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RN MENTAL HEALTH FINAL EXAM PRACTICE QUESTIONS
WITH ANSWERS COMPLETE GUIDE RATED A+
- A nursing student new to psychiatric-mental health nursing asks a peer what resourceshe can use to figure out which symptoms are present in a specific psychiatric disorder. The best answer would be:
aNursing Interventions Classification (NIC)
b) Nursing Outcomes Classification (NOC)
c) NANDA-I nursing diagnoses
d) DSM- 5
- Epidemiological studies contribute to improvements in care for individuals with mentaldisorders by:
A) Providing information about effective nursing techniques.
b) Identifying risk factors that contribute to the development of a disorder.
C Identifying individuals in the general population who will develop a specific disorder.
D Identifying which individuals will respond favorably to a specific treatment.
- Besides antianxiety agents, which classification of drugs is also commonly given totreat anxiety and anxiety disorders?
a. Antipsychotics
b. Mood stabilizers
c. Antidepressants
d. Cholinesterase inhibitors
- What assessment question will provide the nurse with information regarding the effectsof a woman‟s circadian rhythms on her quality of life?
a. “How much sleep do you usually get each night?”
b. “Does your heart ever seem to skip a beat?”
c. “When was the last time you had a fever?”
d. “Do you have problems urinating?”
- You realize that your patient who is being treated for a major depressive disorderrequires more teaching when she makes the following statement:
a) “I have been on this antidepressant for 3 days. I realize that the full effect may not happen for a period of weeks.”
b) “I am going to ask my nurse practitioner to discontinue my Prozac today and let me start taking a monoamine oxidase inhibitor tomorrow.”
c) “I may ask to have my medication changed to Wellbutrin due to the problems I am having being romantic with my wife.”
d) “I realize that there are many antidepressants and it might take a while until we find the one that works best for me.”
- A patient being treated for insomnia is prescribed ramel-teon (Rozerem). Which comorbid mental health condition would make this medication the hypnotic of choice for thisparticular patient?
a) Obsessive-compulsive disorder
b) Generalized anxiety disorder
c) Persistent depressive disorder
d) Substance use disorder
- Which statement made by a patient prescribed bupropion (Wellbutrin) demonstratesthat the medication education the patient received was effective? Select all that apply.
a) “I hope Wellbutrin will help my depression and also help me to finally quit smoking.”
b) “I‟m happy to hear that I won‟t need to worry too much about weight gain.”
c) “It‟s okay to take Wellbutrin since I haven‟t had a seizure in 6 months.”
d) “I need to be careful about driving since the medication could make me drowsy.”
e) “My partner and I have discussed the possible effects this medication could have on our sex life.”
- Which drug group calls for nursing assessment for development of abnormalmovement disorders among individuals who take therapeutic dosages?
b) antipsychotics
c) benzodiazepines
d) tricyclic antidepressants
- The nurse administers each of the following drugs to various patients. The patient who should be most carefully assessed for fluid and electrolyte imbalance is the one receiving:
a. lithium (Eskalith)
b. clozapine (Clozaril)
c. diazepam (Valium)
d. amitriptyline
- A psychiatric nurse is reviewing prescriptions for a patient with major depression at the county clinic. Since the patient has a mild intellectual disability, the nurse would question which classification of antidepressant drugs:
a. Selective serotonin reuptake inhibitors
b. Monoamine oxidase inhibitors
c. Serotonin and norepinephrine reuptake inhibitors
d. All of the above
- The mental health team is determining treatment options for a male patient who is experiencing psychotic symptoms. Which question(s) should the team answer to determine whether a community outpatient or inpatient setting is most appropriate? Select all that apply.
a. “Is the patient expressing suicidal thoughts?”
b. “Does the patient have intact judgment and insight into his situation?”
c. “Does the patient have experiences with either community or inpatient mental healthcare facilities?”
d. “Does the patient require a therapeutic environment to support the management of psychotic symptoms?”
e. “Does the patient require the regular involvement of their family/significant other in planning and executing the plan of care?”
- Pablo is a homeless adult who has no family connection. Pablo passed out on the street and emergency medical services took him to the hospital where he expresses a wish to die. The physician recognizes evidence of substance use problems and mental health issues and recommends inpatient treatment for Pablo. What is the rationale for this treatment choice? Select all that apply.
a. Intermittent supervision is available in inpatient settings.
b. He requires stabilization of multiple symptoms.
c. He has nutritional and self-care needs.
d. Medication adherence will be mandated.
e. He is in imminent danger of harming himself.
- Which statement made by the nurse demonstrates the best understanding of nonverbal communication?
a. “The patient‟s verbal and nonverbal communication is often different.”
b. “When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response.”
c. “If a patient is slumped in the chair, I can be sure he‟s angry or depressed.”
d. “It‟s easier to understand verbal communication that nonverbal communication.”
- Which nursing statement is an example of reflection?
a. “I think this feeling will pass.”
b. “So you are saying that life has no meaning.”
c. “I‟m not sure I understand what you mean.”
d. “You look sad.”
- When should a nurse be most alert to the possibility of communication errors resulting in harm to the patient?
d. “I get the impression you don‟t really want to see your psychiatrist—can you tell me why?”
- Which student behavior is consistent with therapeutic communication?
a. Offering your opinion when asked to convey support.
b. Summarizing the essence of the patient‟s comments in your own words.
c. Interrupting periods of silence before they become awkward for the patient.
d. Telling the patient he did well when you approve of his statements or actions.
- James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for day shift and anxiously reports, “Last night, demons came to my room and tried to rape me.” Which response would be most therapeutic?
a. “There are no such things as demons. What you saw were hallucinations.”
b. “It is not possible for anyone to enter your room at night. You are safe here.”
c. “You seem very upset. Please tell me more about what you experienced last night.”
d. “That must have been very frightening, but we‟ll check on you at night and you‟ll be safe.”
- Therapeutic communication is the foundation of a patient- centered interview. Which of the following techniques is not considered therapeutic?
a. Restating
b. Encouraging description of perception
c. Summarizing
d. Asking “why” questions
- Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the patient states, “I don‟t need to come see you anymore. I have found a therapy app on my phone that I love.” How should Carolina respond to this news?
a. “That sounds exciting, would you be willing to visit and show me the app?”
b. “At this time, there is no real evidence that the app can replace our therapy.”
c. “I am not sure that is a good idea right now, we are so close to progress.”
d. “Why would you think that is a better option than meeting with me?”
- Which statement demonstrates a well-structured attempt at limit setting?
a. “Hitting me when you are angry is unacceptable.”
b. “I expect you to behave yourself during dinner.”
c. “Come here, right now!”
d. “Good boys don‟t bite.”
- Which activity is most appropriate for a child with ADHD?
a. Reading an adventure novel
b. Monopoly
c. Checkers
d. Tennis
- Cognitive-behavioral therapy is going well when a 12-year- old patient in therapy reports to the nurse practitioner:
a. “I was so mad I wanted to hit my mother.”
b. “I thought that everyone at school hated me. That‟s not true. Most people like me and I have a friend named Todd.”
c. “I forgot that you told me to breathe when I become angry.”
d. “I scream as loud as I can when the train goes by the house.”
- What assessment question should the nurse ask when attempting to determine a teenager‟s mental health resilience? Select all that apply.
a. “How did you cope when your father deployed with the Army for a year in Iraq?”
b. “Who did you go to for advice while your father was away for a year in Iraq?”
c. “How do you feel about talking to a mental health counselor?”
d. “Where do you see yourself in 10 years?”
e. “Do you like the school you go to?”
c. April enjoys time-out, and acts out to get some alone time.
d. Time-out will need to be replaced with seclusion and restraint.
- Adolescents often display fluctuations in mood along with undeveloped emotional regulation and poor tolerance for frustration. Emotional and behavioral control usually increases over the course of adolescence due to:
a. Limited executive function
b. Cerebellum maturation
c. Cerebral stasis and hormonal changes
d. A slight reduction in brain volume
- Which characteristic in an adolescent female is sometimes associated with the prodromal phase of schizophrenia?
a. Always afraid another student will steal her belongings.
b. An unusual interest in numbers and specific topics.
c. Demonstrates no interest in athletics or organized sports.
d. Appears more comfortable among males.
- Which nursing intervention is particularly well chosen for addressing a population at high risk for developing schizophrenia?
a. Screening a group of males between the ages of 15 and 25 for early symptoms.
b. Forming a support group for females aged 25 to 35 who are diagnosed with substance use issues.
c. Providing a group for patients between the ages of 45 and 55 with information on coping skills that have proven to be effective.
d. Educating the parents of a group of developmentally delayed 5- to 6-year-olds on the importance of early intervention.
- To provide effective care for the patient diagnosed with schizophrenia, the nurse should frequently assess for which associated condition? Select all that apply.
a. Alcohol use disorder
b. Major depressive disorder
c. Stomach cancer
d. Polydipsia
e. Metabolic syndrome
- A female patient diagnosed with schizophrenia has been prescribed a first-generation antipsychotic medication. What information should the nurse provide to the patient regarding her signs and symptoms?
a. Her memory problems will likely decrease.
b. Depressive episodes should be less severe.
c. She will probably enjoy social interactions more.
d. She should experience a reduction in hallucinations.
- Which characteristic presents the greatest risk for injury to others by the patient diagnosed with schizophrenia?
a. Depersonalization
b. Pressured speech
c. Negative symptoms
d. Paranoia
- Gilbert, age 19, is described by his parents as a “moody child” with an onset of odd behavior about at age 14, which caused Gilbert to suffer academically and socially. Gilbert has lost the ability to complete household chores, is reluctant to leave the house, and is obsessed with the locks on the windows and doors. Due to Gilbert‟s early and slow onset of what is now recognized as schizophrenia, his prognosis is considered:
a. Favorable with medication
b. In the relapse stage
c. Improvable with psychosocial interventions
d. To have a less positive outcome
d. The ability to express his needs.
- Which nursing response demonstrates accurate information that should be discussed with the female patient diagnosed with bipolar and her support system? Select all that apply.
a. “Remember that alcohol and caffeine can trigger a relapse of your symptoms.”
b. “Due to the risk of a manic episode, antidepressant therapy is never used with bipolar disorder.
c. “It‟s critical to let your healthcare provider know immediately if you aren‟t sleeping well.”
d. “Is your family prepared to be actively involved in helping manage this disorder?”
e. “The symptoms tend to come and go and so you need to be able to recognize the early signs.”
- Which statement made by the patient demonstrates an understanding of the effective use of newly prescribed lithium to manage bipolar mania? Select all that apply.
a. “I have to keep reminding myself to consistently drink six 12 - ounce glasses of fluid every day.”
b. “I discussed the diuretic my cardiologist prescribed with my psychiatric care provider.”
c. “Lithium may help me lose the few extra pounds I tend to carry around.”
d. “I take my lithium on an empty stomach to help with absorption.”
e. “I‟ve already made arrangements for my monthly lab work.”
- The nurse is providing medication education to a patient who has been prescribed lithium to stabilize mood. Which early signs and symptoms of toxicity should the nurse stress to the patient? Select all that apply.
a. Increased attentiveness
b. Getting up at night to urinate
c. Improved vision
d. An upset stomach for no apparent reason
e. Shaky hands that make holding a cup difficult
- A male patient calls to tell the nurse that his monthly lithium level is 1.7 mEq/L. Which nursing intervention will the nurse implement initially?
a. Reinforce that the level is considered therapeutic.
b. Instruct the patient to hold the next dose of medication and contact the prescriber.
c. Have the patient go to the hospital emergency room immediately.
d. Alert the patient to the possibility of seizures and appropriate precautions.
- Which intervention should the nurse implement when caring for a patient demonstrating manic behavior? Select all that apply.
a. Monitor the patient‟s vital signs frequently.
b. Keep the patient distracted with group-oriented activities.
c. Provide the patient with frequent milkshakes and protein drinks.
d. Reduce the volume on the television and dim bright lights in the environment.
e. Use a firm but calm voice to give specific concise directions to the patient.
- Substance abuse is often present in people diagnosed with bipolar disorder. Laura, a 28-year- old with a diagnosis of bipolar disorder, drinks alcohol instead of taking her prescribed medications. The nurse caring for this patient recognizes that:
a. Anxiety may be present.
b. Alcohol ingestion is a form of self-medication.
c. The patient is lacking a sufficient number of neurotransmitters.
d. The patient is using alcohol because she is depressed.
- Ted, a former executive, is now unemployed due to manic episodes at work. He was diagnosed with bipolar I 8 years ago. Ted has a history of IV drug abuse, which resulted in hepatitis C. He is taking his lithium exactly as scheduled, a fact that both Ted‟s wife and his blood tests confirm. To reduce Ted‟s mania the psychiatric nurse practitioner recommends:
a. Clonazepam (Klonopin)
b. Fluoxetine (Prozac)
c. Electroconvulsive therapy (ECT)
d. Lurasidone (Latuda)
d. “I go to sleep around 11 p.m. but I‟m always up by 3 a.m. and can‟t go back to sleep.”
- Which assessment question asked by the nurse demonstrates an understanding of comorbid mental health conditions associated with major depressive disorder? Select all that apply.
a. “Do rules apply to you?”
b. “What do you do to manage anxiety?”
c. “Do you have a history of disordered eating?”
d. “Do you think that you drink too much?”
e. “Have you ever been arrested for committing a crime?”
- Which nursing intervention focuses on managing a common characteristic of major depressive disorder associated with the older population?
a. Conducting routine suicide screenings at a senior center.
b. Identifying depression as a natural, but treatable result of aging.
c. Identifying males as being at a greater risk for developing depression.
d. Stressing that most individuals experience just a single episode of major depression in a lifetime.
- Which characteristic identified during an assessment serves to support a diagnosis of disruptive mood dysregulation disorder? Select all that apply.
a. Female
b. 7 years old
c. Comorbid autism diagnosis
d. Outbursts occur at least once a week
e. Temper tantrums occur at home and in school
- Which chronic medical condition is a common trigger for major depressive disorder?
a. Pain
b. Hypertension
c. Hypothyroidism
d. Crohn‟s disease
- Tammy, a 28-year-old with major depressive disorder and bulimia nervosa, is ready for discharge from the county hospital after 2 weeks of inpatient therapy. Tammy is taking citalopram (Celexa) and reports that it has made her feel more hopeful. With a secondary diagnosis of bulimia nervosa, what is an alternative antidepressant to consider?
a. Fluoxetine (Prozac)
b. Isocarboxazid (Marplan)
c. Amitriptyline
d. Duloxetine (Cymbalta)
- Cabot has multiple symptoms of depression including mood reactivity, social phobia, anxiety, and overeating. With a history of mild hypertension, which classification of antidepressants dispensed as a transdermal patch would be a safe medication?
a. Tricyclic antidepressants
b. Selective serotonin reuptake inhibitors
c. Serotonin and norepinephrine reuptake inhibitors
d. Monoamine oxidase inhibitor
- When a nurse uses therapeutic communication with a withdrawn patient who has major depression, an effective method of managing the silence is to:
a. Meditate in the quiet environment
b. Ask simple questions even if the patient will not answer
c. Use the technique of making observations
d. Simply sit quietly and leave when the patient falls asleep
- The biological approach to treating depression with electrodes surgically implanted into specific areas of the brain to stimulate the regions identified to be underactive in depression is:
a. Transcranial magnetic stimulation
a. Has no memory of the physical abuse he endured.
b. Using both alcohol and marijuana.
c. Often reports being unaware of surroundings.
d. Reports feelings of “not really being here.”
- Which statement accurately describes the effects of emotional trauma on the individual physically?
a. Emotional trauma is a distinct category and unrelated to physical problems
b. The physical manifestations of emotional trauma are usually temporary
c. Emotional trauma is often manifested as physical symptoms
d. Patients are more aware of the physical problems caused by trauma
- The school nurse has been alerted to the fact that an 8-year-old boy routinely playacts as a police officer “locking up” other children on the playground to the point where the children get scared. The nurse recognizes that this behavior is most likely an indication of:
a. The need to dominate others
b. Inventing traumatic events
c. A need to develop close relationships
d. A potential symptom of traumatization
- A pregnant woman is in a relationship with a male who routinely abuses her. Her unborn child may engage in high-risk behavior as a teen as a result of:
a. Maternal stress
b. Parental nurturing
c. Appropriate stress responses in the brain
d. Memories of the abuse
- Maggie, a child in protective custody, is found to have an imaginary friend, Holly. Her foster family shares this information with the nurse. The nurse teaches the family members about
children who have suffered trauma and knows her teaching was effective when the foster mother states:
a. “I understand that imaginary friends are abnormal.”
b. “I understand that imaginary friends are a maladaptive behavior.”
c. “I understand that imaginary friends are a coping mechanism.”
d. “I understand that we should tell the child that imaginary friends are unacceptable.”
- An incest survivor undergoing treatment at the mental health clinic is relieved when she learns that her anxiety and depression are:
a. Going to be eradicated with treatment
b. Normal and will soon pass
c. Abnormal but will pass
d. A normal reaction to posttraumatic events
- During a routine health screening, a grieving widow whose husband died 15 months ago reports emptiness, a loss of self, difficulty thinking of the future, and anger at her dead husband. The nurse suggests bereavement counseling. The widow is most likely suffering from:
a. Major depression
b. Normal grieving
c. Adjustment disorder
d. Posttraumatic stress disorder
- A young child is found wandering alone at a mall. A male store employee approaches and asks where her parents are. She responds, “I don‟t know. Maybe you will take me home with you?” This sort of response in children may be due to:
a. A lack of bonding as an infant
b. A healthy confidence in the child
c. Adequate parental bonding
d. Normal parenting
