Top Tips for Mastering the OIIQ-RN March 2025 Exam Psychiatry Section

Top Tips for Mastering the OIIQ-RN March 2025 Exam Psychiatry Section

Introducing the OIIQ March 2025 Exam Cheat Sheet!

I am excited to share with you my specially created Cheat Sheet designed to help you prepare for the upcoming March 2025 OIIQ exam. This resource is tailored based on the exam themes, focusing on the most common topics and questions you may encounter.

Important Notes about the Cheat Sheet:

• Practice Tool Only: Please remember that this cheat sheet is not a collection of official exam questions. Instead, it serves as a practice guide to help you familiarize yourself with potential answers and topics relevant to the exam theme.

• Format: The content is not structured as multiple-choice questions and is not designed to assess your critical thinking skills.

• Purpose: The primary goal of the cheat sheet is to enhance your understanding of the material and prepare you for the types of questions you may face in the exam.

  
  

Use this cheat sheet as a valuable study aid to boost your confidence and readiness for the OIIQ exam!

NOTE: "The Cheat Sheet (Top Tips for Mastering the OIIQ-RN March 2025 Exam Medical Section) will be continuously updated, so feel free to visit anytime!"

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Top Tips for Mastering the OIIQ-RN March 2025 Exam Psychiatry Section

Top Tips for Mastering the OIIQ-RN March 2025 Exam Psychiatry Section

When are restraints appropriate in patient care?	When a patient is at risk of harming themselves or others and less restrictive interventions have failed.
Can restraints be used for staff convenience or patient punishment?	No, this is considered an ethical and legal violation.
Which medical condition may require soft wrist restraints?	Example: A patient on mechanical ventilation who is pulling at their endotracheal tube.
What must be attempted before using restraints?	Non-restrictive interventions (e.g., verbal de-escalation, distractions, sitter, or environmental modifications).
Who must order restraints before they are applied?	A licensed healthcare provider (HCP), such as a physician or nurse practitioner.
Can a nurse apply restraints without a provider's order?	Yes, in an emergency, but the provider must be notified and issue an order within one hour.
Yes, in an emergency, but the provider must be notified and issue an order within one hour.	False imprisonment.
How often should a nurse assess a patient in restraints?	Every 15 minutes for safety and circulation checks.
How often must restraints be removed for skin and range of motion (ROM) assessment?	Every 2 hours.
What should be assessed when monitoring a patient in restraints?	Skin integrity, circulation, vital signs, hydration, and toileting needs.
What documentation is required for restrained patients?	Reason for restraint, provider’s order, patient response, and ongoing assessments.
What alternatives can be tried before applying restraints?	Verbal de-escalation, reorientation, sitter, bed alarms, distraction techniques, and modifying the environment.
What is a less restrictive alternative to wrist restraints for a confused patient pulling at an IV?	Placing a long-sleeve shirt or mittens on the patient’s hands.
What is an effective alternative for a patient at high fall risk?	Bed alarms, close observation, or placing the patient near the nurses' station.
How should wrist restraints be applied?	With two fingers of space between the restraint and the patient’s skin.
How should a nurse secure restraints to a hospital bed?	Tie them to a non-movable part of the bed frame using a quick-release knot.
What position should a restrained patient be placed in?	Semi-Fowler’s or lateral to prevent aspiration.
What is the priority action if a patient in restraints shows signs of circulatory impairment (e.g., pale, cool fingers)?	Loosen the restraints immediately and reassess circulation.
Why are restraints particularly dangerous in elderly patients?	Increased risk of skin breakdown, delirium, falls, and decreased mobility.
What is an alternative to restraints for a pediatric patient pulling at medical devices?	Using mittens or arm splints instead of wrist restraints.
How should restraints be used in dementia patients with agitation?	As a last resort; try distraction, music therapy, or reorientation first.
What is a common medication used as a chemical restraint?	Lorazepam (Ativan) or haloperidol (Haldol).
When is it appropriate to use a chemical restraint?	When a patient is severely agitated or poses an immediate danger to themselves or others.
What should the nurse monitor after administering a chemical restraint?	Respiratory rate, level of consciousness, and fall risk.
What is an example of a medical restraint?	Soft wrist restraints for a ventilated ICU patient.
What is an example of a behavioral restraint?	Four-point restraints for a violent psychiatric patient.
What additional requirement exists for behavioral restraints?	A face-to-face provider evaluation within one hour of application.
What are the two main types of bipolar disorder?	Bipolar I: Characterized by manic episodes (with or without major depression). Bipolar II: Characterized by hypomania and major depressive episodes (no full mania).
What is the difference between mania and hypomania?	Mania lasts at least 7 days, is more severe, and may require hospitalization; hypomania lasts at least 4 days and does not cause major functional impairment.
What is cyclothymic disorder?	A milder form of bipolar disorder with recurrent mood swings that do not meet full criteria for mania or depression.
Manic Episode Symptoms (Mnemonic: DIG FAST)	D - Distractibility I - Indiscretion (risky behaviors, impulsivity) G - Grandiosity (inflated self-esteem) F - Flight of ideas (racing thoughts) A - Activity increase (hyperactivity) S - Sleep deficit (decreased need for sleep) T - Talkativeness (pressured speech)
Which symptom is most characteristic of mania?	Euphoric mood, excessive energy, and decreased need for sleep.
What is an example of risky behavior in a manic episode?	Excessive spending, hypersexuality, or reckless driving.
What type of speech pattern is seen in mania?	Pressured speech and flight of ideas.
What are common symptoms of a bipolar depressive episode?	Low energy, feelings of worthlessness, anhedonia (loss of interest in activities), suicidal thoughts.
Why is bipolar depression different from major depressive disorder (MDD)?	Bipolar depression follows manic or hypomanic episodes and is more likely to involve hypersomnia and psychomotor retardation.
What is the priority nursing intervention for a patient experiencing mania?	Ensure safety by reducing stimuli, setting clear limits, and redirecting behavior.
What environmental modification is best for a manic patient?	Provide a calm, structured environment with minimal stimuli.
What is an effective way to address a manic patient's excessive talking?	Use simple, firm redirection and set time limits on interactions.
What type of meals should be given to a patient in a manic episode?	High-calorie, portable finger foods due to hyperactivity.
What is the first-line medication for bipolar disorder?	Lithium or valproate.
What is a dangerous lithium level?	>1.5 mEq/L (toxicity risk).
What are early signs of lithium toxicity?	Nausea, vomiting, diarrhea, hand tremors.
What dietary advice should be given to a patient taking lithium?	Maintain consistent salt and fluid intake.
What anticonvulsants are used as mood stabilizers in bipolar disorder?	Valproate (Depakote), carbamazepine (Tegretol), lamotrigine (Lamictal).
What is the major side effect of valproate?	Liver toxicity and thrombocytopenia.
What life-threatening reaction is associated with lamotrigine?	Stevens-Johnson syndrome (rash that requires immediate medical attention).
What atypical antipsychotics are commonly used for acute mania?	Olanzapine, quetiapine, risperidone.
Why are antipsychotics preferred over lithium in acute mania?	They act faster and do not require blood level monitoring.
Why should antidepressants be used cautiously in bipolar disorder?	They can trigger manic episodes.
When are antidepressants appropriate in bipolar disorder?	Only when combined with a mood stabilizer to prevent mania.
Which bipolar phase carries the highest suicide risk?	Depressive phase.
What is the priority nursing intervention for a suicidal bipolar patient?	Implement suicide precautions and ensure close monitoring.
What is a warning sign of impending suicide in a bipolar patient?	Giving away possessions and expressing feelings of hopelessness.
What should families watch for as an early sign of a manic episode?	Decreased sleep, increased energy, and impulsivity.
What should be included in bipolar disorder relapse prevention?	Medication adherence, recognizing triggers, and maintaining a stable routine.
Why should bipolar patients avoid alcohol and recreational drugs?	They can trigger mood episodes and interfere with medications.
What is Generalized Anxiety Disorder (GAD)?	A chronic condition characterized by excessive, persistent, and uncontrollable worry about multiple aspects of life.
How long must symptoms persist for a GAD diagnosis?	At least 6 months.
What differentiates GAD from normal worry?	GAD is excessive, difficult to control, and interferes with daily functioning.
Which psychological symptoms are common in GAD?	Excessive worry, restlessness, irritability, difficulty concentrating, and a constant feeling of apprehension.
What cognitive symptoms often accompany GAD?	Catastrophic thinking and difficulty controlling anxious thoughts.
Physical Symptoms GAD (Mnemonic: WATCHERS)	W - Worry (excessive, persistent) A - Anxiety (chronic) T - Tension in muscles C - Concentration difficulties H - Hyperarousal (easily startled, restless) E - Energy loss (fatigue) R - Restlessness S - Sleep disturbances
What are common physical symptoms of GAD?	Muscle tension, headaches, fatigue, nausea, palpitations, sweating, and insomnia.
What symptom distinguishes GAD from panic disorder?	GAD involves chronic worry, while panic disorder has acute panic attacks.
What is the first nursing intervention for a patient experiencing severe anxiety?	Encourage deep breathing, provide reassurance, and use a calm approach.
What environment is best for a patient with severe anxiety?	A quiet, low-stimulation environment.
What is an effective way to communicate with an anxious patient?	Use short, simple sentences and a calm voice.
How can nurses help patients identify triggers for their anxiety?	Encourage journaling and reflection.
What is the first-line medication for GAD?	Selective serotonin reuptake inhibitors (SSRIs) such as sertraline, escitalopram.
How long does it take for SSRIs to become effective for GAD?	4-6 weeks.
What are common side effects of SSRIs?	Nausea, insomnia, sexual dysfunction, and weight changes.
Why are benzodiazepines not recommended for long-term GAD treatment?	They are addictive and cause tolerance.
Which benzodiazepines are used for acute anxiety relief?	Lorazepam, diazepam, alprazolam.
What is the risk of abruptly stopping benzodiazepines?	Withdrawal symptoms, including seizures.
Why is buspirone a good alternative to benzodiazepines?	It is non-addictive and has no sedative effects.
How long does buspirone take to work?	2-4 weeks.
What is the most effective psychotherapy for GAD?	Cognitive-behavioral therapy (CBT).
What are the key principles of CBT for GAD?	Cognitive restructuring, exposure therapy, and relaxation techniques.
What relaxation techniques help manage GAD?	Deep breathing, progressive muscle relaxation, and guided imagery.
How does mindfulness help with anxiety?	It promotes awareness of the present moment and reduces catastrophic thinking.
How do panic attacks differ from GAD?	Panic attacks are sudden, intense episodes of fear, whereas GAD is a chronic worry condition.
What is the priority nursing action during a panic attack?	Stay with the patient, provide reassurance, and guide slow breathing.
What dietary changes help reduce anxiety?	Reduce caffeine, alcohol, and processed foods.
What lifestyle modification can help a patient with GAD sleep better?	Establish a consistent bedtime routine and limit screen time before bed.
How does regular exercise help with anxiety?	It releases endorphins and reduces muscle tension.
When should a GAD patient be evaluated for suicide risk?	If they express hopelessness or significant distress.
What is the priority intervention for a patient with severe anxiety who cannot focus or follow instructions?	Guide them in slow breathing and remove environmental stressors.
What is Obsessive-Compulsive Disorder (OCD)?	A mental health disorder characterized by persistent, intrusive thoughts (obsessions) and repetitive behaviors (compulsions) performed to reduce anxiety.
What is the key feature of compulsions in OCD?	They are performed to reduce anxiety but do not bring pleasure.
Which statement describes an obsession in OCD?	“I keep thinking that I will get sick if I don’t wash my hands repeatedly.”
What are common themes of OCD obsessions?	Contamination, symmetry, aggressive thoughts, religious fears.
What is a common compulsion seen in OCD?	Excessive handwashing, checking locks multiple times, or counting objects repeatedly.
Why do people with OCD perform compulsions?	To temporarily relieve anxiety caused by obsessions.
What is the priority nursing intervention for a patient with OCD?	Allow time for rituals initially, then gradually introduce limits.
Should a nurse prevent a patient from performing compulsions?	No, abruptly stopping compulsions can cause extreme anxiety.
What type of environment is best for an OCD patient?	A structured and predictable environment.
How should a nurse communicate with an OCD patient about their compulsions?	Use a nonjudgmental, empathetic approach.
What is the first-line medication for OCD?	SSRIs such as fluoxetine, sertraline, or fluvoxamine.
How long does it take for SSRIs to work for OCD?	4-6 weeks.
What are common side effects of SSRIs?	Nausea, headache, insomnia, sexual dysfunction.
What is an alternative medication for OCD if SSRIs are ineffective?	Clomipramine (a tricyclic antidepressant).
What side effects are common with clomipramine?	Dry mouth, dizziness, sedation, constipation.
What is the most effective therapy for OCD?	Cognitive-Behavioral Therapy (CBT) with Exposure and Response Prevention (ERP).
What is Exposure and Response Prevention (ERP) therapy?	Gradual exposure to obsessive fears while preventing compulsive responses.
Why is reassurance-seeking discouraged in OCD therapy?	It reinforces obsessive thinking.
When should a patient with OCD be evaluated for suicide risk?	If they experience severe distress or depression due to their condition.
What is the priority intervention for a patient with OCD experiencing severe anxiety?	Use grounding techniques and deep breathing exercises.
What lifestyle changes help reduce OCD symptoms?	Regular exercise, stress management, and avoiding caffeine.
How does mindfulness help with OCD?	It encourages focusing on the present moment and reduces compulsive behaviors.
How does OCD present differently in children?	They may not recognize their compulsions as excessive.
What should be prioritized when treating a child with OCD?	Involving parents in therapy while encouraging gradual exposure to fears.
What is schizophrenia?	A chronic psychiatric disorder characterized by distorted thinking, hallucinations, delusions, and impaired functioning.
Which neurotransmitter is primarily involved in schizophrenia?	Dopamine (excess dopamine in the brain contributes to symptoms).
What are positive symptoms of schizophrenia? Positive Symptoms (Excess Dopamine - "Added Behaviors")	Hallucinations, delusions, disorganized speech, and bizarre behaviors.
What is the most common type of hallucination in schizophrenia?	Auditory hallucinations (hearing voices).
What are common types of delusions?	Persecutory delusions: "People are out to harm me." Grandiose delusions: "I am a famous historical figure." Erotomanic delusions: "A celebrity is in love with me."
What are negative symptoms of schizophrenia? Negative Symptoms (Reduced Dopamine - "Deficits in Functioning")	Alogia (poverty of speech), anhedonia (lack of pleasure), apathy, flat affect, and social withdrawal.
Why are negative symptoms difficult to treat?	They are less responsive to antipsychotic medications.
What is word salad?	A meaningless jumble of words ("Sky, blue, running, apple").
What is clang association?	Speaking in rhyming words that do not make sense ("Cat, bat, sat, hat").
What is echolalia?	Repeating words spoken by others.
What is the priority intervention for a schizophrenic patient experiencing hallucinations?	Assess for safety risk and ask what the voices are saying.
How should a nurse respond to a patient with delusions?	Do not argue or reinforce the delusion. Redirect to reality-based activities.
What type of environment is best for a schizophrenic patient?	Structured, low-stimulation, and predictable.
What is the primary action of first-generation antipsychotics?	Block dopamine receptors to reduce positive symptoms.
What are common first-generation antipsychotics?	Haloperidol (Haldol), chlorpromazine (Thorazine).
What serious side effect is associated with first-generation antipsychotics?	Extrapyramidal symptoms (EPS).
Why are second-generation antipsychotics preferred over first-generation?	They treat both positive and negative symptoms with fewer EPS.
What are common second-generation antipsychotics?	Risperidone, quetiapine, olanzapine, clozapine.
What life-threatening side effect is associated with clozapine?	Agranulocytosis (severe neutropenia).
What are symptoms of extrapyramidal side effects (EPS)?	Dystonia, akathisia, Parkinsonism, tardive dyskinesia.
What medication is used to treat EPS?	Benztropine (Cogentin) or diphenhydramine (Benadryl).
What is tardive dyskinesia?	Involuntary lip-smacking, tongue movements, or facial grimacing.
How should a nurse respond to a patient experiencing auditory hallucinations?	"I don’t hear the voices, but I understand they are real to you."
What type of speech is best when communicating with schizophrenic patients?	Simple, clear, and direct.
When is hospitalization required for schizophrenia?	If the patient is a danger to themselves or others.
What should a nurse do if a patient reports command hallucinations?	Assess if they are being told to harm themselves or others and ensure safety.
What is the priority action for a violent schizophrenic patient?	Calmly set limits and ensure a safe environment.
What should families watch for as an early sign of schizophrenia relapse?	Social withdrawal, paranoia, and poor medication adherence.
What is the most common reason for schizophrenia relapse?	Non-adherence to medication.
What strategies help prevent schizophrenia relapse?	Regular medication use, stress reduction, and supportive therapy.
Which schizophrenic patient should the nurse assess first?	A patient with command hallucinations telling them to harm someone.
Which patient is at highest risk for suicide?	An elderly male with depression and a history of suicide attempts.
What are the major risk factors for suicide?	Mental illness (e.g., depression, bipolar disorder, schizophrenia) Previous suicide attempt (strongest predictor) Substance abuse (alcohol, drugs) Chronic illness or pain Lack of social support, recent loss, or trauma
Which demographic group has the highest suicide rate?	Older adult males, particularly White males over 65.
Warning Signs of Suicide (Mnemonic: IS PATH WARM?)	Mnemonic: IS PATH WARM? I - Ideation (talking about wanting to die) S - Substance abuse P - Purposelessness (feeling no reason to live) A - Anxiety (agitation, sleep issues) T - Trapped (feeling there’s no way out) H - Hopelessness W - Withdrawal (from friends, family, activities) A - Anger (uncontrolled rage) R - Recklessness (risky behaviors) M - Mood changes (depression, sudden improvement before suicide)
What is the most concerning statement from a patient regarding suicide?	"I don’t want to be a burden anymore."
Which behavioral change may indicate a patient is planning suicide?	Sudden calmness after a period of deep depression.
What is the most important question to ask a patient suspected of suicidal thoughts?	"Do you have a plan to harm yourself?"
What factors increase the lethality of a suicide attempt?	Access to lethal means (e.g., firearms), detailed plan, past suicide attempts.
What is the priority intervention for a patient expressing suicidal thoughts?	Ensure safety by placing the patient on suicide precautions.
What is the safest environment for a suicidal inpatient?	A room with minimal furniture, no sharps, and 1:1 observation.
How can nurses help prevent suicide in high-risk patients?	Create a suicide safety plan, increase supervision, involve family support.
What actions should be taken for a patient on suicide precautions?	Remove belts, shoelaces, and sharp objects; provide 1:1 observation.
Can a patient on suicide watch be left alone for bathroom use?	No, they must be observed at all times.
Which nursing intervention is inappropriate for a suicidal patient?	Assigning the patient to a private room.
What are risk factors for suicide in teenagers?	Bullying, LGBTQ+ identity without family support, substance abuse, history of trauma.
Which statement by a teen should raise concern for suicide?	"Everyone will be better off without me."
Why are elderly men at high risk for suicide?	Social isolation, chronic illness, loss of spouse, financial stress.
What factors increase suicide risk in veterans?	PTSD, traumatic brain injury (TBI), depression, difficulty adjusting to civilian life.
Why should patients taking antidepressants be closely monitored at the beginning of treatment?	Increased energy may lead to a higher risk of suicide.
Which medication is contraindicated for a suicidal patient?	Tricyclic antidepressants (TCAs) like amitriptyline due to overdose risk.
What is the priority intervention after a patient survives a suicide attempt?	Assess for ongoing suicidal ideation and ensure safety.
How should the nurse respond if a patient expresses guilt after surviving a suicide attempt?	Provide nonjudgmental support and encourage expression of feelings.
Can a suicidal patient refuse treatment?	Not if they are a danger to themselves; involuntary hospitalization may be required.
What legal document allows hospitalization of a suicidal patient against their will?	A psychiatric hold (e.g., 72-hour hold, involuntary commitment). AKA Preventive confinement
What is alcohol use disorder (AUD)?	A chronic disease characterized by an inability to control alcohol consumption despite negative consequences.
What factors increase the risk of alcohol use disorder?	Genetics, mental health disorders (e.g., depression, anxiety), social environment, early exposure to alcohol.
Which population is at highest risk for alcoholism?	Men, individuals with a family history of alcohol use disorder, and those with high-stress jobs.
What are physical signs of chronic alcoholism?	Liver damage (jaundice, ascites), gastritis, neuropathy, malnutrition (thiamine deficiency).
What are behavioral signs of alcohol dependence?	Increased tolerance, inability to cut down, withdrawal symptoms, neglect of responsibilities.
What lab findings are consistent with chronic alcohol use?	Elevated liver enzymes (AST, ALT, GGT), low thiamine (B1), macrocytic anemia.
What is the earliest sign of alcohol withdrawal?	Tremors (shaky hands) within 6-12 hours after last drink.
What are the stages of alcohol withdrawal?	Mild withdrawal: Anxiety, tremors, insomnia, nausea. Moderate withdrawal: Increased blood pressure, tachycardia, sweating. Severe withdrawal (Delirium Tremens - DTs): Confusion, hallucinations, seizures.
When do seizures typically occur in alcohol withdrawal?	12-48 hours after last drink.
What is the most life-threatening complication of alcohol withdrawal?	Delirium tremens (DTs), which includes severe confusion, agitation, hallucinations, and autonomic instability.
What medication is the first-line treatment for alcohol withdrawal?	Benzodiazepines (e.g., lorazepam, diazepam, chlordiazepoxide).
Why are benzodiazepines used in alcohol withdrawal?	To prevent seizures and reduce withdrawal symptoms.
Which IV fluid is given to prevent Wernicke’s encephalopathy in alcoholics?	Thiamine (Vitamin B1) before glucose.
What nursing interventions are important for patients in alcohol withdrawal?	Seizure precautions, frequent vital signs, hydration, and CIWA (Clinical Institute Withdrawal Assessment) scoring.
What is Wernicke’s encephalopathy?	A reversible neurological condition caused by thiamine (Vitamin B1) deficiency.
What are signs of Wernicke’s encephalopathy?	Confusion, ataxia (poor coordination), and ophthalmoplegia (eye movement problems).
How is Wernicke’s encephalopathy treated?	IV thiamine before glucose administration.
What is Korsakoff’s syndrome?	Permanent memory loss and confabulation (making up false memories) due to untreated Wernicke’s encephalopathy.
What medication is used to deter alcohol use by causing an aversive reaction?	Disulfiram (Antabuse).
What reaction occurs if a patient drinks alcohol while on disulfiram?	Severe nausea, vomiting, headache, palpitations, hypotension.
What medication reduces alcohol cravings?	Naltrexone (opioid antagonist).
Which medication helps reduce alcohol withdrawal symptoms but is not addictive	Acamprosate (Campral).
What is the most effective therapy for alcohol addiction?	Cognitive-behavioral therapy (CBT) and motivational interviewing.
What is the role of Alcoholics Anonymous (AA)?	Provides peer support and a structured 12-step program for recovery.
How should a nurse respond to a patient in denial about their alcohol use?	Use nonjudgmental, open-ended questions (e.g., “How has alcohol affected your daily life?”).
What is the best approach when a patient with alcoholism relapses?	Encourage them to seek support and develop relapse prevention strategies.
What is the safest amount of alcohol during pregnancy?	No amount of alcohol is safe during pregnancy.
What are characteristic signs of fetal alcohol syndrome (FAS)?	Facial abnormalities (small head, thin upper lip), developmental delays, and learning disabilities.
How does prenatal alcohol exposure affect the brain?	Causes permanent cognitive impairment and behavioral problems.
What are signs of acute alcohol poisoning?	Severe respiratory depression, unconsciousness, vomiting, hypoglycemia.
What is the priority nursing intervention for alcohol poisoning?	Airway protection and respiratory support.
Why should an unconscious alcoholic patient be placed in the side-lying position?	To prevent aspiration of vomit.