Académique Documents
Professionnel Documents
Culture Documents
INSTRUCTIONS: Select the correct answer for each of the following questions. Mark only one answer for each item by making the
box corresponding to the letter of your choice on the answer sheet provided.
1.
2.
The most important role of the Psychiatric nurse as a member of the team is to:
A. carry out medical orders
B. meet the needs for the physical well-being of the client
C. coordinate the psychological care and management of clients
D. keep a constant monitoring of the clients
3.
Therapeutic use of self is essential in relating with psychiatric clients. This is BEST demonstrated in:
A. sympathizing with the miserable feelings of the patient
B. engaging patient in productive activity
C. engaging patient in introspective thinking
D. suppressing her own feelings toward the patient
4.
5.
6.
The unconscious defense mechanism that keeps highly anxious experiences out of conscious awareness is:
A. Introjection
B. Displacement
C. Regression
D. Repression
7.
8.
A male college student who wants to become an athlete but fails becomes a well known writer. This is an example of:
A. Compensation
B. Projection
C. Reaction Formation
D. Sublimation
9.
A third year student does a postmortem care without being disturbed by thought of death. He is using:
A. Isolation
B. Undoing
C. Introjection
D. Projection
24. The pre-morbid personality of a person with a non-psychotic maladaptive response to anxiety may most accurately be described
as:
A. unpredictable, impulsive, aggressive
B. rigid, insecure and conforming
C. dependent, pessimistic, moody
D. anxious, insensitive and self-absorbed
25. The most effective nursing intervention for a severely anxious client who is pacing vigorously would be to:
A. Instruct her to sit down and quit pacing
B. Place her in bed to reduce stimuli and allow rest.
C. Allow her to talk until she becomes physically tired.
D. Give her PRN medication and walk with her at a gradual slowing pace.
26. It is in this level of anxiety where cognitive capacity diminishes. Focus becomes limited and client experiences tunnel of vision.
Physical signs of anxiety become more pronounced.
A. Severe
B. Panic
C. Mild
D. Moderate
27. Antianxiety medications should be used with extreme caution because long term use can lead to:
A. Parkinsonian like syndrome
B. Hypertensive crisis
C. Hepatic failure
D. Addiction
28. It is essential in desensitization for the patient to:
A. have rapport with the therapist
B. assess ones self for the need of an anxiolytic drug
C. use deep breathing or another relaxation technique
D. work through unresolved unconscious conflicts
29. A client with a diagnosis of obsessive-compulsive disorder constantly does repetitive cleaning. The nurse knows that this behavior
is probably most basically an attempt to:
A. decrease the anxiety to a tolerable level
B. focus attention on non threatening tasks
C. control others
D. decrease the time available for interaction with people
30. A client is suffering from Post-traumatic stress disorder following a rape by an unknown assailant. One of the primary goals of
nursing care for this client would be to:
A. establish a safe, supportive environment
B. control aggressive behavior
C. deal with the clients anxiety
D. discuss the clients nightmares and reactions
31. The nursing management of anxiety related with post traumatic stress disorder includes all of the following EXCEPT:
A. encourage participation in recreation or sports activities
B. reassure clients safety while touching the client
C. speak in calm soothing voice
D. remain with the client while fear level is high
32. A clients deafness has been diagnosed as Conversion disorder. Nursing interventions should be guided by which one of the
following?
A. The client will probably express much anxiety about her deafness and require much reassurance
B. The client will have little or no awareness of the psychogenic cause of her deafness
C. The clients need for the symptom should be respected; thus, secondary gains should be allowed
D. The defense mechanisms of suppression and rationalization are involved in creating the symptom.
33. A female client has just received the diagnosis of Hypochondriasis. This client continually focuses on GI problems and constantly
rings for a nurse to meet her every demand. The best nursing approach is to:
A. Ignore the demands because the nurse knows it is not necessary to respond
B. Assign various staff members to work with the client so no staff member will become negative
C. Anticipate the clients demands and spend time with her even though she does not demand it
D. Provide for the clients basic needs, but do not respond to every demand, which reinforces secondary gains
34. Persons with Personality disorders tend to be manipulative. In planning the care of a person with this diagnosis, the nurse would:
A. Allow manipulation so as to not raise the clients anxiety
B. Appeal to the clients sense of loyalty in adhering to rules of the community
C. Know that when the clients manipulation are not successful, anxiety will increase
D. Establish a nurse-client relationship to decrease the clients manipulations
35. A male client in the Psychiatric unit becomes upset and breaks a chair when a visitor does not show up. The first nursing
intervention should be to:
A. Stay with the client during the stressful time
47. When assessing a client for possible suicide, an important clue would be if the client:
A. is hostile and sarcastic to the staff
B. identifies with problems expressed by other clients
C. seems satisfied and detached
D. begins to talk about leaving the hospital
48. The defense mechanism utilized by manic patients to cover up depression is:
A. Reaction-Formation
B. Compensation
C. Displacement
D. Denial
49. A client with the diagnosis of manic episode is pacing around the unit trying to organize the games with the clients. An
appropriate nursing intervention is to:
A. have the client play table tennis
B. suggest video exercises with the other clients
C. Take the clients outside for walk
D. Do nothing, as organizing a game is considered therapeutic
50. A client ahs the diagnosis of manic episode. Her disruptive behavior on the unit has been increasingly annoying to the other
clients. One intervention by the nurse might be to:
A. tell the client she is annoying others and confine her to her room
B. ignore the clients behavior, realizing it is consistent with her illness
C. set limits on the clients behavior and be consistent in approach
D. make a rigid, structured plan that the client will have to follow
51. While working with an alcoholic client, the most important approach by the nurse would be to:
A. maintain a nonjudgmental attitude toward the client
B. establish strict guidelines of behavior
C. explicitly outline expectations of the client
D. set up a working nurse-client relationship
52. A client is admitted with a diagnosis of delirium tremens. He is exhibiting marked tremors, hallucinations, tachycardia, and is
perspiring profusely. The nurse anticipates an order of:
A. Start an IV with Vitamin B complex supplement
B. Administer valium IM
C. Control the environment with a quiet, single room, side-rails up, and soft lights
D. Get baseline VS
53. A client has the diagnosis of Cognitive disorder, Alzheimers disease. The client is constantly making up stories that are untrue.
This characteristic of the disease is called:
A. Senility
B. Confabulation
C. Lability
D. Memory loss
54. A client in a long-term care facility has the diagnosis of Dementia, Alzheimers disease. His care plan should include the goal of
assisting him to participate in activities that provide him a chance to:
A. interact with other clients
B. compete with others
C. succeed at something
D. get a sense of continuity
55. A 70 yr. old client is admitted with the diagnosis of Cognitive disorder, Dementia Type. In discharge planning with the family, the
nurse would take into account that his prognosis is:
A. Good, because the condition tends to be reversible
B. Unpredictable, because the condition may reverse
C. Poor, because symptoms are reduced intellectual capacity, emotional stability, memory, and judgment
D. Poor, because the condition will rapidly progress
56. The most appropriate short-term nursing goal for Schizophrenic clients is to:
A. Set limits on bizarre behavior
B. Establish trusting, non-threatening relationship
C. Quickly establish a warm, close relationship
D. Protect client from inappropriate responses
57. When the nurse is talking with a Schizophrenic client, she suddenly says, Im frightened, do you hear that? Terrible things.
Which initial response by the nurse would be most appropriate?
A. I dont hear anything.
B. I dont hear anything but you seem frightened.
C. Who is saying terrible things to you?
D. What is he saying to you?
58. One day the nurse overhears a client with the diagnosis of Schizophrenia talking to herself. She is saying, The mazukas are
coming. The mazukas are coming. Her use of the word mazuka is most likely
A.
B.
C.
D.
59. A. 20 yr. old client is admitted to the psychiatric unit with a diagnosis of Schizophrenia, acute episode. He is having auditory
hallucinations and seems disoriented to time and place. The nurse knows that a hallucination can be explained as:
A. Sensory experience without foundation in reality
B. Voice that is heard by the client but is not really there
C. Distortion of real auditory or visual perception
D. Idea without foundation in reality
60. Lilia, 48 y/o, thinks she is being followed by soldiers to kill her. What thought disorder does this indicate?
A. Ideas of reference
B. Flight of ideas
C. Delusion of persecution
D. Delusion of grandeur
61. Marina, 26 y/o is aloof and suspicious of the foods being served to her. She utilizes the defense mechanism of Projection. This
means that she:
A. unconsciously refuses to accept a feeling, thought or impulse and attributes it to someone else
B. justifies behavior, attitudes and feelings with excuses
C. involuntary refuses to acknowledge reality
D. involuntary excludes wishes, impulses, memories and feelings from awareness
62. Which of these nursing approaches is MOST appropriate for the nurse to begin with Marina?
A. Engage her for at least 1hr. in one to one interaction daily
B. Invite her to socialize with other patients
C. Make self available while maintaining distance until she shows readiness to interact
D. Refer her for activity therapy
63. When Marina refuses to take her medication, it is best to:
A. let her read the drug literature to convince her that it is therapeutic
B. force her to take the drug to maintain therapeutic effectiveness
C. have the same nurse, who she interacts with regularly, administer the drug
D. request the doctor to give it to her
64. Another reason why Marina refuses to take Thorazine is because she complains of robot like movements and slurred speech. The
nurses action is:
A. decrease the dosage of Thorazine
B. explain the extrapyramidal side effects and administer Benadryl
C. avoid giving foods that are rich in Tyramine
D. withhold medication until referral is made to the doctor
65. A50 yr. old male client has a history of many hospitalizations for Schizophrenic disorder. He has been on long-term
Phenothiazines (Thorazine), 400 mg/ day. The nurse assessing this client observes that he demonstrates jerky choreiform
movements, lip smacking, neck and back tonic contractions. The nurse concludes that the client develop:
A. Tardive dyskinesia
B. Parkinsonism
C. Dystonia
D. Akathisia
66. A client with the diagnosis of Schizophrenia has orders for Clozapine (Leopnex). The nurse will evaluate the drugs effect as
positive if the:
A. Client develops Leukopenia
B. Psychotic symptoms such as hearing voices are reduced
C. Monthly liver function studies changes moderately
D. Clients energy level and involvement in activities goes up
67. A client with a diagnosis of Paranoid Personality disorder refuses to take his medication and is accusing the nurse of trying to kill
him. The nurses best strategy would be to tell him that:
A. It is not poison and you must take the medication.
B. I will give you an injection if necessary.
C. You may decide if you want to take the medication by mouth or injection, but you must take it.
D. Its all right if you dont take the medication right now.
68. A newly admitted client to the psychiatric unit will receive ECT. ECT is considered most effective in treating:
A. Young clients with depressive reactions
B. Elderly clients with depressive reactions
C. Any age client with Schizophrenia
D. Young clients with paranoid reactions
69. The treatment in Crisis intervention centers is specifically intended to help clients:
A. Return to prior levels of functioning
B. Understand the dynamics underlying symptoms
C. Make long range plans for the future
B. box of cake
C. bottle of coke
D. wallet
82. Situational crisis are usually resolved in a time period of:
A. 1-4 days
B. 2-4 weeks
C. 1-2 months
D. 2-6 months
83. According to crisis theory, the minimal long-term goal in crisis intervention is:
A. relief of acute symptoms
B. relief of panic level anxiety
C. restoration of the functioning level
D. reorganization and reordering of the personality
84. The most critical factor for the nurse to determine during crisis intervention is the clients:
A. developmental history
B. available situational supports
C. underlying unconscious conflict
D. willingness to restructure personality
85. Which of the following statements about Family Violence is Tue?
A.
It affects every socio-economic level
B.
It is caused by drug and alcohol abuse
C.
It predominantly occurs in lower socioeconomic levels
D.
It rarely occurs during pregnancy
86. Secondary level of prevention of domestic violence involves:
A. educational programs that enhance family function
B. early detection and treatment of interpersonal violence
C. psychotherapy for the abuser
D. family therapy
87. You are working in the emergency department conducting an interview with a victim of spousal abuse. Which step should you
take first?
A. contact the appropriate legal services
B. ensure privacy for interviewing the victim away from the abuser
C. establish rapport with the victim and the abuser
D. request the presence of the security personnel
88. The following are characteristic of abuse in the family, EXCEPT
A. victims have little capacity to defend themselves
B. victims may feel emotionally if not physically trapped
C. victims of abuse are often independent of their abuser
D. the abuser is physically stronger than the abused
89. Which of the following is NOT a characteristic of an abuser?
A. was abused as a child
B. rigid in retaining control
C. assertive and socially adept
D. inadequate and impulsive
90. The following interventions are appropriate for a victim of abuse EXCEPT:
A. Communicate acceptance and non moralistic attitude
B. Reinforce her right to be free from abuse
C. Encourage the victim to leave the abuser
D. Help the victim develop a safety plan
91. The nurse is assessing a parent who abused her child. Which of the following
case?
A. flexible role functioning between parents
B. history of the parent having been abused as a child
C. single parent home situation
D. presence of parental mental illness
92. Which of the following assessment findings would lead the nurse to suspect that an 8 yr. old child is a victim of sexual abuse?
A. child is fearful of caregiver and other adults
B. child has a lack of interpersonal relationships
C. child has self-injurious behaviors
D. child has interest in playing with other children
93. Play therapy among victims of abuse is:
A. Playing indoor games to divert attention from the abuse
B. Drawing or playing with dolls rather than talking
C. Allowing the child to talk about hurt feelings and pain