1 >>The psychiatric charge nurse is making shift assignments for the admission unit. The staff includes one registered nurse (RN), two licensed practical nurses (LPNs), four mental health workers (MHWs), and a unit secretary. Which task would be most appropriate to assign to the LPNs? ?
- (A) Update the clients’ individualized care plans.
- (B) Stay in the lobby area and watch the clients.
- (C) Administer routine medications to the clients.
- (D) Transcribe the admission orders for a client.
2 >>The mental health worker (MHW) has tried to calm down the client on the psychiatric unit who is angry and attempting to fight with another client. The nurse observes the MHW “taking down” the client to the floor. Which intervention should the nurse implement? ?
- (A) Assist the MHW with the “take down” of the client.
- (B) Call the hospital security to come and assist the MHW.
- (C) Document the client “take down” in the nurse’s notes.
- (D) Remove the other clients from the day room area.
3 >>The mental health worker (MHW) reports to the psychiatric nurse that two clients were kissing each other while watching the movie in the lobby area. Which action should the nurse implement? ?
- (A) Tell the MHW to tell the clients not to kiss each other again.
- (B) Discuss the inappropriate behavior at the weekly team meeting.
- (C) Transfer one of the clients to another psychiatric unit.
- (D) Talk to the clients about kissing each other in the lobby area.
4 >>The nurse is caring for clients in the psychiatric unit. Which task would be most appropriate for the nurse to delegate to the mental health worker (MHW)? ?
- (A) Instruct the MHW to walk with the client who is agitated and anxious.
- (B) Ask the MHW to clean up the floor where the client has urinated.
- (C) Tell the MHW to phone the HCP to obtain a PRN medication order.
- (D) Request the MHW to explain seizure precautions to another staff member.
5 >>Which behavior by the mental health worker (MHW) is an example of assault requiring immediate intervention by the psychiatric nurse? ?
- (A) The MHW injures a client who is forcibly being put in the “quiet” room.
- (B) The MHW refuses to let the client come into the day room until putting on socks.
- (C) The MHW escorts the client to the anger management class in another building.
- (D) The MHW threatened to forcibly remove the client who is refusing to get out of the bed.
6 >>The charge nurse has assigned the licensed practical nurse (LPN) to administer medications to the clients on an inpatient psychiatric unit. Which client should the LPN force to take the prescribed medications? ?
- (A) The client with bipolar disorder who has been declared incompetent in a court of law.
- (B) The client with major depression who voluntarily admitted herself to the unit.
- (C) The client with paranoid schizophrenia who was involuntarily admitted to the unit.
- (D) The client with a borderline personality who has legal charges pending in the court.
7 >>Which client should the psychiatric charge nurse assign to the nurse from the surgical unit who was assigned to the psychiatric unit for the shift? ?
- (A) The client diagnosed with schizophrenia who is hallucinating and delusional.
- (B) The client with bipolar disorder who is manic and aggressive toward staff and clients.
- (C) The client who is diagnosed with chronic depression and will not talk to anyone.
- (D) The client with schizophrenia and an Axis 2 antisocial personality.
8 >>The psychiatric nurse assigned the mental health worker (MHW) to stay with a client 1-to-1 due to high risk for suicide. Which behavior by the MHW warrants intervention by the nurse? ?
- (A) The MHW stays with the client while in the bathroom.
- (B) The MHW provides the client with plastic utensils for breakfast.
- (C) The MHW stays outside the room during the client’s group therapy.
- (D) The MHW watches the client walking outside from the porch area.
9 >>Which statement by the mental health worker (MHW) warrants intervention by the psychiatric nurse? ?
- (A) “I assisted the client with dressing and hygiene this morning.”
- (B) “I am going to the team meeting for the next hour.”
- (C) “I gave the client with heart burn some Maalox.”
- (D) “I am going to play cards with some clients in the day room.”
10 >>The nurse on the substance abuse unit is administering medications. For which client would the nurse question administering the medication? ?
- (A) The client admitted for alcohol detoxification who is receiving lorazepam (Ativan) and has an apical pulse of 110.
- (B) The client admitted for heroin addiction who is receiving methadone (Methadose) and has a respiratory rate of 22.
- (C) The client admitted for opioid withdrawal who is receiving clonidine (Catapres) and has a blood pressure (BP) of 88/60.
- (D) The client diagnosed with Wernicke-Korsakoff syndrome receiving intravenous thiamine (vitamin B1) who has an oral temperature of 96.8�F.
11 >>The psychiatric nurse overhears a mental health worker (MHW) telling a client diagnosed with schizophrenia, “You cannot use the phone while you are here on the unit.” Which action should the psychiatric nurse take? ?
- (A) Praise the MHW for providing correct information to the client.
- (B) Tell the MHW this is not correct information in front of the client.
- (C) Explain to the MHW that the client does not lose any rights.
- (D) Discuss this situation at the weekly multidisciplinary team meeting.
12 >>The client diagnosed with bipolar disorder is admitted to the psychiatric unit in an acute manic state. The nurse needs to complete the admission assessment, but the client is restless, very energetic, and agitated. Which intervention should the nurse implement? ?
- (A) In a very firm voice, ask the client to sit down.
- (B) Administer lithium (Eskalith), an antimania medication.
- (C) Ask questions while walking and pacing with the client.
- (D) Do not complete the admission assessment at this time.
13 >>The client in the psychiatric setting tells the nurse, “There were so many people at the team meeting; I am not sure what the psychiatric social worker is supposed to do for me.” Which statement is the psychiatric nurse’s best response? ?
- (A) “The social worker evaluates the effectiveness of the client’s medication.”
- (B) “This person provides activities that promote constructive use of leisure time.”
- (C) “The social worker will assist you in keeping your job or help you find a new one.”
- (D) “This person works with your family and community and makes referrals if needed.”
14 >>The male client diagnosed with paranoid schizophrenia is yelling, talking to himself, and blocking the view of the television. The other clients in the day room are becoming angry. Which action should the nurse take first? ?
- (A) Obtain a restraint order from the HCP.
- (B) Escort the other clients from the day room.
- (C) Administer an intramuscular (IM) antipsychotic medication.
- (D) Approach the client calmly along with two mental health workers (MHWs).
15 >>A young child, Joey, was admitted to the pediatric unit with a fractured jaw, bruises, and multiple cigarette burns to the arms. The mother reported the father hurt the child. A man comes to the nurse’s station saying, “I am Joey’s father; can you tell me how he is doing?” Which statement is the nurse’s best response? ?
- (A) “Your son has a fractured jaw and some bruises but he is doing fine.”
- (B) “I am sorry I cannot give you any information about your son.”
- (C) “You should go talk to your wife about your son’s condition.”
- (D) “The social worker can discuss your son’s condition with you.”
16 >>During an interview, the female client tells the psychiatric nurse in a mental health clinic, “Sometimes I feel like life is not worth living. I am going to kill myself.” Which interventions should the nurse implement? Select all that apply. ?
- (A) Make a no-suicide contract with the client.
- (B) Place the client on a 1-to-1 supervision.
- (C) Ask the client whether she has a plan.
- (D) Commit the client to the psychiatric unit.
17 >>The psychiatric nurse is caring for clients on a closed unit. Which client would warrant immediate intervention by the nurse? ?
- (A) The client who refuses to attend the anger management class.
- (B) The client who is requesting to go outside to smoke a cigarette.
- (C) The client who is nauseated and has vomited twice.
- (D) The client who has her menses and has abdominal cramping.
18 >>The clinical manager wants to reward the staff on the psychiatric unit for having no tardies or absences for 1 month. Which action would be most appropriate for the clinical manager? ?
- (A) Provide pizza, drinks, and dessert for all the shifts.
- (B) Post a thank you note on the board in the employee lounge.
- (C) Individually acknowledge this accomplishment with the staff.
- (D) Place official documentation in each staff’s employee file.
19 >>The nurse is working in an outpatient psychiatric clinic. The male client tells the nurse, “I am going to kill my wife if she files for divorce. I know I can’t live without her.” Which action should the nurse implement? ?
- (A) Take no action because this is confidential information.
- (B) Document the statement in the client’s nurse’s notes.
- (C) Inform the client’s psychiatric healthcare provider (HCP) of the comment.
- (D) Encourage the client to talk to his wife about the divorce.
20 >>Which interventions should the inpatient psychiatric nurse implement for the client experiencing sleepwalking? Select all that apply. ?
- (A) Encourage the client to exercise prior to going to bed.
- (B) Place the client on elopement precautions.
- (C) Instruct to client to drink decaffeinated beverages.
- (D) Place an alarm on the bed activated when client gets up.