2023 RASMUSSEN MENTAL HEALTH EXAM 2 REAL
EXAM QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES|AGRADE(COMPLETE EXAM)
You are the nurse responsible for assessing for extrapyramidal side effects
in a patient who has been taking chlorpromazine. Which of the following
may be side effects for this medication? (Select all that apply.)
Akathisia
Acute dystonia
Tardive
Dyskinesia
Answer Amenorrhea
s:
Akathisia
Acute dystonia
Tardive
Dyskinesia
Response
Feedback:
Extrapyramidal side effects of the central nervous system
include involuntary motor movements, resulting in possible
dystonia, akathisia or dyskinesia. Amenorrhea is a possible side
effect of chlorpromazine, but is not an extrapyramidal side
effect.
- Question 2
1 out of 1 points
An adult with depression has been treated with medication and cognitive
behavioral therapy. The patient now verbalizes that being passive and
letting others make decisions for her contributed to the depression. What
referrals could the nurse make to help this patient prevent recurrence of
depression?
Selected
Answer:
Social skills training
Answers: Social skills training
Use of complementary
therapy
Response
Feedback
:
Relaxation training classes
Learning desensitization
techniques
Social skills training is helpful in treating and preventing the
recurrence of depression. Training focuses on assertiveness and
coping skills that lead to positive reinforcement from others.
Use of complementary therapy refers to adjunctive therapies
such as herbals. Assertiveness would be of greater value than
relaxation training because passivity has been identified as a
concern. Desensitization is used in treatment of phobias
- Question 3
A patient with suicidal impulses is placed on the highest level of suicide
1 out of 1 points
precautions. Which measures should be incorporated into the plan of care
by the nurse caring for the patient? (Select all that apply.)
Selected
Answers:
Maintain arm’s-length distance, institute one-on-one nursing
observation around the clock
Allow no glass or metal on meal trays
Remove all potentially harmful objects from the patient’s
possession
Answers: Maintain arm’s-length distance, institute one-on-one nursing
observation around the clock
Allow no glass or metal on meal trays
Keep patient within visual range while awake, but only check
every 15 to 30 minutes while the patient is sleeping
Only check the patient’s whereabouts every 15 minutes and
make frequent verbal contacts.
Remove all potentially harmful objects from the patient’s
possession
Response
Feedback
:
One-on-one observation is necessary for anyone who has
limited control over suicidal impulses. Plastic dishes on trays
and the removal of potentially harmful objects from the
patient’s possession are measures included in any-level suicide
precautions. The remaining options are used in less stringent
levels of suicide precautions. - Question 4
0 out of 1 points
Which statement indicates a patient with major depression’s most likely
outlook on life during the acute phase of the illness?
Selected
Answer:
“If I ignore this, it will go away.”
Answers: “It’s just a matter of time and I’ll
be well.”
“I deserve to be this way.”
“I can fight this and get better.”
“If I ignore this, it will go away.”
Response
Feedback:
Patients with depression feel worthless and often believe they
deserve to have “bad” things happen. Patients with depression
are usually hopeless and would not respond optimistically.
Patients with depression usually feel helpless and unable to
fight.
- Question 5
The nurse knows that sedation is a side effect of many antipsychotics.
Which of the following medications should the nurse question if ordered
for a patient taking antipsychotics?
0 out of 1 points
Selected
Answer:
hydrochlorothia
zide
Answers: hydrochlorothia
zide
diphenhydrami
ne
acetaminophen
verapamil
Response
Feedback:
Diphenhydramine is an antihistamine that is likely to cause
drowsiness and enhance the sedative effect of an antipsychotic.
Hydrochlorothiazide (diuretic), acetaminophen (antipyretic and
pain reliever) and verapamil (antihypertensive) do not cause
sedation. - Question 6
1 out of 1 points
The nurse is caring for a patient who experiences orthostatic hypotension
related to taking chlorpromazine. The nurse should suggest which of the
following interventions for managing this side effect?
Selected
Answer:
Sit on the side of the bed before
standing up.
Answers: Stay in bed for an hour after taking the
medication.
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RASMUSSEN MENTAL HEALTH FIANAL EXAM
LATEST 2023-2024 REAL EXAM ALL 75 QUESTIONS
AND CORRECT ANSWERS|AGRADE
- A child is diagnosed as being on the autistic spectrum. Which clinical manifestations should
the nurse expect? (Select all that apply)
A. Inability to express themselves
B. Repetitive body movements
C. Inability to maintain eye contact
D. Appropriate nonverbal communication
E. Hallucinations - A client is prescribed lorazepam 0.5mg PO four times a day (QID) and 1 mg PO every 8
hours PRN. The maximum daily dose of lorazepam should not exceed 4 mg daily. This client
would be able to receive PRN doses as the maximum number of PRN lorazepam doses.
2 - A nurse is providing care for a client who has anorexia nervosa. Which of the following
nursing interventions should the nurse take?
A. Compliment the client for weight gain
B. Provide privacy when friends visit
C. Allow the client to eat at any time
D. Schedule regular weigh in times - A nurse reports an incident of suspected child abuse. One of the child’s parents becomes
upset and demands to know the reason for the nurse’s action. Which of the following
responses by the nurse is appropriate?
A. “As a nurse, I am required by law to report suspected child abuse.”
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“I am unable to discuss this, but I can contact my supervisor to speak with you.”
“The provider will be coming to explain the situation.”
“I reported the incident to my supervisor, who decided to contact the authorities.”
- A client weighs 215 lb. What is the client’s weight in kg?
97.7 - A child diagnosed on the autism spectrum may experience repetitive behaviors. Which of
thefollowing are examples of repetitive behavior which could be observed? (Select all that
apply)
A. Language delays
B. Limited function play
C. Spinning in circles
D. Avoiding body contact
E. Flapping their hands - The nurse is caring for a client who has just been injured by her male partner. The client
states this is the first time he has been physically abusive, but he apologized and has since
sent her flowers. What is the intervention by the nurse?
Suggest the client and her partner both take time to evaluate the relationship
Ask the client about the level of stress she is experiencing
Give the client a list of anger management resources
D. Teach the client the cycle of battering - A client is admitted with a diagnosis of dependent personality disorder. Which question by
thenurse indicates an understanding of the essential features of the disorder?
B.
C.
D.
A.
B.
C.
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“Do you have problems expressing your feelings?’
“Do you feel awkward in social situations?”
“Do you find you don’t want praise for your accomplishments?”
D. “Are you afraid of being alone?”
- Which statement by the nurse in the emergency department indicates a firm knowledge base
regarding intimate partner violence?
“Abused women are attracted to abusive men.”
“Verbal abuse always proceeds to physical abuse.”
“Abused individuals have a dependent personality disorder.”
D. “Power and control are the central dynamics of abuse.” - A nurse is assessing a parent who lost a 12-year-old child in a car crash two years ago.
Which of the following findings indicates the client is exhibiting manifestations of prolonged
grieving?
Volunteers at a local children’s hospital
Visits the child’s grave every week after worship services
C. Leaves the child’s room exactly as it was before the loss
Talks about the child in the past tense - The nurse has determined that systematic desensitization is the therapy being used to treat
the client with acrophobia. How is this demonstrated?
Visualizing going up steep places
B. Gradual exposure to higher areas
C. Discussing past trauma at certain heights
A.
B.
C.
A.
B.
C.
A.
B.
D.
A.
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RASMUSSEN MENTAL HEALTH EXAM 3 LATEST
2023-2024 REAL EXAM ALL 50 QUESTIONS AND
CORRECT ANSWERS|AGRADE
1.
Q) A nurse is admitting an older client who has a suspected cognitive disorder. Which of the
following tools should be included as part of the admission assessment?
Ans) Mental Status Examination (MSE)
2.
Q) A client is being seen, and during the session constantly talks about their successes, and how
no one understands her. She feels very entitled, believing she is the most important person at her
job and is irreplaceable. She shows no empathy for others and is extremely hypersensitive to
criticism. Given the examples, a nurse would expect which type of personality disorder?
Ans) Narcissistic personality disorder
3.
Q) An older adult client in the intensive care unit has visual and auditory illusions. Which
intervention will be most helpful to the client in managing these illusions?
ANS) Have the client wear their glasses and hearing aids.
4.
Q) What is a nurse’s legal responsibility if child abuse or neglect is suspected?
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ANS) Report the suspected abuse or neglect according to state regulations
5.
Q) A nurse is caring for a client who has antisocial personality disorder and is receiving
behavioral therapy. Which of the following client behaviors indicates effectiveness of the
therapy?
ANS) The client refrains from manipulating others to earn dining room privileges.
6.
Q) The provider has ordered valproate 750 mg PO for a client who has mood disturbance with a
personality disorder. The client reports that they will only take liquid medication. Available is
valproate elixir 250 mg/5 mL. How many mL will the nurse administer with each dose? (Record
answer as a whole number. Do not use a trailing zero. Numerical value only.)
ANS) 15
- Q) A nurse in the emergency department is caring for a client who has alcohol toxicity and is
unresponsive. Which of the following interventions should the nurse take?
ANS) Gather supplies for endotracheal intubation - Q) A client with a history of alcohol use disorder has been prescribed disulfiram. Which
physical effects supports the suspicion that the client has relapsed?
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RASMUSSEN MENTAL HEALTH EXAM 2 LATEST 2023-
2024 REAL EXAM ALL 50 QUESTIONS AND CORRECT
ANSWERS|AGRADE
- A nurse working in an outpatient clinic believesthe client has been non-compliant with
the prescribed medication regime, when assessing the client’s mood, the response is
better but letter, post office, doctors’ office,shrink and sink, pick, the nurse recognizes.
which of the following symptoms?
a. Word salad
b. Neologism
c. Clanging
d. Flight of ideas - A client hasreceived a new prescription for quetiapine (Seroquel). Which statement by
the client reflects an understanding of this teaching?
a. This medication will improve my blood glucose
b. This medication will decrease any seizure activity
c. I will need constant lab drawn for this medication while taking it.
d. My weight will be closely monitored while taking this medication. - Which documentation indicates that the treatment plan for a patient diagnosed with
acute mania has been effective?
a. “Converses with few interruptions; clothing matches; participates in activities.”
b. “Irritable,suggestible, distractible; napped for 10 minutesin afternoon.”
c. “Attention span short; writing copious notes; intrudesin conversations.”
d. “Heavy makeup;seductive toward staff; pressured speech.” - A nurse is providing education to a client recently prescribed buspirone. Which of the
following statement by the client indicates further education is needed?
a. This medication won’t cause severe drowsiness
b. I don’t have to worry about getting addicted to this medication
c. This medication will help with my anxiety
d. This medication will be effective by next week - A client with past traumatic experiences usessublimation. Which of the following would
demonstrate sublimation?
a. The client states she doesn’t think she had a real problem
b. The client identifies these symptoms in others
c. The client speaks at high school about her story.
d. The client forgets these past symptoms. - When educating a client and his family about taking a selective serotonin reuptake
inhibitor (SSRI). Which statement from the family shows an understanding of a priority
for client education?
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a. We will make sure he wears sunscreen.
b. We will make sure to avoid aged meats.
c. It will be important to watch how much salt we use when cooking.
d. If he talks about wanting to hurt himself, we will call the doctor.
- A client diagnosed with nyctophobia has recently started systematic
desensitization therapy. The nurse understandsthistherapy will help the client
through which of the following techniques?
a. The client will watch and mimic someone else in the same situation to decrease
anxiety
b. The client will gradually be exposed to the situation until they do not experience
panic level anxiety
c. The client will gradually limit the amount of time the client spends in the
situation to reduce their anxiety level
d. The client will snap rubber band on their wrist to decrease anxiety in the
situation - A nurse is preparing to administer imipramine 200 mg PO daily divided
equally every 12 hr. The amount available is imipramine 25 mg tablets. How
many tablets should the nurse administer with each dose? (Write the number
only, do not include the label. Round to the nearest 10th. Do not include a
trailing zero. Put a leading zero if applicable)
4 - A client is diagnosed with major depressive disorder (MDD) takes
propranolol/Inderal for hypertension and imipramine/tetralin for depression…
the side effects of these drugs. what would be an essential teaching by the
nurse?
a. Rise slowly when you change from lying to sitting to standing
b. Wear a sunscreen and avoid mid-day direct sun
c. Report extrapyramidal symptoms(EPS)
d. Taking both these drugs may cause increased agitation. - A nurse is preparing to administer clozapine 300 mg PO daily to a client who
has schizophrenia. The amount available is clozapine 200 mg tablets. How
many tablets should the nurse administer? (Write the number only, do not
include the label. Round to the nearest 10th. Do not include a trailing zero. Put
a leading zero if applicable).
1.5 - A client with schizophrenia is about to start medication therapy with clozapine
(Clozaril). Which of the following would be most important for the nurse to do?
a. Monitor for client for a high fever
b. Encourage the client to drink enough fluids daily.
c. Obtain a baseline white blood cell count.
lOMoAR cPSD|19500986
RASMUSSEN MENTAL HEALTH EXAM 1 LATEST 2023-2024
REAL EXAM ALL 50 QUESTIONS AND CORRECT
ANSWERS|AGRADE
- A fully developed outcome for a client goal would include: (SATA)
Attainable for client, measurable terms and time sensitive - The nurse understands a client could be at risk for serotonin syndrome when taking which of
the following medications in addition to over the counter medications or herbal supplements?
-Sertraline - A 4-year-old child grabstoys from siblings, saying “I want that toy now!”. The siblings cry and
the child’s parents become upset with the behavior. Using Freudian theory, a nurse can
interpret the child behavior as a product of impulses originating in the:
-Id - Which expected client outcome should a nurse identify as being correctly formulated?
- Client will initiate interaction with one peer during free time within 2 days.
- A voluntarily hospitalized patient tellsthe nurse, “Get me the formsfor discharge against
medical advice so I can leave now. “Which is the nurse’s best response?
-I will get them for you, but lets talk about your decision to leave treatment - The client is being admitted to the inpatient psychiatric unit. The nurse conducts a mental
status examination. Which of the following items are included in this examination?
-Appearance, mood and effect, thought and cognition - A client with schizophrenia has recently begun a new medication, clozapine (Clozaril). Which
signs and symptoms of a potentially fatal side effect will the nurse teach the client about?
-blurring vision and muscular weakness - Which information suggests that caution is necessary in prescribing a benzodiazepine to an
anxious client?
-The client has a history of alcohol dependence - A brother calls to speak to his sister who has been admitted to the psychiatric unit. The nurse
connects home to the community phone and the sister is summoned. Later the nurse realizes
that the brother was not on the client’s approved call list. What law has the nurse broken?
-The Health Insurance Portability and Accountability Act (HIPPA)
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- The client attempted suicide by overdosing on pain medication. Once the client ingested the
medication, she decided that she did not want to die and she sought immediate treatment.
Once the client recovered from the physical effects of overdoes, the client voluntarily sought
inpatient mental health treatment. Which of the following statements is true of voluntary
admission?
-The client retainsthe right to request release - A nurse says to the client, “Things will look better tomorrow after a good nights sleep.” This
is an example of which communication technique?
-The nontherapeutic technique of giving reassurance - A patient isinvoluntarily admitted to a psychiatric unit after calling a friend and saying, “I’ve
got a gun and I’m going to shoot myself.” Which of the following rights has the patient lost
temporarily?
- The right to leave the hospital without medical approval
- A depressed client states, “I have a chemical imbalance in my brain. I have no control over
my behavior. Medications are my only hope to feel normal again. “Which nursing response is
appropriate?”
-Medications are one way to address chemical imbalances. Environmental and interpersonal
factors can also have an impact on biological factors. - During an intake interview, which question would assist the nurse in gathering data about
the clients judgement?
-“If you found a stamped, addressed envelope in the street, what would you do?” - A nursing instructor asks a student to described the nursing process when initiating care of a
client. The student nurse understands the nursing process order to be correctly identified as:
-Assessment, Nursing Diagnoses, Outcomes, Planning, Implementation, Evaluation - During an intake assessment, a nurse asks both physiological and psychosocial questions.
The client angrily responds, “I’m here for my heart, not my head problems.” Which isthe nurse’s
best response?
-Psychological factors, like excessive stress, have been found to affect medical conditions - A mother rescues two of her four children from a house fire. In an emergency department,
she cries, “I should have gone back in to get them. I should have died, not them.” Which of the
following responses by the nurse is an example of reflection?
-You’re feeling guilty because you weren’t able to save your children
RASMUSSEN MENTAL HEALTH EXAM 1 TEST BANK
LATEST 2023-2024 ACTUAL EXAM 200 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES |AGRADE
- In which scenario is it most urgent for the nurse to act as a patient advocate?
a. An adult cries and experiences anxiety after a near-miss automobile accident on
the way to work.
b. A homeless adult diagnosed with schizophrenia lives in a community expecting
a category 5 hurricane.
c. A 14-year-old girl’s grades decline because she consistently focuses on her
appearance and social networking.
d. A parent allows the prescription to lapse for 1 day for their 8-year-old child’s
medication for attention-deficit/hyperactivity disorder. – ANSWER- B. - The nurse interacts with a veteran of World War II. The veteran says, “Veterans
of modern wars whine and complain all the time. Back when I was in service, you
kept your feelings to yourself.” Select the nurse’s best response.
a. “American society in the 1940s expected World War II soldiers to be strong.”
b. “World War II was fought in a traditional way but the enemy is more difficult to
identify in today’s wars.”
c. “We now have a better understanding of how trauma affects people and the
importance of research-based, compassionate care.”
d. “Intermittent explosive devices (IEDs), which were not in use during World War
II, produce traumatic brain injuries that must be treated.” – ANSWER- C
- A patient reports to a primary care provider about sleeplessness, constant
fatigue, and sadness. In our current health care climate, what is the most likely
treatment approach that will be offered to the patient?
a. Group therapy
b. Individual psychotherapy
c. Complementary therapy
d. Psychopharmacological treatment – ANSWER- D - The nurse prepares outcomes to the plan of care for an adult diagnosed with
mental illness. Which strategy recognizes the current focus of treatment services
for this population?
a. The patient’s diagnoses are confirmed using advanced neuroimaging techniques.
b. The nurse confers with the treatment team to verify the patient’s most significant
disability.
c. The nurse prioritizes the patient’s problems in accordance with Maslow’s
hierarchy of needs.
d. The patient and family participate actively in establishing priorities and selecting
interventions. – ANSWER- D
- Which scenario best demonstrates empathetic caring?
a. A nurse provides comfort to a colleague after an error of medication
administration.
b. A nurse works a fourth extra shift in 1 week to maintain adequate unit staffing.
c. A nurse identifies a violation of confidentiality and makes a report to an agency’s
privacy officer.
d. A nurse conscientiously reads current literature to stay aware of new evidencebased practices. – ANSWER- A - A mentally ill gunman opens fire in a crowded movie theater, killing six people
and injuring others. Which comment about this event by a member of the
community most clearly shows the stigma of mental illness?
a. “Gun control laws are inadequate in our country.”
b. “It’s frightening to feel that it is not safe to go to a movie theater.”
c. “All these people with mental illness are violent and should be locked up.”
d. “These events happen because American families no longer go to church
together.” – ANSWER- C
- The nurse presents a class about mental health and mental illness to a group of
fourth graders. One student asks, “Why do people get mentally ill?” Select the
nurse’s best response.
a. “There are many reasons why mental illness occurs.”
b. “The cause of mental illness is complicated and very hard to understand.”
c. “Sometimes a person’s brain does not work correctly because something bad
happens or they inherit a brain problem.”
d. “Most mental illnesses result from genetically transmitted abnormalities in
cerebral structure; however, some are a consequence of traumatic life experiences.”
- ANSWER- C
- An adult experienced a spinal cord injury resulting in quadriplegia 3 years ago
and now lives permanently in a skilled care facility. Which comment by this
person best demonstrates resiliency?
a. “I often pray for a miracle that will heal my paralysis so I will be whole again.”
RASMUSSEN MENTAL HEALTH FINAL EXAM TEST
BANK LATEST 2023-2024 ACTUAL EXAM 200
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES |AGRADE
A client is diagnosed with antisocial personality disorder. She has a violent verbal,
physically threatening outburst in the dayroom of the unit when the nurse explains
she cannot smoke in the hospital. What is the priority action the nurse should take?
- ANSWER- remove all other clients from the dayroom to ensure safety
What behaviors, by the mother, did Mahler in her theory of object constancy say
caused borderline personality disorder symptoms later in life? – ANSWER- the
mother was seeing mixed messages regarding emotional presence
Which of the following findings would the nurse identify as placing a client at risk
for conversion disorder? – ANSWER- being in an automobile accident a month
earlier in which her best friend died
A nurse is caring for a client with factitious disorder imposed on another. Which of
the following statements by the client would the nurse expect? – ANSWER- I made
my daughter sick because no one was paying use any attention
The family of a 17 yo client diagnosed with anorexia nervosa is encouraged to
attend family therapy sessions. The father states, “We dont have the eating
disorder. Why should we attend?” What is the best response by the nurse? –
ANSWER- Gaining insight about her illness and what contributes to it will be
beneficial
A nurse is teaching a group of students about the risk factors and complications of
anorexia nervosa. Which of the following complications should be stressed as the
most serious? – ANSWER- increased risk of mortality
A client states “I was diagnosed with panic attacks. I have heard of dissociated
disorders. What is the difference?” What is the nurses best response? – ANSWERIn Dissociative disorders, an unconscious memory enters conscious awareness
causing dissociation
A newly admitted client diagnosed with somatization disorder asked for his pain
medication that is ordered on an as-need basis. What is the nurses best reaction to
this request? – ANSWER- matter-of-factly administer the medications as
prescribed
The parent of a child with attention deficit hyperactivity disorder tells the nurse
that the child does not follow directions well, what strategy would be best for the
nurse to recommend? – ANSWER- Try having the child repeat the instructions
before starting the task
When planning the care of a 6-year-old child diagnosed with opposition defiant
disorder, the nurse should include which method of therapy? – ANSWER- behavior
modification
a client diagnosed with dissociative disorder suddenly begins to speak with a childs
vocabulary and voice. What interpretation should the nurse make about this
behavior? – ANSWER- a state of depersonalization
The nurse is assessing the client in a fugue state. What information would the nurse
be most beneficial? – ANSWER- recent history of severe trauma
7 year old male client has severe bruising on his arms and injury to his abdomen.
The nurse should consider child abuse if the parents act in what manner? –
ANSWER- the parents delayed seeking treatment
A 4 yo child states to the nurse, “If i can make a big enough wish, my dad wont be
dead anymore!” What is the conclusion made by the nurse? – ANSWER- the child
is voicing thoughts that are normal for children this age
A female adolescent client says to the nurse, “Hey, you stupid blonde, what are you
looking at? Which of the following responses would be inappropriate for the nurse
to make? – ANSWER- state, “Dont you ever talk to me like that again”
a nursing peer states, “this client always disrupts the unit and then she sings out
against medical advice. She is a pain and a typical borderline.: What is the nurses
best response to this comment? – ANSWER- I wish we could identify what she
needs and help her before she signs out
Which of the following statements by the nurse, who cares for children with
psychiatric disorders, is the reason for concern? – ANSWER- I know exactly how
the child feels since I went through the same thing
What are symptoms of prolonged grief one year after the loss? – ANSWERanhedonia
The nurse observes a client diagnosed with anorexia nervosa doing repeated,
vigorous sit-ups in her room. What is the most therapeutic intervention by the
nurse? – ANSWER- interrupt the routine and offer to walk her
RASMUSSEN MENTAL HEALTH EXAM 2 TEST BANK
LATEST 2023-2024 ACTUAL EXAM 200 QUESTIONS
AND CORREC T DETAILED ANSWERS WITH
RATIONALES |AGRADE
A nurse caring for a client, who has been neglecting personal hygiene,
observes the client coming to breakfast freshly bathed, wearing clean
clothes, and combed and styled hair. Which of the following is the most
therapeutic response by the nurse? – ANSWER- I see you have done
some grooming today
Which of the following would be the best therapeutic response by the
nurse when a client states, “I no longer need my medication since I do
not hear voices.”? – ANSWER- -“What happened the last time you
stopped taking your medication?”
Which documentation indicates that the treatment plan for a patient
diagnosed with acute mania has been effective – ANSWER- “Converses
with few interruptions; clothing matches; participates in activities.”
A nurse is providing education to a client recently prescribed buspirone.
Which of the following statement by the client indicates further
education is needed – ANSWER- This medication will be effective by
next week
When educating a client and his family about taking a selective
serotonin reuptake inhibitor (SSRI). Which statement from the family
shows an understanding of a priority for client education? – ANSWER- .
If he talks about wanting to hurt himself, we will call the doctor
. A client diagnosed with nyctophobia has recently started systematic
desensitization therapy. The nurse understands this therapy will help the
client through which of the following techniques? – ANSWER- The
client will gradually be exposed to the situation until they do not
experience panic level anxiety
A nurse is assessing a client who has schizophrenia and has been treated
with a first-generation antipsychotic. Which of the following findings
should the nursedocument as manifestation of tardive dyskinesia –
ANSWER- b. Twisting tongue movement
Which nursing diagnosis supports the psychoanalytic theory of
development of major depressive disorder? – ANSWER- Social isolation
R/T self directed danger
Which patient is at the highest risk for the diagnosis of major depressive
disorder? – ANSWER- 24 yr old married woman
A patient diagnosed with MDD is being considered for ECT. Which
patient teaching should the nurse prioritize? – ANSWER- Discuss with
the patient and family expected short term memory loss
Which nursing intervention takes priority when working with a newly
admitted patient experiencing suicidal ideations? – ANSWER- Monitor
the patient at a close, but irregular intervals.
A patient diagnosed with major depressive disorder is prescribed Nardil.
Which teachings should the nurse prioritize? – ANSWER- Intruct the
patient & family about the many food-drug & drug-drug interactions?
What symptoms would the nurse expect to assess i a patient
experiencing serotonin syndrome? – ANSWER- Confusion, restlessness,
Tachycardia, Labile BP, & diaphoresis
Which of the following meds would be classified as Tricyclic
antidepressants? – ANSWER- Nortriptyline (Pamelor)
Which of the following are examples of anticholinergic side effects from
tricyclic antidepressants? – ANSWER- Urinary hesitancy, constipation,
and blurred vision
A patient seen in the ED is experiencing irritability, pressured speech,
and increased levels of anxiety. The priority is? – ANSWER- Assess
vital signs and complete a physical assessment
A patient diagnosed with bipolar 1 in the manic phase is yelling at
another peer in the milieu. The priority intervention is? – ANSWERCalmly redirect and remove the patient from the milieu.
A patient diagnosed with bipolar 1 is experiencing auditory
hallucinations and a flight of ideas. Which meds would you expect to
give? – ANSWER- Risperidone (Risperdal) & Lamotrigine (Lamictal)
A patient prescribed Lithium is experiencing excessive output of dilute
urine, tremors and muscular irritability. The RN should? – ANSWERAssess a serum Lithium level of 2.6mEq/L
A patient is newly prescribed Lithium carbonate. Which teaching point
by the nurse takes priority? – ANSWER- Make sure your salt intake is
consistent.
Which is an example of an behavioral response to a moderate level of
anxiety? – ANSWER- Restlessness
Which is an example of a physiological response to a panic level of
anxiety? – ANSWER- Dilated pupils.
A newly admitted patient is diagnosed with PTSD. Which behavioral
symptoms would the nurse expect to assess? – ANSWER- Diminished
participation in significant activities.
A patient on an in patient unit is experiencing a flash back. Which
intervention takes priority? – ANSWER- Maintain and reassure the
patient of his or her safety and security