ANSWER SHEET: 1. 2. CLASSIFIED EXAMINATION 3. 4. 5. 6. 7. 8. 9. 10. 1. People with schizophrenia often resist treatment.

They may not think they need help because they believe their _________or ___________ are real. In planning for the initial care for a client with acute schizophrenia, the nurse must appropriately emphasize: A. Encourage client to join a simple group activity. B. Provide variety of activities to keep patient focus on reality. C. Assign the same staff members to work with the client each day. D. Establish a daily or structured routine to promote orientation to the unit (Ap/SQC) Schizophrenia Management of schizophrenia 2. People with____________ are at increased risk of having a number of other mental-health conditions, committing suicide, and otherwise dying earlier than people without this disorder . The parents of a client with schizophrenia express feelings of responsibility and guilt for their sons problems. How can the nurse best educate the family? A. Refer the family to a support group. B. Explain the biological nature of schizophrenia. C. Teach the parents various ways they must change. D. Acknowledge the parents responsibility. (Ap/HE) Schizophrenia Nursing intervention for Schizophrenia 3. Symptoms can vary, depending on the type of schizophrenia . The __________subtype of schizophrenia often characterized by a childlike silliness and is generally characterized with poor prognosis, whereas the __________ subtype is the most common subtype and is generally associated with better prognosis. A. Disorganized; paranoid C. Catatonic; disorganized B. Undifferentiated; catatonic D. Catatonic; paranoid (An/HE) Subtypes of Schizophrenia 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30.

FOR CRITICAL TEST ANALYSIS PSYCHOTIC DISORDERS

LOCAL NURSING LICENSURE EXAM Prepared by: Ms. Andy lynn Noble-Hizo, RN, MAN, PhD.
Warning: This material is protected by Copyright Laws. Unauthorized use shall be prosecuted in the full extent of the Philippine Laws. For exclusive use of CBRC reviewees only.

delusions are examples of ___________symptoms of schizophrenia, while alogia and avolition are examples of __________ symptoms of schizophrenia. A. Hallmark; depressive B. Negative; positive C. Positive; negative . D. Positive; pathognomonic (An/HE) Symptoms of Schizophrenia 6. People with schizophrenia are not usually ______ In fact, most violent crimes are not committed by people with schizophrenia Andy is pacing up and down the hall rapidly and muttering in an angry manner and had several verbal outbursts but not violent since admission. What is the initial nursing action for Andy diagnosed with paranoid type of schizophrenia? A. Prepare a PRN IM injection to give the client. B. Contact the psychiatrist and request for a seclusion. C. Gather several staff member to approach the client together. D. Observe the clients behavior and approach in a nonthreatening manner. (Ap/SQC) Nursing Management for Schizophrenia

7.

4.

Childhood-onset schizophrenia begins after age_____. Childhood schizophrenia is rare and can be difficult to tell apart from other developmental disorders of childhood, such as autism. Which of the following outcomes related to delusional perceptions of the client would the nurse establish first to a client with paranoid type of schizophrenia? A. The client will take prescribed medications without difficulty. B. The client will participate in unit activities. C. The client will perform daily hygiene and grooming without assistance and supervision. D. The client will demonstrate realistic interpretation of daily events in the unit. (E/QI) Nursing goals for Schizophrenia 5. Schizophrenia symptoms usually develop____ over months or years. Sometimes you may have many symptoms, and at other times you may only have a few. Hallucinations and

_________ controls thoughts and decision-making and acts as a sort of a gatekeeper for which impulses and thoughts become conscious and can be acted upon. Some researchers believe that an abnormally high level of dopamine may be related to the occurrence of: A. Schizophrenia C. Mental depression B. Parkinsons disease D. Alzheimers disease (C/R) Neurotransmitters 8. Schizophrenia affects both ____and _____. It usually begins in the teen years or young adulthood, but may begin later in life. Which information is most essential in the initial teaching session for the family of a young adult with diagnosed with schizophrenia? A. Symptoms of schizophrenia imbalance the brain functioning. B. The genetic history is an important factor to the development of schizophrenia. C. The distressing symptoms of schizophrenia can respond to treatment and medications. D. Schizophrenia is a lifetime disorder. (S/HE) Nursing Intervention for Schizophrenia -1-

DR. CARL E. BALITA REVIEW CENTER TEL. NO. 735-4098/7350740

9.

_______ suffer from depression twice often as____. One out of four women may have depression sometime during their lifetime. Many people suffer with depression but do not seek help. The nurse knows that sadness typically accompanies grief and depression. Which changes indicate major depressions? A. Fear, timidity, lack of interest around B. Lacks initiative, dominating, defensiveness C. Withdrawal, negative attitude, no eye contact D. grandiosity, apathy, self-doubt (An/HE) Depression Symptoms 10. Over half of all suicides occur in adult _____, ages 25-65 . Which method would a nurse use to determine a clients risk for suicide? A. Observe clients behavior for cues of suicide ideation B. Question client directly about suicidal thoughts. C. Wait for the client to bring up subject of suicide. D. Question the client about future plans. (Ap/SQC) Suicide 11. Onset of a manic episode may occur over time, and in some instances, mania may occur rapidly and without warning signs. During manic episodes, people are unable to control their _______ and may need medication to return to a normal state. A client is admitted with a history of extremely elevated and irritable mood for almost a week now. Upon assessment, the nurse notes grandiosity, flight of ideas and insomnia and agitation. The nurse sets a priority short term goal: the client will demonstrate: A. Adequate nutrition and rest B. Stability of mood C. Improvement in judgment D. Understanding medication regimen (S/QI) Nursing Management for Mania 12. A proper ____________ relationship must be established before any nursing care can be made. This involves letting the client feel that the nurse has respent for the client as a whole and regard as a human being. Nurse Laika visited her client, Byron during breakfast one morning, Byron verbalized, I just want to stay in bed. I not in the mood for breakfast today. Nurse Laika should respond initially by saying: A. Why dont you try eating some? B. Byron, its time for you to eat. C. What time do you want to eat? D. Do you want me to feed you? (Ap/C) Therapeutic Communication 13. _____________can happen to anyone, at any age, and to people of any race or ethnic group. It is never a normal part of life. Lolo Karlito, 80 years old is under cardiac medication is frequently seen sitting alone, in tears and nostalgic. While blowing his birthday cake, he says, My life wasnt good at all. This is an example of what subtype of depression? A. Post partum depression B. Melancholic depression C. Atypical depression D. Substance-induced depression (C/C) Subtypes of Depression 14. Mania is a state of excessive or abnormally high arousal, mood and energy levels. Mania is often associated with bipolar disorder, which was known as _____________ disorder in the past. The nurse knows an appropriate shortterm nursing goal for a client exhibiting manic behavior is for the client to: A. Plan for a birthday party for another client B. Paint alone for 10-15 minutes

C. Identify three strengths D. Compete in a volleyball game (Ap/QI) Nursing Management for Mania 15. _____________ is the most treatable of all mental illnesses. About 60 to 80 percent of depressed people can be treated successfully. The nurse assesses a client with a mood disorder for which of the following factors with increased incidence of this problem? A. Female gender C. Age factor B. Male gender D. Family history (C/R) Mood Disorder 16. In ________disorder, experiencing mania or having a manic episode does not mean a person is a maniac . A client with bipolar disorder, manic type exhibits extreme excitement, delusional thinking and command hallucinations. Which nursing diagnosis should be given the highest priority? A. Anxiety B. Impaired social interaction C. Disturbed sensory-perceptual alteration (auditory) D. Risk for other directed violence (S/QI) Nursing Diagnosis 17. People who have depression usually see everything with a more ________ attitude, unable to imagine that any problem or situation can be solved in a _______ way . A disorder characterized by recurrent major depressive episodes with hypomania is: A. Bipolar I C. Cyclothymia B. Bipolar II D. Dysthymia (An/HE) Bipolar Disorders 18. The best way to prevent suicide with clinical depression is to know the risk factors for suicide and to recognize the _________ signs of suicide. Based on the clients history, which would be considered the greatest risk for suicide? A. Had been fired for job B. Has prostate cancer C. Mother committed suicide 3 years ago D. Had attempted suicide 6 months ago (An/SQC) Suicide 19. People with ________ thinking and ___ self-esteem are more likely to develop clinical depression . The nurse understands that ECT is primary used in psychiatric care for the treatment of: A. Mania C. Schizophrenia B. Anxiety disorders D. Depression (Ap/MRE) ECT Depression 20. Depression carries a high risk of _______. Anybody who expresses suicidal thoughts or intentions should be taken very seriously. A client tells the nurse, Everyone would be better off if I wasnt alive. Which nursing diagnosis would be made based on this statement? A. Risk for self-directed violence B. Disturbed thought processes C. Ineffective coping D. Impaired social interaction (S/QI) Nursing Diagnosis 21. There is no cure for____________________. One of the goals for treatment is to slow the progression of the disease, although it is difficult to do. Which nursing intervention is most -2-

DR. CARL E. BALITA REVIEW CENTER TEL. NO. 735-4098/7350740

appropriate for a client with AD who has frequent episodes of emotional lability? A. Reduce environmental stimuli to redirect clients attentions B. Attempt to humor to alter the client mood C. Use logic to point out reality aspects D. Ignore behavior is this is part of aging process (S/SQC) Alzheimers Disease Management

1.

A delusional patient said, I have no head, no stomach. The nurse would record this in which part on the mental status? A. Content of thought B. Emotional state C. Characteristic of talk D. Sensorium or orientation

22. Individuals who _______________ are generally very

confident about their recollections, despite evidence contradicting its truthfulness. A 75 year-old client with dementia of the Alzheimers type and confabulates. The nurse understands that this client will: A. Fills in memory gaps with fantasy B. Pretends to be someone else. C. Denies confusion by being jovial. D. Rationalizes various behaviors (K/C) Alzheimers Disease 23. Researchers theorize that hunger, a drop in BP after a meal (which temporarily takes away oxygen from the brain), or changes in glucose levels in the blood from eating in people with diabetes may bring on agitation and ________ . In the clients with cognitive impairment, the phenomenon of increased confusion in the early evening hours is called: A. Sundown syndrome B. Awakening phenomenon C. Melancholic phenomenon D. Delirium (C/SQC) Alzheimers Disease 24. The most common types of ________ problems due to are disturbances of attention, language, memory and executive function. Executive function is the ability to analyze, interpret, plan, organize, and execute complex instructions. Which if the following will the nurse use when communicating with a client with cognitive impairment? A. Short words and simple sentences B. Stimulating words and phrases C. Picture or gestures instead of words D. Complete explanations with details (Ap/C) Alzheimers Disease Communication 25. _______________ is a loss of brain function that occurs with certain diseases. Alzheimer's disease (AD), is one form of dementia that gradually gets worse over time. It affects memory, thinking, and behavior. The nurse enters the room of a client with cognitive impairment and asks what day of the week it is; the date, month and year are and where the client is. The nurse is attempting to assess the clients: A. Orientation C. Judgment B. Insight D. Confabulation (An/C) Alzheimers Disease Dementia Communication

Situation: Antonia, the mother of two children was cooking dinner and wondering why her husband was so late. Then she received a telephone call from the police notifying her that her husband had just been pulled from the river. Witnesses say her husband jumped from a bridge in the locality. 2. Unable to handle her emotions, Antonia hurls angry and explosive outbursts toward those who are helpful to her. This behavior is an example of: A. Sublimation C. Displacement B. Reaction formation D. Introjections 3. During nurse-patient interactions with Antonia, when she actively works out her rage, which of the following is NOT therapeutic? A. Ask Antonia to describe what is the hardest part of the death for the family. B. Assure that death of husband is not her fault C. An encouragement toward normalcy must be communicated D. The nurse should be non-reactive

Situation: The stress of hospitalization can lead to difficulties between nurses and patients. Following are situations that nurses presented during a monthly nursing circle. 4. The dynamics of behavior underlying manipulative behavior explain that it is a behavior of: A. A sense of security and control B. Exhibiting uncooperative and hostile behavior C. Reducing patients anxiety D. Sensing fear of other people 5. Victoria, an elderly client idealizes some nurses as terrific, the best, or so understanding, but refers to others as mean, incompetent, or indifferent. This behavior can be understood by the staff as: A. Avoiding taking responsibility for her own behavior and underlying feelings B. An understandable behavior of an elderly that must not be taken seriously C. An invitation to have a social and intimate relationship with the nurse D. Immature and childish behavior

-ENDYou CAN succeed at whatever you do, as long as you simply take the right ACTIONS."

POST SCRIPT QUESTIONS

DR. CARL E. BALITA REVIEW CENTER TEL. NO. 735-4098/7350740 -3-