NR 326 CMS Exam Questions and Answers
Latest Versions 2025 Top Rated A+
1. **Alcohol Withdrawal**: What is Nurse John likely to note in a male client
admitted for alcohol withdrawal?
- A. Perceptual disorders (hallucinations/tremors)
- B. Impending coma
- C. Recent alcohol intake
- D. Depression with mutism
**Correct: A** (Common symptoms include tremors, anxiety, and perceptual
disturbances like hallucinations in severe cases.)
2. **Antidepressant Compliance**: A client on amitriptyline (Elavil) for 3 days
complains it "doesn't help" and refuses it. What should the nurse explain?
**Therapeutic response: Antidepressants like TCAs can take 2–4 weeks for full
effect; encourage continuation and monitor for side effects.**
3. **ECT Preparation**: Which action should the nurse take prior to scheduled
ECT?
- A. Witness informed consent
- B. Request an ECG
- C. Obtain serum parathyroid level
, - D. Check blood pressure
**Correct: B** (ECG to assess cardiac status, as ECT involves seizure induction.)
4. **Self-Harm in Bipolar**: A client with bipolar shows fresh self-inflicted cuts.
Priority action?
**Assess lethality, ensure safety (1:1 observation, remove sharps), then address
underlying mania/depression.**
5. **PTSD Intervention**: For a client with PTSD, which is most helpful?
**Encourage examining the meaning of the traumatic event and losses to
prevent worsening symptoms or substance abuse.**
6. **Disulfiram (Antabuse)**: Teaching for alcohol use disorder – it causes
nausea/vomiting with alcohol. This is an example of?
**Aversive therapy/conditioning.**
7. **Conversion Disorder Example**: A client with sudden paralysis (no physical
cause) after stress.
**Diagnosis: Conversion disorder (psychological stress converted to physical
symptoms).**
8. **Schizophrenia Medication Non-Compliance**: A client diagnosed with
schizophrenia states, "I'm not taking that stupid medication anymore." Which
response by the nurse best demonstrates motivational interviewing?
- A. "The medication isn't stupid."
, - B. "You have to take it or you'll get worse."
- C. "Why do you feel that way?"
- D. "Tell me more about why you don't want to take the medication."
**Correct: D** (Motivational interviewing encourages open-ended questions to
explore ambivalence and promote client-driven change.)
9. **Delusion of Persecution**: A client refuses to shower, stating, "The FBI has
placed a camera in here to monitor my every move." What is the most
appropriate nursing response?
- A. "That's not true; there are no cameras."
- B. "I understand you're feeling watched. The shower is private and safe."
- C. "Why do you think the FBI is watching you?"
- D. Ignore the statement and proceed with hygiene assistance.
**Correct: B** (Acknowledge the feeling without reinforcing the delusion; focus
on reality and safety.)
10. **Generalized Anxiety Disorder Admission**: A nurse is admitting a client with
generalized anxiety disorder. Which action should the nurse take first?
- A. Teach guided imagery.
- B. Provide a quiet environment.
- C. Ask about coping mechanisms.
- D. Identify client strengths.
**Correct: B** (Reduce stimuli to decrease anxiety immediately; safety and
comfort are priorities.)
Latest Versions 2025 Top Rated A+
1. **Alcohol Withdrawal**: What is Nurse John likely to note in a male client
admitted for alcohol withdrawal?
- A. Perceptual disorders (hallucinations/tremors)
- B. Impending coma
- C. Recent alcohol intake
- D. Depression with mutism
**Correct: A** (Common symptoms include tremors, anxiety, and perceptual
disturbances like hallucinations in severe cases.)
2. **Antidepressant Compliance**: A client on amitriptyline (Elavil) for 3 days
complains it "doesn't help" and refuses it. What should the nurse explain?
**Therapeutic response: Antidepressants like TCAs can take 2–4 weeks for full
effect; encourage continuation and monitor for side effects.**
3. **ECT Preparation**: Which action should the nurse take prior to scheduled
ECT?
- A. Witness informed consent
- B. Request an ECG
- C. Obtain serum parathyroid level
, - D. Check blood pressure
**Correct: B** (ECG to assess cardiac status, as ECT involves seizure induction.)
4. **Self-Harm in Bipolar**: A client with bipolar shows fresh self-inflicted cuts.
Priority action?
**Assess lethality, ensure safety (1:1 observation, remove sharps), then address
underlying mania/depression.**
5. **PTSD Intervention**: For a client with PTSD, which is most helpful?
**Encourage examining the meaning of the traumatic event and losses to
prevent worsening symptoms or substance abuse.**
6. **Disulfiram (Antabuse)**: Teaching for alcohol use disorder – it causes
nausea/vomiting with alcohol. This is an example of?
**Aversive therapy/conditioning.**
7. **Conversion Disorder Example**: A client with sudden paralysis (no physical
cause) after stress.
**Diagnosis: Conversion disorder (psychological stress converted to physical
symptoms).**
8. **Schizophrenia Medication Non-Compliance**: A client diagnosed with
schizophrenia states, "I'm not taking that stupid medication anymore." Which
response by the nurse best demonstrates motivational interviewing?
- A. "The medication isn't stupid."
, - B. "You have to take it or you'll get worse."
- C. "Why do you feel that way?"
- D. "Tell me more about why you don't want to take the medication."
**Correct: D** (Motivational interviewing encourages open-ended questions to
explore ambivalence and promote client-driven change.)
9. **Delusion of Persecution**: A client refuses to shower, stating, "The FBI has
placed a camera in here to monitor my every move." What is the most
appropriate nursing response?
- A. "That's not true; there are no cameras."
- B. "I understand you're feeling watched. The shower is private and safe."
- C. "Why do you think the FBI is watching you?"
- D. Ignore the statement and proceed with hygiene assistance.
**Correct: B** (Acknowledge the feeling without reinforcing the delusion; focus
on reality and safety.)
10. **Generalized Anxiety Disorder Admission**: A nurse is admitting a client with
generalized anxiety disorder. Which action should the nurse take first?
- A. Teach guided imagery.
- B. Provide a quiet environment.
- C. Ask about coping mechanisms.
- D. Identify client strengths.
**Correct: B** (Reduce stimuli to decrease anxiety immediately; safety and
comfort are priorities.)
