Title:** **The NCLEX-RN Mental Health
**
Marathon: Therapeutic Communication &
Psychiatric Nursing**
---
### Question 1 of 92
A client with major depressive disorder says, “Nothing matters anymore. I just want to sleep forever.”
Which response by the nurse is most therapeutic?
A) “Why do you feel that way?”
B) “You have so much to live for.”
C) “It sounds like you are feeling hopeless.”
D) “Let’s talk about something positive.”
💫RATIONALE✔️✔️: Reflecting feelings (C) validates the client’s experience and encourages further
expression without judgment.
💫ANSWER✔️✔️: C) “It sounds like you are feeling hopeless.”
---
### Question 2 of 92
A client with bipolar disorder in a manic phase is pacing, talking rapidly, and making grandiose
statements. Which intervention should the nurse implement first?
,A) Administer lithium as prescribed.
B) Reduce environmental stimuli.
C) Confront the client’s grandiose delusions.
D) Encourage participation in group therapy.
💫RATIONALE✔️✔️: Reducing stimuli (B) decreases agitation and prevents escalation in acute mania.
Medications take time; confrontation increases agitation.
💫ANSWER✔️✔️: B) Reduce environmental stimuli.
---
### Question 3 of 92
**Select-All-That-Apply (SATA):** A nurse is assessing a client for serotonin syndrome. Which findings
are expected? (Select all that apply.)
A) Hyperthermia
B) Bradycardia
C) Diaphoresis
D) Myoclonus
E) Diarrhea
💫RATIONALE✔️✔️: Serotonin syndrome causes hyperthermia (A), diaphoresis (C), myoclonus (D),
diarrhea (E), tachycardia (not bradycardia), and agitation.
💫ANSWER✔️✔️: A, C, D, E
---
### Question 4 of 92
,A client with paranoid schizophrenia tells the nurse, “The FBI is poisoning my food.” Which response by
the nurse is most appropriate?
A) “That’s not true. No one is poisoning you.”
B) “I understand you believe that, but I don’t see any evidence.”
C) “Why do you think the FBI would do that?”
D) “Let’s talk about something else.”
💫RATIONALE✔️✔️: (B) acknowledges the client’s belief without reinforcing delusion and avoids arguing.
Arguing increases mistrust.
💫ANSWER✔️✔️: B) “I understand you believe that, but I don’t see any evidence.”
---
### Question 5 of 92
A nurse is caring for a client undergoing alcohol withdrawal. Which finding indicates severe withdrawal
(delirium tremens)?
A) Tremors and anxiety
B) Visual hallucinations and fever
C) Insomnia and diaphoresis
D) Headache and nausea
💫RATIONALE✔️✔️: DTs include visual hallucinations, fever (B), seizures, and severe autonomic instability.
Tremors/anxiety are mild withdrawal.
💫ANSWER✔️✔️: B) Visual hallucinations and fever
---
, ### Question 6 of 92
A nurse is providing education to a client starting lithium. Which statement indicates understanding?
A) “I will drink extra water when I exercise.”
B) “I can take ibuprofen for headaches.”
C) “If I miss a dose, I will double the next dose.”
D) “I will stop lithium if I feel better.”
💫RATIONALE✔️✔️: Dehydration increases lithium levels. Maintain consistent fluid/sodium intake (A).
NSAIDs increase lithium levels.
💫ANSWER✔️✔️: A) “I will drink extra water when I exercise.”
---
### Question 7 of 92
**Select-All-That-Apply (SATA):** A nurse is assessing a client with anorexia nervosa. Which findings are
expected? (Select all that apply.)
A) Lanugo hair
B) Bradycardia
C) Hypothermia
D) Hyperkalemia
E) Amenorrhea
💫RATIONALE✔️✔️: Anorexia causes lanugo (A), bradycardia (B), hypothermia (C), amenorrhea (E), and
hypokalemia (not hyperkalemia).
💫ANSWER✔️✔️: A, B, C, E
**
Marathon: Therapeutic Communication &
Psychiatric Nursing**
---
### Question 1 of 92
A client with major depressive disorder says, “Nothing matters anymore. I just want to sleep forever.”
Which response by the nurse is most therapeutic?
A) “Why do you feel that way?”
B) “You have so much to live for.”
C) “It sounds like you are feeling hopeless.”
D) “Let’s talk about something positive.”
💫RATIONALE✔️✔️: Reflecting feelings (C) validates the client’s experience and encourages further
expression without judgment.
💫ANSWER✔️✔️: C) “It sounds like you are feeling hopeless.”
---
### Question 2 of 92
A client with bipolar disorder in a manic phase is pacing, talking rapidly, and making grandiose
statements. Which intervention should the nurse implement first?
,A) Administer lithium as prescribed.
B) Reduce environmental stimuli.
C) Confront the client’s grandiose delusions.
D) Encourage participation in group therapy.
💫RATIONALE✔️✔️: Reducing stimuli (B) decreases agitation and prevents escalation in acute mania.
Medications take time; confrontation increases agitation.
💫ANSWER✔️✔️: B) Reduce environmental stimuli.
---
### Question 3 of 92
**Select-All-That-Apply (SATA):** A nurse is assessing a client for serotonin syndrome. Which findings
are expected? (Select all that apply.)
A) Hyperthermia
B) Bradycardia
C) Diaphoresis
D) Myoclonus
E) Diarrhea
💫RATIONALE✔️✔️: Serotonin syndrome causes hyperthermia (A), diaphoresis (C), myoclonus (D),
diarrhea (E), tachycardia (not bradycardia), and agitation.
💫ANSWER✔️✔️: A, C, D, E
---
### Question 4 of 92
,A client with paranoid schizophrenia tells the nurse, “The FBI is poisoning my food.” Which response by
the nurse is most appropriate?
A) “That’s not true. No one is poisoning you.”
B) “I understand you believe that, but I don’t see any evidence.”
C) “Why do you think the FBI would do that?”
D) “Let’s talk about something else.”
💫RATIONALE✔️✔️: (B) acknowledges the client’s belief without reinforcing delusion and avoids arguing.
Arguing increases mistrust.
💫ANSWER✔️✔️: B) “I understand you believe that, but I don’t see any evidence.”
---
### Question 5 of 92
A nurse is caring for a client undergoing alcohol withdrawal. Which finding indicates severe withdrawal
(delirium tremens)?
A) Tremors and anxiety
B) Visual hallucinations and fever
C) Insomnia and diaphoresis
D) Headache and nausea
💫RATIONALE✔️✔️: DTs include visual hallucinations, fever (B), seizures, and severe autonomic instability.
Tremors/anxiety are mild withdrawal.
💫ANSWER✔️✔️: B) Visual hallucinations and fever
---
, ### Question 6 of 92
A nurse is providing education to a client starting lithium. Which statement indicates understanding?
A) “I will drink extra water when I exercise.”
B) “I can take ibuprofen for headaches.”
C) “If I miss a dose, I will double the next dose.”
D) “I will stop lithium if I feel better.”
💫RATIONALE✔️✔️: Dehydration increases lithium levels. Maintain consistent fluid/sodium intake (A).
NSAIDs increase lithium levels.
💫ANSWER✔️✔️: A) “I will drink extra water when I exercise.”
---
### Question 7 of 92
**Select-All-That-Apply (SATA):** A nurse is assessing a client with anorexia nervosa. Which findings are
expected? (Select all that apply.)
A) Lanugo hair
B) Bradycardia
C) Hypothermia
D) Hyperkalemia
E) Amenorrhea
💫RATIONALE✔️✔️: Anorexia causes lanugo (A), bradycardia (B), hypothermia (C), amenorrhea (E), and
hypokalemia (not hyperkalemia).
💫ANSWER✔️✔️: A, B, C, E
