3.
Which of the following comments if made
PSYCHIATRIC
NURSING MASTERY
TEST PART 2
NLE INTENSIVE REVIEW
1. A woman phones the psychiatric nurse’s
station and tells the nurse that her uncle
was admitted yesterday because of an
overdose of pills. The nurse says “I cannot
release information about psychiatric
patients.” The nurse’s response is:
A. Appropriate because she is supposed to
uphold the client’s dignity.
B. Appropriate because she has to maintain
confidentiality.
C. Inappropriate, because relatives have the
right to know.
D. Inappropriate, because it will prevent
relatives from being supportive.
Clear selection
2. Which of the following actions will be
most effective when encouraging a
depressed patient to be less socially
isolated:
A. Move the patient to a room close to the
nurses’ station.
B. Ask a more stable patient to accompany the
patient to activities.
C. Assign a nurse aide to monitor the patient’s
activity.
D. Explain to the patient that continuous
isolation may delay discharge.
Clear selection
by the patient indicates understanding of
the action of his medication Disulfiram?
A. “I will drink fruit juice at social gatherings.”
B. “I will take my pulse four times each day.”
C. “I will lie down for half an hour after I take the
pill.”
D. “I will take an antacid before my Antabuse.”
Clear selection
4. In which of the following ways should the
nurse intervenes when an elderly
repeatedly talks about the past?
A. Help the patient establish goals for the
future.
B. Give the patient diversionary activity.
C. Ask the patient to talk about recent events.
D. Encourage the patient to share memories.
Clear selection
5. An elderly who has Alzheimer’s disease
calls the nurse by his wife’s name. Which of
the following measures by the nurse will be
appropriate?
A. Respond to whatever name he calls the
nurse.
B. Asking him to remember the nurse’s name.
C. Stating the nurse’s name at each contact
with him.
D. Allowing him extra time to remember the
nurse’s name.
Clear selection
6. When discussing methods of stress
reduction with a patient, the nurse should
use which of the following approaches first?
A. Explain to the patient the psychological
effects of stress.
B. Teach the patient relaxation techniques that
reduce stress.
C. Determine if the patient is able to identify the
source of stress.
D. Describe to the patient the benefits of
relaxation.
7. A manic patient has been monopolizing
group time and the nurse has been setting
limits on his behavior. Which indicates that
the client has benefited from this
intervention?
A. Arrives on time for group therapy.
B. Dress appropriately.
C. Raise the hand before speaking.
D. Remain seated throughout the session.
Clear selection
8. The patient is not allowed to go out on
pass but claims that another nurse allowed
him a one-hour pass. Which is appropriate
to deal with the patient’s routine
manipulation?
A. Give him the pass to avoid allowing him to
manipulate.
B. Call his doctor and get permission to pass.
C. Tell him you and he can go to the nurse to
discuss this.
D. Cut his privileges for attempting another
manipulation
Clear selection
9. Kathy is concerned with her increasing
use of alcohol “to relax” and tremors for
failure to take the substance. Which of the
following indicate withdrawal?
A. A compulsion to use the drug.
B. Loss of control over the usage of the drug.
C. A physiologic need for the substance.
D. Continued use of the drug despite adverse
consequences
Clear selection
10. A severely dehydrated teenager
admitted to the hospital with hypotension
and tachycardia undergoes evaluation for
electrolyte disturbances. Her history
includes anorexia nervosa and a 20-lb (9.1-
kg) weight loss in the last month. She is 5′
7" (1.7 m) tall and weighs 80 lb (36.3 kg).
Which nursing intervention takes highest
priority?
a. Initiating caloric and nutritional therapy as
ordered
b. Instituting behavioral modification therapy as
ordered
c. Addressing the client's low self-esteem
d. Regularly monitoring vital signs and weight
Clear selection
11. A client tells the nurse that he is
having suicidal thoughts every day. In
conferring with the treatment team, the
nurse should make which of the following
recommendations?
a. A no-suicide contract
b. Weekly outpatient therapy
c. A second psychiatric opinion
d. Intensive inpatient treatment
Clear selection
12. A client on Parnate complains of
headache and s brought to the emergency
room. The nurse would continue the
assessment by asking:
A. The dose of Parnate she is taking.
B. What food she has been ingesting.
C. If she recently had flu symptoms. Clear selection
D. What other medications she is taking.
16. A client sitting rigidly, looks angry and
Clear selection says “I’m glad with what’s happening
today,” Which of the following describes
13. Which of the following statements of a
appropriately the client’s behavior?
family member of a client who committed
suicide indicate that he has begun to A. Violation of congruence in communication
B. Flat affect
successfully integrate the experience into
C. Aloof and cold
her life? D. Lack of interest
A. “We are so embarrassed at social functions.
Clear selection
B. “We are angry that our son did this to us.”
C. “We have joined a support group.”
17. A client with multiple hospital
D “We are talking more openly with our friends.”
admissions due to a cardiac condition says
Clear selection “I know I’m sick but I could really take care
of myself.” The nurse recognizes that the
14. A student with a history of drug abuse is
client is attempting to:
brought to the psychiatric ward.
Assessment data shows dilated pupils and A. Deny her illness
B. Reassure the nurses
elevated blood pressure and hallucinations.
C. Suppress her fears
He likely is having: D. Maintain her independence
A. cocaine withdrawal
Clear selection
B. heroine withdrawal
C. shabu intoxication
Situation: Milieu management is vital in
D. alcohol intoxication
improving the client’s adaptation to the real
Clear selection world.

15. During group therapy session a client

tells everyone about her sadness regarding
her impending discharge. It would be most
appropriate for the group leader to respond:
18. A client attending a community meeting
A. “You ought to be happy that you are leaving.” complains that the hospital activities are
B. “Maybe you are not ready to be discharged limited. Ina therapeutic milieu the best
yet.” approach of the nurse is to:
C. “Maybe others in the group have similar
A. Explain the reason for the hospital policy.
feelings that they would share.”
B. Listen to the client and others with similar
D. “How many in the group feel that this
concern.
member is ready for discharge?”.
C. Revise rules based on the complaints.
D. Allow the client to select schedule as
desired.
Clear selection
19. In a psychiatric setting a community
refers to:     22.
A. Group of families with a common set of
beliefs and practices.
B. A group of patients with a common goal.
C. Everyone in the setting who help attain a safe
living environment.
D. The people and officials in the barangay.
Clear selection
20. The nurse leader can best facilitate a
therapeutic environment when she:
A. Provides means to acquire social skills.
B. Provides experiences to gratify dependency
needs.
C. Willingness to be open to clients’ feedback.
D. A laizzes-faire approach.
Clear selection
21. A client is admitted to the psychiatric
unit with a diagnosis of alcohol intoxication
and suspected alcohol dependence. Other
assessment findings include an enlarged
liver, jaundice, lethargy, and rambling,
incoherent speech. No other information
about the client is available. After the nurse
completes the initial assessment, what is
the first priority?
a. Instituting seizure precautions, obtaining
frequent vital signs, and recording fluid intake
and output
b. Checking the client's medical records for
health history information
c. Attempting to contact the client's family to
obtain more information about the client
d. Restricting fluids and leaving the client alone
to "sleep off" the episode
Clear selection
Which nursing action is best when
trying to diffuse a client's impending violent
behavior?
a. Helping the client identify and express
feelings of anxiety and anger
b. Involving the client in a quiet activity to divert
attention
c. Leaving the client alone until the client can
talk about feelings
d. Placing the client in seclusion
Clear selection
23. The nurse is working with a client
who abuses alcohol. Which of the following
facts should the nurse communicate to the
client?
a. Abstinence is the basis for successful
treatment.
b. Attendance at Alcoholics Anonymous
meetings every day will cure alcoholism.
c. For treatment to be successful, family
members must participate.
d. An occasional social drink is acceptable
behavior for the alcoholic
Clear selection
24. Which psychosocial influence has
been causally related to the development of
aggressive behavior and conduct disorder?
a. An overbearing mother
b. Rejection by peers
c. A history of schizophrenia in the family
d. Low socioeconomic status

Clear selection
25. In group therapy, a client who has
used I.V. heroin every day for the past 14
years says, "I don't have a drug problem. I
can quit whenever I want. I've done it
before." Which defense mechanism is the
client using?
a. Denial
b. Obsession
c. Compensation
d. Rationalization
26. A client with a history of cocaine
addiction is admitted to the coronary care
unit for evaluation of substernal chest pain.
The electrocardiogram (ECG) shows a 1-
mm ST-segment elevation the anteroseptal
leads and T-wave inversion in leads V3 to
V5. Considering the client's history of drug
abuse, the nurse expects the physician to
prescribe:  
a. lidocaine (Xylocaine).
b. procainamide (Pronestyl).
c. nitroglycerin (Nitro-Bid IV).
d. epinephrine.
27. A 15-year-old client is brought to the
clinic by her mother. Her mother expresses
concern about her daughter's weight loss
and constant dieting. The nurse conducts a
health history interview. Which of the
following comments indicates that the client
may be suffering from anorexia nervosa?
a. "I like the way I look. I just need to keep my
weight down because I'm a cheerleader."
b. "I don't like the food my mother cooks. I eat
plenty of fast food when I'm out with my
friends."
c. "I just can't seem to get down to the weight I
want to be. I'm so fat compared to other girls."
d. "I do diet around my periods; otherwise, I just
get so bloated."
28. Which is the drug of choice for
treating Tourette syndrome?
a. fluoxetine (Prozac)
b. fluvoxamine (Luvox)
c. haloperidol (Haldol)
d. paroxetine (Paxil)
29. The client tells the nurse he was
involved in a car accident while he was
intoxicated. What would be the most
therapeutic response from the nurse?
a. "Why didn't you get someone else to drive
you?"
b. "Tell me how you feel about the accident."
c. "You should know better than to drink and
drive."
d. "I recommend that you attend an Alcoholics
Anonymous meeting."
30. A client voluntarily admits himself to
the substance abuse unit. He confesses
that he drinks 1 qt or more of vodka each
day and uses cocaine occasionally. Later
that afternoon, he begins to show signs of
alcohol withdrawal. What are some early
signs of this condition?
a. Vomiting, diarrhea, and bradycardia
b. Dehydration, temperature above 101° F (38.3°
C), and pruritus
c. Hypertension, diaphoresis, and seizures
d. Diaphoresis, tremors, and nervousness
31. When monitoring a client recently
admitted for treatment of cocaine addiction,
the nurse notes sudden increases in the
arterial blood pressure and heart rate. To
correct these problems, the nurse expects
the physician to prescribe:   which statement by the client most strongly
a. norepinephrine (Levophed) and lidocaine
(Xylocaine).
b. nifedipine (Procardia) and lidocaine.
c. nitroglycerin (Nitro-Bid IV) and esmolol
(Brevibloc).
d. nifedipine and esmolol
32. A client experiencing alcohol
withdrawal is upset about going through
detoxification. Which of the following goals
is a priority?
a. The client will commit to a drug-free lifestyle.
b. The client will work with the nurse to remain
safe.
c. The client will drink plenty of fluids daily.
d. The client will make a personal inventory of
strengths
33. A client is admitted to a psychiatric
facility by court order for evaluation for
antisocial personality disorder. This client
has a long history of initiating fights and
abusing animals and recently was arrested
for setting a neighbor's dog on fire. When
evaluating this client for the potential for
violence, the nurse should assess for which
behavioral clues?
a. A rigid posture, restlessness, and glaring
b. Depression and physical withdrawal
c. Silence and noncompliance
d. Hypervigilance and talk of past violent acts
34. A client is brought to the psychiatric
clinic by family members, who tell the
admitting nurse that the client repeatedly
drives while intoxicated despite their pleas
to stop. During an interview with the nurse,
supports a diagnosis of psychoactive
substance abuse?
a. "I'm not addicted to alcohol. In fact, I can
drink more than I used to without being
affected."
b. "I only spend half of my paycheck at the bar."
c. "I just drink to relax after work."
d. "I know I've been arrested three times for
drinking and driving, but the police are just
trying to hassle me."
35. A client with borderline personality
disorder is admitted to the psychiatric unit.
Initial nursing assessment reveals that the
client's wrists are scratched from a recent
suicide attempt. Based on this finding, the
nurse should formulate a nursing diagnosis
of:
a. Ineffective individual coping related to
feelings of guilt.
b. Situational low self-esteem related to
feelings of loss of control.
c. Risk for violence: Self-directed related to
impulsive mutilating acts.
d. Risk for violence: Directed toward others
related to verbal threats.
36. A client recently admitted to the
hospital with sharp, substernal chest pain
suddenly complains of palpitations. The
nurse notes a rise in the client's arterial
blood pressure and a heart rate of 144
beats/minute. On further questioning, the
client admits to having used cocaine
recently after previously denying use of the
drug. The nurse concludes that the client is
at high risk for which complication of
cocaine use?
a. Coronary artery spasm
b. Bradyarrhythmias
c. Neurobehavioral deficits
d. Panic disorder
37. A client is being admitted to the
substance abuse unit for alcohol
detoxification. As part of the intake
interview, the nurse asks him when he had
his last alcoholic drink. He says that he had
his last drink 6 hours before admission.
Based on this response, the nurse should
expect early withdrawal symptoms to:   41.
a. begin after 7 days.
b. not occur at all because the time period for
their occurrence has passed.
c. begin anytime within the next 1 to 2 days.
d. begin within 2 to 7 days.
38. The nurse is assigned to care for a
client with anorexia nervosa. Initially, which
nursing intervention is most appropriate for
this client?
a. Providing one-on-one supervision during
meals and for 1 hour afterward
b. Letting the client eat with other clients to
create a normal mealtime atmosphere
c. Trying to persuade the client to eat and thus
restore nutritional balance
d. Giving the client as much time to eat as
desired
39. A client begins to experience
alcoholic hallucinosis. What is the best
nursing intervention at this time?  
a. Keeping the client restrained in bed
b. Checking the client's blood pressure every 15
minutes and offering juices
c. Providing a quiet environment and
administering medication as needed and
prescribed
d. Restraining the client and measuring blood
pressure every 30 minutes
40. Which assessment finding is most
consistent with early alcohol withdrawal?  
a. Heart rate of 120 to 140 beats/minute
b. Heart rate of 50 to 60 beats/minute
c. Blood pressure of 100/70 mm Hg
d. Blood pressure of 140/80 mm Hg
Which client is at highest risk for
suicide?
a. One who appears depressed, frequently
thinks of dying, and gives away all personal
possessions
b. One who plans a violent death and has the
means readily available
c. One who tells others that he or she might do
something if life doesn't get better soon
d. One who talks about wanting to die
42. Which of the following medical
conditions is commonly found in clients with
bulimia nervosa?
a. Allergies
b. Cancer
c. Diabetes mellitus
d. Hepatitis A
43. A high school student is referred to
the school nurse for suspected substance
abuse. Following the nurse's assessment
and interventions, what would be the most
desirable outcome?
a. The student discusses conflicts over drug
use.
b. The student accepts a referral to a substance
abuse counselor.
c. The student agrees to inform his parents of
the problem.
44. A client who reportedly consumes 1
qt of vodka daily is admitted for alcohol
detoxification. To try to prevent alcohol
withdrawal symptoms, the physician is most
likely to prescribe which drug?
a. clozapine (Clozaril)
b. thiothixene (Navane)
c. lorazepam (Ativan)
d. lithium carbonate (Eskalith)
45. A client is being treated for
alcoholism. After a family meeting, the
client's spouse asks the nurse about ways
to help the family deal with the effects of
alcoholism. The nurse should suggest that
the family join which organization?   violence because the husband:
a. Al-Anon
b. Make Today Count
c. Emotions Anonymous
d. Alcoholics Anonymous
46. A client is admitted to the psychiatric
clinic for treatment of anorexia nervosa. To
promote the client's physical health, the
nurse should plan to:   has a recurrence of anorexia nervosa. The
a. severely restrict the client's physical
activities.
b. weigh the client daily, after the evening meal.
c. monitor vital signs, serum electrolyte levels,
and acid-base balance.
d. instruct the client to keep an accurate record
of food and fluid intake.
47. A young man is remanded by the
courts for psychiatric treatment. His police
record, which dates to his early teenage
years, includes delinquency, running away,
auto theft, and vandalism. He dropped out
of school at age 16 and has been living on
his own since then. His history suggests
maladaptive coping, which is associated
with:
A. antisocial personality disorder.
B. borderline personality disorder.
C. obsessive-compulsive personality disorder.
D. narcissistic personality disorder.
48. A husband and wife seek emergency
crisis intervention because he slapped her
repeatedly the night before. The husband
indicates that his childhood was marred by
an abusive relationship with his father.
When intervening with this couple, the
nurse knows they are at risk for repeated
a. has only moderate impulse control.
b. denies feelings of jealousy or
possessiveness.
c. has learned violence as an acceptable
behavior.
d. feels secure in his relationship with his wife.
49. A client whose husband just left her
nurse caring for her realizes that this
exacerbation of anorexia nervosa results
from the client's effort to:
a. manipulate her husband.
b. gain control of one part of her life.
c. commit suicide.
d. live up to her mother's expectations.
50. A client has approached the nurse
asking for advice on how to deal with his
alcohol addiction. The nurse should tell the
client that the only effective treatment for
alcoholism is:
a. psychotherapy.
b. total abstinence.
c. Alcoholics Anonymous (AA).
d. aversion therapy.
51. The nurse is caring for a client with
schizophrenia. Which of the following
outcomes is the least desirable?
a. The client spends more time by himself.
b. The client doesn't engage in delusional
thinking.
c. The client doesn't harm himself or others.
d. The client demonstrates the ability to meet
his own self-care needs.
52. The nurse formulates a nursing
diagnosis of Impaired verbal communication
for a client with schizotypal personality
disorder. Based on this nursing diagnosis,
which nursing intervention is most
appropriate?
a. Helping the client to participate in social
interactions
b. Establishing a one-on-one relationship with
the client
c. Establishing alternative forms of
communication
d. Allowing the client to decide when he wants
to participate in verbal communication with the
nurse
53. Since admission 4 days ago, a client
has refused to take a shower, stating,
"There are poison crystals hidden in the
showerhead. They'll kill me if I take a
shower." Which nursing action is most
appropriate?  
a. Dismantling the showerhead and showing the
client that there is nothing in it
b. Explaining that other clients are complaining
about the client's body odor
c. Asking a security officer to assist in giving
the client a shower
d. Accepting these fears and allowing the client
to take a sponge bath
54. Drug therapy with thioridazine
(Mellaril) shouldn't exceed a daily dose of
800 mg to prevent which adverse reaction?
a. Hypertension
b. Respiratory arrest
c. Tourette syndrome
d. Retinal pigmentation
55. A client with paranoid personality
disorder is admitted to a psychiatric facility.
Which remark by the nurse would best
establish rapport and encourage the client
to confide in the nurse?
a. "I get upset once in a while, too."
b. "I know just how you feel. I'd feel the same
way in your situation."
c. "I worry, too, when I think people are talking
about me."
d. "At times, it's normal not to trust anyone."
56. How soon after chlorpromazine
(Thorazine) administration should the nurse
expect to see a client's delusional thoughts
and hallucinations eliminated?
a. Several minutes
b. Several hours
c. Several days
d. Several weeks
57. A client is about to be discharged
with a prescription for the antipsychotic
agent haloperidol (Haldol), 10 mg by mouth
twice per day. During a discharge teaching
session, the nurse should provide which
instruction to the client?
a. Take the medication 1 hour before a meal.
b. Decrease the dosage if signs of illness
decrease.
c. Apply a sunscreen before being exposed to
the sun.
d. Increase the dosage up to 50 mg twice per
day if signs of illness don't decrease.
58. A client with paranoid schizophrenia
repeatedly uses profanity during an activity
therapy session. Which response by the
nurse would be most appropriate?   pills?" Which of the following is the best
a. "Your behavior won't be tolerated. Go to your
room immediately."
b. "You're just doing this to get back at me for
making you come to therapy."
c. "Your cursing is interrupting the activity. Take
time out in your room for 10 minutes."
d. "I'm disappointed in you. You can't control
yourself even for a few minutes."
59. Which of the following is one of the
advantages of the newer antipsychotic
medication risperidone (Risperdal)?
a. The absence of anticholinergic effects
b. A lower incidence of extrapyramidal effects
c. Photosensitivity and sedation
d. No incidence of neuroleptic malignant
syndrome
60. The etiology of schizophrenia is best
described by:
a. genetics due to a faulty dopamine receptor.
b. environmental factors and poor parenting.
c. structural and neurobiological factors.
d. a combination of biological, psychological,
and environmental factors.
61. A client with schizophrenia who
receives fluphenazine (Prolixin) develops
pseudo parkinsonism and akinesia. What
drug would the nurse administer to
minimize extrapyramidal symptoms?
a. benztropine (Cogentin)
b. dantrolene (Dantrium)
c. clonazepam (Klonopin)
d. diazepam (Valium)
62. A client with a diagnosis of paranoid
schizophrenia comments to the nurse,
"How do I know what is really in those
response?
a. Say, "You know it's your medicine."
b. Allow him to open the individual wrappers of
the medication.
c. Say, "Don't worry about what is in the pills. It's
what is ordered."
d. Ignore the comment because it's probably a
joke.
63. A client tells the nurse that people
from Mars are going to invade the earth.
Which response by the nurse would be
most therapeutic?
a. “That must be frightening to you. Can you tell
me how you feel about it?"
b. "There are no people living on Mars."
c. "What do you mean when you say they're
going to invade the earth?"
d. "I know you believe the earth is going to be
invaded, but I don't believe that."
64. A client with schizophrenia tells the
nurse he hears the voices of his dead
parents. To help the client ignore the
voices, the nurse should recommend that
he:
a. sit in a quiet, dark room and concentrate on
the voices.
b. listen to a personal stereo through
headphones and sing along with the music.
c. call a friend and discuss the voices and his
feelings about them.
d. engage in strenuous exercise.
65. A client with schizophrenia is
receiving antipsychotic medication. Which
nursing diagnosis may be appropriate for
this client?
a. Ineffective protection related to blood
dyscrasias
b. Urinary frequency related to adverse effects
of antipsychotic medication
c. Risk for injury related to a severely decreased
level of consciousness
d. Risk for injury related to electrolyte
disturbances
66. A client with persistent, severe
schizophrenia has been treated with
phenothiazines for the past 17 years. Now
the client's speech is garbled as a result of
drug-induced rhythmic tongue protrusion.
What is another name for this
extrapyramidal symptom?
a. Dystonia
b. Akathisia
c. Pseudoparkinsonism
d. Tardive dyskinesia
67. The nurse is assigned to a client with
catatonic schizophrenia. Which intervention
should the nurse include in the client's plan
of care?
a. Meeting all of the client's physical needs
b. Giving the client an opportunity to express
concerns
c. Administering lithium carbonate (Lithonate)
as prescribed
d. Providing a quiet environment where the
client can be alone
68. A client with a history of medication
noncompliance is receiving outpatient
treatment for chronic undifferentiated
schizophrenia. The physician is most likely
to prescribe which medication for this
client?
a. chlorpromazine (Thorazine)
b. imipramine (Tofranil)
c. lithium carbonate (Lithane)
d. fluphenazine decanoate (Prolixin Decanoate)
69. Propranolol (Inderal) is used in the
mental health setting to manage which of
the following conditions?
a. Antipsychotic-induced akathisia and anxiety
b. The manic phase of bipolar illness as a mood
stabilizer
c. Delusions for clients suffering from
schizophrenia
d. Obsessive-compulsive disorder (OCD) to
reduce ritualistic behavior
70. Every day for the past 2 weeks, a
client with schizophrenia stands up during
group therapy and screams, "Get out of
here right now! The elevator bombs are b. Generativity versus stagnation
c. Integrity versus despair
going to explode in 3 minutes!" The next
d. Trust versus mistrust
time this happens, how should the nurse
respond?   73. During a group therapy session in
the psychiatric unit, a client constantly
a. "Why do you think there is a bomb in the
elevator?" interrupts with impulsive behavior and
b. "That is the same thing you said in exaggerated stories that cast her as a hero
yesterday's session." or princess. She also manipulates the group
c. "I know you think there are bombs in the
with attention-seeking behaviors, such as
elevator, but there aren't."
d. "If you have something to say, you must do it sexual comments and angry outbursts. The
according to our group rules." nurse realizes that these behaviors are
typical of:
71. A 26-year-old client is admitted to the
psychiatric unit with acute onset of a. paranoid personality disorder.
b. avoidant personality disorder.
schizophrenia. His physician prescribes the
c. histrionic personality disorder.
phenothiazine chlorpromazine (Thorazine), d. borderline personality disorder.
100 mg by mouth four times per day. Before
74. The nurse is teaching a psychiatric
administering the drug, the nurse reviews
client about her prescribed drugs,
the client's medication history. Concomitant
chlorpromazine and benztropine. Why is
use of which drug is likely to increase the
benztropine administered?
risk of extrapyramidal effects?
a. To reduce psychotic symptoms
a. guanethidine (Ismelin)
b. To reduce extrapyramidal symptoms
b. droperidol (Inapsine)
c. To control nausea and vomiting
c. lithium carbonate (Lithonate)
d. To relieve anxiety
d. alcohol
75. A client is admitted to the psychiatric
72. A client, age 36, with paranoid
unit with a tentative diagnosis of psychosis.
schizophrenia believes the room is bugged
Her physician prescribes the phenothiazine
by the Central Intelligence Agency and that
thioridazine (Mellaril) 50 mg by mouth three
his roommate is a foreign spy. The client
times per day. Phenothiazines differ from
has never had a romantic relationship, has
central nervous system (CNS) depressants
no contact with family members, and hasn't
in their sedative effects by producing:
been employed in the last 14 years. Based
on Erikson's theories, the nurse should a. deeper sleep than CNS depressants.
b. greater sedation than CNS depressants.
recognize that this client is in which stage of
c. a calming effect from which the client is
psychosocial development? easily aroused.
a. Autonomy versus shame and doubt
d. more prolonged sedative effects, making the
client more difficult to arouse.
76. A woman is admitted to the
psychiatric emergency department. Her
significant other reports that she has
difficulty sleeping, has poor judgment, and
is incoherent at times. The client's speech
is rapid and loose. She reports being a
special messenger from the Messiah. She
has a history of depressed mood for which
she has been taking an antidepressant. The
nurse suspects which diagnosis?
a. Schizophrenia
b. Paranoid personality
c. Bipolar illness
d. obsessive-compulsive disorder (OCD)
77. A client with paranoid schizophrenia
is admitted to the psychiatric unit of a
hospital. Nursing assessment should
include careful observation of the client's:
a. thinking, perceiving, and decision-making
skills.
b. verbal and nonverbal communication
processes.
c. affect and behavior.
d. psychomotor activity.
78. Which information is most important
for the nurse to include in a teaching plan
for a schizophrenic client taking clozapine
(Clozaril)?
a. Monthly blood test is required
b. Report a sore throat or fever to the physician
immediately.
c. Blood pressure must be monitored for
hypertension.
d. Stop the medication when symptoms
subside.
79. Important teaching for clients
receiving antipsychotic medication such as
haloperidol (Haldol) includes which of the
following instructions?
a. Use sunscreen because of photosensitivity.
b. Take the antipsychotic medication with food.
c. Have routine blood tests to determine levels
of the medication.
d. Abstain from eating aged cheese.
80. Positive symptoms of schizophrenia
include which of the following?
a. Hallucinations, delusions, and disorganized
thinking
b. Somatic delusions, echolalia, and a flat affect
c. Waxy flexibility, alogia, and apathy
d. Flat affect, avolition, and anhedonia
81. A client with chronic schizophrenia
receives 20 mg of fluphenazine decanoate
(Prolixin Decanoate) by I.M. injection. Three
days later, the client has muscle
contractions that contort the neck. This
client is exhibiting which extrapyramidal
reaction?
a. Dystonia
b. Akinesia
c. Akathisia
d. Tardive dyskinesia
82. Hormonal effects of the antipsychotic
medications include which of the following?
a. Retrograde ejaculation and gynecomastia
b. Dysmenorrhea and increased vaginal
bleeding
c. Polydipsia and dysmenorrhea
d. Akinesia and dysphasia
83. A client is unable to get out of bed
and get dressed unless the nurse prompts
every step. This is an example of which
behavior?  
a. Word salad
b. Tangential
c. Perseveration
d. Avolition
84. An agitated and incoherent client,
age 29, comes to the emergency
department with complaints of visual and
auditory hallucinations. The history reveals
that the client was hospitalized for paranoid
schizophrenia from ages 20 to 21. The
physician prescribes haloperidol (Haldol), 5
mg I.M. The nurse understands that this
drug is used in this client to treat:
a. dyskinesia.
b. dementia.
c. psychosis.
d. tardive dyskinesia.
85. Yesterday, a client with
schizophrenia began treatment with
haloperidol (Haldol). Today, the nurse
notices that the client is holding his head to
one side and complaining of neck and jaw
spasms. What should the nurse do?
a. Assume that the client is posturing.
b. Tell the client to lie down and relax.
c. Evaluate the client for adverse reactions to
haloperidol.
d. Put the client on the list for the physician to
see tomorrow.
86. A client receiving fluphenazine
decanoate (Prolixin Decanoate) therapy
develops pseudoparkinsonism. The
physician is likely to prescribe which drug to
control this extrapyramidal effect?  
a. phenytoin (Dilantin)
b. amantadine (Symmetrel)
c. benztropine (Cogentin)
d. diphenhydramine (Benadryl)
87. Important teaching for a client
receiving risperidone (Risperdal) would
include advising the client to:
a. double the dose if missed to maintain a
therapeutic level.
b. be sure to take the drug with a meal because
it's very irritating to the stomach.
c. discontinue the drug if the client reports
weight gain.
d. notify the physician if the client notices an
increase in bruising.
88. A client is admitted to the psychiatric
hospital with a diagnosis of catatonic
schizophrenia. During the physical
examination, the client's arm remains
outstretched after the nurse obtains the
pulse and blood pressure, and the nurse
must reposition the arm. This client is
exhibiting:
a. suggestibility.
b. negativity.
c. waxy flexibility.
d. retardation.
89. A client with borderline personality
disorder becomes angry when he is told
that today's psychotherapy session with the
nurse will be delayed 30 minutes because
of an emergency. When the session finally
begins, the client expresses anger. Which
response by the nurse would be most
helpful in dealing with the client's anger?
a. "If it had been your emergency, I would have
made the other client wait."
b. "I know it's frustrating to wait. I'm sorry this
happened."
c. "You had to wait. Can we talk about how this
is making you feel right now?"
d. "I really care about you and I'll never let this
happen again."
90. A client begins clozapine (Clozaril)
therapy after several other antipsychotic
agents fail to relieve her psychotic
symptoms. The nurse instructs her to return
for weekly white blood cell (WBC) counts to
assess for which adverse reaction?
a. Hepatitis
b. Infection
c. Granulocytopenia
d. Systemic dermatitis
91. Which nonantipsychotic medication
is used to treat some clients with
schizoaffective disorder?  
a. phenelzine (Nardil)
b. chlordiazepoxide (Librium)
c. lithium carbonate (Lithane)
d. imipramine (Tofranil)
92. A client diagnosed with
schizoaffective disorder is suffering from
schizophrenia with elements of which of the
following disorders?   c. tell the client specifically and concisely what
a. Personality disorder
b. Mood disorder
c. Thought disorder
d. Amnestic disorder
93. When teaching the family of a client
with schizophrenia, the nurse should
provide which information?
a. Relapse can be prevented if the client takes
the medication.
b. Support is available to help family members
meet their own needs.
c. Improvement should occur if the client has a
stimulating environment.
d. Stressful family situations can precipitate a
relapse in the client.
94. A client is admitted to the psychiatric
unit with active psychosis. The physician
diagnoses schizophrenia after ruling out
several other conditions. Schizophrenia is
characterized by:
a. loss of identity and self-esteem.
b. multiple personalities and decreased self-
esteem.
c. disturbances in affect, perception, and
thought content and form.
d. persistent memory impairment and
confusion.
95. The nurse is providing care to a
client with a catatonic type of schizophrenia
who exhibits extreme negativism. To help
the client meet his basic needs, the nurse
should:  
a. ask the client which activity he would prefer
to do first.
b. negotiate a time when the client will perform
activities.
needs to be done.
d. prepare the client ahead of time for the
activity.
96. The nurse is caring for a client who
experiences false sensory perceptions with
no basis in reality. These perceptions are
known as:
a. delusions.
b. hallucinations. b. question the physician about the order.
c. loose associations. c. administer the order for 200 mg P.O. q.i.d.
d. neologisms. but not for 100 mg P.O. p.r.n.
d. administer the medication as prescribed but
97. The nurse is aware that antipsychotic observe the client closely for adverse effects.
medications may cause which of the
following adverse effects?
a. Increased production of insulin
b. Lower seizure threshold
c. Increased coagulation time
d. Increased risk of heart failure

98. A client is admitted with a diagnosis

of delusions of grandeur. This diagnosis
reflects a belief that one is:
a. highly important or famous.
b. being persecuted.
c. connected to events unrelated to oneself.
d. responsible for the evil in the world.

99. A man with a 5-year history of

multiple psychiatric admissions is brought to
the emergency department by the police.
He was found wandering the streets
disheveled, shoeless, and confused. Based
on his previous medical records and current
behavior, he is diagnosed with chronic
undifferentiated schizophrenia. The nurse
should assign highest priority to which
nursing diagnosis?
a. Anxiety
b. Impaired verbal communication
c. Disturbed thought processes
d. Self-care deficient: Dressing/grooming

100. A client's medication order reads,

"Thioridazine (Mellaril) 200 mg P.O. q.i.d.
and 100 mg P.O. p.r.n." The nurse should:
a. administer the medication as prescribed.