1
Q
Name the communication technique:
Nurse states - “yes, I understand what you said”
A
Accepting (therapeutic)
2
Q
Name the communication technique:
Nurse states - “I see you made your bed”
A
Giving recognition (therapeutic)
3
Q
Name the communication technique:
Nurse states - “I will stay with you for a while”
A
Offering self (therapeutic)
4
Q
Name the communication technique:
Nurse states - “tell me what you are thinking”
Nurse states - “yes I see, go on”
Nurse states - “what would you like to talk about today?”
A
Offering general leads / broad openings (therapeutic)
5
Q
Name the communication technique:
Nurse states - “you seemed uncomfortable when you came in”
Nurse states - “you seem tense”
Nurse states - “I notice you are pacing a lot”
A
Making observations (therapeutic)
6
Q
Name the communication technique:
Nurse states - “what do the voices seem to be saying?”
A
Encouraging description of perceptions (therapeutic)
7
Q
Name the communication technique:
Nurse states - “tell me more about that specific point you brought up”
Nurse states - “this point seems worth looking at more closely, perhaps we can discuss it together”
A
Focusing (therapeutic)
8
Q
Name the communication technique:
Nurse states - “tell me if my understanding agrees with yours”
A
Seeking clarification (therapeutic)
9
Q
Name the communication technique:
Patient states - “I can’t study, my mind wanders”
Nurse states - “you are having difficulty concentrating”
A
Restating (therapeutic)
10
Q
Name the communication technique:
Patient states - “my sister won’t help me with my mother’s care and I have to do it all”
Nurse states - “you feel angry when your sister does not help”
Patient states - “what do you think I should do about my wife’s drinking problem?”
Nurse states - “what do you think you should do?”
A
Reflecting (therapeutic)
11
Q
Name the communication technique:
Nurse states - “tell me more about that particular situation”
Nurse states - “please explain that situation in more detail”
A
Exploring (therapeutic)
12
Q
Name the communication technique:
Nurse states - “I understand that the voices seem real to you, but I do not hear any voices”
Nurse states - “there is no one else in the room but you and me”
A
Presenting reality (therapeutic)
13
Q
Name the communication technique:
Nurse states - “I understand you believe that to be true, but I see the situation differently”
A
Voicing doubt (therapeutic)
14
Q
Name the communication technique:
Patient states - “I am way out in the ocean”
Nurse states - “you must be feelings very lonely now”
A
Translating words into feelings (therapeutic)
15
Q
Name the communication technique:
Nurse states - “what could you do to not let your anger out harmlessly?”
A
Formulating a plan of action (therapeutic)
16
Q
When using humor as a constructive coping behavior, it is important to …
A
NEVER mask feelings / ridicule the patient
17
Q
Name the communication technique:
Nurse states - “I wouldn’t worry if I were you”
Nurse states - “everything will be alright”
A
Giving false reassurance (non-therapeutic)
18
Q
Name the communication technique:
Nurse states - “I’m glad to hear”
Nurse states - “that’s right, I agree”
Nurse states - “that is bad, I rather you would not”
A
Giving approval / disapproval (non-therapeutic)
19
Q
Name the communication technique:
Nurse states - “I think you should…”
Nurse states - “I disagree”
A
Giving advice (non-therapeutic)
20
Q
Name the communication technique:
Nurse states - “No one here would lie to you”
A
Defending (non-therapeutic)
21
Q
Name the communication technique:
Nurse states - “why did you do that?”
Nurse states - “why do you think that?”
A
Requesting an explanation (non-therapeutic)
22
Q
Name the communication technique:
Nurse states - “everyone gets down in the dumps sometimes”
Nurse states - “I feel that way myself sometimes”
A
Belittling feelings (non-therapeutic)
23
Q
Name the communication technique:
Nurse states - “keep your chin up”
Nurse states - “hang in there, it is for your own good”
A
Making stereotyped comments / cliches (non-therapeutic)
24
Q
Name the communication technique:
Patient states - “I don’t have anything to live for”
Nurse states - “did you have visitors this weekend?”
A
Introducing an unrelated topic (non-therapeutic)
25
When is focusing a helpful therapeutic communication technique?
If a patient is rapidly moving from one idea to another - helps the patient concentrate on what is important
26
When is voicing doubt a helpful therapeutic communication technique?
If a patient is experiencing delusional thinking
27
Name the defense mechanism:
Dealing with anxiety by reaching out to others
Altruism
28
Name the defense mechanism:
Substituting unacceptable impulses with acceptable actions
Sublimation
29
Name the defense mechanism:
CONSCIOUSLY denying unpleasant thoughts / feelings
Suppression
30
Name the defense mechanism:
UNCONSCIOUSLY denying unpleasant thoughts / feelings
Repression
31
Name the defense mechanism:
Reverting to childlike behaviors
Regression
32
Name the defense mechanism:
Redirecting feelings to a safer target
Displacement
33
Name the defense mechanism:
Overcompensating by showing opposite behavior
Reaction formation
34
Name the defense mechanism:
Performing act to make up for prior behavior
Undoing
35
Name the defense mechanism:
Creating acceptable explanations for behavior
Rationalization
36
Name the defense mechanism:
Disruption in consciousness / identity
Dissociation
37
Name the defense mechanism:
Refusing to accept reality
Denial
38
Name the defense mechanism:
Emphasizing strengths to offset weakness
Compensation
39
Name the defense mechanism:
Assuming traits of another person / group
Identification
40
Name the defense mechanism:
Separating emotions from facts
Intellectualization
41
Name the defense mechanism:
Stress manifesting as physical symptoms
Conversion
42
Name the defense mechanism:
Inability to integrate good / bad aspects
Splitting
43
Name the defense mechanism:
Attributing unacceptable thoughts / feelings to another person who does not have them
Projection
44
Name the defense mechanism:
Adaptive use - volunteering as a firefighter after losing a family member in a fire
Altruism
45
Name the defense mechanism:
Adaptive use - redirecting anger toward a supervisor into a vigorous gym workout
Sublimation
46
Name the defense mechanism:
Adaptive use - delaying thinking about a fight to focus on a test
Maladaptive use - delaying worrying about bills after losing a job
Suppression
47
Name the defense mechanism:
Adaptive use - forgetting ridicule before a speech
Maladaptive use - avoiding the dentist due to fear
Repression
48
Name the defense mechanism:
Adaptive use - a child wetting the bed after their pet dies
Maladaptive use - an adult throwing objects at work
Regression
49
Name the defense mechanism:
Adaptive use - punching a bag after losing a game
Maladaptive use - a parent destroying a child's toy
Displacement
50
Name the defense mechanism:
Adaptive use - talking to teens about nicotine while quitting
Maladaptive use - becoming an overprotecting caregiver to an aging parent that was mean
Reaction formation
51
Name the defense mechanism:
Adaptive use - doing chores after an argument
Maladaptive use - giving gifts after abusing a partner
Undoing
52
Name the defense mechanism:
Adaptive use - explaining personal rejection to a partner with a prior relationship
Maladaptive use - drunk driving to feed the dog
Rationalization
53
Name the defense mechanism:
Adaptive use - blocking out noise to focus on driving
Maladaptive use - losing identity after assault
Dissociation
54
Name the defense mechanism:
Adaptive use - having initial disbelief after a cancer diagnosis
Maladaptive use - insisting that a deceased loved one will return
Denial
55
Name the defense mechanism:
Adaptive use - excelling academically when unable to play sports
Maladaptive use - avoiding socialization via technology
Compensation
56
Name the defense mechanism:
Adaptive use - a child with a chronic illness playing nurse
Maladaptive use - becoming a bully after witnessing abuse
Identification
57
Name the defense mechanism:
Adaptive use - an officer focusing on the facts during a crime
Maladaptive use - focusing on will / finances over grief
Intellectualization
58
Name the defense mechanism:
Maladaptive use - deafness after a partner requests divorce
Conversion
59
Name the defense mechanism:
Maladaptive use - alternating idealization and devaluation of a nurse
Splitting
60
Name the defense mechanism:
Maladaptive use - accusing a partner of an affair when attracted to someone else
Projection
61
Name the ethical principle:
Competency / capacity for decision making
Autonomy
62
Name the ethical principle:
Do no harm
Nonmaleficence
63
Name the ethical principle:
Preventing harm by removing harmful conditions to benefit the patient
Beneficence
64
Name the ethical principle:
Following through with commitments / keeping promises
Fidelity
65
Name the ethical principle:
Truthfulness during interactions
Veracity
66
Name the ethical principle:
Fairness / providing each patient the care that they deserve
Justice
67
Name the ethical principle:
Patient privacy - should only be broken in case of threats to harm / court orders
Confidentiality
68
Name the ethical principle:
Right to know and understand care
Informed consent
69
Name the tort:
Neglecting to provide needed care
Negligence
70
Name the tort:
Breech of duty / competence (failing to assess for suicide risk)
Malpractice
71
Name the tort:
Threatening to harm
Assault
72
Name the tort:
Physical harm
Battery
73
Name the tort:
Restraining a patient without proper reasoning / documentation
False imprisonment
74
A nurse is coming onto her 7am to 3pm shift on an inpatient mental health unit. One of the patients assigned to the nurse starts constantly calling out for the nurse to ask if Dr. Jones will be in to see her today. Tired of hearing the patient call out, the nurse tells the patient that Dr. Jones will be in to see her after 3pm. The nurse does not know if what she told the patient is true, but it did cause the patient to stop calling out during the nurse’s shift. What ethical principle did the nurse violate in her communication with the patient?
A. Autonomy
B. Beneficence
C. Justice
D. Veracity
E. Nonmaleficence
D
75
At 11pm a nurse tells a patient on an in-patient mental health unit to return to her room and go to sleep. The patient states that she is not tired and wishes to stay in the common area reading her book. The nurse tells the patient if she does not return to her room and go to sleep, she will administer a prn injection the provider ordered that will make her fall asleep. The patient can file a lawsuit against the nurse for which of the following, select all that apply:
A. Assault
B. Battery
C. False imprisonment
D. Breach of confidentiality
A
76
A patient arrives at the hospital seeking help for her depression. When the nurse starts asking the patient questions, the patient wants the nurse to promise that everything he tells the nurse will be kept confidential. What is the best response the nurse can provide the patient:
A. Of course, anything you tell me will remain confidential
B. I do have to share information that impacts your care with the healthcare team
C. Once I know the information, we can discuss who else needs to know
D. Of course, you decide with whom the information is shared
B
77
A nurse is caring for a 74-year-old patient admitted from a memory unit at a long-term care facility following a fall. A provider suggests the patient start an experimental medication aimed at treating the patient’s dementia. The nurse accompanies the provider into the patient’s room so that provider can discuss the medication with the patient, however, the nurse had to leave the room shortly after entering to assist another nurse with a patient. When the nurse returns, the provider asks the nurse to sign the informed consent as a witness. The nurse should:
A. Tell the provider informed consent is not required for a medication
B. Sign as a witness because the nurse knows the provider always discusses the medication with the patient
C. Refuse to sign as a witness because the patient lacks the competency to consent
D. Sign as a witness when the patient correctly answers the nurse’s questions about the medication
C
78
A 31-year-old female presents to the emergency department for evaluation. A concerned family member tells the nurse that the woman keeps repeating that her deceased father is coming today to visit. When the family member tried to talk with the woman, the woman pushed her aside to continue cleaning. The family member states that she was scared to ask the woman anything else about her father’s visit or the cleaning because the woman has previously kicked her. The family member does not think the woman has been taking her Seroquel (antipsychotic medication). The nurse notes that the woman is agitated and demanding to leave because she can hear her father telling her to get her house cleaned for his visit. The nurse understands that which of the following increases the risk for violence, select all that apply:
A. History of violent behavior
B. Hallucination
C. Noncompliance with medication
D. Lack of perceived need for treatment
A, B, C, D
79
A male college student met and began dating a female college student during the fall semester. Over the winter holiday break, the female college student broke off the relationship. The male college student began seeing a therapist at the college during the spring semester to help him deal with the break-up. During a session in the summer, the male college student told his therapist that he planned on killing his former girlfriend. A month later, the male college student went to the home of his former girlfriend where he shot and stabbed her to death. Did the therapist have a duty to warn the female college student of the threat?
A. No, because the information was part of a confidential therapy session
B. No, because the female college student was not a patient of the therapist
C. Yes, because the male college student made a threat of violence against a known person
D. Yes, but only after getting written permission from the male college student to disclose the information
C
80
Patients seeking and receiving mental health care are vulnerable, thus requiring nurses to protect their rights. These rights including, select all that apply:
A. Right to treatment
B. Right to refuse treatment
C. Right to least restrictive treatment
D. Right to absolute confidentiality
A, B, C
81
As a nurse, you are allowed to release information about a patient in the following situations, select all that apply:
A. Patient completes and signs a patient authorization form
B. Court Order
C. Family member who asks for an update on a patient’s treatment
D. Employer requesting information to approve a work related absence
A, B
82
A nurse is caring for a patient who starts acting violently and aggressive. The nurse understands that when considering using a restraint or seclusion , the following apply, select all that apply:
A. Placing the patient in a private, locked room is permissible
B. Restraints or seclusion should be used only to prevent harm
C. Administering a medication to make the patient sleep is permissible
D. Use verbal and behavioral interventions before chemical and mechanical restraints
B, D
83
A 52-year-old woman walks into a community clinic and is taken to a room. In the room, the nurse observes the woman’s hair is unkept, her clothes are dirty, she has poor hygiene, and she is softly mumbling incoherent words while sitting in the chair. She does not provide her name when asked. When nurse asks what brings her to the clinic, the woman suddenly gets up, starts pacing in the room, and repeats phrases such as “devil wants me to burn the children in the oven” and “I must go burn the children”. The nurse alerts the provider and receptionist. The nurse and provider remain with the woman while the receptionist calls 911. The patient continues to pace and mumble about killing children in the oven for the devil. EMS and police arrive and transport the woman to the ED . At the ED, the woman continues behavior observed in the clinic. Which the following would allow the physician to consider involuntary commitment to an acute inpatient psychiatric unit, select all that apply:
A. Unable to care for her basic health and/or safety
B. Imminent risk to others
C. Poverty
D. Hallucinations
A, B
84
A nurse is caring for a 70-year-old female patient voluntarily admitted for inpatient treatment for anxiety. During the shift, the nurse administers 1mg of Ativan (antianxiety) po as ordered. A couple hours later, while walking independently to the bathroom, the woman slips and falls from a puddle of water on the floor. A rapid response is called, and the patient is found to have suffered no injuries from the fall. The woman is discharged a week later to start outpatient therapy. A month after being discharged, the woman files a malpractice case against the hospital. The nurse understands that:
A. The patient’s case does not meet the criteria for a malpractice case
B. The patient’s case is likely to be settled by the hospital
C. The patient has a good case because she should not have been walking independently
D. The patient is unlikely to receive a settlement because she should have seen the puddle of water
A
85
A nurse understands that the best ways to protect his/herself from a malpractice case is to follow the 4 C’s of prevention:
A. Caring, charting, consulting, and compatibility
B. Caring, communication, competence, and charting
C. Charting, consulting, competence, and calling
D. Calling, consulting, caring, and communication
B
86
Determine whether the following is an example of capacity or competence:
A patient with delirium can't understand treatment options today because of confusion from infection
Capacity (may resolve if delirium resolves)
87
Determine whether the following is an example of capacity or competence:
A manic patient refuses meds, changes their mind rapidly, and can't appreciate consequences
Capacity (may resolve if mania resolves)
88
Determine whether the following is an example of capacity or competence:
A psychotic patient believes meds are poison
Capacity (may resolve if psychosis resolves)
89
Determine whether the following is an example of capacity or competence:
An older adult with advanced dementia has a court‑appointed guardian
Competency
90
A nurse in a mental health clinical is preparing to conduct an initial patient interview. When conducting the interview, which of the following actions should the nurse identify as a priority?
A. Coordinate holistic care with social services
B. Identify the patient's perception of their mental status
C. Include the patient's family in the interview
D. Teach the patient about their current mental health disorder
B
91
A charge nurse is discussing mental health examinations with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?
A. To assess cognitive ability, I should ask the patient to count backwards by sevens
B. To assess affect, I should observe the patient's facial expression
C. To assess language ability, I should instruct the patient to write a sentence
D. To assess remote memory, I should have the patient repeat a list of objects
E. To assess abstract thinking, I should ask the patient to identify the most recent presidents
A, B, C
92
A nurse is planning care for a patient who has a mental health disorder. Which of the following actions should the nurse include as a psychobiological intervention?
A. Assist the patient with systematic desensitization therapy
B. Teach the patient appropriate coping mechanisms
C. Assess the patient for comorbid health conditions
D. Monitor the patient for adverse effects of medications
D
93
A nurse hears another nurse discussing a patient's hallucinations in the hallway with another nurse. Which of the following actions should the nurse take first?
A. Notify the nurse manager
B. Tell the nurse to stop discussing the hallucinations
C. Provide an in-service program about confidentiality
D. Complete an incident report
B
94
A nurse in an emergency mental health facility is caring for a group of patients. The nurse should identify which of the following patients requires a temporary emergency admission?
A. A patient who has schizophrenia with delusions of grandeur
B. A patient who has manifestations of depression and attempted suicide a year ago
C. A patient who has borderline personality disorder and assaulted a homeless man with a metal rod
D. A patient who has bipolar disorder and paces quickly around the room while talking to themselves
C
95
A nurse is caring for a patient who is in mechanical restraints. Which of the following statements should the nurse include in the documentation? (Select all that apply)
A. Patient ate most of their breakfast
B. Patient was offered 8 oz of water every hour
C. Patient shouted obscenities at assistive personnel
D. Patient received chlorpromazine 15 mg PO at 1000
E. Patent acted out after lunch
B, C, D
96
A nurse decides to put a patient who has a psychotic disorder in seclusion overnight because the unit is very short-staffed and the patient frequently fights with other patients. The nurse's actions are an example of which of the following torts?
A. Invasion of privacy
B. False imprisonment
C. Assault
D. Battery
B
97
A nurse is caring for a patient who smokes and has lung cancer. The patient reports "I'm coughing because I have that cold that everyone has been getting." The nurse should identify that the patient is using which of the following defense mechanisms?
A. Reaction formation
B. Denial
C. Displacement
D. Sublimation
B
98
A nurse is providing preoperative teaching for a patient who was informed of the need for emergency surgery. The patient has a respiratory rate of 30 breaths per minute, and states "this is difficult to comprehend. I feel shaky and nervous." The nurse should identify that the patient is experiencing which level of anxiety?
A. Mild
B. Moderate
C. Severe
D. Panic
B
99
A nurse is caring for a patient who is experiencing moderate anxiety. Which of the following actions should the nurse take when trying to give necessary information to the patient? (Select all that apply)
A. Reassure the patient that everything will be ok
B. Discuss prior use of coping mechanisms with the patient
C. Ignore the patient's anxiety so that she will not be embarrassed
D. Demonstrate a calm manner while using simple and clear directions
E. Gather information from the patient using closed-ended questions
B, D
100
A charge nurse is conducting a class on therapeutic communication with a group of newly licensed nurses. Which of the following aspects of communication should the nurse identify as a component of verbal communication?
A. Personal space
B. Posture
C. Eye contact
D. Intonation
D
101
A nurse in a mental health practitioner’s office is communicating with a client. The client states, “I can’t sleep. I stay up all night.” The nurse responds, “You are having difficulty sleeping?” Which of the following therapeutic communication techniques is the nurse demonstrating?
A. Offering general leads
B. Summarizing
C. Focusing
D. Restating
D
102
A nurse is talking with the caregiver of a child who has demonstrated recent changes in behavior and mood. When the caregiver asks the nurse for reassurance about their child’s condition, which of the following responses should the nurse make?
A. “I think your child is getting better. What have you noticed?”
B. “I’m sure everything will be okay. It just takes time to heal.”
C. “I’m not sure what’s wrong. Have you asked the doctor about your concerns?”
D. “I understand you’re concerned. Let’s discuss what concerns you specifically.”
D
103
A nurse is communicating with a patient who was admitted for treatment of a substance use disorder. Which of the following communication techniques should the nurse identify as a barrier to therapeutic communication?
A. Offering advice
B. Reflecting
C. Listening attentively
D. Giving information
A
104
A nurse is working in a community mental health facility. Which of the following services does this type of program provide? (Select all that apply)
A. Educational groups
B. Medication dispensing programs
C. Individual counseling programs
D. Detoxification programs
E. Family therapy
A, B, C, E
105
A nurse is planning care for several patients attending community-based mental health programs. Which patient should the nurse visit first?
A. A patient with a minor burn from a hot iron
B. A patient requesting a change in antipsychotic medication
C. A patient hearing a voice saying life is not worth living
D. A patient reporting severe anxiety during a job interview
C
106
A nurse is assisting with discharge planning for a patient with a severe mental illness who requires supervision. The patient's partner works all day but is home by late afternoon. Which strategy should the nurse suggest?
A. Daily care from a home health aide
B. Weekly visits from a nurse case manager
C. Attendance at a partial hospitalization program
D. Daily visits to a community mental health center
C
107
A community mental health nurse is planning care to address depression among older adult patients in the community. Which intervention represents tertiary prevention?
A. Educating patients on health promotion
B. Performing depression screenings
C. Establishing rehabilitation programs
D. Providing support groups for at-risk patient
C
108
A nurse is caring for a group of patients. Which patient should the nurse consider referring to an assertive community treatment (ACT) group?
A. A patient in acute care who is frequently falling
B. A patient who frequently misses monthly antipsychotic injections
C. A patient reporting anxiety during group therapy
D. A patient grieving a partner who died three months ago
B
109
A nurse is talking with a new patient who is at risk for suicide following their partner's death. Which of the following statements explains the purpose of milieu therapy?
A. Milieu therapy is focused on creating a safe, healing, therapeutic environment
B. Milieu therapy is the scheduled activities focused on improved patient socialization
C. Milieu therapy consists of scheduled group sessions addressing common mental health needs
D. Milieu therapy's primary focus is on patient education based on individual treatment goals
A
110
A charge nurse is discussing the characteristics of a nurse-patient relationship with a newly licensed nurse. Which of the following characteristics should the nurse include in the discussion? (Selecta ll that apply)
A. The needs of both participants are met
B. An emotional commitment exists between the participants
C. All encounters are goal-directed
D. Positive behavior changes are encouraged
E. Promotes balance of patient autonomy and safety
C, D, E
111
Scheduled session of all members of the mental health unit to enhance and manage therapeutic milieu refers to ...
A. Psychoeducational groups
B. Community meeting
C. Recreational therapy
D. Individual therapy
E. Group therapy
B
112
Scheduled sessions with a mental health provider to address specific mental health concerns refers to ...
A. Psychoeducational groups
B. Community meeting
C. Recreational therapy
D. Individual therapy
E. Group therapy
D
113
Schedules sessions for a group of patients to address common mental health issues refers to ...
A. Psychoeducational groups
B. Community meeting
C. Recreational therapy
D. Individual therapy
E. Group therapy
E
114
Scheduled sessions focused socialization with others, activities, and outings refers to ...
A. Psychoeducational groups
B. Community meeting
C. Recreational therapy
D. Individual therapy
E. Group therapy
C
115
Schedules sessions focused on education based on patient level of functioning and needs refers to ...
A. Psychoeducational groups
B. Community meeting
C. Recreational therapy
D. Individual therapy
E. Group therapy
A
116
A nurse is planning care for the termination phase of a nurse-patient relationship. Which of the following actions should the nurse include in the plan of care?
A. Discussing ways to use new behaviors
B. Practicing new problem solving skills
C. Developing goals
D. Establishing boundaries
A
117
A nurse is assessing a patient who has major depressive disorder. The nurse should identify which of the following patient statements as an overt comment about suicide?
A. My family will be better off if I'm dead
B. The stress in my life is too much to handle
C. I wish my life was over
D. I don't feel like I can't ever be happy again
E. If I kill myself, my problems will go away
A, C, E
118
A nurse is caring for a patient who states "I plan to commit suicide." Which of the following assessments should be the nurse's priority?
A. Patient's educational and economic background
B. Lethality of the method and availability of the means
C. Quality of the patient's social support
D. Patient's insight into the reasons for the decision
B
119
A nurse is assisting with the development of protocols to address the increasing number of suicide attempts in the community. Which of the following interventions should the nurse include as a primary intervention (Select all that apply)
A. Conducting a suicide risk screening on all new patients
B. Creating a support group for family members of patients who have died by suicide
C. Informing high school teens about suicide prevention
D. Initiating one-on-one observations for a patient who has current suicidal ideation
E. Reinforcing teaching middle school educators about warning indicators of suicide
C, E
120
A nurse is caring for a patient who is on suicide precautions. Which of the following interventions should the nurse include in the plan of care?
A. Assign the patient to a private room
B. Document the patient's behavior every hour
C. Allow the patient to keep perfume in their room
D. Ensure that the patient swallows medication
D
121
A nurse is conducting a class for a group of newly licensed nurses on caring for patients who are at risk for suicide. Which of the following information should the nurse include in the teaching?
A. A patient's verbal threat of suicide is attention-seeking behavior
B. Interventions are ineffective for patients who really want to commit suicide
C. Using the term "suicide" increases the patient's risk for a suicide attempt
D. A no-suicide contract decreases the patient's risk for suicide
D
122
A nurse is discussing the care of a patent with major depressive disorder. Which of the following statements indicates an understanding of the teaching?
A. Care during the continuation phase focuses on treating continued manifestations of MDD
B. Treatment of MDD during the maintenance phase lasts 6 - 12 weeks
C. The patient is at greatest risk for suicide during the first weeks of a MDD episode
D. Medication and psychotherapy are most effective during the acute phase of MDD
C
123
A nurse is caring a for patient with major depressive disorder. Which of the following is a risk factor for depression? (select all that apply)
A. Male sex
B. History of chronic bronchitis
C. Recent death in the family
D. Family history of depression
E. Personal history of panic disorder
B, C, D, E
124
A nurse is interviewing a patient who has a new diagnosis of persistent depressive disorder. Which of the following findings should the nurse expect?
A. Wide fluctuations in mood
B. Minimum of 5 clinical findings of depression
C. Presence of manifestations for at least 2 years
D. Inflated sense of self-esteem
C
125
A nurse is admitting a patient with major depressive disorder and comorbid anxiety disorder. Which of the following actions is the nurse's priority?
A. Placing the patient on one-to-one observation
B. Assisting the patient in performing ADLs
C. Encouraging the patient to participate in counseling
D. Teaching the patient about medication adverse effects
A
126
A nurse is assessing a patient 4 hours after receiving an initial dose of fluoxetine. Which of the following findings should the nurse report as indications of serotonin syndrome? (select all that apply)
A. Hypothermia
B. Hallucinations
C. Muscular flaccidity
D. Diaphoresis
E. Agitation
B, D, E
127
A nurse is discussing relapse prevention with a patient who has bipolar disorder. Which of the following should the nurse include in the teaching? (select all that apply)
A. Use caffeine in moderation to prevent relapse
B. Difficulty sleeping can indicate relapse
C. Begin taking medications as soon as relapse beings
D. Participation in psychotherapy can help prevent relapse
E. Anhedonia is a manifestation of a depressive relapse
B, D, E
128
A nurse is planning care for a patient with bipolar disorder who is experiencing a manic episode. Which interventions should take place? (select all that apply)
A. Provide flexible patient behavior expectations
B. Offer concise explanations
C. Establish consistent limits
D. Disregard patient concerns
E. Use a firm approach with communication
B, C, E
129
A nurse is discussing early indications of lithium toxicity for a patient with bipolar disorder. Which of the following manifestations should be included in the teaching? (select all that apply)
A. Constipation
B. Polyuria
C. Rash
D. Muscle weakness
E. Tinnitus
B, D
130
A nurse is admitting a patient with bipolar disorder who is scheduled to begin lithium therapy. When collecting a medical history, which of the following statements should be reported to the provider?
A. Current medical conditions include diabetes that is controlled by diet
B. Recent medications include a course of prednisone for acute bronchitis
C. Current vaccinations include the flu vaccine last month
D. Current medications include furosemide for CHF
D
131
A nurse is discussing routine follow-up needs with a patient who has a prescription for valproate. Which of the following is recommended for routine monitoring?
A. AST / ALT / LDH
B. BUN / creatinine
C. WBCs / granulocyte counts
D. Sodium / potassium
A
132
A nurse is providing preoperative teaching for a patient who was informed of the need for emergency surgery. The patient has a respiratory rate of 30 breaths per minute, and states "this is difficult to comprehend. I feel shaky and nervous." The nurse should identify that the patient is experiencing which level of anxiety?
A. Mild
B. Moderate
C. Severe
D. Panic
B
133
A nurse is caring for a patient who is experiencing moderate anxiety. Which of the following actions should the nurse take when trying to give necessary information to the patient? (Select all that apply)
A. Reassure the patient that everything will be ok
B. Discuss prior use of coping mechanisms with the patient
C. Ignore the patient's anxiety so that she will not be embarrassed
D. Demonstrate a calm manner while using simple and clear directions
E. Gather information from the patient using closed-ended questions
B, D
134
A nurse is assessing a patient who has major depressive disorder. The nurse should identify which of the following patient statements as an overt comment about suicide? (select all that apply)
A. My family will be better off if I'm dead
B. The stress in my life is too much to handle
C. I wish my life was over
D. I don't feel like I can't ever be happy again
E. If I kill myself, my problems will go away
A, C, E
135
A nurse is caring for a patient who states "I plan to commit suicide." Which of the following assessments should be the nurse's priority?
A. Patient's educational and economic background
B. Lethality of the method and availability of the means
C. Quality of the patient's social support
D. Patient's insight into the reasons for the decision
B
136
A nurse is caring for a patient who is on suicide precautions. Which of the following interventions should the nurse include in the plan of care?
A. Assign the patient to a private room
B. Document the patient's behavior every hour
C. Allow the patient to keep perfume in their room
D. Ensure that the patient swallows medication
D
137
True or false:
Eating disorders have one of the highest mortality rates of all mental health disorders
True
138
Victim or perpetrator:
- Develops excuses
- Rationalizes behavior
Perpetrator
139
Victim or perpetrator:
- Noncommunicative
- No attempt to cooperatively develop a solution
Perpetrator
140
Victim or perpetrator:
- Use of intimidation to control others
- Use of intimidation to temporarily resolve unwanted emotions
Perpetrator
141
Victim or perpetrator:
Use of sex / pornography as a method to relieve unwanted thoughts and feelings
Perpetrator
142
Victim or perpetrator:
- Blames self as reason for abuse
- Frequent feelings of guilt
Victim
143
Victim or perpetrator:
Feels like there is no resolution to behaviors
Victim
144
Victim or perpetrator:
Does not feel like financial / emotional independence is possible
Victim
145
Victim or perpetrator:
- Lack of desire to engage in sexual behaviors
- Setting poor boundaries in sexual engagement with others
Victim
146
Which nursing action is most therapeutic for a client with borderline personality disorder who becomes suddenly angry when limits are set?
A. Ignore the outburst to avoid escalation
B. Restate the limit calmly and consistently
C. Ask the client to explore childhood experiences
D. Offer PRN medication immediately
B
147
Which finding is most characteristic of avoidant personality disorder?
A. Impulsive and dramatic behavior
B. Fear of rejection and social inhibition
C. Disregard for the rights of others
D. Attention‑seeking and shallow affect
B
148
A client with antisocial personality disorder violates unit rules. What is the priority nursing intervention?
A. Discuss consequences and reinforce boundaries
B. Explore reasons for behavior
C. Increase social privileges
D. Reduce monitoring to build trust
A
149
Which statement reflects paranoid personality traits?
A. ‘People are trying to deceive me.’
B. ‘I need others to make decisions for me.’
C. ‘I feel empty and alone.’
D. ‘I act without thinking.’
A
150
The nurse anticipates which primary need for clients with Cluster C patterns?
A. High stimulation
B. Increased autonomy support
C. Emotion regulation work
D. Reality testing interventions
B
151
Which assessment finding in anorexia nervosa requires immediate action?
A. Heart rate 48 bpm
B. Controlled eating rituals
C. Low self‑esteem comments
D. Desire for increased exercise
A
152
Which intervention best supports nutritional stabilization during structured meals?
A. Allow privacy after meals
B. Remain with the client and provide support
C. Encourage vigorous physical activity
D. Avoid discussing emotions around eating
B
153
Which statement reflects body image distortion?
A. ‘I feel anxious around food.’
B. ‘My stomach hurts after eating.’
C. ‘My body is huge even though others disagree.’
D. ‘I want to improve my coping skills.’
C
154
A client with bulimia nervosa has a potassium level of 2.9 mEq/L. What is the priority action?
A. Encourage oral fluids
B. Notify the provider immediately
C. Allow the client to rest
D. Provide reassurance
B
155
Which intervention is most appropriate for preventing compensatory behavior after meals?
A. Permit bathroom use as needed
B. Supervise closely for 60–90 minutes
C. Delay meals until anxiety improves
D. Allow solitary mealtime
B
156
Which observation is most concerning for possible elder abuse?
A. Occasional forgetfulness
B. Bruising in various stages of healing
C. Asking repetitive questions
D. Complaints of loneliness
B
157
A client begins pacing, clenching fists, and speaking loudly. What is the nurse’s priority?
A. Stand close to show support
B. Reduce stimulation and maintain safety
C. Ask the client to describe feelings
D. Encourage deep discussion
B
158
A client discloses intimate partner violence but refuses to leave. What is the nurse’s best response?
A. ‘You must leave for your safety.’
B. ‘Why don’t you get a restraining order?’
C. ‘I respect your decision and can help create a safety plan.’
D. ‘You may be making a mistake.’
C
159
Which action is mandatory when child abuse is suspected?
A. Gather more proof
B. Verify the story with caregivers
C. Report according to state law
D. Document and wait for further
C
160
Which communication approach is most appropriate when supporting a trauma survivor?
A. Encourage detailed retelling
B. Use judgment‑free, validating statements
C. Suggest moving past the event
D. Confront inconsistencies
B
161
Which nursing action is most appropriate for somatic symptom disorder?
A. Reinforce symptom descriptions
B. Validate distress and shift focus to coping
C. Increase diagnostic testing
D. Explore unconscious motives
B
162
Which finding in functional neurologic disorder requires immediate follow‑up?
A. Sudden inability to walk
B. Lack of concern about symptoms
C. Inconsistent neuro findings
D. Difficulty swallowing with drooling
D
163
What is the best initial response to reassurance‑seeking in illness anxiety disorder?
A. Provide repeated reassurance
B. Redirect to anxiety‑management skills
C. Refer for neurologic exam
D. Explain diagnostic criteria
B
164
A client becomes detached and unresponsive after a loud noise. What is the nurse’s priority?
A. Ask the client to explain feelings
B. Guide through grounding techniques
C. Leave the client alone
D. Encourage deep processing
B
165
Which outcome indicates improvement in somatic symptom disorder?
A. More provider visits
B. Increased symptom reporting
C. Fewer healthcare visits
D. Seeking new providers
C
166
A client says, ‘The TV is sending me messages.’ What is the best nursing response?
A. ‘That’s not true.’
B. ‘Tell me more about what you’re experiencing.’
C. ‘You’re imagining things.’
D. ‘We’ve already talked about this.’
B
167
Which symptom requires immediate safety action?
A. Flat affect
B. Social withdrawal
C. Command hallucinations to harm self
D. Poverty of speech
C
168
Which communication technique best supports a client with disorganized speech?
A. Detailed explanations
B. Brief, concrete statements
C. Written instructions only
D. Teaching postponed until symptoms resolve
B
169
Which intervention reduces overstimulation on the unit?
A. Crowded milieu
B. Multiple caregivers
C. Calm, predictable environment
D. TVs for background noise
C
170
A client on antipsychotics reports stiffness and restlessness. What should the nurse do first?
A. Encourage rest
B. Increase fluids
C. Assess for extrapyramidal symptoms
D. Teach about long‑term therapy
C
171
Name the personality cluster:
Mistrust, social distance, cognitive-perceptual peculiarities
Cluster A
172
Name the personality cluster:
Emotional dysregulation, impulsivity, boundary testing
Cluster B
173
Name the personality cluster:
Avoidance, dependence, perfectionism
Cluster C
174
Name the personality disorder:
- Reluctant to confide in others
- Persistently bears grudges
- Perceives attacks on character
Paranoid personality disorder
175
Name the personality disorder:
- Neither desires nor enjoys close relationships
- Little to no interest in having sexual experiences with another person
- Lacks close friends
- Indifference to praise / criticism
Schizoid personality disorder
176
Name the personality disorder:
- Odd thinking / speech
- Odd / eccentric / peculiar behavior
- Believes they have supernatural powers
- Perceptual experiences, including bodily illusions
- Lack of close friends
- Excessive social anxiety
Schizotypal personality disorder
177
Name the personality disorder:
- Irritability / aggressivness
- Reckless regard for the safety of self / others
- Irresponsibility
- Lack of remorse
Antisocial personality disorder
178
Name the personality disorder:
- Unstable interpersonal relationships / self-image / affects
- Recurrent suicidal behavior / gestures / threats
- Affective instability
- Intense, inappropriate anger
Borderline personality disorder
179
Name the personality disorder:
- Shallow emotional expression
- Self-dramatization
- Easily influenced by others
- Considers relationships to be more intimate than they actually are
Histrionic personality disorder
180
Name the personality disorder:
- Sense of entitlement
- Interpersonally exploitative / takes advantage of others to achieve own ends
- Lack of empathy
- Often envious of others / believes others are envious of them
- Arrogant behavior
Narcissistic personality disorder
181
Name the personality disorder:
- Preoccupied with being criticized / rejected in social situations
- Feelings of inadequacy
- Views self as inferior to others
- Reluctant to engage in new activities due to risk of embarrassment
Avoidant personality disorder
182
Name the personality disorder:
- Need for others to assume responsibility
- Exaggerated fears of being able to care for self
- Urgently seeks another relationship when a close relationship ends
Dependent personality disorder
183
Name the personality disorder:
- Reluctancy to delegate tasks due to desire for exact way of doing things
- Inability to discard objects without sentimental value
- Miserly spending style toward self / others
Obsessive-compulsive personality disorder
184
Name the personality disorder:
Donna danced into the party and immediately became the center of attention. With sweeping gestures of her arms and dramatic displays of emotion, she boasted about her career as an actress in a local theater group. During a private conversation, a friend inquired about the rumors that she was having some difficulties in her marriage. In an outburst of anger, she denied any problems and claimed that her marriage was “wonderful and charming as ever.” Shortly thereafter, while drinking her second martini, she fainted and had to be taken home.
Histrionic personality disorder
185
Name the personality disorder:
Willow wandered into the party, but didn’t stay long. The “negative forces” in the room were unsettling to his “psychic soul-spot.” The few guests he spoke to felt somewhat uneasy being with this aloof “space cadet.”
Schizotypal personality disorder
186
Name the personality disorder:
Sherry paraded into the party drunk and continued to drink throughout the night. Laughing and giggling, she flirted with many of the men and to two of them expressed her “deep affection.” After a violent argument with one of them, because he took “too long” to get her a drink, she locked herself into the bathroom and attempted to swallow a bottle of aspirin. Her friends encouraged her to go home, but she was afraid to be alone in her apartment.
Boderline personality disorder
187
Name the personality disorder:
Winston spent most of the time talking about his trip to Europe, his new Mercedes, and his favorite French restaurants. People seemed bored being around him, but he kept right on talking. When he made a critical remark about how one of the women was dressed-and hurt her feelings-he could not apologize for his obvious blunder. He tried to talk his way around it, and even seemed to be blaming her for being upset.
Narcissistic personality disorder
188
Name the personality disorder:
Sally came to the party solo and was somewhat uncomfortable, but also indifferent with compliments from her peers and did not want to socialize. She was only interested in petting the host’s dog and leaving early.
Schizoid personality disorder
189
Name the personality disorder:
Peter arrived at the party exactly on time. He made a point of speaking to every guest for exactly 5 minutes. He talked mostly about finance, avoided any inquiries about feelings or personal life. He left precisely at 10 pm because he had work to do at home.
Obsessive-compulsive personality disorder
190
Name the personality disorder:
Amy was so worried about coming to the party. She almost didn’t come. She was sure the others felt compelled to invite her. She was grateful and humbled by a compliment from a peer, but then was sure that she would be later rejected and humiliated by someone else before the night was over.
Avoidant personality disorder
