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Mental Health Disorders: Final Exam Questions and Answers, Exams of Nursing

Saddleback CollegeNursing

A comprehensive set of final exam questions and answers covering various mental health disorders. It includes questions on topics such as depression, anxiety, schizophrenia, borderline personality disorder, and more. Designed to help students prepare for their final exams in mental health courses.

Typology: Exams

2024/2025

Available from 04/16/2025

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N172 FINAL EXAM QUESTIONS WITH ACCURATE ANSWERS
1) What is Loquaciousness? -- Correct Answer ✔✔ Forced speech difficult to interrupt
2) What is Flight of Ideas? -- Correct Answer ✔✔ Continuous rapid shift from one
topic to another
3) Components of a suicide assessment (what you might find upon assessment) --
Correct Answer ✔✔ Hopelessness) Client unable to see future
Speaks of suicide
Plan
Giving away possessions
Auditory hallucinations
Lack of support
Alcohol or substance abuse
Previous attempts and or familial attempts
Precipitating event
4) What are some risk factors for depression? -- Correct Answer ✔✔ Priority
assessments and risk factors for the depressed patient
5) Priority assessments and risk factors for the depressed patient -- Correct Answer
✔✔ - High risk for suicide, especially for adolescents
- Symptoms may be confused with dementia in older adults
- Medication history
- Mood/affect
- Cognition and memory
- Family dynamics
- Quality of support system
- Spiritual/religious background
6) Symptoms of depression -- Correct Answer ✔✔ *SIG-CAPES*
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N172 FINAL EXAM QUESTIONS WITH ACCURATE ANSWERS

  1. What is Loquaciousness? -- Correct Answer ✔✔ Forced speech difficult to interrupt
  2. What is Flight of Ideas? -- Correct Answer ✔✔ Continuous rapid shift from one topic to another
  3. Components of a suicide assessment (what you might find upon assessment) -- Correct Answer ✔✔ Hopelessness) Client unable to see future Speaks of suicide Plan Giving away possessions Auditory hallucinations Lack of support Alcohol or substance abuse Previous attempts and or familial attempts Precipitating event
  4. What are some risk factors for depression? -- Correct Answer ✔✔ Priority assessments and risk factors for the depressed patient
  5. Priority assessments and risk factors for the depressed patient -- Correct Answer ✔✔ - High risk for suicide, especially for adolescents
  • Symptoms may be confused with dementia in older adults
  • Medication history
  • Mood/affect
  • Cognition and memory
  • Family dynamics
  • Quality of support system
  • Spiritual/religious background
  1. Symptoms of depression -- Correct Answer ✔✔ SIG-CAPES

S- Sleep (increase/decrease) I-Interest diminished G- Guilt or low self-esteem C- Concentration (poor) A- Appetite (increased/decreased) P- Psychomotor (agitation/retardation) E- Energy (decreased) S- Suicidal ideation

  1. What is an appropriate short-term goal for anxiety control in a client experiencing obsessive compulsive disorder? A) The client will consistently control the physical effects of anxiety. B) The client will identify his own patterns of hyperventilation. C) The client will begin breathing exercising when breaths exceed 14 per minute. D) The client will use problem-solving rather than worry. -- Correct Answer ✔✔ B Assessment (identification) comes before implementation. Responses Controlling the physical effects of anxiety, beginning breathing exercises, and using problem- solving are implementation activities that are appropriate longer-term goals.
  2. Benzodiazepines are contraindicated in clients with a history of which of the following? A) Alcohol abuse. B) Drug withdrawal. C) Seizure disorder. D) Suicide attempts. -- Correct Answer ✔✔ A Benzodiazepines in combination with alcohol can be fatal. Drug withdrawal and seizure disorders are major indications for use of benzodiazepines. Suicide attempts using benzodiazepines alone are rarely successful. When these drugs are taken alone, they are almost never fatal.
  3. What statement by the schizophrenic client indicates skill for managing a relapse? A) "I can remember when my hallucinations first began." B) "I know which of my hallucinations trigger a relapse."

A) Dissociation. B) Isolation. C) Regression. D) Repression. -- Correct Answer ✔✔ D Disassociation involves the separating of any group of mental or behavioral processes from the rest of consciousness. In isolation, there is a splitting off of the emotional and thought components of a situation. Regression involves a retreat to behavior characteristic of an earlier developmental period due to stress.

  1. What is Major Depressive Disorder? -- Correct Answer ✔✔ > than 2 weeks with 1 or more depressive episodes
  2. What is Dysthymic Disorder -- Correct Answer ✔✔ Ongoing >2 years of more days depressed than not Does not meet criteria for Major Depressive Disorder
  3. Assessment areas for the person suffering a panic attack) Biologic -- Correct Answer ✔✔ Rule out life-threatening medical causes (symptom evaluation) Substance use Sleep patterns Physical activity
  4. Assessment areas for the person suffering a panic attack) Psychologic -- Correct Answer ✔✔ Self-report scales Mental status exam Cognitive thought patterns) catastrophic misinterpretations
  5. Assessment areas for the person suffering a panic attack) Social -- Correct Answer ✔✔ Family factors Cultural factors
  6. Nursing diagnosis/interventions for the person suffering a panic attack -- Correct Answer ✔✔ Safe and therapeutic environment (reassure that you will not leave, stay, give clear/concise directions, walk/pace with pt, minimal stimulation)

Medication and monitoring of effects (anxiolytics) Individual psychotherapy (allow pt to vent feelings) Psychological testing Priority care issues) safety because of a high risk for suicide

  1. What is Borderline Personality Disorder? -- Correct Answer ✔✔ Disruptive pattern of instability related to self-identity and interpersonal relationships, combined with marked impulsivity and destructive behavior One crisis after another... emotional reactivity with little coping... remissions and recurrences...
  2. What are some problem areas for a pt with Borderline Personality Disorder? -- Correct Answer ✔✔ Regulating moods Developing a self-identity Maintaining interpersonal relationships Maintaining reality-based thinking Avoiding impulsive or destructive behavior
  3. Assessment areas for the person suffering from Borderline Personality Disorder: Biologic -- Correct Answer ✔✔ Nutritional status Sleep patterns Self-injurious behaviors Medication use
  4. Assessment areas for the person suffering from Borderline Personality Disorder: Psychologic -- Correct Answer ✔✔ Loss and grieving Mood fluctuations Impulsivity Cognitive disturbances Dissociation and transient psychotic episodes Risk assessment
  5. Assessment areas for the person suffering from Borderline Personality Disorder: Social -- Correct Answer ✔✔ Social support systems Interpersonal skills
  1. What is the histrionic personality trait? -- Correct Answer ✔✔ - Attention seeking, excitable, emotional, insatiable need for attention and approval
  • Moody; sense of helplessness when others disinterested
  • Sexually seductive to gain attention, uncomfortable with single relationship, provocative appearance, dramatic speech
  • Lack of loyalty and fidelity
  1. What is the dependent personality trait? -- Correct Answer ✔✔ clinging to others in a desperate attempt to keep them close; intense need to be taken care of Total submission and disregard for self Decision making difficult or nonexistent Withdrawal from adult responsibilities
  2. What is the paranoid personality trait? -- Correct Answer ✔✔ Longstanding suspiciousness and mistrust of others Guarded, hostile, angry, unforgiving; holds grudges Persistent ideas of self-importance
  3. Which neurotransmitter is associated with schizophrenia? -- Correct Answer ✔✔ Dopamine hyperactivity
  4. Schizoaffective vs. Schizotypal -- Correct Answer ✔✔ Schizotypal has a life long or at least significant adult history of symptoms. Schizoaffective has an acute 'break'. Schizotypal have their symptoms all the time--there is no waxing or waning. Key features of Schizoaffective) positive and negative symptoms of schizophrenia plus a mood component Key features of Schizotypal) weird affect, odd beliefs, odd speech patterns, odd behavior, magical thinking, NO negative symptoms, no marked disorganization
  5. What are the positive symptoms of schizophrenia? -- Correct Answer ✔✔ Excess or distortion of normal functions Delusions and hallucinations
  1. What are the negative symptoms of schizophrenia? -- Correct Answer ✔✔ Lessening or loss of normal functions
  • Alogia: lack of speech
  • Affective blunting: blunt affect, reduction in range of intensity of emotions
  • Anhedonia: no pleasure/joy
  • Asociality: lack of motivation to engage in social interaction
  • Avolition: No motivation, lack of drive
  • Apathy: lack of feeling emotion or concern
  1. What are the disorganized symptoms of schizophrenia? -- Correct Answer ✔✔ Neurocognitive impairment Involving memory, vigilance, verbal fluency and executive function (i.e., disorganized symptoms)
  2. The "4 As" of schizophrenia diagnosis -- Correct Answer ✔✔ Inappropriate AFFECT Loosening of ASSOCIATIONS ... disconnect from reality AUTISTIC thoughts....Hard to focus, distracted AMBIVALENCE
  3. Alcohol-induced amnestic disorders (permanent brain disorder) -- Correct Answer ✔✔ Wernicke's encephalopathy Korsakoff's amnestic syndrome Wernicke-Korsakoff syndrome
  4. What is Wernicke's encephalopathy? -- Correct Answer ✔✔ Type of Alcohol- induced amnestic disorder... constant depletion of vitamin B and thiamin
  5. What is Korsakoff's amnestic syndrome? -- Correct Answer ✔✔ Type of Alcohol- induced amnestic disorder... brain starts to shrink
  6. What is Wernicke-Korsakoff syndrome? -- Correct Answer ✔✔ Type of Alcohol- induced amnestic disorder... wet brain

Metabolic disturbances Hypoxia and ischemia Advanced age Brain damage Dementia Sensory over- or underload Immobilization Sleep deprivation Psychosocial stress

  1. What is amnestic disorder? -- Correct Answer ✔✔ Impairment in memory caused by a direct physiologic effect of medical condition or persisting effects of a substance Severe memory impairment without other significant cognitive symptoms
  2. Types of emotional affect -- Correct Answer ✔✔ Blunted (little intonation) Flat (no emotional reaction) Inappropriate (different than expected) Labile (extreme change with no stimulus) Restricted or constricted (not as intense as expected)
  3. Your patient in the Emergency Department has a diagnosis of acute alcohol withdrawal syndrome (AWS). He is acting euphoric, yet shy. The APN has prescribed the following care) CAGE questionnaire, serum for toxicology, IV of D 1/2 NS and 1 amp multivitamin (MVI) at 75 mL/h, neuro check q 1 h. What is your first priority? A) Administer the CAGE questionnaire. B) Start the IV. C) Do the neuro check. D) Obtain a serum blood sample -- Correct Answer ✔✔ D Obtain a toxicology sample, as the patient is too euphoric to answer the CAGE questionnaire. The IV and neuro checks can wait.
  4. True or false? Alcohol tolerance develops as a result of the central nervous system's adaptive mechanisms -- Correct Answer ✔✔ True
  1. Which of the following medical conditions has similar signs and symptoms as those seen in a major depressive episode? A) Pancreatitis. B) Cholecystitis. C) Tuberculosis. D) Hypothyroidism. -- Correct Answer ✔✔ D Signs and symptoms of hypothyroidism include changes in weight, sleep disturbances, decreased energy, and difficulty in thinking—just like in depression.
  2. Your patient is ready for discharge after a 30-day hospitalization for manic depression. About 30 minutes before his discharge, his roommate comes to you and says, "He is talking crazy." When you ask your patient how he is feeling, he states, "I feel like Superman. I can do anything. I can fly home today and then become a U.S. Senator." Which type of mania-related symptoms is this patient exhibiting? A) Social. B) Cognitive. C) Behavioral. D) Perceptual. -- Correct Answer ✔✔ B Cognitive symptoms include inflated self-esteem and grandiosity
  3. A 21-year-old patient has a diagnosis of schizophrenia and is stuporous, yet exhibits sudden, excessive motor activity with repetitive sit-ups. What is this behavior called? A) Delusional. B) Hallucinogenic. C) Paranoid. D) Catatonic. -- Correct Answer ✔✔ D Catatonic schizophrenia occurs suddenly and includes motor immobility or excessive motor activity.
  4. Your patient has a diagnosis of schizophrenia and believes that his thoughts are broadcast from his head. What is the most appropriate nursing diagnosis? A) Risk for self-directed violence. B) Disturbed sensory perception.

Focus on the behavior, not the person. Be neutral, but not indifferent.

  1. Smoking cigarettes increases the metabolism of some psychiatric medications. In such a case, if the patient smokes, how should the medication dose be adjusted? A) Decrease the dose. B) Increase the dose. C) Administer the entire dose of medication in the morning. D) Administer the entire dose of medication at bedtime. -- Correct Answer ✔✔ B Increasing the dose will help maintain blood levels based on increased metabolism.
  2. Prior to electroconvulsive therapy (ECT) treatment, the patient receives an injection of a medication that reduces secretions and protects against vagal bradycardia. Which medication will you administer? A) Diphenhydramine (Benadryl). B) Atropine. C) Epinephrine (Adrenalin). D) Fluoxetine (Prozac). -- Correct Answer ✔✔ B Atropine has a vagolytic effect as well as blocks muscarinic responses and has selective depression of central nervous system. Benadryl is an H-1 receptor antagonist and antihistamine with anticholinergic activity and does not protect against vagal bradycardia. Adrenalin is a catecholamine that constricts bronchioles and inhibits histamine release, and Prozac is an antidepressant.
  3. Which of the following physical manifestations are common in patients undergoing grief? A) Nausea, headache, and chest pain. B) Fatigue, exhaustion, and insomnia. C) Diarrhea, vomiting, and hypertension. D) Thought disturbances, constipation, and dry mouth. -- Correct Answer ✔✔ B

Fatigue, exhaustion, and insomnia are common manifestations, along with shortness of breath, chest

  1. Grief increases a person's vulnerability to which physical illness? A) Myocardial infarction. B) Systemic lupus erythematosus (SLE). C) Hip fractures. D) Obsessive-compulsive disorder. -- Correct Answer ✔✔ A Grief increases vulnerability to myocardial infarction, hypertension, depression, drug abuse, malnutrition, and rheumatoid arthritis.
  2. You need to assess Mrs. Wolberg for chronic grief. What physical disturbances would indicate the patient is in chronic grief? A) Anxiety and sinus pain. B) Amnesia and overeating. C) Bilateral lower leg pain and visual cloudiness. D) Cardiovascular and gastrointestinal problems. -- Correct Answer ✔✔ D Cardiovascular and gastrointestinal problems are common in chronic grief. Acute grief is often characterized by weakness, anorexia, tight chest, dry mouth, and gastrointestinal disturbances.
  3. Mr. Allen has psychosis and has been treated with haloperidol (Haldol). You need to assess him for movement disorders as a side effect of Haldol. What is another name for these movement disorders? A) Extrapyramidal reactions. B) Autonomic dysreflexia. C) Biologic rigidity reactions. D) Delusional etiologies. -- Correct Answer ✔✔ A Extrapyramidal reactions include movement disorders such as dystonia, tardive dyskinesia, and pseudoparkinsonism.
  4. Which of the following side effects is related to the effects of anticholinergic medications? A) Pain in great toes.
  1. Mrs. Robinson is a 38-year-old woman being treated on an outpatient basis for depression. Three months ago, her husband revealed that he was having an affair with her best friend and planned to file for divorce. Three weeks ago, Mrs. Robinson's 14-year-old son (her only child) committed suicide on an inpatient psychiatric mental health unit. In today's therapy session, Mrs. Robinson reveals to her nurse therapist that she is seriously contemplating suicide herself. What action should the therapist take? A) None, because people who speak of committing suicide seldom do it. B) Request permission to speak with the husband to suggest marriage counseling. C) Arrange for voluntary hospitalization, if the patient is willing. D) Arrange for immediate hospitalization. -- Correct Answer ✔✔ D The suicide of her son puts this patient at high risk of suicide. This risk is exacerbated by the betrayal of her husband and best friend.
  2. A personality disorder... A) Is a long-standing pervasive pattern of maladaptive behavior that is so severe that it is always an Axis I diagnosis. B) Is caused solely by biological factors. C) Often includes the risk of violence toward self and others. D) Is a "hopeless" diagnosis, as patients with this diagnosis never show any improvement. -- Correct Answer ✔✔ C The lack of impulse control that characterizes some personality disorders leads to the risk of violence toward self and others.
  3. Psychiatric medications have side effects associated with varying degrees of risk. Which of the following side effects always represents a medical emergency? A) Tardive dyskinesia. B) Neuroleptic malignant syndrome. C) Pseudoparkinsonism. D) Postural hypotension. -- Correct Answer ✔✔ B Neuroleptic malignant syndrome is a potentially fatal reaction that occurs in approximately 1% of people who take antipsychotic medications. The case fatality rate is approximately 10%.
  1. Mrs. Shoemaker is taking antipsychotic medications and is a heavy cigarette smoker (3 packs per day). You know that cigarette smoking tends to activate hepatic enzymes that cause medications to be metabolized more quickly. Therefore, how should the antipsychotic medications be prescribed to Mrs. Shoemaker? A) At a higher dose. B) At a lower dose. C) Every 2 hours, with around-the-clock frequency. D) At 4-hour intervals, to be taken with an antacid. -- Correct Answer ✔✔ A Higher doses will counteract the smoking effect.
  2. Clozapine (Clozaril) is contraindicated in clients who have which of the following conditions? A) Bone marrow depression. B) Dry eye syndrome. C) Hypertension. D) Urinary retention. -- Correct Answer ✔✔ A Clients with bone marrow depression have a compromised white blood cell (WBC) count and immune system activity. Agranulocytosis is a life-threatening condition characterized by a marked decrease in the granulated white blood cells. It is the most serious blood-related side effect of psychotropic medication. The risk is highest with clozapine (Clozaril). However, it is also a risk with conventional antipsychotic drugs and benzodiazepines. Clozapine (Clozaril) is not administered unless the WBC in normal. A frequent side effect of clozapine (Clozaril) is orthostatic hypotension, and the drug may increase the effects of antihypertensive drugs. Thus, BP needs careful monitoring. Dry eye syndrome and urinary retention are anticholinergic-related conditions and would most likely not be exacerbated by the drug as anticholinergic self effects are rare with clozapine (Clozeral).
  3. A client's psychotropic medication was changed two weeks ago. The nurse finds the client experiencing symptoms of muscle rigidity, hyperpyrexia, and diaphoresis. The nurse recognizes that these are symptoms of a severe life-threatening side effect of all psychotropic medication known as _____________________.
  1. The most important nursing intervention for serotonin syndrome is which of the following? A) Administration of an anticonvulsant. B) Administration of a muscle relaxant for myoclonus. C) Discontinuation of serotonergic drugs. D) Immediately initiate body cooling procedures. -- Correct Answer ✔✔ C Serotonin syndrome is a potentially lethal reaction following the use of serotomimetic agents (SSRIs, TCSs) alone or in combination with MAOIs. Treatment is immediate discontinuation of all serotonergic drugs. Anticonvulsants and drugs to counteract specific symptoms (muoclonus) are given as necessary. Symptoms of serotonin syndrome are confusion, mania, agitation, myoclonus, hyperreflexia, diaphoresis, shivering, ataxia, coma, low-grade fever.
  2. When distinguishing between a client condition of depression or anxiety, the nurse recognizes that which of the following appears only in the anxious client? A) Sleep disturbances. B) Gastrointestinal complaints. C) Irritability. D) Seeing some prospect for the future. -- Correct Answer ✔✔ D Depressed clients see the future as a blank and have given up all hope where the anxious client has not. All other symptoms are shared by clients experiencing the two conditions. Both also experience difficulty concentrating, appetite changes, and nonspecific cardiopulmonary complaints.
  3. The nurse is educating an alcoholic client about alcohol withdrawal (prevention, signs, and treatment). What statement indicates that the client understands? A) "I do not expect signs of delirium tremens (DTs) until five days after I stop drinking." B) "Disalfiram (Antabuse) will block my craving for alcohol." C) "I will keep my fluid intake to 3,000ml each day." D) "I will keep up my vitamins, especially Vitamin C." -- Correct Answer ✔✔ C Many clients in withdrawal are dehydrated. Fluid up to 3,000ml per day should be encouraged. The peak time of onset of DTs after the last drink is 24-48 hours.

Antabuse blocks an enzyme that metabolizes highly toxic acetaldehyde, producing nausea and hypotension. Naltrexone (ReVia, Trexan) blocks the craving for alcohol. Alcohol interferes with the absorption of the B vitamins. Thus, they should be supplemented.

  1. When planning care for a client experiencing rapid cycling of mania, the nurse recognizes that treatment begins with which of the following? A) An antidepressant and a mood stabilizer. B) A mood stabilizer alone. C) A mood stabilizer plus an atypical antidepressant. D) A mood stabilizer plus a diuretic. -- Correct Answer ✔✔ B Treatment for severe depression begins with a mood stabilizer and an antidepressant. If psychosis is present in the manic client, treatment begins with a mood stabilizer and an atypical antipsychotic. Diuretics have no role in treatment of mania or depression. If a diuretic is given in combination with lithium, blood lithium levels will increase along with the potential for lithium toxicity.
  2. A client has been on a typical antipsychotic fluphenazine (Prolixin) for 12 months. When the client comes into the Community Mental Health Center, the nurse observes that the client has fine, worm-like tongue movements. Which of the following might this behavior indicate? A) A drug-food reaction, probably to grapefruit juice. B) The client has missed several doses of medication. C) Early symptoms of neuroleptic malignant syndrome (NMS). D) Early symptoms of tardive dyskenesia (TD). -- Correct Answer ✔✔ D These are the first symptoms of TD. Discounting the drug at this point may prevent a full-blown (and irreversible) case of TD. TD includes involuntary choreoathelotic movements of the face and tongue, lip smacking, and foot tapping. Prolixin is compatible with grapefruit juice. Missing several doses of the drug would lead to a return of psychotic symptoms. Symptoms of NMS include severe muscle rigidity and altered consciousness.
  3. The Mini Mental State Examination (MMSE) is used to assess which of the following? A) Delirium. B) Dementia.