**The Psychiatric Mental Health Nursing
Proctored: NGN Clinical Judgment &
Pharmacotherapy**
1. A nurse is assessing a client with major depressive disorder. Which finding is most concerning for the
client’s safety?
A) Anhedonia and social withdrawal
B) Insomnia and fatigue
C) Statements of hopelessness and a specific suicide plan
D) Weight loss of 5 pounds in 2 weeks
💫RATIONALE✔️✔️: A specific suicide plan with intent is the highest priority safety risk in depression.
💫ANSWER✔️✔️: C) Statements of hopelessness and a specific suicide plan
---
2. A client with bipolar disorder is in the manic phase. Which intervention is most appropriate?
A) Place the client in a private room with minimal stimulation
B) Encourage competitive games to redirect energy
C) Offer high-calorie finger foods and frequent rest periods
D) Use a firm, authoritative voice to set limits
💫RATIONALE✔️✔️: High-calorie finger foods accommodate increased activity and decreased attention
span; low stimulation prevents escalation.
💫ANSWER✔️✔️: C) Offer high-calorie finger foods and frequent rest periods
---
,3. A nurse is caring for a client with schizophrenia who reports hearing voices telling them to harm
others. Which action should the nurse take first?
A) Document the client’s statement
B) Ask the client if they have a plan to harm others
C) Place the client in seclusion immediately
D) Administer a PRN antipsychotic medication
💫RATIONALE✔️✔️: Assess for command hallucinations and intent/plan to ensure client and staff safety.
💫ANSWER✔️✔️: B) Ask the client if they have a plan to harm others
---
4. A client with post-traumatic stress disorder (PTSD) reports frequent nightmares and flashbacks. Which
medication does the nurse anticipate?
A) Haloperidol
B) Prazosin
C) Lithium
D) Clozapine
💫RATIONALE✔️✔️: Prazosin, an alpha-blocker, is effective for PTSD-related nightmares and sleep
disturbances.
💫ANSWER✔️✔️: B) Prazosin
---
5. A nurse is assessing a client with anorexia nervosa. Which finding is most concerning?
A) Weight 85% of ideal body weight
B) Serum potassium 2.8 mEq/L
C) Lanugo on the back and arms
D) Amenorrhea for 6 months
💫RATIONALE✔️✔️: Hypokalemia (2.8) can cause cardiac dysrhythmias and is a medical emergency.
💫ANSWER✔️✔️: B) Serum potassium 2.8 mEq/L
,---
6. A client with borderline personality disorder reports feeling empty and threatens self-harm. Which
intervention is priority?
A) Place the client on one-to-one observation
B) Allow the client to call a family member
C) Administer a PRN benzodiazepine
D) Encourage the client to attend group therapy
💫RATIONALE✔️✔️: Imminent self-harm requires immediate safety measures, including constant
observation.
💫ANSWER✔️✔️: A) Place the client on one-to-one observation
---
7. A nurse is caring for a client with alcohol use disorder who is experiencing withdrawal. Which finding
indicates severe withdrawal?
A) Insomnia and mild anxiety
B) Diaphoresis and tremors
C) Seizure activity and hallucinations
D) Headache and nausea
💫RATIONALE✔️✔️: Seizures and hallucinations indicate severe withdrawal (delirium tremens), a medical
emergency.
💫ANSWER✔️✔️: C) Seizure activity and hallucinations
---
8. A client with schizophrenia is taking clozapine. Which lab value requires immediate action?
A) Absolute neutrophil count 1,200/mm³
B) White blood cell count 7,500/mm³
C) Hemoglobin 13 g/dL
D) Platelets 200,000/mm³
💫RATIONALE✔️✔️: ANC <1,500 indicates agranulocytosis; stop clozapine and notify provider
immediately.
, 💫ANSWER✔️✔️: A) Absolute neutrophil count 1,200/mm³
---
9. A nurse is assessing a client with generalized anxiety disorder. Which finding is expected?
A) Excessive worry about multiple events for 6 months
B) Panic attacks occurring daily
C) Recurrent, intrusive thoughts
D) Compulsive hand washing
💫RATIONALE✔️✔️: GAD involves excessive, uncontrollable worry lasting at least 6 months.
💫ANSWER✔️✔️: A) Excessive worry about multiple events for 6 months
---
10. A client with major depressive disorder is started on phenelzine. Which food should the nurse
instruct the client to avoid?
A) Fresh salmon
B) Aged cheddar cheese
C) Apples
D) White bread
💫RATIONALE✔️✔️: MAOIs require tyramine restriction; aged cheese, cured meats, and fermented foods
can cause hypertensive crisis.
💫ANSWER✔️✔️: B) Aged cheddar cheese
---
11. A nurse is caring for a client in the emergency department after a sexual assault. Which action is
most important?
A) Offer the client a shower and clean clothes
B) Obtain informed consent for the forensic exam
C) Ask the client detailed questions about the assault
D) Call the client’s family immediately
Proctored: NGN Clinical Judgment &
Pharmacotherapy**
1. A nurse is assessing a client with major depressive disorder. Which finding is most concerning for the
client’s safety?
A) Anhedonia and social withdrawal
B) Insomnia and fatigue
C) Statements of hopelessness and a specific suicide plan
D) Weight loss of 5 pounds in 2 weeks
💫RATIONALE✔️✔️: A specific suicide plan with intent is the highest priority safety risk in depression.
💫ANSWER✔️✔️: C) Statements of hopelessness and a specific suicide plan
---
2. A client with bipolar disorder is in the manic phase. Which intervention is most appropriate?
A) Place the client in a private room with minimal stimulation
B) Encourage competitive games to redirect energy
C) Offer high-calorie finger foods and frequent rest periods
D) Use a firm, authoritative voice to set limits
💫RATIONALE✔️✔️: High-calorie finger foods accommodate increased activity and decreased attention
span; low stimulation prevents escalation.
💫ANSWER✔️✔️: C) Offer high-calorie finger foods and frequent rest periods
---
,3. A nurse is caring for a client with schizophrenia who reports hearing voices telling them to harm
others. Which action should the nurse take first?
A) Document the client’s statement
B) Ask the client if they have a plan to harm others
C) Place the client in seclusion immediately
D) Administer a PRN antipsychotic medication
💫RATIONALE✔️✔️: Assess for command hallucinations and intent/plan to ensure client and staff safety.
💫ANSWER✔️✔️: B) Ask the client if they have a plan to harm others
---
4. A client with post-traumatic stress disorder (PTSD) reports frequent nightmares and flashbacks. Which
medication does the nurse anticipate?
A) Haloperidol
B) Prazosin
C) Lithium
D) Clozapine
💫RATIONALE✔️✔️: Prazosin, an alpha-blocker, is effective for PTSD-related nightmares and sleep
disturbances.
💫ANSWER✔️✔️: B) Prazosin
---
5. A nurse is assessing a client with anorexia nervosa. Which finding is most concerning?
A) Weight 85% of ideal body weight
B) Serum potassium 2.8 mEq/L
C) Lanugo on the back and arms
D) Amenorrhea for 6 months
💫RATIONALE✔️✔️: Hypokalemia (2.8) can cause cardiac dysrhythmias and is a medical emergency.
💫ANSWER✔️✔️: B) Serum potassium 2.8 mEq/L
,---
6. A client with borderline personality disorder reports feeling empty and threatens self-harm. Which
intervention is priority?
A) Place the client on one-to-one observation
B) Allow the client to call a family member
C) Administer a PRN benzodiazepine
D) Encourage the client to attend group therapy
💫RATIONALE✔️✔️: Imminent self-harm requires immediate safety measures, including constant
observation.
💫ANSWER✔️✔️: A) Place the client on one-to-one observation
---
7. A nurse is caring for a client with alcohol use disorder who is experiencing withdrawal. Which finding
indicates severe withdrawal?
A) Insomnia and mild anxiety
B) Diaphoresis and tremors
C) Seizure activity and hallucinations
D) Headache and nausea
💫RATIONALE✔️✔️: Seizures and hallucinations indicate severe withdrawal (delirium tremens), a medical
emergency.
💫ANSWER✔️✔️: C) Seizure activity and hallucinations
---
8. A client with schizophrenia is taking clozapine. Which lab value requires immediate action?
A) Absolute neutrophil count 1,200/mm³
B) White blood cell count 7,500/mm³
C) Hemoglobin 13 g/dL
D) Platelets 200,000/mm³
💫RATIONALE✔️✔️: ANC <1,500 indicates agranulocytosis; stop clozapine and notify provider
immediately.
, 💫ANSWER✔️✔️: A) Absolute neutrophil count 1,200/mm³
---
9. A nurse is assessing a client with generalized anxiety disorder. Which finding is expected?
A) Excessive worry about multiple events for 6 months
B) Panic attacks occurring daily
C) Recurrent, intrusive thoughts
D) Compulsive hand washing
💫RATIONALE✔️✔️: GAD involves excessive, uncontrollable worry lasting at least 6 months.
💫ANSWER✔️✔️: A) Excessive worry about multiple events for 6 months
---
10. A client with major depressive disorder is started on phenelzine. Which food should the nurse
instruct the client to avoid?
A) Fresh salmon
B) Aged cheddar cheese
C) Apples
D) White bread
💫RATIONALE✔️✔️: MAOIs require tyramine restriction; aged cheese, cured meats, and fermented foods
can cause hypertensive crisis.
💫ANSWER✔️✔️: B) Aged cheddar cheese
---
11. A nurse is caring for a client in the emergency department after a sexual assault. Which action is
most important?
A) Offer the client a shower and clean clothes
B) Obtain informed consent for the forensic exam
C) Ask the client detailed questions about the assault
D) Call the client’s family immediately
