NCLEX-RN Mental Health

Question 1 of 5

A client is scheduled for the first electroconvulsive therapy (ECT) treatment in the morning. The client has been unable to sleep, but at 10 p.m. The client is still unable to sleep at 11:15 p.m. In what order should the nurse do the following?

Order the Items

Source Container

Sit quietly with the client.

Encourage the use of Restoril.

Offer use of MP3 player with relaxing music.

Discuss specific concerns.

Correct Answer: D, C, A, B

Rationale: The nurse should first discuss specific concerns to identify anxiety sources od to assess the client's needs, then offer relaxing music to promote relaxation, sit quietly to provide a calming presence, and finally encourage Restoril if prescribed, ensuring safe administration.

Question 2 of 5

The nurse is distinguishing between delusions experienced by a client diagnosed with major depression with psychotic features and the delusions of a client diagnosed with schizophrenia. The essential difference is:

A. Major depression delusions are more likely to be negative than schizophrenic delusions.B. Major depression delusions clear up less quickly than schizophrenic delusions.C. Major depression delusions are more likely than schizophrenic delusions to require long-acting depot antipsychotic medication given intramuscularly.D. Major depression delusions are more mood congruent than schizophrenic delusions.

Correct Answer: D

Rationale: Delusions in major depression with psychotic features are typically mood-congruent (e.g., guilt, worthlessness), unlike the often bizarre delusions in schizophrenia.

Question 3 of 5

The physician orders fluoxetine (Prozac) orally every morning for a 72-year-old client with depression. Which transient adverse effect of this drug requires immediate action by the nurse?

A. Nausea.B. Dizziness.C. Sedation.D. Dry mouth.

Correct Answer: B

Rationale: Dizziness in an elderly client increases fall risk, requiring immediate action to ensure safety.

Question 4 of 5

When developing the teaching plan for the family of a client with severe depression who is to receive electroconvulsive therapy (ECT), which of the following information should the nurse include?

A. Some temporary confusion and disorientation immediately after a treatment is common.B. During an ECT treatment session, the client is at risk for aspiration.C. Clients with severe depression usually do not respond to ECT.D. The client will not be able to breathe independently during a treatment.

Correct Answer: A

Rationale: Temporary confusion and disorientation are common post-ECT effects, and families should be prepared.

Question 5 of 5

When assessing a client who is receiving tricyclic antidepressant therapy, which of the following should alert the nurse to the possibility that the client is experiencing anticholinergic effects?

A. Tremors and cardiac arrhythmias.B. Sedation and delirium.C. Respiratory depression and convulsions.D. Urine retention and blurred vision.

Correct Answer: D

Rationale: Urine retention and blurred vision are classic anticholinergic effects of tricyclic antidepressants.

NCLEX-RN Mental Health | Nurselytic

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