1
NSG 526 EXAM 3 WITH QUESTIONS AND ANSWERS
1.
A 29-year-old patient presents to an outpatient psychiatric clinic after
unexpectedly losing a spouse in a motor vehicle accident. The patient reports
feeling overwhelmed, unable to concentrate, unable to sleep, and unable to make
routine decisions. The patient states, “I know I have to deal with this, but
everything feels impossible right now.” Which intervention should the PMHNP
prioritize during the initial crisis encounter?
A. Explore childhood conflicts that may have contributed to the current reaction
B. Establish immediate safety, identify the precipitating event, and help restore
functioning
C. Begin long-term personality restructuring therapy
D. Encourage the patient to avoid discussing the loss until symptoms resolve
Answer: B
2.
A college student becomes severely distressed after failing an important
examination and being informed that academic dismissal is possible. The student
reports anxiety, insomnia, impaired concentration, and inability to identify an
effective solution. Which type of crisis best describes this situation?
A. Adventitious crisis
B. Maturational crisis
C. Situational crisis
D. Developmental psychosis
Answer: C
3.
A 19-year-old patient leaves home for college and begins experiencing anxiety,
loneliness, uncertainty, and difficulty adjusting to new responsibilities. No unusual
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traumatic event occurred. Which type of crisis is most consistent with this
presentation?
A. Maturational crisis
B. Adventitious crisis
C. Situational crisis
D. Psychotic crisis
Answer: A
4.
Following a major hurricane, a community mental-health team evaluates
residents who have lost homes, experienced displacement, and witnessed serious
injuries. Which intervention represents the primary objective of psychological first
aid during the immediate aftermath?
A. Conduct intensive trauma processing with every survivor
B. Require survivors to discuss the most distressing aspects of the event
C. Diagnose PTSD in all individuals exposed to the disaster
D. Promote safety, stabilization, practical assistance, and connection with support
resources
Answer: D
5.
A patient arrives at an emergency psychiatric clinic after receiving unexpected
news of a terminal cancer diagnosis. The patient is tearful, unable to organize
thoughts, and repeatedly says, “I don't know what to do.” Which nursing response
is most appropriate during crisis intervention?
A. “You need to begin planning for the next several months.”
B. “Let's focus first on what is making you feel most overwhelmed right now.”
C. “Try not to think about the diagnosis until you have more information.”
D. “You should immediately begin long-term psychotherapy.”
Answer: B
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6.
A PMHNP is evaluating a patient experiencing a psychological crisis. The patient
previously managed stressful situations effectively but now cannot use familiar
coping strategies after an unexpected event. Which concept best explains the
patient's current state?
A. Psychological disequilibrium
B. Personality disorganization
C. Chronic psychosis
D. Cognitive dementia
Answer: A
7.
A patient experiencing a crisis states, “I don't see any way out of this. I have
thought about taking all of my medications tonight.” Which action should occur
first?
A. Explore the patient's childhood relationship with parents
B. Discuss long-term coping strategies
C. Assess immediate suicide risk and establish safety
D. Encourage the patient to attend a support group next week
Answer: C
8.
A patient experiencing acute psychological distress becomes increasingly agitated
and begins pacing while stating that no one can help. Which intervention is most
appropriate during the initial phase of crisis care?
A. Provide complex educational materials
B. Ask the patient to analyze the meaning of the crisis
C. Challenge the patient's distorted beliefs
D. Use calm communication, reduce stimulation, and establish immediate safety
Answer: D
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9.
A patient presents after an armed robbery and reports feeling frightened,
detached, and unable to sleep. The event occurred 48 hours ago. Which diagnosis
should the PMHNP consider most carefully at this stage?
A. Acute stress disorder
B. Chronic PTSD
C. Generalized anxiety disorder
D. Persistent depressive disorder
Answer: A
10.
A patient develops intrusive memories, nightmares, avoidance, hypervigilance,
and exaggerated startle responses several months after surviving a serious motor
vehicle accident. Which disorder is most consistent with the presentation?
A. Adjustment disorder
B. Acute stress disorder
C. Post-traumatic stress disorder
D. Panic disorder
Answer: C
11.
A patient with PTSD reports repeatedly avoiding the neighborhood where an
assault occurred because being there produces intense fear and physiological
distress. Which PTSD symptom cluster does this behavior represent?
A. Negative alterations in cognition
B. Avoidance
C. Hyperarousal only
D. Dissociation without avoidance
Answer: B
12.
NSG 526 EXAM 3 WITH QUESTIONS AND ANSWERS
1.
A 29-year-old patient presents to an outpatient psychiatric clinic after
unexpectedly losing a spouse in a motor vehicle accident. The patient reports
feeling overwhelmed, unable to concentrate, unable to sleep, and unable to make
routine decisions. The patient states, “I know I have to deal with this, but
everything feels impossible right now.” Which intervention should the PMHNP
prioritize during the initial crisis encounter?
A. Explore childhood conflicts that may have contributed to the current reaction
B. Establish immediate safety, identify the precipitating event, and help restore
functioning
C. Begin long-term personality restructuring therapy
D. Encourage the patient to avoid discussing the loss until symptoms resolve
Answer: B
2.
A college student becomes severely distressed after failing an important
examination and being informed that academic dismissal is possible. The student
reports anxiety, insomnia, impaired concentration, and inability to identify an
effective solution. Which type of crisis best describes this situation?
A. Adventitious crisis
B. Maturational crisis
C. Situational crisis
D. Developmental psychosis
Answer: C
3.
A 19-year-old patient leaves home for college and begins experiencing anxiety,
loneliness, uncertainty, and difficulty adjusting to new responsibilities. No unusual
,2
traumatic event occurred. Which type of crisis is most consistent with this
presentation?
A. Maturational crisis
B. Adventitious crisis
C. Situational crisis
D. Psychotic crisis
Answer: A
4.
Following a major hurricane, a community mental-health team evaluates
residents who have lost homes, experienced displacement, and witnessed serious
injuries. Which intervention represents the primary objective of psychological first
aid during the immediate aftermath?
A. Conduct intensive trauma processing with every survivor
B. Require survivors to discuss the most distressing aspects of the event
C. Diagnose PTSD in all individuals exposed to the disaster
D. Promote safety, stabilization, practical assistance, and connection with support
resources
Answer: D
5.
A patient arrives at an emergency psychiatric clinic after receiving unexpected
news of a terminal cancer diagnosis. The patient is tearful, unable to organize
thoughts, and repeatedly says, “I don't know what to do.” Which nursing response
is most appropriate during crisis intervention?
A. “You need to begin planning for the next several months.”
B. “Let's focus first on what is making you feel most overwhelmed right now.”
C. “Try not to think about the diagnosis until you have more information.”
D. “You should immediately begin long-term psychotherapy.”
Answer: B
,3
6.
A PMHNP is evaluating a patient experiencing a psychological crisis. The patient
previously managed stressful situations effectively but now cannot use familiar
coping strategies after an unexpected event. Which concept best explains the
patient's current state?
A. Psychological disequilibrium
B. Personality disorganization
C. Chronic psychosis
D. Cognitive dementia
Answer: A
7.
A patient experiencing a crisis states, “I don't see any way out of this. I have
thought about taking all of my medications tonight.” Which action should occur
first?
A. Explore the patient's childhood relationship with parents
B. Discuss long-term coping strategies
C. Assess immediate suicide risk and establish safety
D. Encourage the patient to attend a support group next week
Answer: C
8.
A patient experiencing acute psychological distress becomes increasingly agitated
and begins pacing while stating that no one can help. Which intervention is most
appropriate during the initial phase of crisis care?
A. Provide complex educational materials
B. Ask the patient to analyze the meaning of the crisis
C. Challenge the patient's distorted beliefs
D. Use calm communication, reduce stimulation, and establish immediate safety
Answer: D
, 4
9.
A patient presents after an armed robbery and reports feeling frightened,
detached, and unable to sleep. The event occurred 48 hours ago. Which diagnosis
should the PMHNP consider most carefully at this stage?
A. Acute stress disorder
B. Chronic PTSD
C. Generalized anxiety disorder
D. Persistent depressive disorder
Answer: A
10.
A patient develops intrusive memories, nightmares, avoidance, hypervigilance,
and exaggerated startle responses several months after surviving a serious motor
vehicle accident. Which disorder is most consistent with the presentation?
A. Adjustment disorder
B. Acute stress disorder
C. Post-traumatic stress disorder
D. Panic disorder
Answer: C
11.
A patient with PTSD reports repeatedly avoiding the neighborhood where an
assault occurred because being there produces intense fear and physiological
distress. Which PTSD symptom cluster does this behavior represent?
A. Negative alterations in cognition
B. Avoidance
C. Hyperarousal only
D. Dissociation without avoidance
Answer: B
12.
