NR 326: Mental Health Nursing Proctored Assessment Final Complete Certification Prep and Advanced Study Guide: Detailed Topic Modules, Extensive Test Bank Review, Practice Questions, and Final Exam Readiness Manual

Which question is most important when obtaining a subjective history from a client reporting fatigue? A. “What was your birth weight?” B. “Do you prefer hot or cold beverages?” C. “At what time of day is the fatigue most severe?” D. “Have you ever had a bone fracture?” Correct Answer: C. “At what time of day is the fatigue most severe?” Rationale: A fatigue history should assess onset, duration, daily pattern, severity, aggravating and relieving factors, and effects on daily activities. Determining when fatigue is most severe may help identify sleep-related, endocrine, psychological, medication-related, or systemic causes. Question 2 A client who is 5 feet 6 inches tall and weighs 98 pounds is admitted with anorexia nervosa. Which nursing diagnosis should receive the highest priority during the initial phase of care? A. Risk for social isolation related to withdrawal from peers B. Disturbed body image related to perceived obesity C. Ineffective coping related to preoccupation with food D. Imbalanced nutrition: less than body requirements related to inadequate intake Correct Answer: D. Imbalanced nutrition: less than body requirements related to inadequate intake Rationale: The client’s markedly low body weight represents an immediate physiological threat caused by severe malnutrition. Restoring nutritional and physiologic stability takes priority over psychological and social concerns. Malnutrition can lead to cardiac, electrolyte, and organ complications. Question 3 A client reports persistent fatigue that has been present nearly every day for seven months. How should the nurse classify this symptom? A. Chronic fatigue B. Situational fatigue C. Normal physiologic fatigue D. Temporary fatigue Correct Answer: A. Chronic fatigue Rationale: Fatigue lasting longer than six months is generally classified as chronic. Temporary or situational fatigue typically resolves when the precipitating activity, illness, or stressor ends. Persistent fatigue that interferes with functioning warrants evaluation for medical, psychological, nutritional, or lifestyle causes. Question 4 A hospitalized client with bulimia nervosa returns from lunch and is observed inducing vomiting in the bathroom. Which nursing intervention is most appropriate for future meals? A. Initiate continuous one-to-one observation indefinitely. B. Remove telephone and visitation privileges. C. Monitor the client for approximately one hour after meals. D. Restrict the client to the unit as punishment. Correct Answer: C. Monitor the client for approximately one hour after meals. Rationale: Post-meal observation limits the opportunity to purge and supports development of healthier eating behaviors. Removing privileges or restricting the client is punitive and can damage the therapeutic relationship. Continuous one-to-one observation is generally reserved for clients with an immediate safety risk. Question 5 Which teaching should the nurse emphasize as primary prevention for fatigue? A. Maintain adequate sleep, nutrition, exercise, and stress management. B. Restrict exercise to conserve energy. C. Obtain monthly diagnostic testing for chronic fatigue syndrome. D. Use stimulants whenever tiredness occurs. Correct Answer: A. Maintain adequate sleep, nutrition, exercise, and stress management. Rationale: Primary prevention focuses on reducing fatigue risk through healthy lifestyle practices, including balanced nutrition, regular physical activity, adequate sleep, hydration, and stress management. Stimulants may interfere with sleep and do not address underlying causes. Question 6 A community health nurse finds a client with bulimia nervosa unconscious at home. The client has a history of frequent laxative abuse and severe diarrhea. Which acidbase imbalance should the nurse suspect first? A. Metabolic alkalosis B. Respiratory acidosis C. Metabolic acidosis D. Respiratory alkalosis Correct Answer: C. Metabolic acidosis Rationale: Chronic laxative abuse can cause substantial gastrointestinal bicarbonate loss, resulting in metabolic acidosis. Repeated vomiting, in contrast, commonly causes metabolic alkalosis because gastric hydrochloric acid is lost. The unconscious client also requires immediate assessment of airway, circulation, electrolytes, and overall stability. Question 7 Which client statement most accurately reflects the clinical concept of fatigue? A. “I fall asleep whenever I sit quietly during the day.” B. “My muscles become painful after strenuous exercise.” C. “I become short of breath whenever I climb stairs.” D. “I lack the physical and mental energy needed to complete my usual activities.” Correct Answer: D. “I lack the physical and mental energy needed to complete my usual activities.” Rationale: Fatigue is a subjective perception of insufficient physical or mental energy that interferes with usual or desired activities. Shortness of breath may indicate cardiopulmonary dysfunction, muscle pain is not equivalent to fatigue, and unexpectedly falling asleep suggests excessive daytime sleepiness.