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Psychiatric Mental Health Nursing Saunders NCLEX
Review Questions and Complete Solutions Graded A+
A 48-year-old Hispanic woman is seen by a psychiatric clinical nurse specialist
after receiving a call by her son. According to the son, since his father's death 7
months ago, his mother has lost 30 pounds and can't sleep. During her initial visit,
the patient states, 'My husband talks to me in his visits, but his words make no
sense to me. I don't understand what he wants me to do.' What is an appropriate
nursing diagnosis?
A. Ineffective denial.
B. Bipolar mood disorder.
C. Hyper-religiosity.
D. Grieving. - (answers)D. Grieving.
Reason: Grieving may be characterized by weight loss, sleep disturbances, and
messages from beyond.
Your neighbor's husband comes to talk to you. He says his wife has not left the
house in 2 weeks, has a flat mood, and has lost interest in her usual activities. You
recognize these as the primary symptoms of
A. Depression.
B. Schizophrenia.
C. Suicidal ideation.
D. Bipolar manic episodes. - (answers)A. Depression.
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Reason: Depressed mood and anhedonia (loss of interest or pleasure in activities)
are the primary symptoms of major depression.
Your patient is ready for discharge after a 30-day hospitalization for manic
depression. About 30 minutes before his discharge, his roommate comes to you
and says, 'He is talking crazy.' When you ask your patient how he is feeling, he
states, 'I feel like Superman. I can do anything. I can fly home today and then
become a U.S. Senator.' Which type of mania-related symptoms is this patient
exhibiting?
A. Social.
B. Cognitive.
C. Behavioral.
D. Perceptual. - (answers)B. Cognitive.
Reason: Cognitive symptoms include inflated self-esteem and grandiosity.
You need to assess whether a patient who has a mood disorder is ready for
discharge. Which statement would indicate readiness for discharge?
A. Right now, I can't bathe myself or dress myself, but I feel good about that.
B. Going home will be fun, but if it isn't fun, I can always make my mother help
me or tell her to do so. She better help me.
C. I will take my medicines as I should and know to call the number you gave me if
I have bad thoughts.
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D. Taking care of myself is important, but it's okay if I don't want to do anything. -
(answers)C. I will take my medicines as I should and know to call the number you
gave me if I have bad thoughts.
Reason: Verbalization of a plan for help and demonstration of care are realistic
discharge criteria.
An angry patient is in the community room. She picks up a chair and uses it to hit
another patient on the head. When you come into the community room, what
should your first response to the patient holding the chair be?
A. Are you crazy? Hitting people can hurt them!
B. Hitting others is unacceptable. Please put the chair completely down on the
floor.
C. How would you like it if I hit you over the head with a chair?
D. You're in big trouble now. It's probably prison you are looking at! - (answers)B.
Hitting others is unacceptable. Please put the chair completely down on the floor.
Reason: Use words to indicate your lack of acceptance of the patient's behavior in
a nonthreatening voice or tone.
A 22-year-old female is admitted to the unit following a suicide attempt. She has a
2-week history of depression as well as a history of abusing multiple substances
and anorexia nervosa. What is your first nursing priority?
A. Socialization.
B. Contracting for eating behavior.
Psychiatric Mental Health Nursing Saunders NCLEX
Review Questions and Complete Solutions Graded A+
A 48-year-old Hispanic woman is seen by a psychiatric clinical nurse specialist
after receiving a call by her son. According to the son, since his father's death 7
months ago, his mother has lost 30 pounds and can't sleep. During her initial visit,
the patient states, 'My husband talks to me in his visits, but his words make no
sense to me. I don't understand what he wants me to do.' What is an appropriate
nursing diagnosis?
A. Ineffective denial.
B. Bipolar mood disorder.
C. Hyper-religiosity.
D. Grieving. - (answers)D. Grieving.
Reason: Grieving may be characterized by weight loss, sleep disturbances, and
messages from beyond.
Your neighbor's husband comes to talk to you. He says his wife has not left the
house in 2 weeks, has a flat mood, and has lost interest in her usual activities. You
recognize these as the primary symptoms of
A. Depression.
B. Schizophrenia.
C. Suicidal ideation.
D. Bipolar manic episodes. - (answers)A. Depression.
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Reason: Depressed mood and anhedonia (loss of interest or pleasure in activities)
are the primary symptoms of major depression.
Your patient is ready for discharge after a 30-day hospitalization for manic
depression. About 30 minutes before his discharge, his roommate comes to you
and says, 'He is talking crazy.' When you ask your patient how he is feeling, he
states, 'I feel like Superman. I can do anything. I can fly home today and then
become a U.S. Senator.' Which type of mania-related symptoms is this patient
exhibiting?
A. Social.
B. Cognitive.
C. Behavioral.
D. Perceptual. - (answers)B. Cognitive.
Reason: Cognitive symptoms include inflated self-esteem and grandiosity.
You need to assess whether a patient who has a mood disorder is ready for
discharge. Which statement would indicate readiness for discharge?
A. Right now, I can't bathe myself or dress myself, but I feel good about that.
B. Going home will be fun, but if it isn't fun, I can always make my mother help
me or tell her to do so. She better help me.
C. I will take my medicines as I should and know to call the number you gave me if
I have bad thoughts.
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D. Taking care of myself is important, but it's okay if I don't want to do anything. -
(answers)C. I will take my medicines as I should and know to call the number you
gave me if I have bad thoughts.
Reason: Verbalization of a plan for help and demonstration of care are realistic
discharge criteria.
An angry patient is in the community room. She picks up a chair and uses it to hit
another patient on the head. When you come into the community room, what
should your first response to the patient holding the chair be?
A. Are you crazy? Hitting people can hurt them!
B. Hitting others is unacceptable. Please put the chair completely down on the
floor.
C. How would you like it if I hit you over the head with a chair?
D. You're in big trouble now. It's probably prison you are looking at! - (answers)B.
Hitting others is unacceptable. Please put the chair completely down on the floor.
Reason: Use words to indicate your lack of acceptance of the patient's behavior in
a nonthreatening voice or tone.
A 22-year-old female is admitted to the unit following a suicide attempt. She has a
2-week history of depression as well as a history of abusing multiple substances
and anorexia nervosa. What is your first nursing priority?
A. Socialization.
B. Contracting for eating behavior.
