Psychiatric NCLEX RN Questions
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Question 1 of 5.
A client moves in with her family after her boyfriend of 4 weeks told her to leave. She is admitted to the subacute unit after complaining of feeling empty and lonely, being unable to sleep, and eating very little for the last week. Her arms are scarred from frequent self-mutilation. The nurse should do which of the following from first to last?
- A. Monitor for suicide and self-mutilation.
- B. Discuss the issues of loneliness and emptiness.
- C. Monitor sleeping and eating behaviors.
- D. Discuss her housing options for after discharge.
- A. Monitor for suicide and self-mutilation.
- C. Monitor sleeping and eating behaviors.
- B. Discuss the issues of loneliness and emptiness.
- D. Discuss her housing options for after discharge.
Correct arrangement
Explanation: The order is: 1) Monitor for suicide and self-mutilation to ensure safety (A). 2) Monitor sleeping and eating behaviors to address physical health (C). 3) Discuss loneliness and emptiness to explore emotional triggers (B). 4) Discuss housing options to plan for discharge (D). This prioritizes safety, then physical and emotional needs, and finally future planning.
Question 2 of 5.
The client is taking 50 mg of lamotrigine (Lamictal) daily for bipolar depression. The client shows the nurse a rash on his arm. What should the nurse do?
A. Report the rash to the physician.
B. Explain that the rash is a temporary adverse effect.
C. Give the client an ice pack for his arm.
D. Question the client about recent sun exposure.
Explanation: A rash with Lamictal may indicate a serious reaction like Stevens-Johnson syndrome, requiring immediate physician notification.
Question 3 of 5.
The client exhibits a flat affect, psychomotor retardation, and depressed mood. The nurse attempts to engage the client in an interaction but the client does not respond to the nurse. Which response by the nurse is most appropriate?
A. I'll sit here with you for 15 minutes.'
B. I'll come back a little bit later to talk.'
C. I'll find someone else for you to talk with.'
D. I'll get you something to read.'
Explanation: Sitting quietly with the client provides presence and support, respecting their current inability to engage.
Question 4 of 5.
During an interaction with the nurse, a client states, 'My husband has supported me every time I've been hospitalized for depression. He'll leave me this time. I'm an awful wife and mother. I'm no good. Nothing I do is right.' Based on this information, which of the following nursing diagnoses should the nurse identify when developing the client's plan of care?
A. Impaired social interaction related to unsatisfactory relationships as evidenced by withdrawal.
B. Chronic low self-esteem related to lack of self-worth as evidenced by negative self-statements.
C. Risk for self-directed violence related to feelings of guilt as evidenced by statements of suicidal ideation.
D. Ineffective coping related to hospitalizations as evidenced by impaired judgment.
Explanation: The client's negative self-statements directly indicate chronic low self-esteem, a priority nursing diagnosis.
Question 5 of 5.
The client who has been taking venlafaxine (Effexor) 25 mg P.O. three times a day for the past 2 days states, 'This medicine isn't doing me any good. I'm still so depressed.' Which of the following responses by the nurse is most appropriate?
A. I'm sure the medicine will help you soon.'
B. It usually takes about 2 to 4 weeks for the medicine to work.'
C. Maybe the doctor will change your medicine.'
D. Tell me more about how you're feeling.'
Explanation: Explaining the 2–4 week onset of antidepressants sets realistic expectations and encourages adherence.
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