NCLEX MENTAL HEALTH EXAM Q&A
WITH RATIONALES.
A client is diagnosed with intermittent explosive disorder. The clinic
nurse should anticipate teaching about which medication?
A. Citalopram (Celexa)
B. Risperidone (Risperdal)
C. Fluvoxamine (Luvox)
D. Isocarboxazid (Marplan)
ANS: B
Rationale. An antipsychotic like Risperdal can be prescribed for
intermittent explosive disorder. An antidepressant is not the usual
drug of choice for this disorder.
A nurse is caring for a client who is suspected of having the diagnosis of
trichotillomania. What condition must be ruled out prior to a definitive
diagnosis of this disorder?
,A. Bipolar disorder
B. Alopecia areata
C. Post-traumatic stress disorder
D. Body dysmorphic disorder
ANS: B
RATIONALE. Alopecia areata is a dermatological condition that,
according to the DSM-IV diagnostic criteria for trichotillomania,
must be ruled out to establish this diagnosis.
A nursing instructor is teaching about the correlation between
pathological gambling and abnormalities in the neurotransmitter system.
What statement by the nursing student indicates that learning has
occurred?
A. "Pathological gamblers present with decreased serotonin, increased
norepinephrine, and increased dopamine."
B. "Pathological gamblers present with increased serotonin, increased
norepinephrine, and increased dopamine."
C. "Pathological gamblers present with decreased serotonin, decreased
norepinephrine, and decreased dopamine."
D. "Pathological gamblers present with increased serotonin, decreased
norepinephrine, and decreased dopamine."
ANS: A
,Rationale. Serotonergic function is linked to behavioral initiation,
inhibition, and aggression. Noradrenergic function mediates arousal
and detects novel and aversive stimuli. Dopaminergic function is
associated with reward and reinforcement mechanisms. Thus,
pathological gamblers present with decreased serotonin, increased
norepinephrine, and increased dopamine.
A 13-year-old client's father has recently been deployed to Afghanistan.
Since deployment, the client has begun to participate in isolative
behaviors, truancy, vandalism, and fighting. The pediatric nurse
practitioner should identify this behavior with which adjustment
disorder?
A. An adjustment disorder with anxiety
B. An adjustment disorder with disturbance of conduct
C. An adjustment disorder with mixed disturbance of emotions and
conduct
D. An adjustment disorder unspecified
ANS: C
Rationale. The predominant features of an adjustment disorder with
mixed disturbance of emotions and conduct include symptoms of
anxiety or depression as well as behaviors to include violations of
rights of others, truancy, vandalism, and fighting.
, A client, who recently delivered a stillborn baby, has a diagnosis of
adjustment disorder unspecified. The nurse case manager should expect
which client presentation that is characteristic of this diagnosis?
A. The client worries continually and appears nervous and jittery.
B. The client complains of a depressed mood, is tearful, and feels
hopeless.
C. The client is belligerent, violates the rights of others, and defaults on
legal responsibilities.
D. The client complains of many physical ailments, refuses to socialize,
and quits her job.
ANS: D
Rationale. The diagnosis of adjustment disorder unspecified is
assigned when the maladaptive reaction is not consistent with any of
the other categories. Manifestations may include physical
complaints, social withdrawal, or work or academic inhibition,
without significant depressed or anxious mood.
A client has been extremely nervous ever since a person died as a result
of the client's drunk driving. When assessing for the diagnosis of
adjustment disorder, within what timeframe should the nurse expect the
client to exhibit these symptoms?
A. To meet the DSM-IV criteria for adjustment disorder, the client
should exhibit symptoms within 1 year of the accident.
WITH RATIONALES.
A client is diagnosed with intermittent explosive disorder. The clinic
nurse should anticipate teaching about which medication?
A. Citalopram (Celexa)
B. Risperidone (Risperdal)
C. Fluvoxamine (Luvox)
D. Isocarboxazid (Marplan)
ANS: B
Rationale. An antipsychotic like Risperdal can be prescribed for
intermittent explosive disorder. An antidepressant is not the usual
drug of choice for this disorder.
A nurse is caring for a client who is suspected of having the diagnosis of
trichotillomania. What condition must be ruled out prior to a definitive
diagnosis of this disorder?
,A. Bipolar disorder
B. Alopecia areata
C. Post-traumatic stress disorder
D. Body dysmorphic disorder
ANS: B
RATIONALE. Alopecia areata is a dermatological condition that,
according to the DSM-IV diagnostic criteria for trichotillomania,
must be ruled out to establish this diagnosis.
A nursing instructor is teaching about the correlation between
pathological gambling and abnormalities in the neurotransmitter system.
What statement by the nursing student indicates that learning has
occurred?
A. "Pathological gamblers present with decreased serotonin, increased
norepinephrine, and increased dopamine."
B. "Pathological gamblers present with increased serotonin, increased
norepinephrine, and increased dopamine."
C. "Pathological gamblers present with decreased serotonin, decreased
norepinephrine, and decreased dopamine."
D. "Pathological gamblers present with increased serotonin, decreased
norepinephrine, and decreased dopamine."
ANS: A
,Rationale. Serotonergic function is linked to behavioral initiation,
inhibition, and aggression. Noradrenergic function mediates arousal
and detects novel and aversive stimuli. Dopaminergic function is
associated with reward and reinforcement mechanisms. Thus,
pathological gamblers present with decreased serotonin, increased
norepinephrine, and increased dopamine.
A 13-year-old client's father has recently been deployed to Afghanistan.
Since deployment, the client has begun to participate in isolative
behaviors, truancy, vandalism, and fighting. The pediatric nurse
practitioner should identify this behavior with which adjustment
disorder?
A. An adjustment disorder with anxiety
B. An adjustment disorder with disturbance of conduct
C. An adjustment disorder with mixed disturbance of emotions and
conduct
D. An adjustment disorder unspecified
ANS: C
Rationale. The predominant features of an adjustment disorder with
mixed disturbance of emotions and conduct include symptoms of
anxiety or depression as well as behaviors to include violations of
rights of others, truancy, vandalism, and fighting.
, A client, who recently delivered a stillborn baby, has a diagnosis of
adjustment disorder unspecified. The nurse case manager should expect
which client presentation that is characteristic of this diagnosis?
A. The client worries continually and appears nervous and jittery.
B. The client complains of a depressed mood, is tearful, and feels
hopeless.
C. The client is belligerent, violates the rights of others, and defaults on
legal responsibilities.
D. The client complains of many physical ailments, refuses to socialize,
and quits her job.
ANS: D
Rationale. The diagnosis of adjustment disorder unspecified is
assigned when the maladaptive reaction is not consistent with any of
the other categories. Manifestations may include physical
complaints, social withdrawal, or work or academic inhibition,
without significant depressed or anxious mood.
A client has been extremely nervous ever since a person died as a result
of the client's drunk driving. When assessing for the diagnosis of
adjustment disorder, within what timeframe should the nurse expect the
client to exhibit these symptoms?
A. To meet the DSM-IV criteria for adjustment disorder, the client
should exhibit symptoms within 1 year of the accident.
