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NSG 3450 | MENTAL HEALTH NURSING FINAL EXAM
QUESTIONS & ANSWERS (LATEST 2025-2026)
A patient's history shows intense and unstable relationships with others. The patient initially idealizes an individual and then devalues the person when the patient's needs are not met. Which aspect of mental health is a problem for this patient?
A) maintaining relationships
B) communication skills
C) effectiveness in work
D) productive activities
A) maintaining relationships
In the majority culture of the United States, which individual is at greatest risk to be incorrectly labeled mentally ill?
A) person who expresses strong beliefs about the existence of alien abductions.
B) Wealthy person who gives $20 bills to needy individuals in the community
C) person who is usually pessimistic but strives to meet personal goals
D) person with an optimistic viewpoint about getting his or her own needs met
A 26-month-old child displays negative behaviors. The parent says, "My child refuses toilet training and shouts, 'No!' when given direction. What do you think is wrong?" Select the nurse's best reply.
A) "this is normal for your child's age. the child is striving for independence."
B) "some undesirable attitudes are developing. a child psychologist can help you develop a remedial plan."
C) "the child needs firmer control. punish the child for disobedience and say "no"."
D) "there may be developmental problems. most children are toilet trained by age 2 years."
A) "this is normal for you child's age. the child is striving for independence"
Which situations qualify as abandonment on the part of a nurse? (Select all that apply.)
A) The nurse terminates employment without referring a seriously mentally ill patient for aftercare.
B) The nurse asks another nurse to provide a patient's care because of concerns about countertransference.
C) The nurse calls police to bring a suicidal patient to the hospital after a suicide attempt.
D) The nurse refers a patient with persistent paranoid schizophrenia to community treatment.
E) The nurse allows a patient with acute mania to refuse hospitalization without taking further action.
A) The nurse terminates employment without referring a seriously mentally ill patient for aftercare.
E) The nurse allows a patient with acute mania to refuse hospitalization without taking further action.
The goal for a patient is to increase resiliency. Which outcome should the nurse add to the plan of care to be achieved within three days?
A) patient will describe feelings associated with loss and stress
B) patient will identify healthy coping behaviors in response to stressful events
C) patient will allow others to assume responsibility for major areas of own life
D) patient will meet own needs before considering the rights of others
A 26-month-old child displays negative behavior, refuses toilet training, and often shouts, "No!" when given direction. The nurse's counseling with the parent should be based on the premise that the child is engaged in which of Erikson's psychosocial crises?
A) trust versus mistrust
B) autonomy versus shame and doubt
C) initiative versus guilt
D) industry versus inferiority
B) autonomy versus shame and doubt
A 4-year-old child grabs toys from siblings, saying, "I want that toy now!" The siblings cry, and the child's parent becomes upset with the behavior. Using the Freudian theory, a nurse can interpret the child's behavior as a product of impulses originating in the:
A) id
B) superego
C) ego
D) preconscious
A) id
The parent of a 4 year old rewards and praises the child for helping a younger sibling, being polite, and using good manners. A nurse supports the use of praise because, according to the Freudian theory, these qualities will likely be internalized and become what part of the child's personality?
A) preconscious
B) id
C) ego
D) superego
D) superego
A nurse assesses that a patient is suspicious and frequently manipulates others. Using the Freudian theory, these traits are related to which psychosexual stage?
A) anal
B) oral
C) genital
D) phallic
B) oral
A nurse listens to a group of recent retirees. One says, "I volunteer with Meals on Wheels, coach teen sports, and do church visitation." Another laughs and says, "I'm too busy taking care of myself to volunteer. I don't have time to help others." These comments contrast which developmental tasks?
A) trust vs mistrust
B) industry vs inferiority
C) intimacy vs isolation
D) generativity vs self-absorption
D) generativity vs self-absorption
A nurse uses Maslow's hierarchy of needs to plan care for a psychotic patient. Which problem will receive priority?
A) is reluctant to participate in unit social activities
What cognitive strategy should a nurse use to assist a very dependent patient achieve independence?
A) reveal dream content
B) examine thoughts about being autonomous
C) take prescribed medications
D) role model ways to ask for help from others
B) examine thoughts about being autonomous
The parent of an adolescent diagnosed with schizophrenia asks a nurse, "My child's doctor ordered a positron-emission tomography (PET) scan. What is that?" What is the nurse's best response?
A) 'its a special type of x-ray image that shows structures of the brain and whether a brain injury has ever occurred."
B) "PET is a scan that passes an electrical current through the brain and shows brainwave activity. PET can help diagnose seizures."
C) "PET is a special scan that shows blood flow and activity in the brain"
D) "PET uses a magnetic field and gamma waves to identify problem areas in the brain. does your teenager have any metal implants?"
C) "PET is a special scan that shows blood flow and activity in the brain."
A patient is demonstrating signs of dementia. The health care provider wants to make a differential diagnosis between Alzheimer's disease and multiple infarctions. Which diagnostic procedure should a nurse expect to prepare the patient for first?
A) functional magnetic resonance imaging (fMRI)
B) computed tomography (CT) scan
C) single-photon emission computed tomography (SPECT) scan
D)positron emission tomography (PET) scan
B) computed tomography (CT) scan
A patient has delusions and hallucinations. Before beginning treatment with a psychotropic medication, the health care provider wants to rule out the presence of a brain tumor. For which test will a nurse need to prepare the patient?
A) positron emission tomography (PET) or single photon emission computed tomography (SPECT)
B) computed tomography (CT) scan or magnetic resonance imaging (MRI)
C) functional magnetic resonance imaging (fMRI)
D) cerebral arteriogram
B) computed tomography (CT) scan or magnetic resonance imaging (MRI)
On the basis of current knowledge of neurotransmitter effects, a nurse anticipates that the treatment plan for a patient with memory difficulties may include medications designed to do what?
A) increase dopamine sensitivity
B) inhibit GABA production
C) decrease dopamine at receptor sites
D) prevent destruction of acetylcholine
D) prevent destruction of acetylcholine
A patient's partner, who is a chemist, asks a nurse how serotonin reuptake inhibitors (SSRIs) lift depression. What response will the nurse provide?
A) makes more serotonin available at the synaptic gap
B) blocks muscarinic and alpha1-norepinephrine receptors
C) increases production of acetylcholine and dopamine
D) destroys increased amounts of neurotransmitters
A) makes more serotonin available at the synaptic gap
A nurse administering psychotropic medications should be prepared to intervene when giving a drug that blocks the attachment of norepinephrine to α1-receptors because the patient may experience what effect?
A) severe appetite disturbance
B) hypertensive crisis
C) orthostatic hypotension
D) increased psychotic symptoms
C) orthostatic hypotension
A patient is hospitalized for a reaction to a psychotropic medication and then is closely monitored for 24 hours. During a pre-discharge visit, the case manager learns the patient received a notice of eviction on the day of admission. What is the most appropriate intervention for the case manager to implement?
A) arrange for a temporary place for the patient to stay until new housing can be secured
B) document that the patient's recovery will be hampered because of homelessness
C) contact the landlord who evicted the patient to discuss the situation
D) cancel the patient's discharge from the hospital
A) arrange for a temporary place for the patient to stay until new housing can be secured
A multidisciplinary health care team meets 12 hours after an adolescent is hospitalized after a suicide attempt. Members of the team report their assessments. What outcome can be expected from this meeting?
A) the healthcare team will order neuroimaging studies
B) the team will request a court appointed advocate for the patient
C) assessment of the patients need for placement outside the home will be undertaken
D) a treatment plan will be formulated
D) a treatment plan will be formulated
A nurse assesses an inpatient psychiatric unit, noting that exits are free from obstruction, no one is smoking, the janitor's closet is locked, and all sharp objects are being used under staff supervision. These observations relate to what nursing responsibility?
A) management of milieu safety
B) use of therapeutic intervention strategies
C) management of interpersonal climate
D) coordinating care of patients
A) management of milieu safety
A student nurse prepares to administer oral medication to a patient diagnosed with major depressive disorder. What should the student nurse do when the patient refuses the medication?
A) tell the patient "refusing your medication is not permitted. you are required to take it"
B) Attempt to discuss the patients concerns about the medication and report to the staff nurse
medicine, but I forgot to get my prescription refilled." Which outcome should the nurse add to the plan of care?
A) nurse will obtain prescription refills every 90 days and deliver them to the patient
B) patient will call the nurse weekly to discuss medication-related issues
C) patient will report to hospital for medication follow-up every week
D) patient's spouse will mark dates for prescription refills on the family calendar
D) patient's spouse will mark dates for prescription refills on the family calendar
Which assessment finding for a patient living in the community requires priority intervention by the nurse?
A) purchases and uses marijuana on a frequent basis
B) lives in an apartment with two patients who attend day hospital programs
C) receives social security disability income plus a small check from a trust fund
D) has a sibling who is interested and active in care planning
A) purchases and uses marijuana on a frequent basis
A patient hurriedly tells the community mental health nurse, "Everything's a disaster! I can't concentrate. My disability check didn't come. My roommate moved out, and I can't afford the rent. My therapist is moving away. I feel like I'm coming apart." What should be the immediate focus of nursing care?
A) assisting with the management of anxiety that may lead to psychosocial disequilibrium
B) facilitating the clarification of the patient's misperceptions of the environment
C) helping the patient cope with feelings of abandonment
D) assisting with the clarification of personal values
A) assisting with the management of anxiety that may lead to psychological disequilibrium
Which patient would a nurse refer to partial hospitalization?
A) One who spent yesterday in the 24-hour supervised crisis care center and continues to be actively suicidal.
B) One who has a therapeutic lithium level and reports regularly for blood tests and clinic follow-up.
C) One who states, "I'm not sure I can avoid using alcohol when my spouse goes to work every morning."
D) One who is experiencing agoraphobia and panic episodes and who would benefit from psychoeducation for relaxation therapy.
C) One who states, "I'm not sure I can avoid using alcohol when my spouse goes to work every morning."
What is an example of a lack of parity in health care delivery today?
A) Medicare is provided for only those 65 years of age and older
B) most psychiatric care is provided on an outpatient basis
C) there is sufficient need for mental health care providers
D) payment for psychiatric health care is not equal to that of physical health care
D) payment for psychiatric healthcare is not equal to that of physical healthcare
In a team meeting, a nurse says, "I'm concerned whether we are behaving ethically by using restraint to prevent one patient from self-mutilation while the care plan for another patient who has also self-mutilated calls for one-on-one supervision." Which ethical principle most clearly applies to this situation?
A) fidelity
Several nurses are concerned that agency policies related to restraint and seclusion are inadequate. Which statement about the relationship of substandard institutional policies and individual nursing practice should guide nursing practice?
A) In an institution with substandard policies, the nurse has a responsibility to inform the supervisor and leave the premises.
B) The policies do not absolve an individual nurse of the responsibility to practice according to the professional standards of nursing care.
C) Interpretation of policies by the judicial system is rendered on an individual basis and therefore cannot be predicted.
D) Agency policies are the legal standard by which a professional nurse must act and therefore override other standards of care.
B) The policies do not absolve an individual nurse of the responsibility to practice according to the professional standards of nursing care.
An adolescent hospitalized after a violent physical outburst tells the nurse, "I'm going to kill my father, but I know you can't tell anyone." What is the nurse's best response?
A) "Those kinds of thoughts will make your hospitalization even longer."
B) "You really should share these kinds of thoughts with your psychiatrist."
C) "You're right. Federal law requires me to keep that information private."
D) "I am required to share information like this with your treatment team."
D) "I am required to share information like this with your treatment team."
A nurse cares for an older adult patient admitted for treatment of depression. The health care provider prescribes an antidepressant medication, but the dose is more than the usual adult dose. The nurse is obligated to take what action?
A) give the usual geriatric dosage at the scheduled times
B) hold the medication and then notify the health care provider
C) Implement the order as written but document the concern
D) consult a drug reference if a pharmacist is not available
B) hold the medication and then notify the provider
Which action by a psychiatric nurse best supports a patients rights to be treated with dignity and respect?
A) informing a treatment team that a patient is too drowsy to participate in care planning
B) strongly encouraging a patient to participate in the unit milieu
C) consistently addressing a patient by title and surname
D) discussing a patient's condition with another health care provider in the elevator
C) consistently addressing a patient by title and surname
After leaving work, a staff nurse realizes that documentation of the administration of a medication to a patient was omitted. This off-duty nurse telephones the unit and tells the nurse, "Please document the administration of the medication I forgot to do. My password is alpha1." What action should the on-duty nurse take?
A) access the record and document the information
B) report the request to the patients health care provider
C) suggest the nurse return and document
D) refer the matter to the charge nurse to resolve
D) refer the matter to the charge nurse to resolve
C) precise
D) mixed
D) mixed
A patient tells the nurse, "I don't think I will ever get out of here." Select the nurse's most therapeutic response.
A) "don't talk that way. of course you will leave here"
B) "everyone feels that way sometimes"
C) "you don't think you're making progress?"
D) "keep up the good work and you certainly will"
"you don't think you're making progress?"
Which benefits are most associated with the use of telehealth? (Select all that apply.)
A) rapid development of trusting relationships with patients
B) maximization of care management
C) access to services for patients in rural areas
D) prompt reimbursement by third-party payers
E) cost savings for patients
B) maximization of care management
C) assess to services for patients in rural areas
E) cost savings for patients
During the first interview with a parent whose child died in a car accident, the nurse feels empathic and reaches out to take the patient's hand. Select the correct analysis of the nurse's behavior.
A) It shows empathy and compassion. It will encourage the patient to continue to express feelings.
B) the patient will perceive the gesture as intrusive and overstepping boundaries
C) the action is inappropriate. patients in a psychiatric setting should not be touched
D) the gesture is premature. the patients cultural and individual interpretation of touch is unknown.
D) the gesture is premature. the patients cultural and individual interpretation of touch is unknown.
A school-age child tells the school nurse, "Other kids call me mean names and will not sit with me at lunch. Nobody likes me." Select the nurse's most therapeutic response.
A) "you should make friends with other children."
B) "tell me more about how you feel"
C) "just ignore them and they will leave you alone."
D) "call them names if they do that to you"
B) "tell me more about how you feel"
When a female Mexican-American patient and a female nurse sit together, the patient often holds the nurse's hand. The patient also links arms with the nurse when they walk. The nurse is uncomfortable with this behavior and thinks the patient is misunderstanding the nurse-patient relationship. Which alternative is a more accurate assessment?
A) The patient understands that touch makes the nurse uncomfortable and controls the relationship based on that factor.
