Mood Disorders and Personality
Disorders NCLEX Review | Mental
Health Nursing Practice Exam 100%
Accurate
1. 1. Question
The nurse closely observes the client who has been displaying aggressive
behavior. The nurse observes that the client’s anger is escalating. Which approach
is least helpful for the client at this time?
A. Acknowledge the client’s behavior.
B. Maintain a safe distance from the client.
C. Assist the client to an area that is quiet.
D. Initiate confinement measures.
Correct
Correct
Correct Answer: D. Initiate confinement measures
The proper procedure for dealing with harmful behavior is to first try to calm the
patient verbally. When verbal and psychopharmacologic interventions are not
adequate to handle aggressiveness, seclusion or restraints may be applicable.
Alert staff if a potential for seclusion appears imminent. Usual priority of
interventions would be firmly setting limits; chemical restraints (tranquilizers); and
seclusions.
Option A: Frequently assess client’s behavior for signs of increased agitation
and hyperactivity. Early detection and intervention of escalating mania will
prevent the possibility of harm to self or others, and decrease the need for
seclusions.
Option B: Redirect agitation and potentially violent behaviors with physical
outlets in an area of low stimulation (e.g., punching bag). Can help to relieve
pent-up hostility and relieve muscle tension.
Page 1 of 23
, Option C: Assisting the client in a quiet place an appropriate approach during
the escalation phase of aggression. Decrease environmental stimuli (e.g., by
providing a calming environment or assigning a private room). Helps decrease
escalation of anxiety and manic symptoms.
2. 2. Question
The charge nurse of a psychiatric unit is planning the client assignment for the
day. The most appropriate staff to be assigned to a client with a potential for
violence is which of the following:
A. A timid nurse
B. A mature, experienced nurse
Correct answer
C. An inexperienced nurse
D. A soft-spoken nurse
Correct Answer: B. A mature, experienced nurse
The unstable, aggressive client should be assigned to the most experienced
nurse. Maintain a consistent approach, employ consistent expectations, and
provide a structured environment. Clear and consistent limits and expectations
minimize the potential for the client’s manipulation of staff.
Option A: The timid nurse may not be able to lay out consistent limits to an
angry client. The client can use inconsistencies and value judgments as
justification for arguing and escalating mania.
Option C: An inexperienced nurse may not know how to handle the situation
appropriately. Using a calm and firm approach may provide structure and
control for a client who is out of control.
Option D: A soft-spoken nurse may feel intimidated by the angry patient.
Using short, simple, and brief explanations or statements is appropriate for the
client. A short attention span limits understanding of small pieces of
information.
3. 3. Question
Page 2 of 23
, The client jumps up and throws a chair out of the window. He was restrained
after his behavior can no longer be controlled by the staff. Which of these
documentations indicates the safeguarding of the patient’s rights?
A. There was a doctor’s order for restraints/seclusion.
B. The patient’s rights were explained to him.
C. The staff observed confidentiality.
D. The staff carried out less restrictive measures but were unsuccessful.
Correct
Correct
Correct Answer: D. The staff carried out less restrictive measures but were
unsuccessful.
This documentation indicates that the client has been placed in restraints after
the least restrictive measures failed in containing the client’s violent behavior.
Chart, in nurse’s notes, behaviors; interventions; what seemed to escalate
agitation; what helped to calm agitation; when as-needed (PRN) medications
were given and their effect; and what proved most helpful.
Option A: If nursing interventions (quiet environment and firm limit setting)
and chemical restraints (tranquilizers–e.g., haloperidol [Haldol]) have not
helped dampen escalating manic behaviors, then seclusion might be
warranted.
Option B: Use a calm and firm approach. Provides structure and control for a
client who is out of control. Use short, simple, and brief explanations or
statements. A short attention span limits understanding to small pieces of
information.
Option C: Frequently assess client’s behavior for signs of increased agitation
and hyperactivity. Staff will begin to recognize potential signals for escalating
manic behaviors and have a guideline for what might work best for the
individual client.
4. 4. Question
Situation: Clients with personality disorders have difficulties in their social and
occupational functions.
Clients with a personality disorder will most likely:
Page 3 of 23
Disorders NCLEX Review | Mental
Health Nursing Practice Exam 100%
Accurate
1. 1. Question
The nurse closely observes the client who has been displaying aggressive
behavior. The nurse observes that the client’s anger is escalating. Which approach
is least helpful for the client at this time?
A. Acknowledge the client’s behavior.
B. Maintain a safe distance from the client.
C. Assist the client to an area that is quiet.
D. Initiate confinement measures.
Correct
Correct
Correct Answer: D. Initiate confinement measures
The proper procedure for dealing with harmful behavior is to first try to calm the
patient verbally. When verbal and psychopharmacologic interventions are not
adequate to handle aggressiveness, seclusion or restraints may be applicable.
Alert staff if a potential for seclusion appears imminent. Usual priority of
interventions would be firmly setting limits; chemical restraints (tranquilizers); and
seclusions.
Option A: Frequently assess client’s behavior for signs of increased agitation
and hyperactivity. Early detection and intervention of escalating mania will
prevent the possibility of harm to self or others, and decrease the need for
seclusions.
Option B: Redirect agitation and potentially violent behaviors with physical
outlets in an area of low stimulation (e.g., punching bag). Can help to relieve
pent-up hostility and relieve muscle tension.
Page 1 of 23
, Option C: Assisting the client in a quiet place an appropriate approach during
the escalation phase of aggression. Decrease environmental stimuli (e.g., by
providing a calming environment or assigning a private room). Helps decrease
escalation of anxiety and manic symptoms.
2. 2. Question
The charge nurse of a psychiatric unit is planning the client assignment for the
day. The most appropriate staff to be assigned to a client with a potential for
violence is which of the following:
A. A timid nurse
B. A mature, experienced nurse
Correct answer
C. An inexperienced nurse
D. A soft-spoken nurse
Correct Answer: B. A mature, experienced nurse
The unstable, aggressive client should be assigned to the most experienced
nurse. Maintain a consistent approach, employ consistent expectations, and
provide a structured environment. Clear and consistent limits and expectations
minimize the potential for the client’s manipulation of staff.
Option A: The timid nurse may not be able to lay out consistent limits to an
angry client. The client can use inconsistencies and value judgments as
justification for arguing and escalating mania.
Option C: An inexperienced nurse may not know how to handle the situation
appropriately. Using a calm and firm approach may provide structure and
control for a client who is out of control.
Option D: A soft-spoken nurse may feel intimidated by the angry patient.
Using short, simple, and brief explanations or statements is appropriate for the
client. A short attention span limits understanding of small pieces of
information.
3. 3. Question
Page 2 of 23
, The client jumps up and throws a chair out of the window. He was restrained
after his behavior can no longer be controlled by the staff. Which of these
documentations indicates the safeguarding of the patient’s rights?
A. There was a doctor’s order for restraints/seclusion.
B. The patient’s rights were explained to him.
C. The staff observed confidentiality.
D. The staff carried out less restrictive measures but were unsuccessful.
Correct
Correct
Correct Answer: D. The staff carried out less restrictive measures but were
unsuccessful.
This documentation indicates that the client has been placed in restraints after
the least restrictive measures failed in containing the client’s violent behavior.
Chart, in nurse’s notes, behaviors; interventions; what seemed to escalate
agitation; what helped to calm agitation; when as-needed (PRN) medications
were given and their effect; and what proved most helpful.
Option A: If nursing interventions (quiet environment and firm limit setting)
and chemical restraints (tranquilizers–e.g., haloperidol [Haldol]) have not
helped dampen escalating manic behaviors, then seclusion might be
warranted.
Option B: Use a calm and firm approach. Provides structure and control for a
client who is out of control. Use short, simple, and brief explanations or
statements. A short attention span limits understanding to small pieces of
information.
Option C: Frequently assess client’s behavior for signs of increased agitation
and hyperactivity. Staff will begin to recognize potential signals for escalating
manic behaviors and have a guideline for what might work best for the
individual client.
4. 4. Question
Situation: Clients with personality disorders have difficulties in their social and
occupational functions.
Clients with a personality disorder will most likely:
Page 3 of 23
