DOH Nursing Psychiatric Nursing 1

Question 1

Which therapeutic communication technique is most appropriate when a patient says 'I feel like no one understands me'?

Accepted Answer

Reflect and validate: 'It sounds like you're feeling very alone and misunderstood.'

Answer

Reflection and validation acknowledge the patient's feelings without judgment, fostering therapeutic alliance. False reassurance dismisses feelings and erodes trust. Changing the subject avoids the therapeutic relationship. Giving unsolicited advice undermines autonomy.

Question 2

A patient with schizophrenia reports hearing voices that command them to harm others. What is the priority nursing action?

Accepted Answer

Assess for immediate danger to self or others and initiate safety measures

Answer

Command hallucinations to harm others require immediate risk assessment (intent, plan, means, target) and safety measures including constant observation, removal of means, and notification of the treatment team. Patient and public safety is the priority in psychiatric emergencies.

Question 3

Which finding is a positive symptom of schizophrenia?

Accepted Answer

Hallucinations, delusions, and disorganized speech

Answer

Positive symptoms represent an excess or distortion of normal function: hallucinations, delusions, disorganized thinking/speech, and disorganized or catatonic behavior. Negative symptoms (flat affect, alogia, avolition, anhedonia) represent loss of normal function.

Question 4

What is the priority assessment for a patient admitted following a suicide attempt?

Accepted Answer

Assess current suicidal ideation, intent, plan, lethality of method, and means access

Answer

Immediate risk assessment after a suicide attempt includes: current SI (ideation, intent), plan (specificity), lethality of previous attempt, access to means, and protective factors. This guides the level of observation and safety planning. Medical stability is assessed simultaneously.

Question 5

Which medication class is the first-line pharmacological treatment for generalized anxiety disorder (GAD)?

Accepted Answer

SSRIs (selective serotonin reuptake inhibitors)

Answer

SSRIs (e.g., escitalopram, sertraline) are first-line for GAD due to efficacy and favorable side effect profile. Benzodiazepines are appropriate for short-term acute anxiety but not long-term due to dependence risk. SNRIs (venlafaxine) are also first-line.

DOH Nursing Practice Test

DOH Nursing Practice Test

DOH Nursing Psychiatric Nursing 1