NSRG 126 Exam 1 V3 | NSRG 126 Mental Health
Nursing | Actual Q&A with Rationale (NSRG126
Exam 1) | Ivy Tech
1. A psychiatric nurse is discussing the treatment plan with a client who was involuntarily
admitted. The client asks, ‘Can I refuse this new antipsychotic medication?’ Which response
by the nurse is correct based on patient rights?
A. No, because you are here involuntarily, you must take all prescribed medications.
B. Refusal is only permitted if you have a documented history of adverse reactions to this
specific drug class.
C. You can refuse the medication only if your family agrees with your decision.
D. Yes, you have the right to refuse treatment, including medications, unless there is an
emergency situation where you are a danger to yourself or others.
Correct Answer: D
Explanation: Involuntary admission does not automatically waive a client’s right to refuse
medication. The right to refuse treatment is a fundamental patient right that persists unless
a legal determination of incompetence has been made or an emergency occurs. The nurse
must respect this autonomy while documenting the refusal and notifying the provider.
,2. A nurse is conducting a mental status examination (MSE) on a client with schizophrenia.
The client states, ‘The blue birds fly high because the sky is a pie in the eye.’ The nurse should
document this finding as which of the following?
A. Circumstantiality
B. Neologisms
C. Flight of ideas
D. Clang associations
Correct Answer: D
Explanation: Clang associations are characterized by the choice of words based on their
sound, typically rhyming, rather than their meaning. In this case, the words ‘high’, ‘pie’, and
‘eye’ demonstrate this speech pattern often seen in psychosis or mania. Documenting this
accurately helps in identifying the severity of the client’s thought process disturbance.
3. According to Erikson’s stages of psychosocial development, a 70-year-old client who
expresses regret about past life choices and feels a sense of hopelessness is likely struggling
with which developmental task?
A. Generativity vs. Stagnation
B. Intimacy vs. Isolation
C. Identity vs. Role Confusion
D. Integrity vs. Despair
,Correct Answer: D
Explanation: Integrity vs. Despair is the final stage of Erikson’s theory, occurring in late
adulthood. A successful outcome involves reflecting on life with a sense of fulfillment and
wisdom. Despair occurs when the individual views their life as a series of failures or missed
opportunities, leading to the hopelessness described in the prompt.
4. A nurse is using therapeutic communication techniques with a client who is experiencing
high levels of anxiety. Which of the following responses by the nurse are considered
therapeutic? (Select the best response)
A. ‘Why do you feel so anxious today?’
B. ‘Everything will be fine once the medication starts working.’
C. ‘My sister had anxiety and she found that exercise was the only cure.’
D. ‘I think you should try to focus on something positive instead.’
E. ‘Tell me more about what you are feeling right now.’
Correct Answer: E
Explanation: The technique of ‘exploring’ or using open-ended statements encourages the
client to elaborate on their thoughts and feelings. Avoid ‘why’ questions as they often put
the client on the defensive. Providing false reassurance or giving unsolicited advice are
non-therapeutic blocks to communication.
, 5. Which neurobiological finding is most commonly associated with the pathophysiology of
Alzheimer’s disease?
A. Increased levels of dopamine in the basal ganglia
B. Insufficient levels of gamma-aminobutyric acid (GABA)
C. Decreased levels of acetylcholine and the presence of neuritic plaques
D. Excessive amounts of norepinephrine at the synaptic cleft
Correct Answer: C
Explanation: Alzheimer’s disease is characterized by a significant deficit in acetylcholine,
which is vital for memory and cognitive function. The accumulation of amyloid-beta
plaques and tau tangles are the hallmark physical changes in the brain. Understanding
these neurobiological changes is essential for rationalizing the use of cholinesterase
inhibitors in treatment.
6. A client is admitted to the psychiatric unit with a diagnosis of Major Depressive Disorder.
Which assessment finding should the nurse prioritize as the highest risk to the client’s safety?
A. Poor personal hygiene and disheveled appearance
B. Giving away prized possessions and a sudden shift to a calm mood
C. Weight loss of 5 pounds in the last two weeks
D. Anhedonia and lack of interest in group activities
Correct Answer: B
Nursing | Actual Q&A with Rationale (NSRG126
Exam 1) | Ivy Tech
1. A psychiatric nurse is discussing the treatment plan with a client who was involuntarily
admitted. The client asks, ‘Can I refuse this new antipsychotic medication?’ Which response
by the nurse is correct based on patient rights?
A. No, because you are here involuntarily, you must take all prescribed medications.
B. Refusal is only permitted if you have a documented history of adverse reactions to this
specific drug class.
C. You can refuse the medication only if your family agrees with your decision.
D. Yes, you have the right to refuse treatment, including medications, unless there is an
emergency situation where you are a danger to yourself or others.
Correct Answer: D
Explanation: Involuntary admission does not automatically waive a client’s right to refuse
medication. The right to refuse treatment is a fundamental patient right that persists unless
a legal determination of incompetence has been made or an emergency occurs. The nurse
must respect this autonomy while documenting the refusal and notifying the provider.
,2. A nurse is conducting a mental status examination (MSE) on a client with schizophrenia.
The client states, ‘The blue birds fly high because the sky is a pie in the eye.’ The nurse should
document this finding as which of the following?
A. Circumstantiality
B. Neologisms
C. Flight of ideas
D. Clang associations
Correct Answer: D
Explanation: Clang associations are characterized by the choice of words based on their
sound, typically rhyming, rather than their meaning. In this case, the words ‘high’, ‘pie’, and
‘eye’ demonstrate this speech pattern often seen in psychosis or mania. Documenting this
accurately helps in identifying the severity of the client’s thought process disturbance.
3. According to Erikson’s stages of psychosocial development, a 70-year-old client who
expresses regret about past life choices and feels a sense of hopelessness is likely struggling
with which developmental task?
A. Generativity vs. Stagnation
B. Intimacy vs. Isolation
C. Identity vs. Role Confusion
D. Integrity vs. Despair
,Correct Answer: D
Explanation: Integrity vs. Despair is the final stage of Erikson’s theory, occurring in late
adulthood. A successful outcome involves reflecting on life with a sense of fulfillment and
wisdom. Despair occurs when the individual views their life as a series of failures or missed
opportunities, leading to the hopelessness described in the prompt.
4. A nurse is using therapeutic communication techniques with a client who is experiencing
high levels of anxiety. Which of the following responses by the nurse are considered
therapeutic? (Select the best response)
A. ‘Why do you feel so anxious today?’
B. ‘Everything will be fine once the medication starts working.’
C. ‘My sister had anxiety and she found that exercise was the only cure.’
D. ‘I think you should try to focus on something positive instead.’
E. ‘Tell me more about what you are feeling right now.’
Correct Answer: E
Explanation: The technique of ‘exploring’ or using open-ended statements encourages the
client to elaborate on their thoughts and feelings. Avoid ‘why’ questions as they often put
the client on the defensive. Providing false reassurance or giving unsolicited advice are
non-therapeutic blocks to communication.
, 5. Which neurobiological finding is most commonly associated with the pathophysiology of
Alzheimer’s disease?
A. Increased levels of dopamine in the basal ganglia
B. Insufficient levels of gamma-aminobutyric acid (GABA)
C. Decreased levels of acetylcholine and the presence of neuritic plaques
D. Excessive amounts of norepinephrine at the synaptic cleft
Correct Answer: C
Explanation: Alzheimer’s disease is characterized by a significant deficit in acetylcholine,
which is vital for memory and cognitive function. The accumulation of amyloid-beta
plaques and tau tangles are the hallmark physical changes in the brain. Understanding
these neurobiological changes is essential for rationalizing the use of cholinesterase
inhibitors in treatment.
6. A client is admitted to the psychiatric unit with a diagnosis of Major Depressive Disorder.
Which assessment finding should the nurse prioritize as the highest risk to the client’s safety?
A. Poor personal hygiene and disheveled appearance
B. Giving away prized possessions and a sudden shift to a calm mood
C. Weight loss of 5 pounds in the last two weeks
D. Anhedonia and lack of interest in group activities
Correct Answer: B
