NCLEX RN Psychiatric Questions
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Question 1 of 5.
A client with a cocaine dependency is irritable, anxious, highly sensitive to stimuli, and overreactive to clients and staff on the unit. Which of the following actions is most therapeutic for this client?
A. Secluding and restraining the client as needed.
B. Telling the client to stay in his room until he can control himself.
C. Providing the client with frequent 'time-outs.'
D. Confronting the client about his behaviors.
Explanation: Providing frequent time-outs is therapeutic, as it allows the client to de-escalate in a low-stimulus environment, managing irritability and sensitivity.
Question 2 of 5.
A client was admitted to the inpatient unit 3 days ago with a flat affect, psychomotor retardation, anorexia, hopelessness, and suicidal ideation. The physician prescribed 75 mg of venlafaxine extended release (Effexor XR) to be given every morning. The client interacted minimally with the staff and spent most of the day in his room. As the nurse enters the unit at the beginning of the evening shift, the client is smiling and cheerfully greets the nurse. He appears to be relaxed and joins the group for community meeting before supper. What should the nurse interpret as the most likely cause of the client's behavior?
A. The author is helping the client's symptoms of depression significantly.
B. The client's sudden improvement calls for close observation by the staff.
C. The staff can decrease their observation of the client.
D. The client is nearing discharge due to the improvement of his symptoms.
Explanation: Sudden improvement in a suicidal client may indicate a resolved decision to act on suicidal thoughts, requiring close observation.
Question 3 of 5.
A client who has had three episodes of recurrent endogenous depression within the past 2 years states to the nurse, 'I want to know why I'm so depressed.' Which of the following statements by the nurse is most helpful?
A. I know you'll get better with the right medication.'
B. Let's discuss possible reasons underlying your depression.'
C. Your depression is most likely caused by a brain chemical imbalance.'
D. Members of your family seem very supportive of you.'
Explanation: Discussing possible reasons encourages exploration of triggers and fosters therapeutic engagement.
Question 4 of 5.
A client who experienced sleep disturbances, feelings of worthlessness, and an inability to concentrate for the past 3 months was fired from her job a month ago. The client tells the nurse, 'My boss was wonderful! He was understanding and a really nice man.' The nurse interprets the client's statement as representing the defense mechanism of reaction formation. Which of the following would be the best response by the nurse?
A. But, I don't understand, wasn't he the one who fired you?'
B. Tell me more about having to work while not being able to sleep or concentrate.'
C. It must have been hard to leave a boss like that.'
D. It sounds like he would hire you back if you asked.'
Explanation: Encouraging the client to discuss difficulties at work may uncover underlying feelings masked by reaction formation.
Question 5 of 5.
A client with major depression is to be discharged home tomorrow. When preparing the client's discharge plan, which of the following areas is most important for the nurse to review with the client?
A. Future plans for going back to work.
B. A conflict encountered with another client.
C. Results of psychological testing.
D. Medication management with outpatient follow-up.
Explanation: Medication adherence and outpatient follow-up are critical to prevent relapse in major depression.