Psychiatric Mental Health Nursing NCLEX |\ |\ |\ |\ |\
Questions with answers |\ |\
Flumazenil (Romazicon) has been ordered for a male client who
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
has overdosed on oxazepam (Serax). Before administering the
|\ |\ |\ |\ |\ |\ |\ |\
medication, the nurse should be prepared for which common
|\ |\ |\ |\ |\ |\ |\ |\ |\
adverse effect? |\
A. Seizures
|\
B. Shivering
|\
C. Anxiety
|\
D. Chest pain - CORRECT ANSWERS ✔✔A. Seizures
|\ |\ |\ |\ |\ |\ |\
Rationale: Seizures are the most common adverse effect of using
|\ |\ |\ |\ |\ |\ |\ |\ |\
flumazenil to reverse benzodiazepine overdose. The effect is
|\ |\ |\ |\ |\ |\ |\ |\ |\
magnified if the client has a combined tricyclic antidepressant
|\ |\ |\ |\ |\ |\ |\ |\ |\
and benzodiazepine overdose. Less common adverse effects
|\ |\ |\ |\ |\ |\ |\
includer shivering, anxiety, and chest pain.
|\ |\ |\ |\ |\
The nurse is caring for a client diagnosed with bulimia. The most
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
appropriate initial goal for a client diagnosed with bulimia is to:
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
A. Avoid shopping for large amounts of food
|\ |\ |\ |\ |\ |\ |\
B. Control eating impulses
|\ |\ |\
C. Identify anxiety-causing situations
|\ |\ |\
D. Eat only three meals per day - CORRECT ANSWERS ✔✔C.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Identify anxiety-causing situations
|\ |\
Rationale: Bulimic behavior is generally a maladaptive coping
|\ |\ |\ |\ |\ |\ |\ |\
response to stress and underlying issues. The client must identify
|\ |\ |\ |\ |\ |\ |\ |\ |\
, anxiety-causing situation as that stimulate the bulimic behavior
|\ |\ |\ |\ |\ |\ |\ |\ |\
and then learn new ways of coping with the anxiety. Controlling
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
shopping for large amounts of food isn't a goal early in
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
treatment. Managing eating impulses and replacing them with |\ |\ |\ |\ |\ |\ |\ |\
adaptive coping mechanisms can be integrated into the plan of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
care after initially addressing stress and underlying issues. Eating
|\ |\ |\ |\ |\ |\ |\ |\
three meals per day isn't a realistic goal early in treatment.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
A female client who's at high risk for suicide needs close
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
supervision. To best ensure the client's safety, the nurse should: |\ |\ |\ |\ |\ |\ |\ |\ |\
A. Check on the client frequently at irregular intervals throughout
|\ |\ |\ |\ |\ |\ |\ |\ |\
the night
|\ |\
B. Assure the client that the nurse will hold in confidence
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
anything the client says |\ |\ |\
C. Repeatedly discuss previous suicide attempts with the client
|\ |\ |\ |\ |\ |\ |\ |\
D. Disregard decreased communication by the client because this
|\ |\ |\ |\ |\ |\ |\ |\
is common in suicidal clients - CORRECT ANSWERS ✔✔A. Check
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
on the client frequently at irregular intervals throughout the night
|\ |\ |\ |\ |\ |\ |\ |\ |\
Rationale: Checking the client frequently but at irregular intervals
|\ |\ |\ |\ |\ |\ |\ |\
prevents the client from predicting when observation will take
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
place and altering behavior in a misleading way at these times.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Option B may encourage the client to try to manipulate the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
nurse's or seek attention for having a secret suicide plan. Option
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
C may reinforce a suicidal idea. Decreased communication is a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
sign of withdrawal that may indicate the client has decided to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
commit suicide; the nurse shouldn't disregard it.
|\ |\ |\ |\ |\ |\
Which of the following drugs should the nurse prepare to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
administer to a client with a toxic acetaminophen (Tylenol) level? |\ |\ |\ |\ |\ |\ |\ |\ |\
A. deferoxamine mesylate
|\ |\
,B. succimer (Chemet)
|\ |\
C. flumazenil (Romazicon)
|\ |\
D. acetylcysteine (Mucomyst) - CORRECT ANSWERS ✔✔D.
|\ |\ |\ |\ |\ |\ |\
acetylcysteine (Mucomyth) |\
Rationale: The antidote for acetaminophen toxicity is |\ |\ |\ |\ |\ |\ |\
acetylcysteine. It enhances conversion of toxic metabolites to |\ |\ |\ |\ |\ |\ |\ |\
nontoxic metabolites. Deferoxamine meslyate is the antidote for
|\ |\ |\ |\ |\ |\ |\ |\
iron intoxication. Succimer is an antidote for lead poisoning.
|\ |\ |\ |\ |\ |\ |\ |\ |\
Flumazenil reverses the sedative effects of benzodiazepines.
|\ |\ |\ |\ |\ |\
A male client is admitted to the substance abuse unit for alcohol
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
detoxification. Which of the following medications is the nurse |\ |\ |\ |\ |\ |\ |\ |\ |\
likely to administer to reduce the symptoms of alcohol
|\ |\ |\ |\ |\ |\ |\ |\ |\
withdrawal?
A. naloxone (Narcan)
|\ |\
B. haloperidol (Haldol)
|\ |\
C. magnesium sulfate
|\ |\
D. chlordiazepoxide (Librium) - CORRECT ANSWERS ✔✔D.
|\ |\ |\ |\ |\ |\ |\
clordiazepoxide (Librium) |\
Rationale: Chlordiazepoxide (Librium) and other tranquilizers help
|\ |\ |\ |\ |\ |\
reduce the symptoms of alcohol withdrawal. Haloperidol (Haldol)
|\ |\ |\ |\ |\ |\ |\ |\ |\
may be given to treat clients with psychosis, severe agitation, or
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
delirium. Naloxone (Narcan) is administered for narcotic
|\ |\ |\ |\ |\ |\ |\
overdose. Magnesium sulfate and other anticonvulsant |\ |\ |\ |\ |\ |\
medications are only administer to treat seizures if they occur |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
during the withdrawal. |\ |\
During postprandial monitor, a female client with bulimia nervosa
|\ |\ |\ |\ |\ |\ |\ |\
tells the nurse, "You can sit with me, but you're just wasting your
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
, time. After you sat with me yesterday, I was still able to purge.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Today, my goal is to do it twice." What is the nurse's BEST
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
responses?
A. "I trust you not to purge."
|\ |\ |\ |\ |\ |\
B. "How are you purging and when do you do it?"
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
C. "Don't worry. I won't allow you to purge today."
|\ |\ |\ |\ |\ |\ |\ |\ |\
D. "I know it's important for you to feel in control, but I'll monitor
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
you for 90 minutes after you eat." - CORRECT ANSWERS ✔✔D. "I
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
know it's important for you to feel in control, but I'll monitor you
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
for 90 minutes after you eat."
|\ |\ |\ |\ |\
Rationale: This response acknowledges that the clients is testing |\ |\ |\ |\ |\ |\ |\ |\ |\
limits and that the nurse is setting them by performing
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
postprandial monitoring to prevent self-induced eyes is. Clients |\ |\ |\ |\ |\ |\ |\ |\
with bulimia nervosa need to feel in control of the diet because
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
they feel they lack control over all other aspects of their lives.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Because their therapeutic relationships with caregivers are less
|\ |\ |\ |\ |\ |\ |\ |\
important than their need to purge, they don't fear betraying the |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
nurse's trust by engaging in the activity. They commonly plot
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
purging and rarely share their secrets about it. An authoritarian
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
or challenging response may trigger a power struggle between
|\ |\ |\ |\ |\ |\ |\ |\ |\
the nurse and client.
|\ |\ |\
A male client admitted to the psychiatric unit for treatment of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
substance abuse says to the nurse, "It felt so wonderful to get |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
high." Which of the following is the most appropriate response?
|\ |\ |\ |\ |\ |\ |\ |\ |\
A. "If you continue to talk like that, I'm going to stop speaking to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
you."
B. "You told me you got fired from your past job for missing too
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
may days after taking drugs all night."
|\ |\ |\ |\ |\ |\
C. "Tell me more about how it felt to get high."
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Questions with answers |\ |\
Flumazenil (Romazicon) has been ordered for a male client who
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
has overdosed on oxazepam (Serax). Before administering the
|\ |\ |\ |\ |\ |\ |\ |\
medication, the nurse should be prepared for which common
|\ |\ |\ |\ |\ |\ |\ |\ |\
adverse effect? |\
A. Seizures
|\
B. Shivering
|\
C. Anxiety
|\
D. Chest pain - CORRECT ANSWERS ✔✔A. Seizures
|\ |\ |\ |\ |\ |\ |\
Rationale: Seizures are the most common adverse effect of using
|\ |\ |\ |\ |\ |\ |\ |\ |\
flumazenil to reverse benzodiazepine overdose. The effect is
|\ |\ |\ |\ |\ |\ |\ |\ |\
magnified if the client has a combined tricyclic antidepressant
|\ |\ |\ |\ |\ |\ |\ |\ |\
and benzodiazepine overdose. Less common adverse effects
|\ |\ |\ |\ |\ |\ |\
includer shivering, anxiety, and chest pain.
|\ |\ |\ |\ |\
The nurse is caring for a client diagnosed with bulimia. The most
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
appropriate initial goal for a client diagnosed with bulimia is to:
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
A. Avoid shopping for large amounts of food
|\ |\ |\ |\ |\ |\ |\
B. Control eating impulses
|\ |\ |\
C. Identify anxiety-causing situations
|\ |\ |\
D. Eat only three meals per day - CORRECT ANSWERS ✔✔C.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Identify anxiety-causing situations
|\ |\
Rationale: Bulimic behavior is generally a maladaptive coping
|\ |\ |\ |\ |\ |\ |\ |\
response to stress and underlying issues. The client must identify
|\ |\ |\ |\ |\ |\ |\ |\ |\
, anxiety-causing situation as that stimulate the bulimic behavior
|\ |\ |\ |\ |\ |\ |\ |\ |\
and then learn new ways of coping with the anxiety. Controlling
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
shopping for large amounts of food isn't a goal early in
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
treatment. Managing eating impulses and replacing them with |\ |\ |\ |\ |\ |\ |\ |\
adaptive coping mechanisms can be integrated into the plan of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
care after initially addressing stress and underlying issues. Eating
|\ |\ |\ |\ |\ |\ |\ |\
three meals per day isn't a realistic goal early in treatment.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
A female client who's at high risk for suicide needs close
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
supervision. To best ensure the client's safety, the nurse should: |\ |\ |\ |\ |\ |\ |\ |\ |\
A. Check on the client frequently at irregular intervals throughout
|\ |\ |\ |\ |\ |\ |\ |\ |\
the night
|\ |\
B. Assure the client that the nurse will hold in confidence
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
anything the client says |\ |\ |\
C. Repeatedly discuss previous suicide attempts with the client
|\ |\ |\ |\ |\ |\ |\ |\
D. Disregard decreased communication by the client because this
|\ |\ |\ |\ |\ |\ |\ |\
is common in suicidal clients - CORRECT ANSWERS ✔✔A. Check
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
on the client frequently at irregular intervals throughout the night
|\ |\ |\ |\ |\ |\ |\ |\ |\
Rationale: Checking the client frequently but at irregular intervals
|\ |\ |\ |\ |\ |\ |\ |\
prevents the client from predicting when observation will take
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
place and altering behavior in a misleading way at these times.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Option B may encourage the client to try to manipulate the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
nurse's or seek attention for having a secret suicide plan. Option
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
C may reinforce a suicidal idea. Decreased communication is a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
sign of withdrawal that may indicate the client has decided to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
commit suicide; the nurse shouldn't disregard it.
|\ |\ |\ |\ |\ |\
Which of the following drugs should the nurse prepare to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
administer to a client with a toxic acetaminophen (Tylenol) level? |\ |\ |\ |\ |\ |\ |\ |\ |\
A. deferoxamine mesylate
|\ |\
,B. succimer (Chemet)
|\ |\
C. flumazenil (Romazicon)
|\ |\
D. acetylcysteine (Mucomyst) - CORRECT ANSWERS ✔✔D.
|\ |\ |\ |\ |\ |\ |\
acetylcysteine (Mucomyth) |\
Rationale: The antidote for acetaminophen toxicity is |\ |\ |\ |\ |\ |\ |\
acetylcysteine. It enhances conversion of toxic metabolites to |\ |\ |\ |\ |\ |\ |\ |\
nontoxic metabolites. Deferoxamine meslyate is the antidote for
|\ |\ |\ |\ |\ |\ |\ |\
iron intoxication. Succimer is an antidote for lead poisoning.
|\ |\ |\ |\ |\ |\ |\ |\ |\
Flumazenil reverses the sedative effects of benzodiazepines.
|\ |\ |\ |\ |\ |\
A male client is admitted to the substance abuse unit for alcohol
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
detoxification. Which of the following medications is the nurse |\ |\ |\ |\ |\ |\ |\ |\ |\
likely to administer to reduce the symptoms of alcohol
|\ |\ |\ |\ |\ |\ |\ |\ |\
withdrawal?
A. naloxone (Narcan)
|\ |\
B. haloperidol (Haldol)
|\ |\
C. magnesium sulfate
|\ |\
D. chlordiazepoxide (Librium) - CORRECT ANSWERS ✔✔D.
|\ |\ |\ |\ |\ |\ |\
clordiazepoxide (Librium) |\
Rationale: Chlordiazepoxide (Librium) and other tranquilizers help
|\ |\ |\ |\ |\ |\
reduce the symptoms of alcohol withdrawal. Haloperidol (Haldol)
|\ |\ |\ |\ |\ |\ |\ |\ |\
may be given to treat clients with psychosis, severe agitation, or
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
delirium. Naloxone (Narcan) is administered for narcotic
|\ |\ |\ |\ |\ |\ |\
overdose. Magnesium sulfate and other anticonvulsant |\ |\ |\ |\ |\ |\
medications are only administer to treat seizures if they occur |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
during the withdrawal. |\ |\
During postprandial monitor, a female client with bulimia nervosa
|\ |\ |\ |\ |\ |\ |\ |\
tells the nurse, "You can sit with me, but you're just wasting your
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
, time. After you sat with me yesterday, I was still able to purge.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Today, my goal is to do it twice." What is the nurse's BEST
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
responses?
A. "I trust you not to purge."
|\ |\ |\ |\ |\ |\
B. "How are you purging and when do you do it?"
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
C. "Don't worry. I won't allow you to purge today."
|\ |\ |\ |\ |\ |\ |\ |\ |\
D. "I know it's important for you to feel in control, but I'll monitor
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
you for 90 minutes after you eat." - CORRECT ANSWERS ✔✔D. "I
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
know it's important for you to feel in control, but I'll monitor you
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
for 90 minutes after you eat."
|\ |\ |\ |\ |\
Rationale: This response acknowledges that the clients is testing |\ |\ |\ |\ |\ |\ |\ |\ |\
limits and that the nurse is setting them by performing
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
postprandial monitoring to prevent self-induced eyes is. Clients |\ |\ |\ |\ |\ |\ |\ |\
with bulimia nervosa need to feel in control of the diet because
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
they feel they lack control over all other aspects of their lives.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Because their therapeutic relationships with caregivers are less
|\ |\ |\ |\ |\ |\ |\ |\
important than their need to purge, they don't fear betraying the |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
nurse's trust by engaging in the activity. They commonly plot
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
purging and rarely share their secrets about it. An authoritarian
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
or challenging response may trigger a power struggle between
|\ |\ |\ |\ |\ |\ |\ |\ |\
the nurse and client.
|\ |\ |\
A male client admitted to the psychiatric unit for treatment of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
substance abuse says to the nurse, "It felt so wonderful to get |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
high." Which of the following is the most appropriate response?
|\ |\ |\ |\ |\ |\ |\ |\ |\
A. "If you continue to talk like that, I'm going to stop speaking to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
you."
B. "You told me you got fired from your past job for missing too
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
may days after taking drugs all night."
|\ |\ |\ |\ |\ |\
C. "Tell me more about how it felt to get high."
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
