Psychiatric Nursing NCLEX Review Part 1

1. Which statement describes how elderly clients react to medication?

a. At increased risk for adverse reactions

b. Tolerate medication better because they’re less active

c. Metabolize medications quickly

d. All of the above

2. Nursing interventions for a male client taking central nervous system (CNS) stimulants include monitoring the client for which condition?

a. Hyperpyrexia, slow pulse, and weight gain

b. Tachycardia, weight loss, and mood swings

c. Hypotension, weight gain, and listlessness

d. All of the above

3. The charge nurse in an acute care setting assigns to a male client, who’s on one-to-one suicide precautions, to a psychiatric aide. This assignment is considered:

a. Poor nursing practice because a registered nurse should work with this client

b. Reasonable nursing practice because one-to-one supervision requires the total attention of a staff member

c. Outside the responsibility of an aide

d. Illegal to delegate to an aide

4. What’s a nurse most important role in caring for an adult client with a mental disorder?

a. To offer advice

b. To know how to solve the client’s problem

c. To establish trust and rapport

d. To set limits with the client

5. Unhealthy personal boundaries are a product of dysfunctional families and a lack of positive role models. Unhealthy boundaries may also be a result of:

a. Structured limit setting

b. A supportive environment

c. Abuse and neglect

d. Direction and attention

6. The nurse in-charge is displaying assertive behavior when she:

a. Says what’s on her mind at the expense of others

b. Expresses an air of superiority

c. Avoids unpleasant situations and circumstances

d. Stands up for her rights while respecting the rights of others.

7. In a group therapy setting, one male member is very demanding, repeatedly interrupting others and taking most of the group time. The nurse’s best response would be:

a. “Will you briefly summarize your point because others need time also?”

b. “Your behavior is obnoxious and drains the group.”

c. To ignore the behavior and allow him vent

d. “I’m so frustrated with your behavior”

8. The nurse is aware that the primary indication for the use of electroconvulsive therapy (ECT) is:

a. Severe agitation

b. Antisocial behavior

c. Noncompliance with treatment

d. Major depression with psychotic features

9. Two nurses are discussing a female client’s condition in the elevator. The employer of the mentioned client overhears the conversation and fires the client. The nurses may be liable for which act?

a. Assault

b. Battery

c. Neglect

d. Breach of confidentiality

10. A nurse at a substance abuse center answers the phone. A probation officer asks if the male client is in treatment. The nurse responds, “No, the client you’re looking for isn’t here.” Which statement best describes the nurse’s response?

a. Correct because she didn’t give out information about the client

b. A violation of confidentiality because she informed the officer that the client wasn’t there

c. A breach of the principle of veracity because the nurse is misleading the officer

d. Illegal because she’s withholding information from law enforcement agents.

11. The employer of a female client on the psychiatric unit calls the nursing station inquiring about the client’s progress. The nurse doesn’t know if consent has been given by the client to allow the staff to give information out to caller on the phone. Which response by the nurse would be best?

a. “I’m not permitted to discuss her progress.”

b. “I’ll give you the name and telephone number of her physician.”

c. “I’ll have her call you.”

d. “I can’t confirm whether your employee is a client here.”

12. A voluntary male client in a health care facility decided to leave the unit before treatment is complete. To detain the client, the nurse refuses to return his personal effects. This is an example of:

a. False imprisonment

b. Limit setting

c. Slander

d. Violation of confidentiality

13. Which statement is guideline to help nurses avoid liability?

a. Follow every physician’s order

b. Do what the client desires even though you may disagree

c. Practice within the scope of the Nurse Practice Act

d. Obtain malpractice insurance

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

a. Once per hour

b. Once per 8-hour shift

c. Every 15 minutes

d. Every 2 hours

15. Which clinical condition meets the criteria for involuntary commitment?

a. A single parent who leaves her minor children unattended and stays out all night drinking

b. A person who lives alone and has schizophrenia with delusions of persecution

c. A man who threatens to kill his wife

d. A person with depression who says he’s tired of living but doesn’t have a suicide plan

16. An adult client in an acute care mental health program refuses his morning dose of an oral antipsychotic medication and believes he’s being poisoned. The nurse should respond by taking which action?

a. Administering the medication by injection

b. Omitting the dose and trying again the next day

c. Crushing the medication and putting it in his food

d. Consulting with the physician about a care plan

17. A nurse is working with a female dying client and his family. Which communication technique is most important to use?

a. Reflection

b. Interpretation

c. Clarification

d. Active listening

18. A male client receiving morphine for long-term pain management develops tolerance. Tolerance is defined as:

a. An increased response to a medication

b. A diminished response to a drug so that more is required to achieve the same effect

c. An allergic reaction to a medication

d. An ability to take the same drug for extended periods of time.

19. The nurse is aware that the goal of crisis intervention is:

a. To solve the client’s problems for him

b. Psychological resolution of the immediate crisis

c. To establish a means for long-term therapy

d. To provide a means for admission to an acute care facility

20. A male client in a group therapy is restless. His face is flushed and he makes sarcastic remarks to group members. The nurse responds by saying, “You look angry.” The nurse is using which technique?

a. A broad opening statement

b. Reassurance

c. Clarifying

d. Making observations

21. A male patient with antisocial personality disorder smokes where it is prohibited and refuses to follow other unit and hospital rules. The patient gets others to do the laundry and other personal chores, splits the staff, and will work only with certain nurses. The plan of care for this patient should focus primarily on:

a. A consistently enforcing unit rules and hospital policy

b. Isolating the patient to decrease contact with easily manipulated patients

c. Engaging in power struggles with the patient to minimize manipulative behavior

d. Using behavior modification to decrease negative behavior by using negative reinforcement

22. The nurse knows that the doctor in charge has ordered the liquid form of the drug chlorpromazine rather than the tablet form because the liquid?

a. Has a more predictable onset of action

b. Produces fewer anticholinergic effects

c. Produces fewer drug infections

d. Has a longer duration of action

23. A male patient receiving fluphenazine (Prolixen) therapy develops pseudoparkinsonism. The doctor is likely to prescribe which drug to control this extrapyramidal effect?

a. Phenytoin (Dilantin)

b. Amantadine (Symmetrel)

c. Benztropine (Cogentin)

d. Diphenhydramine

24. During a panic attack, a male patient runs to the nurse and reports breathing difficulty, chest pain, and palpitations. The patient is pale, with the mouth wide open and eyebrows raised. What should the nurse do first?

a. Assist the patient to breath deeply into a paper bag

b. Orient the patient to person, place and time

c. Set limits for acting out delusional behaviors

d. Administer an I.M. anxiolytic agent

25. A husband and wife seek emergency crisis intervention because he slapped her repeatedly the night before. The husband says he grew up in a household where his father frequently abused both his mother and him. When interviewing with this couple, the nurse in charge knows they are at risk for repeated violence because the husband:

a. Has only moderate impulse control

b. Denies feelings of jealousy or possessiveness

c. Has learned violence as an acceptable behavior

d. Feels secure in his relationship with his wife

26. What occurs during the working phase of the nurse-patient relationship?

a. The nurse assesses the patient’s needs and develops a plan of care

b. The nurse and patient together evaluate and modify the goals of the relationship

c. The nurse and patient discuss their feelings about terminating the relationship

d. The nurse and patient explore each other’s expectations of the relationship

27. When caring for a male adolescent patient diagnosed with depression, the nurse should remember that depression manifests differently in adolescents and adult. In an adolescent, signs and symptoms of depression are likely to include:

a. Helplessness, hopelessness, hypersomnolence, and anorexia

b. Truancy, a change of friends, social withdrawal, and oppositional behavior

c. Curfew breaking, stealing from family members, truancy, and oppositional behavior

d. Hypersomnolence, obsession with body image, and valuing of peer’s opinion.

28. During the admission assessment, a male patient with a panic disorder begins to hyperventilate and says, “I’m going to die if I don’t get out of here right now!” What is the nurse’s best response?

a. “Just calm down. You’re getting overly anxious.”

b. “What do you think is causing your panic attack?”

c. “You can rest alone in your room until you feel better.”

d. “You’re having panic attack. I’ll stay here with you.”

29. In a female patient with a conversion disorder who reports blindness, ophthalmologic examinations reveal that no organic disorder is causing progressive vision loss. The most likely source of this patient’s blindness is:

a. A family history of major depression

b. Having been forced to watch a loved one’s torture

c. Noncompliance with a psychotropic medication regimen

d. Daily use of antianxiety agents and alcoholic beverages

30. A busy attorney with a successful law practice is admitted to an acute care facility with epigastric pain. Since admission, the patient has called the nurse 15 minutes with one request or another. This patient is exhibiting:

a. Repression

b. Somatization

c. Regression

d. Conversion

Answers and Rationale

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