NCLEX Mental Health and Psychiatric Nursing 3 — Questions and Answers
Question 1: A client with schizophrenia states, 'The radio is sending me secret messages to save the world.' This is an example of which symptom?
- Delusion of grandeur (Correct answer)
- Auditory hallucination
- Illusion
- Flight of ideas
Correct answer: Delusion of grandeur
A fixed false belief of special importance or mission is a grandiose delusion.
Question 2: A client taking haloperidol develops a temperature of 104°F, muscle rigidity, and altered consciousness. The nurse suspects which emergency?
- Tardive dyskinesia
- Neuroleptic malignant syndrome (Correct answer)
- Akathisia
- Dystonia
Correct answer: Neuroleptic malignant syndrome
High fever, severe rigidity, and altered mental status indicate neuroleptic malignant syndrome, a life-threatening reaction to antipsychotics.
Question 3: A nurse responds therapeutically to a hallucinating client by saying:
- 'There is no voice; you are imagining it.'
- 'I don't hear a voice, but I understand you do.' (Correct answer)
- 'What exactly is the voice telling you to do?' in a dismissive tone
- 'Just ignore the voices and they will stop.'
Correct answer: 'I don't hear a voice, but I understand you do.'
The nurse presents reality without arguing while acknowledging the client's experience, which is therapeutic.
Question 4: Which intervention is appropriate for a client experiencing acute mania?
- Provide a stimulating group activity
- Offer finger foods the client can eat while moving (Correct answer)
- Engage in lengthy detailed conversations
- Encourage competitive games
Correct answer: Offer finger foods the client can eat while moving
Manic clients are too active to sit and eat, so high-calorie finger foods support nutrition while they move about.
Question 5: A client with obsessive-compulsive disorder washes hands repeatedly. During early treatment, the nurse should:
- Forbid the client from washing hands
- Allow time for the ritual while setting gradual limits (Correct answer)
- Ridicule the behavior to discourage it
- Ignore the client completely
Correct answer: Allow time for the ritual while setting gradual limits
Abruptly stopping a ritual increases anxiety, so the nurse initially allows it while gradually setting limits.
Question 6: A client abruptly stopping long-term benzodiazepine use is at risk for which dangerous complication?
- Hypoglycemia
- Seizures (Correct answer)
- Constipation
- Weight gain
Correct answer: Seizures
Abrupt benzodiazepine withdrawal can cause life-threatening seizures, so tapering is required.
Question 7: Which finding best indicates that a client with depression is improving?
- Increased isolation
- Resumed attention to personal hygiene (Correct answer)
- Giving away prized possessions
- Sudden calm after deep despair
Correct answer: Resumed attention to personal hygiene
Renewed self-care such as attending to hygiene signals improvement in depression.
NCLEX Mental Health and Psychiatric Nursing 3
A client with schizophrenia states, 'The radio is sending me secret messages to save the world.' This is an example of which symptom?