Psychiatric Nursing - Free NCLEX Test 2024 - Free NCLEX Exam Practice

 

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1. What is essential for the nurse to do when approaching a client during a period of overactivity?

• Use a firm but caring and consistent approach.
• Anticipate and physically control the hyperactivity.
• Allow the client to choose the activities in which to participate.
• Let the client know the staff will not tolerate destructive behavior.

2. During the orientation tour for three new staff members, a young, hyperactive manic client greets them by saying, “Welcome to the funny farm. I’m Jo-Jo, the head yo-yo.” Which meaning can the nurse assign to the client’s statement?

• Trying to fill the “life-of-the-party” role
• Looking for attention from the new staff
• Unable to distinguish fantasy from reality
• Anxious over the arrival of new staff members

3. A severely depressed client is to have electroconvulsive therapy (ECT). What should a nurse include when discuss­ing this therapy with the client?

• Sleep will be induced and treatment will not cause pain.
• Treatment is totally safe with the new methods of administration.
• You can ask any question you like, but it is better not to talk about it.
• There may be some unrecoverable short-term and long­term memory loss.

4. A nurse is assisting with the administration of electrocon­vulsive therapy (ECT) to a severely depressed client. What side effect of the therapy should the nurse anticipate?

• Loss of appetite
• Postural hypotension
• Complete temporary loss of memory
• Confusion immediately after the treatment

5. A recovering alcoholic joins Alcoholics Anonymous (AA) to help maintain sobriety. What type of group is AA?

• Social group
• Self-help group
• Resocialization group
• Psychotherapeutic group

6. A depressed client often sleeps past the expected time of awakening and spends excessive time resting and sleeping. Which nursing intervention is appropriate for this client?

• Restrict the client’s access to the bedroom.
• Offer the client a series of relaxation tapes.
• Reschedule the client’s bedtime to an earlier hour.
• Suggest that the client exercise before going to bed.

7. A nurse identifies that a client is pretending to be ill. What does this behavior usually indicate?

• Psychosis
• Malingering
• Out of contact with reality
• Use of conversion defenses

8. A client with the diagnosis of bipolar disorder, manic episode, is extremely active, talks constantly, and tends to badger the other clients, some of whom are now becoming agitated. What is the best strategy for a nurse to use with this client?

• Humor
• Sympathy
• Distraction
• Confrontation

9. What therapeutic nursing intervention may redirect a hyperactive, manic client?

• Suggesting that the client write a short story
• Having the client initiate group social activities on the unit
• Asking the client to guide other clients as they clean their rooms
• Encouraging the client to tear pictures out of magazines for a scrapbook

10. A client with a diagnosis of antisocial personality disorder is being discharged from the hospital. The client asks the nurse, “Can I have your phone number so that I can call you for a date.” What is the nurse’s best response?

• “We are not permitted to date clients.”
• “It is against my professional ethics to date clients.”
• “Our relationship is professional; therefore, I will not see you socially.”
• “I’m glad you like me; however, I cannot give out my phone number.”

11. What is the best nursing intervention when the language of a client in the manic phase of a bipolar disorder becomes vulgar and profane?

• State, “We do not like that kind of talk around here.”
• Ignore it, since the client is using it to gain attention.
• Recognize that the behavior is part of the illness, but set limits on it.
• State, “We will talk to you when you can speak in an acceptable way.”

12. A client with an alcohol dependence problem asks whether the nurse can see the bugs that are crawling on the bed. What is the nurse’s initial reply?

• “No, I don’t see any bugs.”
• “I will get rid of them for you.”
• “I will stay here until you are calmer.”
• “Those bugs are a part of your sickness.”

13. An adolescent is admitted to the psychiatric service in stable physical condition with the diagnosis of anorexia nervosa. The adolescent has lost 20 pounds in 6 weeks and is very thin but is excessively concerned about being overweight. What is the most important initial nursing intervention?

• Compliment the physical appearance of the adolescent.
• Explore the reasons why the adolescent does not want to eat
• Explain the value of adequate nutrition to the adolescent.
• Attempt to establish a trusting relationship with the adolescent.

14. What treatment should a nurse anticipate will be ordered for a client with severe, persistent, intractable depression and suicidal ideation?

• Electroconvulsive therapy
• Short-term psychoanalysis
• Nondirective psychotherapy
• High doses of anxiolytic drugs

15. How should the nursing staff provide for the nutritional needs of a client experiencing periods of extreme mania and hyperactivity?

• Accept that the client will eat if hungry.
• Allow the client to prepare meals to eat when desired.
• Offer high-calorie snacks frequently that the client can hold.
• Leave food in the client’s room that can be eaten when desired.

16. A client has the diagnosis of histrionic personality disorder. Which behavior should the nurse expect when assessing this client?

• Boastful and egotistical
• Rigid and perfectionistic
• Extroverted and dramatic
• Aggressive and manipulative

17. A nurse is orienting a new client to the unit when another client rushes down the hallway and asks the nurse to sit down to talk. The client requesting the nurse’s attention is manipulative and uses acting-out behaviors when demands are unmet. How should the nurse intervene?

• Suggest that the client requesting attention speak with another staff member.
• Leave the new client, saying, “I’ll talk with the other client until things calm down.”
• Introduce the two clients and suggest that the client join them on a tour of the facility.
• Tell the interrupting client, “I’ll be back to talk with you after I orient this new client.”

18. A client with a borderline personality disorder receives the wrong meal tray for lunch and angrily states, “The next time I see the dietician, I am going to throw this tray at her!” What is the nurse’s most appropriate response?

• Suggest that the client calm down and explain that sometimes trays get mixed up.
• Inform the client that the behavior is inappropriate and send the client out of the dining room.
• Tell the client it is frustrating not to get the correct tray, but throwing the tray at the dietician is unacceptable behavior.
• Inform the client that throwing the tray at the dietician will make matters worse and may result in being placed in seclusion.

19. During a group discussion, it is learned that a group member hid suicidal urges and committed suicide several days ago. The nurse leading the group should be prepared to manage the:

• guilt of the co-leaders that they failed to anticipate and prevent the suicide.
• guilt that group members feel because they could not prevent another’s suicide
• lack of concern over the suicide expressed by several of the members in the group.
• ear by some members that their own suicidal urges may go unnoticed and unprotected.

20. What should a nurse identify as the most important factor in rehabilitation of a client addicted to alcohol?

• Motivational readiness
• Availability of community resources
• Accepting attitude of the client’s family
• Qualitative level of the client’s physical state

21. A client is admitted to a psychiatric hospital after a month of unusual behavior that included eating and sleeping very little, talking and singing constantly, and going on frequent shopping sprees. In the hospital, the client is demanding, bossy, and sarcastic. Which disorder does the nurse associate with these behaviors?

• Bipolar disorder, manic phase
• Antisocial personality disorder
• Obsessive-compulsive disorder
• Chronic undifferentiated schizophrenia

22. The clients on a mental health unit go on a supervised day trip to a baseball game. When returning to the bus, a client with a narcissistic personality disorder insists on leaving the group to get an autograph from a player. What is the most appropriate response by the nurse?

• Hold the client by the arm to prevent leaving the group.
• Instruct the client with a loud voice to get in the bus so the group can go home.
• Inform the client in a matter-of-fact tone that everyone must remain with the group.
• Tell the client that the baseball player will not be permitted to give anyone an autograph.

23. A depressed client tells a nurse, “I want to die.” Which is the nurse’s most therapeutic response?

• “You would rather not live.”
• “You are not alone in feeling this way.”
• “When was the last time you felt this way?”
• “Do you believe that there is life after death?”

24. A hospitalized client who was diagnosed with a borderline personality disorder consistently breaks the unit’s rules. How will confronting the client about this behavior help the client?

• Controls anger
• Reduces anxiety
• Sets realistic goals
• Becomes more self-aware

25. A client is diagnosed with an adjustment disorder with mixed anxiety and depression. What should the nurse anticipate as the client’s primary problem?

• Low self-esteem
• Deficient memory
• Intolerance to activity
• Disturbed personal identity

26. A client with a personality disorder tells a nurse, “I want to tell you something, but you must promise to keep it a secret.” Which response could lead to splitting among the staff?

• "I am part of a team that shares important information about clients.”
• “Your comments will be kept confidential because I am your advocate.”
• "I cannot promise to keep what you say confidential from the rest of the staff.”
• "Trust me to do what is in your best interests with the information, which includes discussing it with the team.”

27. A client is admitted to a mental health facility for depres­sion. What action should a nurse take to help the client develop a positive self-regard?

• Set limits on the client’s negative behaviors.
• Involve the client in activities that promote success.
• Demonstrate approval of the client’s efforts at every opportunity.
• Encourage the client to participate in activities with other clients.

28. Which nursing intervention is most important for a client who has the diagnosis of antisocial personality disorder?

• Teach and role-model assertiveness.
• Use a gentle and reassuring approach.
• Provide clear boundaries and consequences.
• Present an empathetic and democratic approach.

29. A nurse is caring for a client with antisocial personality disorder. What client characteristic should the nurse con sider when formulating a plan of care?

• Suffers from extreme anxiety
• Rapidly learns by experience if punished
• Usually is unable to postpone gratification
• Has a great sense of responsibility toward others

30. A nurse is discussing plans with a client who has decided to withdraw from alcohol. What should the nurse recommend as one of the most effective treatments for alcoholism?

• Individual or group psychotherapy
• Admission to an alcoholic unit in a hospital
• Daily administration of disulfiram (Antabuse)
• Active membership in Alcoholics Anonymous

31. A cachectic adolescent with the diagnoses of anorexia nervosa, dehydration, and electrolyte imbalances is admitted to a mental health facility. The adolescent has been obsessed with weight, has exercised for hours every day, has taken enemas and laxatives several times a week, and has engaged in self-induced vomiting. Which is a priority when a nurse plans care for this client?

• Identifying personal strengths
• Controlling impulsive behaviors
• Correcting electrolyte imbalances
• Developing a contract for treatment goals

32. A nurse is working in the orientation phase of a therapeutic relationship with a client who has borderline personality disorder. What will be most difficult for the client at this stage of the relationship?

• Controlling anxiety
• Terminating the session on time
• Accepting the psychiatric diagnosis
• Setting mutual goals for the relationship

33. A client exhibiting manic behavior is admitted to the psy­chiatric hospital. In which room should the nurse manager place the client?

• One that has basic simple furnishings
• One with another client who is very quiet
• A room that will provide a variety of stimuli
• A room with another client exhibiting similar behavior

34. An adult is diagnosed with schizotypal personality disorder. How should a nurse describe the clients behavior?

• Rigid and controlling
• Submissive and immature
• Arrogant and attention seeking
• Introverted and emotionally withdrawn

35. A psychologist has been a client on a mental health unit for 3 days. The client has questioned the authority of the treatment team, advised other clients that their treatment plans are wrong, and has been disruptive in group therapy. What is the nurse’s most appropriate intervention?

• Tell the other clients to disregard what the client is saying.
• Ignore the client’s disruptive behavior and wait until it subsides.
• Restrict the client’s contact with other clients until the disruptive behavior ceases.
• Accept that the client is unable to control this behavior, and set appropriate limits.

36. When a nurse sits next to a depressed client and begins to talk, the client states, “I’m stupid and useless. Talk with the other people who are more important.” Which response is most therapeutic?

• “Everyone is important.”
• “Do you feel that you are not important?”
• “Why do you feel you are not important?”
• “I want to talk with you because you are important to me"

37. Evaluation of clients with anorexia nervosa requires reassessment of behaviors after admission. Which finding indicates that the therapy is beginning to become effective?

• Food is hidden in pockets of clothing
• Statement that the hospitalization has been helpful
• Weight gain of six pounds since admission 3 weeks ago
• Remains in the dining room eating for 1 hour after others have left

38. What is an appropriate behavior modification goal for a client with anorexia nervosa?

• Eat every meal for a week.
• Gain 1 pound of weight a week.
• Attend group therapy every day.
• Talk about food for 1 hour a day.

39. A client who is in a four-bed room since admission becomes extremely anxious and is having difficulty sleeping. What is the nurse’s best response?

• “You seem unable to sleep at night.”
• “I’m going to move you to a private room.”
• “I’ll get you the sedative that was prescribed.”
• “You’ll be able to fall asleep when you’re tired.”

40. What should the nurse include when developing a plan of care for a client in the manic phase of bipolar disorder?

• Focus the client’s interest in reality.
• Encourage the client to talk as much as needed.
• Redirect the client’s excess energy to constructive channels.
• Persuade the client to complete any task that has been started.

41. What should a nurse conclude that a client is doing when making up stories to fill in blank spaces of memory?

• Lying
• Denying
• Rationalizing
• Confabulating

42. A nurse begins a relationship with a client with the diagnosis of schizotypal personality disorder. What is the best initial nursing action?

• Set limits on manipulative behavior.
• Encourage participation in group therapy.
• Respect the clients need for social isolation.
• Recognize that seductive behavior is expected.

43. An extremely depressed client signed the consent for elec­troconvulsive therapy (ECT) but continues to express anxiety about the procedure. What is most important for a nurse to emphasize when discussing ECT with the client?

• “The procedure may cause a headache.”
• “The procedure will make you feel better.”
• “You will not be left alone during the procedure.”
• "You will have periods of amnesia after the procedure.”

44. A client with bipolar disorder, manic episode, has a superior, authoritative manner and constantly instructs other clients about how to dress, what to eat, and where to sit. The nurse should intervene because these behaviors eventually will cause the other clients to feel:

• angry
• dependent
• inadequate
• ambivalent

45. A nurse is working with clients with a variety of eating disorders. Which characteristic unique to bulimia nervosa differentiates this disorder from anorexia nervosa?

• Is obese and attempting to lose weight
• Has a distorted body image and sees the body as fat
• Has behaviors and an appearance that appear appropriate
• Is struggling with a conflict of dependence versus independence

46. A nurse is caring for a hyperactive, manic client who exhibits flight of ideas and is not eating. What may be the reason why the client is not eating?

• Feels undeserving of the food
• Is too busy to take the time to eat
• Wishes to avoid others in the dining room
• Believes that there is no need for food at this time

47. Clients addicted to alcohol often use the defense mechanism of denial. What is the reason why this defense is so often used?

• Reduces their feelings of guilt
• Creates the appearance of independence
• Helps them live up to others’ expectations
• Makes them look better in the eyes of others

48. A client with a history of alcoholism is diagnosed with Wernicke encephalopathy associated with Korsakoff syndrome. What does the nurse anticipate will be prescribed?

• Traditional phenothiazine
• Judicious use of antipsychotics
• Intramuscular injections of thiamine
• Oral administration of chlorpromazine

49. During an assessment interview the client relates experiencing overwhelming, irresistible attacks of sleep. Which sleep disorder does the nurse conclude the client is experiencing?

• Insomnia
• Narcolepsy
• Sleep terror
• Sleep apnea

50. The nursing staff is discussing the best way to develop a relationship with a new client who has antisocial personality disorder. What characteristic of clients with antisocial personality should the nurses consider when planning care?

• Engages in many rituals
• Feels independent from others
• Exhibits lack of empathy for others
• Possesses limited communication skills