NCLEX-RN
NCLEX RN Mental Health Questions Questions
Extract:
Question 1 of 5
A nurse notices a client with a history of self-harm hiding sharp objects. Which is the priority nursing action?
Correct Answer: C
Rationale: Initiating one-on-one observation ensures immediate safety by monitoring the client closely, preventing self-harm. Seclusion, searching belongings, or sedation are more invasive or less immediate without ongoing supervision.
Question 2 of 5
The nurse is with the parents of a 16-year-old boy who recently attempted suicide. The nurse cautions the parents to be especially alert for which of the following?
Correct Answer: C
Rationale: Giving away valued items is a warning sign of suicidal intent, requiring immediate attention.
Question 3 of 5
While conducting a home visit for a client diagnosed with paranoid schizophrenia discharged 1 week ago, the client's mother tearfully states, 'I can hardly sleep because I'm so worried about my daughter. I'm afraid to leave her alone in the house. What if something should happen while I'm gone?' Which of the following problems related to the caregiver would be the most inclusive one for the nurse to incorporate into the client's plan of care?
Correct Answer: A
Rationale: Caregiver role strain encompasses the mother's anxiety, fear, and sleep disturbances, as it reflects the overall burden of caregiving, making it the most inclusive problem to address.
Question 4 of 5
A nurse notices a client with a history of self-harm hiding sharp objects. Which is the priority nursing action?
Correct Answer: C
Rationale: Initiating one-on-one observation ensures immediate safety by monitoring the client closely, preventing self-harm. Seclusion, searching belongings, or sedation are more invasive or less immediate without ongoing supervision.
Question 5 of 5
A soldier is stationed in Iraq on his second tour of duty. His division was notified of the date they will be deployed to Afghanistan. As this date approaches, he is showing signs of excess anxiety and irritability and inability to sleep at night because of nightmares of IED (improvised explosive devices) tragedies, all leading to poor work performance. He is admitted to the base hospital for an evaluation. The admitting nurse should take the following actions in order of priority from first to last?
Order the Items
Source Container
Correct Answer: C, A, D, B
Rationale: The order is: 1) Remove weapons for safety (
C). 2) Remind him feelings are typical to normalize symptoms (
A). 3) Acknowledge injustices and offer empathy to build rapport (
D). 4) Ask about experiences to explore trauma (
B). Safety is the priority, followed by support and exploration.