Looking for more NCLEX Questions for practice? Check this 30-item Psychiatric NCLEX Review Quiz:

1. When the nurse detects that a client is using defense mechanisms, the nurse should make which of these interpretations of the client’s behavior?
1. The client is attempting to reestablish emotional equilibrium.
2. The client is using self-defeating measures.
3. The client is demonstrating illness.
4. The client is asking for support from significant others.

2. To master his anxiety, the client must first:
1. Recognize that he is feeling anxious.
2. Identify the situations that precipitated his anxiety.
3. Understand the basis for his anxiety.
4. Select a strategy to cope with his anxiety.

3. The treatment goal for a client with severe anxiety will have been achieved when the client demonstrates which of these behaviors?
1. The client recognizes the source of the anxiety.
2. The client is able to use the anxiety constructively.
3. The client can function without any sense of anxiety.
4. The client identifies the physical effects of the anxiety.

4. The nurse is assessing a 22-month-old child who is thought to be autistic. During an interview with the nurse, the child’s mother makes all of the following statements about his behavior until he was one year old. Which statement most strongly suggests that the child may be autistic?
1. “He was a good baby and rarely cried when I left the room.”
2. “He slept very well after each feeding.”
3. “He spit out every new food the first time I gave it to him.”
4. “He started to walk without learning to crawl first.”

5. In attempting to establish a therapeutic relationship with a child who may be autistic, the nurse should expect to encounter which of these problems?
1. Hallucinating. 2. Impaired hearing.
3. Bizarre behavior. 4. Clinging to others.

6. To initiate a relationship with a child who may be autistic, the nurse would probably be most effective by using which of these approaches?
1. Playing peek-a-boo.
2. Having him point to designated body parts.
3. Sitting with him.
4. Telling him a story.

7. The nurse is caring for a 75 year old widow admitted to the psychiatric hospital by her daughter who became concerned when her mother began to talk in a confused manner about her husband who has been dead for 7 years. In the hospital, especially at night, the client wanders in the other client’s rooms looking for her husband. What is the most appropriate action for the nurse to take when this woman wanders in the rooms of the other clients?
1. Lock the door to her room.
2. Tell her to stay in her room except for meals.
3. Take her by the hand and guide her back to her room.
4. Tell her that she will be restrained if she continues to wander.

8. The nurse is caring for an elderly woman admitted with chronic organic brain disease. When her daughter visits, she asks, “Are you my maid?” The nurse describes the client’s behavior as:
1. Impaired judgment. 2. Disorientation.
3. Impairment of abstract thinking. 4. Delusions.

9. An elderly woman is hospitalized with chronic organic brain syndrome. When her daughter visits, she does not recognize her. The daughter begins to cry and shares her concerns with the nurse. Which statement by the nurse would demonstrate an empathetic response?
1. “It must be difficult for you to visit your mother when she is confused about who you are.”
2. “If you are going to cry when you come to visit maybe you should not visit.”
3. “It is not unusual for people in your mother’s condition to forget who other people are.”
4. “If these visits upset you, maybe you should telephone your mother instead of visiting.”

10. An elderly woman with chronic organic brain syndrome refuses to eat and begins to lose weight. Which approach by the nurse will likely be most effective in getting the client to eat?
1. Explaining to her the necessity of eating three meals daily.
2. Asking the client what she thinks should be done about her lack of eating.
3. Telling the client that if she doesn’t eat, she will be given tube feedings.
4. Accompanying her to meals and assisting her in eating.

11. A 22-year-old woman has admitted herself to the psychiatric unit for treatment of Valium addiction. She has been hospitalized three times in the past two years for detoxification from various drugs. She is currently taking 150 mg p.o. of Valium per day, which she gets from various doctors or buys off the streets. The first night she is on the unit, she dresses in a skimpy nightgown and approaches the male nurse. She states she is “coming down” and just needs a little comforting and conversation. The best initial response by the nurse would be:
1. “Please put on your bathrobe and then we can talk.”
2. “I’m very busy now. Maybe the other nurse can spend some time with you.”
3. “What seems to be the problem?”
4. “What you are experiencing is very common. It should get better soon.”

12. A 22-year-old woman has admitted herself to the psychiatric unit for treatment of Valium addiction. A schedule of drug withdrawal is ordered by the doctor. Which of the following may the nurse expect to see as the Valium dose is decreased?
1. Decreased blood pressure. 2. Tremors and hyperactivity.
3. Increase in appetite. 4. Grandiosity.

13. Three days after admission for treatment of Valium addiction, a young woman is seen in t he hospital parking lot talking to a male visitor. When approached by the nurse about her leaving the unit without permission, she laughs and says, “I needed to see my old man. He’s squeamish about hospitals, and ten minutes is no big deal.” The best initial nursing response is
1. “Next time ask a staff member to accompany you.”
2. “You do not have pass privileges and your willingness to follow the rules is essential to your treatment program.”
3. “I’m going to have to report your activities to the doctor.”
4. “I can understand needing to see your friend, but next time invite him to the unit.”

14. Three days after admission for treatment of Valium addiction, a young woman is seen in the hospital parking lot talking to a male visitor. That evening, the client appears calm, happy, and more social than before. The nurse suspects that the client has taken some illicit drugs. The best strategy for dealing with the situation would first be for the nurse to:
1. Talk to the client about her observations.
2. Chart her observations.
3. Search the client’s room without her knowledge.
4. Immediately call her psychiatrist.

15. Three days after admission for treatment of Valium addiction, a young woman is seen in the hospital parking lot talking to a male visitor. Her psychiatrist has threatened to discharge her for noncompliance with the treatment program. The client seems very despondent, refusing to get out of bed. The evening nurse finds the client crying, “I’ve screwed everything up. It’s hopeless. It’s no use.” The nurse may anticipate and plan for which of the following?
1. The client will be more able to utilize the evening group therapy session.
2. The client will need to be observed carefully as she might attempt to hurt herself.
3. The client will continue to be non-compliant with her treatment program.
4. The client is beginning to verbalize her feelings and this is the first step in rehabilitation.

16. Three days after admission for treatment of Valium addiction, a young woman is seen in the hospital parking lot talking to a male visitor. Her psychiatrist has threatened to discharge her for noncompliance with the treatment program. The client seems very despondent, refusing to get out of bed. The evening nurse finds the client crying, “I’ve screwed everything up. It’s hopeless. It’s no use.” In responding to the client, which of the following would be most appropriate?
1. “You’ve screwed everything up?”
2. “Why do you feel it’s no use?”
3. “Sometimes we have to hit bottom before things get better.”
4. “You sound like you’re feeling very despondent. Are you thinking about harming yourself?”

17. The client seems very despondent, refusing to get out of bed. The evening nurse finds the client crying, “I’ve screwed everything up. It’s hopeless. It’s no use.” The client states to the nurse that at times she wishes she were dead. Which is the best initial nursing intervention?
1. Call the doctor about her suicide ideations.
2. Assess further her suicide thoughts and plans.
3. Assign a 1:1 to stay with her.
4. Have her sign a “suicide contract”.

18. A young woman is in a treatment program for Valium addiction. She begins to participate in her treatment program. Which of the following would indicate that she is ready for discharge?
1. She has formulated a plan to return home and continue therapy.
2. She has talked to her boss about returning to work.
3. She has identified her weak areas and is working on them.
4. She is now asking the staff for advice about her future.
19. A client who has completed an inpatient program for Valium addiction is leaving this afternoon. Which of the following responses demonstrates that the nurse has a good understanding of the termination of a relationship?
1. “You’ve done some good work here, I hope you’re able to follow through on it.”
2. “You’ve worked really hard the last three weeks. Good-bye and good luck.”
3. “Stop by and let us know how things are going.”
4. “Good-bye and good luck. Hopefully we won’t be seeing you here again.”

20. A 49-year-old woman is admitted to the detoxification unit. She admits to drinking increasingly larger amounts of alcohol for the past 5 years. Her husband accompanies her to the hospital. He states that he has threatened to leave her unless she has treatment. What question is most important for the nurse to ask initially?
1. “How much alcohol do you drink daily?”
2. “When was your last drink?”
3. “When did you last eat?”
4. “What type of alcoholic beverages do you drink?”

21. The morning after admission for withdrawal from alcohol a client is restless, tremulous, and somewhat agitated. The nurse should take which of these actions at this time?
1. Obtain an order for lithium carbonate. 2. Observe her behavior closely.
3. Darken the client’s room. 4. Prepare to place her in restraints.

22. Two nights after admission for alcohol withdrawal, the client runs out of her room. She is confused and disoriented. She says, “Let me out of here. Bugs are crawling all over that room.” The nurse should take which of these actions?
1. Escort her back to her room and show her that there is nothing to fear.
2. Assist her back into bed and then search her room for alcohol.
3. Take her to a quiet area and ask her if she has had nightmares in the past.
4. Have a staff member stay with her and notify the physician.

23. The nurse is caring for a client who is experiencing delirium tremens. At this time, which of these nursing diagnoses should be given priority in caring for this client?
1. Potential for physical injury related to impulsiveness.
2. Noncompliance with medical regimen related to denial of illness.
3. Anticipatory grieving related to her husband’s threat of abandoning her.
4. Translocation syndrome related to transfer to a strange environment.

24. Which of these goals will be most important while a client has delirium tremens?
1. To increase her ability to cope with stress.
2. To maintain the support of significant others.
3. To support her physical adaptation.
4. To acknowledge that she is dependent on alcohol.

25. Following withdrawal from alcohol, the client agrees to participate in group therapy sessions for a period before being discharged. Initially, group therapy may have which of these effects on the client?
1. She will develop insight into her reasons for needing alcohol.
2. She will experience periods of extreme anxiety.
3. She will be able to set realistic goals for herself.
4. She will be able to identify the personality traits she needs to change.

26. Following withdrawal from alcohol a client is to receive disulfiram (Antabuse). The medication is prescribed for which of these purposes?
1. To minimize the effects of alcohol.
2. To improve detoxification by the liver.
3. To increase her utilization of vitamins.
4. To help her refrain from drinking alcohol.

27. A client asks the nurse about participation in Alcoholics Anonymous. In addition to arranging for a visit by someone from Alcoholics Anonymous, the nurse should explain that the primary purpose of the organization is to:
1. Explore the individual member’s need for dependence on alcohol.
2. Help members abstain from alcohol.
3. Teach members how to manage social situations without the need for alcohol.
4. Increase public awareness of the results of alcoholism.

28. A young woman was referred to the psychiatrist by her family physician because she is fearful of getting into elevators. During the course of therapy, it was discovered that her initial fear was of men and that it had changed to elevators. Which of the following mechanisms is demonstrated by this change?
1. Repression. 2. Identification.
3. Projection. 4. Displacement.

29. A client says to the nurse, “I have something to tell you because I know you can keep a secret,” To respond to his statement, the nurse should make which of these remarks?
1. “It’s nice that you trust me to keep a secret.”
2. “I would like to hear your secret.”
3. “I cannot promise that I can keep your secret.”
4. “A secret is not a secret when it is repeated.”

30. A homeless woman is admitted to the hospital. When she is admitted, she is asked to keep her possessions in a locker that is in her room. She insists on removing several articles to carry around with her. Following nursing interventions she continues to carry most of her possessions around with her. The nurse should make which of these interpretations of this behavior
1. The client needs to keep busy.
2. The client needs to maintain her identity.
3. The client needs to be a focus of attention.
4. The client needs a means of becoming involved with others.

Are you done answering these NCLEX review Questions? Here’s the Answers and Rationales for Download.

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