Comprehensive Mental Health and Psychiatric Nursing NCLEX Practice

Quiz #1: 75 Questions

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Flumazenil (Romazicon) has been ordered for a male client who
has overdosed on oxazepam (Serax). Before administering the
medication, nurse Gina should be prepared for which common
adverse effect?
Seizures
A. Seizures
B. Shivering
C. Anxiety
D. Chest pain
Nurse Tamara is caring for a client diagnosed with bulimia. The
most appropriate initial goal for a client diagnosed with bulimia is
to:
A. Avoid shopping for large amounts of food. Identify anxiety-causing situations.
B. Control eating impulses.
C. Identify anxiety-causing situations.
D. Eat only three meals per day.
A female client who's at high risk for suicide needs close super-
vision. To best ensure the client's safety, Nurse Mary should:
A. Check the client frequently at irregular intervals throughout the
night.
Check the client frequently at irregular intervals throughout the
B. Assure the client that the nurse will hold in confidence anything
night.
the client says.
C. Repeatedly discuss previous suicide attempts with the client.
D. Disregard decreased communication by the client because this
is common with suicidal clients.
Which of the following drugs should Nurse Mary prepare to ad-
minister to a client with a toxic acetaminophen (Tylenol) level?
A. Deferoxamine mesylate (Desferal)
D. Acetylcysteine (Mucomyst)
B. Succimer (Chemet)
C. Flumazenil (Romazicon)
D. Acetylcysteine (Mucomyst)
A male client is admitted to the substance abuse unit for alcohol
detoxification. Which of the following medications is Nurse Alice
most likely to administer to reduce the symptoms of alcohol with-
drawal?
D. Chlordiazepoxide (Librium)
A. Naloxone (Narcan)
B. Haloperidol (Haldol)
C. Magnesium sulfate
D. Chlordiazepoxide (Librium)
During postprandial monitoring, a female client with bulimia ner-
vosa tells the nurse, "You can sit with me, but you're just wasting
your time. After you had sat with me yesterday, I was still able to
purge. Today, my goal is to do it twice." What is the nurse's best
response? D. "I know it's important for you to feel in control, but I'll monitor you
A. "I trust you not to purge." for 90 minutes after you eat."
B. "How are you purging and when do you do it?"
C. "Don't worry. I won't allow you to purge today."
D. "I know it's important for you to feel in control, but I'll monitor
you for 90 minutes after you eat."
A male client admitted to the psychiatric unit for treatment of
substance abuse says to the nurse, "It felt so wonderful to get
high." Which of the following is the most appropriate response?
A. "If you continue to talk like that, I'm going to stop speaking to
B. "You told me you got fired from your last job for missing too many
you."
days after taking drugs all night."
B. "You told me you got fired from your last job for missing too
many days after taking drugs all night."
C. "Tell me more about how it felt to get high."
D. "Don't you know it's illegal to use drugs?"
For a female client with anorexia nervosa, Nurse Jimmy is aware
that which goal takes the highest priority?
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 Comprehensive Mental Health and Psychiatric Nursing NCLEX Practice
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A. The client will establish adequate daily nutritional intake.
B. The client will make a contract with the nurse that sets a target
weight.
C. The client will identify self-perceptions about body size as A. The client will establish adequate daily nutritional intake.
unrealistic.
D. The client will verbalize the possible physiological conse-
quences of self-starvation.
When interviewing the parents of an injured child, which of the
following is the strongest indicator that child abuse may be a
problem?
A. The injury isn't consistent with the history or the child's age.
B. The mother and father tell different stories regarding what A. The injury isn't consistent with the history or the child's age.
happened.
C. The family is poor.
D. The parents are argumentative and demanding with emergency
department personnel.
For a female client with anorexia nervosa, nurse Rose plans to
include the parents in therapy sessions along with the client. What
fact should the nurse remember to be typical of parents of clients
with anorexia nervosa?
A. They tend to overprotect their children.
A. They tend to overprotect their children.
B. They usually have a history of substance abuse.
C. They maintain emotional distance from their children.
D. They alternate between loving and rejecting their children.
In the emergency department, a client with facial lacerations
states that her husband beat her with a shoe. After the health care
team repairs her lacerations, she waits to be seen by the crisis
intake nurse, who will evaluate the continued threat of violence.
Suddenly the client's husband arrives, shouting that he wants to
"finish the job." What is the first priority of the health care worker B. Calling a security guard and another staff member for assis-
who witnesses this scene? tance.
A. Remaining with the client and staying calm.
B. Calling a security guard and another staff member for assis-
tance.
C. Telling the client's husband that he must leave at once.
D. Determining why the husband feels so angry.
Nurse Mary is caring for a client with bulimia. Strict management
of dietary intake is necessary. Which intervention is also impor-
tant?
A. Fill out the client's menu and make sure she eats at least half
of what is on her tray.
C. Let the client choose her own food. If she eats everything she
B. Let the client eat her meals in private. Then engage her in social
orders, then stay with her for 1 hour after each meal.
activities for at least 2 hours after each meal.
C. Let the client choose her own food. If she eats everything she
orders, then stay with her for 1 hour after each meal.
D. Let the client eat food brought in by the family if she chooses,
but she should keep a strict calorie count.
Nurse Mary is assigned to care for a suicidal client. Initially, which
is the nurse's highest care priority?
A. Assessing the client's home environment and relationships
outside the hospital.
B. Exploring the nurse's own feelings about suicide.
B. Exploring the nurse's own feelings about suicide.
C. Discussing the future with the client.
D. Referring the client to a clergyperson to discuss the moral
implications of suicide.
A 24-year old client with anorexia nervosa tells the nurse, "When
I look in the mirror, I hate what I see. I look so fat and ugly." Which
strategy should the nurse use to deal with the client's distorted
perceptions and feelings?
A. Avoid discussing the client's perceptions and feelings.
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 Comprehensive Mental Health and Psychiatric Nursing NCLEX Practice
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B. Focus discussions on food and weight.
C. Avoid discussing unrealistic cultural standards regarding
D. Provide objective data and feedback regarding the client's
weight.
weight and attractiveness.
D. Provide objective data and feedback regarding the client's
weight and attractiveness.
Nurse Alice is caring for a client being treated for alcoholism.
Before initiating therapy with disulfiram (Antabuse), the nurse
teaches the client that he must read labels carefully on which of
the following products?
B. Aftershave lotion
A. Carbonated beverages
B. Aftershave lotion
C. Toothpaste
D. Cheese
Nurse Harry is developing a plan of care for a client with anorexia
nervosa. Which action should the nurse include in the plan?
A. Restrict visits with the family until the client begins to eat.
C. Set up a strict eating plan for the client.
B. Provide privacy during meals.
C. Set up a strict eating plan for the client.
D. Encourage the client to exercise, which will reduce her anxiety.
17. Question
Nurse Taylor is aware that the victims of domestic violence should
be assessed for what important information?
A. Reasons they stay in the abusive relationship (for example, lack
B. Readiness to leave the perpetrator and knowledge of re-
of financial autonomy and isolation).
sources.
B. Readiness to leave the perpetrator and knowledge of re-
sources.
C. Use of drugs or alcohol.
D. History of previous victimization.
A male client is hospitalized with fractures of the right femur and
right humerus sustained in a motorcycle accident. Police suspect
the client was intoxicated at the time of the accident. Laboratory
tests reveal a blood alcohol level of 0.2% (200 mg/dl). The client
later admits to drinking heavily for years. During hospitalization,
the client periodically complains of tingling and numbness in the
B. Thiamine deficiency
hands and feet. Nurse Gian realizes that these symptoms proba-
bly result from:
A. Acetate accumulation
B. Thiamine deficiency
C. Triglyceride buildup.
D. A below-normal serum potassium level
A parent brings a preschooler to the emergency department for
treatment of a dislocated shoulder, which allegedly happened
when the child fell down the stairs. Which action should make the
nurse suspect that the child was abused?
C. The child doesn't cry when the shoulder is examined.
A. The child cries uncontrollably throughout the examination.
B. The child pulls away from contact with the physician.
C. The child doesn't cry when the shoulder is examined.
D. The child doesn't make eye contact with the nurse.
When planning care for a client who has ingested phencyclidine
(PCP), nurse Wayne is aware that the following is the highest
priority?
A. Client's physical needs B. Client's safety needs
B. Client's safety needs
C. Client's psychosocial needs
D. Client's medical needs
The nurse is aware that the outcome criteria would be appropriate
for a child diagnosed with oppositional defiant disorder?
A. Accept responsibility for own behaviors.
A. Accept responsibility for own behaviors.
B. Be able to verbalize own needs and assert rights.
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 Comprehensive Mental Health and Psychiatric Nursing NCLEX Practice
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C. Set firm and consistent limits with the client.
D. Allow the child to establish his own limits and boundaries.
A male client is found sitting on the floor of the bathroom in the
day treatment clinic with moderate lacerations on both wrists.
Surrounded by broken glass, he sits staring blankly at his bleeding
wrists while staff members call for an ambulance. How should
Nurse Anuktakanuk approach her initially?
A. Enter the room quietly and move beside him to assess his
D. Approach him slowly while speaking in a calm voice, calling his
injuries.
name, and telling him that the nurse is here to help him.
B. Call for staff back-up before entering the room and restraining
him.
C. Move as much glass away from him as possible and sit next to
him quietly.
D. Approach him slowly while speaking in a calm voice, calling his
name, and telling him that the nurse is here to help him.
A female client with anorexia nervosa describes herself as "a
whale." However, the nurse's assessment reveals that the client
is 52 83 (1.7 m) tall and weighs only 90 lb (40.8 kg). Considering the
client's unrealistic body image, which intervention should nurse
Angel be included in the plan of care?
A. Asking the client to compare her figure with magazine pho-
D. Telling the client of the nurse's concern for her health and desire
tographs of women her age.
to help her make decisions to keep her healthy.
B. Assigning the client to group therapy in which participants
provide realistic feedback about her weight.
C. Confronting the client about her actual appearance during
one-on-one sessions, scheduled during each shift.
D. Telling the client of the nurse's concern for her health and desire
to help her make decisions to keep her healthy.
Eighteen hours after undergoing an emergency appendecto-
my, a client with a reported history of social drinking displays
these vital signs: temperature, 101.6° F (38.7° C); heart rate,
126 beats/minute; respiratory rate, 24 breaths/minute; and blood
pressure, 140/96 mm Hg. The client exhibits gross hand tremors
and is screaming for someone to kill the bugs in the bed. Nurse B. Alcohol withdrawal
Melinda should suspect:
A. A postoperative infection
B. Alcohol withdrawal
C. Acute sepsis.
D. Pneumonia.
Clonidine (Catapres) can be used to treat conditions other than
hypertension. Nurse Sally is aware that the following conditions
might the drug be administered?
A. Phencyclidine (PCP) intoxication C. Opiate withdrawal
B. Alcohol withdrawal
C. Opiate withdrawal
D. Cocaine withdrawal
A male client with a history of cocaine addiction is admitted to
the coronary care unit for evaluation of substernal chest pain. The
electrocardiogram (ECG) shows a 1-mm ST-segment elevation of
the anteroseptal leads and T-wave inversion in leads V3 to V5.
Considering the client's history of drug abuse, nurse Greg expects
C. Nitroglycerin (Nitro-Bid IV).
the physician to prescribe:
A. Lidocaine (Xylocaine).
B. Procainamide (Pronestyl).
C. Nitroglycerin (Nitro-Bid IV).
D. Epinephrine.
27. Question
A 14-year-old client was brought to the clinic by her mother. Her
mother expresses concern about her daughter's weight loss and
constant dieting. Nurse Kris conducts a health history interview.
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 Comprehensive Mental Health and Psychiatric Nursing NCLEX Practice
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Which of the following comments indicates that the client may be
suffering from anorexia nervosa?
A. "I like the way I look. I just need to keep my weight down
because I'm a cheerleader."
C. "I just can't seem to get down to the weight I want to be. I'm so
B. "I don't like the food my mother cooks. I eat plenty of fast food
fat compared to other girls."
when I'm out with my friends."
C. "I just can't seem to get down to the weight I want to be. I'm so
fat compared to other girls."
D. "I do diet around my periods; otherwise, I just get so bloated."
Nurse Fey is aware that the drug of choice for treating Tourette
syndrome?
A. Fluoxetine (Prozac)
C. Haloperidol (Haldol)
B. Fluvoxamine (Luvox)
C. Haloperidol (Haldol)
D. Paroxetine (Paxil)
A male client tells the nurse he was involved in a car accident while
he was intoxicated. What would be the most therapeutic response
from nurse Julia?
A. "Why didn't you get someone else to drive you?"
B. "Tell me how you feel about the accident."
B. "Tell me how you feel about the accident."
C. "You should know better than to drink and drive."
D. "I recommend that you attend an Alcoholics Anonymous meet-
ing."
A male adult client voluntarily admits himself to the substance
abuse unit. He confesses that he drinks one (1) qt or more of vodka
each day and uses cocaine occasionally. Later that afternoon, he
begins to show signs of alcohol withdrawal. What are some early
signs of this condition? D. Diaphoresis, tremors, and nervousness
A. Vomiting, diarrhea, and bradycardia
B. Dehydration, temperature above 101° F (38.3° C), and pruritus
C. Hypertension, diaphoresis, and seizures
D. Diaphoresis, tremors, and nervousness
When monitoring a female client recently admitted for treatment
of cocaine addiction, nurse Aaron notes sudden increases in the
arterial blood pressure and heart rate. To correct these problems,
the nurse expects the physician to prescribe:
D. Nifedipine and Esmolol
A. Norepinephrine (Levophed) and Lidocaine (Xylocaine)
B. Nifedipine (Procardia) and Lidocaine.
C. Nitroglycerin (Nitro-Bid IV) and Esmolol (Brevibloc)
D. Nifedipine and Esmolol
A 25 -year old client experiencing alcohol withdrawal is upset
about going through detoxification. Which of the following goals
is a priority?
A. The client will commit to a drug-free lifestyle. B. The client will work with the nurse to remain safe.
B. The client will work with the nurse to remain safe.
C. The client will drink plenty of fluids daily.
D. The client will make a personal inventory of strength.
A male client is admitted to a psychiatric facility by court order for
evaluation for antisocial personality disorder. This client has a long
history of initiating fights and abusing animals and recently was
arrested for setting a neighbor's dog on fire. When evaluating this
client for the potential for violence, nurse Perry should assess for
A. A rigid posture, restlessness, and glaring
which behavioral clues?
A. A rigid posture, restlessness, and glaring
B. Depression and physical withdrawal
C. Silence and noncompliance
D. Hypervigilance and talk of past violent acts
A male client is brought to the psychiatric clinic by family mem-
bers, who tell the admitting nurse that the client repeatedly drives
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 Comprehensive Mental Health and Psychiatric Nursing NCLEX Practice
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while intoxicated despite their pleas to stop. During an interview
with the nurse Linda, which statement by the client most strongly
supports a diagnosis of psychoactive substance abuse?
A. "I'm not addicted to alcohol. In fact, I can drink more than I used
D. "I know I've been arrested three times for drinking and driving,
to without being affected."
but the police are just trying to hassle me."
B. "I only spend half of my paycheck at the bar."
C. "I just drink to relax after work."
D. "I know I've been arrested three times for drinking and driving,
but the police are just trying to hassle me."
A female client with borderline personality disorder is admitted
to the psychiatric unit. Initial nursing assessment reveals that
the client's wrists are scratched from a recent suicide attempt.
Based on this finding, the nurse Lenny should formulate a nursing
diagnosis of:
C. Risk for violence: Self-directed related to impulsive mutilating
A. Ineffective individual coping related to feelings of guilt.
acts.
B. Situational low self-esteem related to feelings of loss of control.
C. Risk for violence: Self-directed related to impulsive mutilating
acts.
D. Risk for violence: Directed toward others related to verbal
threats.
A male client recently admitted to the hospital with sharp, sub-
sternal chest pain suddenly complains of palpitations. Nurse Ryan
notes a rise in the client's arterial blood pressure and a heart rate
of 144 beats/minute. On further questioning, the client admits to
having used cocaine recently after previously denying use of the
drug. The nurse concludes that the client is at high risk for which A. Coronary artery spasm
complication of cocaine use?
A. Coronary artery spasm
B. Bradyarrhythmias
C. Neurobehavioral deficits
D. Panic disorder
A male client is being admitted to the substance abuse unit for al-
cohol detoxification. As part of the intake interview, the nurse asks
him when he had his last alcoholic drink. He says that he had his
last drink six (6) hours before admission. Based on this response,
nurse Lorena should expect early withdrawal symptoms to:
C. Begin anytime within the next one (1) to two (2) days.
A. Begin after seven (7) days.
B. Not occur at all because the time period for their occurrence
has passed.
C. Begin anytime within the next one (1) to two (2) days.
D. Begin within two (2) to seven (7) days.
Nurse Helen is assigned to care for a client with anorexia nervosa.
Initially, which nursing intervention is most appropriate for this
client?
A. Providing one-on-one supervision during meals and for one (1)
hour afterward. A. Providing one-on-one supervision during meals and for one (1)
B. Letting the client eat with other clients to create a normal hour afterward.
mealtime atmosphere.
C. Trying to persuade the client to eat and thus restore nutritional
balance.
D. Giving the client as much time to eat as desired.
A female client begins to experience alcoholic hallucinosis. Nurse
Joy is aware that the best nursing intervention at this time?
A. Keeping the client restrained in bed.
B. Checking the client's blood pressure every 15 minutes and
C. Providing a quiet environment and administering medication as
offering juices.
needed and prescribed.
C. Providing a quiet environment and administering medication as
needed and prescribed.
D. Restraining the client and measuring blood pressure every 30
minutes.

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 Comprehensive Mental Health and Psychiatric Nursing NCLEX Practice
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Nurse Bella is aware that assessment finding is most consistent
with early alcohol withdrawal?
A. Heart rate of 120 to 140 beats/minute
A. Heart rate of 120 to 140 beats/minute
B. Heart rate of 50 to 60 beats/minute
C. Blood pressure of 100/70 mmHg
D. Blood pressure of 140/80 mmHg
Nurse Amy is aware that the client is at highest risk for suicide?
A. One who appears depressed frequently thinks of dying and
gives away all personal possessions.
B. One who plans a violent death and has the means readily B. One who plans a violent death and has the means readily
available. available.
C. One who tells others that he or she might do something if life
doesn't get better soon.
D. One who talks about wanting to die.
Nurse Penny is aware that the following medical conditions are
commonly found in clients with bulimia nervosa?
A. Allergies
C. Diabetes mellitus
B. Cancer
C. Diabetes mellitus
D. Hepatitis A
Kellan, a high school student is referred to the school nurse for
suspected substance abuse. Following the nurse's assessment
and interventions, what would be the most desirable outcome?
A. The student discusses conflicts over drug use. B. The student accepts a referral to a substance abuse counselor.
B. The student accepts a referral to a substance abuse counselor.
C. The student agrees to inform his parents of the problem.
D. The student reports increased comfort with making choices.
A male client who reportedly consumes one (1) qt of vodka daily
is admitted for alcohol detoxification. To try to prevent alcohol
withdrawal symptoms, Dr. Smith is most likely to prescribe which
drug?
C. Lorazepam (Ativan)
A. Clozapine (Clozaril)
B. Thiothixene (Navane)
C. Lorazepam (Ativan)
D. Lithium carbonate (Eskalith)
A male client is being treated for alcoholism. After a family meet-
ing, the client's spouse asks the nurse about ways to help the fam-
ily deal with the effects of alcoholism. Nurse Lily should suggest
that the family join which organization?
A. Al-Anon
A. Al-Anon
B. Make Today Count
C. Emotions Anonymous
D. Alcoholics Anonymous
A female client is admitted to the psychiatric clinic for treatment of
anorexia nervosa. To promote the client's physical health, nurse
Tair should plan to:
A. Severely restrict the client's physical activities.
C. Monitor vital signs, serum electrolyte levels, and acid-base
B. Weigh the client daily, after the evening meal.
balance.
C. Monitor vital signs, serum electrolyte levels, and acid-base
balance.
D. Instruct the client to keep an accurate record of food and fluid
intake.
Kevin is remanded by the courts for psychiatric treatment. His
police record, which dates to his early teenage years, includes
delinquency, running away, auto theft, and vandalism. He dropped
out of school at age 16 and has been living on his own since then. A. Antisocial personality disorder
His history suggests maladaptive coping, which is associated
with:
A. Antisocial personality disorder
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B. Borderline personality disorder
C. Obsessive-compulsive personality disorder
D. Narcissistic personality disorder
Macoy and Helen seek emergency crisis intervention because he
slapped her repeatedly the night before. The husband indicates
that his childhood was marred by an abusive relationship with his
father. When intervening with this couple, nurse Gerry knows they
are at risk for repeated violence because the husband: C. Has learned violence as an acceptable behavior.
A. Has only moderate impulse control.
B. Denies feelings of jealousy or possessiveness.
C. Has learned violence as an acceptable behavior.
D. Feels secure in his relationship with his wife.
A client whose husband just left her has a recurrence of anorexia
nervosa. Nurse Vic caring for her realizes that this exacerbation
of anorexia nervosa results from the client's effort to:
A. Manipulate her husband. B. Gain control of one part of her life.
B. Gain control of one part of her life.
C. Commit suicide.
D. Live up to her mother's expectations.
A male client has approached the nurse asking for advice on how
to deal with his alcohol addiction. Nurse Sally should tell the client
that the only effective treatment for alcoholism is:
A. Psychotherapy B. Total abstinence
B. Total abstinence
C. Alcoholics Anonymous (AA)
D. Aversion therapy
Which nursing intervention would be most appropriate if a male
client develops orthostatic hypotension while taking amitriptyline
(Elavil)?
A. Consulting with the physician about substituting a different type
of antidepressant.
B. Advising the client to sit up for 1 minute before getting out of
B. Advising the client to sit up for 1 minute before getting out of
bed.
bed.
C. Instructing the client to double the dosage until the problem
resolves.
D. Informing the client that this adverse reaction should disappear
within 1 week.
Mr. Cruz visits the physician's office to seek treatment for de-
pression, feelings of hopelessness, poor appetite, insomnia, fa-
tigue, low self-esteem, poor concentration, and difficulty making
decisions. The client states that these symptoms began at least 2
years ago. Based on this report, the nurse Tiffany suspects: D. Dysthymic disorder.
A. Cyclothymic disorder.
B. Atypical affective disorder.
C. Major depression.
D. Dysthymic disorder.
After taking an overdose of phenobarbital (Barbita), Mario is
admitted to the emergency department. Dr. Trinidad prescribes
activated charcoal (Charcocaps) to be administered by mouth
immediately. Before administering the dose, the nurse verifies the
dosage ordered. What is the usual minimum dose of activated
C. 30 g mixed in 250 ml of water
charcoal?
A. 5 g mixed in 250 ml of water
B. 15 g mixed in 500 ml of water
C. 30 g mixed in 250 ml of water
D. 60 g mixed in 500 ml of water
What herbal medication for depression, widely used in Europe, is
now being prescribed in the United States? C. St. John's wort
A. Ginkgo biloba
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B. Echinacea
C. St. John's wort
D. Ephedra
Cely with manic episodes is taking lithium. Which electrolyte level
should the nurse check before administering this medication?
A. Calcium
B. Sodium
B. Sodium
C. Chloride
D. Potassium
Nurse Josefina is caring for a client who has been diagnosed with
delirium. Which statement about delirium is true?
A. It's characterized by an acute onset and lasts about 1 month.
B. It's characterized by a slowly evolving onset and lasts about 1
D. It's characterized by an acute onset and lasts hours to a number
week.
of days.
C. It's characterized by a slowly evolving onset and lasts about 1
month.
D. It's characterized by an acute onset and lasts hours to a number
of days.
Edward, a 66-year-old client with slight memory impairment and
poor concentration, is diagnosed with primary degenerative de-
mentia of the Alzheimer's type. Early signs of this dementia
include subtle personality changes and withdrawal from social
interactions. To assess for progression to the middle stage of
B. Impaired communication.
Alzheimer's disease, the nurse should observe the client for:
A. Occasional irritable outbursts.
B. Impaired communication.
C. Lack of spontaneity.
D. Inability to perform self-care activities.
Isabel with a diagnosis of depression is started on imipramine
(Tofranil), 75 mg by mouth at bedtime. The nurse should tell the
client that:
A. This medication may be habit-forming and will be discontinued
as soon as the client feels better. D. This medication may initially cause tiredness, which should
B. This medication has no serious adverse effects. become less bothersome over time.
C. The client should avoid eating such foods as aged cheeses,
yogurt, and chicken livers while taking the medication.
D. This medication may initially cause tiredness, which should
become less bothersome over time.
Kathleen is admitted to the psychiatric clinic for treatment of
anorexia nervosa. To promote the client's physical health, the
nurse should plan to:
A. Severely restrict the client's physical activities.
C. Monitor vital signs, serum electrolyte levels, and acid-base
B. Weigh the client daily, after the evening meal.
balance.
C. Monitor vital signs, serum electrolyte levels, and acid-base
balance.
D. Instruct the client to keep an accurate record of food and fluid
intake.
Celia with a history of polysubstance abuse is admitted to the
facility. She complains of nausea and vomiting 24 hours after
admission. The nurse assesses the client and notes piloerection,
pupillary dilation, and lacrimation. The nurse suspects that the
client is going through which of the following withdrawals? D. Opioid withdrawal
A. Alcohol withdrawal
B. Cannabis withdrawal
C. Cocaine withdrawal
D. Opioid withdrawal
Mr. Garcia, an attorney who throws books and furniture around
the office after losing a case, is referred to the psychiatric nurse in
the law firm's employee assistance program. Nurse Beatriz knows
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that the client's behavior most likely represents the use of which
defense mechanism?
A. Regression
A. Regression
B. Projection
C. Reaction-formation
D. Intellectualization
Nurse Anne is caring for a client who has been treated long term
with antipsychotic medication. During the assessment, Nurse
Anne checks the client for tardive dyskinesia. If tardive dyskinesia
is present, Nurse Anne would most likely observe:
A. Abnormal movements and involuntary movements of the A. Abnormal movements and involuntary movements of the
mouth, tongue, and face. mouth, tongue, and face.
B. Abnormal breathing through the nostrils accompanied by a
"thrill."
C. Severe headache, flushing, tremors, and ataxia.
D. Severe hypertension, migraine headache.
Dennis has a lithium level of 2.4 mEq/L. The nurse immediately
would assess the client for which of the following signs or symp-
toms?
A. Weakness C. Blurred vision
B. Diarrhea
C. Blurred vision
D. Fecal incontinence
Nurse Jannah is monitoring a male client who has been placed
in restraints because of violent behavior. Nurse determines that it
will be safe to remove the restraints when:
A. The client verbalizes the reasons for the violent behavior.
C. No acts of aggression have been observed within 1 hour after
B. The client apologizes and tells the nurse that it will never happen
the release of two of the extremity restraints.
again.
C. No acts of aggression have been observed within 1 hour after
the release of two of the extremity restraints.
D. The administered medication has taken effect.
Nurse Irish is aware that Ritalin is the drug of choice for a child
with ADHD. The side effects of the following may be noted by the
nurse:
A. Increased attention span and concentration. A. Increased attention span and concentration.
B. Increase in appetite.
C. Sleepiness and lethargy.
D. Bradycardia and diarrhea.
Kitty, a 9-year-old child has a very limited vocabulary and interac-
tion skills. She has an I.Q. of 45. She is diagnosed to have Mental
retardation of this classification:
A. Profound C. Moderate
B. Mild
C. Moderate
D. Severe
The therapeutic approach in the care of Armand an autistic child
includes the following EXCEPT:
A. Engage in diversionary activities when acting-out.
D. Rearrange the environment to activate the child.
B. Provide an atmosphere of acceptance.
C. Provide safety measures.
D. Rearrange the environment to activate the child.
Jeremy is brought to the emergency room by friends who state
that he took something an hour ago. He is actively hallucinating,
agitated, with irritated nasal septum.
A. Heroin B. Cocaine
B. Cocaine
C. LSD
D. Marijuana

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 Comprehensive Mental Health and Psychiatric Nursing NCLEX Practice
Quiz #1: 75 Questions
Study online at https://quizlet.com/_9mtvpg
Nurse Pauline is aware that Dementia unlike delirium is charac-
terized by:
A. Slurred speech
B. Insidious onset
B. Insidious onset
C. Clouding of consciousness
D. Sensory perceptual change
A 35-year-old female has intense fear of riding an elevator. She
claims " As if I will die inside." The client is suffering from:
A. Agoraphobia
C. Claustrophobia
B. Social phobia
C. Claustrophobia
D. Xenophobia
Nurse Myrna develops a counter-transference reaction. This is
evidenced by:
A. Revealing personal information to the client.
B. Focusing on the feelings of the client.
A. Revealing personal information to the client.
C. Confronting the client about discrepancies in verbal or nonver-
bal behavior.
D. The client feels angry towards the nurse who resembles his
mother.
Tristan is on Lithium and has suffered from diarrhea and vomiting.
What should the nurse in-charge do first:
A. Recognize this as a drug interaction.
B. Give the client Cogentin. D. Hold the next dose and obtain an order for a stat serum lithium
C. Reassure the client that these are common side effects of level.
lithium therapy.
D. Hold the next dose and obtain an order for a stat serum lithium
level.
Nurse Sarah ensures a therapeutic environment for all the clients.
Which of the following best describes a therapeutic milieu?
A. A therapy that rewards adaptive behavior.
C. A living, learning or working environment.
B. A cognitive approach to change behavior.
C. A living, learning or working environment.
D. A permissive and congenial environment.
Anthony is very hostile toward one of the staff for no apparent
reason. He is manifesting:
A. Splitting
B. Transference
B. Transference
C. Countertransference
D. Resistance
Marielle, 17 years old was sexually attacked while on her way
home from school. She is brought to the hospital by her mother.
Rape is an example of which type of crisis:
A. Situational B. Adventitious
B. Adventitious
C. Developmental
D. Internal

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