Saudi Prometric Nursing Mental Health Nursing 5 — Questions and Answers
Question 1: Which behavior by a patient with anorexia nervosa should be addressed as the highest priority by the nurse?
- Distorted body image and fear of weight gain
- Cardiac arrhythmias due to severe electrolyte imbalance (Correct answer)
- Social withdrawal and difficulty with peer relationships
- Preoccupation with food-related rituals
Correct answer: Cardiac arrhythmias due to severe electrolyte imbalance
Electrolyte imbalances, particularly hypokalemia, can cause life-threatening cardiac arrhythmias and represent the highest physiological priority.
Question 2: A patient in a psychiatric unit accuses the nurse of being against them and refuses medications. The nurse's best response is:
- 'You must take this medication or I will call security.'
- 'I understand you're concerned. Can you tell me what worries you about the medication?' (Correct answer)
- 'The doctor ordered this, so you have no choice.'
- 'I'll leave it here and you can take it when you're ready.'
Correct answer: 'I understand you're concerned. Can you tell me what worries you about the medication?'
Acknowledging the patient's concern and inviting dialogue demonstrates respect for autonomy and builds therapeutic alliance.
Question 3: A nurse observes a patient with major depressive disorder beginning to show increased energy and sudden cheerfulness after weeks of profound depression. What is the most important nursing action?
- Document this as a sign of recovery and reduce observation
- Increase suicide precautions and monitor closely (Correct answer)
- Notify the family that the patient is improving
- Decrease the antidepressant dose as it is working
Correct answer: Increase suicide precautions and monitor closely
A sudden lift in depression with increased energy can indicate the patient now has enough energy to act on suicidal plans.
Question 4: A patient is admitted with opiate overdose. Which medication does the nurse anticipate administering?
- Flumazenil
- Naloxone (Correct answer)
- Methadone
- Disulfiram
Correct answer: Naloxone
Naloxone is an opioid receptor antagonist that rapidly reverses opiate-induced respiratory depression.
Question 5: Which assessment finding indicates a patient is experiencing neuroleptic malignant syndrome (NMS)?
- Slow, rhythmic movements of the mouth and tongue
- Hyperthermia, muscle rigidity, and altered consciousness (Correct answer)
- Akathisia and pacing behavior
- Hypersalivation and weight gain
Correct answer: Hyperthermia, muscle rigidity, and altered consciousness
NMS is a life-threatening reaction to antipsychotics presenting with the triad of hyperthermia, lead-pipe rigidity, and altered mental status.
Question 6: A nurse is planning discharge teaching for a patient with schizophrenia. Which instruction is most important for preventing relapse?
- Avoid all stressful social interactions permanently
- Take antipsychotic medications consistently even when feeling well (Correct answer)
- Reduce medication dosage gradually without medical supervision
- Only take medications during acute episodes
Correct answer: Take antipsychotic medications consistently even when feeling well
Medication non-adherence is the leading cause of relapse in schizophrenia; consistent use prevents psychotic episodes.
Question 7: A child brought to the ER exhibits flat affect, avoidance of eye contact, regressive behavior, and age-inappropriate sexual knowledge. The nurse should first suspect:
- Autism spectrum disorder
- Child sexual abuse (Correct answer)
- Childhood schizophrenia
- Separation anxiety disorder
Correct answer: Child sexual abuse
Age-inappropriate sexual knowledge combined with behavioral regression and flat affect are key indicators of sexual abuse in children.
Saudi Prometric Nursing Mental Health Nursing 5
Which behavior by a patient with anorexia nervosa should be addressed as the highest priority by the nurse?