Psychiatric Medications NCLEX Practice Quiz: 75 Questions

8. Question What is the priority care for a client with dementia resulting from AIDS? A. Planning for remotivation therapy. B. Arranging for long-term custodial care. C. Providing basic intellectual stimulation. D. Assessing pain frequently.

C. Providing basic intellectual stimulation.

31. Question Aira has taken amitriptyline HCL (Elavil) for 3 days, but now complains that it "doesn't help" and refuses to take it. What should the nurse say or do? A. Withhold the drug. B. Record the client's response. C. Encourage the client to tell the doctor. D. Suggest that it takes a while before seeing the results.

D. Suggest that it takes a while before seeing the results.

40. Question Alfred was newly diagnosed with anxiety disorder. The physician prescribed buspirone (BuSpar). The nurse is aware that the teaching instructions for newly prescribed buspirone should include which of the following? A. A warning about the drug's delayed therapeutic effect, which is from 14 to 30 days. B. A warning about the incidence of neuroleptic malignant syndrome (NMS). C. A reminder of the need to schedule blood work in 1 week to check blood levels of the drug. D. A warning that immediate sedation can occur with a resultant drop in pulse.

A. A warning about the drug's delayed therapeutic effect, which is from 14 to 30 days.

7. Question 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 D. Hypervigilance

A. Accentuated premorbid traits

13. Question 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 need attention too." This statement shows that the nurse's use of: A. Defensive behavior B. Reality reinforcement C. Limit-setting behavior D. Impulse control

A. Defensive behavior

3. Question 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.

A. Facilitating progressive review of the accident and its consequences.

69. Question Tranylcypromine sulfate (Parnate) is prescribed for a depressed client who has not responded to the tricyclic antidepressants. After teaching the client about the medication, Nurse Marian evaluates that learning has occurred when the client states, "I will avoid: A. Citrus fruit, tuna, and yellow vegetables." B. Chocolate milk, aged cheese, and yogurt" C. Green leafy vegetables, chicken, and milk." D. Whole grains, red meats, and carbonated soda."

B. Chocolate milk, aged cheese, and yogurt"

24. Question Nurse Gerry is aware that the defense mechanism commonly used by clients who are alcoholics is: A. Displacement B. Denial C. Projection D. Compensation

B. Denial

32. Question Dervid, an adolescent has a history of truancy from school, running away from home and "borrowing" other people's things without their permission. The adolescent denies stealing, rationalizing instead that as long as no one was using the items, it was all right to borrow them. It is important for the nurse to understand the psychodynamically, this behavior may be largely attributed to a developmental defect related to the: A. Id B. Ego C. Superego D. Oedipal complex

C. Superego

18. Question In recognizing common behaviors exhibited by a 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

C. Withdrawal, regressed behavior, and lack of social skills

39. Question Nurse Krina knows that the following drugs have been known to be effective in treating obsessive-compulsive disorder (OCD): A. benztropine (Cogentin) and diphenhydramine (Benadryl). B. chlordiazepoxide (Librium) and diazepam (Valium) C. fluvoxamine (Luvox) and clomipramine (Anafranil) D. divalproex (Depakote) and lithium (Lithobid)

C. fluvoxamine (Luvox) and clomipramine (Anafranil)

37. Question After seeking help at an outpatient mental health clinic, Ruby who was raped while walking her dog is diagnosed with posttraumatic stress disorder (PTSD). Three months later, Ruby returns to the clinic, complaining of fear, loss of control, and helpless feelings. Which nursing intervention is most appropriate for Ruby? A. Recommending a high-protein, low-fat diet. B. Giving sleep medication, as prescribed, to restore a normal sleep-wake cycle. C. Allowing the client time to heal. D. Exploring the meaning of the traumatic event with the client.

D. Exploring the meaning of the traumatic event with the client.

19. Question 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.

D. Feeling more anxious today.

26. Question Mr. Marquez reports losing his job, not being able to sleep at night, and feeling upset with his wife. Nurse John responds to the client, "You may want to talk about your employment situation in group today." The Nurse is using which therapeutic technique? A. Observations B. Restating C. Exploring D. Focusing

D. Focusing

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? A. Librium B. Valium C. Ativan D. Haldol

D. Haldol

67. Question Nurse Mylene recognizes that the most important factor necessary for the establishment of trust in a critical care area is: A. Privacy B. Respect C. Empathy D. Presence

D. Presence

50. Question Tim is admitted with a diagnosis of delusions of grandeur. The nurse is aware that this diagnosis reflects a belief that one is: A. Highly important or famous. B. Being persecuted. C. Connected to events unrelated to oneself. D. Responsible for the evil in the world.

A. Highly important or famous.

56. Question Nicolas is experiencing hallucinations and tells the nurse, "The voices are telling me I'm no good." The client asks if the nurse hears the voices. The most appropriate response by the nurse would be: A. "It is the voice of your conscience, which only you can control." B. "No, I do not hear your voices, but I believe you can hear them". C. "The voices are coming from within you and only you can hear them." D. "Oh, the voices are a symptom of your illness; don't pay any attention to them."

B. "No, I do not hear your voices, but I believe you can hear them".

12. Question Grace is exhibiting withdrawn patterns of behavior. Nurse Johnny is aware that this type of behavior eventually produces a feeling of: A. Repression B. Loneliness C. Anger D. Paranoia

B. Loneliness

41. Question Richard with agoraphobia has been symptom-free for 4 months. Classic signs and symptoms of phobias include: A. Insomnia and an inability to concentrate. B. Severe anxiety and fear. C. Depression and weight loss. D. Withdrawal and failure to distinguish reality from fantasy.

B. Severe anxiety and fear.

72. Question David with paranoid schizophrenia repeatedly uses profanity during an activity therapy session. Which response by the nurse would be most appropriate? A. "Your behavior won't be tolerated. Go to your room immediately." B. "You're just doing this to get back at me for making you come to therapy." C. "Your cursing is interrupting the activity. Take time out in your room for 10 minutes." D. "I'm disappointed in you. You can't control yourself even for a few minutes."

C. "Your cursing is interrupting the activity. Take time out in your room for 10 minutes."

35. Question What parental behavior toward a child during an admission procedure should cause Nurse Ron to suspect child abuse? A. Flat affect B. Expressing guilt C. Acting overly solicitous toward the child. D. Ignoring the child.

C. Acting overly solicitous toward the child.

54. Question Nurse Mickey is caring for a client diagnosed with bulimia. The most appropriate initial goal for a client diagnosed with bulimia is to: A. Avoid shopping for large amounts of food. B. Control eating impulses. C. Identify anxiety-causing situations. D. Eat only three meals per day.

C. Identify anxiety-causing situations.

73. Question Nurse Maureen knows that the non-antipsychotic medication used to treat some clients with schizoaffective disorder is: A. phenelzine (Nardil) B. chlordiazepoxide (Librium) C. lithium carbonate (Lithane) D. imipramine (Tofranil)

C. lithium carbonate (Lithane)

9. Question 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. Affective instability

42. Question Which medications have been found to help reduce or eliminate panic attacks? A. Antidepressants B. Anticholinergics C. Antipsychotics D. Mood stabilizers

A. Antidepressants

63. Question Nurse Krina recognizes that the suicidal risk for depressed client is greatest: A. As their depression begins to improve. B. When their depression is most severe. C. Before any type of treatment is started. D. As they lose interest in the environment.

A. As their depression begins to improve.

36. Question Nurse Lynnette notices that a female client with obsessive-compulsive disorder washes her hands for long periods each day. How should the nurse respond to this compulsive behavior? A. By designating times during which the client can focus on the behavior. B. By urging the client to reduce the frequency of the behavior as rapidly as possible. C. By calling attention to or attempting to prevent the behavior. D. By discouraging the client from verbalizing anxieties.

A. By designating times during which the client can focus on the behavior.

68. Question When establishing an initial nurse-client relationship, Nurse Hazel should explore with the client the: A. Client's perception of the presenting problem. B. Occurrence of fantasies the client may experience. C. Details of any ritualistic acts carried out by the client. D. Client's feelings when external; controls are instituted.

A. Client's perception of the presenting problem.

30. Question What is Nurse John likely to note in a male client being admitted for alcohol withdrawal? A. Perceptual disorders B. Impending coma C. Recent alcohol intake D. Depression with mutism

A. Perceptual disorders

22. Question Nurse John recognizes that paranoid delusions usually are related to the defense mechanism of: A. Projection B. Identification C. Repression D. Regression

A. Projection

17. Question 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 B. Depersonalization C. Hypochondriasis D. Echolalia

A. Somatic delusions

55. Question Rudolf is admitted for an overdose of amphetamines. When assessing the client, the nurse should expect to see: A. Tension and irritability B. Slow pulse C. Hypotension D. Constipation

A. Tension and irritability

28. Question Junnel, who is manic, but not yet on medication, comes to the drug treatment center. The nurse would not let this client join the group session because: A. The client is disruptive. B. The client is harmful to self. C. The client is harmful to others. D. The client needs to be on medication first.

A. The client is disruptive.

43. Question A client seeks care because she feels depressed and has gained weight. To treat her atypical depression, the physician prescribes tranylcypromine sulfate (Parnate), 10 mg by mouth twice per day. When this drug is used to treat atypical depression, what is its onset of action? A. 1 to 2 days B. 3 to 5 days C. 6 to 8 days D. 10 to 14 days

B. 3 to 5 days

70. Question Nurse John is aware that most crisis situations should resolve in about: A. 1 to 2 weeks B. 4 to 6 weeks C. 4 to 6 months D. 6 to 12 months

B. 4 to 6 weeks

66. Question The psychiatrist orders lithium carbonate 600 mg p.o t.i.d for a female client. Nurse Katrina would be aware that the teaching about the side effects of this drug were understood when the client state, "I will call my doctor immediately if I notice any: A. Sensitivity to bright light or sun. B. Fine hand tremors or slurred speech. C. Sexual dysfunction or breast enlargement. D. Inability to urinate or difficulty when urinating.

B. Fine hand tremors or slurred speech.

48. Question Nurse Cristina is caring for a client who experiences false sensory perceptions with no basis in reality. These perceptions are known as: A. Delusions B. Hallucinations C. Loose associations D. Neologisms

B. Hallucinations

4. Question 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.

B. Invite the client to lunch and accompany him to the dining room.

20. Question 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.

B. Leave the client alone until he stops talking.

53. Question Richard is admitted with a diagnosis of schizotypal personality disorder. Which signs would this client exhibit during social situations? A. Aggressive behavior B. Paranoid thoughts C. Emotional affect D. Independence needs

B. Paranoid thoughts

44. Question A 65 years old client is in the first stage of Alzheimer's disease. Nurse Patricia should plan to focus this client's care on: A. Offering nourishing finger foods to help maintain the client's nutritional status. B. Providing emotional support and individual counseling. C. Monitoring the client to prevent minor illnesses from turning into major problems. D. Suggesting new activities for the client and family to do together.

B. Providing emotional support and individual counseling.

23. Question 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.

B. Providing the client with activities in which success can be achieved.

14. Question 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: A. Verbalizing the need for anxiety medications. B. Recognizing each existing personality. C. Engaging in object-oriented activities. D. Eliminating defense mechanisms and phobia.

B. Recognizing each existing personality.

74. Question Which information is most important for the nurse Trinity to include in a teaching plan for a male schizophrenic client taking clozapine (Clozaril)? A. Monthly blood tests will be necessary. B. Report a sore throat or fever to the physician immediately. C. Blood pressure must be monitored for hypertension. D. Stop the medication when symptoms subside.

B. Report a sore throat or fever to the physician immediately.

60. Question Miranda, a psychiatric client is to be discharged with orders for haloperidol (Haldol) therapy. When developing a teaching plan for discharge, the nurse should include cautioning the client against: A. Driving at night. B. Staying in the sun. C. Ingesting wines and cheeses. D. Taking medications containing aspirin.

B. Staying in the sun.

38. Question Meryl, age 19, is highly dependent on her parents and fears leaving home to go away to college. Shortly before the semester starts, she complains that her legs are paralyzed and is rushed to the emergency department. When physical examination rules out a physical cause for her paralysis, the physician admits her to the psychiatric unit where she is diagnosed with conversion disorder. Meryl asks the nurse, "Why has this happened to me?" What is the nurse's best response? A. "You've developed this paralysis so you can stay with your parents. You must deal with this conflict if you want to walk again." B. "It must be awful not to be able to move your legs. You may feel better if you realize the problem is psychological, not physical." C. "Your problem is real but there is no physical basis for it. We'll work on what is going on in your life to find out why it's happened." D. "It isn't uncommon for someone with your personality to develop a conversion disorder during times of stress."

C. "Your problem is real but there is no physical basis for it. We'll work on what is going on in your life to find out why it's happened."

16. Question 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 C. Adolescence D. Puberty

C. Adolescence

29. Question Dervid, an adolescent boy, was admitted for substance abuse and hallucinations. The client's mother asks Nurse Armando to talk with his husband when he arrives at the hospital. The mother says that she is afraid of what the father might say to the boy. The most appropriate nursing intervention would be to: A. Inform the mother that she and the father can work through this problem themselves. B. Refer the mother to the hospital social worker. C. Agree to talk with the mother and the father together. D. Suggest that the father and son work things out.

C. Agree to talk with the mother and the father together.

57. Question The nurse is aware that the side effect of electroconvulsive therapy that a client may experience: A. Loss of appetite B. Postural hypotension C. Confusion for a time after treatment D. Complete loss of memory for a time

C. Confusion for a time after treatment

2. Question 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? A. Shake B. Tea C. Cranberry Juice D. Grape juice

C. Cranberry Juice

62. Question When assessing a premorbid personality characteristics of a client with a major depression, it would be unusual for the nurse to find that this client demonstrated: A. Rigidity B. Stubbornness C. Diverse interest D. Over meticulousness

C. Diverse interest

45. Question The nurse is assessing a client who has just been admitted to the emergency department. Which signs would suggest an overdose of an antianxiety agent? A. Combativeness, sweating, and confusion B. Agitation, hyperactivity, and grandiose ideation C. Emotional lability, euphoria, and impaired memory D. Suspiciousness, dilated pupils, and increased blood pressure

C. Emotional lability, euphoria, and impaired memory

25. Question 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

C. Irritability, heightened alertness, jerky movements

47. Question Nurse Amy is providing care for a male client undergoing opiate withdrawal. Opiate withdrawal causes severe physical discomfort and can be life-threatening. To minimize these effects, opiate users are commonly detoxified with: A. Barbiturates B. Amphetamines C. Methadone D. Benzodiazepines

C. Methadone

75. Question Ricky with chronic schizophrenia takes neuroleptic medication and is admitted to the psychiatric unit. Nursing assessment reveals rigidity, fever, hypertension, and diaphoresis. These findings suggest which life-threatening reaction: A. Tardive dyskinesia B. Dystonia C. Neuroleptic malignant syndrome D. Akathisia

C. Neuroleptic malignant syndrome

11. Question 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. Discourage his participation in programs.

C. Provide foods, fluids, and rest.

6. Question 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 D. Restitution

C. Resolving the loss

49. Question Nurse Marco is developing a plan of care for a client with anorexia nervosa. Which action should the nurse include in the plan? A. Restricts visits with the family and friends until the client begins to eat. B. Provide privacy during meals. C. Set up a strict eating plan for the client. D. Encourage the client to exercise, which will reduce her anxiety.

C. Set up a strict eating plan for the client.

33. Question In preparing a female client for electroconvulsive therapy (ECT), Nurse Michelle knows that succinylcholine (Anectine) will be administered for which therapeutic effect? A. Short-acting anesthesia B. Decreased oral and respiratory secretions C. Skeletal muscle paralysis D. Analgesia

C. Skeletal muscle paralysis

5. Question The initial nursing intervention for the significant-others during shock phase of a grief reaction should be focused on: A. Presenting the 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.

C. Staying with the individuals involved.

59. Question The outcome that is unrelated to a crisis state is: A. Learning more constructive coping skills. B. Decompensation to a lower level of functioning. C. Adaptation and a return to a prior level of functioning. D. A higher level of anxiety continuing for more than 3 months.

D. A higher level of anxiety continuing for more than 3 months.

46. Question The nurse is caring for a client diagnosed with an antisocial personality disorder. The client has a history of fighting, cruelty to animals, and stealing. Which of the following traits would the nurse be most likely to uncover during the assessment? A. History of gainful employment. B. Frequent expression of guilt regarding antisocial behavior. C. Demonstrated ability to maintain close, stable relationships. D. A low tolerance for frustration.

D. A low tolerance for frustration.

58. Question A dying male client gradually moves toward resolution of feelings regarding impending death. Basing care on the theory of Kubler-Ross, Nurse Trish plans to use nonverbal interventions when assessment reveals that the client is in the: A. Anger stage B. Denial stage C. Bargaining stage D. Acceptance stage

D. Acceptance stage

21. Question 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

D. After going to bed

52. Question Ramon is admitted for detoxification after a cocaine overdose. The client tells the nurse that he frequently uses cocaine but that he can control his use if he chooses. Which coping mechanism is he using? A. Withdrawal B. Logical thinking C. Repression D. Denial

D. Denial

64. Question Nurse Kate would expect that a client with vascular dementia would experience: A. Loss of remote memory related to anoxia. B. Loss of abstract thinking related to emotional state. C. Inability to concentrate related to decreased stimuli. D. Disturbance in recalling recent events related to cerebral hypoxia.

D. Disturbance in recalling recent events related to cerebral hypoxia.

65. Question Josefina is to be discharged on a regimen of lithium carbonate. In the teaching plan for discharge the nurse should include: A. Advising the client to watch the diet carefully. B. Suggesting that the client take the pills with milk. C. Reminding the client that a CBC must be done once a month. D. Encouraging the client to have blood levels checked as ordered.

D. Encouraging the client to have blood levels checked as ordered.

10. Question The primary nursing diagnosis for a female client with a medical diagnosis of major depression would be: 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

D. Impaired verbal communication related to depression

34. Question Nurse Gina is aware that the dietary implications for a client in manic phase of bipolar disorder is: A. Serve the client a bowl of soup, buttered French bread, and apple slices. B. Increase calories, decrease fat and decrease protein. C. Give the client pieces of cut-up steak, carrots, and an apple. D. Increase calories, carbohydrates, and protein.

D. Increase calories, carbohydrates, and protein.

51. Question Nurse Jen is caring for a male client with manic depression. The plan of care for a client in a manic state would include: A. Offering high-calorie meals and strongly encouraging the client to finish all food. B. Insisting that the client remain active through the day so that he'll sleep at night. C. Allowing the client to exhibit hyperactive, demanding, manipulative behavior without setting limits. D. Listening attentively with a neutral attitude and avoiding power struggles.

D. Listening attentively with a neutral attitude and avoiding power struggles.

71. Question Nurse Judy knows that statistics show that in adolescent suicidal behavior: A. Females use more dramatic methods than males. B. Males account for more attempts than do females. C. Females talk more about suicide before attempting it. D. Males are more likely to use lethal methods than are females.

D. Males are more likely to use lethal methods than are females.

61. Question Jen, a nursing student is anxious about the upcoming board examination but is able to study intently and does not become distracted by a roommate's talking and loud music. The student's ability to ignore distractions and to focus on studying demonstrates: A. Mild-level anxiety B. Panic-level anxiety C. Severe-level anxiety D. Moderate-level anxiety

D. Moderate-level anxiety

15. Question 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: A. Phobia B. Powerlessness C. Punishment D. Rejection

D. Rejection

27. Question Tony refuses his evening dose of Haloperidol (Haldol), then becomes extremely agitated in the dayroom while other clients are watching television. He begins cursing and throwing furniture. Nurse Oliver first action is to: A. Check the client's medical record for an order for an as-needed I.M. dose of medication for agitation. B. Place the client in full leather restraints. C. Call the attending physician and report the behavior. D. Remove all other clients from the dayroom.

D. Remove all other clients from the dayroom.