Question: Your client with intense suicidal ideation has been hospitalized for 1 week, during which time he has received an SSRI. He reports “no change” in suicidal ideation, although he demonstrates a wider range of affect and takes more initiative in self-care. The health care team is considering his imminent discharge. It is essential to consider which of the following factors:

Answer Options:
A. The health care team must plan for discharge from the day of admission
B. The client may have enough energy to plan and complete a suicide attempt
C. The client has reached the therapeutic time frame and will need to be switched
D. For 1 week of pharmacotherapy, the client has been free of side effects

Answer: B

Question: Which of the following is not associated with use of Tricyclic Antidepressants (TCA)?

Answer Options:
A. Dry mouth
B. Urinary Incontinence
C. Constipation
D. Blurred vision

Answer: B (They cause urinary retention, not incontinence.)

Question: Medication Calculation: A client is prescribed Vistaril 25 mg capsules by mouth every 4 hours. How many capsules will the client receive after 24 hours?

Answer Options:
(Short answer calculation)

Answer: 6 capsules
(24 hours ÷ 4 hours = 6 doses)

Question: Dysthymic disorder differs from major depressive disorder in the following ways:

Answer Options:
A. Symptoms are less severe but last longer
B. Symptoms only affect women during the winter months
C. Symptoms include hallucinations and delusional thinking
D. Symptoms are more severe and last longer

Answer: A

Question: A client diagnosed with major depression began taking a tricyclic antidepressant 1 week ago. The patient complains of dizziness upon standing. The nurse will:

Answer Options:
A. Update the client’s mental status examination
B. Teach the client strategies to manage postural hypotension
C. Withhold the drug, force oral fluids, and notify the HCP
D. Limit the patient’s activities to sitting position

Answer: B

Question: Nurse W. is admitting a client suspected to have suicidal ideation. The best course of action for Nurse W. to take is to:

Answer Options:
A. Arrange for commitment to avoid harm to self or others
B. Ask the patient’s significant other if the patient is suicidal
C. Avoid the subject to avoid pushing him further
D. Ask the patient if he’s having thoughts of suicide

Answer: D

Question: Valproate (Depakote / Depakene) has surpassed lithium in treating acute mania and helps prevent future manic episodes. It is important to monitor which lab tests?

Answer Options:
A. Urine analysis & Culture and Sensitivity
B. Liver function and platelet count
C. Rash and drug levels
D. Fasting blood glucose, waist circumference, and lipids

Answer: B

Question: A client was referred by the court after excessive spending sprees, flamboyant behavior, no sleep, etc. These behaviors are consistent with a DSM-V diagnosis of:

Answer Options:
A. obsessive compulsive
B. mania
C. dysthymia
D. depression

Answer: B

Question: A biological symptom which is NOT associated with depression is

Answer Options:
A. Increased sexual interest
B. Poor concentration
C. Loss of appetite
D. Sleep disturbance

Answer: A

Question: A nursing diagnosis that is appropriate to consider for a patient with antisocial personality disorder is:

Answer Options:
A. alteration in body image
B. disturbed sensory perception
C. impaired social interaction
D. anxiety

Answer: C (Impaired social interaction)

Question: Second Generation Antipsychotics (SGAs) are approved for acute mania. What serious side effect must be monitored with SGAs?

Answer Options:
A. Decreased appetite
B. Urinary retention
C. Metabolic syndrome
D. Severe vitamin deficiency

Answer: C

Question: Within mood disorders, two key symptoms of a manic episode are:

Answer Options:
A. Extremely elevated mood and grandiose ideas
B. Psychomotor retardation and flight of ideas
C. Distractibility and social phobia
D. Delusional thinking and intense fear of weight gain

Answer: A

Question: Which behavior would be most characteristic of an individual with narcissistic personality disorder?

Answer Options:
A. Belief that he is entitled to special privileges that others may not have
B. A lifelong pattern of social withdrawal
C. Belief that they possess special powers
D. The person requires frequent reassurance, difficulty with decision making, and puts others first

Answer: A

Question: A client with borderline personality disorder tells the nurse that her ex-boyfriend was “perfect” then became “the worst person in the world.” She cut herself after he left for a baseball game. The client’s behavior is best described as:

Answer Options:
A. antisocial
B. impulsive
C. paranoid
D. passive aggressive

Answer: B

Question: A suicidal client is found by a nurse as he tries to hang himself from the shower in the bathroom. What nursing intervention would address the patient’s need for safety?

Answer Options:
A. Tell him he may use the bathroom only with staff supervision
B. Request that he remain with the patient group at all times
C. Assign a staff member to remain with him at all times
D. Place him in the seclusion room with 15-minute checks

Answer: C