Saudi Prometric Nursing Mental Health Nursing 3 — Questions and Answers
Question 1: A patient on lithium therapy reports coarse tremors, confusion, and ataxia. Serum lithium level is 2.4 mEq/L. What is the priority nursing action?
- Administer an additional dose to stabilize levels
- Hold the medication and notify the physician immediately (Correct answer)
- Encourage increased fluid intake to dilute the drug
- Reassure the patient and monitor for 2 hours
Correct answer: Hold the medication and notify the physician immediately
A lithium level above 2.0 mEq/L indicates severe toxicity requiring immediate drug discontinuation and physician notification.
Question 2: Which therapeutic communication technique does a nurse use when saying, 'You mentioned feeling hopeless. Can you tell me more about that?'
- Offering self
- Exploring (Correct answer)
- Voicing doubt
- Summarizing
Correct answer: Exploring
Exploring encourages the patient to elaborate on a specific topic to gain deeper understanding.
Question 3: A nurse is caring for a patient with obsessive-compulsive disorder (OCD) who performs handwashing rituals for 3 hours daily. What is the most appropriate initial nursing intervention?
- Set strict time limits on handwashing immediately
- Allow the rituals while establishing a therapeutic relationship (Correct answer)
- Distract the patient with group activities during rituals
- Administer a sedative to interrupt the compulsive behavior
Correct answer: Allow the rituals while establishing a therapeutic relationship
Initially allowing rituals while building trust prevents increased anxiety; reduction of rituals is a gradual process.
Question 4: A patient with schizophrenia states, 'The television is sending me secret messages.' This is an example of:
- Auditory hallucination
- Delusion of reference (Correct answer)
- Delusion of grandeur
- Thought broadcasting
Correct answer: Delusion of reference
Ideas of reference involve the belief that external events or objects are personally directed at oneself.
Question 5: Which medication class is considered first-line treatment for generalized anxiety disorder (GAD) in outpatient settings?
- Benzodiazepines
- Selective serotonin reuptake inhibitors (SSRIs) (Correct answer)
- Typical antipsychotics
- Monoamine oxidase inhibitors (MAOIs)
Correct answer: Selective serotonin reuptake inhibitors (SSRIs)
SSRIs are first-line for GAD due to their efficacy and favorable safety profile without dependence risk.
Question 6: A nurse observes a patient with borderline personality disorder threatening self-harm after a disagreement with staff. What is the priority intervention?
- Leave the patient alone to de-escalate independently
- Ensure patient safety and maintain a calm, non-reactive presence (Correct answer)
- Immediately apply physical restraints
- Discharge the patient from the unit
Correct answer: Ensure patient safety and maintain a calm, non-reactive presence
Safety is the priority; a calm, consistent response avoids reinforcing splitting behavior and reduces escalation.
Question 7: When planning care for a patient in the manic phase of bipolar disorder, which environment is most therapeutic?
- A busy unit with group activities to channel energy
- A calm, low-stimulation environment with limited interactions (Correct answer)
- A room with bright lights and music to match the patient's mood
- An open ward with free access to all areas
Correct answer: A calm, low-stimulation environment with limited interactions
Reducing environmental stimuli helps decrease the escalation of manic episodes.
Saudi Prometric Nursing Mental Health Nursing 3
A patient on lithium therapy reports coarse tremors, confusion, and ataxia.
Serum lithium level is 2.4 mEq/L.
What is the priority nursing action?