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Question 1

WRONG

If a client is a chain smoker, how should his medication dosage be


adjusted?
Same medication dose
Increase the dose
Decrease the dose
Withhold the dose

Question 1 Explanation:
Smoking cigarettes increases the metabolism of some
psychiatric medications, thus, medication dose should be
increased.

The 12-year old male patient looks like the nurses younger
brother who is missing for years. During assessment and in the
implementation of nursing care the nurse prioritizes this client.
One day, when she found the boy crying in his room she hugged
him and cried with him. This is an example of:
Counter-transference
Transference
Resistance
Denial

Question 2 Explanation:
When the nurse displays affection or emotion toward the
client counter-transference is occurring. Transference is
observed when the patient is displaying emotions
towards the nurse.

A schizophrenic client is under your care. In reinforcing the


functional behavior of this client what will the nurse do?
Enumerate the symptoms of schizophrenia to the
client
Correct delusional thoughts to orient to reality
Compliment the client for cessation of acting
out behaviors
Encourage the client to drink his medications
religiously

Question 3 Explanation:
According to B.F. Skinners behavior medication
technique, a client should be praise for good behaviors to
help him modify his faulty actions.

Restraints are only used for a certain reason. Which of the


following is an appropriate reason for placing a client in
restraints?
Punishment for stealing the other clients things
Self- harming behaviors
Verbal abuse
Not drinking medications

Question 4 Explanation:
One the patient attempts to harm himself, restraints is
acceptable.
The appropriate therapeutic distance between you and a
psychiatric patient is?
12 inches
35 inches

12 feet
4 feet

Question 5 Explanation:
Intimate zone: 0-18 inches. Parents with young children,
people who mutually desire personal contact, or people
whispering. Personal zone: 18-36 inches. Between family
and friends talking. Social zone: 4-12 feet.
Communication in social, work and business settings.
Public zone: 12-25 inches. Speaker and an audience.
Therapeutic distance: 3-6 feet.

Nurse Anna is instructing the new nurse to the psychiatric set-up.


She also reminded her to use her therapeutic communication
skills in dealing with clients. Which of the following techniques
enlaces therapeutic communication?
What are you thinking about?
What made you think that way?
Why did you say that?
Lets not talk about that. What do you think?

Question 6 Explanation:
This is using the therapeutic technique BROAD OPENING
that allows the client to take the initiative to introduce a
topic.
When the client told the nurse that he feels good when he
mutilates or cuts himself the novice psychiatric nurse answered,
Do you know the risks involved when you cut yourself? what
type of nontherapeutic communication is the nurse using?
Defending

Testing
Making stereotyped comments
Disagreeing

Question 7 Explanation:
Testing is appraising a clients degree of insight such as
by asking the patient of the risks involved when he cut
himself. This forces the client to recognize his problems.
Defending is attempting to protect someone from a
verbal attack. Stereotyped comments are meaningless
clichs such as its for your own good.
A therapy that assists with discharge planning and rehabilitation,
focusing on vocational skills and activities of daily living (ADL) to
raise self-esteem and promote independence is called:
Behavior modification
Milieu therapy
Recreational therapy
Occupational therapy

Question 8 Explanation:
Occupational therapy - Assists with discharge planning
and rehabilitation, focusing on vocational skills and
activities of daily living (ADL) to raise self-esteem and
promote independence.
A client was brought to the ER. Based on the significant others,
the client had a history of shop stealing. However, no selfmutilating activities are committed by the client. During the
interview, the client is very manipulative and aggressive and
impulsive. What personality disorder most likely the client has?
Antisocial
Histrionic

Narcissistic
Borderline

Question 9 Explanation:
Antisocial P.D is characterized by aggression,
manipulation and impulsivity. Histrionic people are
emotional, dramatic and theatrical. Narcissistic people
are boastful, egotistical and have superiority complex.
Borderline PD is characterized by impulsivity, selfdestruction and very unstable mood.

Mr. Juan is diagnosed with Alzheimers disease. The nurses


intervention should focus on helping the client be oriented with the
physical set-up and daily events. Which of the following is the
most effective nursing intervention in orienting patients who has
Alzheimers disease?
Encourage the client to talk to family members to
reminisce things
Provide simple and easily understood
directions
Perform tasks with a variety of activities each day
Have the client socialize with other patients

Question 10 Explanation:
Providing a daily routine and directions easily understood
by the client would help orienting a client with
Alzheimers disease.
The client is sharing Nurse Marie about his experiences.
Suddenly, he paused, looked to the nurse and is hesitant to
continue. The nurse responded, Go on, and tell me about it.
What therapeutic communication technique is the nurse using?

Exploring
Focusing
Encouraging expression
General leads

Question 11 Explanation:
General leads indicate that the nurse is listening and
following what the client is saying without taking away
the initiative for the interaction. They also encourage the
client to continue if he or she is hesitant or uncomfortable
of the topic. Examples include, Go on, Tell me about
it, and And then?
A therapy that focuses on the remotivation of clients by directing
their attention outside themselves to relieve preoccupation with
personal thoughts, feelings, and attitudes is known as:
Pharmacologic therapy
Music therapy
Occupational therapy
Recreational therapy

Question 12 Explanation:
Recreational therapy- Focuses on remotivation of clients
by directing their attention outside themselves to relieve
preoccupation with personal thoughts, feelings, and
attitudes. Clients learn to cope with stress through
activity. Activities are planned to meet specific needs and
encourage the development of leisure-time activities or
hobbies. Recreational therapy is especially useful with
those people who have difficulty relating to others (e.g.,
the regressed, withdrawn, or immobilized person).
Examples of recreational activities include group bowling,
picnics, sing-along, and bingo.

To ensure that your client knows about the procedure, risks and
outcome and has been informed of the other alternative therapy.
Which of the following must be accomplished?
A signed informed consent by a clients family
member
A signed informed consent by a 23-year old
client who has voluntarily admitted himself in
the unit
A signed informed consent of a 23-year old clients
parent
A signed informed consent by a 17-year old client

Question 13 Explanation:
Clients of legal age can sign an informed consent.
The Distance that is observed when family members or friends
are talking is under what zone:
Intimate
Therapeutic
Personal
Social

Question 14 Explanation:
Personal zone: 18-36 inches. Between family and friends
talking. Intimate zone: 0-18 inches. Parents with young
children, people who mutually desire personal contact, or
people whispering. Social zone: 4-12 feet. Communication
in social, work and business settings. Therapeutic
distance: 3-6 feet.

In using a therapeutic communication technique interpreting client


cues and signals is very important. Clear statements of intent
such as the client saying that he wants to kill himself is a/an:
Covert cues
Abstract messages
Concrete messages
Overt cues

Question 15 Explanation:
Overt cues are clear statements of intent such as the
client saying, I want to die. Covert cues are vague or
hidden messages such as if a client verbalizes, No one
can help me. Abstract messages are unclear patterns of
words that often contain figures of speech that are
difficult to interpret. Example is when the nurse asked the
client, What are you doing here? Concrete messages
are patterns of words that the nurse uses where words
are explicit and does need an explanation.
A client is scheduled for an electroconvulsive therapy (ECT).
Which of the following medications can be given to the client
before the procedure?
Atropine
Epinephrine
Hydralazine
Phenobarbital

Question 16 Explanation:
Before ECT atropine can be given to the client to
decrease oral and respiratory function thereby preventing
risks of aspiration. Atropine is antiarrythmic and at the
same time an anticholinergic medication.

An 18 year old client is brought to the ER due to a suicidal


attempt. Her mother told the nurse that she has been drinking
alcohol for the last 3 weeks and is depressed. In caring for this
patient what is the most important consideration?
Administering antidepressant medications
Alcohol detoxification
Allowing the client to participate in a therapy
Close monitoring

Question 17 Explanation:
Safety is the most important consideration in client with a
suicidal attempt. This is achieved by removing harmful
objects around the client and monitoring the client
closely.
The client says that he is hearing voices. What is nurses initial
response?
I dont hear any voices.
From where are those voices coming from?
What are the voices telling you?
Are you sure about that?

Question 18 Explanation:
Initially the nurse has to assess what the voices are
telling the client to promote safety. Because if the voices
are telling the client to kill himself or someone safety
precautions must be implemented.

Nurse Marie is caring for a patient that underwent alcohol


detoxification. Which of the following symptoms would Nurse
Marie be most concern?
Fever
Delusions
Excessive sweating
Increase BP

Question 19 Explanation:
Once hallucinations and delusions are present; the
clients condition will most likely progress to delirium
tremens.
In a therapeutic communication, why questions are discouraged.
For what reason is this question not useful?
The question is intimidating and the client
may be defensive in trying to explain
him/herself.
It forces the client to recognize his or her problems.
The clients acknowledgement that s/he doesnt
know things may be helpful to the nurses needs
but not the client.
It indicates that the client is right rather than
wrong.
It tends to make the client used and invaded.

Question 20 Explanation:
Using why question is asking to client the client to
provide reasons for thoughts, feeling and behaviors. The
question is intimidating and the client may be defensive
in trying to explain him/herself.
If a client is on restraints which of the following would the nurse
do?

Leave the client in the room for the whole 8 hours


Do not allow the client to eat
Take pictures of the client for evaluation
Monitor the extremity circulation

Question 21 Explanation:
When a client is placed on restraint, monitor the
circulation to prevent physiologic damage of the
extremity.
What is the most important criteria that must be accomplished by
the nurse before dealing with psychiatric patients?
Salary rate
Self-awareness
Self-understanding
Standard of nursing practice

Question 22 Explanation:
Before a nurse can understand him/herself, being aware
of what his/her strengths, weaknesses, limitations, belief
and principles is very essential. A nurse who barely knows
and understand herself cannot effectively establish a
therapeutic communication with psychiatric clients.
Your patient is very dependent and submissive. There are times
that the patient is very clingy. This behavior reflects what type of
personality disorder?
Antisocial personality
Dependent Personality
Manic behavior
Anxiety disorder

Question 23 Explanation:
Dependent personality is characterized by dependence,
submission and being clingy. Antisocial personality is
impulsive, aggressive and manipulative.

A client was admitted due to self-mutilation. One day during one


of the sessions, the client told the nurse that cutting himself feels
great. What would be the nurses best response?
Do you know the risks involved when you cut
yourself?
I dont want to hear about that!
The behavior of cutting is not acceptable.
Tell me more about that.

Question 24 Explanation:
Presenting reality is the best in this situation as it is
obvious that the client is misinterpreting the reality.
Asking the client to tell the nurse more about is validating
the actions of cutting himself.
A behavior that can indicate the speakers thoughts, feelings,
needs and values that he or she acts out unconsciously is called:
Verbal communication
Communication
Nonverbal communication
Congruent message

Question 25 Explanation:
Nonverbal communication is the behavior that
accompanies verbal content such as body language, eye
contact, facial expression, tone of voice, speed and

hesitations in speech, grunts and groans and distance


from the listeners. This type of communication can
indicate the speakers thoughts, feelings, needs and
values that he or she acts out unconsciously.