NUR 2120 EXAM #2 PRACTICE
QUESTIONS AND SOLUTIONS
A nurse admits an older client who is experiencing memory loss, confused
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thinking, and apathy. You suspect depression. What is the rationale for
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performing a mini-mental status exam?
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A. To rule out schizophrenia
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B. To rule out dementia
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C. To rule out an anxiety disorder
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D. To rule out thyroid problems - ANSWER: B. To rule out dementia
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Thyroid problems wouldn't be related to general mental status; schizophrenia and
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
anxiety disorders cannot be ruled out by an MMSE
bnb bnb bnb bnb bnb bnb bnb bnb bnb
A patient who you know is taking an MAOI is discussing what foods they take
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
during a nutritional coaching session. Which of the following foods they name is
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of the highest concern and should be addressed promptly by the nurse?
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A. Lettuce
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B. Cottage cheese
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C. Corned beef
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D. Potato salad
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E. Corn - ANSWER: C. Corned beef
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Lettuce, corn, and potato salad are all fresh and not high in tyramine; cottage
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
cheese is not fermented or aged so it is not high in tyramine; corned beef is a
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
cured product and thus high in tyramine
bnb bnb bnb bnb bnb bnb bnb
You are preparing a patient for electroconvulsive treatments that they will receive
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
in an hour. Which of the following statements indicate you must conduct further
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assessment to ensure patient safety around ECT?
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A. "I took a shower last night so that I could go right to the procedure today."
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B. "My partner won't be there and that makes me anxious."
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C. "My dental implants started aching last night."
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D. "I just got a call from my son that he changed his cell number. I'll have to
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
remember that after the procedure." - ANSWER: C. "My dental implants started
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
aching last night."
bnb bnb bnb
Other answers are not related to safety; taking a shower the night before is best
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
practice so their hair is not wet during the procedure
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
,Which statement by a patient with a history of major depression indicates a need
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
for further assessment of mental health status?
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A. "I had a great trip to the Smoky Mountains. It was fun."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
B. "Going back to work, well, it's not bad; it's ok."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
C. "I just don't like going to the movies like I did before."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
D. "I can't wait to go to my son's wedding next weekend. It will be nice to have
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
the whole family together." - ANSWER: C. "I just don't like going to the movies
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
like I did before."
bnb bnb bnb bnb
Indicates that the patient is having trouble enjoying things, a sign of a depressed
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
state; A and D raise no concerns; B indicates that there may be problems but
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
requires further assessment (maybe their job is just not great)
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
Ms. Kim is on an inpatient medical/surgical floor after kidney stones led to
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
possible acute kidney injury. Which of her home medications should the nurse
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
hold and for what test to determine safety?
bnb bnb bnb bnb bnb bnb bnb bnb
A. Lithium, awaiting ultrasound of bladder
bnb bnb bnb bnb bnb
B. Lithium, awaiting a 24 hour urine test with creatinine clearance
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
C. Cymbalta, awaiting a CD4 count and viral load
bnb bnb bnb bnb bnb bnb bnb bnb
D. Cymbalta, awaiting a liver enzyme panel - ANSWER: B. Lithium, awaiting a 24
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
hour urine test with creatinine clearance
bnb bnb bnb bnb bnb bnb
Cymbalta is not filtered by the kidneys and has nothing to do with CD4 or viral
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
load; bladder ultrasound will not give significant useful information
bnb bnb bnb bnb bnb bnb bnb bnb bnb
You are working on an inpatient psychiatry floor when a patient is admitted with
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
major depressive disorder, severe, who has been having deficits in self-care
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
activities. Which of the following is a good goal for the first day of nursing care.
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A. Patient will attend dance therapy group and participate
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B. Patient will not leave room and will be searched regularly for sharp objects
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C. Patient will attend meals in common area with nurse
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D. Patient will feel better - ANSWER: C. Patient will attend meals in common
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area with nurse
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Is an achievable goal that encourages social engagement and daily life activities;
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A is difficult to achieve on a first meeting; D is too vague; B is wrong because
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there is no evidence of suicidal ideation and isolation will be damaging to mental
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health
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A client becomes very dejected and states, "No one really cares what happens to
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
me. Life isn't worth living anymore." Which of the following responses should the
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
nurse make?
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A. "Of course people care. Your family comes to visit every day."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
B. "Why do you feel that way?"
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C. "Tell me who you think doesn't care about you."
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, D. "I care about you, and I am concerned that you feel so sad." - ANSWER: D.
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"I care about you, and I am concerned that you feel so sad."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
A nurse is providing discharge teaching to a client who has bipolar disorder and
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
will be discharged with a prescription for lithium. The nurse should teach the
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
client that which of the following factors puts her at risk for lithium toxicity?
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
A. The client runs 4 miles outdoors every afternoon.
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B. The client drinks 2 liters of liquids daily.
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C. The client eats 2 to 3 gm of sodium-containing foods daily.
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D. The client eats foods high in tyramine. - ANSWER: A. The client runs 4 miles
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outdoors every afternoon
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A nurse who works in a psychiatric unit is caring for a client who has bipolar
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
disorder. The client comes to the nurse's station at 0300 demanding that the
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
nurse call the provider immediately. Which of the following responses by the
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
nurse is appropriate?
bnb bnb bnb
A. "You are being unreasonable, and I will not call your doctor at this hour."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
B. "Go back to your room, and I'll try to get in touch with your doctor."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
C. "I can't call a doctor in the middle of the night unless it's an emergency."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
D. "You must be very upset about something." - ANSWER: D. "You must be very
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
upset about something."
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A nurse asks a client who is suicidal to make a safety contract, but the client
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
declines. Which of the following actions should the nurse identify as the priority?
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
A. Lock the doors to the unit and secure windows so they cannot be opened.
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
B. Provide the client with plastic eating utensils for meals.
bnb bnb bnb bnb bnb bnb bnb bnb bnb
C. Remove any objects from the client's environment that could be used for self-
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
harm.
D. Assign a staff member to stay with the client at all times. - ANSWER: D.
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Assign a staff member to stay with the client at all times
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
A nurse observes that a client who has depression is sitting alone in the room
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
crying. As the nurse approaches, the client states, "I'm feeling really down and
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
don't want to talk to anyone right now." Which of the following responses should
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
the nurse make?
bnb bnb bnb
A. "It might help you feel better if you talk about it."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
B. "I'll just sit here with you for a few minutes then."
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C. "I understand. I've felt like that before, too."
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D. "Why are you feeling so down?" - ANSWER: B. "I'll just sit here with you for a
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few minutes then."
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A nurse is caring for a client who has bipolar disorder and a new prescription for
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valproate. Which of the following instructions should the nurse give the client
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about the use of this medication?
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A. Thyroid function tests should be performed every 6 months.
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B. A pretreatment electroencephalogram (EEG) will be done.
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QUESTIONS AND SOLUTIONS
A nurse admits an older client who is experiencing memory loss, confused
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
thinking, and apathy. You suspect depression. What is the rationale for
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
performing a mini-mental status exam?
bnb bnb bnb bnb bnb
A. To rule out schizophrenia
bnb bnb bnb bnb
B. To rule out dementia
bnb bnb bnb bnb
C. To rule out an anxiety disorder
bnb bnb bnb bnb bnb bnb
D. To rule out thyroid problems - ANSWER: B. To rule out dementia
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
Thyroid problems wouldn't be related to general mental status; schizophrenia and
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
anxiety disorders cannot be ruled out by an MMSE
bnb bnb bnb bnb bnb bnb bnb bnb bnb
A patient who you know is taking an MAOI is discussing what foods they take
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
during a nutritional coaching session. Which of the following foods they name is
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
of the highest concern and should be addressed promptly by the nurse?
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
A. Lettuce
bnb
B. Cottage cheese
bnb bnb
C. Corned beef
bnb bnb
D. Potato salad
bnb bnb
E. Corn - ANSWER: C. Corned beef
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Lettuce, corn, and potato salad are all fresh and not high in tyramine; cottage
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
cheese is not fermented or aged so it is not high in tyramine; corned beef is a
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
cured product and thus high in tyramine
bnb bnb bnb bnb bnb bnb bnb
You are preparing a patient for electroconvulsive treatments that they will receive
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
in an hour. Which of the following statements indicate you must conduct further
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
assessment to ensure patient safety around ECT?
bnb bnb bnb bnb bnb bnb bnb
A. "I took a shower last night so that I could go right to the procedure today."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
B. "My partner won't be there and that makes me anxious."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
C. "My dental implants started aching last night."
bnb bnb bnb bnb bnb bnb bnb
D. "I just got a call from my son that he changed his cell number. I'll have to
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
remember that after the procedure." - ANSWER: C. "My dental implants started
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
aching last night."
bnb bnb bnb
Other answers are not related to safety; taking a shower the night before is best
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
practice so their hair is not wet during the procedure
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
,Which statement by a patient with a history of major depression indicates a need
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
for further assessment of mental health status?
bnb bnb bnb bnb bnb bnb bnb
A. "I had a great trip to the Smoky Mountains. It was fun."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
B. "Going back to work, well, it's not bad; it's ok."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
C. "I just don't like going to the movies like I did before."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
D. "I can't wait to go to my son's wedding next weekend. It will be nice to have
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
the whole family together." - ANSWER: C. "I just don't like going to the movies
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
like I did before."
bnb bnb bnb bnb
Indicates that the patient is having trouble enjoying things, a sign of a depressed
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
state; A and D raise no concerns; B indicates that there may be problems but
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
requires further assessment (maybe their job is just not great)
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
Ms. Kim is on an inpatient medical/surgical floor after kidney stones led to
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
possible acute kidney injury. Which of her home medications should the nurse
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
hold and for what test to determine safety?
bnb bnb bnb bnb bnb bnb bnb bnb
A. Lithium, awaiting ultrasound of bladder
bnb bnb bnb bnb bnb
B. Lithium, awaiting a 24 hour urine test with creatinine clearance
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
C. Cymbalta, awaiting a CD4 count and viral load
bnb bnb bnb bnb bnb bnb bnb bnb
D. Cymbalta, awaiting a liver enzyme panel - ANSWER: B. Lithium, awaiting a 24
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
hour urine test with creatinine clearance
bnb bnb bnb bnb bnb bnb
Cymbalta is not filtered by the kidneys and has nothing to do with CD4 or viral
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
load; bladder ultrasound will not give significant useful information
bnb bnb bnb bnb bnb bnb bnb bnb bnb
You are working on an inpatient psychiatry floor when a patient is admitted with
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
major depressive disorder, severe, who has been having deficits in self-care
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
activities. Which of the following is a good goal for the first day of nursing care.
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
A. Patient will attend dance therapy group and participate
bnb bnb bnb bnb bnb bnb bnb bnb
B. Patient will not leave room and will be searched regularly for sharp objects
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
C. Patient will attend meals in common area with nurse
bnb bnb bnb bnb bnb bnb bnb bnb bnb
D. Patient will feel better - ANSWER: C. Patient will attend meals in common
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
area with nurse
bnb bnb bnb
Is an achievable goal that encourages social engagement and daily life activities;
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
A is difficult to achieve on a first meeting; D is too vague; B is wrong because
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
there is no evidence of suicidal ideation and isolation will be damaging to mental
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
health
bnb
A client becomes very dejected and states, "No one really cares what happens to
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
me. Life isn't worth living anymore." Which of the following responses should the
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
nurse make?
bnb bnb
A. "Of course people care. Your family comes to visit every day."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
B. "Why do you feel that way?"
bnb bnb bnb bnb bnb bnb
C. "Tell me who you think doesn't care about you."
bnb bnb bnb bnb bnb bnb bnb bnb bnb
, D. "I care about you, and I am concerned that you feel so sad." - ANSWER: D.
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
"I care about you, and I am concerned that you feel so sad."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
A nurse is providing discharge teaching to a client who has bipolar disorder and
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
will be discharged with a prescription for lithium. The nurse should teach the
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
client that which of the following factors puts her at risk for lithium toxicity?
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
A. The client runs 4 miles outdoors every afternoon.
bnb bnb bnb bnb bnb bnb bnb bnb
B. The client drinks 2 liters of liquids daily.
bnb bnb bnb bnb bnb bnb bnb bnb
C. The client eats 2 to 3 gm of sodium-containing foods daily.
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
D. The client eats foods high in tyramine. - ANSWER: A. The client runs 4 miles
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
outdoors every afternoon
bnb bnb bnb
A nurse who works in a psychiatric unit is caring for a client who has bipolar
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
disorder. The client comes to the nurse's station at 0300 demanding that the
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
nurse call the provider immediately. Which of the following responses by the
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
nurse is appropriate?
bnb bnb bnb
A. "You are being unreasonable, and I will not call your doctor at this hour."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
B. "Go back to your room, and I'll try to get in touch with your doctor."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
C. "I can't call a doctor in the middle of the night unless it's an emergency."
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
D. "You must be very upset about something." - ANSWER: D. "You must be very
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
upset about something."
bnb bnb bnb
A nurse asks a client who is suicidal to make a safety contract, but the client
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
declines. Which of the following actions should the nurse identify as the priority?
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
A. Lock the doors to the unit and secure windows so they cannot be opened.
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
B. Provide the client with plastic eating utensils for meals.
bnb bnb bnb bnb bnb bnb bnb bnb bnb
C. Remove any objects from the client's environment that could be used for self-
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
harm.
D. Assign a staff member to stay with the client at all times. - ANSWER: D.
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
Assign a staff member to stay with the client at all times
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
A nurse observes that a client who has depression is sitting alone in the room
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
crying. As the nurse approaches, the client states, "I'm feeling really down and
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
don't want to talk to anyone right now." Which of the following responses should
bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb bnb
the nurse make?
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A. "It might help you feel better if you talk about it."
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B. "I'll just sit here with you for a few minutes then."
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C. "I understand. I've felt like that before, too."
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D. "Why are you feeling so down?" - ANSWER: B. "I'll just sit here with you for a
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few minutes then."
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A nurse is caring for a client who has bipolar disorder and a new prescription for
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valproate. Which of the following instructions should the nurse give the client
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about the use of this medication?
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A. Thyroid function tests should be performed every 6 months.
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B. A pretreatment electroencephalogram (EEG) will be done.
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