family B. The nurse knows that being overweight is a major health hazard C.

The nurse wants to stop all the mainstream weightloss diets D. The nurse has to find out what people are eating 10. A young overweight adult smokes 5-10 sticks of cigarettes/day, ambitious, looks at life as challenging and perfect and never considers change in his lifestyle, initially needs: A. Commitment C. Skills to attempt change B. Information D. Motivation Situation - Bernie and John in their late 40s have been married for 20 years and at the peak of their careers. Suddenly, Bernie discovered that her husband was falling in love with another woman. Shaken by this situation, she started to have problems sleeping and could not function well at work and at the risk of losing her job. John asked forgiveness and regret very much the hurt his wife was going through and suffered guilt feelings: 11. Bernie and John are going through a: A. Situational crisis C. Anticipated crisis B. Developmental crisis D. Both developmental and situational crisis 12. All of these are characteristics of crisis EXCEPT: A. A hazardous or threatening event occurs b. It has a growth promoting potential c. Usual problem solving methods and coping mechanisms produce a solution d. Anxiety or depression continue to increase 13. The nurse employs this approach in crisis intervention: A. Problem-solving C. Role-playing B. Behavior modification D. Nurse-patient relationship 14. Assessment data of the nurse include all the following EXCEPT: A. Coping mechanisms C. Perception of the event B. Situational support D. Repressed problems 15. The duration of crisis usually lasts several days and usually: A. 2 4 weeks C. 1 2 months B. 1 2 weeks D. 4 6 weeks Situation - The community health nurse encounters special children in the community. 16. An individual with antisocial personality disorder lacks remorse, shame and guilt in going against the norms of society. Psychodynamically, this defect in the personality reflects a disturbance of the: A. Ego C. Ego ideal B. Super ego D. Id 17. The nurse teaches parents about childrens beginning concepts of right and wrong by emphasizing child rearing attitude and practices during the: A. School age C. Infancy period B. Toddler age D. Latency period 18. It is BEST for parents to teach healthy interpersonal relationships to their children by: A. Modeling to their children B. Encouraging their children to attend secondary school C. Encouraging their children at home to behave properly D. Teaching their children good manners and right conduct 19. An important principle for the nurse to follow in interacting with retarded children is:

NURSING PRACTICE V - SET B NURSING PRACTICE V Care of Clients with Physiologic and Psychosocial Alterations (Part C) Situation Felisa has a ritualistic pattern of constantly washing her hands with soap and water followed by rubbing alcohol. 1. The behavior is categorized as: A. Delusional B. Normal C. Neurotic D. Psychotic 2. A therapeutic intervention in this situation is: A. Avoid limits on her behavior to release her anxiety B. Call attention to her ritualistic pattern C. Provide alternative behaviors to deal with increased anxiety D. Ignore her behavioral totality 3. The anxiety of Felisa is disabling and interferes with her job performance. Interpersonal relationships and other activities of daily living. To minimize such problems, she is likely to be given: A. Diazepam (Valium) B. Haloperidol (Haldol) C. Imipramine HCL ( Tofranil) D. Chlorpromazine (Thorazine) 4. Felisa understands the effects of her medicine when expresses: A. I should watch out for signs of sore lips or sore throat B. I might have constipation C. I might feel changes in my body temperature D. I should not drive or operate machines 5. The level of anxiety that Felisa is experiencing is: A. Panic C. Mild B. Severe D. Moderate Situation - The nurse recognizes the need to learn to cope with stress and change. She becomes interested to practice natural ways to enhance well being. 6. Lifestyle modification begins with: A. Minimizing eating in fast food restaurants B. Having an exercise regimen to follow regularly C. Recognizing the impact of unhealthy habits D. Avoiding pollutants in the environment 7. All of these are the behavior intervention to stress management. EXCEPT: A. Guided imagery C. Meditation B. Pharmacotherapy D. Progressive muscle relaxation 8. Basic to progressive muscle relaxation is: A. Focusing on an image to relax B. Relaxing muscles from tension C. Use of industrial equipment D. Stopping disturbing thoughts 9. Dietary practices are very important to the health of the Filipino family. The nurse needs to assess this lifestyle because: A. The nurse wants to change the eating patterns of the Filipino

A. Seen that if the child appears contented, his needs are being met B. Provide an environment appropriate to their development task as scheduled C. Treat the child according to his chronological age D. Treat the child according to his developmental level 20. Mental retardation is: A. A delay in normal growth and development caused by an inadequate environment B. A lack of development of sensory abilities C. A condition of subaverage intellectual functioning that originates during the developmental period and is associated with impairment in adaptive behavior D. A severe lag in neuromuscular development and motor abilities Situation - As a professional, it is imperative that the nurse is accountable to oneself hence the importance of personal and professional development. 21. Nurse: I feel personally involved with my clients problems demonstrates: A. Counter transference C. Transference B. Empathy D. Sympathy 22. The nurse has achieved self-awareness in which of the following verbalizations? A. Every time people around me yell, I feel upset and withdrawn B. When the patient yelled at me I became speechless C. With the patients tone of voice and stare, I got reminded of how my father would be so angry and this made me anxious D. I thought it was rude for the patient to yell hence I kept quiet 23. An accepting attitude requires being: A. Aware of ones biases B. Tolerant of the faults of others C. Non judgmental D. In control of tendency to blame 24. Self-awareness, knowledge and understanding of human behavior and communication skills define what is essential in caring for every nurse to be able to demonstrate: A. Positive self-projection B. Assertiveness C. Therapeutic use of self D. Self-mastery 25. Considering that man is by nature social, it is BEST for the nurse to gain self-awareness by: A. Participating in intensive group experiences B. Individual psychotherapy C. Hypnotherapy D. Writing an autobiography for self introspection Situation Ninety year old Purita is confined at the medical unit for respiratory ailment for which a breathing apparatus is prescribed for her to use while she sleeps. She refuses to wear it continuously though she full understands the medical indication for it: 26. Which of these ethical principles can guide the nurse in her action? A. Beneficence B. Fidelity C. Autonomy D. Nonmaleficence 27. Purita has six children who are already adults. They differ in their opinion whether or not to allow their mother to decide for her. The nurse would encourage family conference for:

A. The eldest childs opinion to be given priority B. Majority of the children to decide C. Allowing the medical staff to decide in their behalf D. Consensus building 28. Breathing treatments are to be given to Purita. In anticipation that Purita might refuse. Dino, one of the children requests that he be the one to sign the consent in behalf of their mother. The nurse explains that Purita is rational in her thinking and which of this clients right must be regarding? A. Right to refuse treatment B. Right privacy C. Right to informed consent D. Right of habeas consent 29. Which of these would be the nurses priority following the treatment principle of least restrictive alternative? A. One of one staffing B. use of on site guard/watcher C. Physical restraint D. Seclusion

30. Purita talks about her joy in having responsible and accomplished children and recalls challenging career as a lawyer. She is demonstrating a sense of: A. Ego integrity B. Industry C. Generativity D. Autonomy Situation The supervising nurse received report that a staff nurse is displaying frequent irritation, anger and even indifference toward clients and co-workers. 31. The initial action of the supervisor would be to: A. Post guidelines on proper decorum of nurses in the bulleting board B. Write a memo of warning to the house C. Request anecdotal report form nurses co-workers D. Call the nurse for a one on one conference 32. The nurse expressed increasing feelings of dissatisfaction. The supervising nurse intervenes therapeutically by taking the role of: A. Administrator by relieving her of responsibilities B. Therapist by delving into the nurses internal conflict C. Counselor by actively listening D. Educator by reorienting her of her role as a nurse 33. Coupled with poor work performance, mental and physical fatigue and actual withdrawal from client contact and nursing duties, the nurse can be said to be suffering from: A. Psychotic anxiety B. Staff burnout C. Personality maladjustment D. Neurotic depression 34. A priority in the nurses personal development would be to: A. Address her physical well-being B. Boost her self-confidence C. Provide social support D. Help her find value and meaning in her work 35. The most relevant professional program for her would be: A. Assertiveness training B. Stress management C. Group dynamics and team building D. Behavior modification Situation A nurse assigned in the neurologic unit is taking of clients with varying degree of degenerative disorders. 36. Mr. A with myasthenia gravis is having difficulty speaking. What communication strategies should the nurse avoid when interacting with Mr. A? A. Repeating what the client says for better

understanding B. Using paper and pencil in communication with the client C. Encouraging the client to speak slowly D. Encouraging the client to speak quickly 37. When planning for nursing care for Mr. B who has Parkinsons disease. Which of the following goals would be most appropriate? A. To improve muscle tone B. To start rehabilitation as much as possible C. To treat the disease D. To maintain optimal body function 38. For the past 10 years. Alma, 42 years old has had multiple sclerosis Client with multiple sclerosis experience many different symptoms. As part of the rehabilitation planned for Alma, the nurse suggested therapy and hobbies to help her: A. Strengthen muscle coordination B. Establish routine C. Develop perseverance and motivation D. Establish good health habits 39. On his second day of hospitalization, Mr. Santos was unable to stand and is having difficulty swallowing and talking. Which of the following is the priority of the nurse in assisting Mr. Santos? A. To prevent bladder distention B. To prevent decubitus ulcer C. To prevent contracture D. To prevent aspiration pneumonia 40. The wife of a seventy two year old man with a diagnosis of Alzheimers disease begins to cry and tells the nurse, I could not understand my husband anymore. He has changed drastically. Which of the following responses of the nurse is MOST appropriate? A. The physician an the staff will make sure that your husband will be comfortable and safe here B. This has been a difficult time for you. Let us walk and find a quiet place where we can talk C. He will soon recover in this condition D. You need not worry, we are doing the best we could Situation Annie has a morbid fear of heights. She asks the nurse what desensitization therapy is: 41. The accurate information of the nurse the goal of desensitization is: A. To help he clients relax and progressively work up a list of anxiety provoking situations through imagery B. To provide corrective emotional experience through a oneto-one intensive relationship C. To help clients in a group therapy setting to take on specific roles and reenact in front of an audience, situations in which interpersonal conflict is involved D. To help client cope with their problems by learning behaviors that we are more functional and be better equipped to face reality and make decision 42. It is essential in desensitization for the patient to: A. Have rapport with the therapist B. use deep breathing or another relaxation technique C. Assess ones self for the need of an anxiolytic drug D. Work through unresolved unconsciousness conflicts 43. In this level of anxiety, cognitive capacity diminishes. Focus becomes limited and client experiences lurned vision. Physical signs of anxiety become more pronounced. A. Sever anxiety B. Panic C. Mild anxiety D. Moderate anxiety 44. Anti-anxiety medication should be used with extreme caution because long term use can lead to: A. Parkinsonian like syndrome

B. Hypertensive crisis C. Hepatic failure D. Risk of addiction 45. The nursing management of anxiety related with post traumatic stress disorder include all of the following, EXCEPT: A. Encourage participation in recreation or sports activities B. Reassurance clients safety while touching client C. speak in a calm soothing voice D. Remain with the client while fear level is high Situation The nurse is often met with the following situations when clients become angry and aggressive individual, the nurse should: 46. To maintain a therapeutic eye contact and body posture while inter-acting with angry and aggressive individual, the nurse should: A. Keep on eye contact while staring at the client B. Keep his/her hands behind his/her back or in ones pockets C. Fold his/her arms across his/her chest D. Keep an open posture, e.g. hands by sides but palms turned outwards 47. During the pre-interaction phase of the N-P relationship, the nurse recognizes this normal INITIAL reaction to an assultive or potentially assaultive person. A. To remain and cope with the incident B. Display empathy towards the patient C. To call for help from other members of the team D. To stay and fight or run away

48. Which of the following is an accurate way of reporting and recording an incident? A. When asked about his relationship with his father, client became anxious B. When asked about his relationship with his father, client clenched his jaw, teeth, made a fist and turned away from the nurse. C. When asked about his relationship with his father, client was resistant to respond D. When asked about his relationship with his father, his anger was suppressed 49. To encourage thoughts, which of the following approaches is NOT therapeutic? A. Why do you feel angry? B. When do you usually feel angry? C. How do you usually express anger? D. What situations provoke you to be angry? 50. A patient grabs and about to throw it. The nurse best responds saying: A. Stop! Put that chair down B. Dont be silly C. Stop! The security will be here in a minute D. Calm down Situation A vehicle hit some pedestrians while waiting for a bus ride. Some of the victims suffered injuries in different part of the body. The victims were brought to the nearby hospital. One of the victims, Josephine was confirmed to have a fractures left arm. While waiting or plaster cast to be applied, Josephine appears to be anxious. 51. To reduce anxiety, the nurse teaches the procedure to the client, which of the following topics should NOT be included in the teaching plan? A. Leave the cast uncovered to promote drying B. Bear weight on the plaster for one hour. A stockinet

will be placed over the left arm to be placed in cast C. Handle hardening cast with palm of hands D. Trim and reshape finish cast with knife or cutter 52. Cast was applied on Josephines left arm. In assessing the neurovascular status of the client, which of the following assessment findings should be reported to the physician? A. Pain on the left arm B. Swelling of the fingers C. Skin abrasion on the edges of the plaster cast D. Nail bed capillary refill time of 10 seconds 53. One of the victims a sixty year old woman sustained hip fracture. Prior to surgery, a Bucks extension traction is to be applied. The rationale of traction is primarily based on the understanding that Bucks extension traction: A. Reduces muscle spasms and helps to immobilize the fracture B. Allows reduction of the fracture site for bone healing C. Secures the fractures site to prevent damage to the muscle tissues D. Secures the fracture site for rigid immobilization 54. Philip was placed in skeletal leg traction with an overbed frame. He is not allowed to move from side to side. Which of the following nursing interventions is useful in maintaining: A. Assist the client by holding the trapeze and raising the hips off the bed B. Check the apparatus that weights hand free and knots in the rope are tied securely C. Suspend a trapeze within easy reach of the client D. Support the affected extremity while the weights are removed 55. To prevent complication when a child is in Bucks traction, the nurse should: A. Clean the extremity and keep the skin dry B. Assess any skin and circulatory disturbances C. Clean the pin sites as necessary D. Provide high fiber small meals 56. The following concept are true EXCEPT: A. Hostility is destructive B. Frustration develops in response to unmet needs, wants and desire C. Anger is incompatible with love D. Aggression can be expressed in a constructive as well as a destructive manner 57. Carlo is acting out hostile and aggressive feeling by kicking the chairs in the room, the MOST effective way to deal with Carlos behavior is initially to: A. Set limits on the behavior by verbal command B. Administer PRN tranquilizer C. Remove the chairs from the room D. Retrain the patient and place him in the Isolation Room 58. Mrs. Dizon was visiting her son at the Psychiatry Ward. Which of the following items will the nurse NOT allow to be brought inside the ward? A. String rosary bracelet B. Box of cake C. Bottle of Coke D. Rubber shoes 59. Which of the following will probably be most therapeutic for a patient on a behavioral modification ward? A. If the client is agitated, discuss the feelings especially anger B. Insist to stop obscene language by verbal reprimand C. Give client support and positive feedback for

controlling use of obscene language D. Provide a punching bag as an alternative to express upset emotions 60. Which of the following must be considered while planning activities for the depressed patient? A. Activities which require exertion of energy B. Challenging activities to get him out of his depression C. Structured activities that the client can participate D. Variety of unstructured activities Situation The nurse works with Mina to help her work through termination of the nurse- patient relationship. 61. Preparation for termination of the nurse-patient relationship begins during the: A. Termination phase B. Working phase C. Pre-orientation phase D. Orientation phase 62. Minas past reaction to ending relationships is withdrawal. The nurse assists her to practice better ways of coping termination by providing opportunities to: A. Test new patterns of behavior B. Plan for alternatives C. Conceptualize her problem D. Value and find meaning in experience 63. During the early part of the interaction, the nurse asked after a period of silence. Perhaps we would talk about leaving. The nurse utilized which communication technique: A. Encouraging B. Suggesting C. Focusing on client D. Understanding 64. The longest and the most productive phase of the NPR is: A. Termination phase B. Working phase C. Pre-orientation phase D. Orientation phase 65. The objection of the nurse-patient relationship is to provide an opportunity of the patient to: A. Clarify problems B. Develop insights C. Have a corrective emotional experience D. Develop interpersonal relationship Situation As a program manager: the mental health psychiatric nurse is tasked to provide general patient management. 66. The nurse is aware that identifying the aspects of general patient management and identifying interventions for meeting these basic needs are distinctions of: A. Psychotherapy B. Therapeutic milieu C. Pharmacotherapy D. Behavior therapy 67. In order to get active participation of the clients, to carry out the objective of the program is BEST for the nurse to conduct a/an: A. Community meeting B. Survey C. Observation D. Selective interviews of patients 68. Through the nurses role modeling of effective communication, the clients learned new ways of dealing with authority figures. This gives the clients a venue to: A. Communicate

B. Socialize C. Identify their problems D. Test new patterns of behavior 69. This element of communication facilities evaluation of the program: A. Receiver B. Message C. Sender D. Feedback 70. The nurses style of leadership in milieu therapy is: A. Autocratic B. Laissez-faire C. Democratic D. Benevolent Situation Loretta is a 28 years old, unemployed patient, admitted to the psychiatric unit with diagnosis of chronic undifferentiated schizophrenia. She described herself as the Virgin Mary and her mission is to propagate peace. She was observed laughing and talking to herself. Her thought processes were profoundly disorganized. She was also fearful and suspicious of others. 71. Lorettas claim of being the Virgin Mary is a/an: A. Imagination B. Delusion C. Hallucination D. Obsession 72. Her mission to propagate peace is: A. A serious call for a need of transformation B. An attempt to overcome low selfesteem C. Realistic and laudable D. An advocacy that she can participate in 73. Which of this intervention would NOT be therapeutic in decreasing Lorettas anxiety? A. Joke about her thought to help her feel at ease B. Listen to her thoughts and feelings C. Simply accept D. Do not convince her that her perception 74. The nurse evaluates that Lorettas ready for rehabilitation program when she: A. Approaches the nurse at frequent intervals B. Ceases to talk about Virgin Mary C. Goes to the coffee shop alone more often D. Carries a book The Purpose Driven Life

D. Develop and practice general coping skills 77. Social skills training is NOT primarily indicated for psychiatric patients who are: A. In acute stage of illness B. Having difficulties starting and maintaining interpersonal relationships C. Having chronic episodes of stress and anxiety while interacting with others D. Experiencing recurrence of symptoms in front of particular people or among people in general 78. The focus of the group interaction is here and now. An appropriate topic would be: A. Ways to celebrate Valentines Day in February B. How to spend the summer vacation C. An unforgettable experience as a child D. How to tell a joke 79. An appropriate technique for the participants to practice how to communicate effectively is through/a: A. Lecture B. Seminar C. Role play D. Psychodrama 80. Considering that it is BEST to learn example, it is MOST practical to A. Model good social skills throughout the session B. Relate successful past experiences C. Invite a resource person D. Watch a movie Situation Andy, 30 years old, was admitted to the Psychiatric Ward because of religious pre-occupation, deterioration in self-care and disturbed thoughts. He believes that he has committed a lot of sins. He is threatened by people reaching out to him. His fasting for several days was not sufficient for him to feel forgiven. 81. Andy is demonstrating. A. Religious delusion B. Delusion of grandeur C. Somatic delusion D. Delusion of being controlled 82. A delusion is: A. B. C. D. Psychomotor disturbance Mood disturbance Disturbance of thought Disturbance of perception

75. The nurse is leading a group meeting of patients to prepare them to be discharged. An appropriate goal for the group members is to develop: A. Attitudes of society towards the mentally ill B. Skills for maintaining daily living C. Awareness of interpersonal patterns of interactions D. Insight into personal problems Situation A group of adult chronic schizophrenic patient were recommended to undergo social skill training. 76. The following are the objectives of a social skills training program EXCEPT: A. Explore deep seated intrapsychic conflicts B. Practice skills in relating with people C. Help build self esteem and self confidence

83. The nursing goal for Andy is to: A. Have him see a priest for confession B. Encourage him to pray to atone for his sins C. Help him develop a positive self image D. Socialize him with a group to keep him in touch with reality 84. As Andy talks about his sins, that he believes make people look down upon him. It is BEST to: A. Agree with him and sympathize how sinful he ha really been B. Explore the nature of the sins C. Explain that he is depreciating himself too much D. Acknowledge how he feels and focus on reality oriented topics 85. Which of the following drugs will most likely decrease Andys hallucination? A. Chlorpromazine (Thorazine) B. Chlomipramine (Anafranil) C. Fluoxetine (Prozac) D. Carbamazepine (Tegretol)

86. Which of this client situation appropriately illustrate horticulture therapy? A. The therapist brings bongos, tambourine, and belis and encourages client participation B. Tommy, Karen, Jon and Pia play scrabble every night after supper C. Every afternoon, Vic goes in the garden where he work with plants, seedlings, tree planting and watering them D. Paul finds sketching relaxing and rewarding 87. The beginning professional nurse can do mental health counseling with the following clients, EXCEPT: A. Actively psychotic patients B. Out of school adolescents C. Parents with child rearing concerns D. School children with behavioral problem 88. A professional responsibility of the mental health psychiatric nurse is to provide a safe and therapeutic environment. This is BEST reflected in: A. Restraining patients who violates policies and do not follow schedule of activities B. Maintaining a closed door policy to prevent from absconding C. Keeping a restrictive environment to prevent patients from becoming assaultive and hostile D. Ensuring physical safety and maintaining therapeutic attitude towards the patients 89. The foundation of the therapeutic process is the therapeutic relationship. What is the essential component that the nurse must bring to the relationship? A. Humor B. Empathy C. Reframing D. Confrontation 90. Which of these people, the highest in population groups that would need priority mental health therapy? A. Adults going through active skills B. Simple elderly with no social support C. Young professionals entering the workplace D. Women preparing for overseas employment Situation The nurse observed that Marie, age 28 years old had not participating in activity therapies. 91. Which of the following remarks from the nursing attendants indicates a need to further teaching and observation? A. Marie made no response to an invitation to play B. Marie is aloof and indifferent to copatients C. Marie read a book while other patients played a ballgame

C. Ballgames should be limited to male patients only D. Age and needs of patients should be considered in the choice of game 93. To encourage active participation among patients, it is BEST to plan activities they can engage in through a: A. One to one interaction B. Community meeting C. Checklist D. Feedback evaluation forum 94. In planning activities for the patients, it is essential to consider FOREMOST: A. Safety and security B. Variety and fun C. Novelty and creativity D. Excitement and challenge 95. Adults, singing and acting like children is a form of: A. Displacement B. Regression C. Sublimation D. Compensation Situation Nursing care for elderly. 96. In planning care for a patient with Parkinsons disease, which of these nursing diagnoses should have priority? A. Potential for injury B. Altered nutritional state C. Ineffective coping D. Altered mood state 97. The frequent use of the older clients name by the nurse is MOST effective in alleviating which of the following responses to old age? A. Loneliness B. Suspicion C. Grief D. Confusion 98. An elderly who has lot of regrets, unhappy and miserable is experiencing? A. Crisis B. Despair C. Loss D. Ambivalence 99. The pre-morbid personality of an schizophrenic elderly client is: A. Schizoid B. Extrovert C. Ambivert D. Cycloid 100. Schizophrenia is a/an: A. Anxiety disorder B. Neurosis C. Psychosis D. Personality disorder

92. Marie said I dont like to be a part of it, Look, they are being laughed at because they are singing and acting like children. The nurse notes that in order for the activity therapy to be therapeutic: A. The staff should decide solely what activities to be done and what rules apply B. Patients should be allowed solely to decide what they want to do on their own