NP5 - PSYCHIATRIC NURSING

1. Maintaining a therapeutic environment and promoting growth through role modeling are components
of which basic level function?
Milieu therapy
2. A client is experiencing hallucinations and delusions. The nurse would expect the physician to order
which classification of medication?
Antipsychotic
3. Lithium was one of the first psychotropic drugs developed. Lithium is in which of the following
medication classifications?
Mood stabilizer
4. What neurological activity associated by the serotonin?
Mood
5. What lobe of the brain affected by schizophrenia?
Frontal
6. A client is receiving clozapine. For which life-threatening disorder should the nurse be alert
when assessing this client?
Agranulocytosis
7. Antipsychotics function by blocking receptors of which neurotransmitter?
dopamine
8. A client is seen in an outpatient mental health clinic for complaints of involuntary tongue movement,
blinking, and facial grimacing. This syndrome would be identified correctly as what?
Tardive dyskinesia
9. Benzodiazepines increase which neurotransmitter function?
GABA
10. A client diagnosed with myasthenia gravis has a decrease in which receptor.
Acetylcholine
11. Which antidepressant classifiable is lethal in overdose.
Phenelzine
12. Which is an inaccurate depiction of selfawareness
It involves changing one's values or beliefs.
13. Which is a difference between counseling and psychotherapy?
Generalist psychiatric nurses may perform counseling interventions, but psychotherapy is
an advanced practice role.
14. Initially, the nurse should focus on successfully achieving which goal in order to effectively provide
care for a client diagnosed with a mental illness?
Establishing trust and rapport with the client
15. A client is receiving clozapine. For which life-threatening disorder should the nurse be alert
when assessing this client?
Agranulocytosis
16. A patient who will undergo MRI
client with pacemaker
17. The mental health nurse instructs a client prescribed phenelzine to avoid aged foods, such as wine
and cheese. For which reasons are these instructions important for client safety?
The foods contain tyramine, which may provoke hypertensive crisis.
18. Which term is used to describe the amount of the drug needed to achieve the maximum effect?
 Potency
19. When haloperidol is given as a depot injection, it has an effectiveness of which duration?
4 weeks
20. ----
21. Which medication classification blocks serotonin reuptake?
antidepressant

22. It is the nurse's responsibility to define the boundaries of the relationship during which phase of
the nurse-client relationship?
orientation phase
23. The spouse of a client with borderline personality disorder calls the clinic and reports that the client
has self-inflicted superficial lacerations to the arm. The spouse tells the nurse, "When I prepare to
travel for work, my spouse does this to stop me from leaving. It's not an attempt of serious harm."
What is the best response by the nurse?
Your spouse should be seen in the clinic today

24. What should the nurse avoid when demonstrating genuine interest for a client by making a
self- disclosure?
shifting the emphasis to the nurse
25. Which nursing intervention demonstrates congruence in a therapeutic nurse-client relationship?
getting an appointment with the client at the time previously agreed upon
26. What occurs during the working phase of the nurse-client relationship?

a)The client and nurse identify goals of the relationship.

b) The client identifies the goals accomplished in the relationship.
c)The client participates actively in the relationship.
d)The client genuinely expresses concerns to the nurse.
e)The client describes the role that the nurse plays in the relationship.

27. A nurse has approached a new client on the psychiatric care unit in order to establish a
therapeutic relationship and conduct a focused assessment. As the nurse approaches the
client, the client says, "Oh good.Here comes one more person to tell me that I'm crazy." Which
of the nurse's following responses would constitute countertransference?
"There's no need to get rude with me. I'm just trying to do my job and to help you out."

28. A nursing instructor is describing the nurse-client relationship to a group of nursing students.
Which would the instructor emphasize as most important to establishing and maintaining the
relationship? self-awareness
29. Which statement would indicate that the nurse has a non-judgmental attitude?
"The client has struggled with her life circumstance of living with a man who beats her,
and she is trying very hard to make the changes necessary to help herself."
30. A nurse is providing teaching for a client who is scheduled to receive electroconvulsive therapy
(ECT) for the treatment of major depressive disorder. Which of the following client statements
indicates understanding of the teaching?
"I will receive a muscle relaxant to protect me from injury during ECT."
31. Which statement by the nurse is an example of assertive communication?
"I understand that group can be difficult to attend but coming late is disruptive". Allysa
 Allysa Eliw
32. Which question should be avoided because it may be perceived as criticism by the client?
why?
33. ------
34. Which statement made by the client demonstrates hardiness when faced with a health issue?
"What do I need to do to manage this illness?"
35. Which statement by the client best demonstrates a healthy relationship with family?
"I feel better after I visit with my Mom."
36. Which type of affect is represented by showing no facial expression?
Flat
37. A nurse is interviewing a client who is a survivor of abuse. The client is telling the nurse about
how the violence occurred. Which statement would the nurse interpret as reflecting phase 2 of
the cycle of violence?
"He threw me against the wall and started punching my face."

A nurse is interviewing a client who is a survivor of abuse. The client is telling the nurse
about how the violence occurred. Which statement would the nurse interpret as reflecting
phase 3 of the cycle of violence?

d) "He tells me that he is sorry and that he will never hit me again."

38. A person brings a parent to the clinic and tells the nurse that the parent has begun to act
strangely in the past few days, with unprovoked outbursts of anger. After the incidents, the
parent expresses remorse for the outburst. The person says, "I've never seen my parent act this
way." Which question would be most appropriate for the nurse to ask next?
"Has your parent suffered any traumatic injury to the brain recently?"
39. -----
40. An adult client is pacing and yelling. What is the best response by the nurse?
When did this feelings begin?
41. A client diagnosed with schizophrenia has been prescribed clozapine. Which is a potentially
fatal side effect of this medication?
agranulocytosis
27. A client has been taking neuroleptic medications for many years as a treatment for
schizophrenia. The client is exhibiting tongue protrusion, facial grimacing, and excessive
blinking. These manifestations are characteristic of which extrapyramidal side effects (EPS)?
Tardive dyskinesia
28. Which medication classification has been most effective in treating akathisia?
Beta-blocker
29. Which speech patterns is exhibited by the client stating, " I will take a pill if i go up the hill but
not if my name is jill, I dont want to kil"?
Clang association
30. How often must client receiving clozapine get white blood cell counts drawn?
Every week for the first 6 months
31. A client is watching the news and tells the nurse that the newscaster is sending a message to
the client. What term is used to identify this symptom?
Idea of reference
32. The nurse is assessing a patient who is complaining of hearing voices. What is this patient
experiencing?
Hallucinations
 33. A client diagnosed with schizoaffective disorder with severe depression is being treated with
antipsychotic medications. The client tells the nurse about difficulty with self-care activities.
Which nursing intervention would be the most important for this client? The nurse should help
the client to:
Establish routine and set goals
34. Which type of communication used when the patient imitates or repeat the nurse saying
Echolalia
35. A client tells the nurse that the client has bugs in the client's brain and asks the nurse if the
nurse can see them. Which response by the nurse is most therapeutic?
"No, I don't see any bugs. You seriously can't have any bugs in your brain."
36. Which of the following would be an appropriate intervention of a client experiencing an anxiety
attack?
Staying with the client and speaking in short sentences
37. Which statement, made by a client diagnosed with an anxiety disorder, should trigger the
nurse's concern about the client's understanding of the use of defense mechanisms?
"When I have a problem, I just deny it until it goes away."
38. The nurse is assessing a client who recently experienced their first panic attack while at the
grocery store. What question should the nurse ask to identify complications of the disorder?
"Do you have any problems going out alone to public places?"
39. Which term describes feelings of being disconnected from oneself as seen in a panic attack?
Depersonalization
40. Which medication classification has been found out to be effective in reducing or
eliminating panic attacks?
Antidepressants
41. A nurse is caring for a client with delirium. The client sees a thermometer in the nurses table and
shout “don’t stab me”.
Illusion
42. What is the best benefit support groups provide to the caregivers of patients with
dementia?
They help connect groups of people who have similar experiences and challenges
43. Which is the primary treatment for delirium?
Identify and treat any causal or contributing medical conditions
44. Which type of hallucination most commonly occurs in clients diagnosed with dementia?
Visual
45. Which of the following medication is not known to cause delirium?
Loop Diuretics

46. A client comes to the emergency department reporting severe pounding headache in temples
and a stiff neck. The client is flushed and diaphoretic. The client states that the client is treated
for depression with an MAOI. Which question by the nurse would be the most important to ask
this time?
What have you had to eat or drink today?
47. Which characterestics is most common among suicidal clients?
Ambivalence
48. Which psychiatric disorder is at high risk for suicide?
Schizoprenia
49. A 42 year old client with major depression is in an inpatient psychiatric hospital. The client has
been taking phenelzine, a monoamine oxidase inhibitor (MAOI), for depression. The therapist
 writes an order to discontinue the phenelzine and begin fluoxetine. Which action by the nurse is
indicated?
Call the therapist to discuss the need for washout period before staring fluoxetine.
50. -----
51. ------
67. The nurse knows that the most dangerous time period following a previous suicide attempt is
what?
First 3 months
68. In a therapy session, a client with a diagnosis of major depression admits to the nurse-therapist, "I
actually went out driving on the interstate this morning and had every intention of getting up to speed
and plowing right into the overpass by my exit. Maybe tomorrow." The nurse would recognize the
client's statement as what?
Suicidal intent
69. Limit setting is most appropriate in which patient population?
Manic
70. When teaching a group of new mental health nurses about the major difference between bipolar I
and bipolar II disorders, which would be most appropriate for the nurse to include?
The mania symptoms of bipolar II disorder have little effect on functioning.
71. what is the common personality disorder in the clinical setting.
Borderline Personality
72. ----
73. Which of the following occurs when a client tends to adore and idealize other people even after a
brief acquaintance but then quickly leaves them if these others do not meet the client's expectations
in some way?
Splitting
74. Which personality disorder is characterized by a pervasive pattern of grandiosity, need for
admiration, and lack of empathy?
Narcissistic
75. A client with paranoid personality disorder is admitted to a psychiatric facility. Which remark by the
nurse would best establish rapport and encourage the client to confide in the nurse?
"I get upset once in a while, too."
76. Which is a dental complication associated with purging?
Erosion of dental enamel
77. A severely dehydrated teenager admitted to the hospital with hypotension and tachycardia
undergoes evaluation for electrolyte disturbances. The client's history includes anorexia nervosa
and a 15-pound weight loss in the last month. The client is 5 feet 5 inches tall and weighs 75
pounds. Which is the priority nursing intervention?
Initiating total parenteral nutrition as ordered
78. Following a series of visits to the primary care provider and the hospital, a 22-year-old retail clerk
has been diagnosed with anorexia nervosa. Which of the client's statements demonstrates an
accurate understanding of the diagnosis?
"I guess it's probably safe to say that anorexia runs in my family."

79. A client with anorexia nervosa self describes as "a whale". However, the nurses assessment reveals
that the client is 5 feet 8 inches tall and weighs only 90 pounds. Considering the client's unrealistic
body, what intervention should be included in the care plan?
Telling the client of the nurse's concern for the client's health and desire to help the client
make decisions to keep the client healthy
80. A client with anorexia nervosa self-describes as a "whale" However, the nurses assessment reveals
 that the client is 5 feet 8 inches tall and only weighs 90 pounds. The nurse identifies this as reflecting
what?
Body imagine disturbance
81. Which of the following areas of the brain has been associated with the symptoms of eating disorders?
Hypothalamus

82. Which is a typical characteristic of parents of clients diagnosed with anorexia nervosa?
Overprotective of their children
83. For clients who purge, what is the most important goal?
Stop the behavior
84. Which is a metabolic complication related to weight loss?
Hypothyroidism
85. Which medication classification has been shown to be effective in some cases of somatoform
disorder?
SSRI
86. The la belle indifference occurs in which somatoform disorder?
Conversion Disorder
87. ------
88. The major difference of somatoform disorder and factitious disorders is what?
In somatoform disorder, client are not consciously aware that they are meeting needs
through physical complain
89. A client is admitted to the hospital and was unable to move the clients right arm. The client
diagnosis is conversion reaction. Which is the consequence of the condition would be an example of
primary gain? Relief from anxiety
90. The primary factor of differentiation of somatization disorder and conversion disorder os what?
Somatization disorder affects multiple organ system, whereas conversion disorders usually
involve only one system
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92. The nurse on the mental health unit received report on 4 clients. Which client should the nurse
see FIRST?
Client diagnosed with post-traumatic stress disorder who reports an anxiety level of 8/10
and is pacing in the room

93. A client states, "I just don't know what to do about this situation with my parents," and the nurse
replies, "I'm sure you will do the right thing." Which summary is true regarding the nurse's response?
The response devalues the client's feelings and gives false reassurance
94. An elderly client with dementia frequency exhibits sundowning behavior while living in a community-
based residential facility. When the nurse finds the client wandering at night, which of the following
statements is most appropriate?
"It's time to get back to bed now."
95. A 10-year-old client with autism spectrum disorder is hospitalized for a diagnostic workup. Which is
the most appropriate nursing action?
Giving the client a schedule of daily activities
96. The nurse is caring for a client with schizophrenia who has been experiencing visual hallucinations.
The client says in a trembling voice,"There's a bad man standing over there in the corner of my
room." What is the BEST response by the nurse?
"I know you are frightened, but I do not see a man in your room."
97. The nurse is caring for a dying child on a palliative unit. Which statement by the nurse is most
 important to make to the parents immediately following the death of their child? - Some parents
like to cuddle and speak to the child.
Some parents like to cuddle and speak to the child. Take the time you need.Take the time
you need.
98. The nurse is caring for a new mother whose infant has been diagnosed with Down syndrome. The
client says to the nurse, "I'm so worried. My husband is so devastated that he won't even look at the
baby." What is the best response by the nurse?
"How are you feeling about your baby?"

99. -----
100. A nurse is caring for a client who was admitted following a suicide attempt. which client
statement is most concerning?
very soon everything will be much better

Add Ons:
 A nurse is providing teaching for a client who has a new prescription for clozapine (Clozaril).
Which of the following client statements indicates a need for further teaching?
“This medication will help prevent seizures."
 A client has been diagnosed with major depression and placed on amitriptyline. Which is a side
effect od amitriptyline
Orthostatic hypotension