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Mental Health Practice Exam Questions And Answers
Mental Health Practice Exam Questions And Answers
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Mental Health Practice ExamQuestions And Answers
The nurse is conducting discharge teaching for a client with schizophrenia
who plans to live in a group home. Which statement is most indicative of the
need for careful follow-up after discharge?
a. Crickets are a good source of protein.
b. I have not heard any voices for a week.
c. Only my belief in God can help me.
d. Sometimes I have a hard time sitting still - -*C. Only my belief in God can
help me.*
The most frequent cause of increased symptoms in psychotic clients is non-
compliance with the medication regimen. If clients believe that "God alone"
is going to heal them (C) then they may discontinue their medication, so (C)
would pose the greatest threat to this client's prognosis. (A) would require
further teaching, but is not as significant a statement as (C). (B) indicates an
improvement in the client's condition. (D) may be a sign of anxiety that could
improve with tx, but does not have the priority of (C).
-A child is brought to the ER with a broken arm. Because of other injuries,
the nurse suspects the child may be a victim of abuse. When the nurse tries
to give the child an injection, the child's mother becomes very loud and
shouts, "I won't leave my son! Don't you touch him! You'll hurt my child!"
What is the best interpretation of the mother's statements? The mother is
a. regressing to an earlier behavior pattern.
b. sublimating her anger.
c. projecting her feelings onto the nurse.
d. suppressing her fear. - -*C. projecting her feelings onto the nurse.*
Projection is attributing one's own thoughts, impulses, or behaviors onto
another--it is the mother who is probably harming the child and she is
attributing her actions to the nurse (C). The mother may be immature, but
(A) is not the best description of her behavior. (B) is substituting a socially
acceptable feeling for an unacceptable one. These are not socially
acceptable feelings. The mother may be suppressing her fear (D) by
displaying anger, but such an interpretation cannot be concluded from the
data presented.
-An elderly female client with advanced dementia is admitted to the hospital
with a fractured hip. The client repeatedly tells the staff, "Take me home. I
want my Mommy." Which response is best for the nurse to provide?
,a. Orient the client to the time, place, and person.
b. Tell the client that the nurse is there and will help her.
c. Remind the client that her mother is no longer living.
d. Explain the seriousness of her injury and need for hospitalization. - -*B.
Tell the client that the nurse is there and will help her.*
Those with dementia often refer to home or parents when seeking security
and comfort. The nurse should use the techniques of "offering self" and
"talking to the feelings" to provide reassurance (B). Clients with advanced
dementia have permanent physiological changes in the brain (plaques and
tangles) that prevent them from comprehending and retaining new
information, so (A, C, and D) are likely to be of little use to this client and do
not help the clients emotional needs.
-A 27 y/o F client is admitted to the psychiatric hospital with a dx of bipolar
disorder, manic phase. She is demanding and active. Which intervention
should the nurse include in this client's plan of care?
a. Schedule her to attend various group activities.
b. Reinforce her ability to make her own decisions.
c. Encourage her to identify feelings of anger.
d. Provide a structured environment with little stimuli. - -*D. Provide a
structured environment with little stimuli.*
Clients in the manic phase of bipolar disorder require decreased stimuli and
a structured environment (D). Plan noncompetitive activities that can be
carried out alone. (A) is contraindicated; stimuli should be reduced as much
as possible. Impulsive decision-making is characteristic of clients with bipolar
disorder. To prevent future complications, the nurse should monitor these
clients' decisions and assist them in decision-making process (B). (C) is more
often associated with depression than with bipolar disorder.
-An adult male client who was admitted to the mental hospital unit
yesterday tells the nurse that microchips were planted in his head for
military surveillance of his every move. Which response is best for the nurse
to provide?
a. You are in the hospital, and I am the nurse caring for you.
b. It must be difficult for you to control your anxious feelings.
c. Go to occupational therapy and start a project.
d. You are not in a war area now; this is the United States. - -* C. Go to
occupational therapy and start a project.*
Delusions often generate fear and isolation, so the nurse should help the
client participate in activities that avoid focusing on the false belief and
,encourage interaction with others (C). Delusions are often well-fixed, and
though (A) reinforces reality, it is argumentative and dismisses the clients
fears. It is often difficult for the client to recognize the relationship between
delusions and anxiety (B), and the nurse should reassure the client that he is
in a safe place. Dismissing delusional thinking (D) is unrealistic because
neurochemical imbalances that cause positive symptoms of schizophrenia
require antipsychotic drug therapy.
-A 38 y/o F client is admitted with a dx of paranoid schizophrenia. When her
tray is brought to her, she refuses to eat and tells the nurse, "I know you're
trying to poison me with that food." Which response is most appropriate for
the nurse to make?
a. I'll leave your tray here. I am available if you need anything else.
b. You're not being poisoned. Why do you think someone is trying to poison
you?
c. No one on this unit has ever died from poisoning. You're safe here.
d. I will talk to your HCP about the possibility of changing your diet. - -*A. I'll
leave your tray here. I am available if you need anything else.*
(A) is the best choice cited. The nurse doesn't argue with the client nor
demand that she eat, but offers support by agreeing to "be there if needed",
e.g., to warm the food. (B and C) are arguing with the client's delusions, and
(B) asks "why" which is usually not a good question for a psychotic client. (D)
has nothing to do with the actual problem; i.e., the problem is not the diet
(she thinks any food given to her is poisoned).
-A homeless person who is in the manic phase of bipolar disorder is
admitted to the mental health unit. Which lab finding obtained on admission
is most important for the nurse to report to the HCP?
a. Decreased TSH level.
b. Elevated liver function profile.
c. Increased WBC count.
d. Decreased Hct and Hgb levels. - -*A. Decreased TSH level.*
Hyperthyroidism causes an increased level of serum thyroid hormones (T3
and T4), which inhibits the release of TSH (A), so the client's manic behavior
may be related to an endocrine disorder. (B, C, and D) are abnormal findings
that are commonly found in the homeless population because of poor
sanitation, poor nutrition, and the prevalence of substance abuse
-The nurse is planning discharge teaching for a male client with
schizophrenia. The client insists that he is returning to his apartment,
although the HCP informed him that he will be moving to a boarding home.
What is the most important nursing dx for discharge planning?
, a. Ineffective denial r/t situational anxiety.
b. Ineffective coping r/t inadequate support.
c. Social isolation r/t difficult interactions.
d. Self-care deficit r/t cognitive impairment. - -*A. Ineffective denial r/t
situational anxiety.*
The best nursing dx is (A) because the client is unable to acknowledge the
move to a boarding home. (B, C, and D) are potential nursing diagnoses, but
denial is most important because it is a defense mechanism that keeps the
client from dealing with his feelings about living arrangements.
-A client who has been admitted to the psychiatric unit tells the nurse, "My
problems are so bad that no one can help me." Which response is best for
the nurse to make?
a. How can I help?
b. Things probably aren't as bad as they seem right now.
c. Let's talk about what is right with your life.
d. I hear how miserable you are, but things will get better soon. - -*A. How
can I help?*
Offering self shows empathy and caring (A), and is the best of the choices
provided. Combining the first part of (D) with (A) would be the best response,
but this is not a fill-in-the-blank or an essay test! Choose the best of those
choices provided and move on. (B) dismisses the client, things are bad as far
as this client is concerned. (C) avoids the clients problems and promotes
denial. "I hear how miserable you are" is an example of reflective dialogue
and would be the best choice if it were not for the rest of the sentence--"but
things will get better" which is offering false reassurance.
-A young adult male client, diagnosed with paranoid schizophrenia, believes
the world is trying to poison him. What intervention should the nurse include
in this client's plan of care?
a. Remind the client that his suspicions are not true.
b. Ask one nurse to spend time with the client daily.
c. Encourage the client to participate in group activities.
d. Assign the client to a room closest to the activity room. - -*B. Ask one
nurse to spend time with the client daily.*
A client with paranoid schizophrenia has difficulty with trust and a
developing trusting relationship with one nurse (B) is likely to be therapeutic
for this client. (A) is argumentative. Stress increases anxiety, and anxiety
increases paranoid ideation; (C) would be too stressful and anxiety-
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