NR 661 Exam 1 Questions and Correct Answers
2025| Complete with Correct Answers and
Explanations for Guaranteed Pass
Question 1: Assessing disturbances in circadian rhythms in a patient with major depression.
Which question should the nurse ask?
a) Have you ever seen or heard things that others do not?
b) What are your worst and best times of the day?
c) How would you describe your thinking?
d) Do you think your memory is failing?
Correct Answer: b) What are your worst and best times of the day?
Explanation: Major depression often disrupts circadian rhythms, affecting sleep and mood
patterns. Asking about the best and worst times of the day helps identify diurnal mood variations,
a key indicator of circadian disturbance.
Question 2: Reviewing roles and responsibilities of psychiatric unit nurses. Which publication
should the nurse bring?
Diagnostic and Statistical Manual of Mental Disorders
American Nurses Credentialing Center certification requirements
American Nurses Association, Code of Ethics
Psychiatric Mental Health Nursing Standards of Practice
Correct Answer: 4) Psychiatric Mental Health Nursing Standards of Practice
Explanation: The Psychiatric Mental Health Nursing Standards of Practice, published by the
American Nurses Association (ANA), outline the scope, roles, and responsibilities of psychiatric
nurses, making it the most relevant for this committee.
Question 3: Organization providing guidance for standards of professional performance for
psychiatric nurses:
,North American Nursing Diagnosis Association
American Nurses Credentialing Center
National League for Nursing
American Nurses Association
Correct Answer: 4) American Nurses Association
Explanation: The ANA publishes the Standards of Professional Performance for Psychiatric
Mental Health Nursing, guiding nurses in professional conduct and practice.
Question 4: Comment by a new graduate nurse indicating need for clarification of the generalist-
nursing role:
I would feel better if you would look at my documentation that addresses progress toward
treatment goals.
I will spend time each day evaluating the effectiveness of the therapeutic milieu.
I am a little nervous about conducting psychotherapy with clients.
I am doing some reading on how to incorporate complementary interventions into treatment
plans.
Correct Answer: 3) I am a little nervous about conducting psychotherapy with clients.
Explanation: Generalist psychiatric nurses focus on assessment, milieu management, and basic
interventions, not conducting psychotherapy, which is typically reserved for advanced practice
nurses or therapists.
Question 5: Client asking about prevention of sexually transmitted diseases. Most appropriate
action per Psychiatric Mental Health Nursing Standards:
Consult with the mental health care team.
Teach safer sexual practices.
Investigate the questions in individual psychotherapy.
,Notify the attending psychiatrist.
Correct Answer: 2) Teach safer sexual practices.
Explanation: Per ANA standards, psychiatric nurses provide health education, including safer
sexual practices, to promote holistic care and address client concerns directly.
Question 6: Client requests changes in the unit milieu. Action indicating understanding of the
nursing role:
Refer requests to the psychiatric social worker.
Discuss the desired changes with the client.
Refer requests to the psychosocial rehabilitation worker.
Instruct the client that no changes can be made.
Correct Answer: 2) Discuss the desired changes with the client.
Explanation: Engaging the client in discussion supports their autonomy and fosters a therapeutic
milieu, aligning with the nurse’s role in facilitating patient-centered care.
Question 7: Task to delegate to the psychosocial rehabilitation worker:
Conflict resolution teaching to a small group of clients
Comparison of physicians’ orders with medication records
Routine medication administration to a stable client
Assessment of a long-term client
Correct Answer: 1) Conflict resolution teaching to a small group of clients
Explanation: Psychosocial rehabilitation workers are trained to lead psychoeducational groups,
such as conflict resolution, while medication administration and assessments are nursing
responsibilities.
, Question 8: Major focus area for assessment using Orem’s theory:
Adapt and function to meet various role expectations.
Care about self and participate in self-healing.
Implement self-care to meet psychosocial needs.
Enter into a therapeutic one-to-one relationship with the nurse.
Correct Answer: 3) Implement self-care to meet psychosocial needs.
Explanation: Orem’s Self-Care Deficit Theory emphasizes assessing a client’s ability to perform
self-care to meet physical and psychosocial needs, guiding nursing interventions.
Question 9: Intervention based on Watson’s theory of caring:
One-to-one debriefing sessions with nurses and unit manager
Clarification of values and cultural beliefs posing barriers to caring
Identification of coping skills for new nurses
Discussion of hospital policy changes’ impact on staff
Correct Answer: 2) Clarification of values and cultural beliefs posing barriers to caring
Explanation: Watson’s Theory of Human Caring emphasizes cultural sensitivity and self-
awareness to foster caring relationships, making clarification of values a key intervention.
Question 10: Theoretical base for advocating self-awareness among psychiatric nursing staff:
Jean Watson’s theory of human caring
Dorothea Orem’s theory of self-care
Martha Rogers’s principles of homeodynamics
Sister Callista Roy’s adaptation theory
2025| Complete with Correct Answers and
Explanations for Guaranteed Pass
Question 1: Assessing disturbances in circadian rhythms in a patient with major depression.
Which question should the nurse ask?
a) Have you ever seen or heard things that others do not?
b) What are your worst and best times of the day?
c) How would you describe your thinking?
d) Do you think your memory is failing?
Correct Answer: b) What are your worst and best times of the day?
Explanation: Major depression often disrupts circadian rhythms, affecting sleep and mood
patterns. Asking about the best and worst times of the day helps identify diurnal mood variations,
a key indicator of circadian disturbance.
Question 2: Reviewing roles and responsibilities of psychiatric unit nurses. Which publication
should the nurse bring?
Diagnostic and Statistical Manual of Mental Disorders
American Nurses Credentialing Center certification requirements
American Nurses Association, Code of Ethics
Psychiatric Mental Health Nursing Standards of Practice
Correct Answer: 4) Psychiatric Mental Health Nursing Standards of Practice
Explanation: The Psychiatric Mental Health Nursing Standards of Practice, published by the
American Nurses Association (ANA), outline the scope, roles, and responsibilities of psychiatric
nurses, making it the most relevant for this committee.
Question 3: Organization providing guidance for standards of professional performance for
psychiatric nurses:
,North American Nursing Diagnosis Association
American Nurses Credentialing Center
National League for Nursing
American Nurses Association
Correct Answer: 4) American Nurses Association
Explanation: The ANA publishes the Standards of Professional Performance for Psychiatric
Mental Health Nursing, guiding nurses in professional conduct and practice.
Question 4: Comment by a new graduate nurse indicating need for clarification of the generalist-
nursing role:
I would feel better if you would look at my documentation that addresses progress toward
treatment goals.
I will spend time each day evaluating the effectiveness of the therapeutic milieu.
I am a little nervous about conducting psychotherapy with clients.
I am doing some reading on how to incorporate complementary interventions into treatment
plans.
Correct Answer: 3) I am a little nervous about conducting psychotherapy with clients.
Explanation: Generalist psychiatric nurses focus on assessment, milieu management, and basic
interventions, not conducting psychotherapy, which is typically reserved for advanced practice
nurses or therapists.
Question 5: Client asking about prevention of sexually transmitted diseases. Most appropriate
action per Psychiatric Mental Health Nursing Standards:
Consult with the mental health care team.
Teach safer sexual practices.
Investigate the questions in individual psychotherapy.
,Notify the attending psychiatrist.
Correct Answer: 2) Teach safer sexual practices.
Explanation: Per ANA standards, psychiatric nurses provide health education, including safer
sexual practices, to promote holistic care and address client concerns directly.
Question 6: Client requests changes in the unit milieu. Action indicating understanding of the
nursing role:
Refer requests to the psychiatric social worker.
Discuss the desired changes with the client.
Refer requests to the psychosocial rehabilitation worker.
Instruct the client that no changes can be made.
Correct Answer: 2) Discuss the desired changes with the client.
Explanation: Engaging the client in discussion supports their autonomy and fosters a therapeutic
milieu, aligning with the nurse’s role in facilitating patient-centered care.
Question 7: Task to delegate to the psychosocial rehabilitation worker:
Conflict resolution teaching to a small group of clients
Comparison of physicians’ orders with medication records
Routine medication administration to a stable client
Assessment of a long-term client
Correct Answer: 1) Conflict resolution teaching to a small group of clients
Explanation: Psychosocial rehabilitation workers are trained to lead psychoeducational groups,
such as conflict resolution, while medication administration and assessments are nursing
responsibilities.
, Question 8: Major focus area for assessment using Orem’s theory:
Adapt and function to meet various role expectations.
Care about self and participate in self-healing.
Implement self-care to meet psychosocial needs.
Enter into a therapeutic one-to-one relationship with the nurse.
Correct Answer: 3) Implement self-care to meet psychosocial needs.
Explanation: Orem’s Self-Care Deficit Theory emphasizes assessing a client’s ability to perform
self-care to meet physical and psychosocial needs, guiding nursing interventions.
Question 9: Intervention based on Watson’s theory of caring:
One-to-one debriefing sessions with nurses and unit manager
Clarification of values and cultural beliefs posing barriers to caring
Identification of coping skills for new nurses
Discussion of hospital policy changes’ impact on staff
Correct Answer: 2) Clarification of values and cultural beliefs posing barriers to caring
Explanation: Watson’s Theory of Human Caring emphasizes cultural sensitivity and self-
awareness to foster caring relationships, making clarification of values a key intervention.
Question 10: Theoretical base for advocating self-awareness among psychiatric nursing staff:
Jean Watson’s theory of human caring
Dorothea Orem’s theory of self-care
Martha Rogers’s principles of homeodynamics
Sister Callista Roy’s adaptation theory
