PSYCHIATRIC NURSING

PSYCHIATRIC NURSING

1. Marco approached Nurse Trish asking for advice

on how to deal with his alcohol addiction. Nurse

Trish should tell the client that the only effective

treatment for alcoholism is:

a. Psychotherapy

b. Alcoholics anonymous (A.A.)

c. Total abstinence

d. Aversion Therapy

2. Nurse Hazel is caring for a male client who

experience false sensory perceptions with no

basis in reality. This perception is known as:

a. Hallucinations

b. Delusions

c. Loose associations

d. Neologisms

3. Nurse Monet is caring for a female client who

has suicidal tendency. When accompanying the

client to the restroom, Nurse Monet should…

a. Give her privacy

b. Allow her to urinate

c. Open the window and allow her to get

some fresh air

d. Observe her

4. Nurse Maureen is developing a plan of care for a

female client with anorexia nervosa. Which

action should the nurse include in the plan?

a. Provide privacy during meals

b. Set-up a strict eating plan for the client

c. Encourage client to exercise to reduce

anxiety

d. Restrict visits with the family

5. A client is experiencing 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

6. A female client is admitted with a diagnosis of

delusions of GRANDEUR. This diagnosis reflects a

belief that one is:

a. Being Killed

b. Highly famous and important

c. Responsible for evil world

d. Connected to client unrelated to oneself

7. A 20 year old client was diagnosed with

dependent personality disorder. Which behavior

is not likely to be evidence of ineffective

individual coping?

a. Recurrent self-destructive behavior

b. Avoiding relationship

c. Showing interest in solitary activities

d. Inability to make choices and decision

without advise

8. A male client is diagnosed with schizotypal

personality disorder. Which signs would this

client exhibit during social situation?

a. Paranoid thoughts

b. Emotional affect

c. Independence need

d. Aggressive behavior

9. Nurse Claire is caring for a client diagnosed with

bulimia. The most appropriate initial goal for a

client diagnosed with bulimia is?

a. Encourage to avoid foods

b. Identify anxiety causing situations

c. Eat only three meals a day

d. Avoid shopping plenty of groceries

10. Nurse Tony was caring for a 41 year old female

client. Which behavior by the client indicates

adult cognitive development?

a. Generates new levels of awareness

b. Assumes responsibility for her actions

c. Has maximum ability to solve problems

and learn new skills

d. Her perception are based on reality

11. A neuromuscular blocking agent is administered

to a client before ECT therapy. The Nurse should

carefully observe the client for?

a. Respiratory difficulties

b. Nausea and vomiting

c. Dizziness

d. Seizures

12. A 75 year old client is admitted to the hospital

with the diagnosis of dementia of the

Alzheimer’s type and depression. The symptom

that is unrelated to depression would be?

a. Apathetic response to the environment

b. “I don’t know” answer to questions

c. Shallow of labile effect

d. Neglect of personal hygiene

13. Nurse Trish is working in a mental health facility;

the nurse priority nursing intervention for a

newly admitted client with bulimia nervosa

would be to?

a. Teach client to measure I & O

b. Involve client in planning daily meal

c. Observe client during meals

d. Monitor client continuously

14. Nurse Patricia is aware that the major health

complication associated with intractable

anorexia nervosa would be?

a. Cardiac dysrhythmias resulting to

cardiac arrest

b. Glucose intolerance resulting in

protracted hypoglycemia

c. Endocrine imbalance causing cold

amenorrhea

d. Decreased metabolism causing cold

intolerance

15. Nurse Anna 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

16. A 39 year old mother with obsessive-compulsive

disorder has become immobilized by her

elaborate hand washing and walking rituals.

Nurse Trish recognizes that the basis of O.C.

disorder is often:

a. Problems with being too conscientious

b. Problems with anger and remorse

c. Feelings of guilt and inadequacy

d. Feeling of unworthiness and

hopelessness

17. Mario 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

18. Conney with borderline personality disorder who

is to be discharge soon threatens to “do

something” to herself if discharged. Which of the

following actions by the nurse would be most

important?

a. Ask a family member to stay with the

client at home temporarily

b. Discuss the meaning of the client’s

statement with her

c. Request an immediate extension for the

client

d. Ignore the clients statement because it’s

a sign of manipulation

19. Joey a client with antisocial personality disorder

belches loudly. A staff member asks Joey, “Do

you know why people find you repulsive?” this

statement most likely would elicit which of the

following client reaction?

a. Depensiveness

b. Embarrassment

c. Shame

d. Remorsefulness

20. Which of the following approaches would be

most appropriate to use with a client suffering

from narcissistic personality disorder when

discrepancies exist between what the client

states and what actually exist?

a. Rationalization

b. Supportive confrontation

c. Limit setting

d. Consistency

21. Cely is experiencing alcohol withdrawal exhibits

tremors, diaphoresis and hyperactivity. Blood

pressure is 190/87 mmhg and pulse is 92 bpm.

Which of the medications would the nurse

expect to administer?

a. Naloxone (Narcan)

b. Benzlropine (Cogentin)

c. Lorazepam (Ativan)

d. Haloperidol (Haldol)

22. Which of the following foods would the nurse

Trish eliminate from the diet of a client in

alcohol withdrawal?

a. Milk

b. Orange Juice

c. Soda

d. Regular Coffee

23. Which of the following would Nurse Hazel

expect to assess for a client who is exhibiting

late signs of heroin withdrawal?

a. Yawning & diaphoresis

b. Restlessness & Irritability

c. Constipation & steatorrhea

d. Vomiting and Diarrhea

24. To establish open and trusting relationship with

a female client who has been hospitalized with

severe anxiety, the nurse in charge should?

a. Encourage the staff to have frequent

interaction with the client

b. Share an activity with the client

c. Give client feedback about behavior

d. Respect client’s need for personal space

25. Nurse Monette recognizes that the focus of

environmental (MILIEU) therapy is to:

a. Manipulate the environment to bring

about positive changes in behavior

b. Allow the client’s freedom to determine

whether or not they will be involved in

activities

c. Role play life events to meet individual

needs

d. Use natural remedies rather than drugs

to control behavior

26. Nurse Trish would expect a child with a diagnosis

of reactive attachment disorder to:

a. Have more positive relation with the

father than the mother

b. Cling to mother & cry on separation

c. Be able to develop only superficial

relation with the others

d. Have been physically abuse

27. When teaching parents about childhood

depression Nurse Trina should say?

a. It may appear acting out behavior

b. Does not respond to conventional

treatment

c. Is short in duration & resolves easily

d. Looks almost identical to adult

depression

28. Nurse Perry is aware that language development

in autistic child resembles:

a. Scanning speech

b. Speech lag

c. Shuttering

d. Echolalia

29. A 60 year old female client who lives alone tells

the nurse at the community health center “I

really don’t need anyone to talk to”. The TV is

my best friend. The nurse recognizes that the

client is using the defense mechanism known as?

a. Displacement

b. Projection

c. Sublimation

d. Denial

30. When working with a male client suffering

phobia about black cats, Nurse Trish should

anticipate that a problem for this client would

be?

a. Anxiety when discussing phobia

b. Anger toward the feared object

c. Denying that the phobia exist

d. Distortion of reality when completing

daily routines

31. Linda is pacing the floor and appears extremely

anxious. The duty nurse approaches in an

attempt to alleviate Linda’s anxiety. The most

therapeutic question by the nurse would be?

a. Would you like to watch TV?

b. Would you like me to talk with you?

c. Are you feeling upset now?

d. Ignore the client

32. 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

33. Nurse Benjie is communicating with a male client

with substance-induced persisting dementia; the

client cannot remember facts and fills in the

gaps with imaginary information. Nurse Benjie is

aware that this is typical of?

a. Flight of ideas

b. Associative looseness

c. Confabulation

d. Concretism

34. Nurse Joey is aware that the signs & symptoms

that would be most specific for diagnosis

anorexia are?

a. Excessive weight loss, amenorrhea &

abdominal distension

b. Slow pulse, 10% weight loss & alopecia

c. Compulsive behavior, excessive fears &

nausea

d. Excessive activity, memory lapses & an

increased pulse

35. A characteristic that would suggest to Nurse

Anne that an adolescent may have bulimia

would be:

a. Frequent regurgitation & re-swallowing

of food

b. Previous history of gastritis

c. Badly stained teeth

d. Positive body image

36. Nurse Monette is aware that extremely

depressed clients seem to do best in settings

where they have:

a. Multiple stimuli

b. Routine Activities

c. Minimal decision making

d. Varied Activities

37. To further assess a client’s suicidal potential.

Nurse Katrina should be especially alert to the

client expression of:

a. Frustration & fear of death

b. Anger & resentment

c. Anxiety & loneliness

d. Helplessness & hopelessness

38. A nursing care plan for a male client with bipolar

I disorder should include:

a. Providing a structured environment

b. Designing activities that will require the

client to maintain contact with reality

c. Engaging the client in conversing about

current affairs

d. Touching the client provide assurance

39. When planning care for a female client using

ritualistic behavior, Nurse Gina must recognize

that the ritual:

a. Helps the client focus on the inability to

deal with reality

b. Helps the client control the anxiety

c. Is under the client’s conscious control

d. Is used by the client primarily for

secondary gains

40. A 32 year old male graduate student, who has

become increasingly withdrawn and neglectful

of his work and personal hygiene, is brought to

the psychiatric hospital by his parents. After

detailed assessment, a diagnosis of

schizophrenia is made. It is unlikely that the

client will demonstrate:

a. Low self esteem

b. Concrete thinking

c. Effective self-boundaries

d. Weak ego

41. 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 statement illustrate:

a. Neologisms

b. Echolalia

c. Flight of ideas

d. Loosening of association

42. A long term goal for a paranoid male client who

has unjustifiably accused his wife of having many

extramarital affairs would be to help the client

develop:

a. Insight into his behavior

b. Better self-control

c. Feeling of self-worth

d. Faith in his wife

43. A male client who is experiencing disordered

thinking about food being poisoned is admitted

to the mental health unit. The nurse uses which

communication technique to encourage the

client to eat dinner?

a. Focusing on self-disclosure of own food

preference

b. Using open ended question and silence

c. Offering opinion about the need to eat

d. Verbalizing reasons that the client may

not choose to eat

44. Nurse Nina 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 Nina 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

45. Nurse Tina is caring for a client with delirium and

states that “look at the spiders on the wall”.

What should the nurse respond to the client?

a. “You’re having hallucination, there are

no spiders in this room at all”

b. “I can see the spiders on the wall, but

they are not going to hurt you”

c. “Would you like me to kill the spiders”

d. “I know you are frightened, but I do not

see spiders on the wall”

46. Nurse Jonel is providing information to a

community group about violence in the family.

Which statement by a group member would

indicate a need to provide additional

information?

a. “Abuse occurs more in low-income

families”

b. “Abuser Are often jealous or selfcentered”

c. “Abuser use fear and intimidation”

d. “Abuser usually have poor self-esteem”

47. During electroconvulsive therapy (ECT) the client

receives oxygen by mask via positive pressure

ventilation. The nurse assisting with this

procedure knows that positive pressure

ventilation is necessary because?

a. Anesthesia is administered during the

procedure

b. Decrease oxygen to the brain increases

confusion and disorientation

c. Grand mal seizure activity depresses

respirations

d. Muscle relaxations given to prevent

injury during seizure activity depress

respirations.

48. When planning the discharge of a client with

chronic anxiety, Nurse Chris evaluates

achievement of the discharge maintenance

goals. Which goal would be most appropriately

having been included in the plan of care

requiring evaluation?

a. The client eliminates all anxiety from

daily situations

b. The client ignores feelings of anxiety

c. The client identifies anxiety producing

situations

d. The client maintains contact with a crisis

counselor

49. 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

50. Mario 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