Professional Documents
Culture Documents
BOARD OF NURSING
✓ NO OPEN OF NOTES
✓ EVALUATE YOUR RETENTION
✓ EVALUATE YOUR UNDERSTANDING/COMPREHENSION
✓ EVALUATE YOUR CRITICAL THINKING SKILLS & APPLICATION
2. The client has a sustained ICP of 20mmHg. The nurse should position
the client:
A. With the head of bed elevated 30 to 45 degrees
B. In Trendelenburg’s position
C. In Sim’s position
D. With the head elevated on two pillows
10. The most common complaint of a client with ear disorder is?
A. Earache C. Hearing loss
B. Discharge from ear D. Tinnitus
11. On a visit to the clinic, a client reports the onset of early symptom
of Rheumatoid Arthritis. Which of the following would the nurse most
likely assess?
A. Limited motion of joint
B. Deformed form of the hands
C. Early morning stiffness
D. Rheumatoid arthritis
12. The nurse is planning care for the client with femoral fracture who is
in balanced suspension traction. Which of the following would the
nurse least likely to include in the plan of care?
A. Use the fracture bedpan
B. Check for redness over ischial tuberosity
C. Elevation of the head no more than 25 degrees
13. A client who had a right total elbow joint replacement yesterday is
complaining of numbness on the lateral surface of the right leg and the
dorsal surface of the right foot. After assessing the neurovascular
status of both upper and lower extremities, the nurse finds no other
discrepancy except the numbness. The nurse should:
A. Administer the ordered pain medication
B. Reposition the leg to a neutral position and notify the physician
C. Inform client that this finding is not uncommon after surgery
D. Reassure the client and share this data at the change-of-shift
report
15. Nursing care of a client with a fractured hip should include the
assessment of pedal pulses. The important characteristics of pedal
pulses are:
A. Contractility and rate
B. Color of skin and rhythm
C. Amplitude and symmetry
D. Local temperature and visible pulsations
Situation 4: The body’s most organized and complex system, the nervous
system, profoundly affects both psychological and physiological functions.
Even more fascinating is the knowledge of man’s ability to comprehend,
learn, act and, feel as an individual organism.
20. Which goal is the most realistic and appropriate for a client diagnosed
with Parkinson’s disease?
A. To cure the disease
21. You have reviewed and reread the physiologic changes that elderly
clients undergo. You consider that it is most difficult for Fred to
distinguish colors especially the color:
A. Purple C. Yellow
B. Red D. Green
22. You are aware that elderly clients are prone to pressure sores because
of inactive lifestyle and immobility. The following nursing
interventions are appropriate in the prevention of pressure sores among
bed ridden elderly clients EXCEPT:
A. Massage bony prominences
B. Apply alcohol on the skin
C. Keep the skin clean and dry
D. Turn the client every 1 to 2 hours
26. A client approaches a nurse and tells her that he hears a voice telling
that he’s evil and deserves to die. Which of the following terms
describes the client’s perception?
A. Delusion C. Hallucination
B. Disorganized speech D. Idea of reference
28. A client was hospitalized after his son filed a petition for
involuntary hospitalization for safe reasons. The son seeks out the
nurse because his father is angry and refuses to talk with him. He is
29. A client asks a nurse if she hears the voice of the non-existent man
speaking to him. Which of the following response is best?
A. “No one is in your room except you”
B. “Yes, I hear him, but I won’t listen to him”
C. “What has he told you? Is it helpful advice?”
D. “No I don’t hear him, but I know you do what is he saying?”
32. When developing a plan of care for a depressed client, the approach
that would be most therapeutic would be:
A. Allowing time for the client’s slowness when planning activities
B. Helping the client focus on family strength and support systems
C. Encouraging the client to perform menial tasks to meet the need for
punishment
D. Repeating again and again that the staff views the client as
worthwhile and important
36. When caring for a client with a generalizing anxiety disorder, the
nurse should be aware that one of the best indicators of the client’s
present condition is the client’s:
A. Memory C. Judgment
B. Behavior D. Responsiveness
37. The nurse recognizes that it would be unusual for an individual with
anxiety disorders to handle the anxiety by:
A. Acting it out with antisocial behavior
B. Converting it into a physical symptoms
C. Regressing to earlier levels of adjustment
D. Displacing it on to less threatening objects
39. Compulsive symptoms, such as using paper towels to open doors develop
because the clients are:
A. Consciously using this method to punish themselves
B. Listening to voices that tell them the door knobs are unclean
C. Unconsciously controlling unacceptable impulses or feelings
D. Fulfilling a need to punish others by carrying out an annoying
procedure
40. The nurse could most appropriately begin to help an extremely anxious
client with a sleep problem who has been assigned to a four bed room
since admission by saying:
A. “You seem unable to sleep at night”
B. “I’m going to move you to a private room”
C. “Don’t worry; you’ll sleep when you’re tired”
D. “I’ll get you the sedative your doctor ordered”
Situation 8: Tina was always a chubby child. When she was 23 year old,
she lost considerable weight by dieting. Shortly thereafter, she began
seriously dating and was married. Tina was thrilled with her new look and
worked hard to maintain her weight loss, consistently keeping her weight
slightly under the ideal for her height. After 2 years of marriage, Tina
became pregnant. The thought of gaining weight during her pregnancy upset
42. Tina started to tell the nurse that she has developed hair in most of
her body. Which of the following conditions may be associated with
this?
A. Anemia C. Dehydration
B. Osteoporosis D. Electrolyte imbalance
43. Tina tells the nurse, “I feel so awful and inadequate.” Which of the
following responses is best?
A. “You’re being too hard on yourself”
B. “Somebody you’ll feel better about things”
C. “Tell me something you like about yourself”
D. “Maybe relaxing by yourself will help you feel better
45. During a prenatal interview, the nurse becomes aware that Tina has a
history of PICA. The most appropriate nursing action would be to:
A. Seek a psychologic referral for the client
B. Make sure the client’s diet is nutritionally adequate
C. Inform the client of the danger this poses to her baby
D. Obtain an order for multivitamin supplement for the client
46. A nurse assesses a client for signs of alcohol withdrawal. During the
period of early withdrawal, which of the following findings are
expected?
A. Depression C. Insomnia
B. Hyperactivity D. Nausea
49. The nurse evaluates that a male client has accepted his drinking as a
problem when he:
A. Attends scheduled in-patient group meetings
B. Takes his anti-abuse each morning as ordered
C. Attends alcoholics anonymous meetings daily
D. Volunteers to be a sponsor for another alcoholic
52. A client approaches the nurse and points to the sky, showing her where
the men would be coming from to get him. Which is the most therapeutic
response?
A. “Why do you think the men are coming here?”
B. “You’re safe here, we won’t let them harm you”
C. “It seems like the world is pretty slow for you, but you‘re safe
here”
D. “There are no bad men in the sky because no one lives that close to
earth”
53. An older adult client has not been eating well since admission. The
client repeatedly states, “No one cares.” The most appropriate
response by the nurse would be:
A. “We all care about you; now please eat.”
B. “You know you have to eat to stay alive”
C. “I care about you. What foods do you especially like?”
D. “I care about you. Please eat some of this food for me”
54. During a one-to-one interaction with a nurse, the client states, “I’m
worried about going home.” The nurse responds, “Tell me more about
this.” This response is an example of:
A. Clarifying C. Refocusing
B. Reflecting D. Acknowledging
58. When a client starts to openly masturbate, the nurse’s most appropriate
action would be to:
A. Not react to the behavior
B. Put the client in seclusion
C. Restrain the client’s hands
D. State that such behavior is unacceptable
59. Billy yelled at the nurse and said, “You think you’re so damned perfect
and good. I think you stink!!! The best response of the nurse would
be:
A. “You seem angry with me”
B. “Stink? Now look who’s talking”
C. “Boy, you’re in a bad mood”
D. “I can’t be all that bad, can I?”
61. The nurse is aware that the approach to be used during crisis
intervention should be:
A. Passive and reflective C. Future – oriented and passive
B. Active and goal-directed D. Interpretative and analytic
64. The most advantageous therapy for a preschool age child with a history
of physical and sexual abuse would be:
A. Play C. Family
B. Group D. Psychodrama
66. When caring for psychiatric-mental health clients whose ability to give
informed consent depends on their degree of psychiatric impairment, the
nurse’s priority obligation is to:
A. Assess the client’s legal capacity when that client is asked to
give consent
B. Prevent the client form revoking consent
C. Obtain informed consent when the primary provider cannot be present
D. Persuade the client to consent
A. 3 and 2 C. 4 and 1
B. 3 and 4 D. 4 and 2
68. A client has developed a therapeutic relationship with the nurse. Upon
discharge, she asks for the nurse’s home phone number so she can “keep
in touch.” The nurse likes the client very much but tells her that a
friendship would violate the boundaries of the therapeutic
69. A 35-year old man was hospitalized 2 weeks ago for Acute Anemia. Upon
admission, he made many lewd and offensive comments to the nurse. The
nurse finds it hard to have a conversation with the client now, even
though his offensive remarks have ceased. The nurse’s ethical dilemma
involves which principle?
A. Justice C. Beneficence
B. Veracity D. Paternalism
74. Persons selected for comparison and experimental research groups are
known as the:
A. Subjects C. Researchers
B. Control group D. Experimental group
76. A client tells the nurse that her coworkers are sabotaging the
computer. When the nurse asks questions, the client becomes
argumentative. This behavior shows personality traits associated with
which of the following personality disorders?
A. Antisocial C. Paranoid
B. Histrionic D. Schizotypal
83. A 6-year old girl with autism is nonverbal and has limited eye contact.
To promote social interaction, the nurse initially should:
Situation 17: Philip Wilson has a long history of mental problems. Mr.
Wilson is a patient in the state hospital system. Mr. Wilson is diagnosed
with Schizophrenia.
86. Mr. Wilson repeats the nurse’s phrases and shows motor immobility with
prominent grimacing. Which type of schizophrenia is Mr. Wilson having?
A. Catatonic C. Residual
B. Disorganized D. Undifferentiated
87. While talking to Mr. Wilson, the nurse notes that Mr. Wilson frequently
uses unrecognizable words with no common meaning. The nurse knows that
this is termed as:
A. Echolalia C. Neologism
B. Clang association D. Word Salad
88. The nurse is talking with Mr. Wilson’s family. The Significant Other
(SO) asks, “What causes this disorder?” Which of the following
explanations is most widely accepted?
A. Prenatal or post partum central nervous system damage
B. Bacterial infections in the mother during pregnancy or delivery
C. A biological predisposition exacerbated by environmental stressors
D. Lack of bonding and attachment during infancy, which teals to
depression in later life
89. A nurse observes the client in the corner of the room moving his lips
as if he were talking to himself. Which of the following actions is
the most appropriate?
A. Ask him why he’s talking to himself
B. Leave him alone until he stops talking
C. Tell him it isn’t good for him to talk to himself
D. Invite him to join in a card game with the nurse
92. A client recently lost a spouse. Which behavior indicates that the
client is going through a normal stage of grieving?
A. The client starts using chemicals
B. The client becomes an over achiever
C. The client shows signs of hyperactivity
D. The client shows loss of warmth when interacting with others
93. Which of the following therapies has been most strongly advocated for
the treatment of Post Trauma Stress Disorder (PTSD)?
A. ECT C. Group therapy
B. Hypnotherapy D. Individual therapy
95. A long-term therapy goal for a female client hospitalized for a major
depressive episode should be that the client will be:
A. Able to talk about her depressed feelings
B. Able to develop new defense mechanisms
C. More realistic in accepting herself and others
D. Aware of the unconscious source of her anger
96. A client tells the nurse, “I want to tell you something but you must
promise to keep it a secret.” Which response would impair the
therapeutic relationship? “I would like to hear what you have to say:
A. “Ana as a client advocate, I will respect your right to
confidentiality”
B. “But I am part of a team that shares important information about
clients”
C. “But I cannot promise to keep what you say confidential from the
rest of the staff”
D. “Ana I hope that you will trust me to do what is in your best
interests with the information”
97. In psychiatric nursing, the most important tool the nurse brings to a
helping relationship is:
A. Oneself and desire to keep
B. Advanced communication skills
C. Knowledge of psychopathology
D. Years of experience in milieu therapy
99. A nurse has been assigned to work with a depressed client on a one-to-
one basis. The next morning the client refuses to get out of bed
saying, “I’m too sick to be helped and I don’t want to be bothered.”
The nurse’s best response would be:
A. “You will not feel better unless you make the effort to get up and
get dressed”
B. “I know you will feel better again if only you make the attempt to
help yourself”
C. “Everyone feels this way in the beginning as they confront
repressed feelings. I’ll sit down with you”
D. “I know you don’t feel like getting up, but you probably will feel
better if you do. Let me help you get started.”
100. A nurse asks the supervisor, “What coping strategy could I develop to
prevent over responding to stress in the future? The supervisor could
best respond:
A. “Have your problem-solving skills”
B. “Ignore situations that you can change”
C. “Improve your time management skills”
D. “Develop a wide variety of coping strategies”