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Mental Health Final NCLEX presentation questions
Terms in this set (34)
you are talking to a new nurse about symptoms of schizophrenia. Select all choices that are positive or negative symptoms.
A. paranoia, hallucinations
B. Anhedonia, social discomfort
C. mania and depression
D. disorganized or bizarre thoughts
A patient with schizophrenia comes into the ER with muscle rigidity, altered consciousness, dysphagia, and a high fever. The patient states they are taking Haloperidol. Based on these symptoms, what adverse effect is occurring to this patient?
A. serotonin syndrome
B. stevens-johnson syndrome
C. lithium toxicity
D. neuroleptic malignant syndrome
a newly admitted client is diagnosed with dissociative identity disorder. Which nursing intervention is a priority?
A. establish an atmosphere of safety and security
B. identify relationships among subpersonalities and work with each equally
C. process events associated with the origins of the disorder
D. teach new coping skills to replace dissociative behaviors
dissociative identify disorder is characterized by
A. the inability to recall important information
B. sudden unexpected travel away from home and inability to remember the past
C. the existence of two or more subpersonalities, each with its own patterns of thinking
D. recurring feeling of detachment from one's body or mental processes
a nurse is caring for a client with borderline personality disorder. The client says "the nurse on evening shift is always nice! You are the meanest nurse ever!" The nurse should recognize the client's statement as an example of which of the following defense mechanisms?
A charge nurse is preparing a staff education session on personality disorders. Which of the following personality characteristics associated with all of the personality disorders should the charge nurse include in the teaching?
A. difficulty getting along with other members of a group
B. belief in the ability to become invisible during times of stress
C. display of defense mechanisms when routines are changed
D. claiming to be more important than other people
E. difficulty understanding why it is inappropriate to have a personal relationship with the staff
a highly agitated client paces the unit and states "I could buy and sell this place." The client's mood fluctuates from fits of laughter to outbursts of anger. Which is the most accurate documentation of this client's behavior?
A. rates mood 8/10. Exhibiting looseness of associated. Euphoric"
B. mood euthymic. Exhibiting magical thinking. Restless.
C. Mood labile. Exhibiting delusions of reference. Hyperactive
D. agitated and pacing. Exhibiting grandiosity. Mood labile.
A client is diagnosed with bipolar disorder: manic episode. Which nursing intervention would be implemented to achieve the outcome of "client will gain 2 lb by the end of the week?"
A. provide client with high-calorie finger foods throughout the day
B. accompany client to cafeteria to encourage adequate dietary consumption
C. initiate total parenteral nutrition to meet dietary needs
D. teach the importance of varied diet to meet nutritional needs
A 71 year old patient with Alzheimer's disease who is being admitted to a long term care facility has had several episodes of wandering away from home. Which action will the nurse include in the plan of care?
A. reorient the patient several times daily
B. have the family bring in familiar items
C. place the patient in a room close to the nurse's station
D. ask the patient why the wandering episodes have occurred
when administering a mental status examination to a patient with delirium, the nurse should...
A. wait until the patient is well rested
B. administer an anxiolytic medication
C. choose a place without distracting stimuli
D. reorient the patient during the examination
which symptoms are associated with mania (select all that apply)
A. unusual talkativeness
B. racing thoughts
E. reckless and impulsive
which intervention is not appropriate for a client with bipolar disorder who is experiencing mania?
B. family therapy
C. light therapy
which of the following are manifestations of GAD? select all that apply.
A. procrastination in decision making
B. shortness of breath
C. muscle tension
D. choking or smothering sensation
E. sleep disturbance
a nurse working on an acute mental health unit is admitting a client who has major depressive disorder and comorbid anxiety disorder. Which of the following actions is the nurse's priority?
A. assess for self harm
B. assisting the client to perform ADLs
C. encourage the client to participate in counseling
D. teaching the client about medication adverse effects
which is a nursing priority for a nurse who is planning the care of a patient who has obsessive compulsive disorder (OCD)?
A. administer antipsychotic's PRN
B. provide exposure therapy to help with patients ritualistic behaviors
C. provide a stress free environment to help eliminate stressors and limit ritualistic behaviors
D. eliminate clients need to complete ritualistic behaviors by not allowing them time to perform said behaviors
which medication could be utilized by someone who has compulsive obsessive disorder (OCD)?
a mother has brought her child into the clinic because she suspects he may have autism spectrum disorder. Which of the following symptoms supports this diagnosis? (select all that apply)
A. makes appropriate eye contact
B. lacks facial expression
C. has appropriate social interactions
D. performs activities that can cause harm, such as head banging
E. performs repetitive movements, such as rocking
which of the following points is important for the nurse to teach the family of a client with autism spectrum disorder?
A. make the environment as overstimulating as possible
B. avoid vaccinations
C. establish a routine for the client
D. the patient will not need a special learning environment
after being robbed and beaten by an unknown assailant, a patient is diagnosed with post-traumatic stress disorder (PTSD). When developing a plan of care for the patient, which of these interventions will the HCP implement first?
A. assist the patient in recalling the details of the event
B. teach the patient coping skills to deal with anxiety
C. promote the establishment of a trusting relationship
D. ensure the patient is taking medications as prescribed
a nurse is assessing a newly admitted client for symptoms of PTSD. Which symptoms are typically seen with this diagnosis? (select all that apply)
A. anger with numbing of other emotions
B. exaggerated startle response
C. feeling that one is having a heart attack
D. frequent thoughts about contaminiation
E. frequent nightmares
F. survivor's guilt
a client is diagnosed with schizophrenia is experiencing dysphoria, apathy, and anhedonia. Which nursing diagnosis addresses the priority concern regarding this client's symptoms?
A. impaired social interaction
B. disturbed sensory perception
C. risk for suicide
D. disturbed thought process
a patient diagnosed with schizophrenia is experiencing auditory hallucinations. What is the best way a nurse can respond to the patient?
A. what are the voices telling you
B. what are you hearing
C. you are not really hearing anything
D. ignore the patient
a nurse is caring for a client with OCD. Which of the following would the nurse identify as a compulsive behavior?
A. excessive religious and moral doubt
B. fear of flying
C. repeatedly applying and removing makeup
D. imagining having harmed others
a nurse is caring for a client who is experiencing a delusion. Which of the following is the best option for the nurse to address the client's delusion?
A. adamantly deny the validity of their delusion
B. leave the client alone so they can relax
C. agree with the client's delusion in order to avoid confrontation
D. focus on the client's feelings, and gently offer reasonable explanations
a nurse sees her client is going to be taking an SSRI, paroxetine, for the first time. Which of the following are important for the nurse to teach the client with this medication? (select all that apply)
A. this medication will take effect immediately
B. it is important to monitor for increased suicidal thoughts
C. nausea and vomiting are not common side effects and need to contact primary care provider if this happens
D. may cause a decrease in sextual function
all of the following are effective treatment strategies and therapies for post traumatic stress disorder EXCEPT
A. flooding patient with data regarding the past events
B. cognitive behavioral therapy
C. EMDR (eye movement desensitization and reprocessing)
D. teaching effective coping skills, like reducing strategies
over the past year, a woman has cooked gourmet meals for her family but only eats tiny servings. She wears layered, loose clothing and now has amenorrhea. Her current weight is 95lbs, a loss of 35lbs. Which medical diagnosis is most likely?
A. binge eating disorder
B. anorexia nervosa
C. bulimia nervosa
the family of a client diagnosed with anorexia nervosa becomes defensive when the treatment team calls for a family meeting. Which is the appropriate nursing response?
A. tell me why this family meeting is causing you to be defensive. All clients are required to participate in two family sessions.
B. eating disorders have been correlated to certain familial patterns; without addressing these, your child's condition will not improve
C. family dynamics are not linked to eating disorders. The meeting is to provide your child with family support.
D. clients diagnosed with anorexia nervosa are part of the family system, and any alteration in family processes need to be addressed
a nurse is caring for a client who has schizophrenia and exhibits a lack of grooming and a flat affect. The nurse should expect a prescription for which of the following medications?
a nurse is providing discharge teaching for a client who has schizophrenia and a new prescription for iloperidone. Which of the following client statements indicates understanding of the teaching?
A. I will be able to stop this medication as soon as I feel better
B. If I feel drowsy during the day, I will stop the medication and call my provider
C. I will be careful not to gain too much weight while taking this medication
D. this medication is highly addictive and must be withdrawn slowly
an adolescent with a depressive disorder is more likely than an adult with the same disorder to exhibit:
A. negativism and acting out
B. sadness and crying
C. suicidal thoughts
D. weight gain
a nurse is caring for a client who has major depressive disorder. Which of the following should the nurse identify as a risk factor for depression? (select all that apply)
A. male sex
B. history of chronic bronchitis
C. recent death in client's family
D. family history of depression
E. personal history of panic disorder
the nurse recognizes that the client is experiencing insomnia when the client reports... (select all that apply)
A. extended time to fall asleep
B. falling asleep at inappropriate times
C. difficulty staying asleep
D. feeling tired after a night's sleep
which of the following sleep disorders is most prevalent?
D. sleep-awake schedule disturbance
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