Mental Health & Psychiatric Nursing NCLEX
Practice Exam (Quiz #6: 25 Questions)
1. 1. Question
Nurse Tony should first discuss terminating the nurse-client relationship
with a client during the:
o A. Termination phase when discharge plans are being made.
o B. Working phase when the client shows some progress.
o C. Orientation phase when a contract is established.
o D. Working phase when the client brings it up.
Answer
Correct Answer: C. Orientation phase when a contract is established.
When the nurse and client agree to work together, a contract should be
established, the length of the relationship should be discussed in terms of
its ultimate termination. Termination of a meaningful nurse-client
relationship should be final in any setting. To provide the client with even a
hint that the relationship will continue is inappropriate, unprofessional, and
unethical; for example, the LPN informs the client that he/she may contact
the client on social media to check on their condition after discharge.
• Option A: Termination occurs when the care provided by the
nurse is no longer required for the context of care; for
example, a client who was hospitalized for pneumonia has
recovered and no longer requires nursing care is now
discharged home. In this phase, the nurse and client evaluate
the client’s response to treatment and explore the meaning of
the relationship and what goals have been achieved.
Discussing the achievements, how the client and nurse feel
about concluding the relationship, and plans for the future are
an important part of the termination phase.
• Option B: The problem-solving phase of the relationship,
paralleling the planning and implementation phases of the
nursing process. Within this phase, relevant treatment goals
are established to guide nursing interventions and client
, actions, and the conversation in the working phase turns to
active problem solving related to assessed needs. Clients can
more deeply disclose concerns/issues that they are having.
• Option D: The nurse begins to build a sense of trust by
providing the client with basic information (name, professional
status, and essential information about the purpose and
nature of the relationship). Introductions are important even
when the client is confused, aphasic, unresponsive, or unable
to respond. Nonverbal supportive communication such as a
handshake, eye contact, a smile, and appropriate body
language reinforce spoken words.
2. 2. Question
Malou is diagnosed with major depression and spends the majority of the
day lying in bed with the sheet pulled over his head. Which of the following
approaches by the nurse would be the most therapeutic?
o A. Question the client until he responds.
o B. Initiate contact with the client frequently.
o C. Sit outside the client's room.
o D. Wait for the client to begin the conversation.
Answer
Correct Answer: B. Initiate contact with the client frequently
The nurse should initiate brief, frequent contacts throughout the day to let
the client know that he is important to the nurse. This will positively affect
the client’s self-esteem. Initially, provide activities that require minimal
concentration (e.g., drawing, playing simple board games). Depressed
people lack concentration and memory. Activities that have no “right or
wrong” or “winner or loser” minimizes opportunities for the client to put
himself/herself down.
• Option A: Eventually involve the client in group activities (e.g.,
group discussions, art therapy, dance therapy). Socialization
minimizes feelings of isolation. Genuine regard for others can
increase feelings of self-worth. Eventually maximize the client’s
contacts with others (first one other, then two others, etc.).
, Contact with others distracts the client from self-
preoccupation.
• Option C: When the client is in the most depressed state,
Involve the client in a one-to-one activity. Maximizes the
potential for interactions while minimizing anxiety levels.
Involve the client in gross motor activities that call for very
little concentration (e.g., walking). Such activities will aid in
relieving tensions and might help in elevating the mood.
• Option D: Evaluate the client’s need for assertiveness training
tools to pursue things he or she wants or needs in life. Arrange
for training through community-based programs, personal
counseling, literature, etc. Low self-esteem individuals often
have feelings of unworthiness and have difficulty determining
their needs and wants. Encourage the client to participate in a
group therapy where the members share the same
situations/feelings that they have. To minimize the feelings of
isolation and provide an atmosphere where positive feedback
and a more realistic appraisal of self are available.
3. 3. Question
Joe who is very depressed exhibits psychomotor retardation, a flat affect,
and apathy. The nurse in charge observes Joe to be in need of grooming
and hygiene. Which of the following nursing actions would be most
appropriate?
o A. Waiting until the client’s family can participate in the client’s
care.
o B. Asking the client if he is ready to take shower.
o C. Explaining the importance of hygiene to the client.
o D. Stating to the client that it’s time for him to take a shower.
Answer
Correct Answer: D. Stating to the client that it’s time for him to take a
shower
The client with depression is preoccupied, has decreased energy, and is
unable to make decisions. The nurse presents the situation, “It’s time for a
shower”, and assists the client with personal hygiene to preserve his dignity
, and self-esteem. Encourage the use of soap, washcloth, toothbrush,
shaving equipment, make-up, etc. Being clean and well-groomed can
temporarily increase self-esteem.
• Option A: Allow the patient to perform personal care
activities. Paying attention to grooming serves as a first step
towards achieving a positive self-image. Give positive
feedback after a task is achieved. Positive reinforcement has a
big part in building self-esteem.
• Option B: Work with the client to identify cognitive distortions
that encourage negative self-appraisal. Cognitive distortions
reinforce a negative, inaccurate perception of self and the
world. Evaluate the client’s need for assertiveness training
tools to pursue things he or she wants or needs in life. Arrange
for training through community-based programs, personal
counseling, literature, etc. Low self-esteem individuals often
have feelings of unworthiness and have difficulty determining
their needs and wants.
• Option C: Give step-by-step reminders such as “Brush the
teeth “Clean the outer surfaces of your upper teeth, then your
lower teeth. . .” Slowed thinking and difficulty concentrating
make organizing simple tasks difficult. Involve the client in
activities that he or she wants to improve by using problem-
solving skills. Assess and evaluate the need for more teaching
in this area. Feelings of low self-esteem can interfere with
usual problem-solving abilities.
4. 4. Question
When teaching Mario with a typical depression about foods to avoid while
taking phenelzine(Nardil), which of the following would the nurse in charge
include?
o A. Roasted chicken
o B. Fresh fish
o C. Salami
o D. Hamburger
Answer
Practice Exam (Quiz #6: 25 Questions)
1. 1. Question
Nurse Tony should first discuss terminating the nurse-client relationship
with a client during the:
o A. Termination phase when discharge plans are being made.
o B. Working phase when the client shows some progress.
o C. Orientation phase when a contract is established.
o D. Working phase when the client brings it up.
Answer
Correct Answer: C. Orientation phase when a contract is established.
When the nurse and client agree to work together, a contract should be
established, the length of the relationship should be discussed in terms of
its ultimate termination. Termination of a meaningful nurse-client
relationship should be final in any setting. To provide the client with even a
hint that the relationship will continue is inappropriate, unprofessional, and
unethical; for example, the LPN informs the client that he/she may contact
the client on social media to check on their condition after discharge.
• Option A: Termination occurs when the care provided by the
nurse is no longer required for the context of care; for
example, a client who was hospitalized for pneumonia has
recovered and no longer requires nursing care is now
discharged home. In this phase, the nurse and client evaluate
the client’s response to treatment and explore the meaning of
the relationship and what goals have been achieved.
Discussing the achievements, how the client and nurse feel
about concluding the relationship, and plans for the future are
an important part of the termination phase.
• Option B: The problem-solving phase of the relationship,
paralleling the planning and implementation phases of the
nursing process. Within this phase, relevant treatment goals
are established to guide nursing interventions and client
, actions, and the conversation in the working phase turns to
active problem solving related to assessed needs. Clients can
more deeply disclose concerns/issues that they are having.
• Option D: The nurse begins to build a sense of trust by
providing the client with basic information (name, professional
status, and essential information about the purpose and
nature of the relationship). Introductions are important even
when the client is confused, aphasic, unresponsive, or unable
to respond. Nonverbal supportive communication such as a
handshake, eye contact, a smile, and appropriate body
language reinforce spoken words.
2. 2. Question
Malou is diagnosed with major depression and spends the majority of the
day lying in bed with the sheet pulled over his head. Which of the following
approaches by the nurse would be the most therapeutic?
o A. Question the client until he responds.
o B. Initiate contact with the client frequently.
o C. Sit outside the client's room.
o D. Wait for the client to begin the conversation.
Answer
Correct Answer: B. Initiate contact with the client frequently
The nurse should initiate brief, frequent contacts throughout the day to let
the client know that he is important to the nurse. This will positively affect
the client’s self-esteem. Initially, provide activities that require minimal
concentration (e.g., drawing, playing simple board games). Depressed
people lack concentration and memory. Activities that have no “right or
wrong” or “winner or loser” minimizes opportunities for the client to put
himself/herself down.
• Option A: Eventually involve the client in group activities (e.g.,
group discussions, art therapy, dance therapy). Socialization
minimizes feelings of isolation. Genuine regard for others can
increase feelings of self-worth. Eventually maximize the client’s
contacts with others (first one other, then two others, etc.).
, Contact with others distracts the client from self-
preoccupation.
• Option C: When the client is in the most depressed state,
Involve the client in a one-to-one activity. Maximizes the
potential for interactions while minimizing anxiety levels.
Involve the client in gross motor activities that call for very
little concentration (e.g., walking). Such activities will aid in
relieving tensions and might help in elevating the mood.
• Option D: Evaluate the client’s need for assertiveness training
tools to pursue things he or she wants or needs in life. Arrange
for training through community-based programs, personal
counseling, literature, etc. Low self-esteem individuals often
have feelings of unworthiness and have difficulty determining
their needs and wants. Encourage the client to participate in a
group therapy where the members share the same
situations/feelings that they have. To minimize the feelings of
isolation and provide an atmosphere where positive feedback
and a more realistic appraisal of self are available.
3. 3. Question
Joe who is very depressed exhibits psychomotor retardation, a flat affect,
and apathy. The nurse in charge observes Joe to be in need of grooming
and hygiene. Which of the following nursing actions would be most
appropriate?
o A. Waiting until the client’s family can participate in the client’s
care.
o B. Asking the client if he is ready to take shower.
o C. Explaining the importance of hygiene to the client.
o D. Stating to the client that it’s time for him to take a shower.
Answer
Correct Answer: D. Stating to the client that it’s time for him to take a
shower
The client with depression is preoccupied, has decreased energy, and is
unable to make decisions. The nurse presents the situation, “It’s time for a
shower”, and assists the client with personal hygiene to preserve his dignity
, and self-esteem. Encourage the use of soap, washcloth, toothbrush,
shaving equipment, make-up, etc. Being clean and well-groomed can
temporarily increase self-esteem.
• Option A: Allow the patient to perform personal care
activities. Paying attention to grooming serves as a first step
towards achieving a positive self-image. Give positive
feedback after a task is achieved. Positive reinforcement has a
big part in building self-esteem.
• Option B: Work with the client to identify cognitive distortions
that encourage negative self-appraisal. Cognitive distortions
reinforce a negative, inaccurate perception of self and the
world. Evaluate the client’s need for assertiveness training
tools to pursue things he or she wants or needs in life. Arrange
for training through community-based programs, personal
counseling, literature, etc. Low self-esteem individuals often
have feelings of unworthiness and have difficulty determining
their needs and wants.
• Option C: Give step-by-step reminders such as “Brush the
teeth “Clean the outer surfaces of your upper teeth, then your
lower teeth. . .” Slowed thinking and difficulty concentrating
make organizing simple tasks difficult. Involve the client in
activities that he or she wants to improve by using problem-
solving skills. Assess and evaluate the need for more teaching
in this area. Feelings of low self-esteem can interfere with
usual problem-solving abilities.
4. 4. Question
When teaching Mario with a typical depression about foods to avoid while
taking phenelzine(Nardil), which of the following would the nurse in charge
include?
o A. Roasted chicken
o B. Fresh fish
o C. Salami
o D. Hamburger
Answer
