NCLEX Psychiatric Nursing Practice Exam #01 In Text Mode: All questions and answers are given for reading and answering at your own pace.
Question 1. A male client who is experiencing disordered thinking about food being poisoned is admitted to the mental health unit. The nurse uses which communication technique to encourage the client to eat dinner?
A). Offering opinion about the need to eat.
B). Focusing on self-disclosure of own food preference.
C). Using open ended question and silence.
D). Verbalizing reasons that the client may not choose to eat.
Question 1 Answer: C). Using open ended question and silence.
Question 1 Explanation: Open ended questions and silence are strategies used to encourage clients to discuss their problem in descriptive manner.
Question 2. A 60 year old female client who lives alone tells the nurse at the community health center “I really don’t need anyone to talk to”. The TV is my best friend. The nurse recognizes that the client is using the defense mechanism known as?
Question 2 Answer: B). Denial.
Question 2 Explanation: The client statement is an example of the use of denial, a defense that blocks problem by unconscious refusing to admit they exist.
Question 3. When teaching parents about childhood depression Nurse Trina should say?
A). It may appear acting out behavior.
B). Looks almost identical to adult depression.
C). Does not respond to conventional treatment.
D). Is short in duration & resolves easily.
Question 3 Answer: A). It may appear acting out behavior.
Question 3 Explanation: Children have difficulty verbally expressing their feelings, acting out behavior, such as temper tantrums, may indicate underlying depression.
Question 4. A 23 year old client has been admitted with a diagnosis of schizophrenia says to the nurse “Yes, its march, March is little woman”. That’s literal you know”. These statement illustrate:
B). Loosening of association.
C). Flight of ideas.
Question 4 Answer: B). Loosening of association.
Question 4 Explanation: Loose associations are thoughts that are presented without the logical connections usually necessary for the listening to interpret the message.
Question 5. Nurse Monet is caring for a female client who has suicidal tendency. When accompanying the client to the restroom, Nurse Monet should…
A). Open the window and allow her to get some fresh air.
B). Give her privacy.
C). Observe her.
D). Allow her to urinate.
Question 5 Answer: C). Observe her.
Question 5 Explanation: The Nurse has a responsibility to observe continuously the acutely suicidal client. The Nurse should watch for clues, such as communicating suicidal thoughts, and messages; hoarding medications and talking about death.
Question 6. Which of the following foods would the nurse Trish eliminate from the diet of a client in alcohol withdrawal?
B). Orange Juice.
C). Regular Coffee.
Question 6 Answer: C). Regular Coffee.
Question 6 Explanation: Regular coffee contains caffeine which acts as psychomotor stimulants and leads to feelings of anxiety and agitation. Serving coffee top the client may add to tremors or wakefulness.
Question 7. Which of the following approaches would be most appropriate to use with a client suffering from narcissistic personality disorder when discrepancies exist between what the client states and what actually exist?
C). Limit setting.
D). Supportive confrontation.
Question 7 Answer: D). Supportive confrontation.
Question 7 Explanation: The nurse would specifically use supportive confrontation with the client to point out discrepancies between what the client states and what actually exists to increase responsibility for self.
Question 8. Nurse Maureen is developing a plan of care for a female client with anorexia nervosa. Which action should the nurse include in the plan?
A). Encourage client to exercise to reduce anxiety.
B). Provide privacy during meals.
C). Restrict visits with the family.
D). Set-up a strict eating plan for the client.
Question 8 Answer: D). Set-up a strict eating plan for the client.
Question 8 Explanation: Establishing a consistent eating plan and monitoring client’s weight are important to this disorder.
Question 9. Mario is complaining to other clients about not being allowed by staff to keep food in his room. Which of the following interventions would be most appropriate?
A). Allowing a snack to be kept in his room.
B). Reprimanding the client.
C). Ignoring the clients behavior.
D). Setting limits on the behavior.
Question 9 Answer: D). Setting limits on the behavior.
Question 9 Explanation: The nurse needs to set limits in the client’s manipulative behavior to help the client control dysfunctional behavior. A consistent approach by the staff is necessary to decrease manipulation.
Question 10. Linda is pacing the floor and appears extremely anxious. The duty nurse approaches in an attempt to alleviate Linda’s anxiety. The most therapeutic question by the nurse would be?
A). Would you like to watch TV?.
B). Are you feeling upset now?.
C). Would you like me to talk with you?.
D). Ignore the client.
Question 10 Answer: C). Would you like me to talk with you?.
Question 10 Explanation: The nurse presence may provide the client with support & feeling of control.
Question 11. Nurse Joey is aware that the signs & symptoms that would be most specific for diagnosis anorexia are?
A). Excessive weight loss, amenorrhea & abdominal distension.
B). Compulsive behavior, excessive fears & nausea.
C). Excessive activity, memory lapses & an increased pulse.
D). Slow pulse, 10% weight loss & alopecia.
Question 11 Answer: A). Excessive weight loss, amenorrhea & abdominal distension.
Question 11 Explanation: These are the major signs of anorexia nervosa. Weight loss is excessive (15% of expected weight).
Question 12. Joey a client with antisocial personality disorder belches loudly. A staff member asks Joey, “Do you know why people find you repulsive?” this statement most likely would elicit which of the following client reaction?
Question 12 Answer: A). Defensiveness.
Question 12 Explanation: When the staff member ask the client if he wonders why others find him repulsive, the client is likely to feel defensive because the question is belittling. The natural tendency is to counterattack the threat to self image.
Question 13. Nurse Monette is aware that extremely depressed clients seem to do best in settings where they have:
A). Varied Activities.
B). Minimal decision making.
C). Multiple stimuli.
D). Routine Activities.
Question 13 Answer: D). Routine Activities.
Question 13 Explanation: Depression usually is both emotional & physical. A simple daily routine is the best, least stressful and least anxiety producing.
Question 14. Nurse Perry is aware that language development in autistic child resembles:
A). Speech lag.
B). Scanning speech.
Question 14 Answer: C). Echolalia.
Question 14 Explanation: The autistic child repeat sounds or words spoken by others.
Question 15. Nurse Claire is caring for a client diagnosed with bulimia. The most appropriate initial goal for a client diagnosed with bulimia is?
A). Eat only three meals a day.
B). Avoid shopping plenty of groceries.
C). Identify anxiety causing situations.
D). Encourage to avoid foods.
Question 15 Answer: C). Identify anxiety causing situations.
Question 15 Explanation: Bulimia disorder generally is a maladaptive coping response to stress and underlying issues. The client should identify anxiety causing situation that stimulate the bulimic behavior and then learn new ways of coping with the anxiety.
Question 16. When planning the discharge of a client with chronic anxiety, Nurse Chris evaluates achievement of the discharge maintenance goals. Which goal would be most appropriately having been included in the plan of care requiring evaluation?
A). The client eliminates all anxiety from daily situations.
B). The client identifies anxiety producing situations.
C). The client maintains contact with a crisis counselor.
D). The client ignores feelings of anxiety.
Question 16 Answer: B). The client identifies anxiety producing situations.
Question 16 Explanation: Recognizing situations that produce anxiety allows the client to prepare to cope with anxiety or avoid specific stimulus.
Question 17. When planning care for a female client using ritualistic behavior, Nurse Gina must recognize that the ritual:
A). Is under the client’s conscious control.
B). Helps the client focus on the inability to deal with reality.
C). Helps the client control the anxiety.
D). Is used by the client primarily for secondary gains.
Question 17 Answer: C). Helps the client control the anxiety.
Question 17 Explanation: The rituals used by a client with obsessive compulsive disorder help control the anxiety level by maintaining a set pattern of action.
Question 18. Conney with borderline personality disorder who is to be discharge soon threatens to “do something” to herself if discharged. Which of the following actions by the nurse would be most important?
A). Ask a family member to stay with the client at home temporarily.
B). Discuss the meaning of the client’s statement with her.
C). Request an immediate extension for the client.
D). Ignore the clients statement because it’s a sign of manipulation.
Question 18 Answer: B). Discuss the meaning of the client’s statement with her.
Question 18 Explanation: Any suicidal statement must be assessed by the nurse. The nurse should discuss the client’s statement with her to determine its meaning in terms of suicide.
Question 19. A client is experiencing anxiety attack. The most appropriate nursing intervention should include?
A). Leaving the client alone.
B). Turning on the television.
C). Ask the client to play with other clients.
D). Staying with the client and speaking in short sentences.
Question 19 Answer: D). Staying with the client and speaking in short sentences.
Question 19 Explanation: Appropriate nursing interventions for an anxiety attack include using short sentences, staying with the client, decreasing stimuli, remaining calm and medicating as needed.
Question 20. Nurse Hazel is caring for a male client who experience false sensory perceptions with no basis in reality. This perception is known as:
A). Loose associations.
Question 20 Answer: B). Hallucinations.
Question 20 Explanation: Hallucinations are visual, auditory, gustatory, tactile or olfactory perceptions that have no basis in reality.
Question 21. A 39 year old mother with obsessive-compulsive disorder has become immobilized by her elaborate hand washing and walking rituals. Nurse Trish recognizes that the basis of O.C. disorder is often:
A). Feelings of guilt and inadequacy.
B). Problems with anger and remorse.
C). Problems with being too conscientious.
D). Feeling of unworthiness and hopelessness.
Question 21 Answer: A). Feelings of guilt and inadequacy.
Question 21 Explanation: Ritualistic behavior seen in this disorder is aimed at controlling guilt and inadequacy by maintaining an absolute set pattern of behavior.
Question 22. Nurse Penny is aware that the symptoms that distinguish post traumatic stress disorder from other anxiety disorder would be:
A). Re-experiencing the trauma in dreams or flashback.
B). Lack of interest in family & others.
C). Depression and a blunted affect when discussing the traumatic situation.
D). Avoidance of situation & certain activities that resemble the stress.
Question 22 Answer: A). Re-experiencing the trauma in dreams or flashback.
Question 22 Explanation: Experiencing the actual trauma in dreams or flashback is the major symptom that distinguishes post traumatic stress disorder from other anxiety disorder.
Question 23. When working with a male client suffering phobia about black cats, Nurse Trish should anticipate that a problem for this client would be?
A). Denying that the phobia exist.
B). Anxiety when discussing phobia.
C). Distortion of reality when completing daily routines.
D). Anger toward the feared object.
Question 23 Answer: B). Anxiety when discussing phobia.
Question 23 Explanation: Discussion of the feared object triggers an emotional response to the object.
Question 24. Nurse Tony was caring for a 41 year old female client. Which behavior by the client indicates adult cognitive development?
A). Assumes responsibility for her actions.
B). Generates new levels of awareness.
C). Has maximum ability to solve problems and learn new skills.
D). Her perception are based on reality.
Question 24 Answer: B). Generates new levels of awareness.
Question 24 Explanation: An adult age 31 to 45 generates new level of awareness.
Question 25. A neuromuscular blocking agent is administered to a client before ECT therapy. The Nurse should carefully observe the client for?
B). Nausea and vomiting.
D). Respiratory difficulties.
Question 25 Answer: D). Respiratory difficulties.
Question 25 Explanation: Neuromuscular Blocker, such as SUCCINYLCHOLINE (Anectine) produces respiratory depression because it inhibits contractions of respiratory muscles.
Question 26. Nurse Tina is caring for a client with depression who has not responded to antidepressant medication. The nurse anticipates that what treatment procedure may be prescribed?
A). Short term seclusion.
B). Electroconvulsive therapy.
C). Neuroleptic medication.
Question 26 Answer: B). Electroconvulsive therapy.
Question 26 Explanation: Electroconvulsive therapy is an effective treatment for depression that has not responded to medication..
Question 27. Nurse Patricia is aware that the major health complication associated with intractable anorexia nervosa would be?
A). Decreased metabolism causing cold intolerance.
B). Endocrine imbalance causing cold amenorrhea.
C). Cardiac dysrhythmias resulting to cardiac arrest.
D). Glucose intolerance resulting in protracted hypoglycemi.
Question 27 Answer: C). Cardiac dysrhythmias resulting to cardiac arrest.
Question 27 Explanation: These clients have severely depleted levels of sodium and potassium because of their starvation diet and energy expenditure, these electrolytes are necessary for cardiac functioning.
Question 28. Nurse Trish is working in a mental health facility; the nurse priority nursing intervention for a newly admitted client with bulimia nervosa would be to?
A). Teach client to measure I & O.
B). Monitor client continuously.
C). Involve client in planning daily meal.
D). Observe client during meals.
Question 28 Answer: B). Monitor client continuously.
Question 28 Explanation: These clients often hide food or force vomiting; therefore they must be carefully monitored.
Question 29. Mario is admitted to the emergency room with drug-included anxiety related to over ingestion of prescribed antipsychotic medication. The most important piece of information the nurse in charge should obtain initially is the:
A). Length of time on the med..
B). Name of the nearest relative & their phone number.
C). Name of the ingested medication & the amount ingested.
D). Reason for the suicide attempt.
Question 29 Answer: C). Name of the ingested medication & the amount ingested.
Question 29 Explanation: In an emergency, lives saving facts are obtained first. The name and the amount of medication ingested are of outmost important in treating this potentially life threatening situation.
Question 30. A female client is admitted with a diagnosis of delusions of GRANDEUR. This diagnosis reflects a belief that one is:
A). Highly famous and important.
B). Responsible for evil world.
C). Connected to client unrelated to oneself.
D). Being Killed.
Question 30 Answer: A). Highly famous and important.
Question 30 Explanation: Delusion of grandeur is a false belief that one is highly famous and important.
Question 31. A nursing care plan for a male client with bipolar I disorder should include:
A). Engaging the client in conversing about current affairs.
B). Providing a structured environment.
C). Designing activities that will require the client to maintain contact with reality.
D). Touching the client provide assurance.
Question 31 Answer: B). Providing a structured environment.
Question 31 Explanation: Structure tends to decrease agitation and anxiety and to increase the client’s feeling of security.
Question 32. Nurse Nina is assigned to care for a client diagnosed with Catatonic Stupor. When Nurse Nina enters the client’s room, the client is found lying on the bed with a body pulled into a fetal position. Nurse Nina should?
A). Sit beside the client in silence and occasionally ask open-ended question.
B). Ask the client direct questions to encourage talking.
C). Rake the client into the dayroom to be with other clients.
D). Leave the client alone and continue with providing care to the other clients.
Question 32 Answer: A). Sit beside the client in silence and occasionally ask open-ended question.
Question 32 Explanation: Clients who are withdrawn may be immobile and mute, and require consistent, repeated interventions. Communication with withdrawn clients requires much patience from the nurse. The nurse facilitates communication with the client by sitting in silence, asking open-ended question and pausing to provide opportunities for the client to respond.
Question 33. During electroconvulsive therapy (ECT) the client receives oxygen by mask via positive pressure ventilation. The nurse assisting with this procedure knows that positive pressure ventilation is necessary because?
A). Anesthesia is administered during the procedure.
B). Grand mal seizure activity depresses respirations.
C). Decrease oxygen to the brain increases confusion and disorientation.
D). Muscle relaxations given to prevent injury during seizure activity depress respirations..
Question 33 Answer: D). Muscle relaxations given to prevent injury during seizure activity depress respirations..
Question 33 Explanation: A short acting skeletal muscle relaxant such as succinylcholine (Anectine) is administered during this procedure to prevent injuries during seizure.
Question 34. A male client is diagnosed with schizotypal personality disorder. Which signs would this client exhibit during social situation?
A). Aggressive behavior.
B). Emotional affect.
C). Independence need.
D). Paranoid thoughts.
Question 34 Answer: D). Paranoid thoughts.
Question 34 Explanation: Clients with schizotypal personality disorder experience excessive social anxiety that can lead to paranoid thoughts.
Question 35. Nurse Jonel is providing information to a community group about violence in the family. Which statement by a group member would indicate a need to provide additional information?
A). “Abuser use fear and intimidation”.
B). “Abuse occurs more in low-income families”.
C). “Abuser usually have poor self-esteem”.
D). “Abuser are often jealous or self-centered”.
Question 35 Answer: B). “Abuse occurs more in low-income families”.
Question 35 Explanation: Personal characteristics of abuser include low self-esteem, immaturity, dependence, insecurity and jealousy.
Question 36. A 20 year old client was diagnosed with dependent personality disorder. Which behavior is most likely to be evidence of ineffective individual coping?
A). Recurrent self-destructive behavior.
B). Inability to make choices and decision without advise.
C). Showing interest in solitary activities.
D). Avoiding relationship.
Question 36 Answer: B). Inability to make choices and decision without advise.
Question 36 Explanation: Individual with dependent personality disorder typically shows indecisiveness submissiveness and clinging behavior so that others will make decisions with them.
Question 37. Nurse Benjie is communicating with a male client with substance-induced persisting dementia; the client cannot remember facts and fills in the gaps with imaginary information. Nurse Benjie is aware that this is typical of?
A). Associative looseness.
B). Flight of ideas.
Question 37 Answer: D). Confabulation.
Question 37 Explanation: Confabulation or the filling in of memory gaps with imaginary facts is a defense mechanism used by people experiencing memory deficits.
Question 38. A characteristic that would suggest to Nurse Anne that an adolescent may have bulimia would be:
A). Badly stained teeth.
B). Previous history of gastritis.
C). Frequent regurgitation & re-swallowing of food.
D). Positive body image.
Question 38 Answer: A). Badly stained teeth.
Question 38 Explanation: Dental enamel erosion occurs from repeated self-induced vomiting.
Question 39. A 32 year old male graduate student, who has become increasingly withdrawn and neglectful of his work and personal hygiene, is brought to the psychiatric hospital by his parents. After detailed assessment, a diagnosis of schizophrenia is made. It is unlikely that the client will demonstrate:
A). Low self esteem.
B). Concrete thinking.
C). Weak ego.
D). Effective self boundaries.
Question 39 Answer: D). Effective self boundaries.
Question 39 Explanation: A person with this disorder would not have adequate self-boundaries.
Question 40. A long term goal for a paranoid male client who has unjustifiably accused his wife of having many extramarital affairs would be to help the client develop:
A). Feeling of self worth.
B). Better self control.
C). Insight into his behavior.
D). Faith in his wife.
Question 40 Answer: A). Feeling of self worth.
Question 40 Explanation: Helping the client to develop feeling of self worth would reduce the client’s need to use pathologic defenses.
Question 41. Which of the following would Nurse Hazel expect to assess for a client who is exhibiting late signs of heroin withdrawal?
A). Constipation & steatorrhea.
B). Restlessness & Irritability.
C). Yawning & diaphoresis.
D). Vomiting and Diarrhea.
Question 41 Answer: D). Vomiting and Diarrhea.
Question 41 Explanation: Vomiting and diarrhea are usually the late signs of heroin withdrawal, along with muscle spasm, fever, nausea, repetitive, abdominal cramps and backache.
Question 42. To further assess a client’s suicidal potential. Nurse Katrina should be especially alert to the client expression of:
A). Anxiety & loneliness.
B). Helplessness & hopelessness.
C). Frustration & fear of death.
D). Anger & resentment.
Question 42 Answer: B). Helplessness & hopelessness.
Question 42 Explanation: The expression of these feeling may indicate that this client is unable to continue the struggle of life.
Question 43. Cely is experiencing alcohol withdrawal exhibits tremors, diaphoresis and hyperactivity. Blood pressure is 190/87 mmhg and pulse is 92 bpm. Which of the medications would the nurse expect to administer?
A). Benzlropine (Cogentin).
B). Haloperidol (Haldol).
C). Naloxone (Narcan).
D). Lorazepam (Ativan).
Question 43 Answer: D). Lorazepam (Ativan).
Question 43 Explanation: The nurse would most likely administer benzodiazepine, such as lorazepan (ativan) to the client who is experiencing symptom: The client’s experiences symptoms of withdrawal because of the rebound phenomenon when the sedation of the CNS from alcohol begins to decrease.
Question 44. Nurse Tina is caring for a client with delirium and states that “look at the spiders on the wall”. What should the nurse respond to the client?
A). “I can see the spiders on the wall, but they are not going to hurt you”.
B). “I know you are frightened, but I do not see spiders on the wall”.
C). “You’re having hallucination, there are no spiders in this room at all”.
D). “Would you like me to kill the spiders”.
Question 44 Answer: B). “I know you are frightened, but I do not see spiders on the wall”.
Question 44 Explanation: When hallucination is present, the nurse should reinforce reality with the client.
Question 45. To establish open and trusting relationship with a female client who has been hospitalized with severe anxiety, the nurse in charge should?
A). Encourage the staff to have frequent interaction with the client.
B). Share an activity with the client.
C). Give client feedback about behavior.
D). Respect client’s need for personal space.
Question 45 Answer: D). Respect client’s need for personal space.
Question 45 Explanation: Moving to a client’s personal space increases the feeling of threat, which increases anxiety.
Question 46. Nurse Monette recognizes that the focus of environmental (MILIEU) therapy is to:
A). Allow the client’s freedom to determine whether or not they will be involved in activities.
B). Use natural remedies rather than drugs to control behavior.
C). Role play life events to meet individual needs.
D). Manipulate the environment to bring about positive changes in behavior.
Question 46 Answer: D). Manipulate the environment to bring about positive changes in behavior.
Question 46 Explanation: Environmental (MILIEU) therapy aims at having everything in the client’s surrounding area toward helping the client.
Question 47. Marco approached Nurse Trish asking for advice on how to deal with his alcohol addiction. Nurse Trish should tell the client that the only effective treatment for alcoholism is:
B). Alcoholics anonymous (A.A.).
C). Total abstinence.
D). Aversion Therapy.
Question 47 Answer: C). Total abstinence.
Question 47 Explanation: Total abstinence is the only effective treatment for alcoholism.
Question 48. Nurse Trish would expect a child with a diagnosis of reactive attachment disorder to:
A). Be able to develop only superficial relation with the others.
B). Have more positive relation with the father than the mother.
C). Have been physically abuse.
D). Cling to mother & cry on separation.
Question 48 Answer: A). Be able to develop only superficial relation with the others.
Question 48 Explanation: Children who have experienced attachment difficulties with primary caregiver are not able to trust others and therefore relate superficially
Question 49. Nurse Anna can minimize agitation in a disturbed client by?
A). ensuring constant client and staff contact.
B). limiting unnecessary interaction.
C). increasing appropriate sensory perception.
D). Increasing stimulation.
Question 49 Answer: B). limiting unnecessary interaction.
Question 49 Explanation: Limiting unnecessary interaction will decrease stimulation and agitation.
Question 50. A 75 year old client is admitted to the hospital with the diagnosis of dementia of the Alzheimer’s type and depression. The symptom that is unrelated to depression would be?
A). Apathetic response to the environment.
B). Shallow of labile effect.
C). “I don’t know” answer to questions.
D). Neglect of personal hygiene.
Question 50 Answer: B). Shallow of labile effect.
Question 50 Explanation: With depression, there is little or no emotional involvement therefore little alteration in affect.