Mental Health RN NCLEX Questions
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Question 1 of 5.
Extract:The nurse in the behavioral health clinic is caring for a 48-year-old male client. • Diagnostic Results Diagnostic, Result ,Reference Range Calcium, 10.5 mg/di (2.75mmol/I), 9.0-10.5 mg/dL (2.25-2.75 mmol/L) Chloride, 99 mEq/1 (99 mmol/l), 98 to 106 mEq/L (98 to 106 mmol/l) Creatinine, 0.9 mg/dI (79.6mcmol/L), 0.6 to 1.2 mg/di (53-106 mcmol/L) Potassium, 3.8 mEq/1 (3.8, mmol/D), 3.5-5.0 mEq/L (3.5-5.0 mmol/L) Sodium,137 mEq/1 (137mmol/l), 135 to 145 mEq/1 (135 to 145 mmol/I) Blood urea nitrogen,12 mg/di (4.2mmol/I), 10-20 mg/dL (3.6-7.1 mmol/L) Fasting glucose ,202 mg/dL (11.2mmol/L), 70-110 mg/dL (4-6 mmol/L) White blood cell, 11,000/mm3 (11 × 109 /L), 5,000-10,000/mm 3 (5-10 × 109 /L) Hemoglobin (Hgb), 15 g/dL (150 g/L), Male: 14-18 g/dL (140-180 g/L) Female: 12-16 g/dL (120-160 g/L) Hematocrit (Hct), 45% (0.47), Male: 42%-52% (0.42-0.52) Female: 37%-47% (0.37-0.47) Lithium level, 0.4 mEg/L , 0.6-1.2 mEg/L • Nurses' Notes 1230: Client presents for a follow-up appointment. He reports 100% adherence with prescribed ziprasidone. Two weeks ago, he was prescribed lithium, for which he reports a mild thirst. This thirst is causing him to go to the bathroom more frequently overnight. He reports that he recently got a second job to save for a vacation. On assessment, the client is alert and completely oriented. He had a logical thought process. Lung sounds clear bilaterally, and peripheral pulses were 2+. Skin is warm, dry, and normal for ethnicity. Rapid eye blinking and persistent chewing motions in his mouth despite not eating any food or gum. He reports that this started two weeks ago. Current weight is 128 kg (282 pounds). Current BMI is 26kg/m2. Previous weight one month ago was 126 kg (277 pounds). The most recent hospitalization was one month ago for a manic episode. Laboratory data reviewed.
The nurse performs the Abnormal Involuntary Movement Scale and determines that the client is experiencing tardive dyskinesia. For each potential intervention, click to specify whether the intervention is indicated or not indicated for the client
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Explanation: Discontinuation of ziprasidone is indicated because the client is exhibiting signs of tardive dyskinesia, which is a serious and potentially irreversible side effect of long-term antipsychotic use. The most effective initial approach to managing tardive dyskinesia is to stop the offending agent, especially when symptoms are newly emerging. Ordering a hemoglobin A1C is appropriate given that the client has a fasting glucose of 202 mg/dL (11.2 mmol/L), which is in the diabetic range. A hemoglobin A1C would provide information on the average blood glucose over the past two to three months, helping to confirm a diagnosis of diabetes mellitus (type two) and guide long-term treatment planning. It is also important to inquire further about the client's adherence to lithium. The serum lithium level is currently 0.4 mEq/L, which is subtherapeutic. Understanding whether the client is taking the medication as prescribed or missing doses will help determine if a dose adjustment or adherence support is needed to ensure effective mood stabilization.
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.
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