Psychiatric and Mental Health Nursing - D449 Proctored

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Sample questions from Psychiatric and Mental Health Nursing - D449 Proctored

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

1. 1.A client hospitalized for major depressive disorder says, "My family would be better off without me." Which response should the nurse make first?

   • A.Your family would be devastated if anything happened to you.
   • B.Are you thinking about killing yourself?
   • C.What activities usually improve your mood?
   • D.You should discuss those feelings during group therapy.

   Rationale: Directly asking about suicide establishes whether an immediate safety threat exists and does not increase suicidal behavior. Describing the family's potential distress may increase guilt and discourage disclosure. Exploring activities or deferring discussion to group therapy delays essential assessment. The priority is to assess suicidal thoughts, followed by intent, plan, access to means, and protective factors.

2. 2.A client admitted after a suicide attempt reports an ongoing intention to die and describes a plan to use an item available on the unit. Which nursing intervention is the priority?

   • A.Ask the client to sign a promise not to attempt suicide.
   • B.Place the client near the nurses' station and check every 30 minutes.
   • C.Initiate continuous observation according to policy and remove accessible hazards.
   • D.Encourage the client to identify three reasons for living before intervening.

   Rationale: Current intent, a specific plan, and access to means require immediate environmental safety measures and continuous observation according to policy. A promise not to attempt suicide does not reliably establish safety. Proximity to the nurses' station and intermittent checks are insufficient for an imminent threat. Identifying reasons for living may support later treatment but cannot replace immediate protection.

3. 3.A client says, "Since my partner died, I do not know how to get through the evenings." Which response best demonstrates therapeutic communication?

   • A.Tell me what the evenings have been like for you.
   • B.You need to keep busy so you do not think about the loss.
   • C.At least your partner is no longer suffering.
   • D.I know exactly how you feel because I lost someone too.

   Rationale: An open-ended invitation allows the client to describe the experience and helps the nurse assess coping and support needs. Advising the client to stay busy prematurely directs the conversation instead of exploring feelings. An 'at least' statement minimizes grief. Claiming to know exactly how the client feels shifts attention away from the client's unique experience.

4. 4.A client with schizophrenia says, "The television announcer is sending me secret instructions." Which response is most appropriate?

   • A.What instructions is the announcer sending to everyone else?
   • B.That is impossible; television announcers cannot communicate with you.
   • C.If you ignore the announcer, the messages will stop.
   • D.I do not hear personal messages from the television, but this seems frightening to you.

   Answer and rationale are in the full material.

5. 5.A client appears distracted and says, "A voice keeps telling me to do something." Which question is the nurse's priority?

   • A.How long have you been hearing voices?
   • B.What exactly is the voice telling you to do?
   • C.Does listening to music make the voice quieter?
   • D.Have other people in your family heard voices?

   Answer and rationale are in the full material.