NURSING PRACTICE V part 1

NURSING PRACTICE V

Situation: Understanding different models of care is a

necessary part of the nurse patient relationship.

1. The focus of this therapy is to have a positive

environmental manipulation, physical and social

to effect a positive change.

A. Milieu

B. Psychotherapy

C. Behaviour

D. Group

2. The client asks the nurse about Milieu therapy.

The nurse responds knowing that the primary

focus of milieu therapy can be best described by

which of the following?

A. A form of behavior modification therapy

B. A cognitive approach of changing the

behaviour

C. A living, learning or working

environment

D. A behavioural approach to changing

behaviour

3. A nurse is caring for a client with phobia who is

being treated for the condition. The client is

introduced to short periods of exposure to the

phobic object while in relaxed state. The nurse

understands that this form of behaviour

modification can be best described as:

A. Systematic desensitization

B. Self-control therapy

C. Aversion Therapy

D. Operant conditioning

4. A client with major depression is considering

cognitive therapy. The client say to the nurse,

“How does this treatment works?” The nurse

responds by telling the client that:

A. “This type of treatment helps you

examine how your thoughts and

feelings contribute to your difficulties”

B. “This type of treatment helps you

examine how your past life has

contributed to your problems.”

C. “This type of treatment helps you to

confront your fears by exposing you to

the feared object abruptly.

D. “This type of treatment will help you

relax and develop new coping skills.”

5. A Client state, “I get down on myself when I

make mistake.” Using Cognitive therapy

approach, the nurse should:

A. Teach the client relaxation exercise to

diminish stress

B. Provide the client with Mastery

experience to boost self esteem

C. Explore the client’s past experiences that

causes the illness

D. Help client modify the belief that

anything less than perfect is horrible

6. The most advantageous therapy for a preschool

age child with a history of physical and sexual

abuse would be:

A. Play

B. Psychoanalysis

C. Group

D. Family

7. An 18 year old client is admitted with the

diagnosis of anorexia nervosa. A cognitive

behavioural approach is used as part of her

treatment plan. The nurse understands that the

purpose of this approach is to:

A. Help the client identify and examine

dysfunctional thoughts and beliefs

B. Emphasize social interaction with clients

who withdraw

C. Provide a supportive environment and a

therapeutic community

D. Examine intrapsychic conflicts and past

events in life

8. The nurse is preparing to provide reminiscence

therapy for a group of clients. Which of the

following clients will the nurse select for this

group?

A. A client who experiences profound

depression with moderate cognitive

impairment

B. A catatonic, immobile client with

moderate cognitive impairment

C. An undifferentiated schizophrenic client

with moderate cognitive impairment

D. A client with mild depression who

exhibits who demonstrates normal

cognition

9. Which intervention would be typical of a nurse

using cognitive-behavioral approach to a client

experiencing low self-esteem?

A. Use of unconditional positive regard

B. Analysis of free association

C. Classical conditioning

D. Examination of negative thought

patterns

10. Which of the following therapies has been

strongly advocated for the treatment of posttraumatic

stress disorders?

A. ECT

B. Group Therapy

C. Hypnotherapy

D. Psychoanalysis

11. The nurse knows that in group therapy, the

maximum number of members to include is:

A. 4

B. 8

C. 10

D. 16

12. The nurse is providing information to a client

with the use of disulfiram (antabuse) for the

treatment of alcohol abuse. The nurse

understands that this form of therapy works on

what principle?

A. Negative Reinforcement

B. Operant Conditioning

C. Aversion Therapy

D. Gestalt therapy

13. A biological or medical approach in treating

psychiatric patient is:

A. Million therapy

B. Behavioral therapy

C. Somatic therapy

D. Psychotherapy

14. Which of these nursing actions belong to the

secondary level of preventive intervention?

A. Providing mental health consultation to

health care providers

B. Providing emergency psychiatric

services

C. Being politically active in relation to

mental health issues

D. Providing mental health education to

members of the community

15. When the nurse identifies a client who has

attempted to commit suicide the nurse should:

A. call a priest

B. counsel the client

C. refer the client to the psychiatrist

D. refer the matter to the police

Situation: Rose seeks psychiatric consultation because of

intense fear of flying in an airplane which has greatly

affected her chances of success in her job.

16. The most common defense mechanism used by

phobic clients is:

A. Supression

B. Denial

C. Rationalization

D. Displacement

17. The goal of the therapy in phobia is:

A. Change her lifestyle

B. Ignore tension producing situation

C. Change her reaction towards anxiety

D. Eliminate fear producing situations

18. The therapy most effective for client’s with

phobia is:

A. Hypnotherapy

B. Cognitive therapy

C. Group therapy

D. Behavior therapy

19. The fear and anxiety related to phobia is said to

be abruptly decreased when the patient is

exposed to what is feared through:

A. Guided Imagery

B. Systematic desensitization

C. Flooding

D. Hypotherapy

20. Based on the presence of symptom, the

appropriate nursing diagnosis is:

A. Self-esteem disturbance

B. Activity intolerance

C. Impaired adjustment

D. Ineffective individual coping

Situation: Mang Jose, 39 year old farmer, unmarried, had

been confined in the National center for mental health

for three years with a diagnosis of schizophrenia.

21. The most common defense mechanism used by

a paranoid client is:

A. Displacement

B. Rationalization

C. Suppression

D. Projection

22. When Mang Jose says to you: “The voices are

telling me bad things again!” The best response

is:

A. “Whose voices are those?”

B. “I doubt what the voices are telling you”

C. “I do not hear the voice you say you

hear”

D. “Are you sure you hear these voices?”

23. A relevant nursing diagnosis for clients with

auditory hallucination is:

A. Sensory perceptual alteration

B. Altered thought process

C. Impaired social interaction

D. Impaired verbal communication

24. During mealtime, Jose refused to eat telling that

the food was poisoned. The nurse should:

A. Ignore his remark

B. Offer him food in his own container

C. Show him how irrational his thinking is

D. Respect his refusal to eat

25. When communicating with Jose, The nurse

considers the following except:

A. Be warm and enthusiastic

B. Refrain from touching Jose

C. Do not argue regarding his hallucination

and delusion

D. Use simple, clear language

Situation: Gringo seeks psychiatric counselling for his

ritualistic behavior of counting his money as many as 10

times before leaving home.

26. An initial appropriate nursing diagnosis is:

A. Impaired social interaction

B. Ineffective individual coping

C. Impaired adjustment

D. Anxiety Moderate

27. Obsessive compulsive disorder is BEST described

by:

A. Uncontrollable impulse to perform an

act or ritual repeatedly

B. Persistent thoughts

C. Recurring unwanted and disturbing

thought alternating with a behavior

D. Pathological persistence of unwilled

thought, feeling or impulse

28. The defense mechanism used by persons with

obsessive compulsive disorder is undoing and it

is best described in one of the following

statements:

A. Unacceptable feelings or behavior are

kept out of awareness by developing the

opposite behavior or emotion

B. Consciously unacceptable instinctual

drives are diverted into personally and

socially acceptable channels

C. Something unacceptable already done

is symbolically acted out in reverse

D. Transfer of emotions associated with a

particular person, object or situation to

another less threatening person, object

or situation

29. To be more effective, the nurse who cares for

persons with obsessive compulsive disorder

must possess one of the following qualities:

A. Compassion

B. Patience

C. Consistency

D. Friendliness

30. Persons with OCD usually manifest:

A. Fear

B. Apathy

C. Suspiciousness

D. Anxiety

Situation: The patient who is depressed will undergo

electroconvulsive therapy.

31. 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 defences to deal

with this attack.

32. The preparation of a patient for ECT ideally is

MOST similar to preparation for a patient for:

A. electroencephalogram

B. general anesthesia

C. X-ray

D. electrocardiogram

33. Which of the following is a possible side effect

which you will discuss with the patient?

A. hemorrhage within the brain

B. encephalitis

C. robot-like body stiffness

D. confusion, disorientation and short

term memory loss

34. Informed consent is necessary for the treatment

for involuntary clients. When this cannot be

obtained, permission may be taken from the:

A. social worker

B. next of kin or guardian

C. doctor

D. chief nurse

35. After ECT, the nurse should do this action before

giving the client fluids, food or medication:

A. assess the gag reflex

B. next of kin or guardian

C. assess the sensorium

D. check O2 Sat with a pulse oximeter

Situation: Mrs Ethel Agustin 50 y/o, teacher is afflicted

with myasthenia gravis.

36. Looking at Mrs Agustin, your assessment would

include the following except;

A. Nystagmus

B. Difficulty of hearing

C. Weakness of the levator palpebrae

D. Weakness of the ocular muscle

37. In an effort to combat complications which

might occur relatives should he taught;

A. Checking cardiac rate

B. Taking blood pressure reading

C. Techniques of oxygen inhalation

D. Administration of oxygen inhalation

38. The drug of choice for her condition is;

A. Prostigmine

B. Morphine

C. Codeine

D. Prednisone

39. As her nurse, you have to be cautious about

administration of medication, if she is under

medicated this can cause;

A. Emotional crisis

B. Cholinergic crisis

C. Menopausal crisis

D. Myasthenia crisis

40. If you are not extra careful and by chance you

give over medication, this would lead to;

A. Cholinergic crisis

B. Menopausal crisis

C. Emotional crisis

D. Myasthenia crisis

Situation: Rosanna 20 y/o unmarried patient believes

that the toilet for the female patient in contaminated

with AIDS virus and refuses to use it unless she flushes it

three times and wipes the seat same number of times

with antiseptic solution.

41. The fear of using “contaminated” toilet seat can

be attributed to Rosanna’s inability to;

A. Adjust to a strange environment

B. Express her anxiety

C. Develop the sense of trust in other person

D. Control unacceptable impulses or feelings

42. Assessment data upon admission help the nurse

to identify this appropriate nursing diagnosis

A. Ineffective denial

B. Impaired adjustment

C. Ineffective individual coping

D. Impaired social interaction

. An effective nursing intervention to help Rosana

is;

A. Convincing her to use the toilet after the

nurse has used it first

B. Explaining to her that AIDS cannot be

transmitted by using the toilet

C. Allowing her to flush and clear the

toilet seat until she can manage her anxiety

D. Explaining to her how AIDS is transmitted

44. The goal for treatment for Rosana must be

directed toward helping her to;

A. Walk freely about her past experience

B. Develop trusting relationship with others

C. Gain insight that her behaviour is due

to feeling of anxiety

D. Accept the environment unconditionally

45. Psychotherapy which is prescribed for Rosana is

described as;

A. Establishing an environment adapted to

an individual patient needs

B. Sustained interaction between the

therapist and client to help her develop

more functional behaviour

C. Using dramatic techniques to portray

interpersonal conflicts

D. Biologic treatment for mental disorder

Situation: Dennis 40 y/o married man, an electrical

engineer was admitted with the diagnosis of paranoid

disorders. He has become suspicious and distrustful 2

months before admission. Upon admission, he kept on

saying, “my wife has been planning to kill me.”

46. A paranoid individual who cannot accept the

guilt demonstrate one of the following defense

mechanism;

A. Denial

B. Projection

C. Rationalization

D. Displacement

47. One morning, Dennis was seen tilting his head as

if he was listening to someone. An appropriate

nursing intervention would be;

A. Tell him to socialize with other patient to

divert his attention

B. Involve him in group activities

C. Address him by name to ask if he is

hearing voices again

D. Request for an order of antipsychotic

medicine

48. When he says, “these voices are telling me my

wife is going to kill me.” A therapeutic

communication of the nurse is which one of the

following;

A. “i do not hear the voices you say you

hear”

B. “are you really sure you heard those

voices?”

C. “I do not think you heard those

voices?”

D. “Whose voices are those?”

49. The nurse confirms that Dennis is manifesting

auditory hallucination. The appropriate nursing

diagnosis she identifiesis;

A. Sensory perceptual alteration

B. Self-esteem disturbance

C. Ineffective individual coping

D. Defensive coping

50. Most appropriate nursing intervention for a

client with suspicious behavior is one of the

following;

A. Talk to the client constantly to reinforce

reality

B. Involve him in competitive activities

C. Use Non Judgmental and Consistent

approach

D. Project cheerfulness in interacting with

the patient