Mental Health 3450 – Exam 2 - Version 1 Questions
1. Which medication should the nurse be prepared to educate patients on when they
are prescribed an SSRI for panic attacks?
A. Alprazolam (Xanax)
B. Fluoxetine (Prozac)
C. Clonazepam (Klonopin)
D. Venlafaxine (E exor)
Correct answer: B
Rationale: Fluoxetine is an SSRI commonly used for panic disorder and requires
education about delayed onset, black-box warning for suicidality in young people,
and potential side e ects (GI upset, sexual dysfunction). Alprazolam and
clonazepam are benzodiazepines useful for acute relief but not first-line
maintenance; venlafaxine is an SNRI that can be e ective but is not an SSRI.
2. Which statement(s) made by the nurse demonstrates an understanding of the
e ective use of relaxation therapy for anxiety management? Select all that apply.
A. “Relaxation therapy’s main goal is to prevent exhaustion by removing muscle
tension.”
B. “Muscle relaxation promotes the relaxation response.”
C. “Show me how you learned to deep breathe in yesterday’s therapy session.”
D. “You’ve said that going to group makes you nervous, so let’s start relaxing now.”
E. “I’ve given you written descriptions of the various relaxation exercises for you to
review.”
Correct answers: B, C, D, E
Rationale: Progressive muscle relaxation facilitates a parasympathetic “relaxation
response” (B). Coaching return-demonstration (C), timely use before a trigger (D),
and providing written reinforcement (E) are all evidence-based. Option A
overgeneralizes a single mechanistic goal and is not an accurate teaching focus.
3. To maximize the therapeutic e ect, which lifestyle practice should the nurse
discourage for a patient newly prescribed an antianxiety medication?
A. Eating high-protein foods
B. Using acetaminophen without first discussing it with a healthcare provider
C. Taking medications after dinner or with a bedtime snack
D. Buying a large co ee with sugar and extra cream each morning on the way to
work
, Correct answer: D
Rationale: Excess ca eine can worsen anxiety, counteracting therapy. Protein
intake (A) and dosing with food (C) are generally fine unless a drug-specific
instruction says otherwise. Acetaminophen (B) does not typically interact with
antianxiety meds; NSAIDs and alcohol are more concerning depending on the
medication.
4. In a parent–teacher conference, the school nurse meets with the parents of a
profoundly shy 8-year-old girl. The parents hold hands, speak softly, respond briefly,
and have poor eye contact. The nurse recognizes that the child is most likely
exposed to parental modeling and:
A. The inherited shyness trait
B. A lack of a ection in the home
C. Severe punishment by the parents
D. Is afraid to say something foolish
Correct answer: A
Rationale: Temperament has a heritable component, and children model parental
social style. While environment matters, there’s no evidence here of harsh
punishment (C) or low a ection (B). Fear of saying something foolish (D) could
happen, but the scenario points more strongly to modeling plus inherited
temperament.
5. Isabel is a straight-A student with severe test anxiety seeking medical attention. The
nurse recognizes e ective teaching about mild anxiety when Isabel states:
A. “I would like to try a benzodiazepine for my anxiety.”
B. “If I study harder, my anxiety level will go down.”
C. “Mild anxiety is okay because it helps me focus.”
D. “I have fear that I will fail at college.”
Correct answer: C
Rationale: Mild anxiety can enhance alertness and performance. Benzodiazepines
(A) are not first-line for performance anxiety in students. Studying harder (B) doesn’t
address anxiety mechanisms. Statement D is content for exploration, not evidence
of understanding.
6. The activity of gamma-aminobutyric acid (GABA) contributes to slowing of neural
activity. Which drug class facilitates the action of GABA?
, A. Benzodiazepines
B. Antihistamines
C. Anticonvulsants
D. Noradrenergic agents
Correct answer: A
Rationale: Benzodiazepines potentiate GABA_A receptor activity, producing
anxiolysis and sedation. Some anticonvulsants influence GABA but are not the best
answer in this context. Antihistamines act primarily at H1 receptors; noradrenergic
agents increase CNS arousal.
7. Samantha is new to the clinic for “severe anxiety.” She self-medicates with alcohol
and uses herbal kava long-term. Knowing kava can inhibit CYP450 and cause
hepatotoxicity, the nurse orders which test?
A. Electrocardiogram
B. Liver enzymes
C. Glomerular filtration rate
D. Complete blood count
Correct answer: B
Rationale: Kava has been linked to liver injury; LFTs are appropriate. ECG (A) is
unrelated. GFR (C) and CBC (D) do not screen for kava-related hepatotoxicity.
8. A homebound patient with agoraphobia has been receiving therapy at home.
Teaching is e ective when the patient states:
A. “I may never leave the house again.”
B. “Having groceries delivered is very convenient.”
C. “My risk for agoraphobia is increased by my family history.”
D. “I will go out again, someday, just not today.”
Correct answer: C
Rationale: Acknowledging genetic vulnerability shows insight. Options A and D
reflect avoidance/indefinite delay. B normalizes avoidance behaviors rather than
addressing exposure-based recovery.
9. A nurse wants to teach alternative coping strategies to a patient with severe anxiety.
Which action should the nurse perform first?
A. Verify learning style
B. Lower the patient’s current anxiety
, C. Create outcomes and a teaching plan
D. Assess how the patient uses defense mechanisms
Correct answer: B
Rationale: With severe anxiety, cognitive processing is impaired; first reduce
arousal (grounding, breathing, meds PRN) to enable learning. Learning style and
planning follow stabilization.
10. A patient experiencing moderate anxiety says, “I feel undone.” An appropriate
response is:
A. “What would you like me to do to help you?”
B. “Why do you suppose you are feeling anxious?”
C. “I’m not sure I understand. Give me an example.”
D. “You must get your feelings under control before we can continue.”
Correct answer: C
Rationale: Seeking clarification helps concretize concerns and supports problem
solving. “Why” questions (B) can feel accusatory. A (asking for directives) may be
too open-ended; D is dismissive and non-therapeutic.
11. During the first meeting of a new outpatient anxiety-skills group, which leader action
best reflects the orientation phase of group development?
A. Invite members to debate di ering coping philosophies to stimulate engagement.
B. Ask each member to introduce themselves, review confidentiality, and clarify the
group’s purpose and structure.
C. Assign paired role-plays to practice conflict resolution for homework.
D. Encourage members to give each other direct corrective feedback about
avoidance behaviors.
Correct answer: B
Rationale: The orientation phase centers on establishing safety, respect,
confidentiality, trust, and clarity about the purpose/structure while facilitating
introductions. Debates and corrective feedback (A, D) are working-phase tasks
once cohesion exists. Homework role-plays (C) also fit better in the working phase
after norms are set.
12. A CBT group with good cohesion begins to disagree about the “right” way to use
exposure hierarchies. Which leader response best demonstrates working-phase
responsibilities? Select all that apply.
A. “Let’s pause and define the shared goal; then we’ll problem-solve together how
1. Which medication should the nurse be prepared to educate patients on when they
are prescribed an SSRI for panic attacks?
A. Alprazolam (Xanax)
B. Fluoxetine (Prozac)
C. Clonazepam (Klonopin)
D. Venlafaxine (E exor)
Correct answer: B
Rationale: Fluoxetine is an SSRI commonly used for panic disorder and requires
education about delayed onset, black-box warning for suicidality in young people,
and potential side e ects (GI upset, sexual dysfunction). Alprazolam and
clonazepam are benzodiazepines useful for acute relief but not first-line
maintenance; venlafaxine is an SNRI that can be e ective but is not an SSRI.
2. Which statement(s) made by the nurse demonstrates an understanding of the
e ective use of relaxation therapy for anxiety management? Select all that apply.
A. “Relaxation therapy’s main goal is to prevent exhaustion by removing muscle
tension.”
B. “Muscle relaxation promotes the relaxation response.”
C. “Show me how you learned to deep breathe in yesterday’s therapy session.”
D. “You’ve said that going to group makes you nervous, so let’s start relaxing now.”
E. “I’ve given you written descriptions of the various relaxation exercises for you to
review.”
Correct answers: B, C, D, E
Rationale: Progressive muscle relaxation facilitates a parasympathetic “relaxation
response” (B). Coaching return-demonstration (C), timely use before a trigger (D),
and providing written reinforcement (E) are all evidence-based. Option A
overgeneralizes a single mechanistic goal and is not an accurate teaching focus.
3. To maximize the therapeutic e ect, which lifestyle practice should the nurse
discourage for a patient newly prescribed an antianxiety medication?
A. Eating high-protein foods
B. Using acetaminophen without first discussing it with a healthcare provider
C. Taking medications after dinner or with a bedtime snack
D. Buying a large co ee with sugar and extra cream each morning on the way to
work
, Correct answer: D
Rationale: Excess ca eine can worsen anxiety, counteracting therapy. Protein
intake (A) and dosing with food (C) are generally fine unless a drug-specific
instruction says otherwise. Acetaminophen (B) does not typically interact with
antianxiety meds; NSAIDs and alcohol are more concerning depending on the
medication.
4. In a parent–teacher conference, the school nurse meets with the parents of a
profoundly shy 8-year-old girl. The parents hold hands, speak softly, respond briefly,
and have poor eye contact. The nurse recognizes that the child is most likely
exposed to parental modeling and:
A. The inherited shyness trait
B. A lack of a ection in the home
C. Severe punishment by the parents
D. Is afraid to say something foolish
Correct answer: A
Rationale: Temperament has a heritable component, and children model parental
social style. While environment matters, there’s no evidence here of harsh
punishment (C) or low a ection (B). Fear of saying something foolish (D) could
happen, but the scenario points more strongly to modeling plus inherited
temperament.
5. Isabel is a straight-A student with severe test anxiety seeking medical attention. The
nurse recognizes e ective teaching about mild anxiety when Isabel states:
A. “I would like to try a benzodiazepine for my anxiety.”
B. “If I study harder, my anxiety level will go down.”
C. “Mild anxiety is okay because it helps me focus.”
D. “I have fear that I will fail at college.”
Correct answer: C
Rationale: Mild anxiety can enhance alertness and performance. Benzodiazepines
(A) are not first-line for performance anxiety in students. Studying harder (B) doesn’t
address anxiety mechanisms. Statement D is content for exploration, not evidence
of understanding.
6. The activity of gamma-aminobutyric acid (GABA) contributes to slowing of neural
activity. Which drug class facilitates the action of GABA?
, A. Benzodiazepines
B. Antihistamines
C. Anticonvulsants
D. Noradrenergic agents
Correct answer: A
Rationale: Benzodiazepines potentiate GABA_A receptor activity, producing
anxiolysis and sedation. Some anticonvulsants influence GABA but are not the best
answer in this context. Antihistamines act primarily at H1 receptors; noradrenergic
agents increase CNS arousal.
7. Samantha is new to the clinic for “severe anxiety.” She self-medicates with alcohol
and uses herbal kava long-term. Knowing kava can inhibit CYP450 and cause
hepatotoxicity, the nurse orders which test?
A. Electrocardiogram
B. Liver enzymes
C. Glomerular filtration rate
D. Complete blood count
Correct answer: B
Rationale: Kava has been linked to liver injury; LFTs are appropriate. ECG (A) is
unrelated. GFR (C) and CBC (D) do not screen for kava-related hepatotoxicity.
8. A homebound patient with agoraphobia has been receiving therapy at home.
Teaching is e ective when the patient states:
A. “I may never leave the house again.”
B. “Having groceries delivered is very convenient.”
C. “My risk for agoraphobia is increased by my family history.”
D. “I will go out again, someday, just not today.”
Correct answer: C
Rationale: Acknowledging genetic vulnerability shows insight. Options A and D
reflect avoidance/indefinite delay. B normalizes avoidance behaviors rather than
addressing exposure-based recovery.
9. A nurse wants to teach alternative coping strategies to a patient with severe anxiety.
Which action should the nurse perform first?
A. Verify learning style
B. Lower the patient’s current anxiety
, C. Create outcomes and a teaching plan
D. Assess how the patient uses defense mechanisms
Correct answer: B
Rationale: With severe anxiety, cognitive processing is impaired; first reduce
arousal (grounding, breathing, meds PRN) to enable learning. Learning style and
planning follow stabilization.
10. A patient experiencing moderate anxiety says, “I feel undone.” An appropriate
response is:
A. “What would you like me to do to help you?”
B. “Why do you suppose you are feeling anxious?”
C. “I’m not sure I understand. Give me an example.”
D. “You must get your feelings under control before we can continue.”
Correct answer: C
Rationale: Seeking clarification helps concretize concerns and supports problem
solving. “Why” questions (B) can feel accusatory. A (asking for directives) may be
too open-ended; D is dismissive and non-therapeutic.
11. During the first meeting of a new outpatient anxiety-skills group, which leader action
best reflects the orientation phase of group development?
A. Invite members to debate di ering coping philosophies to stimulate engagement.
B. Ask each member to introduce themselves, review confidentiality, and clarify the
group’s purpose and structure.
C. Assign paired role-plays to practice conflict resolution for homework.
D. Encourage members to give each other direct corrective feedback about
avoidance behaviors.
Correct answer: B
Rationale: The orientation phase centers on establishing safety, respect,
confidentiality, trust, and clarity about the purpose/structure while facilitating
introductions. Debates and corrective feedback (A, D) are working-phase tasks
once cohesion exists. Homework role-plays (C) also fit better in the working phase
after norms are set.
12. A CBT group with good cohesion begins to disagree about the “right” way to use
exposure hierarchies. Which leader response best demonstrates working-phase
responsibilities? Select all that apply.
A. “Let’s pause and define the shared goal; then we’ll problem-solve together how
