Mental Health Practice Exam Questions
1. The nurse is conducting discharge teaching for a client with
schizophrenia who plans to live in a group home. Which statement is most
indicative of the need for careful follow-up after discharge?
a. Crickets are a good source of protein.
b. I have not heard any voices for a week.
c. Only my belief in God can help me.
d. Sometimes I have a hard time sitting still: *C. Only my belief in God can help
me.*
The most frequent cause of increased symptoms in psychotic clients is non-
compliance with the medication regimen. If clients believe that "God alone" is
going to heal them (C) then they may discontinue their medication, so (C) would
pose the greatest threat to this client's prognosis. (A) would require further
teaching, but is not as significant a statement as (C). (B) indicates an
improvement in the client's condition. (D) may be a sign of anxiety that could
improve with tx, but does not have the priority of (C).
2. A child is brought to the ER with a broken arm. Because of other injuries,
the nurse suspects the child may be a victim of abuse. When the nurse tries
to give the child an injection, the child's mother becomes very loud and
shouts, "I won't leave my son! Don't you touch him! You'll hurt my child!"
What is the best interpretation of the mother's statements? The mother is
a. regressing to an earlier behavior pattern.
b. sublimating her anger.
c. projecting her feelings onto the nurse.
d. suppressing her fear.: *C. projecting her feelings onto the nurse.*
Projection is attributing one's own thoughts, impulses, or behaviors onto another--it
is the mother who is probably harming the child and she is attributing her actions to
the nurse (C). The mother may be immature, but (A) is not the best description of
her behavior. (B) is substituting a socially acceptable feeling for an unacceptable
one. These are not socially acceptable feelings. The mother may be suppressing
her fear (D) by displaying anger, but such an interpretation cannot be concluded
from the data presented.
, Mental Health Practice Exam Questions
3. An elderly female client with advanced dementia is admitted to the hospital
with a fractured hip. The client repeatedly tells the staff, "Take me home. I
want my Mommy." Which response is best for the nurse to provide?
a. Orient the client to the time, place, and person.
b. Tell the client that the nurse is there and will help her.
c. Remind the client that her mother is no longer living.
d. Explain the seriousness of her injury and need for hospitalization.: *B. Tell
the client that the nurse is there and will help her.*
Those with dementia often refer to home or parents when seeking security and
comfort. The nurse should use the techniques of "offering self" and "talking to the
feelings" to provide reassurance (B). Clients with advanced dementia have
permanent physiological changes in the brain (plaques and tangles) that prevent
them from comprehending and retaining new information, so (A, C, and D) are likely
to be of little use to this client and do not help the clients emotional needs.
4. A 27 y/o F client is admitted to the psychiatric hospital with a dx of bipolar
disorder, manic phase. She is demanding and active. Which intervention
should the nurse include in this client's plan of care?
a. Schedule her to attend various group activities.
b. Reinforce her ability to make her own decisions.
c. Encourage her to identify feelings of anger.
d. Provide a structured environment with little stimuli.: *D. Provide a structured
environment with little stimuli.*
Clients in the manic phase of bipolar disorder require decreased stimuli and a
structured environment (D). Plan noncompetitive activities that can be carried out
alone. (A) is contraindicated; stimuli should be reduced as much as possible.
Impulsive decision-making is characteristic of clients with bipolar disorder. To
prevent future complications, the nurse should monitor these clients' decisions and
assist them in decision-making process (B). (C) is more often associated with
depression than with bipolar disorder.
5. An adult male client who was admitted to the mental hospital unit yesterday
tells the nurse that microchips were planted in his head for military
surveillance of his every move. Which response is best for the nurse to
provide?
, Mental Health Practice Exam Questions
a. You are in the hospital, and I am the nurse caring for you.
b. It must be difficult for you to control your anxious feelings.
c. Go to occupational therapy and start a project.
d. You are not in a war area now; this is the United States.: * C. Go to
occupational therapy and start a project.*
Delusions often generate fear and isolation, so the nurse should help the client
participate in activities that avoid focusing on the false belief and encourage
interaction with others (C). Delusions are often well-fixed, and though (A) reinforces
reality, it is argumentative and dismisses the clients fears. It is often difficult for the
client to recognize the relationship between delusions and anxiety (B), and the
nurse should reassure the client that he is in a safe place. Dismissing delusional
thinking (D) is unrealistic because neurochemical imbalances that cause positive
symptoms of schizophrenia require antipsychotic drug therapy.
6. A 38 y/o F client is admitted with a dx of paranoid schizophrenia. When
her tray is brought to her, she refuses to eat and tells the nurse, "I know
you're trying to poison me with that food." Which response is most
appropriate for the nurse to make?
a. I'll leave your tray here. I am available if you need anything else.
b. You're not being poisoned. Why do you think someone is trying to poison
you?
c. No one on this unit has ever died from poisoning. You're safe here.
d. I will talk to your HCP about the possibility of changing your diet.: *A. I'll
leave your tray here. I am available if you need anything else.*
(A) is the best choice cited. The nurse doesn't argue with the client nor demand
that she eat, but offers support by agreeing to "be there if needed", e.g., to warm
the food. (B and C) are arguing with the client's delusions, and (B) asks "why"
which is usually not a good question for a psychotic client. (D) has nothing to do
with the actual problem; i.e., the problem is not the diet (she thinks any food given
to her is poisoned).
7. A homeless person who is in the manic phase of bipolar disorder is
admitted to the mental health unit. Which lab finding obtained on admission
is most important for the nurse to report to the HCP?
a. Decreased TSH level.
b. Elevated liver function profile.
, Mental Health Practice Exam Questions
c. Increased WBC count.
d. Decreased Hct and Hgb levels.: *A. Decreased TSH level.*
Hyperthyroidism causes an increased level of serum thyroid hormones (T3 and T4),
which inhibits the release of TSH (A), so the client's manic behavior may be related
to an endocrine disorder. (B, C, and D) are abnormal findings that are commonly
found in the homeless population because of poor sanitation, poor nutrition, and the
prevalence of substance abuse
8. The nurse is planning discharge teaching for a male client with
schizophrenia. The client insists that he is returning to his apartment,
although the HCP informed him that he will be moving to a boarding home.
What is the most important nursing dx for discharge planning?
a. Ineffective denial r/t situational anxiety.
b. Ineffective coping r/t inadequate support.
c. Social isolation r/t difficult interactions.
d. Self-care deficit r/t cognitive impairment.: *A. Ineffective denial r/t situational
anxiety.*
The best nursing dx is (A) because the client is unable to acknowledge the move to
a boarding home. (B, C, and D) are potential nursing diagnoses, but denial is most
important because it is a defense mechanism that keeps the client from dealing with
his feelings about living arrangements.
9. A client who has been admitted to the psychiatric unit tells the nurse, "My
problems are so bad that no one can help me." Which response is best for the
nurse to make?
a. How can I help?
b. Things probably aren't as bad as they seem right now.
c. Let's talk about what is right with your life.
d. I hear how miserable you are, but things will get better soon.: *A. How can I
help?*
Offering self shows empathy and caring (A), and is the best of the choices provided.
Combining the first part of (D) with (A) would be the best response, but this is not a
fill-in-the-blank or an essay test! Choose the best of those choices provided and
move on. (B) dismisses the client, things are bad as far as this client is concerned.
1. The nurse is conducting discharge teaching for a client with
schizophrenia who plans to live in a group home. Which statement is most
indicative of the need for careful follow-up after discharge?
a. Crickets are a good source of protein.
b. I have not heard any voices for a week.
c. Only my belief in God can help me.
d. Sometimes I have a hard time sitting still: *C. Only my belief in God can help
me.*
The most frequent cause of increased symptoms in psychotic clients is non-
compliance with the medication regimen. If clients believe that "God alone" is
going to heal them (C) then they may discontinue their medication, so (C) would
pose the greatest threat to this client's prognosis. (A) would require further
teaching, but is not as significant a statement as (C). (B) indicates an
improvement in the client's condition. (D) may be a sign of anxiety that could
improve with tx, but does not have the priority of (C).
2. A child is brought to the ER with a broken arm. Because of other injuries,
the nurse suspects the child may be a victim of abuse. When the nurse tries
to give the child an injection, the child's mother becomes very loud and
shouts, "I won't leave my son! Don't you touch him! You'll hurt my child!"
What is the best interpretation of the mother's statements? The mother is
a. regressing to an earlier behavior pattern.
b. sublimating her anger.
c. projecting her feelings onto the nurse.
d. suppressing her fear.: *C. projecting her feelings onto the nurse.*
Projection is attributing one's own thoughts, impulses, or behaviors onto another--it
is the mother who is probably harming the child and she is attributing her actions to
the nurse (C). The mother may be immature, but (A) is not the best description of
her behavior. (B) is substituting a socially acceptable feeling for an unacceptable
one. These are not socially acceptable feelings. The mother may be suppressing
her fear (D) by displaying anger, but such an interpretation cannot be concluded
from the data presented.
, Mental Health Practice Exam Questions
3. An elderly female client with advanced dementia is admitted to the hospital
with a fractured hip. The client repeatedly tells the staff, "Take me home. I
want my Mommy." Which response is best for the nurse to provide?
a. Orient the client to the time, place, and person.
b. Tell the client that the nurse is there and will help her.
c. Remind the client that her mother is no longer living.
d. Explain the seriousness of her injury and need for hospitalization.: *B. Tell
the client that the nurse is there and will help her.*
Those with dementia often refer to home or parents when seeking security and
comfort. The nurse should use the techniques of "offering self" and "talking to the
feelings" to provide reassurance (B). Clients with advanced dementia have
permanent physiological changes in the brain (plaques and tangles) that prevent
them from comprehending and retaining new information, so (A, C, and D) are likely
to be of little use to this client and do not help the clients emotional needs.
4. A 27 y/o F client is admitted to the psychiatric hospital with a dx of bipolar
disorder, manic phase. She is demanding and active. Which intervention
should the nurse include in this client's plan of care?
a. Schedule her to attend various group activities.
b. Reinforce her ability to make her own decisions.
c. Encourage her to identify feelings of anger.
d. Provide a structured environment with little stimuli.: *D. Provide a structured
environment with little stimuli.*
Clients in the manic phase of bipolar disorder require decreased stimuli and a
structured environment (D). Plan noncompetitive activities that can be carried out
alone. (A) is contraindicated; stimuli should be reduced as much as possible.
Impulsive decision-making is characteristic of clients with bipolar disorder. To
prevent future complications, the nurse should monitor these clients' decisions and
assist them in decision-making process (B). (C) is more often associated with
depression than with bipolar disorder.
5. An adult male client who was admitted to the mental hospital unit yesterday
tells the nurse that microchips were planted in his head for military
surveillance of his every move. Which response is best for the nurse to
provide?
, Mental Health Practice Exam Questions
a. You are in the hospital, and I am the nurse caring for you.
b. It must be difficult for you to control your anxious feelings.
c. Go to occupational therapy and start a project.
d. You are not in a war area now; this is the United States.: * C. Go to
occupational therapy and start a project.*
Delusions often generate fear and isolation, so the nurse should help the client
participate in activities that avoid focusing on the false belief and encourage
interaction with others (C). Delusions are often well-fixed, and though (A) reinforces
reality, it is argumentative and dismisses the clients fears. It is often difficult for the
client to recognize the relationship between delusions and anxiety (B), and the
nurse should reassure the client that he is in a safe place. Dismissing delusional
thinking (D) is unrealistic because neurochemical imbalances that cause positive
symptoms of schizophrenia require antipsychotic drug therapy.
6. A 38 y/o F client is admitted with a dx of paranoid schizophrenia. When
her tray is brought to her, she refuses to eat and tells the nurse, "I know
you're trying to poison me with that food." Which response is most
appropriate for the nurse to make?
a. I'll leave your tray here. I am available if you need anything else.
b. You're not being poisoned. Why do you think someone is trying to poison
you?
c. No one on this unit has ever died from poisoning. You're safe here.
d. I will talk to your HCP about the possibility of changing your diet.: *A. I'll
leave your tray here. I am available if you need anything else.*
(A) is the best choice cited. The nurse doesn't argue with the client nor demand
that she eat, but offers support by agreeing to "be there if needed", e.g., to warm
the food. (B and C) are arguing with the client's delusions, and (B) asks "why"
which is usually not a good question for a psychotic client. (D) has nothing to do
with the actual problem; i.e., the problem is not the diet (she thinks any food given
to her is poisoned).
7. A homeless person who is in the manic phase of bipolar disorder is
admitted to the mental health unit. Which lab finding obtained on admission
is most important for the nurse to report to the HCP?
a. Decreased TSH level.
b. Elevated liver function profile.
, Mental Health Practice Exam Questions
c. Increased WBC count.
d. Decreased Hct and Hgb levels.: *A. Decreased TSH level.*
Hyperthyroidism causes an increased level of serum thyroid hormones (T3 and T4),
which inhibits the release of TSH (A), so the client's manic behavior may be related
to an endocrine disorder. (B, C, and D) are abnormal findings that are commonly
found in the homeless population because of poor sanitation, poor nutrition, and the
prevalence of substance abuse
8. The nurse is planning discharge teaching for a male client with
schizophrenia. The client insists that he is returning to his apartment,
although the HCP informed him that he will be moving to a boarding home.
What is the most important nursing dx for discharge planning?
a. Ineffective denial r/t situational anxiety.
b. Ineffective coping r/t inadequate support.
c. Social isolation r/t difficult interactions.
d. Self-care deficit r/t cognitive impairment.: *A. Ineffective denial r/t situational
anxiety.*
The best nursing dx is (A) because the client is unable to acknowledge the move to
a boarding home. (B, C, and D) are potential nursing diagnoses, but denial is most
important because it is a defense mechanism that keeps the client from dealing with
his feelings about living arrangements.
9. A client who has been admitted to the psychiatric unit tells the nurse, "My
problems are so bad that no one can help me." Which response is best for the
nurse to make?
a. How can I help?
b. Things probably aren't as bad as they seem right now.
c. Let's talk about what is right with your life.
d. I hear how miserable you are, but things will get better soon.: *A. How can I
help?*
Offering self shows empathy and caring (A), and is the best of the choices provided.
Combining the first part of (D) with (A) would be the best response, but this is not a
fill-in-the-blank or an essay test! Choose the best of those choices provided and
move on. (B) dismisses the client, things are bad as far as this client is concerned.
