TEST BANK
MENTAL HEALTH
NCLEX LATEST
EXAM 2022-2025
Mental Health NCLEX Exam
2022–2024 | 100% Correct
Questions & Rationales | A+
Graded | Latest Updated Version
, lOMoAR cPSD| 19500986
1. Question
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?
o A. Seizures
o B. Shivering
o C. Anxiety
o D. Chest pain
Correct Answer: A. Seizures
Seizures are the most common serious adverse effect of using flumazenil to
reverse benzodiazepine overdose. The effect is magnified if the client has a
combined tricyclic antidepressant and benzodiazepine overdose.
Benzodiazepine reversal has correlations with seizures. Seizures may happen
more frequently in patients who have been on benzodiazepines for long-term
sedation or in patients who are showing signs of severe tricyclic antidepressant
overdose. The required dosage of Flumazenil should be measured and prepared
by the practitioners to manage seizures. Flumazenil use requires caution in
patients relying on a benzodiazepine for seizure control.
, lOMoAR cPSD| 19500986
o Option B: Shivering is not an adverse effect of flumazenil. Monitor the
patient for the possible return of sedation, mostly in those who are
tolerant of benzodiazepines. Patients should have monitoring for
respiratory depression, benzodiazepine withdrawal, and other residual
effects of benzodiazepines for at least 2 hours.
o Option C: Anxiety is a rare adverse effect for people using flumazenil.
Flumazenil has some associations with precipitation of seizures in patients
with benzodiazepine dependence with a history of seizures. Flumazenil
overdose is extremely rare. There is no precise antidote for flumazenil
toxicity. In mild to severe toxicity, symptomatic and supportive treatment
should be a consideration.
o Option D: An overdose of flumazenil in a patient who is not a chronic
benzodiazepine user would not be expected. Chronic
benzodiazepines users may experience withdrawal with abrupt
discontinuation of the drug. Administration of benzodiazepines or
barbiturates may be necessary for seizure control.
• 2. Question
Nurse Tamara is caring for a client diagnosed with bulimia. The most appropriate
initial goal for a client diagnosed with bulimia is to:
o A. Avoid shopping for large amounts of food.
o B. Control eating impulses.
o C. Identify anxiety-causing situations.
o D. Eat only three meals per day.
, lOMoAR cPSD| 19500986
Correct Answer: C. Identify anxiety-causing situations
Bulimic behavior is generally a maladaptive coping response to stress and
underlying issues. The client must identify anxiety-causing situations that
stimulate the bulimic behavior and then learn new ways of coping with the
anxiety. Bulimia nervosa is a condition that occurs most commonly in adolescent
females, characterized by indulgence in binge-eating, and inappropriate
compensatory behaviors to prevent weight gain.
o Option A: Controlling shopping for large amounts of food isn’t a goal early
in treatment. It is important to educate patients who abuse laxatives that
these medications work in the gastrointestinal tract after the areas where
caloric absorption has occurred primarily. It is crucial to inform patients
that a period of edema and weight gain may follow up to several weeks
after discontinuation of purging behavior.
o Option B: Managing eating impulses and replacing them with adaptive
coping mechanisms can be integrated into the plan of care after initially
addressing stress and underlying issues. The primary objective of
treatment is a cessation of the binging and purging behavior. Selective
serotonin reuptake inhibitors such as fluoxetine, citalopram, and
sertraline have shown to reduce symptoms of bulimia nervosa. Fluoxetine
is the only FDA approved medication for bulimia nervosa. It appears that
a higher
dose (60 mg) is significantly better than a placebo in decreasing the
frequency of binge and vomiting episodes.
o Option D: Eating three meals per day isn’t a realistic goal early in
treatment. Patients with bulimia nervosa who purge by vomiting often
brush their teeth immediately after purging, which can accelerate dental
erosion. The clinician should instruct the patients who persist in vomiting
to rinse their mouths with water or fluoride rather than brushing their
teeth within 30 minutes of each episode. Consider consulting a dentist to
address dental issues associated with vomiting.
• 3. Question
A female client who’s at high risk for suicide needs close supervision. To best
ensure the client’s safety, Nurse Mary should:
o A. Check the client frequently at irregular intervals throughout the night.
, lOMoAR cPSD| 19500986
o B. Assure the client that the nurse will hold in confidence anything the client
says.
o C. Repeatedly discuss previous suicide attempts with the client.
o D. Disregard decreased communication by the client because this is common
with suicidal clients.
Correct Answer: A. Check the client frequently at irregular intervals
throughout the night
Checking the client frequently but at irregular intervals prevents the client
from predicting when observation will take place and altering behavior in a
misleading way at these times. Once the patient is deemed to be at risk for
suicide, then intervention steps must be initiated right away. The individual
must not be left alone. Enlist the help of a support person while at home. The
suicidal individual must be treated in a safe and secure place. In addition, the
place has to be monitored.
o Option B: This may encourage the client to try to manipulate the nurse
or seek attention for having a secret suicide plan. Assessing the
individual’s judgment is critical. One should
, lOMoAR cPSD| 19500986
try and determine how the individual can handle stress. Does he or she
have an impairment in decision making? Does the individual know that
jumping in front of a train is dangerous? Reflect empathy and concern.
Offer a hand to help. Provide the patient with confidence that he or she
can overcome the issues.
o Option C: This may reinforce suicidal ideas. Help develop internal coping
strategies (e.g., exercise, journaling, reading, developing a hobby).
Utilize the help of healthcare professionals to follow up on therapy. Once
the individual is safe as an inpatient or outpatient, a formal treatment
plan should be established. The next step is to refer all patients deemed
to be at higher risk for suicide to a mental health counselor as soon as
possible. Every state has laws and procedures regarding this process
which must be incorporated into the clinical practice when addressing
individuals at high suicide risk.
o Option D: Decreased communication is a sign of withdrawal that may
indicate the client has decided to commit suicide; the nurse shouldn’t
disregard it. In some cases, assessment of the mental status may provide
a clue to the individual’s potential for self-harm. Depressed patients will
often tend to appear unclean and unkempt. The clothing may not be
ironed or dirty. The risk of suicide is often high in people who appear very
anxious or depressed. The patient may exhibit a flat affect or no emotions
at all. Some depressed patients may develop hallucinations that may be
telling him or her to kill themselves. The majority of these hallucinations
are auditory.
• 4. Question
Which of the following drugs should Nurse Mary prepare to administer to a client
with a toxic acetaminophen (Tylenol) level?
o A. Deferoxamine mesylate (Desferal)
o B. Succimer (Chemet)
o C. Flumazenil (Romazicon)
MENTAL HEALTH
NCLEX LATEST
EXAM 2022-2025
Mental Health NCLEX Exam
2022–2024 | 100% Correct
Questions & Rationales | A+
Graded | Latest Updated Version
, lOMoAR cPSD| 19500986
1. Question
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?
o A. Seizures
o B. Shivering
o C. Anxiety
o D. Chest pain
Correct Answer: A. Seizures
Seizures are the most common serious adverse effect of using flumazenil to
reverse benzodiazepine overdose. The effect is magnified if the client has a
combined tricyclic antidepressant and benzodiazepine overdose.
Benzodiazepine reversal has correlations with seizures. Seizures may happen
more frequently in patients who have been on benzodiazepines for long-term
sedation or in patients who are showing signs of severe tricyclic antidepressant
overdose. The required dosage of Flumazenil should be measured and prepared
by the practitioners to manage seizures. Flumazenil use requires caution in
patients relying on a benzodiazepine for seizure control.
, lOMoAR cPSD| 19500986
o Option B: Shivering is not an adverse effect of flumazenil. Monitor the
patient for the possible return of sedation, mostly in those who are
tolerant of benzodiazepines. Patients should have monitoring for
respiratory depression, benzodiazepine withdrawal, and other residual
effects of benzodiazepines for at least 2 hours.
o Option C: Anxiety is a rare adverse effect for people using flumazenil.
Flumazenil has some associations with precipitation of seizures in patients
with benzodiazepine dependence with a history of seizures. Flumazenil
overdose is extremely rare. There is no precise antidote for flumazenil
toxicity. In mild to severe toxicity, symptomatic and supportive treatment
should be a consideration.
o Option D: An overdose of flumazenil in a patient who is not a chronic
benzodiazepine user would not be expected. Chronic
benzodiazepines users may experience withdrawal with abrupt
discontinuation of the drug. Administration of benzodiazepines or
barbiturates may be necessary for seizure control.
• 2. Question
Nurse Tamara is caring for a client diagnosed with bulimia. The most appropriate
initial goal for a client diagnosed with bulimia is to:
o A. Avoid shopping for large amounts of food.
o B. Control eating impulses.
o C. Identify anxiety-causing situations.
o D. Eat only three meals per day.
, lOMoAR cPSD| 19500986
Correct Answer: C. Identify anxiety-causing situations
Bulimic behavior is generally a maladaptive coping response to stress and
underlying issues. The client must identify anxiety-causing situations that
stimulate the bulimic behavior and then learn new ways of coping with the
anxiety. Bulimia nervosa is a condition that occurs most commonly in adolescent
females, characterized by indulgence in binge-eating, and inappropriate
compensatory behaviors to prevent weight gain.
o Option A: Controlling shopping for large amounts of food isn’t a goal early
in treatment. It is important to educate patients who abuse laxatives that
these medications work in the gastrointestinal tract after the areas where
caloric absorption has occurred primarily. It is crucial to inform patients
that a period of edema and weight gain may follow up to several weeks
after discontinuation of purging behavior.
o Option B: Managing eating impulses and replacing them with adaptive
coping mechanisms can be integrated into the plan of care after initially
addressing stress and underlying issues. The primary objective of
treatment is a cessation of the binging and purging behavior. Selective
serotonin reuptake inhibitors such as fluoxetine, citalopram, and
sertraline have shown to reduce symptoms of bulimia nervosa. Fluoxetine
is the only FDA approved medication for bulimia nervosa. It appears that
a higher
dose (60 mg) is significantly better than a placebo in decreasing the
frequency of binge and vomiting episodes.
o Option D: Eating three meals per day isn’t a realistic goal early in
treatment. Patients with bulimia nervosa who purge by vomiting often
brush their teeth immediately after purging, which can accelerate dental
erosion. The clinician should instruct the patients who persist in vomiting
to rinse their mouths with water or fluoride rather than brushing their
teeth within 30 minutes of each episode. Consider consulting a dentist to
address dental issues associated with vomiting.
• 3. Question
A female client who’s at high risk for suicide needs close supervision. To best
ensure the client’s safety, Nurse Mary should:
o A. Check the client frequently at irregular intervals throughout the night.
, lOMoAR cPSD| 19500986
o B. Assure the client that the nurse will hold in confidence anything the client
says.
o C. Repeatedly discuss previous suicide attempts with the client.
o D. Disregard decreased communication by the client because this is common
with suicidal clients.
Correct Answer: A. Check the client frequently at irregular intervals
throughout the night
Checking the client frequently but at irregular intervals prevents the client
from predicting when observation will take place and altering behavior in a
misleading way at these times. Once the patient is deemed to be at risk for
suicide, then intervention steps must be initiated right away. The individual
must not be left alone. Enlist the help of a support person while at home. The
suicidal individual must be treated in a safe and secure place. In addition, the
place has to be monitored.
o Option B: This may encourage the client to try to manipulate the nurse
or seek attention for having a secret suicide plan. Assessing the
individual’s judgment is critical. One should
, lOMoAR cPSD| 19500986
try and determine how the individual can handle stress. Does he or she
have an impairment in decision making? Does the individual know that
jumping in front of a train is dangerous? Reflect empathy and concern.
Offer a hand to help. Provide the patient with confidence that he or she
can overcome the issues.
o Option C: This may reinforce suicidal ideas. Help develop internal coping
strategies (e.g., exercise, journaling, reading, developing a hobby).
Utilize the help of healthcare professionals to follow up on therapy. Once
the individual is safe as an inpatient or outpatient, a formal treatment
plan should be established. The next step is to refer all patients deemed
to be at higher risk for suicide to a mental health counselor as soon as
possible. Every state has laws and procedures regarding this process
which must be incorporated into the clinical practice when addressing
individuals at high suicide risk.
o Option D: Decreased communication is a sign of withdrawal that may
indicate the client has decided to commit suicide; the nurse shouldn’t
disregard it. In some cases, assessment of the mental status may provide
a clue to the individual’s potential for self-harm. Depressed patients will
often tend to appear unclean and unkempt. The clothing may not be
ironed or dirty. The risk of suicide is often high in people who appear very
anxious or depressed. The patient may exhibit a flat affect or no emotions
at all. Some depressed patients may develop hallucinations that may be
telling him or her to kill themselves. The majority of these hallucinations
are auditory.
• 4. Question
Which of the following drugs should Nurse Mary prepare to administer to a client
with a toxic acetaminophen (Tylenol) level?
o A. Deferoxamine mesylate (Desferal)
o B. Succimer (Chemet)
o C. Flumazenil (Romazicon)
