FINAL COACHING

PSYCHIATRIC NURSING
Prepared by: Prof. Lester Lintao
Take One Nursing

1. Alcohol detoxification is based on which type of therapy? *

a. Biomedical therapy
b. Pharmacotherapy
c. Aversion therapy
d. Psychoanalysis

2. The physician has ordered imipramine (Tofranil), 75 mg tid, for a client. An appropriate nursing action when givingthis
drug is to:
a. Avoid administration of barbiturates or steroid with this drug.
b. Warn the client not to eat cheese, fermenting products, and chicken liver.
c. Observe the client for increased tolerance so that the therapeutic dosage is maintained.
d. Have the client checked for intraocular pressure and provide instructions to watch for symptoms of glaucoma.

3. A psychiatric client is to be discharged with orders for haloperidol (Haldol) therapy. When developing a teaching
plan for discharge, the nurse should include cautioning the client against:
a. Driving at night
b. Staying in the sun
c. Ingesting wines and cheeses
d. Taking medications containing aspirin

4. Drugs such as trihexyphenidyl (Artane), biperiden (Akineton), or benztropine (Cogentin) is often prescribed in
conjunction with:
a. Barbiturates
b. Antidepressants
c. Antianxiety agents/anxiolytics
d. Antipsychotic agents/neuroleptics

5. Photosensitization is a side effect associated with the use of:

a. Sertraline HCl (Zoloft)
b. Lithium carbonate (Lithane)
c. Methyphenidate hydrochloride (Ritalin)
d. Chlorpromazine hydrochloride (Thorazine)

6. An extrapyramidal symptom that is a potentially irreversible side effect of antipsychotic drugs is;
a. Torticollis
b. Oculogyric crisis
c. Tardive dyskinesia
d. Pseudoparkinsonism

7. Haloperidol (Haldol) 5 mg tid is ordered for a patient with schizophrenia. Two days later, the patient complains of
“tight jaws and a stiff neck.” The nurse should recognize that these complaints are:
a. Common side effects of antipsychotic medications that will diminish over time.
b. Early symptoms of extrapyramidal reactions to the medication.
c. Psychosomatic complaints resulting from a delusional system.
d. Permanent side effects of Haldol.

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8. A patient with a history of alcoholism is brought to the emergency room in an agitated state. He is vomiting and
diaphoretic. He says he had his last drink five hours ago. The nurse would expect to administer which of the following
medications?
a. Chlordiazepoxide hydrochloride (Librium)
b. Methadone hydrochloride (Dolophine)
c. Disulfiram (Antabuse)
d. Naloxone hydrochloride (Narcan)

9. While teaching the patient the nurse explains the purpose of antipsychotic drugs. These medications have been
proven to be effective in:
a. Curing symptoms
b. Controlling symptoms
c. Preventing psychosis
d. Curing mental illness

10. The nurse promptive reports which symptom when the patient is taking psychotic medications?
a. Mild rash
b. Dry mouth
c. Sore throat
d. Photosensitivity

11. The nurse is providing patient to the patient who has just diagnosed with major depression and prescribed
amitriptyline (Elavil) 50 mg hs. The patient is instructed that medication will take effect.
a. Immediately
b. In about 36 hours
c. In 14-21 days
d. In about a month

12. 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 evaluate this level as:
a. Therapeutic
b. Below therapeutic
c. Potentially dangerous
d. Fatally toxic

13. The nurse assesses increasing restless, agitation, swinging of legs, and pacing in the patient who has been talking
Thorazine 400 mg daily. The nursing evaluation is:
a. EPS
b. NMS
c. Dystonia
d. Akathisia

14. The nurse is conducting discharge teaching for a client taking tranylcypromine (Parnate). The nurse determines that
the client understands the instructions given if the client refrains from eating which of the following favorite foods?
a. Potato chips
b. Salami
c. Chicken
d. Oat cereal

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15. Lorazepam (Ativan) is primarily effective in treating which of the following?
a. Hallucinations
b. Delusions
c. Anxiety
d. Incoherent speech

16. Which classification of psychotropic drugs includes sertraline (Zoloft)?

a. Tricyclic antidepressants
b. Monoamine oxidase inhibitors
c. Phenothiazines
d. Selective serotonin reuptake inhibitors

17. Three days after a client is started on a tricyclic antidepressant, the client still exhibits signs of agitation, anxiety,and
restlessness. What is the most likely explanation for this?
a. The client is not taking the medication
b. The client is not responding to the medication
c. Therapeutic effects of these agents occur in 2 to 3 weeks
d. The dosage is too small to be effective

18. As part of a teaching plan on lithium carbonate, clients are instructed to have lithium levels determined every 1to 3
months when they are outpatients. Which statement best describes the reason for this?
a. Lithium carbonate can produce potassium and magnesium depletion
b. Triglyceride levels can increase as the lithium level increases
c. Lithium carbonate in large quantities produces sedation resulting in safety risks
d. A narrow margin of safety exists between therapeutic and toxic levels of lithium carbonate

19. A client is receiving monoamine oxide inhibitors (MAOs) as part of the treatment. Which food would be most
important for the nurse to stress to avoid?
a. Organ meats
b. Sardines
c. Shellfish
d. Legumes

20. A patient receiving lithium carbonate complains of blurred vision and appears confused. The nurse also noticesthat
the client is having difficulty maintaining balance. Which of these nursing actions are appropriate?
a. Administer a PRN anti-parkinsonism drug and hold all other drugs
b. Take the client's vital signs and administer high-potassium foods
c. Hold the client's next dose of medication and notify the physician immediately
d. Sit with client to talk and teach the side effects of lithium

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21. The drug of choice for anxiety disorders is:
a. Zoloft
b. Valium
c. Disulfiram
d. Librium

22. When working with the client in crisis, which of the following is most important?
a. Obtaining a complete assessment of the client’s past history
b. Remaining focused on the immediate problem
c. Determining whether the client may have had a part in the emergence of the crisis
d. Assisting the client to identify what is similar about this crisis to other crises in the client’s life

23. When caring for a client in crisis the nurse assists the client in asking for help from others by role modeling because
clients in crisis:
a. Often are overwhelmed, feel isolated, and may be unable to ask for help on their own
b. Lose their ability to act autonomously
c. Have an external locus of control
d. Feel guilty

24. Which of the following is the best approach for the nurse to use in crisis counseling?
a. Reassuring
b. Passive listening
c. Explore early life experiences
d. Active, with focus on current situation

25. The nurse is reviewing the assessment data of a client admitted to the mental health unit. The nurse notes that the
admission nurse has documented that the client is experiencing anxiety as a result of a situational crisis. The nurse
determines that this type of crisis could be caused by:
a. Experiencing menarche
b. A death of a loved one
c. A storm that destroyed a client’s home
d. A pending retirement

26. The nurse is conducting an initial assessment on a client in crises. When assessing the client’s perception of the
precipitating event that led to the crisis, the appropriate question to ask is:
a. “With whom do you live?”
b. “Who is available to help you?”
c. “What leads you seek help now?”
d. “What do you usually do to feel better?”

27. The nurse is developing a plan of care for the client in a crisis state. When developing the plan, the nurse considers
which of the following?
a. A crisis state indicates that the individual is suffering from a mental illness.
b. A crisis state indicates that the individual is suffering from an emotional illness.
c. Presenting symptoms in a crisis situation are similar for all individuals experiencing a crisis.
d. A client’s response to a crisis is individualized and what constitutes a crisis for one person may not constitute
a crisis for another.

28. Rape victims develop phobia as a defense reaction to the incident such as fear of being alone. This is known asone
of the following:
a. Mysophobia
b. Agoraphobia
c. Monophobia
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 d. Claustrophobia

29. A client is admitted to a mental health unit for treatment of psychotic behavior. The client is at the locked exit door
and is shouting. “Let me out. There’s nothing wrong with me. I don’t belong here” The nurse analyzes this behavior
as:
a. Denial
b. Projection
c. Regression
d. Rationalization

30. They are used in everyday situations, mostly unconsciously. Of the following, who uses displacement as a defense
mechanism?
a. Nurse Orly is specially kind and courteous to a patient whom he had a fight with and filed a complaint against
him the other day.
b. Nurse Mimi, after being reprimanded by the head nurse shouts at the nursing aide for accidentally knocking
over the patient’s milk
c. Nurse Jen who is thinking too much about her promotion that it interferes with her work. She chooses to set
her thoughts aside until she finishes her duty
d. Nurse Ayo who gave the wrong dosage of medication to a patient, points the finger at the physician for having
bad handwriting

31. The most common defense mechanism is:

a. Denial
b. Regression
c. Introjection
d. Rationalization

32. The supervisor reprimands the nurse in charge of the nursing unit because the charge nurse has not adhered to the
unit budget. Later that afternoon, the charge nurse accuses the nursing staff of wasting supplies. This behavior is an
example of:
a. Denial
b. Repression
c. Suppression
d. Displacement

33. Benny, a male college student, who is smaller than average and unable to participate in sports, becomes the lifeof
the party and a stylish dresser. This is an example of the defense mechanism of:
a. Introjection
b. Compensation
c. Sublimation \
d. Reaction Formation

34. A nurse should know that sublimation is a defense mechanism that helps the individual:
a. Act out in reverse something already done or thought
b. Return to an earlier, less mature, stage of development
c. Channel unacceptable sexual desires into socially approved behavior
d. Exclude from consciousness things that are psychologically disturbing

35. After his teammates told Karl that he has a resemblance to a famous basketball player, Karl started trying to
imitate the player’s mannerisms and style in playing. Karl is using which defense mechanism?
a. Idealization
b. Identification
c. Introjection
d. Substitution
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36. Mrs. Martin is too sad to eat and started to act unusual after the death of her husband. She is diagnosed of having
major depression. During a one on one interaction with the nurse, Mrs. Martin says, “I don’t cry because I don’t want
my children to see me crying.” The nurse needs to be aware that the client is using:
a. Suppression
b. Repression
c. Undoing
d. Rationalization

37. After not passing the board exams, Oma told a friend, “I was not able to concentrate well on answering the test
questions because I had a terrible headache then.”
a. Denial
b. Projection
c. Rationalization
d. Intellectualization

38. Assessment data of children with autism includes the following, except:
a. Social interaction impairment
b. Aggression towards people
c. Delay in language development
d. Stereotypic behavior

39. A 3-year-old client has been diagnosed with attention deficit/hyperactivity disorder (ADHD). Which medication is
most likely to be prescribed?
a. Amitriptyline (Elavil)
b. Paroxetene (Paxil)
c. Methylphenidate (Ritalin)
d. Pemoline (Cyclert)

40. When planning the discharge of a client with chronic anxiety, the nurse directs the goal at promoting a safe
environment at home. The appropriate maintenance goal should focus on which of the following?
a. Ignoring feelings of anxiety
b. Identifying anxiety-producing situations.
c. Continued contact with a crisis counselor
d. Eliminating all anxiety from daily situations

41. A woman comes into the emergency in a severe state of anxiety following a car accident. The appropriate nursing
intervention is to:
a. Remain with client.
b. Put a client in a quiet room.
c. Teach the client deep breathing.
d. Encourage the client to talk about their feelings and concerns.

42. A client is admitted to a medical nursing unit with a diagnosis of acute blindness. Many tests are performed, and
there seems to be no organic reason why his client cannot see. The nurse later learns that the client became blind
after witnessing a hit-and-run car accident, when a family of three was killed. The nurse suspects that the client may
be experiencing a:
a. Psychosis
b. Repression
c. Conversion disorder
d. Dissociative disorder

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43. A nurse is assessing a client diagnosed with dependent personality disorder. Which of the following characteristicsis a
major component of this disorder?
a. Abrasive disorder
b. Indifferent to others
c. Manipulative of others
d. Overreliance on others

44. A patient with a Borderline Personality Disorder is most likely to demonstrate:

a. Apathy
b. Introspection
c. Disappointment
d. Impulsivity

45. Which of the following best explains common responses of clients with antisocial personality disorders?
a. low self-esteem and poor impulse control
b. distance and aloofness
c. extreme guilt and dependency on others for approval
d. selfishness and a lack of concern for others

46. A client has the diagnosis of histrionic personality disorder. When assessing this client, the nurse should expectthat
the client’s behavior would be:
a. Boastful and egotistical
b. Dramatic and theatrical
c. Rigid and perfectionist
d. Aggressive and manipulative

47. The client is admitted for evaluation of aggressive behavior and diagnosed with antisocial personality disorder. A key
part of the care of such clients is:
a. Setting realistic limits
b. Encouraging the client to express remorse for behavior
c. Minimizing interactions with other clients
d. Encouraging the client to act out feelings of rage

48. Which of the following nursing interventions would be appropriate for a patient with avoidant personality
disorder?
a. Provide opportunities for exploration
b. Help identify patient strengths
c. Encourage to lead a group therapy
d. Do limit-setting for manipulative behavior

49. The nurse is aware that as anxiety increases, one’s concept of reality alters. Therefore, when caring for a client
with a generalized anxiety disorders, the nurse’s first intervention should be to:
a. Have the client verbalize feelings of anxiety.
b. Administer the PRN medication ordered by the physician.
c. Remove as many stimuli from the client’s environment as possible.
d. Have the client list the relief behaviors that are used to reduce anxiety.

50. Those individuals who demonstrate obsessive-compulsive behavior can best be treated by:
a. Restricting their movements
b. Calling attention to their behavior
c. Keeping them busy to distract them.
d. Supporting but limiting their behavior.