Comprehensive Exam for Psychiatric Nursing

College of Medicine

1. The nurse understands that the major difference between neurotic disorders and psychotic disorders
is that in psychotic disorders the clients
a. are aware that their behaviors are maladaptive
b. are aware that they are experiencing distress
c. experience no loss of contact with reality
d. exhibit a flight from reality
2. A male client with schizophrenia tells you that his roommate is putting thoughts in his mind against his
will.This is an example of:
a.thought broadcasting c.thought insertion
b.thought blocking d.thought control
3. Covering up a real or perceived weakness by emphasizing a trait one considers more desirable is:
a.conversion b.displacement c.denial d.compensation
4. An older employee is publicly embarassed by a younger boss at work and angrily cuts a driver off on
the way home.What defense mechanism is this?
a.projection b.identification c.diaplacement d.regression
5. An executive who has cancer,requests all studies and blood work,and discusses in detail with her
doctor,as if she was speaking about someone else.What defense mechanism did she exhibit?
a.intellectualization c.sublimation
b.reaction formation d.identification
6. Flumazenil (Romazicon) has been ordered for a male client who has overdosed on oxazepam
(Serax). Before administering the medication, nurse Gina should be prepared for which common
adverse effect?
A. Seizures
B. Shivering
C. Anxiety
D. Chest pain

7. Nurse Tamara is caring for a client diagnosed with bulimia. The most appropriate initial goal for a
client diagnosed with bulimia is to:
A. Avoid shopping for large amounts of food
B. Control eating impulses
C. Identify anxiety-causing situations
D. Eat only three meals per day

8. A female client who’s at high risk for suicide needs close supervision. To best ensure the client’s
safety, Nurse Mary should:
A. Check the client frequently at irregular intervals throughout the night
B. Assure the client that the nurse will hold in confidence anything the client says
 C. Repeatedly discuss previous suicide attempts with the client
D. Disregard decreased communication by the client because this is common with suicidal clients

9. Which of the following drugs should Nurse Mary prepare to administer to a client with a toxic
acetaminophen (Tylenol) level?
A. Deferoxamine mesylate (Desferal)
B. Succimer (Chemet)
C. Flumazenil (Romazicon)
D. Acetylcysteine (Mucomyst)

10. A male client is admitted to the substance abuse unit for alcohol detoxification. Which of the
following medications is Nurse Alice most likely to administer to reduce the symptoms of alcohol
withdrawal?
A. Naloxone (Narcan)
B. Haloperidol (Haldol)
C. Magnesium sulfate
D. Chlordiazepoxide (Librium)

11. A mother of a child killed in a drive-by shooting becomes involved in legislative change for gun laws
and gun violence. Why defense mechanism did she exhibit?
a.intellectualization c.reaction formation
b.identification d.sublimation
12. A group therapy client strongly dislikes another member but claims that it is the member
who”dislikes her.” What defense mechanism is this?
a.projection c.displacement
b.identification d.regression
13. When security is threatened,the individual protects the personality by:
a.affective reaction c.ritualistic behaviors
b.defense mechanism d.withdrawal patterns
14. .Sublimation is a defense mechanism that helps the individual:
a.act out the opposite of one’s true feelings
b.engage in earlier mode of behavior
c.exclude from the conscious thoughts that causes anxiety
d.express unacceptable thoughts and wishes into socially approved behavior
15. A middle aged patient says to the nurse”I don’t deserve to live”.The most therapeutic initial response
by the nurse would be:
a.continue to listen to the patient while maintaining direct eye contact
b.remain with the client until she states she feels better
c.say to the client”you sound depressed” and lean toward her
d.ask the patient what she means by”I don’t deserve to live”.
16. A patient tells the nurse”The group therapist does not like me”.Which of the ff. responses,if made by
the nurse,would be most therapeutic?
 a.why do you say that?
b.I wouldn’t take it personally
c.would you like me to talk to the therapist for you
d.you need to discuss that concern with the therapist
17. A client has just began to discuss important feelings when the time of interview is up.The next day
when the nurse meets with client the agreed-upon time,the initial intervention would be to say:
a.”good morning ,how are you today”
b.”yesterday you were talking about some very important feelings.let’s continue”
c.”what would you like to talk about today”
d.nothing and wait for the client to introduce a topic
18. A technique that enhances communication is suggesting collaboration which is illustrated by one of
the ff. statements.
a.”You mean to say your life is worthless?”
b.”Perhaps you and I can discuss what causes your anxiety”.
c.”What have you been thinking of lately”
d.”I’m not sure I understand what you are saying”
19. .It is founded by Frederick Perls,emphasized identifying the person’s feelings and thoughts in the here
and now.
a.gestalt therapy
b.reality therapy
c.cognitive therapy
d.logo therapy
20. The fear of being in places or situations from which escape might be difficult or in which help might
not be available in the event of a panic attack.
a.agoraphobia
b.social phobia
c.specific phobia
d.none of the above
21. It involves obsessions(thoughts,impulses,images) that cause marked anxiety and/or(repetitive
behaviors) that attempt to neutralize anxiety.
a.panic disorder
b.generalized anxiety disorder
c.post traumatic stress disorder
d.obsessive compulsive disorder
22. It is characterized by the re-experiencing of an extremely traumatic event,avoidance of stimuli
associated with the event,numbing of responsiveness,and persistent increased arousal; it begins with
3 months to years after the event and may last a few months or years .
a.panic disorder
b.generalized anxiety disorder
c.post traumatic stress disorder
d.obsessive compulsive diasorder
23. It focuses on immediate thought processing how a person perceives or interprets his experience and
determines how he feels and behaves.
a.gestalt therapy
b.reality therapy
c.cognitive therapy
d.logo therapy
24. A nonjudgemental caring for the client that is not dependent on the clients behavior.
a.genuineness
b.empathetic understanding
c.sympathetic understanding
d.unconditional positive regard
25. In which the therapist senses the feelings and personal meaning from the client and communicates
this understanding to the client.
a.genuineness
b.empathetic understanding
c.humanism
d.unconditional positive regard
26. It begins when the patient works independently with the nurse,expresses feelings and begins to feel
stronger.
a.orientation phase
b.identification phase
c.exploitation phase
d.resolution phase
27. In which the therapist senses the feelings and personal meaning from the client and communicates
this understanding to the client.
a.genuineness
b.empathetic understanding
c.humanism
d.unconditional positive regard
28. It begins when the patient works independently with the nurse,expresses feelings and begins to feel
stronger.
a.orientation phase
b.identification phase
c.exploitation phase
d.resolution phase
29. A client is experiencing anxiety attack.The most appropriate nursing intervention should include?
a.turning on the TV
b.leaving the client alone
c.staying with the client and speaking in short sentences
d.ask the client to play with other clients
30. A person who cheats on a spouse brings the spouse a bouquet of roses is what type of defense
mehanism?
a.undoing b.reaction formation c.sublimation d.regression

31. Nurse Mara should first discuss terminating the nurse-client relationship with a client during the:
a.termination phase
b.working phase
c.orientation phase
d.none of the above
32. When assessing a female client who is receiving tricyclic antidepressant therapy,which of the
following would alert the nurse to the possibility that the client is experiencing anticholinergic
effect?
a.urine retention and blurred vision
b.respiratory depression and covulsion
c.delirium and sedation
d.tremors and cardiac arrythmias
33. When developing the plan of care for a client receiving haloperidol,which of the folowing medications
would Nurse Carissa may anticipate administering if the client develops EPS?
a.olanzapine(zyprexa)
b.paroxetine(paxil)
c.benztropine mesylate(cogentin)
d.lorazepam(ativan)

34. After administering naloxone(narcan),an opiod antagonist,Nurse Charisse should monitor the female
client carefully for which of the ff.?
a.respiratory depression
b.epilepsy
c.kidney failure
d.cerebral edema
35. On admission, the nurse in her assessment would note which of the following signs and symptoms:

a. Bradycardia hypotension
b. Palpitation and hypertension
c. Tachycardia hypertension
d. Nausea and vomiting

36. The nurse identities one of the following nursing diagnosis as the most important to include in her
plan of care:
A. Impaired gas exchange
b. Sensory perceptual alteration
c. Decreased fluid volume
 d.Altered nutrition: less than body requirements

37. After lunch, Ina was observed to purge in the bathroom. What would be the appropriate nursing
intervention?

A. Observe Ina for 24 hours for any incidence of purging

B. Tell Ina that she would be forced to eat the food served for her soon after purging
C. Tell Ina that she would be given extra food
D. Ina should be observed two hours after each meal
38. 4.A 23-year old man was voluntarily admitted to the inpatient unit with a diagnosis of paranoid
schizophrenia.As the nurse approaches the client, he says,”If you come any closer,I’ll die”.This is an
example of
a.hallucination b.delusions
c.illusion d.ideas of reference

39. The best response for the nurse to make to this behavior is
a.”How can I hurt you?”
b.”I’m the nurse”
c.”Tell me more about this”
d.”That’s silly thing to say”

40. A young man admitted with a diagnosis of paranoid schizophrenia is pacing the halls and is
agitated.The nurse hears him saying”I have to get away from those doctors”.They are trying to
commit me to another hospital”.The nurse’s continued assessment should include
a.clarifying the information to the doctor
b.observing the client for rising anxiety
c.reviewing history of involuntary commitment
d.checking the dosage of prescribed medication

41. .When communicating with a paranoid client,the main principle is to

a.use logic and be persistent
b.provide an anxiety-free environment
c.express doubt and do not argue
d.encourage ventilation of anger

42. Which of the ff. assessment findings would the nurse observe in a client with with schizophrenia?
a.associative looseness,affect disturbance,ambivalence,autistic thinking
b.euphoria,distractability,dramatic,energetic
c.argumentative,anhedonia,poor judgement,manipulative
d.psychomotor retardation,intense sadness,loss of energy
43. A client with schizophrenia reports to the nurse that he hears a voice that says”Don’t take those
poisoned pills from that nurse”. Which one of the ff. nursing diagnoses would it be appropriate for
the nurse to make regarding this stament?
a.disturbed sensory perceptual:auditory, related to anxiety as manifested by auditory hallucinations
b.disturbed thought processes related to anxiety as manifested by delusions of persecution
c.defensive coping related to impaired reality testing as manifested by paranoid ideation
d.impaired verbal communication related to disturbances in form of thinking as manifested by use of
symbolic references

44. An adult is admitted with a diagnosis of catatonic schizophrenia,excited phase.She shouts and paces
continuously and seems to be responding to internal stimuli.A realistic short-term goal for the nurse
to formulate is
a.the client will groom self daily
b.the client will maintain adequate nutrition
c.the client will sleep 8 hours per night
d.the client will attend unit social activities

45. In teaching a client for whom clozapine has been prescribed,the nurse would include which of the ff.
a.the drug will be given every 4 weeks by IM
b.the drug will probably cause weight reduction
c.there is a high incidence of extrapyramidal side effects
d.the signs and symptoms of blood dyscrasia

46. An adult is to go on a 3-day pass and has his maintenance supply of chlorpromazine(thorazine).Which
statement indicates to the nurse that he understands instructions regarding this medication?
a.I’ll take my pills when I hear those voices
b.I’ll drink beer but no wine while I’m away
c.I’ll cover up when I go to the beach
d.I’ll stop taking it if my mouth stays dry

47. Which of the ff. behaviors indicates to the nurse that the client’s antipychotic medication is having a
desired effect?
a.the client states that her “voices” are not as threatening
b.the client reports having innner feelings of restlessness
c.the client sleeps all day
d.the client reports muscular stiffening in her face and arms

48. The nurse is preparing to administer lithium to a client with bipolar disorder.The client complains of
nausea and muscle weakness,and his speech is slurred.His lithium level is 1.6 mEq/L.The best action
for the nurse to take is to
a.chart the client’s symptoms after giving the lithium
b.explain that these are common side effects
 c.withhold the client’s lithium
d.administer a prn antiparkinsonian drug

49. Which of the ff. behaviors indicates to the nurse that the client understsands her teaching related to
lithium treatment therapy?
a.takes her lithium 1 hour after meals
b.states that she will stop taking her lithium when her mania subsides
c.goes on a low salt diet to counter weight gain
d.states she will withhold her lithium if she experiences diarrhea,vomiting and diaphoresis

50. A client for whom Nardil was prescribed for depression is brought to the ER with severe occipital
headaches after eating pepperoni pizza for lunch.Which of th ff. interpretations is it important for the
nurse to make regarding these findings?
a.allergic reaction related to ingestion of processed foods
b.hypertensive crisis related to drug and food reaction
c.panic anxiety related to unresolved issues
d.conversion disorder related to uncontrolled anxiety

51. Association of words by sound rather than meaning.She cried till she died but could not hide from the
ride.
a.loose associations b.tangential thinking
c.clang associations d.echolalia

52. The nurse is caring for a male client who experience false sensory perceptions with no basis in
reality.This perception is known as:
a.hallucinations b.delusions
c.loose associations d.neologisms

53. A male client who is experiencing disordered thinking about food being poisoned is admitted to the
mental health unit.The nurse uses which communication technique to encourage the client to eat
dinner?
a.focusing on self-disclosure of own food preference
b.using open ended question and silence
c.offering opinion about the need to eat
d.verbalizing reasons that the client may not choose to eat

54. 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 ff.would be the best response of thenurse?
a.giving the client canned supplements until the delusions subside
b.asking what kind of poison the client suspects is being used
c.serving foods that come in sealed packages
d.allowing the client to be the first to open the cart and get a tray
55. When asking the parents about the onset of problems in young client with the diagnosis of
schizophrenia,the nurse would expect that they would relate the client’s difficulties began in:
a.early childhood b.late childhood
c.adolescence d.puberty

56. Jose who has beenhospitalized with schizophrenia tells the nurse,”My heart has stopped and my
veins have turned to glass”.The nurse is aware that this is an example of:
a.somatic delusions b.depersonalization
c.hypochondriasis d.echolalia

57. A 48 –year old male client is brought to the psychiatric ER 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

58. 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

59. The psychiatric nurse visits a client with chronic schizophrenia who has recently discharged after a
prolong stay in a hospital.The client lives in a friend,reports no family involvement,and has little
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

60. 20. When planning care for a client who has ingested phencyclidine (PCP), nurse Wayne is aware
that the following is the highest priority?
A. Client’s physical needs
B. Client’s safety needs
C. Client’s psychosocial needs
D. Client’s medical needs
61. The nurse is aware that the outcome criteria would be appropriate for a child diagnosed with
oppositional defiant disorder?
A. Accept responsibility for own behaviors
B. Be able to verbalize own needs and assert rights.
C. Set firm and consistent limits with the client
D. Allow the child to establish his own limits and boundaries

62. A male client is found sitting on the floor of the bathroom in the day treatment clinic with moderate
lacerations on both wrists. Surrounded by broken glass, he sits staring blankly at his bleeding wrists
while staff members call for an ambulance. How should Nurse Anuktakanuk approach her initially?
A. Enter the room quietly and move beside him to assess his injuries
B. Call for staff back-up before entering the room and restraining him
C. Move as much glass away from him as possible and sit next to him quietly
D. Approach him slowly while speaking in a calm voice, calling him name, and telling him that the
nurse is here to help him

63. A female client with anorexia nervosa describes herself as “a whale.” However, the nurse’s
assessment reveals that the client is 5′ 8″ (1.7 m) tall and weighs only 90 lb (40.8 kg). Considering
the client’s unrealistic body image, which intervention should nurse Angel be included in the plan of
care?

A. Asking the client to compare her figure with magazine photographs of women her age
B. Assigning the client to group therapy in which participants provide realistic feedback about her
weight
C. Confronting the client about her actual appearance during one-on-one sessions, scheduled during
each shift
D. Telling the client of the nurse’s concern for her health and desire to help her make decisions to
keep her healthy

64. Eighteen hours after undergoing an emergency appendectomy, a client with a reported history of
social drinking displays these vital signs: temperature, 101.6° F (38.7° C); heart rate, 126
beats/minute; respiratory rate, 24 breaths/minute; and blood pressure, 140/96 mm Hg. The client
exhibits gross hand tremors and is screaming for someone to kill the bugs in the bed. Nurse Melinda
should suspect:

A. A postoperative infection
B. Alcohol withdrawal
C. Acute sepsis.
D. Pneumonia.

65. Clonidine (Catapres) can be used to treat conditions other than hypertension. Nurse Sally is aware
that the following conditions might the drug be administered?
 A. Phencyclidine (PCP) intoxication
B. Alcohol withdrawal
C. Opiate withdrawal
D. Cocaine withdrawal

66. A female client is admitted with a diagnosis of delusions of grandeur.This diagnosis reflects a belief
that one is:
a.being killed b.highly famous and important
c.responsible for evil world d.connected to client unrelated to oneself

67. When a client’s hallucination becomes more insistent,demanding and difficult to ignore,the nurse
assesses his mental status as:
a.improving b.deteriorating
c.remaining the same d.showing more evidence of paranoia

68. A 23-year old has been admitted with a diagnosis of shizophrenia”Yes its march,march is little woman
”That’s literal you know”.These staments illustrate:
a.neologism b.echolalia
c.flight of ideas d.loosening of association

69. A nurse is caring for a client with delirium and states that”look at the spiders on the wall”.What
should the nurse respond to the client?
a.”You’re having hallucination,there are no spiders in this room at all”
b.”I can see the spiders on the wall,but they are not going to hurt you”
c.”would you like me to kill the spiders”
d.”I know you are frightened,but I do not see spiders on the wall”

70. Everything in the environment is somehow related to the person.A television news broadcast has a
special message for this person solely. What type of delusion describes this?
a.ideas of reference
b.somatic delusion
c.religious delusion
d.delusion of grandeur
71. 31.The client at the psychiatric ward says” I want to go home,go home and go home”.The nurse
would state this kind of unusual speech pattern of client with schizophrenia as:
a.neologism b.verbigeration
c.clang associations d.echolalia

72. .Shane who is very depressed exhibits psychomotor retardation,a flat affect and apathy.The nurse in
charge observes Shane to be in need of grooming and hygiene.Which of the ff. nursing actions would
be most appropriate?
 a.waiting until the client’s family can participate in the client’s care
b.asking the client if she is ready to take a shower
c.explaining the importance of hygiene to the client
d.stating to the client that it’s time for her to take a shower

73. It is the flow of unconnected words that convey no meaning to the listener
a.word salad b.loose associations
c.affect d.tangential thinking

74. It is wandering off the topic and never providing the information requested
a.word salad b.loose associations
c.affect d.tangential thinking
75. This involves unexplained usually sudden deficits in sensory and motor functions.
a.conversion disorder c.pain disorder
b.hypochondriasis d.body dysmorphic disorder
76. It is characterized by multiple physical symptoms and includes a combination of pain, GIT,sexual and
pseudoneurologig symptoms.
a.hypochondriasis c.somatization disorder
b.conversion disorder d.la belle indifference
77. It occurs when a person inflicts illness or injury on someone else to gain the attention of emergency
personnel.
a.factitious disorder c.munchausen syndrome by proxy
b.malingering d.body dysmorphic disorder
78. It includes people whose behavior appears odd and eccentric.
a.cluster A c.cluster C
b.cluster B d.cluster D
79. It is characterized by a persistent pattern of detachment from social relationships and a restricted
range of emotional expression in interpersonal settings.
a.paranoid personality disorder
b.shizoid personality disorder
c.dependent personality disorder
d.avoidant personality disorder
80. It is characterized by pervasive mistrust and suspiciousness of others.
a.shizotypal
b.paranoid personality disorder
c.dependent personality disorder
d.obsessive-compulsive personality disorder
81. Sublimation is a defense mechanism that helps the individual:
a.act out the opposite of one’s true feelings
b.engage in earlier mode of behavior
c.exclude from the conscious thoughts that causes anxiety
d.express unacceptable thoughts and wishes into socially approved behavior
82. An elderly client remarks to the nurse in of their interactions “I realized I have not been a good
husband and father.I wish I could turn back time and undo things.”The client has probably failed to
accomplish Erikson’s developmental task of:
a.autonomy vs. shame and doubt
b.identification vs. role diffusion
c.generativity vs. stagnation
d.ego integrity vs. despair
83. A middle aged patient says to the nurse”I don’t deserve to live”.The most therapeutic initial response
by the nurse would be:
a.continue to listen to the patient while maintaining direct eye contact
b.remain with the client until she states she feels better
c.say to the client”you sound depressed” and lean toward her
d.ask the patient what she means by”I don’t deserve to live”.
84. A patient tells the nurse”The group therapist does not like me”.Which of the ff. responses,if made by
the nurse,would be most therapeutic?
a.why do you say that?
b.I wouldn’t take it personally
c.would you like me to talk to the therapist for you
d.you need to discuss that concern with the therapist
85. A client has just began to discuss important feelings when the time of interview is up.The next day
when the nurse meets with client the agreed-upon time,the initial intervention would be to say:
a.”good morning ,how are you today”
b.”yesterday you were talking about some very important feelings.let’s continue”
c.”what would you like to talk about today”
d.nothing and wait for the client to introduce a topic
Abel,a 15 year old sophomore student visits the school clinic for complaints of insomnia,loss of
apetite,headache and poor concentration in class.

86. Abel reveals that he was in a vehicular accident during the final exam week in his freshman year.He
suffered minor injuries,but a young man in the other car died.Based on this information,the nurse
suspects that Abel is experiencing which one of the ff.?
a.phobic disorder c.post traumatic stress disorder
b.conversion disorder d.panic disorder
87. One of the ff. is a therapeutic approach most effective in helping Abel:
a.strengthening current coping mechanism
b.helping him to relax so he can concentrate in class
c.providing new mechanism
d.requesting the doctor to prescribe an antianxiety drug
88. Sullivan postulated that anxiety is:
a.an adaptive behavior
b.a result of unconscious psychic conflict
c.always perceived as a negative feeling
 d.interpersonal in origin
89. A technique that enhances communication is suggesting collaboration which is illustrated by one of
the ff. statements.
a.”You mean to say your life is worthless?”
b.”Perhaps you and I can discuss what causes your anxiety”.
c.”What have you been thinking of lately”
d.”I’m not sure I understand what you are saying”
90. Which of the ff. best explains why tricyclic antidepressants are used with caution in elderly patients?
a.CNS effects
b.cardiovascular effects
c.GIT system effects
d.serotonin syndrome effects
91. The nurse describes a client is anxious.Which of the ff. statement about anxiety is true?
a.it is usually pathological
b.it is directly observable
c.it is usually harmful
d.it is a response to threat
92. A client with phobia is treated with systemic desenzitisation.The nurse understands that this
approach will do which of the ff.?
a.help the client to execute actions that are feared
b.help the client develop insight into irrational fears
c.help the client substitute one’s fear for another
d.help the client decrease anxiety
93. Which client outcome would best indicate successful treatment for a client with an antisocial
personality disorder?
a.client exhibits charming behavior when around authority figures
b.client has decreased episodes of impulsive behaviors
c.client makes statements of self-satisfaction
d.client’s staements indicate no remorse for behaviors
94. Which of the ff. is the most distinguishing feature of a client with an antisocial personality disorder?
a.attention to detail and order
b.bizzare mannerisms and thoughts
c.submissive and dependent behavior
d.disregard for social and legal norms
95. Nurse Lourdes is caring for a female client who has suicidal tendency.When accompanying the client
to the restroom,Nurse Lourdes should:
a.give her privacy
b.allow her to urinate
c.open the window and allow her to get some fresh air
d.observe her
96. A male client is diagnosed with schizotypal personality disorder.Which signs would this client exhibit
during social situation?
 a.paranoid thoughts
b.emotional affect
c.independence need
d.aggressive behavior

97. A 39 year ols mother with obsessive-compulsive disorder has become immobilized by her elaborate
handwashing and walking rituals.Nurse Charisse recognizes that the basis of O.C. disorder is often:
a.problems with being too conscientious
b.problems with anger and remorse
c.feelings of guilt and inadequacy
d.feelings of unworthiness and hopelessness
98. Corazon with borderline personality disorder who is to be discharged soon threatens to “do
something” to herself if discharged.Which of the following actions by the nurse would be most
important?
a.ask a family member to stay with the client at home temporarily
b.discuss the meaning of the client’s statement with her
c.request an immediate extension for the client
d.ignore the client’s statement because it’s a sign of manipulation
99. Which of the ff. approaches would be most appropriate to a client suffering from narcissistic
personality disorder when discrepancies exist between what the client states and what actually
exists?
a.rationalization
b.supportive confrontation
c.limit setting
d.consistency
100. Cely is experiencing alcohol withdrawal exhibits tremors,diaphoresis and hyperactivity.BP is
190/70mmhg and pulse is 92bpm.Which of the medications would the nurse expect to administer?
a.naloxone(narcan) b.benztropin(cogentin) c.lorazepam(ativan) d.haloperidol
101. To establish open and trusting relationshipwith a female client who has been hospitalized with
severe anxiety,the nurse in charge should?
a.encourae the staff to have frequent interaction with the client
b.share an activity with the client
c.give client feedback about the behavior
102. When planning care for a female client using ritualistic behavior,the nurse must recognize that the
ritual:
a.helps the client focus on the inability to deal with reality
b.helps the client control anxiety
c.is under the client’s conscious control
d.is used by the client primarily for secondary gains
103. It is a sensitizing agent that causes an adverse reaction when mixed with alcohol in the body.
a.dopamine b.disulfiram c.levodopa d.amphetamines
104. It involves the unconscious emotional reaction that patients have in current situation that is
actually based on previous,even childhood,relationships and experiences.
a.transference b.counter transference c.denial d.manipulation
105. Nurse Carmela is aware that the therapy that has the highest success rate for people with
phobias would be:
a.psychotherapy
b.psychoanalytical exploration of repressed conflicts of an earlier development phase
c.systemic desensitization using relaxation technique
d.insight therapy to determine the origin of the anxiety and fear
106. Andy is admitted to the psychiatric unit with the diagnosis of borderline personality
disorder.Nurse Joy should expect 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
107. PROPANOLOL(INDERAL) is used in the mental health setting to manage which of the ff.
conditions?
a.antipsychotic-induced akathisia and anxiety
b.OCD –to reduce ritualistic behavior
c.delusions for clients suffering from psychosis
d.mood stabilizer
108. Which of the ff. statements should be included when teaching clients about MAOI
antidepressants?
a.Do not take aspirin or NSAIDS
b.have blood levels be screened for leukopenia
c.Avoid strenuous activity because of the cardiac effects of the drug
d.Do not take over the counter medications without consulting the doctor
109. Initial interventions for Marco with acute anxiety include all except which of the ff.?
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,private place
110. Nurse Charisse is assessing a client suffering from stress and anxiety.A common physiological
response to stress and anxiety is:
a.urticaria b.vertigo c.sedation d.diarrhea
111. When performing a physical examination on a female anxious client.Nurse Lourdes would expect to
find which of the ff. effects produced by the parasymphatetic system?
a.muscle tension b.hyperactive bowels c.decreased urine output d.constipation
112. Tony with agoraphobia has been symptom-free for 4 months.Classic signs and symptoms of phobia
include:
a.severe anxiety and fear b.withrawal and failure to distinguish reality from fantasy
c.depression and weight loss d.insomnia and inability to cocentrate
113. Jose who is receiving MAOI should avoid tyramine,a compound found in which of te ff. foods?
a.pigs and cream cheese b.fruits and yellow vegetables
c.aged cheese and chianti wine d.green leafy vegetables
114. Nurse Mara is assessing a client who has just been admitted to the ER.which signs would suggest
an overdose of an antianxiety agent?
a.suspiciousness,dilated pupils
b.agitation,hyperactivity,grandiose ideation
c.combativeness,sweating and confusion
d.emotional lability,euphoria and impaired memory
115. Discharge instructins for a male client receiving tricyclic antidepressants include which of the ff.
information?
a.restrict fluids and sodium intake
b.do not consume alcohol
c.discontinue if dry mouth and blurred vision occur
d.none of the above

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