Exam Review

A nurse is preparing discharge teaching for a patient starting lithium therapy for bipolar disorder. Which of the following instructions should the nurse include to ensure safe and effective use of lithium?
A)
"Avoid all physical activity to reduce the risk of dehydration."
B)
"You should stop the medication immediately if you experience increased thirst or frequent urination."
C)
"Maintain a consistent salt and fluid intake daily to help prevent hum toxicity"
D)
"You do not need regular blood tests once you feel better on the medication"
A psychiatric nurse is assigned to advocate for equitable access to mental health services for a diverse patient population in an underserved community. Several clients require specialized therapy, but limited resources restrict availability to only a few individuals. Which action by the nurse best reflects the principle of justice?
A)
Offering therapy only to clients who have insurance coverage to maximize resource efficiency.
B)
Allowing clients to self-select into therapy groups on a first-come, first-served basis.
C)
Prioritizing therapy for clients who demonstrate the highest motivation for treatment.
D)
Ensuring therapy resources are allocated fairly based on clinical need and without discrimination.
A psychiatric nurse is caring for a client with severe depression who refuses medication due to fear of side effects. The client expresses hopelessness but is not suicidal. The nurse believes that medication could significantly improve the client's condition. Which nursing action best demonstrates the principle of beneficence?
A)
Respect the client's decision and avoid discussing medication to maintain trust.
B)
Provide education about the benefits and risks of the medication.
C)
Insist that the client take the medication to prevent worsening of symptoms.
D)
Administer the medication covertly to ensure the client receives treatment.
A nurse is educating a patient who has been prescribed an MAOI for treatment-resistant depression. Which of the following side effects and precautions should the nurse emphasize during discharge teaching?
A)
"You may develop muscle rigidity and confusion, which are early signs of serotonin syndrome."
B)
"You must limit salt and potassium to prevent kidney damage while taking this medication."
C)
"Avoid foods high in tyramine, as they may cause a sudden dangerous increase in blood pressure."
D)
"You may experience weight gain and hypernatremia, so increase your fluid intake.

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Exam Review

A nurse is conducting a home visit for a client suspected of experiencing intimate partner violence. The client appears withdrawn, has multiple bruises in various stages of healing, and hesitates when asked about their relationship. The client explains, "He didn't mean to hurt me: it just gets worse sometimes." Which nursing action is most appropriate to promote the client's safety and autonomy?
A)
Advise the client to document all injuries and seek a restraining order.
B)
Encourage the client to immediately leave the relationship for their safety.
C)
Provide nonjudgmental support and educate the client about the cycle.
D)
Refer the client to couples counseling to address relationship issues.
A 29-year-old client with schizophrenia is brought to the emergency department by police after being found wandering into traffic while shouting about government surveillance. The client is disoriented, agitated, and refuses treatment, stating, "You're trying to poison me with your drugs. Based on legal and clinical criteria for involuntary psychiatric admission, which of the following best justifies the nurse's support for initiating involuntary commitment?
A)
The client has a history of noncompliance with medication and frequent psychiatric hospitalizations.
B)
The client refuses treatment and does not acknowledge their mental illness.
C)
The client's family reports erratic behavior and wants them admitted for evaluation.
D)
The client is a danger to self or others due to disorganized thinking and impaired judgment
A nurse is performing a neurological assessment on a patient who recently suffered an ischemic stroke affecting the occipital lobe. Which of the following findings would be most consistent with this area of brain injury?
A)
The patient exhibits impaired judgment and difficulty with impulse control.
B)
The patient has visual hallucinations and difficulty identifying visual stimuli.
C)
The patient is unable to maintain balance and shows a wide-based gait
D)
The patient is unable to understand spoken language and displays fluent but nonsensical speech.
A nurse is caring for a client with schizophrenia who has been receiving haloperidol for the past 10 days. The client becomes increasingly restless, frequently shifting in their chair, and states. "I feel like I need to keep moving, but I don't know why." Vitals are stable, and no distress is reported aside from the restlessness. Which of the following actions should the nurse take first?
A)
Reassure the client that this is a temporary side effect.
B)
Document the finding as an expected response to antipsychotic medication.
C)
Notify the provider and request a dose reduction of haloperidol.
D)
Administer the prescribed dose of diphenhydramine PRN

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Exam Review

A patient 38-year-old patient came back from the army and is experiencing signs and symptoms of PTSD. What findings are expected in a patient with posttraumatic stress disorder (PTSD)? (Select All that Apply.)
(SATA)
A)
Recurring nightmares
B)
Avoidance
C)
Hyperarousal
D)
Increased appetite
E)
Enhanced memory recall
F)
Decreased reflexes
G)
Euphoria and elation
A nurse is caring for a patient who recently began treatment with haloperidol. The patient suddenly develops a high fever, muscle rigidity, altered mental status, and sweating. Which of the following should the nurse suspect?
A)
Serotonin Syndrome
B)
Tardive Dyskinesia
C)
Neuroleptic Malignant Syndrome (NMS)
D)
Extrapyramidal Side Effects (EPS)
A client who recently lost their spouse exhibits signs of withdrawal, expresses feelings of hopelessness, and reports difficulty sleeping and eating. Which stage of grief is the client most likely experiencing, and what is the nurse's most appropriate intervention?
A)
Anger: encourage the client to express feelings toward family members.
B)
Denial: gently provide information to help the client acknowledge the loss.
C)
Acceptance: assist the client in planning for future goals and activities.
D)
Depression: offer empathetic support and assess for risk of self-harm.
A nurse is caring for a patient with schizophrenia who has been prescribed aripiprazole. Which statement best reflects the primary therapeutic action of this medication?
A)
"This medication works by completely blocking dopamine activity to eliminate hallucinations."
B)
This medication enhances dopamine release to improve motivation and energy."
C)
This drug balances dopamine activity."
D)
This medication works only on serotonin receptors to reduce depressive symptoms.”

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Exam Review

A client frequently expresses intense feelings of guilt and self-criticism after minor mistakes, striving for perfection and strict adherence to rules. According to Freud's psychoanalytic theory, which function of the superego best explains this behavior?
A)
it internalizes societal and parental standards to enforce moral judgments.
B)
It mediates between the demands of the id and the constraints of reality.
C)
It represses unconscious conflicts to reduce anxiety and protect the ego.
D)
It seeks immediate gratification of instinctual desires regardless of consequences.
A client in the emergency department following a motor vehicle crash is pacing, clenching their fists, and shouting. "I can't think! I don't know what to do!" The nurse observes that the client is unable to follow simple instructions, appears disoriented, and is hyperventilating. Which of the following nursing interventions is most appropriate for the client's current level of anxiety?
A)
Use open-ended questions to encourage the client to express their feelings.
B)
Encourage the client to identify and explore the source of their anxiety.
C)
Provide concise, direct instructions in a calm, firm voice.
D)
Offer educational materials about coping mechanisms for stress
A psychiatric nurse is involved in the care of a client who attempted self-harm after a missed suicide risk assessment. The client's family is considering a malpractice lawsuit. Which of the following elements must the family prove to establish malpractice against the nurse? (Select all that apply.)
A)
The nurse owed a duty of care to the client.
B)
Voluntary Act
C)
The act was willful
D)
The nurse breached the standard of care expected of them
E)
The client experienced harm
A nurse is educating a client diagnosed with major depressive disorder about Cognitive Behavioral Therapy (CBT). Which statement by the client indicates a correct understanding of CBT?
A)
"CBT involves taking medications to balance the chemicals in my brain
B)
CBT focuses on changing my negative thinking patterns to improve my mood."
C)
CBT encourages me to avoid situations that cause me stress
D)
CBT helps me explore my unconscious thoughts and childhood experiences

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Exam Review

A client is frustrated and angry with their supervisor at work but chooses to express this anger by yelling at their family members at home. According to Freud's psychoanalytic theory, this behavior is an example of which defense mechanism?
A)
Displacement
B)
Denial
C)
Projection
D)
Sublimation
A nurse in a pediatric behavioral unit is assessing a 6-year-old child who has been exhibiting regressive behaviors such as thumb-sucking clinging to the parent and expressing jealousy toward a newborn sibling. According to Freud's stages of psychosexual development, which of the following interpretations is most consistent with the child's behavior?
A)
The child is in the phallic stage and is displaying typical Oedipal conflict and rivalry.
B)
The child is fixated at the oral stage and is seeking oral gratification due to unmet early needs.
C)
The child is experiencing regression to the anal stage, often marked by control and defiance.
D)
The child is in the latency stage, and the regression suggests unresolved earlier conflicts.
A nurse is assessing a client who lost their spouse 11 months ago. The client reports persistent sadness, withdrawal from social activities, and states, "I still talk to him every night and can't imagine a future without him." Which of the following are signs and symptoms of complicated grieving? (Select all that apply.)
A)
Acceptance of the loss
B)
Difficulty trusting others since the loss
C)
Previous history of depression
D)
Understanding of what happened
E)
No emotion
A client with major depressive disorder says to the nurse. 1 don't think I can go on living like this anymore." Which of the following responses by the nurse demonstrate nontherapeutic communication techniques? (Select all that apply.)
A)
"Try not to think about it. Things always work out in the end."
B)
"Have you thought about how this will affect your family?
C)
"You shouldn't talk like that-you have so much to live for."
D)
"Why would you feel like that when you have people who care about you?
E)
"Let's talk about what's making you feel this way."

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Exam Review

A nurse is assessing a newly admitted client in the emergency department who is visibly agitated, pacing, clenching their fists, and shouting, "Everyone here is trying to hurt me!" The nurse needs to de-escalate the situation safely. Which of the following approaches is most appropriate at this time?
A)
"I need you to sit down, relax, and try and talk to me
B)
"Can you help me understand what's making you feel unsafe right now?
C)
"How long have you been feeling like people want to harm you?
D)
"What do you think the staff is doing that makes you feel this way?"
In behavioral therapy, which of the following best describes the effect of random reinforcement on a client's behavior?
A)
Slowest way to increase behavior but has a longer lasting effect.
B)
it causes the client to only perform the behavior when prompted by immediate rewards.
C)
It is less effective than fixed-ratio reinforcement for maintaining long-term behavior change.
D)
Fastest way to increase behavior but does not last long after reward stops.
A 74-year-old client with advanced dementia is hospitalized for aggressive behavior and medication noncompliance. The psychiatric team determines the client lacks decision-making capacity. The client's adult son presents a court order granting him full legal guardianship. During discharge planning, the client refuses to go to the recommended memory care facility and insists on returning home alone. Which of the following best reflects the nurse's legal and ethical responsibility in this situation?
A)
Follow the legal guardian's decision for discharge, despite the client's refusal
B)
Delay discharge until the client agrees to the plan, to avoid violating the client's rights
C)
Arrange discharge home with home health services to compromise with the client
D)
Respect the client's autonomy and support their decision to return home
During a psychiatric assessment, a client displays behaviors consistent with fixation at the oral stage of Freud's psychosexual development. Which of the following behaviors would most likely indicate oral fixation according to Freud's theory?
A)
Overindulgence in eating, smoking, or nail-biting.
B)
Fear of abandonment and intense dependency on others.
C)
Excessive orderliness stubbornness, and a need for control.
D)
Difficulty with authority and rebelliousness during adolescence.

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