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Question 1
A nurse is communicating with a client who is experiencing anxiety. Which response
demonstrates therapeutic communication?
A. “You shouldn’t worry about that.”
B. “Everything will be fine soon.”
C. “Tell me more about what you are feeling.”
D. “I know exactly how you feel.”
Answer: C
Rationale: Therapeutic communication encourages clients to express feelings and
thoughts. Asking open-ended questions like “Tell me more about what you are feeling”
promotes exploration and emotional expression. Options A and B minimize the client’s
feelings, while D falsely claims understanding of the client’s experience, which can
block communication.
Question 2
A client with schizophrenia reports hearing voices. What is the nurse’s priority
intervention?
A. Ask the client to describe the voices in detail
B. Tell the client the voices are not real
C. Assess for command hallucinations
D. Encourage the client to ignore the voices
,Answer: C
Rationale: The priority is safety. Command hallucinations may instruct the client to harm
self or others, so assessment of content is essential. Telling the client voices are not
real may increase frustration, and encouraging ignoring them does not address
immediate risk. Detailed exploration may be done later once safety is established.
Question 3
Which defense mechanism is the client using when blaming others for personal
mistakes?
A. Projection
B. Sublimation
C. Repression
D. Regression
Answer: A
Rationale: Projection involves attributing one’s unacceptable feelings or behaviors to
others. Sublimation redirects impulses into acceptable activities. Repression
unconsciously blocks distressing thoughts, and regression involves returning to earlier
developmental behaviors under stress.
Question 4
A client with major depression states, “Nothing matters anymore.” What is the nurse’s
best response?
A. “Why do you feel that way?”
B. “You have so much to live for.”
C. “Tell me more about what you’re experiencing.”
D. “You shouldn’t think like that.”
Answer: C
Rationale: Open-ended exploration encourages expression of feelings and assessment
of suicide risk. “Why” questions may feel accusatory. Minimizing or dismissing feelings
can reduce trust and hinder assessment.
,Question 5
Which symptom is most characteristic of mania?
A. Decreased energy and hypersomnia
B. Grandiosity and decreased need for sleep
C. Persistent sadness and guilt
D. Social withdrawal and flat affect
Answer: B
Rationale: Mania is characterized by elevated mood, grandiosity, increased activity, and
decreased need for sleep. The other options reflect depression or negative symptoms of
schizophrenia.
Question 6
A nurse is caring for a client placed in restraints. What is the nurse’s priority?
A. Obtain a restraint prescription after application
B. Ensure circulation and skin integrity are maintained
C. Apply restraints tightly to prevent movement
D. Document behavior once per shift
Answer: B
Rationale: Client safety is the priority, including monitoring circulation, skin integrity, and
respiratory status. Restraints require a prescription before application (except
emergency situations), must never be overly tight, and documentation must be frequent.
Question 7
Which finding indicates a panic attack rather than generalized anxiety disorder?
A. Chronic worry lasting months
B. Sudden intense fear with physical symptoms
C. Mild restlessness and irritability
, D. Persistent fatigue and sleep disturbance
Answer: B
Rationale: Panic attacks are sudden episodes of intense fear with physical symptoms
such as chest pain, palpitations, and shortness of breath. Generalized anxiety disorder
involves chronic, ongoing worry.
Question 8
A client diagnosed with antisocial personality disorder is most likely to demonstrate:
A. Excessive dependence on others
B. Manipulative and deceitful behavior
C. Fear of abandonment
D. Emotional instability due to mood swings
Answer: B
Rationale: Antisocial personality disorder is characterized by disregard for others,
deceitfulness, and manipulation. Dependence is seen in dependent personality
disorder, fear of abandonment in borderline personality disorder, and mood instability
also in borderline personality disorder.
Question 9
Which medication is commonly used as a mood stabilizer in bipolar disorder?
A. Sertraline
B. Lithium
C. Haloperidol
D. Alprazolam
Answer: B
Rationale: Lithium is a first-line mood stabilizer for bipolar disorder. Sertraline is an
SSRI antidepressant, haloperidol is an antipsychotic, and alprazolam is an anxiolytic
benzodiazepine.