,BRAND NEW TEST BANK – VARCAROLIS’S CANADIAN PSYCHIATRIC
MENTAL HEALTH NURSING, THIRD EDITION (JAKUBEC &
POLLARD) | PROVIDED WITH QUESTIONS AND ANSWERS |- A
MASTERPIECE RELEASE & UPDATE OF 2025/2026-
1 A client with schizophrenia tells the nurse, “Aliens are putting microchips in my brain.” Which
therapeutic response best addresses this delusion without reinforcing it?
a) “That sounds frightening, but I don’t believe aliens exist.”
b) “Tell me more about the microchips.”
c) “You are safe here; no aliens can enter this unit.”
d) “Let’s focus on something real, like your lunch.”
➢ CORRECT ANSWER a) “That sounds frightening, but I don’t believe aliens exist.”
➢ Rationale: Validates the emotion without endorsing the false belief; this aligns with
reality orientation while maintaining therapeutic alliance.
DIF: Cognitive Level: Apply | TOP: Therapeutic Communication | MSC: Psychosocial Integrity
2. A nurse is assessing a First Nations client for depression. Which action demonstrates culturally
competent care?
a) Avoiding eye contact as a sign of respect.
b) Asking direct closed-ended questions about suicidal thoughts.
c) Using only Western depression screening tools without modification.
d) Assuming the client will prefer individual over family counselling.
➢ CORRECT ANSWER a) Avoiding eye contact as a sign of respect.
➢ Rationale: In many Indigenous cultures, direct eye contact may be seen as disrespectful;
adapting approach shows cultural safety.
DIF: Cognitive Level: Apply | TOP: Cultural Competence | MSC: Psychosocial Integrity
3. A client with bipolar I disorder stops lithium after feeling “cured.” What is the nurse’s priority
assessment?
a) Sleep patterns and energy level.
b) Serum lithium level.
,c) Presence of pressured speech and grandiosity.
d) Risk for self-harm due to depressive rebound.
➢ CORRECT ANSWER c) Presence of pressured speech and grandiosity.
➢ Rationale: Abrupt lithium cessation often triggers manic relapse; early signs include
grandiosity, decreased need for sleep, and pressured speech.
DIF: Cognitive Level: Analyze | TOP: Mood Disorders | MSC: Pharmacological Therapies
4. During a mental status exam, a client cannot remember the name of the current prime minister.
Which cognitive domain is impaired?
a) Registration.
b) Recent memory.
c) Remote memory.
d) New learning ability.
➢ CORRECT ANSWER b) Recent memory.
➢ Rationale: Knowing current political leaders tests recent memory (events from past
months to years), not remote (childhood) or immediate.
DIF: Cognitive Level: Understand | TOP: Cognitive Disorders | MSC: Assessment
5. A client with borderline personality disorder says, “You’re the only nurse who actually cares.
The night nurse is a monster.” Which nursing response is most therapeutic?
a) “I’m glad you feel safe with me.”
b) “The night nurse is very experienced and kind.”
c) “I see things as less black and white. Let’s talk about the whole day.”
d) “You shouldn’t say that about a colleague.”
➢ CORRECT ANSWER c) “I see things as less black and white. Let’s talk about the whole
day.”
➢ Rationale: Addresses splitting (idealization/devaluation) by modelling integrated thinking
without defending the other nurse directly.
DIF: Cognitive Level: Apply | TOP: Personality Disorders | MSC: Psychosocial Integrity
6. A client prescribed clozapine reports sore throat, fever, and lethargy. What is the nurse’s
priority action?
, a) Administer acetaminophen and encourage fluids.
b) Hold the next dose and notify the prescriber immediately.
c) Reassure the client these are common side effects.
d) Obtain a throat swab for culture.
➢ CORRECT ANSWER b) Hold the next dose and notify the prescriber immediately.
➢ Rationale: Fever and sore throat can indicate agranulocytosis, a life-threatening clozapine
side effect requiring immediate blood work.
DIF: Cognitive Level: Analyze | TOP: Psychopharmacology | MSC: Physiological Integrity
7. A client says, “I want to die but don’t have a plan.” Which question best assesses immediate
risk?
a) “Have you ever attempted suicide before?”
b) “What has stopped you from making a plan?”
c) “Do you own any weapons or have access to medications?”
d) “How long have you felt this way?”
➢ CORRECT ANSWER c) “Do you own any weapons or have access to medications?”
➢ Rationale: Means assessment is critical even without current plan; access to lethal means
dramatically raises short-term risk.
DIF: Cognitive Level: Apply | TOP: Suicide Prevention | MSC: Safety
8. A nurse observes another staff member physically restraining a client face-down. What should
the nurse do first?
a) Document the incident in the client’s chart.
b) Report to the nurse manager after the shift.
c) Intervene immediately to stop prone restraint.
d) Ask the staff member if they have completed restraint training.
➢ CORRECT ANSWER c) Intervene immediately to stop prone restraint.
➢ Rationale: Prone (face-down) restraint is dangerous and linked to asphyxiation; Canadian
standards prohibit it, requiring immediate action.
DIF: Cognitive Level: Apply | TOP: Legal/Ethical Issues | MSC: Safety
MENTAL HEALTH NURSING, THIRD EDITION (JAKUBEC &
POLLARD) | PROVIDED WITH QUESTIONS AND ANSWERS |- A
MASTERPIECE RELEASE & UPDATE OF 2025/2026-
1 A client with schizophrenia tells the nurse, “Aliens are putting microchips in my brain.” Which
therapeutic response best addresses this delusion without reinforcing it?
a) “That sounds frightening, but I don’t believe aliens exist.”
b) “Tell me more about the microchips.”
c) “You are safe here; no aliens can enter this unit.”
d) “Let’s focus on something real, like your lunch.”
➢ CORRECT ANSWER a) “That sounds frightening, but I don’t believe aliens exist.”
➢ Rationale: Validates the emotion without endorsing the false belief; this aligns with
reality orientation while maintaining therapeutic alliance.
DIF: Cognitive Level: Apply | TOP: Therapeutic Communication | MSC: Psychosocial Integrity
2. A nurse is assessing a First Nations client for depression. Which action demonstrates culturally
competent care?
a) Avoiding eye contact as a sign of respect.
b) Asking direct closed-ended questions about suicidal thoughts.
c) Using only Western depression screening tools without modification.
d) Assuming the client will prefer individual over family counselling.
➢ CORRECT ANSWER a) Avoiding eye contact as a sign of respect.
➢ Rationale: In many Indigenous cultures, direct eye contact may be seen as disrespectful;
adapting approach shows cultural safety.
DIF: Cognitive Level: Apply | TOP: Cultural Competence | MSC: Psychosocial Integrity
3. A client with bipolar I disorder stops lithium after feeling “cured.” What is the nurse’s priority
assessment?
a) Sleep patterns and energy level.
b) Serum lithium level.
,c) Presence of pressured speech and grandiosity.
d) Risk for self-harm due to depressive rebound.
➢ CORRECT ANSWER c) Presence of pressured speech and grandiosity.
➢ Rationale: Abrupt lithium cessation often triggers manic relapse; early signs include
grandiosity, decreased need for sleep, and pressured speech.
DIF: Cognitive Level: Analyze | TOP: Mood Disorders | MSC: Pharmacological Therapies
4. During a mental status exam, a client cannot remember the name of the current prime minister.
Which cognitive domain is impaired?
a) Registration.
b) Recent memory.
c) Remote memory.
d) New learning ability.
➢ CORRECT ANSWER b) Recent memory.
➢ Rationale: Knowing current political leaders tests recent memory (events from past
months to years), not remote (childhood) or immediate.
DIF: Cognitive Level: Understand | TOP: Cognitive Disorders | MSC: Assessment
5. A client with borderline personality disorder says, “You’re the only nurse who actually cares.
The night nurse is a monster.” Which nursing response is most therapeutic?
a) “I’m glad you feel safe with me.”
b) “The night nurse is very experienced and kind.”
c) “I see things as less black and white. Let’s talk about the whole day.”
d) “You shouldn’t say that about a colleague.”
➢ CORRECT ANSWER c) “I see things as less black and white. Let’s talk about the whole
day.”
➢ Rationale: Addresses splitting (idealization/devaluation) by modelling integrated thinking
without defending the other nurse directly.
DIF: Cognitive Level: Apply | TOP: Personality Disorders | MSC: Psychosocial Integrity
6. A client prescribed clozapine reports sore throat, fever, and lethargy. What is the nurse’s
priority action?
, a) Administer acetaminophen and encourage fluids.
b) Hold the next dose and notify the prescriber immediately.
c) Reassure the client these are common side effects.
d) Obtain a throat swab for culture.
➢ CORRECT ANSWER b) Hold the next dose and notify the prescriber immediately.
➢ Rationale: Fever and sore throat can indicate agranulocytosis, a life-threatening clozapine
side effect requiring immediate blood work.
DIF: Cognitive Level: Analyze | TOP: Psychopharmacology | MSC: Physiological Integrity
7. A client says, “I want to die but don’t have a plan.” Which question best assesses immediate
risk?
a) “Have you ever attempted suicide before?”
b) “What has stopped you from making a plan?”
c) “Do you own any weapons or have access to medications?”
d) “How long have you felt this way?”
➢ CORRECT ANSWER c) “Do you own any weapons or have access to medications?”
➢ Rationale: Means assessment is critical even without current plan; access to lethal means
dramatically raises short-term risk.
DIF: Cognitive Level: Apply | TOP: Suicide Prevention | MSC: Safety
8. A nurse observes another staff member physically restraining a client face-down. What should
the nurse do first?
a) Document the incident in the client’s chart.
b) Report to the nurse manager after the shift.
c) Intervene immediately to stop prone restraint.
d) Ask the staff member if they have completed restraint training.
➢ CORRECT ANSWER c) Intervene immediately to stop prone restraint.
➢ Rationale: Prone (face-down) restraint is dangerous and linked to asphyxiation; Canadian
standards prohibit it, requiring immediate action.
DIF: Cognitive Level: Apply | TOP: Legal/Ethical Issues | MSC: Safety
