ANCC Psychiatric-Mental Health Nursing 1 — Questions and Answers
Question 1: A patient diagnosed with schizophrenia is experiencing command hallucinations. Which nursing intervention is the priority?
- Assess whether the patient intends to act on the commands (Correct answer)
- Administer an antipsychotic medication immediately
- Place the patient in a quiet room alone
- Document the hallucinations without intervening
Correct answer: Assess whether the patient intends to act on the commands
Assessing the patient's intent to act on command hallucinations is the priority because it determines the immediate safety risk.
Question 2: Which medication class is considered first-line pharmacotherapy for generalized anxiety disorder (GAD) in adults?
- Benzodiazepines
- SSRIs/SNRIs (Correct answer)
- Tricyclic antidepressants
- Monoamine oxidase inhibitors
Correct answer: SSRIs/SNRIs
SSRIs and SNRIs are first-line treatments for GAD due to their efficacy and more favorable safety profile compared to benzodiazepines.
Question 3: A nurse is using motivational interviewing with a patient who abuses alcohol. Which statement best reflects the 'rolling with resistance' technique?
- 'You must stop drinking or your liver will fail.'
- 'It sounds like you're not ready to make changes yet, and that's okay.' (Correct answer)
- 'Tell me about the times alcohol has caused problems for you.'
- 'Here is a list of AA meetings in your area.'
Correct answer: 'It sounds like you're not ready to make changes yet, and that's okay.'
Rolling with resistance means acknowledging ambivalence without confrontation, validating the patient's current position.
Question 4: Which of the following is the hallmark symptom that distinguishes bipolar I disorder from bipolar II disorder?
- Persistent depressive episodes
- At least one full manic episode (Correct answer)
- Hypomanic episodes only
- Rapid cycling between moods
Correct answer: At least one full manic episode
Bipolar I disorder requires at least one full manic episode, while bipolar II involves hypomania without full mania.
Question 5: A patient taking lithium reports nausea, vomiting, coarse tremor, and confusion. What is the nurse's priority action?
- Give the next lithium dose with food
- Hold the lithium and notify the provider immediately (Correct answer)
- Reassure the patient that these are expected side effects
- Administer an antiemetic and monitor closely
Correct answer: Hold the lithium and notify the provider immediately
These symptoms indicate lithium toxicity, which requires immediate medication hold and provider notification to prevent serious harm.
Question 6: Which therapeutic communication technique is most appropriate when a patient states, 'I feel like nobody cares about me'?
- 'Of course people care about you.'
- 'Why do you feel that way?'
- 'It sounds like you're feeling very alone right now.' (Correct answer)
- 'You should call your family more often.'
Correct answer: 'It sounds like you're feeling very alone right now.'
Reflecting the patient's feelings demonstrates empathy and encourages further exploration of their emotional experience.
ANCC Psychiatric-Mental Health Nursing 1
A patient diagnosed with schizophrenia is experiencing command hallucinations.
Which nursing intervention is the priority?