Why are open-ended questions commonly used during mental health interviews?
A. To obtain brief, direct responses
B. To encourage clients to express themselves freely and promote meaningful dialogue
C. To limit the flow of conversation
D. To quickly reach a diagnostic conclusion
Correct Answer: B. To encourage clients to express themselves freely and promote meaningful dialogue
Rationale:
Open-ended questions help clients elaborate on their experiences and feelings, which supports a more comprehensive and therapeutic assessment process.
Which of the following actions by a nurse violates HIPAA?
A. Discussing a patient’s diagnosis with their spouse after obtaining written permission
B. Texting a provider about a patient’s change in condition using a secure hospital app
C. Discussing a patient’s condition at the nurse’s station with another nurse
D. Sharing information with a nursing student not assigned to the patient
Answer: D
Rationale: Information should only be shared with staff directly involved in the patient’s care.
A client is pacing, has SOB, chest pain, and says, “I think I’m dying.” Which action should the nurse take first?
A. Call a code
B. Offer PRN lorazepam
C. Stay with the client and speak calmly
D. Explain that the symptoms are from anxiety
Answer: C
Rationale: Safety and presence are priorities during a panic attack.
Which is a known risk factor for addiction?
A. Low IQ
B. Hyperthyroidism
C. Family history of substance abuse
D. Lack of ambition
Answer: C
Rationale: Genetic predisposition is a strong risk factor.
A nurse frequently volunteers to give narcotics and has excessive absences. What is the priority action?
A. Report to the nursing supervisor
B. Ignore the behavior
C. Confront the nurse directly
D. Talk to coworkers about suspicions
Answer: A
Rationale: Suspected drug diversion must be reported through proper channels to ensure patient and nurse safety.
A client with schizophrenia says, “The voices are telling me I’m worthless.” Which is the best response by the nurse?
A. “You’re not worthless, you are a valuable person.”
B. “You need to ignore the voices.”
C. “I don’t hear any voices.”
D. “That must be very frightening. Can you tell me more about what the voices are saying?”
Answer: D
Rationale: This is a therapeutic, empathetic, open-ended response that encourages communication without denying the client’s experience.
A client becomes physically aggressive. Which of the following is the priority before applying physical restraints?
A. Ensure the order is signed by the physician
B. Document the behavior
C. Attempt de-escalation techniques
D. Notify the family
Answer: C
Rationale: Restraints are a last resort; all less restrictive interventions must be attempted first.
Which of the following findings distinguishes GAD from normal anxiety?
A. Anxiety that occurs only before an exam
B. Anxiety that is triggered by a specific event
C. Excessive anxiety occurring most days for 6 months
D. Anxiety that improves with relaxation
Answer: C
Rationale: GAD is persistent, excessive, and lasts ≥6 months.
Which of the following findings in a client with alcohol use disorder requires immediate attention?
A. BP 140/88
B. Fine hand tremors
C. Confusion and hallucinations
D. Nausea and vomiting
Answer: C
Rationale: These are signs of delirium tremens, a life-threatening emergency.
A client reports washing their hands for over an hour each morning to prevent illness. This behavior is best described as:
A. An irrational fear
B. A hallucination
C. A compulsion
D. A delusion
Correct Answer: C
Rationale: Compulsions are repetitive behaviors performed to reduce anxiety caused by obsessions (e.g., fear of contamination).
Which factor is most likely to affect a client’s learning?
A. The nurse’s knowledge of the topic
B. The client’s motivation to learn
C. The availability of Internet access
D. The client's insurance coverage
Correct Answer: B
Rationale: Motivation directly impacts the client’s engagement and retention of information.
The primary purpose of a psychiatric advance directive is to:
A. Assign a power of attorney for property
B. Allow a client to refuse treatment during an emergency
C. Guide treatment preferences if the client becomes unable to make decisions
D. Legally prevent involuntary hospitalization
Answer: C
Rationale: It outlines the client's treatment choices for future mental health crises.
A client with OCD washes their hands for an hour each morning. Which intervention is most therapeutic?
A. Set a time limit on handwashing
B. Tell them to stop the ritual
C. Allow the ritual to continue uninterrupted
D. Perform handwashing with the client
Answer: A
Rationale: Time limits help gradually reduce compulsive behavior while respecting the client’s need for control.
A nurse is caring for a client withdrawing from opioids. Which symptoms should the nurse expect?
A. Sweating, rhinorrhea, and muscle aches
B. Hallucinations, disorientation, and tremors
C. Euphoria and sedation
D. Bradycardia and hypotension
Answer: A
Rationale: Opioid withdrawal presents with flu-like symptoms.
Which of the following symptoms is characteristic of a panic attack?
A. Gradual onset of worry and nervousness
B. Persistent sadness and hopelessness
C. Sudden episodes of intense fear with chest pain and shortness of breath
D. Repetitive handwashing to reduce stress
Correct Answer: C
Rationale: Panic attacks involve the abrupt onset of intense fear or discomfort, often with physical symptoms like palpitations, dizziness, chest pain, and fear of dying.
Which of the following is an example of the clarifying technique?
A. “I understand how you feel.”
B. “Tell me more about that.”
C. “What do you mean when you say you’re ‘tired of trying’?”
D. “Why don’t you try getting some rest?”
Correct Answer: C
Rationale: Clarifying helps ensure understanding of ambiguous or vague statements.
Which of the following best explains why psychotherapy notes receive special protection under HIPAA regulations?
A. They are used to bill insurance providers
B. They contain sensitive personal and analytical content not found in the medical record
C. They are required for legal proceedings
D. They are necessary for medication management
Correct Answer: B
Rationale: Psychotherapy notes often include detailed personal reflections and therapist analysis, so HIPAA gives them extra protection beyond standard medical records.
Which of the following is a common symptom of Generalized Anxiety Disorder (GAD)?
A. Short, intense episodes of fear
B. Excessive worry occurring more days than not for at least 6 months
C. Repetitive intrusive thoughts about contamination
D. Flashbacks of a traumatic event
Correct Answer: B
Rationale: GAD is characterized by excessive, uncontrollable worry present on most days for at least 6 months, often accompanied by symptoms such as fatigue, restlessness, and muscle tension.
Which type of question is most effective in facilitating spontaneous responses and interactive discussions when assessing a client with panic disorder?
A. Open-ended questions
B. Closed-ended questions
c. Projective questions
D. Presupposition questions
Open-ended questions
Rationale: Open-ended questions facilitate spontaneous responses and encourage interactive discussion.
Which statement best describes the relationship between obsessions and compulsions in OCD?
A. Obsessions are actions taken to eliminate compulsions.
B. Compulsions are performed to reduce anxiety caused by obsessions.
C. Obsessions and compulsions are completely unrelated.
D. Compulsions increase anxiety and lead to more obsessions.
Compulsions are performed to reduce anxiety caused by obsessions.
Rationale: Compulsions are repetitive behaviors performed to reduce anxiety caused by obsessive thoughts.
Which action best demonstrates therapeutic communication during a client interview?
A. Telling the patient what you would do in their situation
B. Nodding and saying “Uh-huh” while the client talks
C. Asking “Why are you feeling that way?”
D. Changing the subject if the client becomes emotional
Correct Answer: B
Rationale: This shows active listening. Asking "why" can feel judgmental, and advice-giving or redirecting emotion isn't therapeutic.
In which situation can a psychiatric advance directive be legally set aside/ disregarded?
A. When a competent patient asks to revise it during a mental health crisis
B. When immediate treatment is necessary to protect the patient or others from serious harm
C. If the patient's family disagrees with the documented wishes
D. If the document was created more than five years ago
Correct Answer: B. When immediate treatment is necessary to protect the patient or others from serious harm
Rationale:
A psychiatric advance directive can be overridden in emergencies when a delay in treatment would pose a significant risk to the patient or others. This ensures safety takes priority when urgent intervention is needed.
Which treatment approach is considered most effective for OCD?
A. Exposure and response prevention (ERP) therapy
B. Psychoanalysis
C. Hypnosis
D. Electroconvulsive therapy (ECT)
Correct Answer: A
Rationale: ERP is a specific form of cognitive-behavioral therapy (CBT) shown to be highly effective for reducing compulsive behaviors and obsessive thoughts.
A nurse is assessing a client for possible alcohol use disorder using a validated screening tool. Which of the following screening tools is the most appropriate for identifying hazardous drinking and alcohol-related problems in a primary care setting?
A. CAGE Questionnaire
B. Mini-Mental State Examination (MMSE)
C. Beck Depression Inventory (BDI)
D. Hamilton Anxiety Rating Scale (HAM-A)
Answer:
A. CAGE Questionnaire
Rationale:
The CAGE questionnaire is a brief, validated screening tool commonly used to identify potential alcohol use disorder. It focuses on four questions related to Cutting down, Annoyance by criticism, Guilty feelings, and Eye-openers. The MMSE is a cognitive screening tool, the BDI screens for depression, and the HAM-A assesses anxiety symptoms.
Which of the following are goals or techniques included in Socratic questioning as used in therapy? (Select all that apply)
A. Encouraging the client to examine the evidence behind their thoughts
B. Guiding the client to discover alternative perspectives
C. Providing immediate solutions to the client’s problems
D. Helping the client identify cognitive distortions
E. Challenging irrational beliefs through guided dialogue
F. Reinforcing the client's initial assumptions to build confidence
Correct Answers: A, B, D, E
Rationale:
Socratic questioning involves a structured method of guided inquiry that helps clients analyze their thoughts, evaluate evidence, identify distortions, and consider alternative interpretations. It is not about giving direct answers (C) or reinforcing unhelpful beliefs (F).