Behavioral Health Exam Questions

Behavioral Health Exam Questions

Behavioral Health Exam Questions Part 1

Question 1: At what point should the nurse determine that a patient is at risk for developing a mental disorder? Answer: When maladaptive responses to stress are coupled with interference in daily functioning.

Question 2: What patient teaching instructions should be included for Lamotrigine (Lamictal)? Answer: Report any rashes to your provider immediately.

Question 3: Mr. Brown has recently been admitted involuntarily to the adult behavioral health unit. He has a diagnosis of schizophrenia and is very concerned that the camera on the ceiling at the nurse’s station has been placed there by the FBI to watch him. Mr. Brown refuses all his morning medications. What is the most appropriate nursing intervention? Answer: Notify the psychiatrist about your mental status assessment and medication refusal.

Behavioral Health Exam Question 4: The nurse is working with a 22-year-old patient who is receiving pre-operative education for a double mastectomy for breast cancer treatment. Which statement by the patient would indicate they are in the bargaining phase of grief? Answer: “Maybe if I eat healthier or do more treatments, I can get back to how I used to be. I’ll do anything to feel normal again.”

Question 5: Kylo Benson Case Study:
The Presentation:
Kylo Benson is a 27-year-old male brought to the Emergency Department (ED) by his friends after attending a “pharm party.” Upon arrival, the nurse notes that Kylo is exhibiting bizarre, aggressive behavior described as “gorilla-like.” He is agitated, disoriented to time and place, and is struggling with the staff.
Clinical Background:
During the assessment, it is revealed that Kylo has a significant history of substance use. He reports drinking alcohol daily and frequently going on “benders” that last for several days. His friends mention he may have ingested unknown pills at the party.

Which findings should the nurse assess first? Select all that apply.
Answer: Level of consciousness, Respiration quality

Question 6: Identify each assessment question as either priority or not priority based on the Kylo Benson ED Nurses’ Notes.
• What type of substances did you take before coming to the hospital? Priority
• When was the last time you took any substance? Priority
•How often do you take these substances? Priority
• Priority: How long have you been taking substances? Priority
• Does taking substances cause you to fight with your wife or peers? Not Priority
• Do you abuse substances more frequently alone or with your peers? Not Priority
• How do you obtain the substances you take? Not Priority
• Do your peers encourage you to participate in “pharm” parties? Not Priority

Question 7: Which of the following is the top risk for this patient (Kylo Benson)?
Answer: Alcohol withdrawal

Question 8: What nursing interventions should the nurse include in the plan of care to prevent complications related to suspected alcohol withdrawal? Select all that apply. Answers:

• Initiate seizure precautions
• Provide an environment free of excess stimulation
• Notify the physician of changes in patient’s condition

Question 9: What should the nurse teach the client about the treatment plan involving disulfiram (Antabuse)? Select all that apply. Answers

• When taking this medication, you should not consume or use hand sanitizer, vanilla extract, cough syrups, and certain mouthwashes, among other things
• This medication is a form of behavioral therapy known as aversion therapy
• You should wear a medical alert bracelet for the duration of this therapy

Question 10: A patient diagnosed with Schizophrenia tells the nurse, “The sun is shining because I am happy.” The nurse recognizes this as which of the following? Answer: Magical thinking

Question 11: A client with Schizophrenia says to the nurse, “A person should always be kind to others.” The nurse recognizes this as which of the following? Answer: Concrete thinking

Question 12: A patient diagnosed with Schizophrenia tells the nurse, “I need to go to the store to buy some red, bed, fed, head.” The nurse recognizes this as which of the following? Answer: Clang association

Question 13: Which of the following is a positive symptom of Schizophrenia? Answer: Hallucinations

Question 14: A nurse is assessing a client for negative symptoms of Schizophrenia. Which of the following should the nurse expect? Answer: Affective flattening

Question 15: A patient is experiencing a manic episode. Which of the following is the priority nursing intervention? Answer: Maintaining patient safety

Exam Questions Part 2(Questions 16-30)

Question 16: A client is prescribed Lithium. Which of the following should the nurse include in the teaching? Answer: Maintain a consistent intake of sodium.

Question 17: A nurse is caring for a patient with obsessive-compulsive disorder (OCD). What is the primary purpose of the patient’s rituals? Answer: To reduce anxiety

Question 18: A patient is admitted with a diagnosis of Post-Traumatic Stress Disorder (PTSD). Which of the following symptoms should the nurse expect? Answer: Hypervigilance

Question 19: A nurse is conducting a group session for patients with substance use disorders. Which of the following is a primary goal of the group? Answer: To provide peer support and feedback

Question 20: A patient is being treated for alcohol withdrawal. Which of the following medications is commonly used to prevent seizures? Answer: Chlordiazepoxide (Librium)

Question 21: A nurse is teaching a client who has a new prescription for alprazolam (Xanax). Which of the following information should the nurse include? Answer: This medication can cause sedation and dizziness.

Question 22: A client is admitted to the hospital with a diagnosis of anorexia nervosa. Which of the following is the priority nursing intervention? Answer: Assessing the client’s nutritional status and electrolyte balance.

Question 23: A nurse is caring for a client who is experiencing a panic attack. Which of the following actions should the nurse take? Answer: Stay with the client and provide a calm, quiet environment.

Question 24: A nurse is providing discharge teaching for a client who has a prescription for phenelzine (Nardil), an MAOI. Which of the following foods should the nurse instruct the client to avoid? Answer: Aged cheese and pepperoni

Question 25: A patient is displaying symptoms of neuroleptic malignant syndrome (NMS) after taking an antipsychotic. Which finding should the nurse prioritize? Answer: High fever (hyperpyrexia)

Question 26: A nurse is assessing a client with a history of antisocial personality disorder. Which of the following characteristics should the nurse expect? Answer: Lack of remorse for actions

Question 27: A client tells the nurse, “I don’t think I can ever stop drinking; it’s just too hard.” The nurse responds, “It sounds like you feel overwhelmed by the process of recovery.” Which therapeutic technique is the nurse using? Answer: Reflection

Question 28: Which of the following is the primary goal of the “Working Phase” of the nurse-client relationship? Answer: Promoting patient change and problem-solving.

Question 29: A patient is diagnosed with Borderline Personality Disorder. The nurse should expect the patient to exhibit which of the following? Answer: Splitting (viewing people as all good or all bad)

Question 30: A patient is receiving ECT (electroconvulsive therapy). What is the nurse’s priority assessment immediately following the procedure? Answer: Assessing airway and vital signs

Here is the next set of Behavioral Health Exam Questions Part 3(Questions 31–50):

Question 31: A client is diagnosed with Agoraphobia. Which of the following is the most appropriate nursing intervention? Answer: Encourage the client to gradually face the feared situation.

Question 32: A nurse is caring for a patient who is experiencing auditory hallucinations. Which of the following statements by the nurse is therapeutic? Answer: “I don’t hear the voices, but I understand they are real to you.”

Question 33: A patient with Depression states, “I’m a failure, and I’ve let my family down.” Which therapeutic communication technique is the nurse using by stating, “You feel like you’ve disappointed your family?” Answer: Restating

Question 34: Which of the following is a symptom of Generalized Anxiety Disorder (GAD)? Answer: Excessive worry about everyday things for at least 6 months.

Question 35: A nurse is assessing a patient for suicide risk. Which of the following is the most important factor to consider? Answer: The presence of a specific plan and access to means.

Question 36: A client is experiencing severe anxiety. Which of the following physical symptoms should the nurse expect? Answer: Tachycardia and rapid breathing

Question 37: A kindergarten student is frequently violent toward other children. A school nurse notices bruises and burns on the child’s face and arms. What other symptoms should indicate to the nurse that the child might have been physically abused? Answer: The child withdraws at the approach of adults.

Question 38: A patient with an altered thought process has an expected patient outcome of recognizing delusional thinking. Which intervention should the nurse implement first to address this problem? Answer: Convey understanding that the patient’s experience is real to them.

Question 39: Which patient is most likely to benefit from group therapy? Answer: The patient diagnosed with schizophrenia being followed up in an out-patient clinic.

Question 40: A nurse doing an assessment with a patient with anorexia nervosa would expect which findings? Select all that apply. Answers:

Question 41: Which are anticholinergic side effects that may occur with the use of antipsychotic drugs? Select all that apply. Answers:

• Blurred vision
• Constipation
• Urinary retention
• Dry mouth

Question 42: The nurse decides to use cognitive therapy techniques as she works with a patient with anorexia nervosa. Which statement by the nurse is consistent with the use of cognitive therapy principles? Answer: “Let’s explore your thoughts about happiness and being thin.”

Question 43: A woman in an outpatient clinic is prescribed olanzapine (Zyprexa) 10 mg QHS. At her 3-month follow-up, the patient states, “I knew it was a possible side effect, but I can’t believe I am not getting my period anymore.” Which is a priority teaching need? Answer: “Although your periods have stopped, there is still a potential for you to become pregnant.”

Question 44: The psychiatric nurse is caring for a patient who recently moved to the United States after escaping war in their homeland. Which of the following must the nurse prioritize when caring for this patient? Answer: Assessing the patient’s cultural needs and preferences.

Question 45: What information should the nurse give to the family of a patient who has experienced a dissociative episode? Answer: Dissociation is a method for coping with severe stress.

Question 46: A patient who is delirious yells out to the nurse, “I’m not staying in this hell hole, get me your supervisor.” Which is the best nursing response in this situation? Answer: “I can see you’re very upset. I will stay with you.”

Question 47: The nurse understands that which psychosocial influence has been related to the development of aggressive behavior and conduct disorder? Answer: Rejection by parents or peers.

Question 48: A patient in group therapy is restless, face flushed, and sarcastic with group members. The nurse responds by stating, “You seem angry.” The nurse is using which technique? Answer: Making observations.

Question 49: When an 8-year-old child has a temper tantrum on the unit, the staff take away his TV privileges for the day. The nurse understands that a behavioral therapist would consider which type of intervention? Answer: Punishment.

Question 50: The nurse states to the patient, “You say that you are sad, but you are smiling and laughing.” Which explanation describes the purpose of this therapeutic communication technique? Answer: To bring incongruencies or inconsistencies into awareness.

Behavioral Health Exam Questions Part 4 (Questions 51–80):

Behavioral Health Exam Question 51: On assessment, a patient reports that they stopped going to work, they are feeling hopeless with symptoms of insomnia, weight gain, and early morning rising for the last month. The nurse recognizes that these symptoms are indicative of which mental illness? Answer: Major Depressive Disorder

Question 52: A nurse is caring for a patient who has been diagnosed with Schizotypal Personality Disorder. Which of the following is a characteristic of this disorder? Answer: Magical thinking or odd beliefs

Question 53:The nurse is caring for a patient with Schizoid Personality Disorder. Which of the following would the nurse expect to find during the assessment? Answer: Emotional detachment and preference for solitary activities

Question 54: A patient is admitted to the psychiatric unit with a diagnosis of Borderline Personality Disorder. Which behavior is the nurse most likely to observe? Answer: Impulsivity and unstable relationships

Question 55: Which of the following is a primary feature of Narcissistic Personality Disorder? Answer: Grandiosity and a need for admiration

Question 56: A patient with Histrionic Personality Disorder is likely to demonstrate which of the following behaviors? Answer: Attention-seeking behavior and extreme emotionality

Question 57: A nurse is assessing a patient with Schizophrenia. Which of the following statements about the etiology of schizophrenia is true? Answer: Life events can precipitate symptoms in a genetically predisposed individual

Question 58: During a suicide assessment, the most important question for the nurse to ask is: Answer: “Share with me what exactly do you plan to do the next time?”

Question 59: When a patient is experiencing hallucinations, the most therapeutic response by the nurse is: Answer: “I do not hear the voices that you say you hear.”

Question 60: For a patient experiencing severe anxiety, the nurse should: Answer: Sit with the patient, and use a calm but directive approach

Question 61: Hildegard Peplau’s theory of nursing focuses on: Answer: The therapeutic nurse-patient relationship

Question 62: In psychoimmunology, it is understood that: Answer: Stress reduces white blood cells, the infection fighters

Question 63: Before administering Amitriptyline, the nurse should check the patient’s: Answer: History of cardiac arrhythmia

Question 64: A characteristic behavior of someone with Antisocial Personality Disorder is: Answer: Exploits and manipulates others for personal gain

Question 65: A patient with PTSD may exhibit which of the following symptoms? Answer: Shame; Inability to sleep at house; Nightmares; Avoiding home

Question 66: Which of the following increases a patient’s risk for seizures? Answer: Discontinuing Lunesta; Lithium toxicity; Beginning Wellbutrin

Question 67: After completing a series of parenting training sessions with parents of an 8-year-old client with oppositional defiant disorder, the child’s parent calls the nurse with concerns. The parent states, “What you taught us isn’t working. Can you please talk to my child about their behavior?” Which is the nurse’s most effective response? Answer: “Tell me how you have been using negotiation when limit setting with your child.”

Question 68: During a panic attack, which nursing intervention would be most helpful for the patient? Answer: Stay with the patient and remain calm, confident, and reassuring

Question 69: A patient is taking clozapine (Clozaril) and complains of a sore throat. The nurse is aware that this symptom may be an indication of which adverse reaction? Answer: Agranulocytosis

Question 70: A patient with a history of depression and frequent hospitalizations for somatic illnesses reports severe pain in the back and joints. What should the nurse encourage the patient to do next? Answer: Share symptoms with the physician to determine a cause

Question 71: Parents of a 8-year-old child newly diagnosed with attention-deficit/hyperactivity disorder (ADHD) have been referred by their physician to an outpatient community health center with an unfilled Concerta prescription and for family therapy. At the initial assessment, which behavior is the nurse most likely to see in the child or note in the history? Answer: Squirms in his seat and interrupts the conversation

Question 72: The nurse needs to administer Zyprexa to a patient who is agitated. The order reads Zyprexa 6 mg IM q 6 hours PRN for agitation. The nurse mixes 10 mL NS into the vial to yield 10mg/mL of Zyprexa. How many mLs should the nurse give to the patient? Round to the nearest tenth. Answer: 0.6

Question 73: Nursing assessment of a child with a history of Tourette’s syndrome includes determining the presence of which symptom? Answer: Excessive eye blinking

Question 74: A patient who is angry with his wife asks the nurse how to handle the problem. How should the nurse respond? Answer: “What are your ideas about how to handle it?”

Question 75: The patient has an order for Neurontin twice a day for a total maximum dose of 2400mg/day. The scheduled AM dose is 900mg. The medication is supplied in 300mg capsules. How many capsules would the patient receive for the scheduled PM dose? Answer: 5

Question 76: During a nurse-patient interaction, the patient stands up and shouts at the nurse, “You’re just like my wife. You want me to do everything your way.” What assessment can be made about the patient’s behavior? Answer: Transference

Question 77: A patient with anorexia nervosa is resistant to the idea of weight gain. What is the rationale for establishing a contract with the patient in which she agrees to participate in measures designed to produce a specified weekly weight gain? Answer: Patient involvement in decision making increases sense of control and promotes compliance with treatment.

Question 78: A nurse passed over for a promotion says nothing to his boss but belittles his coworkers. He is using which defense mechanism? Answer: Displacement

Question 79: The nurse should teach the patient that maintenance of a therapeutic serum level of lithium (Eskalith) is dependent upon serum levels of which electrolyte? Answer: Sodium

Question 80: A patient in the Emergency Department complains of suicidal ideation and feelings of worthlessness. He has a family history of suicide. The nurse is assessing the patient to determine treatment recommendations. What is the most important factor for the nurse to consider? Answer: An active, feasible suicide plan