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Question A 32-year-old patient is admitted to the psychiatric unit with a diagnosis of schizophrenia. The patient exhibits signs of auditory hallucinations and is observed responding to unseen voices. The nurse understands that an important aspect of care includes assessing the patient’s safety. Which of the following actions should the nurse take first?
A) Encourage the patient to participate in group therapy sessions.

B) Administer antipsychotic medication as prescribed.

C) Assess the patient’s understanding and interpretation of the hallucinations.

D) Arrange for a family meeting to discuss the patient’s condition.

E) Implement a strict schedule to provide structure for the patient.
Rationale: Assessing the patient’s understanding and interpretation of the hallucinations is crucial as it helps in determining the patient’s insight into their condition, their potential reaction to these hallucinations, and whether these perceptions might lead them to harm themselves or others. It’s a foundational step that informs subsequent interventions, including the need for medication, the appropriateness of group therapy, and the level of supervision required. This assessment can also guide the nurse in developing therapeutic communication strategies and in planning care that addresses both safety concerns and the patient’s specific experiences. It prioritizes the immediate need to understand the patient’s mental state over the implementation of structured activities or family involvement. Correct Answer: C) Assess the patient’s understanding and interpretation of the hallucinations.

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Question A 32-year-old patient is admitted to the psychiatric unit with a diagnosis of schizophrenia. The patient exhibits signs of auditory hallucinations and is observed responding to unseen voices. The nurse understands that an important aspect of care includes assessing the patient’s safety. Which of the following actions should the nurse take first?
A) Encourage the patient to participate in group therapy sessions.

B) Administer antipsychotic medication as prescribed.

C) Assess the patient’s understanding and interpretation of the hallucinations.

D) Arrange for a family meeting to discuss the patient’s condition.

E) Implement a strict schedule to provide structure for the patient.
Rationale: Assessing the patient’s understanding and interpretation of the hallucinations is crucial as it helps in determining the patient’s insight into their condition, their potential reaction to these hallucinations, and whether these perceptions might lead them to harm themselves or others. It’s a foundational step that informs subsequent interventions, including the need for medication, the appropriateness of group therapy, and the level of supervision required. This assessment can also guide the nurse in developing therapeutic communication strategies and in planning care that addresses both safety concerns and the patient’s specific experiences. It prioritizes the immediate need to understand the patient’s mental state over the implementation of structured activities or family involvement. Correct Answer: C) Assess the patient’s understanding and interpretation of the hallucinations.

Question A 26-year-old patient with bipolar disorder is experiencing a manic episode characterized by grandiosity, decreased need for sleep, and rapid speech. The nurse’s assessment reveals that the patient has not slept for 36 hours and is becoming increasingly irritable. In managing this patient’s care, which of the following interventions should the nurse prioritize?
A) Engage the patient in high-energy physical activities.

B) Provide a quiet environment and encourage sleep.

C) Encourage the patient to express feelings in a group setting.

D) Offer multiple choices for activities to keep the patient engaged.

E) Increase the frequency of family visits to improve the patient’s mood.
Rationale: In a manic episode, the priority is to address behaviors that could exacerbate the episode, such as lack of sleep, which can increase mania severity. Providing a quiet environment and encouraging sleep are critical to help stabilize the patient’s mood and prevent further deterioration. This intervention aims to reduce sensory stimulation and promote relaxation, which can be beneficial in breaking the cycle of mania. It focuses on the immediate physiological need for rest, which is essential for mental health recovery, and precedes the involvement in activities or social interactions that could further stimulate the patient. Correct Answer: B) Provide a quiet environment and encourage sleep.

Question A patient diagnosed with major depressive disorder reports feeling worthless and expresses suicidal thoughts. The patient has a plan to overdose on medication. Which of the following nursing actions is most important to implement first?
A) Encourage the patient to talk about their feelings.

B) Secure a no-suicide contract with the patient.

C) Remove all harmful items from the patient’s environment.

D) Contact the patient’s family to inform them of the patient’s status.

E) Schedule daily sessions with the psychiatric counselor.
Rationale: When a patient expresses suicidal thoughts and has a specific plan, the immediate nursing priority is ensuring the patient’s physical safety. Removing all harmful items from the patient’s environment directly addresses the risk of self-harm and is a critical first step in suicide prevention. This action should precede engagement in therapeutic communication or planning future interventions, as it deals with an immediate life-threatening situation. Ensuring a safe environment provides the foundation for further therapeutic interventions and supports the patient’s safety as the primary concern. Correct Answer: C) Remove all harmful items from the patient’s environment.

Question A 45-year-old patient with generalized anxiety disorder (GAD) reports constant worry about daily activities, which is affecting their ability to function at work and maintain relationships. The patient is visibly restless and has difficulty concentrating. Which of the following interventions should the nurse prioritize to help manage the patient’s anxiety?
A) Teach the patient about the use of anxiolytic medication.

B) Encourage the patient to avoid situations that trigger anxiety.

C) Implement relaxation techniques and deep breathing exercises.

D) Advise the patient to increase caffeine intake to improve concentration.

E) Suggest the patient start a journal to record anxious thoughts.
Rationale: For a patient with generalized anxiety disorder, teaching and implementing relaxation techniques and deep breathing exercises are effective non-pharmacological interventions that can help reduce symptoms of anxiety. These techniques help the patient gain control over physiological responses to anxiety, such as restlessness and difficulty concentrating, by promoting relaxation and reducing stress levels. Unlike avoidance of anxiety-provoking situations, which can limit coping skills and adaptation, relaxation strategies empower the patient with tools to manage anxiety in various situations. This intervention also complements other therapeutic measures, such as medication or cognitive therapy, and can be easily incorporated into daily routines to improve overall functioning. Correct Answer: C) Implement relaxation techniques and deep breathing exercises.

Question A patient with post-traumatic stress disorder (PTSD) experiences severe anxiety and flashbacks when exposed to loud noises. The nurse is planning care for this patient. Which of the following interventions should the nurse include to help manage the patient’s symptoms?
A) Limit exposure to television and radio news.

B) Provide detailed explanations before performing any procedures.

C) Use a white noise machine to mask background noise.

D) Schedule regular visits from a therapy dog.

E) Encourage participation in high-intensity group exercise classes.
Rationale: Using a white noise machine to mask background noise can be a therapeutic intervention for a patient with PTSD who experiences anxiety and flashbacks triggered by loud noises. This approach can create a calming environment and reduce the likelihood of triggers by providing a consistent and soothing sound backdrop, which can help prevent sudden noises from causing distress. It respects the patient’s sensitivity to auditory stimuli and offers a sense of safety and control over their environment. Additionally, this intervention can be used in conjunction with other therapeutic approaches, such as cognitive-behavioral therapy, to provide comprehensive care aimed at managing symptoms and improving the patient’s quality of life. Correct Answer: C) Use a white noise machine to mask background noise.

Question A 22-year-old patient is brought to the emergency department by friends after exhibiting signs of acute panic attack, including palpitations, shortness of breath, and a feeling of impending doom. The patient has a history of panic disorder. Which of the following actions by the nurse is most appropriate initially?
A) Start an intravenous line for medication administration.

B) Encourage the patient to talk about their feelings and fears.

C) Guide the patient in slow, deep breathing exercises.

D) Prepare the patient for immediate psychiatric evaluation.

E) Administer oxygen therapy to alleviate shortness of breath.
Rationale: Guiding the patient in slow, deep breathing exercises is an immediate and effective intervention for managing acute panic attacks. This technique helps the patient control hyperventilation, a common symptom of panic attacks, and can lead to a reduction in other physical symptoms such as palpitations and shortness of breath. It also serves as a grounding technique, helping to distract the patient from overwhelming feelings of fear or doom. This non-pharmacological approach is a first-line response that can be rapidly implemented to provide relief and can be a precursor to further assessment and treatment once the patient’s acute symptoms are under control. Correct Answer: C) Guide the patient in slow, deep breathing exercises.

Question A patient with obsessive-compulsive disorder (OCD) spends several hours a day washing their hands due to a fear of contamination. This behavior significantly interferes with the patient’s daily activities and quality of life. Which of the following interventions should the nurse prioritize to help manage the patient’s OCD symptoms?
A) Encourage the patient to avoid situations that trigger the washing behavior.

B) Schedule more frequent hand-washing sessions to reduce anxiety.

C) Engage the patient in cognitive-behavioral therapy (CBT) sessions.

D) Recommend wearing gloves to reduce the need for hand washing.

E) Increase social activities to distract from the compulsion.
Rationale: Cognitive-behavioral therapy (CBT) is a highly effective treatment for patients with obsessive-compulsive disorder (OCD) and should be prioritized to help manage the patient’s symptoms. CBT helps the patient identify, challenge, and change unhealthy beliefs and behaviors, such as excessive hand washing due to fear of contamination. This approach addresses the root causes of OCD symptoms, providing strategies to cope with and reduce compulsive behaviors and obsessive thoughts. Engaging the patient in CBT offers a structured method to gain control over OCD symptoms, improving the patient’s ability to function in daily life and enhancing their quality of life. Correct Answer: C) Engage the patient in cognitive-behavioral therapy (CBT) sessions.

Question A 55-year-old patient with chronic depression has recently been expressing feelings of hopelessness and a lack of interest in previously enjoyed activities. The patient has been on antidepressant medication for several months with no significant improvement. Which of the following actions should the nurse take first?
A) Recommend increasing the dose of the current antidepressant.

B) Suggest the patient engage in more physical activities.

C) Arrange for a psychiatric evaluation to reassess the treatment plan.

D) Encourage the patient to join a support group for individuals with depression.
E) Advise the patient to use light therapy to improve mood.
Rationale: Arranging for a psychiatric evaluation to reassess the treatment plan is a critical first step when a patient with chronic depression shows no significant improvement on their current medication regimen. This action ensures that the patient receives a comprehensive assessment that may identify the need for adjustments in medication, the addition of psychotherapy, or alternative treatment options. A reassessment can uncover factors contributing to the treatment’s lack of efficacy, such as incorrect diagnosis, inadequate dosage, or the presence of other underlying conditions. It prioritizes a personalized approach to care, focusing on optimizing the treatment plan to address the patient’s specific needs and improve their overall mental health outcomes. Correct Answer: C) Arrange for a psychiatric evaluation to reassess the treatment plan.

Question A 30-year-old patient with social anxiety disorder avoids all social interactions and has difficulty maintaining employment. The patient expresses a desire to overcome these challenges but feels powerless to change. Which of the following interventions should the nurse prioritize to help the patient improve their social functioning?A) Initiate pharmacotherapy with anxiolytic medications.

B) Recommend daily exposure to social situations to desensitize anxiety.

C) Encourage the use of online social platforms to enhance social skills.

D) Facilitate participation in a social skills training program.

E) Arrange for a comprehensive psychiatric evaluation to explore underlying causes.
Rationale: Facilitating participation in a social skills training program is an effective intervention for patients with social anxiety disorder who struggle with social interactions and employment. Social skills training provides structured learning and practice in social interactions, communication techniques, and coping strategies for anxiety, addressing the specific challenges faced by individuals with social anxiety disorder. This intervention supports the patient’s expressed desire to overcome social challenges by equipping them with the tools and confidence needed to engage in social situations more effectively. It also complements other treatment modalities, such as pharmacotherapy or cognitive-behavioral therapy, offering a holistic approach to improving the patient’s social functioning and quality of life. Correct Answer: D) Facilitate participation in a social skills training program.

Question A patient diagnosed with borderline personality disorder (BPD) exhibits impulsive behavior, unstable relationships, and a fear of abandonment. The patient frequently experiences intense episodes of anger and depression. In planning care for this patient, which of the following interventions should the nurse prioritize?
A) Enforce strict boundaries and consequences for negative behaviors.

B) Implement dialectical behavior therapy (DBT) sessions.

C) Arrange for weekly family therapy sessions to address relationship issues.

D) Prescribe mood-stabilizing medications to control anger episodes.

E) Encourage participation in high-risk activities to channel impulsivity.
Rationale: Implementing dialectical behavior therapy (DBT) sessions is a priority intervention for patients diagnosed with borderline personality disorder (BPD). DBT is specifically designed to address the complex needs of individuals with BPD, including managing impulsive behaviors, regulating emotions, improving interpersonal relationships, and reducing self-harm behaviors. Through individual therapy, group skills training, and crisis support, DBT helps patients develop coping mechanisms for dealing with intense emotions and conflict in relationships. This evidence-based approach is effective in reducing symptoms of BPD, enhancing the patient’s ability to function in daily life, and improving their overall well-being. Correct Answer: B) Implement dialectical behavior therapy (DBT) sessions.

Mental Health disorders

More: Mental Health NCLEX questions

4) The nurse is caring for a 26-year-old male inpatient diagnosed with bipolar disorder and mania. What interventions will the nurse take? (select all that apply)

A. Encourage group activities

B. Speak calmly and use slow interactions

C. Avoid arguing with the patient

D. Organize team sport activities for the patient

5) A 45 year-old male  with a history of hypertension, asthma, GERD and major depressive disorder is reporting his symptoms over the last three weeks. The symptoms of depression does the nurse expects to document, (select all that apply)

A. Weight loss

B. Hypervigilance

C. Helplessness

D. Lack of desire to spend time with friends and family

6) The nurse is caring for a patient who is being treated with lithium. What is the appropriate therapeutic lithium blood level?

A. 1.0 to 3.2 mEq/L

B. 0.2 to 0.8 mEq/mL

C. 0.6 to 1.2 mEq/L

D. 2.6 to 8.2 mmol/L

7) The nurse is caring for an inpatient with mania who is diagnosed with bipolar disorder. What are important strategies for activities? (select all that apply)

A. Encouraging competitive sport activities

B. Set limits for inappropriate behavior

C. Keep hazardous objects away from the patient

D. Encourage the patient to talk about their feelings

8) The patient tells the nurse he was prescribed a drug to treat depression and mood that blocks the reuptake of serotonin in the brain. The nurse expects the medication record to show, (select all that apply)

A. doxepin

B. citalopram

C. imipramine

D. fluoxetine

9) A father tells the nurse that his son was started on a tricyclic antidepressant for depression. The nurse expects the boy’s medication record to show, (select all that apply)

A. doxepin

B. citalopram

C. nortriptyline

D. bupropion

10) The nurse is speaking with a mother whose teenage son is being treated for depression and narrow-angle glaucoma. What are some drugs that should be avoided? (select all that apply)

A. doxepin

B. imipramine

C. nortriptyline

D. phenelzine

Answers to NCLEX-style Questions

Mental Health NCLEX Questions

1. A,C
Depression may persist for weeks or wax and wane over years. Patients may experience low mood, low self-esteem, guilt, helplessness, fatigue and social withdrawal. Sleep, affect, and appetite may be affected.
2. B,D
Bipolar disorder results in mood swings that include mania and depression. Treatment is effective with medication. Mania is characterized by high energy, extreme self-confidence, quick anger, and excessive financial spending. Depression may be characterized by extreme lows.
3. D
Trazodone potentiates the effects of serotonin causing an increase in mood. One of its therapeutic effects is an increase in sleep time that helps patients with insomnia.
4. B,C
When caring for patients with bipolar disorder and acute mania, the nurse should avoid exciting the patient and provide a safe environment. Prescribed medications should be administered under observation to ensure compliance.
5. A, D
Moderate and severe depression causes sleep disturbance, irritability, anxiety and may increase substance use including drugs and alcohol.
6. C
The therapeutic drug level of lithium is 0.6 to 1.2 mEq/L. When therapy is first begun, the level must be monitored closely. Signs of lithium toxicity include ataxia, muscle twitching, hyperreflexia and seizures.
7. B,C,D
Bipolar disorder results in mood swings that include mania and depression. Mania is characterized by high energy, extreme self-confidence, quick anger, and excessive financial spending.
8. B,D
This question examines if the nursing student recognizes the class of drugs known as serotonin reuptake inhibitors (SSRI). Citalopram and fluoxetine are examples of common SSRI’s.
9. A,C
This question will determine if the nursing student recognizes the class of drugs known as tricyclic antidepressants (TCAs). Doxepin and nortriptyline are examples of common TCAs.
10. A,B,C
(D) Phenelzine is not a tricyclic antidepressant. (A), (B) and (C) are tricyclic antidepressants and this class of drugs should not be prescribed to patients with narrow angle glaucoma.

can you drink on abilify?

Alcohol use is contraindicated with most mental health medications. Alcohol can increase the effects of some of the drugs that are prescribed. Furthermore, some of the medications are metabolized in the liver and would be contraindicated with hepatic insufficiency or severe liver disease.

discharge planning for depression patient

Patients who have been recently discharged after hospitalization for depression should be instructed to follow up with regular meetings with a therapist.

communicating with difficult patients

Nursing considerations include being available to the patient. It may include spending time with the patient before they are fully ready to engage in conversation.

nursing care plan for mania

What is your approach to a patient with acute mania who is refusing their prescription? What is the best response? Remember, that if the patient is competent and was admitted voluntarily, you can’t force the patient to take the medication. An appropriate therapeutic response would be to briefly explain to the patient that the medication will make the patient feel better, relieve the symptoms and feel calm. The patient with acute mania will have difficulty concentrating so a brief clear explanation will be the most beneficial.

bipolar disorder relapse symptoms

When the nurse is educating a patient who has been hospitalized for bipolar disorder, what are signs of relapse? A decreased need for sleep, increased spending, impulsivity, and racing thoughts. This information should be shared with the family members to assist with monitoring behavior at home. Remember these patients can go from extreme highs to depression.

electroconvulsive therapy procedure

Electroconvulsive therapy is safe. Nurses can reassure the patient and the family that a muscle relaxant and sedative or general anesthesia is usually prescribed. After treatment, patients may have a mild headache. Electroconvulsive therapy may be recommended for patients with severe depression, schizophrenia, and bipolar that have not responded to medication.

management of aggressive patient

If the nurse witnesses inappropriate behavior on the unit, including inappropriate speech or language, the nurse should approach the client and ask to speak with him or her privately. Tell the client that the behavior is not appropriate and what is expected going forward. Additional action can be taken if needed.

Diagnosing Depression

If you have a patient who presents with fatigue, depression, unexplained weight gain, and dry skin, what are some nursing considerations? Your physical exam and assessment should look for signs of hypothyroidism in the patient, for example, hair loss. Keep in mind that patients with hypothyroidism and other conditions may have depressive symptoms. These patients may need to be referred by the health care provider for evaluation, and a medical workup.

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Can you answer the following questions?
What is bipolar disorder?
Describe how to treat bipolar disorder?
Can you describe the signs and symptoms of depression?
What is schizophrenia?
How do you define generalized anxiety disorder?
What is the difference between anxiety disorder and a panic attack?
What is post traumatic stress disorder?