Psych NCLEX Questions and Answers 6-10

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 6. On review of the client’s record, the nurse notes that the admission was voluntary. Based on this information, the nurse anticipates which client behavior?

a) Fearfulness regarding treatment measures.
b) Anger and aggressiveness directed toward others.
c) An understanding of the pathology and symptoms of the diagnosis.
d) A willingness to participate in the planning of the care and treatment plan.

7. Psych NCLEX Questions and Answers about a client who was admitted voluntarily for treatment of an anxiety disorder demands to be released from the hospital. Which action should the nurse take initially?

a) Contact the client’s health care provider (HCP).
b) Call the client’s family to arrange for transportation.
c) Attempt to persuade the client to stay “for only a few more days.”
d) Tell the client that leaving would likely result in an involuntary commitment.

8. When reviewing the admission assessment, the nurse notes that a client was admitted to the mental health unit involuntarily. Based on this type of admission, the nurse should provide which intervention for this client?

a) Monitor closely for harm to self or others
b) Assist in completing an application for admission
c) Supply the client with written information about their mental illness
d) Provide an opportunity for the family to discuss why they felt the admission was needed

9. The nurse is preparing a client for the termination phase of the nurse-client relationship. The nurse prepares to implement which nursing task that is most appropriate for this phase?

a) Planning short-term goals
b) Making appropriate referrals
c) Developing realistic solutions
d) Identifying expected outcomes

10. The nurse is providing care to a client admitted to the hospital with a diagnosis of acute anxiety disorder. The client says to the nurse, “I have a secret that I want to tell you. You won’t tell anyone about it, will you?” What is the most appropriate nursing response?

a) “No, I won’t tell anyone.”
b) “I cannot promise to keep a secret.”
c) “It depends on what the secret is about.”
d) “If you tell me the secret, I may need to document it.”





Psych NCLEX Questions and Answers and Rationale

6) D
- Rationale: In general, clients seek voluntary admission. If a client seeks voluntary admission, the most likely expectation is that the client will participate in the treatment program since they are actively seeking help. The remaining options are not characteristics of this type of admission. Fearfulness, anger, and aggressiveness are more characteristic of an involuntary admission. Voluntary admission does not guarantee a client’s understanding of their illness, only of their desire for help.

- Test-Taking Strategy: Focus on the subject, voluntary admission. This should direct you to the correct option. Note the relationship between the word voluntary and the correct option.

7) A
- Psych NCLEX Questions and Answers Rationale: In general, clients seek voluntary admission. Voluntary clients have the right to demand and obtain release. The nurse needs to be familiar with the state and facility policies and procedures. The best nursing action is to contact the HCP, who has the authority to discuss discharge with the client. While arranging for safe transportation is appropriate it is premature in this situation and should be done only with the client’s permission. While it is appropriate to discuss why the client feels the need to leave and the possible outcomes of leaving against medical advice, attempting to get the client to agree to staying “a few more days” has little value and will not likely be successful. Many states require that the client submit a written release notice to the facility staff members, who reevaluate the client’s condition for possible conversion to involuntary status if necessary, according to criteria established by law. While this is a possibility, it should not be used as a threat to the client.

- Test-Taking Strategy: Note the strategic word initially. Noting the type of hospital admission will assist in directing you to the correct option while eliminating those that are unlikely to occur. Calling the family should be eliminated, based on the issues of client rights and confidentiality. To “persuade” a client to stay in the hospital is inappropriate. Threatening the client is inappropriate and illegal.

8) A
- Rationale: Involuntary admission is necessary when a person is a danger to self or others or is in need of psychiatric treatment regardless of the client’s willingness to consent to the hospitalization. A written request is a component of a voluntary admission. Providing written information regarding the illness is likely premature initially. The family may have had no role to play in the client’s admission.

- Psych NCLEX Questions and Answers Test-Taking Strategy: Focus on the subject, involuntary admission. Use Maslow’s Hierarchy of Needs theory: safety is the priority if a physiological need does not exist. This should direct you to the correct option. Also, note that the remaining options are not always true of an involuntary admission.

9) B
- Rationale: Tasks of the termination phase include evaluating client performance, evaluating achievement of expected outcomes, evaluating future needs, making appropriate referrals, and dealing with the common behaviors associated with termination. The remaining options identify tasks appropriate for the working phase of the relationship.

- Test-Taking Strategy: Note the strategic words most appropriate. Focusing on the subject, the termination phase, should direct you to the correct option.

10) B
- Rationale: The nurse should never promise to keep a secret. Secrets are never appropriate in a therapeutic relationship. The nurse needs to be honest and tell the client that a promise cannot be made to keep the secret. The remaining options are inappropriate responses since they either promise to keep the secret or provide the criteria for when a secret may be appropriately kept.

- Test-Taking Strategy: Note the strategic words most appropriate. Understanding the need for open, honest communication with the client will direct you to the correct option. The remaining options can be eliminated because they do not foster the nurse-client relationship.


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Psych NCLEX Questions and Answers 11-15

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Psych NCLEX Questions and Answers 1-5

Psych NCLEX Questions and Answers are a mainstay in the NCLEX-RN. Increase your knowledge with this 5-item quiz covering topics.

 1. A client with a diagnosis of major depression who has attempted suicide says to the nurse, “I should have died. I’ve always been a failure. Nothing ever goes right for me.” Which response demonstrates therapeutic communication?

a) “You have everything to live for.”
b) “Why do you see yourself as a failure?”
c) “Feeling like this is all part of being depressed.”
d) “You’ve been feeling like a failure for a while?”

2. When the community health nurse visits a client at home, the client states, “I haven’t slept at all the last couple of nights.” Which response by the nurse illustrates a therapeutic communication response to this client?

a) “I see.”
b) “Really?”
c) “You’re having difficulty sleeping?”
d) “Sometimes, I have trouble sleeping too.”

3. Psych NCLEX Questions and Answers about a client who is experiencing disturbed thought processes believes that his food is being poisoned. Which communication technique should the nurse use to encourage the client to eat?

a) Using open-ended questions and silence
b) Sharing personal preference regarding food choices
c) Documenting reasons why the client does not want to eat
d) Offering opinions about the necessity of adequate nutrition

4. A client admitted to a mental health unit for treatment of psychotic behavior spends hours at the locked exit door shouting, “Let me out. There’s nothing wrong with me. I don’t belong here.” What defense mechanism is the client implementing?

a) Denial
b) Projection
c) Regression
d) Rationalization

5. A client diagnosed with terminal cancer says to the nurse, “I’m going to die, and I wish my family would stop hoping for a cure! I get so angry when they carry on like this. After all, I’m the one who’s dying.” Which response by the nurse is therapeutic?

a) “Have you shared your feelings with your family?”
b) “I think we should talk more about your anger with your family.”
c) “You’re feeling angry that your family continues to hope for you
to be cured?”
d) “You are probably very depressed, which is understandable with such a diagnosis.”





Psych NCLEX Questions and Answers with Rationale

1) D
- Rationale: Responding to the feelings expressed by a client is an effective therapeutic communication technique. The correct option is an example of the use of restating. The remaining options block communication because they minimize the client’s experience and do not facilitate exploration of the client’s expressed feelings. In addition, use of the word “why” is nontherapeutic.

- Test-Taking Strategy: Use knowledge of therapeutic communication techniques to direct you to the option that directly addresses the client’s feelings and concerns. Also, the correct option is the only one stated in the form of a question that is open-ended; it will encourage the verbalization of feelings.

2) C
- Psych NCLEX Questions and Answers Rationale: The correct option uses the therapeutic communication technique of restatement. Although restatement is a technique that has a prompting component to it, it repeats the client’s major theme, which assists the nurse to obtain a more specific perception of the problem from the client. The remaining options are not therapeutic responses since none encourage the client to expand on the problem. Offering personal experiences moves the focus away from the client and onto the nurse.

- Test-Taking Strategy: Use knowledge of therapeutic communication techniques. “I see” is a general lead but does not provide the client with the opportunity to continue the discussion. “Really” can be a response that may make the client feel that he or she is not believable. Providing personal experiences focuses on the nurse’s problem and thus minimizes the client’s concerns. The correct option will provide the perception of the problem from the client’s perspective.

3) A
- Rationale: Open-ended questions and silence are strategies used to encourage clients to discuss their problems. Sharing personal food preferences is not a client-centered intervention. The remaining options are not helpful to the client because they do not encourage the client to express feelings. The nurse should not offer opinions and should encourage the client to identify the reasons for the behavior.

- Psych NCLEX Questions and Answers Test-Taking Strategy: Use knowledge of therapeutic communication techniques. First eliminate options that do not support the client’s expression of feelings. Any option that is not client-centered should be eliminated next. Focusing on the client’s feelings will direct you to the correct option.

4) A
- Rationale: Denial is refusal to admit to a painful reality, which is treated as if it does not exist. In projection, a person unconsciously rejects emotionally unacceptable features and attributes them to other persons, objects, or situations. Regression allows the client to return to an earlier, more comforting, although less mature, way of behaving. Rationalization is justifying illogical or unreasonable ideas, actions, or feelings by developing acceptable explanations that satisfy the teller and the listener.

- Psych NCLEX Questions and Answers Test-Taking Strategy: Focus on the subject, defense mechanisms. The words in the question that should direct you to the correct option are There’s nothing wrong with me. Select the option that recognizes the client’s attempt to avoid looking at the reality of the situation. The other options lack this characteristic.

5) C
- Rationale: Restating is a therapeutic communication technique in which the nurse repeats what the client says to show understanding and to review what was said. While it is appropriate for the nurse to attempt to assess the client’s ability to discuss feelings openly with family members, it does not help the client discuss the feelings causing the anger. The nurse’s attempt to focus on the central issue of anger is premature. The nurse would never make a judgment regarding the reason for the client’s feeling; this is nontherapeutic in the one-to-one relationship.

- Test-Taking Strategy: Use knowledge of therapeutic communication techniques. The correct option is the only one that identifies the use of a therapeutic technique (restatement) and focuses on the client’s feelings.


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Psych NCLEX Questions and Answers 6-10