l OM oAR cP SD | 19 50 0 98 6
MENTAL HEALTH NCLEX LATEST
EXAM 2022-2024 / MENTAL
HEALTH LATEST EXAM 2022-
2024 QUESTIONS AND 100%
CORRECT ANSWERS AND
RATIONALES/GRADED A
- / 4
l OM oAR cP SD | 19 50 0 98 6
- Question
Flumazenil (Romazicon) has been ordered for a male client who has overdosed on oxazepam (Serax). Before administering the medication, nurse Gina should be prepared for which common adverse effect?
- Seizures
- Shivering
- Anxiety
- Chest pain
Correct Answer: A. Seizures
Seizures are the most common serious adverse effect of using flumazenil to reverse benzodiazepine overdose. The effect is magnified if the client has a combined tricyclic antidepressant and benzodiazepine overdose. Benzodiazepine reversal has correlations with seizures. Seizures may happen more frequently in patients who have been on benzodiazepines for long-term sedation or in patients who are showing signs of severe tricyclic antidepressant overdose. The required dosage of Flumazenil should be measured and prepared by the practitioners to manage seizures. Flumazenil use requires caution in patients relying on a benzodiazepine for seizure control.
o Option B: Shivering is not an adverse effect of flumazenil.
Monitor the patient for the possible return of sedation, mostly in those who are tolerant of benzodiazepines. Patients should have monitoring for respiratory depression, benzodiazepine withdrawal, and other residual effects of benzodiazepines for at least 2 hours.
o Option C: Anxiety is a rare adverse effect for people using
flumazenil. Flumazenil has some associations with precipitation of seizures in patients with benzodiazepine dependence with a history of seizures. Flumazenil overdose is extremely rare. There is no precise antidote for flumazenil toxicity. In mild to severe toxicity, symptomatic and supportive treatment should be a consideration.
o Option D: An overdose of flumazenil in a patient who is not
a chronic benzodiazepine user would not be expected. Chronic 2 / 4
l OM oAR cP SD | 19 50 0 98 6
• 2. Question Nurse Tamara is caring for a client diagnosed with bulimia. The most
appropriate initial goal for a client diagnosed with bulimia is to:
- Avoid shopping for large amounts of food.
- Control eating impulses.
- Identify anxiety-causing situations.
- Eat only three meals per day.
Correct Answer: C. Identify anxiety-causing situations
Bulimic behavior is generally a maladaptive coping response to stress and underlying issues. The client must identify anxiety-causing situations that stimulate the bulimic behavior and then learn new ways of coping with the anxiety. Bulimia nervosa is a condition that occurs most commonly in adolescent females, characterized by indulgence in binge-eating, and inappropriate compensatory behaviors to prevent weight gain.
o Option A: Controlling shopping for large amounts of food
isn’t a goal early in treatment. It is important to educate patients who abuse laxatives that these medications work in the gastrointestinal tract after the areas where caloric absorption has occurred primarily. It is crucial to inform patients that a period of edema and weight gain may follow up to several weeks after discontinuation of purging behavior.
o Option B: Managing eating impulses and replacing them
with adaptive coping mechanisms can be integrated into the plan of care after initially addressing stress and underlying issues. The primary objective of treatment is a cessation of the binging and purging behavior. Selective serotonin reuptake inhibitors such as fluoxetine, citalopram, and sertraline have shown to reduce symptoms of bulimia nervosa. Fluoxetine is the only FDA approved medication for bulimia nervosa. It appears that a higher benzodiazepines users may experience withdrawal with abrupt discontinuation of the drug. Administration of benzodiazepines or barbiturates may be necessary for seizure control. 3 / 4
l OM oAR cP SD | 19 50 0 98 6
Correct Answer: A. Check the client frequently at irregular
intervals throughout the night Checking the client frequently but at irregular intervals prevents the client from predicting when observation will take place and altering behavior in a misleading way at these times. Once the patient is deemed to be at risk for suicide, then intervention steps must be initiated right away. The individual must not be left alone. Enlist the help of a support person while at home. The suicidal individual must be treated in a safe and secure place. In addition, the place has to be monitored.
o Option B: This may encourage the client to try to
manipulate the nurse or seek attention for having a secret suicide plan. Assessing the individual’s judgment is critical. One should
• 3. Question A female client who’s at high risk for suicide needs close supervision.
To best ensure the client’s safety, Nurse Mary should:
- Check the client frequently at irregular
intervals throughout the night.
- Assure the client that the nurse will hold in
confidence anything the client says.
- Repeatedly discuss previous suicide attempts with
the client.
- Disregard decreased communication by the client
because this is common with suicidal clients.
dose (60 mg) is significantly better than a placebo in decreasing the frequency of binge and vomiting episodes.
o Option D: Eating three meals per day isn’t a realistic goal
early in treatment. Patients with bulimia nervosa who purge by vomiting often brush their teeth immediately after purging, which can accelerate dental erosion. The clinician should instruct the patients who persist in vomiting to rinse their mouths with water or fluoride rather than brushing their teeth within 30 minutes of each episode. Consider consulting a dentist to address dental issues associated with vomiting.
- / 4