NURSING 4241
MENTAL HEALTH CONDITIONS
EXAM Q & A
2024
1. A 25-year-old woman is admitted to the psychiatric unit with a diagnosis
of bipolar disorder, manic episode. She is restless, talkative, and has
grandiose ideas. She tells the nurse that she is a famous singer and she has a
concert tonight. The nurse should:
a) Agree with her and ask her to sing a song
b) Confront her with reality and tell her that she is not a singer
c) Ignore her statements and redirect her to another topic
d) Acknowledge her feelings and set limits on her behavior*
Rationale: The nurse should acknowledge the patient's feelings and set
limits on her behavior to prevent further escalation of mania and ensure
safety. Agreeing with her delusions or confronting her with reality may
increase her agitation and anxiety. Ignoring her statements may make her
feel rejected and isolated.
2. A 45-year-old man is brought to the emergency department by his wife,
who says he has been depressed and suicidal for the past two weeks. He
tells the nurse that he has a plan to kill himself by overdosing on his
antidepressants. He says he has no hope for the future and he feels
worthless and guilty. The nurse should:
a) Explore his suicidal plan and assess his level of risk*
b) Reassure him that everything will be okay and he has a lot to live for
c) Leave him alone in a quiet room to calm down
d) Give him a list of crisis hotline numbers and community resources
Rationale: The nurse should explore his suicidal plan and assess his level of
risk to determine the urgency of the situation and intervene accordingly.
Reassuring him or giving him a list of resources may not be helpful if he is
not ready to accept help or change his mind. Leaving him alone may
increase his chance of harming himself.
3. A 35-year-old woman is diagnosed with post-traumatic stress disorder
(PTSD) after being sexually assaulted by a stranger. She has nightmares,
, flashbacks, and avoids places that remind her of the trauma. She is referred
to a cognitive-behavioral therapist, who suggests that she should try
exposure therapy. Exposure therapy is:
a) A technique that involves repeated exposure to the traumatic event in a
safe and controlled environment*
b) A technique that involves relaxation training and positive imagery
c) A technique that involves challenging irrational thoughts and beliefs
related to the trauma
d) A technique that involves expressing emotions and feelings through art
or music
Rationale: Exposure therapy is a cognitive-behavioral technique that
involves repeated exposure to the traumatic event in a safe and controlled
environment, such as imaginal, virtual, or in vivo exposure. The goal is to
reduce fear and anxiety by habituation and extinction of conditioned
responses. Relaxation training, positive imagery, cognitive restructuring, and
expressive therapies are other techniques that may be used for PTSD, but
they are not exposure therapy.
B:
1. Which assessment finding is most indicative of a patient experiencing a
major depressive episode?
a) Inflated self-esteem or grandiosity
b) Flight of ideas or racing thoughts
c) Insomnia or hypersomnia
d) Psychomotor agitation or retardation
Answer: c) Insomnia or hypersomnia
Rationale: Insomnia or hypersomnia (sleep disturbances) is commonly seen
in individuals with major depressive episode.
2. The nurse is preparing to administer a medication for a patient with
bipolar disorder. Which medication should the nurse expect to administer?
a) Sertraline
b) Lithium
c) Diazepam
d) Quetiapine
Answer: b) Lithium
Rationale: Lithium is a mood stabilizing medication commonly used to
manage bipolar disorder.
,3. When assessing a patient with schizophrenia, the nurse observes the
patient exhibiting bizarre and disorganized behavior. Which symptom is
the patient experiencing?
a) Delusions
b) Hallucinations
c) Catatonia
d) Negative symptoms
Answer: c) Catatonia
Rationale: Catatonia refers to a range of motor disturbances seen in
schizophrenia, such as bizarre and disorganized behavior or immobility.
4. A patient with anorexia nervosa is admitted to the psychiatric unit. The
nurse notes the patient's body weight is 15% below the expected weight
range. Which is the nurse's priority intervention for this patient?
a) Implementing a behavioral therapy program
b) Administering antipsychotic medications
c) Establishing a structured meal plan
d) Administering nutritional supplements
Answer: c) Establishing a structured meal plan
Rationale: For patients with anorexia nervosa, reestablishing a structured
meal plan is the priority intervention to restore and maintain proper
nutrition.
5. A patient with post-traumatic stress disorder (PTSD) is experiencing a
flashback. What should the nurse do to provide immediate support?
a) Encourage the patient to talk about the traumatic event
b) Provide a quiet and calming environment
c) Administer an antianxiety medication
d) Engage the patient in physical exercise
Answer: b) Provide a quiet and calming environment
Rationale: During a flashback, it is important to create a safe and quiet
environment to help the patient regain a sense of control and reduce
anxiety.
6. A patient diagnosed with borderline personality disorder frequently
engages in self-harming behaviors. What is the nurse's priority action?
a) Establishing a safety plan for the patient
b) Encouraging the patient to attend therapy sessions regularly
c) Administering antipsychotic medications
d) Restricting the patient to a one-on-one observation
, Answer: a) Establishing a safety plan for the patient
Rationale: The nurse's priority is to ensure patient safety and prevent self-
harm. Establishing a safety plan is crucial to manage and minimize self-
harming behaviors.
7. The nurse is assessing a patient for symptoms of alcohol withdrawal.
Which is the most severe symptom that may lead to life-threatening
complications?
a) Tremors and restlessness
b) Diaphoresis and anxiety
c) Hallucinations and delirium tremens
d) Nausea and vomiting
Answer: c) Hallucinations and delirium tremens
Rationale: Hallucinations and delirium tremens are severe symptoms of
alcohol withdrawal that may lead to life-threatening complications, such as
seizures or cardiovascular instability.
8. A patient with attention deficit hyperactivity disorder (ADHD) is
prescribed methylphenidate (Ritalin). The nurse educates the patient and
family about the medication. Which statement by the patient's mother
requires clarification?
a) "I should administer the medication in the morning."
b) "It is important to monitor the patient's blood pressure regularly."
c) "Methylphenidate can help improve attention span and decrease
impulsivity."
d) "I should discontinue the medication if my child experiences irritability
or mood swings."
Answer: d) "I should discontinue the medication if my child experiences
irritability or mood swings."
Rationale: Methylphenidate, a common medication used for ADHD, can
cause irritability or mood swings as side effects. It is essential to educate the
patient's mother that these side effects should be reported but not
necessarily result in discontinuation.
9. A patient with schizophrenia is prescribed haloperidol (Haldol). What is
the nurse's primary responsibility before administering this medication?
a) Assessing the patient's liver function
b) Assessing the patient's blood glucose level
c) Assessing the patient's blood pressure
d) Assessing the patient's white blood cell count
MENTAL HEALTH CONDITIONS
EXAM Q & A
2024
1. A 25-year-old woman is admitted to the psychiatric unit with a diagnosis
of bipolar disorder, manic episode. She is restless, talkative, and has
grandiose ideas. She tells the nurse that she is a famous singer and she has a
concert tonight. The nurse should:
a) Agree with her and ask her to sing a song
b) Confront her with reality and tell her that she is not a singer
c) Ignore her statements and redirect her to another topic
d) Acknowledge her feelings and set limits on her behavior*
Rationale: The nurse should acknowledge the patient's feelings and set
limits on her behavior to prevent further escalation of mania and ensure
safety. Agreeing with her delusions or confronting her with reality may
increase her agitation and anxiety. Ignoring her statements may make her
feel rejected and isolated.
2. A 45-year-old man is brought to the emergency department by his wife,
who says he has been depressed and suicidal for the past two weeks. He
tells the nurse that he has a plan to kill himself by overdosing on his
antidepressants. He says he has no hope for the future and he feels
worthless and guilty. The nurse should:
a) Explore his suicidal plan and assess his level of risk*
b) Reassure him that everything will be okay and he has a lot to live for
c) Leave him alone in a quiet room to calm down
d) Give him a list of crisis hotline numbers and community resources
Rationale: The nurse should explore his suicidal plan and assess his level of
risk to determine the urgency of the situation and intervene accordingly.
Reassuring him or giving him a list of resources may not be helpful if he is
not ready to accept help or change his mind. Leaving him alone may
increase his chance of harming himself.
3. A 35-year-old woman is diagnosed with post-traumatic stress disorder
(PTSD) after being sexually assaulted by a stranger. She has nightmares,
, flashbacks, and avoids places that remind her of the trauma. She is referred
to a cognitive-behavioral therapist, who suggests that she should try
exposure therapy. Exposure therapy is:
a) A technique that involves repeated exposure to the traumatic event in a
safe and controlled environment*
b) A technique that involves relaxation training and positive imagery
c) A technique that involves challenging irrational thoughts and beliefs
related to the trauma
d) A technique that involves expressing emotions and feelings through art
or music
Rationale: Exposure therapy is a cognitive-behavioral technique that
involves repeated exposure to the traumatic event in a safe and controlled
environment, such as imaginal, virtual, or in vivo exposure. The goal is to
reduce fear and anxiety by habituation and extinction of conditioned
responses. Relaxation training, positive imagery, cognitive restructuring, and
expressive therapies are other techniques that may be used for PTSD, but
they are not exposure therapy.
B:
1. Which assessment finding is most indicative of a patient experiencing a
major depressive episode?
a) Inflated self-esteem or grandiosity
b) Flight of ideas or racing thoughts
c) Insomnia or hypersomnia
d) Psychomotor agitation or retardation
Answer: c) Insomnia or hypersomnia
Rationale: Insomnia or hypersomnia (sleep disturbances) is commonly seen
in individuals with major depressive episode.
2. The nurse is preparing to administer a medication for a patient with
bipolar disorder. Which medication should the nurse expect to administer?
a) Sertraline
b) Lithium
c) Diazepam
d) Quetiapine
Answer: b) Lithium
Rationale: Lithium is a mood stabilizing medication commonly used to
manage bipolar disorder.
,3. When assessing a patient with schizophrenia, the nurse observes the
patient exhibiting bizarre and disorganized behavior. Which symptom is
the patient experiencing?
a) Delusions
b) Hallucinations
c) Catatonia
d) Negative symptoms
Answer: c) Catatonia
Rationale: Catatonia refers to a range of motor disturbances seen in
schizophrenia, such as bizarre and disorganized behavior or immobility.
4. A patient with anorexia nervosa is admitted to the psychiatric unit. The
nurse notes the patient's body weight is 15% below the expected weight
range. Which is the nurse's priority intervention for this patient?
a) Implementing a behavioral therapy program
b) Administering antipsychotic medications
c) Establishing a structured meal plan
d) Administering nutritional supplements
Answer: c) Establishing a structured meal plan
Rationale: For patients with anorexia nervosa, reestablishing a structured
meal plan is the priority intervention to restore and maintain proper
nutrition.
5. A patient with post-traumatic stress disorder (PTSD) is experiencing a
flashback. What should the nurse do to provide immediate support?
a) Encourage the patient to talk about the traumatic event
b) Provide a quiet and calming environment
c) Administer an antianxiety medication
d) Engage the patient in physical exercise
Answer: b) Provide a quiet and calming environment
Rationale: During a flashback, it is important to create a safe and quiet
environment to help the patient regain a sense of control and reduce
anxiety.
6. A patient diagnosed with borderline personality disorder frequently
engages in self-harming behaviors. What is the nurse's priority action?
a) Establishing a safety plan for the patient
b) Encouraging the patient to attend therapy sessions regularly
c) Administering antipsychotic medications
d) Restricting the patient to a one-on-one observation
, Answer: a) Establishing a safety plan for the patient
Rationale: The nurse's priority is to ensure patient safety and prevent self-
harm. Establishing a safety plan is crucial to manage and minimize self-
harming behaviors.
7. The nurse is assessing a patient for symptoms of alcohol withdrawal.
Which is the most severe symptom that may lead to life-threatening
complications?
a) Tremors and restlessness
b) Diaphoresis and anxiety
c) Hallucinations and delirium tremens
d) Nausea and vomiting
Answer: c) Hallucinations and delirium tremens
Rationale: Hallucinations and delirium tremens are severe symptoms of
alcohol withdrawal that may lead to life-threatening complications, such as
seizures or cardiovascular instability.
8. A patient with attention deficit hyperactivity disorder (ADHD) is
prescribed methylphenidate (Ritalin). The nurse educates the patient and
family about the medication. Which statement by the patient's mother
requires clarification?
a) "I should administer the medication in the morning."
b) "It is important to monitor the patient's blood pressure regularly."
c) "Methylphenidate can help improve attention span and decrease
impulsivity."
d) "I should discontinue the medication if my child experiences irritability
or mood swings."
Answer: d) "I should discontinue the medication if my child experiences
irritability or mood swings."
Rationale: Methylphenidate, a common medication used for ADHD, can
cause irritability or mood swings as side effects. It is essential to educate the
patient's mother that these side effects should be reported but not
necessarily result in discontinuation.
9. A patient with schizophrenia is prescribed haloperidol (Haldol). What is
the nurse's primary responsibility before administering this medication?
a) Assessing the patient's liver function
b) Assessing the patient's blood glucose level
c) Assessing the patient's blood pressure
d) Assessing the patient's white blood cell count
