1NURSE is an online review platform available in your desktop and mobile devices. The app contains PNLE practice questions and flashcards to help you prepare for your upcoming board exam. Practice answering these free Psychiatric Nursing questions to measure your prior knowledge in this subject.
Question 1:
While the nurse was taking her blood pressure, the patient suddenly stated.” They are talking about me!” She was referring to other patients who were waiting for their consultation. Which of the following should be the APPROPRIATE nursing action?
a. Present the reality situation
b. Distract patient’s attention
c. Disagree with the patient
d. Validate the statement
Answer: A.
Rationale: The client is presenting false beliefs or delusions. Intervention would include focusing on and directing the client’s attention to concrete things in the environment as a way to present reality.
Question 2:
Situation: An 18 years old, female college student was accompanied by her mother for consultation at the municipal health center. According to her mother the patient had been having difficulty concentrating with her lesson, had a tendency to isolate inside her room and was frequently in an angry mood. The physician ordered for psychiatric consultation. In order to determine the patient’s ability to concentrate and focus, which would be the PRIORITY nursing action?
a. Ask for the academic performance
b. Conduct paper and pencil test
c. Assess the mental status of the patient
d. Refer the patient to the psychiatrist
Answer: C
Rationale: The client is presenting false beliefs or delusions. Intervention would include focusing on and directing the client’s attention to concrete things in the environment as a way to present reality.
Question 3:
A nurse assesses a client who reports feeling full of energy in spite of being awake for the past 48 hours. Which diagnosis is the nurse would likely to find in the client’s medical record?
a. Obsessive-compulsive disorder
b. Bipolar disorder/manic type
c. Bipolar disorder/mixed type
d. Korsakoff’s psychosis
Answer: B.
Rationale: The symptoms of increased psychomotor activity with diminished need for sleep are suggestive of bipolar disorder of the manic type. The client is not reporting recurrent and persistent thoughts or impulses. There is no mention of mood fluctuations of both depression and mania. The symptoms of confusion, loss of recent memory, and confabulation would be present in Korsakoff’s psychosis.
Question 4:
A nurse is assessing a recently admitted client who is exhibiting agitation that appears to be related to acute mania. Which action should a nurse plan to utilize when caring for a client experiencing agitation related to acute mania?
a. Apply restraints to prevent the client from harming self or others
b. Involve the client in group activities to provide structure
c. Leave the client alone
d. Maintain a low level of stimuli in the client’s environment
Answer: D.
Rationale: Maintaining a low level of stimulation minimizes anxiety, agitation, and suspiciousness. The client should be offered the least restrictive treatment alternative. Restraints should be used as a last resort if other interventions are unsuccessful and the client presents imminent risk of harm to self or others. Group activities could increase the level of stimuli and worsen agitation. The client’s behavior must be closely observed to ensure safety. Correct nursing action is to stay with the client.
Question 5:
A client diagnosed with mania tells a nurse, “I think you’re very pretty. Maybe we could go to my room.” Which response by the nurse is most therapeutic?
a. “It’s time for occupational therapy.”
b. “That’s not appropriate and I’m offended.”
c. “I don’t have that kind of relationship with clients.”
d. “Let’s walk down to the seclusion room.”
Answer: A.
Rationale: The most therapeutic response by the nurse is to redirect the client. Hypersexual behavior and impulsivity are symptoms of mania. Rather than confront the client or acknowledge the provocative comment, it is more effective to redirect the client as clients with mania are easily distracted. Secluding the client is unnecessary.
Question 6:
A nurse is developing a care plan for a client diagnosed with bipolar disorder. The inclusion of the nursing diagnosis “Risk for Imbalanced Nutrition” demonstrates that the nurse understands that clients with bipolar disorder:
a. Are compulsive eaters.
b. Often suffer from poor nutrition.
c. Have a greater risk for obesity.
d. Take medications that can cause weight loss.
Answer: C.
Rationale: Clients diagnosed with bipolar disorder have a greater risk for obesity. There is emerging data concerning weight gain in clients diagnosed with bipolar disorder. The reasons are multifactorial, and a client who understands the concept will be better prepared for self-monitoring and making healthy diet choices. Weight gain is a significant factor in medication noncompliance and relapse. Poor nutrition and compulsive eating are not evidence-based concepts related to bipolar disorder. Mood stabilizers cause weight gain, not weight loss.
Question 7:
Which of the following would be MOST helpful to meet the client’s goal of demonstrating improved hygiene and grooming?
a. Identify specific client needs for assistance
b. Ignore messy clothes and lack of hygiene
c. Insist that the client participate in good-grooming group
d. Encourage the client by doing hygiene and grooming for him
Answer: A.
Rationale: This action will promote patient independence allowing them to revert back to their normal function.
Question 8:
Which of the following actions would NOT be helpful when dealing with Paranoid Hallucinations?
a. Help the client relate with real persons
b. Avoid giving attention to the content of hallucination or delusion after an initial investigation
c. Acknowledge the clients belief in the perception but also indicate that is not shared by others
d. Listen carefully to the content of hallucinations and delusion and encourage the client to describe them.
Answer: D.
Rationale: Even if you don't agree that they are under threat or at risk, try to understand how they are feeling. It's important to recognise that their feelings are very real, even if you feel the beliefs they are based on are unfounded. Focus on the level of distress they are feeling and offer comfort. It's possible to recognise their alarm and acknowledge their feelings without agreeing with the reason they feel that way.
Question 9:
Which of the following would NOT be an appropriate goal when working with a client with paranoid hallucination?
a. The client will learn to define and test reality
b. The client will discuss feelings with primary nurse
c. The client will act out fantasies in group therapy
d. The client will devalue internal voices and hallucinations
Answer: C.
Rationale: The nurse should note escalating behaviors and intervene immediately to maintain this client's safety.
Question 10:
Which defense mechanism is MOST characteristics of the client with paranoid schizophrenia?
a. Undoing
b. Rationalization
c. Projection
d. Suppression
Answer: C.
Rationale: Paranoid Personality disorder is characterized by cognitive distortions of delusional intensity, based largely on the classical defense of projection. Projecting one's own negative features onto others fosters suspicion.
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