51. 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.
52. Mr.
Cruz visits the physician's office to seek
treatment
for depression, feelings of
hopelessness,
poor appetite, insomnia, fatigue,
low self-
esteem, poor concentration, and
difficulty
making decisions. The client states that
these
symptoms began at least 2 years ago.
Based on
this report, the nurse Tyfany suspects:
a.
Cyclothymic disorder.
b. Atypical
affective disorder.
c. Major
depression.
d.
Dysthymic disorder.
53. After taking
an overdose of phenobarbital
(Barbita),
Mario is admitted to the emergency
department.
Dr. Trinidad prescribes activated
charcoal
(Charcocaps) to be administered by
mouth
immediately. Before administering the
dose, the
nurse verifies the dosage ordered.
What is the
usual minimum dose of activated
charcoal?
a. 5 g
mixed in 250 ml of water
b. 15 g
mixed in 500 ml of water
c. 30 g
mixed in 250 ml of water
d. 60 g
mixed in 500 ml of water
54. What
herbal medication for depression, widely
used in
Europe, is now being prescribed in the
United
States?
a. Ginkgo
biloba
b.
Echinacea
c. St.
John's wort
d. Ephedra
55. Cely
with manic episodes is taking lithium.
Which
electrolyte level should the nurse check
before
administering this medication?
a. Clcium
b. Sodium
c. Chloride
d.
Potassium
56. Nurse
Josefina is caring for a client who has been
diagnosed
with delirium. Which statement about
delirium is
true?
a. It's
characterized by an acute onset and
lasts about
1 month.
b. It's
characterized by a slowly evolving
onset and
lasts about 1 week.
c. It's
characterized by a slowly evolving
onset and
lasts about 1 month.
d. It's
characterized by an acute onset and
lasts hours
to a number of days.
57. Edward,
a 66 year old client with slight memory
impairment
and poor concentration is diagnosed
with
primary degenerative dementia of the
Alzheimer's
type. Early signs of this dementia
include
subtle personality changes and
withdrawal
from social interactions. To assess
for
progression to the middle stage of
Alzheimer's
disease, the nurse should observe
the client
for:
a.
Occasional irritable outbursts.
b. Impaired
communication.
c. Lack of
spontaneity.
d.
Inability to perform self-care activities.
58. Isabel
with a diagnosis of depression is started
on imipramine
(Tofranil), 75 mg by mouth at
bedtime.
The nurse should tell the client that:
a. This
medication may be habit forming
and will be
discontinued as soon as the
client
feels better.
b. This
medication has no serious adverse
effects.
c. The
client should avoid eating such
foods as
aged cheeses, yogurt, and
chicken
livers while taking the
medication.
d. This
medication may initially cause
tiredness,
which should become less
bothersome
over time.
59.
Kathleen is admitted to the psychiatric clinic for
treatment
of anorexia nervosa. To promote the
client's
physical health, the nurse should plan to:
a. Severely
restrict the client's physical
activities.
b. Weigh
the client daily, after the evening
meal.
c. Monitor
vital signs, serum electrolyte
levels, and
acid-base balance.
d. Instruct
the client to keep an accurate
record of
food and fluid intake.
60. Celia
with a history of polysubstance abuse is
admitted to
the facility. She complains of nausea
and
vomiting 24 hours after admission. The
nurse
assesses the client and notes piloerection,
pupillary
dilation, and lacrimation. The nurse
suspects
that the client is going through which of
the
following withdrawals?
a. Alcohol
withdrawal
b. Cannibis
withdrawal
c. Cocaine
withdrawal
d. Opioid
withdrawal
61. Mr.
Garcia, an attorney who throws books and
furniture
around the office after losing a case is
referred to
the psychiatric nurse in the law firm's
employee
assistance program. Nurse Beatriz
knows that
the client's behavior most likely
represents
the use of which defense
mechanism?
a.
Regression
b.
Projection
c.
Reaction-formation
d.
Intellectualization
62. Nurse
Anne is caring for a client who has been
treated
long term with antipsychotic medication.
During the
assessment, Nurse Anne 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,
63. Dennis
has a lithium level of 2.4 mEq/L. The
nurse
immediately would assess the client for
which of
the following signs or symptoms?
a. Weakness
b. Diarrhea
c. Blurred
vision
d. Fecal
incontinence
64. Nurse
Jannah is monitoring a male client who
has been
placed inrestraints because of violent
behavior.
Nurse determines that it will be safe to
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.
65. Nurse
Irish is aware that Ritalin is the drug of
choice for
a child with ADHD. The side effects of
the
following may be noted by the nurse:
a.
Increased attention span and
concentration
b. Increase
in appetite
c.
Sleepiness and lethargy
d. Bradycardia
and diarrhea
66. Kitty,
a 9 year old child has very limited
vocabulary
and interaction skills. She has an I.Q.
of 45. She
is diagnosed to have Mental
retardation
of this classification:
a. Profound
b. Mild
c. Moderate
d. Severe
67. The
therapeutic approach in the care of Armand
an autistic
child include the following EXCEPT:
a. Engage
in diversionary activities when
acting -out
b. Provide
an atmosphere of acceptance
c. Provide
safety measures
d.
Rearrange the environment to activate
the child
68. Jeremy
is brought to the emergency room by
friends who
state that he took something an
hour ago.
He is actively hallucinating, agitated,
with
irritated nasal septum.
a. Heroin
b. Cocaine
c. LSD
d. Marijuana
69. Nurse
Pauline is aware that Dementia unlike
delirium is
characterized by:
a. Slurred
speech
b.
Insidious onset
c. Clouding
of consciousness
d. Sensory
perceptual change
70. A 35
year old female has intense fear of riding an
elevator.
She claims “ As if I will die inside.” The
client is
suffering from:
a.
Agoraphobia
b. Social
phobia
c.
Claustrophobia
d.
Xenophobia
71. Nurse
Myrna develops a counter-transference
reaction.
This is evidenced by:
a.
Revealing personal information to the
client
b. Focusing
on the feelings of the client.
c.
Confronting the client about
discrepancies
in verbal or non-verbal
behavior
d. The
client feels angry towards the nurse
who
resembles his mother.
72. Tristan
is on Lithium has suffered from diarrhea
and
vomiting. What should the nurse in-charge
do first:
a.
Recognize this as a drug interaction
b. Give the
client Cogentin
c. Reassure
the client that these are
common side
effects of lithium therapy
d. Hold the
next dose and obtain an order
for a stat
serum lithium level
73. Nurse
Sarah ensures a therapeutic environment
for all the
client. Which of the following best
describes a
therapeutic milieu?
a. A
therapy that rewards adaptive
behavior
b. A
cognitive approach to change behavior
c. A
living, learning or working
environment.
d. A
permissive and congenial environment
74. Anthony
is very hostile toward one of the staff
for no
apparent reason. He is manifesting:
a.
Splitting
b.
Transference
c.
Countertransference
d.
Resistance
75.
Marielle, 17 years old was sexually attacked
while on
her way home from school. She is
brought to
the hospital by her mother. Rape is
an example
of which type of crisis:
a.
Situational
b.
Adventitious
c.
Developmental
d. Internal
76. Nurse
Greta is aware that the following is
classified
as an Axis I disorder by the Diagnosis
and
Statistical Manual of Mental Disorders, Text
Revision
(DSM-IV-TR) is:
a. Obesity
b.
Borderline personality disorder
c. Major
depression
d.
Hypertension
77.
Katrina, a newly admitted is extremely hostile
toward a
staff member she has just met, without
apparent
reason. According to Freudian theory,
the nurse
should suspect that the client is
experiencing
which of the following
phenomena?
a.
Intellectualization
b.
Transference
c.
Triangulation
d. Splitting
78. An
83year-old male client is in extended care
facility is
anxious most of the time and
frequently
complains of a number of vague
symptoms
that interfere with his ability to eat.
These
symptoms indicate which of the following
disorders?
a.
Conversion disorder
b.
Hypochondriasis
c. Severe
anxiety
d.
Sublimation
79.
Charina, a college student who frequently visited
the health
center during the past year with
multiple
vague complaints of GI symptoms
before
course examinations. Although physical
causes have
been eliminated, the student
continues
to express her belief that she has a
serious
illness. These symptoms are typically of
which of
the following disorders?
a.
Conversion disorder
b.
Depersonalization
c.
Hypochondriasis
d.
Somatization disorder
80. Nurse
Daisy is aware that the following
pharmacologic
agents are sedative- hypnotic
medication
is used to induce sleep for a client
experiencing
a sleep disorder is:
a.
Triazolam (Halcion)
b.
Paroxetine (Paxil)\
c.
Fluoxetine (Prozac)
d.
Risperidone (Risperdal)
81. Aldo,
with a somatoform pain disorder may
obtain
secondary gain. Which of the following
statement
refers to a secondary gain?
a. It
brings some stability to the family
b. It
decreases the preoccupation with the
physical
illness
c. It
enables the client to avoid some
unpleasant
activity
d. It
promotes emotional support or
attention for the client
82. Dervid
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”
83. 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”
84. 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
85.
Jennifer, an adolescent who is depressed and
reported by
his parents as having difficulty in
school is
brought to the community mental
health
center to be evaluated. Which of the
following
other health problems would the nurse
suspect?
a. Anxiety
disorder
b.
Behavioral difficulties
c.
Cognitive impairment
d. Labile
moods
86.
Ricardo, an outpatient in psychiatric facility is
diagnosed
with dysthymic disorder. Which of the
following
statement about dysthymic disorder is
true?
a. It
involves a mood range from moderate
depression
to hypomania
b. It
involves a single manic depression
c. It’s a
form of depression that occurs in
the fall
and winter
d. It’s a
mood disorder similar to major
depression
but of mild to moderate
severity
87. The
nurse is aware that the following ways in
vascular
dementia different from Alzheimer’s
disease is:
a. Vascular
dementia has more abrupt
onset
b. The
duration of vascular dementia is
usually
brief
c.
Personality change is common in
vascular
dementia
d. The
inability to perform motor activities
occurs in
vascular dementia
88.
Loretta, a newly admitted client was diagnosed
with
delirium and has history of hypertension
and
anxiety. She had been taking digoxin,
furosemide
(Lasix), and diazepam (Valium) for
anxiety.
This client’s impairment may be related
to which of
the following conditions?
a.
Infection
b.
Metabolic acidosis
c. Drug
intoxication
d. Hepatic
encephalopathy
89. Nurse
Ron 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
90. Which
of the following descriptions of a client’s
experience
and behavior can be assessed as an
illusion?
a. The
client tries to hit the nurse when
vital signs
must be taken
b. The
client says, “I keep hearing a voice
telling me
to run away”
c. The
client becomes anxious whenever
the nurse
leaves the bedside
d. The
client looks at the shadow on a wall
and tells
the nurse she sees frightening
faces on
the wall.
91. During
conversation of Nurse John 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
92. Francis
tells the nurse that her coworkers are
sabotaging
the computer. When the nurse asks
questions,
the client becomes argumentative.
This
behavior shows personality traits associated
with which
of the following personality disorder?
a.
Antisocial
b.
Histrionic
c. Paranoid
d.
Schizotypal
93. Which
of the following interventions is
important
for a Cely experiencing with paranoid
personality
disorder taking olanzapine
(Zyprexa)?
a. Explain
effects of serotonin syndrome
b. Teach
the client to watch for
extrapyramidal
adverse reaction
c. Explain
that the drug is less affective if
the client
smokes
d. Discuss
the need to report paradoxical
effects
such as euphoria
94. Nurse
Alexandra notices other clients on the unit
avoiding a
client diagnosed with antisocial
personality
disorder. When discussing
appropriate
behavior in group therapy, which of
the
following comments is expected about this
client by
his peers?
a. Lack of
honesty
b. Belief
in superstition
c. Show of
temper tantrums
d. Constant
need for attention
95. Tommy,
with dependent personality disorder is
working to
increase his self- esteem. Which of
the
following statements by the Tommy shows
teaching
was successful?
342
a. “I’m not
going to look just at the
negative
things about myself”
b. “I’m
most concerned about my level of
competence
and progress”
c. “I’m not
as envious of the things other
people have
as I used to be”
d. “I find
I can’t stop myself from taking
over things
other should be doing”
96. Norma,
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
97. Ivy,
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
98. Jun
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
99. Mike is
admitted to a psychiatric unit with a
diagnosis
of undifferentiated schizophrenia.
Which of
the following defense mechanisms is
probably
used by mike?
a.
Projection
b.
Rationalization
c.
Regression
d.
Repression
100. Rocky
has started taking haloperidol (Haldol).
Which of
the following instructions is most
appropriate
for Ricky before taking
haloperidol?
a. Should
report feelings of restlessness or
agitation
at once
b. Use a
sunscreen outdoors on a yearround
basis
c. Be aware
you’ll feel increased energy
taking this
drug
d. This
drug will indirectly control essential
hypertension
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