Mental Health Nursing Practice Questions

Mental Health Nursing Practice Questions Related

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Kyle, a patient with schizophrenia, began taking the first-generation antipsychotic haloperidol (Haldol) last week. One day you find him sitting very stiffly and not moving. He is diaphoretic, and when you ask if he is okay, he seems unable to respond verbally. His vital signs are: BP 170/100, P 110, T 104.2°F. What is the priority nursing intervention? Select one that does not apply.

  • A. Hold his medication and contact his prescriber.
  • B. Wipe him with a washcloth wet with cold water or alcohol.
  • C. Administer a medication such as benztropine IM to correct this dystonic reaction.
  • D. Reassure him that although there is no treatment for his tardive dyskinesia, it will pass.
Correct Answer: C

Rationale: The patient's symptoms, including stiffness, diaphoresis, inability to respond verbally, and vital sign abnormalities, are indicative of neuroleptic malignant syndrome (NMS), a serious and potentially life-threatening side effect of antipsychotic medications. Administering a medication such as benztropine intramuscularly is the priority to address the dystonic reaction associated with NMS. This intervention can help alleviate symptoms and prevent further complications. Holding the medication and contacting the prescriber may be necessary but addressing the acute symptoms takes precedence. Wiping the patient with a cold washcloth or alcohol would not address the underlying medical emergency. Reassuring the patient about tardive dyskinesia is irrelevant and not the immediate concern in this scenario.

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In a client's history, a significant indicator suggesting marginal coping skills and the need for careful risk assessment for violence is a history of

  • A. childhood trauma.
  • B. family involvement.
  • C. academic problems.
  • D. chemical dependence.
Correct Answer: D

Rationale: A history of chemical dependence is a critical factor indicating marginal coping skills and the need for assessing the risk of violence. Substance abuse can impair judgment, increase impulsivity, and escalate the likelihood of violent behavior. It is essential to thoroughly evaluate and address substance abuse issues in clients to enhance treatment outcomes and ensure safety.

A client displays signs and symptoms indicative of hypochondriasis. The nurse would initially expect to see:

  • A. Self-preoccupation
  • B. La belle indifference
  • C. Fear of physicians
  • D. Insight into the source of their fears
Correct Answer: A

Rationale: In hypochondriasis, individuals are excessively preoccupied with and worried about having a serious illness, despite reassurance from medical professionals. This self-preoccupation is a key characteristic of hypochondriasis. 'La belle indifference' refers to a lack of concern or distress about symptoms, which is not typically seen in hypochondriasis. Fear of physicians may be present due to the individual's persistent belief in their illness despite medical reassurance. Insight into the source of their fears is usually lacking in hypochondriasis, as individuals often believe their physical symptoms are evidence of a serious illness.

When explaining one of the main differences between narcolepsy and obstructive sleep apnea syndrome, what should the nurse mention?

  • A. Symptoms of the two diagnoses are essentially the same, making it difficult to differentiate between them.
  • B. People with narcolepsy awaken from a nap feeling rested and replenished.
  • C. People with obstructive sleep apnea syndrome can experience temporary paralysis during naps.
  • D. Naps are contraindicated for clients with narcolepsy due to their association with catatonia.
Correct Answer: B

Rationale: Narcolepsy is a sleep disorder characterized by excessive daytime sleepiness and sudden attacks of sleep, while obstructive sleep apnea syndrome involves the obstruction of the upper airway during sleep. One of the main differences is that people with narcolepsy often experience refreshing naps, feeling rested and replenished upon waking, which is not the case for obstructive sleep apnea syndrome. This distinction is important for healthcare providers to understand as it helps differentiate between these two sleep disorders.

Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the patient states, <I don't need to come see you anymore. I have found a therapy app on my phone that I love.= How should Carolina respond to this news?

  • A. That sounds exciting, would you be willing to visit and show me the app?
  • B. At this time, there is no real evidence that the app can replace our therapy.
  • C. I am not sure that is a good idea right now, we are so close to progress.
  • D. Why would you think that is a better option than meeting with me?
Correct Answer: A

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Tammy, a 28-year-old with major depressive disorder and bulimia nervosa, is ready for discharge from the county hospital after 2 weeks of inpatient therapy. Tammy is taking citalopram (Celexa) and reports that it has made her feel more hopeful. With a secondary diagnosis of bulimia nervosa, what is an alternative antidepressant to consider?

  • A. Fluoxetine (Prozac)
  • B. Isocarboxazid (Marplan)
  • C. Amitriptyline
  • D. Duloxetine (Cymbalta)
Correct Answer: A

Rationale: Fluoxetine (Prozac) is a suitable alternative antidepressant for Tammy due to its approval for the treatment of bulimia nervosa. It belongs to the selective serotonin reuptake inhibitor (SSRI) class of antidepressants, similar to citalopram, which Tammy is already taking. Fluoxetine has shown efficacy in treating bulimia nervosa and can be a beneficial choice for individuals with this condition.

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