RPN Mental Health and Psychiatric Nursing 1 — Questions and Answers
Question 1: A client with schizophrenia reports hearing voices telling them to harm others. What is the nurse's priority intervention?
- Administer a PRN antipsychotic medication immediately
- Ensure the safety of the client and others by following facility protocols (Correct answer)
- Encourage the client to ignore the voices and focus on activities
- Document the report and notify the physician at the next scheduled call
Correct answer: Ensure the safety of the client and others by following facility protocols
Safety is always the priority; the nurse must protect the client and others according to established facility protocols when a client discloses command hallucinations with violent content.
Question 2: Which therapeutic communication technique involves restating the client's words in the nurse's own words to confirm understanding?
- Reflection
- Clarification
- Paraphrasing (Correct answer)
- Summarizing
Correct answer: Paraphrasing
Paraphrasing is restating the client's message in the nurse's own words to check understanding, while reflection mirrors the client's emotional tone.
Question 3: A client with major depressive disorder states, 'There is no point in anything anymore.' Which nursing response is most therapeutic?
- 'Everyone feels that way sometimes — it will pass.'
- 'You have so much to live for. Think about your family.'
- 'It sounds like you are feeling hopeless. Can you tell me more?' (Correct answer)
- 'Let's focus on positive things and schedule some activities.'
Correct answer: 'It sounds like you are feeling hopeless. Can you tell me more?'
Acknowledging the client's feeling and inviting them to elaborate demonstrates empathy and opens therapeutic dialogue without minimizing or redirecting.
Question 4: Which defense mechanism is a client using when they say, 'My coworker is the one who is always angry, not me'?
- Rationalization
- Displacement
- Projection (Correct answer)
- Reaction formation
Correct answer: Projection
Projection involves attributing one's own unacceptable thoughts, feelings, or impulses onto another person.
Question 5: Which screening tool is most commonly used by nurses to assess for depression in adult clients?
- CAGE questionnaire
- PHQ-9 (Patient Health Questionnaire-9) (Correct answer)
- AUDIT-C
- Mini-Mental State Examination (MMSE)
Correct answer: PHQ-9 (Patient Health Questionnaire-9)
The PHQ-9 is a validated nine-item tool widely used to screen for and monitor the severity of depression in adults.
Question 6: A nurse is caring for a client with bipolar disorder who is in a manic phase. Which nursing intervention is the priority?
- Engage the client in group therapy to channel energy
- Provide a calm, low-stimulation environment and ensure adequate rest (Correct answer)
- Encourage the client to journal thoughts and feelings
- Schedule structured high-activity tasks to reduce restlessness
Correct answer: Provide a calm, low-stimulation environment and ensure adequate rest
During a manic episode, reducing stimulation and ensuring rest and safety are priorities because clients are at risk for exhaustion, injury, and impaired judgment.
Question 7: A client with generalized anxiety disorder is taught diaphragmatic breathing. What is the primary goal of this technique?
- Increase carbon dioxide levels to reduce respiratory alkalosis
- Stimulate the sympathetic nervous system to improve alertness
- Activate the parasympathetic nervous system to reduce physiological arousal (Correct answer)
- Improve oxygen saturation to prevent hypoxia during anxiety episodes
Correct answer: Activate the parasympathetic nervous system to reduce physiological arousal
Diaphragmatic (slow, deep) breathing activates the parasympathetic nervous system, counteracting the fight-or-flight response and reducing physical anxiety symptoms.
RPN Mental Health and Psychiatric Nursing 1
A client with schizophrenia reports hearing voices telling them to harm others.
What is the nurse's priority intervention?