To render quality care for your patients, you need this 50-item NCLEX style questionnaire that will also measure your understanding about Psychiatric Nursing. This nursing exam covers Therapeutic Relationships, Suicide, Psychiatric Drugs, and various topics about Mental Health Nursing.
We also recommend you to try and answer all exams on our NCLEX page!
EXAM TIP: Being nice to yourself isn’t bad, however, putting yourself in a difficult situation isn’t bad either. Efforts can move mountains. Instead of driving yourself into stagnation, challenge yourself and do something that you need to do even if you are afraid.
Motivation means action and action brings results.
Topics or concepts included in this exam are:
- Therapeutic Relationships
- Psychiatric Drugs
- Various topics about Mental Health Nursing
- Read each question carefully and choose the best answer.
- You are given one minute per question. Spend your time wisely!
- Answers and rationales (if any) are given below. Be sure to read them.
- If you need more clarifications, please direct them to the comments section.
In Exam Mode: All questions are shown but the results, answers, and rationales (if any) will only be given after you’ve finished the quiz. You are given 1 minute per question.
Psychiatric Nursing Practice Quiz #6 (50 Questions)
Practice Mode: This is an interactive version of the Text Mode. All questions are given on a single page and correct answers, rationales or explanations (if any) are immediately shown after you have selected an answer. No time limit for this exam.
Psychiatric Nursing Practice Quiz #6 (50 Questions)
In Text Mode: All questions and answers are given for reading and answering at your own pace. You can also copy this exam and make a printout.
1. Nurse Tony should first discuss terminating the nurse-client relationship with a client during the:
A. Termination phase when discharge plans are being made.
B. Working phase when the client shows some progress.
C. Orientation phase when a contract is established.
D. Working phase when the client brings it up.
2. Malou is diagnosed with major depression spends majority of the day lying in bed with the sheet pulled over his head. Which of the following approaches by the nurse would be the most therapeutic?
A. Question the client until he responds
B. Initiate contact with the client frequently
C. Sit outside the client’s room
D. Wait for the client to begin the conversation
3. Joe who is very depressed exhibits psychomotor retardation, a flat affect and apathy. The nurse in charge observes Joe to be in need of grooming and hygiene. Which of the following nursing actions would be most appropriate?
A. Waiting until the client’s family can participate in the client’s care
B. Asking the client if he is ready to take shower
C. Explaining the importance of hygiene to the client
D. Stating to the client that it’s time for him to take a shower
A. Roasted chicken
B. Fresh fish
5. When assessing a female client who is receiving tricyclic antidepressant therapy, which of the following would alert the nurse to the possibility that the client is experiencing anticholinergic effects?
6. For a male client with dysthymic disorder, which of the following approaches would the nurse expect to implement?
B. Psychotherapeutic approach
D. Antidepressant therapy
7. Danny who is diagnosed with bipolar disorder and acute mania, states the nurse, “Where is my daughter? I love Louis. Rain, rain go away. Dogs eat dirt.” The nurse interprets these statements as indicating which of the following?
C. Clang associations
D. Flight of ideas
8. Terry with mania is skipping up and down the hallway practically running into other clients. Which of the following activities would the nurse in charge expect to include in Terry’s plan of care?
A. Watching TV
B. Cleaning dayroom tables
C. Leading group activity
D. Reading a book
9. When assessing a male client for suicidal risk, which of the following methods of suicide would the nurse identify as most lethal?
A. Wrist cutting
C. Use of gun
D. Aspirin overdose
10. Jun has been hospitalized for major depression and suicidal ideation. Which of the following statements indicates to the nurse that the client is improving?
A. “I’m of no use to anyone anymore.”
B. “I know my kids don’t need me anymore since they’re grown.”
C. “I couldn’t kill myself because I don’t want to go to hell.”
D. “I don’t think about killing myself as much as I used to.”
11. Which of the following activities would Nurse Trish recommend to the client who becomes very anxious when thoughts of suicide occur?
A. Using exercise bicycle
C. Watching TV
D. Reading comics
12. When developing the plan of care for a client receiving haloperidol, which of the following medications would nurse Monet anticipate administering if the client developed extrapyramidal side effects?
13. Jon, a suspicious client, states that “I know you nurses are spraying my food with poison as you take it out of the cart.” Which of the following would be the best response of the nurse?
A. Giving the client canned supplements until the delusion subsides
B. Asking what kind of poison the client suspects is being used
C. Serving foods that come in sealed packages
D. Allowing the client to be the first to open the cart and get a tray
14. A client is suffering from catatonic behaviors. Which of the following would the nurse use to determine that the medication administered PRN has been most effective?
A. The client responds to verbal directions to eat
B. The client initiates simple activities without direction
C. The client walks with the nurse to her room
D. The client is able to move all extremities occasionally
15. Nurse Hazel invites new client’s parents to attend the psycho educational program for families of the chronically mentally ill. The program would be most likely to help the family with which of the following issues?
A. Developing a support network with other families
B. Feeling more guilty about the client’s illness
C. Recognizing the client’s weakness
D. Managing their financial concern and problems
16. When planning care for Dory with schizotypal personality disorder, which of the following would help the client become involved with others?
A. Attending an activity with the nurse
B. Leading a sing along in the afternoon
C. Participating solely in group activities
D. Being involved with primarily one to one activities
17. Which statement about an individual with a personality disorder is true?
A. Psychotic behavior is common during acute episodes
B. Prognosis for recovery is good with therapeutic intervention
C. The individual typically remains in the mainstream of society, although he has problems in social and occupational roles
D. The individual usually seeks treatment willingly for symptoms that are personally distressful.
18. Nurse John is talking with a client who has been diagnosed with antisocial personality about how to socialize during activities without being seductive. Nurse John would focus the discussion on which of the following areas?
A. Discussing his relationship with his mother
B. Asking him to explain reasons for his seductive behavior
C. Suggesting to apologize to others for his behavior
D. Explaining the negative reactions of others toward his behavior
19. Tina with a histrionic personality disorder is melodramatic and responds to others and situations in an exaggerated manner. Nurse Trish would recommend which of the following activities for Tina?
A. Baking class
C. Scrapbook making
D. Music group
20. Joy has entered the chemical dependency unit for treatment of alcohol dependency. Which of the following client’s possession will the nurse most likely place in a locked area?
C. Antiseptic wash
21. Which of the following assessment would provide the best information about the client’s physiologic response and the effectiveness of the medication prescribed specifically for alcohol withdrawal?
A. Sleeping pattern
B. Mental alertness
C. Nutritional status
D. Vital signs
23. Which of the following would nurse Ronald use as the best measure to determine a client’s progress in rehabilitation?
A. The way he gets along with his parents
B. The number of drug-free days he has
C. The kinds of friends he makes
D. The amount of responsibility his job entails
24. A female client is brought by ambulance to the hospital emergency room after taking an overdose of barbiturates is comatose. Nurse Trish would be especially alert for which of the following?
25. Joey who has a chronic user of cocaine reports that he feels like he has cockroaches crawling under his skin. His arms are red because of scratching. The nurse in charge interprets these findings as possibly indicating which of the following?
26. Jose is diagnosed with amphetamine psychosis and was admitted to the emergency room. Nurse Ronald would most likely prepare to administer which of the following medication?
27. Which of the following liquids would nurse Leng administer to a female client who is intoxicated with phencyclidine (PCP) to hasten excretion of the chemical?
C. Cranberry Juice
D. Grape juice
28. When developing a plan of care for a female client with acute stress disorder who lost her sister in a car accident. Which of the following would the nurse expect to initiate?
A. Facilitating progressive review of the accident and its consequences
B. Postponing discussion of the accident until the client brings it up
C. Telling the client to avoid details of the accident
D. Helping the client to evaluate her sister’s behavior
29. The nursing assistant tells nurse Ronald that the client is not in the dining room for lunch. Nurse Ronald would direct the nursing assistant to do which of the following?
A. Tell the client he’ll need to wait until supper to eat if he misses lunch
B. Invite the client to lunch and accompany him to the dining room
C. Inform the client that he has 10 minutes to get to the dining room for lunch
D. Take the client a lunch tray and let the client eat in his room
30. The initial nursing intervention for the significant-others during shock phase of a grief reaction should be focused on:
A. Presenting full reality of the loss of the individuals
B. Directing the individual’s activities at this time
C. Staying with the individuals involved
D. Mobilizing the individual’s support system
31. Joy’s stream of consciousness is occupied exclusively with thoughts of her father’s death. Nurse Ronald should plan to help Joy through this stage of grieving, which is known as:
A. Shock and disbelief
B. Developing awareness
C. Resolving the loss
32. When taking a health history from a female client who has a moderate level of cognitive impairment due to dementia, the nurse would expect to note the presence of:
A. Accentuated premorbid traits
B. Enhance intelligence
C. Increased inhibitions
33. What is the priority care for a client with a dementia resulting from AIDS?
A. Planning for remotivational therapy
B. Arranging for long-term custodial care
C. Providing basic intellectual stimulation
D. Assessing pain frequently
34. Jerome who has an eating disorder often exhibits similar symptoms. Nurse Lhey would expect an adolescent client with anorexia to exhibit:
A. Affective instability
B. Dishered, unkempt physical appearance
C. Depersonalization and derealization
D. Repetitive motor mechanisms
A. Situational low self-esteem related to altered role
B. Powerlessness related to the loss of idealized self
C. Spiritual distress related to depression
D. Impaired verbal communication related to depression
36. When developing an initial nursing care plan for a male client with a Bipolar I disorder (manic episode) nurse Ron should plan to?
A. Isolate his gym time
B. Encourage his active participation in unit programs
C. Provide foods, fluids and rest
D. Encourage his participation in programs
37. Grace is exhibiting withdrawn patterns of behavior. Nurse Johnny is aware that this type of behavior eventually produces a feeling of:
38. One morning a female client on the inpatient psychiatric service complains to nurse Hazel that she has been waiting for over an hour for someone to accompany her to activities. Nurse Hazel replies to the client “We’re doing the best we can. There are a lot of other people in the unit who needs attention too.” This statement shows that the nurse’s use of:
A. Defensive behavior
B. Reality reinforcement
C. Limit-setting behavior
D. Impulse control
39. A nursing diagnosis for a male client with a diagnosed multiple personality disorder is chronic low self-esteem probably related to childhood abuse. The most appropriate short-term client outcome would be:
40. A 25 year old male is admitted to a mental health facility because of inappropriate behavior. The client has been hearing voices, responding to imaginary companions and withdrawing to his room for several days at a time. Nurse Monette understands that the withdrawal is a defense against the client’s fear of:
41. When asking the parents about the onset of problems in young client with the diagnosis of schizophrenia, Nurse Linda would expect that they would relate the client’s difficulties began in:
A. Early childhood
B. Late childhood
42. Jose who has been hospitalized with schizophrenia tells Nurse Ron, “My heart has stopped and my veins have turned to glass!” Nurse Ron is aware that this is an example of:
A. Somatic delusions
43. In recognizing common behaviors exhibited by male client who has a diagnosis of schizophrenia, nurse Josie can anticipate:
A. Slumped posture, pessimistic outlook, and flight of ideas
B. Grandiosity, arrogance, and distractibility
C. Withdrawal, regressed behavior, and lack of social skills
D. Disorientation, forgetfulness, and anxiety
44. One morning, nurse Diane finds a disturbed client curled up in the fetal position in the corner of the dayroom. The most accurate initial evaluation of the behavior would be that the client is:
A. Physically ill and experiencing abdominal discomfort
B. Tired and probably did not sleep well last night
C. Attempting to hide from the nurse
D. Feeling more anxious today
45. Nurse Bea notices a female client sitting alone in the corner smiling and talking to herself. Realizing that the client is hallucinating. Nurse Bea should:
A. Invite the client to help decorate the dayroom
B. Leave the client alone until he stops talking
C. Ask the client why he is smiling and talking
D. Tell the client it is not good for him to talk to himself
46. When being admitted to a mental health facility, a young female adult tells Nurse Mylene that the voices she hears frighten her. Nurse Mylene understands that the client tends to hallucinate more vividly:
A. While watching TV
B. During mealtime
C. During group activities
D. After going to bed
47. Nurse John recognizes that paranoid delusions usually are related to the defense mechanism of:
48. When planning care for a male client using paranoid ideation, nurse Jasmin should realize the importance of:
A. Giving the client difficult tasks to provide stimulation
B. Providing the client with activities in which success can be achieved
C. Removing stress so that the client can relax
D. Not placing any demands on the client
49. Nurse Gerry is aware that the defense mechanism commonly used by clients who are alcoholics is:
50. Within a few hours of alcohol withdrawal, nurse John should assess the male client for the presence of:
A. Disorientation, paranoia, tachycardia
B. Tremors, fever, profuse diaphoresis
C. Irritability, heightened alertness, jerky movements
D. Yawning, anxiety, convulsions
Answers and Rationale
Here are the answers and rationale for this exam. Counter check your answers to those below and tell us your scores. If you have any disputes or need more clarification to a certain question, please direct them to the comments section.
1. Answer: C. Orientation phase when a contract is established.
- Option C: When the nurse and client agree to work together, a contract should be established, the length of the relationship should be discussed in terms of its ultimate termination.
2. Answer: B. Initiate contact with the client frequently
- Option B: The nurse should initiate brief, frequent contacts throughout the day to let the client know that he is important to the nurse. This will positively affect the client’s self-esteem.
3. Answer: D. Stating to the client that it’s time for him to take a shower
- Option D: The client with depression is preoccupied, has decreased energy, and is unable to make decisions. The nurse presents the situation, “It’s time for a shower”, and assists the client with personal hygiene to preserve his dignity and self-esteem.
4. Answer: C. Salami
- Option C: Foods high in tyramine, those that are fermented, pickled, aged, or smoked must be avoided because when they are ingested in combination with MAOIs a hypertensive crisis will occur.
5. Answer: A. Urine retention and blurred vision
- Option A: Anticholinergic effects, which result from blockage of the parasympathetic (craniosacral) nervous system including urine retention, blurred vision, dry mouth & constipation.
6. Answer: B. Psychotherapeutic approach
- Option B: Dysthymia is a less severe, chronic depression diagnosed when a client has had a depressed mood for more days than not over a period of at least 2 years. Clients with dysthymic disorder benefit from psychotherapeutic approaches that assist the client in reversing the negative self-image, negative feelings about the future.
7. Answer: D. Flight of ideas
- Option D: Flight of ideas is speech pattern of rapid transition from topic to topic, often without finishing one idea. It is common in mania.
8. Answer: B. Cleaning dayroom tables
- Option B: The client with mania is very active & needs to have this energy channeled in a constructive task such as cleaning or tidying the room.
9. Answer: C. Use of gun
- Option C: A crucial factor in determining the lethality of a method is the amount of time that occurs between initiating the method and the delivery of the lethal impact of the method.
10. Answer: D. “I don’t think about killing myself as much as I used to.”
- Option D: The statement “I don’t think about killing myself as much as I used to.” indicates a lessening of suicidal ideation and improvement in the client’s condition.
11. Answer: A. Using exercise bicycle
- Option A: Using exercise bicycle is appropriate for the client who becomes very anxious when thoughts of suicide occur.
12. Answer: C. Benztropine mesylate (Cogentin)
- Option C: The drug of choice for a client experiencing extrapyramidal side effects from haloperidol (Haldol) is benztropine mesylate (Cogentin) because of its anticholinergic properties.
13. Answer: D. Allowing the client to be the first to open the cart and get a tray
- Option D: Allowing the client to be the first to open the cart & take a tray presents the client with the reality that the nurses are not touching the food & tray, thereby dispelling the delusion.
14. Answer: B. The client initiates simple activities without direction
- Option B: Although all the actions indicate improvement, the ability to initiate simple activities without directions indicates the most improvement in the catatonic behaviors.
15. Answer: A. Developing a support network with other families
- Option A: Psychoeducational groups of families develop a support network. They provide education about the biochemical etiology of psychiatric disease to reduce, not increase family guilt.
16. Answer: C. Participating solely in group activities
- Option C: Attending activity with the nurse assists the client to become involved with others slowly. The client with schizotypal personality disorder needs support, kindness & gentle suggestion to improve social skills & interpersonal relationship.
17. Answer: C. The individual typically remains in the mainstream of society, although he has problems in social and occupational roles
- Option C: An individual with personality disorder usually is not hospitalized unless a coexisting Axis I psychiatric disorder is present. Generally, these individuals make marginal adjustments and remain in society, although they typically experience relationship and occupational problems related to their inflexible behaviors. Personality disorders are chronic lifelong patterns of behavior; acute episodes do not occur. Psychotic behavior is usually not common, although it can occur in either schizotypal personality disorder or borderline personality disorder. Because these disorders are enduring and evasive and the individual is inflexible, prognosis for recovery is unfavorable. Generally, the individual does not seek treatment because he does not perceive problems with his own behavior. Distress can occur based on other people’s reaction to the individual’s behavior.
18. Answer: D. Explaining the negative reactions of others toward his behavior
- Option D: The nurse would explain the negative reactions of others towards the client’s behaviors to make the clients aware of the impact of his seductive behaviors on others.
19. Answer: B. Role-playing
- Option B: The nurse would use role-playing to teach the client appropriate responses to others and in various situations. This client dramatizes events, drawn attention to self, and is unaware of and does not deal with feelings. The nurse works to help the client clarify true feelings & learn to express them appropriately.
20. Answer: C. Antiseptic wash
- Option C: Antiseptic mouthwash often contains alcohol & should be kept in a locked area, unless labeling clearly indicates that the product does not contain alcohol.
21. Answer: D. Vital signs
- Option D: Monitoring of vital signs provides the best information about the client’s overall physiologic status during alcohol withdrawal & the physiologic response to the medication used.
22. Answer: A. Respiratory depression
- Option A: After administering naloxone (Narcan) the nurse should monitor the client’s respiratory status carefully, because the drug is short acting & respiratory depression may recur after its effects wear off.
23. Answer: B. The number of drug-free days he has
- Option B: The best measure to determine a client’s progress in rehabilitation is the number of drug-free days he has. The longer the client is free of drugs, the better the prognosis is.
24. Answer: D. Respiratory failure
- Option D: Barbiturates are CNS depressants; the nurse would be especially alert for the possibility of respiratory failure. Respiratory failure is the most likely cause of death from barbiturate overdose.
25. Answer: B. Formication
- Option B: The feeling of bugs crawling under the skin is termed as formication, and is associated with cocaine use.
26. Answer: D. Haldol
- Option D: The nurse would prepare to administer an antipsychotic medication such as Haldol to a client experiencing amphetamine psychosis to decrease agitation & psychotic symptoms, including delusions, hallucinations & cognitive impairment.
27. Answer: C. Cranberry Juice
- Option C: An acid environment aids in the excretion of PCP. The nurse will definitely give the client with PCP intoxication cranberry juice to acidify the urine to a ph of 5.5 & accelerate excretion.
28. Answer: A. Facilitating progressive review of the accident and its consequences
- Option A: The nurse would facilitate progressive review of the accident and its consequence to help the client integrate feelings & memories and to begin the grieving process.
29. Answer: B. Invite the client to lunch and accompany him to the dining room
- Option B: The nurse instructs the nursing assistant to invite the client to lunch & accompany him to the dining room to decrease manipulation, secondary gain, dependency and reinforcement of negative behavior while maintaining the client’s worth.
30. Answer: C. Staying with the individuals involved
- Option C: This provides support until the individuals coping mechanisms and personal support systems can be immobilized.
31. Answer: C. Resolving the loss
- Option C: Resolving a loss is a slow, painful, continuous process until a mental image of the dead person, almost devoid of negative or undesirable features emerges.
32. Answer: A. Accentuated premorbid traits
- Option A: A moderate level of cognitive impairment due to dementia is characterized by increasing dependence on environment & social structure and by increasing psychologic rigidity with accentuated previous traits & behaviors.
33. Answer: C. Providing basic intellectual stimulation
- Option C: This action maintains for as long as possible, the client’s intellectual functions by providing an opportunity to use them.
34. Answer: A. Affective instability
- Option A: Individuals with anorexia often display irritability, hospitality, and a depressed mood.
35. Answer: D. Impaired verbal communication related to depression
- Option D: Depressed clients demonstrate decreased communication because of lack of psychic or physical energy.
36. Answer: C. Provide foods, fluids and rest
- Option C: The client in a manic episode of the illness often neglects basic needs, these needs are a priority to ensure adequate nutrition, fluid, and rest.
37. Answer: B. Loneliness
- Option B: The withdrawn pattern of behavior presents the individual from reaching out to others for sharing the isolation produces feeling of loneliness.
38. Answer: A. Defensive behavior
- Option A: The nurse’s response is not therapeutic because it does not recognize the client’s needs but tries to make the client feel guilty for being demanding.
39. Answer: B. Recognizing each existing personality
- Option B: The client must recognize the existence of the sub-personalities so that interpretation can occur.
40. Answer: D. Rejection
- Option D: An aloof, detached, withdrawn posture is a means of protecting the self by withdrawing and maintaining a safe, emotional distance.
41. Answer: C. Adolescence
- Option C: The usual age of onset of schizophrenia is adolescence or early childhood.
42. Answer: A. Somatic delusions
- Option A: Somatic delusion is a fixed false belief about one’s body.
43. Answer: C. Withdrawal, regressed behavior, and lack of social skills
- Option C: These are the classic behaviors exhibited by clients with a diagnosis of schizophrenia.
44. Answer: D. Feeling more anxious today
- Option D: The fetal position represents regressed behavior. Regression is a way of responding to overwhelming anxiety.
45. Answer: B. Leave the client alone until he stops talking
- Option B: This provides a stimulus that competes with and reduces hallucination.
46. Answer: D. After going to bed
- Option D: Auditory hallucinations are most troublesome when environmental stimuli are diminished and there are few competing distractions.
47. Answer: A. Projection
- Option A: Projection is a mechanism in which inner thoughts and feelings are projected onto the environment, seeming to come from outside the self rather than from within.
48. Answer: B. Providing the client with activities in which success can be achieved
- Option B: This will help the client develop self-esteem and reduce the use of paranoid ideation.
49. Answer: B. Denial
- Option B: Denial is a method of resolving conflict or escaping unpleasant realities by ignoring their existence.
50. Answer: C. Irritability, heightened alertness, jerky movements
- Option C: Alcohol is a central nervous system depressant. These symptoms are the body’s neurological adaptation to the withdrawal of alcohol.
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Recommended Books and Resources
Selected NCLEX-RN review books:
- MUST HAVE Saunders Comprehensive Review for the NCLEX-RN® Examination, 7th Edition – A must-have book if you're taking the NCLEX-RN. You need to have this.
- Saunders Strategies for Success for the NCLEX – An invaluable guide that will help you master what matters most in passing nursing school and the NCLEX.
- Mosby's Comprehensive Review of Nursing for NCLEX-RN – This book has helped nurses pass the NCLEX exam for over 60 years. Practice with over 600 alternative item question formats.
- Lippincott Q&A Review for NCLEX-RN – A different approach to NCLEX-RN review.
- Prioritization, Delegation, and Assignment: Practice Exercises for the NCLEX Examination – An NCLEX review book that focuses on prioritization, delegation, and patient assignment.