Psychiatric Nursing NCLEX Mastery
Exam | Mental Health RN Practice
Questions and answers 100% accurate
1. 1. Question
A psychotic client reports to the evening nurse that the day nurse put something
suspicious in his water with his medication. The nurse replies, “You’re worried
about your medication?” The nurse’s communication is:
A. An example of presenting reality
B. Reinforcing the client’s delusions
C. Focusing on emotional content
Correct answer
D. A non-therapeutic technique called mind-reading
Correct Answer: C. Focusing on emotional content
The nurse should help the client focus on the emotional content rather than
delusional material. Sometimes during a conversation, patients mention
something particularly important. When this happens, nurses can focus on their
statement, prompting patients to discuss it further. Patients don’t always have an
objective perspective on what is relevant to their case; as impartial observers,
nurses can more easily pick out the topics to focus on.
2. 2. Question
A client is admitted to the inpatient unit of the mental health center with a
diagnosis of paranoid schizophrenia. He’s shouting that the government of
France is trying to assassinate him. Which of the following responses
is most appropriate?
A. “I think you’re wrong. France is a friendly country and an ally of the United
States. Their government wouldn’t try to kill you.”
B. “I find it hard to believe that a foreign government or anyone else is trying
to hurt you. You must feel frightened by this.”
, Correct answer
C. “You’re wrong. Nobody is trying to kill you.”
D. “A foreign government is trying to kill you? Please tell me more about it.”
Correct Answer: B. “I find it hard to believe that a foreign government or
anyone else is trying to hurt you. You must feel frightened by this.”
Responses should focus on reality while acknowledging the client’s feelings.
Sometimes during a conversation, patients mention something particularly
important. When this happens, nurses can focus on their statement, prompting
patients to discuss it further. Patients don’t always have an objective perspective
on what is relevant to their case; as impartial observers, nurses can more easily
pick out the topics to focus on.
3. 3. Question
A client receiving haloperidol (Haldol) complains of a stiff jaw and difficulty
swallowing. The nurse’s first action is to:
A. Reassure the client and administer as needed lorazepam (Ativan) I.M.
B. Administer as needed dose of benztropine (Cogentin) I.M. as ordered.
Correct answer
C. Administer as needed dose of benztropine (Cogentin) by mouth as
ordered.
D. Administer as needed dose of haloperidol (Haldol) by mouth.
Correct Answer: B. Administer as needed dose of benztropine (Cogentin)
I.M. as ordered.
The client is most likely suffering from muscle rigidity due to haloperidol. I.M.
benztropine should be administered to prevent asphyxia or aspiration. The
extrapyramidal symptoms are muscular weakness or rigidity, a generalized or
localized tremor that may be characterized by the akinetic or agitation types of
movements, respectively. Haloperidol overdose is also associated with ECG
changes known as torsade de pointes, which may cause arrhythmia or cardiac
arrest.
4. 4. Question
, The nurse is caring for a client with schizophrenia who experiences auditory
hallucinations. The client appears to be listening to someone who isn’t visible. He
gestures, shouts angrily, and stops shouting in mid-sentence. Which nursing
intervention is the most appropriate?
A. Approach the client and touch him to get his attention.
B. Encourage the client to go to his room where he’ll experience fewer
distractions.
C. Acknowledge that the client is hearing voices but make it clear that the
nurse doesn’t hear these voices.
Correct answer
D. Ask the client to describe what the voices are saying.
Correct Answer: C. Acknowledge that the client is hearing voices but make it
clear that the nurse doesn’t hear these voices.
By acknowledging that the client hears voices, the nurse conveys acceptance of
the client. By letting the client know that the nurse doesn’t hear the voices, the
nurse avoids reinforcing the hallucination. Auditory hallucinations are the sensory
perceptions of hearing voices without an external stimulus. This symptom is
particularly associated with schizophrenia and related psychotic disorders but is
not specific to it. Auditory hallucinations are one of the major symptoms of
psychosis.
5. 5. Question
A client with paranoid schizophrenia has been experiencing auditory
hallucinations for many years. One approach that has proven to be effective for
hallucinating clients is to:
A. Take an as-needed dose of psychotropic medication whenever they hear
voices.
B. Practice saying “Go away” or “Stop” when they hear voices.
Correct answer
C. Sing loudly to drown out the voices and provide a distraction.
D. Go to their room until the voices go away.
, Correct Answer: B. Practice saying “Go away” or “Stop” when they hear
voices.
Researchers have found that some clients can learn to control bothersome
hallucinations by telling the voices to go away or stop. The estimated prevalence
of auditory hallucinations in the general population ranges from 5 to 28%.
Auditory hallucinations are the most commonly reported in psychotic patients.
They are prevalent in 75% of individuals suffering from schizophrenia, 20-50% of
individuals with bipolar disorder, 10% of individuals with major psychotic
depression, and 40% of individuals with PTSD.
Option A: Taking an as-needed dose of psychotropic medication whenever
the voices arise may lead to overmedication and put the client at risk for
adverse effects. Because the voices aren’t likely to go away permanently, the
client must learn to deal with the hallucinations without relying on drugs.
Option C: Although distraction is helpful, singing loudly may upset other
clients and would be socially unacceptable after the client is discharged. In
children and adolescents, the prevalence has been noted to be 9% and
ranging between 5 to 16%, respectively. In children, it is mostly seen in
conjunction with conduct disorder, migraine, and anxiety. The discontinuation
rate of auditory hallucinations in adolescence ranges from 3 to 40% each year.
Option D: Hallucinations are most bothersome in a quiet environment when
the client is alone, so sending the client to his room would increase, rather
than decrease, the hallucinations. Auditory hallucinatory experiences are
psychopathological end-points. Disturbances in consciousness may occur
earlier in the course that includes thought blocking, thought pressure,
obsessive perseveration, and failure to discriminate between thought and
perception.
6. 6. Question
1 point(s)
A client with catatonic schizophrenia is mute, can’t perform activities of daily
living, and stares out the window for hours. What is the nurse’s first priority?
A. Assist the client with feeding
Correct answer
B. Assist the client with showering
C. Reassure the client about safety
Exam | Mental Health RN Practice
Questions and answers 100% accurate
1. 1. Question
A psychotic client reports to the evening nurse that the day nurse put something
suspicious in his water with his medication. The nurse replies, “You’re worried
about your medication?” The nurse’s communication is:
A. An example of presenting reality
B. Reinforcing the client’s delusions
C. Focusing on emotional content
Correct answer
D. A non-therapeutic technique called mind-reading
Correct Answer: C. Focusing on emotional content
The nurse should help the client focus on the emotional content rather than
delusional material. Sometimes during a conversation, patients mention
something particularly important. When this happens, nurses can focus on their
statement, prompting patients to discuss it further. Patients don’t always have an
objective perspective on what is relevant to their case; as impartial observers,
nurses can more easily pick out the topics to focus on.
2. 2. Question
A client is admitted to the inpatient unit of the mental health center with a
diagnosis of paranoid schizophrenia. He’s shouting that the government of
France is trying to assassinate him. Which of the following responses
is most appropriate?
A. “I think you’re wrong. France is a friendly country and an ally of the United
States. Their government wouldn’t try to kill you.”
B. “I find it hard to believe that a foreign government or anyone else is trying
to hurt you. You must feel frightened by this.”
, Correct answer
C. “You’re wrong. Nobody is trying to kill you.”
D. “A foreign government is trying to kill you? Please tell me more about it.”
Correct Answer: B. “I find it hard to believe that a foreign government or
anyone else is trying to hurt you. You must feel frightened by this.”
Responses should focus on reality while acknowledging the client’s feelings.
Sometimes during a conversation, patients mention something particularly
important. When this happens, nurses can focus on their statement, prompting
patients to discuss it further. Patients don’t always have an objective perspective
on what is relevant to their case; as impartial observers, nurses can more easily
pick out the topics to focus on.
3. 3. Question
A client receiving haloperidol (Haldol) complains of a stiff jaw and difficulty
swallowing. The nurse’s first action is to:
A. Reassure the client and administer as needed lorazepam (Ativan) I.M.
B. Administer as needed dose of benztropine (Cogentin) I.M. as ordered.
Correct answer
C. Administer as needed dose of benztropine (Cogentin) by mouth as
ordered.
D. Administer as needed dose of haloperidol (Haldol) by mouth.
Correct Answer: B. Administer as needed dose of benztropine (Cogentin)
I.M. as ordered.
The client is most likely suffering from muscle rigidity due to haloperidol. I.M.
benztropine should be administered to prevent asphyxia or aspiration. The
extrapyramidal symptoms are muscular weakness or rigidity, a generalized or
localized tremor that may be characterized by the akinetic or agitation types of
movements, respectively. Haloperidol overdose is also associated with ECG
changes known as torsade de pointes, which may cause arrhythmia or cardiac
arrest.
4. 4. Question
, The nurse is caring for a client with schizophrenia who experiences auditory
hallucinations. The client appears to be listening to someone who isn’t visible. He
gestures, shouts angrily, and stops shouting in mid-sentence. Which nursing
intervention is the most appropriate?
A. Approach the client and touch him to get his attention.
B. Encourage the client to go to his room where he’ll experience fewer
distractions.
C. Acknowledge that the client is hearing voices but make it clear that the
nurse doesn’t hear these voices.
Correct answer
D. Ask the client to describe what the voices are saying.
Correct Answer: C. Acknowledge that the client is hearing voices but make it
clear that the nurse doesn’t hear these voices.
By acknowledging that the client hears voices, the nurse conveys acceptance of
the client. By letting the client know that the nurse doesn’t hear the voices, the
nurse avoids reinforcing the hallucination. Auditory hallucinations are the sensory
perceptions of hearing voices without an external stimulus. This symptom is
particularly associated with schizophrenia and related psychotic disorders but is
not specific to it. Auditory hallucinations are one of the major symptoms of
psychosis.
5. 5. Question
A client with paranoid schizophrenia has been experiencing auditory
hallucinations for many years. One approach that has proven to be effective for
hallucinating clients is to:
A. Take an as-needed dose of psychotropic medication whenever they hear
voices.
B. Practice saying “Go away” or “Stop” when they hear voices.
Correct answer
C. Sing loudly to drown out the voices and provide a distraction.
D. Go to their room until the voices go away.
, Correct Answer: B. Practice saying “Go away” or “Stop” when they hear
voices.
Researchers have found that some clients can learn to control bothersome
hallucinations by telling the voices to go away or stop. The estimated prevalence
of auditory hallucinations in the general population ranges from 5 to 28%.
Auditory hallucinations are the most commonly reported in psychotic patients.
They are prevalent in 75% of individuals suffering from schizophrenia, 20-50% of
individuals with bipolar disorder, 10% of individuals with major psychotic
depression, and 40% of individuals with PTSD.
Option A: Taking an as-needed dose of psychotropic medication whenever
the voices arise may lead to overmedication and put the client at risk for
adverse effects. Because the voices aren’t likely to go away permanently, the
client must learn to deal with the hallucinations without relying on drugs.
Option C: Although distraction is helpful, singing loudly may upset other
clients and would be socially unacceptable after the client is discharged. In
children and adolescents, the prevalence has been noted to be 9% and
ranging between 5 to 16%, respectively. In children, it is mostly seen in
conjunction with conduct disorder, migraine, and anxiety. The discontinuation
rate of auditory hallucinations in adolescence ranges from 3 to 40% each year.
Option D: Hallucinations are most bothersome in a quiet environment when
the client is alone, so sending the client to his room would increase, rather
than decrease, the hallucinations. Auditory hallucinatory experiences are
psychopathological end-points. Disturbances in consciousness may occur
earlier in the course that includes thought blocking, thought pressure,
obsessive perseveration, and failure to discriminate between thought and
perception.
6. 6. Question
1 point(s)
A client with catatonic schizophrenia is mute, can’t perform activities of daily
living, and stares out the window for hours. What is the nurse’s first priority?
A. Assist the client with feeding
Correct answer
B. Assist the client with showering
C. Reassure the client about safety
