Psychiatric NCLEX RN Questions
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Question 1 of 5.
Extract:The following scenario applies to the next 1 items The nurse in the mental health clinic is caring for a 23-year-old female Item 1 of 1 Nurses' Notes 1545 – Client presented to establish care with psychiatry and was recommended by a few of her professors to seek counseling regarding her attitude. She stated, "I just want to get checked out because they insist something is wrong, but I feel fine." The client did report that she has gone through a few breakups over the past year and states that "guys suck, all they want is to be with you for a short time, and then they leave you. I cannot handle it when someone leaves me." Since her most recent breakup, she reports hanging out with several guys and having indiscriminate sex but is "keeping her distance." The client reports obtaining psychiatric care one year ago but abandoned treatment because "the psychiatrist just didn't get me; he was totally awful." The client reports no psychiatric hospitalizations but two previous suicide attempts when she was a teenager using a butter knife, stating, "I wasn't trying to kill myself; I just wanted my parents to listen to me." On assessment, the client is alert, completely oriented, and has a mood described as "whatever" she appears somewhat hostile during the assessment, and her affect is labile, ranging from euthymic to angry at certain portions of the interview. She denies any hallucinations. She is dressed in normal attire; her hair is well-kept, and she has a slender appearance.
The client is exhibiting manifestations consistent with............... personality disorder. The nurse should prioritize assessing the client for.................. When developing a plan of care for this client, it is strongly recommended that the nurse obtain a prescription for............
A. borderline
B. narcissistic
C. suicide.
D. sexually transmitted infections.
E. an antipsychotic medication.
F. an antidepressant medication.
G. outpatient therapy.
Explanation: The client's labile affect, fear of abandonment, and history of suicide attempts suggest borderline personality disorder. Assessing for suicide risk and prescribing outpatient therapy (e.g., DBT) are priorities.
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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