Situation 1: The nurse is envisioning a career path in mental health psychiatric nursing.

As a beginning professional
nurse, she is guided with basic beliefs about the practice.

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
ANSWER: B
Rationale: Mental health psychiatric nursing is an integral aspect of all nursing and a specialty service to all people
affected by mental illness. This choice reflects the broad scope of mental health nursing, recognizing its
importance across various nursing specialties.
Why not:
A. This choice is more specific to rehabilitation nursing rather than mental health psychiatric nursing.
C. While mental health nursing may contribute to preventing new cases, it is not its primary focus.
D. This choice is more specific to early intervention rather than the comprehensive nature of mental health nursing.

2. The beginning professional nurse can do mental health counseling with the following clients, EXCEPT:
A. actively psychotic patients C. parents with child rearing concerns
B. out of school adolescents D. school children with behavioral problem
ANSWER: A
Rationale: The beginning professional nurse should not conduct mental health counseling with actively psychotic
patients. Actively psychotic patients may not be receptive to counseling, and their immediate needs often require
other interventions.
Why not:
B, C, and D. Counseling with parents, out-of-school adolescents, and school children with behavioral problems are
appropriate roles for the beginning professional nurse.

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
ANSWER: D
Rationale: Ensuring physical safety and maintaining a therapeutic attitude toward the patients best reflects providing a safe and
therapeutic environment. Restraining, maintaining a closed-door policy, and keeping a restrictive environment are not aligned
with promoting a therapeutic atmosphere.
Why not:
A. Restraining patients is not a preferred approach and is usually a last resort.
B. Maintaining a closed-door policy can impede therapeutic interactions and trust.
C. Keeping a restrictive environment is not conducive to therapeutic care.

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 C. reframing
B. empathy D. confrontation
ANSWER: B
Rationale: Empathy is crucial in the therapeutic relationship as it involves understanding and sharing the feelings of the patient. It
fosters a connection and trust between the nurse and the patient, promoting effective communication and collaboration. Other
options lack the empathetic understanding required for a therapeutic alliance.
Why not
a. humor: While humor can be valuable, it is not the essential component in the therapeutic relationship. Depending on humor
alone may not address the deep emotional needs of the patient.
c. reframing: Reframing is a therapeutic technique, but empathy is the foundational attitude that underlies effective communication
and understanding in the therapeutic relationship.
d. confrontation: Confrontation may be used selectively, but it is not the essential component that establishes a trusting and
empathetic connection with the patient.

5. Which of these people, the highest in population groups that would need priority mental health therapy?
A. adults going through active skills C. young professionals entering the workplace
B. single elderly with no social support D. women preparing for overseas employment
ANSWER: C
Rationale: Young professionals entering the workplace would need priority mental health therapy. This group may face significant
stressors associated with transitioning into the workforce, adapting to new responsibilities, and managing career-related
challenges. Early interventions and support can contribute to their mental well-being.
Why not
A. adults going through active skills: While this group may have mental health needs, the stressors associated with young
professionals entering the workplace may be more immediate and intense.
B. single elderly with no social support: The elderly without social support are vulnerable, but the unique stressors of young
professionals entering the workplace make them a higher priority for mental health therapy.
D. women preparing for overseas employment: This group may face stress, but the immediate challenges of young professionals
entering the workplace may necessitate priority attention.

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 C. Activity Therapy Group
B. Alcoholics Anonymous D. Art Therapy Group
ANSWER: B
Rationale: A mental health nurse may not be a member of Alcoholics Anonymous (B). Alcoholics Anonymous follows a self-help
model where support and assistance primarily come from group members themselves. The nurse's role is typically one of
facilitating, guiding, and providing professional support rather than actively participating as a member.
Why not:
A. Remotivation Group: The nurse can be a member or facilitator of Remotivation Groups, as it involves providing support and
motivation to individuals.
C. Activity Therapy Group: The nurse can actively participate or lead activity therapy groups as part of therapeutic interventions.
D. Art Therapy Group: The nurse can participate or lead art therapy groups, incorporating creative expression into mental health
treatment.

7. Which of the following determines the success of client government groups?

A. willingness of psychiatric professionals to be open and receptive to client’s 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
ANSWER: A
Rationale: The success of client government groups is determined by the willingness of psychiatric professionals to be open and
receptive to clients' ideas and suggestions. This openness fosters collaboration, empowers clients, and contributes to the
effectiveness of self-governance within the therapeutic community.
Why not:
B. This choice is not directly related to the success of client government groups. While self-governance can contribute to a more
creative and wholesome life, the primary factor is the professionals' openness.
C. Acquiring social skills is a potential benefit of client government groups but does not directly determine their success.
D. While client government groups may provide an opportunity to learn democratic living, the professionals' receptivity to client
input is crucial for success.

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
ANSWER: C
Rationale: Vic going into the garden to work with plants, seedlings, tree planting, and watering them illustrates horticulture
therapy. Horticulture therapy involves therapeutic gardening activities.
Why not:
A. Bringing musical instruments and encouraging client participation pertains to music therapy.
B. Playing Scrabble every night after supper is an example of recreational therapy.
D. Finding sketching relaxing and rewarding pertains to art therapy.

9. Eva is a member of a group who controls endless talking. Her role is that of a/an:
A. blocker C. recognition seeker
B. self-confessor D. monopolizer
ANSWER: A
Rationale: Eva, who controls endless talking, plays the role of a blocker in the group. A blocker inhibits or stops group
communication and progress.
Why not:
B. Recognition seeker seeks attention.
C. Self-confessor discloses personal information excessively.
D. Monopolizer dominates the group discussion.

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
ANSWER: A
Rationale: Community meetings held as part of milieu therapy on an in-patient psychiatric unit serve to focus on issues arising
from group living. They provide an opportunity for patients to express concerns and discuss topics related to their shared
environment.
Why not:
B. Encouraging expression on topics of interest is not the primary purpose of community meetings.
C and D. Providing direction from the treatment plan and encouraging expression of intrapsychic conflicts are not the primary
objectives of community meetings.

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.
ANSWER: C
Rationale: Studies support electroconvulsive therapy (ECT) as a mode of treatment because it relieves depression psychologically
by increasing the norepinephrine level.
Why not:
A. ECT does not produce massive brain damage with the intent of destroying specific memories.
B. ECT is not seen as a symbolic punishment for guilt and worthlessness.
D. ECT is not seen as a life-threatening experience requiring bodily defense mobilization.

12. The preparation of a patient for ECT ideally is MOST similar to preparation for a patient for:
A. electroencephalogram C. general anesthesia
B. X-ray D. electrocardiogram
ANSWER: C
Rationale: The correct answer is C. The preparation of a patient for ECT is MOST similar to preparation for general anesthesia.
Both involve a pre-procedure assessment, including medical history, physical examination, and fasting before the procedure.

Why not:
A, B, and D. Electroencephalogram, X-ray, and Electrocardiogram do not typically require the same level of preparation as ECT.

13. Which of the following is a possible side effect which you will discuss with the patient?
A. hemorrhage within the brain C. encephalitis
B. robot-like body stiffness D. confusion, disorientation and short term memory loss
ANSWER: D
Rationale: Confusion, disorientation, and short-term memory loss are possible side effects of ECT that should be discussed with
the patient.
Why not:
A. Hemorrhage within the brain and C. Encephalitis are not typical side effects of ECT.
B. Robot-like body stiffness is not a recognized side effect of ECT.

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 C. next of kin or guardian
B. doctor D. chief nurse
ANSWER: C
Rationale: When informed consent cannot be obtained from involuntary clients, permission may be taken from the next of kin or
guardian, as they often have legal authority or responsibility for the individual.
Why not:
A. Social workers typically do not have the legal authority to provide consent for medical treatments on behalf of involuntary
clients.
B. While doctors may be involved in the treatment process, the next of kin or guardian is usually the appropriate party to provide
consent.
D. The chief nurse, although a healthcare professional, may not have the legal authority to provide consent on behalf of an
involuntary client.

15. After ECT, the nurse should do this action before giving the client fluids, food or medication:
A. assess the gag reflex C. next of kin or guardian
B. assess the sensorium D. check O2 Sat with a pulse oximeter
ANSWER: A
Rationale: After ECT, the nurse should assess the gag reflex before giving the client fluids, food, or medication to ensure the
client's ability to swallow and prevent aspiration.
Why not:
B. Assessing sensorium is important but may not directly impact the immediate safety related to swallowing.
D. Checking O2 Sat with a pulse oximeter is relevant for respiratory assessment, but assessing the gag reflex is more directly
linked to the risk of aspiration.
C. Informed consent is related to the decision-making process before ECT and is not directly tied to post-procedure assessments.

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 C. ego ideal
B. super ego D. id
ANSWER: B
Rationale: Antisocial personality disorder is associated with a lack of moral conscience and adherence to societal norms. The
super ego, according to psychodynamic theory, is responsible for incorporating societal values and morals. Therefore, a
disturbance in the super ego can lead to a lack of remorse and guilt.
Why not:
A. ego: The ego primarily deals with reality and mediates between the id and super ego. It is not specifically responsible for moral
values.
C. ego ideal: The ego ideal represents the idealized standards of behavior, but it is the super ego that enforces these standards and
moral values.
D. id: The id is driven by instinctual desires and operates on the pleasure principle. It is not concerned with societal norms or moral
values.

17. The nurse teaches parents about children’s beginning concepts of right and wrong by emphasizing child rearing
attitude and practices during the:
A. school age C. infancy period
B. toddler age D. latency period
ANSWER: B
Rationale: During the toddler age, children begin to develop a sense of autonomy and start to understand right from wrong. This
stage, according to Erikson's psychosocial theory, is the autonomy versus shame and doubt stage, where children start to
assert their independence.
Why not:
A. school age: By the school age, children have already developed a sense of right and wrong during the earlier stages of
development.
C. infancy period: Morality and understanding of right and wrong typically emerge later than infancy.
D. latency period: The latency period is characterized by a focus on intellectual and social development, but the foundational
concepts of right and wrong are usually established earlier.

18. It is BEST for parents to teach healthy interpersonal relationships to their children by:
A. modeling 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
ANSWER: A
Rationale: Modeling behavior is a powerful way for parents to teach healthy interpersonal relationships. Children often learn by
observing and imitating the behavior of their parents and significant others.
Why not:

B. encouraging their children to attend secondary school: This choice is more related to education rather than interpersonal
relationships.
C. encouraging their children at home to behave properly: While encouragement is important, modeling provides a more direct and
impactful way of teaching behavior.
D. teaching their children good manners and right conduct: Teaching is important, but actual demonstration through modeling is
often more effective.

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
ANSWER: D
Rationale: Interacting with retarded children requires understanding and accommodating their developmental level rather than
chronological age. This approach promotes effective communication and support tailored to the child's needs.
Why not:
A. Assuming that the child's needs are met based on contentment might overlook specific developmental requirements.
B. Providing an environment appropriate to their developmental task is a relevant consideration, but it does not address the
interaction aspect directly.
C. Treating the child according to chronological age may not align with the child's actual abilities and may not support their
developmental progress.

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 subaverage intellectual functioning that originates during the developmental period and is
associated with impairment in adaptive behavior
D. a severe lag in neuromuscular development and motor abilities
ANSWER: C
Rationale: Mental retardation is characterized by subaverage intellectual functioning that affects adaptive behavior. It is not solely
a result of environmental factors, sensory deficits, or neuromuscular development.
Why not:
A. a delay in normal growth and development caused by an inadequate environment: This option emphasizes environmental
causes, which are not the sole factors in mental retardation.
B. a lack of development of sensory abilities: Sensory deficits may contribute to developmental challenges, but mental retardation
involves broader intellectual and adaptive deficits.
D. a severe lag in neuromuscular development and motor abilities: This choice focuses on motor development, which is not the
primary characteristic of mental retardation.

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
ANSWER: C
Rationale: Lifestyle modification involves initiating positive changes, and recognizing the impact of unhealthy habits is the first
step toward making informed choices for a healthier lifestyle.
Why not:
A. Minimizing eating in fast-food restaurants is a specific action rather than a foundational step in lifestyle modification.
B. Having an exercise regimen is an action that can be part of lifestyle modification but is not the starting point.
D. Avoiding pollutants in the environment is important for overall health but is not the central focus of lifestyle modification.

22. All of these are the behavior intervention to stress management. EXCEPT:
A. guided imagery C. meditation
B. pharmacotherapy D. progressive muscle relaxation
ANSWER: B
Rationale: Pharmacotherapy involves the use of medications for stress management, which is different from behavioral
interventions like guided imagery, meditation, and progressive muscle relaxation.
Why not:
A. guided imagery: This is a behavioral intervention for stress management.
C. meditation: This is a behavioral intervention for stress management.
D. progressive muscle relaxation: This is a behavioral intervention for stress management.

23. Basic to progressive muscle relaxation is:

A. focusing on an image to relax C. use of industrial equipment
B. relaxing muscles from tension D. stopping disturbing thoughts
ANSWER: B
Rationale: Progressive muscle relaxation involves systematically tensing and then relaxing different muscle groups to reduce
overall tension.
Why not:
A. focusing on an image to relax: This describes guided imagery, not progressive muscle relaxation.
C. use of industrial equipment: This is unrelated to progressive muscle relaxation.
D. stopping disturbing thoughts: This is more associated with cognitive-behavioral interventions rather than progressive muscle
relaxation.
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
ANSWER: A
Rationale:By understanding the eating patterns of the Filipino family, the nurse can provide targeted health education and
interventions to help improve their dietary habits. This approach aligns with the preventive aspect of nursing care, aiming to
positively influence lifestyle choices for better health outcomes.

Why not:

B. the nurse knows that being overweight is a major health hazard: While being overweight is indeed a health concern, the focus of
the assessment is on understanding current eating patterns rather than making assumptions about individuals' weight status.
C. the nurse wants to stop all the mainstream weight-loss diets: This option is not directly related to assessing current dietary
practices but rather assumes a specific approach to weight management, which may not be applicable to everyone.
D. the nurse has to find out what people are eating: While finding out what people are eating is part of the assessment process, the
broader goal is to understand the overall eating patterns to address potential health risks and provide appropriate guidance.

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 C. skills to attempt change
B. information D. motivation
ANSWER: B
Rationale: The individual initially needs information about the health risks associated with smoking, being overweight, and other
lifestyle factors.
Why not:
A. commitment: While commitment is important for behavior change, the individual first needs information to make informed
decisions.
C. skills to attempt change: Skills are essential, but information comes first in the behavior change process.
D. motivation: Motivation is crucial, but providing information often serves as a catalyst for motivation.

Situation 6: Bernie and John in their late 40’s 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 C. anticipated crisis
B. developmental crisis D. both developmental and situational crisis
ANSWER: A
Rationale: Bernie and John are facing a situational crisis triggered by the discovery of John's involvement with another woman. A
situational crisis is an unexpected and external event that can disrupt an individual's normal functioning and coping
mechanisms.
Why not:
B. Developmental crisis: This type of crisis is associated with predictable life stages or events, such as adolescence, marriage, or
retirement. Bernie and John's situation is more related to a specific unexpected event rather than a developmental stage.
C. Anticipated crisis: Anticipated crises are events that can be predicted, and individuals can prepare for them. The situation
described is more sudden and unexpected.
D. Both developmental and situational crisis: While the situation may have implications for their relationship development, the
immediate crisis is situational, triggered by the discovery of the husband's actions.

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
ANSWER: C
Rationale: Crisis situations often overwhelm usual problem-solving methods and coping mechanisms, leading to increased anxiety
or depression.
Why not:
A. a hazardous or threatening event occurs: This is a characteristic of a crisis.
B. it has a growth-promoting potential: Crisis situations may lead to growth, but not all crises have growth-promoting potential.
D. anxiety or depression continue to increase: This is a characteristic of a crisis.

28. The nurse employs this approach in crisis intervention:

A. problem-solving C. role-playing
B. behavior modification D. nurse-patient relationship
ANSWER: A
Rationale: A crisis is characterized by the inability of usual problem-solving methods and coping mechanisms to produce a
solution. In a crisis, individuals may find their usual strategies ineffective, leading to heightened anxiety and a sense of
urgency.

Why not:
A. A hazardous or threatening event occurs: This is a characteristic of a crisis, as crises are often triggered by hazardous or
threatening events.
B. It has a growth-promoting potential: Crises, while challenging, can also present opportunities for growth and positive change.
D. Anxiety or depression continues to increase: Increased anxiety or depression is a common feature of a crisis, indicating the
emotional impact of the challenging

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
ANSWER: D
Rationale: Assessment data should include coping mechanisms, perception of the event, and situational support, but repressed
problems are not typically assessed directly.
Why not:
A. coping mechanisms: Assessing coping mechanisms is important in understanding how the individual is handling the crisis.
B. situational support: Evaluating available support helps in planning appropriate interventions.
C. perception of the event: Understanding the individual's perception provides insight into their emotional response.

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
ANSWER: D
D. 4 – 6 weeks
Rationale: The duration of a crisis typically lasts several days to weeks, and 4-6 weeks is within this timeframe.
Why not:
A. 2 – 4 weeks: While crises can resolve in this timeframe, 4-6 weeks is a more typical duration.
B. 1 – 2 weeks: This may be too short for many crisis situations.
C. 1 – 2 months: This is longer than the typical duration of a crisis.

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 C. neurotic
B. normal D. psychotic
ANSWER: C
Rationale: Neurotic behavior involves excessive anxiety and maladaptive coping mechanisms that do not meet the criteria for
psychosis. Felisa's behavior is ritualistic and anxiety-driven, indicating a neurotic behavior pattern.
Why not:
A. delusional: Delusional behavior involves false beliefs that are resistant to reasoning or contrary evidence.
B. normal: While rituals are a common part of human behavior, Felisa's ritualistic behavior appears to be causing distress and
impairment, making it neurotic.
D. psychotic: Psychotic behavior involves a disconnection from reality, which is not evident in Felisa's case.

32. A therapeutic intervention in this situation is:

A. avoid limits on her behavior to release her anxiety
B. call attention to her ritualistic pattern
C. provide alternative behaviors to deal with increased anxiety
D. ignore her behavior totally
ANSWER: C
Rationale: Providing alternative behaviors helps Felisa cope with anxiety in a more adaptive manner, addressing the underlying
issues without reinforcing maladaptive patterns.
Why not:
A. avoid limits on her behavior to release her anxiety: Avoiding limits would likely perpetuate the ritualistic behavior rather than
addressing the underlying issues.
B. call attention to her ritualistic pattern: This may increase anxiety without providing alternative coping mechanisms.
D. ignore her behavior totally: Ignoring the behavior may not be helpful in addressing the underlying issues causing anxiety.

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 ) C. imipramine Hcl ( Tofranil )
B. haloperidol ( Haldol ) D. chlorpromazine ( Thorazine )
ANSWER: A
Rationale: Diazepam is a benzodiazepine used to treat anxiety disorders. It can help reduce anxiety and promote relaxation.
Why not:
B. haloperidol (Haldol): Haloperidol is an antipsychotic medication and may not be the first choice for anxiety disorders.
C. imipramine Hcl (Tofranil): Imipramine is a tricyclic antidepressant and may be used for anxiety disorders, but diazepam is more
commonly prescribed for acute anxiety.
D. chlorpromazine (Thorazine): Chlorpromazine is an antipsychotic and is not typically used as a first-line treatment for anxiety
disorders.

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”
ANSWER: D
Rationale: Diazepam can cause drowsiness and impair motor skills; therefore, it is important for Felisa to be aware of
potential side effects and take precautions such as avoiding driving or operating machinery.
Why not:
A. "I should watch out for signs of sore lips or sore throat": This is not a common side effect of diazepam.
B. "I might have constipation": Constipation is not a typical side effect of diazepam.
C. "I might feel changes in my body temperature": Changes in body temperature are not commonly associated with
diazepam.

35. The level of anxiety that Felisa is experiencing is:

A. Panic C. Mild
B. Severe D. Moderate
ANSWER: B
Rationale: The disabling nature of Felisa's anxiety, which interferes with her job performance and daily activities,
indicates a severe level of anxiety.
Why not:
A. Panic: Panic level of anxiety usually involves intense and overwhelming fear with physical and cognitive
symptoms.
C. Mild: Mild anxiety is associated with heightened alertness and improved performance.
D. Moderate: Moderate anxiety may cause some interference with daily functioning, but it is not as severe as described
in the scenario.

Situation 8:As a professional, it is imperative that the nurse is accountable to oneself hence the importance of
personal and professional development.

36. Nurse: “ I feel personally involved with my client’s problems” demonstrates:

A. counter transference C. transference
B. empathy D. sympathy
ANSWER: A
Rationale: Countertransference refers to the nurse's emotional response to the client, and feeling personally involved
with the client's problems is an example of countertransference.
Why not:
B. empathy: Empathy involves understanding and sharing the client's feelings, but feeling personally involved suggests
a more emotional reaction associated with countertransference.
C. transference: Transference involves the client's projection of feelings onto the nurse, not the nurse's reaction.
D. sympathy: Sympathy is an emotional response but is not specific to the nurse's feelings about the client's problems.
37. The nurse has achieved self-awareness in which of the following verbalizations?
A. every time people around me yell, I feel upset and withdrawn
B. when the patient yelled at me I became speechless
C. with the patients tone of voice and stare, I got reminded of how my father would be so angry and this made
me anxious
D. I thought it was rude for the patient to yell hence I kept quiet
ANSWER: C
Rationale: This verbalization indicates self-awareness of the nurse's emotional response and recognition of the connection
between the patient's behavior and the nurse's past experiences.
Why not:
A. every time people around me yell, I feel upset and withdrawn: This is a general statement but lacks specific details linking the
nurse's response to the patient's behavior.
B. when the patient yelled at me, I became speechless: This describes a reaction but does not show insight into the underlying
emotional connection.
D. I thought it was rude for the patient to yell, hence I kept quiet: This statement focuses on the patient's behavior but does not
demonstrate self-awareness of the nurse's emotional response.

38. An accepting attitude requires being:

A. aware of ones biases C. non judgmental
B. tolerant of the faults of others D. in control of tendency to blame
ANSWER: A
Rationale: An accepting attitude requires self-awareness of one's biases and a commitment to being open-minded and non-
judgmental.
Why not:
B. tolerant of the faults of others: Tolerance is important, but being aware of biases is a more foundational aspect of an accepting
attitude.
C. non-judgmental: Non-judgmental is part of an accepting attitude but may not necessarily imply awareness of biases.
D. in control of the tendency to blame: While avoiding blame is important, being aware of biases goes beyond controlling blame.

39. Self-awareness, knowledge and understanding of human behavior and communication skills define what is
essential in caring for every nurse to be able to demonstrate:
A. positive self-projection C. therapeutic use of self
B. assertiveness D. self-mastery
ANSWER: C
Rationale: Self-awareness, knowledge, and understanding of human behavior, along with effective communication
skills, define what is essential in caring for every nurse to be able to demonstrate therapeutic use of self.
Why not:
A. positive self-projection: Positive self-projection is not the primary goal in therapeutic use of self.
B. assertiveness: Assertiveness is a communication skill but is only one component of therapeutic use of self.
D. self-mastery: Self-mastery is a broader concept and may not specifically relate to the therapeutic use of self.

40. Considering that man is by nature social, it is BEST for the nurse to gain self-awareness by:
A. participating in intensive group experiences
B. individual psychotherapy
C. hypnotherapy
 D. writing an autobiography for self introspection
ANSWER: A
Rationale: Gaining self-awareness is facilitated through interactions with others, and participating in intensive group
experiences allows for reflection, feedback, and exploration of one's own thoughts and feelings.
Why not:
B. individual psychotherapy: While individual psychotherapy can be beneficial, group experiences provide a different
dynamic and diverse perspectives.
C. hypnotherapy: Hypnotherapy may have specific applications but may not be as widely used for gaining self-
awareness.
D. writing an autobiography for self-introspection: Writing can be a reflective tool, but group experiences offer
interactive and interpersonal learning opportunities.

Situation 9: Recording and the nurse.

41. To facilitate identification of persons and relationships, the family nurse utilizes this diagrammatic representation
of members of a family and their relationships:
A. flowchart C. algorithm
B. genogram D. kardex
ANSWER: B
Rationale: A genogram is a diagrammatic representation that depicts family members and their relationships,
providing a visual tool for understanding family dynamics and identifying patterns.
Why not:
A. flowchart: Flowcharts are more commonly used for representing processes or workflows, not family relationships.
C. algorithm: An algorithm is a step-by-step procedure or set of rules for solving a problem, not a visual representation
of family relationships.
D. kardex: The kardex is a patient care summary, not a diagrammatic representation of family relationships.

42. A problem oriented recording system that utilizes the problem solving process as the basis of patient care
management:
A. NANDA Diagnosis C. Gordon’s Functional Health Patterns
B. Nursing Care Plan D. Problem Oriented Medical Recording
ANSWER: D
Rationale: Problem-Oriented Medical Recording (POMR) is a system that uses the problem-solving process as the
basis for patient care management.
Why not:
A. NANDA Diagnosis: NANDA diagnosis is part of the nursing process, not specifically a problem-oriented medical
recording system.
B. Nursing Care Plan: Nursing care plans are derived from the nursing process but are not synonymous with problem-
oriented medical recording.
C. Gordon’s Functional Health Patterns: Gordon's Functional Health Patterns is a framework for organizing patient
data, not a problem-oriented recording system.

43. This is a SOAP recording of the patient’s problem of “Nervousness”. Which is the subjective data?
A. Mr. Z was nervous during the interview, he moved frequently in the bed and his palms were sweaty.
B. Mr. Z does not seem to tolerate stress too well which will aggravate his cardiac condition. He understands
Little about his health which may be increasing his state of anxiety.
 C. “I am nervous at times”. Exerts himself physically and is hesitant to discuss problems.
D. Mr. Z should:
1. demonstrate an ability to cope with nervousness
2. demonstrate an understanding of the relationship between his nervousness and cardiac condition
ANSWER: C
Rationale: Subjective data are the patient's own verbal expressions and feelings. In this statement, Mr. Z is directly
expressing his feelings of nervousness.
Why not:
A. Objective data: This statement includes observable behaviors, such as Mr. Z being nervous during the interview.
B. Interpretation: This statement provides an interpretation of Mr. Z's ability to tolerate stress and understanding about
his health.
D. Nursing interventions: This part consists of nursing interventions related to addressing Mr. Z's nervousness.

44. The nurse researcher mutually agreed with the research subjects that all personal data of the subjects shall be kept
confidential. To safeguard anonymity of data after the report is written, the nurse researcher should:
A. throw the papers in a wastebasket
B. keep the papers for 5 years and dispose of these after
C. burnt or shred the papers
D. have the papers recycle but not as writing scratch paper
ANSWER: C
Rationale: Shredding or burning confidential papers is a secure method of disposal to safeguard anonymity and protect
the privacy of research subjects.
Why not:
A. Throwing in a wastebasket: This does not ensure confidentiality and privacy and can lead to potential breaches.
B. Keeping for 5 years and disposing of later: Keeping personal data for an extended period poses a risk to privacy, and
the disposal timeline is not specified.
D. Recycling as scratch paper: This could compromise confidentiality and is not a secure method of disposal.

45. A step by step procedure for the management of common problems is a :

A. Gavin chart C. decision tree protocol
B. pedigree chart D. problem listing
ANSWER: C
Rationale: A decision tree protocol is a step-by-step procedure for the management of common problems, providing a visual
representation of options and outcomes.
Why not:
A. Gavin chart: Gavin chart is not a recognized term or tool related to decision-making or problem management.
B. Pedigree chart: Pedigree charts are typically used in genetics to represent family relationships and inheritance patterns.
D. Problem listing: Problem listing is a more general term and does not specifically refer to a step-by-step decision-making
process.

Situation 10:The nurse works with Mina to help her work through termination of the nurse-patient relationship.

46. Preparation for termination of the nurse-patient relationship begins during the:
A. termination phase C. pre-orientation phase
B. working phase D. orientation phase
ANSWER: D
Rationale: The preparation for termination of the nurse-patient relationship begins during the orientation phase. This is the initial
phase of the nurse-patient relationship, where the nurse establishes rapport, assesses the patient's needs, and sets goals for the
therapeutic process. Planning for termination ideally starts at the beginning to ensure a smooth transition when the
relationship concludes.
Why not:
A. Termination phase: The termination phase is the final phase of the nurse-patient relationship when the goals have been
achieved, and closure is imminent.
B. Working phase: The working phase follows the orientation phase and involves active intervention and collaboration to achieve
mutually defined goals.
C. Pre-orientation phase: This phase typically involves the nurse preparing for the initial meeting with the patient, gathering
relevant information, and setting the tone for the therapeutic relationship.

47. Mina’s past reactions to ending relationships is withdrawal. The nurse assists her to practice better ways of coping
termination by providing opportunities to:
A. test new patterns of behavior C. conceptualize her problem
B. plan for alternatives D. value and find meaning in experience
ANSWER: D
Rationale: Given Mina's past reactions of withdrawal, the nurse can assist her in coping with termination by providing
opportunities to value and find meaning in the experience. This involves helping Mina reflect on the significance of the
therapeutic relationship and the personal growth she has achieved during the interactions with the nurse.
Why not:
A. test new patterns of behavior: While testing new patterns can be valuable, finding meaning is more central to coping with
termination.
B. plan for alternatives: Planning for alternatives may not address the emotional aspects of termination.
C. conceptualize her problem: Conceptualizing the problem is important, but finding meaning is a broader goal.

48. During the early part of the interaction, the nurse asked after a period of silence. “Perhaps we would talk about my
leaving”. The nurse utilized which communication technique:
A. encouraging C. focusing on client
B. suggesting D. understanding
ANSWER: B
Rationale: The nurse is suggesting the topic of discussing the nurse's departure during a period of silence, which encourages
communication about the impending termination.
Why not:
A. encouraging: Encouraging involves motivating the patient to express thoughts and feelings, but suggesting is more specific to
bringing up a particular topic.
C. focusing on the client: Focusing involves directing attention to specific issues, but suggesting is more directly related to
introducing a specific subject.
D. understanding: Understanding involves grasping the client's perspective, but suggesting is more focused on guiding the
conversation.

49. Mina: (angrily) “ I am angry, I should never have gotten involved with you” (silence)
Nurse: “You have reason to be disappointed and to feel angry. Just when we were getting somewhere.
I leave you.”
A. reflecting words C. orienting
B. understanding D. reflecting feelings
ANSWER: B
 Rationale: The nurse is expressing understanding of Mina's anger and disappointment, acknowledging her feelings
and the impact of the nurse's departure.
Why not:
A. reflecting words: Reflecting words involves repeating the client's statements, which is not evident in the nurse's
response.
C. orienting: Orienting involves helping the client adjust to time, place, and person, which is not the focus in this
context.
D. reflecting feelings: Reflecting feelings involves mirroring the client's emotions, but the nurse's response is more
about understanding the client's perspective.

50. The objection of the nurse-patient relationship is to provide an opportunity of the patient to:
A. clarify problems C. have a corrective emotional experience
B. develop insights D. develop interpersonal relationship
ANSWER: C
Rationale: The primary objective of the nurse-patient relationship is to provide an opportunity for the patient to have a
corrective emotional experience, addressing and resolving emotional issues within the therapeutic relationship.
Why not:
A. clarify problems: While clarification is a goal, having a corrective emotional experience is broader and more central.
B. develop insights: Developing insights is part of the therapeutic process but may not necessarily lead to a corrective
emotional experience.
D. develop interpersonal relationships: Developing interpersonal relationships is a means to an end, but the main goal is
the corrective emotional experience.

51. The nurse is aware that identifying the aspects of general patient management and identifying interventions for
meeting these basic needs are distinctions of:
A. psychotherapy C. pharmacotherapy
B. therapeutic milieu D. behavior therapy
ANSWER: B
Rationale: The therapeutic milieu refers to the overall environment or surroundings in which patient care is provided. The
distinctions of identifying aspects of general patient management and interventions for meeting basic needs are central to the
concept of therapeutic milieu, which emphasizes creating a therapeutic environment to promote mental health.
Why not:
A. psychotherapy: Psychotherapy involves the use of psychological methods to help individuals overcome mental health
challenges and is not specifically related to the general management of patients or meeting basic needs.
C. pharmacotherapy: Pharmacotherapy focuses on the use of medications for treating mental health conditions and is not directly
related to the broader aspects of patient management.
D. behavior therapy: Behavior therapy is a specific type of therapeutic approach targeting behavior change and may not encompass
the broader aspects of patient management.

52. In order to get active participation of the clients to carry out the objective of the program, it is BEST for the nurse
to conduct a/an:
A. community meeting C. observation
B. survey D. selective interview of patients
ANSWER: A
Rationale: Conducting a community meeting is an effective way for the nurse to engage clients actively and gather their input and
participation in program objectives. Community meetings provide a platform for open communication, collaboration, and
involvement in decision-making.
Why not:
B. survey: While surveys can gather information, they may not foster active participation and collaboration among clients to the
same extent as a community meeting.
C. observation: Observation is a passive method of data collection and may not actively involve clients in the planning and
decision-making process.
D. selective interview of patients: Selective interviews may not involve the entire group and may limit the diversity of perspectives
and input.

53. Through the nurse’s role modeling of effective communication, the clients learned new ways of dealing with
authority figures. This gives the clients a venue to:
A. communicate C. identify their problems
B. socialize D. test new patterns of behavior
ANSWER: D
Rationale: Role modeling effective communication by the nurse provides clients with a model to observe and learn from. The
opportunity to test new patterns of behavior allows clients to practice and apply the communication skills they have learned
in the therapeutic setting. This helps in real-life situations, especially when dealing with authority figures.
Why not:
A. Communicate: While effective communication is a goal, the focus here is on the clients actively trying out and applying new
communication skills.
B. Socialize: The emphasis is on behavior testing rather than general socialization.
C. Identify their problems: While identifying problems is a part of therapeutic communication, the context of the statement implies
a more active testing of communication patterns.

54. This element of communication facilitates evaluation of the program:

A. receiver C. sender
B. message D. feedback
ANSWER: D
Rationale: Feedback is an essential element of communication that facilitates the evaluation of the program. It allows
for information exchange, clarification, and adjustment of interventions based on the responses received.
Why not:
A. receiver: The receiver is a component of the communication process but is not specifically related to program
evaluation.
B. message: While important, the message itself does not directly facilitate evaluation of the program.
C. sender: The sender initiates the communication, but feedback is needed for comprehensive evaluation.

55. The nurse’s style of leadership in milieu therapy is:

A. autocratic C. democratic
B. laissez-faire D. benevolent
ANSWER: C
Rationale: In milieu therapy, a democratic leadership style is often employed, emphasizing collaboration, shared decision-making,
and involvement of group members in the therapeutic process.
Why not:
A. autocratic: Autocratic leadership involves centralized decision-making by the leader, which is not typically aligned with the
principles of milieu therapy.
B. laissez-faire: Laissez-faire leadership allows individuals to act with minimal interference from the leader, but a more active
leadership role is often necessary in milieu therapy.
D. benevolent: Benevolent leadership involves a kind and caring approach but may not necessarily involve active collaboration and
shared decision-making.

Situation 12: Loretta is a 28 years old, unemployed patient, admitted to the psychiatric unit with a diagnosis of
chronic undifferentiated schizophrenia. She described herself as the “Virgin Mary” and her mission is to
propagate peace. She was observed laughing and talking to herself. Her thought processes were profoundly
disorganized. She was also fearful and suspicious of others.

56. Loretta’s claim of being the “Virgin Mary” is a/an:

A. imagination C. hallucination
B. delusion D. obsession
ANSWER: B
Rationale: Loretta's claim of being the "Virgin Mary" is a delusion, which is a fixed, false belief that is resistant to reasoning or
contrary evidence. In this case, she holds a belief about her identity that is not based on reality.
Why not:
A. Imagination: Imagination involves forming mental images or concepts that are not necessarily based on reality, but Loretta's
claim is more rigid and fixed, characteristic of a delusion.
C. Hallucination: Hallucinations involve perceiving things that are not present in reality, such as hearing voices or seeing things.
Loretta's claim is more of a fixed false belief (delusion) than a perceptual disturbance.
D. Obsession: Obsessions are intrusive, unwanted thoughts or urges. Loretta's claim is more of a fixed false belief (delusion) rather
than an obsessive thought.

57. Her mission to propagate peace is:

A. a serious call for a need of transformation C. realistic and laudable
B. an attempt to overcome low self-esteem D. an advocacy that she can participate in
ANSWER: B
Rationale: Loretta's mission to propagate peace is an attempt to overcome low self-esteem. It reflects a desire to engage in a
positive and laudable mission, which may serve as a coping mechanism for underlying emotional issues. Individuals with
schizophrenia may develop delusions and missions as a way to make sense of their experiences and cope with internal
struggles.
Why not:
A. a serious call for a need of transformation - Loretta's mission is more indicative of a coping mechanism than a serious call for
transformation. It is part of her disorganized thought process.
C. realistic and laudable - While the mission may be laudable, it is not necessarily realistic in the context of her mental health
condition. It reflects an attempt to cope with underlying issues rather than a realistic and achievable goal.
D. an advocacy that she can participate in - Loretta's mission is more indicative of a coping mechanism or a way to manage low
self-esteem rather than a rational advocacy in which she can actively participate.

58. Which of this intervention would NOT be therapeutic in decreasing Loretta’s anxiety?
A. joke about her thought to help her feel at ease
B. listen to her thoughts and feelings
C. simply accept
D. do not convince her that her perception is unreal
ANSWER: A
Rationale: Joking about Loretta's delusional thought may not be therapeutic and may increase anxiety. The best
approach is to listen to her thoughts and feelings, simply accept her perspective, and not try to convince her that
her perception is unreal.
Why not:
B. listen to her thoughts and feelings: This is a therapeutic intervention as it acknowledges Loretta's experience without
judgment.
C. simply accept: Acceptance without judgment is a therapeutic approach that respects Loretta's perspective.
D. do not convince her that her perception is unreal: Not trying to convince her aligns with an understanding of her
reality in the context of her mental health condition.

59. The nurse evaluates that Loretta’s ready for a rehabilitation program when she:
A. approaches the nurse at frequent intervals C. goes to the coffee shop alone more often
B. ceases to talk about “Virgin Mary” D. carries a book “The Purpose Driven Life”
ANSWER: B
Rationale: The readiness for a rehabilitation program in Loretta's case can be indicated by her ability to cease talking
about the delusional belief of being the "Virgin Mary." This suggests a reduction in the intensity of psychotic
symptoms, allowing her to focus on more reality-oriented and adaptive behaviors.
Why not:
A. approaches the nurse at frequent intervals: Frequent approaches to the nurse may or may not reflect readiness for
rehabilitation and may be influenced by other factors.
C. goes to the coffee shop alone more often: Going to the coffee shop alone is a positive behavior, but it does not
directly indicate readiness for rehabilitation.
D. carries a book "The Purpose Driven Life": While carrying a book may indicate engagement in meaningful activities,
it does not specifically reflect readiness for rehabilitation.

60. The nurse is leading a group meeting of patients to prepare them to be discharged. An appropriate goal for the
group members is to develop:
A. attitudes of society towards the mentally ill
B. skills for maintaining daily living
C. awareness of interpersonal patterns of interactions
D. insight into personal problems
ANSWER: B
Rationale: Developing skills for maintaining daily living is a practical and achievable goal for individuals preparing for discharge,
ensuring they can independently manage their basic needs and function effectively in daily life.
Why not:
A. attitudes of society towards the mentally ill: While societal attitudes are important, developing daily living skills is more
immediate and applicable to individual functioning.
C. awareness of interpersonal patterns of interactions: Interpersonal awareness is valuable, but daily living skills are more directly
related to practical functioning post-discharge.
D. insight into personal problems: Personal insight is important, but the focus here is on concrete skills necessary for independent
living.

Situation 13: A group of adult chronic schizophrenic patients were recommended to undergo social skills training.
61. The following are the objectives of a social skills training program EXCEPT:
A. explore deep seated intrapsychic conflicts C. help build self esteem and self confidence
B. practice skills in relating with people D. develop and practice general coping skills
ANSWER: A
Rationale: The objectives of social skills training typically focus on practical and observable skills for interacting with others.
Exploring deep-seated intrapsychic conflicts is more aligned with psychotherapy than social skills training.
Why not:
B. practice skills in relating with people: This aligns with the goals of social skills training.
C. help build self-esteem and self-confidence: Building self-esteem and self-confidence is a common goal of social skills training.
D. develop and practice general coping skills: Developing coping skills is a relevant objective of social skills training.

62. Social skills training is NOT primarily indicated for psychiatric patients who are:
A. in acute stage of illness
B. having difficulties starting and maintaining interpersonal relationships
C. having chronic episodes of stress and anxiety while interacting with others
D. experiencing recurrence of symptoms in front of particular people or among people in general
ANSWER: A
Rationale: Social skills training is not typically indicated for individuals in the acute stage of illness. During this stage,
stabilization and symptom management are the primary focus, and social skills training may be more appropriate during the
recovery phase.
Why not:
B. having difficulties starting and maintaining interpersonal relationships: This is a common indication for social skills training.
C. having chronic episodes of stress and anxiety while interacting with others: Chronic stress and anxiety in interpersonal
interactions may warrant social skills training.
D. experiencing recurrence of symptoms in front of particular people or among people in general: Social skills training may be
beneficial in managing symptoms related to interpersonal interactions.

63. The focus of the group interaction is “here and now”. An appropriate topic would be:
A. ways to celebrate Valentine’s Day in February
B. how to spend the summer vacation
C. an unforgettable experience as a child
D. how to tell a joke
ANSWER: D
Rationale: The focus of the group interaction being "here and now" suggests a present-centered discussion. Discussing how to tell
a joke is a topic that relates to the present moment and encourages immediate participation and engagement.
Why not:
A. Ways to celebrate Valentine’s Day in February: This topic involves future planning and is not focused on the "here and now."
B. How to spend the summer vacation: Similar to option A, this topic is future-oriented.
C. An unforgettable experience as a child: This topic involves reminiscing about the past and is not centered on the present
moment.

64. An appropriate technique for the participants to practice how to communicate effectively is through/a:
A. lecture C. role play
B. seminar D. psychodrama
ANSWER: C
Rationale: Role-playing is a valuable technique for participants to practice how to communicate effectively in a safe and
controlled setting. It allows individuals to simulate real-life scenarios and apply social skills in a supportive environment.
Why not:
A. lecture: Lectures are informative but may not provide the interactive practice needed for effective communication.
B. seminar: Seminars typically involve presentations and discussions but may lack the active engagement of role-playing.
D. psychodrama: Psychodrama is a therapeutic technique involving dramatic expression, but role play is more specific to
practicing communication skills.
65. Considering that it is BEST to learn by example, it is MOST practical to:
A. model good social skills throughout the session
B. relate successful past experiences
C. invite a resource person
D. watch a movie
ANSWER: A
Rationale: Learning by example is often effective, and in this context, modeling good social skills throughout the session allows
participants to observe and learn from the nurse's behavior. Demonstrating positive social interactions can have a direct
impact on the learning process.
Why not:
B. Relate successful past experiences: While sharing past experiences can be valuable, it may not provide direct, observable
examples of social skills in action.
C. Invite a resource person: While this can be beneficial, it may not necessarily involve the direct modeling of social skills by the
nurse.
D. Watch a movie: While movies can be used for learning, they may not allow for immediate interaction and feedback, which is
crucial for learning social skills.

Situation 14: Community health nurses integrate their knowledge of mental health with their clients in their practice
when they do mental health counseling.

66. Who among these clients need immediate referral for psychotherapy?
A. those who are plotting to commit suicide
B. those who are not responding to usual motivators
C. those who are not solving their problems which they have the resources to solve
D. those who are engaging in self-defeating behaviors
ANSWER: A
Rationale: Clients who are actively planning to commit suicide need immediate referral for psychotherapy to address the acute
risk of self-harm.
Why not:
B. those who are not responding to usual motivators: This may indicate a need for intervention but may not require immediate
referral for psychotherapy.
C. those who are not solving their problems, which they have the resources to solve: This may warrant counseling and support, but
it may not require immediate psychotherapy.
D. those who are engaging in self-defeating behaviors: This may require intervention, but the urgency depends on the severity and
immediate risk.

67. All of these describe what counseling, EXCEPT:

A. helping people manage their own problems
B. assisting people to use their own resources
C. a set of technique, skills and attitudes
D. giving advices
ANSWER: D
Rationale: Counseling involves assisting individuals in managing their own problems and using their own resources. Giving
advice is not typically a core component of counseling, as it may undermine the individual's autonomy.
Why not:

A. helping people manage their own problems: This is a key aspect of counseling, promoting self-management.
B. assisting people to use their own resources: This is a central goal of counseling, empowering individuals to utilize their own
capabilities.
C. a set of techniques, skills, and attitudes: Counseling involves the application of techniques, skills, and attitudes, making this a
valid description.

68. This quality of the nurse allows “connecting with others feelings”:
A. warmth C. sensitivity
B. courage D. prudence
ANSWER: C
Rationale: Sensitivity allows the nurse to connect with others' feelings, demonstrating an understanding and awareness of
emotional states.
Why not:
A. warmth: Warmth conveys a friendly and approachable demeanor but may not specifically involve connecting with others'
feelings.
B. courage: Courage is not directly related to connecting with others' feelings but may be relevant in certain situations.
D. prudence: Prudence involves careful judgment, but it may not specifically relate to connecting with others' feelings.

69. “ To refuse gossip” is a reflection of the mental health nurses quality of:
A. firmness C. judgment
B. coolness D. trustworthiness
ANSWER: A
Rationale: Refusing gossip reflects a firm stance, indicating that the nurse is setting boundaries and maintaining professionalism.
Why not:
B. coolness: Coolness may imply emotional detachment, but it may not specifically relate to refusing gossip.
C. judgment: Judgment involves the ability to make decisions, but it may not directly address the refusal of gossip.
D. trustworthiness: Trustworthiness is a desirable quality but may not directly address the refusal of gossip.

70. Which of the following concepts BEST describe the nurse’s interaction when she/he can recognize and identify
feelings and emotions of another person without even having personally experienced those feelings and emotions?
A. over involvement C. transference
B. sympathy D. empathy
ANSWER: D
Rationale: Empathy involves recognizing and identifying the feelings and emotions of another person without personally
experiencing those feelings. It goes beyond sympathy, which involves feeling for someone rather than fully understanding
their emotions.
Why not:
A. over-involvement: Over-involvement suggests an excessive level of personal investment, which may not necessarily involve
empathetic understanding.
B. sympathy: Sympathy involves feeling for someone but may not encompass the depth of understanding inherent in empathy.
C. transference: Transference involves the projection of feelings from one relationship to another and is not synonymous with
empathetic understanding.
Situation 15: Communicating effectively with dementia patients is a challenge to psychiatric nurses.

71. Therapeutic ways to engage the elderly to be stimulated include all of the following EXCEPT:
A. singing to or with the patients C. providing a picture album
B. listening to old familiar music D. playing complex computer games
ANSWER: D
Rationale: Playing complex computer games may be challenging for elderly individuals, especially those with dementia, as it may
require cognitive abilities that are compromised in dementia. The other options, such as singing, providing a picture album,
and listening to old familiar music, are more likely to be therapeutic and engaging for elderly individuals.
Why not:
A. singing to or with the patients: Singing can be therapeutic and stimulating for elderly individuals.
B. listening to old familiar music: Listening to familiar music can evoke positive memories and emotions.
C. providing a picture album: Sharing a picture album can stimulate memories and provide a meaningful connection.

72. The LEAST area of satisfying communication with the elderly is on:
A. recall of their courtship and love life C. fashion shown in personal pictures
B. psychological trauma D. memories of their teenage parties
ANSWER:B
Rationale: Communication about psychological trauma may be a sensitive and potentially distressing topic for elderly individuals.
The other options , recall of courtship and love life, fashion shown in personal pictures, and memories of teenage parties, may
be more positive and engaging areas of communication.
Why not:
A. recall of their courtship and love life: This can be a positive and engaging area of communication.
C. fashion shown in personal pictures: Discussing fashion memories can be a positive and stimulating topic.
D. memories of their teenage parties: Discussing positive memories of teenage parties can be engaging.

73. To maximize communication with the elderly, which of the following ways of verbal communication should the
nurse use minimally?
A. asking simple questions C. restating
B. guiding the patient one step at a time D. asking for an open ended response
ANSWER: D
Rationale: Individuals with dementia may have difficulty generating open-ended responses. Therefore, the nurse should use
techniques that provide guidance and structure to facilitate communication, such as asking simple questions, guiding the
patient step by step, and restating information.
Why not:
A. asking simple questions: Simple questions are often easier for individuals with dementia to answer.
B. guiding the patient one step at a time: Providing guidance can help individuals with dementia navigate communication.
C. restating: Restating information can enhance understanding and communication.

74. Unconditional positive regard for the elderly is BEST achieved when the nurse-patient relationship is based upon:
A. vocational choices C. addressing economic problems
B. keeping D. providing warmth and caring
ANSWER:D
Rationale: Unconditional positive regard is best achieved through warmth and caring. This approach emphasizes acceptance and
support for the individual, creating a positive and therapeutic nurse-patient relationship.
Why not:
A. vocational choices: Unconditional positive regard is not dependent on vocational choices.
C. addressing economic problems: While addressing economic problems is important, unconditional positive regard is about the
nurse's attitude toward the patient.
B. keeping: The term "keeping" is unclear in this context and does not relate directly to the concept of unconditional positive
regard.

75. An optimal supportive environment for a person with dementia includes all, EXCEPT:
A. engaging the elderly in logical and abstract thinking
B. developing a realistic uniformed and consistent daily schedule
C. handling memory loss by distracting or diverting patient’s attention to something more positive
D. simple nurse care for the patient day after day
ANSWER:A
Rationale: Individuals with dementia may struggle with logical and abstract thinking. An optimal supportive
environment should focus on activities and communication that are suited to the individual's cognitive abilities
and provide a sense of familiarity and comfort.
Why not:
B. developing a realistic uniformed and consistent daily schedule: Having a consistent daily schedule is beneficial for
individuals with dementia.
C. handling memory loss by distracting or diverting the patient's attention to something more positive: Distraction and
redirection are helpful strategies in dementia care.
D. simple nurse care for the patient day after day: Providing consistent and simple care is generally beneficial for
individuals with dementia.

Situation 16: Harry, age 36 is admitted to the psychiatry unit in an acute manic episode of bipolar disorder.

76. Harry’s condition is a disturbance of:

A. sensorium C. the CNS
B. cognition D. affect
ANSWER: D
Rationale: Affect refers to the observable expression of emotion or mood. In the context of Harry's acute manic episode of bipolar
disorder, his condition primarily involves disturbances in affect, characterized by elevated, expansive, or irritable mood.
Affect encompasses the emotional component of an individual's mental state.
Why not:
A. sensorium - Sensorium refers to the total sum of an individual's sensory experiences and awareness of the external environment.
While manic episodes can affect perception and cognition, the primary disturbance in bipolar disorder is often related to
mood (affect).
B. cognition - Cognition involves mental processes such as thinking, reasoning, and memory. While disturbances in cognition can
occur in bipolar disorder, the primary feature in a manic episode is often changes in mood and affect.
C. the CNS - The Central Nervous System (CNS) includes the brain and spinal cord. While bipolar disorder involves CNS
dysfunction, specifying the disturbance in affect (emotional expression) is more relevant in this context.

77. In the ward, Harry manifests excess energy and is difficult for him to sit still. The MOST useful activity for him
would be:
A. delivering supply of linen to other rooms C. conducting a drama workshop
B. engaging in activity therapy and group exercises D. painting a mural with other patients
ANSWER: B
Rationale: Engaging Harry in activity therapy and group exercises would be the most useful activity for him.
Individuals experiencing excess energy and difficulty sitting still, especially during a manic episode, can benefit
from activities that channel and expend their energy in a structured and therapeutic manner. Activity therapy and
group exercises provide an outlet for physical energy, promote social interaction, and contribute to a more
positive and constructive use of his heightened activity level.

Why not:
A. delivering supply of linen to other rooms: This activity does not involve structured therapeutic engagement and may
not effectively address Harry's excess energy or contribute to his overall well-being.
C. conducting a drama workshop: While drama workshops can be beneficial, engaging in activity therapy and group
exercises may be more immediate and effective in managing excess energy during a manic episode.
D. painting a mural with other patients: While creative activities like painting can be therapeutic, they may not provide
the necessary structure and physical engagement required for someone with excess energy during a manic
episode.

78. Harry’s disruptive behavior on the unit has been increasingly annoying other clients. Which of the following would
the nurse do?
A. set limits on his behavior and be consistent in approach
B. make a rigid structured plan that he will have to follow
C. ignore his behavior
D. tell him that he is annoying other clients and isolate him in his room
ANSWER:A
Rationale: Setting limits on Harry's behavior and being consistent in approach is an appropriate nursing intervention.
Individuals in a manic episode may exhibit disruptive behavior, and setting clear, consistent limits helps maintain
a therapeutic environment for all clients on the unit.
Why not:
B. make a rigid structured plan that he will have to follow: Rigidity may not be well-received by a manic patient, and
flexibility in managing behavior is crucial.
C. ignore his behavior: Ignoring disruptive behavior may not be appropriate, as it can impact other clients and the
therapeutic milieu.
D. tell him that he is annoying other clients and isolate him in his room: Isolation should be used judiciously and in a
manner that preserves the therapeutic relationship.

79. Harry approaches you and says “I have awarded Top Salesman of the Year. My boss will come and celebrate with
me”. You know for a fact that this is NOT true. Harry is demonstrating a delusion of:
A. achievement C. influence
B. reference D. grandeur
ANSWER:D
Rationale: Harry's belief that he has been awarded Top Salesman of the Year and that his boss will celebrate with him is an
example of a delusion of grandeur, a false belief in one's own importance, power, or identity.
Why not:
A. achievement: Delusions of achievement may involve a sense of accomplishment, but grandeur specifically relates to an
exaggerated sense of importance.
B. reference: Delusions of reference involve the belief that external events or stimuli have personal significance.
C. influence: Delusions of influence involve false beliefs about the ability to control or influence external events.

80. The defense mechanism utilized by manic patients to cover up depression is:
A. displacement C. compensation
B. denial D. reaction formation
ANSWER: D
Rationale: Reaction formation is a defense mechanism where an individual expresses the opposite of what they truly feel. In the
case of manic patients, this defense mechanism may be used to cover up underlying depressive feelings.
Why not:
A. displacement: Displacement involves redirecting emotions from a threatening target to a less threatening one and is not
specifically related to covering up depression.
B. denial: Denial involves refusing to accept reality and is not specific to covering up depression.
C. compensation: Compensation involves making up for a perceived deficiency, and it is not a direct mechanism for covering up
depression.

Situation 17: The nurse observed that Marie, age 28 years old had not been participating in activity therapies.

81. Which of the following remarks from the nursing attendants indicates a need for further teaching and observation?
A. Marie made no response to an invitation to play
B. Marie preferred to sit at the bench and watch the ballgame
C. Marie is aloof and indifferent to co-patients
D. Marie read a book while other patients played a ballgame
ANSWER: C
Rationale: The remark indicating that Marie is aloof and indifferent to co-patients suggests a need for further teaching
and observation. It may indicate a lack of understanding or misinterpretation of Marie's behavior, emphasizing the
importance of proper observation and assessment.
Why not:
A. Marie made no response to an invitation to play: This may be a valid individual choice, and not all patients are
obligated to participate in every activity.
B. Marie preferred to sit at the bench and watch the ballgame: Individual preferences for observing rather than actively
participating can be acceptable.
D. Marie read a book while other patients played a ballgame: Engaging in a different activity does not necessarily
indicate a problem, as individuals have varied interests.

82. Marie said “I don’t like to be a part of it. Look, they are being laughed at because they are singing and acting like
children”. The nurse notes that in order for the activity therapy to be therapeutic:
A. the staff should decide solely what activities to be done and what rules apply
B. patients should be allowed solely to decide what they want to do on their own
C. ballgames should be limited to male patients only
D. age and needs of patient should be considered in the choice of games
ANSWER:D
Rationale: Marie's comment emphasizes the importance of considering the age and needs of patients when planning
activities. This aligns with the principle of individualizing activities to cater to the preferences and requirements
of the patients.
Why not:
A. the staff should decide solely what activities to be done and what rules apply: This is a more authoritarian approach
that may not consider individual preferences and needs.
B. patients should be allowed solely to decide what they want to do on their own: Complete patient autonomy may not
always be practical or therapeutic.
C. ballgames should be limited to male patients only: Gender-based limitations may be discriminatory and do not
consider individual preferences.

83. To encourage active participation among patients, it is BEST to plan activities they can engage in through a:
A. one to one interaction C. checklist
B. community meeting D. feedback evaluation forum
ANSWER:A
Rationale: One-to-one interaction allows for personalized engagement and encouragement of active participation
among patients. It facilitates a more individualized approach to meet the unique needs and preferences of each
patient.
Why not:
B. community meeting: While community meetings can be useful, they may not provide the same level of personalized
interaction.
C. checklist: A checklist is a tool but does not involve direct interaction with patients.
D. feedback evaluation forum: This involves feedback but may not be as direct or personal as one-to-one interaction.

84. In planning activities for the patients, it is essential to consider FOREMOST:

A. safety and security C. novelty and creativity
B. variety and fun D. excitement and challenge
ANSWER:A
Rationale: Safety and security should be prioritized in planning activities to ensure the well-being of the patients.
While variety, fun, excitement, and challenge are important, safety is paramount.
Why not:
B. variety and fun: Variety and fun are important but should not compromise safety.
C. novelty and creativity: Novelty and creativity can enhance engagement but should also consider safety.
D. excitement and challenge: Excitement and challenge are valuable but must be balanced with safety considerations.

85. Adults, “ singing and acting like children” is a form of:

A. displacement C. sublimation
B. regression D. compensation
ANSWER: B
Rationale: The adults "singing and acting like children" is a form of regression—a return to an earlier stage of
development. It involves reverting to behaviors associated with a previous, less mature age.
Why not:
A. displacement: Displacement involves redirecting emotions from a threatening target to a less threatening one and is
not applicable here.
C. sublimation: Sublimation involves channeling socially unacceptable impulses into socially acceptable activities.
D. compensation: Compensation involves making up for a perceived deficiency and is not applicable to the described
behavior.

Situation 18: A research was conducted on. “ The effects of the nurse expressive role in the reduction of anxiety in
patients who will undergo nasogastric tube insertion”.

86. The research is experimental which means that utilized:

A. an interview scheduled C. a questionnaire
B. a survey D. control and experimental groups
ANSWER: D
Rationale: In experimental research, the use of control and experimental groups is a key characteristic. The control
group serves as a baseline or comparison, while the experimental group receives the intervention being studied.
This design allows researchers to assess the impact of the intervention by comparing outcomes between the two
groups.
Why not:
A. an interview schedule: An interview schedule is a data collection method but is not exclusive to experimental
research.
B. a survey: A survey is a data collection method but does not inherently involve control and experimental groups.
C. a questionnaire: A questionnaire is a data collection tool but does not inherently involve control and experimental
groups.

87. The independent variable is:

A. patients C. reduction of anxiety
B. expressive role D. nasogastric insertion
ANSWER:B
Rationale: The independent variable is the variable that is manipulated or changed in an experiment. In this study, the
nurse's expressive role is likely being manipulated to observe its effects on anxiety reduction.
Why not:
A. patients: Patients are the subjects of the study but are not being manipulated as the independent variable.
C. reduction of anxiety: Reduction of anxiety is the desired outcome but is not manipulated in the study.
D. nasogastric insertion: Nasogastric insertion may be an aspect of the study but is not likely the variable being
manipulated.

88. The dependent variable is:

A. nasogastric ingestion C. expressive role
B. patients D. reduction of anxiety
ANSWER:D
Rationale: The dependent variable is the variable that is measured or observed in response to the manipulation of the
independent variable. In this study, the researcher is likely investigating the impact of the nurse's expressive role
(independent variable) on the reduction of anxiety in patients undergoing nasogastric tube insertion.
Why not:
A. nasogastric ingestion: Nasogastric ingestion is related to the procedure but is not the variable being measured.
B. expressive role: The expressive role is manipulated as the independent variable, not measured as a dependent
variable.
C. reduction of anxiety: This is the correct answer, as it is the outcome being measured.
89. This study was done to check the procedures of the research:
A. protest study C. pilot study
B. proposal D. test-retest
ANSWER: C
Rationale: A pilot study is conducted to check the procedures of the research, identify potential problems, and make necessary
adjustments before conducting the full-scale study.
Why not:
A. protest study: A protest study involves investigating opinions or preferences rather than checking procedures.
B. proposal: A proposal outlines the plan for the research but does not involve testing procedures.
D. test-retest: Test-retest involves measuring reliability by repeating measurements over time, not checking procedures.

90. Which of the following is NOT a characteristic of experimental research?

A. value plays a significant part in research
B. research ideas are capable of being tested
C. results of tests made on the groups are compared
D. research subjects are randomly selected and placed into groups for the purpose of manipulation
ANSWER: A
Rationale: Experimental research aims to minimize the impact of personal values and biases by using controlled conditions,
randomization, and blinding to ensure objectivity and reliability.
Why not:
B. research ideas are capable of being tested: This is a characteristic of experimental research.
C. results of tests made on the groups are compared: This is a characteristic of experimental research.
D. research subjects are randomly selected and placed into groups for the purpose of manipulation: This is a characteristic of
experimental research, emphasizing randomization.

Situation 19: 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.

91. 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
ANSWER: B
Rationale: Staying with the client in a calm environment is a supportive and therapeutic intervention. It provides a
sense of security and reassurance, helping the client manage anxiety.
Why not:
A. encourage her to participate in an ongoing activity in the ward: Encouraging participation in activities may not be
suitable during high levels of anxiety.
C. tell her to stop thinking that she is going crazy: Instructing the client to stop thinking a certain way may not be
effective and could be invalidating.
D. isolate the client in a quiet room: Isolation can escalate anxiety and is generally not recommended.

92. Which of the following is a behavioral manifestation of anxiety?

A. hyperventilation C. panic
B. tachycardia D. rapid pulse
ANSWER: C
Rationale: Panic is a behavioral manifestation of anxiety. Panic is an intense and overwhelming feeling of fear or
dread, often accompanied by physical symptoms such as rapid heart rate (tachycardia), hyperventilation (rapid
breathing), and other signs of autonomic arousal.
Why not:
A. hyperventilation: Hyperventilation is a physical symptom that can occur during panic but is not a behavioral
manifestation.
B. tachycardia: Tachycardia is a physical symptom that can accompany anxiety but is not a behavioral manifestation.
D. rapid pulse: Rapid pulse is a physical symptom associated with anxiety but is not a behavioral manifestation.

93. 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
ANSWER: C
Rationale: Anxiety at excessive levels can be destructive and impact a person's well-being. However, moderate levels
of anxiety can be adaptive and serve as a protective mechanism.
Why not:
A. anxiety is contagious: Anxiety is not a contagious condition.
B. repressed unresolved conflicts create anxiety: Repressed unresolved conflicts can contribute to anxiety.
D. reactions to a perceived threat may be real or imaginary: This is true and is consistent with the nature of anxiety.

94. 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
ANSWER:A
Rationale: In the moderate level of anxiety, there is increased tension and reduced ability to perceive and
communicate, leading to "selective attention." Individuals experiencing moderate anxiety may have difficulty
focusing on tasks, and their attention becomes selective, concentrating on certain aspects while neglecting others.
Why not:
C. panic- In the panic level of anxiety, there is typically an overwhelming sense of fear or dread, and cognitive
functioning is severely impaired. Individuals in a panic state may have difficulty processing information or
focusing on anything specific.
B. severe- Severe anxiety is characterized by a high level of discomfort and an increased inability to function.
However, it may not necessarily involve selective attention. Cognitive functioning may be more globally impaired
in severe anxiety.
D. mild - In mild anxiety, there is minimal or no impairment in cognitive functioning. Individuals in a mild state of
anxiety may even experience heightened awareness and improved performance in some tasks. Selective attention
is not typically a characteristic of mild anxiety.

95. This medication is indicated for anxious patients:

A. Tofranil (Imipramine HCL) C. Valium (Diazepam)
B. Haldol (Haloperidol) D. Thorazine (Chlorpromazine)
ANSWER: C
Rationale: Valium (Diazepam) is a medication indicated for anxiety and can have a calming effect.
Why not:
A. Tofranil (Imipramine HCL): Tofranil is an antidepressant and may not be the first choice for anxiety.
B. Haldol (Haloperidol): Haldol is an antipsychotic and may be used for severe agitation but is not a first-line treatment
for anxiety.
D. Thorazine (Chlorpromazine): Thorazine is an antipsychotic and is not typically used as a first-line treatment for
anxiety.

Situation 20: 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.

96. Andy is demonstrating:

A. religious delusion C. somatic delusion
B. delusion of grandeur D. delusion of being controlled
ANSWER:A
Rationale: Andy's belief that he has committed a lot of sins, fasting for forgiveness, and feeling threatened by people
reaching out to him indicates a religious preoccupation and distorted thoughts related to his religious beliefs.
Therefore, he is demonstrating a religious delusion.
Why not:
B. delusion of grandeur - Delusion of grandeur involves an exaggerated sense of self-importance or abilities, which is
not evident in Andy's case. His concerns are centered around religious themes and guilt.
C. somatic delusion - Somatic delusion involves false beliefs related to the body or health. Andy's concerns are
primarily related to religious preoccupation, sin, and forgiveness, not somatic issues.
D. delusion of being controlled - Delusion of being controlled typically involves a belief that external forces or people
are controlling one's thoughts or actions. This is not evident in Andy's case, where the primary focus is on
religious themes and guilt.forces.

97. A delusion is:

A. psychomotor disturbance C. disturbance of thought
B. mood disturbance D. disturbance of perception
ANSWER: C
Rationale: Delusions are a disturbance of thought, involving false beliefs that are resistant to reasoning or contrary to
reality.
Why not:
A. psychomotor disturbance: Psychomotor disturbance involves changes in motor activity and is not specific to
delusions.
B. mood disturbance: Mood disturbance involves changes in mood and is not specific to delusions.
D. disturbance of perception: Disturbance of perception involves alterations in sensory experiences, not necessarily
related to delusions.

98. 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
ANSWER: C
Rationale: This involves working towards improving his self-esteem and reducing negative self-perception. Encouraging him to
see a priest for confession or pray may not address the underlying issues related to his disturbed thoughts and self-image.
Socializing him with a group can be beneficial for reality orientation but may not directly address the development of a
positive self-image.
Why not:
A. have him see a priest for confession: While spiritual support may be beneficial, developing a positive self-image is a broader
goal.
B. encourage him to pray to atone for his sins: Encouraging prayer may be part of spiritual support but may not address the core
issue of self-image.
D. socialize him with a group to keep him in touch with reality: Socializing can be helpful, but the primary goal is to address his
self-image.

99. 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
ANSWER: D
Rationale: In interacting with a person experiencing delusions or distorted thoughts, such as Andy, it is generally recommended to
acknowledge their feelings while gently redirecting the conversation to reality-oriented topics. Agreeing with delusional
beliefs may reinforce them, and exploring the nature of his sins may further exacerbate his distress. It is important to maintain
a supportive and non-confrontational approach.
Why not:
A. agree with him and sympathize how sinful he has really been - Agreeing with delusional beliefs may not be helpful and may
contribute to reinforcing distorted thoughts. The focus should be on maintaining a connection and gently redirecting the
conversation.
B. explore the nature of his sins - Exploring the nature of his sins might intensify his distress and contribute to the preoccupation
with distorted thoughts. It is generally more appropriate to focus on reality-oriented topics.
C. explain that he is depreciating himself too much - While providing reassurance is important, directly stating that he is
depreciating himself too much might be confrontational. A more gentle approach involves acknowledging his feelings and
gently redirecting the conversation.

100. The psychosocial task that Andy needs to work on is a sense of:
A. identity C. autonomy
B. trust D. intimacy
ANSWER: D
Rationale: The psychosocial task that Andy needs to work on is a sense of intimacy. Andy's religious preoccupation, disturbed
thoughts, and belief that fasting for several days is necessary for forgiveness suggest difficulties in forming close and
meaningful connections with others. Intimacy, in the context of Erik Erikson's psychosocial development stages, refers to the
ability to form close, meaningful relationships.
Why not:
A. identity: Identity is a psychosocial task related to developing a sense of self.
B. trust: Trust is a psychosocial task related to establishing confidence in oneself and others.
C. autonomy: Autonomy is a psychosocial task related to developing a sense of independence and control.