2025 Exam 1 Comprehensive Review – Psychiatric and Mental Health Nursing Practice ACTUAL EXAM TESTBANK - 3 VERSIONS WITH VERIFIED ANSWERS FINAL EXAM BUNDLE 2026/2027 (REAL EXAM QUESTIONS)WITH Comprehensive Practice Questions and Expert Rational

You are caring for an adult, obese patient who is 5 days post-discharge from a hospitalization due to a DVT. Which instructions would you NOT give to minimize the recurrence of a thrombosis? • A. Start vigorous exercise immediately • B. Use support stockings daily • C. Report bleeding of gums and bruising • D. Avoid prolonged inactivity • Correct Answer: A • Rationale: Initiating vigorous exercise shortly after a acute deep vein thrombosis (DVT) exponentially elevates intravascular shear stress, increasing the risk of clot dislodgment and subsequent life-threatening pulmonary embolism (PE). Activity should be lowimpact and titrated gradually under direct medical guidance. You are evaluating a 65-year-old male with known PVD and who is a current smoker. What is your initial evaluation? • A. Order a venous reflex study • B. Assess the pedal and posterior tibial pulses • C. Order compression stockings • D. Order a venogram • Correct Answer: B • Rationale: In a patient with known peripheral vascular (arterial) disease (PVD/PAD), performing a physical assessment of the dorsalis pedis and posterior tibial pulses is the mandatory initial step to determine the degree of arterial insufficiency. ️ Clinical Warning: Ordering compression stockings (Option C) without checking arterial patency is strictly contraindicated, as compression can totally occlude compromised arterial flow and induce tissue necrosis. You review a lower extremity duplex study to discover the diagnosis of a non-septic, superficial thrombophlebitis. What is the recommended treatment? • A. Cool compresses, elevate extremity, ibuprofen 400mg TID, Keflex 500 mg TID for 10 days • B. Warm compresses, elevate extremity, naproxen sodium 500mg BID with food • C. Hospital admission, IV antibiotics • D. Hospital admission, IV heparin, then warfarin PO for 3-6 months • Correct Answer: B • Rationale: Non-septic superficial thrombophlebitis is an inflammatory process rather than an infectious or deep thrombotic event. It is managed conservatively with warm compresses to promote localized blood flow, limb elevation to facilitate venous return, and NSAIDs (like naproxen) to inhibit prostaglandin synthesis, managing pain and inflammation. A 35-year-old female presents with intermittent episodes of color changes in her fingertips (blue, white, red), numbness, and tingling, lasting 2-3 hours. Symptoms worsen in winter months. What is the possible diagnosis? • A. Diabetic neuropathy • B. Poor circulation • C. Raynaud's phenomenon • D. PVT • Correct Answer: C • Rationale: The classic triphasic color response—pallor (white/vasospasm), cyanosis (blue/hypoxia), and rubor (red/hyperemia)—triggered predictably by cold temperatures or emotional stress is pathognomonic for Raynaud's phenomenon. You are treating a 35-year-old female with Raynaud's phenomenon. She is a smoker and works in an unheated warehouse. What education should you provide? (Select all that apply.) • A. Wear gloves and thick socks • B. Take warm showers daily • C. Change jobs • D. Smoking cessation and avoid cold weather • Correct Answers: A, D • Rationale: Primary management focuses on preventing vasospastic triggers. Nicotine is a potent vasoconstrictor that drastically exacerbates symptoms, making smoking cessation critical. Environmental protection via heavy insulation (gloves and socks) directly prevents the cold-induced digital vasospasms. ENT & Respiratory Conditions A 64-year-old presents with tonsillar exudate, anterior cervical adenopathy, fever, and no cough. What is the most likely causative agent? • A. Group A beta-hemolytic streptococcus • B. Rhinovirus • C. Epstein-Barr virus • D. Haemophilus influenzae • Correct Answer: A • Rationale: Utilizing the Centor Criteria for pharyngitis, this patient scores a 4 (tonsillar exudates, tender anterior cervical lymphadenopathy, history of fever, and the structural absence of a cough). This clinical presentation yields a very high positive predictive value for Group A beta-hemolytic streptococcus (GABHS). An 18-year-old male has a persistent sore throat, fever, and malaise not relieved with penicillin therapy. What should you order next? • A. A throat culture • B. A monospot test • C. A rapid antigen test • D. A Thayer-Martin plate test • Correct Answer: B • Rationale: A severe, febrile pharyngitis that fails to respond to beta-lactam antibiotics (penicillin) strongly points toward a viral etiology, specifically Infectious Mononucleosis (Epstein-Barr virus). A Heterophile Antibody Test (Monospot) is the appropriate diagnostic step. A 19-year-old male is diagnosed with mononucleosis. Which statement is true? • A. Mono is rarely contagious • B. John should avoid contact sports and heavy lifting • C. The offending organism is bacterial and should be treated with antibiotics • D. Convalescence is usually only a few days, and John should be back to normal in a week • Correct Answer: B • Rationale: Lymphocyte proliferation during an EBV infection routinely causes benign splenomegaly. To eliminate the catastrophic risk of splenic rupture, patients must strictly avoid contact sports, heavy lifting, or vigorous activities for a minimum of 3–4 weeks from symptom onset. A 52-year-old male with chronic allergic rhinitis is taking cimetidine (Tagamet) for GERD. Which medication should you NOT prescribe? • A. A first-generation antihistamine • B. A decongestant • C. A second-generation antihistamine • D. A topical nasal corticosteroid • Correct Answer: A • Rationale: Cimetidine is a potent hepatic CYP450 enzyme inhibitor. Concomitant administration with first-generation antihistamines (e.g., diphenhydramine) slows the clearance of the antihistamine, severely amplifying central nervous system (CNS) side effects like extreme sedation, anticholinergic toxicity, and cognitive impairment. A 25-year-old woman with seasonal allergic rhinitis asks when the pollen count is lowest. You respond: A. Early in the morning B. When the sky is overcast C. After a rain shower • D. During breezy times of the day • Correct Answer: C • Rationale: Atmospheric precipitation mechanically forces airborne particulates out of suspension. Rain showers strip pollen grains directly from the air, creating a temporary period of significantly diminished pollen counts. Conversely, warm, breezy mornings exhibit peak pollen dispersion. You prescribe nasal corticosteroid spray for a patient with allergic rhinitis. What is the anticipated onset of symptom relief with its use? • A. 2 or more weeks • B. 1-2 days • C. Immediately with the first spray • D. A few days to a week • Correct Answer: D • Rationale: Intranasal corticosteroids exert their effect by downregulating inflammatory gene transcription. Because this involves cellular protein modification rather than a direct mechanical blockade, patients will not experience immediate relief; peak therapeutic benefit typically builds within a few days to one full week of continuous daily adherence. Which of the following medications is most appropriate for allergic rhinitis therapy in an acutely symptomatic 24 y/o machine operator? • A. Diphenhydramine • B. Nasal cromolyn • C. Flunisolide nasal spray • D. Loratadine • Correct Answer: D • Rationale: For an individual operating heavy, potentially dangerous machinery, a secondgeneration antihistamine (Loratadine) is the ideal selection. It acts as a selective peripheral H1 antagonist and does not readily cross the blood-brain barrier, providing rapid relief from acute histaminergic symptoms without causing the dangerous sedation of first-generation agents like diphenhydramine. Oral decongestants should be discouraged in patients with: • A. Allergic rhinitis • B. Chronic bronchitis • C. Migraine headache • D. Cardiovascular disease • Correct Answer: D • Rationale: Oral decongestants (such as pseudoephedrine) are systemic alpha-1 adrenergic agonists. By causing widespread systemic vasoconstriction, they routinely cause elevated blood pressure (hypertension) and tachycardia, which increases myocardial oxygen demand and places patients with pre-existing cardiovascular disease at high risk for arrhythmias or ischemic events. Which of the following findings is most consistent with the diagnosis of acute bacterial rhinosinusitis (ABRS)? • A. Upper respiratory tract infections persisting or worsening after 7-10 days • B. Marked eyelid edema • C. Periauricular lymphadenopathy • D. Mild midfacial fullness and tenderness • Correct Answer: A • Rationale: While viral rhinosinusitis typically peaks by day 5 and resolves within a week, ABRS is clinically characterized by a "double-sickening" phenomenon or signs/symptoms that persist worsening or unchanged for 10 or more days, or severe symptoms (high fever, purulent nasal discharge) lasting for 3–4 consecutive days at the start of the illness.