Psychiatric nursing(lec)

Situation: The nurse is interviewing a handsome man. He is intelligent and very

charming. When asked about his family, he states he has been married four times. He
says three of those marriages were "shotgun" weddings. He states he never really loved
any of his wives. He doesn't know much about his three children. "I've lost track," he
states.
1. If a patient is very resistant in taking responsibility of his action and asks, "Can you
just give me some medication?" the best response is:
a. "The medication has too many side effects."
b. "You don't want to take medication, do you?"
c. "Medication is given only as a East resort."
d. "There is no medication specific for your condition."

2. The patient asks the nurse, "What is this therapy for anyway. I just don't understand
it." the best reply is: a."It keeps you from being put on medications."
b."It helps you to change others in the family."
c. "The purpose of therapy is to help you change."
d. "No one but professionals can really understand."

3. For patient in group therapy, the goal is:

a. Exchanging information and ideas
b. Developing insight by relating to others
c. Learning that everyone has problems
d. AOTA

Situation: The patient with bipolar disorder is pacing continuously and is skipping meals.

4. Blood levels are drawn on the patient who has been taking Lithium for about six
months. The present level is 2.1 meq/L. The nurse evaluates this level as:
a. Therapeutic
b. Below therapeutic B
c. Potentially dangerous
d. Fatally toxic

5. The priority in working in patient with a thought disorder is:

a. Get him to understand what you're saying."
b. Get him to do his ADLs.
c. Reorient him to reality.
d. Administer antipsychotic medications.

6. The most recent Lithium level on bipolar patient indicates a drop in non-therapeutic
level. What associated behavior does the nurse assess?
a. Ataxia.
B. Confusion.
c. Hyperactivity.
d. Lethargy.
7. Adequate fluid intake for a patient on Lithium is:
a. 1,000 ml per day.
b.,500 ml per day.
c. 2,000 ml per day.
d. 3,600 ml per day.

8. The physician orders Lithium Carbonate (Eskalith) for the bipolar patient. The nurse
is aware that:
a. The patient should be put on a special diet.
b. The medication should be given only at night.
c. A salt-free should be provided for the patient.
d. The drug level should be monitored regularly.

9. The nursing care plan should emphasize:

a. Offering him finger foods.
b. Telling him he must sit down and eat.
c. Serving food in his room and staying with him.
d. Telling him to order fast food of he wants to eat.

Situation: Marinella, 23 years old was raped six months ago states, "I just can't seem to
get over this. My husband and I don't even have sex anymore. What can I do?"

10. Supportive therapy to the rape victim is directed at overwhelming feeling that the
victim experiences just after the rape has occurred?
a. Guilt
b. Rage
c. Damaged
d. Despair

11. Marinella asks, "Why do I need to have pelvic exam?" The nurse explains:
a. "To make sure you're not pregnant."
b. "To see if you got an infection."
c. "To make sure you were really raped."
d. To gather legal evidence that is required."

12. In providing support therapy, the nurse explains that rape has nothing to do with
sexual desires or heeds. The two most common elements in rape are:
a. Guilt and shame.
b Shame and jealousy.
C. Embarrassment and envy.
d. Power and anger.

13. The rape victim will not talk, is withdrawn and depressed. The defensive mechanism
being used is: a. a.Rationalization
b. Denial
c. Repression
d. Regression

14. The composite picture of rape victim reveals that most victimized women are:
a. Secretaries
b. Elderly
c. Students
d. Professionals

15. The best nursing intervention on this situation is:

a. Tell her it just takes a long time.
b. Ask her if her husband is angry.
c.. Refer her and her husband to sex therapy.
d. Tell her she is suffering PTSD.

Situation: Obsessions are recurring thoughts that become prevalent in the

consciousness and may be considered as senseless or repulsive white compulsion are
the repetitive acts that follow obsessive thoughts.

16. To understand the meaning of the cleaning rituals, the nurse must realize:
a. The patient cannot help herself.
b. The patient cannot change.
C. Rituals relieve intense anxiety.
d. Medications cannot help.

17. Upon admission to the hospital the patient increases the ritual behavior at bedtime.
She cannot sleep. The treatment plan should include:
a. Recommending a sedative medication.
B. Modifying the routine to diminish her bedtime anxiety.
c. Reminding her to perform rituals early in the evening.
d. Limit the amount of time she spends washing her hands.

18. A patient has been diagnosed with a personality disorder with compulsive traits. Of
the following behavior's, which one would you expect the patient to exhibit?
a. inability to make decisions.
b. Spontaneous playfulness.
c. Inability to alter plans.
d. Insistence that things be done his way.

19. The patient will not be able to stop her compulsive washing routines until she:

a. Acquires more superego.

B. Recognizes the behavior is unrealistic.
c. No longer needs them to manage her feelings of anxiety.
d. Regains contact with reality.
20. A 48-year-old female patient is brought to the hospital by her husband because her
behavior is blocking her ability to meet her family's needs. She has uncontrollable and
constant desire to scrub her hands, the walls, floors and sofa. She keeps repeating,"
Everything is dirty." This is an example of:
a. Compulsion
b. Obsession
c. Delusion
d. Hallucination

21. The female patient is preoccupied with rules and regulations. She becomes upset if
others do not follow her lead and adhere to the rules exactly. This is a characteristic of
which of the following personality?
a. Compulsive
b. Borderline
c. Antisocial
d. Schizoid

22. In planning care focused on decreasing the patient's anxiety, what plan should the
nurse have in regards to the rituals?
a. Encourage the routines.
b. Ignore rituals.
C. Work with her to develop limits of behavior.
d. Restrain her from the rituals.

23. After the patient entered the hospital, she began to increase her ritualistic hand
washing at bedtime and could not sleep. The nurse plans care around the fact that this
patient needs:
a. A substitute activity to relieve anxiety.
b. Medication for sleeping.
c. Anti-anxiety medication such as Xanax.
d. More scheduled activities during the day.

24. The patient states, "I know all this scrubbing is silly but I can't help it.", this
statement indicates that the patient
does not recognize:
a. What she is doing.
b. Why she is cleaning.
c. Her level of anxiety.
d. Need for medication.

Situation: Defense mechanisms are unconscious intrapsychic process implemented to

cope with anxiety. The use of some of these mechanisms is healthy, while she use of
others is unhealthy.

25. A patient cries and curls in a fetal position refusing to move or talk. This is an
example of.
a. Regression
b. Suppression
C. Conversion
d. Sublimation

26. A person who expands sexual energy in a nonsexual, socially accepted way is using
the coping mechanism of.
a. Projection
b. Conversion
c. Sublimation
d. Compensation

27. "The reason I did not do well on the exam is that I was tired." This is an example of.
a. Rationalization
b. Projection
c. Compensation
d. Substitution

28. An unattractive girl becomes a very good student. This is an example of:
a. Displacement
b. Regression
c. Compensation
d. Projection

29. A patient has been sharing a painful experience of sexual abuse during his
childhood. Suddenly he stops and says, "I can't remember anymore." The nurse
assesses his behavior as:
a. Stubbornness
b. Forgetfulness
c. Blocking
d. Transference

30. The patient has a phobia about walking down in dark halls. The nurse recognizes
that the coping mechanism usually associated with phobia is:
a. Compensation
b. Denial
c. Conversion
d. Displacement

Situation: The nurse suspects a client is denying his feelings of anxiety.

31. The nurse is monitoring a patient who is experiencing increasing anxiety related to
recent accident. She notes an increase in vital signs from 130/70 to 160/30, pulse rate
of 120, respiration 36. He is having difficulty communicating. His level of anxiety is:
a. Mild
b. Moderate
c. Severe
d. Panic

32. The patient who suffers panic attacks is prescribed a medication for short-term
therapy. The nurse prepares to
administer:
a. Amitriptyline (Elavil)
b. Chlordiazepoxide (Librium)
c. Paroxetine (Paxil)
d. Thioridazine (Mellaril)

33. In attempting to control a patient who is suffering panic attack, the nursing priority is:
a. Provide safety.
b. Hold the patient.
c. Describe the crisis in detail.
d. Demonstrate ADLs frequently.

34. Which assessment would the nurse most likely find in a person who is suffering
increased anxiety?
a. Increasing BP, increasing heart rate and respirations.
b. Decreasing BP, heart rate and respirations.
c. Increased BP and decreased respirations.
d. Increased respirations and decreased heart rate.

35. A patient who suffers an acute anxiety disorder approaches the nurse and while
clutching at his shirt states "I think I'm having a heart attack." The priority nursing action
is:
a Reassure him he is okay.
b. Take vital signs STAT.
c. Administer Valium IM.
d. Administer Xanax PO.

36. In teaching stress management, the goal of therapy is to:

a. Get rid of the major stressor.
b. Change lifestyle completely.
c. Modify responses to stress.
d. Learn new ways of thinking.

37. Another client walks in to the mental health outpatient center and States, "I've had it.
I can't go on any longer. You've got to help me. "The nurse asks the client to be seated
in a private interview room. Which action should the nurse take next?
a. Reassure the client that someone will help him soon.
b. Assess the client's insurance coverage.
c. Find out more about what is happening to the client.
d. Call the client's family to come and provide support.
38. Mr. Juan Phillip is admitted for panic attack. He frequently experiences shortness of
breath, palpitations, nausea, diaphoresis, and terror. What should the nurse include in
the care plan for Mr. Juan Phillip when he is having a panic attack?
a. Calm reassurance, deep breathing and medications as ordered.
b. Teach Mr. Juan problem solving in relation to his anxiety.
c. Explain the physiologic responses of anxiety.
d. Explore alternate methods for dealing with the cause of his anxiety.

39. Ms. Nina is pacing about the unit and wringing his hands. She is breathing rapidly
and complains of palpitations and nausea, and she has difficulty focusing on what the
nurse is saying. She says she is having a heart attack but refuses to rest. The nurse
would interpret her level of anxiety as:
a. Mild
b. Moderate
c. Severe
d. Panic

40. When assessing this client, the nurse must be particularly alert to:
a. Restlessness.
b. Tapping of the feet.
c. Wringing of the hands.
d. His or her own anxiety level.

Situation: The police bring a patient to the emergency department. He has been locked
in his apartment for the past 3 days, making frequent calls to the police and emergency
services and stating that people are trying to kill him.

41. A client on an inpatient psychiatric unit refuses to eat and states that the staff is
poisoning her food. Which action should the nurse include in the client's care plan?
a. Explain to the client that the staff can be trusted.
b. Show the client that others eat the food without harm.
c. Offer the client factory-sealed foods and beverages..
d. Institute behavioral modification with privileges dependent on intake.

42. The client tells the nurse that he can't eat because his food has been poisoned. This
statement is an indication of which of the following?
a. Paranoia
b) Delusion of persecution
C. Hallucination
d. Illusion

43. The client on antipsychotic drug therapy begins to exhibit signs and symptoms of
which of the following extrapyramidal reactions?
a. Akinesia
b. Parkinsonism
c. Tardive dyskinesia
d. Oculogyric crisis

44. During a patient history, a patient state that she used to believe she was God. But
she knows this isn't true. Which of the following would be your best response?
a. "Does it bother you that you used to believe that about yourself?"
b. "Your thoughts are now more appropriate."
c. "Many people have these delusions."
d. "What caused you to think you were God?"

45. The nurse is caring for a client who is experiencing auditory hallucination. What
would be most crucial for the nurse to assess?
a. Possible hearing impairment
b. Family history of psychosis
c. Content of the hallucination
d. Otitis media

46. A patient with schizophrenia reports that the newscaster on the radio has a divine
message especially for her. You would interpret this as indicating:
a. Loosé of associations
b. Delusion of reference C
c. Paranoid speech
d. Flight of ideas

Situation: Helen, with a diagnosis of disorganized schizophrenia is creating a

disturbance in the day room. She is yelling and pointing at another patient, accusing him
of stealing her purse. Several patients are in the day room when this incident starts.

47. The nurse is preparing to care for a client diagnosed with catatonic schizophrenia. In
anticipation of this client's arrival, what should the nurse do?
a. Notify security.
b. Prepare a magnesium sulfate drip.
c. Place a specialty mattress overlay on the bed.
d. Communicable the client's nothing-by-mouth status to the dietary department.

46. The nurse is caring for a client whom she suspects is paranoid. How would the
nurse confirm this assessment?
a. Indirect questioning
b. Direct questioning
C.Les-ad-in-sentences
d. Open-ended sentences

47. Which of the following is an example of a negative symptom of schizophrenia?

a. Delusions
b. Disorganized speech
c. Flat affect
d. Catatonic behaviour

48. The patient tells you that a "voice" keeps laughing at him and tells him he must
crawl on his hands and knees like a dog. Which of the following would be the most
appropriate response?
a. "They are imaginary voices and we're here to make them go, away."
b. "If it makes you feel better, do what the voices tell you."
c. "The voices can't hurt you here in the hospital"
d. "Even though I don't hear the voices, I understand thatyou do."

Situation: Ceddie is admitted with a diagnosis of paranoid schizophrenia.

49. You're reaching a community group about schizophrenia disorders. You explain the
different types of schizophrenia and delusional disorders. You also explain that, unlike
schizophrenia, delusional disorders:
a. Tend to begin in early childhood
b. Affect more men than women
c. Affect more women than men
d. May be related to certain medical conditions

50. A patient with schizophrenia (catatonic type) is mute and can't perform activities of
daily living. The patient stares out the window for hours. What is your first priority in this
situation?
a. Assist the patient with feeding.
b. Assist the patient with showering and tasks for hygiene.
c. Reassure the patient about safety, and try to orient him to his surroundings.
d. Encourage socialization with peers, and provide a stimulating environment.

51. Which of the following would you suspect in a patient receiving Chlorpromazine
(Thorazine) who complains of a sore throat and has a fever?
a. An allergic reaction
b. Jaundice
c. Dyskinesia
d. Agranulocytosis

52. While providing information for the family of a patient with schizophrenia, you should
be sure to inform them about which of the following characteristics of the disorder?
a. Relapse can be prevented if the patient takes medication.
b. Support is available to help family members meet their own needs.
c. Improvement should occur if the patient's environment is carefully maintained.
d. Stressful situations in the family in the family can precipitate a relapse in the patient.

53. Which nursing diagnosis is most likely to be associated with a person who has a
medical diagnosis of schizophrenia, paranoid type?
a. Fear of being along.
b. Perceptual disturbance related to delusion of persecution.
c. Social isolation related to impaired ability to trust.
d. Impaired social skills related to inadequate developed superego.

54. Which of the following behaviors can the nurse anticipate with this client?
a. Negative cognitive distortions.
b. Impaired psychomotor development.
c. Delusions of grandeur and hyperactivity.
d. Alteration of appetite and sleep pattern.

55. When preparing to conduct group therapy, the nurse keeps in mind that the optimal
number of clients in a group would be:
a. 6 to 8
b. 10 to 12
c.3 to 5
d.Unlimited

56. A 42 year-old homemaker arrives at the emergency department with uncomfortable

crying and anxious. Her husband of 17 years has recently asked her for a divorce. The
patient is sitting in a chair, rocking back and forth. Which is the best response for the
nurse to make?
a. "You must stop crying so that we can discuss your feelings about the divorce."
b. "Once you find a job, you will feel much better and more secure."
c. "I can see how upset you are. Let's sit in the office so that we can talk about how
you're feeling."
d. "Once you have a lawyer looking out for your interests, you will feel better."

57. Tony refuses his evening dose of Haloperidol (Haldol), then becomes extremely
agitated in the dayroom while other clients are watching television. He begins cursing
and throwing fumiture. Nurse Triane first action is to:
a. Check the client's medical record for an order for an as-needed I.M. dose of
medication for agitation.
b. Place the client in full leather restraints.
c. Call the attending physician and report the behavior.
d. Remove all other clients from the dayroom.

58. In preparing a female client for electroconvulsive therapy (ECT), Nurse Jeremy
knows that Succinylcholine (Anectine) will be administered for which primary therapeutic
effect?
a. Short-acting anesthesia
b. Decreased oral and respiratory secretions.
c. Skeletal muscle paralysis.
d. Analgesia.

59. After seeking help at an outpatient mental health clinic, Mika who was raped while
walking her dog is diagnosed with posttraumatic stress disorder (PTSD). Three months
later, Mika returns to the clinic, complaining of fear, loss of control, and helpless
feelings. Which nursing intervention is most appropriate for Mika?
a. Recommending a high-protein, low-fat diet.
b. Giving sleep medication, as prescribed, to restore a normal sleep-wake cycle.
c. Allowing the client time to heal.
d. Exploring the meaning of the traumatic event with the client.

60. Anthony was newly diagnosed with anxiety disorder. The physician prescribed
Buspirone (BuSpar). The nurse is aware that the teaching instructions for newly
prescribed Buspirone should include which of the following?
a. A warning about the drugs delayed therapeutic effect, which is from 14 to 30 days.
b. A warning about the incidence of neuroleptic malignant syndrome (NMS).
c. A reminder of the need to schedule blood work in 1 week to check blood levels of the
drug.
d. A warning that immediate sedation can occur with a resultant drop in pulse.

61. Zanjoe with agoraphobia has been symptom-free for 4 months. Classic signs and
symptoms of phobias include:
a. Insomnia and an inability to concentrate.
b. Severe anxiety and fear.
c. Depression and weight loss.
d. Withdrawal and failure to distinguish reality from fantasy.

62. Which medications have been found to help reduce or eliminate panic attacks?
a. Antidepressants
b. Anticholinergics
c. Antipsychotics d. Mood stabilizers
d. mood stabilizer

63. A client seeks care because she feels depressed and has lost weight. To treat her
atypical depression, the physician prescribes Tranylcypromine sulfate (Parnate), 10 mg
by mouth twice per day. When this drug is used to treat atypical depression, what is its
full clinical response of action?
a. 1 to 2 days
b. 3 to 5 days
c. 6 to 8 days
d. 10 to 14 days

64. The nurse is assessing a client who has just been admitted to the emergency
department. Which signs would suggest an overdose of an antianxiety agent?
a. Combativeness, sweating, and confusion
b. Agitation, hyperactivity, and grandiose ideation
c. Emotional lability, euphoria, and impaired memory
d. Suspiciousness, dilated pupils, and increased blood pressure

65. Tim-Ang is admitted with a diagnosis of delusions of grandeur. The nurse is aware
that this diagnosis reflects a
belief that one is:
a. Highly important or famous.
b. Being persecuted.
c. Connected to events unrelated to oneself.
d. Responsible for the evil in the world.

66. Aaron is experiencing hallucinations and tells the nurse, "The voices are telling me
I'm no good." The client asks
if the nurse hears the voices. The most appropriate response by the nurse would be:
a. "It is the voice of your conscience, which only you can control."
b. "No, I do not hear your voices, but I believe you can hear them."
c. "The voices are coming from within you and only you can hear them.
d. "Oh, the voices are a symptom of your illness; don't pay any attention to them."

67. The nurse is aware that the side effect of electroconvulsive therapy that a client may
experience:
a. Loss of appetite
b. Postural hypotension
c. Confusion for a time after treatment
d. Complete loss of memory for a time

68. A dying male client gradually moves toward resolution of feelings regarding
impending
death. Basing care on the theory of Kubler-Ross, Nurse Ched plans to use nonverbal
interventions when assessment reveals that the client is in the:
a. Anger stage
b. Denial stage
c. Bargaining stage
d. Acceptance stage

69. Pimiento, a psychiatric client is to be discharged with orders for Haloperidol (Haldol)
therapy. When developing a teaching plan for discharge, the nurse should include
cautioning the client against:
a. Driving at night.
b. Staying in the sun.
c. Ingesting wines and cheeses.
d. Taking medications containing aspirin.

70. Gab, a nursing student is anxious about the upcoming board examination but is able
to study intently and does not become distracted by a roommate's talking and loud
music. The student's ability to ignore distractions and to focus on studying
demonstrates:
a. Mild-level anxiety
b. Panic-level anxiety
c. Severe-level anxiety
d. Moderate-level anxiety
71. Josefina is to be discharged on a regimen of Lithium Carbonate (Eskalith). In the
teaching plan for discharge the nurse should include:
a. Advising the client to watch the diet carefully
b. Suggesting that the client take the pills with milk
c. Reminding the client that a CBC must be done once a month.
d. Encouraging the client to have blood levels checked as ordered.

72. The psychiatrist orders lithium carbonate 600 mg P.O. T.I.D for a female client.
Nurse Katrina would be aware that the teachings about the side effects of this drug
were understood when the client state, "I will call my doctor immediately if I notice any:
a. Sensitivity to bright light or sun
b. Fine hand tremors or slurred speech
c. Sexual dysfunction or breast enlargement
d. Inability to urinate or difficulty when urinating

73. Tranylcypromine sulfate (Parnate) is prescribed for a depressed client who has not
responded to the tricyclic antidepressants. After teaching the client about the
medication, Nurse Cyan evaluates that learning has occurred when the client states, "I
will avoid:
a. "Citrus fruit, tuna, and yellow vegetables."
b. "Chocolate milk, aged cheese, and yogurt"
c. "Green leafy vegetables, chicken, and milk."
d. "Whole grains, red meats, and carbonated soda."

74. Lorenzo with chronic schizophrenia takes neuroleptic medication is admitted to the
psychiatric unit. Nursing assessment reveals rigidity, fever, hypertension, and
diaphoresis. These findings suggest which life-threatening reaction:
a. Tardive dyskinesia.
b. Dystonia.
c. Neuroleptic malignant syndrome.
d. Akathisia.

75. Which nursing intervention would be most appropriate if a male client develop
orthostatic hypotension while taking amitriptyline (Elavil)?
a. Consulting with the physician about substituting a different type of antidepressant.
b. Advising the client to sit up for 1 minute before getting out of bed.
c. Instructing the client to double the dosage until the problem resolves.
d. Informing the client that this adverse reaction should disappear within 1 week.

76. Celia, with manic episodes is taking Lithium Carbonate (Eskalith). Which electrolyte
level should the nurse check before administering this medication?
a. Calcium
b. Sodium
c. Chloride
d. Potassium
77. Nurse Bryan is caring for a client who has been treated long term with antipsychotic
medication. During the assessment, Nurse Bryan checks the client for tardive
dyskinesia. If tardive dyskinesia is present, Nurse Anne would most likely observe:
a. Abnormal movements and involuntary movements of the mouth, tongue, and face.
b. Abnormal breathing through the nostrils accompanied by a "thrill."
c. Severe headache, flushing, tremors, and ataxia.
d. Severe hypertension, migraine headache.

78. Nurse Sam is monitoring a male client who has been placed in-restraints because of
violent behavior. Nurse Sam determines that it will be safe remove the restraints when:
a. The client verbalizes the reasons for the violent behavior.
b. The client apologizes and tells the nurse that it will never happen again.
c. No acts of aggression have been observed within 1 hour after the release of two of
the extremity restraints.
d. The administered medication has taken effect.

79. David is diagnosed with panic disorder with agoraphobia is talking with the nurse in-
charge about the progress made in treatment. Which of the following statements
indicates a positive client response?
a. "I went to the mall with my friends last Saturday."
b. "I'm hyperventilating only when I have a panic attack." C. "Today I decided that I can
stop taking my medication."
d. "Last night I decided to eat more than a bowl of cereal."

80. The effectiveness of monoamine oxidase (MAO) inhibitor drug therapy in a client
with posttraumatic stress disorder can be demonstrated by which of the following client
self-reports?
a. "I'm sleeping better and don't have nightmares
b. "I'm not losing my temper as much"
c. "I've lost my craving for alcohol"
d. I've lost my phobia for water"

81. Mark, with a diagnosis of generalized anxiety disorder wants to stop taking his
lorazepam (Ativan). Which of the following important facts should nurse Betty discuss
with the client about
discontinuing the medication?
a. Stopping the drug may cause depression
b. Stopping the drug increases cognitive abilities
c. Stopping the drug decreases sleeping difficulties
d. Stopping the drug can cause withdrawal symptoms

82. Nurse Darwin enters a client's room, the client says, "They're crawling on my
sheets! Get them off my bed!" Which of the following assessment is the most accurate?
a. The client is experiencing aphasia
b. The client is experiencing dysarthria
c. The client is experiencing a flight of ideas
d. The client is experiencing visual hallucination

83. During conversation of Nurse Hanns with a client, he observes that the client shift
from one topic to the next on a regular basis. Which of the following terms describes this
disorder?
a. Flight of ideas
b. Concrete thinking
c. Ideas of reference
d. Loose association

84. Nora, a 42-year-old client with a diagnosis of chronic undifferentiated schizophrenia

lives in a rooming house that has a weekly nursing clinic. She scratches while she tells
the nurse she feels creatures eating away at her skin. Which of the following
interventions should be done first?
a. Talk about his hallucinations and fears
b. Refer him for anticholinergic adverse reactions
c. Assess for possible physical problems such as rash
d. Call his physician to get his medication increased to control his psychosis

85. lan, who is on the psychiatric unit is copying and imitating the movements of her
primary nurse. During recovery, she says, "I thought the nurse was my mirror. I felt
connected only when I saw my nurse." This behavior is known by which of the following
terms?
a. Modeling
b. Echopraxia
c. Ego-syntonicity
d. Ritualism

86. Jomar approaches the nurse and tells that he hears a voice telling him that he's evil
and deserves to die. Which of the following terms describes the client's perception?
a. Delusion
b. Disorganized speech
c. Hallucination
d. Idea of reference

87. Rob is admitted to a psychiatric unit with a diagnosis of undifferentiated

schizophrenia.
Which of the following defense mechanisms is probably used by Rob?
a. Projection
b. Rationalization
c. Regression
d. Repression
88. A client is experiencing an anxiety attack. The most appropriate nursing intervention
should include?
a. Turning on the television.
b. Leaving the client alone.
c. Staying with the client and speaking in short sentences.
d. Ask the client to play with other clients.

89. Nurse Benedict can minimize agitation in a disturbed client by?

a. Increasing stimulation
b. Limiting unnecessary interaction
c. Increasing appropriate sensory perception
d. Ensuring constant client and staff contact

90. John Lloyd is complaining to other clients about not being allowed by staff to keep
food in his room. Which of the following interventions would be most appropriate?
a. Allowing a snack to be kept in his room.
b. Reprimanding the client.
c. Ignoring the clients behavior.
d. Setting limits on the behavior.

91. Nurse Penny is aware that the symptoms that distinguish post-traumatic stress
disorder from other anxiety disorder would be:
a. Avoidance of situation & certain activities that resemble the stress
b. Depression and a blunted affect when discussing the traumatic situation
c. Lack of interest in family & others
d. Re-experiencing the trauma in dreams or flashback

92. A 23-year-old client has been admitted with a diagnosis of schizophrenia says to the
nurse "Yes, its march, March is little woman". That's literal you know". These statements
illustrate:
a. Neologisms
b. Echolalia
c. Flight of ideas
d. Loosening of association

93. Nurse Diane is assigned to care for a client diagnosed with Catatonic Stupor. When
Nurse Nina enters the client's room, the client is found lying on the bed with a body
pulled into a fetal position. Nurse Diane should?
a. Ask the client direct questions to encourage talking.
b. Rake the client into the dayroom to be with other clients.
c. Sit beside the client in silence and occasionally ask open-ended question.
d. Leave the client alone and continue with providing care to the other clients.

94. Nurse Tina is caring for a client with depression who has not responded to
antidepressant medication. The nurse anticipates that what treatment procedure may be
prescribed?
a. Neuroleptic medication
b. Short term seclusion
c. Psychosurgery
d. Electroconvulsive therapy
95. Dex is admitted to the emergency room with drug-included anxiety related to over
ingestion of prescribed antipsychotic medication. The most important piece of
information the nurse in charge should obtain initially is the:
a. Length of time on the med.
b. Name of the ingested medication & the amount ingested
c. Reason for the suicide attempt
d. Name of the nearest relative & their phone number

96. A client tells the nurse, "I am a spy for the FBI. I am an eye, an eye in the sky." The
nurse recognizes that this is an example of?
a. Echolalia
b. Word salad
c. Clang associations
d. Loosened associations

97. Nurse Zaduire is reviewing a client's diagnostic results recognizes that a possible
positive indication for a diagnosis of schizophrenia is:
a. Abnormally high blood flow to the frontal lobes.
b. Atrophy of the lateral and/or third ventricles of the brain.
c. Atrophy of both limbic structures and cerebellum.
d. Abnormally small fissures on the surface of the brain.

98. An emergency department nurse is preparing to care for a client with rape-trauma
syndrome. Which goal is appropriate for the client at this time?
a. Client will accept the trauma that has happened.
b. Client will not experience psychological trauma.
c. Client will not use defense mechanisms.
d. Client will begin the healthy grieving process.

99. A client comes to the emergency room following an assault and is extremely
agitated, trembling, and hyperventilating. The appropriate initial nursing action would be
to:
a. Encourage the client to discuss the assault.
b. Place the client in a quiet room alone to decrease stimulation.
c. Remain with the client until the anxiety decreases.
d. Begin to teach relaxation techniques.

100. A client with paranoia tells the nurse that she will not attend the group therapy
session because a student nurse has been sent to spy on her. The nurse makes which
response to the client?
a. "If you attend group therapy, I'll take you for a walk."
b. "What makes you think the student is spying on you?"
c. "Student nurses attend group therapy as part of their education."
d. "Com to therapy with me. I'll protect you."