Saudi Prometric Nursing Mental Health Nursing — Questions and Answers
Question 1: What is the priority nursing intervention for a patient expressing suicidal ideation?
- Leave the patient alone to calm down
- Ensure immediate safety, stay with the patient, remove harmful objects, activate the safety protocol, and notify the psychiatrist (Correct answer)
- Administer sedation immediately
- Discharge the patient to family care
Correct answer: Ensure immediate safety, stay with the patient, remove harmful objects, activate the safety protocol, and notify the psychiatrist
Suicidal patient priority: never leave them alone, ensure environmental safety (remove sharps, belts, cords), activate hospital safety/suicide prevention protocol, perform a thorough suicide risk assessment, notify the psychiatrist, and provide one-to-one continuous observation.
Question 2: What are the therapeutic communication techniques used in mental health nursing?
- Giving personal opinions and advice
- Active listening, open-ended questions, reflection, silence, summarizing, and empathic responses (Correct answer)
- Changing the subject when uncomfortable
- Telling the patient not to worry
Correct answer: Active listening, open-ended questions, reflection, silence, summarizing, and empathic responses
Therapeutic communication includes: active listening (full attention), open-ended questions ('Tell me about...'), reflection (repeating key thoughts), therapeutic silence, summarizing, empathy, and validation. These build trust and encourage patient expression in Saudi mental health settings.
Question 3: What is the nursing management for a patient experiencing an acute psychotic episode?
- Argue with the patient's delusions
- Maintain a calm, safe environment, use clear simple communication, ensure patient safety, administer prescribed medications, and avoid challenging delusions (Correct answer)
- Agree with the patient's hallucinations
- Restrain the patient immediately
Correct answer: Maintain a calm, safe environment, use clear simple communication, ensure patient safety, administer prescribed medications, and avoid challenging delusions
During acute psychosis: ensure safety (patient and staff), maintain calm demeanor, use clear simple language, don't argue with or reinforce delusions, administer antipsychotic medications as prescribed, reduce environmental stimulation, and provide reassurance.
Question 4: What are the common side effects of antipsychotic medications that nurses should monitor?
- Improved mood only
- Extrapyramidal symptoms (dystonia, akathisia, tardive dyskinesia), sedation, weight gain, and metabolic syndrome (Correct answer)
- Only headache
- No side effects occur with modern medications
Correct answer: Extrapyramidal symptoms (dystonia, akathisia, tardive dyskinesia), sedation, weight gain, and metabolic syndrome
Antipsychotic side effects include: EPS (muscle stiffness, tremors, restlessness, involuntary movements), sedation, significant weight gain, metabolic syndrome (diabetes risk), orthostatic hypotension, and rare but dangerous neuroleptic malignant syndrome (NMS).
Question 5: What is the nurse's role in caring for a patient with anxiety disorder?
- Tell the patient there is nothing to worry about
- Provide a calm environment, teach relaxation techniques, administer anxiolytics as prescribed, and use therapeutic communication (Correct answer)
- Avoid discussing the patient's concerns
- Give caffeinated drinks to energize the patient
Correct answer: Provide a calm environment, teach relaxation techniques, administer anxiolytics as prescribed, and use therapeutic communication
Anxiety nursing care: maintain calm therapeutic presence, teach deep breathing and progressive muscle relaxation, administer medications as prescribed (monitor for benzodiazepine dependence), use therapeutic communication, help identify triggers, and support cognitive behavioral strategies.
Question 6: What are the signs of neuroleptic malignant syndrome (NMS) that require immediate intervention?
- Mild headache
- High fever, severe muscle rigidity, altered consciousness, autonomic instability, and elevated creatine kinase (Correct answer)
- Appetite increase
- Improved sleep patterns
Correct answer: High fever, severe muscle rigidity, altered consciousness, autonomic instability, and elevated creatine kinase
NMS is a life-threatening reaction to antipsychotics: hyperthermia (>38°C), severe muscle rigidity ('lead pipe'), altered mental status, autonomic instability (BP/HR fluctuations, sweating), and elevated CK levels. This is a medical emergency requiring immediate medication discontinuation and ICU care.
Saudi Prometric Nursing Mental Health Nursing
What is the priority nursing intervention for a patient expressing suicidal ideation?