Psychiatric Nursing Practice Test 150 Items

 

Psychiatric Nursing Practice Test Part 1

6. A female female clie client nt is admi admitte tted d with with a diagnos diagnosis is of delusions of GRANDEUR. GRANDEUR. This diagnosis reflects a belief that one is:

1.

Marco approached Nurse Trish asking for 

a.

Being K Kiilled

advice on how to deal with his alcohol

b.

Highl Hi ghly y famo famous us and and imp import ortan antt

addiction. Nurse Trish should tell the client

c.

Re Respo spons nsib ible le fo forr e evi vill w worl orld d

that the only effective treatment for 

d.

Con Connect nected ed to cli client ent unrela unrelated ted to oneself 

alcoholism is: 7.

A 20 year old client was diagnosed with

a.

Ps Psyc ycho hoth ther erap apy y

 b.

Alcoholics anonymous (A.A.)

dependent personality disorder. Which

c.

To Tottal a ab bsti stinenc nence e

behavior is not most likely to be evidence of 

d.

Av Aver ersi sion on T The hera rapy py

ineffective individual coping? a.

Rec Recurr urrent ent sel self-d f-dest estruc ructiv tive eb beha ehavio vior  r 

experience false sensory perceptions with

b.

Av Avoi oidi ding ng rel relat atio ionsh nship ip

no basis in reality. This perception is known

c.

Sho Showin wing g inter interest est in soli solitar tary y ac activ tiviti ities es

as:

d.

Inabil Ina bility ity to make make choi choices ces and and deci decisio sion n

2. Nur Nurse se Ha Hazel zel is ca cari ring ng fo forr a ma male le clien clientt wh who o

without advise

a.

Hall Ha lluc uciina nati tion ons s

b.

Delusions

c.

Loos Loose e asso associ ciat atio ions ns

personality disorder. Which signs would this

d.

Neologisms

client exhibit during social situation?

8. A male male cli client ent is is diagno diagnosed sed w with ith schi schizot zotypa ypall

3. Nur Nurse se Mo Monet net iis s caring caring ffor or a fem female ale c cli lient ent who has suicidal tendency. When

a. b.

Pa Para rano noid id th thou ough ghtts Emot Em otio iona nall af affe fect ct

accompanying the client to the restroom,

c.

Indep ndepen end dence ence n ne eed

Nurse Monet should…

d.

Ag Aggr gres essi sive ve beh behav avio ior  r 

9. Nurse Nurse Clair Claire e is carin caring g for a clien clientt dia diagno gnosed sed

a.

Gi Give ve he herr p pri riva vacy cy

b.

Al Allo low w her her to urin urinat ate e

with bulimia. The most appropriate initial

c.

Ope Open n the the w wind indow ow and all allow ow her to get

goal for a client diagnosed with bulimia is?

d.

some fresh air 

a.

En Enco cour urag age e tto o avo avoid id fo food ods s

Observe he her  

b.

Identi Ide ntify fy anxi anxiety ety cau causin sing g situa situati tions ons

c.

Ea Eatt o onl nly y tthre hree e mea meals ls a day day

d.

Avo Avoid id shoppi shopping ng ple plenty nty of grocer groceries ies

4. Nur Nurse se Ma Maure ureen en is dev develo elopin ping g a pl plan an of c care are for a female client with anorexia nervosa. Which action should the nurse include in the

10. Nurs Nurse e Tony was caring caring for for a 41 year old old female client. Which behavior by the client

plan?

indicates adult cognitive development?

a.

Pr Provi ovide de pri priva vacy cy dur durin ing g me meal als s

b.

Set-up Set -up a str strict ict eat eating ing pla plan n for for the the

a.

Gen Genera erates tes new le level vels so off aware awarenes ness s

client

b.

Ass Assume umes s re respon sponsib sibili ility ty ffor or her her actio actions ns

Enc Encour ourage age client client to exer exercis cise e to reduce reduce

c.

Has Ha s maxi maximu mum m abil abilit ity y to sol solve ve

c.

problems and learn new skills

anxiety d.

Res Restri trict ct visits visits wit with h tthe he fam family ily

5. A cli client ent is expe experie rienci ncing ng anxiet anxiety y att attack ack.. The

d.

Her per percep ceptio tion n are are b base ased d on rea realit lity y

11. A neurom neuromuscul uscular ar blocking blocking agent is is

most appropriate nursing intervention should

administered to a client before ECT therapy.

include?

The Nurse should carefully observe the

a.

Turning on the television

a.

Re Respi spirat rator ory y diff diffic icul ulti ties es

b. c.

Lea Leavi ving ng th the ec cli lien entt a alo lone ne Stayin Sta ying g with with the the clie client nt and and spea speakin king g in

b.

Naus Na usea ea an and d vom vomit itin ing g

short sentences

c.

Dizziness

Ask tthe he cl clien ientt to play play with with o othe therr cli client ents s

d.

Seizures

d.

client for?

 

12. A 75 year ol old d clien clientt is admi admitted tted to to the

17. Mari Mario o is complai complaining ning to other clients clients about about

hospital with the diagnosis of dementia of 

not being allowed by staff to keep food in his

the Alzheimer’s type and depression. The

room. Which of the following interventions

symptom that is unrelated to depression

would be most appropriate?

would be? a.

a.

Ap Apat athe heti tic c res respo pons nse e tto o the the

Al Allo lowi wing ng a sna snack ck to to be kep keptt in his his room

environment

b.

Repr Re prim iman andi ding ng th the e cli client ent

b.

“I don’ don’tt know know”” answ answer er to to ques questio tions ns

c.

Ig Igno norin ring g the the clie client nts s be beha havi vior  or 

c.

Sh Shal allo low wo off llab abil ile e eff effect ect

d.

Se Sett ttin ing g li limi mits ts on the the b beha ehavi vior  or 

d.

Negl Neglect ect of pe pers rson onal al hyg hygie iene ne

13. Nurse Tri Trish sh is working in a mental health

18. Conney w with ith borderline personality disorder  who is to be discharge soon threatens to “do

facility; the nurse priority p riority nursing intervention

something” to herself if discharged. Which of 

for a newly admitted client with bulimia

the following actions by the nurse would be

nervosa would be to?

most important?

a.

Te Teac ach h clie client nt to measu measure re I & O

b.

Inv Involv olve e cl clien ientt in planni planning ng d dail aily y me meal al

c.

Obse Ob serv rve e clie client nt du duri ring ng me meal als s

d.

Mon Monit itor or cl clie ient nt c cont ontin inuo uous usly ly

14. Nurse Patr Patricia icia is aware that the major health

a.

client at home temporarily b.

a.

c.

b.

c.

d.

Req Request uest an imm immedi ediate ate extens extension ion for  the client

d.

Cardia Car diac c dysr dysrhyt hythmi hmias as res result ulting ing to cardiac arrest

Discus Dis cuss s the the meani meaning ng of of the the clie client’ nt’s s statement with her 

complication associated with intractable anorexia nervosa would be?

Ask a famil family y membe memberr to sta stay y with with the

Ign Ignore ore the cli client ents s st state atemen mentt be becau cause se it’s a sign of manipulation

19. Joey a client with antisocial personality

Glu Glucose cose intole intoleran rance ce result resulting ing in

disorder belches loudly. A staff member asks

protracted hypoglycemia

Joey, “Do you know why people find you

End Endocr ocrine ine imbala imbalance nce cau causin sing g cold cold

repulsive?” this statement most likely would

amenorrhea

elicit which of the following client reaction?

Dec Decrea reased sed met metabo abolis lism mc caus ausing ing col cold d

a.

Dep De pen ensi sive vene ness ss

intolerance

b.

Emba Embarr rra ass ssm men entt

c.

Shame

d.

Re Rem morse orsefful ulne ness ss

15. Nurse A Anna nna can mini minimize mize agitatio agitation n in a disturbed client by?

20. Whic Which h of the following following approaches approaches would be

a.

In Incre creas asin ing g stim stimul ulat atio ion n

b.

lim limit iting ing unn unnece ecessa ssary ry int intera eracti ction on

most appropriate to use with a client

c.

incr increa easi sing ng app approp ropri riat ate e sen sensor sory y

suffering from narcissistic personality

perception

disorder when discrepancies exist between

ensuri ens uring ng cons constan tantt clie client nt and sta staff  ff 

what the client states and what actually

contact

exist?

d.

16. A 39 year ol old d mother w with ith obsessiv obsessivee-

a.

Ra Rati tion onal aliz izat atio ion n

compulsive disorder has become

b.

Supp Su ppor orti tive ve con confr fron onta tati tion on

immobilized by her elaborate hand washing

c.

Limit s se etting

and walking rituals. Nurse Trish recognizes

d.

Consi sis stency

that the basis of O.C. disorder is often:

21. Cely is experi experiencin encing g alcohol wit withdrawa hdrawall

a.

Proble Pro blems ms wit with h being being too too cons conscie cienti ntious ous

exhibits tremors, diaphoresis and

b.

Pro Proble blems ms wit with ha ange ngerr a and nd rem remors orse e

hyperactivity. Blood pressure is 190/87

c.

Fe Feel elin ings gs of guil guiltt and iina nade dequ quac acy y

mmhg and pulse is 92 bpm. Which of the

d.

Fe Feel elin ing g of un unwo wort rthi hine ness ss and and

medications would the nurse expect to

hopelessness

administer? a.

Na Nalo loxo xone ne (N (Nar arca can) n)

 

b.

Be Benz nzlr lrop opin ine e (C (Cog ogen enti tin) n)

a.

It may appear appear acting acting out behavi behavior  or 

c.

Lora Loraze zepa pam m (Ati (Ativa van) n)

b.

Doe Does s not not respon respond d tto o conv convent ention ional al

d.

Ha Halo lope peri rido doll (Ha (Hald ldol ol))

treatment

22. Which of the fol followi lowing ng foods would would the nurse

c.

Is s shor hortt in durati duration on & resolv resolves es easi easily ly

Trish eliminate from the diet of a client in

d.

Lo Look oks s almost almost iiden denti tical cal tto o adult adult

alcohol withdrawal?

depression

28. Nurs Nurse e Perry is aware aware that language language

a.

Milk

b.

Oran range Juice

c.

Soda

a.

Sc Scan anni nin ng s spe pee ech

d.

Re Regu gullar Co Cofffee

b.

Speech lag

c.

Shuttering

d.

Echolalia

development in autistic child resembles:

23. Which of the fol followi lowing ng would Nurse Nurse Hazel expect to assess for a client who is exhibiting late signs of heroin withdrawal?

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

a.

Ya Yawn wnin ing g & diap diapho hore resi sis s

tells the nurse at the community health

b.

Rest Restle less ssne ness ss & Irr Irrit itab abil ilit ity y

center “I really don’t need anyone to talk to”.

c.

Cons Consti tipa pati tion on & ste steat atorr orrhe hea a

The TV is my best friend. The nurse

d.

Vo Vomi miti ting ng and and D Dia iarr rrhe hea a

recognizes that the client is using the

24. To establ establish ish open and trusti trusting ng relati relationship onship

defense mechanism known as?

with a female client who has been

a.

Displacement

hospitalized with severe anxiety, the nurse

b.

Projection

in charge should?

c. d.

Sublimation Denial

a.

Enc Encour ourage age the staff staff tto o have have ffreq requen uentt interaction with the client

30. When wor working king with with a male client suffering suffering

b.

Sha Share re a an na acti ctivit vity y wi with th the client client

phobia about black cats, Nurse Trish should

c.

Giv Give e clie client nt fee feedba dback ck about about beh behavi avior  or 

anticipate that a problem for this client would

d.

Res Respec pectt clie client’ nt’s s need need for per person sonal al

be?

space

25. Nurse Mo Monette nette recogniz recognizes es that the focus of  environmental (MILIEU) therapy is to: a.

Mani Manipul pulate ate the enviro environme nment nt tto o br bring ing

a.

An Anxi xiet ety y when when di disc scus ussi sing ng phob phobia ia

b.

An Ange gerr towa toward rd the the ffea eared red ob obje ject ct

c.

De Deny nyin ing g that that the the p pho hobi bia a exis existt

d.

Dis Distor tortio tion n of rreal eality ity when when compl completi eting ng daily routines

about positive changes in behavior  b.

c.

d.

Allo Allow w th the e clie client nt’s ’s ffre reed edom om to to

31. Linda iis s pacing pacing the floor floor and appears appears

determine whether or not they will be

extremely anxious. The duty nurse

involved in activities

approaches in an attempt to alleviate Linda’s

Role play life events to

anxiety. The most therapeutic question by

meet individual needs

the nurse would be?

Use nat natural ural rem remedi edies es rather rather tha than n

a.

Wo Woul uld dy you ou lik like e tto o watc watch h TV? TV?

drugs to control behavior 

b.

Woul Would dy you ou like like me to talk talk w with ith you? you?

c.

Ar Are e you you fe feel elin ing g ups upset et no now? w?

d.

Ignor gnore e tthe he c cli lien entt

26. Nurse T Trish rish would would expec expectt a child wit with ha diagnosis of reactive attachment disorder to: a.

Hav Have em more ore posi positiv tive e re relat lation ion wit with h tthe he

32. Nurs Nurse e Penny is aware aware that the the symptoms symptoms

father than the mother 

that distinguish post traumatic stress

b.

Cli Cling ng to m moth other er & cry on sep separa aratio tion n

disorder from other anxiety disorder would

c.

Be a able ble to dev develo elop p only only sup superf erfici icial al

be:

relation with the others d.

a.

activities that resemble the stress

Have Have been been p phy hysi sical cally ly ab abus use e

27. When teac teaching hing parents parents about chil childhood dhood depression Nurse Trina should say?

Avo Avoida idance nce of sit situat uation ion & c cert ertain ain

b.

Dep Depress ression ion and a bl blunt unted ed a aff ffect ect when when discussing the traumatic situation

 

c.

Lac Lack k of int intere erest st iin n fami family ly & other others s

a.

Pro Provid viding ing a s stru tructu ctured red env enviro ironme nment nt

d.

ReRe-exp experi erienc encing ing the trauma trauma in d dream reams s

b.

Des Design igning ing acti activit vities ies tthat hat will will requir require e the client to maintain contact with

or flashback

33. Nurse Benji Benjie e is communicating w with ith a male client with substance-induced persisting

reality c.

dementia; the client cannot remember facts and fills in the gaps with imaginary information. Nurse Benjie is aware that this is typical of? a.

Fliight Fl ght of of iid deas eas

b.

Asso Associ ciat ativ ive e lo loos osen enes ess s

c.

Co Conf nfab abul ulat atiion

d.

Concretism

34. Nurse J Joey oey is aw aware are tha thatt the signs signs & symptoms that would be most specific for 

about current affairs d.

Exc Excess essive ive wei weight ght los loss, s, ame amenor norrhe rhea a&

Tou Touchi ching ng the the cli client ent provid provide e assur assuranc ance e

39. When pla planning nning car care e for a female female client using using ritualistic behavior, Nurse Gina must recognize that the ritual: a.

Hel Helps ps the the clien clientt focus focus o on n the the inabi inabilit lity y to deal with reality

b.

Hel Helps ps the the clie client nt c cont ontrol rol the anxiet anxiety y

c.

Is u unde nderr the the cl clien ient’ t’s s consc consciou ious s contr control ol

d.

Is u used sed by tthe he clie client nt primari primarily ly for 

diagnosis anorexia are? a.

Eng Engagi aging ng the cli client ent in con conver versin sing g

secondary gains

40. A 32 year old mal male e graduate graduate student student,, who

abdominal distension

has become increasingly withdrawn and

Slow Slow p pul ulse se,, 10 10% % weig weight ht llos oss s&

neglectful of his work and personal hygiene,

alopecia

is brought to the psychiatric hospital by his

c.

Com Compul pulsive sive beh behavi avior, or, exc excess essive ive fea fears rs & nausea

parents. After detailed assessment, a diagnosis of schizophrenia is made. It is

d.

Exc Excess essive ive act activi ivity, ty, memory memory llaps apses es &

unlikely that the client will demonstrate:

b.

a.

Lo Low w sel self est estee eem m

b.

Co Conc ncre rete te th thin inki king ng

Anne that an adolescent may have bulimia

c.

Ef Effe fect ctiv ive e self self bou bound ndari aries es

would be:

d.

Weak ego

an increased pulse

35. A characteri characteristic stic that would suggest to Nurse

a.

Fre Frequ quen entt regu regurgi rgita tati tion on & rere-

41. A 23 year old cli client ent has been admitte admitted d with

swallowing of food

a diagnosis of schizophrenia says to the

b.

Pr Previ eviou ous s histo history ry of g gas astr trit itis is

nurse “Yes, its march, March is little

c.

Ba Badl dly y sta stain ined ed te teet eth h

woman”. That’s literal you know”. These

d.

Po Posi siti tive ve body body im imag age e

statement illustrate:

36. Nurse Mo Monette nette is aware aware that extrem extremely ely

a.

Neologisms

depressed clients seem to do best in

b.

Echolalia

settings where they have:

c.

Fl Flig ight ht of id idea eas s

d.

Lo Loos osen enin ing g of of ass associ ociat atio ion n

a.

Mu Mult ltip iple le st stim imul ulii

b.

Ro Rout utin ine e Ac Acti tivi viti ties es

c.

Mi Mini nima mall de deci cisi sion on ma maki king ng

who has unjustifiably accused his wife of 

d.

Va Vari ried ed Ac Acti tivi viti ties es

having many extramarital affairs would be to

37. To furt further her asses assess s a client’s client’s suici suicidal dal

42. A long ter term m goal for a paranoid paranoid male male client

help the client develop:

potential. Nurse Katrina should be especially

a.

In Insi sigh ghtt iint nto o his his behav behavio ior  r 

alert to the client expression of:

b.

Be Bett tter er self self cont contro roll

a.

Fru Frust stra rati tion on & fe fear ar o off d dea eath th

c.

Fe Feel elin ing g of of s sel elff w wor orth th

b.

An Ange gerr & rese resent ntme ment nt

d.

Fa Faiith in his his wi wiffe

c.

An Anxi xiet ety y & llon onel elin ines ess s

d.

Help Helple less ssne ness ss & ho hope pele less ssne ness ss

38. A nursi nursing ng care plan for for a male client client with bipolar I disorder should include:

43. A male client who who is experiencing experiencing disordered disordered thinking about food being poisoned is admitted to the mental health unit. u nit. The

 

nurse uses which communication technique

pressure ventilation. The nurse assisting

to encourage the client to eat dinner?

with this procedure knows that positive

a.

Foc Focusi using ng on sel self-d f-disc isclo losure sure of own food preference

b.

pressure ventilation is necessary because? a.

Usin Using g op open en end ended ed que quest stio ion n an and d silence

c.

Off Offeri ering ng opin opinion ion about about the the n need eed to e eat at

d.

Ver Verbal balizi izing ng reas reasons ons tha thatt tthe he c clie lient nt

procedure b.

De Decre creas ase e oxyg oxygen en to to the the brai brain n increases confusion and disorientation

c.

may not choose to eat

44. Nurse Ni Nina na is assig assigned ned to care for a cl client ient

Ane Anesth sthesi esia a is admi adminis nister tered ed durin during g the the

Gra Grand nd mal mal sei seizure zure act activi ivity ty depre depresse sses s respirations

d.

Mus Muscle cle rel relaxa axatio tions ns given given tto o prev prevent ent

diagnosed with Catatonic Stupor. When

injury during seizure activity depress

Nurse Nina enters the client’s room, the

respirations.

client is found lying on the bed with a body

48. When planning the discharge of a client with with

pulled into a fetal position. Nurse Nina

chronic anxiety, Nurse Chris evaluates

should?

achievement of the discharge maintenance

a.

b.

Ask the cli client ent direct direct que questi stions ons to

goals. Which goal would be most

encourage talking

appropriately having been included in the

Rak Rake e tthe he clien clientt into into the the d dayro ayroom om to be be

plan of care requiring evaluation? e valuation?

with other clients c.

Sit bes beside ide the cli client ent in sil silenc ence e an and d

d.

occasionally ask open-ended question Lea Leave ve the the c clie lient nt a alon lone e and and co conti ntinue nue

a.

daily situations b. c.

with providing care to the other clients

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

client? a.

b.

The client client ignore ignores s fe feeli elings ngs of a anxi nxiety ety The client client identi identifie fies s anxiet anxiety y produci producing ng situations

d.

and states that “look at the spiders on the wall”. What should the nurse respond to the

The client client el elimi iminat nates es al alll anxie anxiety ty ffrom rom

The client client mainta maintains ins con conta tact ct with with a crisis counselor 

49. Nurs Nurse e Tina is caring caring for a client client with depression who has not responded to

“Yo “You’re u’re hav having ing hal halluc lucina inati tion, on, ther there e are

antidepressant medication. The nurse

no spiders in this room at all”

anticipates that what treatment procedure

“I c can an s see ee tthe he spid spiders ers on the the wall wall,, but but

may be prescribed?

they are not going to hurt you”

a.

Ne Neur urol olept eptic ic medi medica cati tion on

c.

“Wou “Would ld y you ou llike ike me tto o ki kill ll the spi spider ders” s”

b.

Sh Shor ortt tter erm m sec seclu lusi sion on

d.

“I k know now you are fri fright ghtene ened, d, but but I do

c.

Psychosu surrgery

not see spiders on the wall”

d.

El Elec ectr troc ocon onvu vuls lsiv ive e th ther erap apy y

46. Nurse Jon Jonel el is provid providing ing informati information on to a

50. Mar Mario io is admit admitted ted to the emergenc emergency y room

community group about violence in the

with drug-included drug-included anxiety related to over 

family. Which statement by a group member 

in inge gest stio ion n

would indicate a need to provide additional

medica med icatio tion. n. The mos mostt import important ant pie piece ce of 

information?

in info form rmat atio ion n th the e nurse nurse in ch char arge ge sh shou ould ld

a.

b.

“Ab “Abuse use occ occurs urs more more in in llowow-inc income ome

of

pres prescr crib ibed ed

an anti tips psyc ycho hoti tic c

obtain initially is the:

families”

a.

Le Leng ngth th of ti time me on th the em med ed..

“Ab “Abuse userr A Are re o oft ften en jjeal ealous ous or s self elf--

b.

Na Name me of th the e in inge gest sted ed me medi dica cati tion on &

centered”

the amount ingested

c.

“Ab “Abuse userr use use fea fearr and and intimi intimidat dation ion””

c.

Re Reas ason on for for the the s sui uici cide de att attem empt pt

d.

“A “Abu buse serr usual usually ly h hav ave e poor poor se self lf--

d.

Na Name me of th the e nea neare rest st rela relati tive ve & th thei eir  r 

esteem”

47. Duri During ng electroconvul electroconvulsive sive therapy (EC (ECT) T) the client receives oxygen by mask via positive

phone number 

 

Answers and Rationale Psychiatric Nursing Practice Test Part 2

12. C. With depres depression, sion, ther there e is little or n no o emotiona emotionall

involvement therefore little alteration in affect. 13. D. These cli clients ents often hid hide e food or forc force e vomiting vomiting;;

therefore they must be carefully monitored. 1.

C. Total abstinence absti nence is the only effective effecti ve treatment treatme nt for alcoholism.

2.

A. Hallucinations Hallucin ations are visual, vi sual, auditory, audit ory, gustatory, gustato ry, tactile or olfactory perceptions that have no

3.

basis in reality. D. The Nurse Nurs e has a responsibi res ponsibility lity to observe o bserve continuously the acutely suicidal client. The Nurseshould watch for clues, such as

4.

5.

functioning. 15. B. Limiting unn unnecessar ecessary y interacti interaction on will decre decrease ase

stimulation and agitation. 16. C. Ritualis Ritualistic tic behavi behavior or seen in thi this s disorder iis s

maintaining an absolute set pattern of 

about death.

behavior.

B. Establishing Establis hing a consistent cons istent eating eati ng plan and

17. D. The nurse needs to s set et limits in the cl client’s ient’s

monitoring client’s weight are important to this

manipulative behavior to help the client

disorder.

control dysfunctional behavior. A consistent

C. Appropriate Appropria te nursing interventi inte rventions ons for an anxiety

B. Delusion Delusio n of grandeur grandeu r is a false belief beli ef that one is highly famous and important.

9.

electrolytes are necessary for cardiac

messages; hoarding medications and talking

calm and medicating as needed.

8.

starvation diet and energy expenditure, these

aimed at controlling guilt and inadequacy by

with the client, decreasing stimuli, remaining

7.

sodium and potassium because of their 

communicating suicidal thoughts, and

attack include using short sentences, staying

6.

14. A. These cli clients ents have sev severely erely depl depleted eted lev levels els of 

D. Individual Individua l with dependent depend ent personality persona lity disorder  disord er 

approach by the staff is necessary to decrease manipulation. 18. B. Any suici suicidal dal sta statement tement mus mustt be asses assessed sed

by the nurse. The nurse should discuss the client’s statement with her to determine its meaning in terms of suicide. 19. A. When the staff membe memberr ask the c client lient if h he e

typically shows

wonders why others find him repulsive, the

indecisiveness submissiveness and clinging

client is likely to feel defensive because the

behavior so that others will make decisions

question is belittling. The natural tendency is

with them.

to counterattack the threat to self image.

A. Clients with schizotypa sch izotypall personality personal ity disorder  disorde r 

20. B. The nurse wo would uld speci specifically fically u use se supporti supportive ve

experience excessive social anxiety that can

confrontation with the client to point out

lead to paranoid thoughts.

discrepancies between what the client states

B. Bulimia disorder di sorder generall g enerally y is a maladaptive maladap tive coping response to stress and underlying issues. The client should identify anxiety

and what actually exists to increase responsibility for self. 21. C. The nurse would mo most st likel likely y admini administer  ster 

causing situation that stimulate the bulimic

benzodiazepine, such as lorazepan (ativan) to

behavior and then learn new ways of coping

the client who is experiencing symptom: The

with the anxiety.

client’s experiences symptoms of withdrawal

10. A. An adult age 31 to 45 4 5 generates genera tes new level le vel of 

awareness. 11. A. Neuromuscular Neuro muscular Blocker, Blocker , such as

SUCCINYLCHOLINE (Anectine) produces

because of the rebound phenomenon when the sedation of the CNS from alcohol begins to decrease. 22. D. Regular c coffee offee contai contains ns caffein caffeine e which acts as

respiratory depression because it inhibits

psychomotor stimulants and leads to feelings

contractions of respiratory muscles.

of anxiety and agitation. Serving coffee top the client may add to tremors or wakefulness.

 

23. D. Vomiting and an d diarrhea diarrhe a are usually usual ly the late

38. A. Structur Structure e tends to decrease agitati agitation on and

signs of heroin withdrawal, along with muscle

anxiety and to increase the client’s feeling of 

spasm, fever, nausea, repetitive, abdominal

security.

cramps and backache. 24. D. Moving to a client’s cli ent’s personal pers onal space spac e increases increase s

the feeling of threat, which increases anxiety. 25. A. Environmental Environm ental (MILIEU) (MIL IEU) therapy thera py aims at having havi ng

everything in the client’s surrounding area toward helping the client. 26. C. Children who have experience exp erienced d attachment attachme nt

39. B. The ritu rituals als used by a clie client nt with ob obsessiv sessive e

compulsive disorder help control the anxiety level by maintaining a set pattern of action. 40. C. A person w with ith this d disorder isorder would no nott have

adequate self-boundaries. associatio ociations ns are th thoughts oughts th that at are 41. D. Loose ass presented without the logical connections

difficulties with primary caregiver are not able

usually necessary for the listening to interpret

to trust others and therefore relate

the message.

superficially 27. A. Children have ha ve difficulty difficul ty verbally expressin ex pressing g

their feelings, acting out behavior, such as temper tantrums, may indicate underlying depression. 28. D. The autistic auti stic child chi ld repeat sounds or words

spoken by others. cli ent statement stateme nt is an example ex ample of the th e use 29. D. The client

42. C. Helping th the e client to dev develop elop feel feeling ing of sel self  f 

worth would reduce the client’s need to use pathologic defenses. 43. B. Open en ended ded ques questions tions an and d silenc silence e are

strategies used to encourage clients to discuss their problem in descriptive manner. 44. C. Clients who are w withdrawn ithdrawn may be immob immobile ile

and mute, and require consistent, repeated

of denial, a defense that blocks problem by

interventions. Communication with withdrawn

unconscious refusing to admit they exist.

clients requires much patience from the

30. A. Discussion Discuss ion of the feared object o bject triggers tri ggers an

emotional response to the object. 31. B. The nurse presence pr esence may provide pr ovide the client c lient with

support & feeling of control. 32. D. Experiencing Experien cing the actual ac tual trauma in i n dreams or 

flashback is the major symptom that distinguishes post traumatic stress disorder from other anxiety disorder. Confabul ation or the th e filling in i n of memory gaps 33. C. Confabulation with imaginary facts is a

nurse.The nurse facilitates communication with the client by sitting in silence, asking open-ended question and pausing to provide opportunities for the client to respond. 45. D. When hal hallucina lucination tion is p present, resent, the

nurse should reinforce reality with the client. 46. A. Personal c character haracteristics istics of abu abuser ser inclu include de low

self-esteem, immaturity, dependence, insecurity and jealousy. 47. D. A short acting sk skeletal eletal mus muscle cle relax relaxant ant such as

defense mechanismused by people

succinylcholine (Anectine) is administered

experiencing memory deficits.

during this procedure to prevent injuries

34. A. These are the th e major signs sig ns of anorexia nervosa. nervosa .

Weight loss is excessive (15% of expected weight). 35. C. Dental enamel ena mel erosion erosi on occurs from fro m repeated

self-induced vomiting. 36. B. Depression Depres sion usually usu ally is both b oth emotional emotio nal &

physical. A simple daily routine is the best, least stressful and least anxiety producing. 37. D. The expression expres sion of these thes e feeling may indicate

that this client is unable to continue the struggle of life.

during seizure. 48. C. Recognizi Recognizing ng situati situations ons that pro produce duce anx anxiety iety

allows the client to prepare to cope with anxiety or avoid specific stimulus. 49. D. Electroco Electroconvulsiv nvulsive e therapy is an eff effective ective

treatment for depression that has not responded to medication. 50. B. In an emer emergency, gency, lilives ves savi saving ng facts a are re

obtained first. The name and the amount of  medication ingested are of outmost important

 

in treating this potentially life threatening

c. Salami

situation.

d. Hamburger  5.

Psychiatric Nursing Practice Test Part 2

tricyclic antidepressant therapy, which of the following would alert the nurse to the

1. Nurse Tony should should first first discu discuss ss termin terminating ating the

possibility that the client is experiencing

nurse-client relationship with a client during

anticholinergic effects?

the:

a. Uri Urine ne rrete etenti ntion on a and nd b blur lurred red vis vision ion e. Te Term rmina inati tion on ph phas ase e whe when n discharge plans are being made.

b. Res Respir pirato atory ry depre depressi ssion on and and con convul vulsio sion n c. De Deli liri rium um an and d Se Seda dati tion on

f.

d. Tre Tremo mors rs and and c card ardiac iac arr arrhyt hythmi hmias as

Wo Work rkin ing g pha phase se when when the the cli clien entt shows some progress.

6.

g. Orie Orienta ntation tion phase phase when when a contr contract act

nurseexpect to implement?

h. Wo Work rkin ing g phase phase when when the the clie client nt

a. ECT

brings it up.

b. Psy Psycho chothe therap rapeut eutic ic app approa roach ch

Malou is diagnosed with major depression spends

c. Psych sycho oanal analys ysis is

majority of the day lying in bed with the sheet pulled over his head. Which of the following

d. An Anti tidep depre ress ssan antt th ther erap apy y 7.

acute mania, states the nurse, “Where is my

a. Que Questi stion on th the e client client until until he res respon ponds ds

away. Dogs eat dirt.” The nurse interprets

b. Ini Initia tiate te contac contactt with the the cli client ent freq frequen uently tly

these statements as indicating which of the

c. Si Sitt outs outsid ide e the the clie client nts s room room

following?

d.

a. Echolalia

daughter? I love Louis. Rain, rain go

Wait for the client to begin the

b. Neologism

Joe who is very depressed exhibits psychomotor 

c. Cl Clan ang ga ass ssoc ocia iati tion ons s

retardation, a flat affect and apathy. The nursein charge observes Joe to be in need of 

d. Flig Flight ht of id ideas eas 8.

Terry with mania is skipping up and down the

grooming and hygiene. Which of the following

hallway practically running into other 

nursing actions would be most appropriate?

clients. Which of the

a. Wai Waitin ting g until until the the cl clien ient’s t’s fami family ly can can

following activities would the nurse in charge

participate in the client’s care

expect to include in Terry’s plan of care?

b. Ask Asking ing the the clie client nt iiff he is is re ready ady to to take take

a. Watching TV

shower 

b. Cl Clea eanin ning g da dayr yroo oom m ttab able les s

c. Exp Explai lainin ning g the import importanc ance e of hygi hygiene ene to to

c. Le Lead ading ing grou group p acti activi vity ty

the client d. Sta Statin ting g to the the client client that that it’s it’s ti time me for for him to to take a shower  4.

Danny who is diagnosed with bipolar disorder and

approaches by the nurse would be the most therapeutic?

conversation 3.

For a male client with dysthymic disorder, which of the following approaches would the

is established.

2.

When assessing a female client who is receiving

When teaching Mario with a typical depression

d. Re Rea adin ding a book book 9.

When assessing a male client for suicidal risk, which of the following methods of suicide would the nurse identify as most lethal?

about foods to avoid while taking

a. Wr Wris istt cut cutti tin ng

phenelzine(Nardil), which of the following

b. Head b ba anging

would the nurse in charge include?

c. Use of gun

a. Ro Roas aste ted d ch chic icke ken n

d. As Aspi piri rin no ove verd rdos ose e

b. Fresh ffiish

 

10. Jun has been hospitalized for major depression

a. The cl clien ientt resp respond onds s to ver verbal bal di direc rectio tions ns to

and suicidal ideation. Which of the following statements indicates to the nurse that the

eat  b.

The client initiates simple activities without

client is improving? a. “I’m “I’m of no use use to to an anyon yone e anymo anymore. re.””

direction c.

The client walks with the nurse to her 

b. “I k know now my kids kids don don’t ’t need need me me anymo anymore re since they’re grown.”

room d. The c clie lient nt is a able ble tto o mo move ve al alll ext extrem remiti ities es

c. “I co could uldn’t n’t kill kill m myse yself lf becau because se I don’t don’t w want ant to go to hell.” d. “I do don’t n’t thin think k about about killi killing ng mysel myselff as much much as I used to.” 11. Which of the following activities would Nurse Trish

occasionally 15. Nurse Hazel invites new client’s parents to attend

the psycho educational program for families of  the chronically mentally ill. The program would be most likely to help the family with which of 

recommend to the client who becomes very v ery

the following issues?

anxious when thoughts of suicide occur?

a. Dev Develo elopin ping g a sup suppor portt net networ work k with with oth other  er 

a. Us Usin ing g exe exerc rcis ise e bic bicyc ycle le b. Meditati tin ng

families b. Fee Feeling ling mor more e gu guilt ilty y abo about ut tthe he c clie lient’ nt’s s

c. Watching TV TV d. Read Readin ing gc com omic ics s 12. When developing developing the the plan of care for a client client

illness c. Rec Recogn ognizi izing ng the client client’s ’s weak weaknes ness s d. Man Managi aging ng th their eir financ financial ial c conc oncern ern a and nd

receiving haloperidol, which of the following medications would nurse Monet anticipate

problems 16. When plann planning ing care for Dory with schi schizotyp zotypal al

administering if the client developed extra

personality disorder, which of the following

pyramidal side effects?

would help the client become involved with

a. Ol Olan anza zapi pine ne (Z (Zyp ypre rexa xa))

others?

b. Pa Paro roxe xeti tine ne (Pax (Paxil il))

a.

c. Ben Benztr ztropi opine ne mes mesyla ylate te (Co (Cogen gentin tin))

b. Lea Leading ding a sin sing g a lo long ng in the aftern afternoon oon

d. Lora Loraze zepa pam m (Ati (Ativa van) n)

c.

Participating solely in group activities

d.

Being involved with primarily one to

13. Jon a suspicious client states that “I know you

nurses are spraying my food with poison as you take it out of the cart.” Which of the

Attending an activity with the nurse

one activities 17. Which sta statemen tementt about an indiv individual idual with a

following would be the best response of the

personality disorder is true?

nurse?

a. Psy Psycho chotic tic b beha ehavio viorr is c comm ommon on du durin ring g

a. Givi Giving ng the the client client canne canned d supple supplemen ments ts until until the delusion subsides b. Ask Asking ing what what kind kind of p pois oison on tthe he clien clientt suspects is being used c. Ser Servin ving g fo foods ods that that come come in seal sealed ed packages d. All Allowi owing ng the the client client to to be the the first first tto o open open the cart and get a tray 14. A client is suffering from catatonic

acute episodes b. Pro Progno gnosis sis for rec recove overy ry iis s go good od w with ith therapeutic intervention c. The iindi ndivid vidual ual ttypi ypical cally ly rrema emains ins iin n th the e mainstream of society, although he has problems in social and occupational roles d. The iindi ndivid vidual ual u usua sually lly se seeks eks treatm treatment ent willingly for symptoms that are

behaviors. Which of the following would the

personally distressful.

nurse use to determine that the medication

18. Nurse John is talking with a client who has been

administered PRN have been most effective?

diagnosed with antisocial personality about how to socialize during activities without being

 

seductive. Nurse John would focus the

23. Which of th the e followin following g would nurse Ron Ronald ald use as

discussion on which of the following areas?

the best measure to determine a client’s

a. Dis Discus cussin sing g his rel relati ations onship hip with with his mo mothe ther  r 

progress in rehabilitation?

b. Ask Asking ing him him to to expla explain in reaso reasons ns for for his his

a. The w way ay h he e get gets s alo along ng wi with th h his is pa paren rents ts

seductive behavior  c. Sug Sugges gestin ting g to apol apologi ogize ze to oth others ers for for his his behavior  d. Exp Explai lainin ning g the negati negative ve reacti reactions ons of ot other hers s toward his behavior  19. Tina with a histrionic personality disorder is

b. The num number ber of d drug rug-fr -free ee days days he h has as c. The The ki kind nds s of frie friend nds s he ma make kes s d. The a amou mount nt of resp respons onsibi ibilit lity y his jo job b ent entail ails s 24. A female client is brought by ambulance to the

hospital emergency room after taking an overdose of barbiturates is comatose. Nurse

melodramatic and responds to others and

Trish would be especially alert for which of the

situations in an exaggerated manner. Nurse

following?

Trish would recommend which of the

a. Epilepsy

following activities for Tina?

b. My Myoc ocar ardi dial al Infa Infarc rcti tion on

a. Bakin king cl class

c. Re Ren nal failu ailure re

b. Role pl playing

d. Re Resp spir irat ator ory y fail failur ure e

c. Sc Scra rap p bo book ok maki making ng d. Music group 20. Joy has entered the chemical dependency unit for 

25. Joey who has a chronic user of cocaine reports

that he feels like he has cockroaches crawling under his skin. His arms are red because of 

treatment of alcohol dependency. Which of 

scratching. The nurse in charge interprets

the following client’s possession will the

these findings as possibly indicating which of 

nurse most likely place in a locked area?

the following?

a. Toothp hpa aste

a. Delusion

b. Shampoo

b. Formicatio tion

c. An Anti tise sep pti tic c wash wash

c. Flash back

d. Moisturizer 

d. Confusion

21. Which of the following following assessme assessment nt would provide

26. Jose is diagnosed with amphetamine psychosis

the best information about the client’s

and was admitted in the emergency

physiologic response and the effectiveness of 

room. Nurse Ronald would most likely prepare

the medication prescribed specifically for 

to administer which of the following

alcohol withdrawal?

medication?

a. Sl Slee eepi ping ng pa patt tter ern n

a. Librium

b. Me Ment ntal al aler alertn tnes ess s

b. Valium

c. Nu Nutr trit itio iona nall stat status us

c. Ativan

d. Vital signs

d. Haldol

22. After administering administering naloxone (Narcan), an opioid

27. Which of the foll following owing liquid liquids s would nurse Leng

antagonist, Nurse Ronald should monitor the

administer to a female client who is

female client carefully for which of the

intoxicated with phencyclidine (PCP) to hasten

following?

excretion of the chemical?

a. Resp Respir irat ator ory y depre depressi ssion on

a. Shake

b. Epilepsy

b. Tea

c. Kid Kidney ney ffai ailu lure re

c. Cra Cranbe nberry rry Ju Juic ice e

d. Cere Cerebr bral al edem edema a

d. Grape juice 28. When developing a plan of care for a female client

with acute stress disorder who lost her sister 

 

in a car accident. Which of the following would

b. En Enha hanc nce e inte intell llige igenc nce e

the nurse expect to initiate?

c. Incr Increa ease sed d inhi inhibi biti tion ons s

a. Fac Facili ilitat tating ing prog progress ressive ive revi review ew of tthe he

d. Hy Hype perr vigi vigila lanc nce e

accident and its consequences

33. What is the pri priority ority car care e for a client with a

b. Pos Postpo tponin ning g discussi discussion on of the the acci acciden dentt until until

dementia resulting from AIDS?

the client brings it up c. Tel Tellin ling g the cli client ent to avoi avoid d det detail ails s of the the accident d. Hel Helpin ping g the clien clientt to evalu evaluate ate her her siste sister’s r’s behavior  29. The nursing assistant tells nurse Ronald that the

a. Pla Planni nning ng fo forr re remot motiva ivation tional al th thera erapy py b. Arr Arrang anging ing ffor or lo long ng te term rm cu custo stodia diall car care e c. Pro Provid viding ing ba basic sic in intel tellect lectual ual st stimu imulat lation ion d. Asse Assess ssin ing g pai pain n fr freq eque uent ntly ly 34. Jerome who has eating disorder often exhibits similar symptoms. Nurse Lhey would expect

client is not in the dining room for lunch. Nurse

an adolescent client with anorexia to exhibit:

Ronald would direct the nursing assistant to

a. Affe Affect ctiv ive e ins insta tabi bili lity ty

do which of the following?

b. Dis Disher hered, ed, u unke nkempt mpt p phys hysica icall app appear earanc ance e

a. Tel Telll the cli client ent he’ll he’ll need need to wait wait until until

c. Dep Depers ersona onaliz lizati ation on a and nd d dere ereali alizat zation ion

supper to eat if he misses lunch b. Inv Invite ite the the clien clientt to lunch lunch a and nd ac accom compan pany y him to the dining room c. Inf Inform orm the the clien clientt that that he has has 10 minu minutes tes to to get to the dining room for lunch d. Tak Take e the the client client a lunch lunch tray tray and and let let the the client eat in his room 30. The initial nursing intervention intervention for the signif significanticant-

d. Rep Repeti etitiv tive e mot motor or mec mechan hanism isms s 35. The prima primary ry nursing diag diagnosis nosis for a femal female e client with a medical diagnosis of major depression would be: a. Situat Situation ional al low s self elf-es -estee teem m relate related d to altered role b. Pow Powerl erless essnes ness s rel relate ated d to tthe he lo loss ss o of  f  idealized self 

others during shock phase of a grief reaction

c. Spi Spirit ritual ual di distr stress ess rrela elated ted tto o dep depres ressio sion n

should be focused on:

d. Impai Impaired red ve verba rball com commun munica icatio tion n rela related ted tto o

a. Pre Presen sentin ting g full full realit reality y of the the lo loss ss of the individuals b. Dir Direct ecting ing the the individu individual’ al’s s acti activit vities ies at this this time

depression 36. When deve developin loping g an initial nursi nursing ng care plan fo forr a male client with a Bipolar I disorder (manic episode) nurse Ron should plan to?

c. Sta Stayin ying g wi with th the the iindi ndivid vidual uals s invol involved ved

a. Isol Isolat ate e hi his sg gym ym ttim ime e

d. Mob Mobili ilizing zing the the indivi individua dual’s l’s suppo support rt system system

b. Enc Encour ourage age hi his s act active ive p part artici icipat pation ion in u unit nit

31. Joy’s stream of consciousness is occupied

programs

exclusively with thoughts of her father’s

c. Prov Provid ide e fo food ods, s, fflu luid ids s and rres estt

death. Nurse Ronald should plan to help Joy

d. Enc Encour ourage age hi his s par partic ticipa ipatio tion n in pro progra grams ms

through this stage of grieving, which is known

37. Grace is exhibiting withdrawn patterns of 

as:

behavior. Nurse Johnny is aware that this type

a. Sh Shoc ock ka and nd dis disbe beli lief  ef 

of behavior eventually produces feeling of:

b. Deve Develo lopin ping g awar awaren enes ess s

a. Repression

c. Re Reso solv lvin ing g tthe he lo loss ss

b. Loneline iness

d. Restitution

c. Anger  

32. When taking taking a health history from from a female client who has a moderate level of cognitive

d. Paranoia 38. One morning a female client on the inpatient

impairment due to dementia, the nurse would

psychiatric service complains to nurse Hazel

expect to note the presence of:

that she has been waiting for over an hour for 

a. Acc Accent entuat uated ed pre premor morbid bid tra traits its

someone to accompany her to

 

activities. Nurse Hazel replies to the client

a. So Soma mati tic cd del elus usio ions ns

“We’re doing the best we can. There are a lot

b. De Depe pers rson onal aliz izat atio ion n

of other people on the unit who needs

c. Hy Hypo poch chon ondr dria iasi sis s

attention too.” This statement shows that the

d. Echolalia

nurse’s use of:

43. In recogn recognizing izing commo common n behaviors exhib exhibited ited by

a. De Defe fens nsiv ive e beha behavi vior  or 

male client who has a diagnosis of 

b. Real Realit ity y rrei einf nfor orce ceme ment nt

schizophrenia, nurse Josie can anticipate:

c. Li Limi mitt-se sett ttin ing g be beha havi vior  or 

a. Slu Slumpe mped d post posture ure,, pes pessim simist istic ic ou outt loo look k and

d. Im Impu puls lse e co cont ntro roll

flight of ideas b. Gra Grandi ndiosi osity, ty, arr arroga ogance nce and dis distra tracti ctibili bility ty

39. A nursing diagnosis for a male client with a

diagnosed multiple personality disorder is chronic low self-esteem probably related to childhood abuse. The most appropriate short term client outcome would be: a. Ver Verbal balizi izing ng the the need need for for anxie anxiety ty medications

c. Wit Withdr hdrawa awal, l, regr regress essed ed be behav havior ior a and nd la lack ck of social skills d. Dis Disori orient entati ation, on, fo forge rgetf tfulne ulness ss and anxi anxiety ety 44. One morning, nurse Diane finds a disturbed client

curled up in the fetal position in the corner of  the dayroom. The most accurate initial

b. Rec Recogn ognizi izing ng each each exist existing ing pers persona onalit lity y

evaluation of the behavior would be that the

c. Eng Engagi aging ng in obje objectct-ori orient ented ed activi activitie ties s

client is:

d. Eli Elimin minati ating ng defe defense nse mechan mechanism isms s an and d

a. Phy Physic sicall ally y ill an and d expe experie rienci ncing ng abd abdomi ominal nal

phobia 40. A 25 year old male is admitted to a mental health

facility because of inappropriate behavior. The

discomfort b. Tired Tired an and d pro probab bably ly di did d not s slee leep p wel welll las lastt night

client has been hearing voices, responding to

c. Att Attemp emptin ting g to to hi hide de ffrom rom the nur nurse se

imaginary companions and withdrawing to his

d. Feel Feeling ing m mor ore e an anxi xiou ous s to toda day y

room for several days at a time. Nurse

45. Nurse Bea notices a female client sitting alone in

Monette understands that the withdrawal is a

the corner smiling and talking to

defense against the client’s fear of:

herself.Realizing that the client is

a. Phobia

hallucinating. Nurse Bea should:

b. Powe Powerl rles essn snes ess s

a. Inv Invite ite the c clie lient nt tto o he help lp de decor corate ate tthe he

c. Punishment d. Rejection 41. When asking asking the parents parents about the the onset of  problems in young client with the diagnosis of  schizophrenia, Nurse Linda would expect that they would relate the client’s difficulties began in: a. Earl Early y chil childh dhoo ood d

dayroom b. Lea Leave ve th the e cli client ent alo alone ne un until til h he e sto stops ps talking c. Ask the client client why he is is sm smili iling ng a and nd talking d. Tel Telll the c clie lient nt it iis s no nott goo good d for h him im to ttalk alk to himself  46. When being admitted to a mental health facility, a

b. Lat Late ch chil ildh dhoo ood d

young female adult tells Nurse Mylene that

c. Adolescence

the voices she hears frighten her. Nurse

d. Puberty

Mylene understands that the client tends to

42. Jose who has been hospitalized with

hallucinate more vividly:

schizophrenia tells Nurse Ron, “My heart has

a. Wh Whil ile ew wat atch chin ing gT TV V

stopped and my veins have turned to

b. Du Duri ring ng me meal al time time

glass!” Nurse Ron is aware that this is an

c. Du Duri ring ng grou group pa act ctiv ivit itie ies s

example of:

d. Af Afte terr goi going ng to bed bed

 

47. Nurse John recognizes that paranoid delusions

usually are related to the defense mechanism

know that he is important to the nurse. This will positively affect the client’s self-esteem. 53. D. The client clien t with depression dep ression is

of: a. Projection b. Iden Identi tifi fica cati tion on c. Repression d. Regression 48. When planning planning care for a male male client using using paranoid ideation, nurse Jasmin should realize the importance of: a. Givi Giving ng the the client client diffi difficul cultt tas tasks ks to pr provi ovide de stimulation b. Pro Provid viding ing th the e client client with with activi activitie ties s in whi which ch success can be achieved c. Rem Removi oving ng st stres ress s so that that the cli client ent can relax d. Not pla placin cing g any demand demands s on the the clien clientt 49. Nurse Gerry Gerry is aware that that the defense defense mechanism commonly used by clients who are alcoholics is: a. Disp Displa lace cem ment ent b. Denial c. Projection d. Com Compens pensat atio ion n 50. Within a few hours of alcohol alcohol withdrawal, withdrawal, nurse John should assess the male client for the

preoccupied, has decreased energy, and is unable to make decisions. The nurse presents the situation, “It’s time for a shower”, and assists the client with personal hygiene to preserve his dignity and selfesteem. h igh in tyramine, tyr amine, those th ose that are 54. C. Foods high fermented, pickled, aged, or smoked must be avoided because when they are ingested in combination with MAOIs a hypertensive crisis will occur. 55. A. Anticholin Anticholinergic ergic effects, effe cts, which result from

blockage of the parasympathetic (craniosacral) nervous system including urine retention, blurred vision, dry mouth & constipation. 56. B. Dysthymi Dysthymia a is a less le ss severe, seve re, chronic chron ic

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. 57. D. Flight of ideas idea s is speech speec h pattern of o f rapid

presence of:

transition from topic to topic, often without

a. Dis Disori orient entati ation, on, paran paranoia oia,, tachyca tachycardia rdia

finishing one idea. It is common in mania.

b. Tre Tremor mors, s, fe fever ver,, profus profuse e diapho diaphores resis is c. Irr Irrita itabil bility ity,, heighte heightened ned al alert ertnes ness, s, jerky jerky movements d. Yaw Yawning ning,, anxiet anxiety, y, con convul vulsio sions ns

58. B. The clie client nt with mania ma nia is very ve ry active &

needs to have this energy channeled in a constructive task such as cleaning or tidying the room. 59. C. A crucial factor fac tor is determining deter mining the lethality le thality

Answers and Rationale Psychiatric Nursing Practice Test Part 2

of a method is the amount of time that occurs between initiating the method & the delivery of the lethal impact of the method. 60. D. The statement statemen t “I don’t think th ink about killing k illing

myself as much as I used to.” Indicates a 51. C. When the nu nurse rse and cli client ent agree to work

together, a contract should be established, the length of the relationship should be

lessening of suicidal ideation and improvement in the client’s condition. 61. A. Using exe exercise rcise bicycle bicy cle is appropriate appro priate for  fo r 

discussed in terms of its ultimate termination. should hould init initiate iate brief, frequent f requent 52. B. The nurse s contacts throughout the day to let the client

the client who becomes very anxious when thoughts of suicidal occur. 62. C. The drug of choice for a client clie nt

experiencing extra pyramidal side effects from haloperidol (Haldol) is benztropine

 

mesylate (cogentin) because of its anti

behaviors to make the clients aware of the

cholinergic properties.

impact of his seductive behaviors on others.

63. D. Allowing tthe he clien clientt to be th the e first to open

69. B. The nurse wo would uld use role-playin ro le-playing g to teach

the cart & take a tray presents the client with

the client appropriate responses to others

the reality that the nurses are not touching

and in various situations. This client

the food & tray, thereby dispelling the

dramatizes events, drawn attention to self,

delusion.

and is unaware of and does not n ot deal with

64. B. Althoug Although h all the actions indicate

feelings. The nurse works to help the client

improvement, the ability to initiate simple

clarify true feelings & learn to express them

activities without directions indicates the

appropriately.

most improvement in the catatonic behaviors. Psychoeducationa ucationall groups fo forr families 65. A. Psychoed develop a support network. They provide education about the biochemical etiology of 

70. C. Antiseptic mouthwash mo uthwash often o ften contains cont ains

alcohol & should be kept in locked area, unless labeling clearly indicates that the product does not contain alcohol. 71. D. Monitoring of vital signs sign s provides provide s the best

psychiatric disease to reduce, not increase

information about the client’s overall

family guilt.

physiologic status during alcohol withdrawal

66. C. Attending a activity ctivity with tthe he nurse assists a ssists

the client to become involved with others slowly. The client with schizotypal

& the physiologic response to the medication used. 72. A. After admini administering stering naloxone na loxone (Narcan) (Na rcan) the

personality disorder needs support, kindness & gentle suggestion to improve

nurse should monitor the client’s respiratory status carefully, because the drug is short

social skills & interpersonal relationship.

acting & respiratory depression may recur 

individual al with pers personality onality d disorder  isorder  67. C. An individu usually is not hospitalized unless a

after its effects wear off. 73. B. The best mea measure sure to determine de termine a client’s clie nt’s

coexisting Axis I psychiatric disorder is

progress in rehabilitation is the number of 

present. Generally, these individuals make

drug- free days he has. The longer the client

marginal adjustments and remain in society,

is free of drugs, the better the prognosis is.

although they typically experience

74. D. Barbiturates Barbitura tes are CNS depressants; depre ssants; the t he

relationship and occupational problems

nurse would be especially alert for the

related to their inflexible behaviors.

possibility of respiratory failure. Respiratory

Personality disorders are chronic lifelong

failure is the most likely cause of death from

patterns of behavior; acute episodes do not

barbiturate over dose.

occur. Psychotic behavior is usually not

75. B. The fee feeling ling of bugs bu gs crawling crawlin g under the

common, although it can occur in either 

skin is termed as formication, and is

schizotypal personality disorder or 

associated with cocaine use.

borderline personality disorder. Because

76. D. The nurse would wo uld prepare prepa re to administer admini ster an

these disorders are enduring and evasive

antipsychotic medication such as Haldol to a

and the individual is inflexible, prognosis for 

client experiencing amphetamine psychosis

recovery is unfavorable. Generally, the

to decrease agitation & psychotic symptoms,

individual does not seek treatment because

including delusions, hallucinations &

he does not perceive problems with his own

cognitive impairment.

behavior. Distress can occur based on other  people’s reaction to the individual’s behavior. 68. D. The nurse wo would uld explain expla in the negative nega tive

reactions of others towards the client’s

77. C. An acid environment env ironment aids ai ds in the excretion exc retion

of PCP. The nurse will definitely give the client with PCP intoxication cranberry juice to acidify the urine to a ph of 5.5 & accelerate excretion.

 

78. A. The nurse wo would uld facilita facilitate te progressive progre ssive

90. D. An aloof, detached, de tached, withdrawn with drawn posture pos ture is

review of the accident and its consequence

a means of protecting the self by

to help the client integrate feelings &

withdrawing and maintaining a safe,

memories and to begin the grieving process.

emotional distance.

79. B. The nurse in instructs structs the nursing a assistant ssistant

91. C. The usual age a ge of onset of o f schizophrenia schizop hrenia

to invite the client to lunch & accompany him

is adolescence or early childhood. delusion lusion is a fixed fi xed false belief  b elief  92. A. Somatic de

to the dinning room to decrease manipulation, secondary gain, dependency

about one’s body. 93. C. These are the th e classic behaviors b ehaviors exhibited

and reinforcement of negative behavior  while maintaining the client’s worth.

by clients with a diagnosis of schizophrenia.

80. C. This provid provides es suppo support rt until the individual in dividuals s

94. D. The fetal position pos ition represents repr esents regressed re gressed

coping mechanisms and personal support

behavior. Regression is a way of responding

systems can be immobilized.

to overwhelming anxiety.

81. C. Resolvin Resolving g a loss is a slow, painful,

95. B. This pro provides vides a stimulus that t hat competes comp etes

continuous process until a mental image of 

with and reduces hallucination.

the dead person, almost devoid of negative

hallucina tions are most 96. D. Auditory hallucinations

or undesirable features emerges.

troublesome when environmental stimuli are

82. A. A moderate level of cognitive cog nitive impa impairment irment

diminished and there are few competing

due to dementia is characterized by

distractions. 97. A. Projectio Projection n is a mechanism me chanism in i n which inner  in ner 

increasing dependence on environment & social structure and by increasing psychologic rigidity with accentuated

thoughts and feelings are projected onto the environment, seeming to come from outside

previous traits & behaviors.

the self rather than from within.

action on maint maintains ains for as long as 83. C. This acti

d evelop selfs elf98. B. This will help the client develop

possible, the clients intellectual functions by

esteem and reduce the use of paranoid

providing an opportunity to use them.

ideation.

Individuals als with anorexia ano rexia often ofte n display 84. A. Individu

method thod of resolving res olving conflict con flict or  99. B. Denial is a me

irritability,, hospitality, and a depressed irritability

escaping unpleasant realities by ignoring

mood.

their existence.

Depressed ed clients clien ts demonstrate demon strate 85. D. Depress

100.

C. Alcohol is a central cent ral nervous nervo us

decreased communication because of lack

system depressant. These symptoms are

of psychic or physical energy.

the body’s neurologic adaptation to the

clientt in a man manic ic episod episode e of the 86. C. The clien

withdrawal of alcohol.

illness often neglects basic needs, these needs are a priority to ensure adequate nutrition, fluid, and rest.

Psychiatric Nursing Practice Test Part 3

87. B. The with withdrawn drawn pattern pat tern of b behavior  ehavior 

presents the individual from reaching out to others for sharing the isolation produces feeling of loneliness. nurse’s ’s respon response se is not the therapeutic rapeutic 88. A. The nurse because it does not recognize the client’s needs but tries to make the client feel guilty

1.

Francis who is addicted to cocaine withdraws from the drug. Nurse Ron should expect to observe: a. Hy Hype perracti activi vitty b. Depression

for being demanding.

89. B. The client mu must st recog recognize nize the exi existence stence

of the sub personalities so that interpretation can occur.

c. Suspicion d. Delirium 2. Nur Nurse se John John is a awar ware e that that a ser seriou ious s ef effec fectt of  inhaling cocaine is?

 

3.

a. Det Deteri eriora oratio tion n of of nasal nasal septum septum

the “rotten nursing care”. When assessing the

b. Acu Acute te flui fluid d and elec electro trolyt lyte e imbalan imbalances ces

situation, the nurse recognizes that the client

c. Ext Extra ra pyram pyramidal idal tract tract sym sympto ptoms ms

may be using the coping mechanism of:

d. Es Esop opha hage geal al var varic ices es

a. Projection

A tentative diagnosis of opiate addiction, Nurse Candy should assess a recently hospitalized

c. Denial

client for signs of opiate withdrawal. These

d. Re Reac acti tion on fo form rmat atio ion n

signs would include:

determine during crisis intervention would be the client’s:

b. Nau Nausea sea,, dilate dilated d pupils, pupils, cons constip tipati ation on

a. Ava Availa ilable ble situat situationa ionall supp support orts s

c. Lac Lacrim rimati ation, on, vom vomiti iting, ng, drowsi drowsines ness s

b. Wil Willin lingne gness ss to re restr struct ucture ure th the e pers persona onalit lity y

d. Mus Muscle cle aches aches,, papill papillary ary co const nstric rictio tion, n,

c. De Deve velo lopm pmen enta tall theo theory ry

A 48 year old male client is brought to the

d. Und Underl erlyin ying g un uncon consci scious ous con confli flict ct 9. Nurse Trish sugge suggests sts a cr crisis isis inter interventio vention n gro group up to

psychiatric emergency room after attempting

a client experiencing a developmental

to jump off a bridge. The client’s wife states

crisis.These groups are successful because

that he lost his job several months ago and

the:

has been unable to find another job. The

a. Cri Crisis sis in inter terven ventio tion n work worker er is a psy psycho cholog logist ist

primary nursing intervention at this time would be to assess for: a. A past past his histo tory ry of de depr pres essi sion on b. Cur Curren rentt plans plans to com commit mit suicid suicide e c. The presen presence ce of of mari marital tal diff difficu iculti lties es d. Fee Feelin lings gs of excess excessive ive fai failur lure e 5. Bef Before ore help helping ing a male male c clie lient nt who who has been been sexually assaulted, nurse Maureen should recognize that the rapist is motivated by

and understands behavior patterns b. Cri Crisis sis g grou roup p supp supplie lies s a work workabl able e solu solutio tion n to the client’s problem c. Client Client is e enco ncoura uraged ged to talk talk a abou boutt personal problems d. Client Client is as assis sisted ted to inves investig tigate ate alt altern ernati ative ve approaches to solving the identified problem 10. Nurse Ronald co could uld evaluate tthat hat the s staff’s taff’s

feelings of:

approach to setting limits for a demanding,

a. Hostility

angry client was effective if the client:

b. Inadequacy

a. Apo Apolog logize izes s for di disru srupti pting ng the un unit’ it’s s rout routine ine

c. Incom ncompe pete tenc nce e d. Passion 6. Whe When n workin working g wit with h childr children en who who have have bee been n sexually abused by a family member it is important for the nurse to understand that these victims usually are overwhelmed with feelings of: a. Humili lia ation

7.

8. The m most ost c crit ritica icall fac factor tor ffor or nu nurse rse L Lind inda a to

a. Rhi Rhinor norrhe rhea, a, convu convulsi lsions ons,, subnor subnorma mall temperature

yawning 4.

b. Disp Displa lace cem ment ent

when something is needed b. Und Unders erstan tands ds the the rea reason son w why hy ffreq requen uentt calls to the staff were made c. Dis Discus cuss s con concer cerns ns regar regardin ding g the em emoti otiona onall condition that required hospitalizations d. No lo longe ngerr cal calls ls tthe he n nurs ursing ing staf stafff fo for  r  assistance 11. Nurse John is aware that the therapy that has the

b. Confusion

highest success rate for people with phobias

c. Self blame

would be:

d. Hatred

a. Psy Psycho chothe therap rapy y aim aimed ed at rea rearra rrangi nging ng

Joy who has just experienced her  second spontaneous abortion expresses anger towards her physician, the hospital and

maladaptive thought process

 

b. Psy Psycho choana analyt lytica icall explorat exploration ion of repr repress essed ed conflicts of an earlier development phase c.

Systematic desensitization using relaxation technique

d. Ins Insigh ightt therap therapy y to deter determin mine e the orig origin in of  the anxiety and fear  12. When nurse Hazel considers considers a client’s placement

b. Obs Obsess essive ive – com compul pulsiv sive e disord disorder er ((OCD) OCD) to reduce ritualistic behavior  c. Del Delusi usions ons ffor or c clie lients nts suf suffer fering ing from from schizophrenia d. The m mani anic c ph phase ase o off bi bipol polar ar ilillne lness ss a as sa mood stabilizer  17. Which medication can control the extra pyramidal effects associated with antipsychotic agents?

on the continuum of anxiety, a key in determining the degree of anxiety being

a. Cl Clor oraz azep epat ate e (T (Tra ranx nxen ene) e) b. Am Aman anta tadi dine ne ((Sy Symm mmet etre rel) l)

experienced is the client’s:

c. Do Doxe xepi pin n (Si (Sine nequ quan an))

a. Pe Perc rcep eptu tual al fiel field d

d. Pe Perp rphe hena nazin zine e (Tr (Tril ilaf afon on))

b. De Delu lusi sion onal al sy syst stem em

18. Which of the foll following owing stat statement ements s should be

c. Memory st state

included when teaching clients about

d. Crea Creati tivi vity ty le leve vell

monoamine oxidase inhibitor (MAOI)

13. In the diagnosis of a possible pervasive

developmental autistic disorder. The nurse would find it most unusual for a 3 year old child to demonstrate: a. An iint nter eres estt in in mus music ic b. An att attac achm hmen entt to odd odd obje object cts s c. Ritu Ritual alis isti tic c be beha havi vior  or  d. Res Respon ponsiv sivene eness ss to the parent parents s 14. Malou with schizophrenia tells Nurse Melinda, “My

intestines are rotted from worms chewing on them.” This statement indicates a:

antidepressants? a. Don Don’t ’t ta take ke a aspi spirin rin o orr non nonste steroi roidal dal a anti nti-inflammatory drugs (NSAIDs) b. Hav Have e blood blood lleve evels ls s scre creene ened d wee weekly kly for  leucopenia c. Avo Avoid id st stren renuou uous s act activi ivity ty b beca ecause use of tthe he cardiac effects of the drug d. Don Don’t ’t ta take ke p pres rescri cribed bed o orr ove overr the c coun ounter  ter  medications without consulting the physician 19. Kris periodically has acute panic attacks. These

a. Je Jeal alou ous s de delu lusi sion on

attacks are unpredictable and have no

b. So Soma mati tic c del delus usio ion n

apparent association with a specific object or 

c.

situation. During an acute panic attack, Kris

Delusion of grandeur 

d. Delu Delusi sion on of of pers persec ecut utio ion n 15. Andy is admitted to the psychiatric unit with a

may experience: a. He Heig ight hten ened ed con conce cent ntra rati tion on

diagnosis of borderline personality

b. De Decr crea ease sed d per perce cept ptua uall fie field ld

disorder. Nurse Hilary should expects the

c. De Decr crea ease sed d card cardia iac c rat rate e

assessment to reveal:

d. De Decr crea ease sed d res respi pira rato tory ry ra rate te

a. Col Coldne dness, ss, deta detachm chment ent and and lack lack of tend tender  er  feelings b. So Soma mati tic c sym sympt ptom oms s c. Ina Inabil bility ity to func functio tion n as respo responsi nsible ble pa paren rentt d. Unp Unpred redict ictabl able e behav behavior ior and intens intense e interpersonal relationships 16. PROPRANOLOL PROPRANOLOL (Inderal) (Inderal) is used in the mental health setting to manage which of the following conditions? a. Ant Antips ipsych ychoti otic c – induce induced d akathi akathisia sia and and anxiety

20. Initial interventions for Marco with acute anxiety include all except which of the following? a. Tou Touchi ching ng th the e cl clien ientt in an a atte ttempt mpt to comfort him b. App Approa roachin ching g the cl clien ientt in cal calm, m, co confi nfiden dentt manner  c. Enc Encour ouragin aging g th the e cl clien ientt to ver verbal balize ize feelings and concerns d. Pro Provid viding ing tthe he cl clien ientt wit with h a safe, safe, q quie uiett and private place

 

21. Nurse Jessie is assessing a client suffering from

26. Rosana is in the second stage of Alzheimer’s

stress and anxiety. A common physiological

disease who appears to be in pain. Which

response to stress and anxiety is:

question by Nurse Jenny would best elicit

a. Uticaria

information about the pain?

b. Vertigo

a. “W “Whe here re is you yourr pa pain in lo loca cate ted? d?””

c. Sedation

b. “Do you hur hurt? t? ((pau pause) se) ““Do Do y you ou h hurt urt?” ?”

d. Diarrhea

c. “C “Can an y you ou d des escr crib ibe e yo your ur p pai ain? n?””

22. When performin performing g a phys physical ical examination examination on a female anxious client, nurse Nelli would expect to find which of the following effects

d. “W “Whe here re d do o yo you uh hur urt? t?”” 27. Nursi Nursing ng prepara preparation tion for a client under undergoing going electroconvulsive therapy (ECT) resemble

produced by the parasympathetic system?

those used for:

a. Muscl uscle e ten tensi sio on

a. Ge Gene nera rall an anes esth thes esia ia

b. Hy Hype pera ract ctiv ive e bowe bowell so soun unds ds

 b.

c. De Decr crea ease sed d urin urine e ou outp tput ut

c. Ne Neur urol olog ogic ic ex exam amin inat atio ion n

d. Cons Consttipa ipati tion on

d. Ph Phys ysic ical al ther therap apy y

23. Which of the followin following g drugs have been been known to

Cardiac stress testing

28. Jose who is receiv receiving ing monoam monoamine ine oxidase

be effective in treating obsessive-compulsive

inhibitor antidepressant should avoid

disorder (OCD)?

tyramine, a compound found in which of the

a. Div Divalp alproe roex x (depa (depakot kote) e) and and L Lith ithium ium

following foods?

(lithobid) b. Chl Chlord ordiaz iazepo epoxid xide e (Lib (Libriu rium) m) an and d dia diazep zepam am (valium) c. Flu Fluvox voxami amine ne (Luv (Luvox) ox) and clomip clomipram ramine ine (anafranil) d. Benz Benztr trop opin ine e (Coge (Cogent ntin in)) and diphenhydramine (benadryl) 24. Tony with agoraphobia has been symptom-free

a. Figs Figs an and dc cre ream am chee cheese se b. Frui Fruits ts an and d yel yello low w veg veget etab able les s c. Ag Aged ed che chees ese e an and d Ch Chia iant ntii wi wine ne d. Gr Gree een n lea leafy fy vege vegeta tabl bles es 29. Erlinda, age 85, with major depression undergoes

a sixth electroconvulsive therapy (ECT) treatment. When assessing the client immediately after ECT, the nurse expects to

for 4 months. Classic signs and symptoms of 

find:

phobia include:

a. Per Perman manent ent s shor hort-t t-term erm m memo emory ry lo loss ss an and d

a. Seve Severe re an anxi xiet ety ya and nd fea fear  r  b. Wit Withdr hdrawa awall and fai failur lure e to dist disting inguis uish h reality from fantasy c. De Depr pres essi sion on and and wei weigh ghtt loss loss d. Ins Insomn omnia ia and and inabil inability ity tto o con concen centra trate te 25. Which nursing nursing action is most appropriat appropriate e when trying to diffuse a client’s impending violent behavior?

hypertension b. Per Perman manent ent llong ong-te -term rm m memo emory ry lo loss ss a and nd hypomania c. Tra Transi nsitor tory y sho shortrt-ter term m me memor mory y los loss s an and d permanent long-term memory loss d. Tra Transi nsitor tory y sho short rt an and d lon long g ter term m me memor mory y loss and confusion 30. Barbara with bipolar disorder is being treated with

a. Pl Plac ace e the the clien clientt in secl seclus usio ion n

lithium for the first time. Nurse Clint should

b. Lea Leaving ving the the clien clientt alone alone un until til he he can ttalk alk

observe the client for which common c ommon adverse

about his feelings c. Inv Involv olving ing tthe he clien clientt in a quiet quiet acti activit vity y to divert attention d. Hel Helpin ping g the clie client nt ident identify ify a and nd ex expre press ss feelings of anxiety and anger 

effect of lithium? a. Polyuria b. Seizures c. Co Con nstip stipat atio ion n d. Se Sexu xual al dy dysf sfun unct ctio ion n

 

31. Nurse Fred is assessing a client who has just

been admitted to the ER department. Which signs would suggest an overdose of an

c. Stab Stabili iliza zati tion on of sero seroto toni nin n d. St Stim imul ulat atio ion n of G GAB ABA A 36. Which of the following be best st explains why tricyclic

antianxiety agent?

antidepressants are used with caution in

a. Sus Suspic piciou iousne sness, ss, dilate dilated d pu pupil pils s and

elderly patients?

incomplete BP b. Agi Agitat tation ion,, hyperac hyperactiv tivity ity and and grandio grandiose se ideation c. Com Combat bative iveness ness,, sweat sweating ing and and confu confusion sion d. Emo Emotio tional nal labili lability, ty, euph euphori oria a and impai impaired red memory

a. Cen Centra trall Ne Nervo rvous us Sys System tem effect effects s b. Car Cardio diovas vascul cular ar sys system tem effect effects s c. Gas Gastro troint intest estina inall sy syste stem me effe ffects cts d. Ser Seroto otonin nin syn syndro drome me effect effects s 37. A client with dep depressiv ressive e sympto symptoms ms is given prescribed medications and talks with his

32. Discharge instructions instructions for a male client receiving

therapist about his belief that he is worthless

tricyclic antidepressants include which of the

and unable to cope with life. Psychiatric care

following information?

in this treatment plan is based on which

a. Res Restri trict ct fluid fluids s an and d sodiu sodium m intak intake e

framework?

b. Don’ Don’tt c con onsu sume me al alco coho holl

a. Be Beha havi vior oral al fram framew ewor ork k

c. Dis Discon contin tinue ue ifif dry dry m mout outh h and and blurr blurred ed

b. Co Cogn gnit itiv ive e fram framew ewor ork k

vision occur  d. Res Restri trict ct flu fluid id and and sodi sodium um intake intake 33. Important teaching teaching for women women in their childbearing

c. Inte Interp rper erso sonal nal fram framew ewor ork k d. Psyc Psycho hody dyna nami mic c frame framewo work rk 38. A nurse who expla explains ins that a client’s psychoti psychotic c

years who are receiving antipsychotic

behavior is unconsciously motivated

medications includes which of the following?

understands that the client’s disordered

a. Inc Increa reased sed inci inciden dence ce of dys dysme menor norrhe rhea a

behavior arises from which of the following?

while taking the drug b. Occ Occurr urrenc ence e of inco incompl mplete ete libido libido due due to to medication adverse effects c. Con Contin tinuin uing g previo previous us us use e of cont contrac racept eption ion during periods of amenorrhea d. Ins Instru tructi ction on that ameno amenorrh rrhea ea is irrever irreversib sible le 34. A client refuses refuses to remain on psychotrop psychotropic ic

a. Ab Abno norm rmal al tthi hink nkin ing g b. Alte Altered red neu neuro rotr tran ansm smit itte ters rs c. Inter nterna nall nee needs ds d. Re Resp spon onse se tto o st stim imul ulii 39. A client with dep depressio ression n has been hospital hospitalized ized for  treatment after taking a leave of absence from work. The client’s employer expects the client

medications after discharge from an inpatient

to return to work following inpatient treatment.

psychiatric unit. Which information should the

The client tells the nurse, “I’m no good. I’m a

community health nurse assess first during

failure”. According to cognitive theory, these

the initial follow-up with this client?

statements reflect:

a. Inc Income ome leve levell and living living arra arrange ngemen ments ts

a. Lear Learne ned d beha behavi vior  or 

b. Inv Involv olveme ement nt of of fami family ly and and s supp upport ort

b. Pun Puniti itive ve sup supere erego go an and d dec decrea reased sed s self elf--

systems c. Re Reas ason on for for inpat inpatien ientt admis admissi sion on d. Rea Reason son ffor or refus refusal al to take take m medi edicat cation ions s 35. The nurse understands that that the therapeutic effects of typical antipsychotic medications are associated with which neurotransmitter 

esteem c. Fau Faulty lty tthou hought ght p proc rocess esses es tthat hat gov govern ern behavior  d. Evi Eviden dence ce of d diff ifficu icult lt re relat lation ionshi ships ps in th the e work environment 40. The nurse desc describes ribes a client as anxi anxious. ous. Which of 

change?

the following statement about anxiety is true?

a. Decr Decrea ease sed d dopa dopami mine ne lev level el

a. Anx Anxiet iety y is is u usua sually lly pat pathol hologi ogical cal

b. Inc Increa reased sed acetyl acetylcho cholin line e lev level el

b. Anx Anxiet iety y is is d dire irectl ctly yo obse bserva rvable ble

 

c. An Anxi xiet ety y is us usua uall lly y harm harmfu full

feelings of guilt about not meeting family

d. Anx Anxiet iety y is a respo response nse to a threat threat

expectations?

41. A client with with a phobic disorder disorder is treated treated by

a. Anxiety

systematic desensitization. The nurse

b. Di Dist stur urbe bed db bod ody y imag image e

understands that this approach will do which

c. De Defe fens nsiv ive e co copi ping ng

of the following?

d. Pow ower erle less ssne ness ss

a. Hel Help p the clie client nt execu execute te actio actions ns that that are are feared

46. A nurse is eva evaluatin luating g therapy wit with h the famil family y of a client with anorexia nervosa. Which of the

b. Hel Help p the the clien clientt devel develop op iinsi nsight ght into into irrational fears

following would indicate that the therapy was successful?

c. Hel Help p the the client client substi substitut tutes es on one e fear fear for  for 

a. The pa paren rents ts rei reinfo nforce rced d incr increas eased ed dec decisi ision on

another  d. Hel Help p the the c clie lient nt d decr ecreas ease e anxi anxiety ety 42. Which client client outcome outcome would best indicate indicate successful treatment for a client with an antisocial personality disorder? a. The c clie lient nt exhi exhibit bits s charm charming ing beha behavio vior  r  when around authority figures b. The cli client ent has decrea decreased sed episod episodes es of  impulsive behaviors c. The cli client ent makes makes stat stateme ements nts of self self-satisfaction

making by the client b. The p pare arents nts cle clearl arly y ver verbal balize ize tthei heir  r  expectations for the client c. The c clie lient nt ve verba rbaliz lizes es th that at fa famil mily y mea meals ls ar are e now enjoyable d. The cl clien ientt tel tells ls her p pare arents nts a abou boutt fee feelin lings gs of low-self esteem 47. A client with dysthymic disorder reports to a nurse that his life is hopeless and will never improve in the future. How can the nurse best respond using a cognitive approach?

d. The c clie lient’ nt’s s state statemen ments ts indic indicate ate no no

a. Agr Agree ee wi with th th the e cli client ent’s ’s painf painful ul fe feeli elings ngs

remorse for behaviors

b. Cha Challen llenge ge th the e acc accura uracy cy of the c clie lient’ nt’s s

43. The nurse nurse is caring caring for a client client with an

belief 

autoimmune disorder at a medical clinic,

c. Den Deny y th that at tthe he situ situati ation on iis s ho hopel peless ess

where alternative medicine is used as an

d. Pres Presen entt a che cheer erfu full att attit itud ude e

adjunct to traditional therapies. Which

48. A client with maj major or depress depression ion has not verbal verbalized ized

information should the nurse teach the client

problem areas to staff or peers since

to help foster a sense of control over his

admission to a psychiatric unit. Which activity

symptoms?

should the nurse recommend to help this

a. Pat Pathop hophys hysiol iology ogy of dise disease ase proces process s

client express himself?

b. Pr Prin inci ciple ples s of good good nu nutr trit itio ion n

a. Art Art th ther erap apy y in a sm smal alll gr grou oup p

c. Si Side de eff effec ects ts of of medi medica cati tion ons s

b. Bas Basket ketbal balll gam game e wit with h pe peers ers o on n th the e uni unitt

d. Str Stress ess man manage agemen mentt techni technique ques s

c. Rea Readin ding gas self elf-he -help lp b book ook on d depr epress ession ion

44. Which of the following following is the most distinguish distinguishing ing feature of a client with an antisocial

d. Wat Watchi ching ng m movi ovie e wi with th the the peer peer gro group up 49. The home health psychiatric nurse visits a client

personality disorder?

with chronic schizophrenia who was recently

a. At Atte tent ntion ion to to deta detail il and and or orde der  r 

discharged after a prolong stay in a state

b. Biz Bizarr arre e mann manneri erisms sms and though thoughts ts

hospital. The client lives in a boarding home,

c. Sub Submis missiv sive e and and dep depend endent ent behavi behavior  or 

reports no family involvement, and has little

d. Dis Disreg regard ard for for soci social al an and d legal legal norms norms

social interaction. The nurse plan to refer the

45. Which nursing nursing diagnosis diagnosis is most appropriate appropriate for a client with anorexia nervosa who expresses

client to a day treatment program in order to help him with: a. Ma Mana nagi ging ng hi his s hal hallu luci cina nati tion ons s

 

b. Medi Medica cati tion on te teac achi hing ng

assisting them to explore new alternatives

c. So Soci cial al sk skil ills ls trai trainin ning g

for coping. It considers realistic situations

d. Vo Voca cati tion onal al trai traini ning ng

using rational and flexible problem solving

50. Which activity activity would be most appropria appropriate te for a severely withdrawn client? a. Art act activi ivity ty w with ith a staff staff member  member  b. Boa Board rd game game wi with th a small small group group o off client clients s c. Team Team sp spor ortt iin n the the gy gym m d. Watc Watchi hing ng TV TV in the the dayr dayroo oom m

methods. 110.

C. This would document documen t that th the e

client feels comfortable enough to discuss the problems that have motivated the behavior. 111.

C. The most successful succes sful therapy thera py for 

people with phobias involves behavior  modification techniques using

Answers and Rationale Psychiatric Nursing Part 3 101.

B. There is no set of symptoms

associated with cocaine withdrawal, only the depression that follows the high caused by the drug. 102.

A. Cocaine is a chemical che mical tha thatt when

inhaled, causes destruction of the mucous membranes of the nose. 103.

D. These adaptat adaptations ions ar are e

associated with opiate withdrawal which occurs after cessation or reduction of  prolonged moderate or heavy use of 

B. Whether Whethe r there is a suicid suicide e plan is

a criterion when assessing the client’s determination to make another attempt. 105.

A. Rapists are a re believ believed ed to ha harbor  rbor 

and act out hostile feelings toward all women through the act of rape. 106.

C. These ch children ildren often of ten have hav e

nonsexual needs met by individual and are powerless to refuse.Ambivalence results in self-blame and also guilt. 107.

B. The client’s c lient’s anger o over ver the

abortion is shifted to the staff and the hospital because she is unable to deal with the abortion at this time. 108.

A. Personal Persona l interna internall strength streng th and

supportive individuals are critical factors that can be employed to assist the individual to cope with a crisis. 109.

112.

A. Percep Perceptual tual field is a key indicator 

of anxiety level because the perceptual fields narrow as anxiety increases. 113.

D. One of the t he symptoms sympto ms of autistic auti stic

child displays a lack of responsiveness to others. There is little or no extension to the external environment. 114.

B. Somatic delusions delusion s focus on

bodily functions or systems and commonly include delusion about foul odor emissions, insect manifestations, internal parasites and misshapen parts. 115.

D. A client clien t with borderlin b orderline e

personality displays a pervasive pattern of  unpredictable behavior, mood and self 

opiates. 104.

desensitization.

D. Crisis in intervent tervention ion group helps

client reestablish psychologic equilibrium by

image. Interpersonal relationships may be intense and unstable and behavior may be inappropriate and impulsive. 116.

A. Propranolol is a potent beta

adrenergic blocker and producing a sedating effect, therefore it is used to treat antipsychotic induced akathisia and anxiety. 117.

B. Amantad Amantadine ine is an anticholinergic anticho linergic

drug used to relive drug-induced extra pyramidal adverse effects such as muscle weakness, involuntary muscle movements, pseudoparkinsonism and tar dive dyskinesia. 118.

D. MAOI antidepress an tidepressants ants when whe n

combined with a number of drugs can cause life-threatening hypertensive crisis. It’s imperative that a client checks with his physician and pharmacist before taking any other medications. 119.

B. Panic is the most severe s evere level le vel of 

anxiety. During panic attack, the client

 

experiences a decrease in the perceptual

129.

D. ECT commonly common ly causes cause s transitory transit ory

field, becoming more focused on self, less

short and long term memory loss and

aware of surroundings and unable to

confusion, especially in geriatric clients. It

process information from the

rarely results in permanent short and long

environment. The decreased perceptual field

term memory loss.

contributes to impaired attention andinability to concentrate. 120.

A. The emergenc e mergency y nurse must

establish rapport and trust with the anxious

130.

A. Polyuria commonly occurs early

in the treatment with lithium and could cou ld result in fluid volume deficit. 131.

D. Signs of o f anxiety agent overdose o verdose

client before using therapeutic

include emotional lability, euphoria and

touch. Touching an anxious client may

impaired memory.

actually increase anxiety. 121.

D. Diarrh Diarrhea ea is i s a common

132.

B. Drinking alcohol can pote potentiate ntiate

the sedating action of tricyclic

physiological response to stress and

antidepressants. Dry mouth and blurred

anxiety.

vision are normal adverse effects of tricyclic

122.

B. The parasympath para sympathetic etic nerv nervous ous

system would produce incomplete G.I.

antidepressants. 133.

C. Women may experience exp erience

motility resulting in hyperactive bowel

amenorrhea, which is reversible, while

sounds, possibly leading to diarrhea.

taking antipsychotics. Amenorrhea doesn’t

123.

C. The antide antidepressan pressants ts fluvoxa fluvoxamine mine

indicate cessation of ovulation thus, the

and clomipramine have been effective in the treatment of OCD.

client can still be pregnant. 134. D. The first are for assessment assessme nt

124.

A. Phobias cause se severe vere an anxiety xiety

would be the client’s reason for refusing

(such as panic attack) that is out of 

medication. The client may not understand

proportion to the threat of the feared object

the purpose for the medication, may be

or situation. Physical signs and symptoms of 

experiencing distressing side effects, or may

phobias include profuse sweating, poor 

be concerned about the cost of medicine. In

motor control, tachycardia and elevated B.P.

any case, the nurse cannot provide

125.

D. In many instance instances, s, the nurse n urse can

appropriate intervention before assessing

diffuse impending violence by helping the

the client’s problem with the medication. The

client identify and express feelings of anger 

patient’s income level, living arrangements,

and anxiety. Such statement as “What

and involvement of family and support

happened to get you this angry?” may help h elp

systems are relevant issues following

the client verbalizes feelings rather than act

determination of the client’s reason for 

on them.

refusing medication. The nurse providing

126.

B. When speaking sp eaking to a clien clientt with

follow-up care would have access to the

Alzheimer’s disease, the nurse should use

client’s medical record and should already a lready

close-ended questions.Those that the client

know the reason for inpatient admission.

can answer with “yes” or “no” whenever 

135.

A. Excess dopamine is thought thoug ht to

possible and avoid questions that require

be the chemical cause for psychotic

the client to make choices. Repeating the

thinking. The typical antipsychotics act to

question aids comprehension.

block dopamine receptors and therefore

127.

A. The nurse nur se shoul should d prepa prepare re a clien clientt

for ECT in a manner similar to that for  general anesthesia. 128.

C. Aged ch cheese eese an and d Chianti wine

contain high concentrations of tyramine.

decrease the amount of neurotransmitter at the synapses. The typical antipsychotics do not increase acetylcholine, stabilize serotonin, stimulate GABA. 136.

B. The TCAs a affect ffect norepinephr nore pinephrine ine

as well as other neurotransmitters, neurotransmitters, and thus

 

have significant cardiovascular side effects.

of irrational fears, the purpose of the

Therefore, they are used with caution in

procedure is specifically related to

elderly clients who may have increased risk

performing activities that typically are

factors for cardiac problems because of their 

avoided as part of the phobic response.

age and other medical conditions. The

142.

B. A clien clientt with antisocial ant isocial personali p ersonality ty

remaining side effects would apply to any

disorder typically has frequent episodes of 

client taking a TCA and are not particular to

acting impulsively with poor ability to delay

an elderly person.

self-gratification. self-gratificati on. Therefore, decreased

137.

B. Cognitive thinking therapy therap y

frequency of impulsive behaviors would be

focuses on the client’s misperceptions about

evidence of improvement. Charming

self, others and the world that impact

behavior when around authority figures and

functioning and contribute to symptoms.

statements indicating no remorse are

Using medications to alter neurotransmitter 

examples of symptoms typical of someone

activity is a psychobiologic approach to

with this disorder and would not indicate

treatment. The other answer choices are

successful treatment. Self-satisfaction would

frameworks for care, but hey are not

be viewed as a positive change if the client

applicable to this situation.

expresses low self-esteem; however this is

138.

C. The con concept cept tha thatt behavior behav ior is

motivated and has meaning comes from the psychodynamic framework. According to this

not a characteristic of a client with antisocial personality disorder. 143.

D. In autoimmune auto immune disorders, di sorders, stress

perspective, behavior arises from internal wishes or needs. Much of what motivates

and the response to stress can exacerbate symptoms. Stress management techniques

behavior comes from the unconscious. The

can help the client reduce the psychological

remaining responses do not address the

response to stress, which in turn will help

internal forces thought to motivate behavior.

reduce the physiologic stress response. This

139.

C. The clie client nt is demonstratin de monstrating g faulty

will afford the client an increased sense of 

thought processes that are negative and that

control over his symptoms. The nurse can

govern his behavior in his work situation –

address the remaining answer choices in

issues that are typically examined using a

her teaching about the client’s disease and

cognitive theory approach. Issues involving

treatment; however, knowledge alone will

learned behavior are best explored through

not help the client to manage his stress

behavior theory, not cognitive theory. Issues

effectively enough to control symptoms.

involving ego development are the focus

144.

D. Disregard Disrega rd for establishe est ablished d rules o of  f 

of psychoanalytic theory. Option 4 is incorrect

society is the most common characteristic of 

because there is no evidence in this

a client with antisocial personality disorder.

situation that the client has conflictual

Attention to detail and order is characteristic

relationships in the work environment.

of someone with obsessive compulsive

140.

D. Anxiety is a resp response onse to a threat

arising from internal or external stimuli. 141.

A. Systematic Systemat ic desen desensitization sitization is a

disorder. Bizarre mannerisms and thoughts are characteristics of a client with schizoid or  schizotypal disorder. Submissive and

behavioral therapy technique that helps

dependent behaviors are characteristic of 

clients with irrational fears and avoidance

someone with a dependent personality.

behavior to face the thing they fear, without

145.

D. The client clien t with anorexia ano rexia typically typ ically

experiencing anxiety. There is no attempt to promote insight with this procedure, and the

feels powerless, with a sense of o f having little control over any aspect of life besides eating

client will not be taught to substitute one fear 

behavior. Often, parental expectations and

for another. Although the client’s anxiety

standards are quite high and lead to the

may decrease with successful confrontation

clients’ sense of guilt over not measuring up.

 

146.

A. One of o f the core is issues sues

rehabilitation facility; the client described in

concerning the family of a client with

this situation would not be a candidate for 

anorexia is control. The family’s acceptance

this service.

of the client’s ability to make independent

150.

A. The best approach with a

decisions is key to successful family

withdrawn client is to initiate brief,

intervention. Although the remaining options

nondemanding activities on a one-to-one

may occur during the process of therapy,

basis. This approach gives the nurse an

they would not necessarily indicate a

opportunity to establish a trusting

successful outcome; the central family

relationship with the client. A board game

issues of dependence and independence

with a group clients or playing a team sport

are not addresses on these responses.

in the gym may overwhelm a severely

147.

B. Use of cognitive c ognitive techniques techniqu es

withdrawn client. Watching TV is a solitary

allows the nurse to help the client recognize

activity that will reinforce the client’s

that this negative beliefs may be distortions

withdrawal from others.

and that, by changing his thinking, he can adopt more positive beliefs that are realistic and hopeful. Agreeing with the client’s feelings and presenting a cheerful attitude are not consistent with a cognitive approach and would not be helpful in this situation. Denying the client’s feelings is belittling and may convey that the nurse does not understand the depth of the client’s distress. 148.

A. Art therapy provides a

nonthreatening vehicle for the expression of  feelings, and use of a small group will help the client become comfortable with peers in a group setting. Basketball is a competitive game that requires energy; the client with major depression is not likely to participate in this activity. Recommending that the client read a self-help book may increase, not decrease his isolation. Watching movie with a peer group does not guarantee g uarantee that interaction will occur; therefore, the client may remain isolated. 149.

C. Day treatment programs provide

clients with chronic, persistent mental illness training in social skills, such as meeting and greeting people, asking questions or  directions, placing an order in a restaurant, taking turns in a group setting activity. Although management of hallucinations and medication teaching may also be part of the program offered in a day treatment, the nurse is referring the client in this situation because of his need for socialization skills. Vocational training generally takes place in a