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Mental Health & Psychiatric Nursing NCLEX Challenge Exam (Quiz #1: 50 Questions) WITH ANSWERS AND DETAILED EXPLANATION $12.99
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Mental Health & Psychiatric Nursing NCLEX Challenge Exam (Quiz #1: 50 Questions) WITH ANSWERS AND DETAILED EXPLANATION

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  • Mental Health & Psychiatric Nursing NCLEX

Title: Mental Health & Psychiatric Nursing ATI NCLEX Challenge Exam (Quiz #1: 50 Questions) WITH ANSWERS AND DETAILED EXPLANATION Description: Prepare for success in your mental health and psychiatric nursing exams with our comprehensive ATI NCLEX Challenge Exam (Quiz #1: 50 Questions) package,...

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  • May 10, 2024
  • 69
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers
  • Mental Health & Psychiatric Nursing NCLEX
  • Mental Health & Psychiatric Nursing NCLEX
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Mental Health & Psychiatric Nursing NCLEX
Challenge Exam (Quiz #1: 50 Questions)
WITH ANSWERS AND DETAILED
EXPLANATION
1. 1. Question

1 point(s)
Flumazenil (Romazicon) has been ordered for a male client who has
overdosed on oxazepam (Serax). Before administering the medication,
nurse Gina should be prepared for which common adverse effect?

o A. Seizures
o B. Shivering
o C. Anxiety
o D. Chest pain
Correct
Correct Answer: A. Seizures
Seizures are the most common serious adverse effect of using flumazenil
to reverse benzodiazepine overdose. The effect is magnified if the client
has a combined tricyclic antidepressant and benzodiazepine overdose.
Benzodiazepine reversal has correlations with seizures. Seizures may
happen more frequently in patients who have been on benzodiazepines for
long-term sedation or in patients who are showing signs of severe tricyclic
antidepressant overdose. The required dosage of Flumazenil should be
measured and prepared by the practitioners to manage seizures.
Flumazenil use requires caution in patients relying on a benzodiazepine for
seizure control.
• Option B: Shivering is not an adverse effect of flumazenil.
Monitor the patient for the possible return of sedation, mostly
in those who are tolerant of benzodiazepines. Patients should
have monitoring for respiratory depression, benzodiazepine

, withdrawal, and other residual effects of benzodiazepines for
at least 2 hours.
• Option C: Anxiety is a rare adverse effect for people using
flumazenil. Flumazenil has some associations with
precipitation of seizures in patients with benzodiazepine
dependence with a history of seizures. Flumazenil overdose is
extremely rare. There is no precise antidote for flumazenil
toxicity. In mild to severe toxicity, symptomatic and supportive
treatment should be a consideration.
• Option D: An overdose of flumazenil in a patient who is not a
chronic benzodiazepine user would not be expected. Chronic
benzodiazepines users may experience withdrawal with abrupt
discontinuation of the drug. Administration of
benzodiazepines or barbiturates may be necessary for seizure
control.
2. 2. Question

1 point(s)
Nurse Tamara is caring for a client diagnosed with bulimia. The most
appropriate initial goal for a client diagnosed with bulimia is to:

o A. Avoid shopping for large amounts of food.
o B. Control eating impulses.
o C. Identify anxiety-causing situations.
o D. Eat only three meals per day.
Answer
Correct Answer: C. Identify anxiety-causing situations
Bulimic behavior is generally a maladaptive coping response to stress and
underlying issues. The client must identify anxiety-causing situations that
stimulate the bulimic behavior and then learn new ways of coping with the
anxiety. Bulimia nervosa is a condition that occurs most commonly in
adolescent females, characterized by indulgence in binge-eating, and
inappropriate compensatory behaviors to prevent weight gain.
• Option A: Controlling shopping for large amounts of food
isn’t a goal early in treatment. It is important to educate
patients who abuse laxatives that these medications work in

, the gastrointestinal tract after the areas where caloric
absorption has occurred primarily. It is crucial to inform
patients that a period of edema and weight gain may follow
up to several weeks after discontinuation of purging behavior.
• Option B: Managing eating impulses and replacing them with
adaptive coping mechanisms can be integrated into the plan
of care after initially addressing stress and underlying issues.
The primary objective of treatment is a cessation of the
binging and purging behavior. Selective serotonin reuptake
inhibitors such as fluoxetine, citalopram, and sertraline have
shown to reduce symptoms of bulimia nervosa. Fluoxetine is
the only FDA approved medication for bulimia nervosa. It
appears that a higher dose (60 mg) is significantly better than
a placebo in decreasing the frequency of binge and vomiting
episodes.
• Option D: Eating three meals per day isn’t a realistic goal early
in treatment. Patients with bulimia nervosa who purge by
vomiting often brush their teeth immediately after purging,
which can accelerate dental erosion. The clinician should
instruct the patients who persist in vomiting to rinse their
mouths with water or fluoride rather than brushing their teeth
within 30 minutes of each episode. Consider consulting a
dentist to address dental issues associated with vomiting.
3. 3. Question

1 point(s)
A female client who’s at high risk for suicide needs close supervision. To
best ensure the client’s safety, Nurse Mary should:

o A. Check the client frequently at irregular intervals throughout
the night.
o B. Assure the client that the nurse will hold in confidence anything
the client says.
o C. Repeatedly discuss previous suicide attempts with the client.
o D. Disregard decreased communication by the client because this is
common with suicidal clients.

, Correct
Correct Answer: A. Check the client frequently at irregular intervals
throughout the night
Checking the client frequently but at irregular intervals prevents the client
from predicting when observation will take place and altering behavior in a
misleading way at these times. Once the patient is deemed to be at risk for
suicide, then intervention steps must be initiated right away. The individual
must not be left alone. Enlist the help of a support person while at home.
The suicidal individual must be treated in a safe and secure place. In
addition, the place has to be monitored.
• Option B: This may encourage the client to try to manipulate
the nurse or seek attention for having a secret suicide plan.
Assessing the individual’s judgment is critical. One should try
and determine how the individual can handle stress. Does he
or she have an impairment in decision making? Does the
individual know that jumping in front of a train is dangerous?
Reflect empathy and concern. Offer a hand to help. Provide
the patient with confidence that he or she can overcome the
issues.
• Option C: This may reinforce suicidal ideas. Help develop
internal coping strategies (e.g., exercise, journaling, reading,
developing a hobby). Utilize the help of healthcare
professionals to follow up on therapy. Once the individual is
safe as an inpatient or outpatient, a formal treatment plan
should be established. The next step is to refer all patients
deemed to be at higher risk for suicide to a mental health
counselor as soon as possible. Every state has laws and
procedures regarding this process which must be incorporated
into the clinical practice when addressing individuals at high
suicide risk.
• Option D: Decreased communication is a sign of withdrawal
that may indicate the client has decided to commit suicide; the
nurse shouldn’t disregard it. In some cases, assessment of the
mental status may provide a clue to the individual’s potential
for self-harm. Depressed patients will often tend to appear
unclean and unkempt. The clothing may not be ironed or dirty.
The risk of suicide is often high in people who appear very

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