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Psych Mental Health Exam 2 - Practice Test

Instructions: This practice test mirrors the format and content your instructor would likely use. Answer all questions, then check your responses against the answer key at the end.

PART I: MULTIPLE CHOICE

Choose the BEST answer for each question.

PSYCHOPHARMACOLOGY

1. A 10-year-old patient on methylphenidate (Ritalin) for ADHD reports stomachaches and has lost 8 pounds in 6 weeks. The nurse should recognize this as:

  • A) Normal growth pattern for this age
  • B) Expected side effects of stimulant medication
  • C) Signs of medication overdose requiring immediate discontinuation
  • D) Unrelated symptoms requiring separate evaluation

2. When using the AIMS scale, which finding would be MOST concerning for tardive dyskinesia?

  • A) Slight hand tremor when reaching for objects
  • B) Repetitive lip smacking and tongue protrusion
  • C) Muscle stiffness in arms and legs
  • D) Slow, deliberate movements

3. A patient taking sertraline (Zoloft) is prescribed tramadol for pain. Within 24 hours, the patient develops hyperthermia (102°F), agitation, and hyperreflexia. The nurse should suspect:

  • A) Neuroleptic malignant syndrome
  • B) Serotonin syndrome
  • C) Lithium toxicity
  • D) Anticholinergic crisis

4. Which statement by a patient indicates good understanding of medication adherence?

  • A) "I'll stop taking this when I feel better"
  • B) "I can skip doses if I'm having side effects"
  • C) "I should take this medication exactly as prescribed, even when I feel well"
  • D) "I'll take extra when I'm really anxious"

5. A patient with schizophrenia experiences auditory hallucinations. The most appropriate first-line medication would be:

  • A) Lorazepam (Ativan)
  • B) Lithium carbonate
  • C) Risperidone (Risperdal)
  • D) Fluoxetine (Prozac)

6. An elderly patient taking lorazepam (Ativan) is found confused and unsteady. This represents:

  • A) Expected therapeutic effect
  • B) Paradoxical reaction requiring increased dose
  • C) Adverse CNS depression effects
  • D) Drug interaction with food

7. A patient on lithium has a serum level of 1.8 mEq/L and reports nausea, vomiting, and hand tremors. The nurse should recognize this as:

  • A) Therapeutic level with expected side effects
  • B) Mild lithium toxicity
  • C) Severe lithium toxicity requiring dialysis
  • D) Subtherapeutic level requiring dose increase

8. Antipsychotics are contraindicated in which population?

  • A) Young adults with first-episode psychosis
  • B) Patients with dementia-related behavioral symptoms
  • C) Patients with bipolar disorder
  • D) Patients with severe depression with psychotic features

ANXIETY DISORDERS

9. A patient reports 8 months of excessive worry about work, family, and finances, accompanied by muscle tension and fatigue. This presentation is most consistent with:

  • A) Panic disorder
  • B) Generalized anxiety disorder
  • C) Social anxiety disorder
  • D) Specific phobia

10. A patient with a history of childhood abuse (ACEs score of 7) presents with multiple anxiety disorders. The nurse understands that:

  • A) Childhood trauma has no impact on adult mental health
  • B) High ACEs scores are correlated with increased anxiety disorders
  • C) Only physical abuse affects anxiety development
  • D) ACEs only affect children, not adults

11. A patient is pacing, states "I can't think straight," and has difficulty concentrating. This represents which level of anxiety?

  • A) Mild anxiety
  • B) Moderate anxiety
  • C) Severe anxiety
  • D) Panic level anxiety

SCHIZOPHRENIA/PSYCHOSIS

12. A patient with schizophrenia sits alone, rarely speaks, shows no emotion, and has poor hygiene. These behaviors represent:

  • A) Positive symptoms
  • B) Negative symptoms
  • C) Cognitive symptoms
  • D) Medication side effects

13. When a patient says "The CIA is watching me through the TV," the most therapeutic response is:

  • A) "That's not true, the CIA isn't watching you"
  • B) "You're right, we should unplug the TV"
  • C) "I don't see any evidence of that, but I can see you're frightened"
  • D) "Why would the CIA want to watch you?"

14. The prevalence of schizophrenia in the general population is approximately:

  • A) 5%
  • B) 1%
  • C) 10%
  • D) 0.1%

15. The most common comorbidity with schizophrenia is:

  • A) Diabetes
  • B) Substance use disorders
  • C) Hypertension
  • D) Obesity

STRESS RESPONSES

16. Which factor would MOST influence a patient's stress response?

  • A) Age alone
  • B) Current stressors only
  • C) Genetic predisposition, past trauma, and coping skills
  • D) Socioeconomic status only

17. A patient experiencing chronic stress would most likely exhibit:

  • A) Increased heart rate and blood pressure only during stressful events
  • B) Frequent infections, GI problems, and sleep disturbances
  • C) Improved immune function
  • D) Enhanced cognitive performance

THERAPIES

18. A patient with negative thought patterns and depression would benefit most from:

  • A) Dialectical Behavior Therapy (DBT)
  • B) Cognitive Behavioral Therapy (CBT)
  • C) Family therapy
  • D) Group therapy

19. DBT would be most appropriate for a patient with:

  • A) Mild depression
  • B) Borderline personality disorder with self-harm behaviors
  • C) Specific phobia
  • D) Generalized anxiety disorder

DEMENTIA

20. A patient shows progressive memory loss (recent events first), gets lost in familiar places, and has language difficulties. This pattern suggests:

  • A) Vascular dementia
  • B) Lewy body dementia
  • C) Alzheimer's disease
  • D) Frontotemporal dementia

21. Visual hallucinations, parkinsonian symptoms, and fluctuating cognition are characteristic of:

  • A) Alzheimer's disease
  • B) Vascular dementia
  • C) Lewy body dementia
  • D) Frontotemporal dementia

MOVEMENT DISORDERS

22. Resting tremor, bradykinesia, and rigidity are classic signs of:

  • A) Huntington's disease
  • B) Parkinson's disease
  • C) Tardive dyskinesia
  • D) Dystonia

LANGUAGE/LEARNING DISORDERS

23. A child has normal intelligence but significant difficulty with reading despite adequate instruction. This suggests:

  • A) Dysgraphia
  • B) Dyscalculia
  • C) Dyslexia
  • D) Aphasia

AUTISM SPECTRUM DISORDER

24. Parents of a newly diagnosed autistic child ask about the cause. The nurse should explain:

  • A) "It's caused by poor parenting"
  • B) "It's a neurological condition, not caused by parenting"
  • C) "It's caused by vaccines"
  • D) "The exact cause is unknown, but it's likely behavioral"

25. Core features of autism include:

  • A) Hyperactivity and impulsivity
  • B) Social communication difficulties and repetitive behaviors
  • C) Memory problems and confusion
  • D) Aggressive behaviors and mood swings

ADHD

26. A child loses homework, forgets lunch, and has difficulty following through on tasks. This pattern suggests:

  • A) ADHD hyperactive-impulsive type
  • B) ADHD inattentive type
  • C) ADHD combined type
  • D) Oppositional defiant disorder

LOSS AND BEREAVEMENT

27. A patient who lost their spouse says "If only I had called the doctor sooner, maybe they would still be alive." This represents which stage of grief?

  • A) Denial
  • B) Anger
  • C) Bargaining
  • D) Depression

28. When caring for a grieving patient, the most appropriate nursing response is:

  • A) "I know exactly how you feel"
  • B) "They're in a better place now"
  • C) "You should focus on the positive memories"
  • D) "This must be very difficult for you"

29. In end-of-life care, when family wishes conflict with patient's advance directive, the nurse should:

  • A) Follow the family's wishes
  • B) Advocate for the patient's documented wishes
  • C) Compromise between both
  • D) Ask the physician to decide

ERIKSON'S STAGES

30. A 25-year-old patient struggles with forming close relationships and feels socially isolated. According to Erikson, this represents difficulty with:

  • A) Identity vs. Role Confusion
  • B) Intimacy vs. Isolation
  • C) Generativity vs. Stagnation
  • D) Integrity vs. Despair

31. A 45-year-old patient expresses feeling "stuck" and questions their life's purpose. This reflects:

  • A) Identity vs. Role Confusion
  • B) Intimacy vs. Isolation
  • C) Generativity vs. Stagnation
  • D) Integrity vs. Despair

NURSING SELF-CARE

32. A nurse reports feeling exhausted, cynical, and ineffective at work. This suggests:

  • A) Normal job stress
  • B) Burnout
  • C) Depression
  • D) Anxiety disorder

PART II: MULTIPLE SELECT

Choose ALL that apply.

33. Which findings would indicate serotonin syndrome? (Select all that apply)

  • A) Hyperthermia
  • B) Muscle rigidity
  • C) Hyperreflexia
  • D) Bradycardia
  • E) Diaphoresis
  • F) Agitation

34. Factors that influence medication adherence include: (Select all that apply)

  • A) Side effects
  • B) Cost of medication
  • C) Complexity of regimen
  • D) Patient education level
  • E) Stigma associated with mental illness
  • F) Therapeutic relationship with provider

35. Positive symptoms of schizophrenia include: (Select all that apply)

  • A) Hallucinations
  • B) Delusions
  • C) Flat affect
  • D) Disorganized thinking
  • E) Avolition
  • F) Disorganized behavior

36. Effective coping strategies for stress include: (Select all that apply)

  • A) Deep breathing exercises
  • B) Progressive muscle relaxation
  • C) Social isolation
  • D) Regular exercise
  • E) Mindfulness meditation
  • F) Substance use

37. Clinical manifestations of ADHD inattentive type include: (Select all that apply)

  • A) Difficulty sustaining attention
  • B) Frequently loses things
  • C) Fidgets with hands
  • D) Forgetful in daily activities
  • E) Talks excessively
  • F) Doesn't follow through on instructions

PART III: CATEGORIZATION

Categorize each item into the correct group.

38. Categorize the following as either Positive Symptoms or Negative Symptoms of schizophrenia:

Items to categorize:

  • Auditory hallucinations
  • Flat affect
  • Delusions of persecution
  • Avolition (lack of motivation)
  • Disorganized speech
  • Anhedonia (inability to feel pleasure)
  • Bizarre behavior
  • Alogia (poverty of speech)

39. Categorize the following medications by their PRIMARY indication:

Medications:

  • Methylphenidate (Ritalin)
  • Risperidone (Risperdal)
  • Lorazepam (Ativan)
  • Lithium carbonate
  • Sertraline (Zoloft)

Categories:

  • ADHD treatment
  • Antipsychotic
  • Anxiolytic
  • Mood stabilizer
  • Antidepressant

40. Match each anxiety level with its characteristics:

Anxiety Levels:

  • Mild anxiety
  • Moderate anxiety
  • Severe anxiety
  • Panic level

Characteristics:

  • Increased alertness, better problem-solving
  • Tunnel vision, decreased concentration
  • Scattered thoughts, prominent physical symptoms
  • Complete inability to function, may be violent

ANSWER KEY

MULTIPLE CHOICE:

  1. B) Expected side effects of stimulant medication
  2. B) Repetitive lip smacking and tongue protrusion
  3. B) Serotonin syndrome
  4. C) "I should take this medication exactly as prescribed, even when I feel well"
  5. C) Risperidone (Risperdal)
  6. C) Adverse CNS depression effects
  7. B) Mild lithium toxicity
  8. B) Patients with dementia-related behavioral symptoms
  9. B) Generalized anxiety disorder
  10. B) High ACEs scores are correlated with increased anxiety disorders
  11. C) Severe anxiety
  12. B) Negative symptoms
  13. C) "I don't see any evidence of that, but I can see you're frightened"
  14. B) 1%
  15. B) Substance use disorders
  16. C) Genetic predisposition, past trauma, and coping skills
  17. B) Frequent infections, GI problems, and sleep disturbances
  18. B) Cognitive Behavioral Therapy (CBT)
  19. B) Borderline personality disorder with self-harm behaviors
  20. C) Alzheimer's disease
  21. C) Lewy body dementia
  22. B) Parkinson's disease
  23. C) Dyslexia
  24. B) "It's a neurological condition, not caused by parenting"
  25. B) Social communication difficulties and repetitive behaviors
  26. B) ADHD inattentive type
  27. C) Bargaining
  28. D) "This must be very difficult for you"
  29. B) Advocate for the patient's documented wishes
  30. B) Intimacy vs. Isolation
  31. C) Generativity vs. Stagnation
  32. B) Burnout

MULTIPLE SELECT:

  1. A, B, C, E, F (Hyperthermia, Muscle rigidity, Hyperreflexia, Diaphoresis, Agitation)
  2. A, B, C, D, E, F (All apply)
  3. A, B, D, F (Hallucinations, Delusions, Disorganized thinking, Disorganized behavior)
  4. A, B, D, E (Deep breathing, Progressive muscle relaxation, Regular exercise, Mindfulness meditation)
  5. A, B, D, F (Difficulty sustaining attention, Frequently loses things, Forgetful in daily activities, Doesn't follow through on instructions)

CATEGORIZATION:

  1. Positive Symptoms: Auditory hallucinations, Delusions of persecution, Disorganized speech, Bizarre behavior Negative Symptoms: Flat affect, Avolition, Anhedonia, Alogia
  2. ADHD treatment: Methylphenidate Antipsychotic: Risperidone Anxiolytic: Lorazepam Mood stabilizer: Lithium carbonate Antidepressant: Sertraline
  3. Mild anxiety: Increased alertness, better problem-solving Moderate anxiety: Tunnel vision, decreased concentration Severe anxiety: Scattered thoughts, prominent physical symptoms Panic level: Complete inability to function, may be violent

SCORING GUIDE:

  • 90-100%: Excellent preparation, ready for exam
  • 80-89%: Good preparation, review missed topics
  • 70-79%: Adequate preparation, focus study on weak areas
  • Below 70%: Needs significant additional study

Study Tips:

  • Review any missed questions thoroughly
  • Focus on understanding the "why" behind each answer
  • Practice more reverse clinical reasoning scenarios
  • Review your study guide for areas of weakness
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