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Psychiatric and Mental Health Nursing · Mental Health Nursing Practice Quiz

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Showing all 15 practice questions with expert explanatory rationales.

Question 1 of 15

Case excerpt

A client taking an SSRI for depression says, 'I feel a little better, so I stopped it yesterday.'

Which teaching should the nurse provide?

A. Replace the prescription with St. John's wort without consultation
B. Stop and restart the medicine whenever mood changes
C. Take two doses tomorrow to make up for missed doses
D. The medication works only when taken as needed
E. Discuss any medication change with the prescriber; abrupt discontinuation can cause symptoms

Expert Explanatory Rationale

Correct Answer: E. Discuss any medication change with the prescriber; abrupt discontinuation can cause symptoms

SSRIs should not be stopped abruptly without clinical guidance because discontinuation symptoms and relapse may occur.

Question 2 of 15

Case excerpt

A client with obsessive-compulsive disorder spends 90 minutes washing hands and has cracked skin.

Which initial nursing approach is most appropriate?

A. Set an abrupt ban on all handwashing
B. Ridicule the behavior to increase insight
C. Assess the ritual's triggers and impact, then collaborate on gradual treatment goals
D. Perform the ritual for the client
E. Ignore skin breakdown because the behavior is psychological

Expert Explanatory Rationale

Correct Answer: C. Assess the ritual's triggers and impact, then collaborate on gradual treatment goals

Assessment and collaborative, gradual interventions support treatment while protecting skin integrity and avoiding power struggles.

Question 3 of 15

Case excerpt

A client with mania has slept two hours in three days, is intrusive, and cannot remain seated during meals.

Which intervention is best?

A. Require attendance at a lengthy group discussion
B. Encourage competitive games
C. Offer high-calorie finger foods and fluids in a low-stimulation setting
D. Confront the client publicly about disruptive behavior
E. Provide unlimited caffeine

Expert Explanatory Rationale

Correct Answer: C. Offer high-calorie finger foods and fluids in a low-stimulation setting

A structured low-stimulation environment, portable nutritious foods, hydration, and rest support clients experiencing mania.

Question 4 of 15

Case excerpt

A client with borderline personality disorder tells one nurse, 'You are the only good nurse here; the others are cruel.'

Which team response is most therapeutic?

A. Compete with other staff for the client's approval
B. Allow the client to choose which rules apply each shift
C. Share negative opinions about colleagues
D. Maintain consistent limits and communicate the care plan across staff
E. Change boundaries whenever the client becomes upset

Expert Explanatory Rationale

Correct Answer: D. Maintain consistent limits and communicate the care plan across staff

Consistent, clearly communicated limits reduce splitting and support a predictable therapeutic environment.

Question 5 of 15

Case excerpt

A client with dementia becomes agitated each evening and repeatedly asks to go home.

Which response is most appropriate?

A. Acknowledge the emotion and redirect to a familiar, calming activity
B. Turn on loud television to distract the client
C. Argue that the client already lives there
D. Use restraints before assessing possible causes
E. Quiz the client repeatedly about the date

Expert Explanatory Rationale

Correct Answer: A. Acknowledge the emotion and redirect to a familiar, calming activity

Validation, reassurance, and gentle redirection are preferable to arguing or repeatedly testing orientation.

Question 6 of 15

Case excerpt

A client with anorexia nervosa is beginning a supervised nutritional rehabilitation plan.

Which complication should the nurse monitor for during early refeeding?

A. Hypercalcemia from every meal
B. Refeeding syndrome with electrolyte shifts, especially low phosphate
C. Permanent suppression of insulin
D. Iron overload after one snack
E. Immediate improvement in cardiac function

Expert Explanatory Rationale

Correct Answer: B. Refeeding syndrome with electrolyte shifts, especially low phosphate

Refeeding can cause dangerous shifts in phosphate, potassium, and magnesium; monitor laboratory values and clinical status closely.

Question 7 of 15

Case excerpt

A client who recently started an antipsychotic develops a temperature of 40°C (104°F), severe muscle rigidity, confusion, and unstable blood pressure.

Which complication should the nurse suspect?

A. Mild akathisia
B. Neuroleptic malignant syndrome
C. Seasonal affective disorder
D. Simple dehydration only
E. Expected medication adjustment

Expert Explanatory Rationale

Correct Answer: B. Neuroleptic malignant syndrome

Hyperthermia, rigidity, altered mental status, and autonomic instability are hallmark warning signs of neuroleptic malignant syndrome.

Question 8 of 15

Case excerpt

A client with generalized anxiety disorder says worry prevents sleep and concentration most days.

Which intervention should the nurse discuss as part of a longer-term plan?

A. Cognitive behavioral therapy and evidence-based anxiety management
B. Relying only on reassurance from family
C. Using alcohol to induce sleep
D. Stopping all prescribed treatment once anxiety decreases
E. Avoiding all activity that causes mild stress

Expert Explanatory Rationale

Correct Answer: A. Cognitive behavioral therapy and evidence-based anxiety management

Cognitive behavioral therapy is an evidence-based treatment for generalized anxiety disorder and can be combined with other individualized care.

Question 9 of 15

Case excerpt

For Mental Health Nursing Practice Quiz: A nurse is caring for a client experiencing acute mania. Which interventions are appropriate.

A nurse is caring for a client experiencing acute mania. Which interventions are appropriate? (Select all that apply)

A. Set consistent limits on unsafe behavior
B. Use brief, clear directions
C. Schedule multiple competitive group activities
D. Reduce environmental stimulation
E. Offer portable, high-calorie foods

Expert Explanatory Rationale

Correct Answer: A. Set consistent limits on unsafe behavior; B. Use brief, clear directions; D. Reduce environmental stimulation; E. Offer portable, high-calorie foods

Low stimulation, simple communication, nutrition, hydration, rest, and consistent limits support care during mania.

Question 10 of 15

Case excerpt

For Mental Health Nursing Practice Quiz: A client with obsessive-compulsive disorder is receiving cognitive behavioral therapy. Which interventions may be included in exposure and response prevention.

A client with obsessive-compulsive disorder is receiving cognitive behavioral therapy. Which interventions may be included in exposure and response prevention? (Select all that apply)

A. Performing the ritual immediately after every exposure
B. Tracking anxiety and progress
C. Gradual exposure to a feared trigger
D. Developing a hierarchy of anxiety-provoking situations
E. Practicing delaying or resisting the ritual

Expert Explanatory Rationale

Correct Answer: B. Tracking anxiety and progress; C. Gradual exposure to a feared trigger; D. Developing a hierarchy of anxiety-provoking situations; E. Practicing delaying or resisting the ritual

Exposure and response prevention uses planned exposure and reduction of compulsive responses while monitoring progress.

Question 11 of 15

Case excerpt

For Mental Health Nursing Practice Quiz: A client with dementia becomes agitated during evening care. Which nursing actions may reduce distress.

A client with dementia becomes agitated during evening care. Which nursing actions may reduce distress? (Select all that apply)

A. Reduce excess noise and stimulation
B. Use familiar objects or calming activities
C. Argue repeatedly to correct inaccurate memories
D. Maintain a predictable routine
E. Check for pain, hunger, toileting needs, and fatigue

Expert Explanatory Rationale

Correct Answer: A. Reduce excess noise and stimulation; B. Use familiar objects or calming activities; D. Maintain a predictable routine; E. Check for pain, hunger, toileting needs, and fatigue

Assess unmet needs, preserve routine, reduce stimulation, and use familiar calming approaches rather than arguing.

Question 12 of 15

Case excerpt

For Mental Health Nursing Practice Quiz: A client prescribed an SSRI is receiving discharge education. Which statements should the nurse include.

A client prescribed an SSRI is receiving discharge education. Which statements should the nurse include? (Select all that apply)

A. Consult the prescriber before stopping the medication
B. Take extra doses when a dose is missed
C. Ask before adding serotonergic medicines or supplements
D. Full benefit may take several weeks
E. Report worsening suicidal thoughts or unusual behavioral changes

Expert Explanatory Rationale

Correct Answer: A. Consult the prescriber before stopping the medication; C. Ask before adding serotonergic medicines or supplements; D. Full benefit may take several weeks; E. Report worsening suicidal thoughts or unusual behavioral changes

SSRIs take time to work; monitor safety, avoid abrupt changes, and check for interactions.

Question 13 of 15

Case excerpt

For Mental Health Nursing Practice Quiz: A client with panic disorder is learning coping strategies. Which techniques may help manage early symptoms.

A client with panic disorder is learning coping strategies. Which techniques may help manage early symptoms? (Select all that apply)

A. Slow, paced breathing
B. Recognizing early physical warning signs
C. Reducing caffeine if it worsens symptoms
D. Breathing rapidly into a paper bag
E. Grounding by naming objects in the environment

Expert Explanatory Rationale

Correct Answer: A. Slow, paced breathing; B. Recognizing early physical warning signs; C. Reducing caffeine if it worsens symptoms; E. Grounding by naming objects in the environment

Paced breathing, grounding, awareness of early signs, and reducing triggers can help; paper-bag rebreathing is unsafe.

Question 14 of 15

Case excerpt

Mental Health Nursing Practice Quiz: A client is prescribed 0.5 mg of lorazepam. Tablets available are 0.25 mg each. How many tablets make one dose? Enter the number only.

A client is prescribed 0.5 mg of lorazepam. Tablets available are 0.25 mg each. How many tablets make one dose? Enter the number only.

Expert Explanatory Rationale

Correct Answer: 2

0.5 mg ÷ 0.25 mg/tablet = 2 tablets.

Question 15 of 15

Case excerpt

Mental Health Nursing Practice Quiz: A client develops suspected neuroleptic malignant syndrome. Place the nursing actions in the safest order.

A client develops suspected neuroleptic malignant syndrome. Place the nursing actions in the safest order.

A. Recognize fever, rigidity, and altered mental status as an emergency
B. Hold the antipsychotic and activate urgent medical response
C. Assess airway, breathing, circulation, and vital signs
D. Prepare for prescribed supportive treatment and monitoring
E. Reassess temperature, muscle status, and organ function

Expert Explanatory Rationale

Correct Answer: A. Recognize fever, rigidity, and altered mental status as an emergency; B. Hold the antipsychotic and activate urgent medical response; C. Assess airway, breathing, circulation, and vital signs; D. Prepare for prescribed supportive treatment and monitoring; E. Reassess temperature, muscle status, and organ function

Recognize the emergency, stop the causative medication, stabilize and assess, provide supportive treatment, and monitor.

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