Questions 73

NCLEX-RN

NCLEX-RN Test Bank

NCLEX RN Questions on Psychiatric Nursing Questions

Extract:


Question 1 of 5

The client is fidgeting and has trouble sitting still. He has difficulty concentrating and is tangential. Which of the following interventions should help manage this client's level of anxiety? Select all that apply.

Correct Answer: A,B,C,E

Rationale: Managing anxiety involves refocusing attention, allowing ventilation, suggesting time-outs, and assisting with problem solving. IM medication is a last resort.

Question 2 of 5

A client with schizophrenia states, 'The voices are telling me to jump out the window.' Which of the following responses by the nurse is most therapeutic?

Correct Answer: B

Rationale: Exploring the content of the voices helps assess the risk and builds trust without reinforcing the hallucination.

Question 3 of 5

A suicidal client is placed in the seclusion room and given lorazepam (Ativan) because she tried to harm herself by banging her head against the wall. After 10 minutes, the client starts to bang her head against the wall in the seclusion room. Which of the following should the nurse do next?

Correct Answer: B

Rationale: Restraints are necessary to prevent immediate self-harm when other interventions fail.

Question 4 of 5

Police bring a client to the emergency department after she threatens to kill her ex-husband. She states emphatically, 'The police should bring him in, not me. He's paranoid about my dating and has been stalking me for weeks. He's probably off his medicines. His case manager and the police won't do anything.' In which order should the following nursing actions be done from first to last?

Order the Items

Source Container

Ask about the marital problems leading to the divorce.
Assess the client's risk for harm to self and others.
Obtain the name of her ex-husband's case manager.
Interview the client about her current needs and situation.

Correct Answer: B,D,C,A

Rationale: Safety is the priority, so assessing risk for harm comes first. Interviewing the client about her needs and situation provides context, followed by obtaining the case manager's name to coordinate care. Asking about marital problems is less urgent and comes last.

Question 5 of 5

A client diagnosed with paranoid schizophrenia is still withdrawn, unkempt, and unmotivated to get out of bed. A mental health aide asks the nurse why he is this way after being on fluphenazine (Prolixin) 10 mg for 7 days. The nurse should tell the health aide:

Correct Answer: A

Rationale: Fluphenazine, a typical antipsychotic, is more effective for positive symptoms (e.g., hallucinations, delusions) than negative symptoms (e.g., withdrawal, lack of motivation), which explains the client's persistent symptoms.

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