COLEGIO DE DAGUPAN

COLLEGE OF NURSING

NCM 101 – PSYCHIATRIC NURSING

FINAL EXAMINATION
OCTOBER 16, 2010

1. Nurse Tony should first discuss terminating the nurse-client relationship with a
client during the:
a. Termination phase when discharge plans are being made.
b. Working phase when the client shows some progress.
c. Orientation phase when a contract is established.
d. Working phase when the client brings it up.

2. To establish open and trusting relationship with a female client who has been
hospitalized with severe anxiety, the nurse in charge should?
a. Encourage the staff to have frequent interaction with the client
b. Share an activity with the client
c. Give client feedback about behavior
d. Respect client’s need for personal space

3. When teaching Mario with a typical depression about foods to avoid while taking
phenelzine(Nardil), which of the following would the nurse in charge include?
a. Roasted chicken
b. Fresh fish
c. Salami
d. Hamburger

4. 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 effects?
a. Urine retention and blurred vision
b. Respiratory depression and convulsion
c. Delirium and Sedation
d. Tremors and cardiac arrhythmias

5. Danny who is diagnosed with bipolar disorder and acute mania, states the nurse,
“Where is my daughter? I love Louis. Rain, rain go away. Dogs eat dirt.” The
nurse interprets these statements as indicating which of the following?
a. Echolalia
b. Neologism
c. Clang associations
d. Flight of ideas

6. Nurse Hazel 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

7. 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

8. A 20 year old client was diagnosed with dependent personality disorder. Which
behavior is not most likely to be evidence of ineffective individual coping?
a. Recurrent self-destructive behavior
b. Avoiding relationship
c. Showing interest in solitary activities
d. Inability to make choices and decision without advise

9. 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

10. A 39 year old mother with obsessive-compulsive disorder has become

immobilized by her elaborate hand washing and walking rituals. Nurse Trish
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. Feeling of unworthiness and hopelessness

11. Conney with borderline personality disorder who is to be discharge 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 clients statement because it’s a sign of manipulation

12. Which of the following approaches would be most appropriate to use with a client
suffering from narcissistic personality disorder when discrepancies exist between
what the client states and what actually exist?
a. Rationalization
b. Supportive confrontation
c. Limit setting
d. Consistency

13. Joey a client with antisocial personality disorder belches loudly. A staff member
asks Joey, “Do you know why people find you repulsive?” this statement most
likely would elicit which of the following client reaction?
a. Defensiveness
b. Embarrassment
c. Shame
d. Remorsefulness

14. Nurse Tony was caring for a 41 year old female client. Which behavior by the
client indicates adult cognitive development?
a. Generates new levels of awareness
b. Assumes responsibility for her actions
c. Has maximum ability to solve problems and learn new skills
d. Her perception are based on reality
15. When developing the plan of care for a client receiving haloperidol, which of the
following medications would nurse Monet anticipate administering if the client
developed extra pyramidal side effects?
a. Olanzapine (Zyprexa)
b. Paroxetine (Paxil)
c. Benztropine mesylate (Cogentin)
d. Lorazepam (Ativan)

16. 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 following would be the best
response of the nurse?
a. Giving the client canned supplements until the delusion subsides
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

17. A client is suffering from catatonic behaviors. Which of the following would the
nurse use to determine that the medication administered PRN have been most
effective?
a. The client responds to verbal directions to eat
b. The client initiates simple activities without direction
c. The client walks with the nurse to her room
d. The client is able to move all extremities occasionally

18. When planning care for Dory with schizotypal personality disorder, which of the
following would help the client become involved with others?
a. Attending an activity with the nurse
b. Leading a sing a long in the afternoon
c. Participating solely in group activities
d. Being involved with primarily one to one activities

19. Which statement about an individual with a personality disorder is true?

a. Psychotic behavior is common during acute episodes
b. Prognosis for recovery is good with therapeutic intervention
c. The individual typically remains in the mainstream of society,
although he has problems in social and occupational roles
d. The individual usually seeks treatment willingly for symptoms that are
personally distressful.

20. Nurse John is talking with a client who has been diagnosed with antisocial
personality about how to socialize during activities without being seductive.
Nurse John would focus the discussion on which of the following areas?
a. Discussing his relationship with his mother
b. Asking him to explain reasons for his seductive behavior
c. Suggesting to apologize to others for his behavior
d. Explaining the negative reactions of others toward his behavior

21. Tina with a histrionic personality disorder is melodramatic and responds to others
and situations in an exaggerated manner. Nurse Trish would recommend which
of the following activities for Tina?
a. Baking class
b. Role playing
c. Scrap book making
d. Music group

22. Joey who has a chronic user of cocaine reports that he feels like he has
cockroaches crawling under his skin. His arms are red because of scratching.
 The nurse in charge interprets these findings as possibly indicating which of the
following?
a. Delusion
b. Formication
c. Flash back
d. Confusion

23. When asking the parents about the onset of problems in young client with the
diagnosis of schizophrenia, Nurse Linda would expect that they would relate the
client’s difficulties began in:
a. Early childhood
b. Late childhood
c. Adolescence
d. Puberty

24. Jose who has been hospitalized with schizophrenia tells Nurse Ron, “My heart
has stopped and my veins have turned to glass!” Nurse Ron is aware that this is
an example of:
a. Somatic delusions
b. Depersonalization
c. Hypochondriasis
d. Echolalia

25. In recognizing common behaviors exhibited by male client who has a diagnosis
of schizophrenia, nurse Josie can anticipate:
a. Slumped posture, pessimistic out look and flight of ideas
b. Grandiosity, arrogance and distractibility
c. Withdrawal, regressed behavior and lack of social skills
d. Disorientation, forgetfulness and anxiety

26. One morning, nurse Diane finds a disturbed client curled up in the fetal position
in the corner of the dayroom. The most accurate initial evaluation of the behavior
would be that the client is:
a. Physically ill and experiencing abdominal discomfort
b. Tired and probably did not sleep well last night
c. Attempting to hide from the nurse
d. Feeling more anxious today

27. Nurse Bea notices a female client sitting alone in the corner smiling and talking to
herself. Realizing that the client is hallucinating. Nurse Bea should:
a. Invite the client to help decorate the dayroom
b. Leave the client alone until he stops talking
c. Ask the client why he is smiling and talking
d. Tell the client it is not good for him to talk to himself

28. When being admitted to a mental health facility, a young female adult tells Nurse
Mylene that the voices she hears frighten her. Nurse Mylene understands that
the client tends to hallucinate more vividly:
a. While watching TV
b. During meal time
c. During group activities
d. After going to bed

29. Nurse John recognizes that paranoid delusions usually are related to the defense
mechanism of:
a. Projection
b. Identification
 c. Repression
d. Regression

30. When planning care for a male client using paranoid ideation, nurse Jasmin
should realize the importance of:
a. Giving the client difficult tasks to provide stimulation
b. Providing the client with activities in which success can be achieved
c. Removing stress so that the client can relax
d. Not placing any demands on the client

31. Nurse Gerry is aware that the defense mechanism commonly used by clients
who are alcoholics is:
a. Displacement
b. Denial
c. Projection
d. Compensation

32. Which nursing intervention is best for facilitating communication with a

psychiatric client who speaks a foreign language?
a. Rely on nonverbal communication.
b. Select symbolic pictures as aids.
c. Speak in universal phrases.
d. Use the services of an interpreter.

33. The nurse explains to a mental health care technician that a client’s obsessive-
compulsive personality are related to unconscious conflict between id impulses
and the superego (or conscience). On which of the following theories does the
nurse base this statement?
a. Behavioral theory
b. Cognitive theory
c. Interpersonal theory
d. Psychoanalytic theory

34. The nurse observes a client pacing in the hall. Which statement by the nurse
may help the client recognize his anxiety?
a. “I guess you’re worried about something, aren’t you?
b. “Can I get you some medication to help calm you?”
c. “Have you been pacing for a long time?”
d. “I notice that you’re pacing. How are you feeling?”

35. A client tells a nurse. “Everyone would be better off if I wasn’t alive.” Which
nursing diagnosis would be made based on this statement?
a. Disturbed thought processes
b. Ineffective coping
c. Risk for self-directed violence
d. Impaired social interaction

36. Which information is most essential in the initial teaching session for the family of
a young adult recently diagnosed with schizophrenia?
a. Symptoms of this disease imbalance in the brain.
b. Genetic history is an important factor related to the development of
schizophrenia.
c. Schizophrenia is a serious disease affecting every aspect of a person’s
functioning.
d. The distressing symptoms of this disorder can respond to treatment
with medications.
37. A nurse is working with a client who has schizophrenia, paranoid type. Which of
the following outcomes related to the client’s delusional perceptions would the
nurse establish?
a. The client will demonstrate realistic interpretation of daily events in
the unit.
b. The client will perform daily hygiene and grooming without assistance.
c. The client will take prescribed medications without difficulty.
d. The client will participate in unit activities.

38. A client who abuses alcohol and cocaine tells a nurse that he only uses
substances because of his stressful marriage and difficult job. Which defense
mechanisms is this client using?
a. Displacement
b. Projection
c. Rationalization
d. Sublimation
39. Two nurses are co-leading group therapy for seven clients in the psychiatric unit.
The leaders observe that the group members are anxious and look to the leaders
for answers. Which phase of development is this group in?
a. Conflict resolution phase
b. Initiation phase
c. Working phase
d. Termination phase

40. Group members have worked very hard, and the nurse reminds them that
termination is approaching. Termination is considered successful if group
members:
a. Decide to continue.
b. Elevate group progress
c. Focus on positive experience
d. Stop attending prior to termination.

41. A client taking the monoamine oxidase inhibitor (MAOI) antidepressant

isocarboxazid (Marplan) is instructed by the nurse to avoid which foods and
beverages?
a. Aged cheese and red wine
b. Milk and green, leaf vegetables
c. Carbonated beverages and tomato products
d. Lean red meats and fruit juices

42. Prior to administering chlorpromazine (Thorazine) to an agitated client, the nurse

should:
a. Assess skin color and sclera
b. Assess the radial pulse
c. Take the client’s blood pressure
d. Ask the client to void

43. The nurse understands that electroconvulsive therapy is primary used in

psychiatric care for the treatment of:
a. Anxiety disorders.
b. Depression.
c. Mania.
d. Schizophrenia.
44. A client taking the MAOI phenelzine (Nardil) tells the nurse that he routinely takes
all of the medications listed below. Which medication would cause the nurse to
express concern and therefore initiate further teaching?
a. Acetaminophen (Tylenol)
 b. Diphenhydramine (Benadryl)
c. Furosemide (Lasix)
d. Isosorbide dinitrate (Isordil)

45. The nurse is administering a psychotropic drug to an elderly client who has
history of benign prostatic hypertrophy. It is most important for the nurse to teach
this client to:
a. Add fiber to his diet.
b. Exercise on a regular basis.
c. Report incomplete bladder emptying
d. Take the prescribed dose at bedtime.

46. The nurse correctly teaches a client taking the benzodiazepine oxazepam
(Serax) to avoid excessive intake of:
a. Cheese
b. Coffee
c. Sugar
d. Shellfish

47. The doctor has prescribed haloperidol (Haldol) 2.5 mg. I.M. for an agitated client.
The medication is labeled haloperidol 10 mg/2 ml. The nurse prepares the
correct dose by drawing up how many milliliters in the syringe?
a. 0.3
b. 0.4
c. 0.5
d. 0.6

48. The nurse enters the room of a client with a cognitive impairment disorder and
asks what day of the week it is: what the date, month, and year are; and where
the client is. The nurse is attempting to assess:
a. Confabulation
b. Delirium
c. Orientation
d. Perseveration

49. Which of the following will the nurse use when communicating with a client who
has a cognitive impairment?
a. Complete explanations with multiple details
b. Picture or gestures instead of words
c. Stimulating words and phrases to capture the client’s attention
d. Short words and simple sentences

50. The parents of a young man with schizophrenia express feelings of responsibility
and guilt for their son’s problems. How can the nurse best educate the family?
a. Acknowledge the parent’s responsibility.
b. Explain the biological nature of schizophrenia.
c. Refer the family to a support group
d. Teach the parents various ways they must change.

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