PSYCHIATRIC AND MENTAL HEALTH NURSING INSTRUCTIONS: Select the correct answer for each of the following questions. Mark only one answer for each item by
... [Show More] making the box corresponding to the letter of your choice on the answer sheet provided. 1. Which of the following statements best describes a mentally healthy individual? A. Has ability to make decisions B. Does not exhibit physical and emotional problems C. Has self-acceptance and can meet his own basic needs D. Has absence of anxiety and happy 2. The most important role of the Psychiatric nurse as a member of the team is to: A. carry out medical orders B. meet the needs for the physical well-being of the client C. coordinate the psychological care and management of clients D. keep a constant monitoring of the clients 3. Therapeutic use of self is essential in relating with psychiatric clients. This is BEST demonstrated in: A. sympathizing with the miserable feelings of the patient B. engaging patient in productive activity C. engaging patient in introspective thinking D. suppressing her own feelings toward the patient 4. The superego is the part of the psyche which: A. has sense of punishment B. contains primitive and instinctual drives C. makes use of defense mechanism D. forms adequate solutions to a problem 5. Suppression is best defined as: A. voluntary exclusion from consciousness unpleasant feelings, experiences, and thoughts B. involuntary exclusion from consciousness unpleasant feelings, experiences and thoughts C. channeling unacceptable desires into a socially acceptable behavior D. excessive reasoning or logic to avoid disturbed feelings 6. The unconscious defense mechanism that keeps highly anxious experiences out of conscious awareness is: A. Introjection B. Displacement C. Regression D. Repression 7. A defense mechanism wherein the individual dispels an action is: A. Fantasy B. Undoing C. Symbolism D. Substitution 8. A male college student who wants to become an athlete but fails becomes a well known writer. This is an example of: A. Compensation B. Projection C. Reaction Formation D. Sublimation 9. A third year student does a postmortem care without being disturbed by thought of death. He is using: A. Isolation B. Undoing C. Introjection D. Projection 10. A Biological/Medical approach to patient care utilizes which of the following? A. Milieu Therapy B. Somatic Therapy C. Behavioral Therapy D. Psychotherapy 11. The psychiatric nurse’s role in primary prevention includes the following EXCEPT: A. Providing sex education classes for adolescents BSU Achievement Exam February 7, 8, 14, 2009 B. Educating the public about mental health C. Handling crisis intervention in an outpatient setting D. Stress education and psychosocial support 12. Which of these nursing actions belong to the secondary level of prevention? A. Providing mental health consultation to health care providers B. Providing emergency psychiatric services C. Being politically active in relation to mental illness issues D. Providing mental health education to members of the community 13. The community health nurse was invited by a Principal of an Elementary school and was asked to give a talk to parents. An appropriate topic would be: A. the legal aspects of drug abuse B. disciplining children at home and school C. marital crisis D. problems of out of school youth 14. Trust may develop in the nurse-client relationship when the nurse: A. Avoids limit setting B. Encourages the client to use “testing” behaviors C. Tells the client how he should behave D. Uses consistency in approaching the client 15. In a therapeutic nurse-patient relationship, information about the termination phase is introduced: A. During the orientation phase B. During the working phase C. When the patient can tolerate it D. As the goals of the relationship are reached 16. Which of the following tasks should occur during working phase of the nurse-patient relationship? A. establishes trust and open communication B. assess the patient’s needs and develops plan of care C. promotes development of insight and self-concept D. establishes reality of separation and loss 17. Mrs. Reyes remarked, “I am worried about people visiting- with all the media news about child kidnapping and robberies.” The nurse BEST response would be: A. “Would you rather wish that I don’t come and visit you? You regard me as a stranger?” B. “I get that.” The nurse diverts the attention to talk about non-threatening topics C. “It must be distressing to think and feel the way that you do.” D. “I acknowledge what you are saying. My concern is the health care of your family and information are strictly confidential.” 18. Mrs. Reyes expressed that her socializing with neighbors is limited because her husband thinks she is getting overly friendly with a guy next door. Which of the following would the nurse emphasize as basic? A. Keeping trust in the relationship B. Avoid relating with neighbors to minimize conflict C. Be assertive to express her individuality D. Ignore the husband and just be supportive 19. A client has just begun to discuss important feelings when the time of the interview is up. The next day, when the nurse meets with the client at the agreed upon time, the initial intervention would be to say: A. “Good morning, how are you today?” B. “Yesterday you were talking about some very important feelings. Let’s continue.” C. “What would you like to talk about today?” D. Nothing and wait for the client to introduce a topic. 20. A new staff nurse is on orientation tour with the head nurse. A client approaches her and says, “I don’t belong here. Please try to get me out.” The staff nurse’s best response would be: A. “What would you do if you were out of the hospital?” B. “I am new staff member, and I’m on tour. I’ll come back and talk with you later.” C. “I think you should talk with the head nurse about that.” D. “I can’t do anything about that.” 21. The nurse is in the day room with a group of clients when a client who has been quietly watching TV suddenly jumps up screaming and runs out of the room. The nurse’s priority intervention would be to: A. Turn off the TV, and ask the group what they think about the client’s behavior B. Follow after the client to see what has happened. C. Ignore the incident because these outbreaks are frequent. D. Send another client out of the room to check on the agitated client. 22. A nurse observes a client sitting alone in her room crying. As the nurse approaches her, the client states, “I’m feeling sad. I don’t want to talk now.” The nurse’s best response would be: A. “It will help you feel better if you talk about it.” B. “I’ll come back when you feel like talking.” C. “I’ll stay with you a few minutes.” D. “Sometimes it helps to talk.” 23. A student failed her Statistics Final Exam and spent the entire evening berating the teacher and the course. This behavior would be an example of which defense mechanism? A. Reaction-Formation B. Compensation C. Projection D. Displacement 24. The pre-morbid personality of a person with a non-psychotic maladaptive response to anxiety may most accurately be described as: A. unpredictable, impulsive, aggressive B. rigid, insecure and conforming C. dependent, pessimistic, moody D. anxious, insensitive and self-absorbed 25. The most effective nursing intervention for a severely anxious client who is pacing vigorously would be to: A. Instruct her to sit down and quit pacing B. Place her in bed to reduce stimuli and allow rest. C. Allow her to talk until she becomes physically tired. D. Give her PRN medication and walk with her at a gradual slowing pace. 26. It is in this level of anxiety where cognitive capacity diminishes. Focus becomes limited and client experiences tunnel of vision. Physical signs of anxiety become more pronounced. A. Severe B. Panic C. Mild D. Moderate 27. Antianxiety medications should be used with extreme caution because long term use can lead to: A. Parkinsonian like syndrome B. Hypertensive crisis C. Hepatic failure D. Addiction 28. It is essential in desensitization for the patient to: A. have rapport with the therapist B. assess one’s self for the need of an anxiolytic drug C. use deep breathing or another relaxation technique D. work through unresolved unconscious conflicts 29. A client with a diagnosis of obsessive-compulsive disorder constantly does repetitive cleaning. The nurse knows that this behavior is probably most basically an attempt to: A. decrease the anxiety to a tolerable level B. focus attention on non threatening tasks C. control others D. decrease the time available for interaction with people 30. A client is suffering from Post-traumatic stress disorder following a rape by an unknown assailant. One of the primary goals of nursing care for this client would be to: A. establish a safe, supportive environment B. control aggressive behavior C. deal with the client’s anxiety D. discuss the client’s nightmares and reactions 31. The nursing management of anxiety related with post traumatic stress disorder includes all of the following EXCEPT: A. encourage participation in recreation or sports activities B. reassure client’s safety while touching the client C. speak in calm soothing voice D. remain with the client while fear level is high 32. A client’s deafness has been diagnosed as Conversion disorder. Nursing interventions should be guided by which one of the following? A. The client will probably express much anxiety about her deafness and require much reassurance B. The client will have little or no awareness of the psychogenic cause of her deafness C. The client’s need for the symptom should be respected; thus, secondary gains should be allowed D. The defense mechanisms of suppression and rationalization are involved in creating the symptom. 33. A female client has just received the diagnosis of Hypochondriasis. This client continually focuses on GI problems and constantly rings for a nurse to meet her every demand. The best nursing approach is to: A. Ignore the demands because the nurse knows it is not necessary to respond B. Assign various staff members to work with the client so no staff member will become negative C. Anticipate the client’s demands and spend time with her even though she does not demand it D. Provide for the client’s basic needs, but do not respond to every demand, which reinforces secondary gains 34. Persons with Personality disorders tend to be manipulative. In planning the care of a person with this diagnosis, the nurse would: A. Allow manipulation so as to not raise the client’s anxiety B. Appeal to the client’s sense of loyalty in adhering to rules of the community C. Know that when the client’s manipulation are not successful, anxiety will increase D. Establish a nurse-client relationship to decrease the client’s manipulations 35. A male client in the Psychiatric unit becomes upset and breaks a chair when a visitor does not show up. The first nursing intervention should be to: A. Stay with the client during the stressful time B. Ask direct questions about the client’s behavior C. Set limits and restrict the client’s behavior D. Plan with the client for how can he better handle the situation 36. The nurse has been interviewing a client who has not been able to discuss any feelings. 5 minutes before the time is over, the client begins to talk about important feelings. The intervention is to: A. Go over the agreed upon time, as the client is finally able to discuss his feelings with him B. Tell the client that it is time to end the session now, but another nurse will discuss his feelings with him C. Set an extra meeting time a little later to discuss these feelings D. End just as agreed, but tell the client that these are very important feelings and he can continue tomorrow 37. The psychodynamics of depression is: A. lax super-ego B. weak super-ego C. internalized hostility feelings D. id dominance 38. In working with a depressed client, the nurse should understand that depression is most directly related to a person’s: A. Experiencing poor interpersonal relationships with others B. Having experienced a sense of loss C. Remembering his traumatic childhood D. Stage in life 39. A 45 yr. old female client has been in the hospital for 3 days with a diagnosis of depression. During this time, she has not put on a clean dress, washed her hair, or participated in any of the unit activities. The next day, the nurse observes that she is wearing a clean dress and has combed her hair. The appropriate statement to the client is: A. “Oh, I’m so pleased that you finally put on a clean dress.” B. “Something is different about you today. What is it?” C. “That’s good. You have on a clean dress and have combed your hair.” D. “I see that you have on a clean dress and have combed your hair.” 40. Which of these drugs is likely given for depression? A. Haloperidol (Serenace) B. Diazepam (Valium) C. Imipramine (Tofranil) D. Fluphenazine (Prolixin) 41. Which of the following must be considered while planning activities for the depressed patient? A. activities which require exertion of energy B. challenging activities to foster self expression C. reading materials to divert his thoughts D. variety of unstructured activities 42. The BEST Attitude therapy that a nurse utilize for a depressed client is: A. Active Friendliness B. Matter of Fact C. Kind Firmness D. Passive Friendliness 43. When encouraged to join an activity, a depressed client on the psychiatric unit refuses and says, “What’s the use?” The approach by the nurse that would be most effective is to: A. Sit down beside her and ask her how she is feeling B. Tell her it is time for the activity, help her out of the chair, and go with her to the activity C. Convince her how helpful it will be to engage in the activity D. Tell her that this is a self-defeating attitude and it will only make her feel worse 44. A 60 yr. old male client has been admitted to the psychiatric unit, the symptoms ranging from fatigue, an inability to complete everyday tasks, to refusal care to care for him and preferring to sleep all day. One of the first interventions should be aimed to: A. developing a good nursing care plan B. Talking to his wife for cues to help him C. Encouraging him to join activities on the unit D. Developing a structured routine for him to follow 45. When a depressed client becomes more active and there is evidence that her mood has lifted, an appropriate goal to add to the nursing care plan is to: A. Encourage her to go home for the weekend B. Move her to a room with three other clients C. Monitor her whereabouts D. Begin to explore the reasons she became depressed 46. The nurse is assigned to a client who is potentially suicidal. Of the following nursing objectives, which one is the most important? A. Observe the client closely at all times B. Recognize a continued desire to commit suicide C. Involve the client in activities with others to mobilize him D. Provide a safe environment to protect the client 47. When assessing a client for possible suicide, an important clue would be if the client: A. is hostile and sarcastic to the staff B. identifies with problems expressed by other clients C. seems satisfied and detached D. begins to talk about leaving the hospital 48. The defense mechanism utilized by manic patients to cover up depression is: A. Reaction-Formation B. Compensation C. Displacement D. Denial 49. A client with the diagnosis of manic episode is pacing around the unit trying to organize the games with the clients. An appropriate nursing intervention is to: A. have the client play table tennis B. suggest video exercises with the other clients C. Take the clients outside for walk D. Do nothing, as organizing a game is considered therapeutic 50. A client ahs the diagnosis of manic episode. Her disruptive behavior on the unit has been increasingly annoying to the other clients. One intervention by the nurse might be to: A. tell the client she is annoying others and confine her to her room B. ignore the client’s behavior, realizing it is consistent with her illness C. set limits on the client’s behavior and be consistent in approach D. make a rigid, structured plan that the client will have to follow 51. While working with an alcoholic client, the most important approach by the nurse would be to: A. maintain a nonjudgmental attitude toward the client B. establish strict guidelines of behavior C. explicitly outline expectations of the client D. set up a working nurse-client relationship 52. A client is admitted with a diagnosis of delirium tremens. He is exhibiting marked tremors, hallucinations, tachycardia, and is perspiring profusely. The nurse anticipates an order of: A. Start an IV with Vitamin B complex supplement B. Administer valium IM C. Control the environment with a quiet, single room, side-rails up, and soft lights D. Get baseline VS 53. A client has the diagnosis of Cognitive disorder, Alzheimer’s disease. The client is constantly making up stories that are untrue. This characteristic of the disease is called: A. Senility B. Confabulation C. Lability D. Memory loss 54. A client in a long-term care facility has the diagnosis of Dementia, Alzheimer’s disease. His care plan should include the goal of assisting him to participate in activities that provide him a chance to: A. interact with other clients B. compete with others C. succeed at something D. get a sense of continuity 55. A 70 yr. old client is admitted with the diagnosis of Cognitive disorder, Dementia Type. In discharge planning with the family, the nurse would take into account that his prognosis is: A. Good, because the condition tends to be reversible B. Unpredictable, because the condition may reverse C. Poor, because symptoms are reduced intellectual capacity, emotional stability, memory, and judgment D. Poor, because the condition will rapidly progress 56. The most appropriate short-term nursing goal for Schizophrenic clients is to: A. Set limits on bizarre behavior B. Establish trusting, non-threatening relationship C. Quickly establish a warm, close relationship D. Protect client from inappropriate responses 57. When the nurse is talking with a Schizophrenic client, she suddenly says, “I’m frightened, do you hear that? Terrible things.” Which initial response by the nurse would be most appropriate? A. “I don’t hear anything.” B. “I don’t hear anything but you seem frightened.” C. “Who is saying terrible things to you?” D. “What is he saying to you?” 58. One day the nurse overhears a client with the diagnosis of Schizophrenia talking to herself. She is saying, “The mazukas are coming. The mazukas are coming.” Her use of the word mazuka is most likely A. an example of associative looseness B. flight of ideas C. a neologism D. a hallucination 59. A. 20 yr. old client is admitted to the psychiatric unit with a diagnosis of Schizophrenia, acute episode. He is having auditory hallucinations and seems disoriented to time and place. The nurse knows that a hallucination can be explained as: A. Sensory experience without foundation in reality B. Voice that is heard by the client but is not really there C. Distortion of real auditory or visual perception D. Idea without foundation in reality 60. Lilia, 48 y/o, thinks she is being followed by soldiers to kill her. What thought disorder does this indicate? A. Ideas of reference B. Flight of ideas C. Delusion of persecution D. Delusion of grandeur 61. Marina, 26 y/o is aloof and suspicious of the foods being served to her. She utilizes the defense mechanism of Projection. This means that she: A. unconsciously refuses to accept a feeling, thought or impulse and attributes it to someone else B. justifies behavior, attitudes and feelings with excuses C. involuntary refuses to acknowledge reality D. involuntary excludes wishes, impulses, memories and feelings from awareness 62. Which of these nursing approaches is MOST appropriate for the nurse to begin with Marina? A. Engage her for at least 1hr. in one to one interaction daily B. Invite her to socialize with other patients C. Make self available while maintaining distance until she shows readiness to interact D. Refer her for activity therapy 63. When Marina refuses to take her medication, it is best to: A. let her read the drug literature to convince her that it is therapeutic B. force her to take the drug to maintain therapeutic effectiveness C. have the same nurse, who she interacts with regularly, administer the drug D. request the doctor to give it to her 64. Another reason why Marina refuses to take Thorazine is because she complains of robot like movements and slurred speech. The nurse’s action is: A. decrease the dosage of Thorazine B. explain the extrapyramidal side effects and administer Benadryl C. avoid giving foods that are rich in Tyramine D. withhold medication until referral is made to the doctor 65. A50 yr. old male client has a history of many hospitalizations for Schizophrenic disorder. He has been on long-term Phenothiazines (Thorazine), 400 mg/ day. The nurse assessing this client observes that he demonstrates jerky choreiform movements, lip smacking, neck and back tonic contractions. The nurse concludes that the client develop: A. Tardive dyskinesia B. Parkinsonism C. Dystonia D. Akathisia 66. A client with the diagnosis of Schizophrenia has orders for Clozapine (Leopnex). The nurse will evaluate the drug’s effect as positive if the: A. Client develops Leukopenia B. Psychotic symptoms such as hearing voices are reduced C. Monthly liver function studies changes moderately D. Client’s energy level and involvement in activities goes up 67. A client with a diagnosis of Paranoid Personality disorder refuses to take his medication and is accusing the nurse of trying to kill him. The nurse’s best strategy would be to tell him that: A. “It is not poison and you must take the medication.” B. “I will give you an injection if necessary.” C. “You may decide if you want to take the medication by mouth or injection, but you must take it.” D. “It’s all right if you don’t take the medication right now.” 68. A newly admitted client to the psychiatric unit will receive ECT. ECT is considered most effective in treating: A. Young clients with depressive reactions B. Elderly clients with depressive reactions C. Any age client with Schizophrenia D. Young clients with paranoid reactions 69. The treatment in Crisis intervention centers is specifically intended to help clients: A. Return to prior levels of functioning B. Understand the dynamics underlying symptoms C. Make long range plans for the future D. Accept their illness 70. A client comes to the emergency room with complaints of headache and vomiting. Upon interview, the client says she is taking the drug Marplan. The nurse would continue the assessment by first asking: A. The dose of Marplan she is taking B. If she recently had flu symptoms C. What foods she has been eating D. What other medication she is taking 71. A client is to take Lithium regularly after she is discharged from the hospital. The most important information to impart to the client and his family is that the client should: A. Have an adequate intake of sodium B. Limit his fluid intake C. Have a limited intake of sodium D. Not eat foods that have a high tyramine content 72. A hospitalized male adolescent flirts with and is sexually provocative toward a female nurse. The nurse can respond MOST therapeutically by doing which of the following? A. Telling him she is married and too old for him B. Introducing him to female clients his own age C. Encouraging him to watch TV in his room D. Ignoring his flirtatious and provocative behaviors 73. The pedophile’s choice of a sex object is primary based on: A. difficulty relating with adults B. feelings of tenderness towards children C. fears of incestuous impulses D. preferred for a passive sexual role 74. The attitude therapy that is best to be used for Carlo who is aggressive is: A. Kind Firmness B. No Demand C. Active Friendliness D. Passive Friendliness 75. Jim would count pencils in a mug over and over with the thought that stopping could result in something bad happening. These are many things Jim seems he has to do to keep himself from feeling: A. Confused B. Suspicious C. Excited D. Anxious 76. He has to change clothes 20 times before work, chew each bite he eats 24 times and go up and down the stairs 4-5 times before it feels right. He is demonstrating; A. ideas of reference B. denial and projection C. obsession and compulsion D. rationalization and over reaction 77. The objective of nursing care for Jim is to develop or increase feelings of: A. self-mastery B. self-worth C. self-actualization D. self-determination 78. All of these are therapeutic interventions for Jim EXCEPT: A. impose limits every time the behavior becomes repetitive B. establish a routine for him C. assign task that can be done repetitively D. facilitate self-expression 79. Jim is aware of his behavior, yet realizes that it is very disturbing to him. This is a pattern of: A. personality disorder B. psychosis C. neurosis D. habitual disorder 80. An appropriate nursing diagnosis for Jim is: A. Altered Thought Process B. Ineffective Individual Coping C. Impaired Adjustment D. Self-care deficit 81. Which of the following items will the nurse NOT allow to be brought inside a psychiatric unit? A. Pocket book B. box of cake C. bottle of coke D. wallet 82. Situational crisis are usually resolved in a time period of: A. 1-4 days B. 2-4 weeks C. 1-2 months D. 2-6 months 83. According to crisis theory, the minimal long-term goal in crisis intervention is: A. relief of acute symptoms B. relief of panic level anxiety C. restoration of the functioning level D. reorganization and reordering of the personality 84. The most critical factor for the nurse to determine during crisis intervention is the client’s: A. developmental history B. available situational supports C. underlying unconscious conflict D. willingness to restructure personality 85. Which of the following statements about Family Violence is Tue? A. It affects every socio-economic level B. It is caused by drug and alcohol abuse C. It predominantly occurs in lower socioeconomic levels D. It rarely occurs during pregnancy 86. Secondary level of prevention of domestic violence involves: A. educational programs that enhance family function B. early detection and treatment of interpersonal violence C. psychotherapy for the abuser D. family therapy 87. You are working in the emergency department conducting an interview with a victim of spousal abuse. Which step should you take first? A. contact the appropriate legal services B. ensure privacy for interviewing the victim away from the abuser C. establish rapport with the victim and the abuser D. request the presence of the security personnel 88. The following are characteristic of abuse in the family, EXCEPT A. victims have little capacity to defend themselves B. victims may feel emotionally if not physically trapped C. victims of abuse are often independent of their abuser D. the abuser is physically stronger than the abused 89. Which of the following is NOT a characteristic of an abuser? A. was abused as a child B. rigid in retaining control C. assertive and socially adept D. inadequate and impulsive 90. The following interventions are appropriate for a victim of abuse EXCEPT: A. Communicate acceptance and non moralistic attitude B. Reinforce her right to be free from abuse C. Encourage the victim to leave the abuser D. Help the victim develop a safety plan 91. The nurse is assessing a parent who abused her child. Which of the following risk factors would the nurse expect to find in this case? A. flexible role functioning between parents B. history of the parent having been abused as a child C. single parent home situation D. presence of parental mental illness 92. Which of the following assessment findings would lead the nurse to suspect that an 8 yr. old child is a victim of sexual abuse? A. child is fearful of caregiver and other adults B. child has a lack of interpersonal relationships C. child has self-injurious behaviors D. child has interest in playing with other children 93. Play therapy among victims of abuse is: A. Playing indoor games to divert attention from the abuse B. Drawing or playing with dolls rather than talking C. Allowing the child to talk about hurt feelings and pain D. Opening communication channels with the family 94. What is the priority nursing intervention for a child or elder victim of abuse? A. assess the scope of the abuse problem B. analyze family dynamics C. implement measures to ensure the victim’s safety D. teach appropriate coping skills 95. When communicating with a child, which approach would be most effective EXCEPT: A. use simple language B. ask questions indirectly to obtain specific information C. Talk about reality, focusing on the present D. Speak calmly but firmly when reinforcing behavioral limits 96. A child with Separation Anxiety disorder has not attended school for 3weeks, and she cries and exhibits clinging behaviors when her mother encourages attendance. The priority nursing intervention by the nurse would be to: A. assist the child to return to school immediately with family support B. arrange for a home-school teacher to visit for 2 weeks C. encourage family discussion of various problem areas D. use play therapy to help the child express her feelings 97. Diagnostic criteria for Separation Anxiety disorder include which of the following? A. inattention and hyperactivity B. poor relationship with peers and adults C. impaired social interaction D. presence of nightmares in the absence of primary caregiver 98. Which behavioral assessment in a child is most consistent with a diagnosis of Conduct disorder? A. arguing with adults B. gross impairment in communication C. physical aggression toward others D. refusal to separate from caregiver 99. The primary nursing intervention in working with a child with a Conduct disorder is to: A. Plan activities that provide opportunities for success B. Give the child unconditional acceptance for good behaviors occur C. Recognize behaviors that precede the onset of aggression and intervene before violence occurs D. Provide immediate positive feedback for acceptable and unacceptable behaviors 100.Misinterpretation of bodily sensations or symptoms is a chief feature of: A. Somatization disorder B. Conversion disorder C. Hypochondriasis D. Phobia Show Less [Show Less]