Saudi Prometric Nursing Psychiatric and Mental Health Nursing 4

Question 1

A patient with borderline personality disorder self-harms by cutting. Which nursing response is most therapeutic?

Accepted Answer

Respond calmly without increased attention to the cutting, explore underlying feelings

Answer

Dialectical Behavior Therapy (DBT) is the evidence-based treatment for BPD. Nurses should avoid reinforcing self-harm through excessive attention (which can perpetuate behavior) while acknowledging distress, maintaining safety, and exploring the emotional trigger underlying the act.

Question 2

A patient is started on clozapine for treatment-resistant schizophrenia. Which potentially fatal side effect requires regular monitoring?

Accepted Answer

Agranulocytosis — requires weekly CBC monitoring

Answer

Clozapine causes agranulocytosis in approximately 1–2% of patients, which can be fatal if undetected. A mandatory REMS program requires weekly CBC for the first 6 months, then biweekly. Patients must be enrolled in the registry before dispensing.

Question 3

The nurse notes that a patient with schizophrenia speaks with long pauses and difficulty expressing thoughts. This symptom is called:

Accepted Answer

Alogia (poverty of speech)

Answer

Alogia refers to poverty of speech or thought — reduced verbal output and difficulty expressing ideas. It is a negative symptom of schizophrenia. Tangentiality and flight of ideas involve excessive but disconnected speech (positive symptoms). Word salad is incoherent speech.

Question 4

A nurse is administering olanzapine to a patient with schizophrenia. Which metabolic side effects should be monitored?

Accepted Answer

Weight gain, hyperglycemia, and dyslipidemia (metabolic syndrome)

Answer

Second-generation (atypical) antipsychotics, especially olanzapine and clozapine, are associated with metabolic syndrome: significant weight gain, diabetes (hyperglycemia), and dyslipidemia. Regular monitoring of weight, glucose, and lipids is essential.

Question 5

A patient states: 'I am going to kill my roommate tonight.' The nurse has a duty to:

Accepted Answer

Warn the identified potential victim and take steps to protect them (Tarasoff duty)

Answer

The Tarasoff ruling established the 'duty to protect' — when a patient makes a specific, credible threat against an identifiable person, the clinician must take reasonable steps to protect the intended victim (warning them, notifying police, hospitalization). This overrides confidentiality.

Saudi Prometric Nursing Practice Test

Saudi Prometric Nursing Practice Test

Saudi Prometric Nursing Psychiatric and Mental Health Nursing 4