient group for clients with schizophrenia. Which statements
address the two main categories of nursing activities?
1. “We will listen to each other’s best and worst experiences of the last week.”
2. “We will go around the room and each person will state a personal goal for today.”
3. “If you can increase your self-assessment skills, you”ll be able to tell when you”re
getting more stressed.”
4. “We”re going to discuss current events.”
5. “Group members can help each other identify and improve their coping skills so that
each has a better “tool chest” to draw from when experiencing stress.”
Answer:
A client diagnosed with bipolar disorder is hyperverbal during the initial assessment. In
an effort to help the client understand what is required in treatment, the nurse has a
calm demeanor, decreases stimuli, and talks to the client one-on-one. The nurse is
responding to the client’s:
1. Cognitive style.
2. Negative behavior.
3. Positive behavior style.
4. Mania.
Answer:
The client who is recovering from schizophrenia has just seen the psychiatrist and tells
the nurse that the Olanzapine (Zyprexa) is being reduced from 20 mg to 15 mg. This
client asks the nurse why the Olanzapine is just not discontinued since the client has not
had a hallucination for two months. Which nursing response to the client is correct?
1. “I will check your serum level to see if it was too high and the reason for the
reduction.”
2. “This medication is gradually reduced and continued to prevent a relapse.”
3. “I think that you should call your psychiatrist and ask to discontinue the Olanzapine.”
4. “The 20 mg of Olanzapine is above the recommended dose and was reduced due to
the risk of toxicity.”
Answer:
A 15-year-old girl is brought by her mother to see a psychiatric nurse practitioner. The
client’s mother demands that her daughter be admitted for treatment of “behavioral
problems.” Her mother states that the daughter stays out until 4 a.m. and is hanging out
with “bad” kids. The nurse will recommend which of the following?
1. Involuntary admission for the daughter
2. Therapy for the daughter
3. Outpatient therapy for the mother and daughter
4. Therapy for the mother
Answer:
The client is diagnosed with bulimia nervosa. What is the most appropriate nursing
intervention that focuses on purging behaviors?
1. Provide frequent small meals.
2. Weigh the client after eating.
3. Observe the client for at least one hour after meals.
4. Have the nurse eat with the client.
Answer:
Select the responses which are true regarding the interactional model for schizophrenia.
Standard Text: Select all that apply.
1. People with schizophrenia have a greater potential for vulnerability to stress.
2. People with schizophrenia have a greater likelihood of relapsing if they are from
families demonstrating high expressed emotion (EE).
3. People with schizophrenia are less sensitive to interpersonal stressors.
4. Vulnerability, stressors, and risk factors enhance and potentiate each other in people
with schizophrenia.
5. People with schizophrenia are less responsive to environmental stressors.
Answer:
A client was brought to the hospital at two a.m. She had been drinking and she fell,
fracturing her femur. If the client is going to experience withdrawal symptoms, the
nurse should be alert for them to peak around which time?
1. 24″48 hours after drinking stops
2. 72″92 hours after drinking stops
3. 54″72 hours after drinking stops
4. 6″12 hours after drinking stops
Answer:
The client with schizophrenia was started on imipramine (Tofranil) for a depressed
mood and subsequently started hearing voices again and refuses to take the Tofranil
because the client thinks it is poison. The nursing response is based on what
information?
1. Tricyclic antidepressants can trigger overt symptoms in someone with schizophrenia.
2. There is no evidence that tricyclic antidepressants trigger psychotic symptoms in
susceptible clients.
3. Often new antipsychotic medications like imipramine have paradoxical effects.
4. MAOIs do not interact well with other antipsychotic medications and can cause
worsening of symptoms.
Answer:
The spouse of a client on an antipsychotic medication asks the nurse why they routinely
assess the client for movements, especially around the mouth and extremities. What
nursing response is correct?
1. “Abnormal involuntary movements can be an irreversible side effect of antipsychotic
medications.”
2. “Antipsychotic medications can lead to this type of dystonia.”
3. “Abnormal involuntary movements can be easily treated and less annoying to the
client.”
4. “Movements around the mouth herald the approaching medication tolerance that the
client is developing.”
Answer:
A statement which accurately describe genetics and schizophrenia would be:
1. One single gene is responsible for producing schizophrenia.
2. There is strong evidence that environmental factors do not affect the risk of
developing schizophrenia.
3. 10% of first degree relatives (children, siblings, parents) are diagnosed with
schizophrenia at some point in their lives.
4. The chance of monozygotic (identical) twins both having schizophrenia is 100%.
Answer:
A client is administered the dexamethasone suppression test (DST), which attempts to
assess the hypothalamic-pituitary-adrenal (HPA) axis. How will the results of the test be
used?
1. To identify genetic predisposition
2. To diagnose psychiatric illness
3. To identify appropriate treatment
4. To identify pathology in the HPA axis function
Answer:
A nurse interviews a Chinese client who has been given a diagnosis of schizophrenia.
The family is present during the interview. Which cultural values should the nurse
consider as she prepares to interact with the client and family?
1. Talking circles
2. Medicine men
3. Fatalism
4. Kinship solidarity
Answer:
A family member says to the nurse, “I think my sister needs more medication because
she says she cannot sit still and is moving her legs back and forth.” The client’s
risperidone (Risperdal) was recently increased to 10 mg daily. What is the correct
nursing response?
1. “I will check with your sister because what you are describing sounds like a side
effect called akathisia.”
2. “I will check to see what your sister has been prescribed because some clients get
anxious when their medications are increased.”
3. “I will see if your sister has been prescribed a medication to counteract the dystonic
reaction that she is having.”
4. “I will call the doctor and report that your sister is developing a tolerance to
risperidone and the dose is not effective.”
Answer:
A 72-year-old client has Alzheimer’s dementia. Her husband of 50 years is no longer
able to care safely for her at home and has her placed in a long-term care facility. When
her husband visits, she smiles and talks about their many travels around the world.
Intrigued, the nurse asks the husband to describe his travels. The husband laughs and
says, “We’ve never been out of the states.” The client’s tales are an example of:
1. Delirium.
2. Apraxia.
3. Aphasia.
4. Confabulation.
Answer:
A client is taking fluoxetine (Prozac) and wonders if adding St. John’s wort would help.
Knowing that St. John’s wort acts similar to selective serotonin reuptake inhibitors
(SSRIs), the nurse is concerned that by taking both, the client may develop:
1. Nothing since these substances do not interact.
2. Serotonin syndrome.
3. Mania.
4. Depression.
Answer:
The nurse is caring for a 15-month-old who is admitted to the hospital for the fifth time
in six months with severe diarrhea. The patient’s mother has been diagnosed with
Munchausen by proxy syndrome (MBPS) as she has been giving her child large doses
of laxatives to make the child sick. The nurse is having difficulty dealing with the
situation. Which of the following is the best way for the nurse to proceed?
1. Confront the mother about making her child sick.
2. Seek clinical supervision to cope with situation.
3. Refuse to take care of the child and family.
4. Have as little contact with the mother as possible.
Answer:
A client who has hallucinations is no longer benefiting from medication. The client’s
wife has heard that repetitive transcranial magnetic stimulation (rTMS) might be
helpful. The nurse knows that rTMS may be promising for this client because it:
1. Acts more quickly than electroconvulsive therapy (ECT).
2. Does not cause pain and, therefore, does not require anesthesia.
3. Acts more quickly than antipsychotic medications.
4. Has been around longer than ECT and has more research evidence for its use.
Answer:
The client who was taking zaleplon (Sonata) took about an hour to fall asleep the first
night after it was discontinued. The client asks the nurse if this means that the client is
addicted to the medication. Which nursing response is correct?
1. There are no sedative”hypnotics that can be addictive.
2. This medication is not associated with withdrawal symptoms.
3. Usually the medication is tapered off over six weeks to prevent withdrawal.
4. The client is addicted, but withdrawal is mild.
Answer:
A nurse is asked to provide a brief presentation comparing and contrasting the
modalities within one category of complementary and alternative therapies, as
identified by NCCAM. The nurse chooses to speak about whole medical systems;
therefore, the presentation would include:
Standard Text: Select all that apply.
1. Traditional Chinese medicine.
2. Herbal products.
3. Naturopathic medicine.
4. Homeopathic medicine.
5. Ayurveda.
Answer:
The nursing student asks the nurse the reason that knowledge of nursing theories is
important. The nurse should respond that nurses use nursing theories to do which of the
following?
Standard Text: Select all that apply.
1. Organize assessment data.
2. Generate goals.
3. Evaluate outcomes.
4. Plan interventions.
5. Generate nursing actions.
Answer:
The caregiving team may also need support to process traumatic events in the
community or in the care setting. Critical Incident Stress Debriefing (CISD) is a model
of effective group crisis intervention. This group intervention:
Standard Text: Select all that apply.
1. Includes a several-phase group discussion.
2. Includes psychological and psychoeducational elements.
3. Includes guidelines similar to AA.
4. Is most effective in emergency settings.
Answer:
What factor contributes to a poor outcome for clients with anorexia nervosa?
1. Treatment approaches are fragmented and controversial.
2. The client with anorexia nervosa actively resents or refuses treatment.
3. There is no cure for anorexia nervosa.
4. Changes in the client’s behavior are irreversible.
Answer:
The nurse is reviewing the plan of care with a client who has been diagnosed with
schizophrenia. The client is not compliant with the medications he has been placed on
for treatment of his illness. Which of the following is the most appropriate response by
the nurse in order to modify the plan of care?
1. “I am going to tell the doctor you have not been taking your medication and she will
be upset with you.”
2. “Why would you stop taking your medications? That is stupid.”
3. “Tell me what is going on with your medications.”
4. “Does your family know you stopped taking your medication?”
Answer:
Knowing that the nurse is familiar with CAM modalities, a colleague asks the nurse for
advice on dealing with the symptoms of the colleague’s mother’s recent diagnosis of
early-stage Alzheimer’s disease. The nurse discusses the potential for the use of certain
dietary supplements and suggests that the mother’s diet include:
1. Kava.
2. Thiamine.
3. Omega-3 fatty acids.
4. Ginkgo leaf extract.
Answer:
The nurse educator is teaching a group of students about stigma. The educator states
that stigma can affect the judgment of which of the following people about the person
who is labeled as mentally ill?
1. God or other higher powers
2. Family
3. Health care providers
4. Co-workers
5. Friends
Answer:
In a supervision session, several of the nurses discuss methods for preventing agitated
and angry outbursts in clients diagnosed with dementia. One nurse appropriately
suggests:
1. Ignoring the behavior.
2. Distraction or a quieter environment at the first sign of agitation.
3. Attempting a rational discussion of the issue with the client.
4. Distraction and engagement in high-energy activities.
Answer:
The nurse working in a clinic specializing in treating addiction knows that, in addition
to Alcoholics Anonymous and other support groups, a complementary way in which
someone might deal with alcohol abuse is to:
Standard Text: Select all that apply.
1. Drink chamomile tea.
2. Do nothing since there are no CAM practices that support AA recovery.
3. Drink kudzu tea.
4. Receive auricular acupuncture.
5. Practice yoga.
Answer:
The nurse is working with a client who suffers from addiction. What treatment
approach would be most appropriate for this client who has had multiple substance
abuse treatments and has relapsed?
1. 12-step self-help program
2. Long-term outpatient therapy
3. Lifestyle change
4. One week detoxification program
Answer:
Nurses are instrumental in helping clients during cognitive therapy. The nurse helps
clients:
1. Correct the id and the superego in relation to self-awareness.
2. Examine connections of the mind, body, and spirit.
3. Determine the best course of treatment.
4. Identify unrealistic and negative thoughts.
Answer:
Following a difficult family session, an adolescent client in the inpatient
psychiatric”mental health unit has become combative. Prior to communicating with this
client, the nurse must consider:
1. The child’s emotional state.
2. The number of points to take away.
3. Which consequences to use for punishment.
4. The developmental age of the client.
Answer:
A psychiatric home health nurse makes home visits in a neighborhood that has a high
incidence of reported crimes. What reasonable safety measures should the nurse
implement during home visits?
Standard Text: Select all that apply.
1. Make all visits in the daytime
2. Ask for a police escort during visits
3. Call the client before arrival at the home
4. Carry a cell phone at all times
5. Ask to be accompanied on visits by a co-worker
Answer:
A client admitted to the inpatient psychiatric unit after a recent suicide attempt tells the
nurse, “Even though suicide is against my religion, I was in so much emotional distress
that I didn’t think I could keep on living. I”m really struggling with my spiritual
conscience and don”t know what I should do.” Which of the following nurse responses
is most appropriate?
1. “It sounds like spirituality plays a significant role in your life. Tell me what beliefs
are most important to you.”
2. “I”m not very comfortable discussing religious matters. This is something you should
talk to your priest or pastor about.”
3. “I think you should pray for forgiveness and turn all your problems over to God.”
4. “I hear that you are having a real struggle with your spiritual beliefs. Tell me what I
can do to help.”
Answer:
The nurse is working with a client who started therapy after losing his wife in an
automobile accident. Which of the following client behaviors indicates he is ready to
terminate the therapeutic nurse-client relationship?
Standard Text: Select all that apply.
1. Initial client treatment goals have been accomplished.
2. Symptoms no longer interfere with the client’s comfort.
3. The client refuses to change due to unresolved resistances.
4. Dissatisfaction with interpersonal relationships is expressed.
5. Client well-being and satisfaction is dependent upon the nurse.
Answer:
When instructing nursing students on therapy termination strategies for families and
clients with mental health disorders, the nursing instructor teaches that effective family
nursing strategies include:
1. Helping families achieve realistic goals.
2. Giving criticism in a calm voice.
3. Knowing effective communication skills.
4. Monitoring nonverbal communication.
Answer:
A unit has a protocol for research on medications. The protocol identifies essential
items that must be shared with clients to ensure ethical nursing practice. Which of the
following factors should be shared with clients?
1. Problems that all other clients have had in the study
2. Risks that can be encountered
3. All aspects of the research study
4. Cost of the research
Answer:
A mental health nurse is reviewing the post-test responses for a staff educational session
that the nurse provided on the chronological development of psychiatric medications.
Which of the following responses would indicate the participants understood the
information correctly?
Standard Text: Select all that apply.
1. The newer antidepressants, the SSRI group, have fewer side effects than the older
antidepressants.
2. The effectiveness of antidepressants has led to research resulting in a better
understanding of brain biochemistry.
3. The discovery of chlorpromazine (Thorazine) dramatically changed psychiatric
treatment.
4. Few new psychiatric medications are needed due to the large number of safe and
effective current medications.
5. Each new type of psychiatric medication was developed due to a focus on a specific
psychiatric illness and not due to chance.
Answer:
The nurse is explaining the nurse”client relationship to a client in their first formal
counseling session. Which of the following characteristics should the nurse describe as
part of this one-to-one relationship?
Standard Text: Select all that apply.
1. Sympathetic
2. Shared dignity
3. Harmonious
4. Mutually defined
5. Goal directed
Answer:
The nurse notices that a client is unable to control anger when criticized during a group
meeting, even though the client had been able to do this effectively for several weeks.
Which of the following interventions would be most appropriate in the nurse’s next
one-to-one therapeutic session with the client?
1. Encourage the client to express responses to criticism freely.
2. Insist the client take a “time-out” until anger is back under control.
3. Offer the client a PRN dose of ziprasidone (Geodon).
4. Encourage a detailed exploration of how the client reacts to criticism.
Answer:
A preceptor nurse is discussing the substance abuse program with a new graduate nurse.
The new graduate nurse asks the preceptor what is the most important initial outcome
for clients in substance abuse programs. Which of the following is the best answer from
the preceptor?
1. Make a moral inventory of self
2. Make amends for people they have hurt
3. Overcome denial
4. Learn problem-solving
Answer:
A new nurse asks the difference between dementia and delirium. The best response is:
1. The cause of delirium is unknown.
2. Delirium develops over several weeks.
3. Delirium is often confused with depression in clients over the age of 60.
4. Delirium is a common occurrence in hospitalized clients over the age of 60.
Answer:
For a substance-abusing client, the most appropriate nursing goal is to:
1. Assume responsibility for the choice to use substances.
2. Allow family to determine the plan of intervention.
3. Use acceptable amounts of legal substances.
4. Learn to avoid feelings of low self-esteem.
Answer:
Which of the following is a priority assessment for a child in the initial stages of
antidepressant treatment?
1. School successes
2. Food preferences
3. Suicide assessment
4. Family functioning
Answer: