Professional Documents
Culture Documents
When asked
about his family, he states he has been married four times. He says three of those marriages were
"shotgun" weddings. He states he never really loved any of his wives. He doesn't know much about his
three children. "I've lost track," he states.
1. If a patient is very resistant in taking responsibility of his action and asks, "Can you just give me
some medication?" the best response is:
2. The patient asks the nurse, "What is this therapy for anyway. I just don't understand it." the best
reply is:
4. In planning care for the patient with a personality disorder, the nurse realizes that this patient will
most likely:
5. The person with an antisocial personality is participating in therapy while a patient at a psychiatric
hospital. The nurse’s expectations are that he will:
6. One of the reasons that persons with antisocial personalities may marry repeatedly or get into
trouble with legal authorities is:
a. Bipolar disorder
b. Alcoholic personality
c. Antisocial personality
d. Borderline personality
Situation: The patient with bipolar disorder is pacing continuously and is skipping meals.
8. Blood levels are drawn on the patient who has been taking Lithium for about six months. The
present level is 2.1 meq/L. The nurse evaluates this level as:
a. Therapeutic
b. Below therapeutic
c. Potentially dangerous
d. Fatally toxic
10. The most recent Lithium level on bipolar patient indicates a drop non-therapeutic level. What
associated behavior does the nurse assess?
a. Ataxia
b. Confusion
c. Hyperactivity
d. Lethargy
12. The physician orders Lithium carbonate for the bipolar patient. The nurse is aware that:
Situation: Anna, 25 years old was raped six months ago states, "I just can't seem to get over this. My
husband and I don't even have sex anymore. What can I do?"
14. Supportive therapy to the rape victim is directed at overwhelming feeling that the victim
experiences just after the rape has occurred?
a. Guilt
b. Rage
c. Damaged
d. Despair
15. Anna asks, "Why do I need to have pelvic exam?" The nurse explains:
16. In providing support therapy, the nurse explains that rape has nothing to do with sexual desires or
heeds. The two most common elements in rape are:
17. The rape victim will not talk, is withdrawn and depressed. The defensive mechanism being used is:
a. Rationalization
b. Denial
c. Repression
d. Regression
18. The composite picture of rape victim reveals that most victimized women are:
a. Secretaries
b. Elderly
c. Students
d. Professionals
Situation: Obsessions are recurring thoughts that become prevalent in the consciousness and may be
considered as senseless or repulsive white compulsion are the repetitive acts that follow obsessive
thoughts.
20. To understand the meaning of the cleaning rituals, the nurse must realize:
21. Upon admission to the hospital the patient increases the ritual behavior at bedtime. She cannot
sleep. The treatment plan should include:
22. A patient has been diagnosed with a personality disorder with .compulsive traits. Of the following
behavior's, which one would you expect the patient to exhibit?
23. The patient will not be able to stop her compulsive washing routines until she:
24. A 48-year-old female patient is brought to the hospital by her husband because her behavior is
blocking her ability to meet her family's needs. She has uncontrollable and constant desire to scrub
her hands, the walls, floors and sofa. She keeps repeating," Everything is dirty." This is an example of:
a. Compulsion
b. Obsession
c. Delusion
d. Hallucination
25. The female patient is preoccupied with rules and regulations. She becomes upset if others do not
follow her lead and adhere to the rules exactly. This is a characteristic of which of the following
personality?
a. Compulsive
b. Borderline
c. Antisocial
d. Schizoid
26. In planning care focused on decreasing the patient's anxiety, what plan should the nurse have in
regards to the rituals?
27. After the patient entered the hospital she began to increase her ritualistic hand washing at
bedtime and could; not sleep. The nurse plans care around the fact that this patient needs:
28. The patient states, "I know all this scrubbing is silly but I can’t help it:'', this statement indicates
that the patient does not recognize:
29. The nurse is monitoring a drug abuser who states he was given cocaine and heroine that war cut
with cornstarch or some other kind of powder. He states, "It was really bad stuff." Which complication
is most threatening to this patient?
a. Endocarditis
b. Gangrene
c. Pulmonary abscess
d. Pulmonary embolism
30. The chronic drug abuser is suffering lymphedema in all extremities, but particularly in the arm
where the drug was obviously injected. There is severe obstruction of veins and lymphatics. The nurse
suspects the patient used:
31. The nurse is assessing a heroin user who injected the drug into an artery instead of a vein. Which
complication is the nurse most likely to expect?
a. Infection
b. Cardiac dysrhythmias
c. Gangrene
d. Thrombophlebitis
32. The nurse is assessing a 16-year-old patient for drug abuse. The patient is incoherent. Because she
notes irritation of eyes, nose and mouth, she suspects inhalants. Which sign is most indicative of
inhalant abuse?
a. Vomiting
b. Bad breath
c. Bad trip
d. Sudden fear
33. An impaired nurse has been admitted for treatment of Demerol addiction. She asks, "When will
the withdrawal begin?" the best response is:
34. The patient has a blood pressure of 180/100, heart rate of 120, associated with extreme
restlessness. He is very suspicious of the hospital environment and actions of healthcare workers. The
nurse should confront this patient on abuse of;
a. Marijuana
b. Cocaine
c. Barbiturates
d. Tranquilizers
35. The nursing interventions most effective in working with substance dependent patients are:
36. An adolescent patient has bloodshot eyes, a voracious appetite (especially for junk foods), and a
dry mouth. Which drug of abuse would the nurse most likely suspect?
a. Marijuana
b. Amphetamines
c. Barbiturates
d. Anxiolytics
Situation: Defense mechanisms are unconscious intrapsychic process implemented to cope with anxiety.
The use of some of these mechanisms is healthy, while she use of others is unhealthy.
37. A patient cries and curls in a fetal position refusing to move or talk. This is an example of:
a. Regression
b. Suppression
c. Conversion
d. Sublimation
38. A person who expands sexual energy in a nonsexual, socially accepted way is using the coping
mechanism of.
a. Projection
b. Conversion
c. Sublimation
d. Compensation
39. "The reason I did not do well on the exam is that I was tired." This is an example of:
a. Rationalization
b. Projection
c. Compensation
d. Substitution
40. An unattractive girl becomes a very good student. This is an example of:
a. displacement
b. Regression
c. Compensation
d. Projection
41. A patient has been sharing a painful experience of sexual abuse during his childhood. Suddenly he
stops and says, “l can't remember any more." The nurse assesses his behavior as:
a. Stubbornness
b. Forgetfulness
c. Blocking
d. Transference
42. The patient has a phobia about walking down in dark halls. The nurse recognizes that the coping
mechanism usually associated with phobia is:
a. Compensation
b. Denial
c. Conversion
d. Displacement
43. The patient is denying that he is an alcoholic He states that his wife is an alcoholic. The defense
mechanism he is utilizing is: v
a. Sublimation
b. Projection
c. Suppression
d. Displacement
Situation: Ms. Dwane, 17 years old, is admitted with anorexia nervosa. You have been assigned to sit
with her while she eats her dinner. Ms. Dwane says "My primary nurse trusts me. I don't see why you
don't."
44. Which observation of the client with anorexia nervosa indicates the client is improving?
45. The nurse is caring for a client with anorexia nervosa who is to be placed on behavioral
modification. Which is appropriate to include in (he nursing care plan?
a. Remind the client frequently to eat all the food served on the tray
b. Increased phone calls allowed for client by one per day for each pound gained
c. Include the family of the client in therapy sessions two times per week
d. Weigh the client each day at 6:00 am in hospital gown and slippers after she voids
46. A nursing intervention based on the behavior modification model of treatment for anorexia
nervosa would be:
47. While admitting Ms. Dwane, the nurse discovers a bottle of pills that Ms. Dwane calls antacids.
She takes them because her stomach hurts. The nurse's best initial response is:
48. The primary objective in the treatment of the hospitalized anorexic client is to:
50. The nurse is monitoring a patient who is experiencing increasing anxiety related to recent
accident. She notes an increase in vital signs from 130/70 to 160/30, pulse rate of 120, respiration 36.
He is having difficulty communicating. His level of anxiety is:
a. Mild
b. Moderate
c. Severe
d. Panic
51. The patient who suffers panic attacks is prescribed a medication for short-term therapy. The nurse
prepares to administer.
a. Elavil
b. Librium
c. Xanax
d. Mellaril
52. In attempting to control a patient who is suffering panic attack, the nursing priority is:
a. Provide safely
b. Hold the patient
c. Describe crisis in detail
d. Demonstrate ADLs frequently
53. Which assessment would the nurse most likely find in a person who is suffering increased anxiety?
54. A patient who suffers an acute anxiety disorder approaches the nurse and while clutching at his
shirt states "I think I'm having a heart attack." The priority nursing action is:
a. Reassure him he is OK
b. Take vital signs stat
c. Administer Valium IM
d. Administer Xanax PO
56. Another client walks in to the mental health outpatient center and States, "I've had it. I can't go on
any longer. You've got to help me. "The nurse asks the client to be seated in a private interview room.
Which action should the nurse take next?
57. Mr. Juan is admitted for panic attack. He frequently experiences shortness of breath, palpitations,
nausea, diaphoresis, and terror. What should the nurse include in the care plan for Mr. Juan? When
he is shaving a panic attack?
58. Ms. Wendy is pacing about the unit and wringing his hands. She is breathing rapidly and complains
of palpitations and nausea, and she has difficulty focusing on what the nurse is saying. She says she is
having a heart attack but refuses to rest. The nurse would interpret her level of anxiety as:
a. Mild
b. Moderate
c. Severe
d. Panic
59. When assessing this client, the nurse must be particularly alert to:
a. Restlessness
b. Tapping of the feet
c. Wringing of the hands
d. His or her own anxiety level
Situation: Raul aged 70 was recently admitted to a nursing home because of confusion, disorientation,
and negativistic behavior. Her family states that Raul is in good health. Raul asks you, "Where am I?"
60. Another patient, Mr. Pat, has been brought to the psychiatric unit and is pacing up and down the
hall. The nurse is to admit him to the hospital. To establish a nurse-client relationship, which approach
should the nurse try first?
61. If Raul will say "I'm so afraid! Where I am? Where is my family'?" How should the nurse respond?
a. "You are in the hospital and you're safe here. Your family will return at 10 o'clock, which is one hour
from now"
b. "You know were you are. You were admitted here 2 weeks ago. Don’t worry your family will be back
soon."
c. "I just told you that you're in the hospital and your family will be here soon."
d. "The name of the hospital is on the sigh over the door. Let's go read it again."
62. Raul has had difficulty sleeping since admission. Which of the following would be the best
intervention?
63. Which activity would you engage in Raul at the nursing home?
a. Reminiscence groups
b. Sing-along
d. Discussion groups
c. Exercise class
64. Which of the following would be an appropriate strategy in reorienting a confused client to where
her room is?
Situation: The police bring a patient to the emergency department. He has been locked in his apartment
for the past 3 days, making frequent calls to the police and emergency services and stating that people
are trying to kill him.
66. A client on an inpatient psychiatric unit refuses to eat and states that the staff is poisoning her
food. Which action should the nurse include in the client's care plan?
67. The client tells the nurse that he can't eat because his food has been poisoned. This statement is
an indication of which of the following?
a. Paranoia
b. Delusion of persecution
c. Hallucination
d. Illusion
68. The client on antipsychotic drugs begins to exhibit signs and symptoms of which disorder?
a. Akinesia
b. Pseudoparkinsonism
c. Tardive dyskinesia
d. Oculogyric crisis
69. During a patient history, a patient state that she used to believe she was God. But she knows this
isn't true. Which of the following would be your best response?"
a. "Does it bother you that you used to believe that about yourself?"
b. "Your thoughts are now more appropriate"
c. "Many people have these delusions."
d. "What caused you to think you were God?"
70. The nurse is caring for a client who is experiencing auditory hallucination. What would be most
crucial for the nurse to assess?
71. A patient with schizophrenia reports that the newscaster on the radio has a divine message
especially for her. You would interpret this as indicating.
a. Loose of associations
b. Delusion of reference
c. Paranoid speech
d. Flight of ideas
Situation: Helen, with a diagnosis of disorganized schizophrenia is creating a disturbance in the day
room. She is yelling and pointing at another patient, accusing him to stealing her purse. Several patients
are in the day room when this incident starts.
73. The nurse is preparing to care for a client diagnosed with catatonic schizophrenia. In anticipation
of this client's arrival, what should the nurse do?
a. Notify security
b. Prepare a magnesium sulfate drip
c. Place a specialty mattress overlay on the bed
d. Communicable the client's nothing-by-mouth status to the dietary department
74. The nurse is caring for a client whom she suspects is paranoid. How would the nurse confirm this
assessment?
a. indirect questioning
b. Direct questioning
c. Les-ad-in-sentences
d. Open-ended sentences
a. Delusions
b. Disorganized speech
c. Flat affect
d. Catatonic behavior
76. The patient tells you that a "voice" keeps laughing at him and tells him he must crawl on his hands
and knees like a dog. Which of the following would be the most appropriate response?
a. "They are imaginary voices and we're here to make them go, away."
b. "If it makes you feel better, do what the voices tell you."
c. "The voices can't hurt you here in the hospital"
d. "Even though I don't hear the voices, I understand that you do."
77. A 23-year-old patient is receiving antipsychotic medication to treat his schizophrenia. He's
experiencing some motor abnormalities called extrapyramidal effects. Which of the following
extrapyramidal effects occurs most frequently in younger make patients?
a. Akathisia
b. Akinesia
c. Dystonia
d. Pseudoparkinsonism
78. Which of the following should you do next?
79. You're reaching a community group about schizophrenia disorders. You explain the different types
of schizophrenia and delusional disorders. You also explain that, unlike schizophrenia, delusional
disorders:
80. A patient with schizophrenia (catatonic type) is mute and can't perform activities of daily living.
The patient stares out the window for hours. What is your first priority in this situation?
81. Which of the following would you suspect in a patient receiving Chlorpromazine (Thorazine) who
complains of a sore throat and has a fever?
a. An allergic reaction
b. Jaundice
c. Dyskinesia
d. Agranulocytosis
82. While providing information for the family of a patient with schizophrenia, you should be sure to
inform them about which of the following characteristics of the disorder?
83. While caring for John, the nurse knows that John may have trouble with:
85. Which of the following behaviors can the nurse anticipate with this client?
Situation: A client is admitted to the hospital. During the assessment the nurse notes that the client has
not slept for a week. The client is talking rapidly, and throwing his arms around randomly.
86. When writing an assessment of a client with mood disorder, the nurse should specify:
a. Fear
b. Anxiety
c. Antisocial
d. Schizoid
a. Fear
b. Anxiety
c. Antisocial
d. Schizoid
a. Menstruation
b. Role changes
c. Rape
d. Divorce
90. What would be the highest priority in formulating a nursing care plan for this client?
a. Isolate the client until he or she adjusts to 'the hospital
b. Provide nutritious food and a quite place to rest
c. Protect the client and others from harm
d. Create a structured environment
Situation: Wendell, 24 year-old student with a primary sleep disorder, is unable to initiate maintenance
of sleep. Primary sleep disorders may be categorized as dyssomnias or parasomnias.
91. The nurse is caring for a client who complains; of fat?gue, inability to concentrate, and
palpitations. The client stales that she has been experiencing these symptoms for the past 6 months.
Which factor in the client’s history has most likely contributed to.these symptoms?
92. If Wendell complains of experiencing an overwhelming urge to sleep and states that he's been
falling asleep while studying and reports that these episodes occur about 5 times daily Wendell is
most likely experiencing which sleep disorder?
93. The nurse is preparing a teaching plan for a client diagnosed with primary insomnia. Which of the
following teaching topics should be included in the plan?
95. When preparing to conduct group therapy, the nurse keeps in mind that the optimal number of
clients in a group would be:
a. 6 to 8
b. 10 to 12
c. 3 to 5
d. Unlimited
a. The nurse assesses the client's needs and develops a plan of care
b. The nurse and client together evaluate and modify the goals of the relationship
c. The nurse and client discuss their feelings about terminating the relationship
d. The nurse and client explore each other's expectations of-the relationship
97. A 42 year-old homemaker arrives at the emergency department with uncomfortable crying and
anxiety. Her husband of 17 years has recently asked her for a divorce. The patient is sitting in a chair,
rocking back and forth. Which is the best response for the nurse to make?
a. "You must stop crying so that we can discuss your feelings about the divorce."
b. "Once you find a job, you will feel much better and more secure."
c. "I can see how upset you are. Let's sit in the office so that we can talk about how you're feeling."
d. "Once you have a lawyer looking out for your interests, you will feel better."
98. A client on the unit tells the nurse that his wife's nagging really gets on his nerves. He asks the
nurse if she will talk with his wife about nagging during their family session tomorrow afternoon.
Which of the following would be most therapeutic response to client?
99. The nurse is working with a client who has just stimulated her anger by using a condescending
tone of voice. Which of the following responses by the nurse would be the most therapeutic?
100. A 35 year-old client tells the nurse that he never disagrees with anyone and that he has loved
everyone he's ever known. What would be the nurse's best response to this client?