Psychological

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Sample questions from Psychological

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on an adolescent psychiatric unit, a 16-year-old client with depression has eaten little and has been withdrawn. The client tells the outgoing nurse, "I have a plan to take the pills I saved at home, but I do not want to die today." Vital signs are T 36.8 C, HR 92, RR 16, BP 116/70, and SpO2 99% on room air. Which action should the oncoming nurse take first?

   • A.Encourage the client to attend group therapy before discussing the disclosure further.
   • B.Ask the unlicensed assistive personnel to keep the client in the dayroom.
   • C.Ask the client to describe the plan, access to the pills, and current intent while maintaining observation.
   • D.Arrange for the client's parent to bring the client home for a family meeting.

   Rationale: The specific plan and reported access to pills indicate a potentially imminent suicide risk, so the nurse must assess intent and access directly and maintain safety. A family meeting may be useful later but does not replace immediate risk assessment and precautions. Delegating observation without a clear safety plan is inadequate, and delaying assessment for group therapy places the client at avoidable risk. Direct, nonjudgmental suicide questions support safe clinical judgment.

2. 2.Refer to the client's chart. In the emergency department, a 34-year-old client with bipolar disorder is being evaluated after several nights of minimal sleep. Which actions should the nurse take now? Select all that apply.

   • A.Offer a low-stimulation environment and brief, simple directions.
   • B.Notify the psychiatric prescriber promptly about the change in behavior and the lithium result.
   • C.Ask the client to sign a no-suicide contract and discontinue observation if the client agrees.
   • D.Give the scheduled lithium dose now because the client is displaying manic behavior.
   • E.Initiate continuous observation and remove accessible hazards while following facility suicide precautions.

   Rationale: Continuous observation and hazard reduction are indicated by the client's stated self-harm thought and escalating behavior. The nurse should promptly report the abrupt change and lithium level of 1.7 mEq/L, which is above the stated therapeutic range and requires prescriber review before another dose. A quiet environment and simple directions can reduce stimulation and support safe communication. Giving lithium without clarifying the elevated level is unsafe, and a no-suicide contract does not replace observation or a formal safety assessment.

3. 3.During a home visit, a 72-year-old client with major depression says, "I stopped taking sertraline because I felt better, and now I feel dizzy and have electric-shock sensations." The client is alert, has no focal weakness, and has a supine BP of 128/74 mm Hg and standing BP of 124/72 mm Hg. Which response is the nurse's priority?

   • A.Assess when the client stopped the medication, review current symptoms and safety, and contact the prescriber about the abrupt discontinuation.
   • B.Recommend taking sertraline only on days when depressive symptoms return.
   • C.Explain that these sensations indicate a stroke and arrange emergency transport.
   • D.Tell the client to restart the previous dose immediately and take an extra dose to make up for missed doses.

   Rationale: Abrupt sertraline discontinuation can cause distressing discontinuation symptoms, so the nurse should clarify timing and symptoms, assess for safety concerns, and coordinate a prescriber-directed plan. Restarting or doubling a dose without an order is unsafe, and intermittent use is not an appropriate treatment plan. The reported symptoms without focal deficits or acute instability do not establish a stroke, although new neurologic red flags would require urgent evaluation. Medication teaching should emphasize consultation before stopping or changing antidepressants.

4. 4.In a long-term care facility, an 81-year-old resident with dementia becomes frightened and begins shouting during evening care. The resident's temperature is 38.1 C, HR 104, RR 22, BP 148/82, and SpO2 95% on room air; staff report this behavior is new. Which action should the nurse take first?

   • A.Ask the provider for a standing order for a sedative before continuing care.
   • B.Have staff complete bathing quickly so the resident returns to the usual routine.
   • C.Move the resident to a room near the nurses' station and document the behavior as dementia progression.
   • D.Assess for an acute physical cause, including pain, infection, medication effects, and changes in cognition.

   Answer and rationale are in the full material.

5. 5.On a pediatric medical unit, a 9-year-old client hospitalized for asthma is tearful and refuses a prescribed nebulizer treatment, saying, "It makes me feel weird." The client is speaking in full sentences, has mild expiratory wheezing, RR 24, HR 110, BP 104/66, and SpO2 95% on room air. Which nursing action best supports both safety and the client's participation?

   • A.Withhold all further asthma medication until the client agrees to the nebulizer.
   • B.Ask what the client means by "weird," assess the response to prior treatments, and explain the purpose in age-appropriate terms.
   • C.Ask the parent to sign consent for the treatment and leave the room.
   • D.Tell the client the treatment is mandatory and ask the parent to hold the client's arms.

   Answer and rationale are in the full material.