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SET A Seat No.____

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NURSING PRACTICE 3C: NURSING CARE OF CLIENT WITH PHYSIOLOGICAL AND PSYCHOSOCIAL ALTERATIONS
DIRECTION: Choose the letter of the BEST answer by shading the corresponding letter of your choice on the answer sheet provided. STRICTLY ! ER"S#RE$ Situation 1: The nurse is envisioning a career path in mental health ps chiatric nursing! As a "eginning

pro#essional nurse$ she is gui%e% &ith "asic "elie#s a"out the practice!
'! (hich o# the #ollo&ing statement re#lects the scope o# mental health ps chiatric nursing) A! it inclu%es nursing actions aime% at returning the patient to his highest potential o# pro%uctivit ! B. it is an inte !a" as#e$t o% a"" nu!sin an& a s#e$ia"t' se!(i$e to a"" #eo#"e a%%e$te& )' *enta" i""ness. C! it inclu%es nursing actions to re%uce the rate o# ne& cases o# mental %isor%er in population *! it consist o# earl recognition an% treatment o# mental %isor%ers to re%uce severit an% %uration o# mental illness +! The "eginning pro#essional nurse can %o mental health counseling &ith the #ollo&ing clients$ E,CEPT: A. a$ti(e"' #s'$+oti$ #atients C! parents &ith chil% rearing concerns -! out o# school a%olescents *! school chil%ren &ith "ehavioral pro"lem 3! A pro#essional responsi"ilit o# the mental health ps chiatric nurse is to provi%e a sa#e an% therapeutic environment! This is -EST re#lecte% in: A! restraining patients &ho violates policies an% %o not #ollo& sche%ule o# activities! -! maintaining a close% %oor polic to prevent patients #rom a"scon%ing! C! .eeping a restrictive environment to prevent patients #rom "ecoming assaultive an% hostile D. ensu!in #+'si$a" sa%et' an& *aintainin t+e!a#euti$ attitu&e to,a!&s t+e #atients /! The #oun%ation o# the therapeutic process is the therapeutic relationship! (hat is the essential component that the nurse must "ring to the relationship) A! humor C! re#raming B. e*#at+' *! con#rontation 0! (hich o# these people$ the highest in population groups that &oul% nee% priorit mental health therap ) A! a%ults going through active s.ills C. 'oun #!o%essiona"s ente!in t+e ,o!-#"a$e -! single el%erl &ith no social support *! &omen preparing #or overseas emplo ment Situation .: Some activit therapies are organi1e% an% con%ucte% in groups &here nurses ma participate in! 2! A mental health nurse ma not "e a mem"er o# this sel# help group "ecause help given to mem"ers comes #rom mem"ers themselves: A! Remotivation Group C! Activit Therap Group -! A"$oholics Anon mous *! Art Therap Group 3! (hich o# the #ollo&ing %etermines the success o# client government groups) A. ,i""in ness o% #s'$+iat!i$ #!o%essiona"s to )e o#en an& !e$e#ti(e to $"ient/s i&eas an& su estions -! a &a o# permitting clients provi%e themselves &ith a more creative an% &holesome li#e C! means to ac4uire a variet o# social s.ills *! opportunit to learn %emocratic living 5! (hich o# this client situation appropriatel illustrate horticulture therap ) A! the therapist "rings "ongos$ tam"ourine$ an% "ells an% encourages client participation -! Tomm $ 6aren$ 7on an% Pia pla scra""le ever night a#ter supper

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C. e(e!' a%te!noon0 1i$ oes in t+e a!&en ,+e!e +e ,o!- ,it+ #"ants0 see&"in s0 t!ee #"antin An& ,ate!in t+e* *! Paul #in%s s.etching rela8ing an% re&ar%ing 9! Eva is a mem"er o# a group &ho controls en%less tal.ing! :er role is that o# a;an: A. )"o$-e! C! recognition see.er -! sel#-con#essor *! monopoli1er '<! Communit meetings are hel% as a part o# milieu therap on an in-patient ps chiatric unit! The purpose o# these meetings &oul% "e: A. to %o$us on issue a!isin %!o* !ou# "i(in -! to encourage e8pression on topics o# interest

C! to provi%e %irection #rom the treatment plan *! to encourage e8pression o# intraps chic con#licts Situation 2: The patient &ho is %epresse% &ill un%ergo electroconvulsive therap ! ''! Stu%ies on "iological %epression support electroconvulsive therap as a mo%e o# treatment! The rationale is: A! ECT pro%uces massive "rain %amage &hich %estro s the speci#ic area containing memories relate% to the events surroun%ing the %evelopment o# ps chotic con%ition -! The treatment serves as a s m"olic punishment #or the client &ho #eels guilt an% &orthless C. ECT !e"ie(es &e#!ession #s'$+o"o i$a""' )' in$!easin t+e no!e#ine#+!ine "e(e" *! ECT is seen as a li#e-threatening e8perience an% %epresse% patients mo"ili1e all their "o%il %e#enses to %eal &ith this attac.! '+! The preparation o# a patient #or ECT i%eall is =>ST similar to preparation #or a patient #or: A! electroencephalogram C. ene!a" anest+esia -! ,-ra *! electrocar%iogram '3! (hich o# the #ollo&ing is a possi"le si%e e##ect &hich ou &ill %iscuss &ith the patient) A! hemorrhage &ithin the "rain C! encephalitis -! ro"ot-li.e "o% sti##ness D. $on%usion0 &iso!ientation an& s+o!t te!* *e*o!' "oss '/! In#orme% consent is necessar #or the treatment #or involuntar clients! (hen this cannot "e o"taine%$ permission ma "e ta.en #rom the: A! social &or.er C. ne3t o% -in o! ua!&ian -! %octor *! chie# nurse '0! A#ter ECT$ the nurse shoul% %o this action "e#ore giving the client #lui%s$ #oo% or me%ication: A. assess t+e a !e%"e3 C! ne8t o# .in or guar%ian -! assess the sensorium *! chec. >+ Sat &ith a pulse o8imeter Situation 4: The communit health nurse encounters special chil%ren in the communit ! '2! An in%ivi%ual &ith antisocial personalit %isor%er lac.s remorse$ shame an% guilt in going against the norms o# societ ! Ps cho% namicall $ this %e#ect in the personalit re#lects a %istur"ance o# the: A! ego C! ego i%eal B. su#e! e o *! i% '3! The nurse teaches parents a"out chil%ren?s "eginning concepts o# right an% &rong " emphasi1ing chil% rearing attitu%e an% practices %uring the: A! school age C! in#anc perio% B. to&&"e! a e *! latenc perio% '5! It is -EST #or parents to teach health interpersonal relationships to their chil%ren " : A. *o&e"in to t+ei! $+i"&!en -! encouraging their chil%ren to atten% secon%ar school C! encouraging their chil%ren at home to "ehave properl

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*! teaching their chil%ren goo% manners an% right con%uct '9! An important principle #or the nurse to #ollo& in interacting &ith retar%e% chil%ren is: A! seen that i# the chil% appears contente%$ his nee%s are "eing met -! provi%e an environment appropriate to their %evelopment tas. as sche%ule% C! treat the chil% accor%ing to his chronological age D. t!eat t+e $+i"& a$$o!&in to +is &e(e"o#*enta" "e(e" +<! =ental retar%ation is: A! a %ela in normal gro&th an% %evelopment cause% " an ina%e4uate environment -! a lac. o# %evelopment o# sensor a"ilities C. a $on&ition o% su)a(e!a e inte""e$tua" %un$tionin t+at o!i inates &u!in t+e &e(e"o#*enta" #e!io& an& is asso$iate& ,it+ i*#ai!*ent in a&a#ti(e )e+a(io! *! a severe lag in neuromuscular %evelopment an% motor a"ilities Situation 5: The nurse recogni1es the nee% to learn to cope &ith stress an% change! She "ecomes intereste% to

practice natural &a s to enhance &ell "eing!

+'! @i#est le mo%i#ication "egins &ith: A! minimi1ing eating in #ast #oo% restaurants -! having an e8ercise regimen to #ollo& regularl C. !e$o ni6in t+e i*#a$t o% un+ea"t+' +a)its *! avoi%ing pollutants in the environment ++! All o# these are the "ehavior intervention to stress management! E,CEPT: A! gui%e% imager C! me%itation

B. #+a!*a$ot+e!a#' *! progressive muscle rela8ation +3! -asic to progressive muscle rela8ation is: A! #ocusing on an image to rela8 C! use o# in%ustrial e4uipment B. !e"a3in *us$"es %!o* tension *! stopping %istur"ing thoughts +/! *ietar practices are ver important to the health o# the Ailipino #amil ! The nurse nee%s to assess this li#est le "ecause: A! the nurse &ants to change the eating patterns o# the Ailipino #amil -! the nurse .no&s that "eing over&eight is a maBor health ha1ar% C! the nurse &ants to stop all the mainstream &eight-loss %iets D. t+e nu!se +as to %in& out ,+at #eo#"e a!e eatin +0! A oung over&eight a%ult smo.es 0-'< stic.s o# cigarettes;%a $ am"itious$ loo.s at li#e as challenging an% per#ect an% never consi%ers change in his li#est le$ initiall nee%s: A! commitment C! s.ills to attempt change B. in%o!*ation *! motivation Situation 7: -ernie an% 7ohn in their late /<?s have "een marrie% #or +< ears an% at the pea. o# their careers!

Su%%enl $ -ernie %iscovere% that her hus"an% &as #alling in love &ith another &oman! Sha.en " this situation$ she starte% to have pro"lems sleeping an% coul% not #unction &ell at &or. an% at the ris. o# losing her Bo"! 7ohn as.e% #orgiveness an% regret ver much the hurt his &i#e &as going through an% su##ere% guilt #eelings:
+2! -ernie an% 7ohn are going through a: A. situationa" $!isis C! anticipate% crisis -! %evelopmental crisis *! "oth %evelopmental an% situational crisis +3! All o# these are characteristics o# crisis E,CEPT: A! a ha1ar%ous or threatening event occurs -! it has a gro&th promoting potential C. usua" #!o)"e* so"(in *et+o&s an& $o#in *e$+anis*s #!o&u$e a so"ution

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*! an8iet or %epression continue to increase +5! The nurse emplo s this approach in crisis intervention: A. #!o)"e*8so"(in C! role-pla ing -! "ehavior mo%i#ication *! nurse-patient relationship +9! Assessment %ata o# the nurse inclu%e all the #ollo&ing E,CEPT: A! coping mechanisms C! perception o# the event -! situational support D. !e#!esse& #!o)"e*s 3<! The %uration o# crisis usuall lasts several %a s an% usuall : A! + C / &ee.s C! ' C + months -! ' C + &ee.s D. 4 9 7 ,ee-s Situation :: Aelisa has a ritualistic pattern o# constantl &ashing her han%s &ith soap an% &ater #ollo&e% "

ru""ing alcohol!
3'! This "ehavior is categori1e% as: A! %elusional C. neu!oti$ -! normal *! ps chotic 3+! A therapeutic intervention in this situation is: A! avoi% limits on her "ehavior to release her an8iet -! call attention to her ritualistic pattern C. #!o(i&e a"te!nati(e )e+a(io!s to &ea" ,it+ in$!ease& an3iet' *! ignore her "ehavior totall 33! The an8iet o# Aelisa is %isa"ling an% inter#eres &ith her Bo" per#ormance$ interpersonal relationships an% other activities o# %ail living! To minimi1e such pro"lems$ she is li.el to "e given: A. &ia6e#a* ; 1a"iu* < C! imipramine :cl D To#ranil E -! haloperi%ol D :al%ol E *! chlorproma1ine D Thora1ine E 3/! Aelisa un%erstan%s the e##ects o# her me%icine &hen e8presses: A! FI shoul% &atch out #or signs o# sore lips or sore throatG -! FI might have constipationG C! FI might #eel changes in m "o% temperatureG D. = I s+ou"& not &!i(e o! o#e!ate *a$+ines> 30! The level o# an8iet that Aelisa is e8periencing is: A! Panic C! =il%

-! Severe D. ?o&e!ate Situation @:As a pro#essional$ it is imperative that the nurse is accounta"le to onesel# hence the importance o#

personal an% pro#essional %evelopment!

32! Nurse: F I #eel personall involve% &ith m client?s pro"lemsG %emonstrates: A. $ounte! t!ans%e!en$e C! trans#erence -! empath *! s mpath 33! The nurse has achieve% sel#-a&areness in &hich o# the #ollo&ing ver"ali1ations) A! ever time people aroun% me ell$ I #eel upset an% &ith%ra&n -! &hen the patient elle% at me I "ecame speechless C. ,it+ t+e #atients tone o% (oi$e an& sta!e0 I ot !e*in&e& o% +o, *' %at+e! ,ou"& )e so an !' an& t+is *a&e *e an3ious *! I thought it &as ru%e #or the patient to ell hence I .ept 4uiet 35! An accepting attitu%e re4uires "eing: A. a,a!e o% ones )iases C! non Bu%gmental

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-! tolerant o# the #aults o# others *! in control o# ten%enc to "lame 39! Sel#-a&areness$ .no&le%ge an% un%erstan%ing o# human "ehavior an% communication s.ills %e#ine &hat is essential in caring #or ever nurse to "e a"le to %emonstrate: A! positive sel#-proBection C. t+e!a#euti$ use o% se"% -! assertiveness *! sel#-master /<! Consi%ering that man is " nature social$ it is -EST #or the nurse to gain sel#-a&areness " : A. #a!ti$i#atin in intensi(e !ou# e3#e!ien$es -! in%ivi%ual ps chotherap C! h pnotherap *! &riting an auto"iograph #or sel# introspection Situation A: Recor%ing an% the nurse! /'! To #acilitate i%enti#ication o# persons an% relationships$ the #amil nurse utili1es this %iagrammatic representation o# mem"ers o# a #amil an% their relationships: A! #lo&chart C! algorithm B. eno !a* *! .ar%e8 /+! A pro"lem oriente% recor%ing s stem that utili1es the pro"lem solving process as the "asis o# patient care management: A! NAN*A *iagnosis C! Gor%on?s Aunctional :ealth Patterns -! Nursing Care Plan D. P!o)"e* O!iente& ?e&i$a" Re$o!&in /3! This is a S>AP recor%ing o# the patient?s pro"lem o# FNervousnessG! (hich is the su"Bective %ata) A! =r! H &as nervous %uring the intervie&$ he move% #re4uentl in the "e% an% his palms &ere s&eat ! -! =r! H %oes not seem to tolerate stress too &ell &hich &ill aggravate his car%iac con%ition! :e un%erstan%s @ittle a"out his health &hich ma "e increasing his state o# an8iet ! C. =I a* ne!(ous at ti*es>. E3e!ts +i*se"% #+'si$a""' an& is +esitant to &is$uss #!o)"e*s. *! =r! H shoul%: '! %emonstrate an a"ilit to cope &ith nervousness +! %emonstrate an un%erstan%ing o# the relationship "et&een his nervousness an% car%iac con%ition //! The nurse researcher mutuall agree% &ith the research su"Bects that all personal %ata o# the su"Bects shall "e .ept con#i%ential! To sa#eguar% anon mit o# %ata a#ter the report is &ritten$ the nurse researcher shoul%: A! thro& the papers in a &aste"as.et -! .eep the papers #or 0 ears an% %ispose o# these a#ter C. )u!nt o! s+!e& t+e #a#e!s *! have the papers rec cle "ut not as &riting scratch paper /0! A step " step proce%ure #or the management o# common pro"lems is a : A! Gavin chart C. &e$ision t!ee #!oto$o" -! pe%igree chart *! pro"lem listing Situation 1B:The nurse &or.s &ith =ina to help her &or. through termination o# the nurse-patient relationship! /2! Preparation #or termination o# the nurse-patient relationship "egins %uring the: A! termination phase C! pre-orientation phase -! &or.ing phase D. o!ientation #+ase /3! =ina?s past reactions to en%ing relationships is &ith%ra&al! The nurse assists her to practice "etter &a s o# coping termination " provi%ing opportunities to: A! test ne& patterns o# "ehavior C! conceptuali1e her pro"lem

-! plan #or alternatives D. (a"ue an& %in& *eanin in e3#e!ien$e /5! *uring the earl part o# the interaction$ the nurse as.e% a#ter a perio% o# silence! FPerhaps &e &oul% tal. a"out m leavingG! The nurse utili1e% &hich communication techni4ue:

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A! encouraging C! #ocusing on client B. su estin *! un%erstan%ing /9! =ina: Dangril E F I am angr $ I shoul% never have gotten involve% &ith ouG DsilenceE Nurse: FIou have reason to "e %isappointe% an% to #eel angr ! 7ust &hen &e &ere getting some&here! I leave ou!G A! re#lecting &or%s C! orienting B. un&e!stan&in *! re#lecting #eelings 0<! The o"Bection o# the nurse-patient relationship is to provi%e an opportunit o# the patient to: A! clari# pro"lems C. +a(e a $o!!e$ti(e e*otiona" e3#e!ien$e -! %evelop insights *! %evelop interpersonal relationship Situation 11: As a program manager$ the mental health ps chiatric nurse is tas.e% to provi%e general patient

management!
0'! The nurse is a&are that i%enti# ing the aspects o# general patient management an% i%enti# ing interventions #or meeting these "asic nee%s are %istinctions o#: A! ps chotherap C! pharmacotherap B. t+e!a#euti$ *i"ieu *! "ehavior therap 0+! In or%er to get active participation o# the clients to carr out the o"Bective o# the program$ it is -EST #or the nurse to con%uct a;an: A. $o**unit' *eetin C! o"servation -! surve *! selective intervie& o# patients 03! Through the nurse?s role mo%eling o# e##ective communication$ the clients learne% ne& &a s o# %ealing &ith authorit #igures! This gives the clients a venue to: A! communicate C! i%enti# their pro"lems -! sociali1e D. test ne, #atte!ns o% )e+a(io! 0/! This element o# communication #acilitates evaluation o# the program: A! receiver C! sen%er -! message D. %ee&)a$00! The nurse?s st le o# lea%ership in milieu therap is: A! autocratic C. &e*o$!ati$ -! laisse1-#aire *! "enevolent Situation 1.: @oretta is a +5 ears ol%$ unemplo e% patient$ a%mitte% to the ps chiatric unit &ith a %iagnosis o#

chronic un%i##erentiate% schi1ophrenia! She %escri"e% hersel# as the FJirgin =ar G an% her mission is to propagate peace! She &as o"serve% laughing an% tal.ing to hersel#! :er thought processes &ere pro#oun%l %isorgani1e%! She &as also #ear#ul an% suspicious o# others!
02! @oretta?s claim o# "eing the FJirgin =ar G is a;an: A! imagination C! hallucination B. &e"usion *! o"session 03! :er mission to propagate peace is: A! a serious call #or a nee% o# trans#ormation C! realistic an% lau%a"le B. an atte*#t to o(e!$o*e "o, se"%8estee* *! an a%vocac that she can participate in 05! (hich o# this intervention &oul% N>T "e therapeutic in %ecreasing @oretta?s an8iet ) A. Co-e a)out +e! t+ou +t to +e"# +e! %ee" at ease -! listen to her thoughts an% #eelings C! simpl accept *! %o not convince her that her perception is unreal

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09! The nurse evaluates that @oretta?s rea% #or a reha"ilitation program &hen she: A! approaches the nurse at #re4uent intervals C! goes to the co##ee shop alone more o#ten B. $eases to ta"- a)out =1i! in ?a!'> *! carries a "oo. FThe Purpose *riven @i#eG 2<! The nurse is lea%ing a group meeting o# patients to prepare them to "e %ischarge%! An appropriate goal #or the group mem"ers is to %evelop: A! attitu%es o# societ to&ar%s the mentall ill

B. s-i""s %o! *aintainin &ai"' "i(in C! a&areness o# interpersonal patterns o# interactions *! insight into personal pro"lems Situation 12: A group o# a%ult chronic schi1ophrenic patients &ere recommen%e% to un%ergo social s.ills

training!
2'! The #ollo&ing are the o"Bectives o# a social s.ills training program E,CEPT: A. e3#"o!e &ee# seate& int!a#s'$+i$ $on%"i$ts C! help "uil% sel# esteem an% sel# con#i%ence -! practice s.ills in relating &ith people *! %evelop an% practice general coping s.ills 2+! Social s.ills training is N>T primaril in%icate% #or ps chiatric patients &ho are: A. in a$ute sta e o% i""ness -! having %i##iculties starting an% maintaining interpersonal relationships C! having chronic episo%es o# stress an% an8iet &hile interacting &ith others *! e8periencing recurrence o# s mptoms in #ront o# particular people or among people in general 23! The #ocus o# the group interaction is Fhere an% no&G! An appropriate topic &oul% "e: A! &a s to cele"rate Jalentine?s *a in Ae"ruar -! ho& to spen% the summer vacation C! an un#orgetta"le e8perience as a chil% D. +o, to te"" a Co-e 2/! An appropriate techni4ue #or the participants to practice ho& to communicate e##ectivel is through;a: A! lecture C. !o"e #"a' -! seminar *! ps cho%rama 20! Consi%ering that it is -EST to learn " e8ample$ it is =>ST practical to: A. *o&e" oo& so$ia" s-i""s t+!ou +out t+e session -! relate success#ul past e8periences C! invite a resource person *! &atch a movie Situation 14: Communit health nurses integrate their .no&le%ge o# mental health &ith their clients in their

practice &hen the %o mental health counseling!

22! (ho among these clients nee% imme%iate re#erral #or ps chotherap ) A. t+ose ,+o a!e #"ottin to $o**it sui$i&e -! those &ho are not respon%ing to usual motivators C! those &ho are not solving their pro"lems &hich the have the resources to solve *! those &ho are engaging in sel#-%e#eating "ehaviors 23! All o# these %escri"e &hat counseling$ E,CEPT: A! helping people manage their o&n pro"lems -! assisting people to use their o&n resources C! a set o# techni4ue$ s.ills an% attitu%es D. i(in a&(i$es 25! This 4ualit o# the nurse allo&s Fconnecting &ith others #eelingsG: A! &armth C. sensiti(it' -! courage *! pru%ence

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29! F To re#use gossipG is a re#lection o# the mental health nurses 4ualit o#: A! #irmness C! Bu%gment -! coolness D. t!ust,o!t+iness 3<! (hich o# the #ollo&ing concepts -EST %escri"e the nurse?s interaction &hen she;he can recogni1e an% i%enti# #eelings an% emotions o# another person &ithout even having personall e8perience% those #eelings an% emotions) A! over involvement C! trans#erence -! s mpath D. e*#at+' Situation 15: Communicating e##ectivel &ith %ementia patients is a challenge to ps chiatric nurses! 3'! Therapeutic &a s to engage the el%erl to "e stimulate% inclu%e all o# the #ollo&ing E,CEPT: A! singing to or &ith the patients C! provi%ing a picture al"um -! listening to ol% #amiliar music D. #"a'in $o*#"e3 $o*#ute! a*es 3+! The @EAST area o# satis# ing communication &ith the el%erl is on: A! recall o# their courtship an% love li#e C! #ashion sho&n in personal pictures B. #s'$+o"o i$a" t!au*a *! memories o# their teenage parties 33! To ma8imi1e communication &ith the el%erl $ &hich o# the #ollo&ing &a s o# ver"al communication shoul% the nurse use minimall ) A! as.ing simple 4uestions C! restating

-! gui%ing the patient one step at a time D. as-in %o! an o#en en&e& !es#onse 3/! Uncon%itional positive regar% #or the el%erl is -EST achieve% &hen the nurse-patient relationship is "ase% upon: A! vocational choices C! a%%ressing economic pro"lems -! .eeping D. #!o(i&in ,a!*t+ an& $a!in 30! An optimal supportive environment #or a person &ith %ementia inclu%es all$ E,CEPT: A. en a in t+e e"&e!"' in "o i$a" an& a)st!a$t t+in-in -! %eveloping a realistic uni#orme% an% consistent %ail sche%ule C! han%ling memor loss " %istracting or %iverting patient?s attention to something more positive *! simple nurse care #or the patient %a a#ter %a Situation 17: :arr $ age 32 is a%mitte% to the ps chiatr unit in an acute manic episo%e o# "ipolar %isor%er! 32! :arr ?s con%ition is a %istur"ance o#: A! sensorium C! the CNS -! cognition D. a%%e$t 33! In the &ar%$ :arr mani#ests e8cess energ an% is %i##icult #or him to sit still! The =>ST use#ul activit #or him &oul% "e: A. &e"i(e!in su##"' o% "inen to ot+e! !oo*s C! con%ucting a %rama &or.shop -! engaging in activit therap an% group e8ercises *! painting a mural &ith other patients 35! :arr ?s %isruptive "ehavior on the unit has "een increasingl anno ing other clients! (hich o# the #ollo&ing &oul% the nurse %o) A. set "i*its on +is )e+a(io! an& )e $onsistent in a##!oa$+ -! ma.e a rigi% structure% plan that he &ill have to #ollo& C! ignore his "ehavior *! tell him that he is anno ing other clients an% isolate him in his room 39! :arr approaches ou an% sa s FI have a&ar%e% Top Salesman o# the Iear! = "oss &ill come an% cele"arate &ith meG! Iou .no& #or a #act that this is N>T true! :arr is %emonstrating a %elusion o#: A! achievement C! in#luence -! re#erence D. !an&eu! 5<! The %e#ense mechanism utili1e% " manic patients to cover up %epression is:

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A! %isplacement C! compensation -! %enial D. !ea$tion %o!*ation Situation '3: The nurse o"serve% that =arie$ age +5 ears ol% ha% not "een participating in activit therapies! 5'! (hich o# the #ollo&ing remar.s #rom the nursing atten%ants in%icates a nee% #or #urther teaching an% o"servation) A! =arie ma%e no response to an invitation to pla -! =arie pre#erre% to sit at the "ench an% &atch the "allgame C. ?a!ie is a"oo% an& in&i%%e!ent to $o8#atients *! =arie rea% a "oo. &hile other patients pla e% a "allgame 5+! =arie sai% FI %on?t li.e to "e a part o# it! @oo.$ the are "eing laughe% at "ecause the are singing an% acting li.e chil%renG! The nurse notes that in or%er #or the activit therap to "e therapeutic: A! the sta## shoul% %eci%e solel &hat activities to "e %one an% &hat rules appl -! patients shoul% "e allo&e% solel to %eci%e &hat the &ant to %o on their o&n C! "allgames shoul% "e limite% to male patients onl D. a e an& nee&s o% #atient s+ou"& )e $onsi&e!e& in t+e $+oi$e o% a*es 53! To encourage active participation among patients$ it is -EST to plan activities the can engage in through a: A. one to one inte!a$tion C! chec.list -! communit meeting *! #ee%"ac. evaluation #orum 5/! In planning activities #or the patients$ it is essential to consi%er A>RE=>ST: A. sa%et' an& se$u!it' C! novelt an% creativit -! variet an% #un *! e8citement an% challenge 50! A%ults$ F singing an% acting li.e chil%renG is a #orm o#: A! %isplacement C! su"limation B. !e !ession *! compensation Situation 1@: A research &as con%ucte% on! F The e##ects o# the nurse e8pressive role in the re%uction o# an8iet

in patients &ho &ill un%ergo nasogastric tu"e insertionG!

52! The research is e8perimental &hich means that utili1e%: A! an intervie& sche%ule% C! a 4uestionnaire -! a surve D. $ont!o" an& e3#e!i*enta" !ou#s

53! The in%epen%ent varia"le is: A! patients C! re%uction o# an8iet B. e3#!essi(e !o"e *! nasogastric insertion 55! The %epen%ent varia"le is: A! nasogastric ingestion C! e8pressive role -! patients D. !e&u$tion o% an3iet' 59! This stu% &as %one to chec. the proce%ures o# the research: A! protest stu% C. #i"ot stu&' -! proposal *! test-retest 9<! (hich o# the #ollo&ing is N>T a characteristic o# e8perimental research) A. (a"ue #"a's a si ni%i$ant #a!t in !esea!$+ -! research i%eas are capa"le o# "eing teste% C! results o# tests ma%e on the groups are compare% *! research su"Bects are ran%oml selecte% an% place% into groups #or the purpose o# manipulation Situation 1A: The client is &al.ing to an% #ro along the hospital corri%or an% s&inging her han%s! She thin.s she

is going cra1 ! She is having palpitations$ rapi% pulse an% h perventilation!

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9'! Iour nursing intervention shoul% "e to: A! encourage her to participate in an ongoing activit in the &ar% B. sta' ,it+ +e! in a $a"* en(i!on*ent C! tell her to stop thin.ing that she is going cra1 *! isolate the client in a 4uiet room 9+! (hich o# the #ollo&ing is a "ehavioral mani#estation o# an8iet ) A! h perventilation C. #ani$ -! tach car%ia *! rapi% pulse 93! (hich o# the #ollo&ing statements a"out an8iet is N>T true) A! an8iet is contagious -! represse% unresolve% con#licts create an8iet C. an3iet' at an' "e(e" is &est!u$ti(e0 +en$e a t+!eat to a #e!sons ,e"" )ein *! reactions to a perceive% threat ma "e real or imaginar 9/! There is increase% tension an% re%uce% a"ilit to perceive an% communicate$ hence Fselective attentionG in this level o# an8iet : A. *o&e!ate C! panic -! severe *! mil% 90! This me%ication is in%icate% #or an8ious patients: A! To#ranil DImipramine :C@E C. 1a"iu* ;Dia6e#a*< -! :al%ol D:aloperi%olE *! Thora1ine DChlorproma1ineE Situation .B: An% $ 3< ears ol%$ &as a%mitte% to the Ps chiatric (ar% "ecause o# religious preoccupation$

%eterioration in sel#-care an% %istur"e% thoughts! :e "elieves that he has committe% a lot o# sins! :e is threatene% " people reaching out to him! :is #asting #or several %a s &as not su##icient #or him to #eel #orgiven!
92! An% is %emonstrating: A. !e"i ious &e"usion C! somatic %elusion -! %elusion o# gran%eur *! %elusion o# "eing controlle% 93! A %elusion is: A! ps chomotor %istur"ance C. &istu!)an$e o% t+ou +t -! moo% %istur"ance *! %istur"ance o# perception 95! The nursing goal #or An% is to: A! have him see a priest #or con#ession -! encourage him to pra to atone #or his sins C. +e"# +i* &e(e"o# a #ositi(e se"% i*a e *! sociali1e him &ith a group to .eep him in touch &ith realit 99! As An% tal.s a"out his sins that he "elieves ma.e people loo. %o&n upon him! It is -EST to: A! agree &ith him an% s mpathi1e ho& sin#ul he has reall "een -! e8plore the nature o# his sins C! e8plain that he is %epreciating himsel# too much D. a$-no,"e& e +o, +e %ee"s an& %o$us on !ea"it' o!iente& to#i$s '<<! The ps chosocial tas. that An% nee%s to &or. on is a sense o#:

A! i%entit C! autonom B. t!ust *! intimac ---------------------------------------------------------------------------------------------------------------------------------------------------

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