Question 1 Anxiety Disorders, Trauma, and Addiction Client on paroxetine for 1 year for panic disorder: "I feel better; I want to stop." Best response?
A. "You can stop the medication abruptly since you are feeling better." B. "Let me talk to you about tapering off slowly with your provider's guidance." C. "You will need to take this medication for the rest of your life." D. "Stopping the medication will cause your panic attacks to return immediately."
Question 2 Anxiety Disorders, Trauma, and Addiction Alcohol detox, CIWA-Ar 25, receiving thiamine 100 mg IM daily. Purpose of thiamine?
A. Reduce alcohol cravings during withdrawal B. Prevent Wernicke's encephalopathy and Korsakoff syndrome C. Treat liver dysfunction D. Enhance alcohol metabolism
Question 3 Cognitive and Developmental Disorders Schizophrenia, stable on paliperidone q4 wk injection, lives alone — discharge teaching?
A. Skip next injection if side effects occur B. Return to clinic for the next injection as scheduled C. Switch to oral medication after discharge D. Monitor blood levels monthly at home
Question 4 Anxiety Disorders, Trauma, and Addiction "I feel outside my body, things look distorted, like a dream" — onset after witnessing trauma. Most likely?
A. Dissociative identity disorder B. Derealization disorder C. Depersonalization/derealization disorder D. Psychotic disorder
Question 5 Anxiety Disorders, Trauma, and Addiction Adolescent took 20 acetaminophen tablets 2 hr ago: "I just wanted to sleep." Priority action?
A. Administer activated charcoal B. Obtain stat acetaminophen level C. Assess airway and breathing D. Contact parents/guardians
Question 6 Cognitive and Developmental Disorders Insomnia disorder sleep hygiene teaching — which to include?
A. "Take a long nap during the day to make up for lost sleep." B. "Use your bedroom only for sleep and sexual activity." C. "Watch television in bed to help you fall asleep." D. "Exercise vigorously right before bedtime."
Question 7 Anxiety Disorders, Trauma, and Addiction Conversion disorder presenting with sudden blindness, exam negative. Best response?
A. "You are faking blindness to get attention." B. "Your eyes look healthy. Tell me about what was happening before you lost your vision." C. "We will keep you in the hospital until you can prove you can see." D. "This is all in your head. Try harder to see."
Question 8 Mood and Personality Disorders Lithium level 1.8 mEq/L; client has nausea, vomiting, diarrhea, fine tremor. First action?
A. Administer the next dose B. Hold lithium and notify the provider C. Increase fluid intake to flush out excess lithium D. Administer an antiemetic
Question 9 Cognitive and Developmental Disorders Family education on negative symptoms of schizophrenia — which statement shows understanding?
A. "Negative symptoms mean the client is dangerous to others." B. "My son's lack of motivation and isolation are part of the illness, not laziness." C. "Negative symptoms like hallucinations can be reduced by medication." D. "The client must be hospitalized until negative symptoms resolve."
Question 10 Anxiety Disorders, Trauma, and Addiction Body dysmorphic disorder, three rhinoplasties, still believes nose is "crooked." Best intervention?
A. Validate the perception that the nose is crooked B. Reassure that the nose looks normal C. Discourage further cosmetic procedures D. Encourage 30 minutes of mirror viewing daily
Question 11 Anxiety Disorders, Trauma, and Addiction Quitting smoking: "irritable, anxious, can't sleep." Describes?
A. Nicotine intoxication B. Nicotine withdrawal C. Nicotine tolerance D. Tobacco use disorder
Question 12 Anxiety Disorders, Trauma, and Addiction OCD client spends 3 hr/day counting and tapping: "If I don't do it perfectly, something terrible will happen." Underlying purpose?
A. Gain attention from family B. Temporarily reduce anxiety about feared harm C. Punish oneself for guilt D. Establish control over others
Question 13 Cognitive and Developmental Disorders Aripiprazole side effect to report IMMEDIATELY?
A. Mild drowsiness B. Small amount of weight gain C. Fever, muscle stiffness, and confusion D. Dry mouth and constipation
Question 14 Cognitive and Developmental Disorders Dementia client now more confused, lethargic, incontinent; T 38.1°C. Priority action?
A. Administer acetaminophen B. Obtain a urine sample for UA and culture C. Reorient to person, place, time D. Notify the provider
Question 15 Mood and Personality Disorders On fluoxetine 6 wk, minimal improvement; provider adds another medication. Which would the nurse QUESTION?
A. Bupropion B. Olanzapine C. Phenelzine D. Aripiprazole
Question 16 Cognitive and Developmental Disorders Intermittent explosive disorder: smashed TV after minor disagreement, now remorseful. Most characteristic?
A. Premeditated aggression to achieve a goal B. Absence of remorse after aggressive episodes C. Outbursts disproportionate to the trigger D. Aggression only during manic episodes
Question 17 Anxiety Disorders, Trauma, and Addiction Panic disorder cause — most accurate teaching?
A. "Panic attacks are caused by repressed childhood memories." B. "There is a genetic and biological basis, and stress can trigger attacks." C. "Panic attacks occur because you are not trying hard enough to relax." D. "If you avoid stressful situations, you will never have another attack."
Question 18 Mood and Personality Disorders MDD on venlafaxine, missed last 3 doses, now "brain zaps," dizziness, nausea. Most likely?
A. Serotonin syndrome B. Venlafaxine discontinuation syndrome C. Relapse of depression D. Neuroleptic malignant syndrome
Question 19 Anxiety Disorders, Trauma, and Addiction AUD sober 2 weeks: "I don't think I need AA anymore." Best response?
A. "You're right, you seem to be doing well. Just call if you feel like drinking." B. "Alcoholism is a chronic disease. Ongoing support like AA reduces relapse risk." C. "If you don't go to meetings, you will definitely relapse." D. "You can stop AA as long as you don't drink."
Question 20 Cognitive and Developmental Disorders "The aliens are listening to my thoughts; I scream so they can't hear me." Experiencing?
A. Illusion B. Thought broadcasting C. Ideas of reference D. Somatic delusion
Question 21 Mood and Personality Disorders ASPD client manipulating peers and lying to staff. Most effective approach?
A. Allow client to face natural consequences of behavior B. Confront the client angrily C. Ignore the behavior to avoid power struggles D. Ask repeatedly why they lie and manipulate
Question 22 Mood and Personality Disorders ECT for treatment-resistant MDD — which client statement indicates understanding?
A. "I will be awake and can talk to the doctor." B. "ECT will cause permanent memory loss for everything." C. "I will receive muscle relaxants and anesthesia so I sleep through it." D. "ECT is only used if all other treatments have failed."
Question 23 Mood and Personality Disorders Schizoid personality disorder — most likely behavior?
A. Magical thinking and odd beliefs B. Preoccupied with orderliness and rules C. Prefers solitary activities; little interest in relationships D. Emotionally dramatic and attention-seeking
Question 24 Anxiety Disorders, Trauma, and Addiction Benzodiazepine overdose, somnolent but arousable, RR 12, stable VS. Most appropriate action?
A. Administer flumazenil immediately B. Place client in left lateral recumbent position C. Prepare for gastric lavage D. Administer activated charcoal
Question 25 Mood and Personality Disorders PMDD education — which to recommend?
A. Increase intake of simple sugars and processed foods B. Take sertraline only during the luteal phase C. High-intensity exercise only during menstruation D. Avoid all carbohydrates to reduce bloating
Question 26 Foundations and Therapeutic Communication Inpatient psych — assess WHICH client first?
A. Bipolar client pacing rapidly, talking loudly, "on top of the world" B. Schizophrenia client mute, staring at wall for 2 hours C. MDD client refusing lunch and crying in room D. BPD client yelling at another client about a missing charger
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