Psychiatric

Nursing Drills
Face it…
We are all
a little crazy sometimes
Face it…
We are all a little crazy sometimes
1. Jerry, a 19 year old college student
has an intense fear of elevators that he
would not even go near one. He states,
“It’s as if I will die inside. There is just no
escape”. The patient exhibits what type
of phobia?

a. agoraphobia
b. social phobia
c. claustrophobia
d. xenophobia
2. A client rushed in the emergency
department states, “It’s better for me to
die. There’s no more reason to live
anyway”. The nurse is assessing the client
to determine treatment recommendations.
The most important factor to consider is:

a. an active suicide plan and the means to

carry it out.
b. a previous suicide attempt.
c. the client's religion and social status.
d. social support and marital status.
3. In which of the following group of patients will
the nurse institute the highest suicide
precautions?
a.mother of 2 school-aged children, banker who
retires after 40 years, 16 year old with
schizophrenia
b.36 year old single woman, pre-school teacher
who received a pay rise, morbidly obese
diabetic client
c. HIV positive transexual, 22 year old female-
recently widowed, 55 year old carpenter who
got fired from his job
d. 19 year old leukemic patient, 17 year old
laundry woman and mother of 8 children, 1 year
old female with phenylketonuria
4. A nurse is caring for a client who is
suicidal. When accompanying the
client to the bathroom, the nurse
should:

a. give him privacy in the bathroom.

b. allow him to shave.
c. open the window and allow him to get
some fresh air.
d. observe him.
5. A 25-year-old man is in an acute manic
episode. The nurse knows that which client
behavior would be most characteristic of
mania?
a. Agitation, grandiose delusions, euphoria,
difficulty concentrating.
b. Difficulty in decision-making,
preoccupation with self, distorted
perceptions.
c. Paranoia, hallucinations, disturbed
thought processes, hypervigilance.
d. Fear of going crazy, somatic complaints,
difficulties with intimacy, increased
anxiety.
6. Agnes, a severely anorectic patient has
been caught sneaking in diet pills. The best
nursing approach would be?

a. Warn Agnes about the dangers of diet pills

b. Discuss patient’s fears and anxieties in
losing control and gaining weight
c. Discuss fears or worries generated in the
family about current health status
d. Confront the patient about the incident and
point out current state of illness
7. Lara, a 15 year old high school student was
diagnosed wit h anorexia nervosa. During her
progress assessment, she states "I just drank
juice for breakfast, so I don't want to weigh
today." The nurse responds:

a. "It is okay to postpone your weighing if you will

also eat some solid food to go with the juice for
breakfast."
b. "We can weigh you tomorrow instead. Don't
forget to wait before you eat breakfast, though."
c. "I will have to ask the team what to do in this
case and get back to you with the decision."
d. "It is weigh day today. Please step on the scale."
8. Leslie, age 17, used to be the most popular girl in
school although she is 10 lbs-overweight. She usually
hides her concern for her body image through her
amazing humor. Leslie has been recently diagnosed
with bulimia nervosa due to recurrent episodes of
binge-eating and purging. Which of the following
complications would be of primary concern to the
nurse?

a. Presence of Russell’s sign all over Leslie’s

knuckles
b. Erosion of the dental enamel from chronic,
repeated vomiting
c. Development of cardiac arrhythmias and
cardiomyopathy
d. Presence of menstrual irregularities
9. Rizza, who has always been woeful in
sports, excels in music, she can play four
different musical instruments and performs
music recitals all over the region. This
defense mechanism of covering up a
weakness by overemphasizing a desirable
trait is known as

a. Sublimation
b. Conversion
c. Compensation
d. Undoing
10.Leila, 20 year old schizophrenic female
states “Patay na ako. Dalawang linggo na
akong patay”. This statement is an
example of:

a. Somatic delusions
b. Nihilistic delusions
c. Delusions of influence
d. Paranoid delusions
11. Borderline Personality, which is categorized
under Cluster B (Dramatic, Erratic Emotional
Behaviors), is seen in which patient?
a. Jasmine:19-year old girl who likes to talk to
her stuffed animals and dresses like a
seven year old Disney Princess
b. Dexter:17-years old math Olympiad who is
obsessed with his academic performance
c. Judith: 35-year old prostitute who was
admitted to the Emergency Room 4 times
after attempting to kill herself with
acetaminophen.
d. Hazel:28-year old ex-convict wanted for
murder of three people and arson
12. Recurrent, intense, sexually arousing
fantasies, sexual urges or behaviors
involving exposing one’s own genitals to
unsuspecting strangers

a. Frotteurism
b. Exhibitionism
c. Voyeurism
d. Fetishism
13. Which of the following interventions is least
appropriate when caring for a schizophrenic
client with an active hallucination?

a. Allow patient to join in a group painting

activity
b. Explore content of the hallucination
c. Continuously orient hallucinating client to
reality and monitor for self-injurious acts
d. Turn off lights during to decrease
hallucinations and to provide a calm,
relaxing environment
14.This personality process that is
concerned with right and wrong
and provides the ego with an inner
control to cope with id is known
as?
a. Reality principle
b. Superego
c. Ego
d. Id
15. Armand, a chronic alcoholic has been
recently diagnosed with stage III
hepatocellular carcinoma. Instead of
submitting himself for chemotherapy and
radiation, Armand dismisses his diagnosis and
continues to drinks bottles of whiskey every
day. Armand’s refusal to acknowledge the
severity and presence of a problem is seen in
which defense mechanism?
a. Denial
b. Suppression
c. Repression
d. Rationalization
16. Benjo, a former basketball star who lost his
career because of cocaine addiction, is now
an active member of Drugs Anonymous. He is
also very active in information campaigns that
warn teenagers on the detrimental effects of
drug abuse. This defense mechanism is known
as?

a. Denial
b. Undoing
c. Compensation
d. Sublimation
17. Daniel, who was a former alcoholic, is
now an active member of Alcoholics
Anonymous. He is also very active in
information campaigns that warn teenagers
on the detrimental effects of alcohol. This
defense mechanism is known as?

a. Denial
b. Undoing
c. Compensation
d. Sublimation
18. Michael, an abusive husband to her wife is also a
chronic alcoholic who spends the entire day on
drinking sessions with his friends. When confronted
about his alcohol addiction, Michael would always
exhibit defensive behaviors. Which of the following
shoes denial in an alcoholic person?

a. “I have never even touched alcohol or opened a

bottle before”
b. I am an alcoholic and it’s my father’s fault, he was
an alcoholic too”
c. “I am a social drinker and there is no need for me
to go into rehab. I am in control of my drinking”
d. “My life has been destroyed by my drinking and I
think I need help”
19 Eleanor, 16 years old, has been a victim of
verbal abuse and harassment from her
alcoholic father. Her father has now been
placed on a rehabilitation program and
Eleanor also wishes to submit herself for
therapy. She should be referred to:

a. Alcoholics Anonymous
b. ALATEEN
c. Calix Society
d. Families Anonymous
20. The most common defense
mechanism used by alcoholics is:

a. Projection
b. Denial
c. Reaction Formation
d. Repression
21. A 16-year-old boy is admitted to the
health care facility after acting out his
aggressions inappropriately at school.
Predisposing factors to the expression of
aggression include:

a. violence on television,
b. passive parents
c. an internal locus of control
d. a single-parent family.
22. A husband and wife seek emergency crisis
intervention because he slapped her
repeatedly the previous night. The husband
says he grew up in a household in which his
father frequently abused his mother and him.
When intervening with this couple, the nurse
knows they're at risk for repeated violence
because the husband:

a. has only moderate impulse control.

b. denies feelings of jealousy or
possessiveness.
c. has learned violence as an acceptable
behavior.
d. feels secure in his relationship with his wife.
23. A nurse conducts a home visit on the
Ortega family. She suspects that wife and
children are victims of abuse. Which of the
following is most appropriate for the nurse
to ask?
a. “Is something bothering you?
b. “Are you frightened of your partner?”
c. “Are you being threatened or hurt by your
partner?”
d. “What happens when you and your partner
argue?”
24. The primary intervention for a victim
of child abuse is?

a. Assess the scope of the problem

b. Analyze family dynamics
c. Ensure the safety of the victim
d. Teach the victim coping skills
25. Which comment about a 3 year old child if
made by the parent may indicate child
abuse?
a. “When I tell my child to do something once,
I don’t expect to have to tell him twice”
b. My 3 year old loves to say “No”
c. It’s okay if my child wets his bed
sometimes
d. My child is learning how to dress and
undress himself
26. Before eating a meal, a client with obsessive-
compulsive disorder (OCD) must wash his
hands for 18 minutes, comb his hair using 444
strokes, and switch the bathroom light on and
off 44 times. What's the most appropriate
treatment goal for this client?

a. Omit one unacceptable behavior each day.

b. Increase the client's acceptance of
therapeutic drug use.
c. Allow ample time for the client to complete all
rituals before each meal.
d. Systematically decrease the amount of time
spent in — and the number of repetitions of
— rituals.
27.Marijoy, a single-mother of 6 children, who
works at a night club has been recently
diagnosed with AIDS. Upon receiving the
news, she states, “It’s impossible for me to
have AIDS! It just can’t be.” Marijoy is in
what stage of the grieving process?

a. Bargaining
b. Denial
c. Anger
d. Depression
28. . On one occasion Mr. Quel, a patient with
stage II osteosarcoma, says to the nurse,
“If I could just be free of pain for a few
days, I might be able to eat more and regain
strength.” In reference to the stages of
dying, the client indicates:

a. Rationalization
b. Frustration
c. Bargaining
d. Depression
29. This is a state in which two,
opposite, strong feelings exist
simultaneously.

a. Loose associations
b. Autism
c. Ambivalence
d. Paranoia
30. A patient is considered to exhibit labile
affect if he demonstrates which of the
following?

a. A quick change in emotional tone

b. An Inability to generate much affect
c. Inappropriate effect in relation to a
given situation
d. No affect at all
31.A person who is known to exhibit
eccentric behavior, ideas of reference,
magical thinking and paranoid ideation is
said to have which type of personality
disorder?

a. Schizoid personality
b. Schizotypal personality
c. Schizophrenia
d. Schizophreniform personality
32. Various medications are used in patients for
electroconvulsive therapy and the nurse must be
of well educate on the mechanisms of action and
side effects of these drugs in order to sustain
safety throughout the procedure. A competent
nurse knows that Atropine Sulfate is:
a. An ultra-short acting neuromuscular blocker
that prevents the musculoskeletal
complications from induced convulsions
b. An ultra-short barbiturate that induces a light
coma preceding delivery of ECT
c. A prototypical anticholinergic that inhibits
salivation and respiratory tract secretions to
prevent aspiration
d. Not used in ECT
33.The following are indications for
electroconvulsive therapy except

a. Major depression
b. Catatonic Schizophrenia, unresponsive
to medications
c. Attention Deficit Hyperactivity Disorder,
unresponsive to medications
d. Severe Mania
34. Nurse Badge washes his hands 30 times
with water and 30 times with alcohol before
and after touching any patient because he
is afraid to contract any possible disease .
This fear and preoccupation with
contamination is known as?
a. compulsion
b. obsession
c. obsessive-compulsive personality
d. obsessive-compulsive personality
disorder
2. A patient states that he hears voices telling
him that he is Superman and he should
jump off the building because he could fly.
This misperception is called

a. Delusion
b. Hallucination
c. Illusion
d. False Belief
JM, a 24 year old patient diagnosed with
disorganized schizophrenia was heard
responding to voices, saying, “What? From
the building? No! Leave me alone!” What
would be the nurse’s initial response?

a. “What are the voices telling you?”

b. “I know the voices seem real to you, but
you and I are the only people here”
c. “I know you are hearing voices and It
seems you are afraid. I will stay with you”
d. “Don’t worry, I hear the voices too”
2. Augustine, a patient with Major Depression
has been prescribed with Phenelzine (Nardil).
Which of the following will the nurse instruct
Augustine to avoid?

a. bologna, yogurt, banana and raisin cake

b. Cheddar cheese, roasted chicken, red wine
c. Beer, grilled pork, blueberry cheesecake
d. Mango shake, brown muffin, skim milk
Which of the following would be least helpful
in caring for a patient manifesting
disruptive, violent behavior?

a. Modify environment to minimize objects that

can be used as weapons
b. Decrease environmental stimuli and give prn
medication as needed
c. Set limits on disruptive behavior
d. Set opportunities to freely socialize with other
patients in the ward
• These refer to a person’s non-lethal self-
injurious acts that are often seen as a
person’s attention-seeking gestures

a. Suicide
b. Suicide gestures
c. Suicide attempts
d. Suicide threats
4.Linda is caring for a child Kevin, a 5 year
old child who was repeatedly raped by his
foster father. Nurse Linda uses Art
Therapy when she:
a. Gives the child a family of dolls
b. Asks him to verbalize his fears and anger
towards his father
c. Tells him he is a good boy for coming to
therapy on time
d. Gives his crayons and papers to draw a
story
Which of the following interventions will help
Augustine, a depressed patient develop a
positive self-concept?

a. Encourage the patient to join in a regional

chess competition to increase self-esteem
b. Have the patient sign a no-suicide contract
and put the patient on a suicide precaution
c. Praise the patient for being able to wash
dishes without any help
d. Administer antidepressants on scheduled
hours
Which of the following statements is not true
about sociocultural factors leading to anxiety
disorders?

a. Anxiety disorders are commonly seen in

high-technology societies.
b. There is higher incidence of anxiety
disorders in urban communities compared to
rural communities.
c. Women are more commonly diagnosed with
anxiety disorders except for Obsessive-
Compulsive Disorder wherein men are of
higher rates of developing OCD.
d. All of the above
2.
For patients with somatoform disorders
which type of drugs will be prescribed to
treat these disorders?

a) Anticonvulsants
b) Antidepressants
c) Antipsychotic
d) None of the above
2. The client, a veteran of the Vietnam War
who has posttraumatic stress disorder, tells
Nurse Kiko about the horror and mass
destruction of war. He states, “I killed all of
those people for nothing.” Which of the
following responses by Nurse Kiko is
appropriate?
a. “How many people did you kill?”
b. “Maybe you didn’t kill as many people as
you think.”
c. “War is a terrible thing.”
d. “You did what you had to do at that time.”
. A client diagnosed with Post Traumatic Stress
Disorder is readmitted for suicidal thoughts
and continued trouble sleeping. She states
that when she closes her eyes, she has vivid
memories about being awakened at night. “My
dad would be on top of me trying to have sex
with me. I couldn’t breathe.” Which of the
following suggestions would be inappropriate
for the nurse to make for the insomnia?
a. Listening to calming music as she tries to fall
asleep.
b. Processing the content of her flashbacks no
less than hour before bedtime
c. Taking the quetiapine (Seroquel) 25 mg as
needed as ordered by the physician.
d. Trying relaxation techniques to help
decrease her anxiety before bedtime.
2. . The spouse of a patient who experiences
generalized anxiety and frequent panic
attacks asks what is causing the problem.
The best explanation for the nurse to give
is that he problem might lie with an
imbalance between:

A. Serotonin and Dopamine

B. Dopamine and GABA
C. Glutamate and Acetylcholine
D. GABA and Glutamate
2. Brenton, a 13 year old child exhibits
extreme angry outbursts and manipulative
behavior. He is always involved in gang
fights and is suspected to be stealing tires
from the neighborhood. Brenton manifests
sign of which child disorder?

a. Autism
b. Conduct Disorder
c. Oppositional Defiant Disorder
d. Attention-Deficit Hyperactivity Disorder
2. Attention Deficit Hyperactivity Disorder is
characterized by its three hallmark symptoms
which are Inattention, Hyperactivity and
Impulsivity. All of these behaviors show
Inattention, except

a. Difficulty sustaining concentration in tasks

or play
b. Does not seem to listen to what is being
said
c. Had difficulty waiting in lines or awaiting
turn
d. Has difficulties with organizing tasks
2. Eleanor, 16 years old, has been a victim of
verbal abuse and harassment from her
alcoholic father. Her father has now been
placed on a rehabilitation program and
Eleanor also wishes to submit herself for
therapy. She should be referred to:

a. Alcoholics Anonymous
b. ALATEEN
c. Calix Society
d. Families Anonymous
Eleanor, 16 years old, has been a victim of
verbal abuse and harassment from her
alcoholic father. Her father has now been
placed on a rehabilitation program and
Eleanor also wishes to submit herself for
therapy. She should be referred to:

a. Alcoholics Anonymous
b. ALATEEN
c. Calix Society
d. Families Anonymous
2. The client, a veteran of the Vietnam War
who has posttraumatic stress disorder, tells
Nurse Kiko about the horror and mass
destruction of war. He states, “I killed all of
those people for nothing.” Which of the
following responses by Nurse Kiko is
appropriate?
a. “How many people did you kill?”
b. “Maybe you didn’t kill as many people as
you think.”
c. “War is a terrible thing.”
d. “You did what you had to do at that time.”
2. The client, a veteran of the Vietnam War
who has posttraumatic stress disorder, tells
Nurse Kiko about the horror and mass
destruction of war. He states, “I killed all of
those people for nothing.” Which of the
following responses by Nurse Kiko is
appropriate?
a. “How many people did you kill?”
b. “Maybe you didn’t kill as many people as
you think.”
c. “War is a terrible thing.”
d. “You did what you had to do at that time.”
2. The client, a veteran of the Vietnam War
who has posttraumatic stress disorder, tells
Nurse Kiko about the horror and mass
destruction of war. He states, “I killed all of
those people for nothing.” Which of the
following responses by Nurse Kiko is
appropriate?
a. “How many people did you kill?”
b. “Maybe you didn’t kill as many people as
you think.”
c. “War is a terrible thing.”
d. “You did what you had to do at that time.”