NSG 3450 Mental Health Exam 1 Review |
Practice Questions & Detailed Answers |
Psychiatric Nursing Study Guide
Section 1: Foundational Concepts & Theories
1. A nurse is assessing a client who states, "I feel like I'm a failure and that
nothing I do is ever good enough." This statement is an example of which
cognitive distortion?
A. Magnification
B. Personalization
C. All-or-nothing thinking
D. Emotional reasoning
Correct Answer: C. All-or-nothing thinking
Rationale: All-or-nothing thinking (also called dichotomous thinking) involves
viewing situations in only two categories instead of on a continuum. The client's
belief that they are a "failure" and "nothing" is good enough reflects this black-
and-white perspective. Magnification is exaggerating the importance of things,
personalization is taking responsibility for external events, and emotional
reasoning is believing that something is true because one feels it strongly.
2. Which theorist is associated with the development of the therapeutic nurse-
client relationship, identifying phases such as orientation, working, and
termination?
A. Sigmund Freud
B. Hildegard Peplau
C. Erik Erikson
D. Jean Piaget
Correct Answer: B. Hildegard Peplau
Rationale: Hildegard Peplau is considered the mother of psychiatric nursing.
,Her theory of interpersonal relations defines the nurse-client relationship as
having four phases: orientation, identification, exploitation (working), and
resolution (termination). Freud developed psychoanalysis, Erikson developed
psychosocial development theory, and Piaget developed cognitive development
theory.
3. A client is prescribed a benzodiazepine for anxiety. The nurse should monitor
the client for which potential adverse effect?
A. Hypertension
B. Weight loss
C. Sedation
D. Insomnia
Correct Answer: C. Sedation
Rationale: Benzodiazepines are central nervous system (CNS) depressants.
Their primary effects are sedation, hypnosis, decreased anxiety, muscle relaxation,
and anticonvulsant actions. Common side effects include drowsiness, sedation,
and ataxia. They are not typically associated with hypertension, weight loss, or
insomnia.
4. The nurse is caring for a client with major depressive disorder. Which
neurotransmitter is most commonly implicated in the pathophysiology of
depression?
A. Dopamine
B. Acetylcholine
C. Serotonin
D. Glutamate
Correct Answer: C. Serotonin
Rationale: The monoamine hypothesis of depression suggests that a
deficiency in certain neurotransmitters, particularly serotonin, norepinephrine,
and dopamine, contributes to depression. Serotonin is a key target for many
antidepressant medications, such as SSRIs. While other neurotransmitters are
,involved, serotonin is the most commonly cited and primary target of first-line
treatment.
5. A nurse is using a behavioral therapy approach with a client who has a phobia
of spiders. The nurse gradually exposes the client to a spider in a controlled,
step-by-step manner. This technique is known as:
A. Flooding
B. Systematic desensitization
C. Aversion therapy
D. Operant conditioning
Correct Answer: B. Systematic desensitization
Rationale: Systematic desensitization is a behavioral technique where a client
is gradually exposed to a feared stimulus while simultaneously practicing
relaxation techniques. This is different from flooding, which involves intense,
prolonged exposure with no gradual steps. Aversion therapy pairs a behavior with
an unpleasant stimulus, and operant conditioning uses rewards and punishments.
6. Which of the following is a key principle of therapeutic communication?
A. Giving advice to solve the client's problems.
B. Using "why" questions to understand behavior.
C. Maintaining a non-judgmental and accepting attitude.
D. Sharing personal stories to build rapport.
Correct Answer: C. Maintaining a non-judgmental and accepting attitude.
Rationale: Therapeutic communication focuses on the client's needs and
feelings. A non-judgmental and accepting attitude creates a safe environment
where the client feels comfortable sharing. Giving advice, asking "why" questions
(which can be perceived as accusatory), and sharing personal stories (which shifts
focus to the nurse) are considered non-therapeutic techniques.
7. A client is experiencing a panic attack. Which initial nursing intervention is
most appropriate?
A. Encourage the client to talk about their feelings.
B. Stay with the client and provide a calm, quiet environment.
, C. Administer a PRN dose of an antipsychotic medication.
D. Teach the client about the physiology of a panic attack.
Correct Answer: B. Stay with the client and provide a calm, quiet
environment.
Rationale: The priority during a panic attack is to ensure safety and reduce
anxiety. The nurse should stay with the client, use a calm and reassuring voice,
and minimize environmental stimuli. The client's anxiety is too high for rational
thought or teaching, so discussing feelings or teaching are not the first-line
interventions.
8. The defense mechanism in which a person attributes their own unacceptable
feelings or thoughts to another person is called:
A. Projection
B. Displacement
C. Rationalization
D. Sublimation
Correct Answer: A. Projection
Rationale: Projection is a defense mechanism where individuals attribute their
own unacceptable thoughts, feelings, or motives to another person. For example,
a person who is angry at their boss might accuse the boss of being angry at them.
Displacement is redirecting an emotion to a less threatening target.
Rationalization is creating a logical excuse for an irrational behavior. Sublimation is
channeling unacceptable impulses into socially acceptable activities.
9. A nurse is caring for a client taking lithium carbonate. Which of the following
lab values should the nurse monitor most closely?
A. Serum potassium level
B. Serum lithium level
C. White blood cell count
D. Liver function tests
Correct Answer: B. Serum lithium level
Rationale: Lithium has a very narrow therapeutic index, meaning the
Practice Questions & Detailed Answers |
Psychiatric Nursing Study Guide
Section 1: Foundational Concepts & Theories
1. A nurse is assessing a client who states, "I feel like I'm a failure and that
nothing I do is ever good enough." This statement is an example of which
cognitive distortion?
A. Magnification
B. Personalization
C. All-or-nothing thinking
D. Emotional reasoning
Correct Answer: C. All-or-nothing thinking
Rationale: All-or-nothing thinking (also called dichotomous thinking) involves
viewing situations in only two categories instead of on a continuum. The client's
belief that they are a "failure" and "nothing" is good enough reflects this black-
and-white perspective. Magnification is exaggerating the importance of things,
personalization is taking responsibility for external events, and emotional
reasoning is believing that something is true because one feels it strongly.
2. Which theorist is associated with the development of the therapeutic nurse-
client relationship, identifying phases such as orientation, working, and
termination?
A. Sigmund Freud
B. Hildegard Peplau
C. Erik Erikson
D. Jean Piaget
Correct Answer: B. Hildegard Peplau
Rationale: Hildegard Peplau is considered the mother of psychiatric nursing.
,Her theory of interpersonal relations defines the nurse-client relationship as
having four phases: orientation, identification, exploitation (working), and
resolution (termination). Freud developed psychoanalysis, Erikson developed
psychosocial development theory, and Piaget developed cognitive development
theory.
3. A client is prescribed a benzodiazepine for anxiety. The nurse should monitor
the client for which potential adverse effect?
A. Hypertension
B. Weight loss
C. Sedation
D. Insomnia
Correct Answer: C. Sedation
Rationale: Benzodiazepines are central nervous system (CNS) depressants.
Their primary effects are sedation, hypnosis, decreased anxiety, muscle relaxation,
and anticonvulsant actions. Common side effects include drowsiness, sedation,
and ataxia. They are not typically associated with hypertension, weight loss, or
insomnia.
4. The nurse is caring for a client with major depressive disorder. Which
neurotransmitter is most commonly implicated in the pathophysiology of
depression?
A. Dopamine
B. Acetylcholine
C. Serotonin
D. Glutamate
Correct Answer: C. Serotonin
Rationale: The monoamine hypothesis of depression suggests that a
deficiency in certain neurotransmitters, particularly serotonin, norepinephrine,
and dopamine, contributes to depression. Serotonin is a key target for many
antidepressant medications, such as SSRIs. While other neurotransmitters are
,involved, serotonin is the most commonly cited and primary target of first-line
treatment.
5. A nurse is using a behavioral therapy approach with a client who has a phobia
of spiders. The nurse gradually exposes the client to a spider in a controlled,
step-by-step manner. This technique is known as:
A. Flooding
B. Systematic desensitization
C. Aversion therapy
D. Operant conditioning
Correct Answer: B. Systematic desensitization
Rationale: Systematic desensitization is a behavioral technique where a client
is gradually exposed to a feared stimulus while simultaneously practicing
relaxation techniques. This is different from flooding, which involves intense,
prolonged exposure with no gradual steps. Aversion therapy pairs a behavior with
an unpleasant stimulus, and operant conditioning uses rewards and punishments.
6. Which of the following is a key principle of therapeutic communication?
A. Giving advice to solve the client's problems.
B. Using "why" questions to understand behavior.
C. Maintaining a non-judgmental and accepting attitude.
D. Sharing personal stories to build rapport.
Correct Answer: C. Maintaining a non-judgmental and accepting attitude.
Rationale: Therapeutic communication focuses on the client's needs and
feelings. A non-judgmental and accepting attitude creates a safe environment
where the client feels comfortable sharing. Giving advice, asking "why" questions
(which can be perceived as accusatory), and sharing personal stories (which shifts
focus to the nurse) are considered non-therapeutic techniques.
7. A client is experiencing a panic attack. Which initial nursing intervention is
most appropriate?
A. Encourage the client to talk about their feelings.
B. Stay with the client and provide a calm, quiet environment.
, C. Administer a PRN dose of an antipsychotic medication.
D. Teach the client about the physiology of a panic attack.
Correct Answer: B. Stay with the client and provide a calm, quiet
environment.
Rationale: The priority during a panic attack is to ensure safety and reduce
anxiety. The nurse should stay with the client, use a calm and reassuring voice,
and minimize environmental stimuli. The client's anxiety is too high for rational
thought or teaching, so discussing feelings or teaching are not the first-line
interventions.
8. The defense mechanism in which a person attributes their own unacceptable
feelings or thoughts to another person is called:
A. Projection
B. Displacement
C. Rationalization
D. Sublimation
Correct Answer: A. Projection
Rationale: Projection is a defense mechanism where individuals attribute their
own unacceptable thoughts, feelings, or motives to another person. For example,
a person who is angry at their boss might accuse the boss of being angry at them.
Displacement is redirecting an emotion to a less threatening target.
Rationalization is creating a logical excuse for an irrational behavior. Sublimation is
channeling unacceptable impulses into socially acceptable activities.
9. A nurse is caring for a client taking lithium carbonate. Which of the following
lab values should the nurse monitor most closely?
A. Serum potassium level
B. Serum lithium level
C. White blood cell count
D. Liver function tests
Correct Answer: B. Serum lithium level
Rationale: Lithium has a very narrow therapeutic index, meaning the
