Psychiatric Mental Health Nursing Final exam review, complete latest 2026/27 - Miami Dade College, Miami.

Psychiatric Mental Health Nursing Final exam review, complete latest 2026/27 - Miami Dade College, Miami. Question 1 In psychiatric nursing, when a patient is exhibiting high-energy, uncontrolled behavior such as running, kicking, and jumping, the nurse's first priority is to ensure the safety of the client and others. What is the immediate focus? A. Ensure safety / protect from harm B. Administer PRN sedation C. Restrict the patient to their room D. Call for emergency response Question 2 What activity would you AVOID for a patient with bipolar disorder, and what group setting would you place a patient with bipolar? A. Competitive board games B. Arts and crafts C. Group exercise D. Music therapy Question 3 A patient is in a manic episode and hugging others. Someone states, "Tell her to stop hugging me." What is the appropriate response? A. "You must stop touching others. You may talk with them, but do not touch." B. "It's okay, she doesn't mean any harm." C. "Let her be, she's just being friendly." D. "I'll move you to a different area." Question 4 A client is admitted with a diagnosis of major depression and states, "Nothing brings me pleasure anymore." Which behaviors should the nurse assess that correlate with the diagnosis? A. Anhedonia, feelings of worthlessness, and difficulty focusing B. Hyperactivity and grandiosity C. Insomnia and pressured speech D. Agitation and suspiciousness Question 5 A client has just been diagnosed as having major depression. At which time would the nurse expect the client to be at highest risk for self-harm? A. Immediately after a family visit B. On the anniversary of significant life events in the client's life C. During the first few days after admission D. Approximately 2 weeks after starting antidepressant medication Question 6 The nurse is planning care for a client with major depression. Which is an appropriate expected outcome? A. The client will avoid causing harm to others. B. The client will be free from stress. C. The client will independently carry out activities of daily living. D. The client will not experience agitation. Question 7 A client who is manic threatens others on the unit. Which would be the initial nursing action in response to this behavior? A. Administering a sedative that has been prescribed to be used PRN B. Insisting the client take a "time-out" in his room C. Clearing the area of all other clients D. Setting limits on aggressive and intimidating behavior Question 8 Which would most likely be a type of behavior that would be manifested by a client who has histrionic personality disorder? A. Insisting that others follow the rules of the unit B. Wondering why others are being friendly to her C. Having a tantrum if not getting enough attention D. Getting others to make decisions for her Question 9 A client tells the nurse that they are upset because their partner no longer wants to continue the relationship. Which statement made by the client indicates that the end of the relationship is related to the client's narcissistic personality disorder? A. "I don't understand why they left me." B. "I will never find anyone else." C. "I won't be alone long. Everyone wants to be with me because I'm beautiful." D. "It's all my fault." Question 10 The nurse is teaching a client with paranoid personality disorder to validate ideas with another person before taking action on them. Which is the best rationale for this intervention? A. It will assist the client to start basing decisions and actions on reality. B. It will help the client understand the origins of his or her paranoid thinking. C. It will help the client learn to trust other people. D. It will teach the client to differentiate when his or her suspicions are true. Question 11 Which of the following is a realistic outcome for the care of a person with a personality disorder? A. Outcomes that focus on satisfaction with daily life B. Outcomes that focus on the client's perception of others C. Outcomes that focus on increased client insight D. Outcomes that focus on change in behavior Question 12 A client with antisocial personality disorder is begging to use the phone to call his wife, even though it is against the unit rules. The client begs, "It is just this once, and she will be so hurt if I don't call her." Which would be the most appropriate response by the nurse? A. "Only to help your wife, you can call this time." B. "I will get in trouble with my supervisor if I let you call." C. "You may not use the phone to call your wife." D. "You cannot call because you need to focus on your recovery while you are here, not your wife." Question 13 A client with borderline personality disorder says to the nurse, "I feel so comfortable talking with you. You seem to have a special way about you that really helps me." Which would be the most appropriate response by the nurse? A. "I'm glad you feel comfortable with me." B. "I'm here to help you just as all the staff are." C. "You feel others don't understand you?" D. "I cannot be your friend. We need to be clear on that." Question 14 A nurse is teaching a client with borderline personality disorder to reshape thinking patterns. Which is an example of a cognitive restructuring technique that would be helpful for this client? A. When negative thoughts begin, tell yourself "stop." B. Learn to look at situations realistically rather than assuming the worst. C. Recognize negative thoughts and replace them with positive ones. D. Express needs using "I" statements. Question 15 A community health nurse is planning a substance abuse prevention program. Which group would be the best target audience for the nurse to plan a program? A. Teenagers in a high school health class B. School-age children in an after-school program C. Parents attending a parent-teacher association meeting D. Elementary school teachers and counselors Question 16 The nurse is counseling a client that has maintained sobriety for 90 days. The client states, "I still have cravings and I don't know how I am going to stay sober for the rest of my life. What if I can't do it in the long run?" Which is the most therapeutic response by the nurse? A. "You need to think positively." B. "Let's look at this in the short term and determine what you can do to stay sober today." C. "Ninety days is a great accomplishment." D. "Maybe you need a higher level of care." Question 17 You are trying to determine if your patient has developed tolerance. Which statement does your patient need to say to show the patient has developed alcohol tolerance? A. "I feel sick after just one drink now." B. "I started off drinking two beers and now I need 12 to feel the buzz." C. "I can't stop thinking about alcohol." D. "I drink alone most of the time." Question 18 The nurse is talking with the friend of a client with alcoholism. The friend tells the nurse that his relationship with the client was codependent and enabling. Which is an example of codependent behavior? A. The friend called Alcoholics Anonymous when the client expressed a need to stop drinking. B. The friend called the client every night to make sure he got home safely and went looking for him if he was not at home. C. The friend confronted the client on the effect of his drinking on their relationship. D. The friend refused to go out drinking with the client to celebrate the client's birthday. Question 19 A client is being discharged from treatment for addiction to cocaine. Which statement made by the client would cause the most concern for the nurse? A. "I am going to take up a new hobby. It's time to start something new." B. "I can still hang out with my old friends. I am just not going to use." C. "I'm not very comfortable with being alone yet." D. "Shooting baskets helps me not think about getting high." Question 20 A client is being discharged on disulfiram (Antabuse). Which instruction for Antabuse should the client receive? A. Take disulfiram with food to avoid stomach upset. B. Skip the daily dose of disulfiram on days when consumption of alcoholic beverages is likely. C. Disulfiram will prevent the desire to drink alcoholic beverages. D. Read product labels carefully to avoid all products containing alcohol. Question 21 A client is brought to the ER by a family member that found the client unresponsive and barely breathing. The family member states the client is a heroin addict. Which is the priority action by the nurse? A. Administering naloxone immediately B. Starting an IV line C. Checking blood pressure D. Obtaining a urine drug screen Question 22 A client with a history of heavy alcohol use, whose last drink was 24 hours ago, is seen in the emergency department. The client is oriented but is tremulous, weak, and sweaty and has some gastrointestinal (GI) symptoms. Which of the following is typical of these symptoms? A. Alcohol withdrawal syndrome B. Continuing intoxication C. Delirium tremens D. Wernicke-Korsakoff syndrome Question 23 A patient tells the nurse the amount of food is much larger than they would normally eat and after they finish eating, they vomit. Between these binges, the client says that they would diet or exercise, and it makes them feel out of control when they binge. What is a therapeutic response from the nurse? A. "Let's talk about food at dinner and figure out why you're not eating so much at that time." B. "I'm glad you're talking to me about this. What are your feelings before this happens?" C. "There are a lot of people that have eating disorders such as yours because of stress." D. "It will be best for you to eat alone until you have it under control." Question 24 A client diagnosed with anorexia nervosa is brought to the emergency room. A friend states they just passed out. The client is assessed and discovered to have severe dehydration and malnutrition. Which is the priority action by the nurse? A. Start IV fluids as prescribed and obtain consultation for TPN B. Obtain a psychiatric consult C. Weigh the client immediately D. Offer the client a small meal Question 25 While assessing the family dynamics of a client with an eating disorder, which of the following does the nurse most likely discover? A. Multiple siblings B. Lack of interest in the client by other family members C. Supportive and encouraging relationships D. Overcontrolling parents Question 26 The nurse is caring for a client that is 5'7" and 75 pounds. The client states, "I am not eating anything else while I'm here. I look so fat." Which is the best response by the nurse? A. "You need to eat to gain weight." B. "Can we talk about what you see when you look in the mirror?" C. "That is not true, you are very thin." D. "If you don't eat, you will be tube-fed." Question 27 The nurse is assessing a client with an eating disorder. Which personality characteristic would the nurse expect to detect when interacting with the client? A. Careless B. Outspoken C. Defiance D. Eager to please Question 28 Which nursing intervention would be most likely to help the client with anorexia to establish healthy eating patterns? A. Leave the client alone to relax during meals. B. Offer liquid protein supplements if the client is unable to complete a meal. C. Observe the client for 30 minutes after all meals. D. Weigh the client weekly in the same clothing at the same time of day. Question 29 The family members of a client with somatic symptom illness report to the nurse that every time they invite the client to join in an activity, the client declines, saying things like, "I wish I could, but I feel so terrible." Which of the following approaches should the nurse suggest to encourage activity? A. "What does your pain feel like right now?" B. "You are fine, the doctor said so. Let's go." C. "I know this is difficult, but exercise is important. It will be a short walk." or "Can you tell me what is wrong with your stomach and how it hurts?" D. "I'll let you rest. Let me know when you feel better." Question 30 A client is seen in the primary care clinic complaining of headaches. The client appears extremely distressed and insists that she must have a brain tumor. Which diagnosis is most probable for this client? A. Conversion disorder B. Pain disorder C. Brain cancer D. Hypochondriasis Question 31 Which is the primary gain associated with developing physical symptoms in response to stress? A. Accept dependency B. Decrease anxiety C. Experience attention D. Suppress anger Question 32 Which is the primary gain for a client with conversion disorder? A. Emotional detachment B. Emotional support from family C. Identification of anxious feelings D. Relief from emotional conflict Question 33 A patient with somatic symptom disorder needs to be taught to connect the mind with the body and show the relationship between stress and physical symptoms. What intervention would you use to show the connection between the mind and the body? A. Journal to write what is happening and when, or CBT B. Daily meditation sessions C. Group therapy only D. Prescribing antipsychotic medication Question 34 An actor has prepared extensively for his first stage production. On the morning of the opening of the play, the actor awakens with laryngitis. From which disorder is the actor most likely suffering? A. Acute upper respiratory infection B. Conversion disorder C. Hysteria D. Somatization disorder Question 35 The nurse performs a thorough physical examination for a client being admitted for a somatic symptom illness. Which of the following is the best rationale for the physical exam? A. Ease the client's mind that the nurse is looking for physical illness. B. Physical disorders underlie somatic disorders. C. Physical exams are reimbursed by third-party payers. D. Underlying pathology should be ruled out. Question 36 A mother expresses concern to the nurse that the child's regularly scheduled vaccines may not be safe. The mother states that she has heard reports that they cause autism. The most appropriate response by the nurse is: A. "It is recommended that you wait until the child is older to vaccinate." B. "There are safer alternative immunizations available now." C. "There has been no research to establish a relationship between vaccines and autism." D. "The risks do not outweigh the benefits of immunization against childhood diseases." Question 37 A parent informed a nurse that they are concerned that their child might be suffering from ADHD. The child cannot sit still, runs all over the house, and has difficulty in school. Which is the best response by the nurse? A. "From what you are describing, ADHD may be a possibility. We will refer you to a specialist for screening." B. "Your child is just being a normal kid." C. "You should try a stricter discipline approach." D. "This will go away as they get older." Question 38 A child has ADHD and arrives with the parent for a check-up. The nurse assesses that the patient has lost a lot of weight since six months ago. What action will you take to improve the child's nutritional status? A. Stop the medications for treatment until the child regains the weight. B. Have the child sit at the table for three large meals with the family. C. Encourage the parents to include finger foods in the diet. D. Add milkshakes high in sugar to increase weight gain. Question 39 The nurse observes a child with ADHD grab another child in a group session. Which response by the nurse is most effective in stopping the behavior? A. "It's not all right to grab other children when you want something. Ask them." B. "Go to time-out immediately." C. "Why did you do that?" D. "You know better than that." Question 40 A child with ADHD complains to his parents that he does not like the side effects of his medicine, Adderall. The parents ask the nurse for suggestions to reduce the medication's negative side effects. The nurse can best help the parents by offering which advice? A. Give the child his medicine at night. B. Have the child eat a good breakfast and snacks late in the day and at bedtime. C. Limit the number of calories the child eats each day. D. Let the child take daytime naps. Question 41 An 8-year-old with attention deficit hyperactivity disorder is jumping onto the bed onto a chair. Which should be the nurse's first step? A. "I need to talk to you." B. "Stop that right now." C. "You are going to hurt yourself." D. "Why are you jumping off the bed?" Question 42 A nurse working with children with autism spectrum disorder (ASD) hears an unlicensed assistive personnel (UAP) state, "I don't know why we put in so much time educating these parents; they don't seem to care what we say." Which is the best response to the UAP about the importance of educating parents of children with ASD? A. "We help parents feel relieved to have specific strategies that can help them and their child be more successful." B. "You need to be more patient." C. "Parents are the problem." D. "Just do your job and don't worry about it." Question 43 Parents bring their child to the clinic and state to the nurse, "We just don't know what to do anymore. It must be a medical disorder because our child has never been in trouble or acted this way. They are lying, stealing, and destroying property." What is likely to be the most effective intervention for this adolescent? A. Prevention and early intervention B. Incarceration C. Medication only D. Family therapy alone Question 44 A 14-year-old girl is being treated for conduct disorder. She refuses to attend class today, stating that yesterday the other nurse told her she did not have to go to class if she did not want to. Which would be the best response by the nurse? A. "Fine, but you're confined to your room." B. "Missing class is against the rules." C. "You and I both know you're lying." D. "Why do you keep fighting the system?" Question 45 The nurse is meeting with a family of a client with conduct disorder. The nurse discusses changes the parents can make to help their child change problematic behaviors. Which parenting technique would the nurse encourage the parents to use? A. Provide consistent consequences for behaviors. B. Set earlier curfews than the child's peers adhere to. C. Release the child from household responsibilities until he can demonstrate dependable behavior. D. Avoid discussing feelings and expectations with the child. Question 46 The nurse is educating a pregnant client about prenatal care and the potential for decreasing the risk for conduct disorder. The client presently has a child with a conduct disorder and is concerned that this will happen again. Which statement made by the client indicates further education is required? A. "As long as I only have a beer or two a couple of times a week, my unborn child will be OK." B. "I need to avoid alcohol completely during pregnancy." C. "Stress during pregnancy can affect my baby." D. "Prenatal care is important for my baby's development." Question 47 An adolescent seems to be exhibiting out-of-control behavior, yelling and screaming on a behavioral health unit. What is the priority action of the nurse? A. Institute a time-out to allow the client to regain control in a neutral space, preventing further escalation. B. Call security immediately. C. Restrain the client. D. Ignore the behavior. Question 48 When presenting information about conduct disorders to a community group, the nurse is asked, "Which is the best setting for care of a client with conduct disorders when parents cannot provide safe, structured environments and adequate supervision for the client?" Which would be the most appropriate reply by the nurse? A. The acute care setting B. School C. Residential treatment settings D. Jail-diversion program Question 49 Which is an effective way for parents to deal with problem behaviors in children and to prevent later development of conduct disorders? A. Administering medications B. Avoiding setting limits C. Group-based parenting classes D. Being overprotective of the child Question 50 Which is the most important reason for the nurse who cares for children with conduct disorders to discuss feelings, fears, or frustrations with colleagues? A. To make the nurse feel better and avoid burnout B. To encourage camaraderie between colleagues C. To keep negative emotions from interfering with the ability to provide care to clients with problems with aggression D. To ensure that all caregivers have the same attitudes and beliefs about children with conduct disorders Question 51 After being arrested for prostitution, an adolescent client has been referred to a mental health clinic by a juvenile officer. The client has a history of truancy (not going to school) and being physically abusive to siblings. From the history gathered during assessment, the nurse may anticipate which diagnosis? A. Conduct disorder B. Oppositional defiant disorder C. ADHD D. Anxiety disorder Question 52 A client has been referred to a mental health center by juvenile court after being arrested for vandalism. At the mental health center, the client refuses to participate in scheduled activities. The client was seen pushing another client, causing the person to fall. Which approach by the nursing staff would be most therapeutic? A. Establishing firm limits B. Ignoring the behavior C. Allowing the client to negotiate all rules D. Calling the police Question 53 When a young client is disruptive, the nurse responds, "You must take a time-out." What is the priority outcome for intervention with a time-out? A. The client will identify signs of increasing agitation. B. The client will apologize for their behavior. C. The client will complete a written assignment. D. The client will be isolated for one hour. Question 54 The nurse is preparing to set a client with dementia up for breakfast and gives the client a washcloth to clean their face and hands. The client looks at the washcloth without knowing what to do with it. Which is the best response by the nurse? A. "This is a washcloth so you can wash your face and hands." B. "What is wrong with you?" C. "Just wipe your face." D. "I'll do it for you." Question 55 A client with dementia is unable to recognize ordinary objects, such as a pen or notebook. What would this be a symptom of? A. Agnosia B. Amnesia C. Apraxia D. Aphasia Question 56 Which statement made by the nurse would be most appropriate to an 89-year-old patient who is confused but has no history of dementia and is hospitalized for an acute urinary tract infection? A. "You are likely to become progressively more confused now." B. "This should be just a temporary situation." C. "Don't worry about it; everyone is confused when they are in the hospital." D. "I know things are upsetting and confusing right now, but your confusion should clear as you get better." Question 57 The nurse is performing an assessment for a client brought in by a family member who states they think the client has dementia. When evaluating the assessment data, which finding indicates that the client may likely have delirium and not dementia? A. The confusion began suddenly after taking a newly prescribed antidepressant. B. The confusion has been gradual over several years. C. The client has memory loss for remote events. D. The client is able to perform all ADLs independently. Question 58 A client voluntarily admitted to the inpatient psychiatric unit is currently experiencing mild delirium. The client approaches the nurse and states, "I'm going to take a walk outside. I'll be back in about 10 minutes." Which is the most appropriate nursing action? A. Further assess the client's motives for wanting to walk. B. Give the client permission to go on a walk on the grounds. C. Tell the client the walk is not allowed and restrict him to the unit. D. Designate a staff member to accompany the client on the walk. Question 59 The nursing supervisor in an extended care facility is managing the environment to best help the clients with dementia. Which should the nurse include in planning the living environment? A. Plan for the same caregivers to provide care to individuals as much as possible. B. Open the windows and doors to allow fresh air to circulate through the environment. C. Provide a buffet-style menu with many food choices. D. Assign peer-led exercise activities on a daily basis. Question 60 The nurse caring for an elderly woman with dementia has asked the woman's children to bring old photo albums when they visit. Which best describes the usefulness of viewing photos when caring for the dementia client? A. Viewing photos is a form of reminiscence therapy for the client. B. Sharing photos will encourage interaction with other clients. C. This can help the children to correctly identify old photographs. D. Talking about the photos will encourage the client to live in the past.