COLEGIO de KIDAPAWAN

Paramedical Department
COMPETENCY APPRAISAL 2
SY 2013-2014
Level 4
Midterm Exam
NAME: ____________________

DATE:__________________

GENERAL INSTRUCTIONS:
1. Please use ballpen for your final answers.
2. Make alterations by putting a mark (x) on the initial answer, then write the final answer beside it.
Write legibly.
3. The proctors decision regarding cheating is FINAL.
4. Use of cellular phones is strictly prohibited and should be turned off or put in silent mode.
5. No one is allowed to go out of the classroom once the exam has started.
6. Encircle the letter of the correct answer.
TEST I. MULTIPLE CHOICE: Encircle the letter of the correct answer.
1. Which of the following statement reflects the scope of mental health psychiatric nursing?
A. it includes nursing actions aimed at returning the patient to his highest potential of productivity.
B. it is an integral aspect of all nursing and a specialty service to all people affected by mental illness.
C. it includes nursing actions to reduce the rate of new cases of mental disorder in population
D. it consist of early recognition and treatment of mental disorders to reduce severity and duration of
mental illness
2. The beginning professional nurse can do mental health counselling with the following clients, EXCEPT:
A. actively psychotic patients
B. parents with child rearing concerns
C. out of school adolescents
D. school children with behavioral problem
3. A professional responsibility of the mental health psychiatric nurse is to provide a safe and therapeutic
environment. This is BEST reflected in:
A. restraining patients who violates policies and do not follow schedule of activities.
B. maintaining a closed door policy to prevent patients from absconding.
C. keeping a restrictive environment to prevent patients from becoming assaultive and hostile
D. ensuring physical safety and maintaining therapeutic attitude towards the patients
4. The foundation of the therapeutic process is the therapeutic relationship. What is the essential
component that the nurse must bring to the relationship?
A. humor
B. reframing
C. empathy
D. confrontation
5. Which of these people, the highest in population groups that would need priority mental health therapy?
A. adults going through active skills
B. young professionals entering the workplace
C. single elderly with no social support
D. women preparing for overseas employment
Situation 2: Some activity therapies are organized and conducted in groups where nurses may participate
in.
6. A mental health nurse may not be a member of this self help group because help given to members
comes from
members themselves:
A. Remotivation Group
B. Activity Therapy Group
C. Alcoholics Anonymous
D. Art Therapy Group
7. Which of the following determines the success of client government groups?
A. willingness of psychiatric professionals to be open and receptive to clients ideas and suggestions
B. a way of permitting clients provide themselves with a more creative and wholesome life
C. means to acquire a variety of social skills
D. opportunity to learn democratic living
8. Which of this client situation appropriately illustrate horticulture therapy?
A. the therapist brings bongos, tambourine, and bells and encourages client participation
B. Tommy, Karen, Jon and Pia play scrabble every night after supper
C. every afternoon, Vic goes in the garden where he work with plants, seedlings, tree planting and
watering them

D. Paul finds sketching relaxing and rewarding

9. Eva is a member of a group who controls endless talking. Her role is that of a/an:
A. blocker
B. recognition seeker
C. self-confessor
D. monopolizer
10. Community meetings are held as a part of milieu therapy on an in-patient psychiatric unit. The
purpose of these meetings would be:
A. to focus on issue arising from group living
B. to encourage expression on topics of interest
C. to provide direction from the treatment plan
D. to encourage expression of intrapsychic conflicts
Situation 3: The patient who is depressed will undergo electroconvulsive therapy.
11. Studies on biological depression support electroconvulsive therapy as a mode of treatment. The
rationale is:
A. ECT produces massive brain damage which destroys the specific area containing memories related to
the events surrounding the development of psychotic condition
B. The treatment serves as a symbolic punishment for the client who feels guilty and worthless
C. ECT relieves depression psychologically by increasing the norepinephrine level
D. ECT is seen as a life-threatening experience and depressed patients mobilize all their bodily defenses
to deal with this attack.
12. The preparation of a patient for ECT ideally is MOST similar to preparation for a patient for:
A. electroencephalogram
B. general anesthesia
C. X-ray
D. electrocardiogram
13. Which of the following is a possible side effect which you will discuss with the patient?
A. hemorrhage within the brain
B. encephalitis
C. robot-like body stiffness
D. confusion, disorientation and short term memory loss
14. Informed consent is necessary for the treatment for involuntary clients. When this cannot be obtained,
permission may be taken from the:
A. social worker
B. next of kin or guardian
C. doctor
D. chief nurse
15. After ECT, the nurse should do this action before giving the client fluids, food or medication:
A. assess the gag reflex
B. next of kin or guardian
C. assess the sensorium
D. check O2 Sat with a pulse oximeter
Situation 4: The community health nurse encounters special children in the community.
16. An individual with antisocial personality disorder lacks remorse, shame and guilt in going against the
norms of society. Psychodynamically, this defect in the personality reflects a disturbance of the:
A. ego
B. ego ideal
C. super ego
D. id
17. The nurse teaches parents about childrens beginning concepts of right and wrong by emphasizing
child rearing attitude and practices during the:
A. school age
B. infancy period
C. toddler age
D. latency period
18. It is BEST for parents to teach healthy interpersonal relationships to their children by:
A. modelling to their children
B. encouraging their children to attend secondary school
C. encouraging their children at home to behave properly
D. teaching their children good manners and right conduct
19. An important principle for the nurse to follow in interacting with retarded children is:
A. seen that if the child appears contented, his needs are being met
B. provide an environment appropriate to their development task as scheduled
C. treat the child according to his chronological age
D. treat the child according to his developmental level

20. Mental retardation is:

A. a delay in normal growth and development caused by an inadequate environment
B. a lack of development of sensory abilities
C. a condition of sub average intellectual functioning that originates during the developmental period and
is associated with impairment in adaptive behaviour
D. a severe lag in neuromuscular development and motor abilities
Situation 5: The nurse recognizes the need to learn to cope with stress and change. She becomes
interested to practice natural ways to enhance well being.
21. Lifestyle modification begins with:
A. minimizing eating in fast food restaurants
B. having an exercise regimen to follow regularly
C. recognizing the impact of unhealthy habits
D. avoiding pollutants in the environment
22. All of these are the behavior intervention to stress management. EXCEPT:
A. guided imagery
B. meditation
C. pharmacotherapy
D. progressive muscle relaxation
23. Basic to progressive muscle relaxation is:
A. focusing on an image to relax
B. use of industrial equipment
C. relaxing muscles from tension
D. stopping disturbing thoughts
24. Dietary practices are very important to the health of the Filipino family. The nurse needs to assess this
lifestyle because:
A. the nurse wants to change the eating patterns of the Filipino family
B. the nurse knows that being overweight is a major health hazard
C. the nurse wants to stop all the mainstream weight-loss diets
D. the nurse has to find out what people are eating
25. A young overweight adult smokes 5-10 sticks of cigarettes/day, ambitious, looks at life as challenging
and perfect and never considers change in his lifestyle, initially needs:
A. commitment
B. skills to attempt change
C. information
D. motivation
Situation 6: Bernie and John in their late 40s have been married for 20 years and at the peak of their
careers.
Suddenly, Bernie discovered that her husband was falling in love with another woman. Shaken by this
situation, she started to have problems sleeping and could not function well at work and at the risk of
losing her job. John asked forgiveness and regret very much the hurt his wife was going through and
suffered guilt feelings:
26. Bernie and John are going through a:
A. situational crisis
B. anticipated crisis
C. developmental crisis
D. both developmental and situational crisis
27. All of these are characteristics of crisis EXCEPT:
A. a hazardous or threatening event occurs
B. it has a growth promoting potential
C. usual problem solving methods and coping mechanisms produce a solution
D. anxiety or depression continue to increase
28. The nurse employs this approach in crisis intervention:
A. problem-solving
B. role-playing
C. behavior modification
D. nurse-patient relationship
29. Assessment data of the nurse include all the following EXCEPT:
A. coping mechanisms
C. perception of the event
B. situational support
D. repressed problems
30. The duration of crisis usually lasts several days and usually:
A. 2 4 weeks C. 1 2 months
B. 1 2 weeks D. 4 6 weeks

Situation 7: Felisa has a ritualistic pattern of constantly washing her hands with soap and water followed
by rubbing alcohol.
31. This behavior is categorized as:
A. delusional
B. neurotic
C. normal
D. psychotic
32. A therapeutic intervention in this situation is:
A. avoid limits on her behaviour to release her anxiety
B. call attention to her ritualistic pattern
C. provide alternative behaviours to deal with increased anxiety
D. ignore her behaviour totally
33. The anxiety of Felisa is disabling and interferes with her job performance, interpersonal relationships
and other activities of daily living. To minimize such problems, she is likely to be given:
A. diazepam ( Valium )
B. imipramine Hcl ( Tofranil )
C. haloperidol ( Haldol )
D. chlorpromazine ( Thorazine )
34. Felisa understands the effects of her medicine when expresses:
A. I should watch out for signs of sore lips or sore throat
B. I might have constipation
C. I might feel changes in my body temperature
D. I should not drive or operate machines
35. The level of anxiety that Felisa is experiencing is:
A. Panic
C. Mild
B. Severe
D. Moderate
Situation 8: The client is walking to and fro along the hospital corridor and swinging her hands. She
thinks she is going crazy. She is having palpitations, rapid pulse and hyperventilation.
36. Your nursing intervention should be to:
A. encourage her to participate in an ongoing activity in the ward
B. stay with her in a calm environment
C. tell her to stop thinking that she is going crazy
D. isolate the client in a quiet room
37. Which of the following is a behavioral manifestation of anxiety?
A. hyperventilation
C. panic
B. tachycardia
D. rapid pulse
38. Which of the following statements about anxiety is NOT true?
A. anxiety is contagious
B. repressed unresolved conflicts create anxiety
C. anxiety at any level is destructive, hence a threat to a persons well being
D. reactions to a perceived threat maybe real or imaginary
39. There is increased tension and reduced ability to perceive and communicate, hence selective
attention in this level
of anxiety:
A. moderate
C. panic
B. severe
D. mild
40. This medication is indicated for anxious patients:
A. Tofranil (Imipramine HCL)
C. Valium (Diazepam)
B. Haldol (Haloperidol)
D. Thorazine (Chlorpromazine)
Situation 9: Andy, 30 years old, was admitted to the Psychiatric Ward because of religious preoccupation,
deterioration in self-care and disturbed thoughts. He believes that he has committed a lot of sins. He is
threatened by people reaching out to him. His fasting for several days was not sufficient for him to feel
forgiven.
41. Andy is demonstrating:
A. religious delusion

C. somatic delusion
B. delusion of grandeur
D. delusion of being controlled
42. A delusion is:
A. psychomotor disturbance
C. disturbance of thought
B. mood disturbance
D. disturbance of perception
43. The nursing goal for Andy is to:
A. have him see a priest for confession
B. encourage him to pray to atone for his sins
C. help him develop a positive self image
D. socialize him with a group to keep him in touch with reality
44. As Andy talks about his sins that he believes make people look down upon him. It is BEST to:
A. agree with him and sympathize how sinful he has really been
B. explore the nature of his sins
C. explain that he is depreciating himself too much
D. acknowledge how he feels and focus on reality oriented topics
45. The psychosocial task that Andy needs to work on is a sense of:
A. identity
C. Autonomy
B. trust
D. intimacy
Situation 10 Concerted work efforts among members of the surgical team is essential to the success of
the surgical procedure.
46. The sterile nurse or sterile personnel touch only sterile supplies and instruments. When there is a
need for sterile supply which is not in the sterile field, who hands out these items by opening its outer
cover?
a. Circulating nurse
b. Anesthesiologist
c. Surgeon
d. Nursing aide
47. The OR team performs distinct roles for one surgical procedure to be accomplished within a
prescribed time frame and deliver a standard patient outcome. White the surgeon performs the surgical
procedure, who monitors the status of the client like urine output, blood loss?
a. Scrub nurse
b. Surgeon
c. Anesthesiologist
d. Circulating nurse
48. Surgery schedules are communicated to the OR usually a day prior to the procedure by the nurse of
the floor or ward where the patient is confined. For orthopedic cases, what department is usually informed
to be present in the OR?
a. Rehabilitation department
b. Laboratory department
c. Maintenance department
d. Radiology department
49. Minimally invasive surgery is very much into technology. Aside from the usual surgical team who else
to be present when a client undergoes laparoscopic surgery?
a. Information technician
b. Biomedical technician
c. Electrician
d. Laboratory technicial
50. In massive blood loss, prompt replacement of compatible blood is crucial. What department needs to
be alerted to coordinate closely with the patients family for immediate blood component therapy?
a. Security Division
b. Chaplaincy
c. Social Service Section
d. Pathology department
Situation 11 You are assigned in the Orthopedic Ward where clients are complaining of pain in varying
degrees upon movement of body parts.
51. Troy is a one day post open reduction and internal fixation (ORIF) of the left hip and is in pain. Which
of the following observation would prompt you to call the doctor?
a. Dressing is intact but partially soiled
b. Left foot is cold to touch and pedal pulse is absent
c. Left leg in limited functional anatomic position
d. BP 114/78, pulse of 82 beats/minute

52. There is an order of Demerol 50 mg I.M. now and every 6 hours p r n. You injected Demerol at 5 pm.
The next dose of Demerol 50 mg I.M. is given:
a. When the client asks for the next dose
b. When the patient is in severe pain
c. At 11pm
d. At 12pm
53. You continuously evaluate the clients adaptation to pain. Which of the following behaviors-indicate
appropriate adaptation?
a. The client reports pain reduction and decreased activity
b. The client denies existence of pain
c. The client can distract himself during pain episodes
d. The client reports independence from watchers
54. Pain in Ortho cases may not be mainly due to the surgery. There might be other factors such as
cultural or psychological that influence pain. How can you alter these factors as the nurse?
a. Explain all the possible interventions that may cause the client to worry.
b. Establish trusting relationship by giving his medication on time
c. Stay with the client during pain episodes
d. Promote clients sense of control and participation in pain control by listening to his concerns
55. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is your
nursing priority care in such a case?
a. Instruct client to observe strict bed rest
b. Check for epidural catheter drainage
c. Administer analgesia through epidural catheter as prescribed
d. Assess respiratory rate carefully
Situation 12 Records are vital tools in any institution and should be properly maintained for specific use
and time.
56. The patients medical record can work as a double-edged swords. When can the medical record
become the doctors/nurse worst enemy?
a. When the record is voluminous
b. When a medical record is subpoenaed in court
c. When it is missing
d. When the medical record is inaccurate, incomplete, and inadequate
57. Disposal of medical records in government hospitals/institutions must be done in close coordination
with what agency?
a. Department of Interior and Local Government (DILG)
b. Metro Manila Development Authority (MMDA)
c. Records Management Archives Office (RMAO)
d. Depart of Health (DOH)
58. In the hospital, when you need-the medical record of a discharged patient for research, you will
request permission through:
a. Doctor in charge
b. The hospital director
c. The nursing Service
d. Medical records section
59. You readmitted a client who was in another department a month ago. Since you will need the previous
chart, from whom do you request the old chart?
a. Central supply section
b. Previous doctors clinic
c. Department where the patient was previously admitted
d. Medical records section
60. Records Management and Archives Offices of the DOH is responsible for implementing its policies on
record, disposal. You know that your institution is covered by this policy it;
a. Your hospital is considered tertiary
b. Your hospital is in Metro Manila
c. It obtained permit to operate from DOH
d. Your hospital is Philhealth accredited
Situation 13 In the OR, there are safety protocols that should be followed. The OR nurse should be well
versed with all these to safeguard the safety and quality to patient delivery outcome.
61. Which of the following should be given highest priority when receiving patient in the OR?
a. Assess level of consciousness
b. Verify patient identification and informed consent
c. Assess vital signs
d. Check for jewelry, gown, manicure and dentures
62.You are the charge nurse in an emergency department (ED) and must assign two staff members to
cover the triage area. Which team is the most appropriate for this assignment?

a. An advanced practice nurse and an experienced LPN/LVN

b. An experienced LPN/LVN and an inexperienced RN
c. An experienced RN and an inexperienced RN
d. An experienced RN and a nursing assistant
63. You are working in the triage area of an ED, and four patients approach the triage desk at the same
time. List the order in which you will assess these patients.
a. An ambulatory, dazed 25-year-old male with a bandaged head wound
b. An irritable infant with a fever, petechiae, and nuchal rigidity
c. A 35-year-old jogger with a twisted ankle, having pedal pulse and no deformity
d. A 50-year-old female with moderate abdominal pain and occasional vomiting
64. In conducting a primary survey on a trauma patient, which of the following is considered one of the
priority elements of the primary survey?
a. Complete set of vital signs
b. Palpation and auscultation of the abdomen
c. Brief neurologic assessment
d. Initiation of pulse oximetry
65.A 56-year-old patient presents in triage with left-sided chest pain, diaphoresis, and dizziness. This
patient should be prioritized into which category?
a. High urgent
b. Urgent
c. Non-urgent
d. Emergent
66. The physician has ordered cooling measures for a child with fever who is likely to be discharged when
the temperature comes down. Which of the following would be appropriate to delegate to the nursing
assistant?
a. Assist the child to remove outer clothing.
b. Advise the parent to use acetaminophen instead of aspirin.
c. Explain the need for cool fluids.
d. Prepare and administer a tepid bath.
67. It is the summer season, and patients with signs and symptoms of heat-related illness present in the
ED. Which patient needs attention first?
a. An elderly person complains of dizziness and syncope after standing in the sun for several hours to
view a parade
b. A marathon runner complains of severe leg cramps and nausea. Tachycardia, diaphoresis, pallor, and
weakness are observed.
c. A previously healthy homemaker reports broken air conditioner for days. Tachypnea, hypotension,
fatigue, and profuse diaphoresis are observed.
d. A homeless person, poor historian, presents with altered mental status, poor muscle coordination, and
hot, dry, ashen skin. Duration of exposure is unknown.
68. An anxious 24-year-old college student complains of tingling sensations, palpitations, and chest
tightness. Deep, rapid breathing and carpal spasms are noted. What priority nursing action should you
take?
a. Notify the physician immediately.
b. Administer supplemental oxygen.
c. Have the student breathe into a paper bag.
d. Obtain an order for an anxiolytic medication.
69. An experienced traveling nurse has been assigned to work in the ED; however, this is the nurses first
week on the job. Which area of the ED is the most appropriate assignment for the nurse?
a. Trauma team
b. Triage
c. Ambulatory or fast track clinic
d. Pediatric medicine team
70. A tearful parent brings a child to the ED for taking an unknown amount of childrens chewable vitamins
at an unknown time. The child is currently alert and asymptomatic. What information should be
immediately reported to the physician?
a. The ingested childrens chewable vitamins contain iron.
b. The child has been treated several times for ingestion of toxic substances.
c. The child has been treated several times for accidental injuries.
d. The child was nauseated and vomited once at home.
71. You are caring for a victim of frostbite to the feet. Place the following interventions in the correct order.
a. Apply a loose, sterile, bulky dressing.
b. Give pain medication.
c. Remove the victim from the cold environment.
d. Immerse the feet in warm water 100o F to 105o F (40.6o C to 46.1o C)
72. A 36-year-old patient with a history of seizures and medication compliance of phenytoin (Dilantin) and
carbamazepine (Tegretol) is brought to the ED by the MS personnel for repetitive seizure activity that

started 45 minutes prior to arrival. You anticipate that the physician will order which drug for status
epilepticus?
a. PO phenytoin and carbamazepine
b. IV lorazepam (Ativan)
c. IV carbamazepine
d. IV magnesium sulfate
73. One classic symptom of hepatic coma is:
a. elevated cholesterol
b. flapping hand tremors
c. bile-colored stools
d. depressed muscle reflexes
74. Considering the diagnosis, the nurse should assess Mr. Simon for
a. uremic frost
b. hemangioma
c. urticaria
d. d. Icterus
75. The ascites seen in cirrhosis is in part due to:
a. increase plasma colloid pressure due to excessive liver growth and metabolism
b. the escape of lymph into the abdominal cavity directly from the inflamed liver sinusoid
c. compression of the portal veins with resultant increased backpressure in the portal venous system
d.the decreased level of ADH and aldosterone due to increasing metabolic activity in the liver.
76. Liver cirrhosis may promote varicose veins due to:
a. toxic irritating products released into the blood from the disease organ
b. increased plasma hydrostatic pressure in veins of the extremities
c. decrease plasma protein concentration resulting in pooling of the blood in the venous sytem
d. ballooning of the vein walls due to decreased venous pressure and incompetent valves.
77.
A mother who brings her 4rth month old infant to the clinic for a regular check-up is checked
concerned that her infant is not developing appropriately. When the infant, which of the following would
the nurse to expect?
A. ability to seat upon bed
B. fine motor finger to thumb grasp
C. ability to reach for a toy
D. ability to say mama or dada
78.
A mother of 1 month old infant states that she is curious as to whether the infant is developing
normally. Which of the following developmental milestone would the nurse expect the infant to perform?
A. smiling and laughing
B. rolling from back to side
C. holding a rattle briefly
D. turning the head from side to side
79.
A mother thinks that she thinks her 9month old is developing slowly. When assessing the infants
development, the nurse is also concerned because the infant should be demonstrating which of the
following?
A. vocalizing single syllables
B. standing alone
C. building a tower of two cubes
D. drinking from a cup with little spilling
80.
When assessing for pain in a toddler, which of the following methods would be the most
appropriate?
A. ask the child about the pain
B. observe the child for restlessness
C. use a numeric pain scale
D. assess for changes in vital signs
81.
After surgical repair of a myelomeningocele, which of the following would the nurse use to
prevent musculoskeletal deformity in infant?
A. placing the feet in flexion
B. allowing to be abducted
C. maintaining knees in the neutral position
D. placing the legs in adduction
82. Which of the following would alert the nurse initially to suspect hydrocephalus in an infant who has
undergone surgical repair of myelomeningocele?
A. seizures and vomiting
B. frontal bossing and sunset eyes
C. increased head circumference and bulging fontanel
D. irritability and shrill cry

83. The parents of a child with occasional generalized seizures want to send the child to summer camp.
The parents contact the nurse for advice on planning for a camping experience . Which of the following
activities would the nurse and family decide is most important for the child to avoid?
A .rock climbing
B. hiking
C. swimming
D. tennis
84. When interviewing a child, a history of which of the following illness would lead the nurse to suspect
pneumococcal meningitis?
A. Bladder infection
B. Middle ear infection
C. Fractured clavicle
D. Septic arthritis
85. A hospitalized pre- schooler with meningitis with meningitis who is to be discharged becomes angry
when the dischragre is delayed. Which of the following play activities would be most appropriate at this
time?
A. Rendering a child a story
B. Painting with water colors
C. Pounding on a pegboard
D. Stacking a toweroflocks
86. A school aged child is admitted to the hospital with a diagnosis of probable infratentorial brain tumor.
During the childs admission to the pediatric unit, which of the following would the nurse anticipate doing?
a. eliminating the childs anxiety
b. implementing seizure precaution
c. introducing the child to other clients of the same age
d. preparing the parents and child for diagnostic procedure
87.
After the child undergoes craniectomy for an infratentorial brain tumor, thenurse position the child
in which of the following positions to prevent strain on the suture?
a.
prone
b.
semi-fowlers
c.
side-lying
d.
trendelenburg
88.
Which of the following would the nurse do first when noting clear drainage on the childs dressing
and bed linen after craniotomy for brain tumor?
A. Changes the dressing
B. Elevate the head of the bed
C. Test the fluid for glucose
D. Notify the physician
89.
When assessing the development of a 15 month old child with cerebral palsy, which of the
following milestones would the nurse expect a toddler of this age to have achieved?
a.
walking up steps
b.
using spoon
c.
copying a circle
d.
putting a block in a cup
90. A 60-year-old computer programmer is taken to the emergency department with cognitive slowing,
slurred speech, dizziness, and poor muscle coordination. He said he had taken some of his girlfriend's
"nerve pills" because he was uptight and tense about a presentation he had to make to his supervisor. He
cannot remember how many pills he took or their names. Which of the following agents is most likely to
have caused his symptoms?
A. Sertraline (Zoloft)
B. Haloperidol (Haldol)
C. Alprazolam (Xanax)
D. St. John's Wort
91. The client on Haldol has pill rolling tremors and muscle rigidity. He is likely manifesting:
A. akinesia
B. tardive dyskinesia
C. Pseudoparkinsonism
D. Dystonia
92. Which of the following medications is most likely to be prescribed for the client during withdrawal from
alcohol to provide sedation and to ease some of the anxiety and discomfort of the withdrawal process?
a. Paraldehyde (paral)
b. Lorazepam (Ativan)
c. Phenytoin sodium (dilantin)
d. Temazepam
93. Which of the following drugs would be the least favorable treatment for a patient with bulimia nervosa
without comorbidities?
A. Fluoxetine HCl (Prozac, Sarafem)
B. Topiramate (Topamax)

C. Carbamazepine (Carbatrol, Tegretol)

D. Atricyclic antidepressant
E. Cognitive-behavioral therapy
94. Which of the following atypical antipsychotic agents is associated with the most weight gain?
A. Ziprasidone (Geodon)
B. Aripiprazole (Abilify)
C. Olanzapine (Zyprexa)
D. Quetiapine (Seroquel)
E. Risperidone (Risperdal)
95. Medications of choice for the initial treatment of long-standing anxiety disorder include all the
following, except:
A. Venlafaxine (Effexor)
B. Fluoxetine (Prozac, Sarafem)
C. Sertraline (Zoloft)
D. Diazepam (Valium)
E. Citalop ram HBr (Celexa)
96. Which of the following statements about venlafaxine is true?
A. It is a potent inhibitor of dopamine reuptake
B. It has been demonstrated to have the same percentage of response and completeness of
response as fluoxetine in severely depressed individuals
C. It can be tapered during 1 to 2 weeks
D. It has been shown in clinical trials to significantly increase blood pressure with daily doses
between 75 and 225 mg
E. It is approved for the treatment of generalized anxiety disorder
97.
Instructing a client who has just received orders for nitroglycerin, the nurse informs the client that
it should be taken
A) Only when chest pain is not relieved by rest.
B) Every 2 to 3 hours during the day.
C) At the first indication of chest pain.
D) Before every meal and at bedtime.
98.
An obese 14 year old is admitted to the adolescent unit with a tentative diagnosis of type 1
diabetes mellitus. Adolescent diabetics frequently have more difficulty than diabetics in other age groups
because
A) The disease is usually more severe in adolescents than in younger children.
B) Adolescents have difficulty regulating their insulin.
C) Adolescents have a difficult time with long-acting insulin.
D) Adolescents as a group have poor eating habits.
99.
When a new baby's condition of hyperbilirubinemia continues to worsen, he is given an
exchange transfusion. Priority nursing care of the infant following the transfusion is to monitor
A) Fluid balance.
B) Hyperglycemia.
C) Respiratory status.
D) For hemorrhage.
100.
The nurse is assigned a client whose orders include heparin therapy. When administering
heparin, the substance the nurse will keep at the bedside as the antidote is
A) Magnesium sulfate.
B) Vitamin K.
C) Protamine sulfate.
D) Calcium gluconate.

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