CPNRE Mental Health Nursing Concepts 4 — Questions and Answers
Question 1: A client with bipolar disorder is started on lithium. Which laboratory value must be monitored regularly to prevent toxicity?
- Serum sodium
- Serum lithium level (Correct answer)
- Serum potassium
- Serum calcium
Correct answer: Serum lithium level
Lithium has a narrow therapeutic index (0.6–1.2 mEq/L), so serum lithium levels must be monitored regularly to prevent toxicity.
Question 2: A nurse is caring for a client experiencing alcohol withdrawal. Which medication class is most commonly used to manage withdrawal symptoms and prevent seizures?
- Antipsychotics
- Benzodiazepines (Correct answer)
- SSRIs
- Beta-blockers
Correct answer: Benzodiazepines
Benzodiazepines are the first-line treatment for alcohol withdrawal because they reduce CNS excitability and prevent seizures.
Question 3: A client with schizophrenia reports that neighbours are 'sending radio signals' into their head. The nurse documents this as which type of symptom?
- Hallucination
- Illusion
- Delusion of reference (Correct answer)
- Thought broadcasting
Correct answer: Delusion of reference
A delusion of reference is a false belief that external events or objects have special personal significance directed at oneself.
Question 4: Which communication technique is most therapeutic when a client says, 'I feel like no one cares about me'?
- 'Everyone here cares about you.'
- 'Why do you feel that way?'
- 'It sounds like you're feeling alone and unsupported.' (Correct answer)
- 'You shouldn't feel that way.'
Correct answer: 'It sounds like you're feeling alone and unsupported.'
Reflecting and paraphrasing the client's feelings validates their experience and encourages further expression without dismissing or challenging the statement.
Question 5: A nurse is assessing a client on an antipsychotic medication who develops muscle rigidity, hyperthermia, and altered consciousness. The nurse suspects which potentially fatal condition?
- Serotonin syndrome
- Tardive dyskinesia
- Neuroleptic malignant syndrome (Correct answer)
- Acute dystonia
Correct answer: Neuroleptic malignant syndrome
Neuroleptic malignant syndrome (NMS) is a life-threatening reaction to antipsychotics characterized by hyperthermia, muscle rigidity, altered consciousness, and autonomic instability.
Question 6: A client with post-traumatic stress disorder (PTSD) is experiencing a flashback. What is the nurse's priority intervention?
- Leave the client alone to process the memory
- Restrain the client to prevent injury
- Use a calm voice to orient the client to the present environment (Correct answer)
- Administer a PRN antipsychotic medication
Correct answer: Use a calm voice to orient the client to the present environment
Grounding techniques using a calm, reassuring voice help orient the client to the present and interrupt the dissociative flashback experience.
Question 7: Which behaviour best indicates that a client with depression is improving and approaching discharge readiness?
- The client sleeps 12 hours per day
- The client initiates conversation with peers and participates in group therapy (Correct answer)
- The client reports feeling 'fine' and asks to leave immediately
- The client stops eating all meals
Correct answer: The client initiates conversation with peers and participates in group therapy
Increased social engagement and voluntary participation in therapeutic activities indicate improved mood and motivation, signalling recovery.
CPNRE Mental Health Nursing Concepts 4
A client with bipolar disorder is started on lithium.
Which laboratory value must be monitored regularly to prevent toxicity?