1- A client with depression remains in bed most of the day, declines activities and re which

nursing problem has the greatest priority for this client?

A) Loss of interest in diversional activity

B) Social isolation

C) Refusal to address nutritional needs.

D) Low self-esteem

2- The nurse is preparing medications for a client with bipolar disorder and notice

antipsychotic medication was discontinued several days ago. Which medication

discontinued?

A) Lithium (lithotabs)

B) Benztropine (cogetin)

C) Alprazolam ( Xanax)

D) Magnesium (milk of magnesia)

3- A female client requests that her husband be allowed to stay in the room during the

admission assessment. While interviewing the client, the nurse notes a discrepancy

between the client’s verbal and nonverbal communication. What action should the nurse

take?

A) Pay close attention and document the nonverbal message.

B) Ask the client’s husband to interpret the discrepancy

C) Ignore the nonverbal behavior and focus on the client’s verbal message.

D) Integrate the verbal and nonverbal message and interpret them as one.

4- A male client approaches the nurse with an angry expression on his face and raises his

voice, saying, “My roommate is the most selfish, self-centered, angry person I have ever

met. If he loses his temper one more time with me, I am going to punch out! “the nurse

recognizes that client is using which defense mechanism?

A) Denial

B) Projection

C) Rationalization

D) Splitting

5- A male client with bipolar disorder who began taking lithium carbonate five days ago is

complaining of excessive thirst, and the nurse finds him attempting to drink water from

the bathroom sink faucet. Which intervention the nurses implement?

A) Report the client’s serum lithium level to the healthcare provider.

B) Encourage the client to suck on hard candy to relieve the symptoms.

C) No action is needed since polydipsia is a common side effect.

D) Tell the client that drinking from the faucet is not allowed.

6- The nurse is teaching a client about the initiation of a prescribed abstinence therapy using

disulfiram (antabuse). What information should the client acknowledge understanding?

A) Completely abstain from heroin or cocaine use.

B) Remain alcohol free for 12 hours prior to the first dose.

C) Attend monthly meeting of alcoholics anonymous.

D) Admit to other that he is a substance abuser.

7- A male client with schizophrenia is admitted to the mental health unit after abruptly

stopping his prescription for ziprasidone (Geodon) one month ago. Which question is

most important for the nurse to ask the client?

A) Have you lost interest in the things that you used to enjoy?

B) Is your ability to think or concentrate decreased?

C) How many continuous hours do you sleep at night?

D) Do you hear sounds or voices that others do not hear?

8- During an annual physical by the occupational nurse working in a corporate clinic, a male

employee tells the nurse that his high-stress job is causing trouble in his personal life. He

further explains that he often gets so angry while driving to and from work that he has

considered “getting even” with other drivers. How should the nurse respond?

A) “Anger is contagious and could result in a major confrontation”

B) “ Try not to let your anger cause you to act impulsively”

C) “Expressing your anger to a stranger could result in an unsafe situation”

D) “It sound as if there are many situations that make you feel angry”

9- A client who has agoraphobia (a fear of crowds) is beginning desensitization with the

therapist, and the nurse is reinforcing the process. Which intervention has the highest

priority for this client’s plan of care?

A) Encourage substitution of positive thoughts for negative ones.

B) Establish trust by providing a calm, safe environment.

C) Progressively expose the client to larger crowds.

D) Encourage deep breathing when anxiety escalates in a crowd.

10- Which nursing actions are likely to help promote the self-esteem of a male client with

moderate depression? ( select all that apply)

A) Ask the client what his long- term goals are.

B) Discuss the challenges of his medical condition.

C) Include the client in determining treatment protocol.

D) Encourage the client to engage in recreational therapy.

E) Provide opportunities for the client to discuss his concerns.

11- A male client is admitted to the psychiatric unit for recurrent negative symptoms of

chronic schizophrenia and medication adjustment of risperidone (Risperdal). When the

client walks to the nurse’s station in a literally contracted position, he states that

something has made his body confort into a monster. What action should the nurse take?

A) Medicate the client with the prescribed antipsychotic thioridazine (mellaril)

B) Offer the client a prescribed physical therapy hot pack for muscle spasms.

C) Direct client to occupational therapy to distract him from somatic complaints.

D) Administer the prescribed anticholinergic benztropine (Cogentin) for dystonia.

12- A mental health worker (MHW) is caring for a client with escalating aggressive

behavior. Which action by the MHW warrants immediate intervention by the nurse?

A) Is attempting to physically restrain the client.

B) Tells the client to go to the quiet area of the unit.

C) Is using a loud voice to talk to the client.

D) Remains at a distance of 4 feet from the client.

13- A client on the mental health unit is becoming more agitated, shouting at the staff, and

pacing in the hallway. When a PRN medication is offered, the client refuses the

medication and defiantly sits on the floor in the middle of the unit hallway. What nursing

intervention should the nurse implement first?

A) Transport of the client to the seclusion room

B) Quietly approach the client with additional staff members.

C) Take other client in the area to the client lounge.

D) Administer medication to chemically restrain the client.

14- A client is admitted to the mental health unit and reports taking extra antianxiety

medication because, “I’m so stressed out. I just wanted to go sleep” the nurse should plan

one-on- one observation of the client based on which statement?

A) What should I do? Nothing seems to help.”

B) I have been so tired lately and needed to sleep.”

C) I really think that I don’t need to be here.”

D) I don’t want to talk. Nothing matters anymore.”

15- A male hospital employee is pushed out of the way by a female employee because of an

oncoming gurney. The pushed employee becomes very angry and swings at the female

employee. Both employees are referred for counseling with the staff psychiatric nurse.

Which factor in the pushed employee’s history is most related to the reaction that

occurred?

A) Is worried about losing his job to a woman

B) Tortured animals as a child.

C) Was physically abused by his mother

D) Hates to be touched by anyone