A client with a long history of paranoid schizophrenia is readmitted v

Mental Health RN NCLEX Questions

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Question 1 of 5.

A client with a long history of paranoid schizophrenia is readmitted voluntarily after missing his last two injections of haloperidol decanoate (Haldol Decanoate). He reports, 'I'm not sleeping much and my friend says I smell from not showering. God is telling me to protect myself from others. My parents are sick and tired of me and my illness. They wish I were dead.' Which of the following admission notes by the nurse contains assumptions and potentially false accusations? Select all that apply.

A. Client has been noncompliant with his medications, causing decreased sleep and activities of daily living, increased, and the hallucinations, and paranoid delusions about his parents harming him.

B. Client has missed two injections of Haldol Decanoate and was admitted voluntarily. He reports he has decreased sleep and showering and that he hears God's voice telling him to protect himself from others. He stated, 'My parents are sick and tired of me an

C. Client has missed two doses of Haldol Decanoate. He's not sleeping and showering. Has a strained relationship with his parents and discussions that they want him to be necessary admission to restart Haldol Decanoate.

D. Client admitted for noncompliance with Haldol Decanoate injections, sleep disturbance, poor hygiene, auditory hallucinations, and suspiciousness of his parents. Needs to be monitored for suicidal and homicidal ideation.

E. Client admitted because of hallucinations and delusions. His parents may be abusing him. He states he has not taken his medications for 2 days.

Explanation: The notes in A, C, and E make assumptions: A assumes noncompliance caused all symptoms and misinterprets the parents' intentions; C assumes a strained relationship and parental wishes without evidence; E falsely states medication was missed for 2 days and assumes parental abuse without substantiation.

Question 2 of 5.

After a period of unsuccessful treatment with Elavil (amitriptyline), a woman diagnosed with depression is switched to Parnate (tranylcypromine). Which statement by the client indicates the client understands the side effects of Parnate?

A. I must do increase my intake of sodium.'

B. I must refrain from strenuous exercise.'

C. I must refrain from eating aged cheese or yeast products.'

D. I should decrease my intake of foods containing sugar.'

Explanation: Parnate is a monoamine oxidase inhibitor (MAOI), and clients must avoid tyramine-rich foods like aged cheese and yeast products to prevent hypertensive crisis.

Question 3 of 5.

A nurse is conducting a psychoeducational group for family members of clients hospitalized with depression. Which family member's statement indicates a need for additional teaching?

A. My husband will slowly feel better as his medicine takes effect over the next 2 to 4 weeks.'

B. My wife will need to take her antidepressant medicine and go to group to stay well.'

C. My son will only need to attend outpatient appointments when he starts to feel depressed again.'

D. My mother might need help with grocery shopping, cooking, and cleaning for a while.'

Explanation: Depression requires ongoing outpatient care to prevent relapse, not just when symptoms reappear.

Question 4 of 5.

A client is receiving paroxetine (Paxil) 20 mg every morning. After taking the first three doses, the client tells the nurse that the medication upsets his stomach. Which of the following instructions should the nurse give to the client?

A. Take the medication an hour before breakfast.'

B. Take the medication with some food.'

C. Take the medication at bedtime.'

D. Take the medication with 4 oz of orange juice.'

Explanation: Taking paroxetine with food can reduce gastrointestinal side effects like nausea.

Question 5 of 5.

A client who is depressed states, 'I'm an awful person. Everything about me is bad. I can't do anything right.' Which of the following responses by the nurse is most therapeutic?

A. Everybody around here likes you.'

B. I can see many good qualities in you.'

C. Let's discuss what you've done correctly.'

D. You were able to bathe today.'

Explanation: Discussing specific accomplishments challenges negative self-perceptions and promotes cognitive restructuring.