Psychiatric Emergencies and Crisis Intervention | Patients with overactive | Underactive and Violent Behavior | Suicide | Mock Test | Staff Nurse | Guides Academy

Psychiatric emergencies and crisis intervention- Patients with overactive, underactive and violent behaviour, suicide, adverse drug reactions, withdrawal symptoms, a/c psychosis.

Time: 15:00

A client in the emergency department is becoming increasingly agitated, clenching their fists, and pacing. What is the nurse's priority action?

[a] Immediately place the client in four-point restraints.

[b] Attempt verbal de-escalation in a calm, non-threatening manner.

[c] Leave the client alone to give them space to calm down.

[d] Call the client's family to ask for advice.

When assessing a client for suicidal ideation, which question is most direct and therapeutic?

[a] "You're not thinking of hurting yourself, are you?"

[b] "Why would you want to do something like that?"

[c] "Are you currently having thoughts of killing yourself?"

[d] "You seem sad, let's talk about something more positive."

A client taking a first-generation antipsychotic develops a high fever, severe muscle rigidity, and altered mental status. The nurse should suspect which life-threatening adverse drug reaction?

[a] Serotonin Syndrome.

[b] Agranulocytosis.

[c] Neuroleptic Malignant Syndrome (NMS).

[d] Tardive Dyskinesia.

A client with a history of chronic alcoholism is admitted to the hospital. Two days later, they become confused, tremulous, and have visual hallucinations. This is characteristic of:

[a] Korsakoff's psychosis.

[b] Delirium Tremens (DTs).

[c] Wernicke's encephalopathy.

[d] Acute intoxication.

A client is experiencing an acute psychotic episode and states, "The aliens have bugged this room." What is the most therapeutic response from the nurse?

[a] "That's not real. Let's talk about reality."

[b] "Let's search the room together to prove there are no bugs."

[c] "That sounds very frightening for you. You are safe here."

[d] "Why do you think the aliens would bug this room?"

A nurse finds a client with catatonic schizophrenia standing motionless in a bizarre posture. The priority nursing diagnosis for this underactive client is:

[a] Impaired verbal communication.

[b] Social isolation.

[c] Risk for fluid volume deficit.

[d] Disturbed thought process.

The primary goal of crisis intervention is to:

[a] Resolve the client's lifelong personality issues.

[b] Provide long-term psychotherapy.

[c] Completely eliminate stress from the client's life.

[d] Return the client to their pre-crisis level of functioning.

A severely depressed client who has been mute and withdrawn suddenly becomes cheerful and starts giving away prized possessions. The nurse should interpret this as a potential:

[a] Sign of a spontaneous recovery.

[b] Warning sign for suicide.

[c] Positive response to medication.

[d] Indication of a shift to a manic state.

A client taking both an SSRI and St. John's Wort presents with agitation, hyperreflexia, and diaphoresis. These symptoms are indicative of:

[a] Neuroleptic Malignant Syndrome.

[b] Serotonin Syndrome.

[c] Hypertensive Crisis.

[d] Anticholinergic toxicity.

What are the characteristic symptoms of opioid withdrawal?

[a] Seizures, hyperthermia, and delirium.

[b] Hypersomnia, increased appetite, and psychomotor retardation.

[c] Yawning, rhinorrhea, muscle aches, and piloerection.

[d] Pinpoint pupils, respiratory depression, and euphoria.

A client admitted for acute psychosis has command hallucinations telling them to harm their roommate. What is the nurse's priority action?

[a] Encourage the client to listen to music to distract them from the voices.

[b] Initiate one-to-one observation and notify the treatment team.

[c] Ask the roommate to talk to the client to calm them down.

[d] Tell the client the voices are not real.

Which of the following situations best describes a crisis?

[a] A client feels anxious about an upcoming job interview.

[b] An adolescent is upset after an argument with a friend.

[c] A person's usual coping mechanisms fail after their spouse dies suddenly.

[d] A student feels stressed during final exams.

A client taking an MAOI antidepressant must be educated to avoid tyramine-rich foods to prevent which adverse reaction?

[a] Serotonin Syndrome.

[b] Hypertensive Crisis.

[c] Agranulocytosis.

[d] Neuroleptic Malignant Syndrome.

The use of seclusion or restraints on a violent client is only appropriate when:

[a] The unit is short-staffed.

[b] The client is using profane language.

[c] All less restrictive measures have failed and the client is an imminent danger to self or others.

[d] The client refuses to take their medication.

Abrupt cessation of a long-term, high-dose benzodiazepine prescription can lead to which life-threatening withdrawal symptom?

[a] Diarrhea.

[b] Constipation.

[c] Seizures.

[d] Bradycardia.

For a client who is overactive and manic, which nursing intervention best addresses their nutritional needs?

[a] Insist the client sit down for three full, formal meals.

[b] Provide a high-carbohydrate, low-protein diet.

[c] Offer high-calorie, portable "finger foods" and drinks frequently.

[d] Restrict fluids to decrease hyperactivity.

What is a critical component of environmental safety management for a client at high risk for suicide?

[a] Providing the client with a private room to ensure confidentiality.

[b] Allowing the client to keep their personal belongings for comfort.

[c] Implementing contraband checks and removing potentially dangerous items.

[d] Encouraging visits from family and friends at any time.

The most important factor for a nurse's personal safety when interacting with a potentially violent client is to:

[a] Maintain intense eye contact to show authority.

[b] Stand directly in front of the client to block their exit.

[c] Be aware of the environment and maintain a safe distance with an exit route.

[d] Speak loudly and firmly to gain control of the situation.

A client is taking clozapine (Clozaril). The nurse must monitor for which adverse effect that can be a psychiatric emergency?

[a] Weight gain.

[b] Agranulocytosis (sore throat, fever, signs of infection).

[c] Dry mouth.

[d] Sedation.

The primary purpose of psychological first aid (PFA) after a traumatic event is to:

[a] Conduct in-depth psychotherapy.

[b] Make a formal psychiatric diagnosis.

[c] Promote a sense of safety, provide support, and meet immediate needs.

[d] Debrief the individual by having them recount the traumatic event in detail.

For a severely withdrawn and underactive client with major depression, what is an appropriate nursing intervention?

[a] Expect the client to initiate all conversations.

[b] Force the client to participate in a large, stimulating group activity.

[c] Use simple, direct sentences and allow ample time for a response.

[d] Focus the conversation on cheerful topics to elevate their mood.

What is the priority assessment for a client in acute alcohol withdrawal?

[a] Nutritional status.

[b] Sleep patterns.

[c] Vital signs and neurological status.

[d] Family support system.

A client is brought to the ED after being sexually assaulted. The client is calm and appears emotionally "numb." The nurse recognizes this as:

[a] An indication that the client is not truly traumatized.

[b] A sign of a pre-existing personality disorder.

[c] A common and adaptive initial response to an overwhelming crisis.

[d] A symptom of drug or alcohol intoxication.

When a client is experiencing acute psychosis, the nurse's primary focus should be on:

[a] Exploring the client's childhood experiences.

[b] Teaching the client complex coping skills.

[c] Ensuring safety and reality orientation.

[d] Analyzing the symbolic meaning of their delusions.

The term "dual diagnosis" refers to a client who has:

[a] Two different personality disorders.

[b] Both depression and anxiety.

[c] A substance use disorder and another psychiatric disorder.

[d] A physical illness and a mental illness.