PN NCLEX 6th Edition- Mental Health
The nurse is caring for a client who was recently admitted for anorexia nervosa. Upon entering
the client's room, the nurse finds the client in the middle of a series of sets of rapid sit-ups.
Which action should the nurse take? - correct answer Interrupt the client and offer to take her
for a walk.
A client with lung cancer says to the nurse, "I'm sick and tired of my family telling me not to
worry and that a cure will be discovered before I know it." Which response by the nurse is
therapeutic? - correct answer "You're feeling angry that your family is hoping for a cure?"
A client tells the nurse that he is feeling out of control. The nurse observes that the client is
pacing back and forth. Which approach by the nurse is appropriate to maintain a safe
environment? - correct answer Move the client to a quiet room and talk about his feelings.
A client says to the home care nurse, "I can't believe that my wife died yesterday. I keep
expecting to see her everywhere I go in this house, ready to plan our activities for the day."
Which is the therapeutic nursing response? - correct answer "It must be hard to accept that she
has passed away."
The wife of a client who abuses alcohol tells the nurse she cannot "do it alone" any longer and
asks the nurse about the availability of any free support services for "people like me." The nurse
refers the client's wife to which community group? - correct answer Al-Anon
The nurse is caring for a client with depression in the mental health unit who is refusing to take
the prescribed oral antidepressant. Which are the nurse's best actions to this client's
medication refusal? Select all that apply. - correct answer -Notify the health care provider.
-Document the refusal of medication.
-Ask the client why he is refusing the medication.
While the nurse is providing care, a client angrily reports to the nurse that the health care
provider purposefully provided wrong information about her diagnosis and states, "The doctor
lied to me." Which nursing response would likely be a barrier to further communication with
the client? - correct answer "The health care provider would never lie to you."
The nurse is caring for an older adult client who has recently lost her husband. The client says,
"No one cares about me anymore. All the people I loved are dead." Which response by the
nurse is therapeutic? - correct answer "You must be feeling all alone at this point."
A client with a diagnosis of a recurrent major depression, exhibiting psychotic features, is
admitted to the mental health unit. In an attempt to create a safe environment for the client,
,PN NCLEX 6th Edition- Mental Health
the nurse designs a plan of care that deals specifically with which aspect of the client's
disorder? - correct answer Altered thought processes
The nurse is preparing a care plan for the client with obsessive-compulsive disorder (OCD). The
nurse should focus on which as the primary means to accomplish work with this client? -
correct answer Goals and objectives
A client is admitted to the psychiatric unit following a serious suicidal attempt by a drug
overdose. Which action should the nurse implement? - correct answer Remain with the client
at all times.
A client with a phobia will be treated for the condition using a behavior modification technique
known as systematic desensitization. The nurse describes the components of this form of
therapy to the client and reinforces which client instruction? - correct answer The client will be
introduced to short periods of exposure to the phobic object while in a relaxed state.
A client with depression reports to the nurse that she has not been sleeping or eating
adequately. The nurse should plan to do which to assist the client in meeting nutritional needs?
- correct answer Provide small, frequent meals.
A client with a diagnosis of major depression becomes more anxious, reports sleeping poorly,
and seems to display increased anger. The nurse should make which interpretation about the
client's behavior? - correct answer The client is at increased risk for suicide.
The licensed practical nurse is assisting the registered nurse in admitting a client with an
exacerbation of schizophrenia and knows that which signs/symptoms displayed by the client
are considered positive symptoms? Select all that apply. - correct answer Hallucinations
Anhedonia
Delusions
Neologisms
The nurse is collecting data from a client who has recently been violently raped. Which data
indicates that the client is experiencing rape-trauma syndrome? - correct answer The client
reports nightmares involving being stalked when alone at night.
The nurse is caring for a client who has been treated with long-term antipsychotic medication.
As part of the nursing care plan, the nurse monitors for tardive dyskinesia. Which should the
, PN NCLEX 6th Edition- Mental Health
nurse observe with tardive dyskinesia? - correct answer Abnormal movements and involuntary
movements of the mouth, tongue, and face
The nurse observes that a client with a potential for violence is agitated, pacing up and down in
the hallway, and making aggressive and belligerent gestures at other clients. Which statement
is appropriate to make to this client? - correct answer "What is causing you to become
agitated?"
The licensed practical nurse is assisting in the admittance of a client who has been involuntarily
committed to the behavioral health unit. Which actions by the client before hospitalization led
to the commitment? Select all that apply. - correct answer Client threatened to commit suicide.
Client threatened to kidnap his spouse.
An adolescent is returning home after an acute psychiatric hospitalization following a suicide
attempt. Which action would be least effective in preparing the client to return to a safe and
effective care environment? - correct answer Suggest that the mother's boyfriend move out of
the home.
The nurse is monitoring a client with a history of opioid abuse for signs of withdrawal. The
nurse monitors this client for which signs and symptoms associated with opioid withdrawal? -
correct answer Depression, high drug craving, fatigue with altered sleep (insomnia or
hypersomnia), agitation, and paranoia
The nurse awakens a client on the inpatient psychiatric unit for breakfast. The client replies,
"Do you realize it's Sunday? I've worked hard here all week and this is my day of rest. I'll get up
at 11:30." Which would be the nurse's best response? - correct answer "Let me know if you
change your mind, and I'll get you something to eat."
The nurse is collecting data from a client recently diagnosed with paranoid schizophrenia.
Which information best supports that the client is at risk for harming another individual? -
correct answer Sibling stating, "I don't feel safe around my brother."
The nurse is assessing a newly admitted client recently diagnosed with depression. Which data
best supports that the client is at risk for self-harm? - correct answer Reported hopelessness
A client is admitted to the psychiatric nursing unit. When collecting data from the client, the
nurse notes that the client was admitted on an involuntary status. Based on this type of
admission, the nurse expects which? - correct answer The client presents a harm to self.
The nurse in a psychiatric unit is assigned to care for a client admitted to the unit 2 days ago.
On review of the client's record, the nurse notes that the admission was a voluntary admission.
Based on this type of admission, the nurse should expect which? - correct answer The client will
participate in the treatment plan.
The nurse is caring for a client who was recently admitted for anorexia nervosa. Upon entering
the client's room, the nurse finds the client in the middle of a series of sets of rapid sit-ups.
Which action should the nurse take? - correct answer Interrupt the client and offer to take her
for a walk.
A client with lung cancer says to the nurse, "I'm sick and tired of my family telling me not to
worry and that a cure will be discovered before I know it." Which response by the nurse is
therapeutic? - correct answer "You're feeling angry that your family is hoping for a cure?"
A client tells the nurse that he is feeling out of control. The nurse observes that the client is
pacing back and forth. Which approach by the nurse is appropriate to maintain a safe
environment? - correct answer Move the client to a quiet room and talk about his feelings.
A client says to the home care nurse, "I can't believe that my wife died yesterday. I keep
expecting to see her everywhere I go in this house, ready to plan our activities for the day."
Which is the therapeutic nursing response? - correct answer "It must be hard to accept that she
has passed away."
The wife of a client who abuses alcohol tells the nurse she cannot "do it alone" any longer and
asks the nurse about the availability of any free support services for "people like me." The nurse
refers the client's wife to which community group? - correct answer Al-Anon
The nurse is caring for a client with depression in the mental health unit who is refusing to take
the prescribed oral antidepressant. Which are the nurse's best actions to this client's
medication refusal? Select all that apply. - correct answer -Notify the health care provider.
-Document the refusal of medication.
-Ask the client why he is refusing the medication.
While the nurse is providing care, a client angrily reports to the nurse that the health care
provider purposefully provided wrong information about her diagnosis and states, "The doctor
lied to me." Which nursing response would likely be a barrier to further communication with
the client? - correct answer "The health care provider would never lie to you."
The nurse is caring for an older adult client who has recently lost her husband. The client says,
"No one cares about me anymore. All the people I loved are dead." Which response by the
nurse is therapeutic? - correct answer "You must be feeling all alone at this point."
A client with a diagnosis of a recurrent major depression, exhibiting psychotic features, is
admitted to the mental health unit. In an attempt to create a safe environment for the client,
,PN NCLEX 6th Edition- Mental Health
the nurse designs a plan of care that deals specifically with which aspect of the client's
disorder? - correct answer Altered thought processes
The nurse is preparing a care plan for the client with obsessive-compulsive disorder (OCD). The
nurse should focus on which as the primary means to accomplish work with this client? -
correct answer Goals and objectives
A client is admitted to the psychiatric unit following a serious suicidal attempt by a drug
overdose. Which action should the nurse implement? - correct answer Remain with the client
at all times.
A client with a phobia will be treated for the condition using a behavior modification technique
known as systematic desensitization. The nurse describes the components of this form of
therapy to the client and reinforces which client instruction? - correct answer The client will be
introduced to short periods of exposure to the phobic object while in a relaxed state.
A client with depression reports to the nurse that she has not been sleeping or eating
adequately. The nurse should plan to do which to assist the client in meeting nutritional needs?
- correct answer Provide small, frequent meals.
A client with a diagnosis of major depression becomes more anxious, reports sleeping poorly,
and seems to display increased anger. The nurse should make which interpretation about the
client's behavior? - correct answer The client is at increased risk for suicide.
The licensed practical nurse is assisting the registered nurse in admitting a client with an
exacerbation of schizophrenia and knows that which signs/symptoms displayed by the client
are considered positive symptoms? Select all that apply. - correct answer Hallucinations
Anhedonia
Delusions
Neologisms
The nurse is collecting data from a client who has recently been violently raped. Which data
indicates that the client is experiencing rape-trauma syndrome? - correct answer The client
reports nightmares involving being stalked when alone at night.
The nurse is caring for a client who has been treated with long-term antipsychotic medication.
As part of the nursing care plan, the nurse monitors for tardive dyskinesia. Which should the
, PN NCLEX 6th Edition- Mental Health
nurse observe with tardive dyskinesia? - correct answer Abnormal movements and involuntary
movements of the mouth, tongue, and face
The nurse observes that a client with a potential for violence is agitated, pacing up and down in
the hallway, and making aggressive and belligerent gestures at other clients. Which statement
is appropriate to make to this client? - correct answer "What is causing you to become
agitated?"
The licensed practical nurse is assisting in the admittance of a client who has been involuntarily
committed to the behavioral health unit. Which actions by the client before hospitalization led
to the commitment? Select all that apply. - correct answer Client threatened to commit suicide.
Client threatened to kidnap his spouse.
An adolescent is returning home after an acute psychiatric hospitalization following a suicide
attempt. Which action would be least effective in preparing the client to return to a safe and
effective care environment? - correct answer Suggest that the mother's boyfriend move out of
the home.
The nurse is monitoring a client with a history of opioid abuse for signs of withdrawal. The
nurse monitors this client for which signs and symptoms associated with opioid withdrawal? -
correct answer Depression, high drug craving, fatigue with altered sleep (insomnia or
hypersomnia), agitation, and paranoia
The nurse awakens a client on the inpatient psychiatric unit for breakfast. The client replies,
"Do you realize it's Sunday? I've worked hard here all week and this is my day of rest. I'll get up
at 11:30." Which would be the nurse's best response? - correct answer "Let me know if you
change your mind, and I'll get you something to eat."
The nurse is collecting data from a client recently diagnosed with paranoid schizophrenia.
Which information best supports that the client is at risk for harming another individual? -
correct answer Sibling stating, "I don't feel safe around my brother."
The nurse is assessing a newly admitted client recently diagnosed with depression. Which data
best supports that the client is at risk for self-harm? - correct answer Reported hopelessness
A client is admitted to the psychiatric nursing unit. When collecting data from the client, the
nurse notes that the client was admitted on an involuntary status. Based on this type of
admission, the nurse expects which? - correct answer The client presents a harm to self.
The nurse in a psychiatric unit is assigned to care for a client admitted to the unit 2 days ago.
On review of the client's record, the nurse notes that the admission was a voluntary admission.
Based on this type of admission, the nurse should expect which? - correct answer The client will
participate in the treatment plan.
