NURS 354 COMPREHENSIVE
PSYCHIATRIC NURSING EXAM
QUESTIONS AND ANSWERS
1. During the orientation phase of the nurse-client relationship, which nursing action is most
critical to establishing a therapeutic foundation?
A. Developing a plan for termination of the relationship.
B. Establishing the parameters of the relationship and building trust.
C. Promoting the client’s insight into problematic behaviors.
D. Facilitating behavioral change and problem-solving.
Answer: B
Conceptual Explanation: The orientation phase’s primary goal is to establish trust, set
boundaries, and define the purpose of the relationship. Termination is discussed during
orientation, but establishing parameters is the immediate priority.
2. A client is hospitalized for the third time in six months for suicidal ideation. Which ethical
principle is primarily involved when the nurse ensures the client is not discharged
prematurely despite insurance pressure?
A. Autonomy
,B. Beneficence
C. Veracity
D. Fidelity
Answer: B
Conceptual Explanation: Beneficence refers to the duty to act to benefit or promote the
good of others. Protecting a suicidal patient from premature discharge aligns with this
principle.
3. A nurse observes a client pacing and muttering, ‘The spiders are crawling on the walls.’
Which therapeutic response is most appropriate?
A. ‘Why do you think there are spiders on the walls?’
B. ‘I don’t see any spiders, but you seem very frightened.’
C. ‘There are no spiders here; you are just hallucinating.’
D. ‘I will get the bug spray to take care of them for you.’
Answer: B
Conceptual Explanation: Presenting reality while acknowledging the client’s feelings is
therapeutic. It avoids arguing with the hallucination while providing emotional support.
4. Which neurotransmitter abnormality is most closely associated with the pathophysiology
of Alzheimer’s disease?
A. Decreased Acetylcholine
, B. Increased Dopamine
C. Increased Serotonin
D. Decreased GABA
Answer: A
Conceptual Explanation: Acetylcholine is essential for learning and memory. A significant
decrease in acetylcholine levels is found in the brains of patients with Alzheimer’s disease.
5. A client with Generalized Anxiety Disorder (GAD) is prescribed Buspirone. What
information is essential for the nurse to include in the teaching?
A. The medication should be taken only when feeling anxious.
B. Avoid aged cheeses and red wine while taking this drug.
C. This medication carries a high risk for physical dependence.
D. It may take 2 to 4 weeks for the full therapeutic effect to be felt.
Answer: D
Conceptual Explanation: Buspirone is not a PRN medication; it requires consistent dosing
and takes several weeks to become effective. Unlike benzodiazepines, it is not addictive.
6. A client taking Lithium Carbonate for Bipolar I Disorder reports blurred vision and a coarse
hand tremor. The nurse should prioritize which action?
A. Holding the dose and requesting a serum lithium level immediately.
B. Suggesting the client drink more fluids to dilute the lithium.
PSYCHIATRIC NURSING EXAM
QUESTIONS AND ANSWERS
1. During the orientation phase of the nurse-client relationship, which nursing action is most
critical to establishing a therapeutic foundation?
A. Developing a plan for termination of the relationship.
B. Establishing the parameters of the relationship and building trust.
C. Promoting the client’s insight into problematic behaviors.
D. Facilitating behavioral change and problem-solving.
Answer: B
Conceptual Explanation: The orientation phase’s primary goal is to establish trust, set
boundaries, and define the purpose of the relationship. Termination is discussed during
orientation, but establishing parameters is the immediate priority.
2. A client is hospitalized for the third time in six months for suicidal ideation. Which ethical
principle is primarily involved when the nurse ensures the client is not discharged
prematurely despite insurance pressure?
A. Autonomy
,B. Beneficence
C. Veracity
D. Fidelity
Answer: B
Conceptual Explanation: Beneficence refers to the duty to act to benefit or promote the
good of others. Protecting a suicidal patient from premature discharge aligns with this
principle.
3. A nurse observes a client pacing and muttering, ‘The spiders are crawling on the walls.’
Which therapeutic response is most appropriate?
A. ‘Why do you think there are spiders on the walls?’
B. ‘I don’t see any spiders, but you seem very frightened.’
C. ‘There are no spiders here; you are just hallucinating.’
D. ‘I will get the bug spray to take care of them for you.’
Answer: B
Conceptual Explanation: Presenting reality while acknowledging the client’s feelings is
therapeutic. It avoids arguing with the hallucination while providing emotional support.
4. Which neurotransmitter abnormality is most closely associated with the pathophysiology
of Alzheimer’s disease?
A. Decreased Acetylcholine
, B. Increased Dopamine
C. Increased Serotonin
D. Decreased GABA
Answer: A
Conceptual Explanation: Acetylcholine is essential for learning and memory. A significant
decrease in acetylcholine levels is found in the brains of patients with Alzheimer’s disease.
5. A client with Generalized Anxiety Disorder (GAD) is prescribed Buspirone. What
information is essential for the nurse to include in the teaching?
A. The medication should be taken only when feeling anxious.
B. Avoid aged cheeses and red wine while taking this drug.
C. This medication carries a high risk for physical dependence.
D. It may take 2 to 4 weeks for the full therapeutic effect to be felt.
Answer: D
Conceptual Explanation: Buspirone is not a PRN medication; it requires consistent dosing
and takes several weeks to become effective. Unlike benzodiazepines, it is not addictive.
6. A client taking Lithium Carbonate for Bipolar I Disorder reports blurred vision and a coarse
hand tremor. The nurse should prioritize which action?
A. Holding the dose and requesting a serum lithium level immediately.
B. Suggesting the client drink more fluids to dilute the lithium.
