LVN Mental Health & Psychiatric Nursing 4 — Questions and Answers
Question 1: A patient newly admitted for major depression states, 'I've given away all my belongings and said goodbye to everyone.' The LVN should interpret this as:
- Evidence that the patient is feeling better and more hopeful
- A strong warning sign of imminent suicide attempt (Correct answer)
- Normal behavior for someone adjusting to hospitalization
- An indication the patient wants to be transferred to long-term care
Correct answer: A strong warning sign of imminent suicide attempt
Giving away possessions and saying final goodbyes are classic warning signs of imminent suicidal intent requiring immediate safety intervention.
Question 2: Which side effect of antipsychotic medications involves involuntary, rhythmic, repetitive movements of the face, tongue, and extremities that appear after long-term use?
- Akathisia
- Pseudoparkinsonism
- Tardive dyskinesia (Correct answer)
- Acute dystonia
Correct answer: Tardive dyskinesia
Tardive dyskinesia is a late-onset, potentially irreversible extrapyramidal side effect of long-term antipsychotic use characterized by repetitive involuntary movements.
Question 3: The LVN is preparing a patient for discharge after treatment for alcohol use disorder. Which statement by the patient indicates a need for further teaching?
- 'I plan to attend AA meetings three times a week.'
- 'I will call my sponsor if I feel the urge to drink.'
- 'I only need to avoid hard liquor; beer and wine are okay.' (Correct answer)
- 'I should avoid people and places associated with my drinking.'
Correct answer: 'I only need to avoid hard liquor; beer and wine are okay.'
Total abstinence from all forms of alcohol, including beer and wine, is required in alcohol use disorder recovery; no amount is considered safe.
Question 4: A patient with borderline personality disorder frequently tells the nurse, 'You're the only one who understands me; the other nurses are terrible.' This behavior is known as:
- Transference
- Splitting (Correct answer)
- Manipulation
- Countertransference
Correct answer: Splitting
Splitting is a defense mechanism common in borderline personality disorder where people are viewed as all good or all bad, with no middle ground.
Question 5: Which nursing action is most important when a patient is placed in physical restraints?
- Explain the reason for restraints only to the family, not the patient
- Assess circulation, sensation, and skin integrity every 15 minutes (Correct answer)
- Keep restraints in place for a minimum of 4 hours to ensure safety
- Obtain a standing order for restraints to be used as needed
Correct answer: Assess circulation, sensation, and skin integrity every 15 minutes
Frequent assessment of circulation, sensation, and skin integrity prevents complications such as nerve damage, skin breakdown, and impaired circulation in restrained patients.
Question 6: A patient with generalized anxiety disorder asks about buspirone (Buspar). Which statement by the LVN is accurate?
- 'It works immediately and can be taken as needed for acute anxiety.'
- 'It takes 2–4 weeks to reach full therapeutic effect and is not habit-forming.' (Correct answer)
- 'It will cause drowsiness, so avoid driving while taking it.'
- 'It is only effective when combined with a benzodiazepine.'
Correct answer: 'It takes 2–4 weeks to reach full therapeutic effect and is not habit-forming.'
Buspirone is a non-benzodiazepine anxiolytic that requires 2–4 weeks for full effect, does not cause dependency, and generally does not cause significant sedation.
Question 7: The nurse is caring for a patient experiencing a panic attack. Which intervention should be implemented first?
- Teach diaphragmatic breathing techniques
- Stay with the patient and speak in a calm, reassuring voice (Correct answer)
- Administer a PRN anxiolytic as ordered
- Leave the patient in a quiet room to calm down independently
Correct answer: Stay with the patient and speak in a calm, reassuring voice
The immediate priority during a panic attack is to stay with the patient and use a calm, reassuring presence to reduce fear and prevent escalation before other interventions.
LVN Mental Health & Psychiatric Nursing 4
A patient newly admitted for major depression states, 'I've given away all my belongings and said goodbye to everyone.' The LVN should interpret this as: