N3381 MENTAL HEALTH LATEST 2026 EVALUATION
EXAMS QUESTIONS AND ANSWERS SURE A+
✔✔The nurse is monitoring a stress management therapy group that is in the forming
stage. Which activity is characteristic of this stage of group development?
1.Expressing feelings about identifying stressors in their lives 2.Providing examples of
how stress has negatively affected relationships
3.Setting the rules of conduct for members of the stress management group
4.Providing a summary of the personal benefits stress management has provided -
✔✔Setting the rules of conduct for members of the stress management group
Rationale:In the forming or initial stage, the members are identifying tasks and
boundaries (setting rules). Storming involves responding emotionally to tasks. In the
norming stage, members express intimate personal opinions and feelings concerning
personal tasks (options 1 and 2). In the performing stage, members direct group energy
toward the completion of tasks (option 4).
✔✔Which statement by the client best reflects the development of an effective coping
response style and effective processing of information for a hospitalized client
participating in Alcoholics Anonymous (AA)?
, 1."I know I'm ready to be discharged. I feel like I can say no and leave a group of
friends if they are drinking. No problem."
2."I'll keep all my appointments and go to all my AA groups; I'll do everything I'm
supposed to. Nothing will go wrong that way."
3."I'm looking forward to leaving here. I will miss all of you. So, I'm happy and I'm sad,
I'm excited, and I'm scared. I know that I have to work hard to be strong and that not
everyone will be as helpful as you people."
4."This group has really helped a lot. I know it will be different when I go home. But I'm
sure that my family and friends will all help me like the people in this group have. They'll
all help me. I know they will. They won't let me go ba - ✔✔"I'm looking forward to
leaving here. I will miss all of you. So, I'm happy and I'm sad, I'm excited, and I'm
scared. I know that I have to work hard to be strong and that not everyone will be as
helpful as you people."
Rationale:In the defense mechanism of denial, the person denies reality. Avoid an
option that identifies the client demonstrating denial or relying on concrete, inflexible
behavior or on being heavily dependent on others to manage the addiction. The client
demonstrates reality in the statement in the correct option.
✔✔In formulating a discharge teaching plan, the nurse should include which precaution
for a client with bipolar disorder who is prescribed lithium carbonate therapy?
1.Avoid soy sauce, wine, and aged cheese.
2.Have the blood lithium level checked every 2 weeks.
3.Take the medication only as prescribed to avoid becoming addicted.
4.Check with the psychiatrist before using any over-the-counter medications. -
✔✔Check with the psychiatrist before using any over-the-counter medications.
Rationale:Lithium is a mood stabilizer and a medication to treat bipolar disorder. Its
exact mechanism of action remains speculative; however, equilibrium of sodium and
potassium must be maintained at the intracellular membrane to maintain therapeutic
effects. Lithium competes with sodium in the cell. Many over-the-counter medications
contain sodium, and often prescription medications (diuretics) change the sodium-
potassium ratios of the cell, thereby affecting lithium concentrations so that it is more
difficult to achieve therapeutic levels of the medication. Food restriction (tyramine-
restricted diet) is associated with monoamine oxidase inhibitors. Lithium blood levels
are recommended for the client taking lithium, but these tests generally are prescribed
every 3 to 4 months. Lithium is not addictive.
✔✔The home health nurse visits an agoraphobic client who experiences panic attacks.
Which statement by the client would indicate a therapeutic response to behavioral and
pharmacological treatment?
1."I took an extra pill for anxiety and got through the funeral fairly well."
2."I worry that if I don't take my anxiety pill on time, I'll have one of those attacks."
,3."Taking my anxiety pills before I leave has helped me to cross the bridge and go to
work every morning."
4."I went to the movies with my family and stayed through the whole film by sitting in a
seat along the aisle." - ✔✔"I went to the movies with my family and stayed through the
whole film by sitting in a seat along the aisle."
Rationale:Generalizing fears to a specific place or situation is the hallmark of
agoraphobia. Improvement is observed when the client is able to demonstrate
appropriate coping behaviors for anxiety reduction. Taking extra anxiety medication
would not indicate improvement. "Clock-watching" with regard to the medication
schedule is also not a sign that the client is responding well to the treatment.
✔✔The psychiatric home care nurse visits a client diagnosed with a phobia that triggers
panic attacks. When teaching the client to use paradoxical intention, which intervention
will the nurse demonstrate?
1.Having the client confront the anxiety-provoking stimulus and providing support during
the episode
2.Instructing the client to do what the client fears and, if possible, to exaggerate the
outcome of this exposure to the point of humor 3.Presenting the anxiety-provoking
stimulus without any preparation of the client and having him or her remain exposed
until the anxiety subsides
4.Using progressive relaxation toward the client's individual anxiety hierarchy,
increasing the level of difficulty, and pairing relaxation with the gradual exposure to
reduce his or her anxiety - ✔✔Instructing the client to do what the client fears and, if
possible, to exaggerate the outcome of this exposure to the point of humor
Rationale:In cognitive-behavioral therapy, the client with a phobia who experiences
panic attacks will be treated with a combination of cognitive restructuring, exposure
therapy, and paradoxical intention. In paradoxical intention the client is instructed to do
what he fears and, if possible, to exaggerate it to the point of humor. When this occurs
the client is taught to prevent the anxiety by a variety of coping mechanisms. This
assists the client to regain an internal locus of control or feeling of empowerment and to
master response to the anxiety-provoking issue or situation. Other options describe in
vivo therapy, flooding, and systematic desensitization.
✔✔A client diagnosed with a borderline personality disorder says to the nurse,
"Sometimes I do things to get my parents mad, and sometimes I do them because I'm
bored. That's what happened the night I crashed the family car. I wasn't drunk or
suicidal or anything like the police thought. It was just for kicks!" Which is the most
appropriate nursing response?
1."Next time, pick less dangerous and expensive ways to explode." 2."What can you do
to stop your behavior when it gets to that point the next time?"
3."It's a good thing that you don't abuse substances, or you might be dead because of
your recklessness."
, 4."It is scary when you feel out of control with such feelings of emptiness and anger that
you can't stop." - ✔✔"It is scary when you feel out of control with such feelings of
emptiness and anger that you can't stop."
Rationale:Reflection, a technique that prompts the client by repeating the major theme
in the client's process, is a therapeutic communication technique. In option 1 the nurse
inappropriately uses a sardonic response, which is nontherapeutic because it gives
advice. Asking the client what he or she can do next time is premature in the therapy.
The nurse should not agree or make statements that could be interpreted as
threatening.
✔✔The nurse is reviewing the medical record of a hospitalized client who received
electroconvulsive therapy (ECT) 3 years ago for the treatment of depression. Which
assessment data would support that the therapy resulted in retrograde amnesia in the
client?
1.The staff needs to frequently reorient the client to the rules of this current unit.
2.The client has demonstrated difficulty remembering the address of the family's new
home.
3.The medical record states that the client experienced memory loss for 2 days after the
ECT treatment.
4.During the admission interview, the client can't remember why the ECT treatment was
originally prescribed. - ✔✔During the admission interview, the client can't remember
why the ECT treatment was originally prescribed.
Rationale:When ECT is performed, the client may experience disorientation, attention
difficulty, and transient neurological abnormalities, which usually resolve within a few
hours or days. The most prominent adverse effect is short-term anterograde and
retrograde amnesia. Retrograde amnesia is defined as difficulty recalling information
learned before ECT. This kind of amnesia may be long-term. Anterograde amnesia is
defined as the loss of the client's ability to retain newly learned information. This kind of
amnesia usually resolves within the first few weeks after ECT treatments. Memory loss
for 2 days after the procedure indicates short-term amnesia.
✔✔The nurse reviews the assessment data of a client admitted to the hospital with a
diagnosis of anxiety. The nurse should assign priority to which assessment finding?
1.Tearful, self-isolated
2.Affect bland, withdrawn
3.Fist clenched, pounding table, fearful
4.Temperature 98.4º F (36.8º C); respirations 18 breaths/min - ✔✔Fist clenched,
pounding table, fearful
Rationale:Anxiety signs and symptoms may take a physical form and if abnormal should
be addressed as a priority for the client. A temperature of 98.4º F and respirations 18
breaths/min are normal vital signs. Tearfulness, self-isolation, a bland affect, and a
EXAMS QUESTIONS AND ANSWERS SURE A+
✔✔The nurse is monitoring a stress management therapy group that is in the forming
stage. Which activity is characteristic of this stage of group development?
1.Expressing feelings about identifying stressors in their lives 2.Providing examples of
how stress has negatively affected relationships
3.Setting the rules of conduct for members of the stress management group
4.Providing a summary of the personal benefits stress management has provided -
✔✔Setting the rules of conduct for members of the stress management group
Rationale:In the forming or initial stage, the members are identifying tasks and
boundaries (setting rules). Storming involves responding emotionally to tasks. In the
norming stage, members express intimate personal opinions and feelings concerning
personal tasks (options 1 and 2). In the performing stage, members direct group energy
toward the completion of tasks (option 4).
✔✔Which statement by the client best reflects the development of an effective coping
response style and effective processing of information for a hospitalized client
participating in Alcoholics Anonymous (AA)?
, 1."I know I'm ready to be discharged. I feel like I can say no and leave a group of
friends if they are drinking. No problem."
2."I'll keep all my appointments and go to all my AA groups; I'll do everything I'm
supposed to. Nothing will go wrong that way."
3."I'm looking forward to leaving here. I will miss all of you. So, I'm happy and I'm sad,
I'm excited, and I'm scared. I know that I have to work hard to be strong and that not
everyone will be as helpful as you people."
4."This group has really helped a lot. I know it will be different when I go home. But I'm
sure that my family and friends will all help me like the people in this group have. They'll
all help me. I know they will. They won't let me go ba - ✔✔"I'm looking forward to
leaving here. I will miss all of you. So, I'm happy and I'm sad, I'm excited, and I'm
scared. I know that I have to work hard to be strong and that not everyone will be as
helpful as you people."
Rationale:In the defense mechanism of denial, the person denies reality. Avoid an
option that identifies the client demonstrating denial or relying on concrete, inflexible
behavior or on being heavily dependent on others to manage the addiction. The client
demonstrates reality in the statement in the correct option.
✔✔In formulating a discharge teaching plan, the nurse should include which precaution
for a client with bipolar disorder who is prescribed lithium carbonate therapy?
1.Avoid soy sauce, wine, and aged cheese.
2.Have the blood lithium level checked every 2 weeks.
3.Take the medication only as prescribed to avoid becoming addicted.
4.Check with the psychiatrist before using any over-the-counter medications. -
✔✔Check with the psychiatrist before using any over-the-counter medications.
Rationale:Lithium is a mood stabilizer and a medication to treat bipolar disorder. Its
exact mechanism of action remains speculative; however, equilibrium of sodium and
potassium must be maintained at the intracellular membrane to maintain therapeutic
effects. Lithium competes with sodium in the cell. Many over-the-counter medications
contain sodium, and often prescription medications (diuretics) change the sodium-
potassium ratios of the cell, thereby affecting lithium concentrations so that it is more
difficult to achieve therapeutic levels of the medication. Food restriction (tyramine-
restricted diet) is associated with monoamine oxidase inhibitors. Lithium blood levels
are recommended for the client taking lithium, but these tests generally are prescribed
every 3 to 4 months. Lithium is not addictive.
✔✔The home health nurse visits an agoraphobic client who experiences panic attacks.
Which statement by the client would indicate a therapeutic response to behavioral and
pharmacological treatment?
1."I took an extra pill for anxiety and got through the funeral fairly well."
2."I worry that if I don't take my anxiety pill on time, I'll have one of those attacks."
,3."Taking my anxiety pills before I leave has helped me to cross the bridge and go to
work every morning."
4."I went to the movies with my family and stayed through the whole film by sitting in a
seat along the aisle." - ✔✔"I went to the movies with my family and stayed through the
whole film by sitting in a seat along the aisle."
Rationale:Generalizing fears to a specific place or situation is the hallmark of
agoraphobia. Improvement is observed when the client is able to demonstrate
appropriate coping behaviors for anxiety reduction. Taking extra anxiety medication
would not indicate improvement. "Clock-watching" with regard to the medication
schedule is also not a sign that the client is responding well to the treatment.
✔✔The psychiatric home care nurse visits a client diagnosed with a phobia that triggers
panic attacks. When teaching the client to use paradoxical intention, which intervention
will the nurse demonstrate?
1.Having the client confront the anxiety-provoking stimulus and providing support during
the episode
2.Instructing the client to do what the client fears and, if possible, to exaggerate the
outcome of this exposure to the point of humor 3.Presenting the anxiety-provoking
stimulus without any preparation of the client and having him or her remain exposed
until the anxiety subsides
4.Using progressive relaxation toward the client's individual anxiety hierarchy,
increasing the level of difficulty, and pairing relaxation with the gradual exposure to
reduce his or her anxiety - ✔✔Instructing the client to do what the client fears and, if
possible, to exaggerate the outcome of this exposure to the point of humor
Rationale:In cognitive-behavioral therapy, the client with a phobia who experiences
panic attacks will be treated with a combination of cognitive restructuring, exposure
therapy, and paradoxical intention. In paradoxical intention the client is instructed to do
what he fears and, if possible, to exaggerate it to the point of humor. When this occurs
the client is taught to prevent the anxiety by a variety of coping mechanisms. This
assists the client to regain an internal locus of control or feeling of empowerment and to
master response to the anxiety-provoking issue or situation. Other options describe in
vivo therapy, flooding, and systematic desensitization.
✔✔A client diagnosed with a borderline personality disorder says to the nurse,
"Sometimes I do things to get my parents mad, and sometimes I do them because I'm
bored. That's what happened the night I crashed the family car. I wasn't drunk or
suicidal or anything like the police thought. It was just for kicks!" Which is the most
appropriate nursing response?
1."Next time, pick less dangerous and expensive ways to explode." 2."What can you do
to stop your behavior when it gets to that point the next time?"
3."It's a good thing that you don't abuse substances, or you might be dead because of
your recklessness."
, 4."It is scary when you feel out of control with such feelings of emptiness and anger that
you can't stop." - ✔✔"It is scary when you feel out of control with such feelings of
emptiness and anger that you can't stop."
Rationale:Reflection, a technique that prompts the client by repeating the major theme
in the client's process, is a therapeutic communication technique. In option 1 the nurse
inappropriately uses a sardonic response, which is nontherapeutic because it gives
advice. Asking the client what he or she can do next time is premature in the therapy.
The nurse should not agree or make statements that could be interpreted as
threatening.
✔✔The nurse is reviewing the medical record of a hospitalized client who received
electroconvulsive therapy (ECT) 3 years ago for the treatment of depression. Which
assessment data would support that the therapy resulted in retrograde amnesia in the
client?
1.The staff needs to frequently reorient the client to the rules of this current unit.
2.The client has demonstrated difficulty remembering the address of the family's new
home.
3.The medical record states that the client experienced memory loss for 2 days after the
ECT treatment.
4.During the admission interview, the client can't remember why the ECT treatment was
originally prescribed. - ✔✔During the admission interview, the client can't remember
why the ECT treatment was originally prescribed.
Rationale:When ECT is performed, the client may experience disorientation, attention
difficulty, and transient neurological abnormalities, which usually resolve within a few
hours or days. The most prominent adverse effect is short-term anterograde and
retrograde amnesia. Retrograde amnesia is defined as difficulty recalling information
learned before ECT. This kind of amnesia may be long-term. Anterograde amnesia is
defined as the loss of the client's ability to retain newly learned information. This kind of
amnesia usually resolves within the first few weeks after ECT treatments. Memory loss
for 2 days after the procedure indicates short-term amnesia.
✔✔The nurse reviews the assessment data of a client admitted to the hospital with a
diagnosis of anxiety. The nurse should assign priority to which assessment finding?
1.Tearful, self-isolated
2.Affect bland, withdrawn
3.Fist clenched, pounding table, fearful
4.Temperature 98.4º F (36.8º C); respirations 18 breaths/min - ✔✔Fist clenched,
pounding table, fearful
Rationale:Anxiety signs and symptoms may take a physical form and if abnormal should
be addressed as a priority for the client. A temperature of 98.4º F and respirations 18
breaths/min are normal vital signs. Tearfulness, self-isolation, a bland affect, and a
