1. Which neurotransmitter is primarily associated with depression?
Answer: B. Serotonin
Explanation: Serotonin is primarily associated with depression. Low levels of serotonin have been linked to depressive symptoms, and many antidepressant medications work by increasing serotonin levels in the brain. Serotonin is involved in regulating mood, sleep, appetite, and other emotional processes. Imbalances in serotonin can contribute to the development and maintenance of depressive disorders.
2. An episode of mania is being experienced by a person with bipolar disorder. Which medication would be most appropriate to administer?
Answer: D. Lithium
Explanation: Lithium is commonly prescribed for the treatment of manic episodes in bipolar disorder. It helps stabilize mood and reduce the intensity of manic symptoms. Lithium has mood-stabilizing properties and is effective in preventing future episodes of mania and depression. Other medications may also be used in the treatment of bipolar disorder, but lithium is specifically indicated for mania.
3. The primary goal of therapeutic communication in psychiatric nursing is to:
Answer: A. Establish rapport
Explanation: The primary goal of therapeutic communication in psychiatric nursing is to establish rapport with the client. Building a trusting and therapeutic relationship forms the foundation for effective communication and promotes client engagement. Through establishing rapport, the nurse can create a safe and supportive environment, encourage open communication, and facilitate the client’s participation in their own care.
4. Which defense mechanism involves the unconscious denial of the existence of a problem?
Answer: C. Denial
Explanation: Denial is a defense mechanism that involves the unconscious denial of the existence of a problem or a distressing reality. It allows individuals to avoid or minimize anxiety by refusing to acknowledge threatening or unacceptable thoughts, feelings, or experiences. Denial can act as a psychological barrier to protect the individual’s self-esteem and maintain a sense of control.
5. Due to a worry about contamination, an obsessive-compulsive disorder (OCD) patient repeatedly washes their hands. This behavior is an example of:
Answer: A. Compulsion
Explanation: The behavior of repeatedly washing hands due to a worry about contamination is an example of a compulsion in obsessive-compulsive disorder (OCD). Compulsions are repetitive behaviors or mental acts that an individual feels driven to perform in response to obsessions or to prevent a feared outcome. In this case, the compulsion of handwashing is performed to alleviate the distress caused by the obsessive thoughts related to contamination.
6. The nurse is caring for a client diagnosed with schizophrenia. The nurse knows that positive symptoms of schizophrenia include:
Answer: B. Delusions and hallucinations
Explanation: Positive symptoms of schizophrenia refer to the presence of abnormal experiences or behaviors that are not typically seen in individuals without the disorder. Examples of positive symptoms include delusions (false beliefs) and hallucinations (perceptions without corresponding external stimuli). These symptoms reflect an excess or distortion of normal functioning and are often more responsive to antipsychotic medications compared to negative symptoms.
7. As a first-line therapy for attention deficit hyperactivity disorder (ADHD), what drug is frequently prescribed?
Answer: B. Methylphenidate
Explanation: Methylphenidate is frequently prescribed as a first-line therapy for attention deficit hyperactivity disorder (ADHD). It is a stimulant medication that helps improve focus, attention, and impulse control in individuals with ADHD. Other medications, such as amphetamines and non-stimulant options like atomoxetine, may also be used depending on the individual’s specific needs and response to treatment.
8. Electroconvulsive therapy (ECT) is most commonly used in the treatment of:
Answer: C. Bipolar disorder
Explanation: Electroconvulsive therapy (ECT) is most commonly used in the treatmentof severe depression, particularly in cases where other treatments have been ineffective or when rapid and significant improvement is necessary. While ECT can also be used for other conditions, such as schizophrenia and catatonia, it is primarily associated with the treatment of depression. ECT involves the induction of a controlled seizure through electrical stimulation of the brain, leading to changes in brain chemistry and alleviation of depressive symptoms.
9. When conducting a mental status examination, which assessment component evaluates a client’s orientation to person, place, and time?
Answer: C. Sensorium and cognitive abilities
Explanation: The assessment component that evaluates a client’s orientation to person, place, and time is the sensorium and cognitive abilities. It assesses the client’s awareness of their own identity (person), their surroundings (place), and the current date and time (time). This assessment helps determine the client’s level of consciousness, attention, and orientation, which are important indicators of cognitive functioning and overall mental status.
10. Which personality disorder exhibits a pervasive pattern of disdain for and infringement on the rights of others?
Answer: B. Antisocial personality disorder
Explanation: Antisocial personality disorder exhibits a pervasive pattern of disdain for and infringement on the rights of others. Individuals with this disorder often disregard and violate the rights of others, display a lack of empathy or remorse, engage in impulsive and irresponsible behaviors, and exhibit a disregard for societal rules and norms. It is important to note that a formal diagnosis should be made by a qualified healthcare professional based on a comprehensive evaluation.
11. A client is prescribed clozapine for the treatment of schizophrenia. The nurse should monitor the client’s blood work regularly to assess for:
Answer: D. White blood cell suppression
Explanation: When a client is prescribed clozapine, a medication used in the treatment of schizophrenia, regular monitoring of blood work is necessary to assess for white blood cell suppression. Clozapine can cause a decrease in the number of white blood cells, particularly neutrophils, which can increase the risk of severe infections. Regular monitoring is crucial to detect any potential abnormalities and adjust the medication as needed to ensure the client’s safety.
12. Which therapeutic communication technique involves repeating the client’s main idea to encourage further discussion?
Answer: A. Restating
Explanation: Restating is a therapeutic communication technique that involves repeating the client’s main idea or statement using similar or paraphrased words. This technique helps clarify the client’s message and encourages further discussion. By restating, the nurse demonstrates active listening, validates the client’s feelings, and allows the client to elaborate or provide additional information. It facilitates effective communication and shows the client that their thoughts and concerns are being heard and understood.
13. The nurse is caring for a client with anorexia nervosa. Which assessment finding would the nurse expect?
Answer: C. Low blood pressure
Explanation: A nurse caring for a client with anorexia nervosa would expect to find low blood pressure as an assessment finding. Anorexia nervosa is characterized by severe restriction of food intake, which can lead to significant weight loss and malnutrition. Low blood pressure is a common physical manifestation of the cardiovascular effects of malnutrition and can be indicative of the client’s compromised overall health status.
14. Which definition of post-traumatic stress disorder (PTSD) is more accurate?
Answer: B. It is an anxiety condition brought on by a distressing experience.
Explanation: Post-traumatic stress disorder (PTSD) is an anxiety condition brought on by a distressing experience. It is characterized by the development of symptoms such as intrusive thoughts or memories of the traumatic event, avoidance of reminders associated with the trauma, negative changes in mood and cognition, and heightened arousal or reactivity.15.
15. A client is receiving haloperidol for the management of psychosis. The nurse should prioritize which assessment related to the side effects of this medication?
Answer: D. Extrapyramidal symptoms
Explanation: When administering haloperidol, a medication commonly used for managing psychosis, the nurse should prioritize assessing for extrapyramidal symptoms (EPS). EPS are movement disorders that can occur as a side effect of antipsychotic medications, including haloperidol. These symptoms may include muscle rigidity, tremors, abnormal involuntary movements, and dystonia. Prompt recognition and intervention for EPS are important to minimize discomfort and prevent potential complications.
16. Which intervention is most appropriate when caring for a client experiencing a panic attack?
Answer: A. Provide reassurance and a quiet environment.
Explanation: When caring for a client experiencing a panic attack, the most appropriate intervention is to provide reassurance and a quiet environment. Panic attacks are intense episodes of fear or discomfort accompanied by physical and psychological symptoms. Creating a calm and supportive environment helps the client feel safe and can help alleviate anxiety. Reassurance should be offered in a non-judgmental and empathetic manner, encouraging the client to focus on slow breathing and providing comfort until the panic attack subsides.
17. Which defense mechanism involves attributing one’s own unacceptable feelings or thoughts to another person?
Answer: D. Projection
Explanation: Projection is a defense mechanism that involves attributing one’s own unacceptable feelings, thoughts, or impulses to another person. It allows individuals to avoid acknowledging or accepting these unwanted aspects of themselves by projecting them onto others. For example, someone who feels angry or jealous may accuse others of harboring those emotions instead of recognizing and dealing with their own feelings.
18. The nurse is caring for a client with major depressive disorder who has been prescribed fluoxetine. The nurse should monitor the client for the development of:
Answer: B. Serotonin syndrome
Explanation: When caring for a client with major depressive disorder who is prescribed fluoxetine, the nurse should monitor for the development of serotonin syndrome. Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) that increases serotonin levels in the brain. Serotonin syndrome is a potentially life-threatening condition characterized by symptoms such as agitation, confusion, rapid heart rate, high blood pressure, dilated pupils, and increased body temperature. Close monitoring and prompt recognition of serotonin syndrome are essential for timely intervention.
19. A client with schizophrenia is experiencing auditory hallucinations. Which nursing intervention is most appropriate?
Answer: C. Distraction techniques to redirect the client’s attention
Explanation: When a client with schizophrenia is experiencing auditory hallucinations, the most appropriate nursing intervention is to use distraction techniques to redirect the client’s attention. Distraction techniques help shift the client’s focus away from the hallucinations and onto alternative stimuli or activities. This can help reduce the distress associated with the hallucinations and promote engagement in the present moment. The nurse can engage the client in conversation, offer activities, or provide sensory stimuli to divert their attention from the hallucinatory experiences.
20. When planning care for a client with borderline personality disorder, which therapeutic approach is most effective?
Answer: A. Maintaining firm boundaries and consistency
Explanation: When planning care for a client with borderline personality disorder, maintaining firm boundaries and consistency is the most effective therapeutic approach. Clients with borderline personality disorder often struggle with emotional dysregulation and have difficulty establishing and maintaining stable relationships. Setting clear and consistent boundaries helps provide a sense of security, predictability, and structure, which are important for building trust and promoting emotional stability. Consistency in care delivery and boundaries helps establish a therapeutic framework that supports the client’s progress.
21. Which neurotransmitter is primarily associated with schizophrenia?
Answer: D. Dopamine
Explanation: Dopamine is primarily associated with schizophrenia. Imbalances in dopamine transmission and hyperactivity of dopamine pathways have been implicated in the development of schizophrenia. Excess dopamine activity in certain brain regions is believed to contribute to positive symptoms such as delusions and hallucinations. Antipsychotic medications used to treat schizophrenia work by blocking dopamine receptors, helping to reduce dopamine-related symptoms.
22. The nurse is caring for a client with alcohol withdrawal. Which medication is commonly administered to prevent severe withdrawal symptoms and seizures?
Answer: A. Lorazepam
Explanation: Lorazepam is commonly administered to clients with alcohol withdrawal to prevent severe withdrawal symptoms and seizures. Lorazepam belongs to a class of medications called benzodiazepines and helps to stabilize the central nervous system by reducing excitability and promoting relaxation. It is often used as a first-line medication for alcohol withdrawal management due to its effectiveness in preventing seizures and managing withdrawal symptoms.
23. A client diagnosed with delirium is experiencing acute confusion. The nurse should prioritize which intervention?
Answer: B. Providing a calm and structured environment
Explanation: When caring for a client diagnosed with delirium who is experiencing acute confusion, the nurse should prioritize providing a calm and structured environment. Delirium is characterized by acute changes in cognition and attention, often caused by underlying medical conditions or medication side effects. Creating a calm and structured environment can help reduce environmental stimuli and promote a sense of safety, which can aid in minimizing confusion and improving the client’s overall well-being.
24. Which statement accurately describes dissociative identity disorder (DID)?
Answer: C. Two or more separate personalities make up this dissociative illness.
Explanation: Dissociative identity disorder (DID), formerly known as multiple personality disorder, is characterized by the presence of two or more distinct identities or personality states that recurrently take control of the individual’s behavior. Each identity may have its own distinct characteristics, memories, and behaviors. The identities often coexist within the same person and can vary in age, gender, and other features. DID is believed to develop as a result of severe trauma and serves as a coping mechanism to deal with overwhelming experiences.
25. The nurse is assessing a client diagnosed with antisocial personality disorder. Which behavior is commonly associated with this disorder?
Answer: C. Lack of remorse for hurting others
Explanation: A lack of remorse for hurting others is a commonly associated behavior with antisocial personality disorder. Individuals with this disorder often exhibit a disregard for the rights and feelings of others, engage in impulsive and irresponsible behaviors, and show a general disregard for societal rules and norms. They may manipulate or exploit others without remorse or guilt. It is important to note that a formal diagnosis should be made by a qualified healthcare professional based on a comprehensive evaluation.
26. A client with bipolar disorder is experiencing a depressive episode. Which medication would be most appropriate to administer?
Answer: C. Fluoxetine
Explanation: Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), would be the most appropriate medication to administer to a client with bipolar disorder experiencing a depressive episode. SSRIs are commonly used in the treatment of depression and can help alleviate depressive symptoms by increasing serotonin levels in the brain. However, it is important to note that the choice of medication should be individualized based on the client’s specific symptoms, treatment history, and clinician’s judgment.
27. The nurse is caring for a client with anorexia nervosa. Which complication is the client at the highest risk for?
Answer: C. Hypokalemia
Explanation: A client with anorexia nervosa is at the highest risk for developing hypokalemia, which is a deficiency of potassium in the blood.Severe restriction of food intake, characteristic of anorexia nervosa, can lead to imbalances in electrolytes, including potassium. Hypokalemia can result in a variety of complications, including cardiac arrhythmias, muscle weakness, and fatigue. Regular monitoring of electrolyte levels, including potassium, is essential in the care of clients with anorexia nervosa to detect and manage potential complications promptly.
28. Flashbacks are being experienced by a client who has been diagnosed with post-traumatic stress disorder (PTSD). Which intervention is most appropriate?
Answer: B. Provide a safe and calm environment.
Explanation: When a client diagnosed with PTSD is experiencing flashbacks, the most appropriate intervention is to provide a safe and calm environment. Flashbacks are vivid and intrusive re-experiences of the traumatic event. Creating a safe environment helps reduce the client’s anxiety and promotes a sense of security. Providing a calm atmosphere with minimal stimuli can also help ground the client and facilitate the process of returning to the present moment.
29. Which symptom is characteristic of a manic episode in bipolar disorder?
Answer: C. Increased energy and impulsivity
Explanation: Increased energy and impulsivity are characteristic symptoms of a manic episode in bipolar disorder. Mania is a distinct period of abnormally elevated or irritable mood, accompanied by significant changes in energy levels, increased goal-directed activity, and impulsive behavior. Other symptoms may include decreased need for sleep, racing thoughts, inflated self-esteem, and a reduced ability to focus. Manic episodes are typically followed by depressive episodes in bipolar disorder.
30. The nurse is caring for a client with borderline personality disorder who is engaging in self-harm. Which intervention is the nurse’s priority?
Answer: A. Assessing the client’s suicide risk
Explanation: When caring for a client with borderline personality disorder who is engaging in self-harm, assessing the client’s suicide risk is the nurse’s priority. Self-harming behaviors can be indicative of underlying emotional distress and may indicate an increased risk for suicide. It is crucial to assess the client’s immediate safety, including their current suicidal ideation, plans, and access to means. Prompt assessment and intervention can help prevent self-inflicted harm and ensure the client’s well-being.