Mental Health NCLEX Questions

A nursing assistant shares with the nurse that a client with schizophrenia is as difficult to communicate with as "someone with Alzheimer's." The nurse offers the following advice:

"His medication targets his disturbed thought and speech patterns. To maximize improvement he will need positive interactions and support."

A client needs assistance in using coping mechanisms to decrease anxiety. What should the nurse do?

A coping mechanism involves any effort to decrease anxiety and can be constructive or destructive, task-oriented, or defense-oriented. The nurse should first help the client to identify the source of anxiety. Next, the nurse should explore with the client various methods to reduce anxiety, such as relaxation methods. The client may use a defense mechanism to protect himself or herself from anxiety . A defense mechanism is a coping mechanism used in an effort to protect the individual form feelings of anxiety: as anxiety increases and becomes overwhelming, the individual copes by using defense mechanisms to protect the ego and decrease anxiety, If this occurs, the nurse should facilitate appropriate and constructive use of the defense mechanism, and determine whether the defense mechanism used by the client is effective for him or her or creates additional distress. The nurse should never criticize the client's behavior or the use of deference mechanism.

Suicide attempt

Any willful, self-inflicted, or life-threatening attempt by an individual that has not led to death.

Which organs secrete hormones that are a normal component of the body's general response to stress?

Brain, pituitary gland, adrenal glands.

A suspicious client who smokes several packs of cigarettes daily and drinks large quantities of coffee and soda as he is able to afford reacts to every nursing intervention with sarcasm. When asking for advice, the nurse manager's most helpful response is: a. "You are dealing with a very difficult and resistant client, just keep with your plan." b. "If you haven't been able to establish client trust by now, ask for a change of assignment." c. "Remember that sarcasm represents the oral-stage fixation of development." d. "You are attempting to work with a client who likes to keep others off-balance."

C. "Remember that sarcasm represents the oral-stage fixation of development."

An important difference between the developmental theories of Freud and Erikson is: a. Freud considers the entire life span from birth to old age. b. Freud focuses to a greater extent on cognitive development. c. Erikson viewed individual growth in terms of social setting. d. Erikson focuses on the development of individual moral thinking.

C. Erikson viewed individual growth in terms of social setting.

A client's communication is marked by loose associations and word salad. Dysfunction of which portion of the brain is responsible for these symptoms?

Cerebrum

Defense mechanism

Coping mechanism used in an effort to protect the individual from feelings of anxiety. As anxiety increases and becomes overwhelming, the individual copes by using defense mechanisms to protect the ego and decrease anxiety.

A client with a diagnosis of major depression who has attempted suicide says to the nurse, "I should have died. I've always been a failure. Nothing ever goes right for me." Which response demonstrates therapeutic communication? a. "You have everything to live for." b. "Why do you see yourself as a failure?" c. "Feeling like this is all part of being depressed." d. "You've been feeling like a failure for a while?"

D. "You've been feeling like a failure for a while?"

On the basis of the current understanding of neurotransmitters, the nurse can view a client's symptoms of profound depression as likely related in part to..

Decreased serotonin level.

When a tumor of cerebellum is present, the nurse should expect that the client would initially demonstrate:

Disequilibrium

Coping mechanism

Method used to decrease anxiety.

Using the total environment, including the people, setting, and emotional climate, as therapy is called________________ therapy.

Milieu

Cells that respond to stimuli, conduct electrical impulses, and release neurotransmitters are called:

Neurons

Milieu

Physical and social environment in which an individual lives. Milieu therapy focuses on positive physical and social environmental manipulation to produce positive change.

Restraints (Security devices)

Physical restraints include any manual method or mechanical device, material, or equipment that inhibits free movement. Chemical restraints include administration of medications for the specific purpose of inhibiting a specific behavior or movement.

Seclusion

Placing a client alone in a specially designed room that protects the client and allows for close supervision. Seclusion is the last selected measure in a process to maximize safety to the client and others.

Which imaging technique can provide information about brain function?

Positron emission tomography (PET) scan

The incoherent thought and speech patterns of the client with schizophrenia are related to the brain's inability to:

Regulate conscious mental activity.

The behavior of an individual who seems unable to learn right from wrong and who repeatedly violates laws and lies demonstrates problems related to the brain's inability to..?

Regulate social behavior.

A client being medicated for both hallucinations and delusions reports being drowsy. The nurse will correctly interpret this symptom as related to the drug's effect on the brain's ability to regulate.....

Sleep

Which of the following is classified as a circadian rhythm?

Sleep cycle

Addiction

State of dependence or compulsive use. In relation to drug dependence, addiction incorporates the concepts of loss of control with respect to the use of a drug, taking the drug despite related problems and complications, and a tendency to relapse.

Crisis

Temporary state of disequilibrium in which an individual's usual coping mechanisms or problem-solving methods fail. Crisis can result in personality growth or personality disorganization.

Homeostasis is promoted by interaction between the brain and internal organs mediated by:

The autonomic nervous system

Suicide

The ultimate act of self-destruction in which an individual purposefully ends his or her own life.

Abuse

When directed toward another includes acts of misuse, deceit, or exploitation; the wrong or improper use or action toward another individual that results in injury, damage, maltreatment, or corruption.

You are caring for Kiley, a 29-year-old female patient who is being admitted following a suicide attempt. Which of the following illustrates the concept of patient advocacy? a. "Dr. Raye, I notice you ordered Prozac for Kiley, She has stated to me that she does not want to take Prozac because she had adverse effects when it was previously prescribed." b. "Dr. Raye, during her admissions interview Kiley stated that she has had three other suicide attempts in the past." c. "Kiley, can you tell me more about your depression and your suicide attempt?" d. "Kiley, I will take you on a tour of the unit and orient you to the rules."

a. "Dr. Raye, I notice you ordered Prozac for Kiley, She has stated to me that she does not want to take Prozac because she had adverse effects when it was previously prescribed."

The nurse employed in the mental health clinic is greeted by a neighbor in a local grocery store. The neighbor says to the nurse, "How is Carol doing? She is my best friend and is seen at your clinic every week." Which is the most appropriate nursing response? a. "I cannot discuss any client situation with you." b. "If you want to know about Carol, you need to ask her yourself." c. "Only because you're worried about a friend, I'll tell you that she is improving." d. "Being her friend, you know she is having a difficult time and deserves her privacy."

a. "I cannot discuss any client situation with you."

A cognitive therapist would help a client restructure the thought "I am stupid!" to: a. "What I did was stupid." b. "I am not as smart as others." c. "Things usually go wrong for me." d. "Things like this should not happen to anyone."

a. "what i did was stupid."

Treatment of mental illnesses with psychotropic drugs is directed at:

a. Altering brain neurochemistry

The premise underlying behavioral therapy is: a. Behavior is learned and con be modified. b. Behavior is a product of unconscious drives. c. Motives must change before behavior changes. d. behavior is determined by cognitions; change in cognitions produces new behavior.

a. Behavior is learned and can be modified.

A client admitted voluntarily for treatment of an anxiety disorder demands to be released from the hospital. Which action should the nurse take initially? a. Contact the client's health care provider (HCP). b. Call the client's family to arrange for transportation. c. Attempt to persuade the client to stay "for only a few more days." d. Tell the client that leaving would likely result in an involuntary commitment.

a. Contact the client's health care provider (HCP).

A client being seen in the emergency department immediately after being sexually assaulted appears calm and controlled. The nurse analyzes this behavior as indicating which defense mechanism? a. Denial b. Projection c. rationalization d. Intellectualization

a. Denial

Which statement best describes the DSM-5? a. it is a medical psychiatric assessment system. b. it is a compendium of treatment modalities. c. it offers a complete list of nursing diagnoses. d. it suggests common interventions for mental disorders.

a. It is a medical psychiatric assessment system.

The basic functional unit of the nervous system is called a: a. neuron b. synapse c. receptor d. neurotransmitter

a. Neuron

The nurse in the mental health unit recognizes which as being therapeutic communication techniques? Select all that apply: a. Restating b. Listening c. Asking the client, "Why?" d. Maintaining neutral response e. Providing acknowledgment and feedback f. Giving advice and approval or disapproval

a. Restating b. Listening d. Maintaining neutral response e. Providing acknowledgment and feedback

Which statement best clarifies the difference between the art and the science of nursing? a. The art is the care, compassion, and advocacy component, and the science is the applied knowledge base. b. the art is the way in which knowledge is applied, and the science is the technological aspect of caregiving. c. the art is the applied technology of practice, and the science is the problem-solving and teaching aspects of caregiving. d. The art is the assessing and planning phase of the nursing process, and the science lies in implementing and evaluating.

a. The art is the care, compassion, and advocacy component, and the science is the applied knowledge base.

According to the DSM-5, there is evidence that symptoms and causes of mental illness are influenced by: a. cultural and ethnic factors. b. occupation and status. c. birth order. d. sexual preference

a. a cultural and ethnic factors

Current information suggests that the most disabling mental disorders are the result of? a. biological influences b. psychological trauma c. learned ways of behaving d. faulty patterns of early nurturance

a. biological influences

A client admitted to a mental health unit for treatment of psychotic behavior spends hours at the locked exit door shouting, "Let me out. There's nothing wrong with me. I don't belong here." What defense mechanism is the client implementing? a. denial b. projection c. regression d. rationalization

a. denial

The nurse is work with a client experiencing both post-partum depression and very low self-esteem. The client is distrustful of unit staff and "just wants to go home." Initially the nurse's priority is to: a. establish trust with the client. b. teach the client effective mothering skills. c. identify positive traits the client possesses. d. focus on preparing for a speedy discharge.

a. establish trust with the client.

The nurse planning care for a mentally ill client bases interventions on the concept that the client: a. has areas of strength on which to build. b. has right that must be respected. c. comes with experiences that contribute to their problem. d. share fears that are similar to those of all mentally healthy individuals.

a. has areas of strength on which to build.

Maslow's theory of humanistic psychology has provided nursing with a framework for: a. holistic assessment b. determining moral development. c. identifying the potential for success in therapy. d. conducting nurse-client interpersonal interactions.

a. holistic assessment.

A 14-year-old belongs to a neighborhood gang, engages in sexually promiscuous behavior, and has a history of school truancy but reports that her parents are just old-fashioned and don't understand her. The assessment data supports that the client: a. is displaying deviant behavior. b. cannot accurately appraise reality. c. is seriously and persistently mentally ill. d. should be considered for group home placement.

a. is displaying deviant behavior.

When reviewing the admission assessment, the nurse notes that a client was admitted to the mental health unit involuntarily. Based on this type of admission, the nurse should provide which intervention for this client? a. Monitor closely for harm to self or others b. Assist in completing an application for admission c. Supply the client with written information about their mental illness d. Provide an opportunity for the family to discuss why they felt the admission was needed

a. monitor closely for harm to self or others

One implication of Freud's theory of the unconscious on psychiatric mental health nursing is related to the consideration that conscious and unconscious influences can help nurses better understand. a. the root causes of client suffering b. the client's immature behavior c. the client's interpersonal interactions. d. the client's psychological ability to reason.

a. the root causes of client suffering.

A client experiencing disturbed thought processes believes that his food is being poisoned. Which communication technique should the nurse use to encourage the client to eat? a. using open-ended questions and silence. b. sharing personal preference regarding food choices c. documenting reasons why the client does not want to eat. d. offering opinions about the necessity of adequate nutrition.

a. using open-ended question and silence.

The nurse is providing care to a client admitted to the hospital with a diagnosis of acute anxiety disorder. The client says to the nurse, " I have a secret that I want to tell you. You won't tell anyone about it, will you?" What is the most appropriate nursing response? a. "No, I won't tell anyone." b. "I cannot promise to keep a secret." c. "It depends on what the secret is about." d. "If you tell me the secret, I may need to document it."

b. "I cannot promise to keep a secret."

The nurse calls security and has physical restraints applied when a client who was admitted voluntarily becomes both physically and verbally abusive while demanding to be discharged from the hospital. Which represents the possible legal ramifications for the nurse associated with these interventions? Select all that apply: a. Libel b. Battery c. Assault d. Slander e. False imprisonment

b. Battery c. Assault e. False imprisonment

A nurse who is active in local consumer mental health groups and in local and state mental health associations and who keeps aware of state and national legislation affecting mental illness treatment may positively affect the climate for treatment by: a. becoming active in politics leading to a potential political career. b. reducing the stigma of mental illness and advocating for equality in treatment. c. encouraging laws that would make the involuntary long-term commitment process easier and faster for caregivers of mentally ill persons. d. advocating for reduced mental health insurance benefits to discourage abuse of the system by inappropriate psychiatric admissions.

b. Reducing the stigma of mental illness and advocating for equality in treatment.

Which of the following is considered a primary behavioral theorist? a. Freud b. Skinner c. Sullivan d. Peplau

b. Skinner

A client tells the mental health nurse " I am terribly frightened! I hear whispering that someone is going to kill me." Which criterion of mental health can the nurse assess as lacking? a. Control over behavior b. Appraisal of reality c. Effectiveness in work d. Healthy self-concept

b. appraisal of reality

Using Maslow's model of needs, the nurse providing care for an anxious client identifies the priority intervention to be: a. assessing the client's success at fulfilling her appropriate developmental level tasks. b. assessing the client for her strengths upon which a nurse-client relationship can be based. c. planning one-on-one time with the client to assist in identifying the fears behind her anxiety. d. evaluating the client's ability to learn and retain essential information regarding her condition.

b. assessing the client for her strengths upon which a nurse-client relationship can be based.

Which statement about diagnosis of a mental disorder is true? a. The symptoms of each disorder are common among all cultures. b. Culture may cause variations in symptoms for each clinical disorder. c. All mental disorders listed in the DSM-5 are seen in all other cultures. d. Psychiatric diagnoses are listed in separately from other physical disorders in a five axes system.

b. culture may cause variations in symptoms for each clinical disorder.

Freud believed that individuals cope with anxiety by using: a. the superego. b. defense mechanisms. c. security operations. d. suppression.

b. defense mechanisms.

In order to best differentiate whether an Asian client is demonstrating a mental illness when attempting suicide is to: a. ask the client whether he views himself as being depressed. b. identify his culture's view regarding suicide. c. explain to him that suicide is often regarded as a desperate act. d. assess the client for other examples of depressive behaviors.

b. identify his culture's view regarding suicide.

The nurse is preparing a client for the termination phase of the nurse-client relationship. The nurse prepares to implement which nursing task that is most appropriate for this phase? a. Planning short-term goals b. Making appropriate referrals c. Developing realistic solutions d. Identifying expected outcomes

b. making appropriate referrals

Role-playing is associated with which type of therapy? a. psychoanalysis b. modeling c. operant conditioning d. systematic desensitization

b. modeling

Sullivan's term security operations and Freud's term of defense mechanisms both reflect actions that serve to: a. increase self-esteem b. reduce anxiety c. increase self-awareness d. reduce cognitive distortions

b. reduce anxiety

One characteristic of mental health that allows people to adapt to tragedies, trauma, and loss is: a. dependence. b. resilience. c. pessimism. d. altruism.

b. resilience.

Lucas states, "I will always be alone because nobody could love me." This is most likely an example of: a. emotional consequence b. schema c. actualization d. aversion

b. schema

These severe mental illnesses are recognized across cultures: a. antisocial and borderline personality disorders. b. schizophrenia and bipolar disorder. c. bulimia and anorexia nervosa d. amok and social phobia

b. schizophrenia and bipolar disorder.

When asked, the nurse explains that a client's id is: a. the control over the emotional frustration he feels over the loss of his job. b. the source of his instincts to save himself from hurting himself. c. not in place since he was abused after the age of 5 months. d. able to differentiate his believed experiences and reality.

b. the source of his instincts to save himself from hurting himself.

You have graduated with your BSN degree and have taken your first job on a psychiatric unit after becoming a licensed Registered Nurse. You are providing teaching to Mason, a newly admitted patient on the psychiatric unit, regarding his daily schedule. Which of the following would not be an appropriate teaching statement? a. "You will participate in unit activities and groups daily." b. "You will be given a schedule daily of the groups we would like you to attend." c. "You will attend a psychotherapy group that I lead." d. "You will see your provider daily in a 1:1 session."

c. " You will attend a psychotherapy group that I lead."

Which statement demonstrates the best understanding of the nurse's role regarding ensuring that each client's rights are respected? a. "Autonomy is the fundamental right of each and every client." b. "A client's rights are guaranteed by both state and federal laws." c. "Being respectful and concerned will ensure that I'm attentive to my clients' rights." d. "Regardless of the client's condition, all nurses have the duty to respect client rights."

c. "Being respectful and concerned will ensure that I'm attentive to my clients' rights."

A nurse's identification badge includes the term, "Psychiatric Mental Health Nurse." A client with a history of paranoia asks, "what does that title mean?" The nurse responds best by answering: a. "Don't be afraid; it means I'm here to help, not hurt, you." b. "Psychiatric mental health nurses care for people with mental illnesses." c. "We have the specialized skills needed to care for those with mental illnesses." d. "The nurses who work in mental health facilities have that title."

c. "We have the specialized skills needed to care for those with mental illnesses."

A client diagnosed with terminal cancer says to the nurse, "I'm gong to die, and I wish my family would stop hoping for a cure! I get so angry when they carry on like this. After all, I'm the one who's dying." Which response by the nurse is therapeutic? a. "Have you shared your feelings with your family?" b. "I think we should talk more about your anger with your family." c. "You're feeling angry that your family continues to hope for you to be cured?" d. "You are probably very depressed, which is understandable with such a diagnosis."

c. "You're feeling angry that your family continues to hope for you to be cured?"

When the community health nurse visits a client at home, the client states, "I haven't slept at all the last couple of nights." Which response by the nurse illustrates a therapeutic communication response to this client? a. "I see." b. "Really?" c. "You're having difficulty sleeping?" d. "Sometimes, I have trouble sleeping too."

c. "You're having difficulty sleep?"

You are caring for Alyssa, a 28-year-old patient with bipolar disorder who was admitted in a manic state. According to Maslow's Hierarchy of needs theory, which of the following symptoms needs to be the first priority in caring for this patient? a. Rapid, pressured speech b. Grandiose thoughts c. Lack of sleep d. Hyperactive behavior

c. Lack of sleep

Which of the following best demonstrates parity related to mental health care? a. the client is admitted for a 72-hour mental hygiene evaluation. b. advance practice nurse can be certified as psychiatric nurse specialist. c. a client's mental health coverage is equal to his medical/surgical coverage. d. a client who has attempted suicide is hospitalized for a mental health evaluation.

c. a client's mental health coverage is equal to his medical/surgical coverage.

The nurse planning care for a 14-year-old needs to take into account that the developmental task of adolescence is to: a. establish trust. b. gain autonomy. c. achieve identity. d. develop a sense of industry.

c. achieve identity

According to Freud, the nurse recognizes that a client experiencing dysfunction of the conscious as part of the mind will have problems with: a. only recent memory. b. both recent and long-term memory. c. all material that the person is aware of at any one time. d. only material that should be easily retrieved.

c. all material that the person is aware of at any one time.

Sullivan viewed anxiety as: a. emotional experience felt after the age of 5 years. b. a sign of guilt in adults. c. any painful feeling or emotion arising from social insecurity. d. adults trying to go beyond experiences of guilt and pain.

c. any painful feeling or emotion arising from social insecurity

Which branch of epidemiology is the nurse involved in when seeking outcomes for patients whose depression was treated with electroconvulsive therapy (ECT)? a. experimental b. descriptive c. clinical d. analytic

c. clinical

The quantitative study of the distribution of mental disorders in human populations is called: a. Mortality b. Prevalence c. epidemiology d. clinical epidemiology

c. epidemiology

The mental health status of a particular client can best be assessed by considering: a. the degree of conformity of the individual to society's norms. b. the degree to which an individual is logical and rational. c. placement on a continuum from health to illness. d. the rate of intellectual and emotional growth.

c. placement on a continuum from health to illness.

A nursing diagnosis for a client with a psychiatric disorder serves the purpose of: a. justifying the use for certain psychotropic medication. b. providing data essential for insurance reimbursement. c. providing a framework for selecting appropriate interventions. d. completing the medical diagnostic statement.

c. providing a framework for selecting appropriate interventions.

On review of the client's record, the nurse notes that the admission was voluntary Based on this information, the nurse anticipates which client behavior? a. Fearfulness regarding treatment measures. b. Anger and aggressiveness directed toward others. c. An understanding of the pathology and symptoms of the diagnosis. d. A willingness to participate in the planning of the care and treatment plan.

d. A willingness to participate in the planning of the care and treatment plan.

Which client problem would be most suited to the use of interpersonal therapy? a. disturbed sensory perception b. impaired social interaction c. medication noncompliance d. dysfunctional grieving

d. Dysfunctional grieving

You and Jack are two of the nurses working on the psychiatric unit. Jack mentions to you that the biological model for mental illness is the one he embraces, and states, "it's the only one I really believe." Which of the following statements is true regarding believing in only the biological model? a. The biological model is the oldest and most reliable model for explaining mental illness. b. The biological model does not explain every symptom of mental illness. c. The biological model is the most popular theory among leading psychiatrists and therefore the one that should be fully embraced. d. In believing only the biological model, other influences on mental health including cultural, environmental, social, and spiritual influences are not taken into account.

d. In believing only the biological model, other influences on mental health including cultural, environmental, social, and spiritual influences are not taken into account.

A client's unresolved feelings related to loss would be most likely observed during which phase of the therapeutic nurse-client relationship? a. Trusting b. Working c. Orientation d. Termination

d. Termination

As a result of Harry Sullivan's work, the mental health nurse is involved in providing clients with: a. security operations. b. psychoanalysis c. analysis of behavior patterns. d. a psycho-therapeutic environment.

d. a psycho-therapeutic environment.

The prevalence rate over a 12-month period for major depressive disorder is: a. lower than the prevalence rate for panic disorders. b. greater than the prevalence rate for psychotic disorders. c. equal to the prevalence rate for psychotic disorders. d. greater than the prevalence rate for generalized anxiety.

d. greater than the prevalence rate of generalized anxiety.

The nurse providing anticipatory guidance to the mother of a toddler should advise that childhood temper tantrums are best handled by: a. giving the child what he is asking for. b. scolding the child when he displays tantrum behaviors. c. spanking the child at the onset of the tantrum behaviors. d. ignoring the tantrum and giving attention when the child acts appropriately.

d. ignoring the tantrum and giving attention when the child acts appropriately.

The nurse is working with a client who despite making a heroic effort was unable to rescue a neighbor trapped in a house fire. Which client-focused action should the nurse engage in during the working phase of the nurse-client relationship? a. Exploring the client's ability to function b. Exploring the client's potential for self-harm c. Inquiring about the client's perception or appraisal of why the rescue was unsuccessful d. Inquiring about and examining the client's feelings for any that may block adaptive coping.

d. inquiring about and examining the client's feelings for any that may block adaptive coping.

A Client with a history of three failed engagements is concerned about being "too possessive." This concern supports a need for which type of therapy? a. phychodynamic b. cognitive c. behavioral d. interpersonal

d. interpersonal

An individual is found to consistently wear only a bathrobe and neglect to cleanliness of his apartment. When neighbors ask him to stop his frequent outbursts of operatic arias, he acts outraged and tells them he must sing daily and will not promise to be quieter. This behavior supports that he is: a. demonstrating symptoms of bipolar disorder. b. socially deviant. c. egocentric d. not demonstrating any definitive signs of mental illness.

d. not demonstrating any definitive signs of mental illness.