Long Island University, Brooklyn NUR 420; Mental Final RSM; Questions and Answers Latest 2025-26.

Mental Final Spring 25 RSM A 78-year-old patient diagnosed with Alzheimer’s disease picks up a glass from the bedside table but does not recognize the purpose of the object. This inability is associated with which characteristic of the disorder? A) Apraxia B) Anergia C) Aphagia D) Agnosia A nurse is sitting in the day room at an acute care mental health facility with a group of clients who are watching television. Suddenly one of the clients jumps up screaming and runs out of the room. Which of the following actions should the nurse take? Follow the client to determine the cause of the behavior. Ignore the incident because it is an attention-seeking behavior. Ask the group what they think about the client’s behavior. Stay with the group and ask another client to go and check on the situation. A client has been referred to a mental health center by a juvenile court after being arrested for vandalism. As the mental health center, the client refuses to participate in scheduled activities and was observed pushing another client. Which action by the nurse is the most therapeutic? A) Permitting the client to refuse B) Establishing firm limits C) Forcing the client to comply D) Offering rewards in advance A nurse tells a client that the nurse will bring the pain medicine in 5 minutes after checking on another client. The nurse returns ... minutes and administers the medication as planned. The nurse is practicing which principle by returning as promised? A) Nonmaleficence B) Fidelity C) Paternalism D) Autonomy A client diagnosed with a personality disorder insists that a grandmother, through reincarnation, has come back to life as a pet kitten. The thought process described is reflective of which personality disorder? A) Borderline personality disorder B) Dependent personality disorder C) Obsessive-compulsive personality disorder D) Schizotypal personality disorderCluster A includes paranoid, schizoid, and schizotypal personality disorders. Clients diagnosed with schizotypal personality disorder are characterized by peculiarities of ideation, appearance, and behavior; magical thinking; and deficits in interpersonal relatedness that are not severe enough to meet the criteria for schizophrenia. In the question, this client's statement reflects ideations of magical thinking . Ateenage and a teenager’s parents visit the clinic to discuss the teen’s skin picking. There are many bleeding wounds and various stages of scabs up and down both arms. The parents are very upset about the behavior and want it to stop. Which would the health care provider document? A) Control dysfunction B) Body dysmorphic disorder C) Excoriation disorder D) Disrupted family dynamics Rationale:Excoriation disorder (skin picking) is the inability to stop recurrent picking at skin for emotional release or anxiety release. Body dysmorphic disorder is a preoccupation with slight or imagined physical defects that are not apparent to others. There is not enough information to diagnose disrupted family dynamics or control issues within the family unit. . The nurse caring for a client diagnosed with Alzheimer disease can anticipate that the family will need info about which medication ...? A) Acetylcholinesterase inhibitors B) Antidepressants C) Benzodiazepines D) Antihypertensives Memory deficit is thought to be related to a lack of acetylcholine at the synaptic level. Acetylcholinesterase inhibitor drugs prevent the chemical that destroys acetylcholine from acting, thus leaving more available acetylcholine . A nurse tells the child and caregiver that the nurse will interview each of them separately. The caregiver questions why this needs to ... occur. What is the nurse’s best response? A) “By interviewing separately | can validate all the information.” B) “Parents know best and | will determine this during the interview.” C) “Research shows that info validates the child’s feeling.” D) “Both interviews provide unique and meaningful info.” To get an accurate picture of the child, the nurse should interview the child and parent individually because each can provide unique meaningful information. Research has shown that when parent and child are interviewed separately the children provide information about internalizing symptoms and9. 10. 11, 12, 13. the parents provide information about externalizing symptoms. The nurse is providing discharge teaching for a patient diagnosed with posttraumatic stress disorder (PTSD). Which patient statement indicates further teaching? A) “lwill use abdominal breathing at the first sign of anxiety.” B) “l will use distraction techniques when | feel moderate stress.” C) “l'will drink a few beers when | am anxious.” D) “l will go to the gym for kickboxing class when | have negative feeling.” Using alcoholic beverages as a means of controlling anxiety indicates the need for further teaching. The other patient statements indicate understanding of the discharge teaching provided by the nurse. A nurse is caring for a client who begins to yell and scream at staff members. Which of the following should be the nurse’s priority? A) Administer haloperidol IM to the client. B) Engage the client is an activity. C) Move the client to a seclusion room with continuous observation. D) Say to the client, “I can tell that you are upset.” Client suffering from which sleep disorder may be helped by losing excess weight and using oral appliances during sleep? A) Insomnia B) Restlessleg syndrome C) Obstructive sleep apnea syndrome D) Narcolepsy client suffering from obstructive sleep apnea syndrome (OSAS) may be helped by losing excess weight and using oral appliances during sleep. OSAS is characterized by repeated episodes of partial or complete obstruction of the upper airway during sleep, leading to disrupted sleep and decreased oxygen levels. Weight loss can reduce the severity of the airway obstruction, and oral appliances can help keep the airway open. Missing A patient shows no facial expression when engaging in a game with peers during an outing at a park. The nurse uses which of the following terms documenting the patient’s affect? A) Flat affect B) Restricted affect C) Blunt affect D) Broad affect14. 15. 16. 17. 18. 19. Which of the following functions is associated with the occipital lobe of the brain? A) Controlling voluntary movements B) Regulating emotions C) Processing visual info D) Processing auditory info During a night shift, a hospitalized client with depression tells a nurse that the client is going to kill himself or herself. The ... on constant observation. When the client asks to use the toilet, the nurse follows the client into the bathroom. The client ... need to follow me into the bathroom. Give me some space.” Which response by the nurse is most appropriate? A) “You are right. | don’t need to come into the bathroom with you. | will wait outside the door.” B) “If you think you are going to be OK. | will check on you in 5 minutes.” C) “l can’timagine anything dangerous in the bathroom. Go ahead. | will wait for you in the hallway.” D) “I must stay with you until we are sure you will not hurt yourself.” A client diagnosed with schizophrenia insists on stopping medication because it causes the client to gain weight. The client is ... which ethical principle? A) Beneficence B) Autonomy C) Justice D) Veracity A client was admitted to the intensive care unit a fer a motor vehicle accident. The client sustained a right parietal injury, resulting in an acute confusional state or delirium. The client reports that there are “bugs crawling around” on the arms. The nurse understands this ... A) A predisposition to such episodes early in the morning. B) Tactile hallucinations from delirium. C) Preexisting schizophrenia D) Increasing brain damage and poor prognosis. The nurse on an in-patient pediatric psychiatric unit is admitting a client diagnosed with an autistic disorder. Which would the nurse exp...? A) A goodimagination B) A strong connection with siblings C) Absence of language D) Abnormalities in physical appearance. After an intensive argument at the home involving violence the husband apologizes and purchases flowers for his wife the next day. He also proceeds to take her on the shopping trip and is remorseful. This phase of the cycle of violence is referred to as?20. 21. A) Honeymoon B) Peaceful transition C) Violence D) Tension building Which of the following conditions is characterized by multiple motor tics and one or more vocal tics many times throughout the year or more? A) Attention deficit hyperactivity disorder B) Autism spectrum disorder C) Tourette’s syndrome D) Intellectual disability Because older adults are more sensitive to medication interaction, it is important for the nurse to ask the order client about consumption of which of the following? A) Cranberry juice B) Grapefruit juice C) Orange juice D) Lemon juice Grapefruit juice is known to interact with a variety of medications, potentially leading to increased blood levels of the medication and causing adverse effects. This 1s especially important for older adults who may be taking multiple medications. 22. 23. 24. A nurse is working in the emergency department. All of the situations below would lead the nurse to suspect possible abuse EXCEPT? A) A baby with substantial injuries to the brain (abuse) B) A 15-month-old with shortness of breath after peanut ingestion C) A 3-month-old with a fractured femur (abuse) D) A 6-year-old is being seen for the 5" time for a urinary tract infection. (abuse) The nurse is looking to assess the client’s ability to concentrate. Which task should the nurse ask the client to perform? A) Interpret the meaning of a proverb. B) Spell “America” backward. C) Talking about future goals. D) Write names of family members. The parents of a teenage girl who has just been diagnosed with anorexia nervosa are distraught at this development, statin, “... no idea where this all came from.” The anorexia nervosa client is typically what? A) Ahigh achiever B) The first-degree relative or close friend of a person who is obese C) Listless and unmotivated D) Socially withdrawn with below average intelligence25. A 9-year-old client with attention deficit hyperactivity disorder (ADHD) has been placed on the stimulant methylphenidate. The nurse knows that it has been effective when the client’s parents state what? A) “We ‘Il bring the client in every week to get blood levels drawn.” B) “The client will take this medication at bedtime.” C) “The client will have an effect from this drug in about 2 weeks.” D) The client may have some side effects, like insomnia, loss of appetite, or weight loss, but they are rare. 26. A nurse is providing discharge teaching to a client who has bipolar disorder and will be discharged with a prescription for lithium should teach the client that which of the following factors puts her at risk for lithium toxicity A) The client eats 2 to 3 gm of sodium-containing foods dally B) The client eats foods high in tyramine. C) The client runs 4 miles outdoors every afternoon. D) The client drinks 2 liters of liquids daily. Strenuous exercise in outdoor heat, which can lead to dehydration, puts the client at risk for lithium toxicity. Mild to moderate exercise will not lead to lithium toxicity, but if the client engages in strenuous exercise during hot weather, she should take care to replace any water and sodium that have been lost through profuse sweating. This also applies to other factors that can cause the client to become dehydrated, such as having diarrhea or taking diuretics. 27-MISSING 28. A nurse in along term care unit is creating a plan care for a client who has Alzheimer's disease. Which of the following the nurse include in the plan A)Limit time for the client to perform activities. B)Provide an activity schedule that changes from day to day. C)Talk the client through tasks one step at atime. D)Rotate assignment of daily caregivers. The nurse should plan to talk the client through tasks one step at a time to minimize confusion and promote independence, which will decrease the client's anxiety level. 29)The nurse is creating a plan of care for a client admitted with dementia. Which priority outcome will the nurse include in the plan A)The client will remain safe in their environment and will not experience injury B)The client will sleep at least 8-10 hours per night. C)The client will increase their physical stamina from admission to discharge. D)The client will have improved nutritional status30)A client with a history of schizophrenia states to the nurse “l wrote the boat overload showed my goat float tote” This phrase is an example of a pattern known as A) Neologism B) Clang Association C) Echolalia D) Preservation. 31) Which of the following Statements accurately describes the patient education regarding the Use of disulfiram A)Disulfiram can be stopped abruptly without any adverse effects B)Disulfiram should be taken with alcohol to enhance its effects. C)Disulfiram is used to treat depression and anxiety disorders. D)it is important to avoid products that contain alcohol while taking disulfiram. Disulfiram is used to support the treatment of chronic alcoholism by producing an acute sensitivity to ethanol (drinking alcohol). Consuming alcohol while taking disulfiram can cause severe reactions, including nausea, vomiting, headache, and even more serious health risks. Therefore, patients must avoid all products containing alcohol, including certain medications, mouthwashes, and foods. 32) A nurse reports an incident of suspected child abuse. One of the parents of the child becomes upset and demands to know the nurse's actions. Which of the following responses by the nurses is appropriate A)"As a nurse, | am required by law to report suspected child abuse." B)"The provider will be coming to explain the situation." C) "l reported the incident to my supervisor who decided to contact the authorities." D)"l am unable to discuss this, but | can contact my supervisor to speak with you." 33)A 21-year-old client admits to recently using diuretics and laxatives to lose weight quickly. The client doesn't want to feel suit on vacation. The client's sodium level is 150 mEq/L; potassium level is 3.2 mEg/L. The client is 5 feet tall, and weighs 109 lost 75 pounds in 3 weeks.Which goal is a priority at this time. A)Develop a contract with the client to stop using laxatives and diuretics. B)Assist client to begin gaining weight at the rate of 2 to 3 pounds per week until reaching 112 pounds C)Help build self-esteem D)Stabilize electrolyte levels 34) A client diagnosed with schizophrenia is prescribed clozapine( Clozaril). Which client symptoms related to the side effects of this medication should the nurse to intervene immediately A)Hypersalivation B) sore throat, fever, malaise C) dry mouth and urinary retentionD) insomnia 35) A client has escalating behavior issues and is threatening to leave the unit. Which factor is most important for the nurse in type of restraint for this client A) The least restrictive method of restraint should be used to keep the client safe B) Ankle restraints are best to be used to keep a client from escaping from the unit. C) A client can be restrained in the bed with a tightly tucked sheet to limit movement D) Medication administered can also be considered a type of restraint for a client 36)A nurse is working with a client diagnosed with insomnia. When developing an education plan for the client. Which sleep promotion intervention would the nurse implement first? A) Instructing the client to keep regular bedtimes and rising times B) encouraging the client to stop smoking C) encouraging the client to take frequent naps D) administering prescribed sleep medications 37)A nurse in an outpatient mental health clinic is caring for a client who has bulimia nervosa. A nurse in an outpatient mental health clinic is assessing a client during a follow-up visit. Select the 5 assessment findings that indicate a therapeutic response to the treatment plan. Coping Skills ECG Report Creatinine Level Potassium Level Laxative Useoot eA stpatient mental bealth clinic is caring for a client who has bul » o i t june 1 MHeight 63 iIn(5 1S in) Weight: 576 kg (127 1b) BMI 21 Erosion of teeth, reports ¢ e fertal caries Parotid swelling Calluses on hang Periphev al ecoema Muscle wasting CAON "NTS Ovevea £ WEN L e < - e 1 Hhe weeh take MBIy e z N NP M T EEXNTS ODOINEK &7 Eande. d 3 - - 4 N3 N - - ” SRV » » -e * g < X & June 1 Basic Metabolic Profile A nurse s as as sessing the client dur g & fToNore-up viean Select the 4 assessments that indicate a therapautic respor treatment plan - © -~ o - . - - - - - ) Potassium evel 0 ece ) BUN eve (ij Laxative abuse repomnt (“J Lvereaung/purging cycle ‘“‘ Coping svills i o e o S L) vora L) ECG repart L) BUN level ‘ Laxative abuiaes MUY ‘v e 4 mg/dl « 1000 ms o (Nere N/ oae « 100 .”“““ . OPIng awilly ractions (PVE ) 38)A client with chronic schizophrenia receives 20 mg of Haldol (haloperidol) daily. A week later the client has muscle contractions that contort the client is exhibiting which extrapyramidal reaction A) Tardive dyskinesia B) Pseudoparkinsonism C) Akathisia D) DystoniaDystonia is a type of extrapyramidal reaction characterized by involuntary muscle contractions that cause repetitive or twisting movements. These contractions can result in abnormal postures and contortions. In the context of antipsychotic medications like haloperidol (Haldol), dystonia is a known side effect that can occur, especially early in treatment. 39)A nurse assesses an older adult in the clinic who comes in for his follow up appointment with the smell of alcohol on his breath the nurse may consider the use of which assessment A) Abnormal Involuntary Movement Scale (AIMS) B) Mental status exam C) CAGE questionnaire D) Functional assessment 40) A healthcare provider in an outpatient clinic has prescribed fluoxetine(Prozac) to a client with intermittent explosive disorder what should the nurse include in teaching about this medication A) Emphasize the need to seek medical help if suicidal thoughts arise. B) Inform the client appetite loss is a side effect that will persist throughout treatment. C) Remind the client itis uncommon to experience sleep changes with this medication D) Tell the client to stop taking the medication if the client experiences drowsiness. 41) A nurse in a mental health clinic is assessing a client who has manifestations of tardive dyskinesia. For each potential nursing action, click to specify if the action is anticipated, nonessential, or contraindicated for the client. Hold all medications. - contraindicated Assess client's ability to speak and swallow. - anticipated Inform the client that manifestations will be temporary. - contraindication Perform Abnormal Involuntary Movements Scale (AIMS). - anticipated Instruct client to hold one hand with the other. - anticipated Check for bladder distention. - nonessential Contraindicated: Hold all medications. Inform the client that manifestations will be temporary. Anticipated: Assess client's ability to speak and swallow. Perform Abnormal Involuntary Movements Scale (AIMS). Instruct client to hold one hand with the other. Nonessential: Check for bladder distentionFor each potential nursing actior,, cck o s anticipated, nonessential, or contraindicat < A nurse in a mental health clinic Is assessing a client who has manifestations of tardive dyskinesia - e & o - = - © - ~ W Sy Mmyl‘ e SRR Nursing Action Anticipated Medical History Perform Abnormal O Schizophrenia x 15 years LA oo e ik ) Scale (AMS) L Hyperlipidemia s Reflux disease infor the client that O manifestations will be temporary Current medications b R : X Assess client's ability to (:)’ isperidone P 4 mg g PO dail y speak and swalow } Trazodone 50 mg PO TID Check for bladder Metoclopramide 10 mg PO TID distention, Pravastatin 40 mg PO at bedtime Hold all medications Instruct client to hold one nand with the other. . 42)A nurse is caring for a child who has autism spectrum disorder Which of the following findings should the nurse expect? SATA A)Short attention span B)Spinning a toy repetitively C)Ritualistic behavior D)Consistent limit testing E)Delayed language development e Short Attention Span: Children with ASD often have difficulty maintaining focus on tasks or activities for extended periods. e Spinning a Toy Repetitively: Repetitive behaviors, such as spinning objects, are common in children with ASD and serve as a form of self-stimulation or comfort. e Ritualistic Behavior: Children with ASD frequently engage in ritualistic or routine behaviors, which provide a sense of predictability and control. e Delayed Language Development: Delays in speech and language development are typical in children with ASD, often manifesting as limited verbal communication or difficulty understanding language.43)A nurse is caring for a client who was admitted with acute psychosis and is being treated with haloperidol. The nurse should suspect that the client experiencing tardive dyskinesia when the client exhibits which of the following? SATA A)Tongue thrusting and lip smacking B)Facial grimacing and eye blinking C)Urinary retention and constipation D)Fine hand tremors and pill rolling E) Involuntary pelvic rocking and hip thrusting movements Tardive dyskinesia is a side effect of long-term antipsychotic treatment, characterized by involuntary, repetitive movements, particularly of the face and extremities. These movements include tongue thrusting, lip smacking, facial grimacing, eye blinking, and involuntary movements of the pelvis and hips. 44-50 Mlssing