NUR253 Exam 3 V3 | Mental Health
Nursing Q&A with Rationale | Galen
College of Nursing
1. A nurse is caring for a client with Obsessive-Compulsive Disorder (OCD) who spends hours
each day performing handwashing rituals. Which nursing intervention is most appropriate
during the initial phase of treatment?
A. Prohibit the client from using the sink until scheduled times.
B. Inform the client that the handwashing is irrational and must stop.
C. Allow the client to perform the rituals but set time limits gradually.
D. Provide the client with a detailed schedule that excludes all rituals.
Answer: C
Rationale: In the initial phase of treatment for OCD, allowing the ritual is necessary to
prevent the client’s anxiety from reaching panic levels. Abruptly stopping a ritual can cause
extreme distress and is generally counterproductive to the therapeutic process. Over time,
the nurse works with the client to gradually limit the time spent on rituals as healthier
coping mechanisms are developed.
2. Which of the following findings should a nurse expect when assessing a client experiencing
a panic attack?
A. Decreased heart rate and respiratory rate.
,B. Increased appetite and lethargy.
C. Hyperventilation, palpitations, and a sense of impending doom.
D. Apathetic mood and slow speech.
Answer: C
Rationale: Panic attacks are characterized by a sudden onset of intense fear accompanied
by physical symptoms like tachycardia and shortness of breath. Clients often report a
feeling of dying or losing control during these episodes. These symptoms typically reach a
peak within 10 minutes and require immediate nursing presence to ensure safety.
3. A client is prescribed Lorazepam (Ativan) for acute anxiety. Which education point is a
priority for the nurse to include?
A. The medication should be taken on an empty stomach for better absorption.
B. This medication has no potential for addiction or dependence.
C. The client can stop the medication abruptly if symptoms improve.
D. Avoid drinking alcohol while taking this medication.
Answer: D
Rationale: Lorazepam is a benzodiazepine that acts as a central nervous system
depressant. Combining this medication with alcohol can lead to dangerous levels of
respiratory depression and sedation. The nurse must also teach the client that these
,medications carry a high risk of dependence and should never be stopped suddenly due to
withdrawal risks.
4. A nurse is assessing a client with Post-Traumatic Stress Disorder (PTSD). Which symptom is
considered a ‘re-experiencing’ symptom of the disorder?
A. Persistent avoidance of people or places.
B. Intrusive memories or flashbacks of the traumatic event.
C. Negative alterations in mood and cognition.
D. Exaggerated startle response and hypervigilance.
Answer: B
Rationale: Re-experiencing symptoms involve the involuntary return of the trauma into
the client’s consciousness, such as through nightmares or flashbacks. These episodes can
make the client feel as though the event is happening again in real time. While avoidance
and hypervigilance are part of PTSD, they fall under different diagnostic clusters.
5. A nurse is treating a client with Generalized Anxiety Disorder (GAD). Which medication
class is typically preferred for long-term management of this condition?
A. Benzodiazepines
B. Barbiturates
C. Selective Serotonin Reuptake Inhibitors (SSRIs)
D. Antipsychotics
, Answer: C
Rationale: SSRIs are considered first-line treatment for the long-term management of
Generalized Anxiety Disorder because they are non-addictive. Unlike benzodiazepines, they
do not carry the risk of physical dependence or significant sedation. It is important for the
client to know that these medications often take several weeks to reach full therapeutic
effect.
6. A client with a history of Social Anxiety Disorder is asked to give a presentation at work.
The client reports extreme fear of being judged by others. Which type of therapy is most
effective for this condition?
A. Psychoanalytic therapy
B. Electroconvulsive therapy (ECT)
C. Aversion therapy
D. Cognitive Behavioral Therapy (CBT)
Answer: D
Rationale: Cognitive Behavioral Therapy is highly effective for Social Anxiety Disorder as it
helps clients identify and challenge distorted thought patterns. By restructuring these
thoughts, clients can reduce their fear of social scrutiny and judgment. CBT often includes
exposure techniques that allow the client to practice social skills in a controlled
environment.
Nursing Q&A with Rationale | Galen
College of Nursing
1. A nurse is caring for a client with Obsessive-Compulsive Disorder (OCD) who spends hours
each day performing handwashing rituals. Which nursing intervention is most appropriate
during the initial phase of treatment?
A. Prohibit the client from using the sink until scheduled times.
B. Inform the client that the handwashing is irrational and must stop.
C. Allow the client to perform the rituals but set time limits gradually.
D. Provide the client with a detailed schedule that excludes all rituals.
Answer: C
Rationale: In the initial phase of treatment for OCD, allowing the ritual is necessary to
prevent the client’s anxiety from reaching panic levels. Abruptly stopping a ritual can cause
extreme distress and is generally counterproductive to the therapeutic process. Over time,
the nurse works with the client to gradually limit the time spent on rituals as healthier
coping mechanisms are developed.
2. Which of the following findings should a nurse expect when assessing a client experiencing
a panic attack?
A. Decreased heart rate and respiratory rate.
,B. Increased appetite and lethargy.
C. Hyperventilation, palpitations, and a sense of impending doom.
D. Apathetic mood and slow speech.
Answer: C
Rationale: Panic attacks are characterized by a sudden onset of intense fear accompanied
by physical symptoms like tachycardia and shortness of breath. Clients often report a
feeling of dying or losing control during these episodes. These symptoms typically reach a
peak within 10 minutes and require immediate nursing presence to ensure safety.
3. A client is prescribed Lorazepam (Ativan) for acute anxiety. Which education point is a
priority for the nurse to include?
A. The medication should be taken on an empty stomach for better absorption.
B. This medication has no potential for addiction or dependence.
C. The client can stop the medication abruptly if symptoms improve.
D. Avoid drinking alcohol while taking this medication.
Answer: D
Rationale: Lorazepam is a benzodiazepine that acts as a central nervous system
depressant. Combining this medication with alcohol can lead to dangerous levels of
respiratory depression and sedation. The nurse must also teach the client that these
,medications carry a high risk of dependence and should never be stopped suddenly due to
withdrawal risks.
4. A nurse is assessing a client with Post-Traumatic Stress Disorder (PTSD). Which symptom is
considered a ‘re-experiencing’ symptom of the disorder?
A. Persistent avoidance of people or places.
B. Intrusive memories or flashbacks of the traumatic event.
C. Negative alterations in mood and cognition.
D. Exaggerated startle response and hypervigilance.
Answer: B
Rationale: Re-experiencing symptoms involve the involuntary return of the trauma into
the client’s consciousness, such as through nightmares or flashbacks. These episodes can
make the client feel as though the event is happening again in real time. While avoidance
and hypervigilance are part of PTSD, they fall under different diagnostic clusters.
5. A nurse is treating a client with Generalized Anxiety Disorder (GAD). Which medication
class is typically preferred for long-term management of this condition?
A. Benzodiazepines
B. Barbiturates
C. Selective Serotonin Reuptake Inhibitors (SSRIs)
D. Antipsychotics
, Answer: C
Rationale: SSRIs are considered first-line treatment for the long-term management of
Generalized Anxiety Disorder because they are non-addictive. Unlike benzodiazepines, they
do not carry the risk of physical dependence or significant sedation. It is important for the
client to know that these medications often take several weeks to reach full therapeutic
effect.
6. A client with a history of Social Anxiety Disorder is asked to give a presentation at work.
The client reports extreme fear of being judged by others. Which type of therapy is most
effective for this condition?
A. Psychoanalytic therapy
B. Electroconvulsive therapy (ECT)
C. Aversion therapy
D. Cognitive Behavioral Therapy (CBT)
Answer: D
Rationale: Cognitive Behavioral Therapy is highly effective for Social Anxiety Disorder as it
helps clients identify and challenge distorted thought patterns. By restructuring these
thoughts, clients can reduce their fear of social scrutiny and judgment. CBT often includes
exposure techniques that allow the client to practice social skills in a controlled
environment.
