NURSING 4340
PSYCHIATRIC AND MENTAL
HEALTH NURSING
EXAM
2024
1. A nurse is caring for a client who has been diagnosed with major depressive disorder. The client tells
the nurse that he feels hopeless and worthless, and that he has no interest in anything. The nurse should
recognize that these statements indicate which of the following?
a) Anhedonia
b) Apathy
c) Avolition
d) Agoraphobia
*Answer: a) Anhedonia. Rationale: Anhedonia is the inability to experience pleasure or joy in activities
that were previously enjoyable. It is a common symptom of major depressive disorder and can contribute
to the client's feelings of hopelessness and worthlessness.*
2. A nurse is conducting a mental status examination on a client who has schizophrenia. The nurse asks
the client to repeat the phrase "no ifs, ands, or buts". The client responds by saying "no ifs, ants, or nuts".
The nurse should document this response as an example of which of the following?
a) Clang association
b) Echolalia
c) Neologism
,d) Phonemic paraphasia
*Answer: d) Phonemic paraphasia. Rationale: Phonemic paraphasia is a type of speech disturbance in
which the client substitutes or adds sounds to words, resulting in nonsensical or distorted speech. It is
often seen in clients who have schizophrenia or other psychotic disorders.*
3. A nurse is planning care for a client who has bipolar disorder and is experiencing a manic episode. The
nurse should include which of the following interventions in the plan of care?
a) Encourage the client to participate in group activities
b) Provide the client with frequent snacks and fluids
c) Allow the client to have unlimited visitors
d) Restrict the client's physical activity
*Answer: b) Provide the client with frequent snacks and fluids. Rationale: Clients who are experiencing a
manic episode may have increased energy, decreased appetite, and impaired judgment. They may neglect
their basic needs such as nutrition and hydration, which can lead to physical exhaustion and dehydration.
Therefore, the nurse should provide the client with frequent snacks and fluids to maintain their health and
well-being.*
4. A nurse is teaching a client who has obsessive-compulsive disorder (OCD) about exposure and
response prevention (ERP) therapy. The nurse should explain that ERP therapy involves which of the
following?
a) Gradually exposing the client to anxiety-provoking stimuli while preventing them from performing
their compulsive behaviors
b) Repeatedly exposing the client to anxiety-provoking stimuli until they become desensitized and no
longer experience anxiety
c) Systematically exposing the client to anxiety-provoking stimuli while teaching them relaxation
techniques to cope with their anxiety
d) Randomly exposing the client to anxiety-provoking stimuli while distracting them from their
compulsive behaviors
*Answer: a) Gradually exposing the client to anxiety-provoking stimuli while preventing them from
performing their compulsive behaviors. Rationale: ERP therapy is a type of cognitive-behavioral therapy
that aims to reduce the client's anxiety and compulsions by breaking the cycle of avoidance and
reinforcement. The therapist guides the client through a hierarchy of anxiety-provoking stimuli, starting
from the least to the most distressing, while preventing them from engaging in their compulsive
behaviors. This allows the client to learn that they can tolerate their anxiety without resorting to their
compulsions.*
, 5. A nurse is assessing a client who has post-traumatic stress disorder (PTSD). The nurse should ask the
client about which of the following factors that can affect the development and severity of PTSD?
a) The type and duration of the traumatic event
b) The presence and availability of social support
c) The history and frequency of previous trauma
d) All of the above
*Answer: d) All of the above. Rationale: PTSD is a mental health disorder that occurs after exposure to a
traumatic event that involves actual or threatened death, serious injury, or sexual violence. The
development and severity of PTSD can be influenced by various factors, such as the type and duration of
the traumatic event, the presence and availability of social support, and the history and frequency of
previous trauma. The nurse should assess these factors to determine the client's risk and needs for
treatment.*
B:
1. When a patient for whom has been prescribed haloperidol has been prescribed
tells the nurse, “I’m burning up and my muscles are stiff and sore, “the nurse,
suspects neuromuscular malignant syndrome and recognizes the possibility that the
physician many order:
a. Olanapine (Zyprexia)
b. Benztropine (Cogentin)
c. Venlafaxine (Effexor)
d. Dantrolene (Dantrium)
The g3. Goal for a patient is to increase resiliency. Which outcome should a nurse
add to the plan of care? Within 3 days, the patient will:
a. Describe feelings associated with loss and stress.
b. Meet own needs without considering the rights of others.
c. Identify healthy coping behaviors in response to stressful events.
d. Allow others to assume responsibility for major areas of own life.
PSYCHIATRIC AND MENTAL
HEALTH NURSING
EXAM
2024
1. A nurse is caring for a client who has been diagnosed with major depressive disorder. The client tells
the nurse that he feels hopeless and worthless, and that he has no interest in anything. The nurse should
recognize that these statements indicate which of the following?
a) Anhedonia
b) Apathy
c) Avolition
d) Agoraphobia
*Answer: a) Anhedonia. Rationale: Anhedonia is the inability to experience pleasure or joy in activities
that were previously enjoyable. It is a common symptom of major depressive disorder and can contribute
to the client's feelings of hopelessness and worthlessness.*
2. A nurse is conducting a mental status examination on a client who has schizophrenia. The nurse asks
the client to repeat the phrase "no ifs, ands, or buts". The client responds by saying "no ifs, ants, or nuts".
The nurse should document this response as an example of which of the following?
a) Clang association
b) Echolalia
c) Neologism
,d) Phonemic paraphasia
*Answer: d) Phonemic paraphasia. Rationale: Phonemic paraphasia is a type of speech disturbance in
which the client substitutes or adds sounds to words, resulting in nonsensical or distorted speech. It is
often seen in clients who have schizophrenia or other psychotic disorders.*
3. A nurse is planning care for a client who has bipolar disorder and is experiencing a manic episode. The
nurse should include which of the following interventions in the plan of care?
a) Encourage the client to participate in group activities
b) Provide the client with frequent snacks and fluids
c) Allow the client to have unlimited visitors
d) Restrict the client's physical activity
*Answer: b) Provide the client with frequent snacks and fluids. Rationale: Clients who are experiencing a
manic episode may have increased energy, decreased appetite, and impaired judgment. They may neglect
their basic needs such as nutrition and hydration, which can lead to physical exhaustion and dehydration.
Therefore, the nurse should provide the client with frequent snacks and fluids to maintain their health and
well-being.*
4. A nurse is teaching a client who has obsessive-compulsive disorder (OCD) about exposure and
response prevention (ERP) therapy. The nurse should explain that ERP therapy involves which of the
following?
a) Gradually exposing the client to anxiety-provoking stimuli while preventing them from performing
their compulsive behaviors
b) Repeatedly exposing the client to anxiety-provoking stimuli until they become desensitized and no
longer experience anxiety
c) Systematically exposing the client to anxiety-provoking stimuli while teaching them relaxation
techniques to cope with their anxiety
d) Randomly exposing the client to anxiety-provoking stimuli while distracting them from their
compulsive behaviors
*Answer: a) Gradually exposing the client to anxiety-provoking stimuli while preventing them from
performing their compulsive behaviors. Rationale: ERP therapy is a type of cognitive-behavioral therapy
that aims to reduce the client's anxiety and compulsions by breaking the cycle of avoidance and
reinforcement. The therapist guides the client through a hierarchy of anxiety-provoking stimuli, starting
from the least to the most distressing, while preventing them from engaging in their compulsive
behaviors. This allows the client to learn that they can tolerate their anxiety without resorting to their
compulsions.*
, 5. A nurse is assessing a client who has post-traumatic stress disorder (PTSD). The nurse should ask the
client about which of the following factors that can affect the development and severity of PTSD?
a) The type and duration of the traumatic event
b) The presence and availability of social support
c) The history and frequency of previous trauma
d) All of the above
*Answer: d) All of the above. Rationale: PTSD is a mental health disorder that occurs after exposure to a
traumatic event that involves actual or threatened death, serious injury, or sexual violence. The
development and severity of PTSD can be influenced by various factors, such as the type and duration of
the traumatic event, the presence and availability of social support, and the history and frequency of
previous trauma. The nurse should assess these factors to determine the client's risk and needs for
treatment.*
B:
1. When a patient for whom has been prescribed haloperidol has been prescribed
tells the nurse, “I’m burning up and my muscles are stiff and sore, “the nurse,
suspects neuromuscular malignant syndrome and recognizes the possibility that the
physician many order:
a. Olanapine (Zyprexia)
b. Benztropine (Cogentin)
c. Venlafaxine (Effexor)
d. Dantrolene (Dantrium)
The g3. Goal for a patient is to increase resiliency. Which outcome should a nurse
add to the plan of care? Within 3 days, the patient will:
a. Describe feelings associated with loss and stress.
b. Meet own needs without considering the rights of others.
c. Identify healthy coping behaviors in response to stressful events.
d. Allow others to assume responsibility for major areas of own life.
