Nursing Proctored Exam Study Guide & Practice Questions |
ATI Mental Health Content Mastery Series Exam Prep,
Psychiatric Nursing Review, Therapeutic Communication,
Mental Health Assessment, Anxiety & OCD, Trauma & Crisis,
Mood Disorders, Suicide & Self-Harm Safety, Schizophrenia &
Psychosis, Personality Disorders, Substance Use & Addiction,
Neurocognitive Disorders, Eating Disorders, Child &
Adolescent Mental Health, Psychopharmacology, Medication
Adverse Effects, Legal & Ethical Nursing, Client Safety,
Prioritization, Clinical Judgment, NGN-Style Case Studies &
Detailed Rationales
Question 1: A nurse is assessing a client who recently experienced
a traumatic event. The client reports intrusive memories and
avoids reminders of the event. Which finding is most characteristic
of acute stress disorder rather than post-traumatic stress disorder?
A. Symptoms began within 3 days of the trauma and resolve within 1 month
B. Symptoms persist for more than 1 month after the trauma
C. The client experiences dissociative amnesia lasting for years
D. The client has a comorbid diagnosis of major depressive disorder
CORRECT ANSWER: A. Symptoms began within 3 days of the
trauma and resolve within 1 month
Rationale: Acute stress disorder is diagnosed when symptoms occur within
3 days to 1 month following a traumatic event. If symptoms persist beyond
1 month, the diagnosis changes to post-traumatic stress disorder. Option B
describes PTSD, Option C is not a defining temporal feature, and Option D
is a comorbidity, not a distinguishing factor.
Question 2: A nurse is caring for a client with schizophrenia who
has been prescribed clozapine. Which laboratory value requires
immediate notification of the provider?
A. White blood cell count of 3,500/mm³
B. Absolute neutrophil count of 1,200/μL
C. Hemoglobin of 13.5 g/dL
D. Platelet count of 250,000/mm³
CORRECT ANSWER: B. Absolute neutrophil count of 1,200/μL
,Rationale: Clozapine carries a risk of severe neutropenia and
agranulocytosis. An absolute neutrophil count below 1,500/μL is a critical
value requiring immediate intervention. The other values are within normal
ranges.
Question 3: A client with borderline personality disorder tells the
nurse, "You're the only one who understands me. I don't know
what I'd do without you." Which phenomenon is the client
demonstrating?
A. Splitting
B. Idealization
C. Projection
D. Regression
CORRECT ANSWER: B. Idealization
Rationale: Idealization is a defense mechanism common in borderline
personality disorder where the client perceives another person as perfect or
exclusively good. Splitting involves alternating between idealization and
devaluation. Projection involves attributing one's own unacceptable feelings
to others. Regression involves reverting to earlier developmental behaviors.
Question 4: A nurse is conducting a suicide risk assessment. Which
client statement indicates the highest level of imminent risk?
A. "I think about dying sometimes, but I would never actually do it."
B. "I have a plan to shoot myself, and I have access to a gun."
C. "Everyone would be better off if I just disappeared."
D. "I felt this way last year, but I got through it."
CORRECT ANSWER: B. "I have a plan to shoot myself, and I have
access to a gun."
Rationale: The highest imminent risk for suicide is indicated by the
presence of a specific plan with access to lethal means. Options A, C, and D
express distress but lack the combination of a concrete plan and immediate
access to means.
Question 5: A client with anorexia nervosa is admitted to the
inpatient unit. Which nursing intervention takes priority during the
initial phase of treatment?
,A. Establishing a contract for weight gain goals
B. Monitoring vital signs and electrolyte levels
C. Exploring the client's body image distortions
D. Encouraging the client to discuss family dynamics
CORRECT ANSWER: B. Monitoring vital signs and electrolyte levels
Rationale: Physiological stabilization is the priority for clients with anorexia
nervosa, who are at risk for cardiac arrhythmias, electrolyte imbalances,
and refeeding syndrome. Psychotherapeutic interventions follow once the
client is medically stable.
Question 6: A nurse is teaching a client about lithium therapy.
Which statement by the client indicates a need for further
teaching?
A. "I should drink at least 2 to 3 liters of water daily."
B. "I need to maintain a consistent sodium intake."
C. "I can take ibuprofen for headaches without concern."
D. "I will have blood levels checked regularly."
CORRECT ANSWER: C. "I can take ibuprofen for headaches without
concern."
Rationale: Nonsteroidal anti-inflammatory drugs like ibuprofen can increase
lithium levels by reducing renal blood flow, potentially leading to toxicity.
Clients should avoid NSAIDs and use acetaminophen instead. Options A, B,
and D are correct statements about lithium therapy.
Question 7: A nurse is caring for a client experiencing alcohol
withdrawal. Which medication should the nurse anticipate
administering?
A. Naltrexone
B. Disulfiram
C. Lorazepam
D. Acamprosate
CORRECT ANSWER: C. Lorazepam
Rationale: Benzodiazepines such as lorazepam are the first-line treatment
for alcohol withdrawal to prevent seizures and delirium tremens.
Naltrexone, disulfiram, and acamprosate are used for relapse prevention,
not acute withdrawal management.
, Question 8: A client with major depressive disorder is prescribed
sertraline. Which instruction should the nurse include in the
teaching plan?
A. "Take the medication at bedtime to avoid daytime drowsiness."
B. "Expect full therapeutic effects within 3 to 5 days."
C. "Report any increase in suicidal thoughts immediately."
D. "Discontinue the medication if you feel better."
CORRECT ANSWER: C. "Report any increase in suicidal thoughts
immediately."
Rationale: SSRIs may increase suicidal ideation, especially in the initial
weeks of therapy or when doses are adjusted. Clients must be monitored
closely for this adverse effect. Sertraline is typically taken in the morning,
full effects take 2 to 4 weeks, and the medication should not be
discontinued abruptly.
Question 9: A nurse is assessing a client with suspected delirium.
Which finding differentiates delirium from dementia?
A. Gradual onset over months
B. Stable cognitive deficits
C. Acute onset with fluctuating consciousness
D. Preserved attention span
CORRECT ANSWER: C. Acute onset with fluctuating consciousness
Rationale: Delirium is characterized by an acute onset, fluctuating level of
consciousness, and impaired attention. Dementia has a gradual onset with
stable, progressive cognitive decline and typically preserved consciousness
until late stages.
Question 10: A client with obsessive-compulsive disorder performs
handwashing rituals for several hours each day. Which nursing
diagnosis is most appropriate?
A. Impaired social interaction
B. Anxiety related to uncontrollable obsessive thoughts
C. Disturbed body image
D. Chronic low self-esteem
CORRECT ANSWER: B. Anxiety related to uncontrollable obsessive
thoughts