Mental Health Nursing and
Psychiatric Disorders (Part 2)
### Question 1
The nurse is assessing a patient with borderline personality disorder. The patient states, "You're the only
nurse who understands me. Everyone else is incompetent." Which response by the nurse is most
therapeutic?
A. "I appreciate your trust, but I need you to work with all the staff members."
B. "It sounds like you are splitting. This is a pattern that we need to address."
C. "I am glad you feel comfortable with me, but the other nurses are very capable."
D. "Let's focus on your treatment goals rather than comparing staff members."
💫RATIONALE✔️✔️: This response validates the patient's feelings while setting appropriate
boundaries and redirecting focus away from splitting behavior. "Splitting" is a common defense
mechanism in borderline personality disorder where the patient idealizes one person and devalues
others.
,💫ANSWER✔️✔️: A. "I appreciate your trust, but I need you to work with all the staff members."
---
### Question 2
A patient with delusional disorder is being treated with antipsychotic medication. The patient tells the
nurse, "I know the FBI is monitoring my thoughts through the television." Which response by the nurse
is most therapeutic?
A. "That is not true. The FBI is not monitoring your thoughts."
B. "I understand you believe that. It must be frightening for you."
C. "Let's change the channel so you can watch something different."
D. "We need to increase your medication if you are still having these thoughts."
💫RATIONALE✔️✔️: This response acknowledges the patient's feelings without reinforcing the
delusion. The nurse should not argue with the delusion or tell the patient it's not true, as this can
damage the therapeutic relationship. Reality orientation should be gentle and respectful.
💫ANSWER✔️✔️: B. "I understand you believe that. It must be frightening for you."
---
### Question 3
The nurse is providing care to a patient who has been diagnosed with antisocial personality disorder.
Which behavioral pattern is most characteristic of this disorder?
,A. Intense fear of abandonment and unstable relationships
B. Disregard for and violation of the rights of others
C. Extreme emotionality and attention-seeking behavior
D. Social inhibition and hypersensitivity to negative evaluation
💫RATIONALE✔️✔️: Antisocial personality disorder is characterized by a pervasive pattern of
disregard for and violation of the rights of others. Symptoms include deceitfulness, impulsivity,
irritability, aggressiveness, and lack of remorse. This pattern typically begins in childhood or
adolescence.
💫ANSWER✔️✔️: B. Disregard for and violation of the rights of others
---
### Question 4
A patient with obsessive-compulsive disorder (OCD) is being treated with exposure and response
prevention therapy. The nurse should expect the patient to:
A. Perform rituals more quickly to reduce anxiety
B. Gradually face feared situations without performing rituals
C. Avoid all situations that trigger obsessions
D. Take medication only during therapy sessions
💫RATIONALE✔️✔️: Exposure and response prevention (ERP) therapy involves gradually exposing the
patient to feared situations while refraining from performing rituals. This approach is effective in
reducing OCD symptoms by breaking the cycle of obsessions and compulsions.
, 💫ANSWER✔️✔️: B. Gradually face feared situations without performing rituals
---
### Question 5
The nurse is assessing a patient who reports feeling sad, hopeless, and worthless. The patient states, "I
don't think I can go on anymore." Which action should the nurse take first?
A. Ask the patient if they are thinking about suicide
B. Document the patient's statements
C. Notify the healthcare provider
D. Administer antidepressant medication
💫RATIONALE✔️✔️: The nurse should directly ask the patient if they are thinking about suicide, have
a plan, and have the means to carry it out. This is the priority action to assess the patient's risk and
ensure safety.
💫ANSWER✔️✔️: A. Ask the patient if they are thinking about suicide
---
### Question 6
A patient with alcohol use disorder is being treated with disulfiram. The nurse should instruct the
patient to avoid which substance?
Psychiatric Disorders (Part 2)
### Question 1
The nurse is assessing a patient with borderline personality disorder. The patient states, "You're the only
nurse who understands me. Everyone else is incompetent." Which response by the nurse is most
therapeutic?
A. "I appreciate your trust, but I need you to work with all the staff members."
B. "It sounds like you are splitting. This is a pattern that we need to address."
C. "I am glad you feel comfortable with me, but the other nurses are very capable."
D. "Let's focus on your treatment goals rather than comparing staff members."
💫RATIONALE✔️✔️: This response validates the patient's feelings while setting appropriate
boundaries and redirecting focus away from splitting behavior. "Splitting" is a common defense
mechanism in borderline personality disorder where the patient idealizes one person and devalues
others.
,💫ANSWER✔️✔️: A. "I appreciate your trust, but I need you to work with all the staff members."
---
### Question 2
A patient with delusional disorder is being treated with antipsychotic medication. The patient tells the
nurse, "I know the FBI is monitoring my thoughts through the television." Which response by the nurse
is most therapeutic?
A. "That is not true. The FBI is not monitoring your thoughts."
B. "I understand you believe that. It must be frightening for you."
C. "Let's change the channel so you can watch something different."
D. "We need to increase your medication if you are still having these thoughts."
💫RATIONALE✔️✔️: This response acknowledges the patient's feelings without reinforcing the
delusion. The nurse should not argue with the delusion or tell the patient it's not true, as this can
damage the therapeutic relationship. Reality orientation should be gentle and respectful.
💫ANSWER✔️✔️: B. "I understand you believe that. It must be frightening for you."
---
### Question 3
The nurse is providing care to a patient who has been diagnosed with antisocial personality disorder.
Which behavioral pattern is most characteristic of this disorder?
,A. Intense fear of abandonment and unstable relationships
B. Disregard for and violation of the rights of others
C. Extreme emotionality and attention-seeking behavior
D. Social inhibition and hypersensitivity to negative evaluation
💫RATIONALE✔️✔️: Antisocial personality disorder is characterized by a pervasive pattern of
disregard for and violation of the rights of others. Symptoms include deceitfulness, impulsivity,
irritability, aggressiveness, and lack of remorse. This pattern typically begins in childhood or
adolescence.
💫ANSWER✔️✔️: B. Disregard for and violation of the rights of others
---
### Question 4
A patient with obsessive-compulsive disorder (OCD) is being treated with exposure and response
prevention therapy. The nurse should expect the patient to:
A. Perform rituals more quickly to reduce anxiety
B. Gradually face feared situations without performing rituals
C. Avoid all situations that trigger obsessions
D. Take medication only during therapy sessions
💫RATIONALE✔️✔️: Exposure and response prevention (ERP) therapy involves gradually exposing the
patient to feared situations while refraining from performing rituals. This approach is effective in
reducing OCD symptoms by breaking the cycle of obsessions and compulsions.
, 💫ANSWER✔️✔️: B. Gradually face feared situations without performing rituals
---
### Question 5
The nurse is assessing a patient who reports feeling sad, hopeless, and worthless. The patient states, "I
don't think I can go on anymore." Which action should the nurse take first?
A. Ask the patient if they are thinking about suicide
B. Document the patient's statements
C. Notify the healthcare provider
D. Administer antidepressant medication
💫RATIONALE✔️✔️: The nurse should directly ask the patient if they are thinking about suicide, have
a plan, and have the means to carry it out. This is the priority action to assess the patient's risk and
ensure safety.
💫ANSWER✔️✔️: A. Ask the patient if they are thinking about suicide
---
### Question 6
A patient with alcohol use disorder is being treated with disulfiram. The nurse should instruct the
patient to avoid which substance?
