MARYVILLE NURS 663 EXAM 1 STUDY GUIDE | PRACTICE
QUESTIONS, VERIFIED ANSWERS & COMPLETE SOLUTIONS
1. A psychiatric mental health nurse is completing an initial assessment of an
adult client who reports persistent sadness, loss of interest in previously
enjoyable activities, difficulty sleeping, decreased appetite, fatigue, and
difficulty concentrating for several weeks. Which additional assessment
finding is most important for the nurse to obtain first?
A. The client's preferred recreational activities
B. The client's current level of social support
C. The client's history of seasonal allergies
D. The presence of suicidal thoughts, intent, or a specific plan
Answer: D
2. A client who recently lost a spouse reports feeling sad, crying intermittently,
and having difficulty concentrating but continues to maintain personal
hygiene, eat adequately, and participate in necessary daily activities. Which
assessment approach is most appropriate?
A. Determine whether the symptoms are consistent with the expected
grieving process and assess for functional impairment
B. Immediately diagnose a major depressive disorder
C. Assume that any sadness after a loss represents pathological depression
D. Tell the client that grief should resolve within a predetermined number
of days
Answer: A
3. A nurse is assessing a client who reports hearing a voice that no one else
can hear. The client states that the voice is telling them to harm another
person. Which nursing action has the highest priority?
A. Ask the client to describe the voice's appearance
B. Determine the content, frequency, intensity, and commands associated
with the hallucination and assess immediate safety
pg. 1
, C. Tell the client that the voice is not real and should be ignored
D. Encourage the client to participate in a recreational activity
Answer: B
4. A client experiencing a first episode of psychosis believes that hospital staff
members are secretly monitoring every conversation. The client is
frightened and repeatedly asks the nurse whether the staff are conspiring
against them. Which response is most therapeutic?
A. “You are mistaken because nobody in this hospital is monitoring you.”
B. “Why would you believe the staff are conspiring against you?”
C. “I understand that this feels frightening. I do not have evidence that staff
members are conspiring against you.”
D. “You need to stop thinking about the staff because your thoughts are
irrational.”
Answer: C
5. A psychiatric nurse is establishing a therapeutic relationship with a newly
admitted client who is guarded and reluctant to answer questions. Which
nursing intervention is most appropriate during the orientation phase?
A. Establish clear expectations, explain the nurse's role, and maintain
consistent professional boundaries
B. Encourage the client to depend on the nurse for emotional support
C. Share personal experiences to demonstrate that the nurse understands
the client
D. Promise the client that everything discussed will remain completely
confidential regardless of safety concerns
Answer: A
6. A client tells the psychiatric nurse, “I have been thinking that everyone
would be better off if I were dead.” Which response should the nurse make
first?
A. “You have a lot of people who care about you.”
B. “What made you start feeling this way?”
pg. 2
, C. “Are you currently thinking about killing yourself, and do you have a
specific plan?”
D. “You should focus on the positive things in your life.”
Answer: C
7. A client with severe anxiety is pacing rapidly, speaking quickly, and
repeatedly stating that something terrible is about to happen. Which
nursing intervention is most appropriate initially?
A. Ask the client to analyze the causes of the anxiety in detail
B. Use short, simple statements and remain with the client in a calm
environment
C. Provide extensive written information about anxiety disorders
D. Encourage the client to participate in a complex group discussion
Answer: B
8. A client with panic-level anxiety reports chest tightness, trembling,
shortness of breath, and an overwhelming fear of dying. Which nursing
intervention is most appropriate during the acute episode?
A. Encourage the client to make several important decisions
B. Ask detailed questions about childhood experiences
C. Leave the client alone to reduce environmental stimulation
D. Remain with the client, reduce stimulation, and use calm, brief
communication
Answer: D
9. A client with generalized anxiety disorder reports excessive worry about
finances, health, employment, and family responsibilities on most days for
many months. Which nursing assessment finding would most strongly
support the diagnosis?
A. The anxiety is restricted to one specific feared object
B. The worry is persistent across multiple areas of life and is difficult for the
client to control
pg. 3
, C. The client experiences only brief episodes of intense fear
D. The anxiety occurs exclusively after exposure to a traumatic event
Answer: B
10. A client reports repeatedly checking whether the front door is locked
because of an intrusive fear that someone will enter the home. The client
recognizes that the repeated checking is excessive but feels unable to stop.
Which finding is most characteristic of obsessive-compulsive disorder?
A. A fixed false belief that remains unchanged despite evidence
B. A recurrent intrusive thought followed by a repetitive behavior
performed to reduce anxiety
C. A sudden loss of memory associated with psychological stress
D. A persistent elevation in mood with decreased need for sleep
Answer: B
11. A client reports having intrusive thoughts about accidentally contaminating
family members and repeatedly washes the hands for several hours each
day. Which nursing response is most appropriate?
A. “You should simply stop washing your hands when the thoughts occur.”
B. “The thoughts and behaviors are causing significant distress and
interfering with your daily functioning.”
C. “Your family should reassure you every time you have the thought.”
D. “The contamination fear proves that your environment is unsafe.”
Answer: B
12. A client with post-traumatic stress disorder reports recurrent nightmares,
intrusive memories, exaggerated startle responses, avoidance of reminders
of the trauma, and persistent hypervigilance. Which nursing assessment is
most important?
A. Determine whether the client is experiencing current suicidal or
homicidal thoughts
B. Determine whether the client prefers individual or group activities
pg. 4
QUESTIONS, VERIFIED ANSWERS & COMPLETE SOLUTIONS
1. A psychiatric mental health nurse is completing an initial assessment of an
adult client who reports persistent sadness, loss of interest in previously
enjoyable activities, difficulty sleeping, decreased appetite, fatigue, and
difficulty concentrating for several weeks. Which additional assessment
finding is most important for the nurse to obtain first?
A. The client's preferred recreational activities
B. The client's current level of social support
C. The client's history of seasonal allergies
D. The presence of suicidal thoughts, intent, or a specific plan
Answer: D
2. A client who recently lost a spouse reports feeling sad, crying intermittently,
and having difficulty concentrating but continues to maintain personal
hygiene, eat adequately, and participate in necessary daily activities. Which
assessment approach is most appropriate?
A. Determine whether the symptoms are consistent with the expected
grieving process and assess for functional impairment
B. Immediately diagnose a major depressive disorder
C. Assume that any sadness after a loss represents pathological depression
D. Tell the client that grief should resolve within a predetermined number
of days
Answer: A
3. A nurse is assessing a client who reports hearing a voice that no one else
can hear. The client states that the voice is telling them to harm another
person. Which nursing action has the highest priority?
A. Ask the client to describe the voice's appearance
B. Determine the content, frequency, intensity, and commands associated
with the hallucination and assess immediate safety
pg. 1
, C. Tell the client that the voice is not real and should be ignored
D. Encourage the client to participate in a recreational activity
Answer: B
4. A client experiencing a first episode of psychosis believes that hospital staff
members are secretly monitoring every conversation. The client is
frightened and repeatedly asks the nurse whether the staff are conspiring
against them. Which response is most therapeutic?
A. “You are mistaken because nobody in this hospital is monitoring you.”
B. “Why would you believe the staff are conspiring against you?”
C. “I understand that this feels frightening. I do not have evidence that staff
members are conspiring against you.”
D. “You need to stop thinking about the staff because your thoughts are
irrational.”
Answer: C
5. A psychiatric nurse is establishing a therapeutic relationship with a newly
admitted client who is guarded and reluctant to answer questions. Which
nursing intervention is most appropriate during the orientation phase?
A. Establish clear expectations, explain the nurse's role, and maintain
consistent professional boundaries
B. Encourage the client to depend on the nurse for emotional support
C. Share personal experiences to demonstrate that the nurse understands
the client
D. Promise the client that everything discussed will remain completely
confidential regardless of safety concerns
Answer: A
6. A client tells the psychiatric nurse, “I have been thinking that everyone
would be better off if I were dead.” Which response should the nurse make
first?
A. “You have a lot of people who care about you.”
B. “What made you start feeling this way?”
pg. 2
, C. “Are you currently thinking about killing yourself, and do you have a
specific plan?”
D. “You should focus on the positive things in your life.”
Answer: C
7. A client with severe anxiety is pacing rapidly, speaking quickly, and
repeatedly stating that something terrible is about to happen. Which
nursing intervention is most appropriate initially?
A. Ask the client to analyze the causes of the anxiety in detail
B. Use short, simple statements and remain with the client in a calm
environment
C. Provide extensive written information about anxiety disorders
D. Encourage the client to participate in a complex group discussion
Answer: B
8. A client with panic-level anxiety reports chest tightness, trembling,
shortness of breath, and an overwhelming fear of dying. Which nursing
intervention is most appropriate during the acute episode?
A. Encourage the client to make several important decisions
B. Ask detailed questions about childhood experiences
C. Leave the client alone to reduce environmental stimulation
D. Remain with the client, reduce stimulation, and use calm, brief
communication
Answer: D
9. A client with generalized anxiety disorder reports excessive worry about
finances, health, employment, and family responsibilities on most days for
many months. Which nursing assessment finding would most strongly
support the diagnosis?
A. The anxiety is restricted to one specific feared object
B. The worry is persistent across multiple areas of life and is difficult for the
client to control
pg. 3
, C. The client experiences only brief episodes of intense fear
D. The anxiety occurs exclusively after exposure to a traumatic event
Answer: B
10. A client reports repeatedly checking whether the front door is locked
because of an intrusive fear that someone will enter the home. The client
recognizes that the repeated checking is excessive but feels unable to stop.
Which finding is most characteristic of obsessive-compulsive disorder?
A. A fixed false belief that remains unchanged despite evidence
B. A recurrent intrusive thought followed by a repetitive behavior
performed to reduce anxiety
C. A sudden loss of memory associated with psychological stress
D. A persistent elevation in mood with decreased need for sleep
Answer: B
11. A client reports having intrusive thoughts about accidentally contaminating
family members and repeatedly washes the hands for several hours each
day. Which nursing response is most appropriate?
A. “You should simply stop washing your hands when the thoughts occur.”
B. “The thoughts and behaviors are causing significant distress and
interfering with your daily functioning.”
C. “Your family should reassure you every time you have the thought.”
D. “The contamination fear proves that your environment is unsafe.”
Answer: B
12. A client with post-traumatic stress disorder reports recurrent nightmares,
intrusive memories, exaggerated startle responses, avoidance of reminders
of the trauma, and persistent hypervigilance. Which nursing assessment is
most important?
A. Determine whether the client is experiencing current suicidal or
homicidal thoughts
B. Determine whether the client prefers individual or group activities
pg. 4
