Practice Pack (Latest 2026-2028)
1. A nurse is caring for a client who has been prescribed sertraline (Zoloft) for
major depressive disorder. Which statement by the client indicates a need for
further teaching?
A. "I should take this medication at the same time every day."
B. *"I can take St. John's wort with this medication for better results." *
C. "It may take 4 to 6 weeks before I feel the full effects."
D. "I should not stop taking this medication abruptly."
Rationale: St. John's wort interacts with SSRIs like sertraline and can cause serotonin
syndrome. This combination is dangerous and should be avoided. The other statements
are correct regarding SSRI administration.
2. A client with schizophrenia tells the nurse, "The voices are telling me to hurt
myself." Which action should the nurse take first?
A. Administer PRN haloperidol immediately.
B. Place the client in seclusion.
C. *Assess the client's risk for suicide and implement safety precautions. *
D. Tell the client to ignore the voices.
Rationale: Command hallucinations instructing self-harm are a psychiatric emergency.
The nurse must first assess the client's intent, plan, and means and implement immediate
safety precautions. Medications and seclusion are secondary interventions.
3. A nurse is providing education to a client who has a new prescription for
lithium. Which instruction should the nurse include?
A. "Take the medication on an empty stomach."
B. *"Maintain a consistent salt intake and drink at least 2 liters of fluid daily." *
C. "You can stop taking the medication if you feel better."
D. "Monitor for signs of hyperthyroidism."
,Rationale: Lithium levels are affected by sodium and fluid balance. Clients should
maintain consistent salt and fluid intake to prevent toxicity. Lithium should be taken with
food to reduce GI upset.
4. A client with borderline personality disorder threatens to cut herself with a
hidden razor. The nurse identifies this behavior as:
A. Splitting
B. Manipulation
C. *Impulsivity and self-harm *
D. Projection
Rationale: Borderline personality disorder is characterized by impulsivity and self-harm
behaviors. The client's statement represents a direct self-harm threat. Splitting,
manipulation, and projection are also seen but this behavior is self-harm.
5. A client experiencing alcohol withdrawal is prescribed chlordiazepoxide. The
nurse should monitor for which expected therapeutic effect?
A. Increased alertness and energy
B. *Reduction in withdrawal symptoms and prevention of seizures *
C. Decreased need for sleep
D. Elimination of cravings for alcohol
Rationale: Benzodiazepines like chlordiazepoxide are used to reduce withdrawal symptoms
and prevent seizures during alcohol withdrawal. They do not increase energy, decrease
sleep needs, or eliminate cravings.
6. A nurse is caring for a client who is experiencing serotonin syndrome. Which
findings should the nurse expect? (Select all that apply.)
A. *Agitation *
B. *Hyperthermia *
C. Bradycardia
, D. *Diaphoresis *
E. *Tremors *
Rationale: Serotonin syndrome is characterized by agitation, hyperthermia, diaphoresis,
tremors, hyperreflexia, and confusion. Bradycardia is not a finding; tachycardia is more
common.
7. A client with major depressive disorder is being discharged. Which statement
indicates the client understands the treatment plan?
A. "I will stop taking my medication when I feel better."
B. *"I will attend my follow-up appointments and continue my medication as
prescribed." *
C. "I don't need therapy now that I'm on medication."
D. "If I have trouble sleeping, I will take extra medication."
Rationale: Adherence to medication and follow-up appointments is essential for managing
depression. Medications should not be stopped abruptly, and therapy is often used in
conjunction with medication.
8. A nurse is assessing a client who has been taking haloperidol for 6 months.
Which finding indicates a potential adverse effect requiring further evaluation?
A. Dry mouth
B. Drowsiness
C. *Involuntary movements of the tongue and face *
D. Weight gain
Rationale: Involuntary movements of the tongue and face indicate tardive dyskinesia, a
potentially irreversible side effect of long-term antipsychotic use. This requires immediate
reporting and evaluation.
9. A client with generalized anxiety disorder is prescribed buspirone. Which
statement by the client indicates understanding?