EPsychiatric Mental Health Nursing NCLEX Questions (50 Questions) Exam (2025)
comprehensive questions and verified answers ( detailed & elaborated) 2025-2026 graded A+
A male client voluntarily admits himself to the substance abuse unit. He
confesses that he drinks 1 qt or more of vodka each day and uses container
occasionally. Later that afternoon, he begins to show signs of alcohol
withdrawal. What are some early signs of this condition?
A. Vomiting, diarrhea, and bradycardia
B. Dehydration, temperature above 101 F (38.3 C), and pruritis
C. Hypertension, diaphoresis, and seizures
D. Diaphoresis, tremors, and nervousness
D. Diaphoresis, tremors, and nervousness
Rationale: Alcohol withdrawal syndrome includes alcohol withdrawal, alcoholic
hallucinosis, and alcohol withdrawal delirium (formerly delirium tremens). Signs of
alcohol withdrawal include diaphoresis, tremors, nervousness, nausea, vomiting,
malaise, increased blood pressure and pulse rate, sleep disturbances, and irritability.
Although diarrhea may be an early sign of alcohol withdrawal, tachycardia - not -
bradycardia - is associated with alcohol withdrawal. Dehydration and an elevated
temperature may be expected, but a temperature above 101 F indicates an infection
rather than alcohol withdrawal. Pruritus rarely occurs in alcohol withdrawal. If
withdrawal symptoms remain untreated, seizures may arise later.
When monitoring a female client recently admitted for treatment of cocaine
addiction, the nurse notes sudden increases in the arterial blood pressure and
heart rate. To correct these problems, the nurse expects the physician to
prescribe:
A. Norepinephrine (Levophed) and lidocaine (Xylocaine)
B. Nifedipine (Procardia) and lidocaine (Xylocaine)
C. Nitroglycerin (Nitro-Bid IV) and esmolol (Brevibloc)
D. Nifedipine (Procardia) and esmolol (Brevibloc)
D. Nifedipine (Procardia) and esmolol (Brevibloc)
Rationale: This client requires a vasodilator, such as nifedipine to treat hypertension,
and a beta-adrenergic blocker, such as esmolol, to reduce the heart rate. Lidocaine,
an anti arrhythmic, isn't indicated because the client doesn't have an arrhythmia.
,Although nitroglycerin may be used to treat coronary vasospasm, it isn't the drug of
choice in hypertension.
A 25-year-old client experiencing alcohol withdrawal is upset about going
through detoxification. Which of the following goals is a priority?
A. The client will commit to a drug-free lifestyle
B. The client will work with the nurse to remain safe
C. The client will drink plenty of fluids daily
D. The client will make a personal inventory of strengths
B. The client will work with the nurse to remain safe
Rationale: The priority goal in alcohol withdrawal is maintaining the client' safety.
Committing to a drug-free lifestyle, drinking plenty of fluids, and identifying personal
strengths are important goals, but ensure the client's safety is the nurse's top priority.
A male client is admitted to a psychiatric facility by court order for evaluation
for antisocial personality disorder. This client has a long history of initiating
fights and abusing animals and recently was arrested for setting the
neighbor's dog on fire. When evaluating this client for the potential for
violence, the nurse should assess for which behavioral clues?
A. A rigid posture, restlessness, and glaring
B. Depression and physical withdrawal
C. Silence and noncompliance
D. Hyper vigilance and talk of past violent acts
A. A rigid posture, restlessness, and glaring
Rationale: Behavior clues that suggest the potential for violence include a rigid
posture, restlessness, glaring, a change in usual behavior, clenched hands, overtly
aggressive actions, physical withdrawal, noncompliance, overreaction, hostile
threats, recent alcohol ingestion or drug use, talk of past violent acts, inability to
express feelings, repetitive demands and complaints, argumentative ness, profanity,
disorientation, inability to focus attention, hallucinations or delusions, paranoid ideas
or suspicions, and somatic complaints. Violent clients rarely exhibit depression,
silence, or hypervigilance.
Flumazenil (Romazicon) has been ordered for a male client who has overdosed
on oxazepam (Serax). Before administering the medication, the nurse should
be prepared for which common adverse effect?
A. Seizures
, B. Shivering
C. Anxiety
D. Chest pain
A. Seizures
Rationale: Seizures are the most common adverse effect of using flumazenil to
reverse benzodiazepine overdose. The effect is magnified if the client has a
combined tricyclic antidepressant and benzodiazepine overdose. Less common
adverse effects includer shivering, anxiety, and chest pain.
The nurse is caring for a client diagnosed with bulimia. The most appropriate
initial goal for a client diagnosed with bulimia is to:
A. Avoid shopping for large amounts of food
B. Control eating impulses
C. Identify anxiety-causing situations
D. Eat only three meals per day
C. Identify anxiety-causing situations
Rationale: Bulimic behavior is generally a maladaptive coping response to stress and
underlying issues. The client must identify anxiety-causing situation as that stimulate
the bulimic behavior and then learn new ways of coping with the anxiety. Controlling
shopping for large amounts of food isn't a goal early in treatment. Managing eating
impulses and replacing them with adaptive coping mechanisms can be integrated
into the plan of care after initially addressing stress and underlying issues. Eating
three meals per day isn't a realistic goal early in treatment.
A female client who's at high risk for suicide needs close supervision. To best
ensure the client's safety, the nurse should:
A. Check on the client frequently at irregular intervals throughout the night
B. Assure the client that the nurse will hold in confidence anything the client
says
C. Repeatedly discuss previous suicide attempts with the client
D. Disregard decreased communication by the client because this is common
in suicidal clients
A. Check on the client frequently at irregular intervals throughout the night
Rationale: Checking the client frequently but at irregular intervals prevents the client
from predicting when observation will take place and altering behavior in a
misleading way at these times. Option B may encourage the client to try to
comprehensive questions and verified answers ( detailed & elaborated) 2025-2026 graded A+
A male client voluntarily admits himself to the substance abuse unit. He
confesses that he drinks 1 qt or more of vodka each day and uses container
occasionally. Later that afternoon, he begins to show signs of alcohol
withdrawal. What are some early signs of this condition?
A. Vomiting, diarrhea, and bradycardia
B. Dehydration, temperature above 101 F (38.3 C), and pruritis
C. Hypertension, diaphoresis, and seizures
D. Diaphoresis, tremors, and nervousness
D. Diaphoresis, tremors, and nervousness
Rationale: Alcohol withdrawal syndrome includes alcohol withdrawal, alcoholic
hallucinosis, and alcohol withdrawal delirium (formerly delirium tremens). Signs of
alcohol withdrawal include diaphoresis, tremors, nervousness, nausea, vomiting,
malaise, increased blood pressure and pulse rate, sleep disturbances, and irritability.
Although diarrhea may be an early sign of alcohol withdrawal, tachycardia - not -
bradycardia - is associated with alcohol withdrawal. Dehydration and an elevated
temperature may be expected, but a temperature above 101 F indicates an infection
rather than alcohol withdrawal. Pruritus rarely occurs in alcohol withdrawal. If
withdrawal symptoms remain untreated, seizures may arise later.
When monitoring a female client recently admitted for treatment of cocaine
addiction, the nurse notes sudden increases in the arterial blood pressure and
heart rate. To correct these problems, the nurse expects the physician to
prescribe:
A. Norepinephrine (Levophed) and lidocaine (Xylocaine)
B. Nifedipine (Procardia) and lidocaine (Xylocaine)
C. Nitroglycerin (Nitro-Bid IV) and esmolol (Brevibloc)
D. Nifedipine (Procardia) and esmolol (Brevibloc)
D. Nifedipine (Procardia) and esmolol (Brevibloc)
Rationale: This client requires a vasodilator, such as nifedipine to treat hypertension,
and a beta-adrenergic blocker, such as esmolol, to reduce the heart rate. Lidocaine,
an anti arrhythmic, isn't indicated because the client doesn't have an arrhythmia.
,Although nitroglycerin may be used to treat coronary vasospasm, it isn't the drug of
choice in hypertension.
A 25-year-old client experiencing alcohol withdrawal is upset about going
through detoxification. Which of the following goals is a priority?
A. The client will commit to a drug-free lifestyle
B. The client will work with the nurse to remain safe
C. The client will drink plenty of fluids daily
D. The client will make a personal inventory of strengths
B. The client will work with the nurse to remain safe
Rationale: The priority goal in alcohol withdrawal is maintaining the client' safety.
Committing to a drug-free lifestyle, drinking plenty of fluids, and identifying personal
strengths are important goals, but ensure the client's safety is the nurse's top priority.
A male client is admitted to a psychiatric facility by court order for evaluation
for antisocial personality disorder. This client has a long history of initiating
fights and abusing animals and recently was arrested for setting the
neighbor's dog on fire. When evaluating this client for the potential for
violence, the nurse should assess for which behavioral clues?
A. A rigid posture, restlessness, and glaring
B. Depression and physical withdrawal
C. Silence and noncompliance
D. Hyper vigilance and talk of past violent acts
A. A rigid posture, restlessness, and glaring
Rationale: Behavior clues that suggest the potential for violence include a rigid
posture, restlessness, glaring, a change in usual behavior, clenched hands, overtly
aggressive actions, physical withdrawal, noncompliance, overreaction, hostile
threats, recent alcohol ingestion or drug use, talk of past violent acts, inability to
express feelings, repetitive demands and complaints, argumentative ness, profanity,
disorientation, inability to focus attention, hallucinations or delusions, paranoid ideas
or suspicions, and somatic complaints. Violent clients rarely exhibit depression,
silence, or hypervigilance.
Flumazenil (Romazicon) has been ordered for a male client who has overdosed
on oxazepam (Serax). Before administering the medication, the nurse should
be prepared for which common adverse effect?
A. Seizures
, B. Shivering
C. Anxiety
D. Chest pain
A. Seizures
Rationale: Seizures are the most common adverse effect of using flumazenil to
reverse benzodiazepine overdose. The effect is magnified if the client has a
combined tricyclic antidepressant and benzodiazepine overdose. Less common
adverse effects includer shivering, anxiety, and chest pain.
The nurse is caring for a client diagnosed with bulimia. The most appropriate
initial goal for a client diagnosed with bulimia is to:
A. Avoid shopping for large amounts of food
B. Control eating impulses
C. Identify anxiety-causing situations
D. Eat only three meals per day
C. Identify anxiety-causing situations
Rationale: Bulimic behavior is generally a maladaptive coping response to stress and
underlying issues. The client must identify anxiety-causing situation as that stimulate
the bulimic behavior and then learn new ways of coping with the anxiety. Controlling
shopping for large amounts of food isn't a goal early in treatment. Managing eating
impulses and replacing them with adaptive coping mechanisms can be integrated
into the plan of care after initially addressing stress and underlying issues. Eating
three meals per day isn't a realistic goal early in treatment.
A female client who's at high risk for suicide needs close supervision. To best
ensure the client's safety, the nurse should:
A. Check on the client frequently at irregular intervals throughout the night
B. Assure the client that the nurse will hold in confidence anything the client
says
C. Repeatedly discuss previous suicide attempts with the client
D. Disregard decreased communication by the client because this is common
in suicidal clients
A. Check on the client frequently at irregular intervals throughout the night
Rationale: Checking the client frequently but at irregular intervals prevents the client
from predicting when observation will take place and altering behavior in a
misleading way at these times. Option B may encourage the client to try to
