Professional Documents
Culture Documents
1. Francis who is addicted to cocaine withdraws from the drug. Nurse Ron should
expect to observe:
a. Hyperactivity
b. Depression
c. Suspicion
d. Delirium
4. A 48 year old male client is brought to the psychiatric emergency room after
attempting to jump off a bridge. The client’s wife states that he lost his job several
months ago and has been unable to find another job. The primary nursing
intervention at this time would be to assess for:
a. A past history of depression
b. Current plans to commit suicide
c. The presence of marital difficulties
d. Feelings of excessive failure
5. Before helping a male client who has been sexually assaulted, nurse Maureen
should recognize that the rapist is motivated by feelings of:
a. Hostility
b. Inadequacy
c. Incompetence
d. Passion
6. When working with children who have been sexually abused by a family member it
is important for the nurse to understand that these victims usually are
overwhelmed with feelings of:
a. Humiliation
b. Confusion
c. Self blame
d. Hatred
7. Joy who has just experienced her second spontaneous abortion expresses anger
towards her physician, the hospital and the “rotten nursing care”. When assessing
the situation, the nurse recognizes that the client may be using the coping
mechanism of:
a. Projection
b. Displacement
c. Denial
d. Reaction formation
8. The most critical factor for nurse Linda to determine during crisis intervention
would be the client’s:
a. Available situational supports
b. Willingness to restructure the personality
c. Developmental theory
d. Underlying unconscious conflict
10. Nurse Ronald could evaluate that the staff’s approach to setting limits for a
demanding, angry client was effective if the client:
a. Apologizes for disrupting the unit’s routine when something is needed
b. Understands the reason why frequent calls to the staff were made
c. Discuss concerns regarding the emotional condition that required hospitalizations
d. No longer calls the nursing staff for assistance
11. Nurse John is aware that the therapy that has the highest success rate
for people with phobias would be:
a. Psychotherapy aimed at rearranging maladaptive thought process
b. Psychoanalytical exploration of repressed conflicts of an earlier development phase
c. Systematic desensitization using relaxation technique
d. Insight therapy to determine the origin of the anxiety and fear
12. When nurse Hazel considers a client’s placement on the continuum of anxiety, a
key in determining the degree of anxiety being experienced is the client’s:
a. Perceptual field
b. Delusional system
c. Memory state
d. Creativity level
14. Malou with schizophrenia tells Nurse Melinda, “My intestines are rotted from
worms chewing on them.” This statement indicates a:
a. Jealous delusion
b. Somatic delusion
c. Delusion of grandeur
d. Delusion of persecution
15. Andy is admitted to the psychiatric unit with a diagnosis of borderline personality
disorder. Nurse Hilary should expects the assessment to reveal:
a. Coldness, detachment and lack of tender feelings
b. Somatic symptoms
c. Inability to function as responsible parent
d. Unpredictable behavior and intense interpersonal relationships
16. PROPRANOLOL (Inderal) is used in the mental health setting to manage which of
the following conditions?
a. Antipsychotic – induced akathisia and anxiety
b. Obsessive – compulsive disorder (OCD) to reduce ritualistic behavior
c. Delusions for clients suffering from schizophrenia
d. The manic phase of bipolar illness as a mood stabilizer
17. Which medication can control the extra pyramidal effects associated with
antipsychotic agents?
a. Clorazepate (Tranxene)
b. Amantadine (Symmetrel)
c. Doxepin (Sinequan)
d. Perphenazine (Trilafon)
18. Which of the following statements should be included when teaching clients about
monoamine oxidase inhibitor (MAOI) antidepressants?
a. Don’t take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)
b. Have blood levels screened weekly for leucopenia
c. Avoid strenuous activity because of the cardiac effects of the drug
d. Don’t take prescribed or over the counter medications without consulting the
physician
19. Kris periodically has acute panic attacks. These attacks are unpredictable and
have no apparent association with a specific object or situation. During an acute
panic attack, Kris may experience:
a. Heightened concentration
b. Decreased perceptual field
c. Decreased cardiac rate
d. Decreased respiratory rate
20. Initial interventions for Marco with acute anxiety include all except which of the
following?
a. Touching the client in an attempt to comfort him
b. Approaching the client in calm, confident manner
c. Encouraging the client to verbalize feelings and concerns
d. Providing the client with a safe, quiet and private place
21. Nurse Jessie is assessing a client suffering from stress and anxiety. A common
physiological response to stress and anxiety is:
a. Uticaria
b. Vertigo
c. Sedation
d. Diarrhea
22. When performing a physical examination on a female anxious client, nurse Nelli
would expect to find which of the following effects produced by the
parasympathetic system?
a. Muscle tension
b. Hyperactive bowel sounds
c. Decreased urine output
d. Constipation
23. Which of the following drugs have been known to be effective in treating
obsessive-compulsive disorder (OCD)?
a. Divalproex (depakote) and Lithium (lithobid)
b. Chlordiazepoxide (Librium) and diazepam (valium)
c. Fluvoxamine (Luvox) and clomipramine (anafranil)
d. Benztropine (Cogentin) and diphenhydramine (benadryl)
24. Tony with agoraphobia has been symptom-free for 4 months. Classic signs and
symptoms of phobia include:
a. Severe anxiety and fear
b. Withdrawal and failure to distinguish reality from fantasy
c. Depression and weight loss
d. Insomnia and inability to concentrate
25. Which nursing action is most appropriate when trying to diffuse a client’s
impending violent behavior?
a. Place the client in seclusion
b. Leaving the client alone until he can talk about his feelings
c. Involving the client in a quiet activity to divert attention
d. Helping the client identify and express feelings of anxiety and anger
28. Jose who is receiving monoamine oxidase inhibitor antidepressant should avoid
tyramine, a compound found in which of the following foods?
a. Figs and cream cheese
b. Fruits and yellow vegetables
c. Aged cheese and Chianti wine
d. Green leafy vegetables
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 find:
a. Permanent short-term memory loss and hypertension
b. Permanent long-term memory loss and hypomania
c. Transitory short-term memory loss and permanent long-term memory loss
d. Transitory short and long term memory loss and confusion
30. Barbara with bipolar disorder is being treated with lithium for the first time. Nurse
Clint should observe the client for which common adverse effect of lithium?
a. Polyuria
b. Seizures
c. Constipation
d. Sexual dysfunction
31. Nurse Fred is assessing a client who has just been admitted to the ER
department. Which signs would suggest an overdose of an antianxiety agent?
a. Suspiciousness, dilated pupils and incomplete BP
b. Agitation, hyperactivity and grandiose ideation
c. Combativeness, sweating and confusion
d. Emotional lability, euphoria and impaired memory
32. Discharge instructions for a male client receiving tricyclic antidepressants include
which of the following information?
a. Restrict fluids and sodium intake
b. Don’t consume alcohol
c. Discontinue if dry mouth and blurred vision occur
d. Restrict fluid and sodium intake
33. Important teaching for women in their childbearing years who are receiving
antipsychotic medications includes which of the following?
a. Increased incidence of dysmenorrhea while taking the drug
b. Occurrence of incomplete libido due to medication adverse effects
c. Continuing previous use of contraception during periods of amenorrhea
d. Instruction that amenorrhea is irreversible
35. The nurse understands that the therapeutic effects of typical antipsychotic
medications are associated with which neurotransmitter change?
a. Decreased dopamine level
b. Increased acetylcholine level
c. Stabilization of serotonin
d. Stimulation of GABA
36. Which of the following best explains why tricyclic antidepressants are used with
caution in elderly patients?
a. Central Nervous System effects
b. Cardiovascular system effects
c. Gastrointestinal system effects
d. Serotonin syndrome effects
37. A client with depressive symptoms is given prescribed medications and talks with
his therapist about his belief that he is worthless and unable to cope with life.
Psychiatric care in this treatment plan is based on which framework?
a. Behavioral framework
b. Cognitive framework
c. Interpersonal framework
d. Psychodynamic framework
38. A nurse who explains that a client’s psychotic behavior is unconsciously motivated
understands that the client’s disordered behavior arises from which of the
following?
a. Abnormal thinking
b. Altered neurotransmitters
c. Internal needs
d. Response to stimuli
39. A client with depression has been hospitalized for treatment after taking a leave
of absence from work. The client’s employer expects the client to return to work
following inpatient treatment. The client tells the nurse, “I’m no good. I’m a
failure”. According to cognitive theory, these statements reflect:
a. Learned behavior
b. Punitive superego and decreased self-esteem
c. Faulty thought processes that govern behavior
d. Evidence of difficult relationships in the work environment
40. The nurse describes a client as anxious. Which of the following statement about
anxiety is true?
a. Anxiety is usually pathological
b. Anxiety is directly observable
c. Anxiety is usually harmful
d. Anxiety is a response to a threat
41. A client with a phobic disorder is treated by systematic desensitization. The nurse
understands that this approach will do which of the following?
a. Help the client execute actions that are feared
b. Help the client develop insight into irrational fears
c. Help the client substitutes one fear for another
d. Help the client decrease anxiety
42. Which client outcome would best indicate successful treatment for a client with an
antisocial personality disorder?
a. The client exhibits charming behavior when around authority figures
b. The client has decreased episodes of impulsive behaviors
c. The client makes statements of self-satisfaction
d. The client’s statements indicate no remorse for behaviors
43. The nurse is caring for a client with an autoimmune disorder at a medical clinic,
where alternative medicine is used as an adjunct to traditional therapies. Which
information should the nurse teach the client to help foster a sense of control over
his symptoms?
a. Pathophysiology of disease process
b. Principles of good nutrition
c. Side effects of medications
d. Stress management techniques
44. Which of the following is the most distinguishing feature of a client with an
antisocial personality disorder?
a. Attention to detail and order
b. Bizarre mannerisms and thoughts
c. Submissive and dependent behavior
d. Disregard for social and legal norms
45. Which nursing diagnosis is most appropriate for a client with anorexia nervosa
who expresses feelings of guilt about not meeting family expectations?
a. Anxiety
b. Disturbed body image
c. Defensive coping
d. Powerlessness
46. A nurse is evaluating therapy with the family of a client with anorexia nervosa.
Which of the following would indicate that the therapy was successful?
a. The parents reinforced increased decision making by the client
b. The parents clearly verbalize their expectations for the client
c. The client verbalizes that family meals are now enjoyable
d. The client tells her parents about feelings 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?
a. Agree with the client’s painful feelings
b. Challenge the accuracy of the client’s belief
c. Deny that the situation is hopeless
d. Present a cheerful attitude
48. A client with major depression has not verbalized problem areas to staff or peers
since admission to a psychiatric unit. Which activity should the nurse recommend
to help this client express himself?
a. Art therapy in a small group
b. Basketball game with peers on the unit
c. Reading a self-help book on depression
d. Watching movie with the peer group
49. The home health psychiatric nurse visits a client with chronic schizophrenia who
was recently discharged after a prolong stay in a state hospital. The client lives in
a boarding home, reports no family involvement, and has little social interaction.
The nurse plan to refer the client to a day treatment program in order to help him
with:
a. Managing his hallucinations
b. Medication teaching
c. Social skills training
d. Vocational training
50. Which activity would be most appropriate for a severely withdrawn client?
a. Art activity with a staff member
b. Board game with a small group of clients
c. Team sport in the gym
d. Watching TV in the dayroom