1

MENTAL HEALTH & PSYCHIATRIC NURSING

1. Which of the following is the over-all purpose of the therapeutic communication?

A. diagnose the client’s problem
B. ensure cooperation of the client
C. provide emotional support
D. facilitate and maintain a relationship that is helpful
to the client
Ans. D
2. Tatay Doming, a client with dementia is constantly recalling his past. As a nurse, you stay with Tatay Doming to
listen to his reminiscing. The purpose is to:
A. help him recall the past correctly
B. provide an active stimulating environment
C. assess the underlying cause of his personality
disturbance
D. lessen his isolation and loneliness
Ans. D
3. A nurse knows that the interventions employed for anorectic client are successful if:
A. she eats with appetite
B. she knows that treatment for her is good
C. she gains weight steadily
D. she expresses delight in eating
Ans. C
4. During an interview session, a client is expressing to you some painful memories. You use silence as a
communication technique to facilitate free flow of client’s idea. However, you may interrupt silence when the client
is:
A. attempting to understanding what the nurse said
B. using time to organize his thoughts
C. indicating emotional difficulty through non verbal
means
D. continuing to analyze the topic
Ans. C
5. One week after admission, a client is prescribed lithium carbonate. The nurse should consider the following when
administering this drug:
1. blood lithium level of the day should be monitored
2. teach client regarding salt and fluid intake
3. drug should be given in an empty stomach
4. drug can be given any time
A. 1 & 2 C. 1 & 4
B. 1 & 3 D. 2 & 3
Ans. A
6. The main technique of reality therapy is:
A. structured permissiveness relationship
B. attitude change thru direct suggestion and advice
C. focusing on emotions
D. confrontation
Ans. A
7. One of the following characteristics is not common to all forms of personality disorders:
A. limited or unusual solving skills
B. difficulties in social and occupational situations
C. frequent trouble with law enforcers
D. restricted or exaggerated moral development
Ans. A
8. More often than not, substance abuser come from families characterized by:
A. low income
B. overly dependent relationship
C. ambivalent relationship
D. lack of caring and neglect
Ans. D
9. Ego defense mechanisms reduce psychic stress by:
A. operating at the level of awareness
B. bringing about a compromise among conflicting
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impulses
C. allowing threatening impulse to break into a non-seriousness
D. rendering the inner conflicts and drives consciousness
And. B
10. An antisocial individual is likely to exhibit which of the following behavior?
A. manipulativeness C. rituals
B. withdrawal D. obedience
Ans. A
11. During assessment, the nurse will most likely notice that the attitude of a client with organic mental syndrome is
that of:
A. irritability C. aggressiveness
B. guardedness D. apathy
Ans. A
12. During the working phase of the nurse-patient relationship, the following techniques are expected to be utilized by
the nurse, except:
A. observing the patient
B. keeping the issue on focus
C. helping the patient to talk
D. defining the goal and nature of the nurse-patient
relationship
Ans D
13. A manic client has caused animosity among the personnel in the unit by his manipulativeness. The best nursing
intervention for this behavior is:
A. encourage the client toverbalize the reason for his
behavior
B. evaluate whether the client’s behavior is acceptable or not
C. point out to client alternative behavior that are acceptable
D. isolate the client until he behaves properly
Ans. C
14. Which of the following nursing approaches can help the schizophrenic client improve his self-concept:
A. involve him in group activities
B. allow him to display his talents
C. allow him to participate in competitive games
D. involve him in activities where he can experience
success
Ans. A
15. Three of the following symptoms strongly suggest dementia rather than depression in an elderly client:
1. insidious onset
2. high suicide risk
3. symptoms are present for a length of time
4. mental status questions answered incorrectly;
attempt to conceal error.
A. 1,2, & 4 C. 2,3, & 4
B. 1,3, & 4 D. 1,2,& 3
Ans. A
16. When an aggressive client is temporarily put in isolation, the nurse must:
A. check on the client every hour
B. stay with the client
C. restrain the client
D. lock the door of the client’s room
Ans. A
17. A behavior indicative of child neglect is which of the following?
A. poor growth pattern
B. unattended physical problems
C. poor hygiene
D. begging and stealing food
Ans. D
18. The main characteristic of child autism is which of the following?
A. sub-average intellectual and adaptive functioning
B. poor frustration tolerance and temper tantrums
C. failure to develop interpersonal and language skill
and lack of eye contact
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D. distractibility and shifting from one activity to the other

Ans. C
19. A 35 year old client tells you that “a voice is commanding me to kill myself.” Which of the following is the best
intervention?
A. determine what possible method she is going to
use
B. refer client to psychiatrist
C. stay with the client to prevent injury
D. perform a mental status examination.
Ans. A
20. Which group disorder is characterized by altered identity and recall following a severely stressful experience?
A. psychophysiologic disorder
B. somatization disorder
C. anxiety disorder
D. dissociative disorder
Ans. D
Situation #01
Vicky, 25 y.o., was reported to be gradually withdrawing and isolating herself from friends and family members.
She became neglectful of her personal hygiene and observed to be talking irrelevantly and incoherently. She was
diagnosed with schizophrenia. Questions 21 to 25 refer to this situation.
21. The past history of Vicky would most probably reveal that her premorbid personality is:
A. schizoid C. ambivert
B. extrovert D. cycloid
Ans. A
22. Vicky refuses to communicate with anyone because she:
A. feels superior of others
B. anticipate rejection
C is irritable
D. is depressed
Ans. B
23. Which of the following disturbances in interpersonal relationships most often predispose to the development of
schizophrenia?
A. solo parenting
B. extreme rebellion towards authority figures
C. faulty family atmosphere and interaction
D lack of participation in peer groups
Ans. C
24. Vicky’s indifference toward the environment is a compensatory behavior to overcome:
A. insecurity feelings C. guilt feelings
B. narcissistic behavior D. ambivalence
Ans. A
25. Schizophrenhia ia a/an:
A. neurosis C. personality disorder
B. psychosis D. anxiety disorder
Ans. B

Situation # 02
Elisa is rumored to be shoplifting at KCC Mall. She belongs to a well-to-family. She is quarrelsome and have very
few friends. Questions 26 to 30 refer to this situation.
26. Persons with anti-social personality best respond to:
A. gestalt therapy C. behavior therapy
B. psychotherapy D. hypnotherapy
C
27. Which of the following is the most appropriate intervention for a person with anti-social personality disorder?
A. decreased environmental stimuli
B. encourage verbalization of feelings
C. provide option to relieve anxiety
D. friendly atmosphere
B
28. Which of the following is the priority nursing diagnosis for Elisa?
A. impaired social interaction
B. altered thought processes
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C. low self-esteem
D. low emotional support
A
29. Which of the following statement below best describes personality disorder?
A. disturbance of speech and communication
B. progressive and marked deterioration of the
personality
C. exaggerated pathological pattern of behavior destructive to others
D. disturbance of thought processes
C
30. Persons with personality disorders have all of the following, except:
A. are not capable of guilt
B. disregard for the rights of others
C. low in cognitive functioning
D. do not learn from previous mistakes
C
Situation # 03
Lando is alcoholic, brought to the hospital manifesting agitation, slurred speeches and tremors. Questions 31-35
refer to this situation.
31. Lando, while taking disulfiram should avoid:
A. toothpaste C. shaving lotion
B. pastries D. baking soda
C
32. While taking disulfiram for 1 month, Lando ingested 2 bottles of beer. The nurse assesses:
A. craving for additional alcohol
B. no vital signs changes
C. nausea, vomiting and hypotension
D. euphoric
C
33. The following are characteristics of the alcoholic personality disorder, except:
A. high frustration tolerance
B. denial
C. oral fixation
D. underlying depression
A
34. Lando’s wife says, “My husband can still perform his duties even though he drinks.” This is a manifestation of:
A. black out C. enmeshment
B. projection D. codependency
D
35. Lando developed Korsakoff psychosis which is manifested by:
A. confabulation and amnesia
B. echolalia and echopraxia
C. flat effect
D. delusion of grandeur
A
Situation #04 – Mang Lucas is diagnosed of major depression; he easily gets fatigue, experiences difficulty in sleeping,
recurrent suicidal thoughts, decreased psychomotor activity and feeling of worthlessness. Questions 36-40 refer
to this situation.

36. Mang Lucas will undergo ECT. The following are the side effects of the therapy except:
A. headache C. disorientation
B. temporary amnesia D. permanent memory loss
D
37. The side effect of ECT that receives most attention is which of the following
A. nausea and vomiting
B. dizziness
C. memory loss
D. increased BP
Ans. C
38. Which of the following features would be most crucial for the nurse to assess?
A. suicidal ideation C. concentration difficulty
B. easy fatigability D. sleep disturbance
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A
39. Mang Lucas spend the day lying on her bed with blanket pulled over head. Which of the following therapy used by
the nurse is the most therapeutic?
A. matter of fact C. no demand
B. active friendliness D. passive friendliness
B
40. The nurse attempts to begin conversation with the client but the client did not respond. Which of the following
responses would be appropriate?
A. I will see you later so we can talk again
B. I will sit here with you
C. I will get you a pen and paper so you can write
D. I will look for another nurse who will talk to you.
B
Situation #05
-Allan, 30 y.o. is admitted to the psychiatric unit. He believes that the NBI is out to get him. He has paranoid
schizophrenia. Questions 41 to 45 refer to this situation.
41. The appropriate nursing diagnosis for Allan is:
A. disturbed sensory perception
B. impaired reference
C. disturbed thought processes
D. altered role performance
C
42. Allan tells the nurse, “The NBI is out to get me.” The nurse’s best response is which of the following?
A. Don’t believe on that. It is all in your mind.
B. No, the NBI is not out to get you.
C. I am not sure about that. Do you want me to call
NBI?
D. I know your thoughts seem real to you.
A
43. Allan is prescribed anti psychotic drug. To minimize EPS, the nurse is aware that Allan will receive:
A. Serentil C. amantadine
B. aventyl D. Paxil
C
44. The nurse is aware that the appropriate intervention for Allan is:
A. Be matter of fact when interacting with him
B. Promote variability in approach
C. have less eye contact as possible to decrease
suspicion
D. slip medication into juices or food without talking to patient
B
45. During assessment, Allan said, “I know, you nurses are talking to me. This is:
A. concrete association
B. ideas of reference
C. delusion of persecution
D. looseness of association
A
Situation #06
A female married patient is diagnosed with borderline personality disorder. Questions 46-50 refer to this
situation.

46. The following symptoms confirm the diagnosis:

A. suspiciousness, emotional aloofness,
procrastination
B. spontaneity, insensitivity to others, rigidity
C. dependency, impulsiveness, lack of self-esteem
D. flat affect, social withdrawal, ambivalence
C
47. Due to high risk of suicidal attempt¸ the nurse places priority to one of the following needs of the patient:
A. personal hygiene C. safety
B. nutrition D. comfort
C
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48. A relevant nursing diagnosis based on the prioritized need of the patient is:
A. potential for violence: directed to others
B. impaired social interaction
C. potential for violence: self directed
D. ineffective individual coping
C
49. Self-mutilation among borderline patients is a means of:
A. overcoming feeling of insecurity
B. relieving extreme depression
C. overcoming fear of failure
D. relieving extreme anxiety
A
50. The client developed an easy relationship with the hospital personnel. On the morning following the day when her
request to prolong her TV viewing time was not granted, she complained that the stsff has been ignoring her and
not giving the care she needs. This is a defense mechanism used by borderline patients known as:
A. sublimation C. displacement
B. projection D. splitting
D

Situation #11- Pepe is admitted to the hospital with acute anxiety attack. He is perspiring profusely, breathing
rapidly and complaining of dizziness and palpitation. A thorough physical examination did not show any pathologic
findings. Questions 51-55 refer to this situation.
51. The exclusion of unpleasant experiences from conscious awareness is the defense mechanism used by person with
anxiety neurosis. This is known as.
A. sublimation C. repression
B. regression D. projection
Ans. B
52. Normal anxiety is necessary for survival because it helps the person to:
A. slow down his physiological functioning
B. mobilizes the person more physically anf mentally
C. encourage the person to use the ego defense mechanism
D. makes the person more physically and mentally alert.
Ans. D
53. The nurse anticipates that the physician would order which of the following anti-anxiety drug?
A. chlorpromazine (thorazine)
B. amitriptyline (elavil)
C. diazepam (valium)
D. imipramine (tofranil)
Ans. B
54. To relive anxiety which of the following nursing intervention would be included in the plan of care for Pepe?
A. teach behavior modification technique
B. teach assertiveness technique
C. implement desensitization technique
D. encourage relaxation technique
Ans. D
55. Upon discharge, the important factor to consider in evaluating Pepe’s continuing improvement is when he:
A. can describe the situations preceding his feelings of anxiety
B. can alter his methods of handling anxiety
C. understands the reasons for his anxiety
D. recognizes when he is feeling anxious
Ans. B

Situation #12: Lola Tasya, 73 years old is having dementia. Her family is so upset for her increasing forgetfulness and
wandering. Questions 56-60 refer to this situation.
56. A long term goal in the care of of an elderly client with dementia is which of the following?
A. facilitate the highest level of functioning the client is capable of doing
B. prevent further regression
C. facilitate participation in doing ADL
D. facilitate communication skills
Ans. A
57. An appropriate nursing diagnosis for Lola Tasya is:
A. sensory-perceptual alteration
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B. impaired physical mobility

C. altered thought processes
D. impaired verbal communication
Ans. C
58. For Lola TAsya’s impaired memory, which of the following is the appropriate nursing intervention?
A. encourage her to participate in ADL
B. allow her to make stories if she can not recall recent events
C. encourage participation in scheduled daily activities
D. facilitate doing routine activities by scheduling them in the same order each day
Ans. D
59. Lola Tasya has difficulty recognizing her daughter when she came for a visit. She is manifesting:
A. apraxia C. aphasia
B. anomia D. agnosia
Ans. D
60. The daughter asks the nurse how can she help her mother remember objects. The nurse tells her to:
A. let your mother point to the objects she use rather mentioning them only
B. let your mother mention the names of the objects she wants to use everyday
C. place labels on objects that is part of her mother’s daily routine
D. place the objects in their proper places so she can easily remember them
Ans. C

Situation #13- Anton has been acting strangely after he lost his job. He is referred to a mental counselor. Questions 61-
65 refer to this situation.
61. The mental level that best portray one’s attitude, feelings and desires is the:
A. preconscious C. unconscious
B. subconscious D. conscious
Ans. D
62. For emotional balance, an individual always need:
A. recognition and group acceptance
B. security and peace
C. biologic satisfaction and social acceptance
D. family, work and play
Ans. A
63. Functional mental illness is mainly the result of:
A. genetic environment
B. infection
C. social environment
D. deterioration of brain tissue
Ans. C
64. You would suspect mental illness when your client:
A. has difficulty completing activities
B. expresses no desire to work
C. has difficulty relating with others
D. experiences frequent periods of anxiety
Ans. C
65. Communication ties people to their:
A. social environment
B. environmental surroundings
C. physical surroundings
D. materialistic surroundings
Ans. A

Situation #14 – A new psychiatric nurse is reviewing some basic concepts of psychiatric nursing. Questions 66-70 refer
to this situation.
66. A fundamental concept in psychiatric nursing is viewing the child as a whole organism with a unique background.
This implies that the nurse should:
A. refrain from labeling the client as a psychiatric entity
B. uphold the client’s own value system
C. understand the client’s own value system
D. respect the client’s right to make decision
Ans. A
67. An example of maladaptive use of defense mechanism is which of the following?
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A. a short man becomes a good salesman

B. a 5 year old girl dresses in her mother’s dress and meet her father at the door
C. a rehabilitated drug addict talks about the evils of drug abuse
D. a man loses a promotion, starts complaining to others and comes in late for scheduled meetings
Ans. D
68. A nurse who acts as advocate on behalf of the client and family is doing this nursing intervention:
A. refers the client to the social worker
B. teaches the family about the proper care of the client
C. actively participates in health promotion activities in the community
D. Assists the client and family know their rights and responsibilities
Ans. D
69. In therapeutic co9mmunication, one of the techniques is focusing. This is best exemplified by one of the following
statements:
A. “Tell me more about.”
B. “I would like to spend time with you.”
C. “I am not sure I follow.”
D. “This point seems worth looking at more closely.”
Ans. D
70. According to Freud , the ego’s main concern is:
A. strive for perfection rather than pleasure
B. act as intermediary between the ID and the external world
C. obey the pleasure principle
D. influence behavior by satisfying one’s instincts and drives
Ans. B

Situation #15- During the past 3 years, Aling Meding manifested rapid progressive memory impairment related to
Alzheimer’s disease. Questions 71-75 refer to this situation.
71. Which of the following symptoms is indicative of Alzheimer’s disease?
A. akathesia C. aphasia
B. agnosia D. apraxia
Ans. B
72. Aling Meding talks so much when happened when she was young. Which nursing intervention is appropriate for this
behavior?
A. tell her to talk about current events only
B. listen attentively and encourage talking
C. reorient her the present and ignore the past
D. divert her attention by getting her involved in other activities
Ans. B
73. In preparing plan of care for Aling Meding, priority should be given to:
A. restraints of the client
B. diverting attention every time she remembers the past
C. establishing realistic routine activities
D. limiting her decision making
Ans. C
74. An appropriate nursing diagnosis for Aling \meding is:
A. impaired social interaction
B. self-esteem disturbance
C. impaired verbal communication
D. altered thought processes
Ans. D
75. Aling Meding makes up stories about stories she can not recall to:
A. reduce her feelings of anxiety
B. compensate for her ability to recall
C. maintain her self-esteem
D. reduce her feelings of loneliness
Ans. B

Situation: #16 – Ronald, a peanut vendor is highly suspicious with the persistent belief that some students are stealing
his goodies. Questions 76-80 refer to this situation.

76. Ronald is manifesting delusion of:

A. reference C. jealousy
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B. persecution D. grandeur
Ans.
77. The ego defense mechanism commonly used by suspicious person is:
A. introjections C. projection
B. displacement D. sublimation
Ans. C
78. Initially, the appropriate nursing intervention is:
A. encourage him to participate in competitive games
B. allow him to schedule his own activities
C. encourage him to participate occupational therapy group
D. initiate a one to one relationship with him
Ans. D
79. Ronald is on chlorpromazine for 1 week. The nurse should observe him for signs of side effects such as:
A. hypertension C. shuffling gait
B. drowsiness D. dizziness
Ans. C
80. Which of the following manifestations indicate that Ronald is improving?
A. he voluntarily discusses the delusions
B. he attends to his personal hygiene and grooming
C. he participates in scheduled activities
D. he discusses feelings of anxiety to the nurse
Ans. A

Situation #17 – Fely, a moderately obese high school student is worried about her insatiable cravings and consumption
of large amounts of food. Questions 81-85 refer to this situation.
81. In Caring for a client with bulimia nervosa. It is best for the nurse to be:
A. sympathetic C. honest
B. authoritarian D. critical
Ans. C
82. Fely tells the nurse, “I feel like a bloated balloon.” An appropriate response which indicates nurse’s understanding of
the client’s experience is:
A. “Yes, you really look like a bloated balloon.”
B. “You are upset. I can not allow you to deal with it now.”
C. “why don’t you look at yourself at the mirror.”
D. “This causes you to feel anxious?”
Ans. D
83. To prevent Fely from disgorging food after meals, the nurse should:
A. stay with her for one hour after meals
B. ask her to take a walk after meals
C. lock the bathroom door to prevent him from using to vomit
D. ask her to remain with other patients after eating
84. One morning, Fely says, “I hate the way I look. I am really shy when people look at me.” The client’s problem is:
A. impaired adjustment
B. impaired social interaction
C. ineffective individual coping
D. self-esteem disturbance
Ans. D
85. To enhance Fely’s self-esteem, an objective of care should be focused on:
A. assisting her to identify 3 positive qualities about herself
B. teaching her about her eating disorder
C. ineffective individual coping
D. fostering ability to express her feelings
Ans. A

Situation #18- After the brutal death of her brother, Clara, 25 years old started to have intrusive thoughts that strangers
might harm her family. At night, she would get up many times to make sure the doors are locked. Questions 86-90
refer to this situation.
86. OCD is characterized by which of the following?
A. repetitive and intrusive undesirable thoughts and behavior
B. persistent thought and behavior
C. persistent unwanted ideas
D. persistent unwanted thoughts and behavior.
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Ans. A
87. OCD may result from the failure to achieve the developmental task of the oral stage which is:
A. autonomy vs shame and doubt
B. initiative vs guilt
C. trust vs mistrust
D. industry vs inferiority
Ans. A
88. An OCD person is one who:
A. has profound unmet need for attention and affection
B. is self centered and unpredictable
C. is a perfectionist who finds it extremely difficult to admit mistakes
D. has strong feelings of rejection and lack of self respect
Ans. C
89. An appropriate nursing diagnosis is:
A. altered thought processes
B. sensory-perceptual disturbance
C. impaired verbal communication
D. ineffective individual coping
Ans. D
90. If Clara does the same repetitive door checking behavior in the hospital, initially, the nurse should:
A. discuss the meaning of ritualistic behavior with the patient
B. call the patient’s attention
C. protect the patient from comments of other patient
D. allow time for doing the ritualistic act

Situation # 19 – Allan was brought to the rehab center for alcoholics. He is 45 years old, married with 3 children. His
family life deteriorated during the last 2 years. Questions 91-95 refer to this situation.
91. The appropriate nursing diagnosis relative to the above data would be:
A. impaired adjustment
B. defensive coping
C. ineffective family coping: disabling
D. impaired social interaction
Ans. A
92. Allan uses one of following defense mechanism to protect himself against overwhelming anxiety:
A. sublimation C. repression
B. suppression D. projection
Ans. A
93. The nurse should observe Allan for symptoms of Korsakoff’s psychosis which are:
A. Amnesia and confabulation
B. suspiciousness & hallucination
C. delusion & ideas of reference
D. delusion & fearfulness
Ans. A
94. For allan to permanently sober, an essential factor to consider is:
A. obtaining new social support such as new friends
B. voluntary membership to alcoholic anonymous
C. support from his family and peers
D. when he recognizes he has an alcohol problem and his motivation to change
Ans. D
95. Allan will continue to take Disulfiram after discharge. The nurse should instruct Allan to avoid one of these drugs:
A. sedative C. cough medicines
B. analgesic D. antacid
Ans. C

Situation #20 – Ronnie, 18 years old was brought to the psychiatric unit for evaluation. Past history showed repeated
acts of physical assault, stealing and deceitfulness. Questions 96 -100 refer to this question.
96. Personality disorder is best defined as:
A. flexible behavior pattern that cause problems in interpersonal relationship
B. a psychotic state in insight and effect
C. a mental state in which the person’s ability to perceive reality is impaired
D. preoccupation with the idea that one has a serious disease
Ans. A
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97. When interacting with Ronnie, who may become suddenly and explosively angry, the nurse should:
A. tell him to calm down and stop using derogatory language
B. use gentle and caring touch to calm him
C. point out how angry he is becoming, confront the angry behavior
D. take a calm, quiet, non confrontational approach, do not argue
Ans. D
98. A priority nursing diagnosis would be:
A. altered thought processes
B. potential for violence directed at others
C. impaired social interaction
D. personal identity disturbance
Ans. B
99. A therapeutic nurse patient relationship with Ronnie is characterized by one of the following?
A. an atmosphere of trust
B. setting limit on his behavior
C. providing opportunities to identify interpersonal strength
D. providing well structured environment
Ans. B
100. Pablo attributes his own thoughts and impulses to another person. This is:
A. sublimation C. projection
B. suppression D. rationalization
Ans. C

MENTAL HEALTH & PSYCHIATRIC NURSING 2

1. Which cognitive changes would the nurse expect to find after completing, a mental health assessment on a
client with Alzheimer’s disease?

A. Loss of recent memory

B. Amnesia
C. Loss of remote memory
D. No memory lost

2. A client on a MAO inhibitor demonstrate that learning has taken place by naming tyramine-containing foods
and by relating that even moderate amounts of tyramine must be avoided to prevent a hypertensive crisis.
The client would be correct in naming which of the following foods?
A. Yogurt and aged cheese
B. Cottage cheese
C. Milk
D. Ice cream

3. A 25-year-old male schizophrenic has just been transferred to the unit from the forensic hospital. The client
states, “I was in prison cause I attempted to kill a policeman.” What is the nurse’s best therapeutic response?
A. “Why did you do that?”
B. “Did he try to hurt you?”
C. “Why did you kill a policeman?”
D. “What medication are you taking?”
4. Observing a delusional client talking to herself on the unit, the nurse determines that she is hallucinating. What is the
most important information to gather next?

A. Vital signs

B. Whether the voices are telling to her to harm herself

C. Whether she is talking to someone she sees on the unit

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D. Level of antipsychotic medication in her bloodstream

5. The hospital unit with a diagnosis of delirium in preparing to provide nursing care to him, the nurse should assess
which of the following factors first?

A. The interplay of emotions physical reactions

B. The pathophysiology processes leading to train hypoxia
C. The psychopathological changes leading to confusion
D. The intrapsychic changes resulting from dysfunctional family interactions

6. A 33-year-old male is admitted to the hospital for depression. He is actively suicidal. The physician has prescribed
phenelzine (Nardil). After the nurse review dietary restrictions, what would be the next most important information
to give the client?

A. “It may take as long as 2 weeks for the drug to take effect.”
B. “If you notice any unpleasant side effects like dizziness, report it immediately to the nurse.”
C. “Once you start taking the medication, you will begin to feel better.”
D. “You will still need to be on suicide precaution for your own safety.”

7. A nurse is performing a mental health assessment on a confused and disoriented client Which of the following would
best help the nurse assess, the client’s abstract thinking skills?

A. Ask the client to explain the proverb “A rolling store gather no moss.”
B. Ask the client to response to a hypothetical situation such as, “What would you do if you found a letter with a stamp
affixed?”
C. Ask the client to name the last five president of the United State.
D. Ask the client to identify the reason for being admitted to the hospital.

8. A 45-year-old housewife has been treated for major depression for the past 15 years. Her physician has recently
prescribed monoamine oxidase (MAO) inhibitor. Which of the following food should the nurse instruct the client to
avoid?

A. Smoke salmon
B. Milk and eggs
C. Honey
D. Dried nuts

9. What is the best room assignment for a client with bipolar disorder, manic phase?

A. Alone, at the end of the hall

B. Alone. Nearest the nurse’s station
C. With another bipolar client at the end of the hall
D. With a depressed 40 year old near the nurse’s station

10. The client has been on Haloperidol (Haldol) for three days. He tells the nurse that his neck is stiff and is tongue is
pulling to one side of his mouth. The nurse assesses that the client is experiencing:

A. Tardive dyskinesia
B. Acute panic level of anxiety
C. Akathisia
D. Acute dystonia
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11. The alcohol-addicted client complains of feeling tremulous. The BP is now 170/110, P- 116, R- 30, T- 9/F. Which of
the following drugs would most likely to give the client the most immediate relief from the withdrawal symptoms and
effectively reduce the vital signs?

A. Benztropine (Cogentine) 2mg PO

B. Oxazepam (Serax) 30 mg PO
C. Lorazepam (Ativan) 1 mg IM
D. Meperidine (Demerol) 100 mg IM

12. A long term alcoholic client says to the nurse, “I’m tired of using alcohol and I want to stop. The doctor mentioned
the medication that can help me maintain sobriety,” the nurse is aware the medication is:

A. Carbamazepine (Tegretol)
B. Clonidine (Catapres)
C. Disulfiram (Antabuse)
D. Folic acid

13. A long term goal for the nurse in planning care for the depressed, suicidal client would be to:

A. Provide him with a safe and structured environment

B. Assist him to develop more effective coping mechanism
C. Have him sign a “no-suicide” contract
D. Isolate him from stressful situation that may precipitate a depressive episode.

14. A 38-year-old male client complains that his legs are misshape and of a number of other physical defects. Which of
the following statements suggest that the client is suffering from a somatic delusion?

A. “I have a foul odor coming from all over my body.”

B. “My animal has worms coming from the rectum.”
C. “My mother says that my legs are short. I don’t think they are.”
D. “I have a problem with my mother. She accuses me of having body odor.”

15. A 58-year-old female is admitted to a psychiatric unit. During the nursing assessment, she states, “My mother just
walk by the window and I saw her to go to the nursing station.” This behavior is an example of:

A. Hallucination
B. Fantasies
C. Delusions
D. Derealization

16. Nursing care for the substance abuse client experiencing alcoholic withdrawal delirium includes:

A. Maintaining seizure precaution

B. Restricting fluid intake
C. Increasing sensory stimuli
D. Applying ankle and rick restraints

17. The nurse must recognize the side effect of haloperidol (Haldol). This are:

A. Diarrhea and amenorrhea

B. Orthostatic hypotension and increased sexual activity
 14

C. Decreased sweating and increased sexual activity

D. Headache and orthostatic hypotension

18. A 20-year-old woman has recently been diagnosed with paranoid schizophrenia. She has been started on Haloperidol
(Haldol) and seems to be responding less to hallucinations. She has begun to attend an art group for brief period each
day. In planning care to assist the client to be more connected to reality, the nurse should:

A. Reinforce perception and thinking that are in touch with reality

B. Challenge her expressions of distorted thinking
C. Use peer pressure to discourage delusion
D. Ignore distorted thinking bizarre behaviour

19. A nursing responsibility is to teach clients about their medications and how to care self after discharge. A client, who
is taking risperidone (Risperdal) frequently, requests antacid. Which instruction is most important?

A. “You can take antacid anytime.”

B. “Wait 1 hour after each dose of Risperdal before taking antacids.”
C. “It is ok to take antacid and Risperdal at the same time, if you have heartburn.”
D. “When you go home, ask the physician about antacid.”

20. Persons who suffer from seizure disorders are often prescribed a combination of medications to control seizures. The
nurse should know that these are:

A. Pentobarbital (Nembutal) and phenobarbital (Luminal)

B. Alprazolam (Xanax) and primodone (Myidone)
C. Phenytoin (Dilantin) and penobarbital (Luminal)
D. Phenytoin (Dilantin) and pentobarbital (Nembutal)

21. A 43-year-old female has been taking barbiturates for a number of months. She tells the home health nurse that she
would like to see her deceased mother. The initial nursing action should be to assess for:

A. Physical and psychological dependence

B. Suicidal ideation
C. Seizure activity
D. Toxicity

22. A 36-year-old person was rushed to the emergency room complaining of restlessness, drooling, and tremors. The
daughter informed the nurse that her mother was taking chlorpromazine (Thorazine) . The nurse recognized the
behaviours as extrapyramidal symptoms (EPS). The drug of choice used to alleviate these symptoms is:

A. Paroxetine (Paxil)
B. Carbarnazepine (Tegretol)
C. Benztropine (Cogentin)
D. Lorazepam (Ativan)

23. A 60-year-old is receiving Hurazepam (Dalmane) 30 mg at bedtime. Which statement by the client would assure the
nurse that medication teaching has been effective?

A. “Nurse please double the dose, I’m not sleeping.”

B. “Will this medication take away the pain?”
C. “I am dizzy and weak in the morning. Please tell the doctor about this.”
D. “When the doctor comes. Tell him I want to be discharged.”
 15

24. The nurse observes that the client receiving thiorodazine (Mellaril) is restless, agitated, adn exhibiting tremors of the
upper extremities. Which of the following is the best nursing intervention?

A. Discuss the symptoms with the physician

B. Administer a PRN antiparkinsonian agent
C. Report the incident to the nurse manager
D. Ignore the syndrome

25. A 22-year-old is taking tranylcypromine (Parnate), a monoamine oxidase (MAO) inhibitor. The nurse’s discharge
teaching about the medication should emphasize which of the following instructions?

A. Stop the medication if side effects occur

B. Avoid eating chocolate
C. Use over-the-counter medications for headaches
D. Eat yogurt to ensure absorption for tranylcypromine

26. The nursing instructions to a client, who is taking alprazolam (Xanax) three times a day, should include:

A. The potential for dependence and tolerance

B. The importance of discontinuing Xanax immediately if addiction is suspected
C. The importance of increasing the amount of caffeine consumption
D. Reassurance that Xanax is not habit forming

27. A 25-year-old male client is preparing for discharge. The physician ordered sertraline (Zoloft) to be taken daily. Which
one of the following instructions should the nurse give the client?

A. Take sertraline with food to avoid stomach irritation

B. If dose of sertraline is forgotten, double the next dose
C. Do not mix alcohol or over-the-counter medications with sertraline
D. Stop the medication abruptly if the side effects are suspected.

28. A client confides to the nurse that he tasted poison in his evening meal. This would be an example of what type
hallucination?

A. Auditory
B. Gustatory
C. Olfactory
D. Visceral

29. A 30-year-old client is fearful and refuses to talk. Which one of the following interpersonal techniques is most
effective when attempting to engage the client in conversation?

A. Silence
B. Introducing historical events
C. Broad openings
D. Focusing

30. A 23-year-old female client was admitted to the emergency room for treatment of an overdose of lithium carbonate.
She was later transferred to the psychiatric unit. The client said to the nurse, “I will never do that again. My brother
died 6 months ago and he still loves me.” A possible cause of the suicide attempt is:
 16

A. A maturational crisis
B. The inability to express feelings
C. Psychopathology
D. Social crisis

31. If an anorectic client is being forced to eat, it is important for the nurse to implement which one of the following
interventions?

A. Discuss eating behaviours

B. Provide three large meals daily
C. Observe bathroom behavior
D. Use praise or flattery

32. The nurse working with clients who are substance-dependent should know that a hallmark of the maladaptive
behaviour is:

A. Intolerance
B. Withdrawal
C. Irritability
D. Blackout

33. A 50-year-old male client is admitted to the emergency room. His symptoms are incoherent speech, agitation,
disorientation, visual hallucination, and increased blood pressure. The nurse determines that the client is suffering
from:

A. Alcoholic myopathy
B. Delirium tremens
C. Korsakoff’s syndrome
D. Gastritis

34. A 65-year-old female nursing home resident with a diagnosis of schizophrenia has a number of open wounds that she
constantly picks. She asks the nurse for lotion to soothe them. The nurse should evaluate the behavior for:

A. Primary gain
B. Psychological changes
C. Secondary pain
D. Nutritional deficits

35. Which of the following is most essential when planning care for a client who is experiencing a crisis?

A. Focus on emotional deficits

B. Explore underlying personality dynamics
C. Explore previous coping strategies
D. Provide financial assistance

36. The nurse should know that the primary reason for administering lithium carbonate is for which of the following
disorders?

A. Schizoaffective
 17

B. Obsessive-compulsive
C. Manic-depressive
D. Schizophrenia

37. Some persons after receiving ECT complain of physical of physical discomfort. The nurse should assess for:

A. Increased salivation
B. Amnesia
C. Abated depression
D. Muscle soreness

38. A 66-year-old male diagnosed as having schizophrenia is a nursing home resident. He complains to the nurse that his
neck is still and he has difficulty swallowing. The best nursing intervention is to assess for:

A. Dysphonia
B. Tardive dyskinesia
C. Akathisia
D. Echolalia

39. A 35-year-old chronic alcoholic is suffering from peripheral neuropathy. The nurse informs the client that it is the
result of a nutritional deficiency. Which one of the following is the drug of choice for this disorder?

A. Thiamine
B. Vitamin K
C. Vitamin A
D. Ascorbic acid

40. When barbiturates are prescribed to induce sleep for a depressed client, it is important for the nurse to:

A. Check for “cheeking” of the medication

B. Check the respiratory rate frequently throughout the tour of duty
C. Explain the difference between absorption and excretion
D. Check for decreased circulation

41. Which of the following symptoms would the nurse observe if the client’s lithium level is 1.8 mEq/L?

A. Bradycardia
B. Hypotension
C. Psychosis
D. Constipation

42. A 34-year-old client has a diagnosis of bipolar disorder. The nurse should be aware that the medication of choice for
this disorder is:

A. Risperidone (Risperidal)
B. Clozapine (Clozaril)
C. Lorazepam (Ativan)
 18

D. Lithium carbonate (Eskalith)

43. A 32-year-old client is being discharged on haloperidol (Haldol). Which of the following nursing instructions is most
important?

A. “Do not stop taking Haldol abruptly.”

B. “If you forget to take your morning dose of Haldol, double the dose at bedtime.”
C. “Drink plenty of fluids, and that includes cocktails.”

D. “When you go home, sit outside and enjoy the sunshine.”

44. A psychotic client tells the nurse on admission that he is hearing voices telling him to ill the president. Which nursing
diagnosis is the most appropriate for this client?

A. Sensory perceptual alterations

B. Altered thought processes
C. Self-care deficit
D. Spiritual distress

45. The psychotic client tells the nurse, “The ball will fall in the stall. Call me at the mall.” The nurse assesses the client’s
verbalizations as:

A. Neologisms
B. Circumstantiality
C. Clang associations
D. Auditory hallucinations

46. A client with schizophrenia tells the nurse, “I could have presented the earthquake in California in 1980 if I had
wanted to.” Which disturbance in thinking is the client experiencing?

A. Magical thinking
B. Word salad
C. Derailment
D. Blocking

47. As the nurse is making rounds, the client tells the nurse , “The sphopatouliens took my shoes out of my room last
night.” The client’s statement is an example of:

A. An auditory hallucination
B. A neologism
C. Word salad
D. Derailment

48. The client tells nurse 2 hours after admission for addiction treatment, “You know, I haven’t had any real food for
over 3 days.” Assessment reveals the following data: BP 170/100, P 100, R 28 and T 97⁰F. The client’s skin is dry with
poor turgor, his mucous membranes are dry. The most prevalent nursing diagnosis at this time is:

A. Knowledge deficit
B. Fluid volume deficit
C. Altered nutrition: Less than body requirements
 19

D. Ineffective individual coping

49. A client tells the nurse that he is an angel and has capacity to become invisible and go through locked doors. This is
an example of a (an):

A. Grandiose delusion
B. Auditory hallucination
C. Paranoid delusion
D. Visual hallucination

50. The client is placed in a dimly lit room and restrained. As the staff is applying the restraints, the client shouts, “Get
those snakes off my body! Get them off now!” The nurse recognizes that the client is:

A. Experiencing illusion and tactile hallucinations

B. Having paranoid delusions
C. Morbidly afraid of snakes
D. Disoriented to his whereabouts

51. A long term goal for the borderline personality disordered client is to:

A. Stay in psychotherapy for a minimum of 2 years

B. Adjust medications as needed after discharge
C. Develop insight into maladaptive behaviors
D. Demonstrate improved coping behaviors.

52. A 75-year-old female client suffers from confusion and memory loss and exhibits confabulation. Nursing interventions
should include which one of the following?

A. Promote dependence
B. Maintain a stable environment
C. Promote afternoon naps
D. Confront cognitive errors

53. A college students experiences disabling interferences related to social relationship, occupational pursuits, and sexual
adjustments that are alien to the student’s personality. The nurse would recognize this form of personality
disturbance as:

A. Psychosis
B. A character disorder
C. Neurosis
D. A psychophysiological disorder

54. After a complete diagnostic work-up for a client with neurobiological changes, it was determined that the client was
experiencing post-traumatic stress disorder (PTSD). In planning care for the client, the nurse should be aware that:

A. The symptoms are a mechanism that help him cope with an unacceptable situation
B. The symptoms are a mechanism that help him cope and support his dependence
C. The symptoms are a means to manipulate others
D. The symptoms develop from a nonspecific psychic event
 20

55. A 34-year-old female client is diagnosed as having bipolar disorder and is acutely psychotic. The client suffers from
paranoid delusions. She remarks to the nurse that the FBI and AT&T are plotting against her. In documenting the
statement, the nurse may refer to it as a delusion of:

A. Grandeur
B. Control
C. Persecution
D. Reference

56. A 28-year-old client, diagnosed as having borderline personality disorder, presented at the mental health clinic and
demanded to see a counsellor immediately. Which of the following is the best nursing strategy?

A. Instruct the client to leave the clinic

B. Confront demanding behaviors
C. Explain the rules and set limits
D. Help the client problem solve

57. At the time of admission, a female client suffered from insomnia, shortness of breath, and a rapid pulse, the client
was agitated and stated that she was going crazy and losing control. The diagnosis was panic disorder. The nursing
plan of care should include:

A. Large doses of antianxiety medications

B. Family education
C. The etiology and management of panic disorders
D. Cognitive restructuring

58. A 35-year-old client has a history of multiple somatic complaints involving several organ systems. Diagnose studies
revealed no organic or physiological causes. In planning nursing care, it is important that the nurse understand that
the client is suffering from:

A. Psychosis
B. Depression
C. Somatization disorder
D. Delusional disorder

59. During the multidisciplinary team conference, the client explained that she was terrified of rain and practiced
avoidance. The team members understand that the client is:
A. Controlling the intensity of the anxiety
B. Fearful of the internal source of distress
C. Aware of the basic source of anxiety
D. Attempting to undo the source of anxiety

60. A scantily dressed client approached the nurse, saying, “I am a striptease dancer and I am ready for visitors.” Which
action by the nurse would me most appropriate?

A. Inform the client that all privileges will be suspended will be suspended indefinitely
B. Assure the client that her behavior is appropriate
C. Redirect the client to her room and assist her with a change of clothes
D. Allow the client to remain as dressed
 21

61. Which of the following foods would be most appropriate for a client in the manic phase?

A. Finger sandwiches, oranges slices, and a banana

B. Pasta, meatballs, and a salad
C. Fried chicken, steak with sauce and a salad
D. Beef stew, mashed potatoes, and a banana

62. A 40-year-old male client discharge from a psychiatric unit 4days ago presented at the clinic talking loudly, cursing
and crying. Family members stated that they are unable to cope with the behaviour and alternative living
arrangements must be made. Which living arrangement is most suitable?

A. Long-term psychiatric hospitalization

B. Nursing home placement
C. Group home placement
D. Independent living

63. A client’s depression has lifted and she says she feels much better. What is her suicide risk status?

A. No longer a suicide risk

B. Less of a suicide risk than when she was deeply depressed
C. More of a suicide risk than when she was deeply depressed
D. A suicide risk only in the evening

64. The nurse is caring for a 38-year-old male client who was in an automobile accident 3 months ago. He complains of
neck pain and brags about the pending insurance settlement. The nurse suspects that the client is:

A. Malingering
B. Suffering from conversion reaction
C. Exhibiting somatisation disorder
D. A hypochondriac

65. Disclosure of information, beyond members of the multidisciplinary team, without the consent of the client is a
breach of:

A. Anonymity
B. Confidentiality
C. Duty
D. Habeas corpus

66. A 25-year-old male with a history of homicidal ideation toward his ex-wife and left the mental health clinic in a range.
It was feared that he would harm her. The ex-wife was notified about the event. The nurse’s responsibility is to:

A. Maintain confidentiality
B. Protect the client’s will remain
C. Assume the client will remain
D. Warn the potential victim

67. Which of the following ethical guidelines do not relate to client’s rights?
 22

A. Informed consent
B. Treatment
C. Refusal of treatment
D. Judicial commitment

68. The most effective nursing intervention to assist a client is experiencing moderate anxiety is to:

A. Focus on anxiety reduction

B. Probe the cause
C. Investigate decompensation behaviors
D. Accept the level of anxiety

69. A 34-year-old female client suffering from numbness of the extremities, trembling, and dyspnea is admitted with the
diagnosis of severe anxiety disorder. An initial nursing intervention should be to:

A. Discuss functional coping mechanism

B. Determine the source of the problem
C. Quickly administer an anxiolytic medication
D. Provide safety and comfort

70. A 50-year-old male client discussed his pending divorce. He told the nurse that he has been married for 30 years and
doesn’t want the divorce. During the assessment, the nurse learns that the client is suffering from insomnia,
anorexia, feels insecure, and has a history of a suicidal gestures. Which statement by the nurse is most appropriate?

A. “Why are you upset?”

B. “I can see that you are upset. This is a difficult time for you.”
C. “Tell me about the suicidal gestures.”
D. “Thirty years of marriage! You have been a successful person.”

71. Many clients have difficulty expressing anger. Which one of the following nursing interventions would assist a client with
expressing anger appropriately?

A. Isolate from others

B. Encourage acting out
C. Encourage verbalization
D. Introduce self-care improvement

72. A hostile client is admitted with very little insight, disorganized speech, poor contact with reality, and severe
personality decompensation. This behavior is most suggestive of which of the following disorders?

A. Personality disorders
B. Psychosis
C. Neurosis
D. Psychophysiological disorder

73. The client reported to the nurse that the therapy session was a failure and a waste of time. The client then remarked,
“The next time, I’ll just sit there and be a nonparticipant.” What defense mechanism is the client demonstrating?

A. Compensation
B. Identification
C. Rationalization
D. Projection
 23

74. During the initial interview, the client tells the nurse that he grew up on the “wrong side of the tracks.” He feels
rejected by family, socially unacceptable, and works hard to become the meanest fighter in his block. Which of the
following defense mechanisms is the client exhibiting?

A. Projection
B. Compensation
C. Identification
D. Fantasy

75. A 10-year-old boy was hospitalized because he was underweight. He imagined that he was strong and could conquer
the school bully, thus making him the superego. The nurse would recognize this defense mechanism as:

A. Rationalization
B. Compensation
C. Identification
D. Fantasy

76. A 10-year-old girl hit a playmate hit a baseball bat. The school nurse intervened in the incident. The girl shouted, “he
hit me. He hit me. He hit me.” Which of the following defense mechanisms is the girl exhibiting?

A. Displacement
B. Projection
C. Rationalization
D. Sublimation

77. A nurse on the obstetrical unit was preparing a client for discharge after the birth of a son. The client suddenly
developed blindness. After an extensive work-up; no physical problems were evident. Which of the following defense
mechanisms was the client using?
A. Regression
B. Repression
C. Reaction formation
D. Conversion reaction

78. An angry, hostile client complained to the therapist that his promotion was denied, but stated he did not complain to
his employer. When he returned home he beat his wife because of her inability to keep the house clean. Which
defense mechanism is exhibited?

A. Displacement
B. Projection
C. Reaction formation
D. Sublimation

79. A 50-year-old bookkeeper arrives for a follow-up visit after a severe wrist fracture 3 months ago. The tearful client
expresses helplessness, frustration, and anxiety, stating that the injury was the worst experience of her life. The
client’s level of function is severely compromised. She has been unable to return to work and is currently receiving
disability payments. What is the best response for the nurse to make?
A. “I can see how upsetting this is for you. It must be very difficult to be unable to function independently.”
B. “I know how you must feel. I broke my arm a long time ago, but I am fine now. You will be as good as new soon.”
C. ”You are overly anxious. These injuries take time to heal, and you just have so to be patient.”
 24

D. “I know it is difficult, but you’ll just have to get hold of yourself and get on with your life.”

80. A 50-year-old single male is brought to the crisis unit by the police after having escaped unharmed from his
apartment, which was destroyed by a fire caused by his smoking in bed. The nurse observes the client sitting silently,
almost motionless. Several other clients in the waiting room have commented about the heavy odor of smoke around
the man. Which of the following is the nurse’s best approach to the client?

A. “Would you like to change the clothes? The odor of smoke must be very disturbing.”
B. “You have been through a very difficult experience. Let’s move into the office so that we can talk.”
C. “I hope you have learned your lesson today and given up cigarettes.”
D. “You must consider yourself one very lucky man.”

81. A client with decreased mental capacity from dementia is being admitted to the nursing home. Which of the
following actions should take priority to the nurse?
A. Provide a safe environment free from hazards
B. Provide the family with information about nursing home placement and costs
C. Orient family members to the nursing home, and show them where they can put their things
D. Administer the scheduled medications

82. A 45-year-old lawyer has been hospitalized because of severe agitation. He feels that he must pace the floor a
specific number of times each day or something “terrible” will happen to him. He has engaged in this because most
of his adult life. What is the most therapeutic response for the nurse to make?
A. “Nothing will happen to you. You must stop this behaviour.”
B. “Are you looking for attention? There are other ways you can get it.”
C. “This behaviour has created some difficulty for you. It might help if we talked about why you find it necessary to do this.”
D. “I will have the physician prescribe medication that will help you stop pacing.”

83. A 60-year-old widower is hospitalized aftercomplaining of difficulty sleeping, extreme apprehension, shortness of
breath, and a sense of impending doom. What is the best response for the nurse to make?

A. “You have nothing to worry about. You are in a safe place. Try to relax.”
B. “Has anything happened recently or in the past that may triggered these feelings?”
C. “We have given you a medication that will help to decrease these feelings of anxiety.”
D. “Take some deep breaths and try and calm down.”

84. A client with a diagnosis of organic mental disorder becomes verbally and physically abusive when the nurse enters
the client’s room to assist with daily care. Which of the following interventions should the nurse engage in first?
A. Check orders for physical and chemical restraints
B. Set firm limits verbally
C. Give clear directions while gently securing the client’s arm from hitting the nurse
D. Leave the room and let the angry, hostile behaviour work itself out

85. A 22-year-old client has been diagnosed with antisocial personality disorder. She has been having problems since age
15, when she ran away from home. She has had two broken marriages, has been unable to keep a job for more than
2 months, and has had difficulties with the law because she has abused drugs and passed bad checks. Although the
client has made all the telephone calls she is allowed for the day, ahe asks the nurse, “Can I just make one more
phone call?” What is the nurse’s best response?
A. “Okay, but don’t talk too long.”
B. “Okay, if you promise to obey the rules the rest of the day.”
C. “No, you can’t. The rules apply equally to everyone and you are asking to break them.”
D. “No, you can’t. Go watch television.”
 25

86. A client on an inpatient psychiatric unit at a community mental health center is pacing the hallway and appears
agitated. When the nurse approaches him, he says loudly, “Leave me alone.” What is the nurse’s best approach?

A. Say “OK” and walk away.

B. Summon help in case the client becomes aggressive
C. Say nothing and pace with the client
D. Say, “You sound upset, I’d like to help.”

87. Teaching for a client taking antipsychotic medication should include which of the following instructions?

A. Take the medication with antacid to prevent upset stomach

B. Get fresh air and plenty of sunshine
C. If a dose is missed, take two the next time
D. Avoid abrupt withdrawal of the medication

88. A 37-years-old man with a history of schizophrenia is having auditory hallucination. He shouts to the nurse, “You are
stepping on the spiders! Move aside. Don’t you see them ?” what is the nurse’s best response?
A. “No, I don’t. Quit talking foolishly.”
B. “Yes, I see them, and they sure are big ones.”
C. “No, I don’t see them, but I believe that you do see them.”
D. “Let’s go to the recreation room.”

89. A client demonstrates inappropriate affet when she giggles while talking about her brain being destroyed. What
purpose does this behaviour serve?

A. Convince the staff that her problem is physical and not psychological
B. Avoid the nurse’s questions about the problems that resulted in her admission
C. Deny that she is angry with her parents for bringing her to the hospital
D. Protect herself against the painful emotional impact of what she fears is happening to her

90. Which of the following instructions is most important for a client taking lithium carbonate(Eskalith)?

A. Limit fluids to 1 ⅟₂ qt (1,500 ml) daily

B. Maintain a high fluid intake

C. Take advantage of the warm weather by getting outside exercise when possible

D. When feeling a cold coming on, take over-the-counter (OTC) medications

91. A 23-year-old married homemaker has been on the psychiatric unit for 2 days. She has a history of bipolar disorder
and came to the hospital in the manic phase. She stopped taking her medication (lithium carbonate {Escalith}) 2
weeks ago. Which of the following findings would the nurse be least likely to see?

A. Flight of ideas

B. Delusions of grandeur

C. Increased of appetite

D. Restlessness
 26

92. A 28-year-old accountant is admitted to the neurologic unit after a sudden onset of blindness the day before an
important project is due to her boss. After a preliminary evaluation and testing yields no positive findings, the
physician’s initial reaction is that the client may be demonstrating which defense mechanism?

A. Repression

B. Transference

C. Reaction formation

D. Conversion

93. What is the most effective intervention for handling a client with an antisocial personality?

A. Reason with the client

B. Set limits with the client

C. Ignore the client

D. Agree with the client

94. A client with an antisocial personality disorder refuses to take a shower for 3 days. What is the nurse’s best
response?

A. “It is policy here for all clients to bathe daily.”

B. “It is time for your shower, I will help you with it.”

C. “Don’t worry about your shower until tomorrow.”

D. “Do you want people to make fun with you?”

95. A 24-year-old secretary is transferred to your psychiatric unit. Her husband says that she has been overeating and
that she vomits soon after she eats. Her weight stays about the same, at 96lb (44kg). In planning care for the client,
the nurse should anticipate which medical diagnosis?

A. Anorexia

B. Bulimia

C. Mania

D. Schizoprenia

96. A 40-year-old woman is brought to the hospital by her husband, who states that she refused to eat or to get out of
bed for 2 days. The woman says that she is tired all the time and does not feel up to going to work. Her admitting
diagnosis is major depression. Which question would be most appropriate for the admitting the nurse to ask?

A. “What has been troubling you?”

B. “Why do you dislike yourself?”

C. “How do you feel about your life?”

 27

D. “What can we do to help?”

97. A 32-year-old lawyer is admitted to the neurologic unit with a sudden onset of blindness the night before an
important case is scheduled to go to trial. Tests reveal no physical findings. Which of the following best analyzes the
client’s anxiety?

A. It is diffuse and free floating

B. It is consciously experienced

C. It is localized and relieved by the blindness

D. It is projected onto the environment

98. A 16-year-old student has been admitted to your psychiatric unit after fainting in physical education. She has a
diagnosis of anorexia nervosa, weighs 88lb (40 kg) , and is 5’4” 91.6 m) tall. She has been weighing herself several
times a day at home and has lost 30lb (13.5 kg) in the past 3 months. Which nursing diagnosis would be most
appropriate for the client?

A. Altered thought processes

B. Impaired judgement

C. Altered nutrition less than body requirements

D. Altered sexuality patterns

99. A client with major depression states, “Everything is my fault, and I would be better off dead.” What is the priority
nursing intervention?

A. Assess the seriousness of the client’s comment

B. Notify the psychiatrist of the client’s verbalization

C. Assign staff members to a suicide watch

D. Engage the client in a no-suicide contract

100. A noticeably withdrawn 14-year-old female client is being treated on the unit for anorexia nervosa. Which nursing
assessments should be made daily?

A. Edema of the legs

B. Pulse and blood pressure elevation

C. Frequent binging and purging

D. Level of depression and anxiety

ANSWER KEY (PSYCHIATRIC NURSING)

1. A
2. A
3. D
 28

4. B
5. B
6. A
7. A
8. A
9. A
10. A
11. C
12. C
13. C
14. A
15. A
16. A
17. D
18. A
19. B
20. C
21. B
22. C
23. C
24. B
25. B
26. A
27. C
28. B
29. C
30. C
31. C
32. B
33. B
34. C
35. C
36. C
37. D
38. B
39. A
40. A
41. A
42. D
43. A
44. A
45. C
46. A
47. B
48. B
49. A
50. A
51. C
52. B
53. C
54. A
55. C
56. C
57. C
58. C
59. C
60. C
61. A
62. A
63. C
64. A
65. B
 29

66. D
67. D
68. A
69. D
70. B
71. A
72. B
73. C
74. B
75. D
76. A
77. D
78. B
79. A
80. B
81. A
82. C
83. C
84. B
85. C
86. D
87. D
88. C
89. D
90. B
91. C
92. D
93. B
94. B
95. B
96. C
97. C
98. C
99. C
100. D
101.