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7. The nurse is talking with schizophrenic patient when
suddenly the patient cries out and says I am afraid,
did you hear that? It is terrible. The most appropriate
initial response by the nurse would be:
a. I did not hear anything
b. Who is saying terrible things to you.
c. I did not hear anything, but you seem afraid.
d. Is someone saying things to you?
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8. The best explanation for the term depersonalization
as seen in schizophrenics is:
a. A mechanism seen in chronic schizophrenia.
b. A flight from reality related to oneself or the
environment
c. The patient personalizes all threats and uses
projection
d. The patient cannot tolerate personal
relationships.
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9. The nurse observes one the patients is having
auditory hallucinations and seem disoriented to time
and place. The nurse knows that hallucination can be
explained as an:
a. Sensory experience without foundation in
reality
b. Distortion of real auditory or visual perception.
c. Voice that is heard by the client but is not really
true
d. Idea without foundation in reality
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10. The nurse allows a schizophrenic patient who has
improved to attend group therapy meetings. One day,
the patient jumps up from his chair and runs out of the
room after the group has been laughing at a story told
by one of the participants. He says, You arte all
making fun of me. The patient is displaying:
a. Symbolic rejection
b. Hallucination
c. Depersonalization
d. Ideas without foundation in reality
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Situation: The nurse cares for a 23 year old female with
post traumatic stress disorder (PTSD). The nurse
understand that PTSD is a response to a memory of
physical or emotional trauma.
11. Reliving an event repeatedly through dreams or
flashbacks is a characteristic of which category of
signs and symptoms of PTSD?
a. Intrusive
c. Arousal
b. Avoidance
d. Hypervigilance
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12. Characteristics of this category of signs and
symptoms of PTSD include irritability, difficulty in
concentrating, insomnia and exaggerated reactions to
startling situations.
a. Intrusive
c. Arousal
b. Avoidance
d. Hypervigilance
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b. Transsexualism
d. Homosexuality
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33. A transsexual client wishes to have a sexual
reassignment operation. He tells the nurse he is
ready to begin hormonal therapy. Which of the
following facts about the client must be true before
estrogen therapy is started? He has
a. Been functioning sexually as a female
b. Cross-dressed and lived as the opposite sex
for several years
c. Decided he needs more psychotherapy
d. Decided against undergoing the operation
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34. Which of the following reasons best explains the
rationale for estrogen therapy for a male client who
wishes to undergo sexual reassignment surgery? To
a. Assist with cross-dressing
b. Develop breasts
c. Cause menstruation
d. Develop body hair
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35. A 39-year old male wishes to undergo a sexreassignment operation because he feels trapped in
his male body. Which of the following actions is the
next step the client should take if he wants to have
the operation?
a. Attend psychotherapy
b. Tell his family and friends
c. Visit transsexual bars
d. See a surgeon
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Situation 8- A 30 year old female client is admitted to a
mental health facility for depression and suicidal
tendencies
36. The nurse prepares a care plan for this client. Which
of the following nursing care objectives or goals is
given highest priority?
a. Reassure the client of her worthiness in a gentle
manner
b. Use measures to protect the client from
harming herself
c. Maintain calm environment in which the client can
express her feelings and thoughts
d. Provide for contact between the client and her
husband
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37. The nurse formulates a nursing diagnosis for the
client Potential for self-directed violence. Which action
should take priority?
a. Assign the client to a double room occupied by
another client
b. Instruct the client to call any staff member when
she has thoughts of harming herself
c. Remove all potentially harmful objects from
the environment of the client
d. Let the client agree to sign a no-harm contract
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38. Generally, it is difficult for a nurse to maintain
effective relationships with depressed clients who
experience suicidal ideation because of the clients:
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57. The nurse prepares a plan care. Which of the
following is the most important objective?
a. recognized a continued desire to commit suicide
b. observe the client closely at all times
c. involve the client in activities with others to mobilize
him
d. provide a safe environment to protect the client
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58. When assessing a client for possible suicide, the
nurse should observe if the client:
a. begins to talk about leaving the hospital
b. is hostile and sarcastic to the staff
c. seems satisfied and detached
d. identifies with problems expressed by other clients
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59. When assessing a suicidal client who suddenly
appears cheerful and motivated, the nurse should
recognize that the client:
a. is responding to treatment and is no longer
depressed
b. may have finalized a suicide plan
c. is likely sleeping well because of the medications
given
d. has made a new friends and has a support group
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60. The client makes an attempt to commit suicide during
the night shift. The staff intervenes quickly in time to
prevent harm. In assessing the situation, the most
important rationale for the staff to discuss the incident
is that:
a. the staff needs to file an incident report so that the
hospital administration is kept informed
b. the staff needs to reenact the attempted suicide so
that they understand exactly what happened
c. the staff is aware that there is a high probability the
client will make another attempt in the future
d. the staff needs to discuss the behavior of the
client to find out what cues in his behavior
might have warned them that he was
contemplating suicide
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SITUATION: The nurse works in a rehabilitation center
for drug dependents.
61. In caring for an adolescent with suspected narcotic
(heroin) overdose, the nurse will monitor the
adolescent for what signs?
a. euphoric
b. constricted pupils and respiratory depression
c. drowsiness
d. aggressive behavior
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62. Which of the following nursing intervention would
receive the lowest priority for the client with an
overdose of heroin?
a. monitor vital signs
b. monitor breathing patterns
c. discuss treatment options
d. prepare for cardiopulmonary resuscitation
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63. The nurse is aware that drug abuse is best defined
as:
a. a psychological dependence on a drug
b. a physiological need for a drug
c. an excessive drug use inconsistent with
acceptable medical practice
d. a compulsion to take a drug on either continuous or
periodic basis
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64. The nurse understand that hard drugs cause
dependence because of the drugs ability to:
a. decrease motor activity
b. clear sensorium
c. ease pain
d. blur reality
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65. The nurse expect an addicted clients basic
personality to be marked by insecurity and:
a. weak id drives
b. the need to delay gratification
c. infantile passion for self-gratification
d. the use of psychosomatic mechanisms
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SITUATION: The nurse assists a family in the care of
their daughter suffering from post traumatic stress
disorder.
66. While caring for this client, the family notices that loud
noise cause a serious anxiety response. Which of the
following explanations by the nurse would help the
family understand the clients response?
a. clients often experience extreme fear about normal
environmental stimuli
b. environmental triggers can cause the client to
react emotionally
c. after a trauma, the client cannot respond to stimuli
in an appropriate manner
d. the respond indicates that another emotional
problem needs investigation
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67. Which of the following instructions should the nurse
include about relationships for this client with post
traumatic stress disorder?
a. Assess the clients discomfort when talking about
feelings to family members
b. Encourage the client to resume former roles as
soon as possible
c. Warn the client that she will have a tendency to be
overdependent in relationships
d. Explain that avoiding emotional attachment
protects against anxiety
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68. Which of the following nursing interventions would
best help this client and her family handle
interpersonal conflict at home? Have the family
a. discuss how to change dysfunctional family
patterns
b. teach the client to identify defensive behavior
c. agree not to tell the client what to do about
problems
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80. A patient with a diagnosis of obsessive-compulsive
disorder constantly does repetitive cleaning. The nurse
knows that this behavior is most probably an attempt
to:
a. Control others
b. Decrease the time available for interaction with
people
c. Decrease the anxiety to a tolerate level
d. Focus attention on non-threatening tasks
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SITUATION: The nurse cares for a 55 year old male
patient who had heart failure (HF) and is depressed.
The nurse read a recent study which revealed that
while depressed patients may have higher risk of
heart failure; patients suffering from cardiovascular
disease are more prone depressive symptoms
81. A term for a chronic depressive state in which the
patient experiences fewer than five symptoms of
depression that last at least for two years is called:
a. Major depression
c. Dysthymia
b. Depressive psychosis d. Minor depression
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82. Mood disturbance among patients with chronic heart
failure is greatest among those who:
a. Had previously led extremely active social lives
b. Were most uncertain about how the disease
would progress
c. Were unable to continue working
d. Also had other cardiovascular disorders
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83. According to a study conducted in 2003, major
depression is most prevalent among those who are:
a. Younger than 60 years old
c. Female
b. Male d. Older than 80 years old
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84. The risk of dying within a year of diagnosis among
patients with heart failure and with major depression
is:
a. Twice that of patients with heart failure without
major depression
b. About the same as that of patients with heart
failure without major depression
c. Three times that of patients with heart failure
without major depression
d. Half that of patients with heart failure without major
depression
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85. Compared with pharmacologic intervention in patients
with both heart failure and depression, psychosocial
and psychotherapeutic interventions:
a. Are undesirable for most patients
b. Take longer to be effective
c. Tend to increase dyspnea
d. Are considerable less effective
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SITUATION: A nurse reviews the theories and
approaches used in psychiatric care
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b. exploitative
c. hypersensitive
d. seductive
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94. Which of the following characteristics is expected of a
client with paranoid personality disorder who receives
bad news? The client
a. is overly dramatic after hearing the facts
b. focuses on self to not become overanxious
c. responds from a rational, objective point of
view
d. doesnt spend time thinking about the information
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95. The client with paranoid personality disorder discusses
current problems with her nurse. Which of the
following nursing interventions has priority in the care
plan? Have the client
a. look at sources of frustration
b. focus on ways to interact with others
c. discuss the use of defense mechanisms
d. clarify thoughts and beliefs about an event
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Situation: The nurse in a mental health facility assists
in the care
96. Which of the following conditions is correct about fear
and anxiety?
a. decrease respiratory rate
b. Activate the fight or flight survival response
c. Abnormal reactions to a perceived threat
d. Decrease heart rate
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97. A pattern of excessive anxiety and worry about certain
events or activities that lasts 6 months or longer
characterizes:
a. generalized anxiety disorder
b. Panic disorder
c. Obsessive compulsive disorder
d. Procedural anxiety
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98. Signs and symptoms experienced by a patient with
generalized anxiety disorder include:
a. fear of dying
b. a feeling of detachment from reality
c. difficulty in concentrating
d. chest pain
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99. A fear of dying or losing control characterizes:
a. procedural anxiety
b. social anxiety disorder
c. panic disorder
d. generalized anxiety disorder
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100.
Which of the following disorders is characterized
by a persistent, unwanted, intrusive idea?
a. obsessive compulsive disorder
b. social anxiety disorder
c. post traumatic stress disorder
d. panic disorder
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ST. LOUIS REVIEW CENTER INC. BAGUIO BRANCH / TEL. # (074) 445-8085 / 300-2085