1 :

Hint : 🧠Mood symptoms with psychosis.

Correct Answers:

  • Symptoms of major depression or mania


Rationale :

🔷 Schizoaffective disorder is characterized by schizophrenic symptoms (hallucinations, delusions) combined with mood disorder symptoms such as major depression or mania.

🔷 The active phase includes psychotic features that occur concurrently with mood episodes or persist for at least 2 weeks without mood symptoms.

🔷 Differentiation from schizophrenia is based on the prominent mood component in schizoaffective disorder.

🔷 Nurses should assess for suicidal ideation during depressive episodes and impulsivity during manic episodes.

🔷 Treatment involves antipsychotics, mood stabilizers, and psychotherapy.


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2 :

Hint : 🕒ECT requires multiple sessions.

Correct Answers:

  • "Your provider will likely schedule you for several treatments over a period of weeks.”


Rationale :

💎 Electroconvulsive therapy (ECT) is administered in multiple sessions, typically 6 to 12 treatments over 2 to 3 weeks, for therapeutic effectiveness in depression.

💎 Treatments are spaced to minimize side effects, particularly short-term memory loss and confusion.

💎 Clients are under general anesthesia and receive muscle relaxants to prevent injury during the procedure.

💎 Nurses should emphasize that ECT is safe and effective for treatment-resistant depression when performed by trained professionals.

💎 Pre-procedure teaching also includes fasting, removal of dentures or jewelry, and post-procedure observation.


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3 :

Hint : 🤝 Fearful of independent decisions.

Correct Answers:

  • Clients are fearful of making decisions.


Rationale :

⏺️ Dependent personality disorder is marked by an excessive need to be cared for, submissive behaviors, and fear of separation.

⏺️Clients have extreme difficulty making independent decisions and often rely on others for reassurance.

⏺️ They may tolerate mistreatment or inconvenience to avoid losing support from caregivers.

⏺️ Nurses should encourage assertiveness training and gradual decision-making to promote independence.

⏺️ Long-term therapy focuses on building self-confidence and autonomy.


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4 :

Week 1:

Abdominal pain.
Anorexia.

Child has had seven hospitalizations in the past 6 months.

Week 1.

Parent brings school-age child to clinic. States, "My child is always sick. Their stomach hurts all the time. Something is wrong with them. This has been going on for the past 3 months. We've been to several doctors, and they can't find anything wrong." Parent reports that child experiences frequent abdominal pain and has a fever. Child appears emaciated and withdrawn with eyes downcast and looking at floor. Skin is pale with decreased turgor.

Week 3.

Parent brings child back to clinic. Child is vomiting and holding abdomen. Child states, "My stomach hurts so bad." Child looking away from parent. Parent states, "l have taken my child out of school and am home schooling them now. They are too ill to go to school and require my care." Parent is defensive when asked questions related to child's manifestations. Parent is demanding that child be admitted to acute care facility to "have tests run."


The nurse should identify which of the client findings are manifestations of a factitious disorder? (Select all that apply.)


Answer Options

Hint : ⚠️ Repeated unexplained illness = factitious.

Correct Answers:

  • Multiple hospitalizations
  • Unexplained abdominal pain
  • Excessive thinking about health


Rationale :

Multiple hospitalizations

💎 Frequent and unnecessary hospitalizations with no clear medical diagnosis are a hallmark of factitious disorder, as symptoms are often fabricated or exaggerated.

💎 This pattern reflects the caregiver’s or patient’s desire to assume the sick role and gain medical attention.

💎 Nurses should document this behavior meticulously to assist in proper diagnosis and intervention.

Unexplained abdominal pain

💎 Persistent complaints of abdominal pain without diagnostic confirmation suggest intentionally produced or exaggerated symptoms.

💎 In children, this often occurs due to a caregiver inducing or fabricating illness (factitious disorder imposed on another/Munchausen by proxy).

💎 The focus is on obtaining medical procedures rather than relieving real symptoms.

Excessive thinking about health

💎 Caregivers with factitious disorder demonstrate excessive preoccupation with health, insisting on invasive tests despite normal findings.

💎 In this case, the parent’s defensiveness and insistence on hospitalization strongly indicate factitious behavior.


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5 :

Hint : ⚡Hyperactivity + poor focus = mania.

Correct Answers:

  • Mania


Rationale :

💎 Mania is characterized by hyperactivity, increased psychomotor agitation, and poor concentration, which are evident in the client’s pacing and inability to focus during group therapy.

💎 Clients in a manic state often display excessive energy, restlessness, and difficulty remaining seated or engaged in structured activities.

💎 Other common features include rapid speech, flight of ideas, impulsive behaviors, and decreased need for sleep.

💎 Recognizing mania is crucial for implementing safety measures and mood-stabilizing interventions.

💎 Early management helps prevent exhaustion, aggression, or risky behaviors associated with manic episodes.


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6 :

Hint : ⚠️Mood swings = suicide warning.

Correct Answers:

  • Displaying extreme mood swings.


Rationale :

💎 Extreme mood swings are a significant warning sign of potential suicide, particularly in adolescents.

💎 Sudden shifts from deep sadness to an unusually elevated mood can indicate a final decision to commit suicide or severe emotional instability.

💎 Nurses should teach students to watch for other warning signs, such as withdrawal, giving away possessions, and verbalizing hopelessness.

💎 Early identification allows for timely referral to mental health professionals.

💎 Suicide prevention education promotes awareness, early intervention, and peer support.


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7 :

Hint : 🧠More support needed over time.

Correct Answers:

  • The need for resources increases as the disease progresses into adulthood.


Rationale :

🔷 Schizophrenia often begins in late adolescence or early adulthood and requires long-term medical, psychological, and social support.

🔷 As the disorder progresses, clients need continuous medication management, psychosocial rehabilitation, and vocational assistance.

🔷 Family and community resources become critical to maintaining functional independence and preventing relapse.

🔷 Co-occurring mental health illnesses, such as depression or substance use, are common and increase care complexity.

🔷 Early education helps clients and families understand the chronic nature of schizophrenia and the importance of ongoing support.


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8 :

Hint : 🔪Remove all potential weapons.

Correct Answers:

  • "All sharp objects should be removed from the client's room."


Rationale :

🟣Removing sharp or potentially harmful objects is a primary safety intervention in suicide prevention.

🟣Clients on suicide precautions should be placed in safe, closely monitored environments.

🟣 Nurses should also implement 1:1 observation, frequent safety checks, and secure storage of personal items.

🟣 Teaching family members about suicide prevention is important, but immediate environmental safety is the nurse’s responsibility.

🟣 Prioritizing safety prevents self-harm and potential fatal attempts.


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9 :

Hint : 🩸Schizophrenia linked with diabetes.

Correct Answers:

  • Diabetes mellitus


Rationale :

🔷 Schizophrenia is commonly associated with metabolic comorbidities, particularly diabetes mellitus, due to antipsychotic medication side effects (weight gain, insulin resistance).

🔷 Lifestyle factors, including poor diet and low physical activity, also contribute to this risk.

🔷 Regular monitoring of blood glucose, lipid profile, and weight is essential in managing comorbid conditions.

🔷 Addressing physical health improves overall quality of life and psychiatric outcomes.

🔷 Nurses should educate clients on healthy lifestyle changes to minimize metabolic complications.


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10 :

Hint : ❤️Always assess new symptoms.

Correct Answers:

  • Assess the client's vital signs.


Rationale :

💎 Clients with somatic symptom disorder may develop real physical conditions; therefore, all new or acute symptoms must be assessed thoroughly.

💎 Chest pain warrants immediate evaluation to rule out cardiac or other medical emergencies.

💎 Vital signs assessment ensures that life-threatening conditions are not overlooked due to psychiatric history.

💎 Once acute medical issues are ruled out, supportive interventions such as relaxation techniques can be reinforced.

💎 Nurses must maintain a nonjudgmental approach to build trust and ensure ongoing care.


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Total Questions: 10

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