GARDEN CITY UNIVERSITY COLLEGE

FACULTY OF HEALTH SCIENCES

DEPARTMENT OF NURSING

END OF SEMESTER EXAMINATIONS

(SECOND SEMESTER 2020 /2021)
DURATION: 2 HOURS
NURS 368 : PSYCHIATRY AND MENTAL HEALTH NURSING
CREDIT HOURS:3
LEVEL 300 & 400 (RGN)
INDEX NUMBER: ………………………………………………
Instructions:
 There are two sections on this exam paper (section A&B)
 Answer ALL the objective questions
 Circle answers for section A on the question paper
 Answer Section B in the answer booklets provided
 Make sure your INDEX NUMBER is written correctly above
and on all sheets used.

Good luck!

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 GARDEN CITY UNIVERSITY COLLEGE
NURSING DEPARTMENT
END OF SEMESTER EXAMS 2020/2021
COURSE: PSYCHIATRY /MENTAL HEALTH NURSING
DURATION: 1HOUR 15mins INSTRUCTION: CIRCLE THE
CORRECT ANSWER ONLY

1.John likes his environment to be as neat and tidy as possible. According to

S.Freud he is displaying fixation in which of the following stages?
A. Anal
B. Genital
C. Oral
D. Phallic

2.Mrs. Ofosu Amarh bought a new dress for her daughter after smacking her for
being rude. This defense mechanism is known as
A. conversion
B. Fixation
C. Restitution
D. Splitting

3. The nurse’s most unique tool in working with emotionally ill patient’s is
A. milieu talk
B. Nursing intervention
C. Personality make up

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D. Theoretical knowledge Ans……………………………….

4. In the care of a mentally ill patient restraint should be used

A. as a usual means to control aggressive behavior
B. Only as a last resort to control aggression
C. To reassure the patients relatives
D. To routinely protect other patients and staffs

5. Which group of disorder is characterized by altered identity following a stressful

situation?
A. anxiety
B. dissociative
C. Phobic
D. schizophrenic

6. One of the goals of family therapy is

A. Knowing the family members
B. Providing mutual support for the members
C. Recounting the family history to its members
D. Solving problems of the community Ans……………………………….

7. Which of the following factors can lead to functional psychosis?

A. Congenital factors
B. Chromosome abnormality
C. Genetic factors
D. Space occupying lesions

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8. Progressive desensitization may be used in the treatment of
A. Hysterical neurosis
B. Neurotic anxiety
C. Obsessive compulsive neurosis
D. Phobic neurosis Ans……………………………….

8. The most appropriate way to decrease a patient’s anxiety is by

A. Acquiring skills with which to face stressful events
B. Avoiding unpleasant objects and events
C. Introducing an element of pressure into fearful situations
D. Prolonged exposure to fearful situations. Ans……………………………….

9. A young man is admitted with a severe anxiety disorder. He is crying and

wringing the hands. The first nursing intervention should be to
A. Get the patient involved in a non-threatening activity
B. Gently ask what is bothering him.
C. Stay physically close to the patient
D. Tell the patient to sit down and try to relax

10.A manic patient on lithium Carbonate is said to be out of any risk of adverse
side effects, only if the levels are between
a. 1.5- 1.7mEq/L
b. 0.7-1.3mEq/L
c. 0.9-1.97mEq/L
d. 1.8- 2 mEq/L

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11. Manifestation of physical symptoms caused by psychological distress is
termed:

a. Pain disorder
b. Somatization
c. Conversion disorder
d. Psychosomatic

12. Which of the following conditions is considered to be the only absolute

contraindication for ECT?
a. Increased intracranial pressure
b. Recent myocardial infarction
c. Severe underlying hypertension
d. Congestive heart failure

13. Electroconvulsive therapy is thought to affect a therapeutic response by:

a. Stimulation of the CNS
b. Decreasing the levels of acetylcholine and monoamine oxidase
c. Increasing the levels of serotonin, norepinephrine, and dopamine
d. Altering sodium metabolism within nerve and muscle cells

14. The most common side effects of ECT are:

a. Permanent memory loss and brain damage
b. Fractured and dislocated bones
c. Myocardial infarction and cardiac arrest
d. Temporary memory loss and confusion

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15.ideas of reference and magical thinking magical thinking may occur in
a. borderline personality disorder
b. schizotypal personality disorder
c. schizoid personality disorder
d. histrionic personality disorder

16. A patient occupied with details and lists is most likely to have?
a. histrionic PD
b. obsessive Complusive PD
c. Narcissistic PD
d. Borderline

17. The priority nursing intervention before starting ECT therapy is to:
a. Take vital signs and record.
b. Have the patient void.
c. Administer succinylcholine.
d. Ensure that the consent form has been signed.

18.Anti-cholinergic medication may be administered to a client receiving ECT for

what purpose?
a. To alleviate anxiety
b. To decrease secretions
c. To relax muscles
d. As a short-acting anesthetic

19. An antagonist that’s administered for narcotic overdose is:

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 a. Disulfiram
b. Naloxone
c. Diazepam
d. Bupropion

20. Theresa, age 27, was admitted to the psychiatric unit from the medical
intensive care unit where she was treated for taking a deliberate overdose of her
antidepressant medication, Prozac. She says to the nurse, “My boyfriend broke up
with me. We had been together for 6 years. I love him so much. I know I’ll never
get over him.” Which is the best response by the nurse?
a. “You’ll get over him in time, Theresa.”
b. “Forget him. There are other fish in the sea.”
c. “You must be feeling very sad about your loss.”
d. “Why do you think he broke up with you, Theresa?”

21. Dan, who has been admitted to the alcohol rehabilitation unit after being fired
for drinking on the job, states to the nurse, “I don’t have a problem with alcohol. I
can handle my booze better than anyone I know. My boss is a jerk! I haven’t
missed any more days than my coworkers.” The defense mechanism that Dan is
using is:
a. Denial
b. Projection
c. Displacement
d. Rationalization

22. The desired outcome of working with an individual who has witnessed a
traumatic event and is now experiencing panic anxiety is:

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a. The individual will experience no anxiety.
b. The individual will demonstrate hope for the future.
c. The individual will maintain anxiety at manageable level.
d. The individual will verbalize acceptance of self as worthy

23. Abele Yaw, a Makola city firefighter, and his entire unit responded to the
terrorist attacks at the World Trade Center. Working as a team, he and his best
friend, Carlo, entered the area together. Carlo was killed when the building
collapsed. Yaw was injured, but survived. Since that time, yaw has had frequent
nightmares and anxiety attacks. He says to the mental health worker, “I don’t know
why Carlo had to die and I didn’t!” This statement by Andrew suggests that he is
experiencing:
a. Spiritual distress
b. Night terrors
c. Survivor’s guilt
d. Suicidal ideation

24. Intervention with Yaw (from question 22) would include:

a. Encouraging expression of feelings
b. Antianxiety medications
c. Participation in a support group
d. a and c
e. All of the above
25. Your husband says, “You’re crazy to think about going to college! You’re not
smart enough to handle the studies and the housework, too.” Which of the
following is an example of a nonassertive response?
a. “I will do what I can, and the best that I can.”

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b. (Thinking to yourself): “We’ll see how he likes cooking dinner for a change.”
c. “You’re probably right. Maybe I should reconsider.”
d. “I’m going to do what I want to do, when I want to do it, and you can’t stop
me!”

State two differences between agoraphobia and social phobia

26……………………………………………………………………………………
27……………………………………………………………………………………
28. Differentiate between Repression and Regression
………………………………………………………………………………………
29. Define Ego mechanism and state one significance of ego mechanism
………………………………………………………………………………………
………………………………………………………………………………………
30.Explain systematic desensitization using an example
………………………………………………………………………………………
31. From which of the following symptoms might the nurse identify a chronic
cocaine user?
a. Clear, constricted pupils
b. Red, irritated nostrils
c. Muscle aches
d. Conjunctival redness

33. An individual who is addicted to heroin is likely to experience which of the

following symptoms of withdrawal?
a. Increased heart rate and blood pressure
b. Tremors, insomnia, and seizures
c. Incoordination and unsteady gait

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d. Nausea and vomiting, diarrhea, and diaphoresis

33. Which of the following individuals is at highest risk for suicide?

a. Nancy, age 33, Asian American, Catholic, middle socioeconomic group,
alcoholic
b. John, age 72, white, Methodist, low socioeconomic group, diagnosis of
metastatic cancer of the pancreas
c. Carol, age 15, African American, Baptist, high socioeconomic group, no
physical or mental health problems
d. Mike, age 55, Jewish, middle socioeconomic group, suffered myocardial
infarction a year ago

34. Some biological factors may be associated with the predisposition to suicide.
Which of the following biological factors have been implicated?
a. Genetics and decreased levels of serotonin
b. Heredity and increased levels of norepinephrine
c. Temporal lobe atrophy and decreased levels of acetylcholine

d. Structural alterations of the brain and increased levels of dopamine

35. Theresa, age 27, was admitted to the psychiatric unit from the medical
intensive care unit where she was treated for taking a deliberate overdose of her
antidepressant medication, Prozac. She says to the nurse, “My boyfriend broke up
with me. We had been together for 6 years. I love him so much. I know I’ll never
get over him.” Which is the best response by the nurse?
a. “You’ll get over him in time, Theresa.”
b. “Forget him. There are other fish in the sea.”
c. “You must be feeling very sad about your loss.”

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d. “Why do you think he broke up with you, Theresa?”

36. The nurse identifies the primary nursing diagnosis for Theresa as Risk for
Suicide related to feelings of hopelessness from loss of relationship. Which is the
outcome criterion that would most accurately measure achievement of this
diagnosis?
a. The client has experienced no physical harm to herself.
b. The client sets realistic goals for herself.
c. The client expresses some optimism and hope for the future.
d. The client has reached a stage of acceptance in the loss of the relationship with
her boyfriend.

37. A typewritten report for your psychiatric nursing class is due tomorrow at 8
a.m. The assignment was made 4 weeks ago, and yours is ready to turn in. Your
roommate says, “I finally finished writing my report, but now I have to go to work,
and I don’t have time to type it. Please be a dear and type it for me, otherwise I’ll
fail!” You have a date with your boyfriend. Which of the following is an example
of an aggressive response?
a. “Okay, I’ll call Ken and cancel our date.”
b. “I don’t want to stay here and type your report. I’m going out with Ken.”
c. “You’ve got to be kidding! What kind of a fool do you take me for,
anyway?”
d. “Okay, I’ll do it.” However, when your roommate returns from work at
midnight, you are asleep and the report has not been typed.

38.Which of the following factors can lead to functional psychosis?

• A. Congenital factors

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 • B. Chromosome abnormality
• C. Genetic factors
• D. Space occupying lesions .
•
39.Which of the under mentioned is a side effect of tricyclic antidepressants?
• A. Blurred vision
• B. Dry mouth
• C. Hypertension
• D. Retention of urine
40. 3. The ability to tolerate frustration is an example of one of the functions of the
• A. Id
• B. Ego
• C. Superego
• D. Unconscious
41.A person seeing a design on the wall paper perceives it as an animal. This is an
example of a/an
• A. Delusion
• B. Hallucination
• C. Idea of reference
D. Illusion Ans……………………

42. A patient would best comply with treatment if the following condition prevail
• A. Convinced of the need to take the drug
• B. Play with the patient while administering the treatment
• C. Reward of soft drink following the treatment
• D. Reducing the dosage of the drug treatment

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43.Which of the following medications is the physician most likely to order for a
client experiencing alcohol withdrawal syndrome?
A. a. Haloperidol (Haldol)
B. b. Chlordiazepoxide (Librium)
C. c. Methadone (Dolophine)
D. d. Phenytoin (Dilantin

44. Which of the following is not a psychological barrier to listening (as part of
effective communication)
A. Lack of understanding
B. Day dreaming
C. Private planning
D. Debating
45.In counselling the four processes to teach clients and to solve their own
problems includes the following except
A. Listening
B. Explaining
C. Exploring
D. Understanding
E. Problem solving
46. Verbal communication is considered a more accurate description of true
feelings because one has more control over non- verbal reaction
• A. True B. false
47. In counselling the problem which is presented from the informant is always a
true problem
• A. True B. false
48. The era in which medications were used to treat mental ill victims was

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 A. Golden Age Period
B. Political Era
C. Scientific Era
D. Demonological Era

49.The making of hole in the skull of mentally ill victim in order to make a way for
evil spirit is termed as …
A. Casting out
B. Trephining
C. Exorcism
D. Demonological approach

50. The method of treating people afflicted with mental illness by putting them in
ice, flogging and burning then is termed ……
A. Trephining
B. Exorcism
C. cleansing
D. deliverance

51.Which of the following does not promote mental health?

A. Providing basic needs
B. Educating on early report with physical illness
C. Allowing people express themselves despite laws
D. Saying positive words to people
E.
52. Quetiapine as an antipsychotic function by what mechanism
A. Depleting dopamine receptors at axon terminal

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 B. Increasing dopamine at post synaptic cleft
C. Blocking dopamine receptors at axon terminal
D. Blocking dopamine receptors at post synaptic cleft
E.
53. Extrapyramidal effects are best managed with by……………
A. Anticholernergics agents
B. Anitiviral
C. phenothiazine
D. Benzodiazepam
E.
54. Drugs that reduces abnormal electrical activity in the brain work on the NE
transmitter.
• Serotonin
• Dopamine
• GABA
• Glutamate

55. Which neurotransmitter is heightened in a person diagnosed of agoraphobia

• a. Serotonin
• b. Non -epinephrine
• c. Glutamate
• d. GABA
56. Which neurochemical is known to promote pleasure when using cocaine
• a. GABA
• b. Serotonin
• c. Dopamine
• d. Glutamate

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57. I am part of the human personality, what i want is what i want, my
gratification is my focus, but I often don’t get it, a part of me says no the other says
yes when I want pleasure. If I keeping seeking certain pleasure I may not be ok
again . Who am I?.........Ego

58. I am part of the human personality, I reside in all ages, with me there is nothing
like guilt, all what you need is to seek for gratification. You know me very well. I
don’t think I are religious. Who am I?.......ID
59.A patient who reports paralysis with no specific cause but has a history of a
recent stressful event has a probable diagnosis of:
a. Hypochondriasis
b. Somatic illness
c. Conversion disorder
d. Pain disorder

60.Misinterpretation of bodily sensations or symptoms is a chief feature of:

a. Body dysmorphic disorder

b. Somatization
c. Conversion disorder
d. Hypochondriasis

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 GARDEN CITY UNIVERSITY COLLEGE
NURSING DEPARTMENT
END OF SEMESTER EXAMS 2020/2021
NURS 368: PSYCHIATRY /MENTAL HEALTH NURSING
DURATION: 1HOUR 15 MINS
SECTION B
INSTRUCTION: ANSWER ONLY TWO QUESTIONS

QUESTION ONE (COMPULSORY ) 15marks

Miss. J.K, 17 years old female was admitted to the female ward with the
diagnosis of seizure disorder.Her mother reported that patient is a known Epileptic
and on medications. Patient however, had stopped taking the medication about a
month ago due to the believe that she had been healed at church. During
ward rounds you realized she was experiencing a generalized Tonic- Clonic
seizure.

A. Mention FOUR (4) possible precipitating factors of epileptic attack. (2MARKS)

B. How would you manage her during the epileptic attack. (7 MARKS)

C. Mention EIGHT (8) observation will make during and after the seizures

(4MARKS )

D. Mention FOUR (4) anticonvulsant medications (2 MARKS)

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QUESTION TWO 25MARKS
Mrs. B.A and her husband visited the antenatal center at your facility for her
regular checkup. The husband reported to the nurse that, Mrs. B.A often gets
worried about the growing fetus and sometimes she does not sleep and keeps on
having the fear that she will have another miscarriage.

A. What detailed history would you take regarding the complaints.? (6 marks)

B. Identify four behavioral, emotional and cognitive symptoms she may

experience (6marks)

C. Explain briefly two psychological therapies that may help in the

management of her condition”? (4marks)

D. What education would you give the husband concerning the wife’s
condition? 6marks

E. Identify three effects of Mrs. B.A condition on the growing fetus. (3marks)

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