NCLEX-RN
NCLEX RN Questions on Psychiatric Nursing Questions
Extract:
Question 1 of 5
A client experiencing acute mania has been taking lithium carbonate 600 mg P.O. three times daily for 14 days. The client's serum lithium level is 1.8 mEq/L. The nurse should:
Correct Answer: A
Rationale: A lithium level of 1.8 mEq/L is toxic; holding the dose, notifying the provider, and increasing fluids are critical.
Question 2 of 5
The client with histrionic personality disorder is melodramatic and responds to others and situations in an exaggerated manner. The nurse should recommend which of the following activities for this client?
Correct Answer: C
Rationale: A cooking class is appropriate, as it provides a structured, non-dramatic activity that encourages focus and skill-building, helping to reduce exaggerated responses.
Question 3 of 5
The client with bipolar disorder, manic phase, has a valproic acid (Depakote) level of 15 μg/mL. Which of the following client behaviors should the nurse judge to be due to this level of valproic acid? Select all that apply.
Correct Answer: A, B, D
Rationale: A valproic acid level of 15 μg/mL is subtherapeutic (therapeutic range: 50–100 μg/mL), so manic symptoms like irritability, grandiosity, and labile mood persist.
Question 4 of 5
A client on a crisis hotline says, 'My partner left me, and I feel like giving up.' Which response by the nurse is most therapeutic?
Correct Answer: B
Rationale: Asking what 'giving up' means clarifies the client's intent, assessing for suicidal ideation or other risks while fostering communication. Reassurance, counseling suggestions, or normalizing feelings are less immediate without understanding the client's state.
Question 5 of 5
The client states to the nurse at the outpatient clinic, 'I don't feel ready to go back to work. It's only been a week since I left the hospital.' Assessment reveals a flat affect, disheveled appearance, poor posture, and minimal eye contact during interaction. The nurse asks the client whether he is thinking about harming himself. The client tells the nurse he has a loaded revolver at home and will probably use it. Which of the following should the nurse do next?
Correct Answer: D
Rationale: A specific plan with access to a lethal means (loaded revolver) requires immediate hospitalization.