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( Taken from sample questions posted on april & late march)

Psychoanalytical theory suggests that gender identity disorders possibly began with the struggle of
the oedipal conflict. This occurs during which psychosexual stage?
A. oral
B. latent
C. genital
D. phallic
Freud proposed that the development of the Oedipus complex occurred during the phallic stage. He
described this as the child's unconscious desire to eliminate the parent of the same sex and to
possess the parent of the opposite sex for himself or herself.

According to Erik Erikson, developmental delays or partial mastery of the psychosocial

developmental stages can lead to problems in functioning. Failure to master Erikson's first
psychosocial stage of development can lead to:
A. ritualistic behavior
B. acting out behavior
C. paranoid behavior
D. regressive behavior
Non-achievement of Erikson's first stage results in emotional dissatisfaction with the self and others,
suspiciousness, and difficulty with interpersonal relationships

According to Kubler-Ross's Five Stages of Grief, at which stage does the client seek new or
questionable treatment modalities?
A. bargaining
B. acceptance
C. depression
D. anger
During the anger stage, client is demanding, nonadherent, argumentative, and critical of his or her
care and of others.
In the depression stage, client exhibits social withdrawal, agitation, imapired eating, sleep
disturbance, and altered concentration patterns.
During acceptance, client participates in care and verbalizes feelings; appetite, concentration, and
sleeping patterns improve.

Dementia first affects recent and immediate memory, then eventually impairs the ability to recognize
family members, even oneself.
In mild and moderate dementia, clients make up answers to fill in memory gaps. This is known as:
A. agnosia
B. rumination
C. palilalia
ANSWER: D. Confabulation.
Palilalia is repeating words or sounds over and over.
Agnosia is difficulty recognizing familiar objects.
Rumination which refers to negativistic thinking is common in depressed patients.

Which statement made by a client indicates to the nurse that he may have a thought disorder?
A) "I'm so angry about this. Wait until my partner hears about this."
B) "I'm a little confused. What time is it?"
C) "I can't find my 'mesmer' shoes. Have you seen them?"
D) "I'm fine. It's my daughter who has the problem."
The correct answer is C: "I can''t find my ''mesmer'' shoes. Have you seen them?"A Neologism is a
new word self invented by a person and not readily understood by another that is often associated
with a thought disorder.

client who is a former actress enters the day room wearing a sheer nightgown, high heels,
numerous bracelets, bright red lipstick and heavily rouged cheeks. Which nursing action is the best
in response to the clients attire?
A) Gently remind her that she is no longer on stage
B) Directly assist client to her room for appropriate apparel
C) Quietly point out to her the dress of other clients on the unit
D) Tactfully explain appropriate clothing for the hospital
The correct answer is B: Directly assist client to her room for appropriate apparelAllows the client to
maintain self-esteem while modifying behavior.
Crisis intervention is a short term therapy focused on solving the immediate problem.This generally
lasts for how many weeks? A. 1-2 wks B. 2-4 wks C. 4-6 wks D. 6-8 wks
Anser is C .Rationale:4-6 wks the disorganization period of crisis is so distressing that it usually cannot be tolerated
emotionally or physically for more than 4 to 6 wks.If right kind of help is not available and the crisis is not successfully
resolved in that time period.The individual in crisis is likely to become exhausted and physically ill.Adopt disfunctional
coping patterns that manage the intense feelings without solving the problem (that is become emotionaly ill),become
violent,or attempt suicide to escape the pain.

A 16-year-old girl was diagnosed with anorexia. What would be the first assessment of the nurse?
A) What food she likes.
B) Her desired weight.
C) Her body image.
D) What causes her behavior
Answer is A.
* Although all options may appear correct. A is the best because it focuses on a range of possible
positive reinforcers, a basis for an effective behavior modification program. It can lead to concrete,
specific nursing interventions right away and provides a therapeutic use of control for the 16-year-

Nursing Practice 5
Which patient adaptations are unexpected in response to the General Adaptation Syndrome (GAS)?
A. Dilated pupils and bradycardia
B. Mental alertness and tachycardia
C. Increase blood glucose and tachycardia
D. Decreased blood glucose and bradycardia
Test Taking Technique: By carefully reading the stem, you should identify that the word
UNEXPECTED is a significant word in this question. You have just used the test-taking technique
identify key words in the stem that indicate NEGATIVE polarity.
what is General Adaptation Syndrome? http://goo.gl/7vvRv4
or you can watch this video lecture: http://goo.gl/SWKRlL
Test Taking Strategies: If you know that tachycardia is associated with the GAS, you can eliminate
options B and C. This reasoning uses identify Duplicate facts among options. If you recognize that
options C and D are opposites, you should give these options particular consideration. By seriously
considering these options, you are using the strategy of identify opposites in options.
Correct Answer: D
Rationale: During the alarm stage of the General Adaptation Syndrome, both the blood glucose
level and heart rate of the patient increase, not decrease. However in letter A, Tachycardia, not
bradycardia is associated with the GAS, dilated pupils are expected. In letter B both these
adaptations are expected autonomic nervous system response that occur during the alarm stage of
the GAS. Letter C is still the same as letter B. In short these General Adaptation Syndrome is a
sympathetic response (Fight or Flight) wherein there's an vital signs, fuel availability (sugar, fats),
adrenaline, oxygen circulation to vital organs, vasoconstriction or blood clotting (minimizes loss
of blood if wounded), bronchodilation, pupil size and peripheral vision (improves vision), digestion
and salivation.
Gets mga bagets? wink emoticon

The nurse is admitting a client diagnosed with seasonal affective disorder (SAD). Based on the
underlying cause of this illness, which treatment does the nurse anticipate will be initiated for this
Choose one of the following
A. Electroconvulsive therapy.
B. Phototherapy.
C. Relaxation therapy.
D. Group therapy.
The correct answer is B. SAD is depression linked to the shortened days of fall and winter.
Phototherapy increases the exposure to light and increases mood of the client. Electroconvulsive
therapy is used for clients who cannot use or are nonresponsive to antidepressants in major
depression. Relaxation therapy is used in anxiety disorders. Group therapy is used to increase
coping and understanding in many disorders.
(CN: Psychological integrity)

The nurse is assessing a client with anxiety; which of the following observations is the most
Choose one of the following
A. The nurse's own anxiety.
B. The client's tongue movements.
C. Pill-rolling motion by the client.
D. The client's family history.
The correct answer is A. The nurse should be cognizant of her or his own personal anxiety. Anxiety
from the nurse is conveyed to the client. Symptoms such as the tongue movements and pill-rolling
motions by the client may be related to neuroleptic administration and are not related to the anxiety
of the client. The client's family history may be significant, but the nurse is assessing the client at this
moment and in the current setting.
(CN: Psychological integrity)

1 .Rudolf is admitted for an overdose of amphetamines. When assessing the client, the nurse should
expect to see:
a. Tension and irritability
b. Slow pulse
c. Hypotension
d. Constipation
2 .Nicolas is experiencing hallucinations tells the nurse, The voices are telling me Im no good. The
client asks if the nurse hears the voices. The most appropriate response by the nurse would be:
a. It is the voice of your conscience, which only you can control.
b. No, I do not hear your voices, but I believe you can hear them.
c. The voices are coming from within you and only you can hear them.
d. Oh, the voices are a symptom of your illness; dont pay any attention to them.
3.The nurse is aware that the side effect of electroconvulsive therapy that a client may experience:
a. Loss of appetite
b. Postural hypotension
c. Confusion for a time after treatment
d. Complete loss of memory for a time
1. Answer: (A) Tension and irritability
Rationale: An amphetamine is a nervous system stimulant that is subject to abuse because of its
ability to produce wakefulness and euphoria. An overdose increases tension and irritability. Options
B and C are incorrect because amphetamines stimulate norepinephrine, which increase the heart
rate and blood flow. Diarrhea is a common adverse effect so option D in is incorrect.
2. Answer: (B) No, I do not hear your voices, but I believe you can hear them.
Rationale: The nurse, demonstrating knowledge and understanding, accepts the clients perceptions
even though they are hallucinatory.
3. Answer: (C) Confusion for a time after treatment
Rationale: The electrical energy passing through the cerebral cortex during ECT results in a
temporary state of confusion after treatment.

dejavu is experienced when person have?

A. insomnia
B. hypersomnia
C. anorexia
D. hypoxemia
(INSOMNIA) tagalog na lang para mas maintindihan meron tayong right hemisphere and left hemisphere sa brain.
dejavu is also known as "7 seconds phenomenon" yung right hemisphere kasi sya yung present, sya yung
tagatanggap ng mga stimulus yung left hemisphere naman sya yung past / memory.. kapag kulang tayo sa tulog or
pag puyat tayo nagpapahinga yung right hemisphere ng brain natin para di sya mag shut down totally.. so pag
nagpahinga sya, ang tatanggap ng stimulus is yung left hemisphere.. mareregister tuloy sakanya na past na yun..
after 7 seconds malilipat nya na yun stimulus na yun sa right hemisphere kaya mo nasasabi na "ayy! parang nangyari
na to!" and that is DEJAVU

1.) The psychodynamics of depression is:

A. Lax of superego
B. weak superego
C. Internalized hostility feelings
D. Narcissistic personality
2.) The past history of a patient with schizophrenia would most probably reveal that his/her
premorbid personality is:
A. Extrovert
B. schizoid
C. Ambivert
D. Cycloid
3. Evidence of the existence of the unconscious is best demonstrated by:
A. The ease of recall
B. dj vu experiences
C. Slips of the tongue
D. Free floating anxiety
Answers : C, B, C,
No ratio, you can check it out on Carl balita reviewer.

1. Nurse Tony should first discuss terminating the nurse-client relationship with a client during the:
a. Termination phase when discharge plans are being made.
b. Working phase when the client shows some progress.
c. Orientation phase when a contract is established.
d. Working phase when the client brings it up.
2. Malou is diagnosed with major depression spends majority of the day lying in bed with the sheet
pulled over his head. Which of the following approaches by the nurse would be the most
a. Question the client until he responds
b. Initiate contact with the client frequently
c. Sit outside the clients room
d. Wait for the client to begin the conversation
3. Joe who is very depressed exhibits psychomotor retardation, a flat affect and apathy. The nurse in
charge observes Joe to be in need of grooming and hygiene. Which of the following nursing actions
would be most appropriate?
a. Waiting until the clients family can participate in the clients care
b. Asking the client if he is ready to take shower
c. Explaining the importance of hygiene to the client
d. Stating to the client that its time for him to take a shower
4. When teaching Mario with a typical depression about foods to avoid while taking
phenelzine(Nardil), which of the following would the nurse in charge include?
a. Roasted chicken
b. Fresh fish
c. Salami
d. Hamburger
5. When assessing a female client who is receiving tricyclic antidepressant therapy, which of the
following would alert the nurse to the possibility that the client is experiencing anticholinergic effects?
a. Urine retention and blurred vision
b. Respiratory depression and convulsion
c. Delirium and Sedation
d. Tremors and cardiac arrhythmias
6. For a male client with dysthymic disorder, which of the following approaches would the nurse
expect to implement?
a. ECT
b. Psychotherapeutic approach
c. Psychoanalysis
d. Antidepressant therapy
7. Danny who is diagnosed with bipolar disorder and acute mania, states the nurse, Where is my
daughter? I love Louis. Rain, rain go away. Dogs eat dirt. The nurse interprets these statements as
indicating which of the following?
a. Echolalia
b. Neologism
c. Clang associations
d. Flight of ideas
8. Terry with mania is skipping up and down the hallway practically running into other clients. Which
of the following activities would the nurse in charge expect to include in Terrys plan of care?
a. Watching TV
b. Cleaning dayroom tables
c. Leading group activity
d. Reading a book
9. When assessing a male client for suicidal risk, which of the following methods of suicide would the
nurse identify as most lethal?
a. Wrist cutting
b. Head banging
c. Use of gun
d. Aspirin overdose
10. Jun has been hospitalized for major depression and suicidal ideation. Which of the following
statements indicates to the nurse that the client is improving?
a. Im of no use to anyone anymore.
b. I know my kids dont need me anymore since theyre grown.
c. I couldnt kill myself because I dont want to go to hell.
d. I dont think about killing myself as much as I used to..."
-Correct Answers- CBDCA-BDBCD
1.C. When the nurse and client agree to work together, a contract should be established, the length
of the relationship should be discussed in terms of its ultimate termination.
2.B. The nurse should initiate brief, frequent contacts throughout the day to let the client know that
he is important to the nurse. This will positively affect the clients self-esteem.
3.D. The client with depression is preoccupied, has decreased energy, and is unable to make
decisions. The nurse presents the situation, Its time for a shower, and assists the client with
personal hygiene to preserve his dignity and self-esteem.
4.C. Foods high in tyramine, those that are fermented, pickled, aged, or smoked must be avoided
because when they are ingested in combination with MAOIs a hypertensive crisis will occur.
5.A. Anticholinergic effects, which result from blockage of the parasympathetic (craniosacral)
nervous system including urine retention, blurred vision, dry mouth & constipation.
6.B. Dysthymia is a less severe, chronic depression diagnosed when a client has had a depressed
mood for more days than not over a period of at least 2 years. Client with dysthymic disorder benefit
from psychotherapeutic approaches that assist the client in reversing the negative self image,
negative feelings about the future.
7.D. Flight of ideas is speech pattern of rapid transition from topic to topic, often without finishing one
idea. It is common in mania.
8.B. The client with mania is very active & needs to have this energy channeled in a constructive
task such as cleaning or tidying the room.
9.C. A crucial factor is determining the lethality of a method is the amount of time that occurs
between initiating the method & the delivery of the lethal impact of the method.
10.D. The statement I dont think about killing myself as much as I used to. Indicates a lessening of
suicidal ideation and improvement in the clients condition...

A helping relationship is a process characterized by:

A recovery promoting
B Mutual interaction
C Growth facilitating
D Health enhancing
Answer Letter C rationale: In psychiatric nursing, the epitome of all nursing goal should focus on facilitating Growth of
the client.
1. Francis who is addicted to cocaine withdraws from the drug. Nurse Ron should expect to observe:
a. Hyperactivity
b. Depression
c. Suspicion
d. Delirium
2. Nurse John is aware that a serious effect of inhaling cocaine is?
a. Deterioration of nasal septum
b. Acute fluid and electrolyte imbalances
c. Extra pyramidal tract symptoms
d. Esophageal varices
3. A tentative diagnosis of opiate addiction, Nurse Candy should assess a recently hospitalized client
for signs of opiate withdrawal. These signs would include:
a. Rhinorrhea, convulsions, subnormal temperature
b. Nausea, dilated pupils, constipation
c. Lacrimation, vomiting, drowsiness
d. Muscle aches, papillary constriction, yawning
4. A 48 year old male client is brought to the psychiatric emergency room after attempting to jump off
a bridge. The clients wife states that he lost his job several months ago and has been unable to find
another job. The primary nursing intervention at this time would be to assess for:
a. A past history of depression
b. Current plans to commit suicide
c. The presence of marital difficulties
d. Feelings of excessive failure
5. Before helping a male client who has been sexually assaulted, nurse Maureen should recognize
that the rapist is motivated by feelings of:
a. Hostility
b. Inadequacy
c. Incompetence
d. Passion
6. When working with children who have been sexually abused by a family member it is important for
the nurse to understand that these victims usually are overwhelmed with feelings of:
a. Humiliation
b. Confusion
c. Self blame
d. Hatred
7. Joy who has just experienced her second spontaneous abortion expresses anger towards her
physician, the hospital and the rotten nursing care. When assessing the situation, the nurse
recognizes that the client may be using the coping mechanism of:
a. Projection
b. Displacement
c. Denial
d. Reaction formation
8. The most critical factor for nurse Linda to determine during crisis intervention would be the
a. Available situational supports
b. Willingness to restructure the personality
c. Developmental theory
d. Underlying unconscious conflict
9. Nurse Trish suggests a crisis intervention group to a client experiencing a developmental crisis.
These groups are successful because the:
a. Crisis intervention worker is a psychologist and understands behavior patterns
b. Crisis group supplies a workable solution to the clients problem
c. Client is encouraged to talk about personal problems
d. Client is assisted to investigate alternative approaches to solving the identified problem
10. Nurse Ronald could evaluate that the staffs approach to setting limits for a demanding, angry
client was effective if the client:
a. Apologizes for disrupting the units routine when something is needed
b. Understands the reason why frequent calls to the staff were made
c. Discuss concerns regarding the emotional condition that required hospitalizations
d. No longer calls the nursing staff for assistance
1. B. There is no set of symptoms associated with cocaine withdrawal, only the depression that
follows the high caused by the drug.
2. A. Cocaine is a chemical that when inhaled, causes destruction of the mucous membranes of the
3. D. These adaptations are associated with opiate withdrawal which occurs after cessation or
reduction of prolonged moderate or heavy use of opiates.
4. B. Whether there is a suicide plan is a criterion when assessing the clients determination to make
another attempt.
5. A. Rapists are believed to harbor and act out hostile feelings toward all women through the act of
6. C. These children often have nonsexual needs met by individual and are powerless to
refuse.Ambivalence results in self-blame and also guilt.
7. B. The clients anger over the abortion is shifted to the staff and the hospital because she is
unable to deal with the abortion at this time.
8. A. Personal internal strength and supportive individuals are critical factors that can be employed
to assist the individual to cope with a crisis.
9. D. Crisis intervention group helps client reestablish psychologic equilibrium by assisting them to
explore new alternatives for coping. It considers realistic
situations using rational and flexible problem solving methods.
10. C. This would document that the client feels comfortable enough to discuss the problems that
have motivated the behavior.

A 15-year-old female seeks treatment for

a sexually transmitted infection at a local
clinic. With regard to informed consent,
the nurse should perform which action?
A. Ask the client to sign the informed
consent form.
B. Tell the client that a court order for
treatment is needed.
C. Tell the client that parental consent
for treatment is needed.
D. Call the client's mother to obtain telephone
consent for treatment.
Rationale: Parents normally must give informed consent for treatment
of a minor. Some exceptions to this include the need for
emergency treatment; when the consent of the minor is sufficient,
such as for treatment of a sexually transmitted infection; or when a
court order or other legal authorization has been made. Therefore,
options B, C, and D are incorrect.

During medication administration, a client admitted for aggressive behavior yells at the nurse, "You
are a terrorist with poison pills!" What is the nurse's BEST response?
A. "I am not a terrorist."
B. "Why do you think I am trying to poison you?"
C. "It is time to take your medication now."
D. "I am a nurse and I work at this hospital."
-Correct Answer- D
During medication administration, a client admitted for aggressive behavior yells at the nurse, "You
are a terrorist with poison pills!" What is the nurse's BEST response?
A. "I am not a terrorist."
B. "Why do you think I am trying to poison you?"
C. "It is time to take your medication now."
D. "I am a nurse and I work at this hospital."
Strategy: "BEST" indicates discrimination is required to answer the question.
(1.) nontherapeutic defensiveness; reinforces delusion
(2.) reinforces delusion
(3.) does not address patient's concern about who the nurse is; may be misinterpreted as a threat
(4.) reality orientation; addresses patient's concern without reinforcing delusion

Somatoform disorders are characterized as the presence of physical symptoms that suggest a
medical condition without a demonstrable organic basis.
Jun, a rookie of their school's basketball varsity team suddenly lost sensation in his legs on the day
of his first basketball game. The following day, the sensation in his legs returned. Jun experienced
what condition?
A. Somatization disorder
B. Pain disorder
C. Hypochondriasis
D. Conversion disorder
Conversion disorder involves unexplained, usually sudden deficits in sensory and motor function.
Somatization disorder is characterized by multiple physical symptoms.
Pain disorder has the primary physical symptom of pain
Hypochondriasis is preoccupation with the fear that one has a serious disease.

Which of the ff moral theories is based on respect for other humans and belief that relationships are
based on mutual trust
A. Erickson theory
B. Kohlberg theory
C. Freud theory
D. Schulman theory

The nurse is caring for a patient diagnosed with antisocial personality disorder. Which of the
following traits will most likely surface during assessment?
A. Unstable self-image
B. Poor judgment
C. Dependent and self-critical
D. Memory lapses
Answer is B
Rationale :
A patient with antisocial personality disorder generally exercises poor judgment for various reasons.
They pay no attention to the legality of their actions and do not consider morals or ethics when
making decisions.
Their behavior is determined primarily by what they want with no empathy or regard to others.
Deceit and manipulation are central characteristics of this disorder.
Memory lapses are found in patient with cognitive disorders. Unstable self image is present with
borderline personality disorder. A dependent and self-critical attitude is manifested in patients with
dependent personality disorder.

A client is admitted to the inpatient unit of the National Center for Mental Health (NCMH) in
Mandaluyong City with a diagnosis of Paranoid Schizophrenia. He's shouting that the ISIS is trying
to kill him by beheading. Which of the following responses is most appropriate?
A. "Are you kidding me? ISIS are friendly and an ally of our government. Their group wouldn't try to
kill you. Relax!"
B. "I find it hard to believe that ISIS or anyone else is trying to hurt you. You must feel frightened by
C. "You're wrong. Nobody is trying to kill you."
D. "A group of ISIS is trying to kill you? Please tell me more about it."

Correct answer is letter B
Responses should focus on REALITY while ACKNOWLEDGING the client's FEELINGS. Arguing
with the client or denying his belief isn't therapeutic, like letter A and letter C. The word "You're
wrong" makes the statement non therapeutic, napaka literal naman nito. Remember huwag mo
silang pangunahan o masabihan na mali sila at baka masapak ka pa. LOL! Arguing can also inhibit
development of a trusting relationship. Continuing to talk about delusions may aggravate the
psychosis. Asking the client if a group of ISIS is trying to kill him may INCREASE his ANXIETY level
and can REINFORCE his DELUSION. So, ano po ang pinaglalaban ng letter D? nakakita ka lang ng
TELL ME MORE, yun agad? at pati ikaw naniniwala din sa patient mo ah. peace! hehe
: A nurse is caring for a client with schizophrenia who was prescribed to take atypical anti-psychotics.
Which of the following medication is related to atypical anti-psychotics?

A. Risperidone

B. Mellaril

C. Haldol

D. Sinequan

Answer: A - mellaril and haldol are under typical anti-psychotics. While Sinequan is an antidepressant.

Which defense mechanism is typical of patients with borderline personality disorder to avoid the pain
and feelings associated with past abuse and current situations involving threat of rejection or
abandonment? He/she therefore views self and others as either all good or all bad.
A. projection
B. splitting
C. rationalization
D. sublimation
Splitting is defined as the inability to view both self and others as having both good and bad
Projection is the unconscious blaming of unacceptable inclinations or thoughts on an external
Rationalization is excusing own behavior to avoid guilt, and other negative feelings.
Sublimation is substituting a socially acceptable activity for an impulse that is acceptable.

camilia verbalizes."pinag uusapan nila ako,ayaw nila ako ".a therapeutic response is?. A.Nalulungkot
ba ang pakiramdam mo?. B.Hayaan mo sila.ang mahalaga ay ang palagay mo sa sarili mo". C.Sino
ang "nila" na tinutukoy mo? D.Hwag mong isipin yn.hindi tama yan CORRECT ANSWER C:

Nursing Practice 5
Category: Geriatrics in Nursing
Situation: Gerontological nursing is important to meet the health needs of an aging population. Due
to longer life expectancy and declining fertility rates, the proportion of the population that is
considered old is increasing. Between 2000 and 2050, the number of people in the world who are
over age 60 is predicted increase from 605 million to 2 billion. The proportion of older adults is
already high and continuing to increase in more developed countries.
1. End result of a series of changes that may proceed in a definite pattern through chronological age.
A. Terminal care
B. Ageism
C. Aging
D. Dying
2. System of destructive, erroneous beliefs, biases against older people is known as.
A. Terminal care
B. Ageism
C. Aging
D. Abuse
3. Term for the medical specialty that addresses diagnosis & treatment of physiologic & pathologic
problems of the elderly.
A. Geriatrics
B. Gerontology
C. Geropsychiatric
D. Gerophysiology
4. Study of all aspects of aging process.
A. Geriatrics
B. Gerology
C. Geriatry
D. Gerontology
5. Care of dying patients & in the final stages of their lives is called.
A. Terminal care
B. Spiritual care
C. Post mortem care
D. Euthanasia
Correct answers: C B A D A
AGING is an end result of a series of changes that may proceed in a definite pattern through
chronological age.
GERONTOLOGY is the study of all aspects of aging process such as biological, sociological,
psychological factors.
GERIATRICS is the term for the medical specialty that addresses diagnosis & treatment of
physiologic & pathologic problems of the elderly.
GEROPSYCHIATRY is a branch of clinical medicine specializing in psychopathology of the elderly
TERMINAL CARE refers to the care of dying patients & in the final stages of their lives.
AGEISM is a system of destructive, erroneous beliefs, biases against older people.
POST-MORTEM CARE is providing physical care of the body of an expired patient and support for
the family viewing the body or relating to examination of the body after death.

NURSING PRACTICE V- Care of Clients with physiologic and Psychosocial Alterations (Part C)
.Situation 1 Jimmy developed this goal for hospitalization. To get a handle on my nervousness.
The nurse is going to collaborate with him to reach his goal. Jimmy was admitted to the hospital
because he called his therapist that he planned to asphyxiate himself with exhaust from his car but
frightened instead. He realized he needed help...
.1. The nurse recognized that Jimmy had conceptualized his problem and the next priority goal in the
care plan is
A. help the client find meaning in his experience
B. help the client to plan alternatives
C. help the client cope with the present problem
D. help the client to communicate
2. The nurse is guided that Jimmy is aware of his concerns of the here and now when he crossed
out which item from this list of what to know
A. anxiety laden unconscious conflicts
B. subjective idea of the range of mild to severe anxiety
C. early signs of anxiety
D. physiologic indices of anxiety
3. While Jimmy was discussing the signs and symptoms of anxiety with his nurse, he recognized
that complete disruption of the ability to perceive occurs in
A. panic state of anxiety
B. severe anxiety
C. moderate anxiety
D. mild anxiety
4. Jimmy initiates independence and takes an active part in his self care with the following EXCEPT:
A. agreeing to contact the staff when he is anxious
B. becoming aware of the conscious feeling
C. assessing need for medication and medicating himself
D. writing out a list of behaviors that he identified as anxious
5. The nurse notes effectiveness of interventions in using subjective and objective data in the:
A. initial plans or orders
B. database
C. problem list
D. progress notes
Goodluck future RN'S 2015:-)

Hannah is a 34-year-old single mother of three who had been involved in a secret relationship with
her boss, a married man who was 24 years her senior. When her boss suddenly died as the result of
a heart attack, Hannah had difficulty expressing the extent of her loss. The grief that Hannah was
experiencing could best be described as which of the following?
a. Disenfranchised
b. Complicated
c. Normal
d. Anticipatory CORRECT ANSWER IS A:Individuals experience disenfranchised grief when they
cannot openly acknowledge a loss and experience full social support from others. Disenfranchised
grief happens most often in situations in which others regard the persons loss as less significant or

NP5 June 2007 NLE Question

Situation 2 A research study was undertaken in order to identify and analyze a disabled boys
coping reaction pattern during stress.
6. This study which is an in depth study of one boy is a:
A. case study
B. longitudinal study
C. cross-sectional study
D. evaluative study
7. The process recording was the principal tool for data collection. Which of the following is NOT a
part of a process recording?
A. Non verbal narrative account
B. Analysis and interpretation
C. Audio-visual recording
D. Verbal narrative account
8. Which of these does NOT happen in a descriptive study?
A. Exploration of relationship between two or more phenomena.
B. Explanation of relationship between two or more phenomena.
C. Investigation of a phenomenon in real life context.
D. Manipulation of variable
9. The investigator also provided the nursing care of the subject. The investigator is referred to as
A. Participant-observer
B. Observer researcher
C. Caregiver
D. Advocate
10. To ensure reliability of the study, the investigators analysis and interpretations were:
A. subjected to statistical treatment
B. correlated with a list of coping behaviors
C. subjected to an inter-observer agreement
D. scored and compared standard criteria
Situation 3 During the morning endorsement, the outgoing nurse informed the nursing staff that
Regina, 35 years old, was given Flurazepam (Dalmane) 15mg at 10:00pm because she had trouble
going to sleep. Before approaching Regina, the nurse read the observation of the night nurse.
11. Which of the following approaches of the nurse validates the data gathered?
A. I learned that you were up till ten last night, tell me what happened before you were finally able to
sleep and how was your sleep?
B. Hmm.. You look like you had a very sound sleep. That pill you were given last night is effective
isnt it?
C. Regina, did you sleep well?
D. Regina, how are you?
12. Regina is a high school teacher. Which of these information LEAST communicate attention and
care for her needs for information about her medicine?
A. Guided by a medication teaching plan, go over with her the purpose, indications and special
instructions, about the medication and provide her a checklist
B. Provide a drug literature.
C. Have an informal conversation about the medication and its effects
D. Ask her what time she would like to watch the informative video about the medication.
13. The nurse engages Regina in the process of mutual inquiry to provide an opportunity for Regina
A. face emerging problems realistically
B. conceptualize her problem
C. cope with her present problem
D. perceive her participation in an experience
!4. Which of these responses indicate that Regina needs further discussion regarding special
A. I have to take this medicine judiciously
B. I know I will stop taking the medicine when there is advice from the doctor for
me to discontinue.
C. I will inform you and the doctor any untoward reactions I have.
D. I like taking this sleeping pill. It solves my problem of insomnia. I wish
I can take it for life.
15. Regina commits to herself that she understood and will observe all the medicine precautions by:
A. affixing her signature to the teaching plan that she has understood the nurse
B. committing what she learned to her memory
C. verbally agreeing with the nurse
D. relying on her husband to remember the precautions
Situation 4 The nurse-patient relationship is a modality through which the nurse meets the clients
16. The nurses most unique tool in working with the emotionally ill client is his/her :
A. theoretical knowledge
B. personality make up
C. emotional reactions
D. communication skills
17. The psychiatric nurse who is alert to both the physical and emotional needs of clients is working
from the philosophical framework that states:
A. All behavior is meaningful, communicating a message or a need.
B. Human beings are systems of interdependent and interrelated parts.
C. Each individual has the potential for growth and change in the direction of positive mental health.
D. There is a basic similarity among all human beings.
18. One way to increase objectivity in dealing with ones fears and anxieties is through the process
A. observation
B. intervention
C. validation
D. collaboration
19. All of the following responses are non therapeutic. Which is the MOST direct violation of the
concept, congruence of behavior?
A. Responding in a punitive manner to the client.
B. Rejecting the client as a unique human being
C. Tolerating all behavior in the client.
D. Communicating ambivalent messages to the client.
20. The mentally ill person responds positively to the nurse who is warm and caring. This is a
demonstration of the nurses role as:
A. counselor
B. mother surrogate
C. therapist
D. socializing agent
Situation 5 The nurse engages the client in a nurse-patient interaction.
21. The best time to inform the client about terminating the nurse-patient relationship is:
A. when the client asks how long the relationship would be
B. during the working phase
C. towards the end of the relationship
D. at the start of the relationship
22. The client says, I want to tell you something but can you promise that you will keep this a
secret? A therapeutic response of the nurse is:
A. Yes, our interaction is confidential provided the information you tell me
is not detrimental to your safety.
B. Of course yes, this is just between you and me. Promise!
C. Yes, it is my principle to uphold my clients rights.
D. Yes, you have the right to invoke confidentiality of our interaction.
23. When the nurse respects the clients self-disclosure, this is a gauge for the nurses:
A. trustworthiness
B. loyalty
C. integrity
D. professionalism
24. Rapport has been established in the nurse-client relationship. The client asks to visit the nurse
after his discharge. The appropriate response of the nurse would be:
A. The best time to talk is during the nurse-client interaction time. I am committed to have this time
available for us while you are at the hospital and ends after your discharge.
B. Yes, If you keep it confidential, this is part of privileged communication.
C. I am committed for your care.
D. I am sorry, though I would want to, it is against hospital policy.
25. The client has not been visited by relatives for months. He gives a telephone number and
requests the nurse to call. An appropriate action of the nurse would be:
A. Inform the attending physician about the request of the client.
B. Assist the client to bring his concern to the attention of the social worker.
C. Here (gives her mobile phone). You may call this number now.
D. Ask the client what is the purpose of contacting his relatives.
Situation 6 Camila, 25 years old, was reported to be gradually withdrawing and isolating herself
from friends and family members. She became neglectful of her personal hygiene. She was
observed to be talking irrelevantly and incoherently. She was diagnosed as schizophrenia disorder.
26. The past history of Camila would most probably reveal that her premorbid personality is:
A. schizoid
B. extrovert
C. ambivert
D. cycloid
27. Camila refuses to relate with to others because she:
A. is irritable
B. feels superior of others
C. anticipates rejection
D. is depressed
28. Which of the following disturbances in interpersonal relationships MOST often predispose to the
development of schizophrenia?
A. Lack of participation in peer groups
B. Faulty family atmosphere and interaction
C. Extreme rebellion towards authority figures
D. Solo parenting
29. Camilas indifference toward the environment is a compensatory behavior to overcome:
A. Guilt feelings
B. Ambivalence
C. Narcissistic behavior
D. Insecurity feelings
30. Schizophrenia is a/an:
A. anxiety disorder
B. neurosis
C. psychosis
D. personality disorder

A, C, D, A, D, A, B,B, D, B, D, A, C, D, B, D, A A A, D, A, C, A, D, C,

Kelly is a nursing student who has maintained a 4.0 GPA since she has been in nursing school. The
past semester she has started working, is planning a wedding, and has moved into a new home.
Kelly has not been able to maintain the 4.0 GPA this semester and as a result, Kelly is feeling like a
failure. How is this loss best described?
a. Maturational
b. Situational
c. Actual
d. Perceived CORRECT ANSWERS D: Perceived losses are uniquely experienced by a grieving
person and are often less obvious to others. A perceived loss is real to the person who feels the
loss. A person may perceive that she is less loved by her parents, for example, and experiences a
loss of self-esteem. Others often overlook or misunderstand perceived losses.

Harold is a 45-year-old man who recently lost his job as a result of downsizing at his company.
Harold was employed at this company since graduating from college and identifies himself by the
work that he did. He is currently grieving as a result of which type of loss in his life?
a. Maturational
b. Situational
c. Actual
d. Perceived People experience an actual loss when they can no longer touch, hear, see, or have
near them valued people or objects. Examples include the loss of a body part, pet, friend, life
partner, or role at work.
correct answer :C

Jenny is the young mother of three children. Her oldest child has started school this year, and she
cried as she left him at kindergarten on the first day. How is the loss that Jenny is experiencing best
a. Maturational
b. Situational
c. Actual
d. Perceived CORRECT ANSWER A: People experience maturational losses as they go through a
lifetime of normal developmental processes. When a child goes to school for the first time, she will
spend less time with her parent and the parent-child relationship changes. Acknowledging and
grieving maturational losses help a person cope with the change
During the nurse patient interaction, the, the nurse assesses the ff: To determine the patients coping
A How are you feeling right now?
B Do you have anyone to take you home?
C What do you think will help you right now?
D How does your problem affect your life?
D - as in DALLAS
Rationale: this is the only question that determines the effects of
the problem on the client and the ways she is dealing with IT!

Preparing the client for the termination phase begins:

A Pre orientation
B Orientation
C Working
D Termination
Answer letter C Rationale: telling the client that there is a TERMINATION PHASE should be in the ORIENTATION
PHASE , however , in preparing the client for the TERMINATION, it should be done in the working phase .The nurse
will start to lessen the number of meetings to prevent development of transference or counter transference..

ohn Who is diagnosed with Bipolar disorder and acute mania, states the nurse, "Where is my
daughter? I love Louis, Rain, rain go away.Dogs eat dirt." The nurse interprets these statements as
indicating which of the following?
A Echolalia
B Neologism
C Clang Associations
D Flight of ideas
Answer Letter D Rationale Flight of ideas is speech pattern of rapid transition from topic to topic, often without
finishing one idea. It is common in mania.

6. In planning care for a patient with Parkinsons disease, which of these nursing diagnoses should
have priority?
a. potential for injury
b. altered nutritional state
c. ineffective coping
d. altered mood state
Answer: A- give safety

Mood Disorders
A client says, "It's raining outside and it's raining in my heart. Did you know that St. Patrick drove the
snakes out of Ireland? I've never been to Ireland." The nurse would document this behavior as
A ) Perseveration
B ) Circumstantiality
C ) Neologisms
D ) Flight of ideas

The correct answer is D: Flight of ideas

Flight of ideas is characterized by over productivity of talk and verbal skipping from one idea to another. It is classic
with clients diagnosed as bipolar disorder and occurs in the manic state of this disease.

Eating Disorders
1. A teenage female is admitted with the diagnosis of anorexia nervosa. Upon admission, the nurse
finds a bottle of assorted pills in the clients drawer. The client tells the nurse that they are antacids
for stomach pains. The best response by the nurse would be
A ) "These pills arent antacids since they are all different."
B ) "Some teenagers use pills to lose weight."
C ) "Tell me about your week prior to being admitted."
D ) "Are you taking pills to change your weight?"
The correct answer is C: "Tell me about your week prior to being admitted."
This is an open-ended question which is nonjudgemental and allows for further discussion. The topic
is also nonthreatening yet will give the nurse insight into the client''s view of events leading up to
admission. It is the only option that is client centered. The other options focus on the pills.
Test taking Strategy: Select the phrase "Tell me more". Encourage verbalization of client's feelings.
2. A client diagnosed with anorexia nervosa states after lunch, "I shouldnt have eaten all of that
sandwich, I dont know why I ate it, I wasnt hungry." The clients comments indicate that the client is
likely experiencing
A ) Guilt
B ) Bloating
C ) Anxiety
D ) Fear
The correct answer is A: Guilt
If people with anorexia lose control and eat more than they believe to be appropriate, they
experience guilt.
Mood Disorders
An elderly client who lives in a retirement community is admitted with these behaviors as reported by
the daughter: absence in the daily senior group activity, missing the weekly card games, a change in
calling the daughter from daily to once a week, and the client's tomato garden is overgrown with
weeds. The nurse should assign this client to a room with which one of these clients?
A ) An adolescent who was admitted the day before with acute situational depression
B ) A middle aged person who has been on the unit for 72 hours with a dysthymia
C ) An elderly person who was admitted 3 hours ago with cyclothymia
D ) A young adult who was admitted 24 hours ago for detoxification
he correct answer is B: A middle aged person who has been on the unit for 72 hours with a dysthymia
The findings suggest a client who is depressed. The most therapeutic mileu or environment for this client would be
the client with a similar problem and a client that might be more stable. A secondary consideration is to match the age
as close as possible. The client in option A has depression and would be more likely to be unstable since they have
been in the agency for 24 hours. Dysthymia is defined as a mild depression with findings of trouble falling asleep or
no difficulty falling asleep but then wakes up in the middle of the night and with difficulty is able to fall back asleep.
Cycothymia is the occurance of periods for behaviors that do not meet the criteria for manic or major depressive