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Psychiatric Nursing Practice Questions
1. A patient smiles broadly at the nurse and says, "Look at my clean teeth. I brushed
them with scouring power because the label said, 'It brightens and whitens everything.'" Which term should the nurse include when documenting this encounter?
a. Circumstantiality
b. Concrete thinking
c. Poverty of speech
d. Associative looseness: Concrete Thinking
2. A patient diagnosed with schizophrenia says, "I hear the voices every day.
They always say bad things about me." Which action by the nurse has the highest priority?
a. Assess the patient for suicidal thinking and plans.
b. Review the patient's medication regime and compliance.
c. Educate the patient about symptoms associated with schizophrenia.
d. Suggest distracters for the patient to use when auditory hallucinations occur.:
Assess the patient for suicidal thinking and plans.
3. Three days after beginning a new regime of haloperidol (Haldol) 10 mg BID, the
nurse observes that a hospitalized patient is drooling, has stiff and extended extremities, and has skin that is damp and hot to the touch. The patient has difficulty responding verbally to the nurse. What is the nurse's correct analysis and action in this situation?
a. A seizure is occurring; place the patient in a lateral recumbent position and monitor.
b. Serotonin syndrome has developed; place an intravenous line and rapidly infuse D
5 ½ NS.
c. Neuroleptic malignant syndrome has developed; prepare the patient for
immediate transfer to a medical unit.
d. An acute dystonic reaction is occurring; promptly administer an intramus- cular
injection of diphenhydramine (Benadryl).: Neuroleptic malignant syndrome has developed; prepare the patient for immediate transfer to a medical unit.
4. A patient diagnosed with schizophrenia complains to the nurse about per- sistent
feelings of restlessness and says, "I feel like I need to move all the time." What is the nurse's next action?
a. Educate the patient about the low odds of winning the lottery.
b. Present reality by saying to the patient, "That is not good use of your money."
c. Confer with the treatment team about appointing a legal guardian for the patient.
d. Tell the patient, "If you buy lottery tickets, your money will run out before the end
of the month.": Confer with the treatment team about appointing a legal guardian for the patient.
7. Which comment by a patient diagnosed with bipolar disorder best indicates the
patient is experiencing mania?
a. "I have been sleeping about 6 hours each night."
b. "Yesterday I made 487 posts on my social network page."
c. "I am having dreams about my father's death 8 years ago."
d. "My appetite is so robust that I've gained 4 pounds in the past 2 weeks.": -
"Yesterday I made 487 posts on my social network page."
8. A community mental health nurse counsels a group of patients about the
upcoming flu season. What instruction does the nurse provide for patients who are prescribed lithium?
a. "Stop taking your medicine and contact me if you have nausea, vomiting, and/or
diarrhea."
b. "Remember that lithium reduces your immunity, so you are more vulnerable to
catching the flu."
c. "The flu is contagious. Isolate yourself if you get the flu so that you avoid exposing
others to it."
d. "Because you take lithium, you may have flu symptoms that are not typically
experienced by others.": "Stop taking your medicine and contact me if you have nausea, vomiting, and/or diarrhea."
9. A patient was diagnosed with bipolar disorder many years ago. The patient tells the
nurse, "When I have a manic episode, there's always a feeling of gloom behind it and I know I will soon be totally depressed." What is the nurse's best response?
a. "Most patients diagnosed with bipolar disorder report the same types of feelings."
b. "Feelings of gloom associated with depression result from serotonin dys-
regulation."
c. "If you take your medication as it is prescribed, you will not have those
experiences."
d. "Your comment indicates you have an understanding and insight about your
disorder.": "Your comment indicates you have an understanding and insight about your disorder."
10. A patient diagnosed with bipolar disorder lives in the community and is showing
d. Female gender coupled with the stressful profession of teaching: Family history
of mental illness coupled with history of abuse
12. A patient tells the nurse, "No matter what I do, I feel like there's always a dark
cloud following me." Select the nurse's initial action.
a. Assess the patient's current sleep and eating patterns.
b. Explain to the patient, "Everyone feels down from time to time."
c. Suggest alternative activities for times when the patient feels depressed.
d. Say to the patient, "Tell me more about what you mean by 'a dark cloud'."-
: Say to the patient, "Tell me more about what you mean by 'a dark cloud'."
13. A patient experiencing depression says to the nurse, "My health care provider
said I need 'talk' therapy but I think I need a prescription for an antidepressant medication. What should I do?" Select the nurse's best response.
a. "Which antidepressant medication do you think would be helpful?"
b. "There are different types of talk therapy. Most patients find it beneficial."
c. "Let's consider some ways to address your concerns with your health care
provider."
d. "Are you willing to give 'talk therapy' a try before starting an antidepressant
medication?": "Let's consider some ways to address your concerns with your health care provider."
14. The nurse cares for a hospitalized adolescent diagnosed with major de- pressive
disorder. The health care provider prescribes a low-dose antidepressant. In consideration of published warnings about use of antidepressant medications in younger patients, which action should the nurse employ?
a. Notify the facility's patient advocate about the new prescription.
b.Teach the adolescent about Black Box warnings associated with antidepres- sant
medications.
c. Monitor the adolescent closely for evidence of adverse effects, particularly suicidal
thinking or behavior.
d. Remind the health care provider about warnings associated with the use of
antidepressants in children and adolescents.: Monitor the adolescent closely for evidence of adverse effects, particularly suicidal thinking or behavior.
15. Over the past 2 months a patient made eight suicide attempts with increasing
lethality. The health care provider informs the patient and family that electroconvulsive therapy (ECT) is needed. The family whispers
c. Passive aggression
d. Reaction formation: Rationalization
17. A nurse analyzes reports from four adult patients of frightening events they
encountered. Which patient's report most clearly indicates that the resulting fear was mentally healthy?
a. "I saw a large spider crawling along my kitchen wall."
b. "I was at the mall when a gunman began firing an assault weapon."
c. "I was at home when a storm with heavy thunder and lightning lasted over an hour."
d. "I was trapped on an elevator that stopped between floors when the power went
out.": "I was at home when a storm with heavy thunder and lightning lasted over an hour."
18. A nursing student arrives late for a clinical experience and is not wearing the
correct attire. When the instructor privately criticizes the behavior, the student responds, "I'm always the one who gets caught. You're going to cause me to fail." Select the instructor's best response.
a. "Other students get caught as well."
b. "I am not trying to cause you to fail. I am here to help you."
c. "I am sorry you feel that way. I try to treat all my students equally."
d. "The requirements for this experience were discussed during our orienta- tion.":
"The requirements for this experience were discussed during our orienta- tion."
19. Select the best example of altruism.
a. After recovering from a gunshot wound, a police officer attends a local support
group.
b. After recovering from open heart surgery, an individual plays tennis three times a
week.
d. Depersonalization: Eustress
22. A college student has been experiencing significant stress associated with
academic demands. Last month, the student began attending yoga sessions three times a week. Which outcome indicates this activity has been success- ful?
a. The student reports improved feelings of well-being.
b. The student increases use of caffeine to enhance concentration.
c. The student reports, "Now I am sleeping about 10 hours every day."
d. The student says, "I withdrew from two courses to reduce my academic load.":
The student reports improved feelings of well-being
23. An adult required a heart transplant 5 years ago. Multiple medical compli- cations
followed, resulting in persistent irritability, depression, and insomnia. The adult's spouse says, "I've walked on eggshells for five years, never knowing when something else will go wrong." What is the nurse's priority intervention regarding the spouse?
a. Explore the spouse's feelings, showing care and compassion.
b. Encourage the spouse to attend a community support group.
c. Teach stress reduction and relaxation techniques to the spouse.
d. Refer the spouse to the primary care provider for health assessment.: Refer the
spouse to the primary care provider for health assessment.
24. A veteran of the war in Afghanistan tells the nurse, "Everyday, something happens
that makes me feel like I'm still there. My family has grown impatient with me. They say
it's time for me to move on from that time in my life but I can't." What is the nurse's first priority?
a. Assess the veteran for suicide risk.
b. Refer the veteran for specialized mental health services.
c. Assess the veteran for evidence of traumatic brain injury.
d. Refer the veteran's family to a posttraumatic stress disorder group.: Assess the
veteran for suicide risk.
25. An individual lives in a community adjacent to a military base. Loud jets fly
overhead multiple times daily. The person tells the nurse, "They're so loud I can't hear myself think." What is the nurse's best first action?
a. Direct the individual to report the jet noise to local authorities.
b. Teach relaxation and stress reduction techniques to the individual. 129
c. Assess the individual for sensory impairments, particularly auditory.
d. Encourage the individual to form a community action group to oppose noise
pollution.: d. Encourage the individual to form a community action group to oppose noise pollution.
26. A young adult has heavily abused alcohol and prescription drugs since mid-
adolescence. This individual now has an ataxic gait and uses a cane. Which comment by the nurse presents reality while demonstrating compas- sion?
a. "I know you must feel self-conscious about using a cane at your age, but it will help
taken it daily for 3 years for episodes of anxiety
28. A patient tells the nurse, "After many years, I finally quit smoking. Now I use e-
cigarettes only." Which response should the nurse provide?
a. "Using e-cigarettes is now more socially acceptable than using traditional
cigarettes."
b. "Congratulations on quitting, but e-cigarettes contain nicotine and other
hazardous chemicals."
c. "Nicotine is a powerful addiction. Quitting smoking is a big step toward adopting
a healthier lifestyle."
d. "I am glad you have quit smoking. Your loved ones will no longer be exposed to
the hazards of secondhand smoke.": "Congratulations on quitting, but e-cigarettes contain nicotine and other hazardous chemicals."
29. A young adult tells the nurse, "I have a new prescription for medical marijuana. I
use it several times a day for my frequent muscle spasms." What information should the nurse provide first to this patient?
a. Guidance that the prescription should not be shared with peers
b. Directions to weigh self once a week and maintain a log of the results
c. Instructions about safety issues associated with driving or operating ma- chinery
d. Information about the potential for a motivational syndrome and memory
problems: Instructions about safety issues associated with driving or operating machinery
30. A nurse teaches a patient diagnosed with an alcohol addiction about a new
prescription for naltrexone (ReVia, Vivitrol). Which comment by the patient indicates the teaching was effective?
a. "This medicine will stop my cravings for alcohol."
b. "I should take this medication only when I feel cravings to drink alcohol."
c. "This medicine is one part of a bigger treatment plan to help me stay sober."
d. "I should not use products that contain alcohol, such as cough medicine and
aftershave lotion.": "This medicine is one part of a bigger treatment plan to help me stay sober."
31. A parent tells the nurse about the death of a child 2 years ago. Which
comment by this parent warrants the nurse's priority attention?
a. "I still have some of my child's toys and clothes."
b. "A parent should never live longer than their child."
c. "I never returned to church again after the death of my child."
d. "My child has been dead a long time, but it seems like only yesterday.": "A parent
should never live longer than their child."
32. A patient diagnosed with major depressive disorder was hospitalized for 2 weeks
33. On the sixth anniversary of her spouse's death a widow says, "Sometimes life does
not seem worth living anymore. I wish I could go to sleep and never wake up." Which response by the nurse has priority?
a. "Are you considering suicide?"
b. "You still have so much to live for."
c. "Grief can sometimes last for many years."
d. "Why do you continue to grieve something from long ago?": "Are you
considering suicide?"
34. A patient who had a stroke 3 days ago tearfully tells the nurse, "What's the use in
living? I'm no good to anybody like this." Which action should the nurse employ first when caring for a patient demonstrating hopelessness?
a. Implement the institutional protocol for suicide risk.
b. Support the patient to clarify and express feelings of grief.
c. Educate the patient about the success of stroke rehabilitation.
d. Offer the patient an opportunity to confer with the pastoral counselor.: Im- plement
the institutional protocol for suicide risk.
35. A single adult says to the nurse, "Both of my parents died several years ago and
my only sibling committed suicide 2 weeks ago. I feel so alone." After determining that
the adult has no suicidal ideation, the nurse should:
a. Explore the adult's feelings of survivor's guilt.
b. Assess the adult's cultural beliefs and spirituality.
c. Refer the adult for cognitive behavioral therapy (CBT).
d. Refer the adult to a self-help group for suicide survivors.: Refer the adult to a self-
help group for suicide survivors.
36. An adult experiencing a recent exacerbation of ulcerative colitis tells the nurse, "I
had an accident while I was at the grocery store. It was so embar- rassing." Select the nurse's therapeutic response.
a. "Most grocery stores have public restrooms available."
b. "Tell me more about how you felt when that happened."
c. "People usually have compassion about those types of events."
d. "Your disease is now in remission so that is not likely to happen again.": -
"Most grocery stores have public restrooms available."
37. A nurse counsels a widow whose husband died 5 years ago. The widow says, "If I'd
done more, he would still be alive." Select the nurse's therapeutic response.
a. "I understand how you feel after such a terrible loss."
b. "That was a long time ago. Now it's time to move on with your life."
c. "You did a very good job of caring for him, especially since he was sick so long."
