Psychiatry

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Sample questions from Psychiatry

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

1. 1.A 24-year-old client in the emergency department reports a plan to die by suicide tonight and says a loaded firearm is at home. The client is tearful, has a pulse of 108/min, and is medically stable. Which action should the nurse take first?

   • A.Ask the client to sign a no-suicide contract and wait for the provider
   • B.Maintain continuous observation and arrange immediate safety precautions
   • C.Ask the client's family to remove the firearm after the client is discharged
   • D.Encourage the client to attend a group therapy session

   Rationale: Continuous observation and immediate precautions address the imminent risk of self-harm while further assessment and treatment are arranged. A no-suicide contract does not ensure safety, and waiting delays intervention. Family involvement and group therapy may help later but do not protect the client right now. The exam takeaway is to prioritize immediate safety when there is suicidal intent, a specific plan, and access to means.

2. 2.A 32-year-old client admitted to an inpatient psychiatric unit for depression says, "I do not want to wake up tomorrow," but denies having a plan. The client is withdrawn, with a pulse of 76/min and blood pressure of 118/72 mm Hg. Which response by the nurse is best?

   • A."You have a lot to live for, so try to focus on the positive."
   • B."Are you thinking about killing yourself, and have you considered how you would do it?"
   • C."I will tell your family to stay with you at all times."
   • D."Let's talk about this after you have had some rest."

   Rationale: Directly asking about suicidal thoughts, plan, and method supports an accurate risk assessment and does not increase suicide risk. Reassurance can minimize distress, and postponing the discussion delays assessment. Telling family to supervise without first assessing risk or obtaining appropriate consent is not a substitute for clinical evaluation. The exam takeaway is to use clear, direct questions when a client expresses hopelessness or a wish to die.

3. 3.A 45-year-old client with schizophrenia is brought to the clinic by a sibling after stopping medication. The client says, "The television is sending me instructions," and has a pulse of 92/min and temperature of 36.8 C (98.2 F). Which response should the nurse make?

   • A."The television cannot send you messages, so ignore it."
   • B."What are the instructions telling you to do?"
   • C."You should restart your medication at the same dose today."
   • D."Your sibling can explain that this is not happening."

   Rationale: Assessing the content of the perceived message helps determine whether the hallucination is commanding and creates immediate danger. Arguing about the belief can damage trust, and the nurse should not independently prescribe a restart dose. Having the sibling dispute the experience is unlikely to assess safety or reduce distress. The exam takeaway is to acknowledge the client's experience without reinforcing it and assess for harmful commands.

4. 4.A 28-year-old client with schizophrenia tells the nurse, "A voice says I should stab my roommate." The client is on an inpatient unit, appears tense, and has a pulse of 104/min. What should the nurse do first?

   • A.Ask the client to describe the voice and whether the client intends to obey it
   • B.Tell the client that the voice is not real
   • C.Leave the client alone to reduce stimulation
   • D.Ask the roommate to reassure the client

   Answer and rationale are in the full material.

5. 5.A 67-year-old client hospitalized with pneumonia becomes acutely confused overnight, cannot sustain attention, and has a temperature of 38.4 C (101.1 F), pulse 112/min, and oxygen saturation of 89% on room air. Which action is the priority?

   • A.Reorient the client and continue routine psychiatric assessment
   • B.Notify the provider and address the client's oxygenation and acute medical status
   • C.Ask the family to bring familiar photographs
   • D.Administer a prescribed sleep aid so the client can rest

   Answer and rationale are in the full material.