A third-grade child is referred to the mental health clinic by the sch

Psychiatric Mental Health Nursing NCLEX RN Questions

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Question 1 of 5.

A third-grade child is referred to the mental health clinic by the school nurse because he is fearful, anxious, and socially isolated. After meeting with the client, the nurse talks with his mother, who says, 'It's that school nurse again. She's done nothing but try to make trouble for our family since my son started school. And now you're in on it.' The nurse should respond by saying:

A. The school nurse is concerned about your son and is only doing her job.'

B. We see a number of children who go to your son's school. He isn't the only one.'

C. You sound pretty angry with the school nurse. Let's talk about that.'

D. Let me tell you why your son was referred, and then you can tell me about your concerns.'

Explanation: This response de-escalates the situation by providing information and inviting the mother to share her concerns, fostering collaboration.

Question 2 of 5.

A client with schizophrenia completes a self-care task independently. Which response by the nurse is most appropriate?

A. You don't need help anymore.'

B. Great job! Let's try another task.'

C. Why didn't you do this before?'

D. I'll do the next task for you.'

Explanation: Praising the achievement and encouraging further tasks reinforces independence and builds confidence.

Question 3 of 5.

When conducting a mental status examination with a newly admitted client who has an Axis I diagnosis of paranoid schizophrenia, the client states, 'I'm being followed; it's not safe. They're monitoring my every move.' In which of the following areas of the mental status examination should be the mental status examined.

A. Thought content.

B. Quality of speech.

C. Insight.

D. Judgment.

Explanation: The client's statement reflects paranoid delusions, which are assessed under thought content in a mental status examination, as this area evaluates the presence of delusions or hallucinations.

Question 4 of 5.

A client who is suspicious of others including staff is brought to the hospital wearing a wrinkled dress with stains on the front. Assessment also reveals a flat affect, confusion and slow movements. Which goal should the nurse identify as the initial priority in the client's way?

A. Helping the client feel safe and accepted.

B. Introducing the client to other clients.

C. Giving the client information about the program.

D. Providing the client with clean, comfortable clothes.

Explanation: Establishing safety and acceptance is the priority for a suspicious client, as it builds trust and reduces paranoia, which is essential before addressing other needs like hygiene or socialization.

Question 5 of 5.

A client with schizophrenia comes to the outpatient mental health clinic 5 days after being discharged from the hospital. The client was given a 1-week supply of clozapine (Clozaril). The client tells the nurse that she has too much saliva and frequently needs to spit. The nurse interprets the client's statement as indicating which of the following?

A. Delusion, requiring further assessment.

B. Unusual reaction to clozapine.

C. Expected adverse effect of clozapine.

D. Unresolved symptom of schizophrenia.

Explanation: Excessive salivation (sialorrhea) is a common side effect of clozapine, and the nurse should recognize it as an expected adverse effect rather than a delusion or symptom.